基于置信规则库的慢性萎缩性胃炎陈永灿辨证经验挖掘

[目的] 根据名老中医陈永灿(下称陈氏)诊治慢性萎缩性胃炎(chronic atrophic gastritis，CAG)的临床资料和诊疗方案，挖掘基于置信规则库(belief rule base，BRB)的CAG辨证经验。[方法] 对症候信息进行编码，将症候“有、无”分别赋值为“1、0”，以此建立CAG中医症候信息数据库。将编码后的信息作为CAG辅助诊断模型的输入特征，通过BRB挖掘症候信息与证素之间的关系，利用证据推理(evidence reasoning，ER)融合算法对输入特征进行激活处理并输出结果，最后根据输出的证素结果结合临床实际得到证型。[结果] 在收集到的572例CAG病例数据集上对CAG辅助诊断模型进行训练及测试，证实该模型准确率达到79.07%，优于传统的支持向量机(support vector machine，SVM)算法；由预测结果得到的证型主要为脾虚气滞型、寒热错杂型、肝胃郁热型。[结论] CAG辅助诊断模型在实际临床运用中具有可行性，表明人工智能技术有助于名老中医经验的传承和传播。     

Trautmann's triangle anatomy with application to posterior transpetrosal and other related skull base procedures

Trautmann's triangle (TT) faces the cerebellopontine angle and is exposed during posterior transpetrosal approaches. However, reports on the morphometric analysis of this structure are lacking in the literature. The goal was to better understand this important operative corridor. TT was exposed from an external approach (transmastoid) in ten cadavers (20 sides) and from an internal approach on 20 dry adult temporal bones. Measurements included calculation of the area of TT and the distance of the endolymphatic sac from the anterior border of the sigmoid sinus. The area range of TT was 45–210 mm² (mean 151 mm²; SD 37 mm²). Three types of triangles were identified based on area. Type I triangles had areas less than 75 mm², Type II areas were 75–149 mm², and Type III areas were 150 mm² and greater. These types were observed in 37.5%, 35%, and 27.5% of sides, respectively. The distance from the jugular bulb's anterior border to the posterior border of the posterior semicircular canal ranged from 6 to 11 mm (mean 8.5 mm). The endolymphatic sac was located in the inferior portion of TT and traveled anterior to the sigmoid sinus. The horizontal distance from the anterior edge of the sigmoid sinus to the posterior edge of the endolymphatic sac ranged from 0 to 13.5 mm (mean 9 mm). Additional anatomic knowledge regarding TT may improve neurosurgical procedures in this region by avoiding intrusion into the endolymphatic sac and sigmoid sinus. Clin. Anat. 27:994–998, 2014. © 2014 Wiley Periodicals, Inc.     

The Effects of Water and a Protective Agent on Gamma-ray Induced Free Radicals in Mustard Seeds

Summary

Electron-spin-resonance experiments on irradiated seeds have shown that the radicals induced by gamma-radiation are very sensitive to the moisture-content of the seeds. However, at x-band frequencies the dielectric effect of the water in the sample has limited such experiments to moisture-contents of about 12 per cent. By using an E.S.R. spectrometer of low microwave frequency the gamma-induced radicals in white-mustard seeds have been studied with moisture-contents of up to 70 per cent by weight, and measurements made while gamma-irradiation was in progress. Both radical production and radical decay are studied in seed samples of various moisture-contents and in seeds treated with the protective agent AET.     

Intraoperative lateral rectus electromyographic recordings optimized by deep intraorbital needle electrodes

ObjectiveWe demonstrate the advantages and safety of long, intraorbitally-placed needle electrodes, compared to standard-length subdermal electrodes, when recording lateral rectus electromyography (EMG) during intracranial surgeries.MethodsInsulated 25 mm and uninsulated 13 mm needle electrodes, aimed at the lateral rectus muscle, were placed in parallel during 10 intracranial surgeries, examining spontaneous and stimulation-induced EMG activities. Postoperative complications in these patients were reviewed, alongside additional patients who underwent long electrode placement in the lateral rectus.ResultsIn 40 stimulation-induced recordings from 10 patients, the 25 mm electrodes recorded 6- to 26-fold greater amplitude EMG waveforms than the 13 mm electrodes. The 13 mm electrodes detected greater unwanted volume conduction upon facial nerve stimulation, typically exceeding the amplitude of abducens nerve stimulation. Except for one case with lateral canthus ecchymosis, no clinical or radiographic complications occurred in 36 patients (41 lateral rectus muscles) following needle placement.ConclusionsIntramuscular recordings from long electrode in the lateral rectus offers more reliable EMG monitoring than 13 mm needles, with excellent discrimination between abducens and facial nerve stimulations, and without significant complications from needle placement.SignificanceLong intramuscular electrode within the orbit for lateral rectus EMG recording is practical and reliable for abducens nerve monitoring.     

Propionibacterium skull base osteomyelitis complicated by internal carotid artery pseudoaneurysm

The microbiology of skull base osteomyelitis (SBO) is evolving. We present here the first case of SBO caused by Propionibacterium acnes leading to the development of a pseudoaneurysm of the internal carotid artery. Otolaryngologists should recognize this pathogen as a potential cause of invasive temporal bone infection to optimize prompt diagnosis and treatment. Laryngoscope , 127:2337–2339, 2017     

Navigation-guided core needle biopsy for skull base and parapharyngeal lesions: a five-year experience

The aim of this study was to evaluate the diagnostic accuracy of navigation-guided core needle biopsy for skull base and parapharyngeal lesions. Twenty patients with skull base and parapharyngeal lesions were included in this study. The preoperative design and intraoperative real-time image guiding was done using an optical navigation system. A spring-loaded semi-automatic biopsy gun and biopsy needle were used for specimen harvesting. Accuracy was established on the basis of the postoperative pathology. All patients underwent needle biopsy successfully without any immediate or delayed complications. The subzygomatic approach was adopted in all cases. The number of passes ranged from three to five. The diagnostic accuracy was 90% (18/20). Navigation-guided core needle biopsy offers an easy approach for the diagnosis of skull base and parapharyngeal lesions, with a high yield of specimens and good patient tolerance.