多杂质氢气分配网络优化

利用三角图示法确定具有多杂质约束的氢气分配网络的目标值并提出相应的网络设计步骤。引入了层次分析法,用以确定具有多杂质约束条件下氢源的选用次序和氢阱的匹配次序。案例分析中,首先调整浓度数据的数量级,无因次化并重新归一化,进而可以在三角图中合理表征源的存在域、阱的可行域;然后进行源阱的匹配,可以确定出可行解域,从而获得氢源氢阱的匹配网络,同时考虑压缩机的配置,可确定最终优化的氢气分配网络。经过优化之后,氢公用工程用量由17.079×103 Nm3/h减少为14.125×103 Nm3/h,节氢率达到17.29%。案例分析结果验证了该方法的可行性。     

四种品牌CT设备成像质量的研究

目的 该文研究了四种品牌CT设备在采用不同剂量进行扫描且采用两种不同种类重建算法的情况下,四台CT机产生的图像质量的差异,并分析不同品牌厂家的CT设备和重建算法对成像质量产生的影响。方法 本研究使用Catphan500模体作为扫描对象。管电压在120k V的条件下,分别使用临床常规mAs和100m As的扫描剂量下,选择四种品牌高端CT设备对Catphan500模体进行头部的轴位扫描。结果 图像质量对比结果：传统FBP重建、常规扫描剂量下,成像质量排序：256iCT>宝石CT、640CT;迭代重建、常规扫描剂量下,成像质量排序：新双源Force CT>宝石CT、640CT;传统FBP重建、低剂量下,成像质量排序：新双源Force CT>宝石CT;迭代重建、低剂量下,成像质量排序：宝石CT<其它三台CT。迭代算法的影响分析：在低剂量条件下,采用迭代算法与使用传统FBP算法重建相比,这四台CT设备的图像质量有显著性的提高;在常规剂量条件下,采用迭代算法与使用传统FBP算法重建相比,除256iCT以外,其它三台CT图像质量有显著性的提高。结论 在常规剂量的条件下,本研...     

13103例恶性肿瘤填报质量的探讨

目的了解医院恶性肿瘤填报质量现况,促进医疗单位上报疾病工作制度化,规范化;方法选择我院2008年1月-2009年12月13103例恶性肿瘤填报卡,统计迟报率;结果 2008年迟填报率为2.36%。按构成比顺位排序前三位为头颈科,胸科和腹腔科。2009年迟填报率为1.83%。按构成比顺位排序前三位为腹腔科,头颈科和胸科。数据经过χ2检验,χ2=4.52,P〈0.05,有统计学差异;结论通过加强医院病案质量管理环节,以及网络报病工作开展,大大降低了迟填报现象,从而提高医师对恶性肿瘤报表工作重要性的认识和病历书写的专业水平。     

基于改进基音跟踪算法的单通道语音分离

基于计算听觉场景分析（Computational Auditory Scene Analysis,CASA）的语音分离系统通过模拟人耳的听觉感知系统对混合信号进行处理并分离出感兴趣的目标语音,近年来得到了很大的发展。如何在干扰噪声存在的情况下进行正确的基音提取跟踪一直是CASA系统研究的重点。提出了一种基于目标语音源的改进基音跟踪算法。该算法通过对目标源估计和基音检测两个步骤的反复迭代计算,得到最终的基音轨迹。通过在不同噪声干扰条件下与传统基音跟踪算法对比的实验结果证明,该算法能够有效地抑制噪声,提高输出语音的信噪比和语音质量。     

高效液相色谱-高分辨轨道阱质谱联用法对兰索拉唑肠溶制剂的杂质谱研究

采用高效液相色谱-高分辨轨道阱质谱联用检测方法，建立二维在线除盐检测方法对兰索拉唑肠溶制剂法定检验条件下检出的杂质进行结构推定，建立兼容质谱检测器的色谱方法对法检方法无法分离的杂质进行测定和结构推定，检出杂质结构的鉴定方法根据有无杂质对照品而异来推定其结构，以此考察不同企业间产品杂质谱的差异性。二维在线除盐方法的一维色谱条件同《中华人民共和国药典》（2020版）有关物质项下，二维质谱条件采用Waters C₁₈ T3（2.1 mm × 100 mm，1.7 μm）色谱柱，0.1%甲酸水-乙腈流动相，梯度洗脱。兼容质谱的色谱条件采用Agilent Extend C₁₈（4.6 mm × 150 mm， 5 μm）色谱柱，流动相A相：25 mmol/L乙酸铵，B相：25 mmol/L乙酸铵-乙腈（1∶4）[用冰乙酸调节pH至6.5]，梯度洗脱。二维在线除盐方法检出杂质9个，其中5个为已知杂质A ~ E，4个为未知杂质。兼容质谱检测器方法检出杂质14个，其中9个为未知杂质（4个与二维在线除盐方法结果一致，5个为该条件下新检出）。对未知杂质的结构进行了推测和来源归属。本文建立的两个高效液相色谱-高分辨轨道阱质谱联用检测方法对兰索拉唑制剂的质量控制和工艺评价具有指导意义。     

基于入院计划单填写完整率的病案质量持续改进

目的：探讨基于入院计划单填写完整率的病案质量管理持续改进方案。方法：应用PDCA质量改进方法对病案书写质量进行持续改进,将病历书写质量中需要实现的目标、内容分解为计划阶段、执行阶段、检查阶段和总结处理阶段。通过发现问题,制定目标,培训人员,加强检查力度和质量反馈,在每个循环末总结成绩,发现问题,提出整改措施,并将解决发现的问题作为下一循环工作的目标。结果：PDCA质量改进方法可以明显提高病历书写质量,入院计划单填写完整率显著提高。结论： PDCA的质量改进模式是一个行之有效的管理方法,使医院病案书写质量沿着一条规范化、螺旋式的上升轨道运行发展。     

可穿戴式心电信号R峰检测的心拍感知卷积网络

目的 实现可穿戴式心电信号的R峰检测,为准确估计心率、心率变异性等生理参数提供基础。方法 采用全卷积网络预测R峰热图,对热图进行峰值定位获得R峰位置。引入心拍感知模块,联合心拍数量预测任务和R峰热图预测任务进行学习,提高卷积网络对全局上下文信息的提取能力。心拍感知模块预测的心拍数量还可估计R-R间期,用作峰值定位的峰间最小水平距离。为满足移动端的实时应用,采用深度可分离卷积减小模型的参数量和计算量。结果 实验仅使用可穿戴式心电数据训练模型。测试中定位误差容忍度设置为150 ms时,本文方法在可穿戴式心电数据集和公开数据集LUDB上的R峰检测灵敏度均高达100%,真阳率均超过99.9%;对于时长10 s的ECG信号,R峰检测CPU耗时约为23.2 ms。结论 本文方法对可穿戴式和常规心电信号的R峰检测均可达到良好效果,且满足R峰检测的实时性需求。     

最宽不相交多路径均衡路由算法的改进及其分析

针对最宽不相交路径(WDP)算法计算每个可行路径工作量大而且非常耗时——计算n条路径需要耗费O(n3)次迭代的问题,为了减少算法的复杂度和缩短计算候选路径的时间,提出了一种通过减少可行路径集的数量和限制计算迭代次数的改进算法,该算法使用具有可用带宽的可行路径集的子集代替所有可行路径来计算候选路径。性能分析表明:改进后的算法和最初的WDP算法相比具有较快的收敛速度和较低的计算复杂度,对于给定的通信流量能够提升网络性能。     

基层传染病疫情网络直报质量调查

目的了解基层传染病疫情网络直报管理与报告质量现状,发现疫情报告环节中存在的问题,为基层医疗机构疫情报告管理工作提供借鉴。方法抽查普宁市基层卫生院2010年10月～2011年9月的门诊日志,掌握日志登记规范情况;并搜索其中所有的法定传染病病例,与网络直报系统记录进行核对,检查报告卡填写情况,计算漏报率、迟报率及错报率。将结果进行统计学分析对比。结果普宁市乡镇卫生院门诊部的日志登记总规范率为61.33%;法定传染病总漏报率为15.72%;错报率为5.03%;直报及时率为92.97%;网络重报率为1.53%;三个科别的传染病报告质量中,以中医内科最差（日志登记规范率为20%、法定传染病漏报率为100%）,与外科及西医内科的差异有统计学意义。结论必须加强对基层医务人员特别是中医类别医务人员的传染病报告相关知识培训及相关法制教育,提高传染病疫情网络直报质量。     

安顺市2010-2014年传染病网络报告质量综合评价分析

目的掌握安顺市2010-2014年传染病网络报告工作质量,为提高传染病网络报告质量提供科学有效的依据。方法利用传染病报告管理信息系统报告的数据,用Microsoft office excel 2003软件对数据进行统计、汇总。结果2010-2014年传染病网络报告率为94.73%,综合率为97.40%,及时报告率为96.96%,及时审核率为99.46%,重卡率为0.00%,乡镇零缺报率为38.11%。结论各级责任报告单位对传染病报告的管理力度要进一步加大,明确报告责任,强化业务培训学习;卫生行政部门要高度重视传染病网络报告工作,加大对网络直报工作的专项经费投入,加强对传染病报告管理的督导检查,提高安顺市传染病报告的及时性、完整性、准确性和审核及时性,从而提高全市传染病网络直报工作的综合质量。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.