分期手术治疗复杂闭合Pilon骨折

目的:探讨分期手术治疗复杂闭合Pilon骨折的临床疗效。方法:自2019年6月至2021年6月,采用分期手术治疗29例复杂闭合Pilon骨折的患者,其中男18例,女11例;年龄31～68 (43.50±6.62)岁;骨折按照Ruedi-Allgower分型,Ⅱ型7例,Ⅲ型22例。29例患者均为新鲜闭合骨折,且不合并距骨骨折、跟骨骨折等损伤。记录患者从受伤至闭合复位外固定时间、2次分期手术间隔时间、骨折愈合时间及并发症情况,并采用美国足踝外科协会(American Orthopedic Foot and Ankle Society,AOFAS)踝与后足功能评分评价临床疗效,采用Burwell-Charnley系统进行放射学复位评价。结果:29例患者均获得随访,时间13～30(15.43±5.31)个月。术后所有骨折获得骨性愈合,愈合时间2～6(3.77±1.22)个月,未发现内固定断裂、螺钉松动、感染、内固定激惹、踝关节僵硬等并发症。受伤至闭合复位跨踝关节固定时间1.22～7.34 h,2次分期手术间隔5～9 (5.98±2.11) d。术后12个月患侧踝关节AOFAS评分(90.10±...     

基于框架语义分析的社交网络药品不良事件抽取

目的/意义 基于社交网络评论文本抽取药品不良事件,为药品研发和安全监管提供参考。方法/过程 采用框架语义理论,结合《监管活动医学词典》术语集构建药品不良事件分类词表;基于词典和规则匹配的方法识别事件类别和框架元素,利用语义信息实现药品不良事件框架填充。结果/结论 选取社交网络药品评价实例进行药品不良事件信息抽取可行有效,有助于框架语义分析方法在医疗专业领域的深度应用和价值实现。     

血浆suPAR水平与冠状动脉慢血流的相关性分析

目的 观察血浆可溶性尿激酶型纤溶酶原激活物受体(suPAR)水平、高敏C反应蛋白(hs-CRP)与冠状动脉慢血流的关系,探讨suPAR在冠脉慢血流中的作用及影响冠脉慢血流的相关因素。方法 选取疑诊为冠心病但冠脉造影正常的患者,据冠脉TIMI桢数将患者分为慢血流组(53例)和正常对照组(42例),记录其冠心病危险因素,检测血浆suPAR、hs-CRP水平等。结果 两组间糖尿病、高血压病、高脂血症、早发冠心病家族史等比率及血脂水平均无明显差异,慢血流组吸烟率较对照组明显升高 (72％ VS 48％,P=0.02)。同对照组相比,慢血流组血浆suPAR水平(3.01±0.05 vs 1.33±0.06,P＜0.001)和hs-CRP水平(1.07±0.04 vs 0.71±0.05,P＜0.001)均明显升高,差异具有统计学意义。一元回归分析显示,血浆suPAR、hs-CRP水平与冠脉TIMI桢数均呈明显正相关(R2=0.83,P＜0.001;R2=0.71,P＜0.001)。多元回归分析显示,suPAR、hs-CRP、吸烟均与冠脉TIMI桢数呈正相关(R2=0.64,P＜0.001),其中suPAR的影响力最大(标准化β=0.62)。结论 血浆suPAR、hs-CRP水平、吸烟与冠脉慢血流呈明显正相关,而且血浆suPAR水平对冠脉慢血流的预测价值最高。     

When and How Should We Revascularize Patients With Atherosclerotic Renal Artery Stenosis?

Atherosclerotic renal artery stenosis is the leading cause of secondary hypertension and may lead to resistant (refractory) hypertension, progressive decline in renal function, and cardiac destabilization syndromes (pulmonary edema, recurrent heart failure, or acute coronary syndromes) despite guideline-directed medical therapy. Although randomized controlled trials comparing medical therapy with medical therapy and renal artery stenting have failed to show a benefit for renal artery stenting, according to comparative effectiveness reviews by the Agency for Healthcare Research and Quality, the trials may not have enrolled patients with the most severe atherosclerotic renal artery stenosis, who would be more likely to benefit from renal stenting. Because of limitations of conventional angiography, it is critical that the hemodynamic severity of moderately severe (50% to 70%) atherosclerotic renal artery stenosis lesions be confirmed on hemodynamic measurement. The authors review techniques to optimize patient selection, to minimize procedural complications, and to facilitate durable patency of renal stenting. The authors also review the current American College of Cardiology and American Heart Association guidelines and the Society for Cardiovascular Angiography and Interventions appropriate use criteria as they relate to renal stenting.     

实验教学案例在药物分析理论教学中的应用

基于药物分析的学科特点,探讨实验教学案例在药物分析理论教学中的实践与应用,其内容涉及实验案例的建设与选择、理论教学中引入实验案例的教学效果、教学过程中存在问题的讨论等方面.通过实验教学案例与理论知识的有效结合,使得学生更易于进入教学过程中所呈现的具体情境,帮助学生对所设问题进行思考、分析和解决,从而有效培养了学生独立检...     

新型可调式布朗氏架在踝关节骨折治疗中的应用

目的 探讨新型可调式布朗氏架在踝关节骨折患者跟骨结节牵引中的临床应用.方法 前瞻性收集上海交通大学医学院附属仁济医院踝关节骨折行跟骨牵引的患者59例,年龄35～63岁,男性33例,女性26例.根据患者入院的顺序随机分为两组,试验组29例,使用新型可调式布朗氏架,对照组30例,使用传统型布朗氏架,对两组患者的患肢肿胀程度...     

基于J2EE和SAS的医院数据挖掘支持系统

目的建立具有强大数据分析及性能优良的医院管理决策支持系统。方法采用SAS在数据分析方面的强大功能以及J2EE架构,建立医院管理决策支持系统。结果基于J2EE和SAS的医院数据挖掘支持系统能很好地帮助医院进行辅助决策管理。结论该决策系统设计简便、性能优良,对于决策支持系统的设计具有较强的启发性。     

Neural coding of action in three dimensions: Task- and time-invariant reference frames for visuospatial and motor-related activity in parietal area V6A

Goal-directed movements involve a series of neural computations that compare the sensory representations of goal location and effector position, and transform these into motor commands. Neurons in posterior parietal cortex (PPC) control several effectors (e.g., eye, hand, foot) and encode goal location in a variety of spatial coordinate systems, including those anchored to gaze direction, and to the positions of the head, shoulder, or hand. However, there is little evidence on whether reference frames depend also on the effector and/or type of motor response. We addressed this issue in macaque PPC area V6A, where previous reports using a fixate-to-reach in depth task, from different starting arm positions, indicated that most units use mixed body/hand-centered coordinates. Here, we applied singular value decomposition and gradient analyses to characterize the reference frames in V6A while the animals, instead of arm reaching, performed a nonspatial motor response (hand lift). We found that most neurons used mixed body/hand coordinates, instead of “pure” body-, or hand-centered coordinates. During the task progress the effect of hand position on activity became stronger compared to target location. Activity consistent with body-centered coding was present only in a subset of neurons active early in the task. Applying the same analyses to a population of V6A neurons recorded during the fixate-to-reach task yielded similar results. These findings suggest that V6A neurons use consistent reference frames between spatial and nonspatial motor responses, a functional property that may allow the integration of spatial awareness and movement control.