经腹、经阴道与经会阴三种超声途径测量宫颈长度对早产的预测价值

目的:比较经腹、经阴道与经会阴三种超声途径测量宫颈长度对早产的预测价值。方法:选取我院就诊的孕妇780例,根据测量途径不同分为三组,每组260例,分别采用经腹、经阴道与经会阴方法测量宫颈长度。观察并比较三组患者的妊娠结局,以及三种测量方法的敏感度及特异性。结果:三组患者接受率相比,经腹组、经会阴组患者接受率明显高于经阴道组(P0.05);三组患者宫颈显示率相比,经会阴组、经阴道组宫颈显示率显著高于经腹组(P0.05)。经腹组中,宫颈长度2.5 cm的患者早产率为48.46%,明显高于宫颈长度≥2.5 cm的患者早产率17.69%(P0.05);经会阴组中,宫颈长度2.5 cm的患者早产率为37.69%,明显高于宫颈长度≥2.5 cm的患者早产率13.08%(P0.05);经阴道组中,宫颈长度2.5 cm的患者早产率为36.92%,明显高于宫颈长度≥2.5 cm的患者早产率13.46%(P0.05)。结论:三种超声途径测量宫颈长度对预测早产均有很大的临床价值,其中经会阴途径优势更大,值得进一步推广临床使用。     

16层螺旋CT三维重建与DR平片检查对外伤性肋骨骨折的诊断价值比较研究

目的:研究16层螺旋电子计算机断层扫描(CT)三维重建与数字化摄影(DR)平片检查对外伤性肋骨骨折的诊断价值,为临床诊治提供参考。方法:将2017年6月至2018年6月期间于本院接受诊治的82例外伤性肋骨骨折患者作为研究对象,所有患者均接受16层螺旋CT三维重建与DR平片检查,观察并记录患者的骨折发生部位,并比较两种诊断方法对外伤性肋骨骨折诊断的准确率、灵敏度、特异性、阳性预测值、阴性预测值以及漏诊情况。结果:82例外伤性肋骨骨折患者经影像学与临床诊断明确发生骨折179处,多发性骨折发生率为62.20%,单发性骨折发生率为37.80%,骨折肋骨段位中4-10段骨折发生率最高为69.83%,骨折肋骨水平阶段中腋肋骨折发生率最高为59.78%。相较于DR平片,16层螺旋CT三维重建诊断外伤性肋骨骨折的准确率、灵敏度、特异性、阳性预测值、阴性预测值更高,漏诊率更低,差异有统计学意义(P0.05)。结论:相较于DR平片检查,应用16层螺旋CT三维重建检查外伤性肋骨骨折能明显提高临床诊断的准确率、灵敏度和特异性,减少漏诊,可为临床诊治提供更可靠的信息,值得临床推广。     

CD138免疫磁珠细胞分选的FISH技术在多发性骨髓瘤诊断中的应用

为了分析CD138免疫磁珠细胞分选的染色体荧光原位杂交(FISH)技术在提高多发性骨髓瘤(MM)细胞遗传学异常检测敏感性的作用。本研究选取我院收治的30例确诊MM的患者为研究对象,分离骨髓单个核细胞,应用探针组合,同时采用2种方法进行细胞遗传学检测:实验组采用CD138免疫磁珠分选浆细胞后行荧光原位杂交技术(MACS-FISH)检测;对照组直接荧光原位杂交技术(D-FISH)检测。结果:30例MM患者,实验组采用CD138 MACS-FISH检出率为83.3%,对照组D-FISH法细胞遗传异常检出率为46.7%,两组差异具有统计学意义(p<0.05)。研究结果表明:分析不同类型的细胞遗传异常,MACS-FISH法1q21检出率为46.7%,RB1检出率为50.0%,Ig H检出率为70.0%,P53检出率为20.0%;D-FISH法检出率分别为23.3%,30.0%、36.7%、10.0%。通过细胞核型分析,30例MM患者中,发现5例患者为异常核型,仅为16.7%,其中1例患者为单一结构异常,复杂异常核型患者为4例。我们的研究结论表明:进行CD138免疫磁珠分选浆细胞的FISH技术在多发性骨髓瘤诊断应用中可显著提高细胞遗传学异常检测敏感性,具有临床推广应用的价值。     

Inverse Optical Cavity Design for Ultrabroadband Light Absorption Beyond the Conventional Limit in Low‐Bandgap Nonfullerene Acceptor–Based Solar Cells

In the subwavelength regime, several nanophotonic configurations have been proposed to overcome the conventional light trapping or light absorption enhancement limit in solar cells also known as the Yablonovitch limit. It has been recently suggested that establishing such limit should rely on computational inverse electromagnetic design instead of the traditional approach combining intuition and a priori known physical effect. In the present work, by applying an inverse full wave vector electromagnetic computational approach, a 1D nanostructured optical cavity with a new resonance configuration is designed that provides an ultrabroadband (≈450 nm) light absorption enhancement when applied to a 107 nm thick active layer organic solar cell based on a low‐bandgap (1.32 eV) nonfullerene acceptor. It is demonstrated computationally and experimentally that the absorption enhancement provided by such a cavity surpasses the conventional limit resulting from an ergodic optical geometry by a 7% average over a 450 nm band and by more than 20% in the NIR. In such a cavity configuration the solar cells exhibit a maximum power conversion efficiency above 14%, corresponding to the highest ever measured for devices based on the specific nonfullerene acceptor used.     

Assessment of cartilage invasion in case of laryngeal cancer by means of longitudinal sectioning for histopathology – Clinical implications

AimThe aim of the study was to assess the accuracy of radiological diagnosis of laryngeal cartilage infiltration by histopathological examination of laryngeal specimen after total laryngectomy.BackgroundDespite the development of new medical technologies and significant clinical advances allowing early diagnosis and treatment of laryngeal cancer, mortality is still on the rise. Neoplastic infiltration of the laryngeal cartilages is the most common source of error in the assessment of cancer staging. Furthermore, cartilage invasion is listed as a contraindication to partial surgical techniques as well as radiotherapy.Materials and methodsThe study was carried out on 21 larynges following total laryngectomy. Before taking the decision to perform surgery, high-resolution CT scans were performed in all cases. An extended histopathological examination was conducted using a unique vertical cross-section of the whole larynx.ResultsPathology reported 2 cases of arytenoid cartilage invasion, 5 cases of cricoid cartilage invasion, 12 cases of thyroid cartilage penetration, 1 case of internal cortex invasion and 9 cases of extra-laryngeal spread. CT imaging identified 8 of 13 cases (61.5%) of pathologically proven invasion of thyroid cartilage and only 2 cases (2/9, 22%) of extra-laryngeal spread. According to CT results, arytenoid cartilage invasion was correctly identified in 2 cases, cricoid cartilage invasion in 4 (4/5, 80%). The positive predictive values for thyroid, cricoid and arytenoid cartilage invasion and penetration were 80%, 66.7% and 50%, respectively. In case of pre-laryngeal spread the positive predictive value was 100%.ConclusionDespite increasingly advanced methods involved in the diagnosis of laryngeal cancer, many discrepancies may be observed between the radiological and histopathological assessments. CT imaging has limitations especially in thyroid cartilage penetration and extra-laryngeal spread assessment in advanced laryngeal cancer cases. An extended histopathological examination, involving vertical cross-sections of the whole larynx is a very precise study that allows a precise determination of local cancer staging (T).     

黄淮平原农业景观鸟类多样性及生境差异

农业景观中的鸟类多样性对生态系统功能和服务的形成与维持具有重要作用。黄淮平原区是我国最重要的农业景观区之一,为探讨区域内农业景观中鸟类多样性特征和不同生境间的差异,在研究区农业景观不同生境中布设样点,调查繁殖期鸟类多样性特征。结果显示:(1)共记录到32科、49属、66种的10044只个体,但优势科属明显;(2)物种丰富度、多样性和均匀度均表现出在沟渠、湖泊生境中较高,农田和村庄生境中相对较低,但物种多度呈现出村庄生境中最高,其次是沟渠和农田生境,湖泊生境中最低;(3)在区系分布上,各生境中均以广布种为主,生态类群上,鸣禽在各生境中均占绝对优势,涉禽和游禽主要分布在沟渠和湖泊生境中,从居留型来看,留鸟是各生境中的主导类群,候鸟、旅鸟和迷鸟比例很低;(4)鸟类群落异质性分析显示,各生境间的相似性总体上较高,表明区域内农业景观中鸟类组成具有较高的重叠性。研究显示农业景观中湖泊和沟渠的存在能有效的提高区域鸟类的丰富度和多样性,而沟渠的存在能有效的提高鸟类个体多度,农田和村庄有助于特定类群多度的增加,因此在未来的区域持续农业景观的构建中一方面要重视自然、半自然非农生境的作用,另一方面也不能忽视不同生物类群对景观异质性响应和对生境特征需求的差异。     

EDTA-induced Membrane Fluidization and Destabilization： Biophysical Studies on Artificial Lipid Membranes

The molecular mechanism of ethylenediaminetetraacetic acid （EDTA）-induced membrane destabilization has been studied using a combination of four biophysical techniques on artificial lipid membranes. Data from Langmuir film balance and epifluorescence microscopy revealed the fluidization and expansion effect of EDTA on phase behavior of monolayers of either 1,2-dipalmitoyl-sn-glycero-3-phosphocholine （DPPC） or mixtures of DPPC and metal-chelating lipids, such as N^a,N^a-Bis[carboxymethyl]-N^ε [（dioctadecylamino）succinyl]-L-lysine or 1,2-dioleoyl-sn-glycero-3-[N-（5-amino- 1 -carboxypentyl iminodiacetic acid） succinyl]. A plausible explanation could be drawn from the electrostatic interaction between negatively charged groups of EDTA and the positively charged choline head group of DPPC. Intercalation of EDTA into the lipid membrane induced membrane curvature as elucidated by atomic force microscopy. Growth in size and shape of the membrane protrusion was found to be time-dependent upon exposure to EDTA. Further loss of material from the lipid membrane surface was monitored in real time using a quartz crystal microbalance. This indicates membrane restabilization by exclusion of the protrusions from the surface. Loss of lipid components facilitates membrane instability, leading to membrane permeabilization and lysis.     

健康体检人群甲状腺结节多普勒超声检查结果及影响因素分析

目的:研究健康体检人群甲状腺结节多普勒超声检查结果及影响因素。方法:将从2018年1月~2019年12月,于医院接受体检的健康体检人员5270例纳入研究,对所有受试者均进行多普勒超声检查,分析超声检查结果和体检人群基线资料的关系,分析甲状腺结节多普勒超声特征。采用单因素以及多因素Logistic回归分析健康体检人群甲状腺结节的影响因素。结果:在5270例健康体检人群中,甲状腺结节检出率为51.86%(2733/5270),女性甲状腺结节检出率为52.83%(2355/4458),高于男性的46.55%(378/812),且随着年龄的不断增长,健康体检人群甲状腺结节检出率呈逐渐升高趋势(均P<0.05)。甲状腺结节患者的多普勒超声检查特征以低回声以及结节直径<2 cm为主(均P<0.05),但是结节数目以及病变部位比较无明显差异(均P>0.05)。经单因素分析发现:吸烟、甲状腺疾病家族史、高血压及糖尿病的健康体检人员甲状腺结节检出率高于不吸烟、无甲状腺疾病家族史、无高血压及无糖尿病的健康体检人员(均P<0.05),而不同民族、受教育年限、体质量指数(BMI)、是否饮酒的健康体检人员甲状腺结节检出率比较无统计学差异(均P>0.05)。经多因素Logistic回归分析发现:女性、年龄、吸烟、甲状腺疾病家族史、高血压及糖尿病均是健康体检人群甲状腺结节发生的独立危险因素(均OR>1,P<0.05)。结论:甲状腺结节多普勒超声检查特征以低回声以及结节直径≤2 cm为主,其影响因素包括年龄、性别、吸烟、甲状腺疾病家族史、高血压及糖尿病,值得临床重点关注。     

超声检查参数联合血清VEGF、Tg、Gal-1对甲状腺癌的诊断价值及其与淋巴结转移的关系

摘要 目的：探讨超声检查参数联合血清血管内皮生长因子（VEGF）、甲状腺球蛋白（Tg）、半乳糖血凝素-1（Gal-1）对于甲状腺癌的临床诊断价值及其与淋巴结转移的关系。方法：回顾性分析2017年6月至2020年6月入我院就诊的158例甲状腺肿瘤患者的临床资料。77例甲状腺癌患者纳入恶性组,81例甲状腺腺瘤患者纳入良性组,比较两组的超声检查参数及血清VEGF、Tg、Gal-1水平;此外,恶性组患者亚分组为淋巴结转移组（n=51）和无淋巴结转移组（n=26）,比较两组超声检查参数及血清VEGF、Tg、Gal-1水平。以受试者工作特征（ROC）曲线分析超声检查参数联合血清VEGF、Tg、Gal-1对甲状腺癌的诊断效能。采用Sprearman相关系数分析各指标水平变化与甲状腺癌患者发生淋巴结转移的相关性。结果：恶性组患者的血管化指数（VI）、血流指数（FI）及血清VEGF、Tg、Gal-1水平均高于良性组患者（P＜0.05）;淋巴转移组患者的VI、FI及血清VEGF、Tg、Gal-1水平均高于无淋巴结转移组患者（P＜0.05）;超声检查参数VI、FI联合血清VEGF、Tg、Gal-1诊断甲状腺癌的曲线下面积为0.933、敏感度为85.50%、特异度为80.00%,均明显高于五项指标单独检测。Spearman相关性分析结果显示,超声检查参数VI、FI以及血清VEGF、Tg、Gal-1与甲状腺癌患者淋巴结转移均呈正相关（P＜0.05）。结论：联合检测超声检查参数VI、FI及血清VEGF、Tg、Gal-1对甲状腺癌有较高的早期诊断价值,且上述指标均与患者淋巴结转移密切相关。     

北京通州平原生态林空间结构特征

林分空间结构直接反映林木间资源竞争情况和生长空间分配状况,对掌握生态林生长状况、制定林分结构调控措施,提升森林质量和生态服务具有重要作用。本文以北京市通州区油松林、白蜡林、旱柳林、毛白杨林、国槐林、刺槐林和垂柳林7种平原生态林为对象,采用聚集度、角尺度、大小比数、开敞度、树冠指数、竞争指数、边缘效益和空间结构综合指数评价了平原生态林的空间结构特征。结果表明: 研究区林分水平分布格局良好,聚集度处于0.32～1.41,角尺度都分布在0.4左右,大小比数主要分布在0.5附近。林分垂直分布格局有待改善,开敞度介于0.19～0.52,大部分树冠指数在0.7左右,竞争指数均大于50,整体居于高位状态。除刺槐林空间结构综合评价指数为Ⅲ级外,其他6种林分均为Ⅱ级,林分开阔程度较低,生活力一般,各林分空间结构综合评价指数从大到小为刺槐林>垂柳林>油松林>旱柳林>白蜡林>国槐林>毛白杨林。