mlsa-iai-msu-lab/ru_sci_bench_zho_cite_reranking huggingface dataset:
Mutation Analysis of MR-1, SLC2A1, and CLCN1 in 28 PRRT2-negative Paroxysmal Kinesigenic Dyskinesia Patients

Background: Paroxysmal kinesigenic dyskinesia (PKD) is the most common subtype of paroxysmal dyskinesias and is caused by mutations in PRRT2 gene. The majority of familial PKD was identified to harbor PRRT2 mutations. However, over two-third of sporadic PKD patients did not carry anyPRRT2 mutation, suggesting an existence of additional genetic mutations or possible misdiagnosis due to clinical overlap. Methods: A cohort of 28 Chinese patients clinically diagnosed with sporadic PKD and excluded PRRT2 mutations were recruited. Clinical features were evaluated, and all subjects were screened for MR-1, SLC2A1, and CLCN1 genes, which are the causative genes of paroxysmal nonkinesigenic dyskinesia (PNKD), paroxysmal exertion-induced dyskinesia, and myotonia congenita (MC), respectively. In addition, 200 genetically matched healthy individuals were recruited as controls. Results: A total of 16 genetic variants including 4 in MR-1 gene, 8 in SLC2AI gene, and 4 in CLCN1 gene were detected. Among them, SLC2A1 c.363G>A mutation was detected in one case, and CLCN1 c.1205C>T mutation was detected in other two cases. Neither of them was found in 200 controls as well as 1000 Genomes database and ExAC database. Both mutations were predicted to be pathogenic by SIFT and PolyPhen2. The SLC2A1 c.363G>A mutation was novel. Conclusions: The phenotypic overlap may lead to the difficulty in distinguishing PKD from PNKD and MC. For those PRRT2-nQgati\Q PKD cases, screening of SLC2A1 and CLCN1 genes are useful in confirming the diagnosis.
The benefits of understanding complementary medicine options for patients with male factor infertility

Infertility affects roughly 15% of couples; in nearly half of these cases, there is a male contributing factor.1 Along with advances in modern drugs and assisted reproductive technologies, some infertile patients choose to use complementary and alternative medical therapies (CAM). These are either administered as adjuncts or, in some cases, as the sole mode of medical therapy. Reasons for using CAM vary and may include faith, beliefs, economic factors or simply fear of a surgical procedure and apprehension about using hormone-modifying medications.
Vegetation dynamics and its response to climate change in Central Asia

The plant ecosystems are particularly sensitive to climate change in arid and semi-arid regions. However, the responses of vegetation dynamics to climate change in Central Asia are still unclear. In this study, we used the normalized difference vegetation index (NDVI) data to analyze the spatial-temporal changes of vegetation and the correlation of vegetation and climatic variables over the period of 1982-2012 in Central Asia by using the empirical orthogonal function and least square methods. The results showed that the annual NDVI in Central Asia experienced a weak increasing trend overall during the study period. Specifically, the annual NDVI showed a significant increasing trend between1982 and 1994, and exhibited a decreasing trend since 1994. The regions where the annual NDVI decreased were mainly distributed in western Central Asia, which may be caused by the decreased precipitation. The NDVI exhibited a larger increasing trend in spring than in the other three seasons. In mountainous areas, the NDVI had a significant increasing trend at the annual and seasonal scales; further, the largest increasing trend of NDVI mainly appeared in the middle mountain belt (1,700-2,650 m asl). The annual NDVI was positively correlated with annual precipitation in Central Asia, and there was a weak negative correlation between annual NDVI and temperature. Moreover, a one-month time lag was found in the response of NDVI to temperature from June to September in Central Asia during 1982-2012.
Spatio-temporal patterns of satellite-derived grassland vegetation phenology from 1998 to 2012 in Inner Mongolia, China

Spatio-temporal variations of vegetation phenology, e.g. start of green-up season (SOS) and end of vegetation season (EOS), serve as important indicators of ecosystems. Routinely processed products from remotely sensed imagery, such as the normalized difference vegetation index (NDVI), can be used to map such variations. A remote sensing approach to tracing vegetation phenology was demonstrated here in application to the Inner Mongolia grassland, China. SOS and EOS mapping at regional and vegetation type (meadow steppe, typical steppe, desert steppe and steppe desert) levels using SPOT-VGT NDVI series allows new insights into the grassland ecosystem. The spatial and temporal variability of SOS and EOS during 1998-2012 was highlighted and presented, as were SOS and EOS responses to the monthly climatic fluctuations. Results indicated that SOS and EOS did not exhibit consistent shifts at either regional or vegetation type level; the one exception was the steppe desert, the least productive vegetation cover, which exhibited a progressive earlier SOS and later EOS. Monthly average temperature and precipitation in preseason (February, March and April) imposed most remarkable and negative effects on SOS (except for the non-significant impact of precipitation on that of the meadow steppe), while the climate impact on EOS was found to vary considerably between the vegetation types. Results showed that the spatio-temporal variability of the vegetation phenology of the meadow steppe, typical steppe and desert steppe could be reflected by the monthly thermal and hydrological factors but the progressive earlier SOS and later EOS of the highly degraded steppe desert might be accounted for by non-climate factors only, suggesting that the vegetation growing period in the highly degraded areas of the grassland could be extended possibly by human interventions.
Spatio-temporal variation in transpiration responses of maize plants to vapor pressure deficit under an arid climatic condition

The transpiration rate of plant is physically controlled by the magnitude of the vapor pressure deficit (VPD) and stomatal conductance. A limited-transpiration trait has been reported for many crop species in different environments, including Maize (Zea mays L.). This trait results in restricted transpiration rate under high VPD, and can potentially conserve soil water and thus decrease soil water deficit. However, such a restriction on transpiration rate has never been explored in maize under arid climatic conditions in northwestern China. The objective of this study was to examine the transpiration rate of field-grown maize under well-watered conditions in an arid area at both leaf and whole plant levels, and therefore to investigate how transpiration rate responding to the ambient VPD at different spatial and temporal scales. The transpiration rates of maize at leaf and plant scales were measured independently using a gas exchange system and sapflow instrument, respectively. Results showed significant variations in transpiration responses of maize to VPD among different spatio-temporal scales. A two-phase transpiration response was observed at leaf level with a threshold of 3.5 kPa while at the whole plant level, the daytime transpiration rate was positively associated with VPD across all measurement data, as was nighttime transpiration response to VPD at both leaf and whole plant level, which showed no definable threshold vapor pressure deficit, above which transpiration rate was restricted. With regard to temporal scale, transpiration was most responsive to VPD at a daily scale, moderately responsive at a half-hourly scale, and least responsive at an instantaneous scale. A similar breakpoint (about 3.0 kPa) in response of the instantaneous leaf stomatal conductance and hourly canopy bulk conductance to VPD were also observed. At a daily scale, the maximum canopy bulk conductance occurred at a VPD about 1.7 kPa. Generally, the responsiveness of stomatal conductance to VPD at the canopy scale was lower than that at leaf scale. These results indicate a temporal and spatial heterogeneity in how maize transpiration responses to VPD under arid climatic conditions. This could allow a better assessment of the possible benefits of using the maximum transpiration trait to improve maize drought tolerance in arid environment, and allow a better prediction of plant transpiration which underpin empirical models for stomatal conductance at different spatio-temporal scales in the arid climatic conditions.
Effect of Pisha sandstone on water infiltration of different soils on the Chinese Loess Plateau

The infiltration of water into soil is one of the most important soil physical properties that affect soil erosion and the eco-environment, especially in the Pisha sandstone area on the Chinese Loess Plateau. We studied the one-dimensional vertical infiltration of water in three experimental soils, created by mixing Pisha sandstone with sandy soil, irrigation-silted soil, and loessial soil, at mass ratios of 1:1, 1:2, 1:3, 1:4, and 1:5. Our objective was to compare water infiltration in the experimental soils and to evaluate the effect of Pisha sandstone on water infiltration. We assessed the effect by measuring soil bulk density (BD), porosity, cumulative infiltration, infiltration rate and saturated hydraulic conductivity (Ks). The results showed that Pisha sandstone decreased the infiltration rate and saturated hydraulic conductivity in the three experimental soils. Cumulative infiltration over time was well described by the Philip equation. Sandy soil mixed with the Pisha sandstone at a ratio of 1:3 had the best water-holding capacity. The results provided experimental evidence for the movement of soil water and a technical support for the reconstruction and reclamation of mining soils in the Pisha sandstone area.
警惕糖尿病患者的负性情绪

心理因素,特别是情绪因素参与疾病过程,尤其是慢性非传染性疾病的发病、诊疗、预后等各个阶段。而由于学科“壁垒”使医学界对心理因素及生物学因素的认识和临床实践截然分离。本文与业内分享负性情绪在糖尿病致病、诊疗、预后方面的作用,从而树立心身统一的理念以及采用大医学的理念来认识传统意义上的“专科疾病”,以便提高临床治疗的质量,也为研究糖尿病提供新的思考。
Treatment of Fibrillary Glomerulonephritis by Corticosteroids and Tripterygium Glycoside Tablets: A Case Report

Fibrillary glomerulonephritis (FGN) is a rare kidney disease characterized by the deposition of randomly arranged fibril deposits 15-30 nm in diameter, mainly in the mesangium and/or glomerular basement membranes (GBMs), and negative Congo red staining.~((1,2) The diagnosis of FGN is made in about 1% of native kidney biopsy specimens.~((3)) Upon presentation, most patients show high-grade proteinuria and decreased kidney function.(4) At this time, no specific treatment is available for patients with FGN.~((4-6)) Glomerular injury is associated with immunoglobulin and complement deposition, and FGN may be secondary to a B-cell dyscrasia.~((1)) Thus, corticosteroids and immunosuppressive agents may be useful for treatment. In this report, we present a patient with FGN who improved clinically after treatment with corticosteroid and tripterygium glycoside tablets.
感染

抗逆转录病毒治疗的进展显著增加了HIV患者的预期寿命,AIDS相关的死亡自从2005年达到高峰后目前已下降了30%。HIV感染使机体倾向于一种慢性炎症及免疫失调状态,随后的高效抗逆转录病毒疗法(HAART)也可导致代谢改变及血脂异常。在高效抗逆转录治疗后期,冠状动脉疾病被认为是导致HIV病毒感染患者心的主要原因,已超过以前最常见的病因,心肌炎及机会性感染。除年龄小外,冠状动脉疾病在HIV感染患者中的表现与一般人群大致相同,一些抗逆转录病毒的特异度蛋白酶抑制剂通常与脂质代谢紊乱有关,并使HIV感染患者的病情进一步复杂化。最近的研究指出,C-C趋化因子受体5 (CCR5)拮抗剂已成为抗逆转录药物治疗以及抗动脉粥样硬化的潜在靶点,但需要更多的研究。
Capability-Aware Data Placement for Heterogeneous Active Storage Systems

By moving computations from computing nodes to storage nodes, active storage technology provides an efficient for data-intensive high-performance computing applications. The existing studies have neglected the heterogeneity of storage nodes on the performance of active storage systems. We introduce CADP, a capability-aware data placement scheme for heterogeneous active storage systems to obtain high-performance data processing. The basic idea of CADP is to place data on storage nodes based on their computing capability and storage capability, so that the load-imbalance among heterogeneous servers can be avoided. We have implemented CADP under a parallel I/O system. The experimental results show that the proposed capability-aware data placement scheme can improve the active storage system performance significantly.
锥颅穿刺抽吸引流血肿清除术治疗老年高血压脑出血的疗效

目的探讨锥颅穿刺抽吸引流血肿清除术治疗高血压脑出血的疗效。方法选择2012年1月至2014年12月在海南省农垦三亚医院就诊的高血压脑出血患者122例,随机分成两组各61例。对照组接受开颅手术治疗。观察组接受锥颅穿刺抽吸引流血肿清除术治疗。比较两组患者的疗效、美国国立卫生研究院卒中量表(NIHSS)评分以及白细胞介素(IL)-6、超敏C-反应蛋白(hs-CRP)、神经元特异性烯醇化酶(NSE)水平。结果观察组总有效率高于对照组(P<0.05)。治疗后,观察组患者血清IL-6、hs-CRP、NSE水平及NIHSS评分、残留血肿体积都低于对照组(P<0.01)。结论锥颅穿刺抽吸引流血肿清除术治疗高血压脑出血疗效显著,能够减轻患者局部炎症反应、促进受损神经功能的恢复。
血清CD40、CD40L和基质金属蛋白酶-9水平与颈动脉内膜中层厚度的相关性

目的观察颈动脉粥样硬化(CAS)患者颈动脉内膜中层厚度(IMT)、白细胞分化抗原40及其配体(CD40/CD40L)和基质金属蛋白酶9(MMP-9)变化,探讨上述指标之间的关系。方法选择CAS患者94例,其中IMT增厚的有34例,颈动脉斑块形成的有60例;健康体检者20例(IMT正常组)。采用颈动脉超声检测实验组和对照组IMT,采用酶联免疫吸附试验(ELISA)法检测两组血清CD40、CD40L和MMP-9水平。结果随着IMT的增厚,血清CD40、CD40L、MMP-9水平明显升高(P<0.05);有不稳定斑块的CAS患者IMT及血清CD40、CD40L、MMP-9水平较稳定斑块患者明显升高,不稳定斑块CAS患者脑梗死(CI)发病率高于斑块稳定组(P均<0.05)。结论血清CD40、CD40L、MMP-9能促进CAS的形成和增厚,MMP-9能增加斑块的不稳定性,导致CI的发生,监测血清CD40、CD40L、MMP-9水平,能用来预测CAS患者的IMT、斑块的稳定性和疾病的预后。
毕节地区老年社区获得性肺炎流行病学特征

目的探讨毕节地区老年社区获得性肺炎(CAP)流行病学特征及病原体分布情况。方法2010年1月至2014年12月毕节地区共7所医院就诊的2 685例老年(年龄≥60岁)CAP患者进行病原菌检测,静脉血检查衣原体及支原体,采用呼吸道分泌物进行细菌培养,酶联免疫吸附(ELISA)法检测呼吸道病毒抗原。结果与2010~2012年相比,2013~2014年老年CAP发病率显著升高(P<0.05)。不同性别老年CAP发病率无统计学差异(P>0.05),而秋冬季CAP发病率高于春夏季(P<0.05),年龄>80岁的患者CAP发病率显著高于60~70岁及71~80岁的患者(P<0.05)。细菌感染1 308例(48.72%),病毒感染685例(25.51%),支原体/衣原体感染692例(25.77%)。近2年老年CAP细菌性感染比例显著升高,而支原体/衣原体、病毒性感染近几年感染率无明显变化(P>0.05)。对细菌感染患者进行耐药性分析,革兰阳性(G~+)球菌对万古霉素、利奈唑胺敏感率较高。革兰阴性(G~-)杆菌对亚胺培南、阿米卡星的敏感率较高。结论应根据CAP流行病学特征及病原菌分布情况及药敏试验给予针对性干预。
老年人及非老年人胸部恶性肿瘤患者调强放射治疗后常规心电图与动态心电图变化的比较

目的探讨老年人及非老年人胸部恶性肿瘤患者调强放射治疗(IMRT)前、中、后常规心电图(ECG)和动态心电图(AECG)的异常检出率有何不同;探讨两组间患者在IMRT后ECG、AECG异常检出率是否一致。方法选择90例胸部恶性肿瘤IMRT的患者,于IMRT前、中、后进行ECG及AECG检查,按年龄≥60岁及<60岁分为老年组及非老年组,比较两组间前、中、后ECG、AECG的异常检出率情况,并对两组间在IMRT后ECG、AECG异常检出率进行比较。结果ECG异常检出率在老年组与非老年组胸部肿瘤患者在IMRT前、中、后均无明显统计学差异(P>0.05);AECG异常检出率在IMRT前两组间无明显统计学意义(P>0.05),但老年组IMRT中及IMRT后异常检出率均高于非老年组(P<0.05);老年组与非老年组间在IMRT后AECG异常检出率均高于ECG异常检出率(P<0.05)。结论对于IMRT患者特别是老年患者均应进行AECG检测,以期早期发现RIHD并及时进行干预。
甲状腺功能对心脏再同步化治疗的影响

目的观察甲状腺功能对慢性心力衰竭患者心脏再同步化治疗(CRT)的影响。方法选择29例植入CRT/CRT-D患者,根据其术前游离三碘甲状腺原氨酸(FT3)水平分为二组:正常组(FT3>3.50 pmol/L),低FT3组(FT3<3.50 pmol/L),观察二组患者术后6个月心功能分级、QRS波时限、左室射血分数(LVEF)、左室舒张末期内径(LVEDd)、肺动脉收缩压(PASP)等超声心动图指标的变化;并观察二组术后FT3的变化。结果CRT术后6个月,二组患者心功能均明显改善(P<0.05);LVEF升高,其中低FT3组术后LVEF升高更明显(P<0.05);二组患者术后QRS波时限、LVEDd及PASP有下降的趋势。与术前比较,术后6个月低FT3组患者FT3水平显著增高(P<0.01);正常组患者术后FT3水平与术前无差异。结论低FT3心衰患者对CRT反应不逊于FT3正常患者,其机制可能为CRT提高FT3水平,改善心功能。
丁苯酞对阿尔茨海默病大鼠海马p38丝裂原激活蛋白激酶和细胞外信号调节激酶表达的影响

目的探究丁苯酞对阿尔茨海默病(AD)大鼠海马区中p38丝裂原激活蛋白激酶(MAPK)和细胞外信号调节激酶(ERK)表达的影响。方法雄性成年SD大鼠90只随机分为试验组、对照组和空白组各30只,在试验组和对照组大鼠海马区内注射Aβ1~42建立AD模型,建模后第2天开始给予试验组丁苯酞灌胃,对照组和空白组给予相同剂量的食用麻油,共喂养30 d。之后通过Y型迷宫比较三组学习记忆能力,通过免疫组织化学染色方法比较三组脑组织中p38MAPK和ERK的表达水平。结果三组学习记忆能力由强到弱依次为空白组,试验组和对照组;三组CA1海马区p38MAPK表达阳性的细胞数量由高到低依次为对照组、试验组和空白组;三组大脑皮层中ERK表达水平由高到低依次为空白组,试验组和对照组,差异均有统计学意义(P<0.05)。结论丁苯酞可明显改善AD大鼠的学习记忆能力,其原因可能与海马区p38MAPK表达下降及大脑皮层中ERD表达提高有关。
阴道不规则流血4月,CT检查“右下肺占位病变” 10天

总之,耐药和复发已经成为GTN治疗失败及死亡的主要原因,导致化疗耐药的原因很多:化疗方案选择不合理或因惧怕化疗副反应而随意减少药物剂量、化疗方案耐药未及时更换方案、巩固化疗不充分、患者经济能力差及依从性差等。在耐药性GTN的治疗中,应当遵循个体化原则,采用化疗、放疗和手术等多种治疗方法相结合的综合治疗。手术治疗在耐药性GTN的治疗中不容小觑,γ刀治疗颅内单一转移灶也许会成为一种新的有效的方案。
32卷4期疑难病案

术后患者一直诉头昏、恶心,并呕吐少许胃内容物数次,伴轻微下腹疼痛,无肛门坠胀。多次监测各项生命体征指标均在正常范围。术后4小时左右,患者上述症状无明显缓解,收住院观察治疗。当日下午入院后,査体温36℃,呼吸20/min,心率76/min,血压94/60 mmHg,阴道超声检查:右侧卵巢8.8 cm×3.0 cm,左侧卵巢7.7 cm×5.8 cm,盆腔内见7.5 cm × 4.0 cm不规则无回声区,透声尚可。胸部B超检查:双侧胸腔内未见明显无回声区。血常规:WBC 24.6 × 10~9/L,N 0.920, HCT 0.344,Hb 119 g/L。入院后经阴道后穹隆穿刺抽出少许淡红色液体。给予抗感染对症补液等治疗,患者症状无明显缓解。9月7日晨患者心率增快,波动于100 ~ 120/min,血压波动于96 ~ 108/67 ~70 mmHg,复查血常规:WBC 29.7 × 10~9/L, N 0.919,HCT 0.344,Hb 70 g/L。凝血功能:APTT45秒,FIB 1. I g/L。血Na 129 mmol/L,Ca 1.92 mmol/L。阴道超声及腹部B超检查:右侧卵巢8.6 cm ×4.7 cm,左侧卵巢10.2 cm × 8.0 cm,子宫前后方分别见5.2 cm × 3.1 cm、4.3 cm × 2.1 cm不规则无回声区,脾肾间隙,肝肾间隙均可见游离无回声区,最深处约8.0 cm。行经腹壁肝下间隙穿刺抽出不凝血。
The Effect of Variable Stator on Performance of a Highly Loaded Tandem Axial Flow Compressor Stage

Increasing the aerodynamic load on compressor blades helps to obtain a higher pressure ratio in lower rotational speeds. Considering the high aerodynamic load effects and structural concerns in the design process, it is possible to obtain higher pressure ratios compared to conventional compressors. However, it must be noted that imposing higher aerodynamic loads results in higher loss coefficients and deteriorates the overall performance. To avoid the loss increase, the boundary layer quality must be studied carefully over the blade suction surface. Employment of advanced shaped airfoils (like CDAs), slotted blades or other boundary layer control methods has helped the designers to use higher aerodynamic loads on compressor blades. Tandem cascade is a passive boundary layer control method, which is based on using the flow momentum to control the boundary layer on the suction surface and also to avoid the probable separation caused by higher aerodynamic loads. In fact, the front pressure side flow momentum helps to compensate the positive pressure gradient over the aft blade's suction side. Also, in comparison to the single blade stators, tandem variable stators have more degrees of freedom, and this issue increases the possibility of finding enhanced conditions in the compressor off-design performance. In the current study, a 3D design procedure for an axial flow tandem compressor stage has been applied to design a highly loaded stage. Following, this design is numerically investigated using a CFD code and the stage characteristic map is reported. Also, the effect of various stator stagger angles on the compressor performance and especially on the compressor surge margin has been discussed. To validate the CFD method, another known compressor stage is presented and its performance is numerically investigated and the results are compared with available experimental results.
A型肉毒毒素对佐剂关节炎大鼠神经源性炎症机制的研究

本研究希望在分子生物学层面观察关节腔注射A型肉毒毒素(BoNT/A)是否可以减轻关节炎炎性因子的水平,并探讨其在神经源性炎症中的作用。
倒梨形设计的腓肠神经营养血管皮瓣修复小腿及足踝创面缺损

目的探讨倒梨形设计的腓肠神经营养血管皮瓣修复小腿及足踝创面缺损的临床效果。方法自2009年7月至2015年11月,应用倒梨形设计的腓肠神经营养血管皮瓣修复胫前、跟骨、内外踝以及足背等处软组织缺损共37例,其中男31例,女6例。年龄2 ~ 88岁,平均50岁。皮瓣切取面积为4 cm x 3 cm ~18 cm × 12 cm。 结果37例皮瓣全部成活,仅1例修复足背静脉曲张性溃疡创面部分表层坏死,经二期游离植皮愈合。所有皮瓣与钢板及骨、肌腱创面均愈合良好,肤色接近,皮瓣质地及弹性均满意。经随访10 ~ 18个月,足踝部及小腿功能恢复正常或接近正常,供区植皮愈合佳,直接缝合者无明显增生性瘢痕,皮瓣两点辨别觉7~10mm。 结论应用倒梨形设计的腓肠神经营养血管皮瓣可安全有效地保证皮瓣的血供并增加皮瓣面积,更好地修复小腿及足踝部创面缺损。
游离腓骨皮瓣移植修复四肢复合组织缺损七例

目的探讨游离腓骨皮瓣移植修复四肢复合组织缺损的临床应用。方法2010年3月至2013年12月,应用游离腓骨皮瓣移植修复足背及第1跖骨缺损3例,足背皮肤及第5跖骨缺损2例,前臂远端皮肤、桡骨、桡动脉缺损2例,皮瓣面积10 cm x 6 cm ~ 15 cm x 10 cm,均一期修复。结果游离腓骨皮瓣全部成活,经6个月~3年随访,修复肢体功能恢复良好,骨端愈合良好,供区膝、踝关节无明显运动障碍。结论应用游离腓骨皮瓣修复四肢复合组织缺损,可同时修复骨质、皮肤缺损,因移植骨血液循环良好,减少了骨不愈合的机会,是修复四肢复合组织缺损的较好方法。
逻辑思维在人体解剖学教学中的应用

形象思维基于表象,以联想和想象为基本形式。而逻辑思维是思维的基础和核心,创新能力的培养和成果的检验离不开逻辑思维的推理和论证,方法包括抽象与概括、比较与分析、分类与综合、判断与推理,和明确概念的限制、概括、定义及划分。
穿支皮瓣的临床应用原则专家共识

皮瓣的应用发展主要经历了最初的局部旋转皮瓣和后来的远位带蒂皮瓣、游离皮瓣、带血管蒂皮瓣、穿支皮瓣等阶段。近40余年来,显微外科技术的诞生解决了小血管吻合难题,显微解剖研究深入认识了皮瓣的血液供应规律,先后诞生了游离皮瓣和穿支皮瓣。游离皮瓣解决了过去处理极为棘手、治疗效果不佳甚至无法修复的创面难题,是皮瓣外科发展史上的一个里程碑;穿支皮瓣突破了“深筋膜血管网是皮瓣赖以生存必备条件”的传统观念,使皮瓣移植迈向了“自由王国”,实现了以最小的供区损害获得最佳的受区外形和功能,代表目前皮瓣外科的最新进展,是皮瓣外科发展史上又一次飞跃。
基于文献计量分析的生态修复现状研究

以中国知网学术期刊网络出版总库和WEB OF SCIENCE中1997—2015年的期刊论文为数据源,以“生态修复(ecological remediation和ecological restoration) ”为关键词进行检索,利用共词分析方法,同时结合Bibexcel软件对检索结果进行分析,利用Ucinet和Netdraw软件绘制出共词网络可视图,并通过SPSS软件进行多维尺度分析,以此来研究高频关键词之间的内在联系, 探讨国内外生态修复领域中的研究热点以及研究现状。以文献计量学的分析方法客观的评价国内外生态修复的研究概况及研究热点,明确生态修复技术研究探索的方向,从而为加强生态修复技术的研究提供理论依据。
某高扬程长距离供水工程水锤防护措施

某高扬程长距离供水工程水源由已建成的地下水源提供,供水工程需建设集中扬水泵站,分两条管线分别向园区甲和园区乙供水,解决两个园区的生活用水。工程设计总供水规模为1.5万m~3/d,其中园区甲设计供水规模为0.5万m~3/d,园区乙设计供水规模为1.0万m~3/ d。工程属于I型集中式供水工程,泵站等别为Ⅲ级,泵站规模为中型。
新疆塔城市阿不都拉水库设计及坝体应力应变分析

阿不都拉水库位于新疆维吾尔自治区西北部的塔城市境内,水库坝址距阿不都拉乡政府所在地约10 km,距塔城市约31 km,水库坝址以上集水面积259 km~2。水库总库容3560×10~4m~3,根据《水利水电工程等级划分及洪水标准》(SL252—2000),该水库工程规模为中型,工程等别为Ⅲ等,永久性主要建筑物级别为3级。由于坝高超过70 m,大坝级别提高一级,洪水标准不提高,其余永久性主要建筑物级别为3级,永久性次要建筑物级别为4级,临时导流建筑物为4级,其他临时性水工建筑物级别为5级。设计洪水重现期为50年,最大洪峰流量120 m~3/s,校核洪水重现期为1000年,最大洪峰流量262 m~3/s,下游消能防冲设施标准为30年一遇。工程区地震基本烈度为Ⅵ度,区域内地震动峰值加速度0.05g,主要建筑物均按Ⅵ度设防。
规范与推广肺癌小样本取材势在必行

肺癌的发病原因错综复杂、肿瘤异质性高,即使病理类型相同,患者的病情演变过程及对治疗的反应也可能存在很大的差异。当今,对疾病的诊治巳进入精准医疗时代。对肺癌的治疗,需要根据组织病理学亚型和特异性的肿瘤驱动基因突变共同决定。由于肺癌早期缺乏特异性的临床症状,多数患者就诊时巳是中晚期,失去了手术的最佳时机。因此应尽量采用微创的手段,获取小的活检组织和/或细胞学样本来确立诊断,使对患者的损伤降至最低。当前临床最为常用的肺癌小样本取材方法包括经支气管腔内取材和经皮穿刺肺活检两大类。尽管这两种方法巳在我国广泛应用,但对临床疑似和/或已确诊的肺癌小样本活检或再次活检,以及取材过程中及取材前后涉及的重要细节尚存争议,尚缺乏系统的、标准化的指南以供操作者遵循与借鉴。为此制定“肺癌小样本取材相关问题的中国专家共识”,希望藉此规范肺癌小样本取材操作。由于恶性病变性质和预后评估等方面的特殊性,本共识中涉及的一些问题在肺部良性病变的取材中可能不完全适用。
生物制剂在类风湿关节炎合并妊娠患者应用中的研究进展

类风湿关节炎(RA)是以侵蚀性、对称性多关节炎为主要表现的慢性、全身性自身免疫病。我国大陆地区RA的患病率约为0.2% ~0.4%,女性多发,男女比约1:3。RA可发生于任何年龄,其中部分患者处于育龄期。有研究发现,部分女性RA患者在妊娠期间的病情往往会趋于稳定或自发改善,但仍有一部分患者处于病情活动状态。妊娠期的活动性RA不仅影响母体健康,还会增加新生儿早产率、低体重发生率和围产期病死率。孕前或孕期积极控制病情,可避免上述早产等不良反应的发生。目前生物制剂在控制RA的病情方面发挥了很大的作用,它可以防止或延缓关节的破坏,改善患者的身体机能。近年来,RA患者妊娠期应用生物制剂治疗的相关报道日渐增多,现对常用的生物制剂,如英夫利西单抗、依那西普、利妥昔单抗等,在RA患者妊娠期的应用综述如下。
我国外科出院患者延续护理实施现状及建议

随着医疗水平的提升及优质护理的深入开展,患者对医疗服务的要求越来越高,传统医疗照护服务无法满足患者出院后的护理需求,患者在出院后仍会遇到不同的健康问题。在全世界致力于改善患者出院后生活质量的大背景下,患者出院后护理的协调性和连续性问题逐渐受到重视。而延续护理对于改善患者预后、促进患者康复、提高患者生活质量、降低再住院率及卫生服务成本均具有十分重要的意义。所谓延续护理是指通过一系列的行动设计,以确保患者在不同的健康照护场所(如从医院到家庭)及同一健康照护场所(如医院的不同科室)受到不同水平的协调性与延续性的照护。外科患者病情变化迅速,治疗具有一定的创伤性和风险性,但患者实际住院时间短,出院后仍存在潜在的护理风险。因此,为外科出院患者提供延续护理服务具有相当重要的作用。
Effects of land use change on the spatiotemporal variability of soil organic carbon in an urban-rural ecotone of Beijing, China

Understanding the effects of land use changes on the spatiotemporal variation of soil organic carbon (SOC) can provide guidance for low carbon and sustainable agriculture. In this paper, based on the large-scale datasets of soil surveys in 1982 and 2009 for Pinggu District — an urban-rural ecotone of Beijing, China, the effects of land use and land use changes on both temporal variation and spatial variation of SOC were analyzed. Results showed that from 1982 to 2009 in Pinggu District, the following land use change mainly occurred: Grain cropland converted to orchard or vegetable land, and grassland converted to forestland. The SOC content decreased in region where the land use type changed to grain cropland (e.g., vegetable land to grain cropland decreased by 0.7 g kg~(–1); orchard to grain cropland decreased by 0.2 g kg~(–1)). In contrast, the SOC content increased in region where the land use type changed to either orchard (excluding forestland) or forestland (e.g., grain cropland to orchard and forestland increased by 2.7 and 2.4 g kg~(–1), respectively; grassland to orchard and forestland increased by 4.8 and 4.9 g kg~(–1), respectively). The organic carbon accumulation capacity per unit mass of the soil increased in the following order: grain cropland soil
Genetic evaluation and testing for hereditary forms of cancer in the era of next-generation sequencing

The introduction of next-generation sequencing (NGS) technology in testing for hereditary cancer susceptibility allows testing of multiple cancer susceptibility genes simultaneously. While there are many potential benefits to utilizing this technology in the hereditary cancer clinic, including efficiency of time and cost, there are also important limitations that must be considered. The best panel for the given clinical situation should be selected to minimize the number of variants of unknown significance. The inclusion in panels of low penetrance or newly identified genes without specific actionability can be problematic for interpretation. Genetic counselors are an essential part of the hereditary cancer risk assessment team, helping the medical team select the most appropriate test and interpret the often complex results. Genetic counselors obtain an extended family history, counsel patients on the available tests and the potential implications of results for themselves and their family members (pre-test counseling), explain to patients the implications of the test results (post-test counseling), and assist in testing family members at risk.