放射性核素阴囊显像

作了２４例阴囊血流和血池显像，其中睾丸扭转６例、睾丸和附睾炎症１２例、寻找隐睾２例、正常４例。弹丸式注射＾９９ｍＴｃＯ４＾－５５５－７４０ＭＢｑ作动态显像，每２ｓ一帧，共采集２００ｓ，然后立即做静态血池显像。睾丸扭转的病人患侧中心部分呈放射性缺损，睾丸炎症病人则看到患侧显示放射性弥漫性增加。分别在睾丸的正常侧、患侧及相对应的大腿内侧各取一相同大小的感兴趣区（ＲＯＩ），然后分别计算三对ＲＯＩ的计数比     

脑外伤患者的SPECT显像与CT对比观察

对４８例脑外伤２进行了＾９９ｍＴｃ－ＥＣＤ ＳＰＥＣＴ脑血流灌注显像。其中４１例在ＳＰＥＣＴ检查的前后两周同时行脑ＣＴ检查，结果ＳＰＥＣＴ对轻、中、重型外伤的检出率分别为６０％、９０％和１００％；而ＣＴ分别为１０％、６０％和１００％，同一病人中ＳＰＥＣＴ比ＣＴ发现的病灶早、数目多，范围大。对脑外伤综合征及后遗症ＳＰＥＣＴ检出率分别为８０％和９０％，ＣＴ分别为２５％和７１．４２％。显然ＳＰＥＣＴ探测     

CEREBRAL BLOOD FLOW AND METABOLISM EVALUATION IN COMATOSE PATIENTS BY DYNAMIC SPECT

Thirty patients in coma state underwent dynamic SPECT with 133Xe, a validated technique for the quantitation of CBF by SPECT, using a new brain dedicated tomograph: CERTO-96. CMRO2 was computed by multiplying the mean CBF by AVDO2 according to the Fick's principle. The mean values of CBF, AVDO2 and CMRO2 in patients with good outcome were significantly different from those with worse outcome. On the basis of the best "discriminant threshold", CBF and AVDO2 demonstrated an intermediate accuracy in separating the two groups, while CMRO2 showed a satisfactory accuracy.     

基于LSTM与XGBOOST混合模型的孕妇产后出血预测

孕妇产后大出血是造成全球孕妇死亡的重要因素之一,在我国位居孕妇死亡原因首位,然而对产后出血的提前判定一直以来都是医学上一个难题.电子病历的普及,以及机器学习和深度学习技术的发展,为预知孕妇产后大出血提供了基于大数据的解决办法.本文提出利用孕妇的电子病历数据,构建基于LSTM和XGBoost的混合模型来预测孕妇产后大出血.实验结果表明,利用基于LSTM和XGBoost的混合模型对孕妇产后大出血进行预测是可行的,能够为医生判断孕妇产后出血情况提供参考,为孕妇分娩时是否需要备血方案提供决策支持,对降低产后大出血致死率具有积极意义.     

Cerebral arterial inflow assessment with F-FDG PET: Methodology and feasibility

Positron emission tomography (PET) with ¹⁸fluorodeoxyglucose (¹⁸F-FDG) is increasingly used in neurology. The measurement of cerebral arterial inflow (QA) using ¹⁸F-FDG complements the information provided by standard brain PET imaging. Here, injections were performed after the beginning of dynamic acquisitions and the time to arrival (t0) of activity in the gantry's field of view was computed. We performed a phantom study using a branched tube (internal diameter: 4 mm) and a ¹⁸F-FDG solution injected at 240 mL/min. Data processing consisted of (i) reconstruction of the first 3 s after t0, (ii) vascular signal enhancement and (iii) clustering. This method was then applied in four subjects. We measured the volumes of the tubes or vascular trees and calculated the corresponding flows. In the phantom, the flow was calculated to be 244.2 mL/min. In each subject, our QA value was compared with that obtained by quantitative cine-phase contrast magnetic resonance imaging; the mean QA value of 581.4 ± 217.5 mL/min calculated with ¹⁸F-FDG PET was consistent with the mean value of 593.3 ± 205.8 mL/min calculated with quantitative cine-phase contrast magnetic resonance imaging. Our ¹⁸F-FDG PET method constitutes a novel, fully automatic means of measuring QA.     

Morphological alterations of the glomerular (visceral) epithelium in response to pathological and experimental situations

The glomerular (visceral) layer of Bowman's capsule is comprised of a unique population of cells which have been termed “podocytes.:” Arising from these cells are large major processes and numerous smaller foot processes which completely surround underlying glomerular capillary loops. Podocyte foot processes interdigitate with each other and are separated by spaces (filtration slits) which are designed to facilitate flow of a large amount of filtrate across the glomerular wall. Podocytes exhibit dramatic morphological changes in response to the nephrotic syndrome and some forms of acute renal failure and may play an important role in the pathophysiology of these conditions. In vitro and in vivo studies have shown that a reduction in the sialic acid component of a thick anionic surface coat plays a major role in the morphological changes that these cells exhibit in the nephrotic syndrome. Also, it has been shown that filamentous actin concentrated mainly within podocyte foot processes are the contractile elements responsible for altering the shapes of these processes. There is evidence to suggest that by altering the shapes of their foot processes, podocytes in the normal kidney are able to alter the number of fully patent filtration slits and thereby actively regulate the rate of solute efflux across the glomerular wall. In vitro and in vivo studies have indicated that cytoplasmic microtubules are probably not involved in alterations of the podocyte foot processes but do appear important in maintaining the morphological integrity of podocyte cell bodies and their major processes. In the present paper, the morphological changes which glomerular podocytes exhibit in response to the nephrotic syndrome, various forms of acute renal failure, and during in vitro incubation are discussed along with studies of the possible roles of cytoplasmic microtubules, microtubules, and the glomerular anionic surface coat in these changes.     

Regional citrate anticoagulation in CVVH: A new protocol combining citrate solution with a phosphate‐containing replacement fluid

Regional citrate anticoagulation (RCA) is a valid anticoagulation method in continuous renal replacement therapies (CRRT) and different combination of citrate and CRRT solutions can affect acid‐base balance. Regardless of the anticoagulation protocol, hypophosphatemia occurs frequently in CRRT. In this case report, we evaluated safety and effects on acid‐base balance of a new RCA‐ continuous veno‐venous hemofiltration (CVVH) protocol using an 18 mmol/L citrate solution combined with a phosphate‐containing replacement fluid. In our center, RCA‐CVVH is routinely performed with a 12 mmol/L citrate solution and a postdilution replacement fluid with bicarbonate (protocol A). In case of persistent acidosis, not related to citrate accumulation, bicarbonate infusion is scheduled. In order to optimize buffers balance, a new protocol has been designed using recently introduced solutions: 18 mmol/L citrate solution, phosphate‐containing postdilution replacement fluid with bicarbonate (protocol B). In a cardiac surgery patient with acute kidney injury, acid‐base status and electrolytes have been evaluated comparing protocol A (five circuits, 301 hours) vs. protocol B (two circuits, 97 hours): pH 7.39 ± 0.03 vs. 7.44 ± 0.03 (P < 0.0001), bicarbonate 22.3 ± 1.8 vs. 22.6 ± 1.4 mmol/L (NS), Base excess ?2.8 ± 2.1 vs. ?1.6 ± 1.2 (P = 0.007), phosphate 0.85 ± 0.2 vs. 1.3 ± 0.5 mmol/L (P = 0.027). Protocol A required bicarbonate and sodium phosphate infusion (8.9 ± 2.8 mmol/h and 5 g/day, respectively) while protocol B allowed to stop both supplementations. In comparison to protocol A, protocol B allowed to adequately control acid‐base status without additional bicarbonate infusion and in absence of alkalosis, despite the use of a standard bicarbonate concentration replacement solution. Furthermore, the combination of a phosphate‐containing replacement fluid appeared effective to prevent hypophosphatemia.     

CTA血管减影技术在脑静脉系统疾病诊断中的应用

本文将把CTA（Computed Tomographic Angiography）血管减影技术在诊断脑静脉系统疾病的应用的优势与劣势方面与传统的DSA（Digital Subtraction Angiography）、超声、,MRI（Magnetic Resonance Imaging）做客观的比较，来论述CTA减影技术在脑静脉系统疾病的诊断中的应用的优势和不足之处。探讨CTA血管减影技术在脑静脉系统疾病诊断中的应用前景。     

Social (self) Control†

Social control is not concerned with bow an elite controls the rest of us but how society controls itself and its elite as the social equivalent of self control in the individual as he harmonizes his intellectual, moral, sexual, economic and physical being. This is a study not to my knowledge being carried out anywhere else. When it might have arisen under the heading of “conflict” or “peace” studies it was taken over and diverted to become mere extensions of war studies of the sort so extensively pursued under U.S. government auspices and which became the sort of aberrations that lead to the various involvements of U.S. government that have been revealed since Watergate broke and in various attempts to develop schemes for manipulating society by both political and commercial interests.

The scientific, i.e., unchained, study of social control along the lines I describe might have stimulated wiser counsels in government, deeper inquiry by electorates and their representatives and, perhaps, helped towards truer and more natural detente in society than we are experiencing. Detente as between races and classes as well as between states and alliances but also as between man and his environment.