首发精神分裂症女性患者基于Stroop范式的近红外光谱成像的脑血流空间特征分析

目的探讨首发精神分裂症女性患者以Stroop范式的近红外光谱成像(NIRS)的脑血流空间特征。方法前瞻性连续纳入2018年1月至2019年12月深圳市康宁医院急性干预科住院的女性首次发作的精神分裂症患者9例,并纳入观察组,同时纳入年龄、受教育年限与观察组相匹配的健康者作为对照组(9例)。以Stroop测试为范式,行NIRS检测,检测时间共74 s,记录NIRS的数据。其中前面10 s为基线期,任务期共64 s,计算相对于基线期的平均氧合血红蛋白(OxyHb)水平,分析NIRS的空间特征。观察组给予奥氮平[平均剂量(17.78±2.92)mg/d]治疗4周,治疗前后各检测1次NIRS,对照组检测1次。结果观察组患者治疗前通道17、18平均OxyHb水平为0.02(-0.02,0.18)、0.04(-0.07,4.11)mmol/L,均高于对照组[-0.22(-0.33,0.04)、-0.35(-0.69,-0.02)mmol/L],通道20治疗前为-0.17(-0.32,0)mmol/L,低于对照组[0.08(-0.08,0.34)mmol/L],差异均有统计学意义(均P<0.05);通道17、18、20治疗后平均OxyHb水平分别为-0.05(-0.21,0.04)、-0.10(-0.24,0.01)、-0.02(-0.21,0.11)mmol/L,与对照组比较,差异均无统计学意义(均P>0.05)。结论女性精神分裂症患者治疗前存在前额叶右腹部中间区负激活及左中间腹外侧区正激活的情况,治疗后有改善。     

Adjustment of trendy,gaming and less assimilated tweens in the United States

Youth transitioning from childhood to adolescence (tweens) are exposed to increasing amounts of media and advertisement. Tweens have also emerged as a major marketing segment for corporate America with increasing buying power. We examine how tweens relate to popular culture messages and the association of different orientations to popular culture on adjustment. A secondary data analysis was conducted on a marketing survey of 3527 tweens, aged 10–14 years, obtained from 49 schools using stratified sampling methods. A sample of children nationwide described their preferences on popular culture and measures of psychosocial adjustment. Using cluster analysis, we identified three main clusters or adaptation styles of tweens: (1) those who enjoyed gaming, (2) trendy youth and (3) youth less assimilated into popular culture. There were differences in clusters based on adjustment indices. Gaming and trendy tweens reported higher self-perceptions of being smart, caring and confident compared to less assimilated tweens. However, gaming and trendy tweens worried more about fitting in than less assimilated tweens. Gaming and trendy tweens also endorsed future goals and traditional values more strongly than less assimilated tweens. Trendy tweens reported the strongest positive feelings about substance use. Results suggest that for each method of adaptation (gamer, trendy and less assimilated), there are unique differences in adjustment that can impact the child's future. Parents and service providers must recognize the complexity of these decisions and be sensitive to the unique needs of youth as they move from childhood to adolescence.     

139例儿童鼠伤寒沙门菌肠炎的临床特点及耐药性分析

目的 通过分析鼠伤寒沙门菌肠炎的临床特点以及耐药情况,指导本地区鼠伤寒沙门菌肠炎合理使用抗生素.方法 回顾性分析2016年1月—2019年12月河源市妇幼保健院收治139例鼠伤寒沙门菌肠炎患儿的临床特点及耐药情况.结果 发病高峰期为每年5—10月份.139例鼠伤寒沙门菌肠炎患儿中,2016年发病34例,2017年发病3...     

Primary signet-ring cell carcinoma of the colorectum

Background Objective of the study was to investigate particular clinicopathological features of colorectal signet-ring cell carcinoma.Methods The data of 34 patients with primary colorectal signet-ring cell carcinoma were compared with those of 4,458 consecutive patients with primary non-signet-ring cell colorectal adenocarcinoma between 1978 and 1999. For outcome analysis patients, after curative resection of signet-ring cell cancer, were matched for age, gender, tumour site and stage with patients suffering from poorly differentiated non-signet-ring cell colorectal adenocarcinoma.Results Signet-ring cell carcinoma patients were significantly younger than patients with non-signet-ring cell colorectal adenocarcinoma (median age 60 years vs 64 years, P=0.033). The most common tumour sites were the rectum (47%) and the right hemicolon (29%). They presented with significantly more advanced tumour stages and a significantly higher frequency of distant metastases (44% vs 21%, P=0.002). The rate of curative resections was significantly lower (35% vs 79%, P<0.001). However, the prognosis after curative resection of signet-ring cell cancer was as poor as in poorly differentiated non-signet-ring cell colorectal adenocarcinoma of the same stage (5-year survival rate 46% vs 57%, p=0.935).Conclusions Colorectal signet-ring cell carcinoma is characterized by diagnosis in more advanced tumour stages resulting in lower rates of curative resection. Prognosis is as poor as in non-signet-ring cell colorectal cancer of low differentiation in the same stage.     

精神分裂症患者语音信号的临床分析

背景：语音参数是精神分裂症生物学指标研究的一个全新领域,其中一些已被证明与情感反应相关,情感反应是精神分裂症患者显著受限制的一个特点,特别是对那些具有突出阴性症状的患者。
　　目标：评估慢性精神分裂症患者的选择性语音参数与临床症状严重程度之间的关系,并比较患者与所匹配的健康对照者的这些特征。
　　方法：对26例住院慢性精神分裂症患者（入组时和一周后）和30名健康对照者（仅在入组时）通过电话采集的15分钟语音样本,对该样本进行10项语音测量参数的评估,包括6个语音韵律参数、共振峰带宽和振幅、以及2个频谱特征。采用阳性与阴性症状量表(Posiitve and Negaitve Syndrome Scale)、阴性症状评估量表(Scale for the Assessment of Negaitve Symptoms)、临床总体印象量表-精神分裂症分量表(the Clinical Global Impression-Schizophrenia scale)分别在基线和1周后进行患者临床特征的评估。
　　结果：患者组症状在1周的时间间隔中保持稳定,并且10项语音参数的前后一周重测信度良好（内部相关系数[intraclass correlation coefficient, ICC]介于0.55到0.88之间）。语音参数中6项韵律参数、共振峰带宽和振幅参数在患者组和对照组之间没有显著差异,但2项光谱参数在组间有差异：患者组美尔频率倒谱系数(the Mel-frequency cepstral coefficient, MFCC)评分显著低于对照组,并且患者组的线性预测系数(linear prediction coding, LPC)评分显著高于对照组。在患者组中,在10个本研究所考虑的语音参数和17个所考虑的临床参数之间构成的170个相关性中,有10个达到了p<0.05的统计学显着性水平（相关系数>0.40)。结论：这项研究支持了语音参数具有作为精神分裂症阴性症状严重程度指标（即,生物指标）的潜在价值,但在这些语音参数的潜在效用获充分评估前,我们需要对更多样化的患者进行更大样本量、更详细的随访研究。     

乳腺癌骨髓微转移的检测及其临床意义

目的　检测乳腺癌骨髓微转移 ,探讨其与乳腺癌临床病理学因素的关系。方法　采用RT -PCR法 (一步法 )检测骨髓中CK19mRNA表达。结果　 10 2例乳腺癌患者骨髓CK19mR NA表达阳性率 5 6.9%。骨髓CK19mRNA表达率随乳腺癌肿块增大而增高 ;随临床分期增加而增高 ;随组织学分级增加而增高。但与腋淋巴结转移与否无关 ,亦与乳腺癌患者年龄、月经状况及病理类型无关。结论　乳腺癌骨髓微转移与某些临床病理学因素有关。癌细胞播散无固定模式 ,早期乳腺癌亦可发生远处转移。骨髓微转移应作为常规检测方法 ,以更早、更准确地预测全身转移情况 ,进行个体化治疗。     

青年人食管癌临床病理特征及预后

目的 探讨青年人与中老年人食管癌的临床病理特征及预后的差异.方法 回顾性分析1990年1月至1998年12月间在中山大学肿瘤防治中心接受手术治疗的716例食管鳞状细胞癌患者的临床资料,对其中117例45岁以下 （青年组）和599例大于45岁（中老年组）患者的临床病理特征及预后进行对比分析.结果 除肿瘤分期外,青年组与中老年组临床病理特征的差异均无统计学意义（均P＞0.05）.青年组Ⅲ期患者所占比例为47.9％（56/117）,明显高于中老年组的33.6％（201/599,P=0.010）.但青年组与中老年组患者的预后差异并无统计学意义（5年生存率：36.0％比33.8％,10年生存率：29.2％比25.0％,P=0.418）.多因素预后分析显示,患者年龄不是食管癌的独立预后因素 （P=0.160,RR=1.187,95％CI：0.935～1.506）.结论 尽管青年人食管癌的病理分期较晚,但其预后与中老年人并无明显差异.     

浙江省中部地区布鲁菌病六例临床分析

布鲁菌病是由布鲁菌引起的人畜共患性传染病,又称地中海弛张热、马尔他热、波浪热或波状热,属自然疫源性疾病,主要以牛、羊、猪为传染源,人主要是接触病畜而感染。布鲁菌病临床表现复杂,病情轻重不一,可侵犯全身多个系统,常表现为发热、乏力、多汗、关节痛、肝脾肿大等,但症状缺乏典型性。该病一般在内蒙古等北方牧区流行,南方地区很少有该病流行。我们分析了浙江省金华市6例布鲁菌病的流行病学、临床特征、治疗等情况,旨在提高对该病的认识。     

1例男性乳腺癌的临床研究并文献分析

与女性乳腺癌相比,男性乳腺癌非常少见,由于其较少见,无法在临床进行大量研究,临床医生对男性乳腺癌的认识大部分是从一些小型的医疗机构或是回顾性研究以及从女性乳腺癌的治疗经验中得知,因此对于男性乳腺癌的临床、病理和预后仍需要进一步研究,在临床中男性乳腺癌患者虽比较少见,但是近年来发病率也在逐渐上升,同时,很多临床医生缺少管理男性乳腺癌的经验。本文报告了1 例男性乳腺癌的诊断及治疗过程,并复习有关男性乳腺癌诊断治疗和临床管理的相关文献,就男性乳腺癌的病因、流行病学、病理特征、临床特点、诊断及治疗进行综述,为临床治疗男性乳腺癌提供参考。