公立医院多院区发展研究现状的可视化分析

目的:探析国内公立医院多院区发展的研究状况、热点变迁及前沿趋势,为该领域研究提供参考。方法:基于中国知网(CNKI)数据库,借助CiteSpace可视化软件对2014-2024年国内公立医院多院区发展研究文献进行可视化分析,包括发文量、作者和作者机构贡献分析、关键词聚类分析等。结果:经筛选纳入有效样本文献590篇。2014-2023年发文数量呈逐年上升趋势,发文量最多的作者主要是王大庆、刘文生、李卫平等,且多以机构内合作发文为主;发文数量最多的研究机构为华中科技大学同济医学院附属同济医院。研究热点主要为多院区、公立医院、一院多区、同质化等,且随着时间的推移,研究热点从宏观转向微观,更加关注多院区管理过程。结论:新时期研究者对公立医院多院区管理的关注度持续增强,但研究的机构和学者整体上还相对独立,缺少医院之间、地区间的交流与合作。“同质化”作为当前研究的热点还需不断深入剖析,探索建立评价指标体系;同时也需围绕多院区建设内涵,不断挖掘数据与现实案例,为实现公立医院优质资源扩容提供参考和借鉴。

Androgen signaling inhibits de novo lipogenesis to alleviate lipid deposition in zebrafish

Testosterone is closely associated with lipid metabolism and known to affect body fat composition and muscle mass in males.However,the mechanisms by which testosterone acts on lipid metabolism are not yet fully understood,especially in teleosts.In this study,cyp17a1-/-zebrafish(Danio rerio)exhibited excessive visceral adipose tissue(VAT),lipid content,and up-regulated expression and activity of hepatic de novo lipogenesis(DNL)enzymes.The assay for transposase accessible chromatinwithsequencing(ATAC-seq)results demonstrated that chromatin accessibility of DNL genes was increased in cyp17a1-/-fish compared to cyp17a1+/+male fish,including stearoyl-CoA desaturase(scd)and fatty acid synthase(fasn).Androgen response element(ARE)motifs in the androgen signaling pathway were significantly enriched in cyp17a1+/+male fish but not in cyp17a1-/-fish.Both androgen receptor(ar)-/-and wildtype(WT)zebrafish administered with Ar antagonist flutamide displayed excessive visceral adipose tissue,lipid content,and up-regulated expression and activity of hepatic de novo lipogenesis enzymes.The Ar agonist BMS-564929 reduced the content of VAT and lipid content,and down-regulated acetyl-CoA carboxylase a(acaca),fasn,and scd expression.Mechanistically,the rescue effect of testosterone on cyp17a1-/-fish in terms of phenotypes was abolished when ar was additionally depleted.Collectively,these findings reveal that testosterone inhibits lipid deposition by down-regulating DNL genes via Ar in zebrafish,thus expanding our understanding of the relationship between testosterone and lipid metabolism in teleosts.

鲁拉西酮的药理学、药动学及临床研究进展

目的为临床使用鲁拉西酮提供参考。方法通过检索CBM、中国知网、万方、维普、PubMed及WebofScience数据库中鲁拉西酮相关文献,汇总并分析鲁拉西酮的药理学、药动学及临床研究进展。结果与结论鲁拉西酮作为第2代抗精神病药物,已被证实可有效治疗精神分裂症和双相Ⅰ型抑郁症,不良反应发生率低,在代谢、心血管等方面风险低,安全性、耐受性良好。

科研支持服务促进医学科技创新发展实践探索

研究临床医生信息获取能力、科研支持服务需求及利用情况对其参与科研的影响,探讨科研支持服务对临床医学创新的促进作用,以天津市医学科技情报机构为例,分析开展科研支持服务存在的问题并提出相应建议。

海上风电柔直输电系统黑启动研究进展

随着绿色能源的快速发展,海上风电场的规模也越来越大,同时柔性直流也是海上风电场对外传输电能的主要方式.海上风电柔直输电系统在遇日常或故障检修后,需要由换流站等独立完成系统的黑启动.本研究从系统黑启动电源的选择、风电场和换流站的启动方式展开,总结出一种适用于海上风电柔性直流输电系统的黑启动策略,并归纳分析了系统启动过程中注意事项及难点.最后,提出系统黑启动的未来发展方向,为今后海上风电柔直输电系统黑启动的研究和应用提供参考.

Successful Production of an All-Female Common Carp (Cyprinus carpio L.) Population Using cyp17a1-Deficient Neomale Carp

Due to sexual dimorphism in the growth of certain cultured fish species,the production of monosex fishes is desirable for the aquaculture industry.Nowadays,the most widely practiced technique available for the mass production of monosex fish populations is sex steroid-induced sex reversal.Here,a novel strategy for the successful production of all-female(AF)common carp(Cyprinus carpio L.),to take advantage of the sexual dimorphism in growth documented in this species,has been developed using genetic engineering via single gene-targeting manipulation without any exogenous hormone treatments.Male and female heterozygous cyp17a1-deficient common carp were first obtained using the clustered regularly interspaced short palindromic repeats/CRISPR-associated endonuclease 9(CRISPR/Cas9)technique.An all-male phenotype for homozygous cyp17a1-deficient carp,regardless of the individuals’sexdetermination genotypes(XY or XX),has been observed.A male-specific DNA marker newly identified in our laboratory was used to screen the neomale carp population with the XX genotype from the cyp17a1-deficient carp.These neomale carp develop a normal testis structure with normal spermatogenesis and sperm capacity.The neomale common carp were then mated with wild-type(WT)females(cyp17a1^(+/+)XX genotype)using artificial fertilization.All the AF offspring sample fish from the neomale-WT female mating were confirmed as having the cyp17a^(1+/-)XX genotype,and normal development of gonads to ovaries was observed in 100.00%of this group at eight months post-fertilization(mpf).A total of 1000 carp fingerlings,500 from the WT male and female and 500 from the neomale and WT female mating,were mixed and reared in the same pond.The average body weight of cyp17a1^(+/-)XX females was higher by 6.60%(8 mpf)and 32.66%(12 mpf)than that of the control common carp.Our study demonstrates the first successful production of a monosex teleost population with the advantages of sexual dimorphism in growth using genetic manipulation targeting a single locus.

一种在线高精度车用锂电池SOC估计的方案研究

本文针对车用锂电池的高精度SOC估计方法进行研究,首先选取二阶Thevenin等效电路作为本文锂电池的等效电路模型,针对车用锂电池复杂工况难以在线辨识的等效模型参数的问题,提出使用移动指数窗的LS算法在线辨识锂电池的等效电路模型参数,最后通过粒子滤波算法估计SOC。仿真和实验验证了在车用锂电池中使用移动指数窗的LS算法辨识等效电路模型参数具有较高的精度,且SOC估计精度得到提高。

基于冲击响应特性的锂电池SOH估计

随着电动汽车快速增长和智能电网飞速发展的时代的到来,人们对电池的需求与日俱增。健康状态(SOH)是监测电池状态的关键参数,SOH决定了电池能否安全、稳定地运行。本文提出一种基于冲击响应特性的锂电池SOH快速估计方法。首先,本文提出了多种特征提取方法对冲击响应曲线进行特征提取,分别为基于小波变换方法、基于差分电压方法和基于数值微分方法。其次,引入灰色关联度分析(GRA)方法对特征进行相关性分析,并利用改进型模糊小脑模型神经网络(IFCMNN)估计SOH。最后,实验结果表明了所提方法能在较高的SOH分辨精度上实现对处在任意SOC的锂电池进行快速估计SOH,验证了所提方法的有效性。

北京市监测站布局差异分析

为评估北京市空气质量监测站点布局的合理性,对比分析北京市2014年8月-2015年7月市内国家级和全市级空气质量数据,结果表明:全市级监测PM_(2.5)数据高于国家级监测数据5.5μg/m^3(7%),冬季差异最大(15%),国家级站点数据对北京市南部地区评估结果偏低32.5%,北部地区评估结果偏高8.7%;结合监测站点所在地区的污染源、天气扩散条件和常住人口等因素分析,北京市北部地区应增设国家级监测站点,南部地区应对国家级监测网络站点进行加密。

旋扣机构对中性的理论与仿真分析

介绍了铁钻工旋扣机构的结构组成及工作原理,对旋扣机构夹持钻具的运动过程进行了理论分析。与此同时,应用ADAMS软件建立旋扣机构的仿真模型,对旋扣机构夹持钻具的自动对中过程进行运动学仿真分析。将理论分析和仿真结果进行对比,验证理论分析的正确性和可行性。

大区电网互联换流站中交流混合式有源滤波器的设计及应用

介绍了一种首次应用于常规直流换流站的交流混合式有源滤波器(HAPF),重点分析了HAPF的接线、有源滤波器(APF)的阀组设计方案、换流站有源滤波器和交流滤波场的布置方案,同时还介绍了HAPF的控制保护配置情况和运行原则,最后通过分析HAPF在不同运行原则下的滤波性能,验证了HAPF主动滤波的性能。

数字换流站信息架构优化设计方案研究

结合数字换流站的功能实现,分析信息接入需求,研究后台整合的可行性及整合方案,使得换流站的后台数量减少58%,梳理了后台整合后的信息传输路径与规约,并在上述基础上提出数字换流站的信息架构总体方案,为数字换流站的建设提供参考。

Ccdc57 is required for straightening the body axis by regulating ciliary motility in the brain ventricle of zebrafish

Recently,cilia defects have been proposed to contribute to scoliosis.Here,we demonstrate that coiled-coil domain-containing 57(Ccdc57)plays an essential role in straightening the body axis of zebrafish by regulating ciliary beating in the brain ventricle(BV).Zygotic ccdc57(Zccdc57)mutant zebrafish developes scoliosis without significant changes in their bone density and calcification,and the maternal-zygotic ccdc57(MZccdc57)mutant embryos display curved bodies since the long-pec stage.The expression of ccdc57 is enriched in ciliated tissues and immunofluorescence analysis reveals colocalization of Ccdc57-HA with acetylated a-tubulin,implicating it in having a role in ciliary function.Further examination reveals that it is the coordinated cilia beating of multiple cilia bundles(MCB)in the MZccdc57 mutant embryos that is affected at 48 hours post fertilization,when the compromised cerebrospinal fluid flow and curved body axis have already occurred.Either ccdc57 m RNA injection or epinephrine treatment reverses the spinal curvature in MZccdc57 mutant larvae from ventrally curly to straight or even dorsally curly and significantly upregulates urotensin signaling.This study reveals the role of ccdc57 in maintaining coordinated cilia beating of MCB in the BV.

Hyperandrogenism in POMCa-deficient zebrafish enhances somatic growth without increasing adiposity

The endocrine regulatory roles of the hypothalamic-pituitary-adrenocortical axis on anxiety-like behavior and metabolic status have been found throughout animal taxa.However,the precise effects of the balancing adrenal corticosteroid biosynthesis under the influence of adrenocorticotrophic hormone(ACTH),a pro-opiomelanocortin(POMC)-derived peptide,on animal energy expenditure and somatic growth remain unknown.POMC has also been identified as one of the candidate loci for polycystic ovary syndrome,which features hyperandrogenism and some prevalence of obesity in patients.Here we show that zebrafish lacking functional POMCa exhibit similar phenotypes of stress response and body weight gain but not obesity as observed in mammalian models.In contrast with the impaired anorexigenic signaling cascade of melanocyte-stimulating hormones and leptin,which are responsible for their obesity-prone weight gain observed in various pome mutant mammals,analyses with our pomca mutant series indicate that ACTH is the key regulator for the phenotype with enhanced somatic growth without obesity in pomca-deficient zebrafish.Hypocortisolism associated with hyperandrogenism has been observed in the pomca-deficient zebrafish,with enhanced activation of mammalian target of rapamycin complex 1;reutilization of amino acids and fatty acid^-oxidation are observed in the muscle tissue of the pomca-deficient fish.After reducing hyperandrogenism by crossing our pomca mutant fish with a cy p l 7a 1-deficient background,the phenotype of enhanced somatic growth in pomca-deficient fish was no longer observed.Thus,our work also demonstrated that the role of POMCa in stress response seems to be conserved in vertebrates,whereas its effect on adipostasis is unique to teleosts.

Depletion of insulin receptors leads to β-cell hyperplasia in zebrafish

Hyperglycemia in type 2 diabetes results from an inability of insulin to regulate gluconeogenesis.To characterize the role of the insulin/insulin receptor pathway in glycometabolism and type 2 diabetes,we created a zebrafish model in which insulin receptors a and b(insra and insrb) have been ablated.We first observed that insra and insrb were both expressed abundantly during embryonic development and in various adult tissues.Increased expression of insulin and number of b-cells were observed in insra-/-/-insrb-/-fish together with higher glucose in insra-/-,insrb-/-,or insra-/-/-insrb-/-fish,indicating that insra and insrb were knocked out effectively.However,compared to the wild-type fish,insra-/-/-insrb-/-fish died between 5 and 16 days post-fertilization(dpf) with severe pericardial edema and increased level of cell apoptosis,which was not induced by increased total body glucose content.Increased gluconeogenesis and decreased glycolysis were also observed in both single and double knockout fish,but no mortality or malformation was observed in single knockout fish.Given the importance of insulin receptors in glucose homeostasis and embryonic development,transcriptome analysis was used to provide an important model of defective insulin signaling and to study its developmental consequences in zebrafish.The results indicated that both insra and insrb played a pivotal role in glucose metabolism and embryonic development,and insra was more critical than insrb in the insulin signaling pathway.

Genomic polymorphisms at the crhr2 locus improve feed conversion efficiency through alleviation of hypothalamus-pituitary-interrenal axis activity in gibel carp(Carassius gibelio)

Improvement in fish feed conversion efficiency(FCE)is beneficial for sustaining global food fish supplies.Here,we show that a set of polymorphisms at locus of the corticotropin releasing hormone receptor 2(crhr2),which is involved in hypothalamuspituitary-interrenal(HPI)axis signaling,is associated with improved FCE in farmed allogynogenetic gibel carp strain CAS Ⅲ compared with that in the wild gibel carp strain Dongting(DT).This set of polymorphisms downregulates the expression levels of crhr2 mRNA in the brain and pituitary tissues in gibel carp strain CAS Ⅲ compared with those in strain DT.Furthermore,compromised HPI axis signaling is observed in gibel carp strain CAS Ⅲ,such as decreased α-melanocyte stimulating hormone protein levels,plasma cortisol content,and stress responses.Moreover,enhanced activation of protein kinase B/mammalian target of rapamycin complex 1 signaling observed in the muscle tissue of strain CAS Ⅲ in comparison to that in strain DT indicated elevated anabolic metabolism in strain CAS Ⅲ.Thus,these studies demonstrate that the genetic markers associated with compromised HPI axis signaling,such as crhr2,are potentially useful for genetic selection toward improvement in farmed fish growth and FCE,which would reduce fishmeal consumption and thereby indirectly facilitate sustainable fisheries.

Androgen signaling regulates the transcription of anti-Müllerian hormone via synergy with SRY-related protein SOX9A

Anti-Mullerian hormone （amh） is one of the earliest functional genes expressed during testicular differentiation. It has been suggested that androgen signaling regulates critical genes for the differentiation and development of the testis. To elucidate the exact regulatory mechanisms involved in arnh transcription mediated by androgen signaling, androgen signaling was manipulated in zebrafish by cytochrome P450 17al （cyplTal） knockout and Flutamide treatment. In cyp17a1-deficient and Flutamide-treated testes, up-regulated sry-box9a （soxga） and down-regulated amh were observed. Moreover, a physical association of the zebrafish androgen receptor （AR） and SOX9A was found. The interaction between AR and SOX9A was mediated via the DNA binding domain （DBD） of AR and the transactivation domain （TA） of SOX9A, and was further enhanced by 5-alpha dihydrotestosterone （DHT）, one of the most potent androgens. Intriguingly, together with SOX9A, androgen signaling synergistically promoted amh transcription, mainly through the proximal 1 kb of the amh promoter region. Taken together, our data demonstrate a critical mechanism underlying the direct synergy of androgen signaling and SOX9A in the regulation of amh transcription.

Molecular phylogeny of Pamphagidae （Acridoidea, Orthoptera） from China based on mitochondrial cytochrome oxidase II sequences

Phylogenetic relationships of Pamphagidae were examined using cytochrome oxidase subunit II （COIl） mtDNA sequences （684 bp）. Twenty-seven species of Acridoidea from 20 genera were sequenced to obtain mtDNA data, along with four species from the GenBank nucleotide database. The purpose of this study was analyzing the phylogenetic relationships among subfamilies within Pamphagidae and interpreting the phylogenetic position of this family within the Acridoidea superfamily. Phylogenetic trees were reconstructed using neighbor-joining （NJ）, maximurn parsimony （MP） and Bayesian inference （BI） methods. The 684 bp analyzed fragment included 126 parsimony informative sites. Sequences diverged 1.0%-11.1% between genera within subfamilies, and 8.8%-12.3% between subfamilies. Amino acid sequence diverged 0-6.1% between genera within subfamilies, and 0.4%-7.5% between subfamilies. Our phylogenetic trees revealed the monophyly of Pamphagidae and three distinct major groups within this family. Moreover, several well supported and stable clades were found in Pamphagidae. The global clustering results were similar to that obtained through classical morphological classification： Prionotropisinae, Thrinchinae and Pamphaginae were monophyletic groups. However, the current genus Filchnerella （Prionotropisinae） was not a monophyletic group and the genus Asiotmethis （Prionotropisinae） was a sister group of the genus Thrinchus （Thrinchinae）. Further molec- ular and morphological studies are required to clarify the phylogenetic relationships of the genera Filchnerella and Asiotmethis.

Phylogenetic analyses of some genera in Oedipodidae （Orthoptera： Acridoidea） based on 16S mitochondrial partial gene sequences

Basedonthe 16S mitochondrial partial gene sequences of 29 genera, containing 26 from Oedipodidae and one each from Tanaoceridae, Pyrgomorphidae and Tetrigidae （as outgroups）, the homologus sequences were compared and phylogenetic analyses were performed. A phylogenetic tree was inferred by neighbor-joining （N J）. The results of sequences compared show that： （i） in a total of 574 bp of Oedipodidae, the number of substituted nucleotides was 265 bp and the average percentages ofT, C, A and G were 38.3%, 11.4%, 31.8% and 18.5%, respectively, and the content of A＋T （70.1%） was distinctly richer than that of C＋G （29.9%）; and （ii） the average nucleotide divergence of 16S rDNA sequences among genera of Oedipodidae were 9.0%, among families of Acridoidea were 17.0%, and between superfamilies （Tetrigoidea and Acridoidea） were 23.9%, respectively. The phylogenetic tree indicated： （i） the Oedipodidae was a monophyletic group, which suggested that the taxonomic status of this family was confirmed; （ii） the genus Heteropternis separated from the other Oedipodids first and had another unique sound-producing structure in morphology, which is the type-genus of subfamily Heteropterninae; and （iii） the relative intergeneric relationship within the same continent was closer than that of different continents, and between the Eurasian genera and the African genera, was closer than that between Eurasians and Americans.

LRH-1 senses signaling from phosphatidylcholine to regulate the expansion growth of digestive organs via synergy with Wnt/β-catenin signaling in zebrafish

Liver receptor homolog-1(LRH-1)is an orphan nuclear receptor that is critical for the growth and proliferation of cancer cells and other biological processes,including lipid transportation and metabolism,sexual determination and steroidogenesis.However,because homozygous lrh-1mice die in utero,the regulatory mechanisms involved in embryonic development mediated by this receptor are poorly understood.In the present study,we performed transcription activator-like effector nuclease(TALEN)-mediated loss-of-function assays,taking advantage of zebrafish external fertilization,to investigate the function of lrh-1.The digestive organs were affected by lrh-1 depletion as a result of cellcycle arrest(at the checkpoint of G1 to S phase),but not cell apoptosis.Biochemical analysis revealed that LRH-1 augments the transcriptional activity of b-catenin 1 and 2 via physical interactions.Screening the specific ligand(s)sensed by LRH-1 during organogenesis revealed that phosphatidylcholine(PC),a potential ligand,is the upstream target of LRH-1 during endoderm development.These data provide evidence for the crosstalk between the PC/LRH-1 and Wnt/β-catenin signaling pathways during the expansion growth of endoderm organs.