酸枣果肉资源化学成分研究

目的 研究酸枣Ziziphus jujuba var. spinosa果肉的化学成分,为其资源开发提供依据。方法 利用各种色谱方法进行化学成分分离,根据理化性质和波谱数据鉴定化合物的结构。结果 从酸枣果肉中分离鉴定了14个化合物,分别为大枣皂苷I（1）、大枣皂苷II（2）、苹果酸（3）、苹果酸乙酯（4）、水杨酸（5）、豆甾醇-3-O-β-D-葡萄糖苷（6）、胡萝卜苷（7）、D-葡萄糖（8）、芦丁（9）、二十二烷酸（10）、硬脂酸（11）、棕榈酸（12）、油酸（13）、棕榈油酸（14）。结论 所有化合物均为首次从酸枣果肉中分离得到,其中化合物1～6为首次从酸枣植物中分离得到,研究结果为酸枣果肉及酸枣资源的综合利用提供了基础。     

志愿者预防艾滋病同伴教育活动在大学生中的干预效果

目的 对志愿者在大学生中预防艾滋病活动进行干预效果评价.方法 以河北大学2014、2015级预防医学与卫生事业管理系学生为干预组,以河北大学2014、2015级临床医学院学生为对照组.在干预组中通过培训志愿者,采用同伴教育的方式进行干预.并通过干预组和对照组干预前后的比较,对干预效果进行评价.结果 干预组在接受同伴教育前后,艾滋病一般知识知晓率分别为2953%和4137%,艾滋病非传播途径知晓率分别为4352%和5612%,艾滋病预防知识知晓率分别为4663%和6547%,以及艾滋病正确态度持有率分别为3731%和4712%,均有所提高.安全套使用率不足60%,且在干预前后无显著变化.结论 在大学生中依托志愿者开展同伴教育的方法收到了较好的干预效果,但艾滋病相关行为的改善并不理想,还需在今后预防艾滋病的工作中继续探索与重点干预.     

YD383、YD439对JAK-STAT6信号传导通路作用的特异性研究

目的:探讨化合物YD383和YD439对STAT6信号传导通路的作用是否具有特异性.方法:通过瞬时转染的方法将分别依赖于STAT1和STAT6活性的带有荧光素酶报告基因的质粒转染至HeLa细胞株,两种细胞株在各自相应的细胞因子(IFN-γ或IL-4)刺激下激活JAK-STAT1或JAK-STAT6信号传导通路.通过测定荧光素酶的活性来评价细胞株在化合物存在的情况下报告基因的表达.结果:YD383和YD439均能降低相应细胞因子刺激引起的报告基因的表达,并且具有剂量依赖性.随着化合物剂量的增加,报告基因的表达降低(P＜0.05).但化合物引起的两种转染细胞报告基因表达降低的差异比较无统计学意义(P＞0.05).结论:两种化合物对JAK-STAT1和JAK-STAT6信号传导通路均有抑制作用,对JAK-STAT6通路的抑制不具有特异性.     

基于MRI的辽宁汉族成人面部软组织侧貌角度测量及分析

目的 探讨中国辽宁地区汉族成人面部软组织侧貌数据,为正畸、正颌及整形的临床诊疗提供参考数据.方法 随机选取符合纳入标准的辽宁医学院在校学生100人(女性50人、男性50人),使用GE超导1.5T MRI扫描仪对其进行头颈联合扫描.将获取的图像信息导入VG Stduio2.2 MAX软件分析系统实现三维颅面重建,采用Fa...     

吉非替尼治疗化疗失败晚期肺腺癌的临床观察

目的：观察吉非替尼治疗化疗失败的晚期肺腺癌的疗效及安全性。方法：33例患者均每日口服吉非替尼250mg,直到病情进展时停药。同时选择性配合营养支持疗法、降低颅内压和止痛等治疗。观察症状变化、近期疗效、肿瘤进展时间、生存期及不良反应。结果：服药1个月后33例患者CR3例（9．09％）,PR21例（63．6％）,SD8例（24,2％）,PD1例（3．03％）。有效率（RR）为72．7％,疾病控制率（DCR）为96．97％。中位肿瘤进展时间（TTP）9．9个月。疗效以不抽烟者为好,P〈0．05。性别间疗效差异无统计学意义,P〉0．05。3例生存时间〉19个月,6例〉14个月,1年生存率27．3％。13例生存时间〉9个月,8例〉6个月,3倒〉3个月。毒副作用主要为胸面部丘疹及色素沉着和轻微的消化道反应。结论：化疗失败的晚期肺腺癌应用吉非替尼治疗效果较好且安全,患者的耐受性及顺从性好。进一步的疗效和应用范围以及安全性有待更深入地研究、观察。     

数据分类算法智慧诊疗模型在皮肤痤疮诊断中的研究与应用

目的建立一种基于数据分类算法、人工智能与皮肤诊断学等多学科融合的寻常型痤疮智慧诊疗模型。方法通过采集陆军军医大学第一附属医院皮肤科2018-2020年门诊患者中明确确诊的寻常型痤疮皮肤影像数据为依据,利用数据分类算法、卷积神经网络、深度学习等技术定位影像数据中的痤疮关键部位,进而提取、处理、分析和总结归纳寻常型痤疮影像的病理特征。结果建立痤疮分类诊断模型与知识库,构建智慧痤疮诊断模型标准与规范。结论数据分类算法智慧诊疗模型可实现对寻常型痤疮图像的自主诊断,提高诊断准确率与工作效率。     

Using machine learning to aid treatment decision and risk assessment for severe three-vessel coronary artery disease

BACKGROUNDThree-vessel disease (TVD) with a SYNergy between PCI with TAXus and cardiac surgery (SYNTAX) score of ≥ 23 is one of the most severe types of coronary artery disease. We aimed to take advantage of machine learning to help in decision-making and prognostic evaluation in such patients.METHODSWe analyzed 3786 patients who had TVD with a SYNTAX score of ≥ 23, had no history of previous revascularization, and underwent either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) after enrollment. The patients were randomly assigned to a training group and testing group. The C4.5 decision tree algorithm was applied in the training group, and all-cause death after a median follow-up of 6.6 years was regarded as the class label.RESULTSThe decision tree algorithm selected age and left ventricular end-diastolic diameter (LVEDD) as splitting features and divided the patients into three subgroups: subgroup 1 (age of ≤ 67 years and LVEDD of ≤ 53 mm), subgroup 2 (age of ≤ 67 years and LVEDD of > 53 mm), and subgroup 3 (age of > 67 years). PCI conferred a patient survival benefit over CABG in subgroup 2. There was no significant difference in the risk of all-cause death between PCI and CABG in subgroup 1 and subgroup 3 in both the training data and testing data. Among the total study population, the multivariable analysis revealed significant differences in the risk of all-cause death among patients in three subgroups.CONCLUSIONSThe combination of age and LVEDD identified by machine learning can contribute to decision-making and risk assessment of death in patients with severe TVD. The present results suggest that PCI is a better choice for young patients with severe TVD characterized by left ventricular dilation.

Coronary artery disease (CAD) is the leading cause of death and disability worldwide.^[1] Three-vessel disease (TVD) is the most severe form of CAD and is characterized by significant stenosis in all three major coronary arteries. The application of myocardial revascularization techniques, including coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), has significantly improved the clinical outcomes of patients with severe CAD. CABG has traditionally been the standard therapy for complex coronary lesions, including TVD.^[2] In recent years, with the advancements in PCI technology and the accumulation of operators’ experience, the incidence of periprocedural and long-term adverse events of PCI has substantially decreased, and PCI has been gradually applied in the treatment of TVD.^[3,4] Current guidelines recommend use of the SYNergy between PCI with TAXus and cardiac surgery (SYNTAX) score and diabetes status to guide the revascularization strategy for patients with TVD.^[5,6] Current practice guidelines do not recommend PCI for patients with TVD with a SYNTAX score of ≥ 23. However, using the SYNTAX score to guide clinical decision-making between PCI and CABG remains controversial, and its reasonability has been questioned since a newly published meta-analysis showed no significant association between the SYNTAX score and the comparative effectiveness of PCI and CABG.^[7] Moreover, the SYNTAX score is a quantitative indicator of the anatomical complexity of TVD and does not include clinical variables that may have significant effects on the patient’s prognosis. Whether some patients with specific clinical characteristics can obtain a comparable or even greater survival benefit from PCI than from CABG is unclear. Moreover, risk assessment for patients with TVD after revascularization therapy remain challenging.^[8–10]Machine learning has recently emerged as an important research method and has been successfully applied in many scientific fields, including clinical medicine.^[11–13] The decision tree algorithm, a common approach in machine learning, can handle non-linearity, heterogeneous effects, and high-dimensional features and partition a trial population into subgroups characterized by multiple simultaneous characteristics.^[14] In the present study involving a large cohort of patients with TVD with a SYNTAX score of ≥ 23, we employed a decision tree algorithm to generate specific subgroups, compared the long-term prognosis between patients who underwent PCI or CABG in each subgroup, and conducted a comparative analysis of the long-term prognosis between subgroups generated by machine learning. We evaluated whether machine learning can help in selecting the optimal revascularization method and assessing risk in patients with severe TVD.     

浅谈教师专业道德

教师专业化及教师专业道德的发展越来越得到社会各界的重视,相关研究也日益成为研究热点。本文通过分析教师专业道德的内涵和特性,探讨教师专业道德在教师专业化发展中的作用,为促进教师专业化的健康发展提供了理论依据。     

专职随访对捐献肾移植受者生活质量影响的研究

目的 探讨专职随访对器官捐献肾移植受者生活质量的影响。方法 将成人公民逝世后器官捐献肾移植受者192例随机分为对照组97例和试验组95例,对照组采用常规随访模式,试验组实施专职随访,运行科室-门诊-网络闭环随访管理。比较2组患者的非计划再入院率、自我护理能力评分、生活质量评分以及随访满意度情况。结果 出院后6个月,试验组的非计划再入院率18.95%,低于对照组29.90%,差异有统计学意义(P<0.05);出院后1、6个月,试验组自我护理能力得分、生活质量得分、随访满意度均高于对照组,差异有统计学意义(P<0.05)。结论 专职随访可有效降低肾移植受者非计划再入院率,提高自我护理能力,改善生活质量,并提升患者的满意度。     

独立学院应届毕业生心理健康状况调查

目的 了解独立学院应届毕业生心理健康状况,为学校开展心理健康干预提供理论依据.方法 以自编学生一般情况问卷表和症状自评量表对76名应届毕业生进行调查分析.结果 独立学院毕业生心理健康各因子得分中强迫症状、焦虑、敌对和精神症性高于全国青年组常模,差异有统计学意义(P<0.05);文科学生得分高于理科学生,男生得分高于女生...