特发性肺纤维化患者主要照顾者的负担现状及影响因素分析

目的探讨特发性肺纤维化(IPF)患者主要照顾者的负担现状及影响因素。方法选取2018年5月—2019年5月在上海市同济大学附属肺科医院呼吸科就诊的IPF患者及其照顾者各80例为研究对象,收集照顾者的一般资料。采用照顾者负担量表评价其照顾负担,IPF照顾者照顾知识需求问卷评估其专业知识水平,Pearson线性相关分析照顾负担与照顾知识需求评分的相关性。根据照顾者负担量表评价结果,将照顾者分成轻度负担组、负担加重组(中、重度负担者),并用多因素Logistic回归模型分析照顾负担加重的因素。结果在80例主要照顾者中,照顾负担总分(25.20±11.06)分,照顾知识需求总分(83.80±10.75)分。Pearson相关性分析显示,主要照顾者照顾负担与照顾知识需求评分呈正相关(r=0.733,P<0.05)。经单因素分析显示,家庭月收入、照顾时间、患者自理能力及病程与主要照顾者负担加重有关(P<0.05)。多因素Logistic回归模型分析结果提示,家庭月收入≤2500元[O^R=4.031(95%CI:1.589,10.226)]、照顾时间≥17 h/d[O^R=2.985(95%CI:1.316,6.771)]、患者完全无法自理[O^R=3.979(95%CI:1.682,9.413)]、患者病程>3年[O^R=3.096(95%CI:1.496,6.407)]是主要照顾者负担加重的影响因素(P<0.05)。结论IPF患者主要照顾者均存在不同程度的照顾负担,且照顾负担与照顾知识需求密切相关,其照顾负担加重主要与家庭月收入低、照顾时间长,以及患者自理能力差、病程长有关。

Study on the particle breakage of ballast based on a GPU accelerated discrete element method

Breakage of particles will have greatly influence on mechanical behavior of granular material(GM)under external loads,such as ballast,rockfill and sand.The discrete element method(DEM)is one of the most popular methods for simulating GM as each particle is represented on its own.To study breakage mechanism of particle breakage,a cohesive contact mode is developed based on the GPU accelerated DEM code-Blaze-DEM.A database of the 3D geometry model of rock blocks is established based on the 3D scanning method.And an agglomerate describing the rock block with a series of non-overlapping spherical particles is used to build the DEM numerical model of a railway ballast sample,which is used to the DEM oedometric test to study the particles’breakage characteristics of the sample under external load.Furthermore,to obtain the meso-mechanical parameters used in DEM,a black-analysis method is used based on the laboratory tests of the rock sample.Based on the DEM numerical tests,the particle breakage process and mechanisms of the railway ballast are studied.All results show that the developed code can better used for large scale simulation of the particle breakage analysis of granular material.

Gene expression responses in zebrafish to short-term high-hydrostatic pressure

Hydrostatic pressure is one of the main factors limiting the vertical range of marine organisms.However,little is known about the level of hydrostatic pressure that shallow-water fish can tolerate or how they respond to this potential stress.Here,we applied high-hydrostatic pressure treatment to wild-type AB line zebrafish(Danio rerio)and analyzed transcriptome data following treatment.

Testing the Universality of Free Fall by Comparing the Atoms in Different Hyperfine States with Bragg Diffraction

We perform a precision atom interferometry experiment to test the universality of free fall.Our experiment employs the Bragg atom interferometer with 87Rb atoms either in hyperfine state|F=1,mF=0>or|F=2,mF=0>,and the wave packets in these two states are diffracted by one pair of Bragg beams alternatively,which is helpful for suppressing common-mode systematic errors.We obtain an Eotvos ratioη1-2=(0.9±2.7)×10^-10,and set a new record on the precision with improvement of nearly 5 times.This measurement also provides constraint on the difference of the diagonal terms of the mass-energy operator.

Effects of Ginkgo biloba extract adjuvant therapy on inflammatory reaction, adhesion molecules and antioxidant function in patients with cerebral infarction complicated with hyperhomocysteinemia

Objective: To investigate the effects of Ginkgo biloba extract adjuvant therapy on inflammatory reaction, adhesion molecules and antioxidant function in patients with cerebral infarction complicated with hyperhomocysteinemia. Methods: A total of 114 patients with cerebral infarction complicated with hyperhomocysteinemia who were conformed to the research selection criteria were selected as the research objects, according to the random data table method they were evenly divided into the control group (n=57) and the observation group (n=57), patients in the two groups were given conventional supportive treatment, on this basis, the control group patients were given folic acid tablets and vitamin B12 treatment, the observation group was treated with Ginkgo biloba extract dripping pills on the basis of the treatment of the control group. The levels of inflammatory factors, adhesion molecules and antioxidant and antioxidant function were compared between the two groups before and after treatment (after treatment 30 d). Results: There was no significant difference in the levels of hs-CRP, WBC, ICAM-1, VCAM-1, SOD and MDA between the two groups before and after treatment;After treatment, the levels of hs-CRP, WBC, ICAM-1, VCAM-1 and MDA in the observation group were significantly lower than those in control group, all significantly lower than the levels in the same group before treatment, the difference was statistically significant. After treatment, the level of SOD in the observation group was (100.37±9.45) U/mL, which was significantly higher than that of the control group (85.04±9.49) U/mL, which was significantly higher than that before the treatment, the difference was statistically significant. Conclusion: Ginkgo biloba extract adjuvant treatment of cerebral infarction significantly with high homocysteine hyperlipidemia efficacy can effectively reduce the inflammatory response to stress, reduce the release of adhesion molecules, improve the antioxidant function of oxidation, which has an important clinical value.

Prospects of a comprehensive evaluation system for traditional Chinese medicine services

Traditional Chinese medicine （TCM） is a unique health resource in China and one of the main representative traditional medicines globally. TCM has formed a new way of looking at medical practices, health care, scientific research, education, industry and culture. It focuses on promoting and safeguarding the health of people, with an increasing contribution to economic and social development. Establishing a comprehensive evaluation system in accordance with the characteristics of TCM services could promote the scientific merit and the standardization of services management. This would improve health service quality and the social and economic benefits of TCM. It would broaden the field of TCM services research. It would also provide the basis for the formulation of relevant government policies. This study estimates the prospect of establishing a comprehensive evaluation system of TCM services.

现场测试固废填埋场压实黄土覆盖层的气相渗透系数（英文）

目的：我国西北地区黄土分布广泛，黄土作为当地固废填埋场的覆盖土料具有广泛的应用前景。现场尺度测试压实黄土覆盖层的气相渗透系数，从而可用于评估其填埋气减排性能。方法：1．在西安固废填埋场建立压实黄土覆盖层试验基地（图2）；2．在试验基地的膜内核心测试区域布置通气试验系统，包括空气压缩机、通气管网、气压测试装置、含水率测试装置、温度传感器和静态箱（图3，5～7）；3．在覆盖层表面裸露时和植草后分别进行通气试验测试压实黄土覆盖层的气相渗透系数。结论：1．当饱和度低于85％时，干密度为1．45Mg／m3压实黄土的气相渗透系数随含水率增加而降低，但并不明显；但是当饱和度高于85％时，气相渗透系数随含水率增加而显著减小；2．黄土层和碎石层之间的毛细阻滞作用使得上部黄土层储存更多水分，并显著降低其气相渗透系数，这有利于降低填埋气的排放；3．裸露条件下，当压实黄土的体积含水率从36％增加至46％时，其气相渗透系数从3．67×10-12m2降低至5．73×10-14m2；4．植草后压实黄土的气相渗透系数比裸露条件下小近一个数量级，这主要是因为植被根系占据了压实黄土的大孔隙；5．现场尺度的压实黄土气相渗透系数比室内试验的结果高1至2个数量级，这主要是因为现场所用黄土含有大的结团，结团会增加黄土的孔隙直径以及减小孔隙的曲折度。

尺胫针疗法联合点面对应手技法治疗寰枢关节失稳临床研究

Objective:To observe the clinical therapeutic effect on atlantoaxial instability treated with the combination of ulna-tibia needling therapy and"point-to-surface"tuina manipulation.Methods:A total of 64 outpatients diagnosed as atlantoaxial instability were collected and randomized into a control group and an observation group,32 cases in each one.In the control group,flunarizine hydrochloride capsules were used for oral administration.In the observation group,the combined treatment of ulna-tibia needling therapy and"point-to-surface"tuina manipulation was adopted.The ulnatibia needling therapy was exerted at the cutaneous region of hand taiyang meridian on the ulnar region(from carpal joint to elbow joint)on both sides.The"point-to-surface"tuina manipulation included"onepoint and two-surface"technique,"upper-to-lower pressing"method and"lifting-trembling"method.The treatment was provided once daily,consecutively for 5 times.The scores of neck symptoms and physical signs,atlantoaxial axle separation degree and clinical therapeutic results were taken as the observation indicators to evaluate the treatment effect.Results:After treatment,the curative rate and the total effective rate in the observation group were all higher significantly than the control group(all P<0.01).The scores of clinical symptoms and physical signs were statistically different in the self-comparison of each group before and after treatment(all P<0.05).After treatment,the scores of clinical symptoms and physical signs,the excellence rate of atlantoaxial axle separation and the effective rate in the observation group were all significantly better than those of the control group(all P<0.01).Conclusion:The combination of ulna-tibia needling therapy and"point-to-surface"tuina manipulation achieves the better clinical therapeutic effect as compared with flunarizine hydrochloride.

黄土土柱加热加速蒸发的试验模拟研究（英文）

目的:土质覆盖层下的城市固体废弃物由于生化降解反应具有更高温度,该温度梯度增强了土质覆盖层内的水蒸气扩散,在覆盖层的蒸发模拟中不容忽视。与水蒸气扩散相关的参数一般通过瞬态剖面法测量,但在一定蒸发边界下的土体干燥过程会持续很长时间,因此这种传统测量方法十分耗时。本文旨在提出一个底部加热的新方法加速黄土土柱脱湿,更为高效地获取水蒸气运移相关参数。创新点:1.提出一个全新的底部加热方法用于加速土体脱湿,同时利用提出的数值模型反分析得到水蒸气运移的相关参数挠曲度τ;2.发现底部加热加速脱湿的根本原因在于极大增强的水蒸气扩散。方法:1.研制一套室内黄土土柱试验装置(图3);2.在土柱底部施加恒温70°C,监测黄土的水热响应(图4);3.提出一个数值模型模拟这一水热耦合运移过程,利用该模型反分析影响水蒸气运移的关键参数,包括试验黄土的挠曲度τ和经验蒸发公式的参数a。结论:1.在相同蒸发边界下,相比不加热的情况,底部加热使土柱脱湿加速了最高22天;2.在第15天前,加热增强的水蒸气流量主导黄土蒸发过程,一直占总水分损失量的50%以上;3.试验及数值模拟结果均表明,相比传统方法,本文提出的底部加热法可更为高效地获取水蒸气运移参数。