纤维支气管镜下高频电刀术后放置网状支架治疗肿瘤性气道阻塞

目的：观察纤维支气管镜下高频电刀术后放置网状支架治疗肿瘤性气道阻塞的近期疗效。方法：对14例支气管肺癌所致的气道阻塞，进行纤维支气管下高频电刀烧灼切割术后放置网状支架治疗。结果：14例气道阻塞患者临床上气促分级与Kamofsky评分均有明显好转，肺功能指标改善，无明显副反应。结论：纤维支气管镜下高频电刀术后放置网状支架是治疗肿瘤性气道阻塞的有效方法，操作简便易行，值得推广。     

Peripheral Glucose Uptake in Relation to Physiological Levels of Plasma and Lymph Insulin

Abstract. The effects of physiological increments of plasma immunoreactive insulin upon tissue glucose uptake, tissue insulin uptake and lymph insulin levels were studied in the hind-limb (65% muscle, 27% skin and subcutaneous fat) of 38 anaesthetized dogs.
During intravenous glucose tolerance tests, the tissue glucose uptake remained within baseline values, whereas the net rates of glucose utilization and the concentrations of arterial plasma insulin increased as the load of glucose injected was raised. Significant amounts of endogenous insulin were cleared from plasma but were not recovered in lymph.
No glucose response was observed in the hind-limb tissues during intra-arterial infusions of exogenous insulin in conditions of strict normoglycaemia and constant blood flow. The infusions of insulin were designed to simulate the levels of endogenous hormone achieved in plasma during the glucose tolerance tests. Again, a high percentage of the injected insulin was fixed to the hind-limb tissues with no detectable rise of leg-lymph levels. At higher plasma insulin concentrations, both tissue glucose uptake and lymph insulin levels were increased.
The results show that the effect of plasma insulin on glucose uptake by muscle and fat in vivo is a threshold phenomenon. From the present knowledge of the physiology of lymph formation, the threshold phenomenon could largely be accounted for by insulin adsorption to the blood capillary walls.     

Short Duration of DAPT Versus De-Escalation After Percutaneous Coronary Intervention for Acute Coronary Syndromes

ObjectivesThe aim of this study was to compare short dual antiplatelet therapy (DAPT) and de-escalation in a network meta-analysis using standard DAPT as common comparator.BackgroundIn patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), shortening DAPT and de-escalating to a lower potency regimen mitigate bleeding risk. These strategies have never been randomly compared.MethodsRandomized trials of DAPT modulation strategies in patients with ACS undergoing PCI were identified. All-cause death was the primary outcome. Secondary outcomes included net adverse cardiovascular events (NACE), major adverse cardiovascular events, and their components. Frequentist and Bayesian network meta-analyses were conducted. Treatments were ranked on the basis of posterior probability. Sensitivity analyses were performed to explore sources of heterogeneity.ResultsTwenty-nine studies encompassing 50,602 patients were included. The transitivity assumption was fulfilled. In the frequentist indirect comparison, the risk ratio (RR) for all-cause death was 0.98 (95% CI: 0.68-1.43). De-escalation reduced the risk for NACE (RR: 0.87; 95% CI: 0.70-0.94) and increased major bleeding (RR: 1.54; 95% CI: 1.07-2.21). These results were consistent in the Bayesian meta-analysis. De-escalation displayed a >95% probability to rank first for NACE, myocardial infarction, stroke, stent thrombosis, and minor bleeding, while short DAPT ranked first for major bleeding. These findings were consistent in node-split and multiple sensitivity analyses.ConclusionsIn patients with ACS undergoing PCI, there was no difference in all-cause death between short DAPT and de-escalation. De-escalation reduced the risk for NACE, while short DAPT decreased major bleeding. These data characterize 2 contemporary strategies to personalize DAPT on the basis of treatment objectives and risk profile.     

ARIMA时间序列和BP神经网络在传染病预测中的比较

目的比较自回归滑动平均时间序列模型和神经网络对传染病的预测效率。方法根据1985—2004年伤寒、副伤寒按季度发病率数据资料,利用dps7．55软件中的ARIMA时间序列、神经网络建立预测模型,用2005--2007年的伤寒、副伤寒季度发病率对二种预测模型进行检验,从而比较二种模型的优劣。结果用ARIMA时间序列分析得到拟合度为50．15％,验证模型的残差平方和为5154．381用神经网络分析得到拟合度为73．12％,验证模型的残差平方和为3559．24。结论神经网络模型更为适用于预测宁波市镇海区伤寒、副伤寒发病趋势。     

一种基于Petri网的面向方面的用例建模方法

对传统的用例建模方法进行扩展,并针对用例描述的文本语言中经常出现的二义性、冲突以及遗漏信息的问题,提出一种基于Petri网的面向方面的用例建模方法。构建了从面向方面用例模型到面向方面Petri网模型的映射规则,引入面向方面的形式化的建模与分析技术,并利用时态逻辑检验织入时机的正确性。最后给出实例和分析,验证了该方法的有效性。     

湖南省中药上市企业专利产出与经济产出的相关性研究

文中针对湖南省中药上市企业的专利产出与经济产出的关系进行典型相关分析,运用相关回归方法研究了1999-2009年之间湖南省中药上市公司的专利申请数与经济产出(年销售收入/净利润)的相关性。结果表明,株洲千金药业的专利总数与营业额存在显著的正线性相关性(P=0.001),其回归分析曲线为Y=5.141×108+2.490×106X(R2=0.925);九芝堂股份有限公司专利总数与营业收入无明显的相关性,而紫光古汉集团股份有限公司不重视对专利保护。结果提示:①企业对知识产权的重视程度,直接反映知识产权对企业未来经济效益所带来的影响程度,也反映在专利申请数量上。②企业发明专利数,直接反映企业的创新效果和在未来市场的竞争力,最终反映于企业在未来市场竞争中的经济增长率和净利润。创新是中医药企业发展的动力。     

Using schoolchildren's reports of bed net use monitored by schoolteachers as a proxy of community coverage in malaria endemic areas of Uganda

OBJECTIVE: Community-based information on the delivery and use of health interventions is important to monitor the effectiveness of the Roll Back Malaria programme. However, community surveys to determine coverage for insecticide-treated bed nets are time-consuming and costly. We wanted to assess whether schoolchildren's reports of household ownership of a bed net and coverage among high-risk groups monitored by schoolteachers through a questionnaire could be used as a proxy of household ownership of bed net and coverage at community level, for routine monitoring of malaria control programmes. METHOD: 3602 schoolchildren in 39 randomly selected schools and 2798 heads of households in 39 villages were interviewed about their use of either insecticide-treated or untreated bed nets. RESULTS: The overall household ownership of any kind of bed net was 35% in school surveys and 31% in household surveys (P < 0.001). Household ownership of insecticide-treated nets was 23% and 22%, respectively (P = 0.4); household ownership of untreated nets was 15% and 9%, respectively (P < 0.001). There was significant correlation between estimates of any bed net and treated net ownership based on household surveys and estimates based on school surveys (P < 0.01 for both). CONCLUSIONS: In areas with high school attendance rates, schoolchildren's report of bed net use monitored by schoolteachers through a questionnaire could give a good approximation of household ownership of bed net at community level with about +/-5% difference between community and school surveys. However, further operational research is required to investigate how the feasibility of large-scale implementation might be, by sending the questionnaire to the schools through routine channels and by independent handling by the school administration and teachers.