基于压缩感知技术三维MRI用于半月板损伤

目的 探讨压缩感知（CS）技术三维MRI（3D-MRI）用于膝关节成像的可行性及其评估半月板损伤的价值。方法 对26例疑诊膝关节损伤患者（损伤组）及30名健康志愿者（对照组）行膝关节MRI，采集常规脂肪抑制质子加权图像（fsPDWI）和CS-3D-MRI。记录损伤组患者关节镜检查结果。损伤组患者于关节镜检查前接受MRI，以单一DS方式（CS-DS_medium）重建图像，分析CS-3D-MRI诊断结果与关节镜结果的一致性。对照组均行右膝扫描，以3种降噪（DS）水平（CS-DS_weak、CS-DS_medium、CS-DS_strong）重建CS-3D-MRI，采用主、客观方法评价矢状位图像质量。结果 对照组不同方法重建CS图像和fsPDWI图像质量评分差异无统计学意义（Z=0.35，P=0.32）；4个序列图像信噪比（SNR）和对比信噪比（CNR）差异均有统计学意义（F=36.01、9.62，P均<0.05），CS-DS_strong图像SNR最高（P<0.05），fsPDWI与CS-DS_medium图像之间CNR值差异无统计学意义（P>0.05）。损伤组CS-3D-MRI均显示半月板损伤，与关节镜诊断结果的一致性强（Kappa=0.94，P<0.01）。结论 基于CS技术的3D-MRI可用于膝关节成像，能在保证图像质量的前提下缩短扫描时间，评估膝关节半月板损伤有较高价值。     

地高辛与巯甲丙脯酸联合治疗室间隔缺损合并心衰患儿的疗效观察

目的 :评价地高辛和巯甲丙脯酸联合治疗室间隔缺损合并心衰患儿的临床疗效。方法 :3 2例心衰患儿随机分为13例对照组和 19例治疗组。治疗组给地高辛饱和量后维持用药 ,巯甲丙脯酸从小剂量开始递增至每日 0 5～ 1mg/kg ,疗程 3个月。对照组心衰时给以地高辛 ,纠正后即停用 ,随访 6个月。结果 :治疗组心衰控制和罗音消失天数较对照组明显缩短 (t =3 78,P <0 0 1;t =3 5 6,P <0 0 1) ,半年内肺炎反复发作次数减少 (t =4 84,P <0 0 1)。结论 :地高辛和巯甲丙脯酸联合治疗室间隔缺损合并心衰患儿可预防肺炎及心衰发生并缩短其病程。     

腹壁侵袭性纤维瘤病1例报告并文献复习

目的：探讨侵袭性纤维瘤病的临床、病理、影像学特征及治疗方法。方法报告1例腹壁侵袭性纤维瘤病病例,结合文献探讨该病的临床特点、影像学特征、病理学表现、治疗及预后。结果侵袭性纤维瘤病在临床上较为少见,表现为向周围组织侵袭生长的包块,无包膜,界限不清,活动度差。影像学检查无特异性,难以与其他软组织肿瘤相鉴别。病理学特点：主要由梭形的纤维母细胞和肌纤维母细胞呈束状排列,无明显异型性,核分裂象少。本病易复发,手术治疗应彻底,放疗对肿瘤局部控制及降低复发率有一定作用,同时还有化疗和内分泌等治疗方法。结论侵袭性纤维瘤病是一种局部侵袭性较强的病变,应结合临床表现、CT、MRI及病理学特点诊断本病。治疗关键为首次手术切除范围需广泛,切缘距瘤缘3 cm以上,使切缘完全阴性。放疗可局部控制肿瘤生长及降低复发率。     

阿奇霉素联合头孢他啶治疗重症社区获得性肺炎

目的 观察阿奇霉素联合头孢他啶治疗重症社区获得性肺炎的临床疗效。方法 将112例患者随机分为3组：A组32例,阿奇霉素针500mg／d;B组41例,头孢他啶针4～6g／d;C组39例,阿奇霉素针500mg／d和头孢他啶针4—6g／d。观察临床有效率。并对结果进行统计学分析。结果 C组有效率明显高于对照组A、B。结论 阿奇霉素联合头孢他啶治疗重症社区获得性肺炎优于上述单种抗生素。     

西藏高原地区继发性喉结核49例临床分析

目的:总结西藏高原地区继发性喉结核的临床特征,进一步提高其诊疗水平。方法:回顾性分析49例西藏高原地区继发性喉结核患者的临床资料。结果:临床诊断47例,病理诊断2例。病程<1年24例,1～3年11例,>3～5年9例,>5年5例。自述有结核病史38例,否认有结核病史11例。34例曾用抗结核药物治疗,但均未按正规方法服药。患者均有长期声嘶、咳嗽、咽喉肿痛等症状,但局部和全身症状均较轻。42例初诊为慢性喉炎,15例口服或雾化吸入糖皮质激素后病情加重,7例初诊为喉癌。喉部特征性表现为:喉的后部苍白水肿、增生结节或糜烂溃疡,喉前部基本正常或病变轻。49例经肺CT或X线证实均伴有肺结核。12例PPD试验呈强阳性,2例痰涂片发现结核菌。诊断性治疗49例均有效。患者均接受标准化疗方案治疗,沐舒坦联合抗结核药物雾化吸入治疗1～2个月。药物治疗结束时,除1例因意外车祸死亡外,临床治愈43例,好转5例。结论:由于西藏高原地区结核病的高发特点,在高原遇到慢性喉炎表现的患者时应想到喉结核的可能。绝大多数喉结核继发于肺结核,应首选肺CT和喉镜检查。继发性喉结核的诊断与肺结核一样,根据症状、喉部特征性表现、诊断性治疗有效等即可确立临床诊断...     

Panax notoginseng saponins suppress lipopolysaccharide‐induced barrier disruption and monocyte adhesion on bEnd.3 cells via the opposite modulation of Nrf2 antioxidant and NF‐κB inflammatory pathways

Dysfunction of the blood‐brain barrier (BBB) is a prerequisite for the pathogenesis of many cerebral diseases. Oxidative stress and inflammation are well‐known factors accounting for BBB injury. Panax notoginseng saponins (PNS), a clinical commonly used drug against cerebrovascular disease, possess efficient antioxidant and anti‐inflammatory activity. In the present study, the protective effects of PNS on lipopolysaccharide (LPS)‐insulted cerebral microvascular endothelial cells (bEnd.3) were assessed and the underlying mechanisms were investigated. The results showed that PNS mitigated the decrease of Trans‐Endothelial Electrical Resistance, increase of paracellular permeability, and loss of tight junction proteins in bEnd.3 BBB model. Meanwhile, PNS suppressed the THP‐1 monocytes adhesion on bEnd.3 monolayer. Moreover, PNS prevented the pro‐inflammatory cytokines secretion and reactive oxygen species generation in bEnd.3 cells stimulated with LPS. Mechanism investigations suggested that PNS promoted the Akt phosphorylation, activated Nrf2 antioxidant signaling, and inhibited the NF‐κB activation. All the effects of PNS could be abolished by PI3K inhibition at different levels. Taken together, these observations suggest that PNS may act as an extrinsic regulator that activates Nrf2 antioxidant defense system depending on PI3K/Akt and inhibits NF‐κB inflammatory signaling to attenuate LPS‐induced BBB disruption and monocytes adhesion on cerebral endothelial cells in vitro.     

基于时空地理加权回归模型的中国肺结核发病情况及影响因素研究

背景 现有针对肺结核发病影响因素的研究大多是独立的时间或空间回归分析,研究结果存在局限性。目的 探索中国肺结核分布的时间和空间异质性,并分析肺结核发病情况与气象和空气质量因素在时间和空间上的相关关系,为制订相应结核病防控措施提供科学参考。方法 使用2016—2018年全国分地区肺结核分月统计数据,将肺结核发病率作为因变量,将气象和空气质量因素作为自变量,在预先进行多重共线性和空间自相关检验后,分别构建普通最小二乘(OLS)模型、地理加权回归(GWR)模型、时空地理加权回归(GTWR)模型,评估并比较模型优度,选取最优模型以描述肺结核发病情况。分别绘制各变量拟合系数的核密度分布图和时空分布图,以描述拟合系数的时空特异性。结果 我国肺结核总发病率在逐年下降,且空间分布较为集中。GTWR模型的R²值均比OLS和GWR模型要高,同时GTWR模型的修正后的赤池信息量(AICc)值均比OLS和GWR模型要小,表明GTWR模型能更好地解释自变量对肺结核发病情况的影响。各变量核密度图结果显示,风速的增加对大多数城市的肺结核发病呈现显著的保护作用;湿度及空气污染物浓度的增加将显著增...     

硬化剂＋套扎术对食管胃底静脉曲张破裂出血患者的疗效及对血流动力学的影响

目的 探讨硬化剂＋套扎术对食管胃底静脉曲张破裂出血患者的疗效及对血流动力学的影响。方法 收集本院2020年1月-2021年12月收治的食管胃底静脉曲张破裂出血患者158例的资料行回顾性分析,按照治疗方法不同分为对照组（113例）和观察组（45例）,对照组给予静脉曲张套扎治疗,观察组在此基础上给予硬化剂注射术治疗,观察两组患者临床疗效、血流动力学、再出血率、复发率和并发症情况。结果 观察组的治疗有效率高于对照组（P＜0.05）。两组患者中心静脉压(CVP)比较差异无统计学意义（P＞0.05）,观察组治疗后24 h(T1)、72 h(T2)时的门静脉压(PVP)低于对照组（P＜0.05）。观察组的再出血率低于对照组（P＜0.05）;观察组的复发率低于对照组（P＜0.05）。观察组并发症发生率低于对照组（P＜0.05）。结论 食管胃底静脉曲张破裂出血患者使用硬化剂＋套扎术治疗效果理想,可预防再出血,并有效改善患者血流动力学     

Infectious bronchitis virus: S1 gene characteristics of vaccines used in China and efficacy of vaccination against heterologous strains from China.

The entire S1 protein genes of eight infectious bronchitis (IB) vaccine strains used in China were compared with those of the IB virus isolates present in the field in China. The nucleotide and amino acid similarities between the eight IB vaccine strains and the field strain, tl/CH/LDT3/03, which was isolated from a teal (Anas sp.), were not more than 81.1% and 79.2%, respectively. Phylogenetic analysis based on the S1 genes showed that the vaccines and field strains belonged to different clusters and showed larger evolutionary distances, and indicated that they were of different genotypes. Four out of the eight vaccines, in addition to the Massachusetts type vaccine H120, were used for protection tests against challenge by the IB virus isolate tl/CH/LDT3/03. This revealed that each of the five IB vaccines induced poor protection against the teal isolate, as assessed by respiratory protection, clinical signs and mortality, indicating the necessity of developing vaccines from local strains for IB control in China.     

Adaptation and Attenuation of Duck Tembusu Virus Strain Du/CH/LSD/110128 following Serial Passage in Chicken Embryos

Duck Tembusu virus (DTMUV) is a newly emerging pathogenic flavivirus that has caused massive economic losses to the duck industry in China. In the current study, a virulent strain of DTMUV, designated Du/CH/LSD/110128, was isolated from the livers of diseased ducks and attenuated by serial passage in embryonated chicken eggs. The virus was partially attenuated after 50 and 70 passages and was fully attenuated after 90 passages, based on mortality and morbidity rates and viral loads in inoculated ducklings. Fourteen amino acid substitutions were observed in the capsid, prM, envelope, NS1, NS3, NS4A, NS4B, and NS5 proteins of the fully attenuated strain of Du/CH/LSD/110128, which might be responsible for the observed changes in replication and pathogenicity. A 72-nucleotide deletion was also observed in the 3′ untranslated region of the virus after 30 passages. The fully attenuated virus retained the immunogenicity of the parental strain, providing effective protection to challenge with virulent Du/CH/LSD/110128, and may represent a suitable candidate as a vaccine strain against DTMUV infection in ducks. Our results also lay the foundation for future studies on the replication and pathogenic mechanisms of DTMUV.