微创手术治疗中少量高血压脑出血的临床疗效观察

目的:分析中少量高血压脑出血患者应用微创手术治疗的效果。方法:选取2021年5月—2023年5月太仓市第一人民医院收治的中少量高血压脑出血患者62例为研究对象,按照治疗方式不同分为对照组和观察组,各31例。对照组应用开颅血肿清除术治疗,观察组采用微创手术治疗。观察两组患者血肿清除率、再出血发生率、昏迷情况、神经功能缺损情况、自理能力和日常生活情况。结果:两组患者治疗5 d后,观察组血肿清除率高于对照组,再出血发生率低于对照组,差异有统计学意义(P<0.05)。治疗后1、2、3周,两组患者昏迷、神经功能缺损评分与治疗前比较,差异有统计学意义(P<0.05);且两组治疗后2、3周昏迷评分高于治疗后1周,神经功能缺损评分低于治疗后1周,差异有统计学意义(P<0.05);治疗后3周昏迷评分高于治疗后2周,神经功能缺损评分低于治疗后2周,差异有统计学意义(P<0.05)。观察组患者治疗后1、2、3周昏迷评分高于对照组,神经功能缺损评分低于对照组,差异有统计学意义(P<0.05)。随访1年后,观察组自理能力和日常生活能力评分优于对照组,差异有统计学意义(P<0.05)。结论:对中少量高血压脑出血患者中应用微创手术治疗的血肿清除率高,再出血风险低,患者可尽早恢复,并减少神经功能受损,利于患者远期预后康复。

高性能三元NASICON型Na_(3.5−x)Mn_(0.5)V_(1.5−x)Zrx(PO_(4))_(3)/C钠离子电池正极材料

钠离子电池被广泛研究用于储能应用,但实现同时具有高能量密度、稳定性和快速充放电性能的正极材料仍然是一个关键的挑战。本研究合成了一系列NASICON型Na_(3.5−x)Mn_(0.5)V_(1.5−x)Zrx(PO_(4))_(3)/C材料,并掺入Mn、V和Zr元素探讨其对电化学性能的影响。通过在Mn和V的基础上引入Zr,提出一种激活V4+/V5+氧化还原反应新的策略,从而提升能量密度。此外,Zr掺入通过拓宽离子通道并产生额外的钠离子空位,显著促进钠离子迁移,增强电极反应动力学和整体性能。结果表明,Na_(3.5−x)Mn_(0.5)V_(1.5−x)Zrx(PO_(4))_(3)/C材料表现出优异的循环稳定性,在800次循环后保持90%的容量,并具备高倍率性能(20C时,放电比容量为84 m Ah·g^(-1)),显著优于原始的Na_(3.5−x)Mn_(0.5)V_(1.5−x)Zrx(PO_(4))_(3)/C材料。该研究为开发高效且可持续钠离子电池提供了有效途径。

Importance of oxygen-containing functionalities and pore structures of biochar in catalyzing pyrolysis of homologous poplar

Biochar and bio-oil are produced simultaneously in one pyrolysis process,and they inevitably contact and may interact,influencing the composition of bio-oil and modifying the structure of biochar.In this sense,biochar is an inherent catalyst for pyrolysis.In this study,in order to investigate the influence of functionalities and pore structures of biochar on its capability for catalyzing the conversion of homologous volatiles in bio-oil,three char catalysts(600C,800C,and 800AC)produced via pyrolysis of poplar wood at 600 or 800℃or activated at 800℃,were used for catalyzing pyrolysis of homologous poplar wood at 600℃,respectively.The results indicated that the 600C catalyst was more active than 800C and 800AC for catalyzing cracking of volatiles to form more gas(yield increase by 40.2%)and aromatization of volatiles to form more light or heavy phenolics,due to its abundant oxygen-containing functionalities acting as active sites.The developed pores of the 800AC showed no such catalytic effect but could trap some volatiles and allow their further conversion via sufficient aromatization.Nevertheless,the interaction with the volatiles consumed oxygen on 600C(decrease by 50%),enhancing the aromatic degree and increasing thermal stability.The dominance of deposition of carbonaceous material of a very aromatic nature over 800C and 800AC resulted in net weight gain and blocked micropores but formed additional macropores.The in situ diffuse reflectance infrared Fourier transform spectroscopy characterization of the catalytic pyrolysis indicated superior activity of 600C for removal of -OH,while conversion of the intermediates bearing C=O was enhanced over all the char catalysts.

Steam reforming of acetic acid over Ni/biochar of low metal-loading:Involvement of biochar in tailoring reaction intermediates renders superior catalytic performance

Biochar is a reactive carrier as it may be partially gasified with steam in steam reforming,which could influence the formation of reaction intermediates and modify catalytic behaviors.Herein,the Ni/biochar as well as two comparative catalysts,Ni/Al_(2)O_(3) and Ni/SiO_(2),with low nickel loading(2%(mass))was conducted to probe involvement of the varied carriers in the steam reforming.The results indicated that the Ni/biochar performed excellent catalytic activity than Ni/SiO_(2) and Ni/Al_(2)O_(3),as the biochar carrier facilitated quick conversion of the -OH from dissociation of steam to gasify the oxygen-rich carbonaceous intermediates like C=O and C-O-C,resulting in low coverage while high exposure of nickel species for maintaining the superior catalytic performance.In converse,strong adsorption of aliphatic intermediates over Ni/Al_(2)O_(3) and Ni/SiO_(2) induced serious coking with polymeric coke as the main type(21.5%and 32.1%,respectively),which was significantly higher than that over Ni/biochar(3.9%).The coke over Ni/biochar was mainly aromatic or catalytic type with nanotube morphology and high crystallinity.The high resistivity of Ni/biochar towards coking was due to the balance between formation of coke and gasification of coke and partially biochar with steam,which created developed mesopores in spent Ni/biochar while the coke blocked pores in Ni/Al_(2)O_(3) and Ni/SiO_(2) catalysts.

Thermal pretreatment of willow branches impacts yield and pore development of activated carbon in subsequent activation with ZnCl_(2) via modifying cellulose structure

Development of pore structures of activated carbon(AC)from activation of biomass with ZnCl_(2) relies on content and structure of cellulose/hemicellulose in the feedstock.Thermal pretreatment of biomass could induce dehydration and/or aromatization to change the structure of cellulose/hemicellulose.This might interfere with evolution of structures of AC,which was investigated herein via thermal pretreatment of willow branch(WB)from 200 to 360℃and the subsequent activation with ZnCl_(2) at 550℃.The results showed that thermal pretreatment at 360℃(WB-360)could lead to substantial pyrolysis to form biochar,with a yield of 31.9%,accompanying with nearly complete destruction of cellulose crystals and remarkably enhanced aromatic degree.However,cellulose residual in WB-360 could still be activated to form AC-360 with specific surface area of 1837.9 m~2·g^(-1),which was lower than that in AC from activation of untreated WB(AC-blank,2077.8 m~2·g^(-1)).Nonetheless,the AC-200 from activation of WB-200 had more developed pores(2113.9 m~2·g^(-1))and superior capability for adsorption of phenol,due to increased permeability of ZnCl_(2) to the largely intact cellulose structure in WB-200.The thermal pretreatment did increase diameters of micropores of AC but reduced the overall yield of AC(26.8%for AC-blank versus 18.0%for AC-360),resulting from accelerated cracking but reduced intensity of condensation.In-situ infrared characterization of the activation showed that ZnCl_(2) mainly catalyzed dehydration,dehydrogenation,condensation,and aromatization but not cracking,suppressing the formation of derivatives of cellulose and lignin in bio-oil.The thermal pretreatment formed phenolic-OH and C=O with higher chemical innerness,which changed the reaction network in activation,shifting morphology of fibrous structures in AC-blank to“melting surface”in AC-200 or AC-280.

Design of 10 MeV electron linear accelerator for space environment simulation

A compact 10 MeV S-band irradiation electron linear accelerator(linac)was developed to simulate electronic radiation in outer space and perform electron irradiation effect tests on spacecraft materials and devices.According to the requirements of space environment simulation,the electron beam energy can be adjusted in the range from 3.5 to 10 MeV,and the average current can be adjusted in the range from 0.1 to 1 mA.The linac should be capable of providing beam irradiation over a large area of 1 m^(2) with a uniformity greater than 90% and a scanning rate of 100 Hz.A novel method was applied to achieve such a high beam scanning rate by combining a kicker and a scanning magnet.Based on this requirement,a design for the10 MeV linac is proposed with an RF power pulse repetition rate of 500 Hz;it includes a thermal cathode electron gun,a bunching-accelerating section,and a scanning transport line.The detailed physical design and dynamic simulation results of the proposed 10 MeV electron linac are presented in this paper.

High-rate lithium-ion battery performance of a ternary sea urchin-shaped CoNiO_(2)@NiP_(6)Mo_(18)/CNTs composites

Bimetallic oxides are attractive anode materials for lithium-ion batteries(LIBs)due to their large theoretical capacity.However,the low conductivity,short cycle life,and poor rate capability are the bottlenecks for their further applications.To overcome above issues,the basket-like polymolybdate(NiP_(6)Mo_(18))and carbon nanotubes(CNTs)were uniformly embedded on the urchin-shaped CoNiO_(2)nanospheres to yield a ternary composites CoNiO_(2)@NiP_(6)Mo_(18)/CNTs via electrostatic adsorption.The multi-level morphology of urchin spinules accelerates the diffusion rate of Li^(+);CNT improves the conductivity and enhances cycle stability of the material;and heteropoly acid contributes more redox activity centres.Thus,CoNiO_(2)@NiP_(6)Mo_(18)/CNTs as an anode of LIBs exhibits a high initial capacity(1396.7 mA h g^(−1)at 0.1 A g^(−1)),long-term cycling stability(750.2 mA h g^(−1)after 300 cycles),and rate performance(450.3 mA h g^(−1)at 2 A g^(−1)),which are superior to reported metallic oxides anode of LIBs.The density functional theory(DFT)and kinetic mechanism suggest that CoNiO_(2)@NiP_(6)Mo_(18)/CNTs delivers an outstanding pseudocapacitance and rapid Li^(+)diffusion behaviors,which is due to the rich surface area of the urchin-like CoNiO_(2)with the uniform embeddedness of NiP_(6)Mo_(18)and CNTs.This study provides a new idea for optimizing the performance of bimetallic oxides and developing high-rate lithium-ion battery composites.

A Localization Method of High Energy Transients for All-sky Gamma-ray Monitor

Fast and reliable localization of high-energy transients is crucial for characterizing the burst properties and guiding the follow-up observations.Localization based on the relative counts of different detectors has been widely used for all-sky gamma-ray monitors.There are two major methods for this count distribution localization:χ^(2)minimization method and the Bayesian method.Here we propose a modified Bayesian method that could take advantage of both the accuracy of the Bayesian method and the simplicity of the χ^(2)method.With comprehensive simulations,we find that our Bayesian method with Poisson likelihood is generally more applicable for various bursts than the χ^(2)method,especially for weak bursts.We further proposed a location-spectrum iteration approach based on the Bayesian inference,which could alleviate the problems caused by the spectral difference between the burst and location templates.Our method is very suitable for scenarios with limited computation resources or timesensitive applications,such as in-flight localization software,and low-latency localization for rapidly follow-up observations.

Searching for the Highest Energy of Pulsation and Critical Luminosity of Swift J0243.6+6124 Observed by Insight-HXMT

Owing to the broad energy coverage of Insight-HXMT in the hard X-ray band,we detected the highest energy of pulsation exceeding 200 keV around the 2017–2018 outburst peak of the first Galactic pulsating ultraluminous X-ray source (PULX) Swift J0243.6+6124,which is the highest energy detected from PULXs to date.We also obtained the highest energy of pulsation of every exposure during the outburst in 2017–2018,and found the highest energy is roughly positively correlated with luminosity.Using our newly developed method,we identified the critical luminosity being 4×10^(38)erg s^(-1) when the main peaks of the low and high energy pulse profiles became aligned,which separates the fan-beam dominated and pencil-beam dominated accretion regimes.Above the critical luminosity,the phase of the main peak shifted gradually from 0.5 to 0.8 until the outburst peak in al energy bands is reached,which is in agreement with the phase shift found previously at low energies.Our result is consistent with what is derived from spectral analysis.

县级综合卒中中心应用Solitaire支架机械取栓联合Navien导管抽吸技术治疗急性前循环大血管闭塞的效果分析

目的探讨县级综合卒中中心使用Solitaire支架机械取栓联合Navien导管抽吸技术治疗前循环大血管闭塞的安全性及有效性。方法回顾性连续纳入2018年3—12月太仓市第一人民医院卒中中心收治的前循环大血管闭塞患者17例,均接受了Solitaire支架机械取栓联合Navien导管抽吸技术治疗,其中男10例,女7例;美国国立卫生研究院卒中量表(NIHSS)评分8~22分,平均(14±4)分;大脑中动脉M1段闭塞12例,大脑中动脉分叉部闭塞1例,颈内动脉起始段闭塞4例;醒后卒中4例,院内卒中1例。记录患者年龄、性别、发病至入院时间(ODT)、入院至溶栓时间(DNT)、入院至穿刺时间(DPT)、穿刺至再通时间(PRT),对比术前及术后24 h NIHSS评分的改变,评价血管再通情况[脑梗死溶栓(TICI)分级2b^3级为成功再通]、并发症发生比例和术后90 d预后良好[改良Rankin量表(mRS)评分≤2分]比例。结果17例患者中,静脉溶栓后桥接动脉取栓治疗5例,单纯动脉取栓12例;ODT为1.0~5.5 h,中位时间3.0(2.0,4.7)h;DNT为26~35 min,平均(30±4)min;DPT为79~276 min,平均(152±53)min;PRT为27~134 min,平均(57±33)min;支架取栓次数为1~3次,中位次数1(1,2)次。取栓后即刻行DSA检查,17例患者中,TICI 2a级2例,TICI 2b级5例,TICI 3级10例,血管再通占比为15/17,一次取栓成功占比为11/17。17例患者中,1例患者出现远端栓塞,经再次取栓后血管再通;未发生颅内出血。患者取栓后NIHSS评分2~20分,平均(9±5)分,与术前比较,差异有统计学意义(t=5.759,P<0.05)。术后90 d mRS评分≤2分者12例,预后良好占比为12/17。结论县级综合卒中中心使用Solitaire支架机械取栓联合Navien导管抽吸技术治疗前循环大血管闭塞是安全有效的。

Cross-polymerization between bio-oil and polyaniline: synergistic effects on pore development in subsequent activation and adsorption of phenol

Bio-oil is a major product from pyrolysis of biomass which serves as a carbon source to produce carbon material due to its high reactivity towards polymerization itself or cross-polymerization with other organic feedstocks.In this study,activation of polyaniline(PANI)mixed with wheat straw-derived bio-oil and K2C2O4 at 800°C was conducted,aiming to understand the effect of potential interactions of bio-oil with PANI on pore development of resulting activated carbon(AC).The results revealed cross-polymerization reactions between PANI and bio-oil during direct activation,which increased the yield of AC from 13.0%(calculated average)to 15.0%,the specific surface area from 1677.9 m^(2) g^(-1)(calculated average)to 1771.3 m^(2) g^(-1),and the percentage of micropores from 94.3%to 97.1%.In addition,pre-polymerization of PANI and bio-oil at 200°C before activation was also conducted.Such pretreatment could increase the AC yield from 13.0% to 23.3%,but the specific surface area decreased to 1381.8 m^(2) g^(-1).The pre-polymerization formed the organics that were more resistant towards cracking/gasification,but introduced oxygen-rich functionalities.This made AC highly hydrophilic,rendering a much higher capability for adsorption of phenol despite the smaller specific surface area.Additionally,the AC with developed pore structures facilitated dispersion of nickel in Ni/AC and enhanced the catalytic activity for hydrogenation of o-chloronitrobenzene and vanillin.

Expert consensus on the technical specifications of the in vitro skin penetration test of cosmetic product by Franz diffusion cell

Background:Diffusion cell test is one of the most commonly used in vitro model to detect the percutaneous absorption of cosmetic ingredients.Although PRC State Administration of Quality Supervision and Quarantine has issued the guideline for the in vitro test method for the percutaneous absorption of drug molecules,there is still a lack of guideline for the percutaneous absorption test of cosmetic components.Objective:In order to improve the standardized level and make the in vitro percutaneous absorption test of cosmetic ingredients more comparable,based on the international and domestic experience,Transdermal Drug Delivery Committee of the World Federation of Chinese Medicine Societies organized the experts to discuss and formed this consensus as reference for the percutaneous absorption test of cosmetic components.Materials and Methods:To standardize the in vitro diffusion cell test technique for transdermal penetration of functional cosmetic ingredients,the Transdermal Drug Delivery Professional Committee of the World Federation of Societies of Traditional Chinese Medicine has organized many discussions among experts.

肝脏神经内分泌肿瘤报道1例并文献回顾

背景肝脏可疑恶性肿瘤行手术切除后病理诊断肝脏神经内分泌肿瘤(hepatic neuroendocrin neoplasmas,HNENs)病例,此病例易与肝癌混淆,了解转移性和原发性HNENs的特性,对临床治疗手段有很好的指导意义.病例简介一名56岁男性患者体检发现肝脏占位性病变复查腹部增强CT提示肝脏转移性恶性肿瘤可能;胃部包块考虑良性.手术切除胃部包块并行术中冰冻病理检查提示梭形细胞肿瘤;完整切除肝脏包块术后石蜡病理检查结果提示NENs(G2),患者术后恢复佳.结论本文报道了一例HNENs,考虑转移性.术前诊断不能排除肝脏转移性恶性肿瘤可能.通过对患者病情的详细分析,最终行手术切除治疗并行病理检查确诊.同时我们对HNENs相关文献进行了分析,进一步了解原发和转移性HNENs的临床特征、治疗方案以及预后,以期对此类疾病有更深入的了解,对临床治疗方案决策做证据支撑作用.

Clinical Analysis of 137 Cases of Fungal Keratitis

Objective: To analyze the epidemiology, clinical diagnosis and treatment of fungal keratitis (FK) in hospitalized patients at the First Affiliated Hospital of Yangtze University in recent years. Methods: A retrospective investigation was conducted on the data of 137 cases of FK in our hospital from January 2019 to December 2022. The epidemiological characteristics, identification results of fungal strains, clinical treatment, and prognosis of the patients were analyzed. Results: Among the 137 FK patients, 89 were males and 48 were females, and the ratio of male to female was 1.85:1, The age of onset was the largest number of patients in 50-59 years old and 60-69 years old. The disease occurred most in autumn, winter and summer farming season (from September to December, January, May, June). 72 cases (52.6%) had a clear history of corneal injury, and 43 cases (31.4%) had a history of plant injury. Other risk factors include eye surface diseases, ophthalmic surgery, and wearing corneal contact lenses. The top three pathogens were fusarium (38.7%), aspergillus (23.3%), and alternaria (17.5%). 101 eyes showed improvement or cure after treatment with medication, 9 eyes underwent corneal stromal injection, 11 eyes were covered with conjunctival flap covering or amniotic membrane transplantation, 12 eyes were covered with corneal transplantation, and enucleation of ocular contents was performed in 4 eyes;Visual acuity was improved or maintained in 123 patients (about 89.8%). Conclusions: The incidence of FK in our hospital was mostly middle-aged and elderly men, mostly caused by corneal injury in the process of agricultural labor. The pathogens were mainly fusarium and aspergillus. The preferred treatment was medication, with severe cases requiring combined surgical treatment. Most patients can maintain or improve their vision after treatment.

糖尿病视网膜病变及糖尿病性黄斑水肿患者血清中CTRP9的表达

目的:探讨C1q/肿瘤坏死因子相关蛋白9(CTRP9)在不同分期糖尿病视网膜病变(DR)及糖尿病性黄斑水肿(DME)患者血清中的表达水平。方法:选取2021-04/2022-04甘肃省人民医院收治的2型糖尿病患者135例作为试验组,根据免散瞳眼底照相结果分为无DR(NDR)组(n=45)、非增殖型DR(NPDR)组(n=45)、增殖型DR(PDR)组(n=45);根据光学相干断层扫描结果将DR患者分为DME组(n=51)、非DME组(n=39);另选取与试验组年龄、性别相匹配的健康体检者45例作为正常对照组。记录并比较各组受试者的临床资料及生化指标检测结果,分析血清CTRP9水平与其他生化指标的相关性,探讨影响DR及DME发生的危险因素。结果:正常对照组、NDR组、NPDR组、PDR组受试者血清CTRP9水平有明显差异(P<0.001),且正常对照组>NDR组>NPDR组>PDR组;DME组与非DME组患者血清CTRP9水平有明显差异(P<0.001),且非DME组>DME组。Spearman秩相关性分析显示,DR患者血清CTRP9水平与糖尿病病程病程呈负相关(r_(s)=-0.251,P<0.05);DME患者血清CTRP9水平与空腹血糖(FBG)(r_(s)=-0.370,P<0.05)、糖化血红蛋白(HbA1c)(r_(s)=-0.421,P<0.05)呈负相关。Logistic多因素回归分析显示,糖尿病病程(OR=1.194,95%CI:1.068~1.335,P=0.002)、血清CTRP9水平(OR=0.936,95%CI:0.907~0.966,P<0.001)是影响DR发生的危险因素;血清CTRP9水平是影响DME发生的危险因素(OR=0.838,95%CI:0.778~0.903,P<0.001)。结论:血清CTRP9水平降低是DR及DME发生的危险因素,可能对二者的风险评估有重要意义。

睫状体平坦部滤过术与小梁切除术治疗新生血管性青光眼的比较

目的:比较睫状体平坦部滤过术(PPF)和小梁切除术(TRA)治疗新生血管性青光眼(NVG)的安全性和有效性。方法:回顾性分析2020-04/2021-04在我院治疗的NVG患者27例27眼,将行睫状体平坦部滤过术的患者12例12眼纳入PPF组,行小梁切除手术的患者15例15眼纳入TRA组。随访至术后3mo,观察患者的眼压、手术完全成功率、周边前房深度、术后前房形态改变、视力及并发症情况。结果:术后1、3d,1wk,1、3mo两组患者眼压均较术前显著降低(P<0.05),但两组间眼压无差异(P>0.05)。术后3mo,PPF组手术完全成功率显著高于TRA组(92%vs 53%,P<0.05)。术后1wk,PPF组周边前房深度较术前显著加深(P<0.05),TRA组周边前房深度较术前无显著改变(P>0.05),但PPF组周边前房深度较TRA组显著加深(P<0.05)。PPF组术后房角开放、前房加深。两组患者术前和术后3mo视力均无差异(P>0.05),且两组术后3mo视力较术前均无显著改变(P>0.05)。PPF组术后前房出血发生率低于TRA组(8%vs 47%,P<0.05)。结论:PPF和TRA手术均能有效降低和稳定NVG患者的眼压,但PPF术显示更高的手术完全成功率,并能加深周边前房,术后严重并发症较少。

面向群体智能塑造未来教育:一项重要研究课题

群体智能指群体在完成一系列不同任务时表现出的综合能力,是面向未来复杂情境中跨学科、综合型任务解决过程必不可少的关键要素。教育现代化进程中的群体智能教育是面向未来培养公民信息素养、合作能力、问题解决能力的重要载体和实现目标。文章基于当前研究领域中对群体智能基本概念的辨析和探索,从国际视野出发,剖析基于不同的技术手段对群体智能教育的探索和实践,提出教育信息化时代中国教育领域中进一步强化群体智能教育、推动"五育并举"、促进培养复合型人才的可行路径。

区域治理的差序协同实践——基于珠三角大气污染联防联控的案例研究

中国已在国家战略层面确立了区域发展的整体格局,当前亟待对已有的成功实践进行分析。珠江三角洲(以下简称“珠三角”)大气污染联防联控的案例展现了中国区域治理的差序协同实践,即整体性合作和分散式协调的区域协同治理模式。其中,成员之间呈现出圈层嵌套式的差等网络结构,成员个体遵循多层抱团式的级序行动逻辑。这种实践模式的形成依托于上级政府底线分包的纵向介入机制,以及下级政府抱团提标的横向协商机制,并且这种模式有效地组合了利益和信任两种内在驱动。该研究表明,区域发展战略的深化推进不仅需要考虑区域整体合作,也需要重视以“都市圈”为形式的局部抱团,以“上下联动、久久为功”的思路实现区域协调发展。

教育2122:百年愿景和实施路径——未来智能教育国际论坛综述

随着人工智能等数字技术的飞速发展和广泛应用,教育数字化转型已成为教育改革和创新的必由之路和重要手段。因此,深入研究数字技术发展趋势及潜力,探索智能环境下教育教学的新理论、新技术和新模式显得尤为迫切。2022年3月,英国剑桥大学未来数字教育中心与北京师范大学未来教育学院联合举办了“教育2122:百年愿景和实施路径——未来智能教育国际论坛”。此次论坛针对国际教育数字化发展趋势和未来教育教学创新展开前沿讨论,议题包括探索未来智能教育的无限可能、展望互联时代教育新生态和思考未来教育改革和创新的着力点,以及研究如何赋能学习者和教师更好地掌握和使用数字技术等。文章围绕论坛四位特邀专家的主题报告,从课程设计(以学习者为中心的跨学科课程改革)、教育理念(可持续发展的未来教育理念)、学习环境(搭建无边界、自由的教育教学空间)和教学评估(人工智能在未来教育评估中的作用)等四个方面探讨未来教育发展的趋势和挑战;通过视频文本分析、报告人的相关学术研究、教学实践资料的收集和整理,探讨2122年智能教育的愿景和实施路径,梳理教育数字化转型所带来的学生与教师、师生与技术以及学校与社会的复杂互动关系。最后,文章建议教育工作者和所有关注教育发展的人士,都应该积极参与智能教育发展,以更具包容性的态度、更具建构性的对话方式,参与到对未来教育的思考和设计中。

The recurrence and survival of oral squamous cell carcinoma: a report of 275 cases

Oral squamous cell carcinoma(OSCC) is a common malignant tumor of the head and neck, and recurrence is an important prognostic factor in patients with OSCC. We explored the factors associated with recurrence of OSCC and analyzed the survival of patients after recurrence. Clinicopathologic and follow-up data of 275 patients with OSCC treated by surgery in the Cancer Institute and Hospital of Tianjin Medical University between 2002 and 2006 were analyzed. Recurrence factors were analyzed with Chisquare or Fisher′s exact test and multivariate analysis. The prognosis of patients after recurrence was analyzed with the Kaplan-Meier method and log-rank test. The recurrence rate was 32.7%. The recurrence time ranged from 2 to 96 months, with a median of 14 months. Univariate analysis showed that T stage, degree of differentiation, pN stage, flap application, resection margin, and lymphovascular invasion were factors of recurrence (P<0.05). Multivariate analysis showed that T stage, degree of differentiation, and pN stage were independent factors of recurrence (P<0.001). The differences in gender, age, tumor site, region of lymph node metastasis, and perineural invasion between the recurrence and non-recurrence groups were not significant (P>0.05). Kaplan-Meier and log-rank tests showed that the 2- and 5-year survival rates were significantly lower in the recurrence group than in non-recurrence group(67.6% vs. 88.0%, 31.8% vs. 79.9%, P<0.001). Therefore, to improve prognosis, we recommend extended local excision, flap, radical neck dissection, and adjuvant chemoradiotherapy for patients more likely to undergo recurrence.