螺内酯对射血分数轻度降低心力衰竭合并2型糖尿病患者的临床疗效观察及预后研究

目的 探究螺内酯对射血分数轻度降低的心力衰竭合并2型糖尿病患者的临床疗效及预后观察。方法 纳入2019年2月至2022年12月于北京朝阳医院治疗的射血分数轻度降低的心力衰竭合并2型糖尿病患者共409例。所有患者在试验前均未服用过螺内酯,已接受其他心衰标准药物治疗及降糖药物治疗至少半年。通过随机分组将纳入患者分为试验组及对照组,试验组在对照组治疗基础上加用螺内酯10~20 mg/d。比较两组患者治疗前后的糖化血红蛋白(glycated hemoglobin, HbA1c)、体质量指数、血浆N末端B型利钠肽原(NT-proBNP)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、舒张期二尖瓣峰值流速与二尖瓣环舒张早期运动峰速度的比值(E/e’)、血清肌酐(Scr)、血清尿酸(SUA)、肌酐清除率(Ccr)、血钾水平等指标的变化,观察治疗相关不良反应、心血管死亡或心衰恶化再住院复合终点事件发生率,评估临床治疗效果。结果 两组患者于治疗前的一般资料比较差异无统计学意义(P>0.05);治疗后试验组患者的HbA1c水平较对照组下降[(7.2±0.5)vs.(7.9±0.7),P<0.05],NT-proBNP水平较对照组降低[(423±155)vs.(640±157),P<0.05];试验组治疗后的心功能及肾功能多项指标的改善情况优于对照组(均P<0.05),心功能Ⅱ~Ⅳ级的试验组患者于治疗期间血钾水平相对稳定(均P>0.05)。治疗后试验组的临床显效率及总有效率高于对照组(均P<0.05),复合终点事件发生率及药物治疗相关不良反应在两组中差异无统计学意义(均P>0.05)。结论 螺内酯有助于射血分数轻度降低的心力衰竭合并2型糖尿病患者的血糖管理,并能进一步改善心脏功能及肾功能,同时具有良好的药物使用安全性。

Effects of Tongluo Jiedu prescription on immune function and oxidative stress in patients with oral cancer

BACKGROUND Oral cancer,which is caused by mucous membrane variation,represents a prevalent malignant tumor in the oral and maxillofacial region,posing a significant threat to patients’lives and safety.While surgical intervention stands as a cornerstone treatment for oral cancer patients,it carries the risk of incomplete treatment or high rates of postoperative recurrence.Hence,a multifaceted approach incorporating diverse treatment modalities is essential to enhance patient prognosis.AIM To analyze the application effect of Tongluo Jiedu prescription as adjuvant therapy and its influence on patient prognosis in patients with oral cancer.METHODS Eighty oral cancer patients in our hospital were selected and divided into the observation group and control group by a random number table.The control group was treated with continuous arterial infusion chemotherapy of cisplatin and 5-fluorouracil.The observation group was additionally given Tongluo Jiadu prescription.The inflammatory stress level,peripheral blood T-cell subsets,and immune function of the two groups were subsequently observed.SPSS 21.0 was used for data analysis.RESULTS The observation group demonstrated lower levels of interleukin-6 and C-reactive protein,and a higher level of tumor necrosis factor in comparison to the control group.After treatment,the immune function in the observation group was significantly better than in the control group.CONCLUSION Tongluo Jiedu prescription can improve the immune function and oxidative stress level of patients with oral cancer and accelerate the recovery process.

Ultra reliability and massive connectivity provision in integrated internet of military things(IoMT)based on tactical datalink

One of the major challenges arising in internet of military things(IoMT)is accommodating massive connectivity while providing guaranteed quality of service(QoS)in terms of ultra-high reliability.In this regard,this paper presents a class of code-domain nonorthogonal multiple accesses(NOMAs)for uplink ultra reliable networking of massive IoMT based on tactical datalink such as Link-16 and joint tactical information distribution system(JTIDS).In the considered scenario,a satellite equipped with Nr antennas servers K devices including vehicles,drones,ships,sensors,handset radios,etc.Nonorthogonal coded modulation,a special form of multiple input multiple output(MIMO)-NOMA is proposed.The discussion starts with evaluating the output signal to interference-plus-noise(SINR)of receiver filter,leading to the unveiling of a closed-form expression for overloading systems as the number of users is significantly larger than the number of devices admitted such that massive connectivity is rendered.The expression allows for the development of simple yet successful interference suppression based on power allocation and phase shaping techniques that maximizes the sum rate since it is equivalent to fixed-point programming as can be proved.The proposed design is exemplified by nonlinear modulation schemes such as minimum shift keying(MSK)and Gaussian MSK(GMSK),two pivotal modulation formats in IoMT standards such as Link-16 and JITDS.Numerical results show that near capacity performance is offered.Fortunately,the performance is obtained using simple forward error corrections(FECs)of higher coding rate than existing schemes do,while the transmit power is reduced by 6 dB.The proposed design finds wide applications not only in IoMT but also in deep space communications,where ultra reliability and massive connectivity is a keen concern.

Statistical Channel Modeling for Indoor VLC Communications Based on Channel Measurements

Visible light communication(VLC)has attracted much attention in the research of sixthgeneration(6G)systems.Furthermore,channel modeling is the foundation for designing efficient and robust VLC systems.In this paper,we present extensive VLC channel measurement campaigns in indoor environments,i.e.,an office and a corridor.Based on the measured data,the large-scale fading characteristics and multipath-related characteristics,including omnidirectional optical path loss(OPL),K-factor,power angular spectrum(PAS),angle spread(AS),and clustering characteristics,are analyzed and modeled through a statistical method.Based on the extracted statistics of the above-mentioned channel characteristics,we propose a statistical spatial channel model(SSCM)capable of modeling multipath in the spatial domain.Furthermore,the simulated statistics of the proposed model are compared with the measured statistics.For instance,in the office,the simulated path loss exponent(PLE)and the measured PLE are 1.96and 1.97,respectively.And,the simulated medians of AS and measured medians of AS are 25.94°and 24.84°,respectively.Generally,the fact that the simulated results fit well with measured results has demonstrated the accuracy of our SSCM.

螺内酯对左室射血分数中间范围心力衰竭的预后影响

目的探讨左室射血分数(LVEF)中间范围心力衰竭(HFmrEF)患者应用螺内酯后对心功能及临床预后的影响。方法选取经门诊随访的LVEF为40%~49%且氨基末端B型利钠肽前体(NT-proBNP)>125 pg/ml的慢性心力衰竭患者共102例,随机分为治疗组与对照组。在给予心力衰竭常规药物治疗方案的基础上,治疗组加用螺内酯10~20 mg/d,共随访36个月,观察两组随访前后血压、心率、纽约心脏病学会(NYHA)心功能分级、血钾水平、超声心动图测量的左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及LVEF、6 min步行距离等指标的变化,比较两组心力衰竭再住院率、心血管病死亡率并进行生存分析。结果随访后治疗组收缩压、舒张压及LVEDD水平较对照组明显降低,6 min步行试验距离延长,临床总有效率,心血管病死亡率及累积无心血管病死亡率均明显优于对照组(P<0.05),随访中无高钾血症等不良事件。结论HFmrEF患者在心力衰竭常规治疗基础上应用螺内酯安全并可改善预后。

Current Status of Diabetes Prevention and Control in China and Early-Stage Intervention Strategies

In recent years,the prevalence of diabetes in China has continued to rise,with the adult prevalence expected to reach 12.8%by 2023.To control this trend,the government has introduced several policies and invested substantial funds in the prevention and treatment of diabetes,achieving certain results.Prediabetes is a stage where blood glucose metabolism can still be restored.For individuals in this stage,dietary and exercise intervention programs are recommended to prevent or delay the onset of diabetes,improve quality of life,and reduce the burden of disease on individuals,families,and society.

网络新生代与网络社会心态:代际更替、心态变迁与引导路径

网络新生代正在推动中国的价值观代际更替。作为现实社会与网络社会并行互构进程中最为特殊的关键群体,“90后”“00后”在网络化生存、高压化生存和全球化生存状态中,表现出更强的个人主义和反权威性,以超强的网络行动力建构社会支持系统,并主动追求精神价值目标的满足。网络新生代在社会议题、社会情绪、社会价值观方面深刻影响了网络社会心态的变迁,其背后,是这一群体独特的精神需求与网络表达特性。国家、社会要针对网络新生代的生命发展周期与压力提升现状,推进更丰富、更多元、更具新生代政治审美特点的精神文化产品建设,同时充分信任和理解这一代人,激发新生代的政治地位感,增强新生代的政治话语权,通过合适的方式提供更加充分的表达平台和参与空间,增强其政治成就感;在传播内容、传播平台和传播渠道建设等多重维度上同步年轻化,这是主流意识形态能否有效引导网络新生代的核心问题。

CBL结合同伴互助教学法在基础医学实验心血管教学模块中的应用

目的探讨以案例为基础的教学法(case-based learning, CBL)结合同伴互助教学法(peer-assisted learning, PAL)在基础医学实验心血管教学模块中的教学效果。方法选取2015级临床医学专业五年制本科学生72名为研究对象,随机分为实验组和对照组。对照组采用传统的实验教学方法。实验组学生则选取与临床联系紧密,且手术操作难度较大的5部分心血管实验教学模块作为教学试点项目,采用CBL与PAL相结合的教学模式,然后评价考核成绩和教学效果,比较两组之间的差异。结果实验组学生考核成绩测评明显高于对照组(P < 0.05)。实验组中94.4 %以上的学生认可CBL与PAL相结合的教学模式,认为该教学方法能够提升学生们的学习兴趣和个人能力,有利于心血管系统的理论知识的掌握,并且有94.4%以上的学生希望在以后的实验课中广泛开展CBL与PAL相结合的教学模式。结论 CBL与PAL相结合的教学模式能够激发学生的学习兴趣,更好地发挥主观能动性去拓展医学知识和培养创新思维。

Genetic Variation in Salt Stress Response and Germplasm Resource Evaluation among <i>Lycium</i>Accessions

Genetic variation between naturally occurring ecotypes can be helpful to elucidate the mechanism controlling salt stress response in different environments. The salt stress response of 20 natural accessions or cultivars of Lycium was characterized at a physiological level, following exposed to 300 mM NaCl for 15 days. It is shown that salt stress increased Na+, betaine and malondialdehyde (MDA) content, as well as the relative permeability of plasma membranes, but decreased K+, chlorophyll and glutathione (GSH) content, as well as K+/Na+ ratio compared with their respective control value in most of the varieties, though the increasing or decreasing extent has a clear genetic diversity. The physiological response was utilized to evaluate the salt-tolerant capacity of these varieties by principal component analysis and clustering analysis, and in which total chlorophyll, K+/Na+ ratio and partially GSH have the maximum weight relatively. These varieties could be categorized into four sub-groups, means greatly resistance (Heiguo, Ninqi No. 2 and Beifang), moderately resistant, sensitive, and mostly sensitive (Ninqi No. 7) to salt stress. Our results provide a theoretical basis and practical guidance for the improvement of saline-alkali land and rational utilization of Lycium germplasm resources in the future.

陕甘宁边区新闻事业的突围与革新

陕甘宁边区是中国共产党在延安时期局部执政的试验区。20世纪30年代末,在日本帝国主义与国民党的双重夹击下,党的新闻事业工作一度告急,最突出的技术难题在于缺纸。然而,边区新闻事业的突围并非仅仅是技术层面的突围。解决了“卡脖子”的科技问题,纸张如何大规模生产、紧俏局面下如何寻找替代或衍生品、文字信息是否有其他发行方式等,这都是持久的新闻事业突围战中无法绕过的问题。从困顿到大繁荣,边区新闻事业在党不断的自我革新与创新建制中走向成熟。本文希望通过回顾党在紧张的资源条件下统筹新闻事业的“政—研—产—发”过程,勾画出党在被动条件下铺开的主动的自我革新的领导蓝图。

抗VEGF治疗在儿童眼底病中的应用

血管内皮生长因子(VEGF)是胚胎时期眼球发育过程中血管形成的关键介质,也是在多种眼科疾病中引起视网膜新生血管形成和血管通透性改变的重要因子。随着抗VEGF治疗在成人的应用逐渐成熟,越来越多的研究关注于抗VEGF治疗在儿童眼底病的应用,包括早产儿视网膜病变(ROP)、Coats病、家族性渗出性玻璃体视网膜病变(FEVR)、色素失禁症相关视网膜病变、镰状细胞视网膜病、视网膜母细胞瘤及各种病因引起的脉络膜新生血管等。本文将对抗VEGF在这些眼底病中的应用现状作一综述。

Tong xie yao fang relieves irritable bowel syndrome in rats via mechanisms involving regulation of 5-hydroxytryptamine and substance P

AIM: To investigate whether the Chinese medicine Tong Xie Yao Fang(TXYF) improves dysfunction in an irritable bowel syndrome(IBS) rat model. METHODS: Thirty baby rats for IBS modeling were separated from mother rats(1 h per day) from days 8 to 21, and the rectum was expanded by angioplasty from days 8 to 12. Ten normal rats were used as normal controls. We examined the effects of TXYF on defection frequency, colonic transit function and smooth muscle contraction, and the expression of 5-hydroxytryptamine(5-HT) and substance P(SP) in colonic and hypothalamus tissues by Western blot and RT-PCT techniques in both normal rats and IBS model rats with characterized visceral hypersensitivity.in normal rats and 4.5 ± 1.58 in IBS model rats(P < 0.001). However, the defecation frequency was significantly decreased(3.0 ± 1.25 vs 4.5 ± 1.58, P < 0.05), while the time(in seconds) of colon transit function was significantly increased(256.88 ± 20.32 vs 93.36 ± 17.28, P < 0.001) in IBS + TXYF group rats than in IBS group rats. Increased colonic smooth muscle tension and contract frequency in IBS model rats were significantly decreased by administration of TXYF. Exogenous agonist stimulants increased spontaneous activity and elicited contractions of colon smooth muscle in IBS model rats, and all of these actions were significantly reduced by TXYF involving 5-HT and SP down-regulation. CONCLUSION: TXYF can modulate the activity of the enteric nervous system and alter 5-HT and SP activities, which may contribute to the symptoms of IBS.

Effect of Tong Xie Yao Fang on endogenous metabolites in urine of irritable bowel syndrome model rats

BACKGROUND Tong Xie Yao Fang is a representative traditional Chinese prescription for the treatment of liver and spleen deficiency,abdominal pain and diarrhea.It has a unique function in the treatment of gastrointestinal dysfunction including irritable bowel syndrome(IBS),is a common functional bowel disease.Its main symptoms are recurrent abdominal pain,diarrhea,constipation or alternations between diarrhea and constipation.There are obvious differences in metabolites between TCM syndromes.By comparing the body fluid metabolism maps of model animals,metabolomics can discover disease biomarkers,analyze the differences in metabolic pathways and understand the pathological process and the metabolic pathways of substances in the body.Thus,the evaluation of animal models tends to be comprehensive and objective.This may provide further understanding between the interaction between Tong Xie Yao Fang and the IBS model.AIM To evaluate the effect of Tong Xie Yao Fang on IBS rats by using metabolomics method.METHODS Wistar rats were used to establish IBS models,and then randomly divided into four groups:A model control group and three Tong Xie Yao Fang treatment groups(high,medium and low doses).A normal,non-IBS group was established.The rats were treated for 2 wk.On days 0 and 14 of the experimental model,urine was collected for 12 h and was analyzed by ultra-performance liquid chromatography quadrupole time-of-flight mass spectrometry.Nine potential biomarkers were identified,and six major metabolic pathways were found to be related to IBS.RESULTS In the study of metabonomics,nine potential biomarkers including L-serine,4-methylgallic acid,L-threonine,succinylacetone,prolyl-hydroxyproline,valylserine,acetyl citrate,marmesin rutinoside and 5-hydroxy-L-tryptophan were identified in urine,which were assigned to amino acids,organic acids,succinyl and glycosides.Furthermore,the metabolic pathway of L-serine,L-threonine and 5-hydroxy-L-tryptophan was found in the Kyoto Encyclopedia of Genes and Genomes,which mainly involved the metabolism of cysteine and methionine,vitamin B6 metabolism,serotonin synapse,tryptophan metabolism,sphingolipid metabolism,digestion,absorption of protein and amino acid metabolism.These pathways are related to intestinal dysfunction,inflammatory syndrome,nervous system dysfunction and other diseases.CONCLUSION Tong Xie Yao Fang has pharmacological effects on IBS,and its mechanism may be related to the metabolism of the nine potential biomarkers identified above in urine.

昭通渔洞水库流域不同作物种植模式对地表径流、渗漏水中氮磷流失量的影响

【目的】研究不同种植模式对地表径流和渗漏水的土壤表层氮、磷随降雨流失的情况。【方法】在渔洞水库流域的大田里设计了4种典型的作物种植类型。采用分光光度法测定样品中的氮、磷浓度。【结果】不同作物种植模式下地表径流中氮素流失质量浓度总体呈现先下降后上升,之后逐步下降的趋势,土壤渗透水相中氮素流失无明显变化趋势;不同作物种植模式对磷素流失质量浓度影响较大,地表径流和土壤渗透水相中磷素流失平均浓度较高的为苹果(0.71、0.99 mg/L)和青花(0.24、0.27 mg/L)。【结论】该试验设计合理,能为研究不同种植模式的氮磷流失量和吸收规律提供一定的理论依据,也可以为河流附近环境保护区的种植模式选择提供参考。

光纤传感技术在相似材料模型试验中的应用

为解决地下工程模型试验中应变无法量化分析的问题,以四川省九寨沟县青龙水电站引水隧洞为工程背景,设计并制作了隧洞模型试件,将分布式光纤和光栅传感器埋设于模型试件中进行隧洞模拟开挖试验,通过实验对比两种光纤传感技术,同时,探索出一种地质力学模型试验应变量测的可行方法,为研究地下工程的施工开挖及变形破坏提供参考。测量隧洞开挖前、开挖时、开挖后试件内部的应变,分析了其应变变化规律。实验结果表明,分布式光纤与光栅传感器测得应变值相近,说明了标定试验结果的准确性及分布式光纤在模型试验中的适用性,分布式光纤传感器能够真实地反应模型试件内光纤沿线的应变分布,及时准确地测量模型在加压作用和隧洞开挖过程中的应变分布情况。

Expression of lens-related microRNAs in transparent infant lenses and congenital cataract

AIM：To identify the expression of lens-related micro RNAs（miRNAs）in the central epithelium of transparent infant lenses and congenital cataract. METHODS：Lens-related mi RNAs were retrieved from Pub Med database. The expression levels of these mi RNAs in transparent infant lenses and congenital cataract were determined by stem-loop reverse transcription-polymerase chain reaction（RT-PCR）. mi Randa algorithm was used to predict the target genes of these differentially expressed mi RNAs. The target m RNA was validated.RESULTS：Six lens-related mi RNAs were retrieved from screening Pub Med database. The most abundant mi RNA in transparent infant lenses according to stem-loop RT-PCR was mi R-184. miR-182 was up-regulated in congenital cataract. Contrarily,miR-204 and miR-124 was down-regulated.mi R-204 exhibited a more significant decrease in expression than mi R-124. In addition,Meis2 was predicted to be the target of mi R-204 using mi Randa algorithm. mi R-204mimic/antagomir transfection experiments suggested the negative correlation between the expression of mi R-204 and Meis2.CONCLUSION：The expression levels of miR-182,miR-204 and mi R-124 differ between the central epithelium of transparent infant lens and congenital cataract,suggesting their involvement in the pathogenesis of congenital cataract. miR-204 may act via silencing Meis2 to regulate lens development and congenital cataract formation.

中国绣球花主题植物景观营造

绣球花,又名八仙花、紫阳花等,是中国夏季著名的观花植物,除具极高的观赏价值外,绣球花还有很高的生态价值和药用价值。文章剖析了绣球花的主要特性、观赏品系以及绣球花文化内涵,结合国内外已有的景观案例,对我国绣球花主题植物景观营造要点进行了探讨,并对绣球花在我国现代园林中的应用进行了展望。

Comparative transcriptome analysis of atmospheric pressure cold plasma enhanced early seedling growth in Arabidopsis thaliana

The stimulatory effects of atmospheric pressure cold plasma(APCP)on plant growth have attracted much attention due to its great potential as a new approach to increase crop growth and production.However,the transcriptome changes of plants induced by APCP treatment are unknown.Herein,the comparative transcriptome analysis was performed to identify the transcriptional response of Arabidopsis thaliana seedlings to APCP.Results showed that APCP exhibited a dual effect(stimulation or inhibition)on Arabidopsis seedling growth dependent on the treatment time and the maximum stimulatory effects were achieved by 1 min APCP treatment.The metabolic analysis of amino acid,glutathione(GSH)and phytohormone demonstrated that 1 min APCP treatment decreased most amino acids concentrations in Arabidopsis seedling,while the accumulations of GSH,gibberellins and cytokinin were significantly increased.The RNA-Seq analysis showed that a total of218 differentially expressed genes(DEGs)were identified in 1 min APCP-treated seedlings versus the control,including 20 up-regulated and 198 down-regulated genes.The DEGs were enriched in pathways related to GSH metabolism,mitogen-activated protein kinase(MAPK)signaling transduction and plant resistance against pathogens.Moreover,most of the DEGs were defense,stimuli or stressresponsive genes and encoded proteins with oxidoreductase activity.Expression determination of six randomly selected DEGs by quantitative real-time PCR demonstrated similar pattern with the RNASeq data.These results indicated that the moderate APCP treatment may regulate the expression of stimuli/stress-responsive genes involved in GSH,phytohormone/amino metabolism and plant defense against pathogens via MAPK signal transduction pathway,accordingly enhance Arabidopsis seedling growth.This study provides a theoretical basis for the application of APCP in agriculture.

On the intrinsic shape of the gamma-ray spectrum for Fermi blazars

The curvature of the γ-ray spectrum in blazars may reflect the intrinsic distribution of emitting electrons, which will further give some information on the possible acceleration and cooling processes in the emitting region. The γ-ray spectra of Fermi blazars are normally fitted either by a single power-law（PL） or a log-normal（call Logarithmic Parabola, LP） form. The possible reason for this difference is not clear. We statistically explore this issue based on the different observational properties of 1419 Fermi blazars in the 3 LAC Clean Sample. We find that the γ-ray flux（100 Me V–100 Ge V） and variability index follow bimodal distributions for PL and LP blazars, where the γ-ray flux and variability index show a positive correlation. However, the distributions of γ-ray luminosity and redshift follow a unimodal distribution. Our results suggest that the bimodal distribution of γ-ray fluxes for LP and PL blazars may not be intrinsic and all blazars may have an intrinsically curved γ-ray spectrum, and the PL spectrum is just caused by the fitting effect due to less photons.

Physical activity and risk of age-related cataract

AIM: To summarize quantitatively the prospective association between physical activity and age-related cataract(ARC) risk.METHODS: Pub Med, Embase, Web of Science, and Cochrane Library were systematically searched for all relevant follow up studies until July 2019. Multivariableadjusted relative risks(RRs) and corresponding 95% confidence intervals(CIs) from individual studies were used to calculate the overall summary estimates. The doseresponse relationship was assessed using generalized least-squares trend estimation.RESULTS: Six prospective cohort studies, involving 19 173 cases in 6.2-12.1 y follow up of 171 620 participants, were included in the analysis. Increased physical activity was significantly associated with reduced risk of ARC by 10%(RR: 0.90;95%CI: 0.81, 0.99, P=0.04). Stratified analysis by assessment method for physical activity suggest that studies using metabolic equivalent(MET) per day tended to report a slightly stronger association with ARC(RR: 0.85;95%CI: 0.81, 0.90, P<0.001) than studies which assessed activity by weekly activity(RR: 0.96;95%CI: 0.89, 1.03, P=0.24). Dose-response analysis indicated that the risk of ARC decreased by 2%(RR: 0.98;95%CI: 0.98, 0.99, P<0.001) for every 6 METs per day increase in activity.CONCLUSION: The findings from this Meta-analysis provide additional evidence that increased physical activity is inversely associated with ARC risk dose-responsively.