简介:摘要2例1型糖尿病青少年患者分别于2018年和2019年参加上海市儿童青少年糖尿病眼病研究项目中确诊Wolfram综合征。既往1型糖尿病病史分别为12年和4年。视神经萎缩史分别为8年和4年。眼部检查示双眼晶状体轻度后囊膜型白内障,视神经萎缩。光学相关断层扫描检查显示,2位患者双眼视神经下方脉络膜厚度降低,视网膜神经纤维层厚度显著降低,视盘区及黄斑区血流密度及血管密度明显下降,电生理检查示振幅下降明显,视野检查呈双眼熄灭型。临床诊断为Wolfram综合征,随访中。如果1型糖尿病儿童及青少年最佳矫正视力下降且低于0.6,除常规眼科检查外,建议其早期进行视神经区域脉络膜厚度、视网膜神经纤维层厚度、视网膜血流、视网膜电图以及视野检查。有条件者建议行WFS-1基因测序检查。
简介:AbstractThe novel betacoronavirus (Severe Acute Respiratory Syndrome Coronavirus 2, SARS-CoV-2) is a pathogen that causes deadly respiratory disease named coronavirus disease 2019 (COVID-19). The incidence of this disease has increased in the last few months affecting 257,832,881 people in 221 countries and 51,68,069 deaths worldwide according to Worldometer at 04:03 GMT on November 22, 2021. Thus, the emergence of this disease creates a challenge for health care providers in handling this pathogen and reducing its risk of transmission. In developing countries, this virus is treated in biosafety level 2 laboratories, where a high concentration of pathogen can easily affect the laboratory staff and cause the spread of this disease. Based on the epidemiology and characteristics of the SARS-CoV-2 virus already discussed in recent studies, we will provide biosafety guidelines and suggestions for safe handling and transportation of the SARS-CoV-2 virus in dealing with the current pandemic situation with a focus on increased infectivity of emerging new variants.
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简介:摘要:当前在国内篮球联赛中比赛规则的改变,主要涉及合理冲撞区域、限制区域、三分投篮区域、24 秒钟规则、掷界外球入界线这五方面内容,这肯定会对各球队的训练、比赛带来更多的变化、提出更高、更严的要求,例如,提高了队员们在各位置进行投篮的难度、进一步扩大了篮下的攻防面积,给队员们在该区域内完成精彩进攻配合创造了良好条件。
简介:摘要:列控中心(TCC)是CTCS-2级列控系统地面设备的核心部分,采用二乘二取二安全计算机平台。LKD2-T2型列控中心(TCC)通过安全数据网与相邻列控中心、联锁、TSRS进行接口,实现TCC之间、与车站计算机联锁之间安全信息传输。TCC通过CAN总线控制ZPW-2000轨道电路,采集信号机、轨道电路方向继电器、轨道继电器、灾害防护继电器等条件,根据轨道区段占用信息、联锁进路信息、线路限速信息等产生列车行车许可命令。用RS422串行总线通信与CTC站机设备连接,用RS422串行总线与LEU通信,实现列控中心应答器报文的实时编码和LEU数据通信的功能,并通过轨道电路和有源应答器将连续的速度信息及点式信息传输给车载设备,保证其管辖内的所有列车的运行安全。
简介:摘要目的基于全卷积网络U-Net预测宫颈癌近距离治疗(BT)感兴趣区(ROI)三维剂量分布,并评估其预测精度。方法首先选取100例宫颈癌腔内结合组织间插植病例作为整个研究数据集,并将其划分为训练集(72例)、验证集(8例)、测试集(20例);然后利用U-Net建立模型,将是否包含宫腔管及插针作为区分因素训练两个模型;最后对20例测试集病例进行预测,并进行对比分析。模型的性能通过、以及平均绝对离差共同评估。结果包含与未包宫腔管与插植针的模型相比,直肠的上升了(16.83±1.82) cGy (P<0.05),其余ROI的或均相近(均P>0.05);高危靶区、直肠、乙状结肠、小肠、膀胱平均绝对离差分别上升了(11.96±3.78)、(11.43±0.54)、(24.08±1.65)、(17.04±7.17)、(9.52±4.35) cGy (均P<0.05);中危靶区的下降了(120.85±29.78) cGy (P<0.05);6个ROI的平均绝对离差的平均值下降了(7.8±53) cGy (P<0.05),更接近实际计划。结论利用全卷积网络U-Net可以实现宫颈癌患者BT的三维剂量分布预测;结合宫腔管与插植针作为输入参数,比单一使用ROI结构作为输入能得到更准确的预测结果。
简介:AbstractBackground:The complete mesogastrium excision (CME) based on D2 radical gastrectomy is believed to significantly reduce the local-regional recurrence compared with D2 radical gastrectomy in advanced gastric cancer, and it is widely used in China. This study aimed to explore whether D2 + CME is superior to D2 on surgical outcomes during gastrectomy from Chinese data.Methods:Feasible studies comparing the D2 + CME (D2 + CME group) and D2 (D2 group) published up to March 2020 are searched from electronic databases. The data showing surgical and complication outcomes are extracted to be pooled and analyzed.Results:Fourteen records including 1352 patients were included. The D2 + CME group had a shorter mean operative time (weighted mean difference [WMD] = -16.72 min, 95% confidence interval [CI]: -26.56 to - 6.87 min, P < 0.001), lower mean blood loss (WMD = -39.08 mL, 95% CI: -49.94 to -28.21 mL, P < 0.001), higher mean number of retrieved lymph nodes (WMD = 2.13, 95% CI: 0.58-3.67, P = 0.007), shorter time to first flatus (WMD =-0.31 d, 95% CI: -0.53 to - 0.10 d, P = 0.005), and postoperative hospital days (WMD =-1.09, 95% CI: -1.92 to -0.25, P = 0.010) than the D2 group. Subgroup analysis suggested that the advantages from the D2 + CME group were obvious in traditional open radical gastrectomy, proximal gastrectomy, and distal gastrectomy compared with D2 group. The evaluations of post-operative complications showed that the patients who underwent D2 + CME had a lower incidence of post-operative complications than the patients who underwent D2 surgery alone (relative risk [RR] = 0.65, 95% CI: 0.45-0.87, P = 0.003). The D2 radical gastrectomy plus CME improved 3-year overall survival (OS) (RR = 1.16, 95% CI: 1.02-1.32, P = 0.020) and lowered the local recurrence rate (RR = 0.51, 95% CI: 0.28-0.94, P = 0.030). The patients undergoing laparoscopic surgery or total gastrectomy had more significant advantages compared between D2 + CME and D2 groups in 3-year OS.Conclusion:The data from China show that D2 radical gastrectomy plus CME are reliable procedures and safety compared to D2 radical gastrectomy with faster recovery, lower risk, and better prognosis.
简介:摘要2例散发性偏瘫性偏头痛患儿,例1,男,5岁10月龄,因“反复惊厥发作5年余,行为异常20 d”入院。例2,男,4岁6月龄,因“反复惊厥发作3年余,发热伴右侧肢体活动受限1 d”入院。2例患儿均无相关家族史,早期表现为热性惊厥,随年龄增长,在发热等诱因下出现先兆头痛伴急性脑病发作。基因检测均为ATP1A2基因错义变异,分别为c.2143G>A(p.Gly715Arg)、c.2563G>A(p.Gly855Arg)。
简介:摘要患者男性,40岁,胰腺内副脾。另1例患者男性,55岁,肝内及膈肌表面、肝肾间隙异位脾种植。2例患者均无特殊临床症状。术前影像学检查分别怀疑胰腺神经内分泌肿瘤及原发性肝癌。胰腺内副脾患者接受了腹腔镜胰体尾切除+脾切除术;异位脾种植患者先行腹腔镜探查,切取部分腹腔结节术中冰冻病理证实为脾后结束手术,避免了不必要的肝切除。