Y型聚乙二醇干扰素琢-2b注射液治疗HCV基因2/3型慢性丙型肝炎患者疗效和安全性的多中心随机对照试验研究

目的以标准剂量的聚乙二醇干扰素(Peg IFN)α-2a联合利巴韦林作为阳性对照,评价新型试验药物Y型Peg IFNα-2b注射液联合利巴韦林治疗2型/3型慢性丙型肝炎(CHC)患者的疗效和安全性。方法采用多中心、随机开放、阳性药对照的Ⅲ期临床试验,筛选符合要求的2型/3型CHC患者,按照2:1的比例随机分配到Y型Peg IFNα-2b组和Peg IFNα-2a组,同时口服利巴韦林,疗程24 w,停药随访24 w。采用Abbott Real Time HCV Genotype II检测HCV基因型,采用Cobas Taq Man实时定量PCR法检测血清HCV RNA水平。详细记录不良事件。主要疗效指标为持续病毒学应答(SVR),并进行非劣效检验。结果本试验实际入组2型/3型CHC患者255例,实际治疗241例。全分析集(FAS)数据显示,158例试验组和83例对照组患者SVR分别为85.4%(95%CI 79.94%~90.94%)和79.5%(95%CI 70.84%~88.20%,P=0.2402);对符合方案分析集(PPS)人群分析显示,试验组和对照组患者SVR分别为87.9%(95%CI 82.45%~93.27%)和85.9%(95%CI 77.82%~94.01%,P=0.7060),率差的95%可置信区间均符合非劣效标准;对PPS人群分析显示,85.8%受试者获得了早期病毒学应答(RVR),RVR的阳性预测值为90.1%;试验组和对照组不良事件发生率相似,分别为95.6%和95.2%,严重不良事件发生率分别为3.8%和3.6%。结论应用Peg IFNα联合利巴韦林治疗2型/3型CHC患者,新型试验药物Y型Peg IFNα-2b具有与对照药物Peg IFNα-2a相似的疗效和安全性。国家科技部“十二五”重大专项(编号:2012ZX10002-003)；“重大新药创制”十二五科技重大专项(编号:2012ZX09303019)

肠结核的多层螺旋CT肠道造影表现

【目的】总结肠结核（ITB）在多层螺旋CT小肠造影（MSCTE）的表现，探讨MSCTE在ITB的诊断价值。【方法】收集15例经内镜检查或手术后病理确诊为ITB的临床与影像学资料，所有的患者均行MSCTE检查，回顾性分析其MSCTE表现，包括病灶的位置、数目、形状、边界和邻近组织的改变，以及腹部其它脏器、腹膜、大网膜和肠系膜的变化，并与内镜及手术结果相对照。【结果】15例ITB中，13例（86%）主要累及回盲部。4例（27%）表现为多节段肠壁均匀增厚，9例（60%）表现为局部肠壁实质性肿块形成，1例（6%）表现为多发节段性肠壁增厚并肿块形成，1例（6%）表现为不均匀强化的肿块并肠穿孔。12例ITB出现淋巴结肿大，均表现为环形强化。2例（13%）ITB的肠系膜血管出现“梳状征”。按其在MSCTE增强扫描上的强化模式，将该 9例肿块型小肠结核分为3种类型：a. 明显均匀强化型（n=5）；b. “靶征”征象型（n=2）；c. 干酪样坏死型（n=2）。【结论】ITB的影像学征象表现具有多样性。MSCTE能够清楚地显示肠粘膜轮廓、肠壁及其与周围组织的关系，为ITB的诊断提供丰富的信息

The application of computer simulation of spinal osteotomy in making surgical plan for correction of kyphosis in ankylosing spondylitis

目的:探讨计算机辅助设计在强直性脊柱炎后凸畸形矫形术手术方案制定中的应用价值。方法:将5例强直性脊柱炎后凸畸形患者在手术前后进行胸腰椎CT扫描,获得的数据导入Mimics10.01软件进行三维重建。手术前在重建模型上模拟经椎弓根椎体截骨术进行虚拟截骨、预测矫形效果,并测算截骨椎体所需截骨角度及相应在椎板及椎体后缘的截骨宽度。手术后在预测模型及术后重建模型上分别测量全脊柱后凸角,颈7椎体中心点与骶骨后上角的水平距离,截骨节段相邻上下椎体棘突间及双侧横突间距离等指标,并进行比较。结果:5例手术前后均顺利完成三维建模。术前模拟截骨测算出截骨椎体所需截骨角度、椎板截骨宽度和椎体后缘截骨宽度的值分别为(26.34±3.16)°(23.30～30.11°)、(27.71±1.22)mm(26.53～29.15mm)和(14.45±1.62)mm(12.17～16.62mm),在虚拟截骨模型上及术后重建模型上测得的比较指标相近。结论:应用计算机对强直性脊柱炎后凸畸形截骨矫正手术进行仿真模拟设计的方法具有可行性,能比较直观、精确反映矫形效果,可为制定手术方案提供较科学的依据。Objective: To discuss the application of computer simulation of spinal osteotomy in making surgical plans for patients with kyphosis deformity due to ankylosing spondylitis. Methods: 4 patients underwent CT scan before and after the operation and the collected data were put into the Mimics 10.01 to reconstruct 3D images. Virtual vertebrectomies were carried out on the models to guide actual operations. The corrected angle, the width of the lamina, the width of resected lumbar posterior marginal bone was predicted. In the model of virtual vertebrectomies and the postoperative reconstructed, the total spinal kyphosis angle, the distance between the cervical line on the center of C7 and the postero-superior part of S1, the distance of the spinous process and the distance of both sides of transverse process were measured and compared. Results: The models were successfully reconstructed and virtual vertebrectomies were well completed in every case. The mean predictive value of the corrected angle, the width of the lamina, the width of resected lumbar posterior marginal bone were (26.34 ±3.16)° (23.30~30.11° ), (27.71 ±1.22) mm (26.53~29.15 mm), and (14.45 ±1.62) mm (12.17~16.62 mm) respectively. The mean predictive value was close to the mean real values. Conclusions: Computer simulation of vertebrectomy can directly and accurately reflect the correction effects before surgery, which is convenient for defining the best surgical plan as well as improving the safety and accuracy of the operation

JUNO Sensitivity on Proton Decay p→νˉK+p\to \bar\nu K^+ Searches

The Jiangmen Underground Neutrino Observatory (JUNO) is a large liquid scintillator detector designed to explore many topics in fundamental physics. In this paper, the potential on searching for proton decay in $p\to \bar\nu K^+$ mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification. Moreover, the excellent energy resolution of JUNO permits to suppress the sizable background caused by other delayed signals. Based on these advantages, the detection efficiency for the proton decay via $p\to \bar\nu K^+$ is 36.9% with a background level of 0.2 events after 10 years of data taking. The estimated sensitivity based on 200 kton-years exposure is $9.6 \times 10^{33}$ years, competitive with the current best limits on the proton lifetime in this channel

JUNO sensitivity on proton decay p → ν K + searches*

The Jiangmen Underground Neutrino Observatory (JUNO) is a large liquid scintillator detector designed to explore many topics in fundamental physics. In this study, the potential of searching for proton decay in the $p\to \bar{\nu} K^+$ mode with JUNO is investigated. The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification. Moreover, the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals. Based on these advantages, the detection efficiency for the proton decay via $p\to \bar{\nu} K^+$ is 36.9% ± 4.9% with a background level of $0.2\pm 0.05({\rm syst})\pm$$0.2({\rm stat})$ events after 10 years of data collection. The estimated sensitivity based on 200 kton-years of exposure is $9.6 \times 10^{33}$ years, which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies

Prediction of Energy Resolution in the JUNO Experiment

International audienceThis paper presents the energy resolution study in the JUNO experiment, incorporating the latest knowledge acquired during the detector construction phase. The determination of neutrino mass ordering in JUNO requires an exceptional energy resolution better than 3% at 1 MeV. To achieve this ambitious goal, significant efforts have been undertaken in the design and production of the key components of the JUNO detector. Various factors affecting the detection of inverse beta decay signals have an impact on the energy resolution, extending beyond the statistical fluctuations of the detected number of photons, such as the properties of liquid scintillator, performance of photomultiplier tubes, and the energy reconstruction algorithm. To account for these effects, a full JUNO simulation and reconstruction approach is employed. This enables the modeling of all relevant effects and the evaluation of associated inputs to accurately estimate the energy resolution. The study reveals an energy resolution of 2.95% at 1 MeV. Furthermore, the study assesses the contribution of major effects to the overall energy resolution budget. This analysis serves as a reference for interpreting future measurements of energy resolution during JUNO data taking. Moreover, it provides a guideline in comprehending the energy resolution characteristics of liquid scintillator-based detectors