头针联合空气压力波治疗脑卒中后肩手综合征的疗效观察

目的将传统针刺疗法中的头皮针结合空气压力波治疗仪联合现代康复运动疗法与单纯采用现代康复运动疗法治疗脑卒中后肩手综合征的疗效进行对比研究。方法入选90例脑卒中并发肩手综合征患者,用随机数字法分为对照组与治疗组,每组45例;对照组:常规用药+康复训练;治疗组:在对照组的治疗基础上加用头皮针和空气压力波治疗仪的联合治疗,30 d为1个疗程,1个疗程后将两组的观察结果进行统计和对照分析;观察指标:(1)手功能试验(Carroll评分法);(2)疼痛分级指数(pain rating index,PRI评分);(3)手掌围度(使用软尺测量)。结果对照组45例脑卒中并发肩手综合征患者中,疗程结束后总有效28例,无效17例;治疗组45例脑卒中并发肩手综合征患者中,疗程结束后总有效39例,无效6例。两组疗效比较,治疗组中有效患者明显高于对照组,差异有统计学意义(P<0.01)。治疗组脑卒中并发肩手综合征患者手功能试验Carroll评分(57.71±34.34比较46.56±24.08)与疼痛分级指数PRI评分(8.09±3.56vs.17.31±6.08)显著高于对照组脑卒中并发肩手综合征患者,差异有统计学意义(P<0.05)。治疗组脑卒中并发肩手综合征患者手掌围度有效改善率91.1%明显高于对照组脑卒中并发肩手综合征患者57.8%,差异有统计学意义(P<0.01)。结论头针联合空气压力波结合康复训练是一种治疗脑卒中后肩手综合征行之有效的方法,尤其是在缓解肢体肿胀程度上较常规康复疗法显著。     

Pediatric cardiac computed tomography angiography: Expert consensus from the Filiale de Cardiologie Pédiatrique et Congénitale (FCPC) and the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV)

This article was designed to provide a pediatric cardiac computed tomography angiography (CCTA) expert panel consensus based on opinions of experts of the Société Française d’Imagerie Cardiaque et Vasculaire diagnostique et interventionnelle (SFICV) and of the Filiale de Cardiologie Pédiatrique Congénitale (FCPC). This expert panel consensus includes recommendations for indications, patient preparation, CTA radiation dose reduction techniques, and post-processing techniques. The consensus was based on data from available literature (original papers, reviews and guidelines) and on opinions of a group of specialists with extensive experience in the use of CT imaging in congenital heart disease. In order to reach high potential and avoid pitfalls, CCTA in children with congenital heart disease requires training and experience. Moreover, pediatric cardiac CCTA protocols should be standardized to acquire optimal images in this population with the lowest radiation dose possible to prevent unnecessary radiation exposure. We also provided a suggested structured report and a list of acquisition protocols and technical parameters in relation to specific vendors.     

高强度聚焦超声波对细粒棘球绦虫原头节酶活性的影响

目的探索高强度聚焦超声波(HIFU)对体外分离的细粒棘球绦虫原头节的酶活性的影响作用。方法用不致原头节即刻杀伤的高强度聚焦超声剂量照射原头节,行酶组织化学染色观察酸性磷酸酶(ACP)、葡萄糖6-磷酸酶(G-6-P)和琥珀酸脱氢酶(SDH)的活性,了解高强度聚焦超声对体外培养的原头节3种代谢酶活性的影响作用。结果细粒棘球绦虫原头节具有酸性磷酸酶、葡萄糖6-磷酸酶和琥珀酸脱氢酶活性。不致原头节即刻杀伤的高强度聚焦超声波作用后,辐照组原头节葡萄糖6-磷酸酶和琥珀酸脱氢酶活性较对照组明显减弱,而酸性磷酸酶反应产物与对照组相比无明显变化。阴性对照组无酶反应产物产生。结论高强度聚焦超声波辐照对原头节酸性磷酸酶活性无影响,而对葡萄糖6-磷酸酶和琥珀酸脱氢酶的活性有明显的抑制,这可能是影响原头节的代谢功能,最终抑制其增殖的原因之一。     

光强对老鸦瓣生长发育及光合特性的影响

目的:探索不同光强条件(23%,45%,63%,78%,100%自然光强)对老鸦瓣生长发育及光合特性的影响,从而确定适宜老鸦瓣生长的光强。方法:于盛果期测量各处理老鸦瓣叶面积及生物量指标;统计各处理植株开花结果比例;采用LI-6400XT型便携式光合作用测定系统测量叶片光合基本参数、光响应曲线,并进一步计算出响应曲线特征参数;采用LI-6400XT配套的荧光叶室测定叶片叶绿素荧光参数。结果:23%光强及全光照处理的植株生物量显著低于其余各处理而78%光强处理植株生物量最高。随着光照强度的降低,老鸦瓣结果率下降,败育率升高;光饱和点(LSP)和光补偿点(LCP)都显著降低,而表观量子效率(AQY)升高。23%,45%光强处理下净光合速率显著低于其他处理,但表观量子效率高于其他处理;全光照和78%光强处理的净光合速率最高且二者差异不显著。78%光强处理下Fv/Fm,Fv’/Fm’,ΦPSⅡ,ETR,qP均最高。结论:老鸦瓣对光强的适应范围较广,但78%左右光强最适宜老鸦瓣生长。     

应用内镜荧光强度分析法研究溃疡性结肠炎中医证型特征

目的 研究溃疡性结肠炎(ulcerative colitis,UC)不同中医证型自发荧光成像(auto fluorescence imaging,AFI)内镜下荧光强度［绿/红(the ratio of green to red,G/R比值)］的特征,为UC中医辨证提供客观依据。方法 收集UC患者49例,根据白光内镜(white light endoscopy,WLE)黏膜形态和G/R比值对大肠湿热组(19例)、脾胃气虚组(30例)和健康对照组(21名)进行统计分析。结果 脾胃气虚组和大肠湿热组G/R比值分别为(1.147±0.137)和(0.915±0.114),较健康对照组(1.227±0.137)降低,差异均有统计学意义(P<0.05,P<0.01),其中大肠湿热组G/R比值较脾胃气虚组更低(P<0.01)。大肠湿热组活动期内镜活动指数(endoscopic index,EI)以中度（11例）和重度（5例）为主;脾胃气虚组以缓解期（17例）和活动期EI轻度（7例）为主。活动期G/R比值小于缓解期(0.963 vs 1.220,P<0.01),且活动期EI轻、中、重度的G/R比值依次降低,分别为1.044、0.967和0.830(P<0.01)。结论 UC大肠湿热证的炎症程度高于脾胃气虚证。AFI能较好地反映UC的炎症程度。     

宫颈癌螺旋断层放疗与容积旋转调强放疗的剂量学比较

〔摘 要〕 目的：探讨宫颈癌螺旋断层放疗与容积旋转调强放疗的剂量学差异及优势。方法：选择 2021 年 1 月 至 2022 年 1 月蚌埠医学院第一附属医院收治的 20 例宫颈癌患者,均实施螺旋断层放疗（数据作为对照组）,治疗 4 周后,调整为容积旋转调强放疗（数据作为观察组）。比较两种放疗方式的剂量学差异。结果：观察组的最大剂量 （D1、D2）、平均剂量（Dmean）、靶区均匀性指数（HI）高于对照组,靶区处方剂量覆盖（D95）、接近最小剂量（D98）、 适形度指数（CI）、治疗时间、治疗跳数低于对照组,膀胱 Dmean、45 Gy 辐射剂量体积百分比（V45）、40 Gy 辐射剂 量体积百分比（V40）、30 Gy 辐射剂量体积百分比（V30）和股骨头 V45、V40 高于对照组,股骨头 Dmean、V30 低于对照组, 差异均具有统计学意义（P ＜ 0.05）。结论：在宫颈癌的放射治疗中,螺旋断层放疗具有明显的剂量学优势,且靶区 适形度、剂量均匀性更优,容积旋转调强放疗所需治疗时间更短,治疗效率更优。在实际诊疗中,医师可根据患者具 体病情、个体差异,选择适宜的放疗方式。     

A Comparison of the Assay Sensitivity of Average and Worst Pain Intensity in Pharmacologic Trials: An ACTTION Systematic Review and Meta-Analysis

Identifying methods to improve assay sensitivity in randomized clinical trials (RCTs) may facilitate the discovery of efficacious pain treatments. RCTs evaluating pain treatments typically use average pain intensity (API) or worst pain intensity (WPI) as the primary efficacy outcome. However, little evidence is available comparing the assay sensitivity of these 2 measures. In this systematic review and meta-analysis, we comprehensively reviewed all low back pain, osteoarthritis pain, fibromyalgia, diabetic peripheral neuropathy pain, and postherpetic neuralgia RCTs that used a parallel group design. Eligibility required: 1) primary RCT report published between 1980 and 2016, 2) comparing 1 or more active, efficacious pharmacologic pain treatment(s) with placebo, and 3) providing data on the standardized effect size (SES) for API as well as WPI for all treatment arms. Twenty-seven active versus placebo comparisons were identified in 23 eligible articles. Using a random-effects meta-analysis, API SES and WPI SES did not differ significantly (difference?=??.021, 95% confidence interval = ?.047 to .004, P?=?.12). The findings indicate that, depending on the objectives of the study, either API or WPI could be used as a primary outcome measure in clinical trials for the chronic pain conditions included in this analysis.

How can we intervene to mitigate post-transplantation relapse in AML? Strategies to mitigate post-transplantation relapse in AML

Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a curative approach for patients with acute myeloid leukemia (AML), relapse is a common occurrence. Several strategies, such as choice of conditioning regimen, donor lymphocyte infusions, pharmacologic agents, and cellular therapy approaches, are currently being developed to improve transplantation outcomes. This review outlines some important interventions and considerations to lower the burden of post-transplantation relapse in AML.     

Assessment of inflamed synovial membrane in the knee joint by dynamic magnetic resonance imaging

Dynamic magnetic resonance imaging (dynamic MRI) was used to examine the synovial membrane in the knee joints of 15 patients with rheumatoid arthritis (RA) in order to investigate the relationship between pathological and MRI findings. Signal intensities in the regions of interest (ROI), identified as the synovial membrane of the suprapatellar pouch, were measured on MR images. Signal intensities at various times after the injection of contrast medium Gd–diethylenetriaminopentoacetic acid (Gd–DTPA) were normalized relative to the signal intensity at 80s, and designated as the normalized signal intensity (NSI). Pathological findings were quantified, and the types of inflamed synovial membrane were classified as either acute or chronic. A significant difference in NSI was observed between acute and chronic types (P 0.05). Dynamic MRI was capable of classifying acute and chronic RA by measuring NSI 20s after contrast medium injection. Dynamic MRI was therefore shown to be useful for assessing regional synovial inflammation.