纪检内审视角下构建高校附属医院协同监督体系实践探索

高校附属医院不仅具有医疗服务职能,还承担人才培养、科学研究、社会责任等多重任务,目前医疗体制改革深入开展进行中,随着人民群众日益增长的健康需求,提升管理水平,完善监督体系是公立医院回归公益性的必然要求,本文以笔者所在医院为例,从内审角度出发,通过分析高校附属医院目前形式、监督主体、监督方式等有益举措及有待完善地方之处,提出针对性工作建议。

H^(p,q,s)(D)上的复合算子

设φ是复平面C中单位圆盘D上的解析自映射.该文刻画了一般Hardy型空间H^(p,q,s)(D)上使得复合算子Cφ有界或者紧时的符号函数φ.

The Tianlin Mission:A 6m UV/Opt/IR Space Telescope to Explore Habitable Worlds and the Universe

It is expected that ongoing and future space-borne planet survey missions including Transiting Exoplanet Survey Satellite(TESS),PLATO and Earth 2.0 will detect thousands of small to medium-sized planets via the transit technique,including over a hundred habitable terrestrial rocky planets.To conduct a detailed study of these terrestrial planets,particularly the cool ones with wide orbits,the exoplanet community has proposed various follow-up missions.The currently proposed European Space Agency mission Ariel is the first step for this purpose,and it is capable of characterization of planets down to warm super-Earths mainly using transmission spectroscopy.The NASA Large Ultraviolet/Optical/Infrared Surveyor mission proposed in the Astro2020 Decadal Survey white paper will endeavor to further identify habitable rocky planets,and is expected to launch around 2045.In the meanwhile,China is funding a concept study of a 6 m class space telescope named Tianlin(a UV/Opt/NIR large aperture space telescope)that aims to start its operation within the next 10–15 yr and last for 5+yr.Tianlin will be primarily aimed at the discovery and characterization of rocky planets in the habitable zones around nearby stars and to search for potential biosignatures mainly using the direct imaging method.Transmission and emission spectroscopy at moderate to high resolution will be carried out as well on a population of exoplanets to strengthen the understanding of the formation and evolution of exoplanets.It will also be utilized to perform in-depth studies of the cosmic web and early galaxies,and constrain the nature of dark matter and dark energy.We describe briefly the primary scientific motivations and main technical considerations based on our preliminary simulation results.We find that a monolithic off-axis space telescope with primary mirror diameter larger than 6 m equipped with a high contrast coronagraph can identify water in the atmosphere of a habitable-zone Earth-like planet around a Sunlike star.More simulations for the detectability of other key biosignatures including O_(3),O_(2),CH_(4)and chlorophyll are coming.

Assessment of Nutrient Leaching Losses and Crop Uptake with Organic Fertilization,Water Saving Practices and Reduced Inorganic Fertilizer

The increasing world population has forced excessive chemical fertilizer and irrigation to complete the global food demand,deteriorating the water quality and nutrient losses.Short-term studies do not compile the evidences;therefore,the study aimed to identify the effectiveness of reduced doses of inorganic fertilizer and water-saving practices,hence,a six-year experiment(2015-2020)was conducted in China to address the knowledge gap.The experimental treatments were:farmer accustomed fertilization used as control(525:180:30 kg NPK ha^(-1)),fertilizer decrement(450:150:15 kg NPK ha^(-1)),fertilizer decrement+water-saving irrigation(450:150:15 kg NPK ha^(-1)),application of organic and inorganic fertilizer+water-saving irrigation(375:120:0 kg NPK ha^(-1)+4.5 tones organic fertilizer ha^(-1)),and application of controlled-release fertilizer(80:120:15 kg NPK ha^(-1)).Each treatment was replicated thrice following a randomized complete block design.The results achieved herein showed that control has the highest losses in the six-year study for total nitrogen(225.97 mg L^(-1)),total soluble nitrogen(121.58 mg L^(-1)),nitrate nitrogen(0.93 mg L^(-1)),total phosphorus(0.57 mg L^(-1)),and total soluble phosphorus(0.57 mg L^(-1))respectively.Reduced fertilizer and water application improved crop nutrient uptake,nitrogen concentration was significantly enhanced with organic and inorganic fertilizer+water-saving irrigation,P concentration was increased with fertilizer decrement+water-saving irrigation,and K concentration was improved with fertilizer decrement+water-saving irrigation.Hence,this study concludes that reduced inorganic fertilizer dose combined with water-saving practices is significantly helpful in reducing nutrient leaching losses and improving nutrient uptake and water pollution.Further studies are needed to explore the impacts of reduced fertilization and water-saving irrigation on leaching losses.The benefits at different climatic conditions,soil types,and fertilizer types with application methods are also a research gap.

Telomere-to-telomere genome assembly of melon(Cucumis melo L.var.inodorus)provides a high-quality reference for meta-QTL analysis of important traits

Melon is an important horticultural crop with extensive diversity in many horticultural groups.To explore its genomic diversity,it is necessary to assemble more high-quality complete genomes from different melon accessions.Meanwhile,a large number of QTLs have been mapped in several studies.Integration of the published QTLs onto a complete genome can provide more accurate information for candidate gene cloning.To address these problems,a telomere-to-telomere(T2T)genome of the elite melon landrace Kuizilikjiz(Cucumis melo L.var.inodorus)was de novo assembled and all the published QTLs were projected onto it in this study.The results showed that a high-quality Kuizilikjiz genome with the size of 379.2 Mb and N50 of 31.7 Mb was de novo assembled using the combination of short reads,PacBio high-fidelity long reads,Hi-C data,and a high-density genetic map.Each chromosome contained the centromere and telomeres at both ends.A large number of structural variations were observed between Kuizilikjiz and the other published genomes.A total of 1294 QTLs published in 67 studies were collected and projected onto the T2T genome.Several clustered,co-localized,and overlapped QTLs were determined.Furthermore,20 stable meta-QTLs were identified,which significantly reduced the mapping intervals of the initial QTLs and greatly facilitated identification of the candidate genes.Collectively,the T2T genome assembly together with the numerous projected QTLs will not only broaden the high-quality genome resources but also provide valuable and abundant QTL information for cloning the genes controlling important traits in melon.

Evaluating the Effects of Sustainable Chemical and Organic Fertilizers with Water Saving Practice on Corn Production and Soil Characteristics

The rapidly growing world population,water shortage,and food security are promising problems for sustainable agriculture.Farmers adopt higher irrigation and fertilizer applications to increase crop production resulting in environmental pollution.This study aimed to identify the long-term effects of intelligent water and fertilizers used in corn yield and soil nutrient status.A series of field experiments were conducted for six years with treatments as:farmer accustomed to fertilization used as control(CON),fertilizer decrement(KF),fertilizer decrement+watersaving irrigation(BMP1);combined application of organic and inorganic fertilizer+water-saving irrigation(BMP2),and combined application of controlled-release fertilizer(BMP3).A significant improvement was observed in soil organic matter(14.9%),nitrate nitrogen(106.7%),total phosphorus(23.9%),available phosphorus(26.2%),straw yield(44.8%),and grain yield(54.7%)with BMP2 treatment as compared to CON.The study concludes that integrating chemical and organic fertilizers with water-saving irrigation(BMP2)is a good approach to increasing corn productivity,ensuring water safety and improving soil health.The limitations of the current study include the identification of fertilizer type and its optimum dose,irrigation water type,and geographical position.

Current Situation, Reasons and Suggestions of Income and Consumption of Rural Residents

Based on the empirical analysis of rural residents’ income and consumption, we are going to discuss the reasons for the weak income growth and lagging consumption of rural residents in China. Finally, we propose relevant suggestions and measures to increase rural residents’ income, promote rural residents’ consumption and develop rural markets.

Investigation on a vertical radial flow adsorber designed by a novel parallel connection method

Due to the increasing global demand for industrial gas, the development of large-scale cryogenic air separation systems has attracted considerable attention in recent years. Increasing the height of the adsorption bed in a vertical radial flow adsorber used in cryogenic air separation systems may efficiently increase the treatment capacity of the air in the adsorber. However, uniformity of the flow distribution of the air inside the adsorber would be deteriorated using the height-increasing method. In order to reduce the non-uniformity of the flow distribution caused by the excessive height of adsorption bed in a vertical radial flow adsorber, a novel parallel connection method is proposed in the present work. The experimental apparatus is designed and constructed; the Computational Fluid Dynamics(CFD) technique is used to develop a CFD-based model, which is used to analyze the flow distribution, the static pressure drop and the radial velocity in the newly designed adsorber. In addition, the geometric parameters of annular flow channels and the adsorption bed thickness of the upper unit in the parallelconnected vertical radial flow adsorber are optimized, so that the upper and lower adsorption units could be penetrated by air simultaneously. Comparisons are made between the height-increasing method and the parallel connection method with the same adsorber height. It is shown that using the parallel connection method could reduce the difference between the maximum and minimum radial static pressure drop by 86.2% and improve the uniformity by 80% compared with those of using the height-increasing method. The optimal thickness ratio of the upper and lower adsorption units is obtained as 0.966, in which case the upper and lower adsorption units could be penetrated by air simultaneously, so that the adsorbents in adsorption space could be used more efficiently.

Phase Ⅱ open-label study of recombinant circularly permuted TRAIL as a single-agent treatment for relapsed or refractory multiple myeloma

Background: Despite the recent development of new therapies, multiple myeloma(MM) remains an incurable disease. Thus, new, efective treatments are urgently needed, particularly for relapsed or refractory MM(RRMM). In an earlier phase I study, a novel form of recombinant human Apo2L/tumor necrosis factor-related apoptosis-inducing ligand(TRAIL) that is currently in clinical development for the treatment of hematologic malignancies, i.e., circularly permuted TRAIL(CPT), was well tolerated at a dose of 2.5 mg/kg per day and showed promising preliminary activity in patients with RRMM. This phase II, open-label, multicenter study further investigated the eicacy and safety of 2.5-mg/kg per day CPT as single-agent therapy for patients with RRMM.Methods: Patients with RRMM were treated once daily with CPT(2.5 mg/kg, intravenously) for 14 consecutive days for each 21-day cycle. Clinical response and toxicity were assessed after each treatment cycle.Results: Twenty-seven patients received CPT. Using the European Group for Blood and Marrow Transplantation criteria, we calculated the overall response rate of 33.3% with 1 near-complete response(n CR) and 8 partial responses(PRs). The clinical beneit rate(48.1%) included 1 nCR, 8 PRs, and 4 minimal responses. The most common treatmentrelated adverse events(TRAEs) were fever, aspartate aminotransferase elevation, alanine aminotransferase elevation, leucopenia, rash, neutropenia, and thrombocytopenia. We graded toxicity using the Common Toxicity Criteria for Adverse Events, version 3.0, and determined that 37.0% of patients had at least 1 grade 3–4 TRAE.Conclusions: CPT as a single agent can elicit a response in patients with RRMM and is well tolerated. Further clinical investigation is warranted.

A Streptococcus suis serotype 2 caused streptococcal toxic shock syndrome(STSS) in a patient

Streptococcus suis （S. suis） is a Gram-positive, facultatively anaerobic coccus that has been implicated as the cause of a wide range of clinical disease syndromes in swine and other domestic animals. S. suis has also been implicated in disease in humans, especially anaong abattoir workers, swine and pork handlers. Here we report a case of streptococcal toxic shock syndrome（STSS） caused by S. suis in a 59-year-old man. Despite of intensive treatment, the patient died of shock with multiple organ failure 14 h after admission. One bacterial isolate obtained from blood culture was identified to the species level by biochemical tests and serological tests as S. suis serotype 2. Identification was confirmed by PCR amplification of genes encoding 16sRNA of S. suis and the capsule of S. suis serotype 2（cps 23）. Genes encoding virulence factors were also detected. An investigation to identify the source of S. suis revealed that several days before admission the affected man had been handling sick pigs or their meat. Transmission may occur through breaks in the skin of feet with tinea due to that no measures for personal protection was taken. This case should highten awareness of the potential for occupational exposure and human infection with S. suis.

全基因组关联研究发现中国人群前列腺癌两个新易感位点9q31.2和19q13.4

0前言在全球范围内，前列腺癌的发病率和病死率存在着巨大差异。该病在西方发达国家发病率最高，在非裔美国人群病死率最高，而在亚洲人群中发病率及病死率均为全球最低，提示不同人种在前列腺癌的遗传方面存在异质性。在欧美和日本人群中，全基因组关联研究（GWAS）技术已经被用于检测前列腺癌的遗传易感性位点，但至今尚无关于GWAS检测中国人群前列腺癌易感位点的报道。

LATS refining ladle slag modifying with CaO-CaF_2

To reduce the slag sticking onto the snorkel of the ladle during the ladle alloying treatment station （LATS） process, CaO- CaF2 （the mass ratio of CaO/CaF2 is 1：1） was employed as the modifier of the LATS refining ladle slag. The effect of CaO-CaF2 on the melting point, viscosity, and desulfurizing capability of the ladle slag was investigated. The melting point of the unmodified ladle slag is 1439℃. When adding 20wt% CaO-CaF2, the melting point is decreased to 1327℃. At 1500℃. the viscosity of the unmodified ladle slag is 6.5 Pa.s, which can be decreased lower than 2 Pa.s by adding more than 10wt% CaO-CaF2. The experimental results of desulfu- rization of the melts show that the desulfurizing power of the ladle slag can be enhanced by adding CaO-CaF2.

Data-independent acquisition mass spectrometry quantitative proteomic analysis reveals that skin aging-related proteins differ between men and women

The skin is the largest organ of the human body,and its aging is visible to the naked eye.The aging rate of men and women is slightly different.This study compared the protein expression of skin samples on the curved forearms of 11 healthy women and 9 healthy men.Quantitative proteomics analysis found that the expression of epidermal proteins in men and women of the same age group was different.Compared with female skin,in male skin,20 proteins were upregulated,and 7 proteins were downregulated.These data suggest that men and women have differences in the speed of skin aging.For the first time in this experiment,a non-invasive mass spectrometer was used to detect 27 different-related epidermal proteins between men and women.Compared with women,among the 20 epidermal proteins upregulated in men,their functions can be classified into antioxidants,epidermal lipid metabolism,signal transduction,membrane transport,and cell biological processes;the 7 downregulated proteins are involved in a variety of biological processes and inflammatory reactions.Our experiments have discovered epidermal proteins related to the differences between men and women,enriching the library of epidermal differential proteins between men and women and enriching the mechanism of skin aging between men and women from the perspective of epidermal differential proteins.

Meta分析:生存素表达评估胰腺癌预后的价值(英文)

Objective: The aim of the study was to conduct a systematic review of the literature evaluating survivin expression in pancreatic carcinoma as a prognostic indicator. Methods: The relevant literatures were searched using PubMed, EMBASE, and Chinese Biomedicine Databases. A meta-analysis of the association between survivin expression and overall survival in patients with pancreatic cancer was performed. Studies were pooled and summary hazard ratios(HRs) were calculated. Subgroup analysis according to the location of survivin expression was also performed. Results: Seven eligible studies with a total of 448 patients were included in this study. Combined HR suggested that survivin expression had an unfavorable impact on survival of pancreatic cancer patients(HR = 1.65, 95% CI: 1.02–2.68). When stratified according to the location of survivin expression, the combined HR showed that expression in the cytoplasm was significantly associated with poor prognosis of pancreatic cancer patients(HR = 2.09, 95% CI: 1.29–3.40). In contrast, survivin expression in the nucleus was not significantly associated with poor prognosis(HR = 0.83, 95% CI: 0.24–2.81), and the heterogeneity was highly significant(I2 = 87.2%, P = 0.005). Conclusion: Survivin expression was associated with a poor prognosis in patients with pancreatic cancer. Cytoplasmic expression of survivin may be a prognostic factor for pancreatic cancer patients. Based on the current obtained data, there was no evidence that survivin expression in the nucleus had a significant impact on patients' overall survival.

Oxidation of NiAl-Ag Alloys at 1000℃ in 0.1 MPa O_(2)

Small amounts of silver have been added to the intermetallic compound NiAl with the purpose of improving its mechanical properties. Four ternary NiAl-Ag alloys containing 0.5, 1, 5 and 10 at. pct Ag, denoted as NiAl-0.SAg,NiAl-1Ag, NiAl-5Ag and NiAl-10Ag, and the Ag-free NiAl have been oxidized at 1000℃ for 24 h in 0.1 MPa O2 to study the effect of the presence of silver on the oxidation behavior of NiAl. All the NiAl-Ag alloys are composed of a matrix of β-NiAl containing a dispersion of isolated particles of a second silver-rich phase. A continuous external layer of Al2O3 formed on all the alloys. In addition, the scales formed on NiAl-5Ag contained a thin and discontinuous layer of pure silver located at the alloy/Al2O3 interface, while those formed on NiAl-10Ag contained isolated particles as well as discontinuous layers of silver at various locations in the scale extending up to the gas/scale interface. The kinetic curves of all the alloys were generally composed of two main parabolic stages with smaller parabolic rate constants for the final stage. The addition of silver does not significantly affect the oxidation behavior of the NiAl intermetallic compound in all cases, as expected because silver is essentially present only as a second phase due to its very small solubility in β-NiAl.

Enantioseparation of Three Non-Steroidal Anti-Inflammatory Agents on Chiral Stationary Phase by HPLC

This paper reported the enantioseparation of Naproxen, Ketoprofen and Etodolac on tartardiamide-DMB chiral stationary phase (CHI-DMB) and (R,R) –DNB-DPEDA chiral stationary phase,using hexane as the mobile phase with various modifiers. The influence of the mobile phase composition including the type and concentration of the modifiers in hexane and the structures of the analytes on the chiral separation was studied. The results indicated that the steric structure of the solute, especially the environment of the chiral carbon, was the predominant factor for the chiral recognition. The type, the steric structure and the concentration of the modifiers also influence the retention factor and the resolution. The chiral recognition mechanism of the analytes on CHI-DMB and (R,R) –DNB-DPEDA was also discussed. The hydrogen-bonding interaction played an important role on enantioseparation on CHI-DMB, so did the π-π interaction. On (R,R) –DNB-DPEDA the π-π interaction was the key for the solutes retention and enantioseparation, while hydrogen-bonding interaction was not important. Additionally, it has been demonstrated that enantioselectivity and retention was also dependent upon the nature and functional groups on the aromatic ring of solutes and CSP.

辛亥保路运动前夜的四川经济近代化浪潮

辛亥革命之前的19世纪下半叶,随着外国资本主义的大规模侵入,四川经济也由原来的工场手工业向近代工业转变,新式企业纷纷出现。与此相应,在四川民族工业资本家及新兴商人中出现改良主义思潮,四川社会结构也发生重大变化,从而为辛亥保路运动的兴起准备了条件。

Correlation between biotin carboxylase subunit expression and lipid accumulation in Aleurites moluccana L.

Candlenut (Aleurites moluccana L.) is a promising energy crop. To understand function of acetyl-CoA carboxylase (ACCase) in candlenut, biotin carboxylase (BC) subunit was cloned by homology cloning and rapid amplification of cDNA ends (RACE). Correlation between BC subunit expression and oil accumulation during candlenut endosperm development was also investigated. Full-length cDNA of BC subunit (called Am-accC) is 1,607 bp, which comprises 1,116 bp ORF encoding 372 amino acids. Am-accC exhibits high sequence identity with its homologues in other oil plants such as tung tree, physic nut, castor, soybean and peanut. At the onset of seed development, Am-accC expression level was low and then gradually increased. Its relative expression was found to be the highest (69.81) in middle stage (July), and then reduced to 36.37 from July to August, and then to 5.06 from August to September. Expression pattern of Am-accC during candlenut seed development was similar to variation of oil accumulation. These results indicated a positivecorrelation between expression of Am-accC and oil accumulation during fruit development in candlenut.

Penetrating Atherosclerotic Ulcer with Elevated Troponin in A Patient with Old Myocardial Infarction: A Case Report

Penetrating atherosclerotic ulcer(PAU),an uncommon etiology of acute aortic syndrome(AAS),is a potential cause of chest pain seen in emergency departments.As PAU may lead to electrocardiogram(ECG)changes or rarely,elevated troponin levels,it is most likely misdiagnosed as acute coronary syndrome(ACS).Hence,individuals with PAU may be offered potentially life-threatening treatment.This paper reports a case of a 81-year-old male who presented with intermittent chest pain with a history of old inferior myocardial infarction and stent placement in the left circumflex coronary artery(LCX)three years ago.Initially,he was diagnosed with non-ST-elevation myocardial infarction(NSTEMI)based on abnormal ECG changes and raised troponin I.However,emergency coronary angiography(CAG)showed no restenosis in the left circumflex coronary artery(LCX)but with mild stenosis in the left anterior descending artery(LAD)and right coronary artery(RCA).Computed tomographic angiography(CIA)of the whole aorta showed multiple atherosclerotic plaques with penetrating atherosclerotic ulcer in the aortic arch and descending aorta.Endovascular aortic repair with Ankura II covered stent was performed.This case study reminds us that it is clinically difficult to distinguish PAU from ACS.Upon excluding ACS from the diagnosis,we should take into consideration of PAU,especially in elderly patients with positive cTnI.

Non-invasive imaging of pathological scars using a portable handheld two-photon microscope

Background:Pathological scars are a disorder that can lead to various cosmetic,psychological,and functional problems,and no effective assessment methods are currently available.Assessment and treatment of pathological scars are based on cutaneous manifestations.A two-photon microscope(TPM)with the potential for real-time non-invasive assessment may help determine the under-surface pathophysiological conditions in vivo.This study used a portable handheld TPM to image epidermal cells and dermal collagen structures in pathological scars and normal skin in vivo to evaluate the effectiveness of treatment in scar patients.Methods:Fifteen patients with pathological scars and three healthy controls were recruited.Imaging was performed using a portable handheld TPM.Five indexes were extracted from two dimensional(2D)and three dimensional(3D)perspectives,including collagen depth,dermo-epidermal junction(DEJ)contour ratio,thickness,orientation,and occupation(proportion of collagen fibers in the field of view)of collagen.Two depth-dependent indexes were computed through the 3D second harmonic generation image and three morphology-related indexes from the 2D images.We assessed index differences between scar and normal skin and changes before and after treatment.Results:Pathological scars and normal skin differed markedly regarding the epidermal morphological structure and the spectral characteristics of collagen fibers.Five indexes were employed to distinguish between normal skin and scar tissue.Statistically significant differences were found in average depth(t=9.917,P<0.001),thickness(t=4.037,P<0.001),occupation(t=2.169,P<0.050),orientation of collagen(t=3.669,P<0.001),and the DEJ contour ratio(t=5.105,P<0.001).Conclusions:Use of portable handheld TPM can distinguish collagen from skin tissues;thus,it is more suitable for scar imaging than reflectance confocal microscopy.Thus,a TPM may be an auxiliary tool for scar treatment selection and assessing treatment efficacy.