临床病理因素和手术方法对胆囊癌预后的影响

目的 分析与胆囊癌预后有关的临床病理因素.方法 回顾性分析2001-2006年61例进展期胆囊癌外科治疗资料.结果 按第6版UICC/AJCC的胆囊癌临床分期标准,ⅠB期8例,ⅡA期22例,ⅡB期11例,Ⅲ期14例,Ⅳ期6例.姑息性胆囊切除和/或胆道引流术26例;胆囊切除、局部淋巴结清扫14例,保留肝外胆管的根治性切除7例,联合肝外胆管切除的根治术13例;肝胆胰脏器联合切除1例.37例中有18例淋巴结阳性.52例术后得到随访.满6个月生存为41例(67.2%);满1年生存26例(42.6%);存活2年以上者10例(16.4%);3年以上存活7例(11.5%);1例存活5年以上(1.6%).术后2年内死亡的51例中,31例随访到死亡前症候:21例有进行性黄疸;14例有肝脏内多个转移;12例有顽固性腹水.非明确胆道病原因死亡者5例.结论 临床分期和手术方式与胆囊癌患者的预后有关.     

胰腺癌细胞转染hSSTR2基因对下游波形蛋白表达的影响及其意义

目的 探讨生长抑素2型受体(Hsstr2)基因转染胰腺癌细胞对下游蛋白表达的影响及其意义.方法 利用腺病毒载体Ad.CMV.Hsstr2.GFP将Hsstr2全长Cdna导入胰腺癌细胞Panc-1;采用荧光差异双向凝胶电泳技术分离并筛选Hsstr2基因转染胰腺癌细胞前后差异表达蛋白;用反射式基质辅助激光解吸附电离串联飞行时间质谱鉴定差异蛋白.利用免疫印迹验证差异表达的波形蛋白;采用免疫组化检测波形蛋白在胰腺癌组织中的表达,并分析其临床意义.结果 有统计学意义的差异蛋白质点21个;选择1.3倍以上的差异点18个,经质谱鉴定得到13个蛋白质,包括翻译调节蛋白、代谢酶类、与细胞通讯信号传导相关蛋白、细胞结构蛋白、分子伴侣、具有GTPase活性的蛋白及动力蛋白等.波形蛋白在胰腺癌细胞转染Hsstr2基因后表达降低,免疫组化显示波形蛋白主要在低分化的胰腺癌细胞中高表达.结论 筛选的波形蛋白等差异蛋白可能成为新的胰腺癌敏感治疗靶点.波形蛋白也可能成为预测肿瘤恶性程度的一个指标.     

肝脏局灶性结节性增生

目的：探讨肝脏局灶性结节性增生（FNH）的临床诊断特点及治疗选择。方法：回顾性分析28例经手术后病理证实为FNH患者的临床资料。结果：在28例患者中,20例（71.4%）无明显症状,24例（85.7%）肝功能正常,3例（10.7%）HBsAg阳性,甲胎蛋白及癌胚抗原检查均正常。超声检查20个（75.0%）病灶为低回声,超声造影3个（75%）病灶为快进慢出。多数病灶CT和MRI检查有特征性表现。治疗采用肝脏不规则切除术,24例定期随访3个月至6年。患者术后疗效确切,未见肿瘤复发,包括术后病理显示存在不典型增生的4个病灶。结论：FNH无特异性的临床表现;影像检查对其有较高的诊断价值;对有治疗指征者,手术切除是较好的选择。     

名人面孔、动物和人造物类别特异性命名区脑定位的功能磁共振研究(英文)

目的在一些疾病中,病人会出现类别特异性的识别和命名障碍,但有关名人面孔、动物和人造物三种不同类型命名任务的脑定位研究仍存在争议。本研究旨在利用功能磁共振(fMRI)研究这三种不同类型命名任务的脑激活特点。方法采用SPM8软件进行脑功能图像分析,命名任务与基线任务采用t检验统计,然后进行群组分析,结果用MNI坐标表示,解剖位置用XJview8自动标记。结果名人面孔命名区主要位于双侧前颞叶包括海马和杏仁核,且存在左侧优势,同时还激活双侧颞下回三角部和盖部;命名动物主要激活左侧辅助运动区;而命名人造物主要激活左侧运动前区和右侧辅助运动区,三种任务均有双侧梭状回激活,但命名人造物激活区范围比其余两种任务都大。结论人、动物和人造物三种不同类型命名任务的脑定位存在差异,这提示在术中定位功能区过程中,需要选择不同类型的命名任务,以减少阴性刺激和术后永久性功能障碍的发生率。     

The Impact of Wearing a Face Mask during the COVID-19 Pandemic on Temporomandibular Joint: A Radiological and Questionnaire Assessment

Aim  Several health problems have been reported to be triggered or facilitated by prolonged mask usage during the coronavirus disease 2019 (COVID-19) pandemic. While wearing a face mask, people tend to push their jaws forward and downward in a repetitive manner to hold their masks in the right position; these jaw motions may induce temporomandibular joint disorder (TMD). In this study, we aimed to investigate these repetitive jaw movements while wearing face masks and their effects on TMD. Patients and Methods  Patients who applied with TMD signs between June 2020 and May 2021 were evaluated prospectively. A survey using a questionnaire was conducted to define patients with TMD that caused only by mask-related repetitive jaw movements. Demographic data (age and gender), mean duration of daily mask usage, mask type, and magnetic resonance imaging results were recorded. Results  Prolonged daily mask usage (≥8 hours/day) was significantly higher in patients with mask-related habits (group a) with a rate of 40.4% ( p ≈ 0.001). Also, in this group, the disc displacement with reduction rate (54.6%) was higher compared with other groups ( p ≈ 0.010). On the contrary, patients with no underlying risk factor (group c) showed an unexpected high osteoarthritis rate ( p ≈ 0.029). Conclusions  In this study, we demonstrate that correcting the position of a face mask by repetitive jaw movements can increase the occurrence of TMD. Informing individuals wearing face masks about the risk of TMD and the importance of choosing the appropriate mask size according to the face shape are important issues to be addressed in the near future.     

Brief Report: AI-synthesized faces are indistinguishable from real faces and more trustworthy

Artificial intelligence (AI)–synthesized text, audio, image, and video are being weaponized for the purposes of nonconsensual intimate imagery, financial fraud, and disinformation campaigns. Our evaluation of the photorealism of AI-synthesized faces indicates that synthesis engines have passed through the uncanny valley and are capable of creating faces that are indistinguishable—and more trustworthy—than real faces.     

他克莫司国内首例换脸术患者的个体化用药

目的:研究他克莫司(FK506)在换脸术患者体内药动学特征及规律,并以此为依据制定个体化给药方案,确保免疫抑制剂FK506用药的安全有效.方法:口服FK506达稳态后,给药前和给药后0.25,0.5,0.75,1,1.5,2,2.5,3,4,6,8 和12 h 抽取全血样品,采用MEIA法进行全血药物浓度测定,以DAS2.0药动学软件程序拟合求算FK506在体内药动学参数;基于此临床药动学特征,结合该患者临床疗效和不良反应制定合理安全的给药方案,总结出适合该患者的治疗窗.结果:口服FK506达稳态时,其主要的药动学参数:达峰时间Tmax为1.5 h,最大全血浓度Cmax为51.4 ng/mL,消除半衰期T1/2为13.4 h,曲线下面积AUC0-12为600.58 ng/(mL·h);治疗窗谷浓度范围控制在15～20 ng/mL ,活检检验和实验室检查结果显示FK506的剂量控制在安全的治疗窗内,移植术后未出现严重的排异反应和明显的免疫抑制剂的毒副作用.结论:FK506治疗窗谷浓度范围15～20 ng/mL具有良好的免疫抑制效果,此浓度范围既可满足此患者免疫抑制作用,又可减少FK506的毒副作用.     

The Optimization of Mix Proportion Design for SCC: Experimental Study and Grey Relational Analysis

The optimization of mix proportions based on the targeted fresh and hardened performances of self-compacting concrete (SCC) is a foundation for its transition from laboratory research to industrial production. In this paper, the mix proportions of various SCC mixtures were designed by the absolute volume method with changes in the content of river sand and manufactured sand, the content of fly ash and granulated ground blast furnace slag (GGBS) and the maximum particle sizes of coarse aggregates. This experimental study was carried out to verify the workability, density and cubic compressive strength of SCC. The results show that SCC demonstrated good performance with appropriate mix proportions of manufactured sand and river sand. A hybrid effect of fly ash and GGBS appeared on the fresh performance of SCC with a constant strength, and the coarse aggregate with a smaller maximum particle size was beneficial to the workability but detrimental to the compressive strength of SCC. Finally, the optimization of the mix proportion of SCC was evaluated by grey relational analysis, in which the weight of the indicators was determined by the entropy method to improve the evaluation credibility. As a result, the optimal mix proportions of SCC were selected.     

Face Mask Wastes as Cementitious Materials: A Possible Solution to a Big Concern

After more than two years wearing surgical masks due to the COVID-19 pandemic, used masks have become a significant risk for ecosystems, as they are producing wastes in huge amounts. They are a potential source of disturbance by themselves and as microplastic contamination in the water system. As 5500 tons of face masks are estimated to be used each year, there is an urgent need to manage them according to the circular economy principles and avoid their inadequate disposal. In this paper, surgical wear masks (WM), without any further pretreatment, have been introduced as addition to mortars up to 5% in the weight of cement. Mechanical and microstructural characterization have been carried out. The results indicate that adding MW to the cement supposes a decrease in the properties of the material, concerning both strength and durability behavior. However, even adding a 5% of WM in weight of cement, the aspect of the mortars is quite good, the flexural strength is not significantly affected, and the strength and durability parameters are maintained at levels that—even lower than the reference—are quite reasonable for use. Provided that the worldwide production of cement is around 4.1 Bt/year, the introduction of a 5% of WM in less than 1% of the cement produced, would make it possible to get rid of the mask waste being produced.     

地奈德乳膏联合透明质酸修护生物膜治疗成人面部湿疹疗效观察

目的观察地奈德乳膏联合透明质酸修护生物膜治疗成人面部湿疹的近期疗效。方法将入选的116例患者随机分为两组,试验组(61例)予透明质酸修护生物膜联合地奈德乳膏外用治疗,对照组(55例)单纯外用地奈德乳膏治疗,两组患者疗程均为2周。结果治疗第1周后,试验组和对照组的疗效总积分较治疗前显著降低(P均0.05),试验组的总积分与对照组相比,差异有统计学意义(P0.05);试验组疗效(有效率为83.61%)和对照组(有效率为60%)相比差异有统计学意义(P0.05)。治疗第2周后,试验组和对照组的总积分均较治疗前显著下降(P均0.05);试验组的总积分与对照组相比差异无统计学意义(P0.05);试验组疗效(有效率为86.89%)和对照组(有效率为85.45%)差异无统计学意义(P0.05)。第4周试验组复发率为5.67%,低于对照组(19.15%)(P0.05)。结论地奈德乳膏联合透明质酸修护生物膜治疗面部湿疹疗效较好,复发率低。