便携式录播系统在精品视频公开课建设中的应用研究

根据教育部制定的"视频公开课拍摄制作技术标准",结合第二军医大学精品视频公开课建设经验,设计并摸索了一套基于网络的视频公开课拍摄制作方案,实践说明具有较好效益,受到师生欢迎。     

2022年GOLD慢性阻塞性肺疾病诊断、治疗、管理及预防全球策略更新要点解读

慢性阻塞性肺疾病（慢阻肺）全球倡议（global initiative for chronic obstructive lung disease，GOLD）2022年修订版于2021-11-15发布，总体来说其对于慢阻肺的诊断、评估、个体化治疗与GOLD 2021相同，但在10个方面增加了相应内容。本文对新增内容进行简介和解读。     

合并阻塞性睡眠呼吸暂停低通气综合征对慢性阻塞性肺疾病患者心功能的影响

目的分析单纯慢性阻塞性肺疾病(简称慢阻肺)患者与慢阻肺合并阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的临床特征,研究合并OSAHS对慢阻肺患者心功能的影响。方法本研究回顾性纳入2016年9月至2018年10月就诊于北京大学第三医院呼吸与危重症医学科门诊的稳定期慢阻肺患者126例,其中男112例,女14例,年龄48~89岁,中位年龄67岁。以呼吸暂停低通气指数(AHI)5次/h为界值,分为单纯慢阻肺组(31例)和慢阻肺合并OSAHS组(95例),比较患者的人口学特征、呼吸道症状、肺功能、心血管事件发生率和反映患者的患者心功能的超声心动图E/e′比率、左心房前后径(LAD)及左心室射血分数(LVEF)等指标,采用独立样本t检验、卡方检验等对数据进行统计学分析。结果单纯慢阻肺患者与慢阻肺合并OSAHS患者的人口学特征、呼吸道症状、肺功能差异均无统计学意义,各项夜间血氧饱和度水平指标差异均有统计学意义(均P<0.05),两组患者左心室质量指数(LVMI)差异有统计学意义(P=0.047),而心血管事件发生率差异无统计学意义。AHI≥30次/h的合并严重OSAHS的患者与AHI<30次/h的非严重OSAHS的患者相比,超声心动图指标E/e′(P=0.013)、LAD(P=0.006)、LVMI(P=0.051)、LVEF(P=0.030)差异均有统计学意义,冠心病及充血性心力衰竭病史差异有统计学意义(P=0.025,P<0.001)。按轻中重度对慢阻肺合并OSAHS患者严重程度进行分组后,E/e′及LAD与严重程度明显相关(P=0.045,P=0.011)。夜间血氧饱和度水平方面,夜间平均血氧饱和度和E/e′、LAD、LVMI均有显著相关性(r=-0.195,P=0.033;r=-0.197,P=0.030;r=-0.195,P=0.044);血氧饱和度≤90%的比例与LAD有显著相关性(r=0.209,P=0.021)。多元线性回归模型中,AHI每增加一个单位时E/e′平均增加0.070,氧减指数每增加一个单位时E/e′平均增加0.084。结论慢阻肺合并重度OSAHS的患者与慢阻肺合并非重度OSAHS患者相比,左心舒张功能显著降低且发生充血性心力衰竭和冠心病的风险显著增加,且慢阻肺合并OSAHS的严重程度与左心舒张功能受限的严重程度相关,AHI越高、氧减指数越高,左心舒张功能受限及结构改变越严重。     

Direct conversion of C6 sugars to methyl glycerate and glycolate in methanol

The present work deals with the one-pot conversion of C6 sugars to methyl glycerate and glycolate via a cascade of retro-aldol condensation and oxidation processes catalyzed by using MoO₃ as the Lewis acid catalyst and Au/TiO₂ as the oxidation catalyst in methanol. Methyl glycerate (MGLY) is the product of C6 ketose (fructose), while methyl glycolate (MG) is produced from C6 aldose (mannose, glucose). It is found that a good one-pot match between two reactive processes is the key to the production of MGLY and MG with high yield (27.6% MGLY and 39.2% MG). A separated retro-aldol condensation and oxidation process greatly decreases their yields, and even no MGLY can be obtained in this separated process. We attribute this to high instability of glyceraldehyde/glycolaldehyde and their different reaction pathways which mainly depend on whether acetalization of retro-aldol products (glyceraldehyde and glycolaldehyde) occurs with methanol or not. This result opens a new prospect on the accumulation of C3 products other than lactate from biomass-derived carbohydrates.

Methyl glycerate (MGLY) and methyl glycolate (MG) are directly produced in maximum yield by the one-pot conversion of hexose, and the formation of MGLY and MG experience different reaction routes.     

上海老年农村人口心房颤动流行病学调查

目的调查上海市松江区老年农村人口心房颤动（房颤）患病率情况。 方法横断面调查2015年上海市松江区7个乡镇的60岁以上农村居民36 734名,分为60岁~、70岁~、80岁~、≥90岁4个年龄组,依据病史及体检心电图筛查房颤患者。对36 734名60岁以上农村居民中男性和女性房颤患者整体患病率的比较,对同年龄组男性和女性房颤患病率的比较,对同性别各年龄组间房颤患病率的比较,以及对辽宁省≥65岁农村居民房颤患病率和松江区≥65岁农村居民的房颤患病率比较均采用精确四格表χ²检验。 结果上海市松江区7个乡镇60岁以上36 734名农村人口中整体房颤患病率为2.25%（828/36 734）,其中男性的房颤患病率为2.66%（422/15 877）,女性的房颤患病率为1.95%（406/20 857）,男性房颤患病率高于女性,差异具有统计学意义（χ²=20.704,P<0.001）。按年龄组分类的房颤患病率：在男性,60岁~年龄组为1.42%,70岁~年龄组为3.42%,80岁~年龄组为5.81%,≥90岁年龄组为6.49%（各年龄组间比较差异有统计学意义,χ²=135.586,P<0.001）;在女性,60岁~年龄组为0.86%,70岁~年龄组为2.24%,80岁~年龄组为5.02%,≥90岁年龄组为6.20%（各年龄组间比较差异有统计学意义,χ²=223.249,P<0.001）。各年龄组的男性与女性房颤患病率比较,60岁~和70岁~年龄组男性房颤患病率高于女性,差异具有统计学意义（1.42% vs 0.86%,χ²=14.050,P<0.05;3.42% vs 2.24%,χ²=18.406,P<0.05）。辽宁省≥65岁农村老年女性的房颤患病率高于上海松江地区≥65岁女性的房颤患病率,差异具有统计学意义（3.1% vs 2.04%,χ²=4.132,P=0.042）,两个地区≥65岁农村老年男性间的房颤患病率差异无统计学意义（3.3% vs 2.89%,χ²=0.392,P=0.531）。 结论上海市松江区60岁以上农村人口的房颤患病率随年龄增长而升高,且存在显著的性别差异。房颤患病率在我国老年农村人口中可能存在性别差异和地域差异。     

18F-脱氧葡萄糖PET/CT对宫颈癌分期及预后的临床价值

近年来随着影像技术不断进步,成像形式从反映病变解剖结构发展到反映病变代谢及功能特征。18F-脱氧葡萄糖(18F-FDG)PET/CT显像作为分子成像的重要组成,已在临床逐步应用,尤其广泛应用于妇科常见肿瘤宫颈癌中。大量临床应用表明,PET/CT具有更准确的临床分期能力,能更早地判断治疗疗效响应、监测复发和残留肿瘤,以更好地判断预后,较CT和MRI展示出巨大优势和前景。     

Antifungal mechanism of cinnamaldehyde and citral combination against Penicillium expansum based on FT-IR fingerprint,plasma membrane,oxidative stress and volatile profile

Cinnamaldehyde (Cin) and citral (Cit) have been studied as antimicrobial agents and natural preservatives, but their action modes are controversial, and the knowledge of their antifungal mechanism against P. expansum is still incomplete. The present study was conducted to evaluate the antifungal mechanism of the combination of Cin and Cit (Cin/Cit) against P. expansum by observing the cellular ultrastructure, fourier transform infrared spectroscopy (FT-IR) fingerprints, plasma membrane, oxidative stress and volatile profile. Cin/Cit caused membrane invaginations, organelles and cytoplasm destruction, as shown by transmission electron microscopy (TEM) observations. The FT-IR spectra and followed principle component analysis (PCA) presented the significant differences in chemical compounds, particularly phospholipid, protein and fatty acids of cells exposed to Cin/Cit. Compared to controls, Cin/Cit induced a decrease of ergosterol by 39.40%, an increase of unsaturated fatty acid, and protein release level (3.5 times). Besides, membrane damage was further verified through the reduction of the membrane integrity by using a flow cytometer. Moreover, the increase of malondialdehyde (MDA) (40.09%) and reactive oxygen species (ROS) accumulation indicated an induction of oxidative stress in cells by Cin/Cit. To resist the unfavorable stress caused by Cin/Cit, P. expansum metabolized Cin or Cit to the predominant detoxification compounds, cinnamic alcohol, nerol, and geraniol. The alterations in volatile profile demonstrated the influences on specific metabolisms in P. expansum caused by Cin/Cit.

Cinnamaldehyde (Cin) and citral (Cit) have been studied as antimicrobial agents and natural preservatives, but their action modes are controversial, and the knowledge of their antifungal mechanism against P. expansum is still incomplete.     

军队离退休老干部疗养中的景观治疗作用及意义

随着现代医疗水平的飞速发展,我国已提前进入老龄社会,如何提高老年人生活质量已成为社会各部门亟待解决的问题。北戴河疗养院位于美丽的海滨城市秦皇岛市西南的渤海之滨,三面环海,气候宜人,风景秀丽,具有得天独厚的地理环境和历史悠久的人文景观,     

痉挛性肛门直肠痛

痉挛性肛门直肠痛(proctalgia fugax ,PF)是发生在肛门直肠区域的短暂的、反复发作的一过性疼痛.疼痛持续的时间仅仅为几秒到几分钟,通常能够自行缓解,不遗留任何症状直到下次再发生.PF常常无规律的突然出现在白天或晚上,患者会在夜间被痛醒[1].PF首先在1883年由Myrtle报道,后在1935年Thaysen正式将其命名为"痉挛性肛门直肠痛",并对其发作的特征作了详细的描述,而在中国关于PF罕见有报导.PF在一般人群中的患病率为2%～8%[2～5],好发于女性[3,4].因本病发作不频繁,持续时间短暂,往往不被病人所重视,只有17%～20%的PF患者会向医生咨询[6].现从PF的发病机理、临床诊断、治疗等方面综述如下.     

影响医学精品课程质量的技术因素分析及其对策

在调查了医学国家精品课程建设现状的基础上,分析了在网络传播与应用中影响医学精品课程质量的技术因素,阐述了新的网络环境的特征与优势及其对教育的影响,进而针对当前医学精品课程建设中的不足,提出了在新的网络环境下提高其质量的对策.