新型冠状病毒肺炎后潜水员适潜性评估

新型冠状病毒肺炎（COVID?19）自2019年底爆发以来,对人类生命健康造成了极其严重的危害。作为一种呼吸系统疾病,COVID?19对全身几乎所有器官都会产生影响,其中最主要的受累器官为肺和心脏。随着COVID?19 “康复”患者数量不断增加,越来越多的证据表明,因COVID?19而住院治疗得到“康复”的患者中有相当大比例的人群存在着后遗症,主要表现为呼吸系统和心血管系统的症状。对于潜水员,COVID-19后运动耐受、心肺功能的恢复对于其适潜性具有重要的影响。一些组织和机构对于潜水员COVID-19后的适潜性评估,发布了指南。本文对COVID-19后呼吸和心血管后遗症以及相关的适潜性评估方案进行简要介绍,并基于已有的相关要求和我国实际,初步提出我国潜水员COVID-19后的适潜性评估要求。     

基于集成神经网络的类风湿关节炎中医证候分类研究

目的 针对基于AI技术的类风湿关节炎（RA）中医证候多标签分类中存在标签关联性差、泛化性能低等问题,提出构建一种集成神经网络模型来实现RA中医证候分类,并探究其中的特征重要性和风险因素,为RA的诊断和治疗提供参考。方法 本文提出一种集成神经网络模型实现RA中医证候分类。该模型采用一种基于多层神经网络的基分类器提取临床RA多标签样本的深层特征,增强RA特征区分度,根据协方差理论衡量标签相关性,调节分类器链的输入空间,减少RA错误信息传播和冗余度,采用集成学习方法减小分类器链中不合理标签序列对RA特征分类的影响。结果 该模型在10折交叉验证性能参数中表现出优秀的性能,其中汉明损失、1-错误率、准确率和F1值分别为0.0036、0.0248、97.52%、99.18%。与其他常用多标签分类器相比,该模型的性能更为优秀具有更好的分类性能。此外,本文分析了RA中医证候特征重要性,并挖掘了潜在的风险因素。结论 基于集成神经网络模型的RA中医证候分类器具有较高的分类精度和效率,对于RA的临床诊断和治疗具有重要参考价值。     

Short-Term Visual Experience Leads to Potentiation of Spontaneous Activity in Mouse Superior Colliculus

Spontaneous activity in the brain maintains an internal structured pattern that reflects the external environment,which is essential for processing information and developing perception and cognition.An essential prerequisite of spontaneous activity for perception is the ability to reverberate external information,such as by potentiation.Yet its role in the processing of potentiation in mouse superior colliculus(SC)neurons is less studied.Here,we used electrophysiological recording,optogenetics,and drug infusion methods to investigate the mechanism of potentiation in SC neurons.We found that visual experience potentiated SC neurons several minutes later in different developmental stages,and the similarity between spontaneous and visually-evoked activity increased with age.Before eye-opening,activation of retinal ganglion cells that expressed ChR2 also induced the potentiation of spontaneous activity in the mouse SC.Potentiation was dependenton stimulus number and showed feature selectivity for direction and orientation.Optogenetic activation of parvalbumin neurons in the SC attenuated the potentiation induced by visual experience.Furthermore,potentiation in SC neurons was blocked by inhibiting the glutamate transporter GLT1.These results indicated that the potentiation induced by a visual stimulus might play a key role in shaping the internal representation of the environment,and serves as a carrier for short-term memory consolidation.     

Predictors of post coronary artery bypass grafting atrial fibrillation

Objective: To investigate the incidence and relative risk factors of post coronary artery bypass grafting(post-CABG) atrial fibrillation (AF). Methods: 312 patients with CABG were reviewed and divided into an AF group and a non-AF group. Statistical analysis was used to compare the data between the two groups and screen for risk factors of post-CABG AF. Results: 103/312(33.01%) patients developed post-CABG AF. Univariate analysis showed that patients in AF group compared with those in non-AF group were more likely to have advanced age (≥ 70 years), early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement ( ≥40 mm), a history of AF, prolonged p-wave duration ( ≥ 120 ms) and increased number of grafts (≥3). Multivariate logistic regression analysis showed that advanced age (≥70 years), early postoperative withdrawal of β-blockers, hypertension, left atrial enlargement (≥40 mm) and a history of AF were highly related to post-CABG AF. Conclusion: The incidence of AF in patients following CABG was 33.01% in this study. Advanced age, early postoperative withdrawal of β-blockers,hypertension, left atrial enlargement and a history of AF were independent risk factors of post-CABG AF.     

苏州城区中年非体力劳动人群体力活动状况与部分体适能指标的调查

目的通过调查苏州城区中年非体力劳动人群体力活动现状、部分体适能指标的特点以及两者间的关系,为较发达地区人群＂代谢症候群＂的预警提供依据。方法选取苏州城区中年城市非体力劳动者300名,采用国际体力活动问卷（长卷）调查体力活动状况,并对调查者进行了身高、体质量、腰围、臀围及血压、血糖的测试。结果中等强度的体力活动或步行是主要的活动方式,达到低、中、高活动水平的人口比例分别为35%、57%和8%,女性达到体力活动充足的比例（94%）具有高于男性（89%）的趋势,但无统计学意义（P〉0.05）。高水平体力活动人群的腰围（75.44±8.24）cm与腰臀比（0.79±0.04）低于低水平体力活动人群[腰围（80.88±5.28）cm、腰臀比0.84±0.05]（均P〈0.05）。身体质量指数（BMI）、腰围（WC）、腰臀比（WHR）正常组人群的体力活动情况具有较好趋势（均P〈0.05）,而根据血压值划分的正常组在重体力活动与步行各方面均优于高血压组（均P〈0.05）。结论苏州城区中年非体力劳动人群主要参与强度为中等的体力活动或步行,重体力活动参与较少。体适能指标较优者普遍体力活动参与程度较高。     

A mononuclear nine-coordinated Dy(iii) complex exhibiting field-induced single-ion magnetism behaviour

A new mononuclear Dy(iii) complex, with the formula [Dy(Hcpt)₃]·2H₂O (1), has been successfully prepared via self-assembly between Dy(iii) ions and 2-cyano-N′-(1-(pyridin-2-yl)amido)acetyl (Hcpt) ligand. X-ray diffraction study shows that the Dy(iii) ion is nine-coordinated by three Hcpt ligands with a tridentate chelating mode, leading to an approximately monocapped square-antiprismatic (C_4v) geometry. Magnetic data analysis demonstrates that 1 performs field-induced slow magnetic relaxation with a relaxation barrier of 97.90 K, due to the quantum tunneling effect suppressed upon a static dc field of 2000 Oe. To deeply understand the magnetic behaviors, the relaxation mechanisms and magneto-structure relationship are rationally discussed using ab initio calculations as well.

Reaction of Dy(iii) ion with tridentate acylhydrazone ligand leads to a field-induced Dy(iii) SIM, of which the magneto-structural correlation is elucidated by the magnetic and theoretical studies.     

血管紧张素转化酶抑制剂对表皮干细胞增殖、分化、迁移的影响

目的 观察血管紧张素转化酶(ACE)抑制剂卡托普利对表皮干细胞(ESCs)增殖、迁移、分化的影响,探讨ACE在维持ESCs生物学功能中的作用.方法 利用差速贴壁法获得10例儿童的ESCs,进行离体培养,检测ACE在ESCs的表达.用XTT法检测不同浓度(1 ×l0-5、1×10-6、l×10-7、1×10-8mol/L) ACEI卡托普利对ESCs增殖的影响;体外创伤模型观察1×10-6mol/L的卡托普利对ESCs 6、12、18、24h各时间段的迁移能力;流式细胞仪检测K10的表达观察1×10-6mol/L的卡托普利对ESCs分化的影响.结果 培养的细胞经β1-整合素和K19免疫荧光双重标记染色,83.55％细胞为双标记阳性细胞,即ESCs.免疫荧光染色和逆转录-聚合酶链反应(RT-PCR)结果显示ESCs表达ACE.流式细胞仪定量检测培养的细胞ACE阳性率为74.2％.1×10-6mol/L的卡托普利可明显抑制ESCs的增殖(P＜0.05),且在第5天达到峰值.1×10-6 mol/L的卡托普利可明显抑制细胞的迁移能力(P＜0.05)和克隆能力(P＜0.05).流式细胞仪检测结果表明,l×10-6 mol/L的卡托普利并不影响K10的表达(P＞0.05).结论 ACE通过影响ESCs的增殖,迁移从而影响皮肤的损伤修复和自我更新.     

血管紧张素Ⅱ受体在深Ⅱ度烧伤大鼠创面愈合过程中的表达

目的 观察血管紧张素(Ang)Ⅱ1型(AT1)和2型(AT2)受体在烧伤创面愈合过程中的表达及其与细胞增殖和凋亡的关系.方法 在大鼠深Ⅱ度烧伤后即刻、3、7、14和21 d取创面皮肤标本,采用免疫荧光组织化学染色法检测AT1和AT2的表达;采用增殖细胞核抗原(PcNA)标记和原位末端转移酶标记技术(TUNEL)染色法观察细胞增殖和凋亡.结果 在正常皮肤,AT1和AT2表达强度较弱.但伤后第7天表达达高峰,14 d降低,AT1的表达下调更明显.烧伤后7 dPCNA阳性细胞数最多,14 d后降低.烧伤后7～14 d TUNEL阳性细胞数维持在较高水平,随后下降.结论 烧伤愈合过程中AT1和AT2的表达具时空特性,这种变化与创面修复细胞增殖和凋亡密切相关.     

Pol ι表达水平对行食管癌术后辅助放疗患者的生存影响

目的：探讨DNA 聚合酶 ι（DNA polymerase ι,Pol ι）表达水平对行食管癌术后辅助放疗患者的生存影响。方法：采用免疫组化方法检测97例行术后辅助放疗的食管癌患者组织中Pol ι的表达情况,分析Pol ι表达水平对这些患者生存的影响。结果：20例食管癌患者组织中Pol ι呈低表达,77例食管癌患者组织中Pol ι呈高表达;生存曲线显示Pol ι表达水平与行术后辅助放疗的食管癌患者生存呈负相关;COX回归分析显示Pol ι表达水平是影响食管癌根治术后辅助放疗患者生存的独立预后因素。结论：Pol ι可能是判断行食管癌术后辅助放疗患者预后的潜在分子标志物。     

Clinical observation on the effect of perioperative use of antibiotics in episiotomy

目的 探讨会阴侧切术围术期抗生素的应用价值.方法 收集177例自然分娩会阴侧切术的产妇资料,未使用抗生素的为观察组,使用抗生素的为对照组.比较两组的体温、血相、伤口愈合情况、伤口疼痛评分.结果 观察组体温达38.0℃的有6例,对照组有4例,差异无统计学意义(x2=.174,P＞0.05);观察组白细胞总数为(10.2±2.0)×109,对照组为(9.8±1.9)×109,差异有统计学意义(t=0.882,P＜0.05);观察组中性粒细胞比率为(73.3±11.6)％,对照组为(71.9±11.0)％,差异有统计学意义(t=1.152,P＜0.05).观察组伤口甲级愈合76例,乙级愈合8例,丙级愈合2例,对照组分别为80例、10例、1例,差异无统计学意义(x2=0.613,P＞0.05).观察组在第1、第2、第3个24h,VAS评分值分别为(4.6±1.5)分、(3.5±1.3)分、(1.9±1.0)分,对照组分别为(4.4±1.3)分、(3.5±1.2)分、(2.0±1.0)分,同一时间点上差异无统计学意义(P＞0.05).结论 自然分娩会阴侧切是否使用抗生素对伤口的愈合并未起到明显影响,除个别特殊情况外,均无需使用抗生素.