手部爆炸伤的临床分型与治疗

目的探讨手部爆炸伤新的临床分型以指导治疗、提高疗效。方法1997～2004年收治106例手部爆炸伤,按爆炸伤的严重程度和伤情特点将其划分四型：Ⅰ型：仅有皮肤灼伤、挫裂伤或手部的小面积皮肤缺损,治疗选用清创缝合或植皮修复;Ⅱ型：手部皮肤软组织缺损合并肌腱或骨关节损伤,但无手指血运障碍,治疗选用骨与关节复位固定、肌腱修复的同时必须采用皮瓣覆盖;Ⅲ型：手部广泛皮肤软组织缺损,伴有肌腱、血管、神经及骨关节损伤,手指缺血、离断或缺失,治疗必须应用显微外科技术实施血管吻合、断指再植或拇手指再造和皮瓣移植;Ⅳ型：手广泛毁损,治疗选择截肢术。结果本组Ⅰ型12例,手功能恢复正常;Ⅱ型31例,手功能恢复较好,14例遗留皮瓣臃肿或肌腱粘连,需二期治疗。Ⅲ型57例,无1例截肢,45例进行了二期功能重建手术,手功能恢复达正常的30%～80%不等;Ⅳ型6例,手功能完全丧失。结论该分型方法简明具体,便于临床判断受伤类型和选择治疗方法,并可估计愈合,对临床处理手部爆炸伤具有较好的指导意义。     

Information Fusing Recognition of Traditional Chinese Medicine （TCM） Pulse State Based on Stochastic Fuzzy Neural Network

Based on the fuzzy characteristic of the pulse state and syndromes differentiation thinking mode of TCM, an information fusing recognition method of pulse states based on SFNN （Stochastic Fuzzy Neural Network） is presented in this paper. With the learning ability in parameters and structure, SFNN fuses the measurement information of three pulse-state sensors distributed in Cun, Guan, and Chi location of body for the pulse state recognition. The experimental results show that the percentage of correct recognition with new method is higher than that by single-data recognition one, with fewer off-line train numbers.     

Integrated home monitoring predicts lead failure in a pacemaker dependent 4-year-old girl.

A 4-year-old girl with post-surgical complete atrioventricular block received an epicardial dual chamber pacemaker system. During further growth intermittent exit block occurred, first misinterpreted as neurological seizures. The epicardial lead was replaced using a transvenous approach, and a pacemaker with an integrated home monitoring facility was implanted. After her discharge, a rise in the pacing threshold automatically initiated an event message. On the basis of this information, the patient was called in and imminent dislodgement of the ventricular lead was diagnosed by x-ray. The lead was repositioned and was found stable over 1-year follow-up.     

网络环境下高校图书馆功能的嬗变及其应对策略

随着网络信息技术的发展，数字化、网络化信息资源的开发与利用迅速普及，高校图书馆的功能也发生显著的变化：以印刷文献为中心向以数字信息为中心转变；由单一化服务向多样化服务转变；由人工服务向智能化控制转变；由传统的图书存贮、借阅中心将发展成为现代化信息的交流中转站或导航站。本文分析和阐述了网络环境下高校图书馆功能的嬗变特点和规律，提出了具有实践意义的应对策略。     

网络和现实社会交互环境对网民的健康效应及卫生策略

网络社会对人类社会活动和生活方式带来了极大的影响，对人群健康的作用也存在双重效应。网络成瘾、网络孤独以及生理损伤成为网络社会的主要健康问题，但提高网民社会化程度、提供虚拟支持、增加健康信息供给的途径也给网民带来了诸多的健康效益。目前，要积极制定网络社会卫生策略，以促进网络社会化、虚拟支持和网络健康赋权对网民健康的贡献。     

山谷型垃圾填埋场渗滤液场内收集管网系统的设计计算方法研究

以苏州七子山垃圾填埋场为背景，采用理论分析的方法，探讨山谷型垃圾填埋场合理的渗滤液收集系统的形式和定量计算方法。     

Neural classifier construction using regularization, pruning and test error estimation

In this paper we propose a method for construction of feed-forward neural classifiers based on regularization and adaptive architectures. Using a penalized maximum likelihood scheme, we derive a modified form of the entropic error measure and an algebraic estimate of the test error. In conjunction with optimal brain damage pruning, a test error estimate is used to select the network architecture. The scheme is evaluated on four classification problems.     

Postgraduate school of obstetrics and gynecology and nongovernmental organizations: is collaboration possible?

We report the collaboration between the First Postgraduate School of Obstetrics and Gynecology at the University of Milan, Italy, and the nongovernmental organization “Emergency” that operates through its own hospitals in countries devastated by armed conflicts. The collaboration was centered on the maternity clinic that Emergency opened in 2003 in northern Afghanistan. After a woman resident spent 5 months on-site, the collaboration is now extended to all residents with a group with four areas of intervention: guidelines, clinical records and data collection, drugs and medical devices, and teaching material. In addition, it offers consultation by e-mail for any clinical issue that might arise.