目的 设计一种检测早期乳腺癌筛查肿瘤标志物microRNA-21(miRNA-21)的Cy5光学茎环DNA分子信标探针,构建引物堆叠的等温循环链置换荧光定量分析方法,实现对miRNA-21的高灵敏检测.方法 设计Cy5光学标记的茎环hairpinDNA(hDNA)探针,在靶标miRNA-21的配对引发下,激活等温循环链置换扩增反应,采用荧光定量分析方法,优化实验用量,对miRNA-21进行灵敏度、特异度检测,并与反转录荧光定量PCR(qRT-PCR)方法检测结果进行比较.结果 本研究设计的Cy5光学hDNA探针构建的等温循环链置换扩增反应,可对miRNA-21进行高灵敏度检测,其检测限可低至1 fmol/L;检测miRNA-21特异度良好,且不与其他miRNA反应产生荧光,能有效实现单碱基突变miRNA的区分;检测miRNA-21结果与金标准qRT-PCR检测结果的差异无统计学意义(P>0.05),证明本探针检测结果具有可信性.结论 本研究设计的Cy5光学探针检测miRNA-21的灵敏度和特异度高,可实现对早期乳腺癌患者的筛查及诊断.

目的 探讨PET/CT偶发颈动脉斑块的18F-氟代脱氧葡萄糖(18F-FDG)摄取对缺血性脑卒中早期复发的预测价值.方法 回顾性分析因非颈动脉粥样硬化性疾病行18F-FDG PET/CT检查、偶发颈动脉斑块,并行头颈CTA检查的97例缺血性脑卒中患者的临床及影像学资料,随访1年并记录其缺血性脑卒中复发事件.应用Cox比例风险回归模型对影响卒中复发的危险因素进行单因素及多因素分析;通过ROC曲线比较最大标准摄取值(SUVmax)与斑块狭窄率对卒中复发的预测价值以及不同狭窄程度下的SUVmax;采用Kaplan-Meier法和Log-rank检验进行复发时间分析.结果 随访期间共33例患者复发,经Cox比例风险回归模型单因素及多因素分析显示,SUVmax(HR =2.105,95％ CI:1.153 ～3.843)是缺血性脑卒中复发的独立危险因素.SUVmax与斑块狭窄率ROC曲线显示,SUVmax曲线下面积0.707(95％ CI,0.595 ～0.818)大于狭窄率曲线下面积0.625(95％ CI:0.514～0.737).比较颈动脉斑块不同SUVmax患者的卒中复发时间得出,SUVmax≥1.755时,平均复发时间更短,差异有统计学意义(P =0.000).颈动脉轻度狭窄患者的斑块SUVma)x较中度狭窄者低,差异有统计学意义(P =0.016).结论 PET/CT偶发颈动脉斑块的18F-FDG摄取对缺血性脑卒中早期复发事件具有较好的预测价值,可用于评估缺血性脑卒中的复发风险.

目的:探讨内脏脂肪蓄积与脑小血管疾病(CSVD)的相关性.方法:2019年1月至2020年6月在徐州医科大学附属医院完成检查的无脑血管病史的患者共93名纳入研究,并收集人口学资料及临床资料.采用腹部CT测量内脏脂肪面积(VFA)及皮下脂肪面积(SFA),采用MRI检查明确是否存在CSVD.根据是否存在CSVD进行分组,比较两组间相关指标差异.多因素二元logistic回归法分析CSVD的危险因素.结果:CSVD组患者的体重指数、总胆固醇和内脏脂肪面积较非CSVD组高(P＜0.05).多因素二元logistic回归分析显示VFA(OR=1.008,P=0.030)是CSVD的独立危险因素.结论:VFA是CSVD的独立危险因素.VFA增加与CSVD风险增加相关,其对CSVD的临床诊治提供依据.

目的 探讨SRT1720抑制巨噬细胞泡沫化与给药时间的关系.方法 将巨噬细胞RAW264.7种植于3个24孔细胞培养板,每个培养板分3组培养细胞,control组只加培养基,ox-LDL组加60μg/ml ox-LDL,ox-LDL+SRT1720组先加60μg/ml ox-LDL,分别培养不同时间(0、12、24 h)后再加入10μmol/L SRT1720干预,采用油红O染色和胆固醇测定,比较巨噬细胞泡沫化抑制情况.结果 与Control组比较,oxLDL组0、12、24 h胆固醇含量均升高,差异有统计学意义(P<0.05);与ox-LDL组比较,ox-LDL+SRT1720组油红O染色中0、12 h油红染色比均减少,差异有统计学意义(P<0.05),24 h油红染色比略减少,但差异无统计学意义(P>0.05);ox-LDL+SRT1720组0 h胆固醇含量减少,差异有统计学意义(P<0.05),12、24 h胆固醇含量略有减少,但差异无统计学意义(P>0.05).结论 在动脉粥样硬化早期给药,SRT1720抑制效果更佳.

目的 探讨MRI图像纹理分析预测胶质瘤患者Ki-67表达状态的应用价值.方法 搜集经手术病理证实的116例胶质瘤患者,对其T1WI增强图像进行纹理分析,获取整个瘤体的平均值、中位数、标准差、偏度、峰度、能量和熵值等定量参数,并进行统计学分析.结果 对MRI图像纹理分析后所获得的定量参数中,平均值、中位数、标准差3个参数在Ki-67(-)组与Ki-67(+)组间的差异无统计学意义,偏度、峰度、能量和熵值4个参数在Ki-67(-)组与Ki-67(+)组间的差异有统计学意义(P＜0.001);熵值参数鉴别效能明显优于其他参数值,有较高的敏感度、特异度及准确率;对偏度、峰度、能量和熵值4个纹理分析定量参数进行多参数联合分析,AUC值为0.804,当阈值为0.372时,其诊断敏感度95.0％、特异度为76.8％、准确率为85.6％,较利用单个纹理分析定量参数鉴别的效能高.结论 纹理分析定量参数中偏度、峰度、能量和熵值有助于预测胶质瘤患者Ki-67是否表达.

目的 使用钆塞酸二钠(Gd-EOB-DTPA)增强前、后的T1值,联合患者的临床实验室检查及常规MR图像的定性及定量指标,以期找到有效的术前预测肝癌病理分级的方法.方法 回顾性分析2015年7月至2017年9月术前于本院行Gd-EOB-DTPA增强磁共振检查的肝脏局灶性病变患者437例,最终67例肝细胞癌(HCC)患者被纳入本研究.同时记录患者的临床资料,包括年龄,性别,肝脏病史,肝炎病史以及甲胎蛋白(AFP)、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)及肝功能指标.连续性变量采用独立t检验;分类变量采用卡方或Fisher检验进行统计.结果 低级别组HCC的Gd-EOB-DTPA增强前T1值(1080.6±240.1) ms,增强后肝胆特异期T1值为(571.1±190.1) ms,T1值衰减率(△)为0.48 ±0.11;高级别组HCC的Gd-EOB-DTPA增强前T1值为(1121.8 ±317.1)ms,增强后肝胆特异期T1值为(639.4±135.2) ms,△为0.41 ±0.11,两者之间存在统计学差异(P =0.0175).低级别与高级别HCC患者的年龄、性别、AFP水平、肝脏病史(肝硬化、乙型肝炎)、术前肝功能检查均不存在统计学差异.低级别与高级别HCC组之间存在统计学差异的MR定性征象为肿瘤的边界(P =0.007).结论 肿瘤的边界以及Gd-EOB-DTPA增强△可以用来区分低级别与高级别HCC.

随着医疗卫生事业飞速发展,社会对医疗卫生行业从业人员的学历及专业技能要求不断提高,以致地方性高等医学院校毕业生就业门槛不断提高,就业压力不断增大,就业形势日趋严峻.论文以苏北地区唯一一所医学类本科院校徐州医科大学生物医学工程专业2010～2018届本科毕业生为调查对象,对近9届毕业生就业去向及职位满意度、离职情况等进行调研和统计分析,以社会需求为导向,提出改善就业压力、提高就业率的对策及建议.

信息化、智能化时代的到来,对医工结合型人才培养提出了更高要求,在学科薄弱的情况下提高医工结合型专业人才培养质量迫在眉睫.本研究在不打乱本科原有教学计划基础上,导入境内外专家授课模式,以此进行教学改革,受到好评.

毕业生质量跟踪调查是高等教育评价工作的重点内容,目前中国高校普遍采用的跟踪调查方式不能有效满足需求.介绍了一个利用ASP动态网页技术、SQL数据库和Dreamweaver等开发软件构建的动态交互式网站系统,该系统为跟踪调查高校毕业生就业创业动态提供一个网络平台,使高校统计评价毕业生质量的各项指标数据变的更加快捷、全面,考察毕业生质量变的更加方便、准确,对高校开展课程改革、提升人才培养质量、调整专业设置提供了有力的数据支持.该系统在徐州医科大学医学影像学院投入试运行的三年里,系统使用者普遍对系统的功能感到满意,认为该系统能够实现对毕业生信息跟踪以及毕业生质量的统计与分析.

BriefReports 一氧化亚氮(N2O)俗称笑气[1],曾在医学中用作吸入性麻醉剂,后被广泛应用于食品加工剂,吸食者吸入后会产生幻觉和欣快感,从而产生心理依赖.本文报道3例年轻患者滥用笑气导致的脊髓亚急性联合变性(subacutecombineddegeneration, SCD),并复习相关文献,探讨其影像学表现、临床特征及鉴别诊断等,提高对该病的认识水平,为临床早期诊治提供帮助.

Traditional diagnosis and treatment of disease are relatively independent. Although this kind of medical model can mainly meet the clinical needs, it still affects the cure effect of some diseases owing to the hysteresis of the treatment. The appearance of theranostics is expected to significantly eliminate this malpratice. With the rapid development of nanotechnology, the design and preparation of theranostic nanoprobes can accelerate the application of this new medical model. Magnetic resonance imaging (MRI) has been commonly used in medical testing and monitoring because of its noninvasive and superior soft-tissue contrast resolution. Especially with the introduction of contrast agents to further enhance its sensitivity, MRI can provide a higher diagnosis rates for small lesions. The nanoprobes which based on MRI have been arousing great attention. MRI-based theranostic nanoprobes have been constructed to enable early diagnosis, drug delivery and targeted therapy at the same time, with the help of different nanocarriers (liposomes, mesoporous silica, manganese dioxide, graphene oxide, molybdenum disulfide, etc). This paper introduces the design philosophy and application prospects of the currently used magnetic resonance imaging contrast agents as well as the domestic and foreign advanced theranostic nanoprobes. In addition, their broad potential for the development in the field of biomedicine is also discussed.

结合徐州医科大学医学影像学院自身特色,研究医学影像学专业培养目标达成的评价方法和评估流程,以更好地培养创新型医学影像学人才.

大学生创新训练实践项目作为高等学校本科教学质量与教学改革工程的重要组成部分，是全面提高人才培养质量和大学生科研素养的重要途径。然而，在该项目实际申请过程中发现学生自行撰写的申请书质量不高。本文旨在应用PDCA循环来提高大学生创新训练实践项目申报书质量。

Objective:To explore the effective methods for the primary culture of rat renal tubular epithelial cells. Methods:On the basis of the mechanical grinding for the obtainment of tubular epithelial cells, we compared the difference between the experimental SD rats and KunMing mice as the source and optimized theⅠcollagenase digestion time as well as the rational use of liquid that was quitted for the ifrst time. The identiifcation of the collected renal tubular epithelial cells was performed by immunocytochemistry. Results:Compared with SD rats, renal tubular epithelial cells isolated from KunMing mice presented better growth rate with 25 minutes’ Ⅰcollagenase digestion. Additionally, the amount and quality of cells which recovered from the ifrst cell waste liquid were good, showing an effective reutilization. Conclusion:Mechanical grinding and 25 minutes’Ⅰcollagenase digestion with KunMing mice as source is an ideal method for the primary culture of the renal tubular epithelial cells. And the ifrst cell waste liquid could be reused well.

目的:探讨在头颈部CT血管成像(CTA)中,以患者体重指数(BMr)为基础的低剂量扫描方案实施前后对图像质量及辐射剂量的影响.方法:连续选取拟行头颈CTA检查患者186例,按检查先后分为,A组:采用管电压120 kV,滤波反投影法(FBP)重建;B组:采用管电压100kV,自适应性迭代重建(ASiR).A、B组根据患者的BMI进一步分组,A1组和B1组:BMI＜24kg/m2 A2组和B2组:24kg/m2≤BMI＜28kg/m2;A3组和B3组:BMI≥28kg/m.对各组的辐射剂量、客观图像质量评价采用两独立样本t检验.由两名有经验的放射科医师对两组图像质量进行主观评价,并对两名医师的阅片结果进行Kappa检验.结果:B1组、B2组及B3组的CT容积剂量指数(CTDIvol)较AI组、A2组及A3组分别下降29.29％、32.70％及40.24％(均P＜0.05);B1组、B2组及B3组的剂量长度乘积(DLP)较A1组、A2组及A3组分别下降32.44％、35.10％和40.98％(均P＜0.05).头部,颈部以及胸廓入口处的血管CT值B组各分组较A组对应组均增高,图像噪声均减低,信噪比(SNR)和对比噪声比(CNR)均增高,差异均有统计学意义(均P＜0.05).B组各分组的主观评分较A组对应组均高(均P＜0.05),B1组、B2组及B3组图像质量的一致性(Kappa值=0.634,0.644,0.628,均P＜o.05)分别高于A1组、A2组及A3组(Kappa值=0.476,0.566,0.595,均P＜o.05). 结论:不同BMI患者行头颈CTA检查,采用100kV管电压结合ASiR迭代重建扫描方案,可以降低辐射剂量(尤其是肥胖患者),并且可获得满意的图像质量.

Cultivation of undergraduate students'scientific research quality is not only the basic task of higher education , but also the inevitable requirement for construction of an innovative country . This paper first analyzes the importance and cultivation approaches , and then emphasizes the feasibility and importance of the approach based on teacher 's scientific projects .Through our experience and comprehension of supervising undergraduate graduation theses and students 'application for practice and innovation training projects , the authors further analyze and summarize the advantages of teacher 's research projects as the platform for cultivating undergraduates'scientific research quality .

Objective To explore X-ray anatomical landmarks of adult superior vena cava and their applications for localizing cath-eter tip of PICC placement.Methods The authors retrospectively reviewed chest radiographs of 2 1 9 PICC insertions,and 5 7 of them were carried out with chest CT scan in a week.For each patient,the vertical distances from the carina to the right superior heart bor-der or the cavoatrial j unction(CAJ),the right tracheobronchial angle and PICC tip position were measured,recorded,and analyzed, respectively.The obtained data from 5 7 patients were divided into chest X-ray group and CT group,which were then statistically an-alyzed accordingly.Results Between chest X-ray group and CT group,the vertical distances from the carina to CAJ,the right tra-cheobronchial angle and PICC tip position had no significant difference (each P>0.05)and showed positive correlation(r=0.744, 0.332,0.778,each P<0.05).No significant difference existed in PICC catheter tip locations estimated by chest X-ray group and by CT group (P>0.05).The matching coefficient was k=0.542 and was statistical difference (P<0.05).The mean vertical distance from the carina to the right superior heart border was (3.21±0.84)cm and from the carina to the right tracheobronchial angle was (1.38±0.28)cm.The above measured values in males were higher than in females(P<0.05).Conclusion It is applicable and ac-curate that using the carina,right tracheobronchial angle and right superior heart border as the radiographic landmarks for adult supe-rior vena cava and catheter tip positioning of PICC placement.The average vertical distances from the carina to the right tracheo-bronchial angle,and to the right superior heart border in the chest X-rays can provide reference basis for j udging PICC catheter end position in clinical.