Impulsivity is a heterogeneous trait linked to psychiatric vulnerability, but its clinical stratification, neurocognitive mechanisms, and developmental trajectories remain poorly understood. Using baseline and 2-year follow-up data from the Adolescent Brain Cognitive Development (ABCD) Study (N=9,078), we identified three distinct impulsivity profiles through latent profile analysis and latent transition analysis: low impulsivity (baseline: 56.1%; follow-up: 48.9%), motivational impulsivity (high urgency and sensation seeking; baseline: 33.5%; follow-up: 43.6%), and executive impulsivity (low perseverance and premeditation; baseline: 10.4%; follow-up: 7.4%). Cross-sectionally, the executive profile was associated with elevated risks for most psychiatric diagnoses and psychopathology symptoms, poorer performance on all cognitive tests, and distinct structural and functional alterations in certain brain regions at baseline. Longitudinally, this profile showed greater worsening in most psychopathology measures and some cognitive tests over two years, though not in brain metrics. In contrast, the motivational profile exhibited significant but milder effects both cross-sectionally and longitudinally. Additionally, transitions between profiles were associated with changes in some psychopathology and cognitive measures, but not in brain metrics. These findings underscore the clinical and neurobiological specificity of impulsivity profiles, advancing precision psychiatry by mapping impulsivity heterogeneity onto differential risk pathways and neurocognitive mechanisms.

To evaluate the macular anatomical reduction and visual outcome of vitrectomy with internal limiting membrane (ILM) peeling and flap insertion to that with flap inverted in the treatment of myopic macular hole in high myopia. This is a retrospective study. Main outcome measures were best-corrected visual acuity(BCVA) and morphology of macular hole. Collect baseline and postoperative data at 1, 3, and 6 months follow-up. The data collected in the study were obtained from 46 patients (46 eyes), among whom 25 patients had previously undergone vitrectomy combined with ILM insertion, while 21 patients had previously undergone vitrectomy combined with inverted ILM flap. The baseline BCVA of the ILM insertion and inverted ILM flap groups were 1.43 ± 0.68 logMAR and 1.60 ± 0.72 logMAR, which increased to 1.11 ± 0.30 logMAR and 0.98 ± 0.32 logMAR at 6 months post-surgery (p = 0.721). The incidence of anatomical closure of macular hole in the ILM insertion and inverted ILM flap groups were 88.46

This study aimed to investigate whether brain anatomical structures and functional network connectivity are altered after chronic complete thoracic spinal cord injury (cctSCI) and to determine how these changes impact clinical outcomes. Structural and resting-state functional MRI was performed for 19 cctSCI patients (18 for final statistics) and 19 healthy controls. Voxel-based morphometry (VBM) was used to assess gray matter volume (GMV) with differences between cctSCI patients and controls. VBM results were used as seeds for whole-brain functional connectivity (FC) analysis. The relationship between brain changes and clinical variables was investigated. Compared with those of the control group, the left triangular inferior frontal gyrus, middle frontal gyrus, orbital inferior frontal gyrus, precuneus and parietal superior gyrus volumes of SCI patients decreased, while the left superior frontal gyrus and supplementary motor area volumes increased. Additionally, when the regions with increased GMV were used as seeds, the FC of the parahippocampus and thalamus increased. Subsequent partial correlation analysis showed a positive correlation between FC and total sensorimotor score based on the ASIA criteria (p = 0.001, r = 0.746). Overall, the structural and functional changes in the brain after cctSCI occurred in some visual and cognitive areas and sensory or motor control areas. These findings aid in improving our understanding of the underlying brain injury mechanisms and the subsequent structural and functional reorganization to reveal potential therapeutic targets and track treatment outcomes.

This study investigates the interlayer bonding mechanism between epoxy primers and polyurethane topcoats commonly used in marine coatings. Previous studies have focused on the physical bonding between the coatings, but this study focused on the theory of chemical bonding. Using E-44 and HP2000 as primers and MDI toluene solution to simulate a polyurethane topcoat, the changes in the molecular structure at the interface between the epoxy primer and the polyurethane topcoat after curing were revealed by sum-frequency vibrational spectroscopy (SFG) technique. The experiments showed that the hydroxyl (-OH) signals on the surface of the epoxy primer disappeared after contacting with the MDI solution, and the isocyanate (-NCO) and carbonyl (C=O) signals on the urethane topcoat were revealed, suggesting that a chemical reaction occurred between them. The results of SFG analysis were further supported by X-ray photoelectron spectroscopy, Raman spectroscopy, infrared spectroscopy and scanning electron microscopy. It was found that chemical bonding had a positive effect on the macroscopic properties of the coatings, indicating that the interlayer bonding between the primer and the topcoat could be significantly enhanced by chemical bonding, which provides new theoretical support for the interlayer bonding of the coating support system for marine environment.

目的 改善支气管镜周转慢、维修周期长的现状,在不增加支气管镜设备数量的前提下,解决临床支气管镜短缺的问题.方法 以全院共用的支气管镜为研究对象,建立支气管镜租赁中心,在原消毒供应追溯系统中增加租赁计费及设备故障维修保养模块,以此优化信息化管理平台,改善支气管镜周转问题.对支气管镜使用周转率、平均使用时长、延迟归还率以及维修时间等指标进行统计分析.结果 实行租赁模式后,使用科室由原来5大科室10个护理单元,增加至8大科室13个护理单元;电子支气管镜的使用次数增加,纤维支气管镜次数下降,总体支气管镜使用周转率由33.42％提升至40.00％.平均单次使用时长由最长279 min缩短至最短127 min,延迟归还率由45.53％降至11.33％,单次维修维修时长从41.6 d缩短至12.5 d.结论 支气管镜的集中租赁管理模式有助于缩短单次平均使用时长,降低延迟归还率,增加使用次数,提升设备周转率,保障临床设备供应,为提高诊疗质量提供保障.

目的 运用Minitab对磁共振成像(Magnetic Resonance Imaging,MRI)设备性能的长期稳定性进行分析.方法 利用Minitab 17.0软件分析3台MRI设备(MRI-1、MRI-2和MRI-3)性能的长期稳定性,分析项目包括影像均匀性、信噪比、层厚和纵横比;使用时间轴序列法对性能指标中的空间分辨力进行研究.结果 性能检测多数项目的长期质量控制过程为Ⅰ级,过程性能指数Pp＞1.67;MRI-1和MRI-2设备所有检测项目过程性能均为Ⅱ级及以上;MRI-3设备的影像均匀性处于Ⅳ级,应查找原因并增加检测频次.结论 通过使用Minitab对磁共振成像设备进行过程能力分析,可以客观地判断MRI设备生命周期内的性能稳定性,有助于了解设备运行状态,确定质量控制检测频率;通过过程性能分析结果可以判断设备保养情况和关键部件更换周期,保障设备性能处于良好状态,为诊疗服务提供可靠的保障.

目的 利用可靠性验证的基本方法对一体化正电子发射型磁共振成像(Positron Emission Tomography/Magnetic Resonance Imaging,PET/MR)设备临床使用过程中的可靠性水平进行分析.方法 提取2台PET/MR设备(PET/MR-1和PET/MR-2)某一段时间的维修保养、工作日志等数据,对设备的可靠性参数、维修性参数、保障性参数、可用度和核心部件状态进行分析,比较2台设备的可靠性水平.结果 总故障时间PET/MR-2较PET/MR-1短253.0 h,减少27.4%;平均故障间隔时间PET/MR-2较PET/MR-1长206.2 h(P<0.05);两台设备可靠性参数比较,差异不具有统计学意义(P>0.05),核心部件的状态参数基本保持稳定运行,但PET/MR-1由于辅助系统故障,造成核心部件发生2次较大故障.结论 基于可靠性验证的基本方法,对PET/MR设备临床使用过程中的可靠性水平进行分析,可以为医疗机构提供设备长期稳定性的客观评价,并对维护保养工作的重点指明方向.

目的 以人机交互研究取向的可用性概念作为依据,对数字X线摄影术(Digital Radiography,DR)设备的人机交互可用性进行研究.方法 采用专家调研法确定可用性评价的项目指标,采用德尔菲法建立可用性评价模型.对5款国产DR设备分别进行评分,对比不同型号间的可用性评价结果.结果 5款DR设备的可用性评分总分均值和各接口的评分均值在3个组别间均有显著性差异(P<0.05),其中少于3个月组的评分明显低于其他组评分,其他两组间无显著区别(P>0.05).此外,不同型号的DR设备的可用性评价结果,在总分均值和1年以上组别中有显著不同.结论 可用性评价可以全面的评价DR设备各人机接口的安全性和有效性,有助于DR设备的研发改进,促进国产设备完善升级.

目的 评价正电子发射断层显像/X 线计算机体层成像仪(Positron Emission Tomography/Computed Tomography,PET/CT)设备在投入临床使用中的可靠性,分析影响质控通过率的关键参数,探索设备在使用中可靠性评价的具体实践方法.方法 回顾分析PET/CT设备维修维护记录,统计PET/CT设备的可用度、维修、维护相关参数.分析PET探测器矩阵晶体位置校准(LUT漂移系数)、能量漂移、飞行时间技术的数据校准(TOF漂移通过率),并进行Pearson相关分析.结果 固有可用度Ainh和可达可用度Aa在98%以上,两者变化趋势一致,Aa略低;平均故障间隔时间峰值出现在第4年,高于启用前3年平均水平;LUT漂移系数质控通过率100%,与系统湿度呈显著性负相关(r=-0.133,P=0.025);能量漂移系数质控通过率78.32%,其与外环温度存在显著性相关(r=0.162,P=0.006),需关注机房温湿度.结论 PET/CT设备在启用的第4年由初期阶段转入正常期阶段.PET探测器的能量漂移系数易超出范围,其与环境因素相关.研究总结出临床使用中PET/CT可靠性评价的实践方法,为提高设备可靠性提供了参考信息,为设备之间可靠性对比提供了参考方案.

目的 基于低频振荡振幅(ALFF)分析方法,探讨抑郁症、伴混合特征的抑郁症(MMF)、伴混合特征的双相障碍(BMF)和双相障碍患者之间局部自发脑活动的差异.方法 收集2021年6-12月就诊于首都医科大学附属北京安定医院门诊符合DSM-5诊断标准的20例抑郁症、15例MMF、20例BMF、25例双相障碍患者,以及40名性别和年龄与各组患者匹配的健康对照者的静息态功能磁共振数据和一般资料.影像数据预处理后,计算个体ALFF图,采用单因素方差分析和事后检验比较5组受试者局部自发脑活动的差异.结果 单因素方差分析结果显示,5组受试者的左侧颞下回(k=372,P＜0.001)、左侧中缝核(k=271,P＜0.001)、右侧前扣带和旁扣带回(k=193,P＜0.001)、右侧颞中回(k=149,P＜0.001)、右内侧额上回(k=117,P＜0.001)、右侧小脑crus 2区(k=68,P=0.009)、右侧颞下回(k=63,P=0.014)和左侧颞中回(k=49,P=0.048)的ALFF值比较,差异有统计学意义(P均簇水平FWE校正).事后检验结果显示,双相障碍和BMF组患者左侧颞下回的ALFF值高于抑郁症组患者,MMF、双相障碍和BMF组患者右侧小脑的ALFF值低于抑郁症组患者,差异均有统计学意义(均P＜0.01).BMF患者左侧中缝核ALFF值低于MMF和抑郁症组患者,差异有统计学意义(P＜0.05).结论 情感障碍谱系患者额叶、颞叶、小脑、中缝核等多个脑区局部自发脑活动异常,但BMF患者相对于MMF患者,中缝核局部自发脑活动较弱.

目的 探讨正电子发射型磁共振成像(Positron Emission Tomography/Magnetic Resonance Imaging,PET/MR)设备的人机接口协同性,探讨该类设备在临床中的可用性评价方法.方法 采用层次分析法构建可用性评价体系,设立专家组并计算专家权威系数,以德尔菲法设计可用性调查问卷,以操作设备的技师和医生为调查对象,收集全国范围内联影PET/MR设备的问卷打分表.结果 共收集79份调查问卷,涉及医院18家.其中生理信号门控单元接口可用性评价评分最低,PET无源质控可用性评价评分最高;副高级、高级职称人员对指标评分略高于中级及以下人员;人员的不同操作时长对各项接口的评分具有相同趋势,使用时长在3个月内的操作者评分明显低于另外两组,差异均有统计学意义(P<0.05);不同操作时长人员对6个特定评价参数评分差异均有统计学意义(P<0.05).结论 基于层次分析法建立的可用性评价体系能够用于PET/MR设备临床可用性评价,基于德尔菲法形成的可用性调查问卷为探讨PET/MR设备可用性评价方法提供参考.

目的 探讨医学模拟教学与以问题为基础的教学方式(problem-based learning,PBL)等多种教学方法在白内障超声乳化手术(phacoemulsification,Phaco)培训中的应用效果.方法 选取自2015年3月 ～2019年11月在首都医科大学宣武医院参加白内障Phaco培训的眼科医生共12人,随机分为A、B两组.A组学员7人,规范完成包括Phaco观摩、眼科显微手术模拟器训练教学、动物实验操作、临床手术操作及PBL教学等所有培训内容,临床手术操作患者1081例(1081眼);B组学员5人,规范完成包括Phaco观摩、动物实验操作、临床手术操作及传统授课教学方法培训内容,手术操作患者793例(793眼);观察比较两组学员临床手术操作完成情况和手术并发症发生比例.结果 A、B两组学员平均每位完成手术操作例数分别为154.43±5.47和158.60±3.78,差异无统计学意义(P=0.26);A、B两组完成5mm中央连续环形撕囊比例分别为23.03％和9.46％,A组比例大于B组(P=0.00);A、B两组后囊破裂眼数比例分别为4.81％和7.18％,A组比例小于B组(P=0.03);A、B两组术眼中、重度角膜水肿例数比例分别为8.51％和7.44％,差异无统计学意义(P=0.40);A、B两组术眼严重并发症比例分别为0.56％和0.50％,差异无统计学意义(P=0.88).结论 在白内障Phaco手术培训中应用PBL与医学模拟教学等综合教学方法,可以有效减少初学者的手术并发症,提高Phaco培训的教学效果.

Although cognitive behavioral therapy (CBT) is effective for patients with obsessive-compulsive disorder (OCD), 40% of OCD patients show a poor response to CBT. This study aimed to identify the cortical structural factors that predict CBT outcomes in OCD patients. A total of 56 patients with OCD received baseline structural MRI (sMRI) scanning and 14 individual CBT sessions. The linear support vector regression (SVR) models were used to identify the predictive performance of sMRI indices, including gray matter volume, cortical thickness, sulcal depth, and gyrification value. The patients’ OC symptoms decreased significantly after CBT intervention (p < 0.001). We found the model with the comprehensive variables exhibited better performance than the models with single structural indices (MAE = 0.14, MSE = 0.03, R2 = 0.36), showing a significant correlation between the true value and the predicted value (r = 0.63, p < 0.001). The results indicated that a model integrating four cortical structural features can accurately predict the effectiveness of CBT for OCD. Future models incorporating other brain indicators, including brain functional indicators, EEG indicators, neurotransmitters, etc., which might be more accurate for predicting the effectiveness of CBT for OCD, are needed.

目的:分析监护仪中央监护站采集的报警数据,为制订针对性措施以减少无效报警并降低报警疲劳提供依据.方法:对某院ICU在2020年7月2日至2020年8月9日期间监护仪产生的5550条生理参数报警信息进行分析,并通过报警数据信息中的病历号、报警时间等信息回溯护理记录,进一步分析报警来源的有效性.结果:护士平均每小时需要处理8.43条监护仪报警.按报警级别分类,黄色一星报警4548条,占81.9％;红色报警980条,占17.7％;黄色二星报警22条,占0.4％.按报警参数分类,心电报警4851条,占87.4％,其他报警来源包括有创压力断开、窒息报警、血氧饱和度低于限值等.报警高发时段前3位分别为10:00、16:00、14:00.大部分报警属于无效报警,未回溯到相应处理记录.结论:通过监护仪报警数据分析可以帮助管理者掌握监护仪的报警现状,制订针对性的干预措施.

目的 对新型冠状病毒肺炎疫情期间应急使用的CT方舱辐射安全风险进行评估,保证CT方舱安全运行,为放射工作人员、患者和公众的辐射安全提供保障.方法 依据GBZ 130-2020等国家标准,在CT方舱安装完成后使用ATOMTEX AT1 123型辐射剂量监测仪对集成式方舱与组装型方舱的散漏放射线进行放射性防护检测,检测部位包括工作人员操作位、电缆沟、铅玻璃观察窗、工作人员防护门、受检者防护门和四周墙体,对超标部位使用铅板增强屏蔽能力.根据检测结果分析疫情期间CT方舱辐射防护的可行性管理办法,从而建立、健全医院的放射防护和安全管理制度.结果 经检测,组装型方舱的屏蔽体外辐射剂量水平满足国家标准要求(当量率不大于2.5 μSv/h),集成式方舱在整改后亦能满足国家标准要求,但是集成式方舱受检者防护门外最大辐射剂量当量是组装型方舱的10.2倍,在防护门的下缝位置;集成式方舱四周墙体外最大辐射剂量当量是组装型方舱的4.6倍,主要位于墙体的搭接处.结论 CT方舱机房防护能够满足国家标准要求,但由于方舱结构的特殊性,需加强辐射防护监测和安全管理,保证辐射防护最优化和限制个人当量剂量,有效提升应急放射设备的辐射防护和安全管理水平.

BackgroundThe neuroimaging mechanism of major depressive episodes with mixed features (MMF) is not clear.AimsThis study aimed to investigate the functional connectivity of the default mode network (DMN) subsystems among patients with MMF and patients with major depressive disorder without mixed features (MDDnoMF).MethodsThis study recruited 47 patients with MDDnoMFand 27 patients with MMF from Beijing Anding Hospital, Capital Medical University, between April 2021 and June 2022. Forty-five healthy controls (HCs) were recruited. All subjects underwent resting-state functional magnetic resonance imaging scanning and clinical assessments. Intranetwork and internetwork functional connectivity were computed in the DMN core subsystem, dorsal medial prefrontal cortex (dMPFC) subsystem and medial temporal lobe (MTL) subsystem. Analysis of covariance method was performed to compare the intranetwork and internetwork functional connectivity in the DMN subsystems among the MDDnoMF, MMF and HC groups.ResultsThe functional connectivity within the DMN core (F=6.32, pFDR=0.008) and MTL subsystems (F=4.45, pFDR=0.021) showed significant differences among the MDDnoMF, MMF and HC groups. Compared with the HC group, the patients with MDDnoMFand MMF had increased functional connectivity within the DMN MTL subsystem, and the patients with MMF also showed increased functional connectivity within the DMN core subsystem. Meanwhile, compared with the MDDnoMF, the patients with MMF had increased functional connectivity within the DMN core subsystem (mean difference (MDDnoMF−MMF)=−0.08, SE=0.04, p=0.048). However, no significant differences were found within the DMN dMPFC subsystem and all the internetwork functional connectivity.ConclusionsOur results indicated abnormal functional connectivity patterns of DMN subsystems in patients with MMF, findings potentially beneficial to deepen our understanding of MMF’s neural basis.

The prediction of antidepressant response is critical for psychiatrists to select the initial antidepressant drug for patients with major depressive disorders (MDD). The implicated brain networks supporting emotion regulation (ER) are critical in the pathophysiology of MDD and the prediction of antidepressant response. Therefore, the primary aim of the current study was to identify the neuroimaging biomarkers for the prediction of remission in patients with MDD based on the resting-state functional connectivity (rsFC) of the ER networks. A total of 81 unmedicated adult MDD patients were investigated and they underwent resting-state functional magnetic resonance imagining (fMRI) scans. The patients were treated with escitalopram for 12 weeks. The 17-item Hamilton depression rating scale was used for assessing remission. The 36 seed regions from predefined ER networks were selected and the rsFC matrix was caculated for each participant. The support vector machine algorithm was employed to construct prediction model, which separated the patients with remission from those with non-remission. And leave-one-out cross-validation and the area under the curve (AUC) of the receiver operating characteristic were used for evaluating the performance of the model. The accuracy of the prediction model was 82.08% (sensitivity = 71.43%, specificity = 89.74%, AUC = 0.86). The rsFC between the left medial superior frontal gyrus and the right inferior frontal gyrus as well as the precuneus were the features with the highest discrimination ability in predicting remission from escitalopram among the MDD patients. Results from our study demonstrated that rsFC of the ER brain networks are potential predictors for the response of antidepressant drugs. The trial name: appropriate technology study of MDD diagnosis and treatment based on objective indicators and measurement. URL: http://www.chictr.org.cn/showproj.aspx?proj=21377 . Registration number: ChiCTR-OOC-17012566.

目的:运用过程能力分析方法对CT设备长期稳定性进行分析.方法:依据国家标准《X射线计算机断层摄影装置质量保证检测规范》(GB17589-2011),利用Minitab 17.0软件对3台CT设备(CT-1、CT-2和CT-3)的长期稳定性进行过程能力分析,检测项目包括水的CT值、均匀性、噪声、CT值线性、低对比度分辨力、CT剂量指数(CTDIw)和重建层厚偏差.采用时间序列图对空间分辨力进行分析.结果:所有检测项目的测量值均符合GB17589-2011标准限值要求;大部分检测项目的长期质量控制过程处于Ⅱ级及以上水平,且过程性能指数(Pp)≥1.33;重建层厚偏差(s≤2 mm)的过程能力处于Ⅲ级及以下水平(Pp<1.33);CT-3的长期稳定性优于CT-2.结论:通过过程能力分析,可以客观地判断CT性能的长期稳定性情况.对于每台CT设备,通过定期执行稳定性检测,并利用过程能力分析检测结果的变化情况,可以判断其维护保养是否到位,更好的保障设备性能和诊疗质量.

A method combining a heating treatment with the addition of lignin nanocellulose (LNC) was designed to improve the corrosion resistance of a polyvinyl alcohol coating. The heating treatment induced an elimination reaction occurred between the hydroxyl groups, which significantly reduced the water transport channels formed by the intermolecular forces of the hydroxyl groups. Moreover, the lignin nanocellulose worked effectively as a barrier against the penetration of corrosive media. Due to the synergistic effects of the heating treatment and the addition of lignin nanocellulose, the corrosion resistance of the composite coating was greatly improved.

目的:分析距离、角度和测量部位等因素对红外测温仪测量结果的影响,提高防疫期间体温监测的准确性.方法:选取北京地区24名健康志愿者作为体温测量的受试者,采用两种常用国产品牌(A型和B型)红外测温仪,分别采集受试者不同测量距离(1～3 cm、3～5 cm和5～7 cm)、不同测量角度(额头正前垂直、向下倾斜45°)和不同测量部位(额头、内关)的体温测量数据,连续测量7 d,排除缺项后共纳入60组体温测量值数据.同时采用水银体温计测量受试者腋温行自身对照,分析比较不同角度、距离和部位的测量数据.结果:不同测温角度中红外测温仪于有效距离内"垂直"和"斜下"方向的额温,A型红外测温仪3～5 cm和B型红外测温仪1～3 cm垂直和斜下测量差异有统计学意义(Z=-2.62,Z=-4.37;P<0.05).A型红外测温仪和B型红外测温仪垂直测额温距离皮肤1～3 cm、3～5 cm和5～7 cm测温结果比较,差异均有统计学意义(F=24.06,F=26.97;P<0.05).A型红外测温仪距皮肤1～3 cm和3～5 cm测量内关温与额温比较,差异均有统计学意义(t=-4.99,t=-5.006;P<0.01);B型红外测温仪距皮肤1～3 cm测量内关温与额温比较,差异有统计学意义(t=-5.13,P<0.01).结论:测温角度的改变会对测量产生影响,尤其在测量距离增加情况下.当超过有效测量距离时随着距离增加,测量数据准确性将会下降.相较于额温,正常体温人群的内关温更接近于腋温.