Development of a core outcome set for venous leg ulceration (CoreVen) research evaluations (protocol)

BackgroundA venous leg ulcer is a chronic leg wound caused by poor venous blood circulation in the lower limbs. It is a recurring condition causing pain, malodour, reduced mobility, and depression. Randomised controlled trials evaluating treatments for venous leg ulcers provide important evidence to inform clinical decision-making. However, for findings to be useful, outcomes need to be clinically meaningful, consistently reported across trials, and fully reported. Research has identified the large number of outcomes reported in venous leg ulcer trials, impacting both synthesis of results, and clinical decision-making. To address this, a core outcome set will be developed. A core outcome set is an agreed standardised set of outcomes which should be, as a minimum, measured and reported in all trials which evaluate treatment effectiveness for a given indication. A core outcome set has the potential to reduce research waste, improve the utility of RCTs, reduce reporting bias, facilitate treatment comparisons across different sources of evidence and expedite the production of systematic reviews, meta-analyses and evidence-based clinical guidelines.AimThe aim of this project is to develop a core outcome set for research evaluating the effectiveness of interventions for treating venous leg ulceration.MethodsThrough a scoping review of the literature on venous leg ulceration, we will firstly identify a list of candidate outcome domains (broad categories in relation to what is being measured) from randomised controlled trials and qualitative research, and outcomes (specific methods in relation to what is being measured). In two further stages, we will use the resulting lists of outcome domains and outcomes to design two online surveys. A range of stakeholders will be invited to participate in the surveys and they will be asked to indicate which outcome domains and outcomes are most important and should be considered as core in future research reports.     

Temperature-controlled power modulation compensates for heterogeneous nanoparticle distributions: a computational optimization analysis for magnetic hyperthermia

Purpose: To study, with computational models, the utility of power modulation to reduce tissue temperature heterogeneity for variable nanoparticle distributions in magnetic nanoparticle hyperthermia.

Methods: Tumour and surrounding tissue were modeled by elliptical two- and three-dimensional computational phantoms having six different nanoparticle distributions. Nanoparticles were modeled as point heat sources having amplitude-dependent loss power. The total number of nanoparticles was fixed, and their spatial distribution and heat output were varied. Heat transfer was computed by solving the Pennes’ bioheat equation using finite element methods (FEM) with temperature-dependent blood perfusion. Local temperature was regulated using a proportional-integral-derivative (PID) controller. Tissue temperature, thermal dose and tissue damage were calculated. The required minimum thermal dose delivered to the tumor was kept constant, and heating power was adjusted for comparison of both the heating methods.

Results: Modulated power heating produced lower and more homogeneous temperature distributions than did constant power heating for all studied nanoparticle distributions. For a concentrated nanoparticle distribution, located off-center within the tumor, the maximum temperatures inside the tumor were 16% lower for modulated power heating when compared to constant power heating. This resulted in less damage to surrounding normal tissue. Modulated power heating reached target thermal doses up to nine-fold more rapidly when compared to constant power heating.

Conclusions: Controlling the temperature at the tumor-healthy tissue boundary by modulating the heating power of magnetic nanoparticles demonstrably compensates for a variable nanoparticle distribution to deliver effective treatment.     

螺旋CT的预防性维修

尽早发现故障苗头,并将故障消灭于萌芽状态,是预防性维修的目的,是维修工作的最高境界,具体工作包括定期保养,定期检查,随即处置隐患,根据从业多年经验小结了一些针对螺旋CT的预防性维修感受。     

Mozart effect in preschool children?

In 1993, Rauscher et al. reported a temporary increase in spatial-temporal ability after listening to Mozart's music. This led to numerous replication and extension studies with mixed findings in the past decade. This study investigated the 'Mozart effect' in preschool children. Forty-one boys and girls, aged three to five, attempted a series of pencil-and-paper maze tests after each of three listening conditions: Mozart's Piano Concerto in A Major (K488), age-appropriate popular music and silence. Overall, there were no statistically significant differences among the three interventions. The results are discussed in relation to the findings of other investigations of the Mozart effect, and the need for further investigation of possible trends.     

Design of an intravenous oxygenator

The aim of this study was to design a new intravenous blood–gas exchange device and to estimate the design characteristics of the device with a dimensionless function by using a substance that can be used instead of bovine blood. In addition, the characteristics of oxygen transfer were estimated using empirical formulas and the reliability of the equations was ascertained by comparing their output with an experiment performed using bovine blood. The dimensionless function was derived using distilled water and bovine blood to estimate the oxygen transfer rate. Using the derived equations, the calculated oxygen transfer rates for bovine blood and distilled water were similar for Reynolds numbers ranging from 0.7 to 7.0. Therefore, it is possible to estimate the oxygen transfer rate in bovine blood, which is a non-Newtonian fluid, using distilled water, which is a Newtonian fluid. Moreover, it was possible to verify the related equations because the oxygen transfer rate could be estimated using the derived equations, according to the diameters of the various device modules.     

心理因素对小学生脑力工作能力影响的研究

采用横断面研究方法，对180名小学三年级学生脑力工作能力与其智力、性格、学习动机等心理因素和学习、睡眠时间等作息因素的关系进行分析研究。验证了学习、睡眠时间是影响学生脑力工作能力重要的外部因素；脑力工作能力与智力和学习成绩呈正相关。学生自身的心理因素中，学习动机对脑力工作能力有重要影响，所以激发和强化学生的学习动机，是保持和提高学生学习工作能力的有效手段；而性格内外向性、情绪稳定性等因素，对脑力工作能力的影响不明显。     

MISE AU POINT D'UNE TECHNIQUE D'ADMINISTRATION IN VIVO DES VECTEURS GENETIQUES DANS LEMUSCLE CARDIAQUE

Objective In order to improve the in vivo gene transfer into the heart muscle, we have designed a ECG-synchronized microinjection system that allows sequential gene delivery to the myocardium.Methods A cannula was introduced into the right carotid artery of the Wistar rat under general anesthesia.With the ECG-synchronized injection during diastole, the genetic vector (Ad CMV lacZ ) infusion was performed with various concentrations( l07 ～ l010pfu ) and different frequency ( the ratio of heart beats per injection from 1: 1 to 4: 1 ). The hearts of the rats were removed after 7 days for histological examination. Results Best results were obtained with a total vector amount of l09 pfu and a good ratio 3: 1 between heart frequency and injection frequency. The transfection efficiency was increased by use of vasodilators and by an increase of vascular permeability. No signs of myocardial ischemia or ventricular arrythmia were observed. Conclusion We have established a novel and safe method for in vivo gene transfer into the heart. Transgene expression suggests that this method may be useful technique to study cardiac function of treat cardiac diseases by means of gene theratpy.     

On the origin of apparent low tissue signals in balanced SSFP.

Balanced steady-state free precession (bSSFP) has become increasingly important in clinical applications. Its signal properties have been investigated over several years by many groups, and various critical factors for bSSFP signal intensity and stability, such as off-resonances, flow, and eddy currents, have been identified. It is generally accepted that bSSFP signal intensity is a function of relaxation times, excitation angles, and spin densities only. While this is true for simple phantoms, it appears that signals from tissues are significantly less intense than predicted by theory. This work demonstrates that the molecular origin of this apparent signal reduction is due to on-resonance magnetization transfer (MT). High flip angles in combination with very short repetition times (TRs), as commonly used for bSSFP, lead to a considerable saturation in the fraction of macromolecular (MM) pool protons. As a result, bSSFP signal is strongly attenuated by up to a factor of 2 in the human brain compared to the signal expected from theory.     

腓浅神经浅支移植修复桡神经缺损

[目的]探讨腓浅神经浅支修复桡神经缺损的临床效果。[方法]对腓浅神经浅支与桡神经形态结构进行比较，并对腓浅神经浅支移植修复桡神经缺损性损伤5例进行临床分析。[结果]腓浅神经浅支与桡神经形态结构大体一致．5例病例平均随访11(8～26)个月．按文献标准评定，优3例，良2例。[结论]腓浅神经浅支可作为修复桡神经缺损理想的供体神经。     

胶原蛋白-明胶支架材料修复大鼠坐骨神经缺损的研究

目的制备胶原蛋白一明胶神经支架材料（CG材料）并研究其在修复大鼠10mm坐骨神经缺损实验中的疗效。方法以I型胶原蛋白、明胶通过冷冻干燥技术制备具有轴向微管结构的神经支架材料，用其桥接修复sD大鼠坐骨神经10mm缺损。术后16周分别行透射电镜，S-100、β-tubulin class Ⅲ、NFl60免疫荧光染色以及电生理检测，观察支架材料引导神经再生的疗效。结果制备的材料内部为孔径均匀且平行排列的微管结构，术后16周通过透射电镜和免疫荧光染色可见大量再生神经纤维，电生理检测神经传导速度及波幅接近自体神经移植。结论胶原蛋白一明胶支架材料能够有效的促进周围神经再生。