彩超和造影对输卵管积水的诊断价值

目的比较彩超与子宫输卵管造影(hysterosalpingography,HSG)对输卵管积水的诊断率,为宫腹腔镜联合术前输卵管积水的处理提供准确的评估依据。方法选取2011年10月—2015年1月因不孕症在暨南大学医学院附属宝安妇幼保健院生殖健康科就诊,均行彩超和输卵管造影诊断为输卵管积水,且经宫腹腔镜联合手术后证实为输卵管积水的患者共58例,对其彩超结果及输卵管造影结果进行回顾性分析。结果宫腹腔镜术中发现积水输卵管共82条,轻度积水38条,中度积水44条,重度积水7条,彩超结果:轻度积水19条,中度积水24条,重度积水5条;HSG结果:轻度积水26条,中度积水28条,重度积水5条。结论 HSG诊断输卵管积水的准确率明显高于彩超,特别对输卵管轻度积水诊断阳性率更高,两者比较有统计学意义,对中度、重度输卵管积水,特别是重度输卵管积水,两者诊断阳性率差别不大,差异无统计学意义。     

Near-infrared fluorescence probes for surgical navigation

Optical imaging is a promising tool for visualizing fundamental biological processes including disease progression, detection of tumors, and therapeutic monitoring non-invasively. Unlike visible light, near-infrared fluorescence (NIRF) imaging (beyond 700–1,700 nm) offers a competitive advantage to yield high-resolution images within a certain penetration depth (few millimeters to centimeters depending on NIR window). The last few years have witnessed rapid development of new NIRF probes within the span of whole NIR window, including small-molecule dyes, inorganic nanoparticles, and organic macromolecules. Benefitted by this, we observe a continual surge in the number of preclinical and clinical studies of NIRF imaging in surgery and related applications. At present, NIRF-guided imaging has emerged as a quintessential procedure to assist surgeons for intraoperative delineation and resection of tumors. Moreover, NIRF imaging is also used to improve the intraoperative staging, identify the hidden lesion in diseased organs, map lymph node metastases, detect tumor margins, and highlight vital organs intraoperatively. Considering rapid advancement of this field, we review recent progress in the development of NIRF probes, cancer-targeting strategies and their application for surgical navigation, particularly for the sentinel lymph node mapping, detection of tumors, and angiography. Moreover, we spotlight surgical navigation instrumentation that is currently used for intraoperative tumor detection.     

基于光信息处理技术的无创血糖测量方法

血糖无创检测技术是在不损伤皮肤的条件下测量出人体血液中血糖浓度的新方法。它能解除糖尿病患者经常化验所需要的针刺取血的痛苦，避免病毒通过血液传染的危险。同时它能有效地提高对血糖监测的水平，降低患者的危险。本文对国际上无创血糖测量技术的研究现状进行了综述和分析，介绍了几种具有代表性的无创检测仪器的原理，分析了各种测量方法的优缺点，指出了未来血糖无创检测技术研究的发展方向。     

侵蚀性葡萄胎的MRI影像学表现及其诊断效果

为探讨侵蚀性葡萄胎(IHM)的磁共振成像(MRI)影像学表现及其诊断效果,本研究对36例疑似IHM患者均行MRI平扫和动态增强扫描(DCE)检查,观察了IHM的MRI影像学表现,分析了MRI诊断IHM的灵敏度、特异度和准确度。结果显示,IHM的MRI影像学表现具有特征性;MRI诊断IHM的灵敏度为75.00%、特异度为83.33%、准确度为77.78%;IHM组的时间-信号强度曲线(TIC)以Ⅰ型为主,良性病变组的TIC以Ⅲ型和Ⅳ型为主,差异有统计学意义(P<0.05)。本文证实MRI检查可清晰显示宫腔内情况及子宫肌层受侵程度,MRI平扫结合DCE可提高诊断IHM的准确性。     

整体护理对肝胆术后发生胆瘘患者的临床护理效果观察

目的研究对肝胆术后发生胆瘘患者采取整体护理的临床效果。方法对84例肝胆术后发生胆瘘患者进行研究,以知情自愿为原则,将84例患者分为对照组与观察组,每组42例,分别采取常规护理与整体护理。比较两组的引流时间、住院时间、抑郁评分以及焦虑评分。结果观察组的引流时间、住院时间均短于对照组;观察组的抑郁评分、焦虑评分均低于对照组。上述指标的对比,P0.05,差异有统计学意义。结论对肝胆术后发生胆瘘患者采取整体护理有助于改善患者的不良心理状态,对患者的康复具有积极作用。     

微小型甲状腺癌手术治疗的临床效果体会

目的探讨微小型甲状腺癌手术治疗的临床效果体会。方法将2014年3月—2015年3月在广州市番禺区中心医院肿瘤科治疗的70例微小型甲状腺癌患者随机分为两组,对照组采用开放性手术治疗,观察组采用内镜手术治疗,比较两组患者的治疗效果、术中各项指标、并发症发生率。结果两组患者治疗有效率无明显差异(P0.05);观察组手术时间、术中出血量、切口长度、住院时间与对照组相比,均有明显差异(P0.05);观察组术后切口感染、低钙抽搐、呼吸困难、喉返神经损伤等并发症发生率明显低于对照组,差异有统计学意义(P0.05)。结论微小型甲状腺癌采用内镜手术治疗效果更佳,利于患者的术后恢复,并发症的发生率也更低,具有积极的临床意义。     

全胸腔镜手术与胸腔镜辅助小切口手术对Ⅰ期非小细胞肺癌的临床疗效比较

目的比较全胸腔镜手术与胸腔镜辅助小切口手术对Ⅰ期非小细胞肺癌的临床疗效。方法选择86例Ⅰ期非小细胞肺癌患者,按随机数字表法分为使用全胸腔镜手术治疗组（全胸腔镜组46例,采用3孔法）及使用胸腔镜辅助小切口手术治疗组（胸腔镜辅助组40例,采用2孔法）。比较两组患者一般手术情况、术后生存质量及无瘤生存情况。结果两组患者的手术时间、术中出血量、术后带胸管时间及住院时间比较差异均无统计学意义（均P＞0.05）,全胸腔镜组患者术后胸腔液引流量[（217.8±50.5）ml]和视觉模拟评分（VAS）[（3.9±0.6）分]均低于胸腔镜辅助组[（258.0±48.6）ml、（6.5±1.2）分],差异均有统计学意义（t=3.75、12.96,均P＜0.05）。全胸腔镜组患者术后生存质量评分[总分（88.7±9.6）分]高于胸腔镜辅助组[总分（71.1±8.2）分],差异有统计学意义（t=9.1,P＜0.05）。两组患者术后无瘤生存时间比较差异无统计学意义（P＞0.05）。结论全胸腔镜手术治疗Ⅰ期非小细胞肺癌的近、远期疗效均较好,值得推广应用。     

DNA molecule manipulation by motor proteins for analysis at the single-molecule level

Massively parallel and individual DNA manipulation for analysis has been demonstrated by designing a fully self-assembled molecular system using motor proteins. DNA molecules were immobilized by trapping in a polyacrylamide gel replica, and were digested by a restriction enzyme, XhoI, for DNA analysis. One end of the λDNA was modified with biotin and the other end was modified with digoxin molecules by fragment labeling and ligation methods. The digoxin-functionalized end was immobilized on a glass surface coated with anti-digoxigenin antibody. The biotinylated end was freely suspended and experienced Brownian motion in a buffer solution. The free end was attached to a biotinylated microtubule via avidin–biotin biding and the DNA was stretched by a kinesin-based gliding assay. A stretched DNA molecule was fixed between the gel and coverslip to observe the cleavage of the DNA by the enzyme, which was supplied through the gel network structure. This simple process flow from DNA manipulation to analysis offers a new method of performing molecular surgery at the single-molecule scale. Figure DNA molecule manipulation by motor proteins for analysis at the single-molecule level     

A new construction of -manifolds

This paper provides a topological method to construct all simply-connected, spin, smooth -manifolds with torsion-free homology using simply-connected, smooth -manifolds as building blocks. We explicitly determine the invariants that classify these -manifolds from the intersection form and specific homology classes of the -manifold building blocks.

     

HigherG-signatures for Lipschitz manifolds

Using the Teleman signature operator and Kasparov'sKK-theory, we prove a strong De Rham theorem and a higherG-signature theorem for Lipschitz manifolds. These give in particular a substitute for the usualG-signature theorem that applies to certain nonsmooth actions on topological manifolds. Then we present a number of applications. Among the most striking are a proof that nonlinear similarities preserve renormalized Atiyah-Bott numbers, and a proof that under suitable gap, local flatness, and simple connectivity hypotheses, a compact (topological)G-manifoldM is determined up to finite ambiguity by its isovariant homotopy type and by the classes of the equivariant signature operators on all the fixed sets . These could also be proved using joint work of Cappell, Shaneson, and the second author on topological characteristic classes.Partially supported by NSF Grants DMS-87-00551 and DMS-90-02642 (J.R.) and by NSF Grants, a Sloan Foundation Fellowship, and a Presidential Young Investigator award (S.W.).