耳迷走神经刺激治疗失眠

失眠(ID)主要是指睡眠质量差或睡眠不足。ID的病因通常与丘脑功能障碍有关。本研究使用静息态功能磁共振成像技术(fMRI)来研究双侧丘脑、前扣带回和双侧岛叶(显著网络)、岛叶和背侧扣带回(负面情绪网络)以及额顶叶网络(默认模式网络)之间的异常功能连接(FCs)。通过经皮耳迷走神经刺激(taVNS)来确定这些FCs是否易受调节。

新建分院区氧气调试、运行管理中存在问题及优化

0前言面对社会经济发展,广大人民群众对自身健康医疗的重视度不断加深,现有大型综合医院的规模已远远不能满足人们的需求。为此建立新院区,满足人们就医需求就成为了医院发展的新方向,但同时新院区的设计、建设也存在着各种各样的问题。针对医用气体系统的设计便是其中一个重要环节,现针对我院新院区的医用气体集中供气系统在调试、验收、试运行过程中发现的问题与改进意见进行分析。

Mechanism of Surface-Enhanced Raman Scattering and Its Application to Highly Sensitive Protein Detection

Surface-enhanced resonance Raman scattering(SERRS)has recently attracted great interest in analytical science due toenormous enhancement factors that have decreased the detec-tionli mits of a wide variety of molecules to the single moleculelevel.The SERRS-electromagnetic(EM)model describessingle-molecule SERRS

术中应用荧光素钠有利于胶质母细胞瘤浸润边缘的手术切除（英文）

Objective Extent of resection is an important prognostic factor in patients undergoing surgery for glioblastoma( GBM).Recent evidence suggests that intravenously administered fluorescein sodium associates with tumor tissue,facilitating safe maximal resection of GBM. In this study,the authors evaluate the safety and utility of intraoperative fluorescein guidance for the prediction of histopathological alteration both in the contrast-enhancing( CE) regions,where this relationship has been established,and into the nonCE( NCE),diffusely infiltrated margins. Methods Thirty-two patients received fluorescein sodium( 3 mg/kg) intravenously prior to resection. Fluorescence was intraoperatively visualized using a Zeiss Pentero surgical microscope equipped with a YELLOW 560 filter.Stereotactically localized biopsy specimens were acquired from CE and NCE regions based on preoperative MRI in conjunction with neuronavigation. The fluorescence intensity of these specimens was subjectively classified in real time with subsequent quantitative image analysis,histopathological evaluation of localized biopsy specimens,and radiological volumetric assessment of the extent of resection.Results Bright fluorescence was observed in all GBMs and localized to the CE regions and portions of the NCE margins of the tumors,thus serving as a visual guide during resection. Gross-total resection( GTR) was achieved in 84% of the patients with an average resected volume of 95%,and this rate was higher among patients for whom GTR was the surgical goal( GTR achieved in 93. 1% of patients,average resected volume of 99. 7%). Intraoperative fluorescein staining correlated with histopathological alteration in both CE and NCE regions,with positive predictive values by subjective fluorescence evaluation greater than 96% in NCE regions. Conclusions Intraoperative administration of fluorescein provides an easily visualized marker for glioma pathology in both CE and NCE regions of GBM. These findingssupport the use of fluorescein as a microsurgical adjunct for guiding GBM resection to facilitate safe maximal removal.

乳腺癌保乳术后放射治疗中腋窝各站淋巴结实际覆盖剂量的研究

目的 研究乳腺癌保乳保腋窝术后分别采用常规切线野（CTF）、三维适形放疗（3D-CRT）和正向调强放疗（IMRT）技术放疗中Ⅰ站、Ⅱ站和Ⅲ站腋窝淋巴结覆盖剂量。方法 回顾分析连续42例仅行前哨淋巴结活检（SLNB）而未行腋窝淋巴结清扫的乳腺癌保乳术后T1-2N0M0期患者。按照放射治疗肿瘤协作组（RTOG）标准勾画Ⅰ站、Ⅱ站和Ⅲ站腋窝淋巴结引流区。每位患者均制定全乳＋腋窝CTF、3D-CRT和IMRT 3种放疗计划，处方剂量为50 Gy/25次，分析腋窝淋巴结覆盖剂量。结果 CTF、3D-CRT和IMRT放疗计划腋窝各站受照剂量不同，I站累及平均剂量分别为（40.1±6.8）、（35.4±8.3）和（32.9±7.0）Gy（F=10.269，P〈0.05），Ⅱ站分别为（33.2±7.1）、（30.6±6.7）和（30.4±7.0）Gy（P〉0.05），Ⅲ站分别为（9.6±6.8）、（6.4±4.5）和（5.2±3.7）Gy（F=8.377，P〈0.05）。腋窝各站接受相同处方剂量的体积不同，I站V50（接受50 Gy处方剂量体积）分别为21.3%、27.6%和9.6%（F=13.161，P〈0.05），Ⅱ站V50分别为12.9%、15.9%和8.3%（P〉0.05），Ⅲ站V50分别为0.4%、0.1%和0（P〉0.05）。结论 早期乳腺癌保乳保腋窝术后采用CTF、3D-CRT和IMRT 3种放疗技术时腋窝Ⅰ站、Ⅱ站和Ⅲ站淋巴结引流区覆盖剂量有限，因此对于发现腋窝微转移、但未清扫腋窝的患者，应充分评估腋窝淋巴结转移风险，制定个体化放疗计划。