基于图像存档与传输系统的牙片数字化研究

目的 探讨口腔专科医院图像存档与传输系统(PACS)建设中的牙片数字化.方法 通过直接(传感器)和间接(牙片的计算机X线摄影)的方法,实现牙片的数字化,数字化的牙片图像归档至PACS服务器,医生工作站从PACS服务器中调阅所存储的影像数据.结果 医生工作站安装的牙科专用图像处理软件必须支持医学数字影像通讯标准(DICOM)的查询获取功能,才能从PACS服务器中查询并获取所需的牙齿影像;不同公司的牙科专用图像处理软件互不兼容,只能通过PACS系统加以整合,但是PACS系统的浏览软件无法显示牙位.结论 在PACS系统建设中,各类设备采购前需要进行连接测试,以确保将来各系统之间的连通性.     

Therapy of psoriasis in childhood and adolescence ‐ a German expert consensus

Psoriasis of childhood shows an annual prevalence of 0.71 % and accordingly has to be regarded as a frequent chronic inflammatory skin disorder of this age. The impact on the quality of life as well as development of the afflicted children and their parents is evident. On the other side, therapy is demanding with regard to the specific juvenile metabolism, physical development and skin penetration of topical drugs. Long‐term treatment at an early age has to be critically judged regarding the chronicity of the disease. Topical corticosteroids, alternatively dithranol may be used first‐line, followed by vitamin D derivatives. A combination with UV‐light, preferably UV‐B, has to be decided on an individual basis. Systemic treatment may be initiated in recalcitrant disease with methotrexate and cyclosporine where long‐term experience is available from juvenile rheumatology and transplantation medicine. Alternatively fumaric acid esters or retinoids are available. Rehabilitation procedures will help the children and their parents to cope with the disease and its treatment. The different treatment options are presented here as a German expert consensus, as clinical studies are hardly available and only a few therapeutics are licensed for this age. In any case the therapy has to be individually planned and decided together with the patients and their parents to gain maximal safety, comfort and success.     

Calcific tendinitis of the rotator cuff

Calcific tendinitis within the rotator cuff tendon is a common shoulder disorder that should be differentiated from dystrophic calcification as the pathogenesis and natural history of both is totally different. Calcific tendinitis usually occurs in the fifth and sixth decades of life among sedentary workers. It is classified into formative and resorptive phases. The chronic formative phase results from transient hypoxia that is commonlyassociated with repeated microtrauma causing calcium deposition into the matrix vesicles within the chondrocytes forming bone foci that later coalesce. This phase may extend from 1 to 6 years, and is usually asymptomatic. The resorptive phase extends from 3 wk up to 6 mo with vascularization at the periphery of the calcium deposits causing macrophage and mononuclear giant cell infiltration, together with fibroblast formation leading to an aggressive inflammatory reaction with inflammatory cell accumulation, excessive edema and rise of the intra-tendineous pressure. This results in a severely painful shoulder. Radiological investigations confirm the diagnosis and suggest the phase of the condition and are used to follow its progression. Although routine conventional X-ray allows detection of the deposits, magnetic resonance imaging studies allow better evaluation of any coexisting pathology. Various methods of treatment have been suggested. The appropriate method should be individualized for each patient. Conservative treatment includes pain killers and physiotherapy, or "minimally invasive" techniques as needling or puncture and aspiration. It is almost always successful since the natural history of the condition ends with resorption of the deposits and complete relief of pain. Due to the intolerable pain of the acute and severely painful resorptive stage, the patient often demands any sort of operative intervention. In such case arthroscopic removal is the best option as complete removal of the deposits is unnecessary.     

抑郁症患者情绪图片反应特征及杏仁核反应模式的研究

Objective To explore the behavioral and related amygdaiar temporal response to emotional pictures in individuals with major depressive disorder(MDD).Methods Functional magnetic resonance imaging(fMRI)was adopted to examine the neural substrates of emotional pictures processing in 12 first-episode unmedicated MDD subjects(MDD)and 13 healthy controls(HC).Analyses were focused on the temporal dynamics of the blood-oxygen level dependant(BOLD)signal change in the amygdala across blocks of positive,neutral and negative emotional pictures.The crude score to emotional pictures was also recorded.Results(1)The crude score wag(6.6 ±0.2)to positive pictures and(4.7 ±0.1)to neutral pictures in depressed subjects,lower than that in HC(P＜0.01),and(3.4 ±0.3)to negativc pictures in depressed subjects,which was higher than that in HC(2.2±0.2,P＜0.01).(2)The bilateral amygdala showed attenuated and delayed response to the positive pictures.in which the right amygdala showed"group×time"interaction effect to positive pictures(P=0.002).For the negative pictures,there was"group×time"interaction effect in the left amygdala(P=0.008)and group main effect in the right amygdaia(P=0.007),with the attenuated BOLD signal change in MDD group.Conclusions It suggests that amygdala is one of the key neural substrates to the character of the depressed mood or loss of interest in individuals with MDD.Depressed subiects show the attenuated and blunted behavioral and amygdala response to emotional stimuli,which support the hypothesis of the unspecially blunted emotional response in major depressive disorder.     

Now you see it, now you don't: on turning semantic interference into facilitation in a Stroop-like task

We use a masked priming procedure to test two accounts of the picture-word interference (PWI) effect: the lexical selection by competition account (Levelt et al., 1999; Roelofs, 1992) and the response selection account (Lupker, 1979; Miozzo and Caramazza, 2003). In the visible (standard) condition, we replicated the often-observed semantic interference effect. In the masked condition, we observed semantic facilitation. We take the polarity shift as a function of masking to mean that the semantic interference and semantic facilitation in the PWI task should be attributed to two qualitatively different processes. We argue that this conclusion follows naturally from the response selection account, but only with great difficulty from the lexical selection by competition account.     

231例不同季节开颅患者围手术期舌象脉象的观察

观察不同季节231例开颅患者手术前1－3天、手术后1－7天舌象、脉象变化,探讨湿热与季节及手术本身的关系。结果：手术后患者机体湿热化明显,有一定季节特点。舌象、脉象表现为湿热的比例超过60％,与症状频次变化一致,为湿热是术后发热主要病机提供了依据。     

我国PACS和远程影像学存在的问题和解决对策的探讨

笔者分析我国图像存储与通讯系统（Picture Archiving and Communication System,PACS)和远程影像学的现状,发现我国建立PACS的基本条件尚不完全具备,如存在的设备质量良莠不齐,尚无国家质量标准,以普通显示器代替高分辨率诊断专用显示器,计算机软硬件和图像存储介质更新换代过快使医院的投入产出比和经济效益降低,国内厂家规模较小和技术力量有限难以可持续发展等问题。提出了解决问题的对策：医院建立PACS最好分阶段实施,PACS和远程 系统必须装备高分辨诊断专用显示器,尽早建立PACS和远程影像学设备的国家质量标准,推动国内大型企业生产PACS和远程影像学设备,或与国外大公司建立合资公司,并与大型教学医院建立长期研发伙伴关系,以实现我国PACS和远程影像学的可持续发展战略。     

小鼠舌象的显微拍摄

舌诊是中医辨证的重要依据,舌象承载着丰富的辨证信息。因此,实现小鼠舌象的标准观察与分析,是小鼠四诊客观化的一项重要工作。为此,我们探索并初步建立了小鼠麻醉状态下舌象的显微采集和计算机图像红色色素提取,特予以介绍。     

230例舌象图谱中舌色诊断结果分析

[目的]通过10名中医师对230例舌图中舌色诊断结果的分析,探讨并分析不同中医师对观察结果一致性的影响.[方法]让10名中医师在自然光线下,对舌色较为典型、印刷质量较高的230副舌图进行观察并填写舌色观察表,判断结果一致率采用百分比表示.[结果]从舌色诊断结果的分析看出：1）舌诊具体内容丰富,观察结果离散性较大,舌象的复杂性与模糊性使传统的望舌方法难以客观地描述某一舌象.2）不同的中医师因为其视觉生理、知识水平,经验以及语言习惯等因素影响,对同一舌图有不同的判断结果,这样难以准确地判断舌象.[结论]中医需要寻求更客观的方式来诠释舌色的内容,从而减少因为各种原因引起的舌色判别结果的不一致性.所以在传统辨舌的基础上,建立标准舌色样本库以及自动识别系统有重要意义和价值.