空间频域成像在皮肤病定量评估中的研究

利用空间频域成像技术搭建的成像系统检测多种皮肤病组织的光学参数和生理参数信息，并对比分析讨论不同类型的皮肤病与光学参数、生理参数之间的关系。实验结果表明，病变皮肤组织与正常皮肤组织之间在光学参数、生理参数上存在较大差异，这将为临床医生对皮肤病诊治提供一种新颖、可靠、科学的评估方法。     

H型高血压患者舌面诊图像颜色特征参数分析＊

目的 分析H型高血压患者的舌面诊图像颜色参数特征，探讨H型高血压患者的舌诊、面诊变化规律。方法 运用上海中医药大学自行研制的Smart TCM-1型中医舌面一体仪，采集高血压患者舌面诊图像，提取特征参数，分析健康对照组、H型高血压组与非H型高血压组患者舌面颜色参数特征。结果 ①在舌色各项参数中，H型高血压组舌尖部R值、B值、V值均显著小于健康对照组（P < 0.01）；非H型高血压组舌尖部B值显著小于健康对照组（P < 0.01），S值较健康对照组显著增大（P < 0.05）；H型高血压组舌尖部R、V值均明显小于非H型高血压组（P < 0.05）。在舌苔各项参数中，H型高血压组舌中H值、V值均明显小于健康对照组（P < 0.05）；非H型高血压组舌中V值、舌右V值均显著小于健康对照组（P < 0.01）；H型高血压组舌中H值明显小于非H型高血压组（P < 0.05），右侧舌苔S值明显大于非H型高血压组（P < 0.05）。②H型高血压组面色参数鼻G值、下颌G值、口唇R值、口唇V值均明显小于健康对照组（P < 0.05）；非H型高血压组前额H值、目眶H值、脸颊H值、鼻H值、下颌H值、整体H值均明显大于健康对照组（P < 0.05）；H型高血压组前额H值、目眶G值、目眶H值、脸颊H值、鼻G值、鼻H值、下颌R值、下颌G值、下颌H值、下颌V值、口唇R值、口唇G值、口唇V值、整体R值、整体G值、整体H值、整体V值均明显小于非H型高血压组（P < 0.05）。结论 H型高血压患者苔色偏黄，以舌中部为主，且舌右侧黄苔积聚较明显；H型高血压患者面色为黄中带红，口唇、下颌部更为晦暗。H型高血压患者的舌、面诊特征参数的变化，与高血压病阳亢湿盛病机相符。     

A systematic review of the safety and efficacy of non-operative management in patients with high grade liver injury

IntroductionThe liver is the most frequently damaged organ in blunt abdominal trauma. It is widely accepted that hemodynamically stable patients with low-grade liver trauma should be treated with non-operative management, however there is controversy surrounding its safety and efficacy in high-grade trauma. The purpose of this review is to investigate the role of non-operative management in patients with high-grade liver trauma.MethodsPubMed and reference lists of PubMed articles were searched to find studies that examined the efficacy of non-operative management in high-grade liver injury patients, and compare it to operative management. Non-operative management was considered successful if rescue surgery was avoided. Outcomes considered were success, mortality, and complication rates.ResultsThe electronic search revealed 2662 records, 8 of which met the inclusion criteria. All 8 studies contained results suggesting that non-operative management was safe and effective in hemodynamically stable patients with high-grade liver trauma. By combining the outcomes of the different studies, non-operative management had a high success rate of 92.4% (194/210) in high-grade liver trauma patients, which was near the overall 95.0% non-operative management success rate. Non-operative management also had mortality and complication rates of 4.6% (9/194) and 9.7% (7/72) in high-grade injury patients, respectively, compared to operative management's 17.6% (26/148) and 45.5% (5/11).ConclusionNon-operative management of liver trauma is safe and effective in hemodynamically stable patients with high-grade liver injury. It is associated with significantly lower mortality compared with operative management. More studies are required to evaluate complications of non-operative management in high-grade liver injury.     

Estimating Potency for the E max-Model Without Attaining Maximal Effects

The most widely applied model relating drug concentrations to effects is the E_max model. In practice, concentration–effect relationships often deviate from a simple linear relationship but without reaching a clear maximum because a further increase in concentration might be associated with unacceptable or distorting side effects. The parameters for the E_max model can only be estimated with reasonable precision if the curve shows sign of reaching a maximum, otherwise both EC₅₀ and E_max estimates may be extremely imprecise. This paper provides a solution by introducing a new parameter (S₀ ) equal to E_max/EC₅₀ that can be used to characterize potency adequately even if there are no signs of a clear maximum. Simulations are presented to investigate the nature of the new parameter and published examples are used as illustration.     

良性前列腺增生中医证型与尿动力学参数相关性研究

目的:探讨良性前列腺增生(BPH)中医证型与尿动力学参数的相关性。方法:152例BPH患者,中医辨证分为肾阴不足、肾阳虚弱、瘀阻水道、脾气虚弱、肺热气郁、湿热下注、痰浊郁结七型,均进行尿动力学检查。结果:152例BPH患者中,肾阳虚弱型71例(46.71%),瘀阻水道型40例(26.31%),肾阴不足型14例(9.21%)。膀胱出口梗阻为III～VI度肾阳虚弱型有58例,瘀阻水道型有38例,其中严重梗阻(V～VI)26例。膀胱逼尿肌收缩功能极弱中(n=12),肾阳虚弱型4例,占33.33%(4/12),瘀阻水道型7例,占58.33%(7/12);膀胱逼尿肌收缩功能弱者中(n=48),肾阳虚弱型为27例,占56.25%(27/48),瘀阻水道型17例,占35.42%(17/48)。结论:BPH中医各辨证分型与膀胱出口梗阻和膀胱逼尿肌收缩力有一定的相关性,从而为中医证型的量化和客观化提供相应的证据。     

FEEDBACK CONTROL OF A HEAT DIFFUSION SYSTEM WITH TIME-DEPENDENT SPATIAL DOMAIN

The problem of controlling the temperature distribution in a solid cylinder whose length varies with time and with one end in contact with a constant temperature medium is considered. This problem is motivated from that of controlling the temperature and thermal gradient inside a crystal pulled from a melt by the Czochralski method. Boundary feedback controls are derived by considering the time rate of change of a cost functional involving the deviations of both the solid temperature and its gradient from their desired values. The derived feedback controls consist of spatially distributed proportional-plus-rate and lag compensators and a non-linear feedback control involving the temperature gradient at the cylinder surface and the velocity of the spatial domain boundary. The resulting feedback-controlled system has the property that the cost functional along any motion decreases monotonically to zero with time. A numerical scheme for solving the partial differential equation of the feedback-controlled system is proposed. Typical numerical results on the dynamic behaviour of the feedback-controlled system obtained by means of the proposed scheme are presented.     

Model parameters of the smooth pursuit eye movement system with electrooculogram

The visual pursuit test is a method that collects and analyzes the characteristics of pursuit eye movements and examines the function of the eye movement system. This paper analyzes the model parameters of the smooth pursuit eye movement system in order to explore a method for improving the analysis. The input-output relationship of the smooth pursuit system can be expressed by a quasilinear model. We compute the model parameters (gain, phase, spectral purity, cross covariance) by digital signal processing. Eye movement is recorded by electrooculogram. Both eyes are tested individually. The visual target moves at frequencies of 0.2, 0.4, 0.8, 1.2, and 1.6 Hz. Ranges are gain, 1.01 to 0.70; phase, -0.1 ° to -66 °; spectral purity, 0.97 to 0.70; and cross covariance, 0.99 to 0.26. We tested 40 normal subjects as well as patients with ataxia (8), vertigo (18), and ophthalmoplegia (9). The oculomotor system of normal subjects functions as a linear system in the performance of this test at 0.2 to 0.8 Hz. The spectral purity dropped to about 0.70 at 1.6 Hz. The variability of all measures increases greatly at 1.6 Hz, which indicates that this target motion exceeds the tracking ability of many normal subjects and that the oculomotor system of normal subjects functions as a nonlinear system in this condition. Statistical tests show no significant differences between sex, age, and the two eyes. The model parameters tentatively proved effective in clinical application.     

舒芬太尼对心脏瓣膜置换术患者麻醉诱导期血液动力学的影响

目的观察舒芬太尼对心脏瓣膜置换术患者麻醉诱导期血液动力学的影响。方法心脏瓣膜置换手术患者20例,随机分为舒芬太尼组(S组,n=10)和芬太尼组(F组,n=10)。全麻诱导:咪唑安定0.1～0.3mg/kg,维库溴铵0.1～0.2mg/kg。S组使用舒芬太尼1μg/kg,F组使用芬太尼10μg/kg。血液动力学监测:心电Ⅱ导联示波,有创动静脉测压,放置6腔Swan-Ganz导管,采用美国Baxter-2型连续心排血量多功能监测仪,测定心脏指数(CI)和肺毛细血管嵌压(PCWP)。观察心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)、心脏指数(CI)和肺毛细血管嵌压(PCWP)。分别于麻醉诱导前(T1)、麻醉诱导后气管插管前(T2)、插管后1分钟(T3)、5分钟(T4)和10分钟(T5)记录观察指标。结果HR、MAP、CVP和PCWP两组变化趋势基本一致。麻醉诱导后及气管插管后部分时间S组HR和MAP低于F组(P<0.05或P<0.01),插管后S组CVP明显高于F组(P<0.05或P<0.01)。麻醉诱导或气管插管后,F组CI明显下降(P<0.05或P<0.01),S组均无明显变化。观察期间PCWP均无明显变化。结论舒芬太尼可安全的用于心脏瓣膜置换手术。     

先天性心脏病动脉导管未闭介入治疗及血流动力学变化

目的观察动脉导管未闭经皮心导管封堵术前后右心血流动力学的变化,评价其临床意义。方法对50例动脉导管未闭儿童患者,在进行介入性经皮心导管封堵术治疗前应用X线降主动脉造影测量前,术后经导管检测右心血流动力学指标变化。结果未闭动脉导管最窄处直径(5．6±1．3)mm;术前肺动脉平均压(19．1±2．3)mmHg,左向右分流量平均为(0．41±0．13)l／min,血流分流量占肺循环血流量的比例平均为(0．17±0．03);术后肺动脉平均压(14．4±1．7)mmHg,左向右分流量平均为(0．03±0．01)l／min,血流分流量占肺循环血流量的比例平均为(0．02±0．01),相应数据比较,差异有统计学意义(P＜0．05)。结论动脉导管未闭经皮心导管封堵术前后血流动力学会发生改变,肺动脉平均压,左向右分流量以及分流量占肺循环血流量的比例均会不同程度下降,这种改变可以作为评价介入治疗效果的重要指标。