mlsa-iai-msu-lab/ru_sci_bench_zho_cite_reranking huggingface dataset:
Key aspects on the behaviour of the ballast and substructure of a modern railway track:research-based practical observations in Finland

This paper presents an overview on the wide-ranging track structure studies at the Tampere University of Technology(TUT),Finland dealing with the key aspects of track geotechnics related to high-speed passenger traffic on ballasted tracks.Special attention is paid to ballast and sub-ballast,while also considering frost action,embankment stability,track stiffness,track geometry and transition zones.As a result,this paper states that understanding the ballast degradation mechanism and its consequences and assessment of its condition occupy an important role in the construction and maintenance of a smooth high-speed rail line.The choices related to building the sub-ballast also have a dramatic impact on later track deformations and maintenance needs.In cold climate,especially where seasonal frost occurs,understanding and taking into account the frost action mechanism is crucial.Especially in the maintenance and rehabilitation planning of existing tracks,high-class analyses of ground penetrating radar data and its integrated analysis with other data can yield considerable benefits.
Ground-borne vibrations due to dynamic loadings from moving trains in subway tunnels

In this study,ground vibrations due to dynamic loadings from trains moving in subway tunnels were investigated using a 2.5D finite element model of an underground tunnel and surrounding soil interactions.In our model,wave propagation in the infinitely extended ground is dealt with using a simple,yet efficient gradually damped artificial boundary.Based on the assumption of invariant geometry and material distribution in the tunnel’s direction,the Fourier transform of the spatial dimension in this direction is applied to represent the waves in terms of the wave-number.Finite element discretization is employed in the cross-section perpendicular to the tunnel direction and the governing equations are solved for every discrete wave-number.The 3D ground responses are calculated from the wave-number expansion by employing the inverse Fourier transform.The accuracy of the proposed analysis method is verified by a semi-analytical solution of a rectangular load moving inside a soil stratum.A case study of subway train induced ground vibration is presented and the dependency of wave attenuation at the ground surface on the vibration frequency of the moving load is discussed.
SPARC expression and prognostic value in non-small cell lung cancer

Secreted protein,acidic and rich in cysteine(SPARC) is expressed in numerous types of tumors and is suggested to have prognostic value.Moreover,because of its strong affinity for albumin,and hence albumin-bound drugs,SPARC has increasingly become a focus for research.In this study,we aimed to determine SPARC expression in patients with non-small cell lung cancer(NSCLC) and investigate the association of SPARC with disease prognosis.Tissue microarrays were constructed with specimens from 105 patients with NSCLC treated at Sun Yat-sen University Cancer Center,and immunohistochemical analysis was performed on these tissue microarrays to assess SPARC expression.Our results showed that SPARC expression status did not significantly relate with age,gender,and tumor stage.However,SPARC was expressed more frequently in squamous cell carcinoma than in adenocarcinoma(75% vs.43.5%,P = 0.004).Patients with smoking history had higher SPARC expression than non-smokers(68.2% vs.33.3%,P = 0.002).In both univariate and multivariate analyses,SPARC was a prognostic factor of overall survival(HR = 0.32;95% CI:0.16-0.65) but not disease-free survival.Our study indicates that SPARC expression is higher in squamous cell carcinoma than in adenocarcinoma in NSCLC.Most notably,SPARC can be used as a prognostic factor for NSCLC.
Chemical proteomics:terra incognita for novel drug target profiling

The growing demand for new therapeutic strategies in the medical and pharmaceutic fields has resulted in a pressing need for novel druggable targets.Paradoxically,however,the targets of certain drugs that are already widely used in clinical practice have largely not been annotated.Because the pharmacologic effects of a drug can only be appreciated when its interactions with cellular components are clearly delineated,an integrated deconvolution of drug-target interactions for each drug is necessary.The emerging field of chemical proteomics represents a powerful mass spectrometry(MS)-based affinity chromatography approach for identifying proteome-wide small molecule-protein interactions and mapping these interactions to signaling and metabolic pathways.This technique could comprehensively characterize drug targets,profile the toxicity of known drugs,and identify possible off-target activities.With the use of this technique,candidate drug molecules could be optimized,and predictable side effects might consequently be avoided.Herein,we provide a holistic overview of the major chemical proteomic approaches and highlight recent advances in this area as well as its potential applications in drug discovery.
“治未病”学术思想指导肿瘤护理

现代医学认为,肿瘤是一种可控制细胞生长和发展的“恶性基因”发生一系列突变而致的可遗传的基因疾病,目前已成为我国的第二大死亡原因。随着社会的发展,肿瘤患病率的不断升高,肿瘤患者及家属对肿瘤护理人员要求也在不断提高,如何更好地为肿瘤患者减轻病痛,并防止肿瘤的再复发,是值得我们探讨的新问题。本文以中医“治未病”学术思想为指导,探讨中医药“治未病”学术思想在肿瘤护理中的应用。
术后汤对腹部术后使用硬膜外镇痛泵胃肠道功能恢复的研究

目的:探讨术后汤对腹部术后使用硬膜外镇痛泵胃肠道功能恢复的应用效果。方法:将胃癌90例、结肠癌90例分别随机分为实验组和对照组各45例。实验组术后第1天开始胃管注入术后汤,每天2次,每次20ml;对照组采用常规治疗。观察2组肛门排气时间、尿潴留、肠麻痹、胃排空障碍情况。结果:实验组术后肛门排气时间明显早于对照组(P<0.05),尿潴留、肠麻痹、胃排空障碍发生情况明显低于对照组(P<0.01)。结论:术后汤可促进胃肠功能恢复,能够有效预防腹部胃肠术后使用硬膜外镇痛泵引发的胃肠道副反应。
Effect of Combined Use of Brackish Water and Nitrogen Fertilizer on Biomass and Sugar Yield of Sweet Sorghum

Soil salinization and non-point source pollution are among the most important and widespread environmental problems in European Mediterranean regions. Sweet sorghum (Sorghum bicolor (L.) Moench var. saccharatum) is a moderate to high salinity tolerant crop with low water and nutrient needs, seen as an alternative to grow in the water scarce regions. A three-year multifactorial study was conducted in southern Portugal to evaluate the combined effects of saline water and nitrogen application on the dry biomass (total, stems, and leaves), sugar content (total reducing sugars and sucrose contents), and sugar yield (here defined as the product of total reducing sugars and stems dry biomass) functions of sweet sorghum. Sorghum dry biomass and sugar yield showed diminishing returns for each incremental change of nitrogen. The use of saline irrigation waters also led to yield reduction. Exception was sucrose content which increased with increasing levels of sodium in the soil. Nitrogen need decreased as the amount of sodium applied increased. Stem dry biomass, sucrose content, and sugar yield progressively increased with progress in the experiment. The effect could be attributed to the increase of the amount of irrigation applied throughout the years, thus increasing the leaching fraction which promoted salt leaching from the root zone, reduced the salinity stress, increased plant transpiration, nitrogen uptake and biomass yield.
Current Soil Nutrient Status of Intensively Managed Greenhouses

Nine districts covering the main greenhouse vegetable areas in Tianjin Municipality of the North China Plain were selected for the soil investigation in 2010 to survey the current soil nutrient status (soil available N, P and K), acidification and salinization due to excessive input of fertilizers in greenhouses in Tianjin. The study showed that, in particular, soil available P content increased with the age of greenhouses. In contrast, our results did not reveal higher K accumulation and lowered pH in the greenhouse soils compared with cultivation in open fields. Over-fertilization, causing high NO_3~- accumulation, most likely resulted in salinity problems in the greenhouses. Ninety percent of the investigated greenhouse soils had electrical conductivity values of saturated paste extracts of 2-10 d S m~(-1), which might affect the yields of vegetable crops like green bean, pepper, cabbage, carrot, eggplant, lettuce, spinach, celery, cucumber and tomato. The findings of our survey of the current fertility and salinity problems in greenhouse soils suggest that there is an urgent need to improve the farmers’ practices and strategies in fertilization management in greenhouses of China. Because education and the agricultural technical extension services may play a more important role in avoiding overuse of fertilizers, we suggest that current nutrient management practices should be improved in the near future through training of local farmers in farmers’ schools and through strengthening the agricultural extension services with practical techniques.
利奈唑胺治疗医院获得性耐甲氧西林金黄色葡萄球菌肺炎的疗效与安全性

目的观察利奈唑胺治疗医院获得性耐甲氧西林金黄色葡萄球菌(MRSA)肺炎的临床疗效及安全性。方法使用利奈唑胺治疗医院获得性MRSA肺炎58例,观察其临床疗效及安全性。结果利奈唑胺治疗的痊愈率为36.2%(21/58),有效率为67.2%(39/58),细菌清除率为65.5%(38/58),生存率为84.5%(49/58),病死率为15.5%(9/58)。其中确诊后用药组病死率为32.0%,经验性用药组病死率为3.0%,经验性用药组与确诊后用药组比较病死率明显较低(P=0.008)。不良反应发生率为3.5%(2/58),不良反应轻且不影响治疗。结论利奈唑胺治疗医院获得性MRSA肺炎疗效肯定,不良反应轻,可以作为重症患者治疗医院获得性MRSA肺炎的首选药物之一。
自噬对先天性免疫的调控

自噬又称为Ⅱ型程序性细胞死亡方式,是运输细胞质成分进入溶酶体的蛋白降解系统。主要清除细胞内受损细胞结构、衰老的细胞器以及不再需要的生物大分子等,自噬机制失灵将导致细胞异常甚至死亡。通过对酵母遗传学筛选的研究,已发现一些关键的自噬分子,即自噬相关蛋白(Atgs)。在Atgs和其他蛋白作用下可促进自噬清除病原体,从而保护机体免受损害。但某些细菌,如福氏志贺菌,感染后可通过干扰或阻止自噬溶酶体形成等来调控或阻碍自噬,以利于自身存活。可见,自噬在先天性免疫、特别是模式识别受体与病原体成分相互作用过程调控中起重要作用。
流质营养粉对老年鼻饲患者营养状况的影响

目的比较流质营养粉与自制的匀浆膳对老年鼻饲患者的营养支持效果。方法住院的老年鼻饲患者63例,分为两组:观察组31例,使用流质营养粉;对照组32例,使用自制匀浆膳。记录摄入的能量和蛋白质,检测各项生化指标。结果对照组能量摄入(5 617.1±539.6)kJ/d,观察组为(6 897.0±411.5)kJ/d。蛋白质摄入:对照组(53.75±5.16)g/d,观察组(63.75±5.67)g/d。经过治疗后,观察组的白蛋白(Alb)、淋巴细胞数较对照组升高,差异有统计学意义(P<0.05),而胆固醇下降(P<0.01)。与治疗前比较,观察组的总蛋白、Alb上升(P<0.05)。结论流质营养粉可增加老年患者的能量和蛋白质摄入,提高机体蛋白水平,改善营养状况,对血糖水平、肝肾功能无不良影响。
水通道蛋白5与肿瘤发生发展的关系

自DENKER等在人红细胞膜上发现第1种水通道蛋白(aquaporin,AQP)即AQP1以来,迄今的研究已揭示,在哺乳动物中AQP是一个拥有13个成员的蛋白质大家族,分别被命名为AQP0~12。业已证实,AQP5是AQP家族的重要成员,参与了腺体分泌、水平衡等多种病理生理过程。近年发现,AQP5在多种肿瘤组织或细胞中都呈异常表达,对肿瘤生物学功能有着多重影响,如调节肿瘤细胞的增殖和凋亡、影响肿瘤细胞的迁移等。提示AQP5在肿瘤发生发展过程中可能起着重要作用,已成为肿瘤研究的新领域。本文就AQP5的生物学特性及其在肿瘤发生发展中的作用研究与相关进展做一综述。
颈部包块累及颈内静脉的增强CT临床分析

目的探讨增强CT对颈部包块与颈内静脉位置关系方面的价值。方法对43例与颈内静脉临近的颈部包块进行增强CT检查。在横断面扫描图像上测量瘤管角及观察静脉管腔是否狭窄,判断包块是否与颈内静脉粘连,瘤管角为包块包绕颈内静脉的最大角度,与手术对照,计算45°、90°、180°作为诊断包块是否与颈内静脉粘连的敏感度、特异度和准确度,进行统计学分析。结果瘤管角≥90°组和≥180°组对颈内静脉受侵判断的准确度高于≥45°组(P<0.05),且部分瘤管角未达90°便出现了静脉管腔狭窄。结论对于颈内静脉粘连的判断,瘤管角≥90°提示包块与颈内静脉粘连,尤其是伴有管腔狭窄者。
胃炎Ⅰ号含药血清对胃癌细胞株SGC-7901增殖及凋亡的作用

目的探讨胃炎Ⅰ号含药血清对人胃癌细胞株SGC-7901增殖及凋亡的作用。方法不同浓度胃炎Ⅰ号含药血清处理人胃癌细胞株SGC-7901后,MTT法检测细胞增殖变化,流式细胞术检测细胞凋亡变化。结果胃炎Ⅰ号含药血清呈剂量依赖性对SGC-7901细胞有生长抑制作用,低、中、高剂量组增殖抑制率分别为(30.33±1.79)%、(42.02±4.03)%、(60.67±2.75)%,差异有统计学意义(P<0.01)。胃炎Ⅰ号含药血清呈剂量依赖性对SGC-7901细胞有促凋亡作用,低、中、高剂量组凋亡率分别为(20.13±2.26)%、(26.61±4.41)%、(34.58±5.64)%,与空白血清组[(12.98±2.12)%]比较,差异有统计学意义(P<0.01)。结论胃炎Ⅰ号含药血清呈剂量依赖性对SGC-7901细胞有生长抑制和促凋亡作用。
头孢他啶致白细胞升高1例

头孢他啶致白细胞及中性粒细胞比值升高在国内尚无报道,该不良反应可排除已知的病理生理因素、感染加重、药品质量因素、用法用量错误及其他药物所致的白细胞及中性粒细胞比值升高,其原因有待进一步研究。临床医师在使用头孢他啶抗感染时,若临床症状好转而白细胞及中性粒细胞持续升高时应考虑到头孢他啶的不良反应,不能盲目的认为感染未控制而加大药物剂量或更换其他抗菌药物,避免抗菌药物的盲目及不合理使用。
银杏叶提取物注射液治疗椎基底动脉供血不足疗效的Meta分析

目的:系统评价银杏叶提取物注射液治疗椎基底动脉供血不足的有效性及安全性。方法:计算机检索中国生物医学文献数据库、中国期刊全文数据库、中文科技期刊全文数据库、中国医药学位论文全文数据库、中国生物医学期刊数据库,并追查所有纳入文献的参考文献,使用RevMan5.0软件进行Meta分析。结果:共纳入8项个研究,合计798例患者。Meta分析结果显示,与对照组药物相比,在治疗椎基底动脉供血不足临床疗效有效性上,银杏叶提取物注射液优于对照组药物,2组比较差异有统计学意义[OR=0.29,95%CI(0.19,0.44),P<0.000 01];在血液流变学指标改善方面银杏叶提取物注射液优于对照组疗效,且差异具有统计学意义[MD=-0.17,95%CI(-0.22,-0.12),P<0.000 01]。在血流速度指标改善方面银杏叶提取物注射液不及对照组,且差异具有统计学意义[MD=8.80,95%CI(7.96,9.64),P<0.000 01]。结论:在治疗椎基底动脉供血不足疗效及血流变改善方面银杏叶提取物注射液优于对照组,但在血流速度改善方面不及对照组,均有统计学意义。
北方地区高粱籽粒寄藏禾谷镰孢菌群产毒素化学型的分子检测

禾谷镰孢菌群是高梁籽粒主要寄藏真菌。禾谷镰孢菌侵染高粱籽粒的代谢过程中可以产生多种对人类和动物有害的真菌毒素,其中脱氧雪腐镰孢烯醇(deoxynivalenol,DON)、雪腐镰孢烯醇(nivalenol,NIV)、3-乙酰脱氧雪腐镰孢菌烯醇(3-acetyldeoxynivalenol,3-AcDON)和15-乙酰脱氧雪腐镰孢菌烯醇(15-acetyldeoxynivalenol,15-AcDON)毒性较强。高梁是重要的食用、饲用和酿造用作物,其籽粒上禾谷镰孢菌种群产毒素化学型鲜有报道。为此,本研究利用特异性引物检测其产毒素基因化学型,为评估高粱籽粒潜在的毒素污染风险提供科学依据。
茶刺蛾核型多角体病毒大量增殖的最优条件

茶刺蛾Iragoides fasciata Moore又名茶角刺蛾,是我国茶树的主要害虫,常在有机茶园暴发成灾。茶刺蛾核型多角体病毒(Iragoides fasciata nucleopolyhedrovirus,简称IrfaNPV)属杆状病毒科、核型多角体病毒属Ⅰ组,是控制茶刺蛾种群的重要天敌。已有研究表明,该病毒对茶刺蛾幼虫致病力强、田间防效高、大面积示范应用效果在87%以上。该病毒的大量增殖是生物防治茶刺蛾的基础,然而这方面的研究鲜有报道,其增殖的最优条件尚不清楚。目前,国内外均通过昆虫活体实现昆虫病毒的生产,饲毒的虫龄、浓度和温度等是影响病毒产量的主要因子。为此,本试验探讨了IrfaNPV大量增殖的最优条件,旨在为其工厂化生产提供依据。
关于统一规范献血者职业分类的重要意义探讨

随着采供血机构血液信息系统的网络化、规范化、标准化建设,实现全省或者全国联网,献血信息资源共享是必然的趋势。如果各地收集献血者职业分类的数据口径不一样,各地数据就不能共享和汇总,将失去统计分析的价值。即使一些数据通过处理之后汇总了,也有数据上的失真。
器官移植中的输血治疗策略

器官移植已成为目前治疗终末期器官疾病的最佳方法之一,输血是其中重要的支持治疗措施之一。在制定输血方案时,应根据具体病情需要和输血目的,在充分权衡输血利弊前提下,在选择适当的时机合适的血液成分制品及其剂量,以下简要介绍器官移植患者输血治疗原则。
澳门捐血者中低铁蛋白发生情况的追踪研究

目的了解近年来澳门特区捐血者因血色素不合格而暂缓捐血的百分率逐年上升原因,以及捐血次数和频率对本澳捐血者的影响。方法共收集2 268(人)份捐血者的靜脉血样,检验全血计数和血清铁蛋白,对检出的294名低铁蛋白捐血者中可追踪的118人跟进研究。结果1)首次捐血者的低铁蛋白发生率为3.3%,非常规捐血者为6.7%,常规捐血者为18.6%;2)男性低铁蛋白发生率随过去1年捐血次数增加而上升,女性低铁蛋白发生率在过去1年不同捐血次数间差异没有统计学意义(P>0.05);3)于21个月追踪的118名低铁蛋白捐血者个案中,82.4%男性及57.1%女性常规捐血者铁蛋白已恢复正常,平均所需时间分别为8.5个月(254 d)及8.1个月(244d)。结论常规献血者的低铁蛋白发生率较非常规及首次献血者高,且与献血频率相关;血色素不宜作为唯一评估捐血者铁储备状况的指标。
基于PBL教学模式的学生综合能力评价体系研究

课程、教学和评价三者的有机融合、和谐互动是高等护理教育的改革方向之一。目前,以问题为导向学习(problem-based learning,PBL)已成为高等护理教育的创新学习模式。PBL强调小组教学,以现有临床案例的实际情境为脚本,学生在教师指导下,由案例中练习如何"发掘问题、分析问题并且解决问题"。目的在于培养学生主动学习,终身学习,培养分析、解决问题的能力,更重要的是透过小组沟通讨论,培养沟通协调能力。而学生能力的考核是评价教学效果和改进教学方法的一种途径。《国家中长期教育改革和发展规划纲要(2010~2020)》明确提出:改革教育质量评价和人才评价制度。改进教育教学评价,根据培养目标和人才理念,建立科学、多样的评价标准。探索促进学生发展的多种评价方式,激励学生乐观向上、自主自立、努力成才。传统的教学评价方法只注重学生知识结构水平,忽视学生综合能力的体现;只注重评价的甄别、选拔功能,忽视了评价的导向、激励和诊断发展的功能。研究发现,采用不同的评价方法可极大地影响PBL课程的评价结论。可见,传统的评价方法并不能与PBL教学模式相适应。因此,如何建立适当的课程评价体系是PBL教学模式中值得探讨的重要问题。
喘可治对小鼠异基因皮片移植影响及细胞机制研究

目的研究喘可治注射液(CKZ)对小鼠异基因皮片移植排斥作用的影响及体内外CD4~+ CD25~+Tr变化来探究其细胞机制。方法建立小鼠同种异基因与同基因皮片移植模型同时注射喘可治,记录皮片存活时间,流式细胞仪检测手术前后各组小鼠外周血CD4~+ CD25~+T细胞;将喘可治作用于小鼠体外CD4~+ CD25~+T细胞,检测T细胞CD69和CD25表达.结果同种异基因移植CKZ组的移植皮片存活时间较同种异基因移植对照组显著延长,分别为(20.6±3.2)d和(8.3±2.1)d,P<0.01。喘可治抑制ConA诱导T细胞活化标志分子CD69表达却促进CD25表达。结论喘可治可延长小鼠同种异基因移植皮片存活时间,通过升高CD4~+ CD25~+T细胞水平而发挥免疫抑制效应可能是其机理之一。
机械力与U波形成的相关性

U波是ECG上继T波之后0.02~0.04 s出现的一升支陡直而降支平缓的微小波,时限约0.16~0.25 s,平均0.20 s。以V2~V4导联显著;振幅约0.33 mV或T波振幅的11%;具有频率依赖性,在心率低于65次/min者中90%可见,而心率大于95次/min时很少出现;在V2~V5导联倒置属异常。自1903年Einthoven确认并命名后,关于其形成机制及临床意义至今尚未完全清楚。从ECG形成原理分析,该波形在ECG中的出现与心肌的动作电位无对应关系。多数学者认为是机械-电偶联反馈作用所产生,与心脏疾病的发生、发展密切相关。该波与心室活动有关,与QRS波有常数型相伴关系,与T波无关,为一独立的波形,且与心室肌的除极、复极程序不同。根据心动周期与ECG的时间对应关系分析,该波与心室等容舒张期和快速充盈期时间一致。此时,心脏血流动力学变化明显,瓣膜相继开闭,心壁所受机械刺激较大,且心肌已脱离不应期,对刺激可发生相应反应,于刺激达一定强度,可在ECG上表现为独立的波形。本文回顾性分析各时期U波形成机制并重点就机械刺激与U的关系进行阐述。
河北省老年人生存质量及其相关因素

21世纪是人口老龄化的世纪,全球将面临由人口老龄化所引发的一系列社会问题,其中最关键的问题是实现"健康老龄化"。对老年人生存质量评价是衡量"健康老龄化"的重要指标。截止2011年底,我国老年人口有1.849 9亿,占总人口的13.7%,河北省是中国的人口大省,研究老年人生存质量和影响因素对实现河北省“健康老龄化”具有重要意义。
居家老年慢性病患者抑郁情绪与社会支持、应对方式及生命质量的相关性

老年慢性病伴抑郁症状发生率在15.7%~55.16%。随着人口老龄化的加速和生物医学模式向生物-心理-社会医学模式的转变,老年慢性病患者的心理健康和生命质量问题受到越来越多的关注。本文旨在探讨心理社会因素对抑郁发生及抑郁情绪对其生命质量的影响。
B型钠尿肽在老年急性心肌梗死预后评估中的价值

近年来我国急性心肌梗死(AMI)发病率明显升高,每年死于AMI的人数约有55万人,中老年人无痛性AMI发生率高达58.5%,AMI后致残率达48.3%,死亡率更高达63.2%,并且该病在人群中开始呈低龄化发展,2007~2009年中年人群AMI发生率上升了31.4%。有文献显示,B型钠尿肽(BNP)与AMI。本文选取首次AMI发作的老年患者,分析血液BNP水平与患者治疗出院后的心血管急症及并发症发病率的关系。
我国中西部农村老年人的卫生服务可及性分析

目的了解中国中西部农村老年人的卫生服务可及性,分析影响农村老年人卫生服务满意度的因素。方法采用自制问卷调查对952名60岁及以上的老年人进行调查。结果老年人最近2 w患病率为28.3%,患病后去医疗机构就诊治疗的占62.5%,自我治疗的占21.1%,没有进行治疗的占16.4%。最近1年慢性病患病率为54.4%。最近1年因伤病等原因住院的比例为17.0%,经诊断应住院而未住院的比例为24.7%;距家最近的医疗点中乡镇卫生院占48.3%,村卫生室占43.2%;距家最近的医疗点路程不足1 km、1 km~、3 km~和5 km~分别占49.4%、20.6%、15.7%和14.5%;从家步行到最近的医疗点最快时间少于10 min、10 min~、30 min~和60 min~分别占33.6%、27.7%、26.6%和12.1%。最近1年做过体检、医疗机构收费低、距家最近医疗点的路程短的卫生服务让农村老年人感到满意。结论我国中西部农村的卫生服务可及性有待提高,农村老年人的卫生服务满意度需进一步改善。
慢性低剂量LPS刺激对大鼠脑内黑质部小胶质细胞和多巴胺神经元的影响

目的观察大鼠脑内黑质部反复多次低剂量脂多糖(LPS)注射,导致脑内慢性炎性刺激环境,引起脑内细胞因子释放及对小胶质细胞和多巴胺神经元的影响。方法健康雄性SD大鼠两月龄(体重200~250 g)30只,随机分为LPS一次注射组、PBS四次注射组和LPS四次注射组。LPS一次注射组大鼠右侧黑质部注入亚损伤剂量LPS 0.5μg,LPS四次注射组大鼠脑右侧黑质部注入0.5μg LPS,PBS四次注射组大鼠脑右侧黑质部注入等体积PBS,后两组每月注射一次,共注射四次。在每组最后一次注射后一个月取材。免疫组化检测三组大鼠黑质部小胶质细胞和多巴胺神经元生长情况。ELISA法检测三组大鼠黑质部TNF-α、IL-1β炎症介质含量变化。结果仅一次注入低剂量LPS后,黑质部小胶质细胞形态在1个月后处于正常静止状态,多巴胺神经元也没有减少,LPS四次注射组大脑右侧黑质部小胶质细胞形态发生显著改变,多巴胺神经元数量相对于LPS一次注射组及PBS四次注射组大量减少(P<0.05),ELISA检测LPS四次注射组大脑右侧黑质部TNF-α、IL-1β炎症介质含量也显著增加(P<0.05)。结论黑质部反复多次注入亚损伤剂量LPS能够导致脑内慢性炎症环境,引起小胶质细胞形态和功能改变并对多巴胺神经元产生损伤作用。
结直肠腺癌中Tiam1、血管内皮生长因子-C和血管内皮生长因子受体-3的表达及其临床意义

目的检测结直肠腺癌组织中Tiam1、血管内皮生长因子(VEGF)-C和血管内皮生长因子受体(VEGFR)-3的表达,研究三者表达的关系及对预后的判断价值。方法收集结直肠腺癌标本87例作为观察组,正常结肠黏膜组织80例作为对照组。采用免疫组化技术检测两组中Ti-am1、VEGF-C和VEGFR-3的表达特点,研究三者在不同临床特征中的表达不同及对预后的判断价值。结果结直肠腺癌中Tiam1、VEGF-C和VEG-FR-3表达的阳性率明显高于对照组,结直肠腺癌中Tiam1、VEGF-C和VEGFR-3表达均与肿瘤淋巴结转移、淋巴结转移个数、Dukes分期及Ki-67的表达密切相关。线性相关分析显示结直肠腺癌中Tiam1、VEGF-C和VEGFR-3表达具有正相关性。生存分析显示Tiam1、VEGF-C和VEGFR-3的表达均与结直肠腺癌的预后相关。结论结直肠腺癌中Tiam1、VEGF-C和VEGFR-3高表达,三者可能具有协同作用,共同促进肿瘤的发生与进展,术后联合检测Tiam1、VEGF-C和VEGFR-3的表达对判断预后有一定帮助。
髋关节结核延误诊治1例

髋关节结核在我国骨关节结核发病率中占第3位,国外有报道居于第2位,分为单纯滑膜结核、单纯骨结核、早期全关节结核、晚期全关节结核。部分患者病程中无结核毒血症状,早期关节面软骨完好,实验室检查阳性指标少,因此本病早期误诊率很高,需要与以下疾病鉴别: (1)化脓性髋关节炎:急性发病,有高热、寒战,患髋疼痛、功能障碍明显。中性粒细胞增加。关节腔穿刺涂片与细菌培养多阳性;(2)髋关节暂时性滑膜炎:急性起病,多有上呼吸道感染或轻微外伤史,无结核中毒症状,关节功能障碍轻; (3)股骨头骨软骨炎:儿童多见,一般情况好,无结核中毒症状,髋关节活动受限轻,X线见股骨头骨骺致密、碎裂、扁平;(4)单侧髋类风湿性关节炎:关节晨僵,类风湿因子水平增高; (5)骨样骨瘤:夜间疼痛明显,“牛眼征”瘤巢是本病的主要放射学征象,易与结核所致的骨质坏死硬化混淆; (6)股骨头无菌性坏死:软骨面改变,CT或MRI一般无关节囊积液及饱满;血沉一般不高。
带血管的肘部尺神经前移治疗肘管综合征的探讨

[目的]探讨带神经周围血管的肘部尺神经前移治疗肘管综合征的临床意义、手术方法和临床效果。[方法]对26例(28侧)中重度肘管综合征患者,实施了肘部尺神经皮下前移,其中带神经周围血管13侧(A组),不带神经周围血管15侧(B组)。观察随访28侧,术后3个月和12个月时小指指腹两点辨别觉和第一背侧骨间肌以及小指展肌的肌力并与其术前进行比较。[结果]术后3个月时A、B两组小指指腹两点辨别觉差异无统计学意义(P>0.05),第一背侧骨间肌和小指展肌的肌力差异有统计学意义(P<0.05),A组好于B组。术后12个月时A、B两组小指指腹两点辨别觉和第一背侧骨间肌以及小指展肌的肌力差异无统计学意义(P>0.05)。[结论]尺神经前移时连同尺神经周围伴行血管(尺侧上副、尺侧下副及尺侧返血管)一起游离并前移是可行的,尽可能多地保留神经周围血管对早期恢复尺神经血供、促进尺神经松解前移后的早期肌力恢复有明显意义。
客观评价脓毒症生物标志物的临床意义

脓毒症(sepsis)及其诱发的多器官功能障碍综合征(MODS)仍然是目前重症监护病房(ICU)的主要死因,且其发生率呈上升趋势。由于临床上仍缺乏早期敏感性诊断手段,目前病死率依然很高。随着分子生物学和现代生物技术的不断发展,人们发现多种生物标志物(biomarker)在脓毒症的早期诊断、病情及预后判断、疗效评估中发挥重要作用。因此,深入了解脓毒症病理生理机制中不同生物标志物的意义及价值,对于脓毒症及其并发症的早期识别及干预,降低患者的病死率及提高生活质量具有积极意义。
卵巢浆液性癌的研究进展

卵巢浆液性癌以前多认为是起源于卵巢表面上皮或上皮内陷形成的皮质包涵体。近年来,随着分子生物学与分子遗传学技术的不断发展,研究显示卵巢浆液性癌存在二元发病模式,分别为低级别与高级别浆液性癌。低级别癌由良性、交界性肿瘤发展而来,多伴有KRAS、BRAF或ERBB2突变;高级别卵巢癌大多来源于输卵管上皮,常伴有TP53突变。本文现从卵巢浆液性癌的组织学分级、免疫表型及组织起源方面作一综述。
完全植入式静脉输液港应用及护理进展

完全植入式静脉输液港(totally implantable venous access ports,TIVAP)是一种可植入皮下长期留置在体内的静脉输液装置,主要由供穿刺的注射座和静脉导管系统组成,可用于输注各种药物、补充液体、营养支持治疗、输血和血标本采集等。1982年TIVAP在国外被首次报道,此后开始应用于临床。我国于1988年引进TIVAP,1998年在国内首次被报道。随着TIVAP不断发展及其众多优点,该技术逐渐被国内许多医院接受并应用。本文就完全植入式静脉输液港应用及护理方面做一综述。
血小板输注无效的病因和对策

血小板是人体生理性止血和凝血机制中至关重要的血液成分,临床上出现血小板数量减少或功能障碍时,输注血小板是简单有效的治疗措施之一。血小板输注无效(platelet transfusion refractoriness,PTR)是血小板输注中主要的并发症之一,患者可因输入的血小板在体内被迅速破坏而危及生命。
G6PD检测对新生儿红素血症换血治疗的临床意义

新生儿红素血症(neonatal hyperbilirubinemia,NHB)是新生儿时期最常见的疾病之一,对新生儿的健康危害极大。尽管新生儿NHB与红细胞葡萄糖-6-磷酸脱氢酶(glucose 6-phosphate dehydrogenase,G6PD)活性缺乏的关系已引起了国内外临床医师的广泛重视,然而换血血源中的G6PD活性检测尚未作为血库工作中的常规试验。
沈阳地区无偿献血者戊型肝炎病毒感染情况调查

目的调查沈阳地区无偿献血者戊型肝炎病毒感染情况。方法随机抽取2250例无偿献血者标本,采用ELISA方法检测HEV-Ag、抗-HEV IgG和抗-HEV IgM。结果2 250名无偿献血者标本HEV-Ag阳性率为0;抗-HEV IgG阳性率为28.76%(647/2 250);抗-HEV IgM阳性率为2.58%(58/2 250)。ALT异常的抗-HEV IgG和抗-HEV IgM阳性率高于正常样品。结论献血者存在感染HEV情况,可能与ALT异常相关,为保证用血安全,有必要对输血感染风险进行评估。
溶血性输血反应与细菌性输血反应处置流程

近年来,因输血不良反应尤其是溶血性输血反应与细菌性输血反应导致病人死亡事故时有发生。卫生部相继颁布了《医院等级评审标准-输血管理与持续改进》与《三级综合医院评审标准实施细则(2011年版)》4.19.5.4有控制输血严重危害(SHOT)的方案与实施情况记录;卫生部已颁布了《医疗机构临床用血管理办法》(2012年版)第二十四条:医疗机构应当建立输血不良事件监测报告制度。
Population pharmacokinetics of lamotrigine in Chinese children with epilepsy

Aim: To establish a population pharmacokinetics (PPK) model for lamotrigine (LTG) in Chinese children with epilepsy in order to formulate an individualized dosage guideline. Methods: LTG steady-state plasma concentration data from therapeutic drug monitoring (TDM) were collected retrospectively from 284 patients, with a total of 404 plasma drug concentrations. LTG concentrations were determined using a HPLC method. The patients were divided into 2 groups: PPK model group (n=116) and PPK valid group (n=168). A PPK model of LTG was established with NONMEM based on the data from PPK model group according to a one-compartment model with first order absorption and elimination. To validate the basic and final model, the plasma drug concentrations of the patients in PPK model group and PPK valid group were predicted by the two models.Results: The final regression model for LTG was as follows: CL (L/h)=1.01~*(TBW/27.87)~(0.635)~*e~(-0.753*VPA)~*e~(0.868)~*CBZ~*e~(0.633)~*PB, Vd (L)= 16.7~*(TBW/27.87). The final PPK model was demonstrated to be stable and effective in the prediction of serum LTG concentrations by an internal and external approach validation.Conclusion: A PPK model of LTG in Chinese children with epilepsy was successfully established with NONMEM. LTG concentrations can be predicted accurately by this model. The model may be very useful for establishing initial LTG dosage guidelines.
内镜窄带成像技术指导靶向活检提高溃疡型胃癌诊断的研究

目的:探讨内镜窄带成像技术指导靶向活检提高胃癌诊断的价值。方法:对66例首次普通胃镜检查诊断为胃溃疡,溃疡直径>1.5 cm、活检病理检查未诊断为胃癌的患者,1周内再次行窄带成像技术(NBI)内镜检查,NBI清晰显示溃疡周围黏膜胃小凹形态后指导活检行病理检查。结果:66例患者根据病理结果,诊断胃癌9例,良性溃疡57例,其中伴有肠上皮化生5例,轻度异型增生3例,中度异型增生1例。依据NBI内镜下显示的胃溃疡周围黏膜的胃小凹形态活检行病理学检查,11例Ⅵ型者中9例病理诊断为胃癌,1例诊断为中度异型增生,1例诊断为轻度异型增生;5例III+V2型者诊断为肠上皮化生;2例Ⅳ+V:型者诊断为轻度异型增生。9例胃癌均行手术治疗,其中7例为早期胃癌,2例为进展期胃癌,已侵达肌层。结论:对NBI内镜下显示胃溃疡周围黏膜胃小凹形态表现为Ⅵ型者,进行靶向活检病理检查,可提高胃癌,特别是早期胃癌的诊断率。
Changes of Precipitation Infiltration Recharge in the Circumstances of Coal Mining Subsidence in the Shen-Dong Coal Field, China

Coal mining subsidence is a universal environmental-geological problem in mining areas. By selecting the Shen-Dong coal mining subsidence area as the research field, this paper studies the changes in precipitation infiltration recharge in the circumstances of coal mining subsidence by means of field geological investigation and laboratory simulation experiments, which is expected to provide a scientific basis for eco-environmental restoration in the mining area. The results indicate that at the unstable stage of subsidence, three types of subsidence in the Shen-Dong mining area have positive effects on the precipitation infiltration recharge, and the type of full-thickness bedrock subsidence has the greatest influence. In the stable stage of subsidence, the precipitation infiltration process after long-term drought and the moisture migration in the aeration zone undergo three different stages: evaporation-infiltration before precipitation, infiltration-upward infiltration-infiltration during precipitation and evaporation-infiltration after precipitation. During a heavy rainfall infiltration process, the wetting front movement in fine sand, coarse sand and dualistic structure of fine-coarse sand consists of two stages: the stage of wetting front movement during precipitation, in which the wetting front movement distance has linear relationship with the depth, and the stage of wetting front movement after precipitation, in which the wetting front movement distance has the power function relationship with the depth. The wetting front movement velocity is influenced by the rainfall amount and the lithology in the aeration zone. However, as the depth increases, the movement velocity will decay exponentially.