The practicality and sustainability of a community advisory board at a large medical research unit on the Thai-Myanmar border

Community engagement is increasingly promoted to strengthen the ethics of medical research in low-income countries. One strategy is to use community advisory boards (CABs): semi-independent groups that can potentially safeguard the rights of study participants and help improve research. However, there is little published on the experience of operating and sustaining CABs. The Shoklo Malaria Research Unit (SMRU) has been conducting research and providing healthcare in a population of refugees, migrant workers, and displaced people on the Thai-Myanmar border for over 25 years. In 2009 SMRU facilitated the establishment of the Tak Province Community Ethics Advisory Board (T-CAB) in an effort to formally engage with the local communities both to obtain advice and to establish a participatory framework within which studies and the provision of health care can take place. In this paper, we draw on our experience of community engagement in this unique setting, and on our interactions with the past and present CAB members to critically reflect upon the CAB’s goals, structure and operations with a focus on the practicalities, what worked, what did not, and on its future directions.

Multicriteria Analysis by Codification for the Determination of Soil Landscape Units in Forest and Pre-Forest Zones of Cote D’Ivoire: The Case of the Square Degrees of M’Bahiakro and Daloa

The present study, carried out in the forest (Daloa) and pre-forest (M’Bahiakro) zones of Cote d’Ivoire, aims to determine soil landscape units using the coding method. Geological maps and satellite images (SRTM and Landsat) were used for this purpose. The methodological approach adopted consisted in producing maps of slope, geology, land use and topography using the codification method. These various maps, integrated into a GIS using the coding aggregation method, were used to generate soil landscape maps. Twenty-seven (27) soil landscapes have been identified for the pre-forest zone (M’Bahiakro), with a strong dominance of acid rock over a moderate relief under savannah, forest/degraded forest and crops/fallow. However, the forest zone (Daloa), with forty-one (41) soil landscapes identified over the entire zone, is characterized by a majority of mafic rocks on a medium altitude under forest/degraded forest, water and crops/fallow. The criteria used from the codification method (sum of aggregations) made it possible to predict the spatial distribution of soil map units according to agro-ecological environments in the humid intertropical zone. This is essential for the orientation and reinforcement of soil survey tools. However, a comparative evaluation of the different multicriteria analysis methods for coding and weighting soil landscape unit mapping would enable us to identify the most suitable and efficient method for drawing up base maps for soil surveys.

Prevalence of Dyslipidemia among Patients Received at the Biochemistry Unit of the Charles de Gaulle Pediatric University Hospital in Ouagadougou

Introduction: Cardiovascular disease represents a major public health burden worldwide. Research and management of risk factors contribute to the prevention of these diseases. The aim of this study was to assess the prevalence of dyslipidemia in the biochemistry unit of the Charles De Gaulle Pediatric University Hospital (CHUP-CDG) in Ouagadougou. Material and Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection from January 1, 2020 to December 31, 2022. Patients of all ages who performed a lipid panel in the CHUP-CDG biochemistry unit during the study period have been included. Results: A total of 2872 patients have been included. The mean age of the study population was 27.72 ± 19.51 years and the M/F sex ratio was 0.81. Among the patients, 22.84% had at least one dyslipidemia. The prevalences of hypercholesterolemia, hypo-HDL cholesterolemia and hyper-LDL cholesterolemia were 11.57%, 49.19% and 57.50% respectively. Hypertriglyceridemia and mixed hyperlipidemia were present in 9.04% and 2.08% of patients. Hypercholesterolemia was significantly more frequent in the female sex (p = 0.0077);hyper-LDL cholesterolemia (p = 0.0255) and mixed hyperlipidemia (p Conclusion: The relatively high prevalence of dyslipidemia in the study indicates a worrying situation. It would therefore appear essential to extend the search for risk factors nationwide, particularly those that can be modified, in order to reduce morbidity and mortality linked to cardiovascular disease.

Low Birth Weight in Cameroon: Research and Analysis of Factors Associated with Their Occurrence in Douala Maternity Wards

Introduction: Low birth weight (LBW) is defined by the World Health Organization (WHO) as a birth weight strictly below 2500 g, whatever the term of pregnancy. It constitutes a major public health problem, both in developed and developing countries, due to its magnitude and its strong association with infant morbidity and mortality. Main objective was to study the factors associated with the occurrence of small-for-gestational-age newborns in Douala. Methodology: We carried out a cross-sectional analytical study with prospective data collection using a technical pretested sheet in the maternity wards of the Douala General Hospital, the Laquintinie Hospital, and the District hospitals of Deido, Nylon and Bonassama over a period of 4 months (January to April 2020). We were interested in any newborn, born alive, vaginally or by cesarean section, of low weight, seen in the first 24 hours from a full-term single-fetal pregnancy whose mother had given her consent. Our sampling was consecutive and non-exhaustive. We excluded newborns whose term was unclear and those with congenital malformations or signs of embryo-foetopathy. Data collection was done using survey sheets. Statistical analyzes were carried out with CS Pro 7.3 and SPSS version 25.0 software. The Student, Chi-square and Fischer tests were used to compare the means of the variables, the percentages with a significance threshold P value Results: During the study period, 305 full-term newborns were included, divided into 172 boys and 133 girls. The percentage of small-for-gestational-age newborns was 9.8%;after multivariate analysis by logistic regression to eliminate confounding factors, we found maternal factors associated with small for gestational age newborns;maternal age less than 20 years, primiparity, gestational age (37 - 38), a delay in prenatal visits greater than 14 weeks, anemia in pregnancy, positive toxoplasmosis serology in pregnancy, a body mass index of Conclusion: Our study revealed the potential determinants of low birth weight at term in the Cameroonian urban context and specifically in Douala.

Spontaneous Abortions in the Second Trimester of Pregnancy: Research and Analysis of Factors Associated at Laquintinie Hospital in Douala

Introduction: Spontaneous abortion of the second trimester is an interruption of pregnancy with complete expulsion or not of the product of conception between 15 and 28 weeks of pregnancy without any maneuvers. The objective of our study was to determine the factors associated with second trimester spontaneous abortions at Laquintinie Hospital in Douala. Methodology for this purpose: We conducted a case-control study from January to May 2019 on pregnant women who may or may not have had spontaneous second trimester abortions. Results: In total we recorded 1609 pregnancies and recruited 184 patients, including 46 cases and 138 controls;which gave a frequency of spontaneous abortion in the second trimester of pregnancy of 2.85%. A correlative analysis showed that spontaneous abortions in the second trimester were associated with housewife status (OR = 2.89;CI = 1.21 - 6.79;p = 0.010), gestation > 5 (OR = 4.09;CI = 1.02 - 17.66;p = 0.040), multiparity (OR = 3.81;CI = 1.59 - 9.16;p = 0.002), history of endouterine maneuvers (OR = 5.64;CI = 2.43 - 13 .03;p = 0.000), malaria in pregnancy (OR = 3.99;CI = 1.1 - 14.76;p = 0.030), incompleteness on the second trimester ultrasound (OR = 2.37;CI = 1.18 - 4.70;p = 0.010), jolts when traveling (OR = 46.04;CI = 17.29 - 123.66;p = 0.000), long car journeys (OR = 7.05;CI = 1.99 - 27.77;p = 0.000). After logistic regression eliminating the confounding factors, only the following were associated with abortions: Multiparity (OR = 13.90;CI = 2.96 - 65.18;p = 0.000), endo uterine maneuvers (OR = 3.69;CI = 1. 01 - 13.44;p = 0.047), jolts when traveling (OR = 72.63;CI = 19.47 - 270.96;p = 0.000), long car journeys (OR = 15.41;CI = 2.7 - 85, 95;p = 0.000). Conclusion: Our study reveals that a set of factors contribute to the occurrence of spontaneous abortions in the second trimester of pregnancy in our context.

Challenges and Suggestions of Ethical Review on Clinical Research Involving Brain-Computer Interfaces

Brain-computer interface(BCI)technology is rapidly advancing in medical research and application.As an emerging biomedical engineering technology,it has garnered significant attention in the clinical research of brain disease diagnosis and treatment,neurological rehabilitation,and mental health.However,BCI also raises several challenges and ethical concerns in clinical research.In this article,the authors investigate and discuss three aspects of BCI in medicine and healthcare:the state of international ethical governance,multidimensional ethical challenges pertaining to BCI in clinical research,and suggestive concerns for ethical review.Despite the great potential of frontier BCI research and development in the field of medical care,the ethical challenges induced by itself and the complexities of clinical research and brain function have put forward new special fields for ethics in BCI.To ensure"responsible innovation"in BCI research in healthcare and medicine,the creation of an ethical global governance framework and system,along with special guidelines for cutting-edge BCI research in medicine,is suggested.

Epidemiology of carbapenem-resistant Acinetobacter baumannii colonization in neonatal intensive care units:A systematic review and meta-analysis

BACKGROUND The rising prevalence of carbapenem-resistant Acinetobacter baumannii(CRAB)in neonatal intensive care units(NICUs)represents an escalating challenge in healthcare settings,particularly in managing hospital-acquired infections(HAIs).Studies across various World Health Organization regions have documented a significant incidence of CRAB-related HAIs,with rates as high as 41.7 cases per 1000 patients in ICUs,accounting for 13.6%of all HAIs.These infections pose a doubled mortality risk compared to infections with carbapenem-susceptible Acinetobacter baumannii.A particularly concerning aspect of CRAB colonization is its asymptomatic nature,enabling its transmission through healthcare workers(HCWs)or the NICU environment to vulnerable neonates with developing immune systems.AIM To explore the prevalence of CRAB colonization in NICUs,focusing on neonates,healthcare workers,and the environmental samples,to enhance epidemiological understanding and inform targeted interventions.METHODS We conducted according to PRISMA 2020 checklist guidelines,a comprehensive literature search across multiple databases including MEDLINE(Ovid),EMBASE(Ovid),Global Health(Ovid),Web of Science,and Global Index Me-dicus.Studies were selected based on predetermined criteria,primarily involving neonates,HCWs,and environmental swabs,using culture or molecular methods to detect CRAB colonization.We excluded studies that did not specifically focus on NICUs,were duplicates,or lacked necessary data.The study selection and quality assessment were conducted independently by two reviewers.Data extraction involved collecting comprehensive details about each study.Our statistical analysis used a random-effects model to calculate the pooled prevalence and confidence intervals,stratifying results by regional location.We assessed study heterogeneity using Cochran's Q statistic and I²statistic,with regression tests employed to evaluate potential publication bias.RESULTS We analyzed 737 records from five databases,ultimately including 13 studies from ten countries.For neonates,the pooled prevalence was 4.8%(95%CI:1.1%to 10.5%)with the highest rates observed in South-East Asia(10.5%;95%CI:2.4%to 23.3%).Among HCWs,a single Indian study reported a 3.3%prevalence.Environmental samples showed a prevalence of 2.3%(95%CI:0%to 9.3%),with the highest rates in South-East Asia(10%;95%CI:4.2%to 17.7%).Significant heterogeneity was found across studies,and no publication bias was detected.CONCLUSION This systematic review highlights a significant prevalence of CRAB colonization in neonates across various regions,particularly in South-East Asia,contrasting with lower rates in high-income countries.The study reveals a gap in research on HCWs colonization,with only a single study from India reporting moderate prevalence.Environmental samples indicate moderate levels of CRAB contamination,again higher in South-East Asia.These findings underscore the need for more extensive and focused research on CRAB colonization in NICUs,including exploring the roles of HCWs and the environment in transmission,understanding antimicrobial resistance patterns,and developing effective prevention measures.

Machine Learning Mapping of Soil Apparent Electrical Conductivity on a Research Farm in Mississippi

Open-source and free tools are readily available to the public to process data and assist producers in making management decisions related to agricultural landscapes. On-the-go soil sensors are being used as a proxy to develop digital soil maps because of the data they can collect and their ability to cover a large area quickly. Machine learning, a subcomponent of artificial intelligence, makes predictions from data. Intermixing open-source tools, on-the-go sensor technologies, and machine learning may improve Mississippi soil mapping and crop production. This study aimed to evaluate machine learning for mapping apparent soil electrical conductivity (ECa) collected with an on-the-go sensor system at two sites (i.e., MF2, MF9) on a research farm in Mississippi. Machine learning tools (support vector machine) incorporated in Smart-Map, an open-source application, were used to evaluate the sites and derive the apparent electrical conductivity maps. Autocorrelation of the shallow (ECas) and deep (ECad) readings was statistically significant at both locations (Moran’s I, p 0.001);however, the spatial correlation was greater at MF2. According to the leave-one-out cross-validation results, the best models were developed for ECas versus ECad. Spatial patterns were observed for the ECas and ECad readings in both fields. The patterns observed for the ECad readings were more distinct than the ECas measurements. The research results indicated that machine learning was valuable for deriving apparent electrical conductivity maps in two Mississippi fields. Location and depth played a role in the machine learner’s ability to develop maps.

Validation of the Portuguese version of the social isolation scale with a sample of community-dwelling older adults

Objectives The aim of this study was to analyze the psychometric properties(reliability and validity)of the Social Isolation Scale(SIS)in a sample of Portuguese community-dwelling older adults.Methods A transversal descriptive study was carried out with a convenience sample of 250 community-dwelling older adults(≥65 years).The survey comprised a sociodemographic questionnaire,SIS,Geriatric Depression Scale-4(GDS-4),6-item Lubben Social Network Scale(LSNS-6),a loneliness self-assessment question,and Satisfaction with Life Scale(SWLS).Construct validity(confirmatory factor analysis)and convergent validity were analyzed,and ISI internal reliability(composite reliability),external reliability(test-retest,intraclass correlation coefficient)and inter-rater reliability(Cohen’s kappa coefficient)were evaluated.Results Confirmatory factor analysis showed a two-factor model with an excellent index of fit.The SIS showed significant correlations with LSNS-6(rs=0.47),SWLS(rs=0.26),the loneliness self-assessment question(rs=0.35),and GDS-4(rs=−0.16).SIS composite reliability was good(0.708).The inter-class correlation coefficient varied from 0.84 to 0.98.The Cohen’s kappa coefficient ranged from 0.936 to 1.Conclusions SIS has been shown to be a valid and reliable instrument for assessing social isolation among Portuguese community-dwelling older adults.Healthcare professionals,particularly nurses working in community settings,can use SIS to assess social isolation in older adults to design,implement,and evaluate interventions.

抗PCV4 Cap蛋白抗体间接ELISA检测方法的建立

为建立可应用于猪圆环病毒4型(PCV4)候选疫苗特异性抗体检测与评价方法,本研究应用PCV4 Cap蛋白作为抗原,以PCV4多克隆兔源抗体作为一抗,优化各反应的最佳条件并建立了针对PCV4 Cap蛋白抗体的间接ELISA方法。最佳条件为2μg/m L PCV4 Cap纯化蛋白,4℃包被过夜,5%脱脂乳封闭60 min,待检血清稀释比例为1∶800,反应条件为37℃、45 min,酶标抗体稀释比例为1∶5000,反应条件为37℃、60 min,底物显色时间为10 min,Cut of f值为0.157,灵敏度可达102400倍。成功建立的抗PCV4Cap蛋白抗体间接ELISA检测方法具有良好的敏感性、重复性和特异性。可为检测PCV4候选疫苗的特异性抗体水平提供一种精准、高效的方法。

盐酸二甲双胍片在空腹及高脂餐条件下的人体生物等效性试验

目的评价健康受试者在空腹和高脂餐条件下单次服用盐酸二甲双胍片的生物等效性、相对生物利用度及安全性。方法采用单中心、单剂量、开放、随机、双交叉给药设计,选取2017年9月至10月益阳市中心医院的65例健康受试者作为研究对象,空腹入组32例,餐后入组33例。受试者在服用0.25 g盐酸二甲双胍片后检测血浆中的药物浓度,计算药动学参数,并评价药物的生物等效性。结果空腹入组32例受试者,二甲双胍受试制剂、参比制剂的主要药动学参数:C_(max)分别为(769.310±164.148)ng/ml和(738.720±127.457)ng/ml,AUC_(0-t)分别为(4737.900±920.287)h·ng/ml和(4647.700±869.177)h·ng/ml,AUC_(0-∞)分别为(4808.330±928.534)h·ng/ml和(4717.670±875.598)h·ng/ml。餐后入组33例受试者,二甲双胍受试制剂、参比制剂的主要药动学参数:C_(max)分别为(476.100±99.755)ng/ml和(467.520±94.557)ng/ml,AUC_(0-t)分别为(3677.200±770.824)h·ng/ml和(3673.860±754.462)h·ng/ml,AUC_(0-∞)分别为(3762.760±783.383)h·ng/ml和(3745.280±761.178)h·ng/ml。药代动力学参数C_(max)、AUC_(0-t)、AUC_(0-∞)经过对数转换后进行多元方差分析,几何均值比的90%CI均在80.00%~125.00%范围。结论在空腹和高脂餐条件下给药,受试制剂与参比制剂生物等效,药物的安全性、耐受性良好。

国际数据管理计划工具比较研究

采纳一定的标准,特别是以主流、用户量大的数据管理计划(DMP)工具作为代表,遴选出6种研究数据管理计划工具作为研究对象,结合实际试用、前人研究和专家访谈,从科研人员使用和体验视角采用综合性研究方法,厘清工具比较评估的核心要素,构建工具比较评估的三级指标体系,就基本功能、DMP模板内容、用户体验开展比较分析,研究结果呈现通用DMP工具的典型特性和未来发展趋势,供我国出台相关政策和研发工具借鉴参考。

3D打印导板在上颌骨前段牵引成骨中的应用及精度测量

目的·评估上颌骨前段牵引成骨(anterior maxillary segmental distraction osteogenesis,AMSDO)在治疗唇腭裂继发上颌骨发育不足中的作用以及3D打印导板在截骨中的精度。方法·收集12例接受了AMSDO治疗的唇腭裂患者的病例资料。手术前在患者的三维模型上进行虚拟手术,并通过3D打印将患者的截骨线制成牙支持式导板。术前(T0)、巩固期结束(T1)以及巩固期后6个月(T2)进行头影测量以评估AMSDO的效果及稳定性。导板的精度通过术后即刻CT与术前设计CT进行叠加,并通过计算位置和角度误差进行评估。结果·所有患者都顺利完成了牵引治疗,没有发生严重的并发症。SNA(S-N-A角)和覆盖从T0到T1以及T0到T2都发生了显著的改变。ANB(A-N-B角)、面部突度、硬腭长度都发生了变化,但是差异没有统计学意义。SNB(S-N-B角)基本没有发生变化。从T1到T2,所有的参数都没有发生明显变化。导板截骨精度在矢状向的线性均方根误差为0.90 mm,角度均方根误差为5.07°。结论·AMSDO是治疗唇腭裂继发上颌骨发育不足的一种有效方法。3D打印的截骨导板具有良好的精度,在减少手术并发症的同时降低了手术的难度。

外周血指标对鼻息肉患者黏膜中IL-5和金黄色葡萄球菌肠毒素特异性免疫球蛋白E阳性表达的预测价值

目的借助外周血指标预测慢性鼻窦炎伴鼻息肉(CRSwNP)2型生物标志物。方法收集2020年6月~2022年5月在北京同仁医院鼻科住院的CRSwNP患者临床资料,检测外周血中嗜酸粒细胞百分比(Eos%)、Eos计数、骨膜蛋白和总IgE以及CRSwNP黏膜中白细胞介素5(IL-5)和金黄色葡萄球菌肠毒素特异性免疫球蛋白E(Staphylococcus aureus enterotoxinimmunoglobulin E,SE-IgE)。应用受试者工作特征(ROC)曲线评估每个外周血指标对黏膜IL-5/SE-IgE阳性表达预测价值,利用Logistic回归筛选对黏膜IL-5/SE-IgE阳性有预测价值的外周血指标,构建诺模图模型。结果CRSwNP患者哮喘比例、血中Eos%、骨膜蛋白和总IgE在IL-5/SE-IgE阳性和阴性两组之间,均具有统计学差异。ROC曲线单因素分析显示血Eos%、Eos计数、骨膜蛋白和总IgE对黏膜IL-5和SE-IgE阳性预测的AUC分别波动在0.655~0.784和0.721~0.802,Logistic回归确认血中Eos%、总IgE和血中骨膜蛋白、总IgE可分别作为IL-5和SE-IgE阳性的独立预测因素。构建预测CRSwNP黏膜IL-5/SE-IgE阳性的诺模图模型,一致性指数(C-index)为0.804和0.81,提示具有很好的预测准确性。结论血中Eos%、总IgE和血中骨膜蛋白、总IgE分别构建的诺模图,对CRSwNP黏膜IL-5和SE-IgE阳性表达具有很好的预测价值,可以预判CRSwNP内型和表型严重性。

累及鼻腔鼻窦的Rosai-Dorfman病临床特征分析

目的探讨累及鼻腔鼻窦的Rosai-Dorfman病(Rosai-Dorfman disease,RDD)的临床特征性表现。方法对2016年12月~2023年8月在首都医科大学附属北京同仁医院鼻科接受诊治的16例累及鼻腔鼻窦的RDD患者的临床资料回顾性分析。结果男女比例1∶3,平均年龄47.4岁,平均病程22.34个月。主诉鼻塞、鼻干、嗅觉减退、头面部痛和突眼/复视的患者,分别有14、3、5、6和1例,9例存在外鼻肿胀。14例至少累及鼻中隔,12例单纯鼻腔受累,3例累及鼻窦,1例为混合型。10例行快速冰冻病理检查,8例结果误诊或漏诊。鼻内镜检查9例患者的鼻中隔呈现双侧膨隆,7例鼻底和下鼻甲表面有结节状隆起或者颗粒状新生物。鼻窦CT发现9例患者鼻中隔区域呈现类圆形均匀软组织影或对称性软组织增厚影,5例鼻底、下鼻甲呈现明显的软组织增厚影。结论累及鼻腔鼻窦的RDD在外鼻表现、内镜和影像学检查中有一定的典型特征,综合判断有助于提高临床诊断RDD的可行性。

基于深度神经网络的机会性CT骨质疏松筛查和骨密度预测研究

目的建立并评价基于机会性CT检查的骨质疏松筛查分类和骨密度值预测的深度学习神经网络模型。方法以定量计算机断层扫描(Quantitative Computed Tomography,QCT)骨密度测定为标准,将199例机会性CT检查数据用于建立密集卷积网络的深度学习神经网络的骨密度二分类模型和骨密度值预测回归模型,以五折交叉验证和随机分组的方法进行测试,并以来自不同设备的42例机会性CT检查病例进行独立测试,计算和评价模型的性能参数。结果受试者工作特征(Receiver Operating Characteristic,ROC)曲线显示:骨密度二分类模型的测试集和独立测试集的ROC曲线下面积均值分别为0.974、0.938,测试集的F1得分、召回率、精准度、特异性、准确度均≥0.91,独立测试集的上述评价参数均>0.862。在训练集、测试集和独立测试集上,骨密度值预测回归模型的平均绝对误差分别为1.42、8.52和13.89,均方根误差分别为1.93、10.80、20.36,预测值与QCT骨密度值呈极强正相关。结论基于机会性CT检查的深度学习神经网络模型对骨密度正常和降低具有较强的分类能力,且可较准确地预测骨密度值,避免多余的辐射风险,减少时间、经济消耗,有效扩大骨质疏松筛查的范围。

有/无鼻窦炎症状的牙源性鼻窦炎患者的临床特征比较

目的比较牙源性鼻窦炎(odontogenic sinusitis,ODS)患者中有鼻窦炎症状和无鼻窦炎症状群体的临床表现。方法回顾性收集2020年6月至2022年6月在首都医科大学附属北京同仁医院耳鼻咽喉头颈外科行内镜鼻窦手术的92例ODS患者的临床资料,77例有鼻窦炎症状(sinusitis symptoms,SS组),15例无鼻窦炎症状(non-SS组)。比较两组患者的病史、症状、病因、内镜检查和鼻窦电子计算机断层扫描(computed tomography,CT)等。结果non-SS组患者相比SS组患者的病程更短[(4.9±3.4)个月vs(10.4±11.0)个月,P=0.048],首诊口腔科比例更高(100%vs 24.7%,P=0.035)。两组患者报告牙痛、牙齿松动症状阳性率,差异无统计学意义(29.9%vs 53.3%,P=0.133;18.2%vs 35.3%,P=0.085)。牙周-牙髓联合病变(periodontal-endodontic combined lesions,PECL)、根尖周炎(apical periodontitis,AP)、牙周炎(periodontitis,PE)、医源性占SS组和non-SS组患者病因的比例分别为53.2%vs 20%(P=0.024)、28.6%vs 33.3%(P=0.76)、11.7%vs 26.7%(P=0.215)、6.5%vs 20%(P=0.119)。鼻窦CT显示,与non-SS组患者相比,SS组患者窦口鼻道复合体(ostiomeatal complex,OMC)、筛窦、额窦有更高比例的受累(83.1%vs 26.7%,P=0.000;80.5%vs 20%,P=0.000;41.6%vs 0%,P=0.002)。结论耳鼻喉科与口腔科的多学科合作,可以早期发现无鼻窦炎症状的ODS,及时诊治PECL等牙齿相关性疾病,减少内镜手术概率,提升患者生活质量。

先天缺牙患者的种植治疗

先天缺牙患者主要表现为牙数目不足、上下颌骨牙槽突发育不全、颌面部发育不良等,可导致口腔或全身功能异常,危害性大,治疗难度高。种植义齿因其良好的稳定性和舒适度,是修复此类患者缺失牙的理想选择。本文旨在通过分析先天缺牙患者种植治疗中面临的挑战,提出先天缺牙患者口腔功能重建策略。

基于Transformer和CNN交错混合的肺结节分割网络

针对肺结节尺寸多样、形状异质化高等问题,提出基于Transformer和卷积神经网络(CNN)交错混合(IMTC)的肺结节分割网络,该网络是一个对称的层次连接网络,具有很强的多尺度特征提取能力。该网络通过集成2种方案分别解决肺结节多尺寸与形状异质化问题:(1)采用感知注意力模块(inception attention module,IAM),通过并联多个不同大小的卷积核来增加浅层网络的感受野组合,以此捕获更为丰富的浅层特征;(2)为获取更具表示能力的高级语义特征,利用由Transformer和CNN组成的基本骨干网络交错提取结节特征,使得全局特征与局部特征充分融合,从而提高结节特征表示的泛化能力和鲁棒性。实验结果表明:本文模型可以准确分割直径较小以及边缘复杂的肺结节,在LUNA16公开数据集上分割性能良好,Dice和IOU分别达到86.15%和76.10%。

可切除非小细胞肺癌新辅助免疫治疗研究进展

近年来,免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)对晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的改善已成为共识,越来越多的临床研究也逐渐证明了免疫治疗对于可切除NSCLC患者的重要价值。然而,目前关于新辅助治疗背景下免疫联合策略的探索、治疗相关副作用、预后生物标志物等问题仍存在争议。本文综述了可切除NSCLC患者新辅助免疫治疗的最新进展,引发了新的思考,并讨论了其在临床应用中的优势及挑战。