一种新型混杂多官能团齐聚物的固化反应

以N,N,N′,N′-四缩水甘油基-4,4′-二氨基二苯甲烷(TGDDM)和丙烯酸(AA)为原料,合成了一种既含有环氧基又含有乙烯基酯基团的新型混杂多官能团齐聚物树脂(MEVO)。以过氧化甲乙酮(MEKP)为引发剂、甲基四氢苯酐(MeTHPA)为环氧固化剂与MEVO共混制备了MEVO-MEKP、MEVO-MeTHPA和MEVO-MEKP-MeTHPA 3种固化体系。通过非等温DSC和FT-IR研究了MEVO的固化反应,求得了各体系表观反应活化能。结果表明：在MEVO-MEKP固化体系中,乙烯基酯按照自由基聚合机理固化,对环氧基没有影响;在MEVO-MeTHPA固化体系中,环氧基固化过程中乙烯基酯会发生热固化;在MEVO-MEKP-MeTHPA固化体系中,乙烯基酯和环氧基按各自机理固化并互相影响。     

Facile fabrication of polyurethane/epoxy IPNs filled graphene aerogel with improved damping,thermal and mechanical properties

In this article, polyurethane (PU)/epoxy (EP) interpenetrating polymer networks (IPNs) filled graphene aerogel (PEGA) was facilely fabricated by a one-step vacuum-assisted filling process. Effects of PU content on damping performance, thermal stability and mechanical properties of the PEGA composites were studied systematically. Results reveal that addition of graphene aerogel improves damping properties of PU/EP IPNs and increases the thermal decomposition temperature. Mechanical tests show that flexural strength, flexural modulus and Shore D hardness of the PEGA composites also improved by incorporation of graphene aerogel. The enhanced damping, thermal and mechanical properties of PEGA composites can be attributed to the uniform distribution of graphene sheets in the IPN matrix, which benefits from the three-dimensional interconnected porous network structure of the graphene aerogel used and good interfacial adhesion at the nanofiller-matrix interface. It is expected that the PEGA composites can be used as good structural damping materials in future.

PEGA composites were facilely fabricated by a one-step vacuum-assisted filling method, and exhibited improved damping, thermal and mechanical properties.     

Lithium sulfonate-grafted poly(vinylidenefluoride-hexafluoro propylene) ionomer as binder for lithium-ion batteries

Lithium sulfonate-grafted poly(vinylidenefluoride-hexafluoro propylene) P(VDF-HFP) ionomers are synthesized through covalent attachment of taurine and used as binder for the LiFePO₄ cathode of lithium-ion batteries(LIBs). The incorporation of the ionomer binders will add ionic conducting channels inside the electrodes, and prevent electrolyte depletion during rapid charge–discharge processes. It leads to an improved performance of LIBs using the ionomer binders including cycling stability and rate capability compared to that of LIBs using non-ionic binders (PVDF and PVDF-HFP). Therefore, the lithium sulfonate-grafted P(VDF-HFP) ionomers offer a new route to develop high-power LIBs.

Lithium sulfonate-grafted PVDF-HFP was successfully synthesized and used as binder for lithium ion batteries, improving electrochemical performance.     

媒传疾病的疾病负担估算方法研究进展

媒传疾病的疾病负担是指媒传疾病所致患者伤残及早逝对健康寿命、社会经济造成的损失和影响,包括经济负担和个体家庭负担两个方面。伤残调整寿命年是衡量疾病负担的综合指标。疾病经济负担分为直接经济负担、间接经济负担和无形经济负担,直接经济负担的估算方法有微观成本法和宏观成本法,间接经济负担的估算方法包括人力资本法和摩擦成本法,无形经济负担一般用支付意愿法估算。目前卫生经济学评价方法主要是成本-效用分析、成本-效益分析和成本-效果分析法。本文对疟疾等媒传疾病的疾病负担估算方法进行综述,以比较不同方法对指标选择的要求及其应用价值。     

18F-FDG PET/CT对皮肌炎抗MDA5抗体及预后的预测价值

目的:分析抗黑色素瘤分化相关基因5(MDA5)抗体阳性皮肌炎患者的肌肉FDG代谢、肿瘤发生率以及肺间质性改变在¹⁸F-FDG PET/CT的影像特征及其鉴别抗MDA5抗体阳性皮肌炎的价值。 方法:回顾性分析2016年6月至2019年7月在上海交通大学医学院附属仁济医院接受¹⁸F-FDG PET/CT检查的75例(34例抗MDA5抗体阳性,41例抗MDA5抗体阴性)皮肌炎患者[男21例、女54例,年龄(52.3±14.3)岁]和30名健康对照者[男10名、女20名,年龄(53.5±11.8)岁]的影像和临床资料,测定并计算肌肉SUV max及肌肉SUV max平均值(mSUV max);统计皮肌炎患者合并肿瘤性病变的情况;测定皮肌炎合并间质性肺炎患者肺炎病灶的SUV max。采用两独立样本 t检验、单因素方差分析、SNK检验和 χ²检验分析数据;行ROC曲线分析肌肉mSUV max鉴别抗MDA5抗体阳性皮肌炎的诊断效能。 结果:健康对照者、抗MDA5抗体阳性和抗MDA5抗体阴性皮肌炎患者的肌肉mSUV max分别为0.39±0.05、0.66±0.21和0.87±0.29( F=39.93, P<0.001);皮肌炎患者的肌肉mSUV max均高于健康对照者( q值:6.76、12.63,均 P<0.001);抗MDA5抗体阴性患者高于抗MDA5抗体阳性患者( q=5.79, P<0.001)。ROC AUC为0.74,当肌肉mSUV max取最佳阈值0.75时,在皮肌炎中鉴别出抗MDA5抗体阳性的准确性为74.7%(56/75)。抗MDA5抗体阴性患者中,恶性肿瘤6例(14.6%,6/41);抗MDA5抗体阳性患者中,无恶性肿瘤病例(0/34;χ²=5.41, P=0.020)。抗MDA5抗体阴性伴发间质性肺炎11例(26.8%, 11/41),抗MDA5抗体阳性伴发间质性肺炎33例(97.1%, 33/34;χ²=37.81, P<0.001);抗MDA5抗体阳性患者肺炎FDG代谢高于抗MDA5抗体阴性患者(SUV max:3.65±1.83和2.38±1.27;t=2.13, P=0.039)。 结论:抗MDA5抗体阳性皮肌炎患者的肌肉FDG代谢高于健康对照者,但低于抗MDA5抗体阴性患者。抗MDA5抗体阳性患者肿瘤性病变发生率低于抗MDA5抗体阴性患者。抗MDA5抗体阳性患者发生间质性肺炎的比例和严重程度均高于阴性患者。¹⁸F-FDG PET/CT对于鉴别抗MDA5抗体阳性皮肌炎具有一定价值。     

A New Computer Assisted Orthopaedic Surgery System： WATO

Background： The traditional manual orthopaedic technology heavily re- lies on a surgeon＇s experience, so it certainly increases the instability of the surgery. Therefore, computer assisted orthopaedic surgery （CAOS） is becoming a hot research topic for its high accuracy and stability. We developed a new CAOS system WATO, which is mainly designed for total knee replacement （TKR）. Methods： WATO system provides the interactive software for a surgeon＇s preoperative planning. Based on its two infrared cameras, infrared markers and infrared probe, WATO system gives a simple surgical positioning procedure of femur and tibia without additional surgery for the placement of fiducial markers. According to the reference alignment axis from positioning procedure, a surgeon can move the robot of WATO system to do accurate bone resection. Safety checking is also considered in WATO system. Results： Extensive experiments were conducted on phantoms and cadaver bones to verify the accuracy and stability of WATO system. Experimental results showed that TKR using WATO system had better performance compared with traditional and navigated TKR. Conclusion： WATO system shows its superiority in TKR, and has a broad application prospect in the future. We will develop its new functions for other orthopaedic surgery such as total hip replacement （THR）. Current disadvantages such as bigger skin incision have to be resolved in the future.     

颅内生殖细胞瘤适形调强放射治疗及剂量学研究

目的应用半野和适形调强全脑全脊髓放射治疗技术治疗颅内生殖细胞瘤,评价其疗效及毒性反应。方法 12例颅内生殖细胞瘤患者,其中男性10例,女性2例;年龄15～28岁,中位年龄21岁。给予CT模拟定位,采用半野和适形调强放射治疗技术治疗,全脑全脊髓的放射治疗剂量为25.2 Gy（14次）,肿瘤病灶的放射治疗总剂量为45 Gy（25次）,每天每次1.8 Gy,5次/周,治疗后及随后每3个月评价1次疗效,随访时间为1～60个月,中位随访时间36个月。结果放射治疗结束后评价,完全缓解11例,部分缓解1例,近期临床受益率为100%。除1例失访外,其余11例均生存。放射治疗剂量学研究：经适形调强优化后的技术剂量分布优于常规定位技术,定位时间明显缩短[（8.83±1.55）s vs（40.8±2.4）s]。结论半野技术结合适形调强放射治疗技术治疗颅内生殖细胞瘤,优化了放射治疗剂量学,操作方便,疗效好,并发症少。     

曲面体层片与锥形束CT比较分析上颌后牙牙根与上颌窦的关系

目的研究曲面体层片与锥形束CT(cone beam computer tomography,CBCT)判断上颌后牙牙根与上颌窦关系的准确性,为临床医师根据曲面体层片信息治疗上颌后牙区相关疾病提供参考。方法纳入80例符合标准的患者(牙根数671个),以锥形束CT为标准,在曲面体层片及锥形束CT片上测量上颌后牙根尖到上颌窦的距离。结果当曲面体层片显示上颌窦的皮质骨连续,牙根距上颌窦存在明显距离、与上颌窦相切时,曲面体层片判断上颌后牙牙根与上颌窦关系的准确率分别为82.0%、70.0%;当曲面体层片显示上颌窦皮质骨中断,牙根突入上颌窦内时,曲面体层片判断上颌后牙牙根与上颌窦关系的准确率为48.5%。曲面体层片、锥形束CT均显示牙根突入上颌窦时,曲面体层片测量上颌后牙牙根突入上颌窦距离为(2.19±1.82)mm,而锥形束CT测量距离为(1.47±1.01)mm,两者差异具有统计学意义(P<0.05)。结论曲面体层片判断上颌后牙牙根未进入上颌窦的准确率较高,但判断上颌后牙牙根突入上颌窦的准确率较低。