目的 探讨脂肪因子代谢对冠状动脉微血管功能障碍(MVD)的影响及麝香通心滴丸(STDP)的临床应用价值。方法 纳入2018年9月至2019年12月上海交通大学医学院附属新华医院心内科收治的41例冠心病患者,分为非MVD组(20例)和MVD组(21例);29例MV...目的 探讨脂肪因子代谢对冠状动脉微血管功能障碍(MVD)的影响及麝香通心滴丸(STDP)的临床应用价值。方法 纳入2018年9月至2019年12月上海交通大学医学院附属新华医院心内科收治的41例冠心病患者,分为非MVD组(20例)和MVD组(21例);29例MVD患者随机分为基础治疗组(14例)和STDP组(15例),分别进行为期3个月的基础治疗和基础治疗加STDP治疗;分析各组患者主诉、血生物化学指标、血浆炎症因子及脂肪因子水平的变化。采用12~14周龄雄性C57BL/6小鼠制备心肌缺血再灌注(IR)模型,分为假手术组、IR组(生理盐水灌胃)和IR+STDP组(STDP灌胃),每组5只,采用ELISA测定血浆炎症因子水平,通过硫黄素-S荧光密度法测定心脏组织微血管阻塞情况,采用蛋白质组学分析探寻IR组与IR+STDP组间差异表达蛋白质并通过蛋白质印迹法进行验证。结果 与非MVD组比较,MVD组血浆瘦素水平增高[(9.89±2.42)μg/L vs (4.76±1.02)μg/L,P<0.01],脂联素水平下降[(5.02±1.30)pg/mL vs (7.19±1.76)pg/mL,P<0.05],抵抗素水平升高[(9.20±2.03)μg/L vs (5.70±1.32)μg/L,P<0.05]。Pearson相关分析显示血浆瘦素水平与微循环阻力呈正相关(r=0.82,P<0.01)。ROC曲线分析结果显示,根据血浆瘦素水平判断MVD的AUC值为0.855,最佳临界值为>9.395 μg/L,灵敏度为0.714,特异度为0.867。MVD患者治疗3个月后,相较于基础治疗组,STDP组主诉胸闷、胸痛症状改善率较高[73.3%(11/15) vs 21.4% (3/14)],血浆瘦素、IL-6、TNF-α水平均降低[(11.36±0.54)μg/L vs (12.12±0.85)μg/L、(3.96±1.76)pg/mL vs (8.65±1.29)pg/mL、(24.82±3.07)ng/mL vs (32.45±3.32)ng/mL,均P<0.05]。在动物实验中,与IR组相比,IR+STDP组小鼠IR术后无回流面积减少45%(P<0.01)、低回流及无回流面积减少23%(P<0.05),血浆IL-6、TNF-α水平均下降[(378.25±19.66)pg/mL vs (457.32±32.01)pg/mL、(289.71±47.62)pg/mL vs (371.28±41.05)pg/mL,均P<0.05]。蛋白质组学分析结果显示,IR+STDP组小鼠心脏组织中血管性血友病因子(vWF)、细胞间黏附分子-1(ICAM-1)蛋白质表达水平低于IR组,蛋白质印迹法验证结果亦提示IR+STDP组vWF及ICAM-1蛋白质表达较IR组下调(均P<0.01)。结论 MVD患者存在脂肪因子代谢异常,血浆瘦素水平较高。STDP治疗可改善MVD患者的临床症状,降低血浆瘦素水平和炎症指标,机制可能与其抗血小板、抗炎作用有关。展开更多
目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并...目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并发症发生情况。结果28例患者中男性19例、女性9例,平均年龄(31.28±11.52)岁。尺骨冠状突骨折Regan-Morrey I型5例、II型18例、III型5例;桡骨头骨折Mason I型9例、II型13例、III型6例。分别采用不同麻醉方式、手术入路和术式完成骨折内固定和韧带修复,随访结束时28例骨折均骨性愈合(100%),发生1例异位骨化(3.57%)被成功纠治(100%)。与术前比较,患者术后1年的肘关节疼痛(VAS评分:7.21±2.18 VS 2.01±0.21,P<0.001)、肘关节屈伸度(29.68±16.13 VS 130.81±18.95,P<0.001)、前臂旋前范围(10.63±8.25 VS 76.35±2.45,P<0.001)、旋后范围(10.21±8.89 VS 75.32±3.85,P<0.001)、肘关节功能(Mayo评分:38.36±18.63 VS 87.45±12.38,P<0.001)均显著改善。结论手术治疗肘关节恐怖三联征疗效显著,选择合适手术入路及手术模式重建肘关节的稳定性、术后早期康复锻炼,是获得满意疗效的关键。展开更多
Content-based 3D model retrieval is of great help to facilitate the reuse of existing designs and to inspire designers during conceptual design. However, there is still a gap to apply it in industry due to the low tim...Content-based 3D model retrieval is of great help to facilitate the reuse of existing designs and to inspire designers during conceptual design. However, there is still a gap to apply it in industry due to the low time efficiency. This paper presents two new methods with high efficiency to build a Content-based 3D model retrieval system. First, an improvement is made on the ＂Shape Distribution （D2）＂ algorithm, and a new algorithm named ＂Quick D2＂ is proposed. Four sample 3D mechanical models are used in an experiment to compare the time cost of the two algorithms. The result indicates that the time cost of Quick D2 is much lower than that of D2, while the descriptors extracted by the two algorithms are almost the same. Second, an expandable 3D model repository index method with high performance, namely, RBK index, is presented. On the basis of RBK index, the search space is pruned effectively during the search process, leading to a speed up of the whole system. The factors that influence the values of the key parameters of RBK index are discussed and an experimental method to find the optimal values of the key parameters is given. Finally, ＂3D Searcher＂, a content-based 3D model retrieval system is developed. By using the methods proposed, the time cost for the system to respond one query online is reduced by 75% on average. The system has been implemented in a manufacturing enterprise, and practical query examples during a case of the automobile rear axle design are also shown. The research method presented shows a new research perspective and can effectively improve the content-based 3D model retrieval efficiency.展开更多
文摘目的 探讨脂肪因子代谢对冠状动脉微血管功能障碍(MVD)的影响及麝香通心滴丸(STDP)的临床应用价值。方法 纳入2018年9月至2019年12月上海交通大学医学院附属新华医院心内科收治的41例冠心病患者,分为非MVD组(20例)和MVD组(21例);29例MVD患者随机分为基础治疗组(14例)和STDP组(15例),分别进行为期3个月的基础治疗和基础治疗加STDP治疗;分析各组患者主诉、血生物化学指标、血浆炎症因子及脂肪因子水平的变化。采用12~14周龄雄性C57BL/6小鼠制备心肌缺血再灌注(IR)模型,分为假手术组、IR组(生理盐水灌胃)和IR+STDP组(STDP灌胃),每组5只,采用ELISA测定血浆炎症因子水平,通过硫黄素-S荧光密度法测定心脏组织微血管阻塞情况,采用蛋白质组学分析探寻IR组与IR+STDP组间差异表达蛋白质并通过蛋白质印迹法进行验证。结果 与非MVD组比较,MVD组血浆瘦素水平增高[(9.89±2.42)μg/L vs (4.76±1.02)μg/L,P<0.01],脂联素水平下降[(5.02±1.30)pg/mL vs (7.19±1.76)pg/mL,P<0.05],抵抗素水平升高[(9.20±2.03)μg/L vs (5.70±1.32)μg/L,P<0.05]。Pearson相关分析显示血浆瘦素水平与微循环阻力呈正相关(r=0.82,P<0.01)。ROC曲线分析结果显示,根据血浆瘦素水平判断MVD的AUC值为0.855,最佳临界值为>9.395 μg/L,灵敏度为0.714,特异度为0.867。MVD患者治疗3个月后,相较于基础治疗组,STDP组主诉胸闷、胸痛症状改善率较高[73.3%(11/15) vs 21.4% (3/14)],血浆瘦素、IL-6、TNF-α水平均降低[(11.36±0.54)μg/L vs (12.12±0.85)μg/L、(3.96±1.76)pg/mL vs (8.65±1.29)pg/mL、(24.82±3.07)ng/mL vs (32.45±3.32)ng/mL,均P<0.05]。在动物实验中,与IR组相比,IR+STDP组小鼠IR术后无回流面积减少45%(P<0.01)、低回流及无回流面积减少23%(P<0.05),血浆IL-6、TNF-α水平均下降[(378.25±19.66)pg/mL vs (457.32±32.01)pg/mL、(289.71±47.62)pg/mL vs (371.28±41.05)pg/mL,均P<0.05]。蛋白质组学分析结果显示,IR+STDP组小鼠心脏组织中血管性血友病因子(vWF)、细胞间黏附分子-1(ICAM-1)蛋白质表达水平低于IR组,蛋白质印迹法验证结果亦提示IR+STDP组vWF及ICAM-1蛋白质表达较IR组下调(均P<0.01)。结论 MVD患者存在脂肪因子代谢异常,血浆瘦素水平较高。STDP治疗可改善MVD患者的临床症状,降低血浆瘦素水平和炎症指标,机制可能与其抗血小板、抗炎作用有关。
文摘目的评估手术治疗肘关节恐怖三联征的临床疗效。方法连续收集本院2020年1月-2022年1月收住并接受手术治疗28例肘关节恐怖三联征患者的临床资料,动态随访1年,观察患者的VAS疼痛评分、肘关节屈伸、前臂旋转范围、肘关节功能恢复情况和并发症发生情况。结果28例患者中男性19例、女性9例,平均年龄(31.28±11.52)岁。尺骨冠状突骨折Regan-Morrey I型5例、II型18例、III型5例;桡骨头骨折Mason I型9例、II型13例、III型6例。分别采用不同麻醉方式、手术入路和术式完成骨折内固定和韧带修复,随访结束时28例骨折均骨性愈合(100%),发生1例异位骨化(3.57%)被成功纠治(100%)。与术前比较,患者术后1年的肘关节疼痛(VAS评分:7.21±2.18 VS 2.01±0.21,P<0.001)、肘关节屈伸度(29.68±16.13 VS 130.81±18.95,P<0.001)、前臂旋前范围(10.63±8.25 VS 76.35±2.45,P<0.001)、旋后范围(10.21±8.89 VS 75.32±3.85,P<0.001)、肘关节功能(Mayo评分:38.36±18.63 VS 87.45±12.38,P<0.001)均显著改善。结论手术治疗肘关节恐怖三联征疗效显著,选择合适手术入路及手术模式重建肘关节的稳定性、术后早期康复锻炼,是获得满意疗效的关键。
基金supported by National Natural Science Foundation of China(Grant No. 51175287)National Science and Technology Major Project(Grant No. 2011ZX02403)
文摘Content-based 3D model retrieval is of great help to facilitate the reuse of existing designs and to inspire designers during conceptual design. However, there is still a gap to apply it in industry due to the low time efficiency. This paper presents two new methods with high efficiency to build a Content-based 3D model retrieval system. First, an improvement is made on the ＂Shape Distribution （D2）＂ algorithm, and a new algorithm named ＂Quick D2＂ is proposed. Four sample 3D mechanical models are used in an experiment to compare the time cost of the two algorithms. The result indicates that the time cost of Quick D2 is much lower than that of D2, while the descriptors extracted by the two algorithms are almost the same. Second, an expandable 3D model repository index method with high performance, namely, RBK index, is presented. On the basis of RBK index, the search space is pruned effectively during the search process, leading to a speed up of the whole system. The factors that influence the values of the key parameters of RBK index are discussed and an experimental method to find the optimal values of the key parameters is given. Finally, ＂3D Searcher＂, a content-based 3D model retrieval system is developed. By using the methods proposed, the time cost for the system to respond one query online is reduced by 75% on average. The system has been implemented in a manufacturing enterprise, and practical query examples during a case of the automobile rear axle design are also shown. The research method presented shows a new research perspective and can effectively improve the content-based 3D model retrieval efficiency.
