Pathological mechanism of immune disorders in diabetic kidney disease and intervention strategies

Diabetic kidney disease is one of the most severe chronic microvascular complications of diabetes and a primary cause of end-stage renal disease.Clinical studies have shown that renal inflammation is a key factor determining kidney damage during diabetes.With the development of immunological technology,many studies have shown that diabetic nephropathy is an immune complex disease,and that most patients have immune dysfunction.However,the immune response associated with diabetic nephropathy and autoimmune kidney disease,or caused by ischemia or infection with acute renal injury,is different,and has a complicated pathological mechanism.In this review,we discuss the pathogenesis of diabetic nephropathy in immune disorders and the intervention mechanism,to provide guidance and advice for early intervention and treatment of diabetic nephropathy.

Intervention decision-making in MAV/UAV cooperative engagement based on human factors engineering

Aiming at the intervention decision-making problem in manned/unmanned aerial vehicle（MAV/UAV） cooperative engagement, this paper carries out a research on allocation strategy of emergency discretion based on human factors engineering（HFE）.Firstly, based on the brief review of research status of HFE, it gives structural description to emergency in the process of cooperative engagement and analyzes intervention of commanders. After that,constraint conditions of intervention decision-making of commanders based on HFE（IDMCBHFE） are given, and the mathematical model, which takes the overall efficiency value of handling emergencies as the objective function, is established. Then, through combining K-best and variable neighborhood search（VNS） algorithm, a K-best optimization variable neighborhood search mixed algorithm（KBOVNSMA） is designed to solve the model. Finally,through three groups of simulation experiments, effectiveness and superiority of the proposed algorithm are verified.

Neural mechanism of proposer's decision-making in the ultimatum and dictator games

Previous studies have demonstrated that reactions to unfair offers in the ultimatum game are correlated with negative emotion. However, little is known about the difference in neural activity between a proposer＇s decision-making in the ultimatum game compared with the dictator game. The present functional magnetic resonance imaging study revealed that proposing fair offers in the dictator game elicited greater activation in the right supramarginal gyrus, right medial frontal gyrus and left anterior cingulate cortex compared with proposing fair offers in the ultimatum game in 23 Chinese undergraduate and graduate students from Beijing Normal University in China. However, greater activation was found in the right superior temporal gyrus and left cingulate gyrus for the reverse contrast. ＂The results indicate that proposing fair offers in the dictator game is more strongly associated with cognitive control and conflicting information processing compared with proposing fair offers in the ultimatum game.

Convergence mechanism of mindfulness intervention in treating attention deficit hyperactivity disorder:Clues from current evidence

This paper reviews the underlying evidence for various aspects of the convergence mechanism of mindfulness intervention in attention deficit hyperactivity disorder(ADHD).There may be compatibility among various ADHD remission models and the therapeutic mechanism of mindfulness intervention in ADHD may be mainly via the convergence mechanism.However,neuroimaging-based analysis of the mechanisms of mindfulness intervention in treating ADHD is lacking.Differences in the efficacy of various subtypes of mindfulness intervention,and corresponding specific imaging changes need further investigation.Future research may focus on the neuroimaging features of specific mindfulness intervention subtypes.

The modulation recognition based on decision-making mechanism and neural network integrated classifier

A neural network integrated classifier(NNIC) designed with a new modulation recognition algorithm based on the decision-making tree is proposed in this paper.Firstly,instantaneous parameters are extracted in the time domain by the coordinated rotation digital computer(CORDIC) algorithm based on the extended convergence domain and feature parameters of frequency spectrum and power spectrum are extracted by the time-frequency analysis method.All pattern identification parameters are calculated under the I/Q orthogonal two-channel structure,and constructed into the feature vector set.Next,the classifier is designed according to the modulation pattern and recognition performance of the feature parameter set,the optimum threshold is selected for each feature parameter based on the decision-making mechanism in a single classifier,multi-source information fusion and modulation recognition are realized based on feature parameter judge process in the NNIC.Simulation results show NNIC is competent for all modulation recognitions,8 kinds of digital modulated signals are effectively identified,which shows the recognition rate and anti-interference capability at low SNR are improved greatly,the overall recognition rate can reach 100%when SNR is12dB.

Role of ferroptosis in Parkinson’s disease and intervention mechanism of acupuncture and moxibustion

Parkinson’s disease(PD)is the second neurodegenerative disease in the world.The pathological characteristics of PD are degeneration,loss and death of dopaminergic neurons in the substantia nigra of the midbrain.At present,most scholars believe that the main pathogenesis of PD is α-synuclein aggregation,oxidative stress,mitochondrial dysfunction and neuroinflammatory reaction.More and more studies have demonstrated that ferroptosis plays an important role in the occurrence and development of PD.Ferroptosis is a new type of cell death that is significantly different from traditional apoptosis,scorching and necrosis.Its main feature is iron-dependent lipid peroxidation.Some studies have found that the efficacy of acupuncture and moxibustion in the treatment of PD may be related to the regulation of ferroptosis.Therefore,this study mainly discusses the occurrence and development mechanism of ferroptosis and its role in PD,and the possible mechanism of acupuncture and moxibustion in the treatment of PD dopaminergic neurons,so as to provide theoretical basis for acupuncture and moxibustion in the treatment of PD.

Intervention on toll-like receptors in pancreatic cancer

Pancreatic ductal adenocarcinoma(PDA)is a devastating disease with pronounced morbidity and a high mortality rate.Currently available treatments lack convincing cost-efficiency determinations and are in most cases not associated with relevant success rate.Experimental stimulation of the immune system in murine PDA models has revealed some promising results.Tolllike receptors(TLRs)are pillars of the immune system that have been linked to several forms of malignancy,including lung,breast and colon cancer.In humans,TLRs are expressed in the pancreatic cancer tissue and in several cancer cell lines,whereas they are not expressed in the normal pancreas.In the present review,we explore the current knowledge concerning the role of different TLRs associated to PDA.Even if almost all known TLRs are expressed in the pancreatic cancer microenvironment,there are only five TLRs suggested as possible therapeutic targets.Most data points at TLR2 and TLR9 as effective tumor markers and agonists could potentially be used as e.g.future adjuvant therapies.The elucidation of the role of TLR3 in PDA is only in its initial phase.The inhibition/blockage of TLR4-related pathways has shown some promising effects,but there are still many steps left before TLR4 inhibitors can be considered as possible therapeutic agents.Finally,TLR7 antagonists seem to be potential candidates for therapy.Independent of their potential in immunotherapies,all existing data indicate that TLRs are strongly involved in the pathophysiology and development of PDA.

Recent progress in molecular mechanisms of postoperative recurrence and metastasis of hepatocellular carcinoma

Hepatectomy is currently considered the most effective option for treating patients with early and intermediate hepatocellular carcinoma(HCC).Unfortunately,the postoperative prognosis of patients with HCC remains unsatisfactory,predominantly because of high postoperative metastasis and recurrence rates.Therefore,research on the molecular mechanisms of postoperative HCC metastasis and recurrence will help develop effective intervention measures to prevent or delay HCC metastasis and recurrence and to improve the long-term survival of HCC patients.Herein,we review the latest research progress on the molecular mechanisms underlying postoperative HCC metastasis and recurrence to lay a foundation for improving the understanding of HCC metastasis and recurrence and for developing more precise prevention and intervention strategies.

Fuzzy synthetic evaluation on layoff mechanism for human resource

According to the modern theory of human resource management, the condition of buyout mainly depends on two variables of an employee: his interior value of product and exterior work reward. There exist shortages in evaluating the value of the employees in an enterprise. Consequently, a lot of employees might be laid off. Hence, this paper puts forward a two-stage method for decision-making to carry out a selective plan of buyout, based on the fuzzy synthetic evaluation involing many factors impacting on human resource. Moreover, a positive analysis is also given.

Use of Research Evidence in Policy and Decision-Making: Views, Attitudes and Practices of Health Policy Makers in Lusaka Province of Zambia

Background: The integration of relevant high-quality research evidence into the health decision and policy formulation process is a key strategy for improving health systems especially in developing countries such as Zambia. However, the lack of capacity to understand and value research evidence by policy and decision makers makes it difficult for them to find and use research evidence in a timely manner even when motivated to do so. This study aimed to establish the views, attitudes and practices of policy makers on the use of research evidence in policy and decision-making process in Zambia. Methodology: This descriptive cross-sectional study was conducted in Lusaka, Zambia among selected public health decision and policy making institutions. A purposive sample of 21 consenting policy makers who were working in different positions in the Ministry of Health Headquarters, Provincial and District Health Offices, Health Professions Regulatory Bodies, United Nations Agencies, International Non-Governmental Organizations and University Deans from the University of Zambia participated in the study. A self-administered questionnaire was used to collect data. The IBM? SPSS? Statistics for Windows Version 20.0 was used for data analysis. Results: The concept of Evidence Informed Health Policy was not well understood such that only less than half (47.5%) of the participants reported having heard specifically about Evidence Informed Health Policy meanwhile almost two thirds (61.9%) reported that they used research evidence in decision making and policy formulation. Similar discrepancy was expressed in the understanding of and use of rapid response mechanisms such that although (47.6%) of the participants reported having heard about it, (57%) had never used rapid response mechanisms for deci-sion-making. With regard to the sources of information, about half (52.3) of the participants reported scholarly articles as their main source of evidence. Con-clusion and Recommendations: There is need for more sensitization and ca-pacity building among the decision and policy makers on the importance of using research evidence in decision and policy making process as incorporation of relevant high-quality research evidence into the health policy making pro-cess is a key strategy for improving health systems.

Admission Motor Strength Grade Predicts Mortality in Patients with Acute Ischemic Stroke Undergoing Mechanical Thrombectomy

Background: The mortality due to mechanical thrombectomy (MT) in the acute treatment of intracranial arterial occlu- sions can be up to 45%. The SWIFT (Solitaire FR with the Intention for Thrombectomy) and Multi MERCI (mechani- cal embolus removal in cerebral ischemia) trials have evaluated the safety and efficacy of MT. It may be important to determine pre-procedural factors that help predict post-intervention prognosis. We sought to determine if admission medical research council (MRC) motor strength grade along with other factors can be used as predictor of mortality after MT for acute ischemic stroke. Methods: Retrospective analysis of stroke database assessing outcomes in all 62 patients who underwent MT as an intervention for acute ischemic stroke, with or without concurrent intravenous thrombolysis was done. Five baseline variables were included in univariate and multivariate analyses to define the in- dependent predictors of mortality during current hospitalization. The medical research council (MRC) motor grade (0 - 5);modified collateral flow (CS) grading (0 - 3);age;acute and chronic co-morbidities were used as the baseline vari- ables. If motor strength grade were different in upper and lower extremities, then the lower grade was used. Age was analyzed independently as well as dichotomized using 80 as cut-off value. Relevant stroke related acute and chronic co-morbidities were given 1 point each and mean calculated. Results: In the univariate analysis, low (0 - 1) motor strength grade (OR, 0.11;95% CI, 0.021 - 0.33;p = 0.001) and age (OR, 1.06;95% CI, 1.02 - 1.12;p = 0.011) was sig- nificantly associated with mortality. The presence of collateral flow, acute and chronic co-morbidities were not signifi- cantly associated with mortality. In the multivariate analysis, motor grade retained its statistical significance for morta- lity (OR, 0.09;95% CI, 0.01 - 0.32;p = 0.003) along with chronic co-morbidity (OR, 1.52;95% CI 1.05 - 2.43;

The Physical and Psychological Mechanisms of Educational Inequality and Intervention Strategies: The Case of Migrant Workers' Children

Using multiple methods including questionnaires, in-depth interviews, participant observation and field experiments, we have identified two social-psychological mechanisms in educational inequality： the self-fulfilling prophecy ofparentaI expectations at home and the threat of stereotyping encountered at school. The physical mechanism of educational inequality is manifested in the poor health of migrant workers＇ children and their devalued behavior. Targeting these physical and psychological mechanisms, we have designed two simple but effective intervention strategies to raise the children＇s academic achievement： passing on the incremental theory of intelligence and establishing a multiple assessment system. These intervention strategies effectively improved the children＇s academic performance, increased their identification with learning, and lowered the stereotype threat. It is hoped that these strategies can be applied to the new generation of migrant workers entering the labor market.

Research on self-adaptive decision-making mechanism for competition strategies in robot soccer

In the robot soccer competition platform, the cur- rent confrontation decision-making system suffers from dif- ficulties in optimization and adaptability. Therefore, we pro- pose a new self-adaptive decision-making （SADM） strategy. SADM compensates for the restrictions of robot physical movement control by updating the task assignment and role assignment module using situation assessment techniques. It designs a self-adaptive role assignment model that assists the soccer robot in adapting to competition situations similar to how humans adapt in real time. Moreover, it also builds an accurate motion model for the robot in order to improve the competition ability of individual robot soccer. Experimental results show that SADM can adapt quickly and positively to new competition situations and has excellent performance in actual competition.

Path analysis on educational fiscal decision-making mechanism in China

In China’s current educational fiscal decision making,problems are as follows:no law to trust or not abiding by available laws,absence of equity and efficiency,as well as the standardization of decision-making procedures.It is necessary to set up effective fiscal decision-making mechanism in education and rationally devise reliable paths.

Mechanical thrombectomy for acute occlusion of the posterior inferior cerebellar artery: A case report

BACKGROUND Mechanical thrombectomy(MT)has been demonstrated to be useful for the treatment of ischemic stroke in patients with large vessel occlusions.However,recanalization by MT is not recommended for distal vessels such as second-order branches of the middle cerebral artery and posterior inferior cerebellar artery(PICA).Because of the small size and tortuosity of these arteries,the risks of using the available endovascular devices outweigh the benefits of treatment.However,MT appears to be effective in patients with primary distal vessel occlusion in eloquent areas,those with a high National Institutes of Health Stroke Scale score,and those ineligible for recombinant tissue plasminogen activator therapy.Here,we report the use of MT for treating acute occlusion of the PICA using a directaspiration first-pass technique(ADAPT).CASE SUMMARY In this case,the patient received acute occlusion of the PICA with ADAPT when right internal carotid artery stenting was performed.CONCLUSION With the introduction of advanced endovascular devices,MT may now be a feasible treatment for acute occlusion of the PICA.

老年遗忘型轻度认知障碍执行功能的神经机制及数字干预

阿尔茨海默病具有极高的发病率和致死率。遗忘型轻度认知障碍(Amnestic Mild Cognitive Impairment,aMCI)作为临床前驱期,探究其形成和发展机制有助于预防阿尔茨海默病的发生。现有研究显示,多个执行域缺陷与aMCI记忆衰退密切相关,但尚未回答何种执行域是关键致病因子、关键干预治疗靶标等科学问题。为突破以往研究将执行功能视作整体抑或割裂元素的局限性,本研究拟从执行功能结构全貌着眼,在提出aMCI执行功能与记忆损害关系假说的基础上,利用脑电技术系统考察aMCI抑制、刷新和转换三种执行功能子成分的时域、时频和动态脑网络特征;并结合三维卷积神经网络筛选、识别执行功能缺陷的特异性神经靶标,探索将抑制域相关神经标记物加入aMCI早期识别的可能性;最后,通过纵向因果设计分析不同靶向数字干预对aMCI患者的训练效果及神经基础,以揭示抑制域相关额顶控制网络在干预中的重要作用。本研究有望从计算认知神经视角阐明抑制是aMCI执行功能缺损和干预的认知新靶点,进而为aMCI早期识别和制定精准化诊疗方案提供循证依据。

机械介入取栓术联合重组组织型纤溶酶原激活剂治疗急性脑梗死的疗效观察

目的观察机械介入取栓术联合重组组织型纤溶酶原激活剂(recombinant tissue plasminogen activator,rt-PA)治疗急性脑梗死(ACI)的疗效。方法选取作者医院2020年1月至2021年12月收治的107例ACI患者作为回顾性队列研究对象,按治疗方法将患者分为rt-PA静脉溶栓组(以下简称对照组,n=49)和机械介入取栓术联合rt-PA静脉溶栓组(以下简称观察组,n=58)。比较两组患者临床疗效、血清炎症因子、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、血清总超氧化物歧化酶(T-SOD)、血清锰超氧化物歧化酶(Mn-SOD)、血清血管内皮功能指标以及脑血流灌注水平的差异。结果观察组临床总有效率高于对照组(96.55%比81.63%;χ^(2)=5.179,P=0.023);观察组治疗后肿瘤坏死因子α(TNF-α)、白细胞介素-1α(IL-1α)、IL-1β、IL-6、C反应蛋白(CRP)、Lp-PLA2、内皮素-1(ET-1)和血管内皮生长因子(VEGF)水平显著低于对照组(P<0.05),而T-SOD、Mn-SOD、一氧化氮水平及脑血容量(CBV)和脑血流量(CBF)水平明显高于对照组(P<0.05)。结论机械介入取栓术联合rt-PA治疗能够有效改善ACI患者神经功能、炎症状态及Lp-PLA2、T-SOD、Mn-SOD水平,增强脑组织血流灌注及血管内皮功能,整体提高临床疗效。

应激相关成长:数智时代应激研究的挑战和创新

在数字智能时代的背景下,个体所遭遇的社会压力和心理挑战日益复杂多元,使得应激相关成长这一积极适应策略的重要性愈发显著.以数字智能时代为背景,阐述应激相关成长的定义及其相关性指标(如抑制控制和认知灵活性),并强调其在帮助个体应对压力和创伤后积极成长的重要性.在论述认知机制时,提出认知重评、自我肯定和意义建构等适应策略在推动应激相关成长方面的关键性作用.在神经机制的讨论中,基于三元情感神经模型,推断这3种认知过程的对应神经机制,包括奖赏系统、杏仁核以及默认模式网络的激活.在对应激相关成长的干预措施方面,数字化干预可能提供了一种实现应激干预心理服务普及化和公平性的新途径.建议未来的研究能够考虑到个体差异,基于认知神经机制,利用智能平台的多模态数据来提升评估的准确性,同时采用机器学习等前沿技术来提高干预的效果,从而提升个体的应激相关成长.

肺康复治疗对重症肺炎机械通气患者的干预时机及安全性分析

目的分析肺康复治疗对重症肺炎机械通气患者的干预时机及安全性,并为临床决策提供依据。方法采用前瞻性研究方法,选取2021年10月至2024年3月中山市人民医院收治的重症肺炎机械通气患者262例为研究对象。根据康复治疗的开始时长,将患者分为早期组(48 h内开始,n=121)和晚期组(48 h后开始,n=141)。所有患者接受综合治疗,并根据个体情况实施阶段性肺康复治疗。观察指标包括ICU入住时长、总住院时长、医疗总费用、机械通气持续时长、28 d内生存率、镇静药物使用时机、升压药物使用时长、康复1周后的肌力评分和不良事件发生率。结果早期组ICU住院时长、总住院时长、医疗总费用、机械通气时长及镇静药物使用时长均低于晚期组。此外,早期组的28 d内生存率及康复后的肌力评分高于晚期组。安全性评价显示,两组患者的不良事件发生率差异无统计学意义(P>0.05)。结论早期肺康复治疗对重症肺炎机械通气患者安全有效,能够缩短住院时长、减少医疗成本,并提高康复后肌力和生存率。

铁路动车组司机工作压力对不安全行为作用机理研究

铁路动车组司机是确保铁路行车安全的关键岗位,其工作压力极易造成不安全行为,从而引发铁路安全事故。为剖析铁路动车组司机工作压力对不安全行为的作用机理,提高铁路动车组司机不安全行为管理措施的科学性,基于文献分析与理论研究,引入情绪耗竭、心理脱离作为工作压力对不安全行为作用的中介变量,引入组织支持感作为调节变量,构建铁路动车组司机工作压力对不安全行为作用机理概念模型,借鉴成熟量表和专家咨询意见,针对5个变量形成22项测量题项,对铁路动车组司机开展问卷调研,通过实证研究探讨了铁路动车组司机工作压力对不安全行为的作用路径。研究结果表明:铁路动车组司机工作压力正向影响不安全行为、情绪耗竭,负向影响心理脱离,还可通过情绪耗竭、心理脱离中介作用于不安全行为,且工作压力对不安全行为的直接效应大于中介效应;心理脱离负向影响不安全行为和情绪耗竭,情绪耗竭正向影响不安全行为;组织支持感可削弱工作压力与不安全行为的直接关系,也可削弱工作压力与情绪耗竭的直接关系,对工作压力与不安全行为的调节作用更显著。研究成果为制定铁路动车组司机不安全行为干预策略、降低铁路人因安全事故发生率和提高铁路运输安全管理水平具有借鉴意义。