心远意悠然

泉城济南新世界商城的4楼,如同一座迷宫。从电梯进来,就被墨香书画包围。长长的走廊一条又一条,左右皆是字画,穿行其间,忽然有不知身在何处之感。就这样走着,左拐,左拐,左拐——于一间小铺前停步,抬头,"心远斋"便映入眼帘。

“游目汉庭中”:陶渊明与扬雄之关系发微——以《饮酒》其五为中心

陶渊明《饮酒》其五"问君何能尔"句前人多有误读。本诗的"君"字乃是对汉代之新圣扬雄的尊称,全诗乃是借扬雄以自况。这首诗集文化的深厚、哲理的凝重、思想的深淳和情韵的生动等种种艺术特色于一身,以短短五十字的篇幅而成为中国古典诗史中的绝唱。如果我们确定一个包含语言艺术的创造力、思想旨趣的丰富性、远离实际政治或置身于当代行政体制之外的纯粹个体的独立自由精神、对后人文学创作和审美趣味的影响力等四方面要素的综合性的评估标准的话,那么,在华夏古国辉煌灿烂的文学史上是没有另外一首诗能够与之匹敌的。

The future of remote ECG monitoring systems

Remote ECG monitoring systems are becoming commonplace medical devices for remote heart monitoring. In recent years, remote ECG monitoring systems have been applied in the monitoring of various kinds of heart diseases, and the quality of the transmission and re- ception of the ECG signals during remote process kept advancing. However, there remains accompanying challenges. This report focuses on the three components of the remote ECG monitoring system： patient （the end user）, the doctor workstation, and the remote server, reviewing and evaluating the imminent challenges on the wearable systems, packet loss in remote transmission, portable ECG monitoring system, pa- tient ECG data collection system, and ECG signals transmission including real-time processing ST segment, R wave, RR interval and QRS wave, etc. This paper tries to clarify the future developmental strategies of the ECG remote monitoring, which can be helpful in guiding the research and development of remote ECG monitoring.

Effect of a distal protection device on epicardial blood flow and myocardial perfusion in primary percutaneous coronary intervention

Objective: The beneficial effect of percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) has been well established, but there is the problem of no-reflow phenomenon which is an adverse prognostic factor in primary PCI. In the present study the effect of a distal protection device (PercuSurge GuardWire; GW) on epicardial blood flow and myocardial perfusion was evaluated. Methods and Results: Patients with AMI were randomly divided into 2 groups, the GW and the control groups. The GW group included 52 patients with AMI who underwent primary PCI with GW protection and the control group included 60 patients who underwent primary PCI without GW protection. Epicardial blood flow in the infarct-related artery (IRA) and myocardial perfusion were evaluated according to the thrombolysis in myocardial infarction (TIMI) flow grade and the myocardial blush grade (MBG). We found TIMI score of 3 was obtained significantly more frequently in the GW group (96%) than in the control group (80%). The MBG score of 3 was obtained also significantly greater in the GW group (65%) than in the control group (33%). Conclusion: Primary PCI with GW protection can significantly improve epicardial blood flow and myocardial perfusion.

Remote State Preparation of a Greenberger-Horne-Zeilinger Class State

In this paper, we propose a scheme for the remote preparation of a three-particle Greenberger-HorneZeilinger class state by a two-particle entangled state and a three-particle entangled state. It is shown that, by this scheme, only two classical bits and one two-particle projective measurement are enough for such preparation.

Cardiac Remote Conditioning and Clinical Relevance:All Together Now!

Acute myocardial infarction （AMI） is the leading cause of death and disability worldwide. Timely reperfusion is the standard of care and results in decreased infarct size, improving patient survival and prognosis. However, 25% of patients proceed to develop heart failure （HF） after myocardial infarction （MI） and 50% of these will die within five years. Since the size of the infarct is the major predictor of the outcome, including the development of HF, therapies to improve myocardial salvage have great potential. Over the past three decades, a number of stimuli have been discovered that activate endogenous cardioprotective pathways. In ischemic preconditioning （IPC） and ischemic postconditioning, ischemia within the heart initiates the protection. Brief reversible episodes of ischemia in vascular beds remote from the heart can also trigger cardioprotection when applied before, during, or immediately after myocardial ischemia-- known as remote ischemic pre-, per-, and post-conditioning, respectively. Although the mechanism of remote ischemic preconditioning （RIPC） has not yet been fully elucidated, many mechanistic components are shared with IPC. The discovery of RIPC led to research into the use of remote non-ischemic stimuli including nerve stimulation （spinal and vagal）, and electroacupuncture （EA）. We discovered and, with others, have elucidated mechanistic aspects of a non- ischemic phenomenon we termed remote preconditioning of trauma （RPCT）. RPCT operates via neural stimulation of skin sensory nerves and has similarities and differences to nerve stimulation and EA conducted at acupoints. We show herein that RPCT can be mimicked using electrical stimulation of the abdominal midline （EA-like treatment） and that this modality of activating cardioprotection is powerful as both a preconditioning and a postconditioning stimulus （when applied at reperfusion）. Investigations of these cardioprotective phenomena have led to a more integrative understanding of mechanisms related to cardioprotection, and in the last five to ten years, it has become clear that the mechanisms are similar, whether induced by ischemic or non-ischemic stimuli. Taking together much of the data in the literature, we propose that all of these cardioprotective ＂conditioning＂ phenomena represent activation from different entry points of a cardiac conditioning network that converges upon specific mediators and effectors of myocardial cell survival, including NF-KB, Stat3/5, protein kinase C, bradykinin, and the mitoKA^P channel. Nervous system pathways may represent a novel mechanism for initiating conditioning of the heart and other organs. IPC and RIPC have proven difficult to translate clinically, as they have associated risks and cannot be used in some patients. Because of this, the use of neural and nociceptive stimuli is emerging as a potential non-ischemic and non-traumatic means to initiate cardiac conditioning. Clinical relevance is underscored by the demonstration of postconditioning with one of these modalities, supporting the conclusion that the development of pharmaceuticals and electroceuticals for this purpose is an area ripe for clinical development.

Effect of telehealth interventions on major cardiovascular outcomes： a metaanalysis of randomized controlled trials

Background Telehealth interventions （THI） were associated with lower levels of cardiovascular risk factors in adults, whereas the effect of THI on cardiovascular disease （CVD） still remains controversial. A meta-analysis was conducted to summarize the evidence from randomized controlled trials （RCT） which investigated potential impact of THI on the incidence of CVD in patients with or without prior CVD. Methods PubMed, EmBase, and the Cochrane Library were searched to identify RCTs to fit our analysis through December 2016. Relative risk （RR） with its 95% confidence interval （CI） was used to measure the effect of THI using a random-effect model. Sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted. Results Eight RCTs were included and with a total of 1635 individuals. The summarized results indicated that participants who received THI showed a significant reduction of the CVD incidence as compared with usual care （RR： 0.59; 95% CI： 0.47-0.74; P 〈 0.001）. Furthermore, the effect of THI was greater in patients with history ofCVD （RR： 0.55; 95% CI： 0.44-0.70; P 〈 0.001） than in patients without history ofCVD （RR： 0.99; 95% CI： 0.51-1.94; P = 0.977）. Sensitivity analysis suggested that the intervention effect persisted and the conclusion was not changed. Subgroup analysis indi- cated mean age, study quality might play an important role on the risk of CVD. Conclusions The findings of this study indicated THI could reduce the recurrence of CVD. Further large-scale trials are needed to verify the effect of THI on CVD in healthy individuals.

Study of Remote Monitoring and Maintenance Guiding Technique Based on LabVIEW for Machining Centers

The virtual instruments （VIs）, as a new type of instrument based on computer, has many advanced attractive characteristics. This research is based on Vls, and brings condition monitoring and knowledge-based maintenance support together through an integrated （including hate.met, ASP. NET, XML tochnique, Vls） network environme~. Within the enviromnent, machining centers operators, engineers or managers can share real-time data through the browser-based interface and minimize machining centers downtime by providing status monitoring and remote maintenance guiding from service centers.

Long-term mortality in patients with myocardial infarction: impact of early treatment with captopril for 4 weeks

Objective In an earlier interim report of the Chinese Cardiac Study (CCS-1) trial, 15 000 patients up to 36 hours after the onset of suspected acute myocardial infarction (AMI) were randomized to receive either oral captopril or matching placebo for one month. Results showed that captopril was associated with a non-significant reduction in 4-week mortality (681 ［9.1%］ captopril-allocated vs 730 ［9.7%］ placebo-allocated deaths; 2P=0.19), but the long-term effects remained uncertain. The present study reports on the long-term effect of early captopril treatment on mortality and other major events in AMI patients of the earlier CCS-1 trial.Methods Long-term follow-up was carried out in those hospitals which had recruited more than 20 cases in the CCS-1 trial. 8000 patients with MI were thus selected for long-term follow-up. Data on 6749 patients (84.4%) were available. Results Patient characteristics were comparable between the treatment group (n=3391) and the placebo group (n=3358). Average follow-up time was 23.4±16.9 months; average age was 63.6±10.6 years, and 76.2% were male. At the end of the follow-up time, cardiac function of NYHA Ⅲ-Ⅳ was 9.0% in the treatment group and 9.8% in the placebo group; the reinfarction rate was 5.6% vs. 6.0%; total cardiovascular events were 32.9% vs. 34.3%. Total mortality was 11.9% (n=404) vs 13.8% (n=463), with a 13.8% reduction in the captopril group (P=0.03). Cardiovascular mortality was 10.0% vs. 11.8% (P=0.01), death due to heart failure was 4.1% vs. 5.5% (P=0.01). From the above results, it is estimated that early treatment with captopril can save 19 lives per 1000 patients treated; patients with systolic blood pressure (SBP)≥100 mm Hg at entry would have a long-term mortality 12.4% in the treatment group vs. 13.8% in the placebo group (P=0.04) and patients with a heart rate (HR)≥60/minute at entry would have a long term mortality 12.0% in captopril groups vs. 14.5% in the placebo group (P=0.01). Conclusion Early treatment with captopril during AMI for 4 weeks can significantly reduce long-term total mortality.

Distal femoral physeal crush injury with metaphyseal comminution - A report of two cases and a new perspective to physeal injury

The physis of a long bone may get ＇sandwiched＇ and crushed between the metaphysis and the epiphysis if it is traumatically loaded along its long axis. Such a physeal injury may lead to complications like angular deformities and growth restrictions and hence, management of such injuries requires adequate planning and attentive execution. Two patients with distal femoral physeal crush injury were treated using a ring fixator such that one ring had the wires passing through the epiphysis and the other through the femoral shaft. On table image intensifier controlled distraction of the crushed physis was done to bring the height of the physis similar to that of the opposite limb. Patients were followed up for more than two years clinically and radio- logically. There was no clinical or radiological angular deformity of the operated limbs. MRI scans showed intact physes with no physeal bar formation in either of the two patients. The distraction obtained by the ring fixator appears to have provided ample ＇breathing space＇ to the compressed physis and that the growth potential may have been re-gained by the procedure. However, two years is a relatively short duration of follow-up and further follow-up of longer duration and in greater number of patients is needed to gauge the actual effectiveness of the technque used bv us.