证候规范化研究的思路和方法探讨

采取“降维降阶”、“升阶升维”的研究思路,既排除非关键因素的干扰,又能真实反映证候的复杂程度,是证候规范化研究的可行途径。借助古代大型医案数据库,对部分证候及其相关因素进行统计分析,采用国际通用的SAS6．12统计软件中的非务件Logistic多元逐步回归方法筛选变量,最终获得回归方程数学模型,表达为logit（p）=α＋β1X1＋β2X2＋…＋βmXm°通过该模型的运用和统计数据结果的分析,对具有诊断意义的证候内容进行规范化研究,为证候诊断的规范化提供参考。     

Supplementary values of the dosimetric parameters kNR and Em for various types of detectors in 6 and 15 MV photon fields

The present communication broadens the data base for determinations of the non-reference condition correction factor k_NR needed in high-energy photon dosimetry to accomplish the use of various detectors under non-reference conditions. Following our previous strategy of calculating semiempirical values of k_NR and correlating them with the mean photon energy E_m at the point of measurement in a large water phantom, the values of E_m are now stated for 6 and 15 MV photon radiations of accelerators with and without flattening filters, square field sizes from 1 to 30 cm side length and depths from 0 to 28 cm. The unambiguity of the k_NR-E_m correlation is again confirmed and is quantified by fitting formulae for air-filled ionization chambers, TLD detectors and Si diodes. This survey provides a practicable access to the k_NR values, particularly for the non-water equivalent detectors to be used in small-field dosimetry     

Antihepatitis B therapy: a review of current medications and novel small molecule inhibitors

There are approximately 350 million hepatitis B virus (HBV) carriers worldwide. Chronic HBV infection increases the risk of liver cirrhosis and hepatocellular carcinoma. To date, two classes of antiviral drugs have been approved by the Food and Drug Administration for the treatment of hepatitis B, immunomodulators (interferon [IFN]‐α and pegylated‐interferon [PEG‐IFN]‐α) and nucleos(t)ide analogs (lamivudine, telbivudine, adefovir, tenofovir [TDF], and entecavir [ETV]). Of these, ETV, TDF, and PEG‐IFN‐α are the most effective and are currently recommended for anti‐HBV therapy. However, these therapies are less than optimal because of their low rate of viral DNA and surface antigen clearance; thus, there exists a significant unmet medical need for safe and efficacious new anti‐HBV drugs. Covering diverse chemical structures and mechanisms of action, non‐nucleos(t)ide compounds offer great promise in the search for new anti‐HBV drugs. This review summarizes the currently approved anti‐HBV drugs and highlights advances in the identification and characterization of novel small molecule HBV inhibitors. We discuss the sources, structures, anti‐HBV effects, mechanisms of action, and potential toxicities of these novel inhibitors.     

The impact of benefits coverage expansion of social health insurance: Evidence from Korea

Despite mandatory social health insurance in Korea, the fraction of total healthcare spending paid out-of-pocket has been considerably high. In 2013, the Korean government expanded benefits coverage of social insurance for patients diagnosed with the costliest disease groups (cardiovascular and cerebrovascular diseases, cancer, and intractable diseases). We analyze individual longitudinal information from the 2010 to 2016 Korea Health Panel to estimate the impact of the policy change on healthcare spending, utilization, and enrollment in private supplemental health insurance. Impacts on other health-related and financial measures are additionally assessed to evaluate the effects in multiple dimensions. Our difference-in-differences approach with entropy balancing weights shows that the expansion of benefits coverage of public health insurance reduced out-of-pocket spending on health by 30% without accompanying increases in healthcare utilization. The impact was smaller for the individuals with high socioeconomic characteristics, who are more likely to use other costly services that remained unaffected by the policy. We do not find evidence that expanding social insurance benefits coverage changed the demand for supplemental private health insurance.     

Acanthamoeba castellanii supports extracellular survival of Helicobacter pylori in co-culture

This study aimed to demonstrate whether Helicobacter pylori is able to survive in co-culture with a protozoan, Acanthamoeba castellanii, in order to further investigate a possible aqueous environmental mode of transmission. Numbers of H. pylori in co-culture with A castellanii were assessed by colony forming unit (CFU) assay and cell morphology was observed by electron microscopy. Viable and intact H. pylori in co-culture were detected and the number of H. pylori in co-culture with A. castellanii was significantly higher than in bacterial single culture. It was also shown that co-culture of H. pylori with A. castellanii physically separated by a filter membrane negated this survival effect, suggesting that adherence of H. pylori to A. castellanii affects its survival. Scanning electron microscopy revealed helical forms of H. pylori in co-culture with A. castellanii, but not in single culture. These results imply that mutual interaction between H. pylori and A. castellanii in the environment is critical for survival of H. pylori. In addition, the H. pylori gene expression profile was found to differ between single and co-cultured cells using RNA-sequence analysis.     

Factors modulating preferences of female house mice for males differing in t-complex genotype: Role of t-complex genotype,genetic background,and estrous condition of females

The present study investigates factors mediating odor and social preferences in female house mice (Muc domesticus) based on the t-complex geontype of males. Previous studies in this laboratory showed that females prefer the odors of wild-type (+/+) males over those that carry lethal genes (+/t). The purpose of this study was to determine the genetic, hormonal, and environmental factors that regulate these preferences. The variables examined include t-complex genotype, genetic background, estrous condition of test females (+/+ or +/t), and genotype of the test female's parents. Results indicate that female preferences for +/+ males are dependent upon the t-complex genotype and estrous condition of test females. Only +/t females in estrus showed preferences for +/+ males. Estrous cycle condition effects were seen in both wild (+/+w ⁵) and inbred (129 +/tw ⁵)females. Homozygous females (+/+) and diestrous females of both geno-types did not demonstrate preferences for either +/+ or +/t males.     

Impaired acquisition of temporal differentiation performance following lesions of the ascending 5-hydroxytryptaminergic pathways

Nineteen rats received injections of 5,7-dihydroxytryptamine into the dorsal and median raphe nuclei; 16 rats received sham injections. The rats underwent 50 daily training sessions under an interresponse-time-greater-than-15-seconds (IRT >15 s) schedule of sucrose reinforcement. The lesioned group showed impaired acquisition of temporal differentiation, in that their response rates remained significantly higher and their obtained reinforcement frequencies significantly lower than those of the control (sham-lesioned) group. Comparison of the IRT frequency distributions obtained from the two groups during the last 5 days of training showed that the lesioned group produced a significantly higher proportion of very short IRTs (<3 s) than the control group; when these short IRTs were disregarded, the lesioned group displayed a significantly lower mean IRT and a significantly higher coefficient of variation than the control group. The levels of 5-hydroxytryptamine (5HT) and 5-hydroxyindoleacetic acid in the parietal cortex, hippocampus, amygdala, nucleus accumbens and hypothalamus were markedly reduced in the lesioned group, but the levels of noradrenaline and dopamine were not significantly affected by the lesion. The results suggest that destruction of the ascending 5HTergic pathways may reduce animals' capacity to inhibit positively reinforced operant behaviour, and may impair temporal discrimination.     

t-PA在白内障手术中的作用

目的：观察、研究t－PA对于白内障囊外除联合人工晶体植入术后残留晶体皮质及纤维蛋白渗出的作用。方法：在的卡因表面麻醉下，在裂腺灯观察下，用1毫升注射器从角膜缘内1毫米处刺人前房，抽出0．2毫升房水，注入t－PA16微克，点四可膏，包扎术眼。结果：26例患前房内注射t－PA后，残留晶状体皮质全部吸收，视力明显提高。结论：t－PA能使残留晶体皮质迅速吸收，且无前房出血膜损伤等副作用。在预防、治疗白内障囊外除术后后发障以及纤维蛋白渗出等方面有广阔的应用前景。     

The Morphological Studies on M2/t(8;21)Acute Nonlymphocytic Leukemia

（程范军）（杨爱德）（费洪宝）ＴｈｅＭｏｒｐｈｏｌｏｇｉｃａｌＳｔｕｄｉｅｓｏｎＭ２／ｔ（８；２１）ＡｃｕｔｅＮｏｎｌｙｍｐｈｏｃｙｔｉｃＬｅｕｋｅｍｉａ￥ＣＨＥＮＦａｎ－ｊｕｎ，ＹＡＮＧＡｉ－ｄｅ，ＦＥＩＨｏｎｇ－ｂａｏ（ＲｅｓｅａｒｃｈＩｎｓｔｉ...