多分辨分析提取心率变异性中的睡眠结构信息

本文从工程分析的角度探索通过分析心率变异性推知健康人夜间睡眠结构的可行性、针对心率变化在睡眠过程中的特点,对心动间期信号作基于小波变换的多分辨率分析,深入考察了不同睡眠时相中的RRV(R-R interval variability)多分辨率信号,尤其在睡眠时相转换时的变化特点.建立了关于健康人睡眠规律和睡眠RR规律的规则库.综合分析RRV在多分辨率下的信息,用模糊逻辑推理系统对某时间段不同睡眠时相的隶属度进行推理.经对26例健康人睡眠RRV分析,与脑电人工分析结果比较,睡眠基本结构的平均符合率达到85%,醒觉和睡眠状态的平均符合率达到93%,证明用本方法进行睡眠结构分析是可行的.     

A widespread viral entry mechanism: The C-end Rule motif–neuropilin receptor interaction

Many phylogenetically distant animal viruses, including the new coronavirus severe acute respiratory syndrome coronavirus 2, have surface proteins with polybasic sites that are cleaved by host furin and furin-like proteases. Other than priming certain viral surface proteins for fusion, cleavage generates a carboxy-terminal RXXR sequence. This C-end Rule (CendR) motif is known to bind to neuropilin (NRP) receptors on the cell surface. NRPs are ubiquitously expressed, pleiotropic cell surface receptors with important roles in growth factor signaling, vascular biology, and neurobiology, as well as immune homeostasis and activation. The CendR–NRP receptor interaction promotes endocytic internalization and tissue spreading of different cargo, including viral particles. We propose that the interaction between viral surface proteins and NRPs plays an underappreciated and prevalent role in the transmission and pathogenesis of diverse viruses and represents a promising broad-spectrum antiviral target.     

White matter integrity in the vicinity of Broca's area predicts grammar learning success

Humans differ substantially in their ability to implicitly extract structural regularities from experience, as required for learning the grammar of a language. The mechanisms underlying this fundamental inter-individual difference, which may determine initial success in language learning, are incompletely understood. Here, we use diffusion tensor magnetic resonance imaging (DTI) to determine white matter integrity around Broca's area, which is crucially involved in both natural and artificial language processing. Twelve young, right-handed individuals completed an artificial grammar learning task, and DTI of their brains were acquired. Inter-individual variability in performance correlated with white matter integrity (increasing fractional anisotropy (FA)) in fibres arising from Broca's area (left BA 44/45), but not from its right-hemispheric homologue. Variability in performance based on superficial familiarity did not show this association. Moreover, when Broca's area was used as a seed mask for probabilistic tractography, we found that mean FA values within the generated tracts was higher in subjects with better grammar learning. Our findings provide the first evidence that integrity of white matter fibre tracts arising from Broca's area is intimately linked with the ability to extract grammatical rules. The relevance of these findings for acquisition of a natural language has to be established in future studies.     

医学检验不同方法之间一致性比较研究的正确设计和指标的正确表 …

通过对近两年《中华医学检验杂志》所发表的不同检验方法之间的比较的论著进行复习,认为普遍存在研究设计和指标表达不规范,甚至错误的现象。据此。用临床流行病学方法学对其中的典型文章进行评价,提出一些规范化设计的建议,认为高质量的设计和规范化的指标表示法是高水平科研和高质量文章的瓣胆和保证,并建议在医学检验学界制定科研设计规范。     

基于数据挖掘技术分析针灸治疗单纯性肥胖的选穴规律＊

目的 运用数据挖掘技术，探讨近十年针灸治疗单纯性肥胖的用穴规律。方法 通过检索中国知网数据库、万方知识服务平台、维普数据库2011年1月1日至2021年1月20日针灸治疗单纯性肥胖的临床研究文献，利用Excel 2019建立用穴处方数据库，对数据进行提取、筛选、录入、统计分析；运用SPSS Modeler 18.0和SPSS 23.0对高频腧穴进行关联规则分析和聚类分析。结果 纳入文献412篇，涉及149个腧穴，总使用频次为9717次，频数靠前的腧穴为天枢、中脘和足三里；经络选用以足阳明胃经、任脉和足太阴脾经为主；募穴、五腧穴和八会穴为常用特定穴；腧穴分布多在腹部和下肢部；共涉及12种干预手法，其中埋线和针刺使用频率最高；核心穴组以“天枢-足三里-中脘”常见，得到19组关联规则和5个有效聚类群。结论 针灸治疗单纯性肥胖多选用特定穴，经脉以胃经、任脉和脾经为重，先后天并补，注重腹部腧穴的运用，多采用埋线和针刺手法，可为临床提供参考依据。     

《华佗玄门脉诀内照图》“玄门”思想考释

《华佗玄门脉诀内照图》是医道融通的产物,任督二脉交汇、肾藏天一、命门属火、心肾相交以及藏象气机运行与呼吸相配等内丹养生核心概念被引入,用以阐释人体内景图中藏象、经脉、气血之间乃至天人之间如何相应的内在联系。     

Cytoskeletal signaling by way of alpha-actinin-1 mediates ERK1/2 activation by repetitive deformation in human Caco2 intestinal epithelial cells

BACKGROUND: Repetitive deformation stimulates proliferation in human Caco2 intestinal epithelial cells by way of an ERK1/2-dependent pathway. We examined the effects of cytoskeletal perturbation on deformation-induced signaling in Caco2 cells. METHODS: The Caco2 cell cytoskeleton was disrupted with either cytochalasin D, phalloidin, colchicine, or paclitaxel. Levels of alpha-actinin-1 and -4 and paxillin were reduced by specific small interfering RNA. Cells on collagen I-precoated membranes were subjected to 10% repetitive deformation at 10 cycles/min. After 1 hour, cells were lysed for Western blot analysis. RESULTS: Strain-activated ERK1/2, focal adhesion kinase, and Src phosphorylation in dimethyl sulfoxide- and/or nontargeting small interfering RNA-treated control cell populations. Cytochalasin D and paclitaxel, but not phalloidin and colchicine, blocked ERK1/2 phosphorylation. A decrease in alpha-actinin-1, but not in alpha-actinin-4 or paxillin, inhibited ERK1/2 and focal adhesion kinase phosphorylation, whereas Src activation appears to be independent of these effects. CONCLUSIONS: The intestinal epithelial cell cytoskeleton may transduce mechanical signals by way of alpha-actinin-1 into the focal adhesion complex, culminating in ERK1/2 activation and proliferation.     

Automatic generation of computable implementation guides from clinical information models

Clinical information models are increasingly used to describe the contents of Electronic Health Records. Implementation guides are a common specification mechanism used to define such models. They contain, among other reference materials, all the constraints and rules that clinical information must obey. However, these implementation guides typically are oriented to human-readability, and thus cannot be processed by computers. As a consequence, they must be reinterpreted and transformed manually into an executable language such as Schematron or Object Constraint Language (OCL). This task can be difficult and error prone due to the big gap between both representations. The challenge is to develop a methodology for the specification of implementation guides in such a way that humans can read and understand easily and at the same time can be processed by computers. In this paper, we propose and describe a novel methodology that uses archetypes as basis for generation of implementation guides. We use archetypes to generate formal rules expressed in Natural Rule Language (NRL) and other reference materials usually included in implementation guides such as sample XML instances. We also generate Schematron rules from NRL rules to be used for the validation of data instances. We have implemented these methods in LinkEHR, an archetype editing platform, and exemplify our approach by generating NRL rules and implementation guides from EN ISO 13606, openEHR, and HL7 CDA archetypes.     

Rule induction performance in amnestic mild cognitive impairment and Alzheimer’s dementia: examining the role of simple and biconditional rule learning processes

Introduction: Rule induction tests such as the Wisconsin Card Sorting Test require executive control processes, but also the learning and memorization of simple stimulus–response rules. In this study, we examined the contribution of diminished learning and memorization of simple rules to complex rule induction test performance in patients with amnestic mild cognitive impairment (aMCI) or Alzheimer’s dementia (AD). Method: Twenty-six aMCI patients, 39 AD patients, and 32 control participants were included. A task was used in which the memory load and the complexity of the rules were independently manipulated. This task consisted of three conditions: a simple two-rule learning condition (Condition 1), a simple four-rule learning condition (inducing an increase in memory load, Condition 2), and a complex biconditional four-rule learning condition—inducing an increase in complexity and, hence, executive control load (Condition 3). Results: Performance of AD patients declined disproportionately when the number of simple rules that had to be memorized increased (from Condition 1 to 2). An additional increment in complexity (from Condition 2 to 3) did not, however, disproportionately affect performance of the patients. Performance of the aMCI patients did not differ from that of the control participants. In the patient group, correlation analysis showed that memory performance correlated with Condition 1 performance, whereas executive task performance correlated with Condition 2 performance. Conclusions: These results indicate that the reduced learning and memorization of underlying task rules explains a significant part of the diminished complex rule induction performance commonly reported in AD, although results from the correlation analysis suggest involvement of executive control functions as well. Taken together, these findings suggest that care is needed when interpreting rule induction task performance in terms of executive function deficits in these patients.     

党组织在弘扬医院精神中的实践与思考

通过分析医院精神及其伦理涵义得出：医院精神不仅是医院全体人员的精神支柱和活力源泉,也是医院各级各类人员的理想信念、价值取向、道德品质、心理趋向、文化定势以及意志统一和行为准则的集中表现。医院精神的培育和弘扬应以党组织为核心领导,彰显鲜明而深刻的医学伦理原则和规范。并阐述了在孕育、传承和创新医院精神的实践中,医院党委发挥的领导核心作用和取得的成效,对其进行伦理分析,旨在对当前医院精神文明建设提供借鉴。