“正例”与“反例”相结合的高中地理案例教学法研究

随着新课改的实施,案例教学法在高中地理教学中逐渐受到重视。案例教学法可以提高学生的兴趣,有助于学生对知识的理解与掌握,形成良好的知识体系,但目前中学地理教学中运用的案例教学法还存在不足之处。文章采用文献研究的方法,针对地理学科一般性与特殊性、普适性与区域性并存的特点,提出“正例”与“反例”相结合的案例教学方法,以便学生更全面地理解地理规律,形成良好的地理思维能力,为中学地理教师提供教学思路。

Local Responses to Macro Development Policies and Their Effects on Rural System in China's Mountainous Regions:The Case of Shuanghe Village in Sichuan Province

China has promulgated a series of policies including the Western Development Program, the Grain for Green Project, agricultural support policies and building a new countryside strategy to eliminate east-west differences and urban-rural disparities since the late 1990s. This paper gives a holistic examination on local responses to the four typical macro socio-economic development policies and their effects on rural system based on a case study of a mountainous village in southern Sichuan Province. The results showed that the policies have not moved the case study village from its historically marginal status. To some extent, its socio-economic situation might have been worsened by accelerated out- migration of the youth, loss of agricultural land due to afforestation and industrial plants, increased fire hazard due to afforestation and reforestation, increased environmental pollution due to industrial enterprises attracted to the village and a steep decline in agricultural production due to loss of and inefficient use of cultivated land. Factors causing local villages' dilemmas include the nonuniformity of actors' objectives, finiteness of villagers' abilities, and the imperfect incentive and restraint mechanism for local government's activities under existing policy framework composed of uncoordinated one-size-fits- all policies. We suggest that China's rural policy in the new period should gradually shift from a sectoral to a place-based one, from top-down incentives to the development of bottom-up projects, and fully recognize the diversity of rural space, so as to lift localcapacities and make good use of the knowledge shared by different actors. Moreover, it is also necessary to integrate the various sectoral policies, and improve the interministerial and interdepartmental coordination of rural policies at regional and local levels.

Oxaliplatin-induced severe anaphylactic reactions in metastatic colorectal cancer: Case series analysis

AIM: To investigate oxaliplatin-induced severe anaphylactic reactions (SAR) in metastatic colorectal cancer in a retrospective case series analysis and to conduct a systemic literature review. METHODS: During a 6-year period from 2006 to 2011 at Kaohsiung Veterans General Hospital, a total of 412 patients exposed to oxaliplatin-related chemotherapy were retrospectively reviewed. Relevant Englishlanguage studies regarding life-threatening SAR following oxaliplatin were also reviewed in MEDLINE and PubMed search. RESULTS: Eight patients (1.9%, 8 of 412 cases) were identified. Seven patients were successful resuscitated without any sequelae and one patient expired. We changed the chemotherapy regimen in five patients and rechallenged oxaliplatin use in patient 3. Twenty-three relevant English-language studies with 66 patients were reported. Patients received a median of 10 cycles of oxaliplatin (range, 2 to 29). Most common symptoms were respiratory distress (60%), fever (55%), and hypotension (54%). Three fatal events were reported (4.5%). Eleven patients (16%) of the 66 cases were rechallenged by oxaliplatin. CONCLUSION: SAR must be considered in patients receiving oxaliplatin-related chemotherapy, especially in heavily pretreated patients. Further studies on the mechanism, predictors, preventive methods and management of oxaliplatin-related SAR are recommended.

Optimizing Reactors Selection and Sequencing: Minimum Cost versus Minimum Volume

The present investigation targets minimum cost of reactors in series for the case of one single chemical reaction, considering plug flow and stirred tank reactor(s) in the sequence of flow reactors. Using Guthrie's cost correlations three typical cases were considered based on the profile of the reaction rate reciprocal versus conversion. Significant differences were found compared to the classical approach targeting minimum total reactor volume.

Molecular Detection, Culture and Isolation of Mycoplasma Pneumoniae From Reproductive Tract of STD Patients

Objective: To confirm whether Mycoplasma pneumoniae (MP) are present in reproductive tract of STD patients inChina. Methods: Application of nested PCR (nPCR) and DNAsequencing to test samples of urethral/vaginal swabs withMP culture confirmation of several nPCR positive patients. Results: 74 of 786 STD patients were positive for MP bynPCR, with a rate of 9.4%. of the 484 male patients, 10.5%were positive, and among the 302 female patients, 7.6%were positive. There was no significant difference betweenthem (P<0.05). of 12 cases of MP positive samples by nPCR,4 cases were first generation culture-positive, and one ofthem passed to the next generation successfully. DNAsequencing was performed on the nPCR product of oneswab sample and one MP culture isolation. The determinedsequence was identical to the typical MP strain. Conclusion: In China, MP are present in reproductivetract of both male and female STD patients.

Demodulator for Chaotic Secure Communication Based on Proportional-integral Feedback Design

A scheme of chaotic secure communication based on the parameter modulation and the inversion of a chaotic dynamical system is analyzed. According to this scheme, information signal is modulated by a bifurcation parameter of the transmitter, which is in chaotic state. In the receiver, a proportional integral feedback demodulator is used to demodulate the information signal, which only uses the available synchronizing error as well as stateness of receiver. The purpose of this demodulator is proposed to overcome the influence of differentiation operation, nonlinear part and singularities in chaotic system. Numerical simulation is proposed to show the effectiveness of this demodulator.

Early aggressive therapy for severe extensive ulcerative colitis

The current ulcerative colitis （UC） treatment algorithm involves a step-up therapeutic strategy, mainly aiming at inducing and maintaining its clinical remission. Although this therapeutic strategy may seem to be cost-efficient and reduce the risk of side effects, recent trials and case reports have shown that top-down therapy using infliximab induces a rapid clinical response, enhances patient quality of life, promotes mucosal healing, reduces surgeries and indirect cost of treatment for patients with severe UC. Moreover, since long-term treatment with infliximab is safe and well tolerated, early aggressive top-down therapeutic strategy may be a more effective approach, at least in a subgroup of severe extensive UC patients.

Adalimumab in ulcerative colitis: Two cases of mucosal healing and clinical response at two years

Infliximab (IFX) is currently the only biologic therapy used in the treatment of moderate-to-severe ulcerative colitis (UC). In the years to come, more biologic therapies will have a role in the management of moderate-to-severe UC. We report on two patients with steroid-dependent UC who, due to adverse reactions to IFX, have been under therapy with adalimumab for two years. Both patients received concomitant immunosuppressive treatment. Long term clinical remission and mucosal healing are described.

Intelligent model of rehabilitation training program for stroke

In view of the uncertainty and complexity,the intelligent model of rehabilitation training program for stroke was proposed,combining with the case-based reasoning(CBR) and interval type-2 fuzzy reasoning(IT2FR).The model consists of two parts:the setting model based on CBR and the feedback compensation model based on IT2FR.The former presets the value of rehabilitation training program,and the latter carries on the feedback compensation of the preset value.Experimental results show that the average percentage error of two rehabilitation training programs is 0.074%.The two programs are made by the intelligent model and rehabilitation physician.That is,the two different programs are nearly identical.It means that the intelligent model can make a rehabilitation training program effectively and improve the rehabilitation efficiency.

Recurrent inflammatory fibroid polyp of cardia:A case report

Inflammatory fibroid polyp is one of the chronic inflammatory diseases in the digestive tract, which often mimics the submucosal tumor. Precise diagnosis is possible after removal of the detected lesion. Endoscopic removal is recommended as a safe and efficient method of the treatment. In this report the authors present a case of inflammatory fibroid polyp located in the cardia, which has been removed endoscopically. Twelve months later, recurrence of the lesion was noted and the patient was referred to surgical resection.

Investigation on Biovars and Serotypes of Ureaplasma Urealyticum in Cervix in Chinese Gynecologic Check-up Population, Sexually Transmitted Infections Clinic Clients and Sex Workers

Objectives: To characterize the distribution pattern biovars and serotypes of Ureaplasma urealyticum in normahealthy women, sexually transmitted infections clinic clienand in sex workers. Methods: We cultured cervical swabs taken from 26physical check-up clients, 599 STI clinic outpatients and 9sex workers using commercial selective medium. Sompositive cultures were further biotyped and serotyped bPCR. Results: (1) Biovar 1 of U urealyticum (95.0%), especiallsingle infection of serotype 1, 3, and 6 of biovar 1,commonly found in healthy women. (2) U urealyticummore commonly isolated in sex workers (90.8%) than iphysical check-up group (60.9%) and STI outpatients grou(61.3%) (P<0.001). (3) Biovar 2 infection of U urealyticuris more prevalent in sex workers (28.1%) and SToutpatients group (26.6%) than that in physical check-ugroup (4.9%) (P<0.001). (4) Mixed infection caused bmore than one serotype of U. urealyticum is increasing fromphysical check-up group (8.6%) to STI outpatients (12.4%and to sex wokers (23.9%) (P<0.01). (5) There is nstatistic difference in the distribution of serotype 1, 3, and of biovar 1 among these three groups (P=0.763). (6) ThPCR method described here is relatively simple, rapid anspecific for the biotyping and serotyping of biovar 1 of Uurealyticum. Conclusion: we should pay more attention to biovarand mixed infection than single infection of biovar 1 of Uurealyticum in clinic practice. PCR is a good method ibiotyping and serotyping.

Rare Side Effects of Propofol Administration Case Report and a Brief Literature Review

Introduction： Propofol is an intravenous general anesthetic and sedation drug for use in the induction and maintenance of anesthesia or sedation. It is included in WHO Model List of Essential medicines and approved by the FDA （food and drug administration） in 1989. The side effects of Propofol have been studied widely in the last 25 years. They can be easily managed and that is why Propofol has become a fn＇st choice drug for the most of the anesthesiologists worldwide. This paper presents a case report of Propofol induced pulmonary edema and also a review of some of the rarest and unusual manifestations of Propofol side effects. Some of them are urine discoloration, tissue necrosis, rhabdomyolysis and postoperative panereatitis. Methods and materials： A case summary of 18-years old woman with unusual postoperative pulmonary reaction was considered along with other documented cases. Several full-text articles were briefly analyzed for estimating the role of Propofol for a number of strange and potentially life threatening conditions. Results： Despite the low incidence rate, the presented case could be determined as a pulmonary edema due to its clinical features. Furthermore, rare drug reactions such as rhabdomyolysis, tissue necrosis, postoperative pancreatitis etc. may remain unrecognized and create diagnostic and therapeutic issues. Conclusions： Although the officially reported dangerous reaction, Propofol remains one of the best hypnotic and sedative agents. The better knowledge of the full list of drug reactions considered as rare and very rare is a guarantee of an adequate and a better therapeutic behavior.

Enantioselective Hydrogenation of β-keto Esters Using Homogeneous and Heterogeneous Catalysts, a Case Study for Comparison of Different Catalytic Methodologies

The asymmetric reduction of β-keto esters to their corresponding hydroxy alcohols can be performed by employing homogeneous and heterogeneous chemo- and bio-catalysis. This review covers the scope and limitations of different catalysts and methodologies that were employed for the reaction and compare between them on the basis of catalytic performance, product separation and catalyst recycling procedure. In general, heterogeneous catalytic systems are advantageous from industrial point of views as they can be easily separated by filtration and re-used. Nickel modified with tartaric acid and sodium bromide was found to be suitable heterogeneous catalyst for the enantioselective hydrogenation, yet its performance is lower than this of homogeneous chiral metal catalysts such as Ru-BINAP. Heterogenization of the chiral complex via immobilization or entrapment using organic and inorganic supports was thus tested. However, though the resulted heterogeneous analogues were highly enantioselective and could be re-used, the activity of the system is often very low compared to homogeneous system due to mass transfer limitations. Alternatively, performing liquid phase hydrogenation under homogeneous conditions, using Ru-BINAP soluble derivatives, yielded high activit5＇ and enantioselectivity. Product separation and catalysts recycling were facilitated by either extraction of the product with solvent that does not dissolve the complex or by selective filtration of the product. Alternatively, precipitation of the complex at the end of the reaction was also reported.

Development of a Finger-Shaped Muscle Hardness Tester and Its Measurement Cases

As the background of our study, we requested that practitioners use muscle hardness testers to conduct a digital assessment of muscle hardness layers that they can feel by palpation. We developed muscle hardness testers to assess muscle hardness digitally from the reaction force and the depth in pushing a finger-shaped indenter, thereby simulating palpation. To assess muscle hardness digitally, we proposed this means using the reaction force and depth that are measured when the indenter is pushed, along with the elastic constant, and the differential elastic modulus. The tester is designed to be useful to ascertain effects of, or follow the course of, muscle layer treatment applied for shoulder stiffness and other conditions. As described herein, we confirmed the effectiveness of digital assessment using foam rubber consisting of an upper layer and a lower layer, respectively simulating the cortical and muscle layers of a human body. Additionally, monitoring six subjects, we digitally assessed the change of hardness of the trapezius muscle by changing the position of the upper extremity. Next, we were able to measure the change of hardness before and after treatment for 21 subjects with shoulder stiffness.

Reversed and Bidirectional Irrigation Methods for Equal-Scale Virtual Network Embedding Problem

Previous Virtual Network (VN) embedding researches mostly focus on developing heuristic algorithms to enhance the efficiency of a physical resource. However, in the equal-scale condition, where the scale of a VN is similar to that of a substrate network, the number of successfully mapped VNs decreases sharply since bottlenecks form easily in the substrate network and disturb the embedding process. In this paper, reversed and bidirectional irrigation methods are proposed for the equal-scale and all-scale conditions. The two proposed methods can be combined with most of the existing heuristic algorithms and map a relatively large number of VNs by reducing the potential substrate bottlenecks. The simulation results show that the reversed irrigation method almost doubles the successfully mapped Revenue than the traditional one in the equal-scale condition. Meanwhile, the bidirectional irrigation method achieves the synthetically best performance in almost all scale conditions.

Risk Management Strategies of Vulnerable Rural Households in Southeast Asia： A Case Study from Vietnam

In the Uplands of Southeast Asia, poor and near-poor farm households endure considerable livelihood vulnerability. Access to formal insurance services is scarce. Rural farm households in mountainous Northern Vietnam have developed alternative risk management strategies. This article investigates the theoretical links between poverty, vulnerability and risk. The concept of vulnerability to poverty lays the analytical framework. Based on empirical evidence from more than 200 ethnic minority households, major risks and risk management strategies are presented and analyzed. Results suggest that households suffer from limited endowment with and access to capital assets and service institutions. Human and economic risks （e.g. illness of family members and loss of livestock） were identified as the main components affecting rural livelihoods. Constrained access to adequate risk management strategies increase household＇s vulnerability, drowning them more and more in poverty. Major policy implications are that anti-poverty programs should focus on a broader target group, the currently poor as well as the vulnerable households.

Biovars and Serotypes of Ureaplasma Urealyticum among Chinese Women Undergoing Routine Gynecologic Exam, Women with Sexually Transmitted Infections, and Female Sex Workers

Objectives: To characterize the distribution pattern of biovars and scrotypes or Ureaplasma urealyyicum in normalhealthy women, sexually transmitted infections clinic clients,and in sex workers. Methods: We cultured cervical swabs taken from 261physical check-up clients, 599 STI clinic outpatients and 98 sexworkers using commercial selective medium. Some positivecultures were further biotyped and serotyped by PCR. Results: (1) U. urealyticum is more commonly isolated in sexworkers (90.8%) than in the physical check-up group (60.9%)or the STI outpatient group (61.3%) (P<0.001). (2) Biovar 1of U. 'realyticum (95.0%), especially single infection ofserotype 1. 3, and 6 of biovar 1, is commonly found in healthywomen. (3) Biovar 2 infection of U urealyticum is moreprevalent in sex workers (28.1%) and STI outpatients group(26.6%) than that in the physical check-up group (4.9%) (P<0.001). (4) Mixed infection caused by more than one serotypeof U urealyticum increased from physical check-up group(8.6%) to STI utpatients (12.4%) to sex workers (23.9%) (P<0.01). (5) There is no statistically significant difference in thedistribution of serotype 1, 3, and 6 of biovar 1 among thesethree groups (P=0.763). (6) The PCR method described here isrelatively simple, rapid and specific for the biotyping andserotyping of biovar 1 of U urealyticum. Conclusion: We should pay more attention to biovar 2 andmixed infections of U. urealyticum than single infection ofhiovar 1 in clinic practice. PCR is a good method for biotypingand serotvping.

Application of pH control to a tubular flow reactor

Tubular flow reactors are mainly used in chemical industry and waste water discharged units. Control of output variables is very difficult because of the existence of high dead-time in these types of reactors. In the present work, sodium hydroxide and acetic acid solutions were sent to the tubular flow reactor. The aim was to control p H at 7 in the nonlinear region. The p H control of a tubular flow reactor with high time delay and a highly nonlinear behavior in p H neutralization reaction was investigated experimentally in the face of the various load and set point changes. Firstly, efficiency of conventional Proportional-Integral-Derivative(PID) algorithm in the experiments was tested. Then self-tuning PID(STPID) control system was applied by using the ARMAX model. The model parameters were calculated from input–output data by using PRBS signal as disturbance and Bierman algorithm. Lastly, the experimental fuzzy control of p H based on fuzzy model was achieved to compare the success of fuzzy approach with the performance of other control cases studied.

Sequential maximum androgen blockade(MAB) in minimally symptomatic prostate cancer progressing after initial MAB: two case reports

＂Ihe management of castrate-resistant prostate cancer progressing after maximum androgen blockade （MAB） has evolved in the last decade with the development of several novel therapeutic options. However, the initial therapeutic strategy in these patients usually involves withdrawal of anti-androgen that can be associated with biochemical response in approximately 20% of patients. Notably; we have observed evidence of sustained biochemical response in two patients following second- and third-line MAB using rechallenge schedule of previously administered anti-androgen after latent interval. The possibility of response following sequential MAB using the same anti-androgen agent has not yet been reported.