不同ABO血型下肢闭合骨折后下肢深静脉血栓形成的发生率分析

目的:探讨不同ABO血型患者下肢闭合骨折后下肢深静脉血栓形成（DVT）发生率的差异。方法:回顾性研究2014年8月至2018年6月西安交通大学医学院附属红会医院创伤骨科收治的1 951例下肢骨折患者,男924例,女1 027例;年龄中位数为63（46, 78）岁（16~102岁）。按照血型分组：O型组572例,A型组5...     

乳腺肿瘤常规超声联合超声造影影像组学特征与乳腺癌分子分型相关性的研究进展

影像组学（radiomics）是一种从医学影像中高通量地提取影像特征来深入挖掘内部数据信息的技术方法,通过肿瘤分割、特征提取与模型建立来辅助临床对肿瘤的诊断与治疗。在精准医疗时代,乳腺癌（breast cancer,BC）的个体化早期诊治尤为重要。常规超声是诊断乳腺肿瘤的重要影像学方法,超声造影（contrast enhanced ultrasound,CEUS）可以实时显示乳腺肿瘤微血管灌注的形态学及功能学变化,在此基础上产生的超声及超声造影影像组学在乳腺肿瘤良恶性诊断及判断乳腺癌分子分型中具有潜在临床应用价值。本文就乳腺肿瘤常规超声联合超声造影影像组学特征与乳腺癌分子分型相关性方面进行综述。     

A comprehensive knowledge base of synaptic electrophysiology in the rodent hippocampal formation

The cellular and synaptic architecture of the rodent hippocampus has been described in thousands of peer‐reviewed publications. However, no human‐ or machine‐readable public catalog of synaptic electrophysiology data exists for this or any other neural system. Harnessing state‐of‐the‐art information technology, we have developed a cloud‐based toolset for identifying empirical evidence from the scientific literature pertaining to synaptic electrophysiology, for extracting the experimental data of interest, and for linking each entry to relevant text or figure excerpts. Mining more than 1,200 published journal articles, we have identified eight different signal modalities quantified by 90 different methods to measure synaptic amplitude, kinetics, and plasticity in hippocampal neurons. We have designed a data structure that both reflects the differences and maintains the existing relations among experimental modalities. Moreover, we mapped every annotated experiment to identified potential connections, that is, specific pairs of presynaptic and postsynaptic neuron types. To this aim, we leveraged Hippocampome.org , an open‐access knowledge base of morphologically, electrophysiologically, and molecularly characterized neuron types in the rodent hippocampal formation. Specifically, we have implemented a computational pipeline to systematically translate neuron type properties into formal queries in order to find all compatible potential connections. With this system, we have collected nearly 40,000 synaptic data entities covering 88% of the 3,120 potential connections in Hippocampome.org . Correcting membrane potentials with respect to liquid junction potentials significantly reduced the difference between theoretical and experimental reversal potentials, thereby enabling the accurate conversion of all synaptic amplitudes to conductance. This data set allows for large‐scale hypothesis testing of the general rules governing synaptic signals. To illustrate these applications, we confirmed several expected correlations between synaptic measurements and their covariates while suggesting previously unreported ones. We release all data open‐source at Hippocampome.org in order to further research across disciplines.     

云南民族院校学生智齿冠周炎临床资料分析

目的 比较云南民族院校少数民族学生和汉族学生智齿冠周炎复发率以及智齿阻生类型.方法选择549例民族院校学生智齿冠周炎病例,由口腔医生检查下颌智齿阻生类型、急性智齿冠周炎临床症状及复发情况,并进行统计学分析.结果下颌智齿垂直阻生引发的冠周炎最多(58.65%);少数民族学生和汉族学生智齿阻生类型差异无统计学意义(P>0.05);少数民族学生与汉族学生智齿冠周炎复发率间差异有统计学意义(P<0.01).结论民族院校学生智齿冠周炎的发病率和复发率较高.     

从ICU继发感染者不同标本中分离鲍曼不动杆菌耐药性分析

目的分析从ICU重症患者不同标本类型中分离出的鲍曼不动杆菌的耐药性差异,为有效预防和控制ICU内鲍曼不动杆菌感染提供依据。方法回顾性分析本院2010年1月至2014年12月住院ICU患者送检标本中分离的568株鲍曼不动杆菌临床资料。结果从ICU感染患者中分离的鲍曼不动杆菌主要来源为痰液(60.0%);药敏试验表明鲍曼不动杆菌对常用抗菌药物的耐药率呈普遍多重耐药,对替加环素、头孢哌酮/舒巴坦最敏感,耐药率小于40.0%;从痰液和无菌体液中分离的鲍曼不动杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、环丙沙星、左氧氟沙星、阿米卡星的耐药率普遍高于血液和尿液,差异有统计学意义(P0.05)。结论鲍曼不动杆菌对常用抗菌药物多重耐药,在ICU中不同标本类型的耐药性存在差异,临床必须加强耐药性监测,治疗该菌感染时首选替加环素、头孢哌酮/舒巴坦。     

眩晕中医分型的血液流变性和血脂血糖变化

目的:观察眩晕中医分型的血液流变性、血脂和血糖的变化.方法:将434例眩晕患者分为肝阳上亢、痰浊中阻、肾精不足、气血亏虚4型,观察不同中医分型的眩晕患者的血液流变性、血脂和血糖的变化.结果:肝阳上亢、痰浊中阻、肾精不足型眩晕患者全血粘度、血沉、纤维蛋白原、血栓干重、甘油三酯和血糖等指标升高,血清高密度脂蛋白胆固醇则降低(P＜0.05),痰浊中阻型患者的红细胞压积、血清总胆固醇升高(P＜0.05);而气血亏虚型患者RBC压积降低,血沉增快(P＜0.05).各型之间尤以痰浊中阻型患者的全血粘度与RBC压积增加较其它各型有统计学意义(P＜0.05);肾精不足型患者血糖增加有统计学意义(P＜0.05);气血亏虚型患者全血粘度与RBC压积降低、血沉增快有统计学意义(P＜0.05).结论:眩晕患者与正常人的血液流变性、血脂和血糖水平呈现统计学差异,不同中医分型眩晕患者的上述指标亦有所不同.     

心脏穿透伤224例的临床分型和处理

目的　为了比较不同时期心脏穿透伤 (PCT)的流行病学、诊治疗效的发展趋势 ,探讨临床分型对 PCT救治的指导意义以及影响预后的因素。　方法　对 15家三级医院 1990年 1月～ 2 0 0 1年 10月收治的 PCT共 2 2 4例进行回顾性研究 ,按年代的先后将其分为两组 ,组 1(1990年 1月～ 1995年 12月 ,92例 )和组 2 (1996年 1月～ 2 0 0 1年 10月 ,132例 ) ;并根据入院时的临床表现分为亚临床型、临床型 ,后者又分为心脏压塞型和失血休克型。　结果　亚临床型 5 3例 ,其院前时间 (T1)、入院时修订创伤计分 1(RTS1)分别为 0 .74± 0 .5 4小时和 5 .35± 0 .87;临床型171例 ,T1、RTS1分别为 1.5 0± 2 .6 0小时和 4 .2 9± 1.6 4 (P<0 .0 5 ) ,两型的麻醉时修订创伤计分 (RTS2 )、损伤严重度评分 (ISS)差别无显著性意义 (P>0 .0 5 )。全组死亡 36例 ,总死亡率 16 .0 7%。其中亚临床型死亡 2例 ,心脏压塞型 9例 ,失血休克型 2 5例。组 1死亡 2 0例 ,死亡率为 2 1.74 % ;组 2死亡 16例 ,死亡率下降至 12 .12 % (P<0 .0 1)。　结论　 PCT的发生率呈逐年增高趋势 ,要提高 PCT的抢救成功率 ,应加强院前救治和转运 ,简化诊断方法 ,尽早开胸手术治疗。临床分型对救治具有指导意义。     

原发性高血压患者颈动脉粥样硬化与中医证型的关系

目的:探讨原发性高血压患者颈动脉粥样硬化程度与中医辨证分型的关系。方法:用高频(11.4 MHz)彩色多普勒超声检测了130例原发性高血压及心脑血管并发症患者的颈动脉,与37例非高血压心脑血管病患者作对照。结果:高血压各组颈动脉内中膜厚度及斑块检出率均高于对照组,以合并脑血管疾病组内中膜厚度高于单纯高血压组。高血压中医证型之间比较,以痰湿壅盛型内中膜厚度明显高于其他证型,斑块检出率以阴虚阳亢和痰湿壅盛型明显高于其他证型。结论:高血压是引起颈动脉内中膜厚度增加的重要因素。颈动脉粥样硬化程度可作为预测心脑血管病存在的参考指标。动脉硬化的病因病机与痰、瘀密切相关。     

Risk factors for late recurrence in patients with nonvalvular atrial fibrillation after radiofrequency catheter ablation

ObjectiveTo identify the risk factors for postoperative atrial fibrillation (AF) recurrence in nonvalvular AF patients undergoing radiofrequency catheter ablation (CA).MethodsWe retrospectively reviewed the data from 426 of 450 AF patients who underwent CA. Patients were divided into two groups according to recurrence after the operation; the risk factors for AF recurrence were analyzed. A stratification system for lesions was created based on the cutoff of the risk factors; the associations among the subgroups and the AF recurrence rate were analyzed.ResultsAF recurrence occurred in 98 (23.0%) patients. Univariate analysis demonstrated that AF type, hypertrophic cardiomyopathy, left atrial diameter (LAD), left ventricular ejection fraction (LVEF), serum albumin, and D‐dimer concentrations were associated with AF recurrence. AF type (OR =2.907, p < .001), serum albumin concentration (OR =1.112, p < .05), and LAD (OR =1.115, p < .001) were independent risk factors for AF recurrence. The area under the ROC curve of LAD for the prediction of AF recurrence was 0.722 (95% CI: 0.664~0.779) and that of serum albumin for the prediction of AF recurrence was 0.608 (95% CI: 0.545~0.672). Further stratification revealed that patients with persistent or paroxysmal AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L had a higher rate of AF recurrence than the reference group.ConclusionAtrial fibrillation type, LAD, and serum albumin concentration are risk factors for AF recurrence after CA in patients with nonvalvular AF. Patients with persistent AF with LAD ≥43.5 mm and serum albumin concentration ≥42.2 g/L have a higher risk of late AF recurrence after surgery.     

中医调治亚健康状态70例临床观察

目的 观察中医辨证论治配合针灸调治亚健康状态的临床疗效.方法 将明确诊断为亚健康状态的70例患者中医辨证分为4型,根据证型给予中药口服,同时结合针灸治疗,10天为1疗程,3疗程后统计疗效.结果 经调治70例患者总有效率为87%.结论 中医辨证施治调理亚健康状态有优势.