失衡与治理:学术期刊数字出版产业链利益分配问题研究

【目的】 探讨学术期刊数字出版产业链中的市场主体利益分配失衡问题的解决方案,以满足各方的合理利益诉求。【方法】 运用文献法、个案研究法等,对我国学术期刊数字出版产业链上、中、下游市场主体之间利益分配失衡的现状及原因进行分析。【结果】 数据库平台企业的双边市场地位与商业模式、学术期刊数字出版产品特性与收费模式、主管部门监管不到位、行政力量推动下的非完全市场化运行机制、版权维护动力不足,以及尊重知识产权意愿不强是当前学术期刊数字出版产业链利益分配失衡的主要原因。【结论】 充分发挥主管单位与行业协会监管职能、对数据库平台企业进行改革、引入区块链技术、构建基于版权保护的利益分配机制等是平衡各方利益的有效对策。     

针灸干预血液透析失衡综合征的应用

目的：对针灸干预血液透析失衡综合征的效果进行分析。方法选取2011年3月～2014年3月在我院就诊的血液透析失衡综合征患者90例作为研究对象，随机分为干预组和对照组，每组45例患者。对照组患者接受常规护理，干预组在常规护理的同时接受针灸护理30 min，比较两组患者症状缓解效果。结果干预组患者血液透析失衡综合征常见症状与对照组相比程度明显变轻，差异有统计学意义（P＜0.05）。结论针灸应用于临床干预血液透析失衡综合征效果良好，提高了患者预后和护理质量。     

预防性应用抗菌药物后肠道菌群失调及其危险因素分析

目的探讨预防性应用抗菌药物后肠道菌群失调及其危险因素,为临床合理使用抗菌药物提供依据。方法连续收集我院2012年2月至2014年2月收治的112例预防性应用抗菌药物患者的资料,根据是否出现肠道菌群失调分为肠道菌群失调组(58例)和非失调组(54例),对预防性应用抗菌药物患者发生肠道菌群失调的危险因素进行筛选。结果非失调组患者术前应用抗菌药物时间和术中、术后抗菌药物持续应用时间均显著短于失调组,差异均有统计学意义(P<0.05);应用抗菌药物种类两组比较,差异有统计学意义(P<0.05),非失调组联合应用2种或3种抗菌药物的例数显著少于失调组,非失调组应用青霉素类和氨基糖苷类的比例显著高于失调组。非失调组患者营养不良、肠功能障碍比例和肠外营养天数均显著低于失调组,差异均有统计学意义(P<0.05)。两组患者肠道菌群失调情况的比较,差异无统计学意义(P>0.05),两组均以大肠埃希菌、肠球菌和金黄色葡萄球菌失调比例为多。结论影响预防性应用抗菌药物后肠道菌群失调的可能危险因素有术前应用抗菌药物时间和术中、术后抗菌药物持续应用时间、应用抗菌药物种类、营养不良、肠功能障碍比例和肠外营养天数。     

The Genomic Heritage of Lymph Node Metastases: Implications for Clinical Management of Patients with Breast Cancer

Background Metastatic breast cancer is an aggressive disease associated with recurrence and decreased survival. To improve outcomes and develop more effective treatment strategies for patients with breast cancer, it is important to understand the molecular mechanisms underlying metastasis. Methods We used allelic imbalance (AI) to determine the molecular heritage of primary breast tumors and corresponding metastases to the axillary lymph nodes. Paraffin-embedded samples from primary breast tumors and matched metastases (n = 146) were collected from 26 patients with node-positive breast cancer involving multiple axillary nodes. Hierarchical clustering was used to assess overall differences in the patterns of AI, and phylogenetic analysis inferred the molecular heritage of axillary lymph node metastases. Results Overall frequencies of AI were significantly higher (P < 0.01) in primary breast tumors (23%) than in lymph node metastases (15%), and there was a high degree of discordance in patterns of AI between primary breast carcinomas and the metastases. Metastatic tumors in the axillary nodes showed different patterns of chromosomal changes, suggesting that multiple molecular mechanisms may govern the process of metastasis in individual patients. Some metastases progressed with few genomic alterations, while others harbored many chromosomal alterations present in the primary tumor. Conclusions The extent of genomic heterogeneity in axillary lymph node metastases differs markedly among individual patients. Genomic diversity may be associated with response to adjuvant therapy, recurrence, and survival, and thus may be important in improving clinical management of breast cancer patients.     

慢性阻塞性肺疾病血清基质金属蛋白酶-9和组织型金属蛋白酶抑制物-1的检测及其意义

目的 检测慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)急性加重期、稳定期患者和健康对照者血清中基质金属蛋白酶-9 (matrix metalloproteinase-9,MMP-9)和组织型金属蛋白酶抑制物-1 (tissue inhibitor of met...     

基于“调平理论”论治恶性肿瘤和恶性血液病的研究现状与展望

"正邪失衡""阴阳失调"是恶性肿瘤发生发展的根本原因,基于调平理论,及时纠正机体失衡状态,在机体出现病理产物之前建立新动态平衡,让机体自我修复能力在"调平"措施的帮助下,恢复抵御邪气的能力。基于调平理论确立治则治法可用于实体恶性肿瘤和血液系统恶性肿瘤治疗中,解决恶性肿瘤治疗难题,提高生命质量,延长生存期。     

RA患者免疫功能失衡与疾病活动情况的关系研究

目的探讨类风湿关节炎(RA)患者免疫功能失衡与患者疾病活动程度的关系。方法选取我院类风湿免疫科确诊的RA患者90例(RA组)、健康体检志愿者60例作为对照组;检测两组对象外周血中Th17细胞、调节性T细胞(Treg)、血清γ干扰素(IFN-γ)、白细胞介素-4(IL-4)、C反应蛋白(CRP)、血沉(ESR),并分析Th17细胞、Treg、IFN-γ、IL-4与患者关节疼痛数目、类风湿关节炎病情评价(DAS28评分)的相关性。结果 RA组患者的Th17细胞、血清IFN-γ均高于对照组(P<0.05),RA组患者的Treg细胞低于对照组(P<0.05);RA组患者的血清CRP、ESR水平均高于对照组(P<0.05);DAS28评分>5.1分RA患者的Th17细胞、血清IFN-γ均高于≤5.1分的患者(P<0.05),DAS28评分>5.1分RA患者的Treg细胞低于≤5.1分的患者(P<0.05);RA患者的Th17细胞、血清IFN-γ与DAS28评分、压痛关节数目呈显著正相关(P<0.05),RA患者的Treg细胞与DAS28评分、压痛关节数目呈显著负相关(P<0.05)。结论 RA患者T细胞及免疫学因子失衡可能与患者疾病活动程度、病情严重程度有关。     

Circadian control of neural excitability in an animal model of temporal lobe epilepsy

We provide experimental evidence for the emerging imbalance in the firing activity of two distinct classes (type 1 and type 2) of population spikes recorded from the hippocampal area CA1 in an animal model of temporal lobe epilepsy. We show that during the latent period of epileptogenesis following status epilepticus inducing brain injury, there is a sustained increase in the firing rate of type 1 population spikes (PS1) with a concurrent decrease in the firing rate of type 2 population spikes (PS2). Both PS1 and PS2 firing rates are observed to follow a circadian rhythm and are in-phase in control rats. Following brain injury there is an abrupt phase shift in the circadian activity of the PS firing rates. We hypothesize that this abrupt phase shift is the underlying cause for the emergence of imbalance in the firing activity of the two PS. We test our hypothesis in the framework of a simple two-dimensional Wilson–Cowan model that describes the interaction between firing activities of populations of excitatory and inhibitory neurons.     

肾衰竭患者初次血液透析急性并发症临床观察

目的分析初次血液透析急性并发症的发生原因及机制,以求采取干预措施降低发生率。方法回顾性分析206例肾衰竭患者初次血液透析临床资料,统计各种急性并发症的发生率,透析过程中每半小时监测一次心率、呼吸次数、血压,并于透析前后抽血检测钾、钠、氯、血糖、尿素氮和血肌酐,进行比较。结果 206例患者共发生低血压25例(12.1%),失衡综合征20例(9.7%),低血糖症4例(1.9%),低氧血症2例(0.9%),颅内出血1例(0.5%);与透析前相比较,随着透析时间的增加,心率、呼吸次数和血压渐进性下降,差异有统计学意义(P<0.05)。206例患者透析后血钾、血糖、尿素氮和血肌酐明显下降,差异有统计学意义(P<0.05)。结论血液透析可快速缓解尿毒症患者症状,医护人员掌握透析急性并发症的发生原因和机制,积极采取预防措施,可有效降低急性并发症的发生率,使患者平稳、安全度过透析诱导期。