目的借鉴英国皇家放射医师学会会员(Fellowship of the Royal College of Radiologists,FRCR)资格考试解剖模块的形式与内容,初步探讨如何从多方面训练放射科住院医师形成正确的影像解剖思维。方法以FRCR资格考试第一轮解剖部分及相应...目的借鉴英国皇家放射医师学会会员(Fellowship of the Royal College of Radiologists,FRCR)资格考试解剖模块的形式与内容,初步探讨如何从多方面训练放射科住院医师形成正确的影像解剖思维。方法以FRCR资格考试第一轮解剖部分及相应考试复习材料为范本,从题目设计、涵盖内容、考核重点三个方面总结放射科住院医师规范化培训(简称住培)的影像解剖教学中应重视的关键点和侧重方面。结果FRCR资格考试解剖部分的内容为影像解剖教学内容和教学方法提供了诸多启示与经验,包括提高对日常容易忽视的教学内容的重视,重视利用后处理技术及网络贮存与传输系统进行影像解剖教学。结论FRCR资格考试解剖模块为优化放射科住培影像解剖教学的内容与教学方法提供了思路,有利于培养住院医师在培训早期形成正确的影像解剖思维。展开更多
目的:胶质瘤是最常见的颅内原发中枢神经系统肿瘤,胶质瘤的分级对临床治疗及随访方案的选择、预后的评估有重要指导意义。本研究目的在于探讨基于影像组学的logistic回归模型预测胶质瘤病理分级的可行性。方法:回顾性收集2012年1月至201...目的:胶质瘤是最常见的颅内原发中枢神经系统肿瘤,胶质瘤的分级对临床治疗及随访方案的选择、预后的评估有重要指导意义。本研究目的在于探讨基于影像组学的logistic回归模型预测胶质瘤病理分级的可行性。方法:回顾性收集2012年1月至2018年12月经手术病理切片证实为胶质瘤的146例患者。手动分割患者增强T_(1)加权成像(contrast-enhanced T_(1)-weighted imaging,T_(1)WI+C)图像中的胶质瘤区域,形成3D感兴趣区(region of interest,ROI);提取41个影像特征;采用最小绝对收缩和选择运算(least absolute shrinkage and selection operator,LASSO)二元logistic回归法筛选与胶质瘤病理分级最相关的特征并计算影像组学得分(radiomics score,Rad-score);采用单因素logistic回归建模方法建立预测模型;用受试者操作特征(receiver operating characteristic,ROC)曲线评估模型的区分能力,评估指标为曲线下面积(area under the curve,AUC)。利用Hosmer-Lemeshow检验衡量模型预测的准确性。结果:筛选出5个与胶质瘤病理分级最相关的特征,用这5个特征构建的预测胶质瘤病理分级的logistic回归模型的ROC曲线AUC为0.919,具有很好的区分能力,其校准曲线经Hosmer-Lemeshow检验,与理想曲线的差异无统计学意义(P=0.808),预测准确性高。结论:基于影像组学的logistic回归模型可以有效地对胶质瘤病理分级进行预测,有望成为术前预测胶质瘤分级的辅助方法。展开更多
胶质瘤是世界上最常见的原发性脑肿瘤,也是美国癌症和肿瘤基因图谱(the Cancer Genome Atlas,TCGA)工程中最早完成基因测序的恶性肿瘤。2016年更新的WHO中枢神经系统肿瘤分型中,胶质瘤是所有肿瘤疾病之中第一种通过基因表达水平与病理...胶质瘤是世界上最常见的原发性脑肿瘤,也是美国癌症和肿瘤基因图谱(the Cancer Genome Atlas,TCGA)工程中最早完成基因测序的恶性肿瘤。2016年更新的WHO中枢神经系统肿瘤分型中,胶质瘤是所有肿瘤疾病之中第一种通过基因表达水平与病理表现相结合的方法进行分型的肿瘤。影像组学是一种新兴的高通量定量影像数据信息提取分析方法。影像组学是影像特征与基因组学、蛋白质组学的融合,因此在肿瘤诊断、预后及治疗方案选择的临床研究中拥有巨大潜力,对于胶质瘤的研究有着极大帮助。展开更多
[目的]系统评价持续鼻饲喂养和间歇鼻饲喂养对早产儿喂养不耐受的影响。[方法]计算机检索PubMed、Web of Science、EMbase、the Cochrane Library、EBSCO、CINAHL、中国生物医学文献数据库、中国知网、万方和维普中持续鼻饲喂养和间歇...[目的]系统评价持续鼻饲喂养和间歇鼻饲喂养对早产儿喂养不耐受的影响。[方法]计算机检索PubMed、Web of Science、EMbase、the Cochrane Library、EBSCO、CINAHL、中国生物医学文献数据库、中国知网、万方和维普中持续鼻饲喂养和间歇鼻饲喂养对早产儿喂养不耐受影响的随机对照试验,检索时间为建库至2018年10月31日。按照纳入及排除标准筛选文献,提取资料并评价纳入文献的方法学质量。采用RevMan 5.3软件对数据进行分析。[结果]共纳入17篇文献。Meta分析结果显示:持续鼻饲喂养早产儿喂养不耐受发生率低于间歇鼻饲喂养早产儿[RR=1.84,95%CI(1.51,2.24),P<0.00001],住院时间短于间歇鼻饲喂养早产儿[MD=1.80,95%CI(0.04,3.56),P=0.04],恢复至出生体重的时间短于间歇鼻饲喂养早产儿[MD=1.16,95%CI(0.21,2.12),P=0.02]。[结论]现有证据表明:持续鼻饲喂养与间歇鼻饲喂养相比,早产儿喂养不耐受发生率较低,恢复至出生体重的时间及住院时间缩短。但由于证据等级不高,且受到混杂因素影响,为保证新生儿生存质量,护理研究者需要在临床实践中进一步论证本研究结论。展开更多
The Wangchengpo Frasnian section of Dushan County contains two atrypid brachiopod assemblages. The lower is characterized by the Atryparia (Costatrypa) dushanensis fauna that appears at the base of the Hejiazhai Mem...The Wangchengpo Frasnian section of Dushan County contains two atrypid brachiopod assemblages. The lower is characterized by the Atryparia (Costatrypa) dushanensis fauna that appears at the base of the Hejiazhai Member approximately in the falsiovalis to transitans conodont zones: the upper is characterized by the Radiatrypa yangi fauna, which appears in the Lujiazhai Member approximately correspondent with the hassi to Upper rhenana conodont zones. Atrypid brachiopods, together with other brachiopods from the Dushan section show that the Hejiazhai Member is of Frasnian age. Preliminary analyses of Frasnian atrypid brachiopods from sections of South China indicate that there are nine genera and subgenera including Atryparia (Costatrypa), Kyrtatrypa, Spinatrypa, lsospinatrypa, Spinatrypina, lowatrypa, Desquamatia (Desquamatia). Desquamatia (Seratrypa), and Radiatr)pa. Atrypid species diversity did not change much through the Frasnian. On a regional scale in South China, most atrypid species went extinct prior to the Frasnian/Famennian boundary. At any specific locality or section, these atrypids became extinct about 20-40 m below the Frasnian/Famennian (F/F) boundary, within the linguiformis conodont Zone, marking this as the major extinction level. Three new atrypid species are described: Atryparia (Costatrypa) dushanensis, lowatrypa pseudobodini, and Radiatrypa yangi.展开更多
文摘目的借鉴英国皇家放射医师学会会员(Fellowship of the Royal College of Radiologists,FRCR)资格考试解剖模块的形式与内容,初步探讨如何从多方面训练放射科住院医师形成正确的影像解剖思维。方法以FRCR资格考试第一轮解剖部分及相应考试复习材料为范本,从题目设计、涵盖内容、考核重点三个方面总结放射科住院医师规范化培训(简称住培)的影像解剖教学中应重视的关键点和侧重方面。结果FRCR资格考试解剖部分的内容为影像解剖教学内容和教学方法提供了诸多启示与经验,包括提高对日常容易忽视的教学内容的重视,重视利用后处理技术及网络贮存与传输系统进行影像解剖教学。结论FRCR资格考试解剖模块为优化放射科住培影像解剖教学的内容与教学方法提供了思路,有利于培养住院医师在培训早期形成正确的影像解剖思维。
文摘目的:胶质瘤是最常见的颅内原发中枢神经系统肿瘤,胶质瘤的分级对临床治疗及随访方案的选择、预后的评估有重要指导意义。本研究目的在于探讨基于影像组学的logistic回归模型预测胶质瘤病理分级的可行性。方法:回顾性收集2012年1月至2018年12月经手术病理切片证实为胶质瘤的146例患者。手动分割患者增强T_(1)加权成像(contrast-enhanced T_(1)-weighted imaging,T_(1)WI+C)图像中的胶质瘤区域,形成3D感兴趣区(region of interest,ROI);提取41个影像特征;采用最小绝对收缩和选择运算(least absolute shrinkage and selection operator,LASSO)二元logistic回归法筛选与胶质瘤病理分级最相关的特征并计算影像组学得分(radiomics score,Rad-score);采用单因素logistic回归建模方法建立预测模型;用受试者操作特征(receiver operating characteristic,ROC)曲线评估模型的区分能力,评估指标为曲线下面积(area under the curve,AUC)。利用Hosmer-Lemeshow检验衡量模型预测的准确性。结果:筛选出5个与胶质瘤病理分级最相关的特征,用这5个特征构建的预测胶质瘤病理分级的logistic回归模型的ROC曲线AUC为0.919,具有很好的区分能力,其校准曲线经Hosmer-Lemeshow检验,与理想曲线的差异无统计学意义(P=0.808),预测准确性高。结论:基于影像组学的logistic回归模型可以有效地对胶质瘤病理分级进行预测,有望成为术前预测胶质瘤分级的辅助方法。
文摘胶质瘤是世界上最常见的原发性脑肿瘤,也是美国癌症和肿瘤基因图谱(the Cancer Genome Atlas,TCGA)工程中最早完成基因测序的恶性肿瘤。2016年更新的WHO中枢神经系统肿瘤分型中,胶质瘤是所有肿瘤疾病之中第一种通过基因表达水平与病理表现相结合的方法进行分型的肿瘤。影像组学是一种新兴的高通量定量影像数据信息提取分析方法。影像组学是影像特征与基因组学、蛋白质组学的融合,因此在肿瘤诊断、预后及治疗方案选择的临床研究中拥有巨大潜力,对于胶质瘤的研究有着极大帮助。
基金Th is work is supported by the Major Basic Research Project(G2000077700)the National Natural Science Foundation of China(Grant No.401 72006,40232019,and 40472009).
文摘The Wangchengpo Frasnian section of Dushan County contains two atrypid brachiopod assemblages. The lower is characterized by the Atryparia (Costatrypa) dushanensis fauna that appears at the base of the Hejiazhai Member approximately in the falsiovalis to transitans conodont zones: the upper is characterized by the Radiatrypa yangi fauna, which appears in the Lujiazhai Member approximately correspondent with the hassi to Upper rhenana conodont zones. Atrypid brachiopods, together with other brachiopods from the Dushan section show that the Hejiazhai Member is of Frasnian age. Preliminary analyses of Frasnian atrypid brachiopods from sections of South China indicate that there are nine genera and subgenera including Atryparia (Costatrypa), Kyrtatrypa, Spinatrypa, lsospinatrypa, Spinatrypina, lowatrypa, Desquamatia (Desquamatia). Desquamatia (Seratrypa), and Radiatr)pa. Atrypid species diversity did not change much through the Frasnian. On a regional scale in South China, most atrypid species went extinct prior to the Frasnian/Famennian boundary. At any specific locality or section, these atrypids became extinct about 20-40 m below the Frasnian/Famennian (F/F) boundary, within the linguiformis conodont Zone, marking this as the major extinction level. Three new atrypid species are described: Atryparia (Costatrypa) dushanensis, lowatrypa pseudobodini, and Radiatrypa yangi.