角膜浅基质层针刺术联合软性角膜接触镜治疗丝状角膜炎临床观察

目的探讨角膜浅基质层针刺术联合软性角膜接触镜治疗丝状角膜炎的安全性和有效性。方法选择25例丝状角膜炎患者,表麻后刮除丝状物,间距0．5ram密集针刺病灶3ram范围内上皮层至浅基质层,术毕佩戴软性角膜接触镜,眼水点眼治疗原发病,随访观察。结果25例患者中21例症状完全消失,一次性治愈率84％,有效率100％。结论角膜浅基质层针刺联合软性角膜接触镜治疗丝状角膜炎是一种安全有效的方法,具有临床实用价值。     

Combining the Tumor Contact Length and Apparent Diffusion Coefficient Better Predicts Extraprostatic Extension of Prostate Cancer with Capsular Abutment: A 3 Tesla MR Imaging Study

Purpose: To assess the diagnostic performance of the tumor contact length (TCL) and apparent diffusion coefficient (ADC) for predicting extraprostatic extension (EPE) of prostate cancer with capsular abutment (CA).Methods: Ninety-three patients with biopsy-proven prostate cancer underwent 3-Tesla MRI, including diffusion-weighted imaging (b value = 0, 2000 s/mm²) and radical prostatectomy. Two experienced radiologists, blinded to the clinicopathological data, retrospectively assessed the presence of CA on T2-weighted imaging (T2WI). TCL on T2WI and ADC values were measured on detecting CA in prostate cancer. We used the receiver operating characteristic curves to assess the diagnostic performance of TCL and ADC values for predicting EPE.Results: CA was present in 58 prostate cancers among 93 patients. The cut-off value for TCL was 6.9 mm, which yielded an area under the curve (AUC) of 0.75. This corresponded to a sensitivity, specificity, and accuracy of 84.2%, 61.5%, and 69.0%, respectively. The cut-off value for ADC was 0.63 × 10^–3 mm²/s, which yielded an AUC of 0.76. This, in turn, corresponded to a sensitivity, specificity, and accuracy of 84.2%, 59.0%, and 67.2%, respectively. The combined cut-off value of TCL and ADC yielded an AUC of 0.82. The specificity (84.6%) and accuracy (81.0%) of the combined value were superior to their individual values (P < 0.05).Conclusion: A combination of TCL and ADC values provided high specificity and accuracy for detecting EPE of prostatic cancer with CA.     

医院门诊合理用药临床决策支持系统的构建与实施

目的 实现医院合理用药信息化,提高工作质量和效率,保障安全用药。方法 建立包括知识库、即时通信系统和处方点评系统的临床决策支持系统(CDSS),并接入医院信息系统。结果 与结论CDSS可提醒医师正确开具处方,辅助药师实时审核,确保医师、药师高效沟通,实现软件辅助下的全处方点评,从而提升药学服务、保障合理用药。     

Integrated decision strategies for skin sensitization hazard

One of the top priorities of the Interagency Coordinating Committee for the Validation of Alternative Methods (ICCVAM) is the identification and evaluation of non‐animal alternatives for skin sensitization testing. Although skin sensitization is a complex process, the key biological events of the process have been well characterized in an adverse outcome pathway (AOP) proposed by the Organisation for Economic Co‐operation and Development (OECD). Accordingly, ICCVAM is working to develop integrated decision strategies based on the AOP using in vitro, in chemico and in silico information. Data were compiled for 120 substances tested in the murine local lymph node assay (LLNA), direct peptide reactivity assay (DPRA), human cell line activation test (h‐CLAT) and KeratinoSens assay. Data for six physicochemical properties, which may affect skin penetration, were also collected, and skin sensitization read‐across predictions were performed using OECD QSAR Toolbox. All data were combined into a variety of potential integrated decision strategies to predict LLNA outcomes using a training set of 94 substances and an external test set of 26 substances. Fifty‐four models were built using multiple combinations of machine learning approaches and predictor variables. The seven models with the highest accuracy (89–96% for the test set and 96–99% for the training set) for predicting LLNA outcomes used a support vector machine (SVM) approach with different combinations of predictor variables. The performance statistics of the SVM models were higher than any of the non‐animal tests alone and higher than simple test battery approaches using these methods. These data suggest that computational approaches are promising tools to effectively integrate data sources to identify potential skin sensitizers without animal testing. Published 2016. This article has been contributed to by US Government employees and their work is in the public domain in the USA.     

Comfort-Kone硬性角膜接触镜矫治圆锥角膜

目的观察comfort-kone硬性角膜接触镜(rigid gas-permeable contact lens,RGPCL)控制圆锥角膜发展的效果。方法 52例(94眼)患者采用"三点接触法"配戴comfort-kone RGPCL,分析对比配戴后屈光度、角膜地形图参数及泪液情况的变化,评价RGPCL控制圆锥角膜发展的临床效果。结果配戴RGPCL后最佳矫正视力0.83±0.24,与配戴前最佳矫正视力0.58±0.35比较,差异有显著统计学意义(t=-8.87,P=0.00);RGPCL矫正视力与配戴眼屈光度和角膜曲率半径呈显著相关(P=0.001、0.000),与角膜散光度无显著相关性(P=0.081)。随访期间RGPCL矫正视力稳定,角膜健康状况良好;患者主观适应时间为(11.13±9.10)d;长期配戴后基础泪液分泌量显著降低,差异有显著统计学意义(t=2.867,P=0.007)。结论 Comfort-Kone RGPCL能够显著提高圆锥角膜患者的视觉质量,长时间配戴安全、稳定,有效地控制了圆锥角膜的持续发展。     

The natural caesarean: a woman-centred technique

Although much effort has gone into promoting early skin-to-skin contact and parental involvement at vaginal birth, caesarean birth remains entrenched in surgical and resuscitative rituals, which delay parental contact, impair maternal satisfaction and reduce breastfeeding. We describe a 'natural' approach that mimics the situation at vaginal birth by allowing (i) the parents to watch the birth of their child as active participants (ii) slow delivery with physiological autoresuscitation and (iii) the baby to be transferred directly onto the mother's chest for early skin-to-skin. Studies are required into methods of reforming caesarean section, the most common operation worldwide.     

Allergic contact dermatitis from propellants in deodorant sprays in combination with allergy to ethyl chloride

Allergic contact eczema from the use of deodorant sprays is sometimes caused by sensitization to the propellants. Positive reactions were seen in three patients when patch testing to Freon 11 (trichloromonofluoromethane). One patient also reacted to Freon 12 (dichlorofluoromethane). Another patient had an eczematous eruption after ethyl chloride was sprayed on the skin prior to taking biopsy. The two other patients showed strongly positive patch tests with this compound. Further investigations of the sensitizing capacity propellants with chemical resemblance have to be carried out to solve the problem of cross-sensitization.     

橡胶罩所致缝纫工接触性皮炎

本文报告由进口平缝机组装件橡胶罩所致职业性接触性皮炎。199例缝纫工中104例(52.3％)发病。潜伏期1～3周。皮损多限于右膝外侧直接接触橡胶处,甚至波及同侧大小腿或呈对称分布。临床表现与非职业性接触性皮炎相似,伴剧痒。临床调查与斑试结果表明橡胶罩及防老剂IPPD为主要变应原。部分未患皮炎的接触者也对上物呈阳性反应,提示已发生潜在过敏现象。结合接触组发病率高、潜伏期短,不能完全除排致病物本身刺激作用在发病中的影响。     

Study on Corrosion Resistance and Conductivity of TiMoN Coatings with Different Mo Contents under Simulated PEMFC Cathode Environment

TiMoN coatings with different Mo contents on a SS316L substrate are deposited by using closed field unbalanced magnetron sputtering ion plating (CFUMSIP) technology to enhance the corrosion resistance and durability of stainless steel (SS) bipolar plates (BPs) in proton exchange membrane fuel cell (PEMFC) during the start-up/shut-down process. The electrochemical test results illustrate that TiMoN-4A coating has extremely good corrosion resistance compared to other coatings. The potentiostat polarization (+0.6 V_SCE) tests indicate that the corrosion current density (I_corr) of TiMoN-4A coating is 5.22 × 10⁻⁷A cm⁻², which meets the department of energy 2020 targets (DOE, ≤1 × 10⁻⁶ A cm⁻²). Otherwise, TiMoN-4A coating also exhibits the best corrosion resistance and stability in potentiostatic polarization, electrochemical impedance spectroscopy (EIS), and high potential (+1.2V_SCE) polarization tests. The interfacial contact resistance (ICR) measurement results show that TiMoN-4A coating has the minimum ICR of 9.19 mΩ·cm², which meets the DOE 2020 targets (≤10 mΩ·cm²).     

江苏省职业性铅接触人群体内铅超标情况调查

目的:为掌握职业性铅中毒的发病特点、规律和趋势,制定相应对策,遏制职业性铅中毒的高发势头,对本省14家企业中962名铅接触人员体内铅超标情况进行了调查.方法:根据有关规范和标准,采集空气样本并检测空气中铅浓度,计算时间加权平均浓度(TWA),检测血铅与尿铅.结果:生产岗位空气中铅浓度不合格率9.76%,不合格岗位TWA...