温阳宣肺祛风法辨治白癜风经验

白癜风是皮肤科较为常见的色素脱失性疾病,易诊难治。作者在总结前人经验的基础上,结合自身多年临床认为,白癜风实为本虚标实之证。于内以“阳虚”体质为发病基础,于外以感受“风邪”为致病关键,提出以“温阳宣肺祛风法”治疗白癜风,并自拟中药方剂“扫白茴风丸”,在临床中取得满意成效。文章从病因病机、治法方药两方面阐释了温阳宣肺祛风法辨治白癜风的经验,并附验案一则,以期为中医药治疗白癜风拓宽思路。

罗浮山风湿膏药在膝骨关节炎患者中的应用分析

目的探讨罗浮山风湿膏药治疗对膝骨关节炎(knee osteoarthritis,KOA)患者的应用效果。方法选取该院2020年1月—2021年1月治疗的200例KOA患者,随机分为对照组和观察组各100例。对照组口服艾瑞昔布片,0.1 g/次,2次/d;观察组在对照组的基础上外敷罗浮山风湿膏药,1次/d;两组患者均治疗3周。观察两组临床疗效,比较两组运动功能指标、关节疼痛情况。结果治疗后,观察组临床有效率高于对照组(P<0.05)。治疗后,观察组Lysholm膝关节评分(lysholm knee society score,LKSS)和美国膝关节协会评分量表(american knee association,AKS)功能评分显著高于对照组(P<0.05);且观察组视觉模拟评分法(visual analogue scale,VAS)评分在静息状态下、行走时、上下楼时均低于对照组(P<0.05)。结论罗浮山风湿膏药联合艾瑞昔布片治疗可以显著缓解KOA患者疼痛,改善膝关节功能,促进运动功能恢复,提高临床疗效。

玉屏风散加减颗粒联合分时间针刺治疗体外受精-胚胎移植反复移植失败的临床研究

目的分析玉屏风散加减颗粒联合分时间针刺治疗体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)胚胎植入前遗传学筛查(Pre-implantation Genetic Screening,PGS)反复失败(recurrent implantation failure,RIF)患者的临床治疗价值。方法选取2020年1月—2022年1月就诊于医院的RIF患者173例,采用随机数表法分为对照组(常规治疗)41例,观察组1(玉屏风散+常规治疗组)37例,观察组2(分时间针刺+常规治疗组)44例,观察组3(玉屏风散+分时间针刺+常规治疗)51例。对各组患者治疗前后子宫内膜容受性[子宫内膜厚度、血管化血流指数(vascu⁃larization-flow index,VFI)、血管化指数(vascularization index,VI)及血流指数(flow index,FI)]、汉密尔顿焦虑评量表-焦虑自评量表(Hamilton Anxiety Scale-Self-Rating Anxiety Scale,HAMA-SAS)评分及汉密尔顿抑郁量表(Hamilton de⁃pression scale,HAMD)评分和治疗后生化妊娠率、临床妊娠率、早期流产率、异位妊娠率及活产率结果进行分析。结果治疗后观察组3子宫内膜厚度、VFI、VI及FI高于对照组(P<0.05);各观察组HAMA-SAS及HAMD评分均低于对照组(P<0.05);观察组3生化妊娠率及临床妊娠率高于对照组,且各观察组产活率均高于对照组(P<0.05),但各观察组早期流产率与异位妊娠率与对照组相比差异无统计学意义(P>0.05)。结论玉屏风散加减颗粒联合分时间针刺治疗能显著提高RIF患者生化妊娠率、临床妊娠率及产活率,其作用机理可能是改善内膜厚度,增加子宫血流动力学参数,促进内膜生长,提高子宫内膜容受性且减低患者移植失败的焦虑抑郁情绪,调节舒畅情志,从而改善RIF患者妊娠结局。

玉屏风散化学成分、药理作用、临床应用研究进展及质量标志物预测分析

玉屏风散是历代医家常用的经典名方之一,由黄芪、白术、防风3味药组成,具有益气固表止汗之功效,主治表虚自汗症,现代药理学研究表明该方具有抗炎、抗菌、抗病毒、调节机体免疫功能、抗肿瘤等药理作用,临床常用于治疗消化系统、免疫系统、呼吸系统、皮肤科及儿科常见疾病。该文总结了近年来玉屏风散的化学成分、药理作用及临床应用的研究情况,并基于中药质量标志物(Q-marker)“五原则”——传递与溯源、特有性、有效性、复方配伍环境及可测性对玉屏风散的Q-marker进行预测分析,提示黄芪甲苷、毛蕊异黄酮苷、芒柄花素、芒柄花苷、升麻素、升麻素苷、5-O-甲基维斯阿米醇苷、亥茅酚苷、白术内酯I可作为玉屏风散的Q-marker,后续可选择以上成分为指标对玉屏风散及其制剂进行全程质量把控和评价,并建立质量溯源体系。

玉屏风散的研究进展及质量标志物预测分析

玉屏风散为扶正固本的经典名方,主治表虚自汗证,具有抗肿瘤、抗炎、抗菌、抗病毒、调节免疫作用等药理作用,现代临床多用于治疗感冒、过敏性鼻炎、支气管哮喘、肺炎、肾病综合征、慢性肾炎等。总结了近年来玉屏风散的化学成分、药理作用和临床应用,并基于中药质量标志物(Q-Marker)“五原则”对玉屏风散的质量标志物进行预测分析,揭示升麻素、5-O-甲基维斯阿米醇苷、汉黄芩素、槲皮素、山柰酚、亥茅酚苷、芒柄花素、白术内酯Ⅰ-Ⅲ、黄芪皂苷Ⅰ-Ⅱ、毛蕊异黄酮、毛蕊异黄酮-7-O-β-D-葡萄糖苷、β-谷甾醇、黄芩素、大豆皂苷、黄芪皂苷Ⅳ、异黄芪皂苷Ⅰ-Ⅱ、β-香树脂醇、异紫花前胡内酯可作为玉屏风散的质量标志物,可为建立玉屏风散复方制剂的质量控制体系提供科学参考依据。

粤港澳大湾区科技园地域性设计研究综述

文章综述了大湾区科技园地域性设计的理论研究进展;基于科技园地域性设计实践分类标准,对案例的类型及特点进行梳理;提出研究展望,以期为我国高质量发展背景下科技园的地域性设计提供参考。

黄芪赤风汤指纹图谱建立及主要成分含量测定

目的 建立10批黄芪赤风汤供试品溶液的指纹图谱,以及对方中芍药内酯苷、芍药苷、毛蕊异黄酮葡萄糖苷、芒柄花苷、毛蕊异黄酮、芒柄花素、黄芪甲苷7种主要成分进行测定。方法 采用Diamonsil C18(2)色谱柱(4.6 mm×250 mm,5μm);使用0.05%甲酸水(B)-5%四氢呋喃95%乙腈(D)为流动相进行梯度洗脱;流量:1 mL/min;柱温:23℃,进样量:10μL。基于HPLC-ELSD法,漂移管温度:60℃,柱温:30℃,进样量:20μL。结果 10批黄芪赤风汤供试品共标出16个共有峰,其相似度均在0.9以上,并对毛蕊异黄酮葡萄糖苷、芒柄花素、芍药苷、升麻素、5-O-甲基维斯阿米醇苷、毛蕊异黄酮、芍药内酯苷分别进行指认;基于HPLC-ELSD法:10批黄芪赤风汤其相似度均在0.903以上。且7种主要成分在各自的加样范围中线性关系良好,各自加样回收率RSD≤3%,含量为:芍药内酯苷(9.58±1.70)mg/g、芍药苷(8.36±0.78)mg/g、毛蕊异黄酮葡萄糖苷(0.77±0.11)mg/g、芒柄花苷(0.16±0.06)mg/g、毛蕊异黄酮(0.50±0.06)mg/g、芒柄花素(0.25±0.05)mg/g、黄芪甲苷(0.30±0.10)mg/g。结论 本研究建立的黄芪赤风汤指纹图谱分析方法可信度高、稳定,可用于黄芪赤风汤的质量控制及含量测定。

考虑“风-荷”不确定性的海上“风-储”协同调峰优化模型

海上“风-储”协同有利于提高电力系统运行稳定性,但其易受海况影响,运维难度较高。提出在电力物联网的环境下面向海上风电的储能集群协同调峰的控制方法。考虑了海上风电出力的模糊性,建立风电功率的模糊机会约束模型,并将模糊机会约束条件转化为等价清晰类,以最低运行成本和最小弃风量为目标,综合考虑系统以及各设备的运行约束条件,分别建立风-火、风-火-储调峰模型,使用布谷鸟搜索算法求出最优解。通过算例分析,结果表明,火-储联合调峰能够更好地消纳风能,并且减少系统运行成本,提高经济效益。

疏风解毒胶囊对奥密克戎无症状感染者及轻型患者舌象特征的影响

目的 探讨疏风解毒胶囊在隔离观察下对奥密克戎无症状感染者及轻型患者舌象变化特征的影响。方法采取前瞻性研究设计随机对照试验研究设计的方法,将2022年5月1日—2022年5月31日上海崇明岛复兴馆方舱医院收集的100例奥密克戎无症状感染者及轻型患者分为治疗组和对照组各50例。治疗组给予疏风解毒胶囊服用,同时给予患者隔离观察和常规护理,对照组患者给予隔离观察和常规护理。两组均观察治疗前及治疗后第3天(第1疗程)、第6天(第2疗程)的舌象变化与病情的变化,并对舌象与疗效进行分析。结果 治疗后第3天、第6天时,试验组在淡白舌的恢复效果上较对照组明显;试验组苔色(第3天、第6天)、苔质(第3天、第6天)及六经(第6天)较治疗前分布差异有统计学意义(P<0.05);对照组苔色(第6天)、苔质(第6天)及六经(第6天)分布差异有统计学意义(P<0.05),两组虽均有改善,但试验组改善情况显著优于对照组;对照组苔色(第3天)、苔质(第3天)及六经(第6天)分布差异无统计学意义(P>0.05),较治疗前无显著性改善。住院期间所有患者均未发生严重不良反应。结论疏风解毒胶囊治疗奥密克戎无症状感染者及轻型患者在舌象及六经分布的改善情况优于对照组,尤以治疗后第6天时改善更加明显,且安全性良好。

二十八味风湿骨痛汤加减在高海拔地区类风湿性关节炎治疗中的作用

目的观察二十八味风湿骨痛汤加减结合西药治疗高海拔地区类风湿性关节炎的疗效及对血清中胰岛素样生长因子结合蛋白-6(insulin-like growth factor binding protein-6,IGFBP-6)水平影响。方法研究纳入医院收治的高海拔地区类风湿性关节炎患者合计81例(2020年1月—2023年1月收治)以随机数字表法分为西药组与观察组,西药组患者(40例)采取单纯西药治疗,观察组患者(41例)采取西药结合二十八味风湿骨痛汤加减方治疗,观察各组患者临床数据:疗效、中医症候总积分变化及晨僵时间、关节压痛数及关节肿胀数变化、C反应蛋白(C-reactive protein,CRP)及类风湿因子(rheumatoid factor,RF)、血沉指标变化、IGFBP-6水平变化、血浆D-二聚体(plasmaD-dimer,D-D)与纤维蛋白原(fibrinogen,FIB)水平变化、免疫球蛋白A、G、M(ImmunoglobulinA,IgA、ImmunoglobulinG,IgG、ImmunoglobulinM,IgM)指标变化、不良反应。结果观察组患者治疗效果优于西药组,P<0.05;治疗前两组患者中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标比较,P>0.05,治疗后各组患者中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标均改善,且观察组治疗后中医症候总积分、晨僵时间、关节压痛数及关节肿胀数、CRP及RF、血沉、IGFBP-6水平、D-D、FIB、IgA、IgG、IgM等指标均优于西药组,P<0.05;观察组患者治疗不良反应率与西药组相当,P>0.05。结论二十八味风湿骨痛汤加减结合西药治疗高海拔地区类风湿性关节炎的疗效显著,可较好提升患者IGFBP-6水平,改善患者病症及凝血功能、免疫功能,治疗不良反应较少,值得应用。

加减疏风清热汤在扁桃体伴腺样体肥大切除术中的应用

目的探讨加减疏风清热汤在扁桃体伴腺样体肥大切除术中的应用效果。方法选取2019—2022年在该院行扁桃体及腺样体切除术患儿为研究对象,以随机数字表法分为两组,各51例。对照组予以西药头孢唑啉钠治疗,研究组采用加减疏风清热汤治疗。对比两组的疗效、免疫功能、中医证候评分、血清因子水平及并发症发生情况。结果研究组的临床疗效、免疫功能、血清因子水平显优于对照组(P<0.05);而研究组的炎症水平、中医证候评分及并发症发生率显著低于对照组(P<0.05)。结论加减疏风清热汤应用于儿童肺脾气虚型低温等离子切除扁桃体伴腺样体肥大的治疗中,效果极佳,能增强免疫功能,抑制抗炎,改善中医证候积分及血清因子水平,并发症少,值得推广。

汉维语有关“风”的隐喻对比研究

本文以“风”这一自然现象为研究对象,对汉维两种语言中涉及到有关“风”的隐喻表达进行对比,从中梳理出有关汉维语“风”的隐喻的相同点与不同点。汉维语中“风”的隐喻共有隐喻隐秘的消息或者没有根据的话语、隐喻变化、隐喻趋势、隐喻困难这四个相同点;不同点中,汉语中“风”隐喻自然现象、隐喻风气习俗、隐喻男女私情、隐喻没有根据的话语、隐喻音乐、隐喻疾病六个方面;维吾尔语中“风”隐喻虚无、隐喻人际关系、隐喻阻碍三个方面。本文揭示了“风”在两种语言中的语义及文化差异,促进、加深了两民族间的互相学习与交流,能够给今后的学者带来一些参考价值。This article takes the natural phenomenon of “wind” as the research object, compares the metaphorical expressions related to “wind” in Chinese and Uyghur languages, and sorts out the similarities and differences of the metaphors related to “wind” in Chinese and Uyghur. The metaphor of “wind” in both Chinese and Uyghur languages shares four similarities: implicit messages or unfounded discourse, metaphorical changes, metaphorical trends, and metaphorical difficulties;Among the differences, “wind” in Chinese metaphorically refers to six aspects: natural phenomena, cultural customs, romantic relationships between men and women, unfounded language, music, and diseases;The term “wind” in Uyghur language metaphorically refers to three aspects: nothingness, interpersonal relationships, and obstacles. This article reveals the semantic and cultural differences of “wind” in two languages, promoting and deepening mutual learning and communication between the two ethnic groups, which can provide some reference value for future scholars.

消积豁痰汤加减联合玉屏风散对肺脾气虚型支气管哮喘患者疗效及免疫功能的影响

目的 分析消积豁痰汤加减联合玉屏风散对肺脾气虚型支气管哮喘患者的疗效及对免疫功能的影响。方法 62例支气管哮喘患者以随机数字表法分研究组(31例)、对照组(31例),对照组给予玉屏风散,研究组在对照组基础上给予消积豁痰汤加减方剂治疗,两组均持续治疗3个月后评价效果。比较两组中医症状评分、肺功能及临床疗效,对比两组外周血因子、体液免疫因子、细胞免疫因子变化情况,记录两组治疗期间不良事件发生情况。结果 两组治疗后的主症、次症中医证候评分均低于治疗前(P<0.05),研究组治疗后的主症、次症中医证候评分均低于对照组(P<0.05)。两组治疗后第1秒用力肺活量(forced expiratory volume in the first second, FEV1)/用力肺活量(forced vital capacity, FVC)均高于治疗前,最大呼气流量(peak expiratory flow, PEF)变化率与FEV1变化率均低于治疗前(P<0.05),研究组治疗后的FEV1/FVC高于对照组,PEF变化率与FEV1变化率低于对照组(P<0.05)。研究组总有效率(96.77%,30/31)高于对照组(77.42%,24/31)(P<0.05)。两组治疗后血清干扰素γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)、转化生长因子-β(transforming growth factor-β,TGF-β)、白细胞介素-17(interleukin-17,IL-17)均低于治疗前(P<0.05),研究组治疗后的IFN-γ、IL-4、TGF-β、IL-17均低于对照组(P<0.05)。两组治疗后外周血中免疫球蛋白E(immunoGlobin E,IgE)、IgG、IgM均低于治疗前,补体C3、C4均高于治疗前(P<0.05),研究组治疗后的IgE、IgG、IgM均低于对照组,C3、C4均高于对照组(P<0.05)。两组治疗后辅助性T细胞1(Helper T cell 1,Th1)/Th2、Th17/调节性T细胞(Regulatory T cells, Treg)均低于治疗前,CD_(4)^(+)/CD_(8)^(+)均高于治疗前(P<0.05),研究组治疗后的Th1/Th2、Th17/Treg均低于对照组,CD_(4)^(+)/CD_(8)^(+)高于对照组(P<0.05)。两组总不良事件发生率对比差异无统计学意义(P>0.05)。结论 消积豁痰汤加减联合玉屏风散治疗肺脾气虚证支气管哮喘可改善临床症状及肺功能,增强治疗效果,改善患者外周血因子分泌及免疫功能,且安全性良好。

Interdecadal variability of summer precipitation in the Three River Source Region: Influences of SST and zonal shifts of the East Asian subtropical westerly jet

Summer precipitation in the Three Rivers Source Region(TRSR)of China is vital for the headwaters of the Yellow,Yangtze,and Lancang rivers and exhibits significant interdecadal variability.This study investigates the influence of the East Asian westerly jet(EAWJ)on TRSR rainfall.A strong correlation is found between TRSR summer precipitation and the Jet Zonal Position Index(JZPI)of the EAWJ from 1961 to 2019(R=0.619,p<0.01).During periods when a positive JZPI indicates a westward shift in the EAWJ,enhanced water vapor anomalies,warmer air,and low-level convergence anomalies contribute to increased TRSR summer precipitation.Using empirical orthogonal function and regression analyses,this research identifies the influence of large-scale circulation anomalies associated with the Atlantic–Eurasian teleconnection(AEA)from the North Atlantic(NA).The interdecadal variability between the NA and central tropical Pacific(CTP)significantly affects TRSR precipitation.This influence is mediated through the AEA via a Rossby wave train extending eastward along the EAWJ,and another south of 45°N.Moreover,the NA–CTP Opposite Phase Index(OPI),which quantifies the difference between the summer mean sea surface temperatures of the NA and the CTP,is identified as a critical factor in modulating the strength of this teleconnection and influencing the zonal position of the EAWJ.

基于网络药理学及细胞实验探讨扶正透邪解毒方治疗铜绿假单胞菌肺炎作用机制

目的:筛选扶正透邪解毒方抑制铜绿假单胞菌肺炎的中药活性化合物,并通过体外细胞实验研究扶正透邪解毒方治疗铜绿假单胞菌肺炎的作用机制。方法:在GeneCard、OMIM等数据库筛选铜绿假单胞菌肺炎疾病靶点;明确扶正透邪解毒方活性成分与铜绿假单胞菌肺炎的共同潜在靶标;利用String数据库和Cytoscape软件构建蛋白质-蛋白质相互作用(PPI)网络,利用DAVID数据库进行基因本体(GO)功能及京都基因与基因组百科全书(KEGG)通路富集分析;体外细胞实验中采用CD4^(+)T细胞与多重耐药铜绿假单胞菌共培养,以扶正透邪解毒方含药血清干预后,采用RT-PCR检测CD4^(+)T细胞中肿瘤蛋白P53(TP53)mRNA、丝氨酸/苏氨酸蛋白激酶1(AKT1)mRNA、白介素-6(IL-6)mRNA、白介素-10(IL-10)mRNA、白介素-1β(IL-1β)mRNA、肿瘤坏死因子-α(TNF-α)mRNA表达,采用Western blotting检测CD4^(+)T细胞中IL-6、TNF-α、AKT1、IL-1β、TP53、IL-10蛋白表达。结果:筛选出226种潜在活性成分及93个潜在靶点;TP53、AKT1、IL-6、IL-10、IL-1β、TNF-α等是扶正透邪解毒方治疗铜绿假单胞菌肺炎的关键靶点;扶正透邪解毒方主要通过炎症因子、趋化因子、免疫调控等信号通路来发挥治疗铜绿假单胞菌肺炎的作用。扶正透邪解毒方含药血清能降低CD4^(+)T细胞IL-6 mRNA、TNF-αmRNA、AKT1 mRNA、IL-1βmRNA表达(P<0.01),促进CD4+T细胞TP53 mRNA、IL-10 mRNA表达(P<0.01);扶正透邪解毒方含药血清能降低CD4^(+)T细胞IL-6、TNF-α、AKT1、IL-1β蛋白表达(P<0.05),促进CD4^(+)T细胞TP53、IL-10蛋白表达(P<0.05)。结论:扶正透邪解毒方可能是通过调控TNF-α、AKT1、TP53、IL-10等关键因子的表达抑制肺部感染而治疗铜绿假单胞菌肺炎。

A hybrid ventilation scheme applied to bidirectional excavation tunnel construction with a long inclined shaft

The breakage and bending of ducts result in a difficulty to cope with ventilation issues in bidirectional excavation tunnels with a long inclined shaft using a single ventilation method based on ducts.To discuss the hybrid ventilation system applied in bidirectional excavation tunnels with a long inclined shaft,this study has established a full-scale computational fluid dynamics model based on field tests,the Poly-Hexcore method,and the sliding mesh technique.The distribution of wind speed,temperature field,and CO in the tunnel are taken as indices to compare the ventilation efficiency of three ventilation systems(duct,duct-ventilation shaft,duct–ventilated shaft-axial fan).The results show that the hybrid ventilation scheme based on duct-ventilation shaft–axial fan performs the best among the three ventilation systems.Compared to the duct,the wind speed and cooling rate in the tunnel are enhanced by 7.5%–30.6%and 14.1%–17.7%,respectively,for the duct-vent shaft-axial fan condition,and the volume fractions of CO are reduced by 26.9%–73.9%.This contributes to the effective design of combined ventilation for bidirectional excavation tunnels with an inclined shaft,ultimately improving the air quality within the tunnel.

Solar and wind energy potential assessment for Razavi Khorasan Province in Iran

This study aims to evaluate the solar and wind energy potential across Razavi Khorasan Province,Iran,with a specific focus on the Khaf region.A preliminary assessment of mean solar radiation,mean wind speeds,and Weibull distribution parameters was conducted for different towns and zones within the province.The findings showed that Khaf has favorable characteristics for further analysis.The solar and wind energy metrics examined include global horizontal irradiance,clearness index,wind rose patterns,and turbulence intensity.At a height of 40 m,Khaf’s wind power density reached 1650 W/m^(2),indicating exceptional wind energy generation potential.Additionally,Khaf received an average annual solar radiation of 2046 kW·h/m^(2),representing significant solar energy potential.Harnessing these substantial renewable resources in Khaf could allow Razavi Khorasan Province to reduce reliance on fossil fuels,improve energy sustainability,and mitigate climate change impacts.This research contributes an in-depth assessment of Razavi Khorasan's solar and wind energy potential,particularly for the promising Khaf region.Further work may examine optimal sites for renewable energy projects and grid integration strategies to leverage these resources.

Self-management behavior preferences and influencing factors in Chinese patients with recurrent gout:A qualitative study

Objectives:This study aimed to explore the preferences and influencing factors of self-management behaviors in patients with recurrent gout and provide a theoretical basis for developing targeted strategies to improve self-management preferences.Methods:A total of 10 patients with recurrent gout were recruited from the gout specialist outpatient clinic at a tertiary hospital in Shenyang,Liaoning Province,China.Semi-structured interviews were conducted with these patients,and the Kawakita Jiro(KJ)method was used to analyze the interview data.Results:After four rounds of screening by five researchers,35 codes were selected from an initial 132.After three rounds of discussion and induction,the KJ method identified seven domains of selfmanagement behavior preferences in patients with recurrent gout:1)extensive knowledge of gout,yet difficulty in distinguishing between accurate and inaccurate information;2)a passive attitude of“no pain,no management”;3)the challenge of changing entrenched daily habits;4)the optimistic but unrealistic belief of“self-delusion”;5)a tendency to seek medical attention late due to hopelessness of cure and familiarity with recurrences;6)preference for analgesics for gout recurrences while neglecting long-term urate-lowering therapy(ULT);and 7)gout-related stigma.Conclusion:The results of this study showed that the self-management behavior of patients with recurrent gout could be improved,especially in the aspects of medical seeking behavior,medication compliance,daily management and emotional management.At the same time,we found that gout stigma,difficulty in distinguishing true and false knowledge of gout and negative attitude of“ignoring pain”were significantly associated with self-management behavior.

Evaluation of the slipstream in different regions around a train with respect to different nose lengths:A comparison study

In this work,the flow surrounding the train was obtained using a detached eddy simulation(DES)for slipstream analysis.Two different streamlined nose lengths were investigated:a short nose(4 m)and a long nose(9 m).The time-average slipstream velocity and the time-average slipstream pressure along the car bodies were compared and explained in detail.In addition to the time-averaged values,the _(max)imum velocities and the pressure peak-to-peak values around the two trains were analyzed.The result showed that the nose length affected the slipstream velocity along the entire train length at the lower and upper regions of the side of the train.However,no significant effect was recognized at the middle height of the train along its length,except in the nose region.Moreover,within the train’s side regions(y=2.0-2.5 m and z=2-4 m)and(y=2.5-3.5 m and z=0.2-0.7 m),the ratio of slipstream velocity U_(max) between the short and long nose trains was notably higher.This occurrence also manifested at the train’s upper section,specifically where y=0-2.5 m and z=4.2-5.0 m.Similarly,regarding the ratio of _(max)imum pressure peak-to-peak values Cp-p_(max),significant regions were observed at the train’s side(y=1.8-2.6 m and z=1-4 m)and above the train(y=0-2 m and z=3.9-4.8 m).

The impact of perception bias for cardiovascular disease risk on physical activity and dietary habits

Objective:Cardiovascular disease(CVD)remains a significant public health challenge in China.Accurateperception of individual CVD risk is crucial for timely intervention and preventive strategies.This studyaimed to determine the alignment between CVD risk perception levels and objectively calculated CVDrisk levels,then investigate the disparity in physical activity and healthy diet habits among distinct CVDrisk perception categories.Methods:From March to August 2022,a cross-sectional survey was conducted in Zhejiang Province usingconvenience sampling.Participants aged between 20 and 80 years,without prior diagnosis of CVD wereincluded.CVD risk perception was evaluated with the Chinese version of the Attitude and Beliefs aboutCardiovascular Disease Risk Perception Questionnaire,while objective CVD risk was assessed through thePrediction for Atherosclerotic Cardiovascular Disease Risk(China-PAR)model.Participants’demographicinformation,self-reported physical activity,and healthy diet score were also collected.Results:A total of 739 participants were included in the final analysis.Less than a third of participants(29.2%)accurately perceived their CVD risk,while 64.5%over-perceived it and 6.2%under-perceived it.Notably,half of the individuals(50.0%)with high CVD risk under-perceived their actual risk.Compared tothe accurate perception group,individuals aged 60e80 years old(OR=6.569),currently drinking(OR=3.059),and with hypertension(OR=2.352)were more likely to under-perceive their CVD risk.Meanwhile,participants aged 40-<60 years old(OR=2.462)and employed(OR=2.352)were morelikely to over-perceive their risk.The proportion of individuals engaging in physical activity was lowest inthe under-perception group,although the difference among the three groups was not statistically significant(X^(2)=2.556,P=0.278).In addition,the proportion of individuals practicing healthy diet habitswas also lowest in the under-perception group,and a significant statistical difference was observedamong the three groups(X^(2)=10.310,P=0.006).Conclusion:Only a small proportion of participants accurately perceived their CVD risk,especially amongthose with high actual CVD risk.Individuals in the under-perceived CVD risk group exhibited the lowestrates of physical activity engagement and healthy diet adherence.Healthcare professionals should prioritize implementing personalized CVD risk communication strategies tailored to specific subgroups toenhance the accuracy of risk perception.