加味半夏白术天麻汤治疗风痰阻络型脑梗塞的临床研究

目的：观察加味半夏白术天麻汤治疗风痰阻络型脑梗塞的临床疗效及对血液流变学、血清超敏C反应蛋白（he—CRP）的影响。方法：对照组给予阿斯匹林片0．1g,日1次;胞二磷胆碱0．5g加入生理盐水100ml中静脉点滴,日1次;脑水肿明显者应用甘露醇脱水治疗。治疗组在对照组基础上加用半夏白术天麻汤加味。连续治疗一个月后进行临床疗效及神经功能的评定,治疗前后检查血液流变学及he—CRP。结果：治疗组总有效率95％,对照组81．67％,治疗组优于对照组,有显著差异（P〈0．05）;在改善神经功能评分、血液流变学及he—CRP方面,治疗组均优于对照组,有显著性差异（P〈0．05,或P〈0．01）。结论：加味半夏白术天麻汤治疗风痰阻络型脑梗塞临床疗效较好,并能减少神经功能缺损程度评分,改善血液流变学及降低he—CRP。     

暖脐散敷脐配合拔罐治疗小儿风寒证泄泻临床观察

目的观察暖脐散敷脐配合拔罐治疗小儿风寒证泄泻的临床疗效。方法选取60例风寒证泄泻患儿随机分为2组,对照组30例给予蒙脱石和双歧三联活菌胶囊口服,治疗组30例在对照组治疗的基础上予暖脐散敷脐配合神阙穴拔罐,连续治疗5d为1个疗程。结果治疗组总有效率为96．7％,对照组总有效率为83．3％,治疗组总有效率优于对照组（P〈0．05）。治疗组患儿止泻时间,舌苔、指纹恢复时间,总疗程时间均明显短于对照组（P〈0．05）。结论暖脐散敷脐配合拔罐治疗小儿风寒证泄泻疗效显著,不良反应少,经济方便,易被患儿及家长接受,值得临床推广。     

畸变产物耳声发射在唇腭裂婴幼儿听力检查中的应用

目的探讨唇腭裂婴幼儿畸变产物耳声发射（distortion product otoacoustic emission,DPOAE）的特点,并将其与听性脑干反应（auditory brainstem response,ABR）阂值检查的结果加以对照,以探讨DPOAE在这类患儿听力检查中的应用价值。方法DPOAE检查63例（126耳）,年龄2个月-42个月,平均11.83个月。其中单纯腭裂组（以下简称腭裂组）23例（46耳）,腭裂并发唇裂及牙槽裂组（以下简称唇腭裂组）30例（60耳）,单纯唇裂组（以下简称唇裂组）10例（20耳）,每耳均检查8个频率,若2-5kHz4个频点有≥3个频点通过即为该耳通过。在上述患儿中,ABR阈值检查腭裂组17例（34耳）,唇腭裂组10例（20耳）,唇裂组6例（12耳）,以能重复引出V波的最小刺激强度为ABR阈值。结果DPOAE检查：腭裂组通过7耳,未通过39耳,通过率为15.22％;唇腭裂组通过6耳,未通过54耳,通过率为10.00％;唇裂组通过18耳,未通过2耳,通过率为90％。统计分析腭裂组与唇腭裂组无显著差异,而腭裂组与唇裂组,唇腭裂组与唇裂组均有显著差异。ABR阈值检查统计分析结果与DPOAE一致。将各组DPOAE通过率与ABR正常率进行比较,腭裂组及唇腭裂组中二者无差异（P〉0.05）,虽然唇裂组中二者有差异（P〈0.05）,但唇裂组ABR阈值反应的听力下降较轻（均≤50dB nHL）。从总体趋势上说,DPOAE与ABR阈值检查在检测的结果上是一致的。结论唇腭裂患儿DPOAE和ABR检测结果一致,与ABR相比,DPOAE具有快速、简便、易实施等特点,因此DPOAE可以作为唇腭裂婴幼儿听力检查的手段,但仍需进一步结合ABR及其他相关的听力检查,以明确听力损害的程度和类型。     

探析从风论治结缔组织病相关间质性肺疾病

[目的]探析从风论治结缔组织病相关间质性肺疾病(connective tissue disease-associated interstitial lung disease,CTD-ILD)的辨证思路,以期提高临床疗效.[方法]基于风邪致病特点"风为百病之长,善行数变,有内外之分",结合古籍文献及现有文献资料,考究风邪...     

2型糖尿病对小鼠下颌骨骨再生及辅助性T细胞17、调节性T细胞相关因子表达的影响

目的观察2型糖尿病对小鼠下颌骨骨再生以及辅助性T细胞17 (Th17)、调节性T细胞(Treg)相关因子表达的影响。方法将36只6周龄C57BL/6J雄性小鼠随机分为正常对照(NC)组和2型糖尿病(T2DM)组,小鼠下颌骨缺损建模当天(0 d)和术后7、14、28 d检测空腹血糖。于两组小鼠下颌骨缺损建模后7、14、28 d,通过苏木素-伊红(HE)染色观察下颌骨缺损愈合情况,通过免疫组织化学染色的方法观察下颌骨缺损内碱性磷酸酶(ALP)、Runt相关转录因子2 (RUNX2)、叉头框蛋白P3 (Foxp3)、维甲酸相关孤核受体γt(RORγt)和蛋白酪氨酸磷酸酶非受体型2 (PTPN2)的表达情况。结果 HE染色结果显示:T2DM组小鼠的下颌骨缺损范围内新生骨的数量明显少于NC组。免疫组织化学染色结果显示:成骨相关蛋白ALP和RUNX2的表达在T2DM组的骨缺损内明显降低;另外,2型糖尿病小鼠下颌骨缺损范围内的RORγt阳性细胞数量增加,Foxp3阳性细胞数量减少,PTPN2的表达明显降低。结论 2型糖尿病可以显著地抑制小鼠下颌骨骨再生过程,PTPN2的下降以及Treg-Th17向偏...     

Capacity factors for electrical power generation from renewable and nonrenewable sources

Given the dire consequences of climate change and the war in Ukraine, decarbonization of electrical power systems around the world must be accomplished, while avoiding recurring blackouts. A good understanding of performance and reliability of different power sources underpins this endeavor. As an energy transition involves different societal sectors, we must adopt a simple and efficient way of communicating the transition’s key indicators. Capacity factor (CF) is a direct measure of the efficacy of a power generation system and of the costs of power produced. Since the year 2000, the explosive expansion of solar PV and wind power made their CFs more reliable. Knowing the long-time average CFs of different electricity sources allows one to calculate directly the nominal capacity required to replace the current fossil fuel mix for electricity generation or expansion to meet future demand. CFs are straightforwardly calculated, but they are rooted in real performance, not in modeling or wishful thinking. Based on the current average CFs, replacing 1 W of fossil electricity generation capacity requires installation of 4 W solar PV or 2 W of wind power. An expansion of the current energy mix requires installing 8.8 W of solar PV or 4.3 W of wind power.

Greenhouse gas emissions are the driving force behind climate change (1), which threatens biodiversity (2), food security (3), and cultural diversity (4). The main source of carbon emissions in electricity generation is the current mixture of inputs (5). The current state of affairs demands an energy transition, but numerous challenges emerge (6–8). Such a transition implicates different societies in different ways (9–11), but even the conservative United States wants a decarbonized future (12). Actions toward a sustainable future have been taken at different scales from city (13) to country level (14).The current energy system in place has a rigid structure with a modus operandi of “winner takes all” that hampers the establishment of alternatives (15). Policies can be implemented to overcome the status quo. However, unintended consequences can arise, e.g., carbon pricing policies tend to incentivize optimization of the current energy system instead of the required transformations to achieve a decarbonized one (16). This conclusion is not universally accepted (17–19). It seems, however, that renewables will lead the energy transition and solar photovoltaics will play a key role (20–22).Engaging different players in a society for the energy transition is essential. However, the diversity of stakeholders creates communication barriers, particularly when technical details are transmitted to a broad audience. The war in Ukraine and insufficient natural gas supply in Europe have added painful urgency to clear and truthful communication of the potential pitfalls of any energy transition that boil down to the clear understanding of what the different components of electricity generation systems can and cannot do. Regarding power-generation efficiencies of different sources, the use of CF is an excellent tool to connect with a broad set of audiences.CF is a measure of a power plant efficacy (23). In short, it is an indicator of how fully the power plant is used, relative to its thermodynamic and technological constraints and required spare capacity (24). For all technologies, CFs have typical values for a set time interval and input (a fuel, light, water, or wind).An electrical power plant’s CF gives this plant’s average output relative to its maximum capacity. This could be quite misleading for renewables. If a plant works at 50% of nominal capacity, its CF is 0.5. This does not mean that the plant worked 12 h at full capacity and was off over the remaining 12 h. This plant could be down for different reasons such as repairs, maintenance, refueling, or intermittency for renewables. Despite its limitations, CF is a straightforward indicator that can be easily calculated and predict the amount of electricity that will be obtained on average from a specific nominal capacity installed.Comparing CFs across different technologies can be tricky, mainly when some are well established and mature, while others are at pilot-scale or not fully deployed. In the last two decades, solar PV and wind have been growing exponentially. This explosive growth allows one to obtain reliably their CFs. When a technology is more established, the effects of pilot plants, learning curves (25–28), or optimal sites no longer dominate, giving reliable estimates about that technology’s performance. Field tests are the ultimate answer. Theoretical estimates can differ significantly from the measured ones. Such discrepancies have been presented for wind (29) and concentrated solar power plants (30) (SI Appendix, section 10). Knowing the real value of CFs is fundamental to estimating costs, power production, and the future roles of specific technologies.In this work, we analyze the average CFs of different electricity sources (i.e., biomass, fossil fuels, geothermal heat, water, uranium, solar light, and wind) over the period 2000–2017. Global and regional values are estimated to highlight the differences in the performance of different technologies. These average CF values are then used to calculate the required nominal capacity to be installed in the future for our unavoidable energy transition.     

Rapid maxillary expansion vs slow maxillary expansion in patients with cleft lip and/or palate: a systematic review and meta-analysis

ObjectivesTo compare the dentoalveolar outcomes of slow maxillary expansion (SME) and rapid maxillary expansion (RME) used for maxillary expansion before secondary alveolar bone grafting in patients with cleft lip and/or palate (CL/P). Secondarily, the advantages and disadvantages of SME vs RME were reviewed.Materials and MethodsA systematic search was conducted up to November 2021, including Medline (via PubMed), Embase (via Ovid), Web of Science, Cochrane Central, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Risk-of-bias assessment was performed using the Risk of Bias (RoB 2.0) and Risk Of Bias In Non-randomized Studies of Interventions (ROBINS I) tool. Overall quality was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.ResultsOf 4007 records, five studies met the inclusion criteria. The randomized control trial (RCT) had a low risk of bias, the non-RCTs presented with a moderate risk of bias. Arch width and perimeter increased significantly with both SME and RME treatments. No difference in the increase in palatal depth was found. The meta-analysis showed a greater anterior-to-posterior expansion ratio for the Quad Helix (QH) appliance. The results for dental tipping were not conclusive.ConclusionsSME and RME promote equal posterior expansion in cleft patients. The anterior differential expansion is greater with SME (QH appliance). No clear evidence exists concerning the amount of dental adverse effects of SME and RME in cleft patients.     

鲁盈教授祛风除湿法治疗狼疮性肾炎的经验探析

[目的]探讨总结鲁盈教授祛风除湿法治疗狼疮性肾炎(lupus nephritis,LN)的临床经验.[方法]通过跟师临诊,收集风湿内扰证LN患者的医案,并查阅LN的病因病机以及风湿内扰证在LN中的理论渊源和辨证依据,阐述鲁盈教授以祛风除湿法治疗LN的学术观点和临床应用,并附医案一则.[结果]鲁盈教授认为,外感风湿热毒和...     

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目的 了解唇腭裂患儿父母的心理状况,探讨影响唇腭裂患儿父母心理状况的相关因素.方法 采用标准化问卷对2008年9月至2010年5月福建医科大学附属协和医院口腔颌面外科收治的68例唇腭裂患儿的父母进行调查,以艾森克成人个性问卷(EPQ)评价其个性特征,以症状自评表(SCL-90)评价其自觉症状,并采用国内常模作为对照组进行对比分析.结果 唇腭裂惠儿的父母有其特殊的个性特征,存在着明显的心理问题.但父母之间心理状况无明显差异.结论 对唇腭裂患儿父母应采取积极的社会心理干预措施.     

非综合征性唇腭裂患者血浆代谢组学的初步研究

目的初步研究非综合征性唇腭裂患者可能存在的代谢机制,同时探讨基于核磁共振（NMR）的代谢组学技术在临床应用中的可行性。方法分别收集10例非综合征性唇腭裂患者和10例正常人的血浆,在核磁共振仪上对血浆样本进行采样,获得一系列原始的一维NMR谱图,然后使用MESTRE-v4.7软件对NMR谱图进行积分简化数据,将谱图分解成212个区域进行积分,得到积分强度,利用SIMCA-P 11.0软件对积分强度进行主成分分析。结果非综合征性唇腭裂患者和正常人的血浆代谢存在差异,至少存在3种不同的代谢产物,分别为三羟丁酸γ甲基类物质、精氨酸和缬氨酸。非综合征性唇腭裂患者血浆代谢产物以缬氨酸和三羟丁酸γ甲基类物质为主,而正常人血浆代谢产物则以精氨酸为主。结论通过代谢组学技术,可以初步探讨非综合征性唇腭裂患者的代谢机制,同时该技术有望应用于临床。