Epworth量表在飞行人员睡眠呼吸暂停低通气综合征流行病学调查中的应用价值

目的评价Epworth嗜睡评价量表(ESS)在飞行人员睡眠呼吸暂停低通气综合征(SAHS)流行病学调查中的应用价值。方法采用整群抽样法,对1200名飞行人员进行ESS量表及问卷调查,有效率为88.8%。对打鼾者和(或)Epworth量表(ESS)评分≥9分者,随机检测夜间脉搏血氧饱和度(SpO2),对氧减饱和指数(ODI)≥10次/h者,行整夜多导睡眠图(PSG)监测。临床可疑SAHS者,直接行PSG监测。结果保守估计飞行人员SAHS的患病率为0.8%。ESS均值在不打鼾、单纯鼾症及SAHS三组之间呈逐渐增高趋势,各组间有显著性差异。按ESS评分<9分和≥9分分组,各组构成比有显著性差异,ODI结果亦有显著差异(P均<0.001)。在AHI<5次/h和≥5次/h两组间,ESS评分无显著性差异(P>0.05)。结论ESS量表在飞行人员SAHS流行病学调查中具有初筛作用,在SAHS诊断、判断严重程度及治疗效果方面具有一定预测作用。但对飞行人员等特殊职业人群SAHS的筛查可能存在一定局限性,建议补充、限定,提高应用价值。     

Catalyst-free reductive cyclization of bis(2-aminophenyl) disulfide with CO2 in the presence of BH3NH3 to synthesize 2-unsubstituted benzothiazole derivatives

An efficient and catalyst-free methodology for the reductive cyclization of various disulfides using BH₃NH₃ as a reductant and CO₂ as a C1 resource was developed. The desired 2-unsubstituted benzothiazole derivatives were obtained in good to excellent yields. Moreover, mechanism investigation demonstrated that BH₃NH₃ played an important role in the formation of benzothiazole. As a reducing agent, BH₃NH₃ reduced CO₂ and cleaved the S–S bond of the disulfide efficiently. In addition, the N–H bond of the amino group was also activated by BH₃NH₃. To the best of our knowledge, this is an unprecedented catalyst-free protocol for the synthesis of 2-unsubstituted benzothiazole from bis(2-aminophenyl) disulfide and CO₂.

An efficient and catalyst-free methodology for the reductive cyclization of various disulfides using BH₃NH₃ as a reductant and CO₂ as a C1 resource was developed.     

营养素摄入水平与前列腺癌发病因素的相关分析

目的:探讨营养素摄入水平与前列腺癌发病危险的关系。方法:对经病理组织学确诊的96例前列腺癌新发病例实施1∶3配比的病例-对照研究。三类对照共计288例(其中医院癌对照96例,医院非癌对照96例,正常对照96例)。配比条件为同性别、同民族和年龄相差≤±5岁。结果:经条件Logistic回归分析结果显示,总热量(OR值1.22~2.06,P值分别为0.78、0.04和0.032)、总脂肪(OR值1.06~1.89,P值分别为0.98、0.021和0.019)、饱和脂肪酸(OR值1.08~1.79,P值分别为0.92、0.023和0.032)、不饱和脂肪酸(OR值1.07~2.81,P值分别为0.88、0.027和0.007 1)以及动物脂肪(OR值1.14~2.56,P值分别为0.87、0.047和0.008)与前列腺癌发病危险呈正相关;硒与前列腺癌发病危险呈负相关(OR值0.57~0.84,P值分别为0.84、0.031和0.030)。总热量、总脂肪、饱和脂肪酸、动物脂肪与前列腺癌发病存在一定的剂量反应关系。结论:营养素摄入过程中的高脂和微量元素硒缺乏与前列腺癌发病危险存在关联。     

Study on Toughening and Temperature Sensitivity of Polyurethane Cement (PUC)

Polyurethane cement (PUC) is now commonly used in the reinforcement of old bridges, which exhibit various issues such as poor toughness, temperature-sensitive mechanical properties, and brittle failure. These problems can lead to the failure of the reinforcement effect of the PUC on old bridges in certain operating environments, leading to the collapse of such reinforced bridges. In order to alleviate these shortcomings, in this study, the toughness of PUC is improved by adding polyvinyl alcohol (PVA) fiber, carbon fiber, and steel fiber. In addition, we study the change law of the flexural strength of PUC between −40 °C and +40 °C. The control parameters evaluated are fiber type, fiber volume ratio, and temperature. A series of flexural tests and scanning electron microscope (SEM) test results show that the flexural strength first increases and then decreases with the increase in the volume-doping ratio of the three fibers. The optimum volume-mixing ratios of polyvinyl alcohol (PVA) fiber, carbon fiber, and steel fiber are 0.3%, 0.04% and 1%, respectively. Excessive addition of fiber will affect the operability and will adversely affect the mechanical properties. The flexural strength of both fiber-reinforced and control samples decreases with increasing temperature. Using the flexural test results, a two-factor (fiber content, temperature) BP neural network flexural strength prediction model is established. It is verified that the model is effective and accurate, and the experimental value and the predicted value are in good agreement.     

神经内科门诊患者焦虑障碍、睡眠障碍与应对方式的关系

目的 调查神经内科门诊患者焦虑障碍与睡眠障碍之间的关系,并探讨应对方式在二者之间的潜在中介作用。方法 以2019年1—12月该院就诊的102例神经内科门诊患者为研究对象。分别采用综合医院用焦虑量表、匹兹堡睡眠指数问卷和应对方式问卷评估患者的焦虑障碍、睡眠障碍与应对方式。结果 焦虑障碍与睡眠障碍呈正相关(r=0.592,P=0.003)。多元线性回归分析显示,成熟应对方式如问题解决(β=—0.493,P=0.002)与混合应对方式如合理化(β=—0.336,P=0.021)对睡眠障碍与焦虑障碍的关系具有负向预测作用,而不成熟应对方式如幻想(β=0.237,P=0.041)、退避(β=0.223,P=0.040)对睡眠障碍与焦虑障碍的关系具有正向预测作用。结论 有效应对方式能够缓解焦虑障碍对睡眠障碍的负面影响。     

Study on the Conventional Performance and Microscopic Properties of PPA/SBS-Modified Bio-Mixed Asphalt

To promote the construction of environmentally friendly, sustainable pavements and solve the impact of the scarcity of asphalt resources on highway development, bio-mixed asphalt (BMA) modified by SBS and polyphosphoric acid (PPA) was prepared, and the influence of the ratio of bio-asphalt (BA) replacing petroleum asphalt on different PPA/SBS blending schemes was explored through conventional property tests. According to each PPA/SBS blending scheme, the optimal replacement ratio of bio-asphalt was optimized, and the microstructure and distribution morphology of different PPA/SBS-modified BMA were evaluated. Conventional property test results show that with the same PPA/SBS content, the replacement ratio of bio-asphalt has a significant impact on the conventional performance of composite-modified asphalt, but the appropriate replacement ratio of bio-asphalt can improve the storage stability and conventional performance of composite-modified asphalt; in micromorphological analysis, it was found that the number of bee-like structures on the surface of the modified BMA decreased significantly, which indicated that the molecular heterogeneity of various components in the asphalt was reduced. In addition, bio-asphalt changed the particle morphology and improved the dispersity of SBS in asphalt. The composite-modified BMA had a lower SBS content, but its conventional performance was still excellent—so it has significant application prospects in road engineering.     

First-Principles Study of Silicon–Tin Alloys as a High-Temperature Thermoelectric Material

Silicon–germanium (SiGe) alloys have sparked a great deal of attention due to their exceptional high-temperature thermoelectric properties. Significant effort has been expended in the quest for high-temperature thermoelectric materials. Combining density functional theory and electron–phonon coupling theory, it was discovered that silicon–tin (SiSn) alloys have remarkable high-temperature thermoelectric performance. SiSn alloys have a figure of merit above 2.0 at 800 K, resulting from their high conduction band convergence and low lattice thermal conductivity. Further evaluations reveal that Si_0.75Sn_0.25 is the best choice for developing the optimum ratio as a thermoelectric material. These findings will provide a basis for further studies on SiSn alloys as a potential new class of high-performance thermoelectric materials.     

Impact of National Centralized Drug Procurement Policy on Antiviral Utilization and Expenditure for Hepatitis B in China

Background and AimsThe National Centralized Drug Procurement (NCDP) policy was launched in mainland China in April 2019, with entecavir (ETV) and tenofovir disoproxil fumarate (TDF) being included in the procurement list. We conducted the current study to investigate the impact of the NCDP policy on the utilization and expenditures of antiviral therapy for chronic hepatitis B (CHB) in China.MethodsProcurement records, including monthly purchase volume, expenditure, and price of nucleos(t)ide analogs (NAs), were derived from the National Healthcare Security Administration from April 2018 to March 2021. The changes in volumes and expenditures of the first-line NAs and bid-winning products were calculated. The effects of price, volume, and structure related to drug expenditure were calculated by the Addis and Magrini (AM) Index System Analysis.ResultsThe purchase volume of NAs significantly increased from 134.3 to 318.3 million DDDs, whereas the expenditure sharply decreased from 1,623.41 to 490.43 million renminbi (RMB) or 241.94 to 73.09 million US dollars (USD). The proportions of first-line NAs rose from 72.51% (ETV: 69.00%, TDF: 3.51%) to 94.97% (ETV: 77.42%, TDF: 17.55%). AM analysis showed that the NCDP policy decreased the expenditure of all NAs (S=0.91) but increased that of the first-line NAs in the bid-winning list (S=1.13). Assuming the population size of CHB patients remains stable and a compliance rate of ≥75%, the proportion of CHB patients receiving first-line antiviral therapy would increase from 6.36–8.48% to 11.56–15.41%.ConclusionsThe implementation of the NCDP policy significantly increased the utilization of first-line NAs for CHB patients at a lower expenditure. The findings provided evidence for optimizing antiviral therapy strategy and allocating medical resources in China.     

利用LIS监管及优化检验流程

本文利用条形码技术建立＂无纸化＂检验流程,设置流程监控节点,用实验室信息系统（LIS）的回报时间（TAT）分析功能对流程进行评测。研究显示LIS可以有效地对检验流程进行监管和优化。     

血清proGRP、Ctn、CEA在甲状腺髓样癌鉴别诊断和预测颈侧区淋巴结转移中的价值

目的:研究术前血清胃泌素释放肽前体(proGRP)、降钙素(Ctn)和癌胚抗原(CEA)在甲状腺髓样癌(MTC)鉴别诊断和预测颈侧区淋巴结转移中的价值。方法:选取41例MTC(有颈侧区淋巴结转移者22例,无转移者19例)患者(MTC组)和50例分化型甲状腺癌(DTC)患者(DTC组)。比较两组术前血清proGRP、 Ctn和CEA水平,采用受试者工作特征(ROC)曲线分析血清proGRP、 Ctn和CEA诊断MTC及判断MTC患者颈侧区淋巴结转移的价值。结果:MTC组术前血清proGRP、 Ctn和CEA水平均高于DTC组,有颈侧区淋巴结转移的MTC患者高于无转移患者(P<0.001)。术前血清proGRP、 Ctn和CEA单独诊断MTC的截断值[AUC(95%CI)]分别为105.00 ng/L[0.927(0.866～0.988)]、124.02 ng/L[0.958(0.914～1.000)]和8.49μg/L[0.887(0.807～0.967)],敏感度分别为87.8%、90.2%、82.9%,特异度分别为92.0%、100.0%、96.0%。proGRP与Ctn联合诊...