甲状腺机能亢进症危险因素病例对照研究

目的 探讨各危险因素与甲亢的关系。方法 对三亚地区110例甲亢采用1：2配比的病例对照研究,资料处理采用条件Logistic回归分析.结果 甲亢发病与下列5因素关系密切：家庭年收入(OR=2．055)、食用碘盐(OR=2．133)、喜食海产品(OR=2．183)、感染(OR=2．382)、家庭生活事件(OR=3．017) 结论 家庭生活事件、感染、喜食海产品、食用碘盐、家庭年收入增高等是甲亢的危险因素。     

Clinical study on pediatric Fisher's syndrome in Twenty-two cases

目的 :进一步明确小儿 Fisher氏综合征的病因及诊断标准。方法 :对 2 2例小儿 Fisher氏综合征的临床表现、脑脊液进行对比研究。结果 :2 2例患儿均以眼肌麻痹和小脑共济失调为主征 ,伴有肢体不同程度的不完全的弛缓性瘫痪 ,约半数以上病儿脑脊液出现蛋白、细胞分离现象。结论 :Fisher氏综合征是急性感染性神经根神经炎 ( AIP)一种特殊型或变异型 ,是以小脑共济失调为主的颅神经受损的AIP。     

上海市华阳社区糖尿病、高血压、血脂紊乱及代谢综合征基线调查

目的 调查上海市区40岁以上自然人群代谢综合征及有关疾病的患病情况。方法 采用多级分层随机抽样的流行病学调查方法进行问卷调查,并进行75g葡萄糖耐量试验、空腹血脂谱、BMI、血压及心电图测定。结果 上海华阳社区40岁以上中老年人中糖尿病、糖耐量减退/空腹血糖减损、高血压、血脂紊乱、超重/肥胖及代谢综合征患病率分别为13.06%、12.91%、47.04%、84.29%、38.67%、及13.06%。结论 上海城市社区40岁以上中老年人中代谢综合征及相关疾病的患病率很高。     

细胞因子在清肝化瘀汤治疗慢性粒细胞性白血病中的研究

目的观察中药清肝化瘀汤治疗慢性粒细胞性白血病(慢性期)的疗效,并探讨细胞因子水平变化的意义。方法收集45例慢性粒细胞性白血病慢性期患者(治疗组),用清肝化瘀汤治疗,观察患者的临床疗效、细胞因子水平。另用20名正常人作为对照(对照组)。结果治疗组完全缓解率40％,部分缓解率46.7％,总有效率86.7％。治疗组细胞因子水平中白介素2、可溶性白介素2受体、肿瘤坏死因子a治疗前后有显著差异(P<0.05);干扰素γ水平变化无显著差异。且与正常对照组比较无显著差异(P>0.05)。结论清肝化瘀汤有清热泻肝解毒、活血化瘀消癥的功效,研究结果显示,该药对慢性粒细胞性白血病慢性期(肝热血瘀型)疗效确切,其作用机理可能与改善细胞因子水平有关。     

幽门螺杆菌感染与冠心病发病的关系

目的　探讨幽门螺杆菌(Hp)感染是否为增加冠心病发病率的危险因素。方法　采用病例对照研究,从健康体检者中随机挑选127名作为正常对照组。根据病史、心电图、冠脉造影等确诊为冠心病的111例患者作为冠心病组,以血清抗HpIgG抗体阳性为感染标志,并测定血浆纤维蛋白原及脂质过氧化物浓度。结果　冠心病组Hp感染率(61%)高于正常对照组(39%)(P＜0.001);Hp感染是独立于其它冠心病易患因素的危险因素(比值比2.785,x2=14.82,P＜0.001);冠心病组CagA阳性感染率(98.5%)高于正常对照组(67.4%)(P＜0.05);冠心病组Hp阳性者的血浆纤维蛋白原及LPO浓度高于Hp阴性者(P＜0.05)。结论　Hp感染可能是发生冠心病的危险因素。慢性炎症引起脂质过氧化物、血浆纤维蛋白原增高,促进血栓形成可能是Hp感染诱发冠心病的机制之一。     

Outcomes and factors associated with early mortality in pediatric postcardiotomy veno‐arterial extracorporeal membrane oxygenation

Mortality and morbidity of children received veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) support after cardiac surgery remain high despite remarkable advances in medical management and devices. The purpose of this study was to describe outcomes and risk factors of applying VA‐ECMO in the surgical pediatric population. We retrospectively analyzed 85 consecutive pediatric patients (aged <18 years) who received postcardiotomy VA‐ECMO from January 2010 to December 2018. Median (IQR) age at ECMO implantation in this cohort was 12.7 (6.4, 43.2) months, median weight was 8.5 (6.0, 12.8) kg, mean ECMO duration was 143.2 ± 81.6 hours and mean hospital length of stay was 48.4 ± 32.4 days. Seventy‐five patients (88.2%) were indicated for postcardiotomy cardiogenic shock. The successful ECMO weaning rate was 70.6% and in‐hospital mortality was 52.9%. The most common diagnosis was transposition of great arteries (n = 18, 21.2%), while acute kidney injury occurred most often (n = 64, 75.3%). Multivariate logistic regression analysis showed that thrombocytopenia, hemolysis, and nosocomial infection were positively correlated with in‐hospital mortality. Multivariate Cox proportional hazard regression analysis presented that thrombocytopenia significantly increased the 180‐day mortality in patients with successful weaning. Therefore, multiple factors had adverse effects on prognosis. Patient selection and procedures from ECMO implantation to weaning need to be closely monitored and performed in a timely manner to improve outcome.     

Solution of a specific class of nonlinear fractional optimal control problems including multiple delays

This research provides a new framework based on a hybrid of block‐pulse functions and Legendre polynomials for the numerical examination of a special class of scalar nonlinear fractional optimal control problems involving delay. The concepts of the fractional derivative and the fractional integral are employed in the Caputo sense and the Riemann‐Liouville sense, respectively. In accordance with the notion of the Riemann‐Liouville integral, we derive a new integral operator related to the proposed basis called the operational matrix of fractional integration. By employing two significant operators, namely, the delay operator and the integral operator connected to the hybrid basis, the system dynamics of the primal optimal control problem converts to another system involving algebraic equations. Consequently, the optimal control problem under study is reduced to a static optimization one that is solved by existing well‐established optimization procedures. Some new theoretical results regarding the new basis are obtained. Various kinds of fractional optimal control problems containing delay are examined to measure the accuracy of the new method. The simulation results justify the merits and superiority of the devised procedure over the existing optimization methods in the literature.     

Stabilization of positive coupled differential‐difference equations with unbounded time‐varying delays

This paper researches the static output‐feedback stabilization of single‐input single‐output (SISO) positive coupled differential‐difference equations (CDDEs) with unbounded time‐varying delays. First, a necessary and sufficient condition is provided for the positivity and asymptotical stability of CDDEs with unbounded time‐varying delays. For this type of system, based on the constructed estimates of its solution, a necessary and sufficient condition on asymptotical stability is provided. Then, based on this criterion, for CDDEs with unbounded time‐varying delays, a kind of static output‐feedback controller is designed to ensure the positivity and asymptotical stability of the corresponding closed‐loop systems. It is also worth pointing out that the controller is designed by the linear programming method without parameterization technique. This design approach can also be applied to the static state feedback stabilization problem of CDDEs with unbounded time‐varying delays. Finally, two illustrative examples are given to show the effectiveness of our results.     

Optimal control problems with Atangana‐Baleanu fractional derivative

In this paper, we study fractional‐order optimal control problems (FOCPs) involving the Atangana‐Baleanu fractional derivative. A computational method based on B‐spline polynomials and their operational matrix of Atangana‐Baleanu fractional integration is proposed for the numerical solution of this class of problems. With this numerical technique, the FOCPs are reduced to a system of equations which are solved for the unknown parameters with the help of Mathematica® software. Our results show the applicability and usefulness of the numerical technique.