以学生为案例望面色教学实践体会

望面色是望诊的主要内容之一,为了加强学生望面色这一诊断方法的学习效果,在征得学生同意,自愿参加的前提下,在学生中找典型面色进行真实案例教学,调动了学生学习积极性,取得了良好教学效果,实现了教学相长。     

云南漾濞不同地区核桃林下种植重楼的重楼皂苷含量比较

摘 要 目的：对云南漾濞不同地区核桃林下栽种重楼中的4种重楼皂苷含量进行比较。方法: 采集云南漾濞不同地区核桃林下栽种的重楼样品,按中国药典2015年版收载的方法进行含量测定。结果: 云南漾濞不同地区栽种重楼中4种重楼皂苷含量各样品间存在显著差异。样品均为仿野生林下载培,但载培时间长短不一,其中生长年限4~5年的重楼药材中4种重楼皂苷含量明显高于3年生重楼。结论:4种重楼皂苷含量各样品间存在显著差异与重楼生长的生态环境、生长年限和同一物种不同居群间遗传背景等不同有关。     

血小板增高与哮喘的关系探讨

目的：观察血小板计数（PLT）、大血小板比例（LPCR）、平均血小板体积（MPV）变化与哮喘发作的的关系。方法：采用日立产1313—2000型血液分析仪检测血小板计数（PLT）、大血小板比例（LPCR）、平均血小板体积（MPV）三项指标,进行统计分析。结果：观察组大血小板比例和血小板体积明显降低（P〈0．05）,血小板计数明显升高（P〈0．05）。结论：血小板计数（PLT）、大血小板比例（LPCR）、平均血小板体积（MPV）的变化与哮喘有重要关系,可作为血小板活化的标志。     

Associations of Nutritional,Environmental, and Metabolic Biomarkers with Diabetes-Related Mortality in U.S. Adults: The Third National Health and Nutrition Examination Surveys between 1988–1994 and 2016

Background: Nutritional, environmental, and metabolic status may play a role in affecting the progression and prognosis of type 2 diabetes. However, results in identifying prognostic biomarkers among diabetic patients have been inconsistent and inconclusive. We aimed to evaluate the associations of nutritional, environmental, and metabolic status with disease progression and prognosis among diabetic patients. Methods: In a nationally representative sample in the NHANES III (The Third National Health and Nutrition Examination Survey, 1988–1994), we analyzed available data on 44 biomarkers among 2113 diabetic patients aged 20 to 90 years (mean age: 58.2 years) with mortality data followed up through 2016. A panel of 44 biomarkers from blood and urine specimens available from NHANES III were included in this study and the main outcomes as well as the measures are mortalities from all-causes. We performed weighted logistic regression analyses after controlling potential confounders. To assess incremental prognostic values of promising biomarkers beyond traditional risk factors, we compared c-statistics of the adjusted models with and without biomarkers, separately. Results: In total, 1387 (65.2%) deaths were documented between 1988 and 2016. We observed an increased risk of all-cause mortality associated with higher levels of serum C-reactive protein (p for trend = 0.0004), thyroid stimulating hormone (p for trend = 0.04), lactate dehydrogenase (p for trend = 0.02), gamma glutamyl transferase (p for trend = 0.02), and plasma fibrinogen (p for trend = 0.03), and urine albumin (p for trend < 0.0001). In contrast, higher levels of serum sodium (p for trend = 0.005), alpha carotene (p for trend = 0.006), and albumin (p for trend = 0.005) were associated with a decreased risk of all-cause mortality. In addition, these significant associations were not modified by age, sex, or race. Inclusion of thyroid stimulating hormone (p = 0.03), fibrinogen (p = 0.01), and urine albumin (p < 0.0001), separately, modestly improved the discriminatory ability for predicting all-cause mortality among diabetic patients. Conclusions: Our nationwide study findings provide strong evidence that some nutritional, environmental, and metabolic biomarkers were significant predictors of all-cause mortality among diabetic patients and may have potential clinical value for improving stratification of mortality risk.     

Size-Dependent Persistent Luminescence of YAGG:Cr3+ Nanophosphors

In the current work, YAGG:Cr³⁺ nanophosphors were synthesized by the Pechini method and then annealed at different temperatures in the range 800–1300 °C. The structure and morphology of the samples were characterized by X-ray Powder Diffraction (XRPD). The lattice parameters and average crystalline sizes as site occupation by Al³⁺ and Ga³⁺ ions were calculated from the Rietveld refinement data. To investigate the effect of crystalline size of the materials on their optical properties: excitation and emission spectra were recorded and analyzed. Finally, the effect of crystalline size on the probability of carrier recombination leading to PersL was determined experimentally with thermoluminescence analyses. The T_max-T_stop method was applied to determine the trap type and particle size (calcination temperature) effect on their redistribution. A correlation between structural changes and trap redistribution was found. In particular, the extinction of high-temperature TL maximum with increasing annealing temperatures is observed, while low-temperature TL maximum increases and reaches a maximum when the lattice parameter reaches saturation.     

Microstructure and Friction Properties of CoCrFeMnNiTix High-Entropy Alloy Coating by Laser Cladding

To enhance the friction and wear properties of 40Cr steel’s surface, CoCrFeMnNi high-entropy alloy (HEA) coatings with various Ti contents were prepared using laser cladding. X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy dispersive spectroscopy (EDS) were used to characterize the phase composition, microstructure, and chemical composition of the samples. The findings demonstrated that the CoCrFeMnNiTi_x HEA coatings formed a single FCC phase. Fe₂Ti, Ni₃Ti, and Co₂Ti intermetallic compounds were discovered in the coatings when the molar ratio of Ti content was greater than 0.5. The EDS findings indicated that Cr and Co/Ni/Ti were primarily enriched in the dendrite and interdendrite, respectively. Ti addition can effectively enhance the coating’s mechanical properties. The hardness test findings showed that when the molar ratio of Ti was 0.75, the coating’s microhardness was 511 HV0.5, which was 1.9 times the hardness of the 40Cr (256 HV0.5) substrate and 1.46 times the hardness of the CrCrFeMnNi HEA coating (348 HV0.5). The friction and wear findings demonstrated that the addition of Ti can substantially reduce the coating’s friction coefficient and wear rate. The coating’s wear resistance was the best when the molar ratio of Ti was 0.75, the friction coefficient was 0.296, and the wear amount was 0.001 g. SEM and 3D morphology test results demonstrated that the coating’s wear mechanism changed from adhesive wear and abrasive wear to fatigue wear and abrasive wear with the increase in Ti content.     

大学生不安全依恋与拖延的关系：正念与自我控制的作用路径

背景 预防和干预大学生的拖延行为具有重要现实意义。已有研究表明,正念、自我控制、不安全依恋和拖延两两相关,但目前关于不安全依恋对拖延的作用机制仍不清楚,且缺乏二者间作用路径的研究。目的 探讨大学生不安全依恋对拖延的影响以及正念与自我控制的作用路径,以期为大学生拖延问题的干预提供参考。方法 于2023年2月—4月,采用整群随机抽样的方法,选取广东省4所高校的514名在校大学生为研究对象。采用非理性拖延量表（IPS）、成人依恋量表（AAS）、正念注意觉知量表（MAAS）和简式自我控制量表（BSCS）进行调查。使用Pearson相关分析考查各量表评分的相关性,使用Bootstrap法进行中介效应检验。结果 大学生AAS评分与IPS评分呈正相关（r=0.382,P<0.01）,与MAAS和BSCS评分均呈负相关（r=-0.242、-0.353,P均<0.01）;IPS评分与MAAS和BSCS评分均呈负相关（r=-0.314、-0.682,P均<0.01）;MAAS评分与BSCS评分呈正相关（r=0.439,P<0.01）。不安全依恋正向预测拖延（β=0.377,P<0.01）,自我控制是不安全依恋与拖延之间的作用路径,间接效应值为0.163（95% CI：0.105~0.223）,占总效应的43.24%,且正念与自我控制可能是不安全依恋与拖延之间的链式作用路径,间接效应值为0.056（95% CI：0.028~0.089）,占总效应的14.85%。结论 不安全依恋可以直接影响大学生拖延,也可以通过自我控制的独立作用路径及正念与自我控制的链式作用路径影响大学生拖延。     

社区严重精神障碍患者危险行为发生风险预测模型

背景 严重精神障碍患者危险行为发生率较一般人群更高,我国对社区严重精神障碍患者危险行为发生风险的预测研究尚不多见,尤其缺乏除传统预测方法之外的数据挖掘技术预测模型的研究和比较。目的 采用Logistic回归分析及分类决策树构建社区严重精神障碍患者危险行为发生风险的预测模型,检验分类决策树模型是否优于Logistic回归模型。方法 于2023年12月,选取2013年—2022年随访记录完整的11 484名社区严重精神障碍在管患者,按8∶2随机分为训练集（n=9 186）与测试集（n=2 298）。在训练集中,分别使用Logistic回归分析和分类决策树建立预测模型,在测试集评价模型的区分度和校准度。结果 1 115例（9.71%）严重精神障碍患者在随访期间出现危险行为。Logistic回归分析结果显示,城市户籍、贫困、有监护人、精神残疾、危险行为史阳性、自知力不全、自知力缺失、有阳性症状是患者发生危险行为的危险因素（OR=1.778、1.459、2.719、1.483、3.890、1.423、2.528、2.124,P均<0.01）;年龄≥60岁、受过教育、医嘱无需用药以及社会功...