基于机器学习的脑胶质瘤多模态影像分析

脑部胶质瘤是临床中常见的一种原发性脑肿瘤，具有复发率高、死亡率高以及治愈率低的特点。常规临床诊断主要依靠计算机断层扫描(CT)和磁共振成像(MRI)检查技术进行鉴别。随着成像技术和机器学习方法的不断发展，多模态影像智能分析技术已经逐步成为研究热点，在脑胶质瘤的病灶分割测量、肿瘤分级、预后生存周期预测和基因型辨别等方面具有重要的应用前景。本文重点介绍基于机器学习和多模态影像在脑胶质瘤临床辅助诊断和预后评估中的应用进展。     

AlEtCl2／t—BuCl引发α—蒎烯阳离子阳合的反应研究

在实验室绝热反应器中进行了乙苯脱氢制苯乙烯的反应动力学研究。根据不同反应机理，提出五种反应模型，经残差分析及模拟计算规律与实验规律的比较，确定Ｃａｒｒａ双曲模型为最佳反应动力学模型。通过对实验数据的回归拟合，经参数估计求得了速率方程的频率因子和活化能。     

Dietary Habit Is Associated with Depression and Intelligence: An Observational and Genome-Wide Environmental Interaction Analysis in the UK Biobank Cohort

Dietary habits have considerable impact on brain development and mental health. Despite long-standing interest in the association of dietary habits with mental health, few population-based studies of dietary habits have assessed depression and fluid intelligence. Our aim is to investigate the association of dietary habits with depression and fluid intelligence. In total, 814 independent loci were utilized to calculate the individual polygenic risk score (PRS) for 143 dietary habit-related traits. The individual genotype data were obtained from the UK Biobank cohort. Regression analyses were then conducted to evaluate the association of dietary habits with depression and fluid intelligence, respectively. PLINK 2.0 was utilized to detect the single nucleotide polymorphism (SNP) × dietary habit interaction effect on the risks of depression and fluid intelligence. We detected 22 common dietary habit-related traits shared by depression and fluid intelligence, such as red wine glasses per month, and overall alcohol intake. For interaction analysis, we detected that OLFM1 interacted with champagne/white wine in depression, while SYNPO2 interacted with coffee type in fluid intelligence. Our study results provide novel useful information for understanding how eating habits affect the fluid intelligence and depression.     

河南省三级医院低值耗材管理现状调查

目的 了解河南省三级医院低值耗材管理现状,为低值耗材高效管理提供参考.方法 采取自制调查问卷对河南省56所三级医院的220个病区进行耗材管理现况调查.结果 耗材管理人员均为护士;耗材管理中采取传统管理模式136个病区、随时配送模式82个病区、智慧供应链模式2个病区;传统管理流程涉及盘点、申报、领取、分类、计价、效期检查等多个环节,平均耗时(242.91±8.12) min;存在耗材申领过程繁琐、耗材存放不合理、积压、过期浪费、计价不精准、溯源管理难等问题.结论 河南省三级医院低值耗材管理以护士手工管理为主,耗工耗时;医院管理者应引起高度重视,构建智能化管理平台,实现智能供应链管理,提高管理效能.     

从心身同治角度针灸对乳腺癌关节痛患者生命质量改善的临床研究

目的:评价基于《黄帝内经》心身疾病病因的整体选穴与乳腺癌芳香化酶抑制剂(AI)关节痛局部配穴相结合的针灸方法,对乳腺癌康复期AI关节痛患者生命质量及局部关节症状的临床疗效。方法:选取2019年1月至2021年5月南京医科大学第一附属医院乳腺外科筛选使用唑来膦酸的乳腺癌AI患者232例作为研究对象,依据针灸意愿分为对照组(n=19)和观察组(n=16),对照组采用唑来膦酸常规镇痛,观察组在唑来膦酸的基础上采用整体及局部取穴相结合的方法针灸治疗,共治疗4周,分别评价治疗前、治疗2周、4周、8周时的乳腺癌患者生命质量量表(FACT-B)生命质量评分以及简明疼痛评估量表(BPI-SF)关节痛评分,同时评估针灸治疗的安全性。结果:治疗4周以及8周时观察组FACT-B生命质量评分较对照组高,治疗4周时观察组BPI-SF疼痛评分较对照组低,差异有统计学意义(P<0.05)。结论:采用整体配穴调和心身与局部选穴缓急止痛相结合的针灸方法对乳腺癌康复期AI患者的生命质量以及局部关节症状有较好的临床疗效。     

Clinical Features and Mid-Term and Long-Term Outcomes of Surgical Treatment of 8 Patients with Primary Ventricular Tumors

OBJECTIVE To summarize the clinical features and surgical treatment of primary ventricular tumors. METHODS Eight patients with primary ventricular tumor, aged 3 to 52 years, underwent surgical treatment. There were 6 males and 2 females. The pathological diagnoses were as follows: multiple left ventricular myxomas in 2 cases; left ventricular rhabclomyoma, fibroma and malignant neurolemmoma in 1 case for each; right ventricular myxoma and malignant neurolemmoma in 1 case for each; intraseptal fibroma in 1 case. The operations were performed through median sternotomy with moderate hypothermic cardiopulmonary bypass in 7 cases; via left anterolateral thoracotomy without extracorporeal circulation in 1 case. Tumors were totally removed in 7 cases and subtotally resectecl in 1 case. RESULTS Cardiac arrest after anaesthetization occurred in 1 case with postoperative coma for 10 days. One case died of massive gastro-intestinal hemorrhage postoperatively. Seven cases survived, During a follow-up period of 1 to 21 years, there was no recurrence or metastasis in the 6 cases who received complete tumor resection including 2 cases with malignant tumor. One case of partial tumor removal had a mild heart murmur without tumor progression. All patients were asymptomatic with cardiac functiongrade I. CONCLUSION Primary ventricular tumors showed diversity in their histological characteristics. The mid- and long-term outcomes of surgical treatment for primary ventricular tumors appear to be satisfactory.     

脂肪间充质干细胞移植对环磷酰胺诱导的大鼠卵巢功能损伤的影响

目的：探讨脂肪间充质干细胞对化学药物治疗(以下简称化疗)药物环磷酰胺(cyclophosphamide,CTX)诱导的卵巢功能损伤的影响及其作用机制。方法：从雌性SD大鼠脂肪组织中分离脂肪间充质干细胞并进行体外培养,将其分为空白对照组和CTX组,每组15只;再选取45只正常动情周期的SD大鼠,用CTX 75 mg/kg腹腔注射给药1次的方式建立模型,再随机分为对照组(不再予其他处理,A组)、尾静脉注射组[尾静脉注射脂肪间充质干细胞0.6 mL(6×105个细胞),B组]和卵巢原位注射组[经卵巢原位注射脂肪间充质干细胞40 µL(每侧20 µL,2×104个细胞),C组],每组15只。比较A,B,C 3组大鼠用药前后生存质量、体重变化;ELISA法测定血清卵泡刺激素、雌二醇水平;HE染色观察卵巢组织及卵泡计数;免疫组织化学法、real-time PCR法及蛋白质印迹法测定骨形态发生蛋白-15(bone morphogenetic protein 15,BMP-15),Bcl-2和Bax的表达;TdT介导的脱氧尿嘧啶缺口末端标记法(TdT-mediated dUTP nick end labeling,TUNEL)检测A,B,C 3组大鼠卵泡细胞凋亡率。结果：尾静脉注射或卵巢原位注射脂肪间充质干细胞后,与A组比较,B组和C组大鼠生存质量提高,移植前后的体重增长值明显增加,差异均有统计学意义(均P<0.01);与A组比较,B组大鼠血清雌二醇水平明显升高,卵泡刺激素水平明显下降(均P<0.01),C组大鼠血清雌二醇水平升高,卵泡刺激素水平明显下降(分别P<0.05,P<0.01);B组和C组大鼠卵巢组织切片HE染色见颗粒细胞层明显增多,黄体数量增多,各级卵泡计数均增加,可见多个新生卵泡及成熟的卵母细胞;与A组比较,B组大鼠的原始卵泡数、窦状和排卵前卵泡数以及总卵泡数均明显增加,窦前卵泡数也增加(分别P<0.01,P<0.05),C组大鼠的原始卵泡数、窦前卵泡数、窦状和排卵前卵泡数以及总卵泡数均明显增加(均P<0.01);与A组比较,B组和C组大鼠卵巢组织BMP-15和Bcl-2的表达明显增多,Bax的表达明显减少(均P<0.01),大鼠卵巢颗粒细胞的凋亡率明显降低(P<0.01);B组与C组之间比较,大鼠体重增长值,血清雌二醇及卵泡刺激素水平,各级卵泡计数,BMP-15,Bcl-2及Bax的表达水平,卵巢颗粒细胞凋亡率差异均无统计学意义(均P>0.05)。结论：脂肪间充质干细胞移植能够有效地修复CTX化疗所致的卵巢功能损伤,该作用可能是通过抑制颗粒细胞的线粒体凋亡途径实现的。