“一站式”预约系统的设计与研究

目前就诊排队是普遍的社会问题，为提高服务质量，减少候诊时间，设计完成“一站式”预约系统。结合不同检验检查的预约规则、预约模式，建立数学模型，对非抢占有限优先权的预约模式进行结合实际情况的比对分析。在模式设计中，利用简单工厂模式与策略模式相结合的方法，减少代码重用，使系统更加强壮。同时利用数学模型，通过系统给用户一系列的理论值，使用户感受更加直观。理论值与实际情况相比较，进行误差分析，结合门诊预约等多种模式，做到“一站式”预约，即有排队等待的地方就有预约。     

Anti-phase action between the angular accelerations of trunk and leg is reduced in the elderly

Quiet standing posture in humans has often been modeled as a single inverted pendulum pivoting around the ankle joint. However, recent studies have suggested that anti-phase action between leg and trunk segments plays a significant role in stabilizing posture by reducing the acceleration of the center of mass (COM) of the body. The aim of this study is to test the hypothesis that anti-phase action is attenuated in the elderly compared to the young. The anterior–posterior movements of leg and trunk segments were measured using 4 laser displacement sensors from 22 healthy young subjects (age range, 20–35 years) and 38 healthy elderly subjects (age range, 57–80 years) standing quietly for 30 s twice. To focus on the segmental action between trunk and legs, we applied constraints (i.e., wooden splints) on each segment. We found that the velocity and acceleration of the COM (standard deviation of the time series was evaluated) were significantly higher for the elderly subjects than for young subjects. The increase in the acceleration of the COM resulted not only from an increase in the angular acceleration of the segments but also from the reduction of their anti-phase relationship, as demonstrated by an index that quantifies the degree of cancelation between both segments. We conclude that the degree of anti-phase action between trunk and leg segments during quiet standing is smaller for elderly subjects than for young subjects, and that this change of the anti-phase action due to aging resulted in increased COM acceleration in the elderly subjects.     

心理干预对腹腔镜诊疗方法治疗不孕症患者的影响与护理对策

目的：探讨心理干预对腹腔镜诊疗方法治疗不孕症患者的影响与护理对策。方法：将60例不孕患者按随机数字表法分为观察组和对照组各30例，对照组采用常规护理，观察组在常规护理基础上进行心理干预。结果：观察组患者焦虑指数评分、治疗效果明显优于对照组。结论：不孕症患者经腹腔镜诊疗后，医疗护理人员需要及时采用有针对性的心理干预手段，帮助患者走出心理误区。     

Controversy and Strategies Exploration in Blocking Mother-to-Child Transmission of Hepatitis B

Hepatitis B, a serious infectious disease caused by the hepatitis B virus (HBV), remains a worldwide social and public health problem. Hepatitis B has a particularly high incidence rate in the world, whereas approximately 35–50% HBV carriers are infected through vertical transmission. Even after newborn immunoprophylaxis, vertical transmission still accounts for 5–10% in China according to plenty of literature in Chinese language. For these reasons, it is important to determine how to effectively intervene in mother-to-child transmission (MTCT). To date, though, intervention methods and measures remain controversial. In order to understand the mechanism of MTCT intervention further and develop effective preventions and interventions, a comprehensive analysis and presentation on some of its more controversial issues will be given in this paper. And eventually we conclude three measures and strategies for these issues: (1) emancipate the mind and seek truth from facts to understand the controversial issues pertaining to MTCT of HBV; (2) treat the basic rules and changing characteristics of MTCT blocking process of hepatitis B with holistic medical thought dialectically and (3) further explore the interaction of genetic susceptibility and environmental factors of MTCT of hepatitis B.     

Immunological and inflammatory changes after simplifying to dual therapy in virologically suppressed HIV-infected patients through week 96 in a randomized trial

ObjectivesTo evaluate whether simplification of antiretroviral treatment to dual therapy (DT) negatively impacts immune recovery (IR), immune activation and inflammation (IA/I), and HIV reservoir.MethodsAn open-label, single-centre, randomized controlled trial conducted in adult virologically suppressed HIV-infected patients on triple therapy (TT) with elvitegravir-cobicistat, emtricitabine and tenofovir alafenamide or dolutegravir (DTG), abacavir, and lamivudine (3TC). Participants were randomized to continue TT or switch to DTG, or darunavir/cobicistat (DRVc) plus 3TC. IR was assessed by CD4⁺/CD8⁺ ratio at 48 and 96 weeks. Changes in immune activation, proliferation, exhaustion, senescence, and apoptosis in CD4⁺ and CD8⁺ T cells, plasma sCD14, hsCRP, D-dimers, β2-microglobulin, IL-6, TNF-α and IP-10 levels, cell-associated HIV-DNA (CA-DNA), and unspliced HIV-RNA (usRNA) were also analysed.ResultsOne hundred and fifty-one participants were enrolled. Fourteen patients did not complete the follow up. In the ITT and PP analysis, the IR was similar between the treatment arms. In the ITT analysis, the median increase in CD4⁺/CD8⁺ ratio was 0.10, 0.04, and 0.07 at week 48, and 0.09, 0.05, and 0.08 at week 96 for TT, DTG/3TC, and DRVc/3TC, respectively. After adjusting for confounding factors, the slopes of changes in CD4⁺/CD8⁺ ratio over time were independent of treatment (F = 1.699; p = 0.436) and related only to baseline values (F = 756.871; p = 0.000). There were no differences in IA/I, CA-DNA, or usRNA between treatment arms.DiscussionBoth IR and IA/I, CA-DNA, and usRNA were similar in the three treatment groups, regardless of maintaining TT or simplifying to DTG/3TC or DRVc/3TC in virologically suppressed HIV-infected patients.     

Prediction of skin sensitization potency using machine learning approaches

The replacement of animal use in testing for regulatory classification of skin sensitizers is a priority for US federal agencies that use data from such testing. Machine learning models that classify substances as sensitizers or non‐sensitizers without using animal data have been developed and evaluated. Because some regulatory agencies require that sensitizers be further classified into potency categories, we developed statistical models to predict skin sensitization potency for murine local lymph node assay (LLNA) and human outcomes. Input variables for our models included six physicochemical properties and data from three non‐animal test methods: direct peptide reactivity assay; human cell line activation test; and KeratinoSens™ assay. Models were built to predict three potency categories using four machine learning approaches and were validated using external test sets and leave‐one‐out cross‐validation. A one‐tiered strategy modeled all three categories of response together while a two‐tiered strategy modeled sensitizer/non‐sensitizer responses and then classified the sensitizers as strong or weak sensitizers. The two‐tiered model using the support vector machine with all assay and physicochemical data inputs provided the best performance, yielding accuracy of 88% for prediction of LLNA outcomes (120 substances) and 81% for prediction of human test outcomes (87 substances). The best one‐tiered model predicted LLNA outcomes with 78% accuracy and human outcomes with 75% accuracy. By comparison, the LLNA predicts human potency categories with 69% accuracy (60 of 87 substances correctly categorized). These results suggest that computational models using non‐animal methods may provide valuable information for assessing skin sensitization potency. Copyright © 2017 John Wiley & Sons, Ltd.     

从2型糖尿病的发病机制谈糖尿病治疗的新策略

目的探讨对2型糖尿病患者的发病机制进行分析和总结,制定新的糖尿病治疗策略。方法对该院2012年—2013年收治的94例2型糖尿病患者的临床资料进行回顾分析,从其发病机制实现对糖尿病治疗新策略的探讨。结果患者胆固醇数值超过6.6 mmol/L,空腹状态的血糖数值超过6.8 mmol/L,尿白蛋白超过20.3 mg,尿酸超过479.98μmol/L。结论全面认识2型糖尿病的发病机制,并采取相应的处理措施,提出新的糖尿病治疗策略,可实现对糖尿病治疗的有效控制和治疗。