三种快速检测技术诊断早期结核性脑膜炎的评价

目的评价3种快速检测技术在早期结核性脑膜炎诊断中的应用价值。方法采用离心涂片抗酸染色法、改良抗酸染色法、GeneXpert MTB/RIF技术(简称“GeneXpert技术”)对2016年8月至2018年6月河北省胸科医院和石家庄市第五医院收治的根据临床表现、影像学及实验室检查等临床确诊的45例结核性脑膜炎、42例非结核性脑膜炎患者的脑脊液标本进行分枝杆菌检测,并对结果进行分析。采用SPSS19.0软件进行统计学分析,率的比较采用χ^2检验、校正χ^2检验,以P<0.05为差异有统计学意义。结果以临床诊断为标准,45例结核性脑膜炎患者脑脊液分别应用离心涂片抗酸染色法、改良抗酸染色法、GeneXpert技术检测分枝杆菌的敏感度分别为4.44%(2/45)、88.89%(40/45)、35.56%(16/45);依次两两比较,差异均有统计学意义(χ^2值分别为64.46、13.16、27.23,P值均=0.000)。42例非结核性脑膜炎患者的脑脊液用离心涂片抗酸染色法、改良抗酸染色法、GeneXpert技术检测分枝杆菌均为阴性。3种检测技术检测分枝杆菌的特异度均为100.00%。结论改良抗酸染色法较离心涂片法及GeneXpert技术检测分枝杆菌阳性率高,具有较好的确诊结核性脑膜炎的价值。

肝脏血管周上皮样细胞瘤的诊治分析

目的探讨肝脏血管周上皮样细胞瘤(PEComa)的临床特点、诊断与治疗。方法回顾性分析2002年1月—2020年9月湖南师范大学附属第一医院收治的101例肝脏PEComa患者资料。其中,女性95例,男性6例;年龄27~63岁,中位年龄47岁。肿瘤平均直径4.7 cm。采用χ2检验或Fisher精确概率法和Logistic回归模型分析肝脏PEComa术后复发的影响因素。结果99例患者行手术治疗,2例患者仅行超声引导下肝肿块穿刺活检。术后病理诊断均为肝脏PEComa。免疫组织化学检测人黑色素瘤标志物(Melan-A、Melanoma)和肌源性标志物SMA均阳性,99例患者血管源性标志物CD34为阳性。随访2~212个月,复发11例。肿瘤最大直径是否≥5 cm、有无初始症状及Ki-67阳性表达率是否>10%与肝脏PEComa复发有关。Logistic回归模型分析显示,肿瘤最大直径≥5 cm[OR=4.893(95%CI:1.045,22.903)]和有初始症状[OR=6.501(95%CI:1.384,30.551])为肝脏PEComa复发的独立危险因素(P<0.05)。结论肝脏PEComa好发于中年女性,影像学表现具有一定的特异性,但确诊率仍较低,确诊依靠病理学检查,外科手术为主要的治疗方式。由于PEComa的恶性潜能,尤其是存在复发的独立危险因素时,术后应密切随访。

Effect of endostar combined with cisplatin on expression of VEGF and Sema3A of Lewis lung cancer rats

Objective:To evaluate the therapeutic effect of endostar(ED) combined with cisplatin(DDP) on model of C57BL/6 rats,and to further investigate the inhibiting mechanism of endostar from tumor angiogenesis.Methods:Lewis lung cancer cells were inoculated in C57BL/6 mouse,then the mouse were randomized into control group(group A),ED(group B),DDP(group C) and ED/DDP (group D).They were treated according to the plan.And the expressions of VEGF and Sema3A were evaluated by immunhistochemisty.Results:The weight of tumor increased in group A and B.It was decreased in group C and D.The tumor volume was increased in all the 4 groups. The VEGF expression of group D was obviously lower than the other group 3,but the Sema3A expressed of group D was significantly strengthener than the other group 3.The VEGF expression of group B and group D were obviously low especially in the 4th-8th days.Pearson correlated analysis showed that the expression VEGF and Sema3A were negatively correlated(r=-0.72, P【0.05).Conclusions:ED combined with DDP could control the tumor growth effectively,and avoid weight loss.ED could reduce VEGF expression,and enhance Sema3A expression.Tumor vessel presents transient normalization.It is easy for DDP perfusion,and to kill tumor cells.

Effect of tetramethylpyrazin combined with cisplatin on VEGF,KLF4 and ADAMTS1 in lewis lung cancer mice

Objective: To further explore the function of combine use of tetramethylpyrazine(TMP) and cisplatin(DDP) in lung carcinoma. Methods: We used the combination drug to treat Lewis lung cancer mice, investigated the expression level of vascular endothelial growth factor(VEGF), Kruppel-like factor 4(KLF4) and A disintegrin and metalloproteinase with thrombospondin motifs 1(ADAMTS1) and to further explore the inhibitory effects and potential mechanism of TMP combined with DDP on tumor angiogenesis. Results: The tumor growth was suppressed in TMP group, DDP group and TMP combined with DDP group. Furthermore, the weights and volume of tumor, the expression level of VEGF, KLF4 and ADAMTS1 were found significantly changed between experiment group and control group. These findings suggest that TMP with DDP had additional or synergistic effects to inhibit the tumor growth effectively, might be achieved through reducing the expression of angiogenesis promoting factor VEGF and increasing expression of angiogenesis inhibitors KLF4 and ADAMTS1. Conclusion: KLF4 and ADAMTS1 may be synergically involved in the angiogenesis in mouse Lewis lung cancer through the different signal ways.

Artificial intelligence model of complicated flow behaviors for Ti-13Nb-13Zr alloy and relevant applications

The comprehensive nonlinear flow behaviors of a ductile alloy play a significant role in the numerical analysis of its forming process. The accurate characterization of as-forged Ti-13 Nb-13 Zr alloy was conducted by an improved intelligent algorithm, GA-SVR, the combination of genetic algorithm(GA) and support vector regression(SVR). The GA-SVR model learns from a training dataset and then is verified by a test dataset. As for the generalization ability of the solved GA-SVR model, no matter in β phase temperature range or(α+β) phase temperature range, the correlation coefficient R-values are always larger than 0.9999, and the AARE-values are always lower than 0.18%. The solved GA-SVR model accurately tracks the highly-nonlinear flow behaviors of Ti-13 Nb-13 Zr alloy. The stress-strain data expanded by this model are input into finite element solver, and the computation accuracy is improved.

进气状态对磁悬浮高速离心式鼓风机性能影响的研究

以磁悬浮高速离心式鼓风机为研究对象,试验对比不同进气状态下风机性能的变化情况,通过相似原理推导出任意进气状态下的轴功率和出口压力与标准进气状态下测试性能数据的换算关系。采用此方法可快速预测风机在指定进气状态下的性能,大幅降低测试成本,提高选型准确性。根据水处理行业中鼓风机的运行特点,分析进气状态对风机喘振、能耗的影响,在同样出口升压下,进气温度升高或进气压力降低均引起风机流量和轴功率减小,反之则相反。

氢气治疗疾病生物学效应的研究进展

氢气是一种无味、无色且具有还原性的气体。以前人们认为氢气属于生理性惰性气体,因此其在生物体内的作用一直没有受到重视。近年来,越来越多的研究发现氢气在心、脑、肺等多种疾病的治疗中发挥潜在保护作用。多项研究证实,氢气主要通过抗氧化、抗炎、抗凋亡、调节自噬等生物学效应发挥疾病的保护作用。该文就氢气治疗疾病生物学效应的研究进展进行综述。

Cellular toxicity of isoniazid together with rifampicin and the metabolites of isoniazid on QSG-7701 hepatocytes

Objective:To investigate the cellular toxicity of isoniazid together with rifampicin and the metabolites of isoniazid on cultured QSG-7701 cells lines.Methods:Isoniazid,rifampicin, mixture of rifampicin and isoniazid,acetylhydrazine,hydrazine were added in cultural media of QSG-7701 cells and cultured for 48 hours.The survival rate of cells was determined by MTT method.The cultural media and cells were collected and the activity of lactate dehydrogenase was detected by chromatometry.Results:Compared with control group,the survival rate decreased significantly and the lactate dehydrogenase released from cell increased significantly in cells treated with isoniazid,rifampicin,acetylhydrazine,hydrazine.Hydrazine,the metabolite of isoniazid produced significant damage on hepatocytes in low concentration.Conclusions: Rifampicin together with rifampicin and metabolites of isoniazid produce cellular toxic effects and hydrazine may be the most toxiferous metabolite.

A Threshold Signature Scheme Based on TPM

For the traditional threshold signature mechanism does not considers whether the nodes which generate part signature are trusted and the traditional signature strategy doesn’t do well in resisting internal attacks and external attacks and collusion attacks, so this paper presents a new threshold signature based on Trusted Platform Module (TPM), based on TPM the signature node first should finish the trust proof between it an other members who take part in the signature. Using a no-trusted center and the threshold of the signature policy, this strategy can track active attacks of the key management center and can prevent framing the key management center, this strategy takes into account the limited computing power TPM and has parameters of simple, beneficial full using of the limited computing power TPM.

Sex difference in the prevalence of metabolic syndrome and its relationship to BMI and age

Objective:To investigate the prevalence of metabolic syndrome (MetS) in primary aldosteronism(PA) patients with different genders and relationship between body mass index(BMI), age and MetS. Methods:This study included 168 PA patients who were hospitalized in hypertension treatment center of Xinjiang Uygur Autonomous Region People' Hospital, including 94 male patients and 74 female patients and the backgrounds and biochemical parameters of two groups were compared. Based on this, the relationship between BMI, age and MetS were also analyzed. Results:The prevalence of MetS was significantly higher in male patients with PA than female patients with PA(83.0% vs 58.1%,P<0.001). Compared to PA patients without MetS, PA patients with MetS had a higher level of BMI and greater prevalence of obesity (P<0.05). According to the BMI stratification analysis, we found the prevalence of MetS was higher in obese groups than non-obese groups (P<0.05). Moreover, the obese male patients with PA had higher prevalence of every component of MetS and prevalence of MetS with 5 metabolic factors compared to the non-obese group (P<0.05);while the obese female patients with PA only had higher prevalence of abdominal obesity compared to the non-obese group (P<0.001). Among the patients classified by age, the both prevalence of MetS was higher in male than female, and there was no male:female ratio inverted in patients with PA after menopause. Conclusions:The prevalence of MetS in male patients with PA was higher than female patients with PA. In addition, the obese groups had the higher prevalence of MetS than non-obese groups.

Quadratus femoris muscle pedicle bone flap transplantation in the treatment of femoral neck fracture for Chinese young and middle-aged patients： A systematic review and meta-analysis

Purpose： To compare the efficacy of quadratus femoris muscle pedicle bone flap transplantation combined with hollow compression screw fixation versus AO hollow compression screw fixation in the treatment of femoral neck fracture for Chinese young and middle-aged patients. Methods： Case-controlled studies （CCTs） were used to compare the two operative methods in the treatment of femoral neck fractures. Data were retrieved from the Cochrane Library, Pubmed Database, CNKI, Chinese Biomedical Database. Wanfang Data published during the period of January 2005 to December 2014. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical Software Revman S.0 was used for data-analysis. Results： Eight articles were included in the meta-analysis. The results showed that there was statistical significance in the rate of fracture healing [OR = 5.43, 95% CI （2.89, 10.20）, p 〈 0.05], the rate of good function of hip joint [OR=5.12, 95% CI （3.21, 8.17）, p 〈 0.05], the rate of femoral head necrosis [OR = 4.21, 95% CI （2.02, 8.76）, p 〈 0.05], the time of fracture healing [WMD = -46.85, 95% CI （-65.13, -28.56）, p 〈 0.05] between the two groups. Conclusions： For the treatment of femoral neck fractures, the transplantation of quadratus femoris muscle pedicle bone flap combined with hollow compression screw; fixation is superior to the AO hollow compression screw fixation in terms of the rate; of fracture healing, the rate of good function of hip joint, the rate of femoral head： necrosis and the time of fracture healing.

Ilioinguinal approach versus Stoppa approach for open reduction and internal fixation in the treatment of displaced acetabular fractures： A systematic review and meta-analysis

Purpose： To compare the efficacy and safety of open reduction and internal fixation through ilioinguinal approach and Stoppa approach for the treatment of displaced acetabular fractures. Methods： Case-controlled trials （CCTs） published from January 2010 to August 2015 that compared the ilioinguinal approach and Stoppa approach in the management of displaced acetabular fractures were retrieved from the databases of Cochrane Library, Pubmed, CNKI, and so on. Methodological quality of the trials was critically assessed. Statistical software RevMan 5.0 was used for data analysis. Results： Eight articles were included in the meta-analysis. Through comparing the efficacy and safety of ilioinguinal approach and Stoppa approach in the treatment of displaced acetabular fracture, statistical significance was found in the average operation time [WMD = 68.29, 95% CI （10.52, 126.05）, p 〈 0.05] and the median intraoperative blood loss [WMD = 142.26, 95% CI （9.30, 275.23）, p 〈 0.05]. However, there existed no statistical significance in the fracture end reset satisfaction rate [RR = 0.63, 95% CI （0.17, 2.37）, p 〉 0.05], the early complications rate [RR = 0.89, 95% CI （0.33, 2.40）, p 〉 0.05], the late complications rate [RR = 0.91, 95% CI （0.27, 3.01）, p 〉 0.05], and Harris hip score good function rate [RR = 0.52, 95% CI （0.25, 1.10）, p 〉 0.05]. Conclusion： Though both techniques can obtain satisfactory clinical functions in the treatment of displaced acetabular fractures, Stoppa approach is superior to the ilioinguinal approach in terms of operation time and intraoperative blood loss.

汛期地铁行车荷载作用下越江隧道离散元分析（英文）

目的:揭示汛期及常水位条件下地铁随机振动荷载作用下越江隧道管片及周边岩土体的动力响应及变形机制。创新点:建立越江地铁隧道二维离散元模型,并采用随机振动荷载模拟地铁行车荷载,揭示汛期和常水位条件下地铁行车荷载对越江隧道稳定性的影响。方法:采用离散元方法进行数值仿真。1.基于室内三轴试验和离散元数值拟合得到土层的各细观参数;2.采用不同接触模型对隧道内钢轨、轨枕、管片以及周边岩土体进行建模;3.将地铁随机振动荷载施加在钢轨上,对管片及周边岩土体不同区域内颗粒的受力及变形进行监测并分析。结论:1.位于隧道上半部分的周边岩土体颗粒振动偏大;2.随着距离的增大,振动波在周边岩土体内先放大后减小;3.汛期水位条件下地铁行车荷载对管片和周边岩土体的振动影响较小,但是对隧道变形影响较大。

Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma

Background:This study aims to find out the possible optimal therapy and assess the prognosis properly for patient with spontaneous rupture of hepatocellular carcinoma(HCC).Methods:Propensity score matching(PSM)analysis was used to study the data from 325 patients with ruptured HCC(RHCC)and 2,291 patients with non-RHCC.Results:The incidence and hospital mortality of RHCC were 5.1%and 0.8%respectively,with a median overall survival(OS)time of 17 months.There was no difference between ruptured and non-RHCC patients undergoing conservation treatment in terms of OS.Trans-arterial embolization(TAE)was carried out in 69(21.2%)cases with RHCC,with a median OS of 7 months,which was no difference from that of non-RHCC(pre-and post-PSM).One hundred and sixty-nine(52.0%)RHCC cases underwent one-stage hepatectomy,with a median OS and disease-free survival(DFS)of 30 and 6 months respectively,which were shorter than that of non-RHCC(post-PSM).TAE plus two-stage hepatectomy was performed in 30 RHCC cases,with a median OS and DFS of 28 and 10 months respectively;these outcomes were better than that from RHCC patients undergoing TAE alone or one-stage hepatectomy(post-PSM),which were no difference from that of non-RHCC patients undergoing hepatectomy.The risk of death for RHCC patient undergoing one-stage hepatectomy is 1.545 times higher than that of one undergoing TAE+two-stage hepatectomy.Conclusions:TAE plus two-stage hepatectomy might be the optimal treatment for RHCC patient.Under the premise of the same pathological properties,there is no difference in prognosis between ruptured and non-RHCC patients if the therapy is appropriate.

Percutaneous poking reduction and fixation versus open reduction and fixation in the treatment of displaced calcaneal fractures for Chinese patients： A systematic review and meta-analysis

Purpose： To compare the efficacy of percutaneous poking reduction and fixation with open reduction and fixation in the treatment of displaced calcaneal fractures. Methods： Reports of studies using case-controlled trials （CCT） to compare the percutaneous poking reduction and fixation with the open reduction and fixation in the management of calcaneal fractures were retrieved from the Cochrane Library, PubMed Database, CNKI, Chinese Biomedical Database, Wanfang Data （fromJanuary of 2005 to August of 2015）. Methodological quality of the trials was critically assessed, and relevant data were extracted. Statistical software Revman 5.0 was used for data-analysis. Results： Fifteen articles were included in the meta-analysis. Comparison of the efficacy of percutaneous poking reduction and fixation with open reduction and fixation in the treatment of calcaneal fractures revealed statistical significance in the incidence of complications after operation [RR -- 0.32, 95,~ Cl （0.20, 0.5）, p 〈 0.05]. However, there were neither statistical significance in the degrees of recovery for calcaneal Bohler angle [WMD = -1.65, 95% CI （ 3.43, 0.14）, p 〉 0.05] and calcaneal Gissane angle [WMD - -3.21, 95%, Cl （-6.75, 0.33）, p 〉 0.05], nor statistical significance in the rate of good foot function after operation [RR = 0.95, 95Z Cl （0.90, 1.00）, p 〉 0.05]. Conclusion： For the treatment of calcaneal fractures, percutaneous poking reduction and fixation is superior to open reduction and fixation in terms of the incidence of postoperative complications. But both techniques can obtain satisfactory clinical function.

Foam/Film Alternating Multilayer Structure with High Toughness and Low Thermal Conductivity Prepared via Microlayer Coextrusion

Multilayer membranes prepared via microlayer coextrusion have attracted wide attention due to their unique properties and broad applications.In present study,the foam/film alternating multilayer sheets based on ethylene-vinyl acetate copolymer(EVA)and high-density polyethylene are successfully prepared via microlayer coextrusion.The cells in the sheets are single-cell-array along the foamed EVA layers with uniform cell size.In addition,the effects of layer number and foam relative thickness on morphology,mechanical properties,damping and heat insulation properties are investigated.The cell size decreases significantly with increasing layer number due to the enhanced confine effects.The tensile strength,elongation at break,and heat insulation also increase significantly.However,the mechanical damping properties change little in the observed frequency.Meanwhile,with higher relative thickness of EVA foam,the sheets have lower tensile strength and lower thermal conductivity,while the damping properties are enhanced in a specific frequency scope.The elongation at break of the optimized sample comes to 800%and the thermal conductivity decreases to 61 mW·m^(-1)·K^(-1),which shows high toughness and low thermal conductivity,indicating a possible method for preparing materials with high toughness and heat-insulating properties.

Revision and addendum to the manuscript titled“Propensity score matching study of 325 patients with spontaneous rupture of hepatocellular carcinoma”

We gratefully receive the comment entitled“Is transarterial embolization plus two-stage hepatectomy the optimal strategy for the treatment of spontaneous rupture of hepatocellular carcinoma?”(1).We apologize for the two typing errors in the paper:mortality rate of rupture of hepatocellular carcinoma(RHCC)patients was“0.8%”in the abstract should be changed as“0.9%”;“TNM stage”in the discussion should be replaced by“tumor diameter”.Thanks for the careful reading.