mlsa-iai-msu-lab/ru_sci_bench_zho_cite_reranking huggingface dataset:
Minimizing Energy Cost of Air Conditioner in a Residential House under Demand Side Response Model

This research is aimed to develop a consumer demanding side response model to assist electricity consumers to mitigate peak demands during the peak season. The main contribution of this research is showing that consumers can mitigate peak demands by optimizing energy costs of an air conditioner (AC) when a spike happens. It may only occur in a one and a half hours spike during the peak season. This model also investigates how AC applies the pre-cooling method when there is a substantial risk of a price spike. The results indicate that the potential benefit of the model is achieving energy savings for consumers and aggregators, also reducing electricity bills for the consumers. The model is tested with selected characteristics of the room, and based on the standard room in a residential house in Makassar, a city of Indonesia.
Maximum Power Point Tracking in Variable Speed Wind Turbine Based on Permanent Magnet Synchronous Generator Using Maximum Torque Sliding Mode Control Strategy

The present study was carried out in order to track the maximum power point in a variable speed turbine by minimizing electromechanical torque changes using a sliding mode control strategy. In this strategy, first, the rotor speed is set at an optimal point for different wind speeds. As a result of which, the tip speed ratio reaches an optimal point, mechanical power coefficient is maximized, and wind turbine produces its maximum power and mechanical torque. Then, the maximum mechanical torque is tracked using electromechanical torque. In this technique, tracking error integral of maximum mechanical torque, the error, and the derivative of error are used as state variables. During changes in wind speed, sliding mode control is designed to absorb the maximum energy from the wind and minimize the response time of maximum power point tracking (MPPT). In this method, the actual control input signal is formed from a second order integral operation of the original sliding mode control input signal. The result of the second order integral in this model includes control signal integrity, full chattering attenuation, and prevention from large fluctuations in the power generator output. The simulation results, calculated by using MATLAB/m-file software, have shown the effectiveness of the proposed control strategy for wind energy systems based on the permanent magnet synchronous generator (PMSG).
Effects of Cu~(2+) and humic acids on degradation and fate of TBBPA in pure culture of Pseudomonas sp. strain CDT

Soil contamination with tetrabromobisphenol A (TBBPA) has caused great concerns; however,the presence of heavy metals and soil organic matter on the biodegradation of TBBPA is still unclear. We isolated Pseudomonas sp. strain CDT,a TBBPA-degrading bacterium,from activated sludge and incubated it with 14C-labeled TBBPA for 87 days in the absence and presence of Cu~(2+) and humic acids (HA). TBBPA was degraded to organic-solvent extractable (59.4% ± 2.2%) and non-extractable (25.1% ± 1.3%) metabolites,mineralized to CO_2 (4.8% ± 0.8%),and assimilated into cells (10.6% ± 0.9%) at the end of incubation. When Cu~(2+) was present,the transformation of extractable metabolites into non-extractable metabolites and mineralization were inhibited,possibly due to the toxicity of Cu~(2+) to cells. HA significantly inhibited both dissipation and mineralization of TBBPA and altered the fate of TBBPA in the culture by formation of HA-bound residues that amounted to 22.1% ± 3.7% of the transformed TBBPA. The inhibition from HA was attributed to adsorption of TBBPA and formation of bound residues with HA via reaction of reactive metabolites with HA molecules,which decreased bioavailability of TBBPA and metabolites in the culture. When Cu~(2+) and HA were both present,Cu~(2+) significantly promoted the HA inhibition on TBBPA dissipation but not on metabolite degradation. The results provide insights into individual and interactive effects of Cu~(2+) and soil organic matter on the biotransformation of TBBPA and indicate that soil organic matter plays an essential role in determining the fate of organic pollutants in soil and mitigating heavy metal toxicity.
Identification of differentially expressed genes response to TCDD in rat brain after long-term low-dose exposure

Several cohort studies have reported that dioxin and dioxin-like polychlorinated biphenyls might impair the nervous system and lead to neurological or neurodegenerative diseases in the elder people,but there is limited research on the involved mechanism. By using microarray analysis,we figured out the differentially expressed genes between brain samples from SD rats after low-dose (0.1 μg/(kg▪bw)) dioxin exposure for six months and controls. To investigate the function changes in the course of dioxin exposure,Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis were performed on the differentially expressed genes. And the changes of several picked genes have been verified by real-time PCR. A total of 145 up-regulated and 64 down-regulated genes were identified. The metabolic processes,interleukin-1 secretion and production were significantly associated with the differentially expressed genes. And the genes regulated by dioxin also clustered to cholinergic synapse and long-term potentiation. Candidate biomarker genes such as egr1,gad2,gabrb3,abca1,ccr5 and pycard may be toxicological targets for dioxin. Furthermore,synaptic plasticity and neuro-immune system may be two principal affected areas by dioxin.
Robust neural output-feedback stabilization for stochastic nonlinear process with time-varying delay and unknown dead zone

This article investigates the output-feedback control of a class of stochastic nonlinear system with time-varying delay and unknown dead zone. A robust neural stabilizing algorithm is proposed by using the circle criterion, the NNs approximation and the MLP (minimum learning parameter) technique. In the scheme, the nonlinear observer is first designed to estimate the unmeasurable states and the assumption “linear growth” of the nonlinear function is released. Furthermore, the uncertainty of the whole system (including the perturbation of time-varying delay) is lumped and compensated by employing one RBF NNs (radial basis function neural networks). Though, only two weight-norm related parameters are required to be updated online for the merit of the MLP technique. And the gain-inversion related adaptive law is targetly designed to mitigate the adverse effect of unknown dead zone. Comparing with the previous work, the proposed algorithm obtains the advantage: a concise form and easy to implementation due to its less computational burden. The theoretical analysis and comparison example demonstrate the substantial effectiveness of the proposed scheme.
术后加速康复理念应用于腹腔镜右半肝切除治疗巨块型肝癌一例

我中心于2016年收治一例巨块型肝癌患者,对其实施腹腔镜肝切除并结合应用术后加速康复外科(enhanced recovery after surgery,ERAS)理念,取得良好效果,现报道如下。
腹腔镜脾肾分流术治疗肝硬化门静脉高压症

上消道出血是肝硬化门静脉高压症致命性的并发症,传统的外科治疗方法包括各种断流与分流手术。随着对该疾病认识的深入以及技术进步,出现各种基于微创技术的治疗手段,主要包括腹腔镜或手助的腹腔镜脾切除+断流术、脾动脉栓塞术、门静脉系统栓塞术、肝内门体静脉分流术以及胃镜下食管静脉曲张套扎与硬化剂注射等技术。我们在开展腹腔镜胰十二指肠切除术积累经验的基础上,对1例肝硬化门静脉高压症并上消道出血的患者进行了完全腹腔镜巨脾切除+脾肾分流术,近期疗效满意,现报道如下。
A Framework for Disaster Vulnerability in a Small Island in the Southwest Pacific: A Case Study of Emae Island, Vanuatu

The societal costs of disasters around the world are continuing to increase and Pacific Island countries are considered some of the most vulnerable. This is primarily due to a combination of high hazard exposure coupled with a range of social, economic, physical, and political vulnerabilities. This article contributes to the growing body of work that aims to understand the causal factors of disaster vulnerability, but with a specific focus on small island developing states. The article first develops a framework for understanding disaster vulnerability, drawing on extensive literature and the well-established Methods for the Improvement of Vulnerability in Europe (MOVE) framework, and second, applies this adapted framework using empirically-derived data from fieldwork on Emae Island, Vanuatu to provide a working understanding of the causal elements of disaster vulnerability. Drawn from a significant body of scholarship at the time, the MOVE framework was primarily developed as a heuristic tool in which disaster vulnerability is considered to be a function of exposure, susceptibility (socially, economically, physically, culturally, environmentally, institutionally), and a lack of resilience. We posit that this adapted framework for small islands should also include historical susceptibility, and we prefer livelihood resilience (as capabilities, social capital, knowledge, participation, and human rights) over lack of resilience. We maintain that understanding disaster vulnerability holistically, which is inclusive of both strengths and drawbacks, is crucial to ensure that limited resources can target the causal factors that produce vulnerability and help safeguard and improve livelihoods in both the short and long term.
Failure criterion effect on solid production prediction and selection of completion solution

Production of fines together with reservoir fluid is called solid production. It varies from a few grams or less per ton of reservoir fluid posing only minor problems, to catastrophic amount possibly leading to erosion and complete filling of the borehole. This paper assesses solid production potential in a carbonate gas reservoir located in the south of Iran. Petrophysical logs obtained from the vertical well were employed to construct mechanical earth model. Then, two failure criteria, i.e. Mohr-Coulomb and Mogi-Coulomb, were used to investigate the potential of solid production of the well in the initial and depleted conditions of the reservoir. Using these two criteria, we estimated critical collapse pressure and compared themto the reservoir pressure. Solid production occurs if collapse pressure is greater than pore pressure. Results indicate that the two failure criteria show different estimations of solid production potential of the studied reservoir. Mohr-Coulomb failure criterion estimated solid production in both initial and depleted conditions, where Mogi-Coulomb criterion predicted no solid production in the initial condition of reservoir. Based on Mogi-Coulomb criterion, the well may not require completion solutions like perforated liner, until at least 60% of reservoir pressure was depleted which leads to decrease in operation cost and time.
Examining the effect of adverse geological conditions on jamming of a single shielded TBM in Uluabat tunnel using numerical modeling

Severe shield jamming events have been reported during excavation of Uluabat tunnel through adverse geological conditions, which resulted in several stoppages at advancing a single shielded tunnel boring machine (TBM). To study the jamming mechanism, three-dimensional (3D) simulation of the machine and surrounding ground was implemented using the finite difference code FLAC~(3D). Numerical analyses were performed for three sections along the tunnel with a higher risk for entrapment due to the combination of overburden and geological conditions. The computational results including longitudinal displacement contours and ground pressure profiles around the shield allow a better understanding of ground behavior within the excavation. Furthermore, they allow realistically assessing the impact of adverse geological conditions on shield jamming. The calculated thrust forces, which are required to move the machine forward, are in good agreement with field observations and measurements. It also proves that the numerical analysis can effectively be used for evaluating the effect of adverse geological environment on TBM entrapments and can be applied to prediction of loads on the shield and preestimating of the required thrust force during excavation through adverse ground conditions.
从中西医结合视角刍议高血压的五行辨治:脾经篇

脾在五行属土,为中州之脏。脾胃通过运化水谷精微,化生气血津液,维持机体正常的生命活动,因而脾胃被认为是"后天之本,气血生化之源"。由于中医学"重道轻器"的特点,导致对五脏的认识上,中西医之间出现了很多分歧。这一点,在脾的脏象理论上尤为明显。不过,随着中西医学的深入发展和融通,经过很多专家学者多年的研究和探索,目前在脾的认识上,中西医学达成了很多共识。中医的脾,从解剖实体上来说,主要指现代医学中的胰腺和脾脏,也有专家认为,脏腑脾对应着解剖肝。这与胃肠道吸收的营养物质,首先要向肝脏汇集很符合。而中医的脾最主要的指向是其功能状态,主要包括:胃肠道的消化吸收功能、能量及水液代谢、血液生成,乃至有研究认为,中医的脾包含了现代医学中的部分神经-内分泌-免疫网络和微循环系统。
老年人高血压伴低血磷症1例

高血压作为一种慢性非传染性疾病,分布在全球每一个地区,据2016年出版的《中国高血压防控蓝皮书》报告:高血压的患病率已达25.2%,并呈现出年轻化趋势,其作为心脑血管病最重要的危险因素,肆意侵害着人们的健康。高血压虽诊断简单,但影响血压升高的因素较为复杂,应对每一例高血压患者进行继发性因素的病因筛查,待继发性因素去除后血压多可明显下降,甚至根治高血压,进而避免、减少或改善并发症的发生和发展。除所熟知的肾实质性、肾血管性、肾上腺性及主动脉缩窄等继发性高血压因素外,目前甲状旁腺功能亢进症作为血压升高的病因,还未引起足够重视。本案例显示:老年男性患者,联合降压方案下24 h动态血压基本正常,但仍存在头痛及心力衰竭症状,且合并心肌重构等靶器官损害,常规查血电解质发现持续低血磷症,进一步行相关检查确诊为原发性甲状旁腺功能亢进症,且成功手术切除甲状旁腺腺瘤后血压逐渐下降,予低于常用剂量单药治疗血压仍得以平稳控制,术后多次随诊过程中复查iPTH、血磷、血钙持续正常,后期复查心脏结构明显恢复,颈动脉内膜中层厚度及斑块大小较术前明显变薄及缩小,最终予停用降压药,减少了患者的经济和精神负担。另外,多数降压药可影响机体水、电解质稳态,通过常规查血电解质,不仅可以避免电解质紊乱发生,也可对继发性高血压起到初步筛查作用。因此,在高血压诊疗过程中,除了关注血压水平,还应重视患者的症状,常规查血电解质,对钙磷代谢异常者,进一步测定血清PTH,以期尽早发现甲状旁腺功能亢进症所致的高血压,进而早期逆转血压升高及心血管损害,对其预后具有重要的临床价值。
心外膜脂肪与心房颤动

肥胖是心房颤动发生的重要危险因素,研究表明体质量指数(body mass index,BMI)每增加5 kg/m~2,新发心房颤动风险增加10%~30%。心外膜脂肪是一种特殊的内脏脂肪组织,解剖位置和心肌紧密相连,近年研究显示心外膜脂肪与心房颤动关系更为密切,本文就二者之间的关系做一综述。
美国2017年高血压指南要点解读及我们的思考

2017年11月13日，在美国心脏协会（American Heart Association，AHA）年会上，美国心脏病学会(American College of Cardiology，ACC）/AHA成人高血压管理指南重磅发布。新版指南由ACC/AHA主导制定，同时有美国9个相关的重要学会参加。历时3年，写出15个章节的高血压指南，由来自多个专业21位成员组成指南写作委员会，与企业之间无利益关系。指南写作委员会由杜兰大学医学院Paul K. Whelton教授担任主席，弗吉尼亚大学医学院Robert M. Carey教授担任副主席。此部指南依据了循证推荐作为临床应用的推荐，提出的每条建议都含有推荐强度分类（classification of recommendation，COR）、证据质量等级（level of evidence，LOE）。现对美国2017年高血压指南要点作一介绍。
Nitrogen-doped graphene/carbon nanohorns composite as a high-performance supercapacitor electrode

Nitrogen-doped graphene/carbon nanohorns composite (NGLC) was prepared by one-step co-pyrolysis of graphene oxide, carbon nanohorns (CNHs), urea, and lignosulfonate. CNHs as spacers were inserted into graphene nanosheets. The introduction of CNHs and the loosened nano-structure of NGLC make it achieve a high specific capacitance of 363 F g~(–1) at a discharge current density of 1Ag~(–1), and NGLC exhibits an ultrahigh stability of 93.5% capacitance retention ratio after 5000 cycles. The outstanding comprehensive electrochemical performance of NGLC could meet the need of the future acted as an efficient supercapacitor electrode material.
基于数据包络分析的医院综合绩效改革效果研究

目的应用数据包络分析方法的Malmquist模型评价某医院绩效改革前后科室运行效率。方法根据12个样本科室的人力、床位投入及医疗服务产出方面的数据,基于Malmquist指数模型,纵向跨期对其科室运行效率进行系统评价。结果2017年1季度同比2016年,6个改革科室全生产要素平均效率(1. 09)高于未改革6个科室(0. 96) 。结论该医院绩效改革取得成效,改革后科室运行效率提升有统计学意义;样本科室整体体现出规模效率提升困难,技术和效率仍有提升空间。
基于扎根理论与结构方程模型的乡村医生激励措施满意度影响因素研究

目的对新医改形势下,乡村医生对现有激励措施满意度的影响因素及作用机制进行研究。方法采用定量与定性相结合的方法,运用扎根理论对访谈资料进行梳理并结合马斯洛需求层次理论构建假设模型,经过结构方程模型验证,确定乡村医生激励措施满意度的影响因素。结果四项因素(安全因素、生存因素、自我实现因素、尊重因素)对满意度产生直接影响,影响系数为0. 120、0. 440、0. 150和0. 110。生存因素、社交因素、尊重因素通过其他因素对满意度产生间接影响,部分因素间也存在正向影响关系。结论生存因素对乡村医生激励措施满意度的影响最大。从五个层次出发,对相关激励措施进行补充与改进,可提高乡村医生的激励措施满意度,从而保证乡村医生队伍的稳定与发展。
“陆态网络”并址站归心基线精密解算及GNSS基准站数据处理

国际地球参考框架ITRF的解算需要全球导航卫星系统GNSS、甚长基线干涉测量VLBI、人卫激光测距SLR和多普勒卫星定轨和无线电综合定位DORIS技术的观测数据,以及各种技术的并址站归心基线。为了精确确定并址站的空间归心基线及其协方差信息,本文研究了 GNSS/VLBI/SLR并址站的解算理论与方法,解算出中国大陆构造环境监测网络CMONOC(“陆态网络”)7个并址站的空间归心基线,分析了这些归心基线对改善参考框架的作用,并处理了“陆态网络”260个GNSS基准站的观测数据,分析了中国大陆最新地壳形变速度场的变化。
离心收缩训练在膝关节相关疾病康复中的研究进展

膝关节(knee joint)是人体最大、最复杂的关节,也是最容易受伤的关节。膝关节由股骨内、外侧髁和胫骨内、外侧髁以及髌骨组成。其周围被有关节囊、韧带、滑膜囊、肌腱(或肌肉)等结构,外覆筋膜和皮肤。膝关节是极易受累的关节,较为常见的膝关节疾病有前交叉韧带(anterior cruciate ligament, ACL)损伤、髌腱炎、膝关节骨关节炎(knee osteoarthritis, KOA)、半月板损伤等。目前,肌肉力量训练在膝关节相关疾病中扮演着重要的角色,而肌肉力量训练包括等长收缩训练、向心收缩训练以及离心收缩训练。离心收缩因其具有产生力量大而耗能少的特点,在膝关节相关疾病中运用越来越广泛,本文就离心收缩训练在膝关节相关疾病中的应用做一综述。
康复治疗学专业《人体运动学》课程教学的几点思考

随着国家对康复医学的重视,大众康复意识的提高,康复专业教育已如雨后春笋般迅速铺展开来。笔者通过全国高校信息综合查询系统及2011-2015年教育部公布的专业备案数据显示,目前开设康复治疗学专业的本科院校有150余家,高职高专院校超200家,这些院校普遍开设了《人体运动学》这门课程。该课程是本科康复治疗学专业的核心课程和专业基础课程,也是一门多学科交叉的课程,更是康复治疗学专业课程体系中着力培养学生分析问题能力的一门课程。学生对课程内容的掌握程度,将直接影响后续课程的学习、功能障碍的分析、康复治疗方案的合理制定与有效施行及力学操控的实施,对学生的实际工作能力具有重大影响作用。因此,明确课程目标、确定教学重点、根据岗位能力要求选取教学内容、丰富教学方法和手段、改革教学评价等已经成为提高教学水平、确保人才培养质量最为迫切的实际问题。
重复经颅磁刺激对脑卒中患者上肢运动功能恢复的研究进展

脑卒中是导致功能障碍的最常见原因之一,仅有不足40%的患者在康复治疗后可以完全恢复功能。虽然目前康复治疗技术发展迅速,但是上肢运动功能的恢复依然是目前卒中后康复研究的热点和难点。目前认为脑卒中发生后,两大脑半球间兴奋性平衡被打破,非损伤侧皮质可经胼胝体抑制损伤侧皮质兴奋性,阻碍运动功能的恢复。重复经颅磁刺激(repetitive transcranial magnetic stimulation, rTMS)作为近些年发展起来的非侵入性大脑刺激方法,可以通过调节大脑皮质兴奋性,改变脑卒中后两大脑半球间兴奋性的不平衡状态,从而促进上肢运动功能的恢复。随着rTMS在脑卒中后康复方面的研究及应用日益增加,越来越多的报道证明了rTMS刺激大脑运动皮质可以显著提高患者运动恢复,本文将对近几年国内外不同频率的rTMS在脑卒中后上肢运动功能康复方面的研究进展做一综述。
黔南地区(黔紫页1井)发现上古生界海相页岩气

中国页岩气勘探已经在震旦系、寒武系、志留系等多个层系取得突破,而石炭系作为滇黔桂地区重要的泥页岩发育层位,分布广泛,厚度大,却仍未取得页岩气实质发现。黔南地区石炭系打屋坝组页岩具备典型的海相沉积特征,且页岩厚度大,有机质丰度高,热演化程度适中,具备形成页岩气的良好地质条件。然而,由于缺少针对石炭系的页岩气钻井,对该套泥页岩的研究尚处于起步阶段,富有机质页岩层段的空间分布、页岩有利区的预测、 “甜点”层段的优选等均需进一步调查和研究。
Wave propagation analysis of rotating thermoelastically-actuated nanobeams based on nonlocal strain gradient theory

This paper is concerned with the wave propagation behavior of rotating functionally graded (FG) temperature-dependent nanoscale beams subjected to thermal loading based on nonlocal strain gradient stress field. Uniform, linear and nonlinear temperature distributions across the thickness are investigated. Thermo-elastic properties of FG beam change gradually according to the Mori–Tanaka distribution model in the spatial coordinate. The nanobeam is modeled via a higher-order shear deformable refined beam theory which has a trigonometric shear stress function. The governing equations are derived by Hamilton's principle as a function of axial force due to centrifugal stiffening and displacement. The solution of these equations is provided employing a Galerkin-based approach which has the potential to capture various boundary conditions. By applying an analytical solution and solving an eigenvalue problem, the dispersion relations of rotating FG nanobeam are obtained. Numerical results illustrate that various parameters including temperature change, angular velocity, nonlocality parameter, wave number and gradient index have significant effects on the wave dispersion characteristics of the nanobeam under study. The outcome of this study can provide beneficial information for the next-generation research and the exact design of nano-machines including nanoscale molecular bearings, nanogears, etc.
Experimental and numerical studies of impact on filament-wound composite cylinder

This study focused on the impact behavior of carbon-fiber-wrapped composite cylinders subjected to impact from flat-ended, hemispherical-nosed and conical-nosed impactors. Damage morphologies of the cylinders and mechanisms of the damage were analyzed. Change laws of the maximum impact forces, durations of impact processes and energies absorbed by the cylinders after impact with different impactors and impact energies were obtained. A finite element model was developed and the simulation results were in reasonable agreement with the tests. Finally, taking the flat-ended impactor as an example, stress distributions of the cylinders under pressurization and impact were discussed.
Damage evolution and crack propagation in rocks with dual elliptic flaws in compression

To give an insight into the understanding of damage evolution and crack propagation in rocks, a series of uniaxial and biaxial compression numerical tests are carried out. The investigations show that damage evolution occurs firstly in the weak rock, the area around the flaw and the area between the flaw and the neighboring rock layer. Cracks mostly generate as tensile cracks under uniaxial compression and shear cracks under biaxial compression. Crack patterns are classified and divided. The relationship between the accumulated lateral displacement and the short radius ( b ) is fitted, and the equation of crack path is also established.
Computational investigation of the lubrication behaviors of dioxides and disulfides of molybdenum and tungsten in vacuum

Lamellar compounds such as the disulfides of molybdenum and tungsten are widely used as additives in lubricant oils or as solid lubricants in aerospace industries. The dioxides of these two transition metals have identical microstructures with those of the disulfides. The differences in the lubrication behaviors of disulfide and dioxides were investigated theoretically. Tungsten dioxide and molybdenum dioxide exhibit higher bond strengths at the interface and lower interlayer interactions than those of the disulfides which indicates their superlubricity. Furthermore, the topography of the electron density of the single layer nanostructure determined their sliding potential barrier; the dioxides showed a weaker electronic cloud distribution between the two neighboring oxygen atoms, which facilitated the oxygen atoms of the counterpart to go through. For commensurate friction, the dioxides exhibited nearly the same value of friction work, and same was the case for the disulfides. The lower positive value of friction work for the dioxides confirmed their improved lubricity than the disulfides and the higher mechanical strength of the bulk dioxides demonstrated that they are excellent solid lubricants in vacuum.
腋窝逆向淋巴示踪的临床实践及争议

前哨淋巴结活组织检查术(SLNB)是腋窝淋巴结阴性乳腺癌患者标准的腋窝处理术式,而腋窝淋巴结清扫术(ALND)则应用于腋窝淋巴结阳性的乳腺癌患者,两者均可能破坏患侧上肢的淋巴回流,从而导致乳腺癌相关淋巴水肿(BCRL),后者在一定程度上降低了患者术后的生活质量。腋窝逆向淋巴示踪(ARM)旨在通过在SLNB或ALND中显示并保留引流上肢淋巴液的淋巴结/淋巴管(ARM LN/LV),以预防BCRL发生。然而,将ARM应用于临床工作前,仍有几个问题亟待解决,如其预防BCRL的有效性,以及因引流上肢和乳腺的淋巴通道存在交通所致的肿瘤学安全性问题。近期的研究表明,对于腋窝淋巴结临床阴性、前哨淋巴结(SLN)阳性及SLN与ARM LN不重叠的患者而言,ARM在肿瘤学方面是安全的。淋巴回流通道的重建不仅避免了SLN与ARM LN重叠而必须将其切除时所面临的尴尬,而且能有效预防BCRL的发生。ARM作为乳腺癌手术家族中新兴的一员,其应用前景值得期待。
利用Mimics软件对胫骨平台骨折骨缺失量估测的可行性研究

[目的]使用数字医学三维重建探索评估胫骨平台骨折骨缺失量的新方法,并评估此方法的可行性。[方法]收集2009~2015年21例胫骨平台骨折患者,男14例,女7例;年龄24~64岁;左侧14例,右侧7例。按Schatzker分型:II型10例,III型1例,IV型3例,V型2例,VI型5例。运用MIMICS软件对患、健侧胫骨CT数据进行三维重建,并进行镜像、匹配、截骨、匹配度检测,计算健、患侧骨折块的体积差,即骨缺失量。将计算出的骨缺失量与术中实际植骨量进行比较,并进行配对t检验。[结果]21例患者骨折后丢失骨量体积平均[5.60±1.78 (1.06~6.88) ] cm~3。丢失体积占胫骨平台体积的比例为3.54%±2.09% (0.85%~8.23%)。体积差与术中植骨量比较,差异无统计学意义(P>0.05)。[结论]应用此方法对胫骨平台骨折骨缺失量进行估测,准确、简便易行,减少了手术时间。
弹性髓内针顺行固定治疗儿童桡骨远端干骺端移行部骨折

[目的]探讨经皮顺行弹性髓内针固定技术治疗儿童桡骨远端干骺端移行部骨折的可行性。[方法]回顾性分析2012年7月~2016年4月本院收治的桡骨远端干骺端移行部骨折患者11例(男9例、女2例),平均年龄7.3岁(4.1~10.5岁),所有病例均采用闭合复位、近端经皮弹性髓内针顺行固定。术后平均1个月拆除石膏开始功能锻炼,术后6个月去除内固定。分别记录手术时间、临床愈合时间以及术后1、3、6、9个月腕关节屈、伸,前臂内、外旋角度,并采用DASH评分进行综合评估。相关数据进行重复测量方差分析,P<0.05为差异有统计学意义。[结果]平均手术时间27 min (20~45 min),平均临床愈合时间6周(4~8周),除2例术后短期出现皮肤针尾刺激,未有骨折再移位、残留成角畸形及活动受限等并发症发生。前臂旋转及腕关节屈伸功能在石膏拆除后2个月能基本恢复正常,术后3、6、9个月随访结果无明显变化,DASH评分结果也显示相同趋势。[结论]弹性髓内针桡骨近端顺行髓内固定技术可以作为桡骨远端干骺端移行部骨折治疗的可选方法之一。
间歇性管饲结合吞咽训练对脑卒中吞咽障碍患者的影响

目的观察间歇性管饲技术联合常规吞咽康复训练对脑卒中吞咽障碍患者的疗效,并探讨其作用机制。方法共选取60例脑卒中后中重度吞咽障碍患者,采用随机数字表法将其分为治疗组和对照组,每组30例。2组患者均给予常规药物治疗,并针对吞咽功能障碍进行康复训练,对照组采用留置鼻饲管技术给予营养支持,治疗组采用间歇性管饲技术治疗。于治疗前和治疗20 d后(治疗后)对2组患者的吞咽功能进行评定。结果治疗前,2组患者的吞咽障碍分级比较,差异无统计学意义(P>0.05)。与组内治疗前比较,2组患者的吞咽障碍均有所改善,且治疗组吞咽障碍分级改善优于对照组(P<0.05)。治疗组患者的总有效率(96.67%)显著高于对照组患者的总有效率(80.00%),差异有统计学意义(P<0.05)。治疗组患者的吸入性肺炎和腹胀发生率明显低于对照组,差异有统计学意义(P<0.05)。结论间歇性管饲结合吞咽训练可显著改善脑卒中吞咽障碍患者的吞咽功能,减少并发症发生,具有较好的临床疗效。
中国吞咽障碍评估与治疗专家共识(2017年版)第一部分评估篇

吞咽障碍是临床上多学科常见的症状,易导致误吸、吸入性肺炎、营养不良等严重后果。2013年,从事吞咽障碍康复的专家们齐聚广州,讨论并达成共识,授权《中华物理医学与康复杂志》首次发表“中国吞咽障碍评估与治疗专家共识(2013版)”,为从事吞咽障碍康复的专业人员提供吞咽障碍领域的临床工作规范。
成人非性传播淋菌性结膜炎一例

讨论:淋菌性结膜炎是由淋病双球菌感染所致的一种急性化脓性结膜炎,为急性传染性眼病中最剧烈的一种,多发生于新生儿,主要是新生儿在分娩过程中经过淋球菌感染的产道所致,一般为双侧性,多在出生后1周内出现症状,其临床表现为结膜水肿、充血,并伴大量脓性分泌物,病情严重者可出现角膜混浊、溃疡,而导致失明。成人淋菌性结膜炎极其罕见,其潜伏期短,来势凶猛,为一种急性传染性结膜炎,多为单侧,通过手术或接触被分泌物污染的物品所感染。该病特点为潜伏期短,传染性强,病情发展迅速,易引起角膜穿孔、溃疡,甚至失明,故及时诊治甚为重要,而临床易误诊并导致严重后果。本例患者反复治疗无效,最后经检验科微生物培养确诊,进行对应治疗,病情迅速好转。本文所报道的病例进展缓慢,有别于一般病例,可能与前期左氧氟沙星滴眼液用量不足,或该菌株本身毒力的特殊性有关。
SPECTRAL PROJECTED GRADIENT METHOD FOR COMPUTING TENSOR M-EIGENVALUES

In this paper, we present the connection between the M-eigenvalues of a fourth-order partially symmetric rectangular tensor and the Z-eigenvalues of a new fourth-order weakly symmetric square tensor by using the symmetric embedding technique. Based on this, the M-eigenvalue problem can be converted to be the Z-eigenvalue problem. Then we compute the M-eigenpairs by the spectral projected gradient (SPG) method that is for computing the Z-eigenpairs. Some numerical results are reported at the end of this paper.