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简介：目的:研究损伤严重程度感知(ISP)评分法在测试急性挥鞭样损伤患者中的复测可重复性。方法:在基层保健中心连续对急性阶段患急性挥鞭样损伤患者采用ISP评分。ISP是一种通过数字等级进行评分,其测量范围从0到10,受试者被要求指出他们自认为的受伤严重程度。0代表'无损伤',10代表'严重且永久性损伤'。利用ISP问卷对同一批受试者在招募完成时及7天后进行评分。复测可重复性由一致百分率和在两个时间点进行的Kappa分析进行计算。锚定两端分别标记为'没有损伤'(0)和'严重损伤,可能是永久性损伤'(10)。结果:实验包括94名研究对象(34名男性,60名女性,平均年龄为40.6±10.0岁,范围19-60岁),在刚招募时JSP平均得分为4.9±1.7(评分在2-9之间),一周后ISP平均得分为5.1±2.1(评分在2-9之间)。在ISP的两次重复测量中百分比一致率为86%,Kappa系数为0.79。结论:这项研究表明ISP复测可重复性在预后研究中偏倚风险较低。ISP评分法在急性挥鞭样损伤患者的流行病学研究中具有相当高的可靠性。

简介：胆汁酸(BA)由充当tensioactives在肠在胖消化有一个长确定的角色，由于他们的amphipatic特征。BA被肠上皮很高效地重新吸收并且经由大部分被阐明了的运输机制再循环回到肝。BA的运输和合成被特定的血浆膜受体和原子受体紧部分地调整。除了他们的主要效果，BA被宣称在胃肠的癌症，肠的发炎和肠的离子的运输起一个作用。BA不在任何这些生物活动，和结构的要求是相等的通常被识别了。特别地，一些BA可能在煽动性的肠疾病为癌症chemoprevention并且也许是有用的，尽管进一步的研究在这个领域里是必要的。这评论在BA肠的生物学的这些方面盖住最近的开发。

简介：BackgroundThepresenceofachronictotalocclusion(CTO)inanon-infarct-relatedarterymightbeassociatedwithaworseprognosisinlongtermbenefitforST-segmentelevationmyocardialinfarction(STEIMI)patients.Butitstillremaincontroversial.MethodsAll383STEMIpatientsunderwentpercutaneousintervention(PCI)fromJan2015toJan2017inourcenterwereenrolledinthisprospectivestudy.Baselinecharacteristics,medicalhistory,biochemicalfindings,echocardiographicandangiographicparameters,proceduresperformedandcomplicationswererecorded.FactorsrelatedtoworseoutcomeCTOinSTEMIpatientswereanalyzedbythecoxlogisticregressionanalysisforthehazardrate(HR).ResultsInatotalof383patientsenrolledinthisstudy,85caseshadCTOinatleast1coronaryartery.Themeanfollow-upwas352days.1-yearmortalityandMACEratesinpatientswithCTOwere18.8%and11.8%,respectively.Majoradversecardiacevents(MACE)duringfollow-upweresignificantlyhigherinpatientswithCTO(HR=2.88;95%CI,1.82-4.77;P<0.001).ThemultivariateanalysisshowedasignificantassociationbetweenCTOandMACE(HR=2.1195%CI,1.27-3.88;P=0.014).ConclusionChronictotalocclusionisassociatedwithhigherriskofcomorbiditiesandhighermortality,andservesasanindependentpredictorofMACE.

简介：BACKGROUND:Drugaddictioninvolvestwomaincentralnervoussystems,namelythedopamineandnoradrenalinesystems.Thesesystemsareprimarilydistributedinfivebrainregions:theventraltegmentalarea,thenucleusaccumbens,theprefrontalcortex,thehippocampus,andthelocuscoeruleus.OBJECTIVE:Toinvestigateregionalchangesofguaninenucleotidebindingprotein-inhabitant2(Gi2)indopaminergicandnoradrenergicneuronsinbrainsofmorphine-tolerantand-dependentrats.DESIGN,TIME,ANDSETTING:ArandomizedcontrolstudywasperformedattheDepartmentofNeu-robiologyintheSecondMilitaryMedicalUniversityofChinesePLA(Shanghai,China)betweenSeptember2002andMarch2004.MATERIALS:Thirty-six,healthy,male,Sprague-Dawley(SD)ratswereusedtoestablishmorphine-dependentmodels.MorphinehydrochloridewasaproductofShenyangFirstPharmaceuticalFactory(China);naloxonehydrochloridewasaproductofBeijingFour-RingPharmaceuticalFactory(China);andαsubunitofGi2antibodywasofferedbySantaCruzBiotechnology,Inc(USA).METHODS:Thirty-sixSDratswererandomlydividedintosixgroups(n=6):(1)acutemor-phine-dependentgroup,(2)acuteabstinentgroup,(3)acutecontrolgroup,(4)chronicmorphine-dependentgroup,(5)chronicabstinentgroup,and(6)chroniccontrolgroup.Ratsintheacutemorphine-dependentandtheacutegroupswereinjectedwithmorphine(5mg/kg),oneinjectioneverytwohours,foratotalofeightinjections.Intheacuteandchronicmorphine-dependentratmodels,morphinewithdrawalsyndromewasprecipitatedbyaninjectionofnaloxone(5mg/kg).Ratsintheacutecontrolgroupweregivenaperitonealinjectionofphysiologicalsalineatthesameadministrationtimeastheabovetwogroups.Ratsinthechronicmorphine-dependentandchronicabstinentgroupswereinjectedwithmorphinethreetimesperday.Theadministrationdoseonday1wasinitially5mg/kgat20:00,whichincreasedby5mg/kgat8:00,12:00,and20:00untilday7.Onday

简介：列控中心作为铁路信号系统中的重要设备,通过以太网与临时限速服务器、联锁以及相邻列控中心等设备进行通信,从μCOS-II操作系统、TCP/IP协议栈、HTTP接口和非易失存储设备接口等几个方面来分析研究列控中心以太网板。

简介：摘要烧伤是一种小儿比较常见的意外伤害。通过选取我院2010年1月至2012年12月收治20例婴幼儿烧伤、烫伤病例进行分组调查实验，根据结果可以总结出包扎疗法明显优于暴露疗法。本文介绍应用湿润烧伤膏包扎疗法及暴露治疗Ⅱ°烧伤的护理体会，以供参考。

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简介：AbstractBackground:Macrophages are involved in the pathogenesis of idiopathic pulmonary fibrosis, partially by activating lung fibroblasts. However, how macrophages communicate with lung fibroblasts is largely unexplored. Exosomes can mediate intercellular communication, whereas its role in lung fibrogenesis is unclear. Here we aim to investigate whether exosomes can mediate the crosstalk between macrophages and lung fibroblasts and subsequently induce fibrosis.Methods:In vivo, bleomycin (BLM)-induced lung fibrosis model was established and macrophages infiltration was examined. The effects of GW4869, an exosomes inhibitor, on lung fibrosis were assessed. Moreover, macrophage exosomes were injected into mice to observe its pro-fibrotic effects. In vitro, exosomes derived from angiotensin II (Ang II)-stimulated macrophages were collected. Then, lung fibroblasts were treated with the exosomes. Twenty-four hours later, protein levels of α-collagen I, angiotensin II type 1 receptor (AT1R), transforming growth factor-β (TGF-β), and phospho-Smad2/3 (p-Smad2/3) in lung fibroblasts were examined. The Student’s t test or analysis of variance were used for statistical analysis.Results:In vivo, BLM-treated mice showed enhanced infiltration of macrophages, increased fibrotic alterations, and higher levels of Ang II and AT1R. GW4869 attenuated BLM-induced pulmonary fibrosis. Mice with exosomes injection showed fibrotic features with higher levels of Ang II and AT1R, which was reversed by irbesartan. In vitro, we found that macrophages secreted a great number of exosomes. The exosomes were taken by fibroblasts and resulted in higher levels of AT1R (0.22 ± 0.02 vs. 0.07 ± 0.02, t = 8.66, P = 0.001), TGF-β (0.54 ± 0.05 vs. 0.09 ± 0.06, t= 10.00, P < 0.001), p-Smad2/3 (0.58 ± 0.06 vs. 0.07 ± 0.03, t= 12.86, P < 0.001) and α-collagen I (0.27 ± 0.02 vs. 0.16 ± 0.01, t = 7.01, P = 0.002), and increased Ang II secretion (62.27 ± 7.32 vs. 9.56 ± 1.68, t= 12.16, P < 0.001). Interestingly, Ang II increased the number of macrophage exosomes, and the protein levels of Alix (1.45 ± 0.15 vs. 1.00 ± 0.10, t = 4.32, P = 0.012), AT1R (4.05 ± 0.64 vs. 1.00 ± 0.09, t = 8.17, P = 0.001), and glyceraldehyde-3-phosphate dehydrogenase (2.13 ± 0.36 vs. 1.00 ± 0.10, t = 5.28, P = 0.006) were increased in exosomes secreted by the same number of macrophages, indicating a positive loop between Ang II and exosomes production.Conclusions:Exosomes mediate intercellular communication between macrophages and fibroblasts plays an important role in BLM-induced pulmonary fibrosis.

简介：摘要目的探讨游离甲瓣联合对侧趾腓侧皮瓣再造II度缺损手指的方法和效果。方法2016年2月至2018年2月,收治手指末节缺损的患者8例。选择髂骨取骨植骨修复指骨缺损,根据具体需要切取一侧甲瓣联合对侧趾腓侧皮瓣,通过组合的方法再造手指,取甲瓣的供区可植皮或局部皮瓣修复,取皮瓣的供区直接缝合。术后通过门诊随访,对再造指及供区的功能和外形的恢复情况进行分析。结果再造指全部成活,随访6~18个月,再造指功能及外形恢复良好,感觉功能均达到S4以上,TPD为5~10 mm。甲瓣供区存在趾甲缺失,两侧趾整体外形恢复良好,趾底皮肤完整,关节活动良好。结论本方法可有效的恢复伤指的功能和外形,避免足趾趾底感觉皮肤的缺失过多,减少对趾的损害,对足行走功能影响小,是一种末节手指再造的有效方法。

简介：AbstractBackground:Total ankle replacement (TAR) is a viable option for the treatment of end-stage ankle arthritis. In China, the INBONE-II implant is the only total ankle prosthesis approved since 2016. The purpose of this study is to report a large sample of findings for the TAR with INBONE-II prosthesis.Methods:A total of 64 patients with end-stage ankle arthritis, who underwent primary TAR using INBONE-II by the same surgeon from 2016 to 2019, at a single institution were included in this retrospective, single-center study. Clinical data, radiographic findings, survival rate, and complications were recorded and assessed pre-operatively and at the most recent follow-up.Results:A total of 64 patients were available for follow-up at least 2 years after surgery; the mean follow-up duration for clinical outcomes was 37.9 months (24–59 months), and for radiographic findings was 22.8 months (12–59 months). There were significant improvements (P < 0.01) in the American Orthopedic Foot and Ankle Society hindfoot scale, the visual analog scale for pain, and the Short Form-36. There were statistically significant differences between pre-operative and post-operative comparisons of the talar tilt angle (TT) and the tibial lateral surface angle (TLS) in the radiographic findings (TT from 4.7 ± 4.3° to 1.3 ± 1.3°, TLS from 80.4 ± 7.7° to 87.4 ± 2.3°, P < 0.01). There was no statistically significant difference in improvement of the tibial anterior surface angle (P = 0.14). Ten complications (all low grade) were recorded according to the Glazebrook classification system. The survivorship of the prosthesis was 100% (64/64).Conclusion:Patients who underwent TAR with INBONE-II prosthesis demonstrated significant improvements in all measures of pain and function as well as in radiographic findings. High survival and a low incidence of complications were observed in this study.

简介：本文介绍了嵌入式实时操作系统uC／OS-II在通信组合电源监控中的应用。首先对嵌入式操作系统uC／OS-II在AVR单片机的移植做了简曼介绍；对于在通信电源监控系统中的应用．介绍了如何有效地将uC／OS-II应用到目标系统中；最后对该监控系统的可靠性做了一些相应措施，并对调试的工作做了总结。

简介：摘要目的观察切开复位钢针钢丝张力带固定，钢针，锁骨钩板固定手术治疗II-III度肩锁关节脱位失败原因探讨及对策。方法2例患者采用切开复位钢针钢丝张力带内固定，2例患者采用锁骨钩板内固定,2例患者采用2根钢针内固定手术治疗，同时将喙锁韧带修复或重建。结果肩锁关节脱位均手术解剖复位，3例术后2月出现钢针断裂术后，1例3月钢丝断裂，1例锁骨钩板术后3日滑脱，1例术后2月螺钉拔出。结论根据不同类型脱位及有无锁骨远端骨折选用不同材料固定，可提高手术成功率。

简介：摘要目的探讨心理干预对II型糖尿病患者临床疗效和自尊水平的影响。方法选择60例II型糖尿病患者，采用随机数字表法，将患者随机分为观察组和对照组，每组30例。对照组采用糖尿病常规护理模式，观察组应用心理干预护理措施，观察两组护理后的临床疗效（空腹血糖、餐后2h血糖、体重指数）和自尊水平（Rosenberg自尊量表）。结果护理前两组空腹血糖、餐后2h血糖、体重指数无统计学差异，P>0.05，护理后，观察组的空腹血糖、餐后2h血糖明显低于对照组，P<0.05，体重指数比对照组低，但无统计学意义，P>0.05。护理前两组Rosenberg自尊量表评分无显著性差异，P>0.05，护理后，观察组Rosenberg自尊量表评分明显高于对照组，P<0.05。结论心理干预能有效改善II型糖尿病患者的临床疗效，提高自尊水平。

简介：摘要目的探讨应用胰岛素泵强化治疗初诊II型糖尿病患者临床疗效及意义。方法随机选取2009年1月～2013年11月我院初诊II型糖尿病患者68例，均应用胰岛素泵进行强化治疗，同时测定患者治疗前后胰岛功能进行分析。结果本研究中的68例初诊II型糖尿病患者经治疗后，患者的胰岛素、C肽值在治疗后30分钟、120分钟均上升，且差异显著（P＜0.05），具有统计学意义。同时，患者的胰岛素分泌指数上升，而胰岛素抵抗指数明显降低。结论采用胰岛素泵强化治疗初诊II型糖尿病能够促进患者胰岛功能恢复，且费用低，减少并发症的发生，值得临床推广应用。

简介：摘要目前在临床上血管紧张素Ⅱ受体拮抗剂对诸多心血管疾病均会产生十分显著的治疗效果，得到了十分广泛的应用。因此对该类药物作用于心血管系统的机制、药理作用进行充分的了解，对于在今后的临床用药将具有重要意义。本文针对血管紧张素Ⅱ受体拮抗剂的药理作用以及相应的临床作用效果进行了具体阐述。

简介：摘要目的探讨并分析毕II式手术术后患者并发碱性返流性胃炎，经正规药物治疗无效，行进一步手术治疗的效果。方法选择在2003年1月至2014年7月入住我院因既往曾接受传统毕II式手术，术后合并顽固性碱性返流性胃炎，于内，于我院接受再次手术治疗的患者作为研究对象。结果加行空肠侧侧吻合术或Roux-Y胃肠重建术，均可有效缓解因传统毕II式术后并发严重碱性返流性胃炎的患者，具有满意的治疗效果，而前者更具有手术操作简单、手术时间短、创伤较小等优点结论改进毕II式胃肠重建术可有效降低胃大部切除手术后碱性返流性胃炎的发生率，改善患者的生活质量。

简介：Theenergybarriersofthermaldecarboxylationreactionsofpetroleumacidsandcatalyticdecar-boxylationreactionsofBrnstedacidandLewisacidwereanalyzedusingmolecularsimulationtechnology.Comparedwiththermaldecarboxylationreactionsofpetroleumacids,thedecarboxylationreactionsbyacidcatalystswereeasiertooccur.ThedecarboxylatoneffectbyLewisacidwasbetterthanBrnstedacid.Themechanismsofcatalyticdecarboxylationoveracidcatalystwerealsoverifiedbyexperimentsonafixedbedandafluidizedbed,theexperimentalresultsshowedthattherateofacidremovalcouldreachupto97%overtheacidiccatalystatatemperatureabove400.