卡瑞利珠单抗联合仑伐替尼治疗中晚期肝癌的疗效观察

目的探究卡瑞利珠单抗联合仑伐替尼治疗中晚期肝癌的疗效观察。方法选取2020年4月9日~2023年4月6日阜阳市第二人民医院收治的95例使用卡瑞利珠单抗治疗的肝癌中晚期患者。依据诊疗方案将患者分为两组,对照组采用卡瑞利珠单抗联合索拉非尼治疗,观察组采用卡瑞利珠单抗联合仑伐替尼进行治疗。对两组临床疗效、肿瘤指标水平进行对比观察。结果观察组患者总有效率(65.57%)和疾病控制率(90.16%)均显著高于对照组(44.12%、79.41%),差异有统计学意义(χ^(2)=4.123、5.742,P<0.05)。治疗后,观察组患者甲胎蛋白(AFP)和糖类抗原19-9(CA19-9)的肿瘤指标水平均明显低于对照组,差异有统计学意义(t=2.351、2.858,P<0.05)。治疗后,观察组患者的白细胞(WBC)、中性粒细胞绝对值(NEU)以及红细胞(RBC)细胞指标水平均显著优于对照组,差异有统计学意义(t=2.058、2.230、2.254,P<0.05)。观察组患者甲状腺功能减退、腹泻、血压升高以及骨髓抑制的总不良反应发生率(8.20%)明显低于对照组(32.35%),差异有统计学意义(χ^(2)=9.096,P<0.05)。结论卡瑞利珠单抗联合仑伐替尼治疗中晚期肝癌具有较好的临床治疗效果,能有效降低患者机体中的肿瘤指标水平,提升患者细胞水平,并且整体治疗安全性较高,值得临床应用。

渔用菌蜕疫苗研究进展

菌蜕保持了细菌完整的细胞膜结构,能够激发机体强烈的免疫反应,并且不需要添加佐剂,比常规疫苗具有更好的安全性和有效性,逐渐成为一种新颖有效的疫苗制备方法。鱼类疾病大规模爆发,渔用疫苗研究成为热点,本文主要介绍了菌蜕疫苗制备的基本方法和渔用菌蜕疫苗的研究进展。

康复治疗对急性脑梗死患者手运动功能恢复的影响

目的：探究康复治疗在急性脑梗死患者手运动功能恢复上的作用。方法：利用血氧水平依赖性功能磁共振成像（BOLD－fMRI）技术与Fugl－Meyer（Fugl－Meyer assessment scale，FMA）运动功能评分评定方法，以20例健康志愿者为对照，比较分析38例脑梗死急性期患者（康复治疗组和常规治疗组）治疗前、后（2周）手运动中枢激活区（SMC）体积及偏侧化指数（LI）的变化，并比较分析康复治疗组和常规治疗组治疗过程中每周的康复情况。结果：38例脑梗死患者中，其健手被动运动的LI值大于患手；康复治疗组患手（右手）治疗前、后（2周）的运动激活SMC的LI值差异显著；康复治疗组的FMA评分明显高于常规治疗组，且FMA评分的变化趋势呈上升状态，至治疗第12周后趋于平缓。结论：康复治疗对急性脑梗死患者的手运动功能恢复具有积极的作用，以发病后的前12周进行康复治疗的效果为佳。

胺碘酮联合美托洛尔治疗高龄急性冠脉综合征合并快速房颤

急性冠脉综合征（ACS）并发持续的快速心律失常可恶化血流动力学，增加心肌耗氧量，加重心肌缺血缺氧，扩大心肌梗死面积，诱发或加重心功能不全，增加住院期间病死率。胺碘酮目前仍为治疗心房纤颤的主要药物，因其具有扩血管作用，尤其适用于合并ACS者；

Optimization of performance of the KM2A full array using the Crab Nebula

The full array of the Large High Altitude Air Shower Observatory(LHAASO)has been in operation since July 2021.For its kilometer-square array(KM2A),we optimized the selection criteria for very high and ultrahigh energyγ-rays using data collected from August 2021 to August 2022,resulting in an improvement in significance of the detection in the Crab Nebula of approximately 15%,compared with that of previous cuts.With the implementation of these new selection criteria,the angular resolution was also significantly improved by approximately 10%at tens of TeV.Other aspects of the full KM2A array performance,such as the pointing error,were also calibrated using the Crab Nebula.The resulting energy spectrum of the Crab Nebula in the energy range of 10-1000 TeV are well fitted by a log-parabola model,which is consistent with the previous results from LHAASO and other experiments.

Flux variations of cosmic ray air showers detected by LHAASO-KM2A during a thunderstorm on June 10,2021

The Large High Altitude Air Shower Observatory(LHAASO)has three sub-arrays,KM2A,WCDA,and WFCTA.The flux variations of cosmic ray air showers were studied by analyzing the KM2A data during a thunderstorm on June 10,2021.The number of shower events that meet the trigger conditions increases significantly in atmospheric electric fields,with a maximum fractional increase of 20%.The variations in trigger rates(increases or decreases)were found to be strongly dependent on the primary zenith angle.The flux of secondary particles increased significantly,following a trend similar to that of shower events.To better understand the observed behavior,Monte Carlo simulations were performed with CORSIKA and G4KM2A(a code based on GEANT4).We found that the experimental data(in saturated negative fields)were in good agreement with the simulations,assuming the presence of a uniform electric field of-700 V/cm with a thickness of 1500 m in the atmosphere above the observation level.Due to the acceleration/deceleration by the atmospheric electric field,the number of secondary particles with energy above the detector threshold was modified,resulting in the changes in shower detection rate.

Performance of LHAASO-WCDA and observation of the Crab Nebula as a standard candle

The first Water Cherenkov detector of the LHAASO experiment(WCDA-1)has been operating since April 2019.The data for the first year have been analyzed to test its performance by observing the Crab Nebula as a standard candle.The WCDA-1 achieves a sensitivity of 65 mCU per year,with a statistical threshold of 5 cr.To accomplish this,a 97.7%cosmic-ray background rejection rate around 1 TeV and 99.8%around 6 TeV with an ap proximate photon acceptance of 50%is achieved after applying an algorithm to separate gamma-induced showers.The angular resolution is measured using the Crab Nebula as a point source to be approximately 0.45°at 1 TeV and better than 0.2°above 6 TeV,with a pointing accuracy better than 0.05°.These values all match the design specifications.The energy resolution is found to be 33%for gamma rays around 6 TeV.The spectral energy distribution of the Crab Nebula in the range from 500 GeV to 15.8 TeV is measured and found to be in agreement with the results from other TeV gamma ray observatories.

某地区军队干休所老干部衰弱综合征患病情况调查

目的:调查分析某地区军队干休所老干部衰弱综合征患病情况。方法:选择2018年3-6月在我院进行年度健康体检的65岁以上某地区军队干休所离退休老干部共284例,检查常规体检项目,由专人采用综合评估方法,评估老干部的躯体健康、功能状态、心理健康等情况,对衰弱及衰弱前期老年人进行筛查。结果:284例老干部中,无衰弱组、衰弱前期组和衰弱组分别为61例(21.5%)、114例(40.1%)和109例(38.4%)。年龄<75岁的28例老干部中无衰弱发生,衰弱前期发生率为10.7%(3/28);75～84岁的31例老干部中,衰弱前期发生率为29.0%(9/31),衰弱发生率为22.6%(7/31);≥85岁的225例老干部中,衰弱前期发生率为45.3%(102/225),衰弱发生率为45.3%(102/225)。衰弱组、衰弱前期组和无衰弱组近1年内跌倒发生率分别为33.9%(37/109)、35.1%(40/114)和14.8%(9/61),跌倒总体发生率为30.3%;衰弱组和衰弱前期组组跌倒发生率非常显著高于无衰弱组(P<0.01),衰弱组与衰弱前期组比较差异不显著(P>0.05)。衰弱组更多合并认知障碍、营养不良、心理情感障碍等老年综合征,与衰弱前期组和无衰弱组比较差异非常显著(P<0.01);衰弱组失能或部分失能者达100%,非常显著高于衰弱前期组和无衰弱组(P<0.01)。多重用药在衰弱组、衰弱前期组与无衰弱组间两两比较均差异不显著(P>0.05)。结论:随着年龄增高,衰弱发生率快速增加;衰弱老干部更易合并跌倒、营养不良、认知障碍等其他老年综合征;应综合评估老干部健康状况,及时采取干预措施,减缓其机体功能进一步衰退。