MSCTA、2DDSA和3DDSA对颈动脉狭窄测量差异比较的实验研究

目的：比较多层螺旋CT血管造影（MSCTA）与2D数字减影血管造影（DSA）、3DDSA对颈动脉狭窄模型的测量差异。方法根据北美症状性颈动脉内膜切除术试验组（NASCET）标准,利用重力输液管制备30支血管模型,其中0级2支,1级（1％～＜30％）6支,2级（30％～＜70％）和3级（70％～＜100％）各10支,血管闭塞（4级,100％）2支,分别进行MSCTA、直径10mm钢球校准后2DDSA和3DDSA成像分析（AVA）,分别测量模型血管内径、狭窄段的直径狭窄率（DSR）和面积狭窄率（ASR）,并评估其狭窄程度。结果与MSCTA和2DDSA比较,3DDSA对模型内径的测量误差最大[（3．08±0．09）mm],差异具有统计学意义（t＝14．95、11．89,P＜0．01）。3种方法对同一血管狭窄模型所测出的ASR均大于DSR,3DDSA的ASR和DSR均较MSCTA和2DDSA有减低。以ASR和DSR为血管狭窄的评估参考指标,2DDSA为诊断“金标准”,MSCTA与钢球校准后2DDSA对血管狭窄程度分级的诊断一致性最佳（Kappa值分别为0．86和0．91）,3DDSA对血管狭窄程度评估的可靠性较低,Kappa值为0．35和0．42。结论MSCTA能够提供全面、准确的诊断信息,可替代常规DSA用于颈动脉狭窄的诊断性评价,相对于2DDSA和MSCTA,3DDSA对颈动脉的狭窄可能具有一定程度的低估。     

Corn oligopeptides protect against early alcoholic liver injury in rats

Background

The present study aimed to investigate the effects of corn oligopeptides (COPs) on early alcoholic liver injury in rats. A total of 70 Wistar rats were randomly assigned to 7 groups, including a normal control group, 3 alcohol control groups (2.0, 4.0 and 6.0 g/kg/BW ethanol), and 3 COP intervention groups (2.0, 4.0 and 6.0 g/kg/BW ethanol, with 900 mg/kg/BW COPs). The study duration lasted for 4 weeks. Serum markers were assayed, and a histopathological examination was conducted.

Results

We found that the COP treatment prevented the elevation of serum aminotransferase and alleviated the hepatic histological damage that was induced by alcohol. In addition, the COPs counteracted the changes in the SOD activity and the MDA content in serum. Furthermore, the COPs ameliorated the abnormal lipid metabolism.

Conclusion

These findings suggest that COPs have a significant protective effect on early alcoholic liver injury in rats.     

舍曲林合并理性情绪疗法治疗强迫症对照研究

目的 探讨舍曲林合并理性情绪疗法对强迫症的治疗效果.方法 将56例在门诊治疗的强迫症患者分成两组,分别用理性情绪疗法合并舍曲林(28例为观察组)和单用舍曲林(28例为对照组)治疗;于入组时、治疗6周、6个月及1年后分别用Y-BOCS量表、HAMA量表评定病人,并于治疗1年后用SDSS量表评定病人.结果 ①治疗6周后两组...     

基于无线的心电采集与传送系统设计

利用nRF401无线收发芯片设计一个心电信号的前端采集与传送系统。该系统可以嵌入心电监护系统中，实现信号采集系统与信号处理系统分离，增强设备应用的灵活性。     

人体测量学参数与定量CT 测量腹部脂肪的相关性与预测误差

目的：通过比较人体测量学方法与定量CT （QCT ）方法,探讨人体测量方法与QCT测量腹内脂肪的相关性及预测误差。方法测量568名中国成人（男234人,女334人）身高、体质量、腰围、臀围,并进行腰椎CT 扫描。采用Mindways QCT软件的体质成分测量功能定量测量腹部脂肪分布,测得T12、L1、L2、L3、L4、L5椎体下缘水平及脐层面的腹内脂肪面积（VFA）和总脂肪面积（TFA）,计算出皮下脂肪面积（SFA）、总腹内脂肪体积（TVFV）、总皮下脂肪体积（TSFV）、总脂肪体积。采用线性回归分析体质量指数（BMI）、腰围、臀围和腰臀比同VFA的相关性,用标准估计误差（SEE）预测VFA同实际脂肪面积的误差值。结果腰围与不同解剖位置的 VFA相关性均优于臀围、BMI和腰臀比,其相关系数 R2分别为0．48～0．64（男）、0．53～0．66（女）,P＜0．01。腰围预测VFA同实际脂肪面积的 SEE分别为25．36～31．57 cm2（男）,23．64～25．31 cm2（女）。达均值为23．13％～27．78％（男）,25．44％～36．03％（女）。结论人体测量学参数预测VFA的 SEE较显著,而QCT可以更精确地测量VFA ,具有临床应用潜力。     

Significance of increased signal intensity on MRI in prognosis after surgical intervention for cervical spondylotic myelopathy

We aimed to examine whether increased signal intensity (ISI) on T2-weighted MRI can be used to predict the surgical outcome of patients with cervical spondylotic myelopathy (CSM). ISI on T2-weighted MRI are frequently observed but the relevance of this finding remains controversial in patients with CSM. Between September 2007 and February 2009, 52 patients with CSM who underwent surgery were studied prospectively. Preoperative and postoperative functional status was evaluated using the modified Japanese Orthopaedic Association (JOA) scoring system, and the recovery rate was calculated using the Hirabayashi method. An MRI was performed on all patients. For those with ISI on T2-weighted MRI, the ratio of the signal intensity on T2-weighted to T1-weighted MRI (T2:T1 ratio) at the same spinal cord level and of similar area was calculated. Although the clinical outcome of all patients had improved at final follow-up, there was a significant difference between patients with ISI and those without ISI in age, duration of symptoms, preoperative and postoperative JOA scores, and recovery rate. The preoperative and postoperative JOA scores and the recovery rate differed significantly (p < 0.05) between the three groups: patients without a T2-weighted ISI, and those with different levels of a T2:T1 ratio. Patients with an ISI usually had a low preoperative JOA score and experienced less improvement in neurologic function after surgery. The T2:T1 ratio can be used to help predict surgical outcomes.     

Combined resection with radiofrequency ablation for bilobar hepatocellular carcinoma: a single-center experience

Background

Bilobar hepatocellular carcinoma (HCC) is not rare and curative resection often cannot be achieved. However, the long-term results of nonsurgical treatments remain unsatisfactory. This study investigates the safety, efficacy, and long-term outcome of hepatic resection (HR) and resection combined with radiofrequency ablation (RFA) in treating patients with bilobar HCC.

Materials and methods

A retrospective study of 364 patients with bilobar HCC was carried out. Among them, 89 received HR, 114 received resection combined with RFA, and 161 received transarterial chemoembolization (TACE). The clinicopathologic parameters, surgical results, long-term outcomes, and prognostic factors were analyzed.

Results

The median follow-up time was 28 mo (range, 3–84 mo). The 1-, 3-, 5-y overall survival rates were better after HR and resection combined with RFA than those of patients after TACE, that is, 78.9%, 49.4%, and 34.4%; 70.7%, 40.7%, and 22.3%; and 47.2%, 17.4%, and 8.6%, respectively (P < 0.001). Overall survival and recurrence-free survival rates were comparable between the two surgical groups. Child–Pugh stage, liver cirrhosis, and tumor number were identified as significant prognostic factors for overall survival by using the multivariate Cox model.

Conclusions

HR combined with RFA provided a chance for cure to patients with bilobar HCC who were traditionally deemed unresectable and yielded better long-term outcomes than TACE in a subset of patients. With preserved liver function, patients can receive aggressive treatment and survival could be prolonged.     

甲肝减毒活疫苗流行病学效果初步研究

采用随机、对照的方法，考核了国产甲肝减毒活疫苗（Ｈ２株）的流行病学效果。初步的结果表明：疫苗的保护率为７０．９％（９５％可信限：５５．８％～８６．０％）。     

定量CT 与MRI测量腹部脂肪面积及分布的比较

目的：研究定量CT和磁共振成像（MRI）检查在测量腹部脂肪面积及分布的相关性及一致性。方法对44例健康研究对象空腹状态下同一天行腹部定量CT和MRI检查,选取腰椎4／5层面图像,CT 图像采用定量CT分析软件 QCT PRO v5．0测量,M RI图像采用图像分析软件Analyze v12．0进行测量,半自动区分该层面腹内脂肪和皮下脂肪并测量其面积。统计分析两者测量结果的相关性和一致性。结果定量CT 和 MRI对腹部皮下脂肪面积（SFA）、腹内脂肪面积（SFA）、总脂肪面积（TFA）的测量呈明显正相关（r值分别为0．96、0．94、0．96,P＜0．05）。Bland‐Altman分析显示MRI和定量CT测得的腹部脂肪面积的差值很小（差值均数分别为8．6、－2．8、5．7 cm2）。结论定量C T和M RI对腹部脂肪面积的测量结果具有明显相关性和较好的一致性,二者有可比性且在临床应用中可互相代替。     

从“虚-瘀-毒”探讨出血中风的核心病机

出血中风是一种严重脑血管疾病类型之一,其致死、致残率高,严重危害人类生命健康,现代医学暂无有效治疗方法。郭建文教授基于全国名中医陈绍宏教授的中风核心病机论,综合历代医家的学术观点,结合临床实践,提出出血中风的核心病机为“虚-瘀-毒”。即元气亏虚,因虚致瘀,因虚致痰,痰瘀互结,化生诸邪,聚而为毒,腑实不通,毒损脑络,血溢脉外,其中元气亏虚为发病根本,毒损脑络发为发病的最终发病机制,血瘀是发病核心环节,腑实为常候。治疗上应以复元醒脑、破血逐瘀、通腑解毒为法。