数字化X线与螺旋CT影像检查技术对食道异物的诊断价值比较

目的 比较分析数字化X线、螺旋CT影像检查技术对食道异物的诊断价值。方法 回顾性搜集2010年1月至2017年12月来本院就诊的50例疑似食道异物患者为研究对象,50例均行数字化X线检查与螺旋CT检查,并通过消化内镜证实来分析比较数字化X线、CT影像检查技术对食道异物诊断的敏感性、特异性及准确性。结果 50例食道异物中数字化X线(包括普通平片摄影和食道吞钡棉絮检查)检出39例(78%),漏诊11例,多层螺旋CT检出49例(98%),漏诊1例,CT提示5例异物引起食道穿孔。结论 螺旋CT能够更加准确地直观地对异物的位置、形态、大小、走行以及食道周围组织、器官的关系显示,并可及时地发现有无并发症产生,此种检查方法安全、快速、患者又无痛苦,可作诊断食道异物最有效的影像检查方法之一

数字化X线与螺旋CT影像检查技术对食道异物的诊断价值比较

目的比较分析数字化X线、螺旋CT影像检查技术对食道异物的诊断价值。方法回顾性搜集2010年1月至2017年12月来本院就诊的50例疑似食道异物患者为研究对象,50例均行数字化X线检查与螺旋CT检查,并..

Efficacy of Zaozhu Yinchen Recipe for Treating Non-alcoholic Steatohepatitis and Its Effect on Free Fatty Acid and TNF-α

目的观察皂术茵陈方治疗非酒精性脂肪性肝炎(non-alcoholic steatohepatitis,NASH)患者的临床疗效,并探讨其对游离脂肪酸(free fatty acid,FFA)及TNF-α的影响。方法采用随机数字表法将120例NASH患者分为治疗组及对照组,每组60例。治疗组予中药皂术茵陈方,每日1剂;对照组予水飞蓟宾葡甲胺片200 mg口服,每日3次,两组均治疗24周。分别于治疗前后通过检测血清ALT、AST活性及TC、TG水平;行腹部CT计算肝脾CT比值;应用肝组织病理检查评价非酒精性脂肪性肝病活动度积分(NAFLD activity score,NAS)及纤维化程度以评价临床疗效;并检测血清FFA及TNF-α含量。结果与本组治疗前比较,两组治疗后血清ALT、AST、TC、TG、FFA、TNF-α水平、肝组织NAS积分及症状体征积分均明显降低,肝纤维化程度明显改善(P<0.05,P<0.01),且治疗组降低更明显(P<0.05)。治疗24周后,治疗组肝纤维化分期总有效率及临床总有效率分别为80.00%(48/60)、85.00%(51/60),明显高于对照组[60.00%(36/60)、73.33%(44/60)],两组比较,差异有统计学意义(P<0.05,P<0.01)。结论皂术茵陈方可改善NASH患者的临床疗效,其作用可能与抑制血清FFA及TNF-α水平有关。Objective To observe the efficacy of Zaozhu Yinchen Recipe(ZZYCR) on non-alcoholic steatohepatitis(NASH) patients, and to explore its effect on serum free fatty acid(FFA) and tumor necrosis factor α(TNF-α).Methods Totally 120 patients with NASH were randomly assigned to the treatment group(60 cases,treated with ZZYCR, one dose per day) and the control group(60 cases, treated with Silibin Meglumine Tablets, 20 mg each time, thrice per day). The therapeutic course for all was 24 weeks. Serum levels of ALT and AST activities, TC and TG levels were detected before and after treatment. Peritoneal CT was performed in all patients, and CT ratios of liver and spleen calculated. NAFLD activity score(NAS) and degree of hepatic fibrosis were assessed using pathological examinations of liver tissue, and efficacy also evaluated. Serum contents of FFA and TNF-αwere also detected. Results Compared with before treatment in the same group, activities of ALT and AST, serum levels of TC, TG, FFA, and TNF-α, NAS, scores of symptoms and signs all obviously decreased, degree of hepatic fibrosis was obviously improved in the two groups(P < 0. 05, P < 0. 01). These changes were more obviously seen in the treatment group(P < 0. 05). After 24-week treatment, the total effective rate and total clinical efficacy were 80. 00%(48/60 cases) and 85. 00%(51/60 cases) in the treatment group, obviously higher than those in the control group [60. 00%(36/60 cases) and 73. 33%(44/60 cases) respectively], with significant difference(P < 0. 05, P < 0. 01). Conclusion ZZYCR could improve the clinical efficacy of NASH patients, and its mechanism might be associated with inhibiting serum levels of FFA and TNF-α.国家自然科学基金资助项目(No.81503529,81274155);; 福建省自然科学基金面上资助项目(No.2014J01374);; 福建省卫生厅中医药项目(No.wzpw201308);; 厦门市科技计划项目(No.3502Z20134020

Determination of Chondroitin Sulfate with High Sensitivity by Fluorescence Recovery through Shifting the Equilibrium between Anionic Phthalocyanine and Cationic Surfactant

目的建立高灵敏荧光增强法测定硫酸软骨素的新方法,并用于实际样品测定。方法对荧光光谱行为的考察显示,在PH 7.0的介质中,具有共轭结构的阳离子头部和长碳链尾部的阳离子表面活性剂对四磺基铝酞菁(AlS4PC)的荧光具有高效猝灭作用,二者形成无荧光离子缔合物。此离子缔合物可对带有磺酸基团的高分子黏多糖硫酸软骨素(CS)作出灵敏响应。在CS的存在下,反应体系荧光显著恢复,最大恢复倍数可达900倍。由于猝灭效率高,荧光恢复程度大,甚至可实现目视化观测。结果工作曲线响应区间0.2~6μg·Ml-1,检测限0.09μg·Ml-1,工作曲线lOgy=0.158 23ρ-0.035 97,r=0.998 7。本实验对该法用于批量样品分析的可行性进行了考察,结果表明,所建立的方法可望用于高通量分析。结论该法操作简便,灵敏度、稳定性与检测准确性好。所建立的方法成功地用于组成复杂的实际样品中CS的定量分析,解决了实际工作中的难点。OBJECTIVE To propose a novel method for quantitative determination of chondroitin sulfate in real samples using the ion-association phthalocyanine complex as a fluorescent probe emitting at red-region.METHODS The fluorescence of tetrasulpnonated aluminum phthalocyanine( AlS4Pc),an anionic metal phthalocyanine,was quenched dramatically by cationic surfactants which contain a positively-charged head with a conjugated structure and a long carbon chain as tail through the formation of an almost non-fluorescent association complex.Hexadecylpyridinium bromide( CPB) screened from a series of cationic surfactants was selected as a quencher because of its high fluorescence quenching efficiency.It was found that the ion-association complex( AlS4Pc-CPB) emitted strong fluorescence in the presence of chondroitin sulfate,due to the ability of chondroitin sulfate to shift the association equilibrium of the ionassociation complex,which led to the release of AlS4Pc,thus resulting in an increase in the fluorescence of AlS4Pc.The method based on the above-mentioned phenomenon was investigated in the aspects of spectral characteristics,effect of pH,influence of reaction time, order of addition of reagents,the usage of reagents,and interference of foreign substances.RESULTS Under optimal conditions,the linear range of the assay for chondroitin sulfate was 0.2- 6 μg·mL- 1with a detection limit of 0.09 μg·mL- 1.CONCLUSOIN The established method is not only sensitive,accurate but also simple and reliable.It has been used to the analysis of real samples with complicated composition with satisfactory results.It has also been successfully applied in batch test combined with well-reader technique,exhibiting great potential for high-throughput analysis.福建省科技重点资助项目(2012Y0081); 福建省公益类科研院所基本专项(2010R1101)资助项

皂术茵陈方治疗非酒精性脂肪性肝炎的临床观察及其对肠道菌群的影响

目的评价皂术茵陈方调节肠道菌群治疗非酒精性脂肪性肝炎(NASH)的临床疗效及其作用机制。方法选取福建中医药大学附属厦门市中医院肝病中心门诊就诊的NASH患者80例,采用随机数字表法分为治疗组(40例)和对照组(40例)。治疗组予中药皂术茵陈方治疗,对照组予以枯草杆菌二联活菌肠溶胶囊治疗,两组疗程均为12周。评价治疗前后两组患者的症状、体征积分以及血清ALT、AST活性;检测两组患者血清内毒素水平以及肠道菌群变化。结果治疗12周后,治疗组的临床总有效率达87.5%(35/40),较之对照组的65%(26/40)有统计学意义(χ~2=7.966,P<0.05);两组患者ALT、AST活性以及血清内毒素水平较治疗前均有明显下降(P<0.05),且以治疗组的ALT、AST活性下降值大于对照组(t=2.254,t=2.325,P<0.05);两组患者肠道菌群中的双歧杆菌、乳酸杆菌、拟杆菌数量较治疗前显著升高,而肠球菌、肠杆菌显著降低(P<0.05)。结论皂术茵陈方具有改善肝功能、治疗NASH的临床疗效,其作用机制与调节肠道菌群紊乱、恢复肠道微生态平衡、减轻肠源性内毒素血症相关。国家自然青年科学基金资助项目(No.81503529);;福建中医药大学临床专项校管课题基金(No.XB2016080

皂术茵陈方治疗非酒精性脂肪性肝炎40例临床研究

目的:观察皂术茵陈方治疗非酒精性脂肪性肝炎的临床疗效。方法:将78例患者单盲法随机分为治疗组40例和对照组38例;治疗组予中药皂术茵陈方治疗,对照组采用水飞蓟宾葡甲胺片(西利宾安)治疗;两组均治疗2个月。检测治疗前后患者血清谷丙转氨酶(AlT)、谷草转氨酶(AST)活性、血清总胆固醇(TCH)、甘油三酯(Tg)含量;比较患者肝脏b超变化以及症状、体征积分等临床疗效。结果:经过2个月治疗,治疗组的临床总有效率达87.50%,较之对照组的73.68%,差异有统计学意义(P<0.05);两组治疗后症状、体征积分、肝脏b超改善情况、血清AlT、AST活性、血清TCH、Tg含量均较各自治疗前显著改善;较之对照组,治疗组上述改善更加显著(P<0.05)。结论:中药皂术茵陈方对改善非酒精性脂肪性肝炎有较好的临床疗效,可明显改善患者肝功能、血脂、b超影像指标及临床证候。国家自然科学基金(No.81274155); 福建省卫生厅中医药项目(No.wzpw201408); 厦门市重大科技计划项目(No.3502Z20100006

Mechanism of geniposide in improving free fatty acid metabolism in rats with non-alcoholic fatty liver disease

观察栀子苷改善非酒精性脂肪性肝病的效果,从游离脂肪酸探讨栀子苷调节非酒精性脂肪性肝病的作用机制。健康雄性Wistar大鼠40只,随机分为4组:正常组、模型组、栀子苷组和血脂康组,每组大鼠10只,正常组大鼠给予正常大鼠饲料喂养,其余3组大鼠均采用高脂饲料喂养以诱导非酒精性脂肪性肝病,造模时间为8周,从第5周起至第8周末,栀子苷组和血脂康组分别灌服相应的药物。记录大鼠体重、肝湿重、脂肪质量;用相应方法检测肝组织TG,FFA,FAS,AMPK,ACCase及Malonyl-Co A含量,血清CHO,LDL-C的含量,血清AST,ALT的活性;观察肝脏组织肉眼及病理变化(HE染色法)。结果显示,与正常组相比,模型组大鼠的体重;肝湿重;脂肪重;血清CHO,LDL-C,ALT,AST;肝组织TG,FFA,FAS,ACCase及Malonyl-Co A含量皆显著升高(P<0.01);肝组织AMPK活性显著降低(P<0.01),肝组织肉眼外观及病理切片脂肪变性明显,并出现炎症损伤;与模型组相比,栀子苷组大鼠体重、脂肪质量、肝组织FFA含量、血清ALT,AST活性均显著降低(P<0.01),肝湿重,肝组织TG,FAS,ACCase及Malonyl-Co A含量明显降低(P<0.05),肝组织AMPK活性明显增多(P<0.05),肝脏肉眼外观及病理学表现均有所改善;与模型组相比,血脂康组大鼠的肝湿重、脂肪质量、肝组织TG,FFA和血清LDL-C水平明显降低(P<0.05);与血脂康组相比,栀子苷组大鼠的体重、脂肪质量、肝组织FFA含量均显著降低(P<0.01),其他方面无明显差异。结果表明,栀子苷具有显著的改善高脂饮食诱导的大鼠非酒精性脂肪性肝病的药理效应;其改善大鼠非酒精性脂肪性肝病的游离脂肪酸代谢是通过调节"AMPK-ACCase-Malonyl-Co A-FFA"轴来实现的。To observe the effect of geniposide on non-alcoholic fatty liver disease( NAFLD),and discuss the mechanism of geniposide for NAFLD from the aspect of free fatty acid,forty healthy Wistar male rats were randomly divided into normal group,model group,geniposide and Xuezhikang group. The rats in normal group were fed with normal diets,and the rats in other 3 groups were given with high-fat diet for 8 weeks to induce the NAFLD models. From the week 5 to end of week 8,the rats in geniposide and Xuezhikang group were intervened with corresponding medicines. The body weight,liver wet weight,and fat weight of the rats were recorded.Visual and pathological changes in hepatic tissues were observed with HE staining. The contents of TG,FFA,FAS,AMPK,ACCase and Malonyl-Co A in hepatic tissue,contents of CHO and LDL-C in serum and activities of AST and ALT in serum were detected by using corresponding methods. The results showed that the body weight,liver wet weight,and fat weight of the rats,CHO,LDL-C,ALT and AST levels in serum,TG,FFA,FAS,ACCase and Malonyl-Co A levels in hepatic tissues of the rats in model group were significantly higher than those in normal group( P < 0. 01),while AMPK activity was significantly lower than that of the normal group( P < 0. 01),with obvious visual and pathological steatosis in hepatic tissues,and inflammatory injury occurred in model group. Compared with the model group,body weight of the rat,fat weight,levels of FFA in hepatic tissues,ALT and AST activities in serum,liver wet weight,TG,FAS,ACCase and Malonyl-Co A levels were significantly decreased in geniposide group( P < 0. 01),while the AMPK activity in hepatic tissues was significantly increased( P < 0. 05),with improvement in visual and pathological performance.Compared with the model group,liver wet weight,fat weight,TG and FFA levels in hepatic tissues,and LDL-C level in serum were significantly decreased in Xuezhikang group( P < 0. 05). Compared with Xuezhikang group,the body weight of rat,fat weight and FFA level in hepatic tissues were significantly lower in geniposide group( P < 0. 01),but with no significant difference in other aspects. These findings indicated that geniposide was highly effective in improving the pharmacological effect of NAFLD induced by highfat diet,and the mechanism was achieved through AMPK-ACCase-Malonyl-Co A-FFA axis.国家自然科学基金项目(81274155;81503529);; 福建省自然科学基金项目(2014J01374);; 福建省高等学校新世纪人才计划项目;; 厦门市科技计划项目(3502Z20134020);; 福建省中医药科研项目(WZPW201308

非酒精性脂肪肝同病异证与肝活检病理学的相关性研究

目的:观察非酒精性脂肪肝(NAFLD)患者不同中医证型与临床指标、肝活检病理学的关系。方法:选择312例NAFLD患者进行辨证分型,均进行肝组织活检,常规判定NAFLD活动度积分(NAS)和肝纤维化分期。结果:NAFLD患者的中医证型频数分布为痰湿内阻证>肝郁脾虚证>湿热蕴结证>肝郁气滞证>痰瘀互结证。NAFLD患者性别、年龄、病程、血生化、体质量指数、肝硬度值、NAS积分等指标在不同中医证型的分布差异具有统计学意义(P<0.05)。结论:NAFLD患者痰湿内阻证、痰瘀互结证、湿热蕴结证三型NAS积分较高,故NAFLD的治疗应着重于健脾化痰、清热利湿、活血化瘀。国家自然科学基金项目(No.81503529,No.81673660,No.81873242);;福建省科技计划引导性项目(No.2015D007,No.2016D012);;厦门市科技计划项目(No.3502Z20174028);;厦门市重要重大疾病联合攻关项目(No.3502Z20179047);;福建省卫生计生医学创新科研人才培养项目(No.2018-CXB-28);;福建中医药大学基金项目(No.XB2016080);;陈国良名老中医传承工作室(厦门市卫生局资助项目);;全国第六批老中医药专家学术经验继承工作(2017年)~

Assessing User’s Visual Attention on University Library Web Page with Eye Tracking Technology

隨著網際網路的普及，促使大學圖書館紛紛建立網站服務讀者。目前國內各大專院校圖書館網站的建置已達到百分之百，網頁成為行銷各校學術資源最直接快速的管道，而圖書館網頁也利用廣告吸引讀者對於活動訊息的注意。目前國內大學圖書館網站中，並非每個學校均設有廣告來傳播重要的訊息給讀者，即使擁有廣告也是呈現位置不一。在設計上，大學圖書館網站首頁廣告應與整體版面搭配，以引起讀者視覺關注，並達透過廣告成功行銷圖書館資源與活動的目的；而以圖書館行銷的角度考量，惟有促使圖書館網站首頁的廣告被有效注意與理解，才能達到成功行銷廣告內容的目的。 本研究採用真實驗研究法(true-experiment research method），結合網頁視覺設計相關理論對於讀者目光注意力的吸引原則，以及視覺元素之間如何影響讀者的視覺行為為基礎，設計出三種內容相同但廣告放置於不同位置之圖書館網站首頁，比較讀者視覺注意力行為的差異，並以國立中正大學大學部學生五十四名為研究對象，利用「眼球追蹤儀器」(eye tracker)收集受試者眼動指標資料，並進行廣告傳達內容之記憶效應檢測，以及實驗後輔以問卷調查與訪談，探討大學圖書館網站首頁的廣告位置對於讀者視覺注意力及記憶效應的影響。 研究結果發現，讀者在三種不同廣告圖片位置之眼動訊息、記憶效應、瀏覽順序、整體印象滿意度均具有顯著差異。研究結果歸納如下： 一、讀者在廣告置上版面具有較多的注視次數，但是在廣告置左版面則具有較多的視覺停駐。 二、讀者在三種不同廣告位置版面之廣告內容的記憶效應具有顯著差異，廣告圖片位置置左版面具有最佳之記憶效應。 三、讀者在廣告置左版面之廣告內容的記憶效應與眼動指標之「平均注視時間」具有顯著關聯性，其他兩種版面則均無顯著關聯。 四、讀者在三種不同廣告位置版面之其他讀者服務項目所定義興趣區的眼動指標具有顯著差異，廣告置左版面讀者服務項目具有較為平均之視覺分布。 五、讀者在三種不同廣告位置版面之瀏覽順序具有差異，廣告置左版面之廣告較能引起讀者的優先注視。 六、讀者在三種不同廣告位置版面之圖書館網站首頁的整體印象具有顯著差異，廣告置左版面獲得較高的評價；其中版面在「簡單的」、「不散亂的」、「可靠信任的」、「引人注目的」等項目上均顯著高於廣告置右與廣告置上版面。 綜合本研究之研究結果，建議圖書館應善用置左廣告位置提升圖書館行銷相關訊息之目的。此外，圖書館網站首頁應重視視覺元素編排對於版面整體印象的提升效應。圖書館網頁編排也應善用接近性與相似性原則，使得版面呈現具一致性。The popularity of the Internet has pushed university libraries establishing websites to serve readers. The establishment of domestic university library websites has currently reached 100%, web pages become the most direct and rapid channels to market the academic resources, and advertisement on the library web pages is utilized for attracting readers’ attention to activities. So far, not all domestic university library websites are established advertisement for propagating important information to readers; even though there is advertisement, the presentation positions are distinct. In terms of the design, advertisement on the index page of a university library website should match the entire layout so as to appeal readers’ visual saliency and successfully market the library resources and activities. In consideration of library marketing, merely advertisement on the index page of a library website being effectively noticed and comprehended could the successful marketing be achieved. With true-experiment research method, the visual design of web pages to attract readers’ attention in this study is integrated with the effects of visual elements on readers’ visual behaviors to design three identical advertising contents which are placed in different positions on the index page of the library website in order to compare the difference in readers’ visual attention. Furthermore, 54 undergraduate students in National Chung Cheng University are selected as the research participants. An Eye Tracker is utilized for collecting the participants’ eye-tracking indicators, and the memory effect of the advertisement is tested. Furthermore, the questionnaire survey and interviews are proceeded to discuss the effects of advertising position on the index page of a university library website on readers’ visual attention and memory effect. The research findings show that the readers present significant difference on the eye-tracking information, memory effect, browsing order, and overall satisfaction of the three advertisement positions. The research results are concluded as follows. 1.The readers appear more attention on top-layout advertisement, but stay the vision more on left-layout advertisement. 2.The readers reveal remarkable difference on memory effect of advertisement among three advertisement positions, where the optimal memory effect appears on the left-layout advertisement. 3.The readers show significant correlations between memory effect of left-layout advertisement and the eye-tracking indicator of Average Fixation Time, while the rest two layouts do not show notable correlations. 4.The readers show remarkable difference on the eye-tracking indicator of interests defined in other reader service items of three advertisement layouts; the reader service items on the left-layout advertisement appear more average visual distribution. 5.The readers reveal distinct browsing orders on the three advertisement positions; the left-layout advertisement could better appeal the readers’ prior attention. 6.The readers show significantly different impression on the index page of the library website with three advertising positions; the left-layout advertisement acquires higher appraisal, where the items of Simple, Not Disordered, Reliable, Attention Attractive reveal higher appraisal than right-layout and top-layout advertisement. Summing up the research results, the libraries are suggested to well apply left-layout advertisement to enhance the marketing information. What is more, the index page of a library website should focus on the layout of visual elements to promote the overall impression. The layout of library web pages should also well apply the principles of proximity and similarity to present the consistency