Ibrutinib and atrial fibrillation:An in-depth review of clinical implications and management strategies

Ibrutinib,a targeted therapy for B-cell malignancies,has shown remarkable efficacy in treating various hematologic cancers.However,its clinical use has raised concerns regarding cardiovascular complications,notably atrial fibrillation(AF).This comprehensive review critically evaluates the association between ibrutinib and AF by examining incidence,risk factors,mechanistic links,and management strategies.Through an extensive analysis of original research articles,this review elucidates the complex interplay between ibrutinib’s therapeutic benefits and cardiovascular risks.Moreover,it highlights the need for personalized treatment approaches,vigilant monitoring,and interdisciplinary collaboration to optimize patient outcomes and safety in the context of ibrutinib therapy.The review provides a valuable resource for healthcare professionals aiming to navigate the intricacies of ibrutinib’s therapeutic landscape while prioritizing patient well-being.

The Improving Effects of Diabetes Education on Diabetes Awareness and Management in Children and Adolescents with T1DM

Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’s belief in their ability to succeed, encourages following medical advice, and adds to the general enhancement of health. Objective: This study is to investigate the effectiveness of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively manage the condition. Furthermore, it strives to improve nursing care for families whose children have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Design: This research study investigates the efficacy of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively handle the condition. Materials and Methods: A systematic search was conducted between the years 2000 and 2022, utilizing the Medline and Google Scholar databases. The purpose of the search was to uncover relevant papers pertaining to diabetes education, management of Type 1 Diabetes Mellitus (T1DM), nurse care, and empowerment. The search focused on peer-reviewed research, clinical trials, and scholarly articles that evaluated the efficacy of diabetes education in empowering individuals and families. Results: Diabetes education is crucial for understanding and controlling T1DM. It includes personalized sessions, webinars, group classes, and clinics that provide customized therapies. Comprehensive education enhances glycemic control and family dynamics. Nevertheless, the implementation of diabetes education for families requires specific standards, especially in the field of nursing. Conclusion: Diabetes education is essential for effectively managing Type 1 Diabetes Mellitus (T1DM), providing patients and families with crucial knowledge, resources, and confidence. It encourages independence in-home care and provides explicit guidelines for diabetic nurses to improve nursing care.

粗穗披碱草1H^(t)S染色体特异荧光原位杂交标记开发

小麦-粗穗披碱草1H^(t)S.1BL罗伯逊易位系高抗小麦条锈病和叶锈病,是小麦遗传改良的优异基因源。我们前期利用中国春ph1b基因突变体对该易位系进行诱导,获得了一批诱导后代材料,为了从中准确鉴定小麦-粗穗披碱草1H^(t)S小片段易位系,需要建立能够覆盖粗穗披碱草1H^(t)S染色体的荧光原位杂交(FISH)标记。本研究利用21个小麦及其近缘种探针、61个基于中国春基因组序列新开发的小麦1BS染色体探针以及40个根据简单三碱基重复序列新开发的探针对小麦-粗穗披碱草1H^(t)S.1BL易位系进行非变性FISH分析。结果显示,B74、B76和B77等36个探针(33个为新开发的)在1H^(t)S染色体上具有杂交信号,并且杂交信号可分为仅在染色体末端、仅在着丝粒处、同时在着丝粒处和近着丝粒处、覆盖1H^(t)S约3/4染色体臂、覆盖绝大部分1H^(t)S共五种类型。因此,部分探针单独使用或多个探针联合使用,其信号能覆盖1H^(t)S染色体,能够满足小麦-粗穗披碱草1H^(t)S小片段易位系鉴定,这可为小麦背景中粗穗披碱草染色质追踪提供新的检测手段。

Introduction of PIC/S Accession Procedure and Suggestions for Establishing a Unified Quality Management System in China

Objective To introduce the accession procedure and evaluation of PIC/S,and help relevant departments in China to understand the requirements of PIC/S in detail,and to promote the process of China’s entry into PIC/S.Methods The procedures and steps of joining PIC/S,the evaluation process of PIC/S,and the experience of several countries in joining PIC/S were introduced and analyzed,which could help the relevant personnel in China understand the specific contents.Results and Conclusion According to the requirements of PIC/S,it is necessary to establish a unified GMP quality management system.

基于量子衍生涡流算法和T⁃S模糊推理模型的储层岩性识别

鉴于梯度下降法易陷入局部极值、普通群智能优化算法易早熟收敛,提出一种基于量子衍生涡流算法(Quantum Vortex Search Algorithm,QVSA)和T⁃S模糊推理模型的岩性识别方法,QVSA具有操作简单、收敛速度快、寻优能力强等优点,有助于T⁃S模糊推理模型获得最优参数配置,从而实现储层岩性的准确识别。首先利用具有全局搜索能力的QVSA优化T⁃S模糊推理模型的各种参数;然后利用主成分分析方法降低获取的地震属性维度;再利用优化的T⁃S模糊推理模型识别储层岩性。实验结果表明,利用反映储层特征的8个地震属性识别储层岩性时,所提方法的识别正确率达到92%,比普通BP网络方法高5.1%,同时查准率、查全率、F1分数等指标也较BP网络方法提升明显。

Expert Consensus on Clinical Management of T2DM Combined with Obesity Reversal Treatment in China(2023 Edition)

With lifestyle changes,the incidence of type 2 diabetes(T2DM)and obesity has significantly increased,becoming major chronic diseases that seriously threaten the health of China’s residents.Both domestic and international guidelines and consensus exist regarding the diagnosis and management of this disease.In recent years,T2DM treatment has focused more on new tactics that lean towards a patient-centered comprehensive management approach,replacing the traditional glucose-centered approach.Additionally,an increasing amount of evidence in medicine suggests that the reversal of diabetes is possible.However,there is currently no expert consensus on the clinical management of T2DM combined with obesity reversal treatment.Therefore,experts and scholars in China with extensive experience in T2DM combined with obesity reversal treatment have been invited to develop this consensus.The content includes early identification and diagnosis of T2DM combined with obesity,definition and mechanisms of diabetes reversal,disease assessment and grading,staging of diabetes and goals of reversal,the 2+N reversal strategy,inpatient system treatment combined with comprehensive outpatient management(including weight control,precise nutrition,scientific exercise,glucose-lowering medication,psychological intervention,rehabilitation therapy,and remote follow-up through online platforms),and evaluation of post-reversal efficacy.The aim is to further improve the level of T2DM combined with obesity reversal diagnosis,treatment,and management in China,and to implement the Healthy China strategy.

扩展目标跟踪Student’s t逆Wishart平滑算法

脉冲干扰和离群量测信息等因素通常会导致异常的厚尾噪声,这使得以高斯假设为前提的扩展目标跟踪(ETT)估计器的性能急剧降低,针对该问题该文提出一种基于扩展目标随机矩阵模型(RMM)的Student’s t逆Wishart平滑(StIWS)算法。首先,将目标的运动状态以及过程噪声和量测噪声建模为Student’s t分布以表征异常噪声对扩展目标概率分布的影响,将目标扩展状态建模为服从逆Wishart分布的随机矩阵。然后,在Student’s t贝叶斯平滑框架下,详细推导了能在扩展目标的多重特征动态演变的过程中有效估计目标状态的StIWS算法。最后,通过扩展目标跟踪的仿真实验结果和真实场景实验结果验证了所提算法的有效性。

车辆主动悬架自适应变论域T-S模糊控制研究

针对传统变论域模糊控制存在过度依赖专家经验、伸缩因子参数不能自适应调整的问题,提出一种车辆主动悬架自适应变论域T-S模糊控制策略,从而提高车辆的行驶平顺性。结合神经网络和T-S模糊推理建立基于自适应神经模糊推理的一阶T-S模糊控制器,利用神经网络的自学习特性产生完善的模糊规则,进而在传统函数型伸缩因子的基础上,将系统误差和误差变化率作为动态参数引入伸缩因子中,实现伸缩因子参数的自适应调整,解决了传统函数型伸缩因子因参数确定难度大导致控制效果差的问题。通过随机工况下的仿真分析和基于相似理论的缩尺实验,对所提出算法的有效性和工况自适应性进行了验证。结果表明,所提出的自适应变论域T-S模糊控制策略具有较强的工况适应性,在不同车速、路面激励下均可有效提高车辆的平顺性并保证轮胎接地安全性。

帕金森病患者免疫球蛋白、Th9亚群水平变化及其与IGF-1、S-100B蛋白的相关性

目的:研究帕金森病(PD)患者免疫球蛋白(IgG、IgA和IgM)、辅助性T细胞亚群Th9水平变化及其与胰岛素生长因子-1(IGF-1)、S-100B蛋白的相关性。方法:选取2020年12月至2022年12月期间在河北省中医院确诊的108例PD患者,将其作为研究组,并根据患者病变程度分为轻度组(35例)、中度组(44例)和重度组(29例);另选108例健康成人作为对照组。对比研究组和对照组免疫球蛋白和Th9亚群水平,以及轻度组、中度组及重度组免疫球蛋白、Th9亚群、IGF-1和S-100B蛋白水平,采用Pearson相关性分析免疫球蛋白、Th9亚群和IGF-1、S-100B蛋白的相关性。采用Spearman相关性分析PD患者疾病程度和所有差异指标间的相关性。结果:研究组IgM水平较对照组低,且重度组低于中度组,中度组低于轻度组(P<0.05);研究组IgG、IgA、IL-9和Th9亚群水平较对照组高,且重度组高于中度组,中度组高于轻度组(P<0.05)。重度组IGF-1水平低于中度组,中度组低于轻度组;重度组S-100B蛋白水平高于中度组,中度组高于轻度组(P<0.05)。Pearson相关性分析结果显示,PD患者IgM水平与IGF-1水平呈正相关,与S-100B蛋白水平呈负相关;IgG、IgA、IL-9和Th9亚群水平均与IGF-1水平呈负相关,与S-100B蛋白水平呈正相关(P<0.05)。Spearman相关性分析结果显示,PD患者疾病程度与IgM、IGF-1水平呈负相关,与S-100B蛋白、IgG、IgA、IL-9和Th9亚群水平呈正相关(P<0.05)。结论:PD患者IgM水平降低,IgG、IgA、Th9亚群水平升高,且其水平变化与IGF-1、S-100B明显相关,可以用于评估病情的严重程度。

基于T-S模糊故障树的驱动电机冷却系统可靠性分析

车用驱动电机液压冷却系统存在故障机理不确定等问题。本文应用模糊数描述其故障概率和故障程度,建立驱动电机冷却系统的T-S模糊故障树模型,计算系统模糊可能性,分析各部件的概率重要度和关键重要度,找出影响系统可靠性的关键部件。

S-T-S混合式循环互助教学模式用于少学时“化工原理”课程

“化工原理”课程是化工及相关专业的专业基础课程,相关专业的学时少,课程难,需重点解决的问题是“三多”“三不愿”“三不明”。针对痛点问题,提出了线上线下混合式循环互助的创新设计思路,包括:教师帮助学生自制课前、课中、课后习题,学生帮助教师反馈真实学习情况,学生帮助学生组团互助学习。问卷调查和评教结果显示,在一定程度上解决了“三多”“三不愿”的问题;通过建立“助教团队”反馈不同层次学生的学习情况,较好地解决了“三不明”的问题。学生的成绩与教改前相比有明显提高。

混合差分和多种群粒子群算法的T-S模糊模型辨识

为提高T-S模型的辨识精度,针对基本粒子群优化(particle swarm optimization,PSO)算法T-S模型全局优化辨识问题,提出混合差分和多种群粒子群算法的T-S模糊模型辨识方法,将T-S模型前件参数和后件参数整体编码进行全局优化辨识.为避免基本粒子群的早熟收敛和后期收敛速度慢的缺陷对T-S模型辨识精度和速度的影响,算法将种群分为若干个子群,每个子群根据粒子适应度值自适应调整惯性权重,平衡了算法的开发和探索能力,对子群最优粒子,进行差分操作以增强算法的全局搜索能力,采用全局最优粒子替代随机子群的最优粒子以加强子群间的信息交流,维持粒子多样性.典型非线性系统和混沌系统的仿真结果表明,采用混合差分和多种群粒子群算法辨识的T-S模型具有更高的辨识精度.

整体性视域下雷蒙·威廉斯的T.S.艾略特戏剧评论

威廉斯的T.S.艾略特戏剧批评是西方马克思主义戏剧批评史上的经典案例之一。他从整体形式与整体行动的角度切入,前者考察T.S.艾略特文本中的诸要素是否进行了整体把握,是否为经验交流提供了惯例;后者讨论究竟如何理解T.S.艾略特的戏剧,认为它的核心不是个体的死亡,而是集体对现状的默认与妥协。两种批评的角度虽然存在明显的差异,但共同之处是反复强调整体性。威廉斯的整体性批评视域的形成除了根植于深厚的马克思主义批评传统之外,还受到了T.S.艾略特的伊丽莎白时期戏剧批评、F.R.利维斯的小说与诗歌批评的直接影响。整体性批评视域及其文本实践隐含着激进的政治立场。

Correlative factors of poor prognosis and abnormal cellular immune function in patients with Alzheimer’s disease

BACKGROUND Alzheimer’s disease(AD)is a serious disease causing human dementia and social problems.The quality of life and prognosis of AD patients have attracted much attention.The role of chronic immune inflammation in the pathogenesis of AD is becoming more and more important.AIM To study the relationship among cognitive dysfunction,abnormal cellular immune function,neuroimaging results and poor prognostic factors in patients.METHODS A retrospective analysis of 62 hospitalized patients clinical diagnosed with AD who were admitted to our hospital from November 2015 to November 2020.Collect cognitive dysfunction performance characteristics,laboratory test data and neuroimaging data from medical records within 24 h of admission,including Mini Mental State Examination Scale score,drawing clock test,blood T lymphocyte subsets,and neutrophils and lymphocyte ratio(NLR),disturbance of consciousness,extrapyramidal symptoms,electroencephalogram(EEG)and head nucleus magnetic spectroscopy(MRS)and other data.Multivariate logistic regression analysis was used to determine independent prog-nostic factors.the modified Rankin scale(mRS)was used to determine whether the prognosis was good.The correlation between drug treatment and prognostic mRS score was tested by the rank sum test.RESULTS Univariate analysis showed that abnormal cellular immune function,extrapyramidal symptoms,obvious disturbance of consciousness,abnormal EEG,increased NLR,abnormal MRS,and complicated pneumonia were related to the poor prognosis of AD patients.Multivariate logistic regression analysis showed that the decrease in the proportion of T lym-phocytes in the blood after abnormal cellular immune function(odd ratio:2.078,95%confidence interval:1.156-3.986,P<0.05)was an independent risk factor for predicting the poor prognosis of AD.The number of days of donepezil treatment to improve cognitive function was negatively correlated with mRS score(r=0.578,P<0.05).CONCLUSION The decrease in the proportion of T lymphocytes may have predictive value for the poor prognosis of AD.It is recommended that the proportion of T lymphocytes<55%is used as the cut-off threshold for predicting the poor prog-nosis of AD.The early and continuous drug treatment is associated with a good prognosis.

基于T-S模糊逻辑的混合储能孤岛直流微电网功率分配控制

在含混合储能的直流微电网中,传统阻容下垂控制无法解决由线路电阻和负荷功率波动导致的系统功率分配失衡问题。为此,提出一种基于Takagi-Sugeno(T-S)模糊逻辑的自适应阻容下垂控制方法以实现混合储能的分频分配。根据蓄电池和超级电容的物理特性,建立单个蓄电池支路输出电压、蓄电池组间输出功率差额和阻性下垂系数之间的T-S模糊逻辑关系,以及单个超级电容支路输出功率及其变化率、超级电容组间功率差额和容性下垂系数之间的T-S模糊逻辑关系,并由此构建基于T-S模糊逻辑的阻容下垂控制器。推导含混合储能的直流微电网中各部分的平均阻抗模型,并采用阻抗比分析法对微电网的小信号稳定性进行研究。MATLAB/Simulink仿真结果表明,基于T-S模糊逻辑的阻容下垂控制可保证在线路电阻和负荷功率波动情况下系统功率的合理分配。

靶向蛋白S-棕榈酰化修饰在T细胞免疫疗法中的研究进展

S-棕榈酰化是细胞内一种可逆且动态的蛋白质翻译后修饰,参与调控下游靶基因转录、表达以及信号转导,进而影响细胞生命活动。研究发现数千种人类蛋白质经历S-棕榈酰化修饰,表明S-棕榈酰化与疾病发生发展以及治疗之间存在很大程度的关联性。T细胞是机体抗肿瘤免疫的主力军,多种T细胞免疫相关蛋白受S-棕榈酰化调节。本文围绕S-棕榈酰化对T细胞信号转导的影响及在T细胞免疫疗法中的应用展开论述,为T细胞免疫治疗新靶点及多肽抑制剂的开发提供新思路。

Milk fat globule membrane supplementation protects againstβ-lactoglobul-ininduced food allergy in mice via upregulation of regulatory T cells and enhancement of intestinal barrier in a microbiota-derived short-chain fatty acids manner

Milk fat globule membrane(MFGM),which contains abundant glycoproteins and phospholipids,exerts beneficial effects on intestinal health and immunomodulation.The aim of this study was to evaluate the protective effects and possible underlying mechanisms of MFGM on cow’s milk allergy(CMA)in aβ-lactoglobulin(BLG)-induced allergic mice model.MFGM was supplemented to allergic mice induced by BLG at a dose of 400 mg/kg body weight.Results demonstrated that MFGM alleviated food allergy symptoms,decreased serum levels of lipopolysaccharide,pro-inflammatory cytokines,immunoglobulin(Ig)E,Ig G1,and Th2 cytokines including interleukin(IL)-4,while increased serum levels of Th1 cytokines including interferon-γand regulatory T cells(Tregs)cytokines including IL-10 and transforming growth factor-β.MFGM modulated gut microbiota and enhanced intestinal barrier of BLG-allergic mice,as evidenced by decreased relative abundance of Desulfobacterota,Rikenellaceae,Lachnospiraceae,and Desulfovibrionaceae,while increased relative abundance of Bacteroidetes,Lactobacillaceae and Muribaculaceae,and enhanced expressions of tight junction proteins including Occludin,Claudin-1 and zonula occludens-1.Furthermore,MFGM increased fecal short-chain fatty acids(SCFAs)levels,which elevated G protein-coupled receptor(GPR)43 and GPR109A expressions.The increased expressions of GPR43 and GPR109A induced CD103+dendritic cells accumulation and promoted Tregs differentiation in mesenteric lymph node to a certain extent.In summary,MFGM alleviated CMA in a BLG-induced allergic mice model through enhancing intestinal barrier and promoting Tregs differentiation,which may be correlated with SCFAs-mediated activation of GPRs.These findings suggest that MFGM may be useful as a promising functional ingredient against CMA.

咳喘停袋泡颗粒抑制IL-33/ILC2s和致病性T细胞干预过敏性气道炎症的作用机制

目的研究咳喘停袋泡颗粒(Kechuanting,KCT)抑制IL-33/ILC2s和致病性T细胞干预过敏性气道炎症的作用机制。方法网络药理学分析KCT干预哮喘的潜在靶点和机制。以OVA诱导过敏性哮喘模型小鼠。组织病理染色观察肺损伤变化;ELISA和荧光定量PCR分别检测Th2型哮喘中关键炎症因子及其mRNA表达水平;Western blot检测MAPK通路中相关蛋白磷酸化水平;流式细胞术检测ILC2s、Th1、Th17、Th2和Treg细胞的比例。结果网络药理学鉴定出KCT治疗哮喘的227个主要活性成分和143个共同靶点,主要富集到MAPK和IL-17等信号通路。进一步验证实验显示,KCT干预明显减轻了哮喘小鼠肺部炎症损伤程度,减少B细胞数量及IL-4、TNF-α、TGF-β的产生,下调肺组织中JNK磷酸化水平以及Il-33、Bcl11b、Rorα、Tcf-7、Jun、MAPK3、MAPK14 mRNA表达。KCT干预减少了哮喘小鼠肺和脾中ILC2s和Th17数量,抑制肺中Th2细胞浸润。结论KCT对过敏性哮喘气道炎症有较好的治疗作用,其机制与抑制IL-33/ILC2s通路、致病性T细胞亚群和JNK-MAPK信号通路相关。

基于T-S MPC的车辆自适应巡航控制策略研究

针对于汽车自适应巡航系统面对复杂工况时自适应性不强的问题,提出了一种基于T-S模糊变权重模型预测控制(Takagi-Sugeno fuzzy model predictive control,T-S MPC)的自适应巡航分层控制策略。首先上层控制器基于安全距离模型将自适应巡航系统划分为定速巡航模式、多目标优化控制的跟随模式和紧急制动模式;下层控制器基于车辆逆动力学模型,将上层控制器输出的期望加速度转变为节气门开度或制动压力;其次考虑到权重系数对控制精度的影响,建立基于T-S模糊控制的变权重模型预测控制器;最后搭建Carsim Simulink联合仿真平台,验证控制策略的准确性、适应性和跟踪响应速度。结果表明,在定速巡航工况时,T-S MPC控制方法跟踪响应时间为1.54 s,较PID和传统MPC控制跟踪响应快;在跟随和混合工况时,T-S MPC控制方法均方根误差为分别为0.3073、2.775,均低于PID、PID+LQR和传统MPC控制的均方根误差、并且自适应性好,有效提高了跟车性能与安全性。

基于TS-DBN的地铁牵引系统可靠性分析

论文提出一种结合连续时间T-S动态故障树和贝叶斯网络(TS-DBN)的可靠性评估方法来模拟实际运营过程中牵引系统的动静态失效行为。首先,构建基于牵引系统单元结构的故障树模型;然后,通过应用T-S动态门的时序规则,给出T-S门的逻辑定义,进而计算子节点后验概率及重要度参数;将敏感节点进行排序,建立系统连续时间状态下的稳定度函数数学模型。该方法能够直观地反映牵引系统结构单元的敏感薄弱环节,可以为后续维修策略优化提供理论参考。