mlsa-iai-msu-lab/ru_sci_bench_zho_cite_reranking huggingface dataset:
The cost-effectiveness of hypertonic saline inhalations for infant bronchiolitis: a decision analysis

Background This study evaluated the cost-effectiveness of hypertonic saline (HS) inhalations for infant bronchiolitis, compared to normal saline inhalations or standard treatment without inhalations as controls. Methods The decision tree in the decision analysis was used to calculate the expected costs. Actual cost data were obtained from our retrospective case-control study on bronchiolitis treatment. The effectiveness of treatment, based on the hospitalization rate of those admitted to the emergency department and the length of stay (LOS) of those who were hospitalized, was collected from previous studies. For the effectiveness estimations, we made a meta-analysis summarizing the results of the meta-analysis of the Cochrane review in 2013 and the results of 10 studies published after it. Results The mean hospitalization rate was 24.7% in the HS inhalation group and 32.6% in the control group [risk ratio: 0.80,95% confidence interval (CI) 0.67-0.96] and the mean LOS was 3.736 (HS group) and 4.292 (controls) days (mean difference: - 0.55 days, 95% CI - 0.96 to - 0.15), respectively. The expected costs per patient, when both inpatients and outpatients were included, were €816 ($1111) in the HS inhalation group and €962 ($1310) in the control group. The expected costs per hospitalization, when only inpatients were included, were €2600 ($3540) in the HS inhalation group and €2890 ($3935) in the control group. Conclusions HS inhalations slightly reduced the expected hospitalization costs of infant bronchiolitis. However, the low effectiveness, rather than the cost, is the factor that will limit the use of HS inhalations in infant bronchiolitis.
胰岛α细胞功能再认识

胰岛α细胞、β细胞分别通过分泌胰高糖素和胰岛素,共同维持体内糖代谢稳态平衡。在糖尿病发生胰岛β细胞功能障碍及数量减少的同时,常伴随胰岛α细胞的增生和高胰高糖素血症。传统观点认为,后者是造成糖尿病“高糖毒性”、从而持续损伤胰岛β细胞功能的重要因素。随着胰岛内源性胰高糖素样肽-1 (GLP-1)及其受体(GLP-1 receptor,GLP-1R)信号系统以及代谢应激下胰岛β细胞去分化现象的发现,人们对胰岛α细胞的功能作用有了全新的认识。近年来多项研究表明,胰岛α细胞具有高度可塑性,在特定条件下可自发或被诱导转分化为β细胞,从而成为重获功能性胰岛β细胞群的可能来源。胰岛内除了经典的胰岛素、胰高糖素旁分泌调节途径外,α细胞介导的胰岛内源性GLP-1/GLP-1R系统的激活是机体应对代谢应激损伤的重要适应性代偿反应,体现了α细胞对β细胞的调节保护。本文主要叙述胰岛α细胞的功能及其研究进展,以期为糖尿病时胰岛β细胞的调控保护策略并重获功能性胰岛β细胞群提供新的研究方向。
Local probes strongly favor ΛCDM against power-law and R_h = ct universe

We constrain three cosmological models - the concordance cold dark matter plus cosmological constant (ΛCDM) model, the power-law (PL) model, and the R_h=ct model using the available local probes, which include the JLA compilation of type-la supernovae (SNe Ia), the direct measurement of the Hubble constant (H(z)), and the baryon acoustic oscillations (BAO). For the ΛCDM model, we consider two different cases, i.e. zero and non-zero spatial curvature. We find that by using the JLA alone, the ACDM and PL models are indistinguishable, but the R_h=ct model is strongly disfavored. If we combine JLA+H(z),the ΛCDM model is strongly favored over the other two models. The combination of all three datasets supports ΛCDM as the best model. We also use the low-redshift (z<0.2) data to constrain the deceleration parameter using the cosmography method, and find that only the ΛCDM model is consistent with cosmography. However, there is no strong evidence to distinguish between flat and non-flat ΛCDM models by using the local data alone.
代谢综合征合并心房颤动患者左心室整体纵向应变的变化

目的应用二维斑点追踪成像技术(2D-STI)评价代谢综合征(MS)合并心房颤动患者左心室整体纵向峰值应变(GLS),探讨其可能的影响因素。方法收集2015年1月至2016年12月福建医科大学附属泉州第一医院心内科就诊患者资料,按是否合并心房颤动将患者分为MS组(30例)和MS+心房颤动组(30例),以30名同期健康体检者为对照组。观察超声心动图常规指标及左心室GLS。结果与对照组相比,MS组及MS+心房颤动组的左心房内径(LAD)[(3.90±0.54)、(4.30±0.36)比(3.44±0.49)cm,P<0.05]、左心室舒张末期内径(LVEDd)[(4.79±0.29)、(4.83±0.40)比(4.51±0.36)cm,P<0.05]和左心室质量指数(LVMI)[(106.16±14.45)、(108.21±19.01)比(93.23±12.66)g/m~2,P<0.05]均明显增大;3组间左心室射血分数(LVEF)差异无统计学意义。与对照组比较,MS组及MS+心房颤动组左心室GLS峰值明显减低[(-18.20±2.84)%、(-15.06±3.09)%比(-24.35±1.99)%,均P<0.05],以MS+心房颤动组为著;多元线性回归分析显示,合并心房颤动、肥胖及心室率与GLS呈负相关(分别B=-3.793、-3.770、-0.903,均P<0.05)。结论MS患者存在左心室纵向收缩功能受损,心房颤动、肥胖及心室率增快加重这种变化。
Hormone modulation of legume-rhizobial symbiosis

Leguminous plants can establish symbiotic associations with diazotropic rhizobia to form nitrogen-fixating nodules, which are classified as determinate or indeterminate based on the persistence of nodule meristem. The formation of nitrogen-fixing nodules requires coordinating rhizobial infection and root nodule organogenesis. The formation of an infection thread and the extent of nodule formation are largely under plant control, but vary with environmental conditions and the physiological state of the host plants. Many achievements in these two areas have been made in recent decades. Phytohormone signaling pathways have gradually emerged as important regulators of root nodule symbiosis. Cytokinin, strigolactones (SLs) and local accumulation of auxin can promote nodule development. Ethylene, jasmonic acid (JA), abscisic acid (ABA) and gibberellic acid (GA) all negatively regulate infection thread formation and nodule development. However, salicylic acid (SA) and brassinosteroids (BRs) have different effects on the formation of these two nodule types. Some peptide hormones are also involved in nodulation. This review summarizes recent findings on the roles of these plant hormones in legume-rhizobial symbiosis, and we propose that DELLA proteins may function as a node to integrate plant hormones to regulate nodulation.
Impacts of future climate change (2030-2059) on debris flow hazard: A case study in the Upper Minjiang River basin, China

An increase in extreme precipitation events due to future climate change will have a decisive influence on the formation of debris flows in earthquake-stricken areas. This paper aimed to describe the possible impacts of future climate change on debris flow hazards in the Upper Minjiang River basin in Northwest Sichuan of China, which was severely affected by the 2008 Wenchuan earthquake. The study area was divided into 1285 catchments, which were used as the basic assessment units for debris flow hazards. Based on the current understanding of the causes of debris flows, a binary logistic regression model was used to screen key factors based on local geologic, geomorphologic, soil, vegetation, and meteorological and climatic conditions. We used the weighted summation method to obtain a composite index for debris flow hazards, based on two weight allocation methods: Relative Degree Analysis and rough set theory. Our results showed that the assessment model using the rough set theory resulted in better accuracy. According to the bias corrected and downscaled daily climate model data, future annual precipitation (2030-2059) in the study area are expected to decrease, with an increasing number of heavy rainfall events. Under future climate change, areas with a high-level of debris flow hazard will be even more dangerous, and 5.9% more of the study area was categorized as having a high-level hazard. Future climate change will cause an increase in debris flow hazard levels for 128 catchments, accounting for 10.5% of the total area. In the coming few decades, attention should be paid not only to traditional areas with high-level of debris flow hazards, but also to those areas with an increased hazard level to improve their resilience to debris flow disasters.
Segmentation by domestic visitor motivation: Changbai Mountain Biosphere Reserve, China

Protected areas have become important tourism products that promoted as attractions by the tourism industry. Taking the Changbai Mountain Biosphere Reserve in Northeast China as a case, this study addresses visitor needs as a basis for developing a tourism strategy aimed at enhancing tourist opportunities at this reserve. A factor-cluster approach was employed to identify visitor segment profiles based on their visit motivations. Through random sampling, a pencil-and-paper questionnaire in Chinese language was collected from 637 domestic tourists in the study area. A principal components analysis of motivations revealed eight motivational factors, and four distinct groups of tourists – Nature travelers, Cultural landscape tourists, Food & shopping enthusiasts, and Eclectic adventurers – were identified. Understanding the differences in these visitor segments will help the management authority effectively analyze nature reserve attributes and provide alternative activities and services to tourists. Finally, within the dual framework of market segmentation and destination management some management recommendations and marketing implications are suggested.
Sepsis3直击多器官功能衰竭,急诊医生拯救脓毒症如何从源头开始?

脓毒症过程中尤进的炎症反应始终是疾病发展的主线。尽管Sepsis是一个尚未完全清楚的临床过程,也没有一个简单的、统一的临床标准或生物学、实验室、影像学一致性特征能够用于鉴别Sepsis患者,但是,如何早期识别那些可能会发展为脓毒症患者至关重要。同样的感染为什么有些患者会出现一过性感染之后完全恢复?有些患者会直线下降不可逆转?现有研究发现,当感染或组织损伤导致的机体固有免疫的受体如Toll样受体(Toll-likereceptor,TLR)介导病原体相关的分子模式(pathogen-associated molecula pathogen-associated molecular patterns, PAMPs) / 损伤相关的分子模式(damage-associated molecula pathogen-associated molecular patterns, DAMPs)引发的过度炎症反应,通过MyD88(myeloid differentiation factor 88, MyD88)髓样分化因子这一个关键的接头分子,传递上游信息并表达和分泌多种称之为促炎症细胞因子(proinflammatory cytokine),如肿瘤坏死因子(tumor necrosis facter,TNF- α),白细胞介素(IL-12,IL-6等。这些细胞因子可诱导炎症发生,促进抗原提呈。当激活NF-κB和活化蛋白因子表达时过度炎症反应(基因组风暴)不可避免、微循环功能障碍随之出现。NF-κB为细胞内重要的转录因子、高效诱导多种炎症因子的表达。脓毒症相关基因多态性及脓毒症易感性成为广泛关注的焦点。对于急诊医师而言,使用现有的PCT可以第一时间发现细菌感染患者,但是不能预测哪一类患者会发展为脓毒症,如何及早发现一个能够可以预警将会发展为脓毒症的患者成为非常有前景的探索。
一种新的肝脏悬吊方式在腹腔镜胃癌根治术中的应用

在腹腔镜胃癌根治术中,在切除小网膜以及清扫第12a、 5、3、1组淋巴结的操作时,均需要将左肝内叶和左肝外叶向患者头部及前腹壁方向拨开以显露术野。传统的做法是助手持分叶拉钩将左肝拨开,以及近几年新出现的经前腹壁肝脏V型悬吊法。但这些方法均有一定的缺点。广东省佛山市第一人民医院胃肠外科在总结自己和借鉴他人经验的基础之上,创造出了一种更简单易行的肝脏悬吊方式,即左肝外叶医用胶固定法。
Siewert Ⅱ型食管胃结合部腺癌的手术入路--经腹食管裂孔入路的腹腔镜手术之二

近年来,随着食管胃结合部腺癌(adenocarcinoma of the esophagogastric junction,AEG)发病率的增高,其诊治面临的一些议题备受关注。对于AEG定义方面,Siewert分型虽得到了广泛认可,但在日本仍以Nishi分型为常用。而最新版AJCC分期系统中AEG的定义有了更新,肿瘤侵犯胃食管结合部但中心位于胃食管交界线以下2 cm以外区域或肿瘤中心位于胃食管交界线以下2 cm以内,但肿瘤未侵及胃食管交界线应参照胃癌分期;而肿瘤侵及胃食管交界线且中心位于胃食管交界以下2 cm以内则参照食管癌分期。结合Siewert分型来看,按照新分期标准I型归为食管癌、Ⅲ型归为胃癌较为明确,而Ⅱ型则囊括了胃癌和食管癌的可能,分期及治疗的要求也就不同。
步入肺循环——从慢性血栓栓塞性肺动脉高压开始

慢性血栓栓塞性肺动脉高压(chronic thromboembolic pulmonary hypertension,CTEPH)是急性肺栓塞的严重并发症,未经治疗预后非常差。准确了解CTEPH的危险因素、病生理变化、诊断及治疗的进展,对CTEPH及早诊断并采取及时、恰当的治疗至关重要。2015年ESC将肺高压定义为静息状态下,右心导管测定的平均肺动脉压(mean pulmonary artery pressure,mPAP) ≥ 25 mmHg。依据肺高压的病因、临床表现、病生理、血流动力学特征及治疗方案等特点临床上将肺高压分为I~V型。刚刚结束的2018年第6届世界肺高血压会议对肺高压的分型及定义进一步调整,将mPAP≥20mmHg视为肺高压,目的是及早识别肺高压(虽尚未发布相关指南)。CTEPH作为肺高压的第IV类,是指肺动脉血栓栓塞症(pulmonary thromboembolism, PTE)经过正规抗凝治疗3月后, mPAP ≥ 25 mmHg,肺动脉楔压(pulmonary artery wedge pressure, PAWP)≤ 15 mmHg ;同时肺灌注通气扫描明确提示肺血流灌注与通气不匹配,或肺动脉增强CT出现典型的肺栓塞征象即可诊断。其特征为血栓导致的肺动脉纤维化及相关的肺微血管管壁重塑;伴有肺动脉压力及肺循环阻力升高,继而导致右心室扩张乃至右心功能衰竭等表现。肺高压终末期患者运动耐力及生活质量进一步下降,其全因死亡风险较非肺高压患者升高2倍。目前推荐证据级别较高、研究较多的除了I型肺高压(靶向药物治疗),就是Ⅳ型肺高压(肺动脉内膜剥脱术、球囊肺动脉成形术、靶向药物治疗)。且CTEPH及时诊断和准确治疗可以明显改善预后的研究,本章重点介绍有关CTEPH的国内、国外研究进展。
全国名老中医闻庆汉教授“胸椎中焦论”学术思想浅析

在脊柱病推拿临床中,目前大多数医生注重对颈椎、胸椎、腰椎的独立治疗与康复,而常常忽略它们之间的高度关联性,这种颈痛医颈、背痛医背、腰痛医腰的做法虽可以短期内缓解病痛,但长期来讲往往不能解决脊柱平衡的核心问题。闻庆汉教授在中医三焦理论、经络理论与西医脊柱整体观理论指导下,结合多年临床经验提出了“胸椎中焦论”的学术思想,强调胸椎在脊柱整体调整中的重要作用,指出“治颈必治胸”和“治腰必治胸”。文章浅析“胸椎中焦论”,从而为脊柱病推拿临床提供新的治疗思路。
生、醋莪术对大鼠原发性肝癌模型的治疗作用研究

目的探讨莪术对肝癌的疗效及比较生、醋莪术疗效差异。方法于大鼠双后肢皮下注射CCl_4菜籽油溶液;配制二乙基亚硝胺(DEN)溶液供其饮用,建立模型;分组灌胃给药42d后腹主动脉取血及摘取肝脏。ELISA法检测大鼠血清甲胎蛋白(AFP) 、甲胎蛋白异质体(AFP-L3) 、白介素-17(IL-17)水平。结果生、醋莪术组各指标水平均高于空白对照及阳性药组,低于模型组(P < 0.05) ;生高莪术组高于醋高莪术组,生低莪术组高于醋低莪术组(P < 0.05) ;生低莪术组高于生高莪术组,醋低莪术组高于醋高莪术组(P < 0.05) 。结论原发性肝癌模型造模成功;莪术对肝癌有疗效,但不及阳性药;醋莪术比生莪术疗效明显,高浓度比低浓度疗效佳。
Aircraft Engine Gas Path Fault Diagnosis Based on Hybrid PSO-TWSVM

Twin support vector machine(TWSVM)is a new development of support vector machine(SVM)algorithm.It has the smaller computation scale and the stronger ability to cope with unbalanced problems.In this paper,TWSVM is introduced into aircraft engine gas path fault diagnosis.The generalization capacity of Gauss kernel function usually used in TWSVM is relatively weak.So a mixed kernel function is used to improve performance to ensure that the TWSVM algorithm can better balance a strong generalization ability and a good learning ability.Experimental results prove that the cross validation training accuracy of TWSVM using the mixed kernel function averagely increases 2%.Grid search is usually applied in parameter optimization of TWSVM,but it heavily depends on experience.Therefore,the hybrid particle swarm algorithm is introduced.It can intelligently and rapidly find the global optimum.Experiments prove that its training accuracy is better than that of the classical particle swarm algorithm by 5%.
Effect of Thermal Treatment on CFRP Parts Before and After Adhesive Bonding

Numerous non-destructive techniques are being investigated for assuring quality of the adhesive bonds.The research presented here is focused on non-destructive assessment of carbon fibre reinforced polymer(CFRP) parts.The surface condition directly influences the performance of adhesive bonds.The structural joints should ensure safe usage of a structure.However,some modifications of the surface may lead to weak bond that cannot carry the desired load.This is why there is a search for methods of surface assessment before bonding.Moreover,reliable techniques are required to allow to verify the integrity of the adhesive bond after manufacturing or bonded repair.We focus on the laser induced fluorescence(LIF)method for assessing the surface state.The LIF is a noncontact measurement method.In the context of adhesive bond assessment the electromechanical impedance(EMI) method is studied.The EMI uses surface bonded piezoelectric sensors for excitation and sensing.The investigated samples were made of CFRP layers.The samples were treated at elevated temperatures.The influence of the thermal treatment was studied using LIF.The thermal treatment at 220℃could be clearly distinguishedrom the rest of the considered samples.The thermally treated plates were bonded to untreated plate and then they were measured with the EMI method to study the influence of the treatment on the adhesive bond.The changes of EMI spectra were significant for the treatment at 280℃and for some thermally treated samples that were later contaminated with de-icing fluid.
Quantitative Rectangular Notch Detection of Laser-induced Lamb Waves in Aluminium Plates with Wavenumber Analysis

It is difficult to quantitatively detect defects by using the time domain or frequency domain features of Lamb wave signals due to their dispersion and multimodal characteristics.Therefore,it is important to discover an intrinsical parameter of Lamb waves that could be used as a damage sensitive feature.In this paper,quantitative defect detection in aluminium plates is carried out by means of wavenumber analysis approach.The wavenumber of excited Lamb wave mode is a fixed value,given a frequency,a thickness and material properties of the target plate.When Lamb waves propagate to the structural discontinuity,new wavenumber components are created by abrupt wavefield change.The new wavenumber components can be identified in the frequency-wavenumber domain.To estimate spatially dependent wavenumber values,a short-space two-dimensional Fourier transform(FT)method is presented for processing wavefield data of Lamb waves.The results can be used to determine the location,size and depth of rectangular notch.The analysis techniques are demonstrated using simulation examples of an aluminium plate with a rectangular notch.Then,the wavenumber analysis method is applied to simulation data that are obtained through a range of notch depths and widths.The results are analyzed and rules of the technique with regards to estimating notch depth are determined.Based on simulation results,guidelines for using the technique are developed.Finally,experimental wavefield data are obtained in aluminium plates with rectangular notches by a full noncontact transceiving method,i.e.,laser-laser method.Band-pass filtering combined with continuous wavelet transform is used to extract a certain frequency component from the full laser-induced wavefield with wide band.Shortspace two-dimensional FT method is used for further processing full wavefield data at a certain frequency to estimate spatially dependent wavenumber values.The consistency of simulation and experimental results shows the effectiveness of proposed wavenumber method for quantitative rectangular notch detection.
绒毛周围大量纤维蛋白样物质沉积的研究进展

绒毛周围大量纤维蛋白样物质沉积(MPFD)是一种罕见的胎盘疾病,易导致孕妇流产、早产,且在此后妊娠中有较高的复发率,其特征性病理改变为大量纤维蛋白样物质沉积于胎盘。按绒毛及绒毛间隙累及程度分成3型:经典型、边缘型、透壁型。大量沉积使母体向绒毛间隙血流灌注减少,阻碍母胎交换,导致胎儿生长受限、神经系统发育障碍等,严重可危及胎儿存活。MPFD病因至今尚未完全阐明,可能与免疫介导的母-胎排斥有关。MPFD不独立发病,常合并多系统疾病,目前诊断主要通过血清学指标(MBP、MSAFP、sENG、SVEGFR-1、EPO等)与超声检查相结合的方式。使用免疫球蛋白、肝素和阿司匹林联合治疗可改善MPFD胎儿结局。
散光和斜颈

在门诊中如遇到患儿斜颈,通常会考虑两个因素:垂直斜视引起的代偿头位和儿童斜颈。前者是由于垂直斜视引起复视,患儿为避免复视,通过斜颈的代偿头位来减轻或消除复视,对于此类患儿要详细检查眼位和眼球运动;后者是儿童颈部肌肉发育不对称,引起颈部倾斜,可通过从背部观察患儿颈椎,以及触摸颈部两侧肌肉力量来予以评估,必要时到骨科会诊。
鼻腔解剖在火场尸体检验中的应用

在平时法医实践中,因考虑解剖鼻腔对尸体面容的毁损等因素,多不作鼻腔解剖检验,对烧死尸体多根据气管黏膜表面有无烟灰炭末和血液中有无碳氧血红蛋白来确定是否生前烧死。当人处在火场现场时,呼吸系统最先受到损害的是鼻腔,火场尸体如果气管黏膜表面未发现烟灰炭末,血液中未检出碳氧血红蛋白,应作鼻腔解剖检查,寻找有无生前烧死的依据,尤其烧毁严重的尸体,因鼻腔处于头颅中间较深部位,骨性结构,颅腔内有脑组织,含水量较多,在法医实践中所见,多能保存较好。而气管因位置较浅表,肌性结构,且含水量较少,易烧毁。故鼻腔解剖检验对火场尸体有现实的应用价值。
从被移动尸体上提取检验嫌疑人DNA的方法探讨

在凶杀案件中,犯罪分子往往为了掩饰犯罪行为而隐藏尸体。通过尸体的体位状态可分析出犯罪分子移动尸体的方式、动作,从而对嫌疑人接触尸体的部位进行检验,得到嫌疑人的DNA。笔者在工作中遇到2起凶杀案件,均通过尸体的体位状态分析出移动尸体的动作,从而检验出嫌疑人的DNA。
New Zircon U-Pb Ages of Granitic Rocks in Northeastern Jiagedaqi of the Da Hinggan Mountains and their Significance

The research area is located in the north of the Xing'an block and within the Ali River-Zhalantun granite belt in the eastern part of the Xingmeng orogenic belt. The geotectonic setting and geological evolution history of this area are complex with strong magmatic activity and extremely developed granite rocks. Since predecessors have not obtained accurate dating result, there is much controversy over the formation of granitic rocks. Therefore, this work conducted zircon U-Ph dating on alkali-feldspar granite and granite porphyry in the northeast of Jiagedaqi to provide age constraint. The age data shows that the forming age is the Early Cretaceous and provides age basis for the tectonic evolution of the Da Hinggan Mountains.
New Insights into the Late Triassic Nadigangri Formation of Northern Qiangtang, Tibet, China: Constraints from U-Pb Ages and Hf Isotopes of Detrital and Magmatic Zircons

We report here U-Pb age and in situ Hf isotopic results for detrital and magmatic zircons from one conglomerate and four tuffite samples from the Late Triassic Nadigangri Formation across the North Qiangtang depression, Tibet. Coupled with previously published data in the region, this paper proposes new insights into the geochronological framework for the Nadigangri Formation. The deposition ages of tuffite from top to bottom in the Woruo Mountain, Quem Co and Dongqu River, are 203 Ma, 226 Ma, 221.5 Ma and 221.1 Ma, respectively. The detrital zircons yield a younger cluster of ages of 201.5-225 Ma from the conglomerate of the Quem Co Formation. The Late Triassic Nadigangri Formation defines a temporal range approximately between 201 and 225 Ma (Norian-Rhaetian), including three predominant groups of 220-225 Ma , 210-217 Ma and 201-205 Ma, which correspond with the three main rifting episodes of initial rifting, further rifting and final rifting. Positive _(εHf)(t) value and low model ages in younger detrital zircons suggests a juvenile character. However, the Hf isotopes of magmatic zircons display the presence of reworked ancient crust with 1.1-1.8 Ga. These results provide strong constraints not only on the temporal range of the Late Triassic Nadigangri Formation, but also on the onset of the Qiangtang Mesozoic rift basin.
会阴上皮样血管肉瘤一例报告

讨论软组织EA是一种十分罕见的软组织肿瘤。 EA主要发生于深部软组织、肾、肾上腺、甲状腺、膀胱、皮肤和骨等部位,会阴部少见,文献中多为个案报道。发病年龄30~60岁,男女比例约4: 1,临床上大多数表现为单个逐渐增大的肿物,文献报道最大者直径达20 cm,患者全身症状较少,侵袭性强,预后较差。本例患者33岁,表现为会阴部单个肿物,与文献描述相符。
经颅超声检测帕金森病患者中脑黑质强回声定量改变对疾病进展的预测分析

TCS作为一种无创无辐射、操作便捷的检查手段,已渐渐成为辅助诊断PD的重要工具之一。既往研究在对SN强回声和临床特征的关系进行评估后,多数研究支持SN强回声能在较长时间内保持一个相对稳定的状态,与病程以及疾病进展无关;也有结合头颅MRI以及PET等影像学检查,证实了强回声与疾病严重程度之间存在关联性,但目前研究证据尚不充分,且少有利用TCS进行随访的相关研究。因此,为明确SN强回声与疾病进展的关系,我们对PD患者行TCS检查和临床特征评估,并进行动态随访观察,分析以S/M为主要参考指标的SN强回声变化与临床症状进展之间的相关性。
Bioinspired Water-soluble Polymers with Grafted Poly amine Chains: Synthesis and Complexation with Oligonucleotides

The siliceous frustules of diatom algae contain complex proteins known as silaffins, which consist of a peptide chain with grafted polyamine chains. These polyamines contain twenty or more nitrogen atoms with trimethylene groups between the nitrogens. We synthesized a set of polymers containing grafted long-chain polyamine fragments by using acryloyl chloride (ACh) polymers and activated acrylic acid copolymers as the starting materials. The new polymers contained 0.05 mol%-3.2 mol% of polyamine chains, which corresponded to 0.06-3.56 mmol·g~(-1) amine groups. The new amine-containing polymers formed complexes with short (19-21-mer) deoxyribonucleic acid (DNA) and ribonucleic acid (RNA) strands, and these complexes penetrated into model yeast cells and A549 lung cancer cell. This study demonstrates the potential of these species based on long-chain polyamines to serve as novel gene delivery systems.
NMR Analysis to Identify Biuret Groups in Common Polyureas

Polyureas (PU) are well known as a class of high impact engineering materials, and widely used also in emerging advanced applications. As a general observation, most of them are only soluble in a very limited number of highly protonic solvents, which makes their chemical structure analysis a great challenge. Besides the presence of abundant hydrogen bonding, the poor solubility of PU in common organic solvents is often ascribed to the formation of biuret crosslinking in their molecular chains. To clarify the presence of biuret groups in PU has been of great interest. To this end, two samples, based on hexamethylene diisocyanate (HDI) and toluene diisocyanate (TDI) respectively, were synthesized by precipitation polymerization of each of these diisocyanates in water-acetone at 30 ℃. Their chemical structures were analyzed by high resolution magic angle spinning (HR-MAS) NMR, and through comparison of their NMR spectra with those of specially prepared biuret-containing polyurea oligomers, it was concluded that biuret group was absent in all the PU prepared at 30 ℃. In addition, this NMR analysis was also applied to a PU obtained by copolymerization of TDI with ethylene diamine (EDA) and water at 65 ℃ in EDA aqueous solution. It was confirmed that biuret unit was also absent in this PU and that EDA was more active than water towards TDI. The presence of EDA was crucial to the formation of uniform PU microspheres. This study provides therefore a reliable method for the analysis of PU chemical structure.
以急性心肌梗死为首发临床表现的肾病综合征一例

讨论急性心肌梗死在年轻人中较少见,其发病机制大致可以分为2种:一种是在正常冠状动脉的基础上发生血栓形成或栓塞,冠状动脉血栓形成多由于血液高凝状态所致,可见于肾病综合征、抗磷脂抗体综合征、蛋白C或蛋白S缺乏症等;另一种是冠状动脉异常,包括冠状动脉粥样硬化进行性加重、动脉瘤、自发性冠状动脉夹层和冠状动脉起源异常等。肾病综合征是表现为大量蛋白尿(≥3.5 g/24 h)、低白蛋白血症(血清白蛋白≤ 30.0 g/L)、水肿和高脂血症的一组临床症候群。血栓形成和栓塞是肾病综合征最严重并发症之一,在肾病综合征患者中发生率为10% ~ 40%。此类患者可形成静脉或动脉血栓,其中以肺栓塞和肾静脉血栓形成常见,动脉血栓形成罕见,发生率为1.8% ~ 5.0%,冠状动脉血栓形成更为罕见。
婴儿永存第五主动脉弓伴缩窄合并第四动脉弓离断一例

单纯永存第五主动脉弓早期手术效果良好。合并其他畸形且术前状态差的患儿术后并发症发生率及病死率高,远期仍有可能发生再梗阻。本病例患儿术前合并心衰和重症肺炎,经积极治疗后,顺利接受第五主动脉弓成形术,取得良好近期效果,但远期转归有待于进一步随访。
改进手术方式治疗小儿嵌顿性腹股沟疝的临床研究

通过简化手术操作,同样达到了疝囊高位结扎的目的,缩短了手术时间。由于不行疝囊剥离,不横断疝囊,缩短了手术时间,创面渗血渗液明显减少,血清肿、精索血管及输精管损伤发生率下降。在基层医院麻醉技术受限、疝囊壁黏连水肿明显、分离时疝囊壁撕裂等特定情况下可以选择这种方法。
急性早幼粒细胞白血病持续缓解15年后继发慢性粒-单核细胞白血病一例

腹部B超:脾脏稍肿大(厚43 mm,长径123 mm)。根据2008年WHO造血与淋巴组织肿瘤分类的诊断标准,诊断为慢性粒-单核细胞白血病(CMML),IPSS中危-1组,DIPSS中危-2组,DIPSS Plus高危组。于2015年4月12日行单倍型造血干细胞移植,回输患者儿子骨髓及外周血造血干细胞(单个核细胞10.4×10~8kg,CD34~+细胞4.82×10~6/kg)。预处理采用改良Bu/Cy方案(司莫司汀+阿糖胞苷+白消安+环磷酰胺);肝静脉闭塞病(VOD)预防:前列腺素E1 +肝素+熊去氧胆酸;GVHD预防:兔ATG+环孢素A+霉酚酸酯+小剂量甲氨蝶呤;+5 d输注供者骨髓间充质干细胞1.0×lO~6/kg。+12 d中性粒细胞植活,+13 d血小板植活。随访至今未出现急慢性GVHD、感染和复发,骨髓及外周血供者细胞嵌合率为99.5%,JAK2突变阴性,B超示脾脏大小正常,患者已恢复正常生活和工作。