Medición automática de la zona avascular foveal de ojos sanos en angiografía por tomografía de coherencia óptica de dominio espectral Heidelberg

PurposeTo develop and evaluate an automated method to measure the foveal avascular zone (FAZ) area in healthy eyes on Heidelberg Spectralis Optical Coherence Tomography Angiography (HS-OCTA). This method is referred to as the modified Kanno-Saitama macro (mKSM) which is an evolution of the Kanno-Saitama macro (KSM) approach.MethodsThis cross-sectional study included 29 eyes of 25 healthy volunteers who underwent HS-OCTA at the macular area twice at the same time. Regardless of the quality of the images, all of them were included. Macular data on the superficial vascular plexus, intermediate capillary plexus (ICP) and deep capillary plexus were processed by mKSM. The FAZ area was measured twice automatically using the mKSM and KSM and twice manually by two independent examiners.ResultsFrom 174 images, KSM could not measure correctly 31% while mKSM could successfully measure all of them. Intrascan intraclass coefficient ranged from 0.948 to 0.993 for manual measurements and was 1 for mKSM method. Despite that the difference between human examiners is smaller than between human examiners and mKSM according to Bland-Altman plots, the scatterplots show a strong correlation between human and automatic measurements. The best results are obtained in ICP.ConclusionsWith mKSM, the automated determination of the FAZ area in HS-OCTA is feasible and less human-dependent. It solves the inability of KSM to measure the FAZ area in suboptimal quality images which are frequent in daily clinical practice. Therefore, the mKSM processing could contribute to our understanding of the three vascular plexuses.     

双重实时荧光PCR快速鉴别人参和西洋参＊

目的 建立一种能够快速鉴定人参和西洋参的双重实时荧光PCR方法。方法 通过对人参属及其近似种基因序列的分析比对，设计特异性的引物探针，建立双重实时荧光PCR检测方法。PCR反应体系为Premix Ex Taq （Probe qPCR） 10 μL，人参上下游引物各0.5 μL，西洋参上下游引物各0.3 μL，人参与西洋参特异性探针各0.4 μL，DNA模板2 μL，灭菌去离子水补至20 μL。反应条件为95℃预变性30 s；然后以95℃变性5 s，60℃退火延伸30 s进行40个循环。应用该方法测试了27份DNA样品，包括7份人参、6份西洋参、4份人参与西洋参混合样、10份其他人参属样品及其他常见中药材样品的DNA，以确定该方法的特异性。将人参与西洋参样品DNA混合后10倍稀释成不同浓度后进行检测，用以确定该方法的灵敏度。结果 人参及西洋参样品均在特定的荧光通道下出现典型的阳性扩增曲线，人参与西洋参混合样品均同时出现两条阳性扩增曲线，其它对照样品及空白对照均没有出现阳性扩增曲线。灵敏度检测结果显示该方法检测人参及西洋参的最低检测限均为2 pg DNA/反应。结论 本实验建立的双重实时荧光PCR方法能够同时快速、准确、灵敏地鉴别出人参和西洋参。     

脑卒中患者恐惧疾病进展的研究现状

脑卒中患者在面对复杂的治疗期、漫长的康复期及难以预测的病情变化时容易产生对疾病或疾病进展的恐惧。恐惧疾病进展会损害脑卒中患者的身心健康和社会功能,最终影响患者的康复和预后。从恐惧疾病进展的定义、测量工具、国内外研究现状及影响因素几个方面进行综述,为临床护理人员深入了解脑卒中患者恐惧疾病进展现状、开展相关护理实践和临床研究提供依据。     

Precision and Accuracy of Measurements on CT Scout View

ObjectivesThe purposes of this study were to (1) investigate the limits of measurements on scout view in three computed tomography axes, x, y and z and (2) develop a model to provide better understanding of measurement accuracy.MethodsFor the first objective, anteroposterior and lateral scout views of a Catphan phantom 200 mm in diameter and length were acquired with a GE scanner at 21 different table heights. Phantom measurements on scout view were performed by two experienced readers. The comparison of their measures provided estimation of precision. The accuracy was assessed by determining the bias, calculated as the difference between the values measured on scout view and the real phantom size. Second, a model was developed investigating the relationship between the dimensions of the object, its image, and the table height. This relationship was tested on our data.ResultsScout view measurements were precise, with less than 0.53% difference between readers. In addition, small biases of about 1 mm were detected in the z-axis, whatever the table height. In the other axes, serious biases from −13 to +73 mm were measured. Furthermore, at isocentre, overestimations up to 7 mm were shown. The results also indicated that biases in scout view measurements are because of the geometrical projection related to the object-detector distance.ConclusionsMeasurements in the table movement axis are precise and accurate, conferring to scout views an added value for preoperative planning in orthopedic surgery.     

微滴式数字PCR和实时荧光定量PCR对新型冠状病毒肺炎患者不同时间血便尿中核酸检测结果初步探讨

目的 分析微滴式数字PCR(droplet digital PCR, ddPCR)和实时荧光定量PCR(quantitative real-time PCR,qPCR)的核酸检测结果,比较两种方法检测各类样本的差异性,为改进新型冠状病毒核酸检测方案提供数据支持。 方法 利用ddPCR和qPCR技术对已经确诊的3例新型冠状病毒肺炎患者发病不同时间的全血、尿液、粪便共22份标本进行新型冠状病毒核酸检测。 结果 两种方法对人保守区域基因扩增结果一致:全血标本信号最强,尿液次之,粪便最少;ddPCR在1份全血,1份尿液,5份粪便中检出ORF-1ab和N基因的阳性微滴,qPCR仅在3份粪便中检出上述基因,漏检的3个标本基因拷贝数平均浓度为128 copies/ml;ddPCR在发病<5、5~15、>15 d的各类标本中都有检出,qPCR检出以中晚期为主;重症病例用ddPCR均可测到阳性微滴,qPCR检测的各类标本均为阴性;轻症病例的各类标本中qPCR只有粪便核酸检测阳性,ddPCR检出率高于qPCR。 结论 ddPCR可以有效克服qPCR 灵敏度不足的难题,是对qPCR 的有益补充,尤其是针对病毒载量比较低的血液、尿液和可疑的粪便或肛拭子标本,适用于早期感染的判断及患者治愈后出院诊断。     

国内外护理学本科生毕业考核现状与分析

教育测量与评价对实现教育目标具有重要作用。科学的教育评价既促进学生学习,又为教育决策提供依据,以实现持续质量改进。"健康中国2030"的整体目标、医学科学的发展及人民的健康需求,对新时代护理人才的培养提出了更高、更具体的要求。高等护理院校应以国家和社会对护理人才需求、院校培养目标为导向,以测量理论为基础,制定完善的学业评定标准,科学地开展毕业考核,保证人才"出口"质量。毕业考核作为终结性评价,测试内容在评价质量中起核心作用,应符合国家护理学专业培养标准,并与院校培养目标、课程目标契合。院校应关注护理本科生毕业考核质量,在保障测试信度的同时,做到实施公平、评价适当、标准一致,以确保测试的效度。教育管理部门及各院校应优化评价体系,加强对护理本科生毕业管理,在充分开展系统调查与分析的基础上,基于胜任力导向和结果导向,建立综合性评价体系,在教学过程中进行全方位反馈评价管理。文章结合国内外护理学专业本科生毕业考核的现状,从考核目的、内容、方式、评价主体、质量控制等方面进行综述与分析,为我国加强护理学本科教育,完善护理学专业本科生毕业评价体系建设提供借鉴。     

经食管实时三维超声心动图评价房性心律失常对二尖瓣结构和功能的影响

目的:应用经食管实时三维超声心动图(RT-3D-TEE)技术,探讨房性心律失常对二尖瓣结构和功能的影响.方法:选取2018年6月~2019年6月本院收治的房性心律失常拟行射频消融的患者49例纳入观察组,另外选取21例正常窦性心律者作为对照组,所有患者均行经胸超声心电图(TTE)和经食管实时三维超声心动图(RT-3D-TEE)检查,将两组患者的瓣环投影面积(A2D)、瓣环周长(C3D)、瓣环高度(H)、瓣环前后径(DAP)、瓣环前外侧至后内侧直径(DAIPm)、左室射血分数(LVEF)、左心房前后径(Lad)等参数进行比较,并分别计算对合面积和对合指数,之后采取二项Logistic回归分析或逐步线性回归对各参数及临床因素与对合指数的相关性进行分析.结果:两组患者在LVEF和对合面积方面的比较无明显差异(P>0.05),在A2D、C3D、H、DA、PDAIPm、Lad方面的比较,房性心律失常组患者明显高于正常窦性心律组患者(P<0.05),且观察组患者的对合指数明显降低(P<0.05).将49例观察组患者以不同心律失常类型分为持续性房颤、阵发性房颤、房扑、混合型房性心律失常4个亚组,采用单因素方差分析,发现在LVEF、C3D、Lad、对合指数方面的比较,各亚组间无明显差异(P>0.05).采用二项Logistic回归分析发现,女性是导致对合指数低的危险因素,另外对合指数较低、房性心律失常是导致二尖瓣返流的重要因素.结论:房性心律失常对患者二尖瓣的A2D、C3D、H、DA、PDAIPm、Lad等都会造成较大影响,从而降低对合指数,影响二尖瓣的正常功能,导致二尖瓣返流的发生.