肝衰竭分型机制及诊断研究的新认识

肝衰竭是多种病因所致以凝血机制障碍、黄疸、肝性脑病（hepatic encephalopathy,HE）及腹水等为主要表现的一种临床症候群,病死率高,受到国际国内学术界的广泛关注。多年来各国学者对其定义、病因、分类、分型、诊断和治疗、预后判断等问题不断进行探索。随着对肝衰竭研究的逐渐深入,结合国内外最新研究成果，特别是我国十一五及十二五重大专项课题对临床肝衰竭进行了全国系统性研究，经过反复和深入的讨论，我国2012年新版《肝衰竭诊治指南》也已出台并应用4年。

分析侧支循环对脑梗死发病机制分型及NIHSS评分的影响

目的:探讨侧支循环对脑梗死发病机制分型及美国国立卫生院卒中量表(NIHSS)评分的影响。方法:选取2018年4月-2020年4月行CT血管造影(CTA)检查的脑梗死患者115例,了解侧支循环开放情况,并比较侧支循环开放与未开放患者的临床资料、病理机制分型及治疗前后NIHSS评分。结果:115例患者中,CTA检查显示侧支循环开放40例,未开放75例;侧支循环开放与未开放患者的一般资料比较,差异无统计学意义(P>0.05);侧支循环开放组动脉-动脉栓塞、载体动脉阻塞穿支动脉所占比例高于未开放组,低灌注/栓子清除下降所占比例低于未开放组,差异有统计学意义(P<0.05);侧支循环开放组治疗前及治疗后NIHSS评分均低于未开放组,差异有统计学意义(P<0.05);侧支循环开放组与未开放组治疗后NIHSS评分均低于治疗前,差异有统计学意义(P<0.05)。结论:侧支循环可影响脑梗死发病机制分型及NIHSS评分,需引起高度关注。

再生障碍性贫血体外实验分型与临床治疗观察

目的：研究再生障碍性贫血（AA）在发病机制上的分型，以及临床治疗观察。方法：体外实验采用微量甲基纤维素半固体培养方法，治疗随机分组，选用雄激素或加用环胞菌素A（CSA）。结果：AA造血干细胞缺陷型、免疫介导型、微环境缺陷型在AA人群中都存在，以干细胞缺陷型偏多，传统的治疗方法（雄激素治疗）效不佳，部分合用CSA者有显效。结论：AA发病机理是不同的，CSA治疗AA值得进一步研究。

肱骨近端骨折的治疗进展

肱骨近端骨折占所有骨折的5％左右。60岁以上女性为甚，其发生率与老年患者骨质疏松有明显关系。随着社会人口的老龄化，肱骨近端骨折越来越常见，也称为骨质疏松性骨拆。肱骨近端骨折的患者以60岁以上的老年人多见，且老年患者数量在不断增加。由于骨折类型复杂以及患者本身相关因素差别很大，此类骨折一直都是创伤骨科的治疗难点。

跟骨骨折的治疗概述

本文通过简单回顾跟骨骨折的研究历史,扼要阐述其机制及分型,并结合跟骨骨折预后的相关影响因素对跟骨骨折的保守治疗、闭合复位、切开复位等各种治疗方法作比较。笔者认为在术中C臂透视的情况下,对跟骨进行撬拨复位空心螺钉内固定,并于骨缺损处植入适量的同种异体骨,是一种值得提倡的治疗方法。因为这种方法既可有效恢复跟骨后关节面的平整,改善跟骨的整体外形,又可明显减少伤口感染、骨坏死等各种并发症的发生,患者术后可较快恢复正常的工作和生活。

Insights into restrictive cardiomyopathy from clinical and animal studies

Cardiomyopathies are diseases that primarily affect the myocardium, leading to serious cardiac dysfunction and heart failure. Out of the three major categories of cardiomyopathies （hypertrophic, dilated and restrictive）, restrictive cardiomyopathy （RCM） is less common and also the least studied. However, the prognosis for RCM is poor as some patients dying in their childhood. The molecular mechanisms behind the disease development and progression are not very clear and the treatment of RCM is very difficult and often ineffective. In this article, we reviewed the recent progress in RCM research from the clinical studies and the translational studies done on diseased transgenic animal models. This will help for a better understanding of the mechanisms underlying the etiology and development of RCM and for the design of better treatments for the disease.

Molecular epidemiological study on pre-X region of hepatitis B virus and identification of hepatocyte proteins interacting with whole-X protein by yeast two-hybrid

AIM: To identify the pre-X region in hepatitis B virus (HBV)genome and to study the relationship between the genotype and the pre-X region. To investigate the biological function of whole-X (pre-X plus X) protein, we performed yeast two-hybrid to screen proteins in liver interacting with whole-X protein.METHODS: The pre-X region of HBV was amplified by polymerase chain reaction (PCR) method, and was cloned to pGEM Teasy vector. After the target region was sequenced, Vector 8.0 software was used to analyze the sequences. The whole-X bait plasmid was constructed by using yeast two-hybrid system 3. Yeast strain AH109 was transformed. After expression of the whole-X protein in AH109 yeast strains was proved, yeast two-hybrid screening was performed by mating AH109 with Y187 containing liver cDNA library plasmid. The mated yeast was plated on quadruple dropout medium and assayed for α-gal activity. The interaction between whole-X protein and the protein obtained from positive colonies was further confirmed by repeating yeast two-hybrid. After extracting and sequencing of plasmid from blue colonies, we carried out analysis by bioinformatics. RESULTS: After sequencing, 27 of 45 clones (60%) were found encoding the pre-X peptide. Eighteen of twenty-seven clones (66.7%) of pre-X coding sequences were found from genotype C. Five positive colonies that interacted with whole-X protein were obtained and sequenced; namely, fetuin B, UDP glycosyltransferase 1 family-polypeptide A9, mannose-P-dolichol utilization defect 1, fibrinogen-B beta polypeptide, transmembrane 4 superfamily member 4CD81 (TM4SF4).CONCLUSION: The pre-X gene exists in HBV genome.Genes of proteins interacting with whole-X protein in hepatocytes were successfully cloned. These results brought some new clues for studying the biological functions of whole-X protein.

Interferon-γ inhibits ghrelin expression and secretion via a somatostatin-mediated mechanism

AIM- To investigate if and how the proinflammatory cytokine interferon γ （IFNγ） affects ghrelin expression in mice. METHODS： The plasma concentration of ghrelin, and gastric ghrelin and somatostatin expression, were ex- amined in wild-type mice and mice infected with Helico- bacter pylori （H. pylorO. Furthermore, ghrelin expression was examined in two achlorhydric mouse models with varying degrees of gastritis due to bacterial overgrowth. To study the effect of IFNγ, alone, mice were given a subcutaneous infusion of IFNγ, for 7 d. Finally, the influ- ence of IFNγ, and somatostatin on the ghrelin promoter was characterized. RESULTS： H. py/ori infection was associated with a 50% reduction in ghrelin expression and plasma concentration. Suppression of ghrelin expression was in- versely correlated with gastric inflammation in achlorh- dyric mouse models. Subcutaneous infusion of IFNγ, suppressed fundic ghrelin mRNA expression and plasma ghrelin concentrations. Finally, we showed that the ghrelin promoter operates under the control of soma- tostatin but not under that of IFNγ. CONCLUSION： Gastric infection and inflammation is associated with increased IFNγ, expression and reduced ghrelin expression. IFNγ, does not directly control ghre- lin expression but inhibits it indirectly via somatostatin.

浅谈AO内固定技术在闭合性三踝骨折中的应用

三踝骨折则是踝部骨折中复杂程度较高,治疗难度较大的一类损伤,骨科医师若对其认识不足且诊治措施不当,容易导致各种踝部并发症的发生。AO组织积极推广内固定技术和用手术方法治疗三踝骨折,结果明显优于非手术治疗。现就AO内固定技术在三踝骨折手术中的具体使用作一简述。

Is diabetes a causal agent for colorectal cancer? Pathophysiological and molecular mechanisms

The possible relationship between diabetes mellitus (DM) and colorectal cancer (CRC), concerning pathophysiological and molecular mechanisms is highlighted in this review. The most recent and complete articles and developments in this particular field were thoroughly reviewed. Common risk factors, such as obesity, sedentary lifestyle, and Western diet between DM and CRC, led to the theory that DM might be a causal agent for CRC development. Various studies have connected type 2 DM and CRC, either proximal or distal, in both sexes. Additionally, chronic insulin treatment has been linked with increased colorectal tumor risk among type 2 diabetic patients. Interestingly, elevated hemoglobin A1c has been proven to be an independent predictor of aggressive clinical behavior in CRC patients. These mechanisms include the insulin-like growth factor-hyperinsulinemia theory and the participation of oncogenic intracellular signaling pathways. Furthermore, it has been proposed that Cox-2 inhibitors might have a role in decreasing the incidence of CRC. Finally, the use of statins to reduce the risk for colon cancer in patients with diabetes has remained controversial. Diabetic patients over 50 should receive counseling regarding their elevated risk for CRC, and screening colonoscopy should be recommended before initiating insulin therapy. However, there are no current guidelines, and this strategy is not yet applicable to some countries, as the corresponding risk would not allow screening colonoscopy to be adopted. There is strong evidence to indicate that DM is a causal agent for CRC development. This conclusion provides new impetus for re-evaluating CRC screening worldwide.

A GPCR/secretase complex regulates β- and γ-secretase specificity for Aβ production and contributes to AD pathogenesis

Dysregulation of β-site APP-cleaving enzyme （BACE） and/or γ-secretase leads to anomalous production of amyloid-β peptide （Aβ） and contributes to the etiology of Alzheimer＇s disease （AD）. Since these secretases mediate proteolytic processing of numerous proteins, little success has been achieved to treat AD by secretase inhibitors because of inevitable undesired side effects. Thus, it is of importance to unravel the regulatory mechanisms of these secretases. Here, we show that δ-opioid receptor （DOR） promotes the processing of Aβ precursor protein （APP） by BACE1 and γ-secretase, but not that of Notch, N-cadherin or APLP. Further investigation reveals that DOR forms a complex with BACE1 and γ-seeretase, and activation of DOR mediates the co-endocytic sorting of the secretases/ receptor complex for APP endoproteolysis. Dysfunction of the receptor retards the endocytosis of BACE1 and γ-secretase and thus the production of Aβ Consistently, knockdown or antagonization of DOR reduces secretase activities and ameliorates Aβ pathology and Aβ-dependent behavioral deficits, but does not affect the processing of Notch, N-cadherin or APLP in AD model mice. Our study not only uncovers a molecular mechanism for the formation of a DOR/secretase complex that regulates the specificity of secretase for Aβ production but also suggests that intervention of either formation or trafficking of the GPCR/secretase complex could lead to a new strategy against AD, potentially with fewer side effects.

Stability Analysis of Information Spreading on SNS Based on Refined SEIR Model

Investigating the stability of information spreading over SNS helps to understand the principles inherent in the spreading behavior.This paper explores the mechanisms of information spreading including stifling mechanism,latent mechanism and forgetting mechanism,establishes a refined SEIR model,and builds the corresponding mean-field equations.The methods of the differential dynamics and the next generation matrix are used to calculate the equilibriums and the basic reproductive number,and the asymptotical stability of the network equilibriums are proved theoretically.Simulation experiments are carried out to analyze the effect of the spreading mechanisms on the information spreading process and the results support our conclusions.

Molecular mechanisms of insulin resistance in chronic hepatitis C

It is now widely recognized that chronic hepatitis C (CHC)is associated with insulin resistance(IR)and type 2 diabetes,so can be considered a metabolic disease.IR is most strongly associated with hepatitis C virus(HCV)genotype 1,in contrast to hepatic steatosis, which is associated with genotype 3 infection.Apart from the well-described complications of diabetes,IR in CHC predicts faster progression to fibrosis and cirrhosis that may culminate in liver failure and hepatocellular carcinoma.More recently,it has been recognized that IR in CHC predicts a poor response to antiviral therapy. The molecular mechanisms for the association between IR and HCV infection are not well defined.This review will elaborate on the clinical associations between CHC and IR and summarize current knowledge regarding the molecular mechanisms that potentially mediate HCV-associated IR.

Distribution and mechanism of gently dipping fractures subjected to river incision: A case study from Nujiang River, China

Gently dipping fractures subjected to river incision are widely distributed on rock slopes.In this paper,a rock slope on the Nujiang River(China)is investigated to study the role of gently dipping fractures in the rock slopes evolution.Detailed field surveys indicate that gentle fractures are concentrated in four main zones.Moreover,the kinematics of the fracture system suggest that the genesis of these fractures can be synthesized into a progressive evolution model.This model indicates that the joints begin with the formation of an array of en echelon cracks that are subjected to continued crack elongation and shearing before ultimately approaching one another and interacting to form a complex joint system.Geomechanical analysis is performed to reveal the mechanisms of this genesis,and three main fracture patterns are identified based on the slope stress and are classified with respect to the slope evolution.Based on the detail field investigations and the evolutionary history of the river valley,we propose that intermittent incision by the river was the main factor contributing to the concentrated distribution of gently dipping joints.

Free radical reaction model for n-pentane pyrolysis

A mathematical mechanism of the n-pentane pyrolysis process based on free radical reaction model was presented.The kinetic parameters of n-pentane pyrolysis are obtained by quantum chemistry and the reaction network is established. The solution of the stiff ordinary differential equations in the n-pentane pyrolysis model is completed by semi implicit Eular algorithm. Then the pyrolysis mechanism based on free radical reaction model is built,and the computational efficiency increases 10 times by algorithm optimization. The validity of this model and its solution method is confirmed by the experimental results of n-pentane pyrolysis.

Stochastic Differential Game Model for Decentralized Power Control with Wisdom Regulation Factor in Wearable Audio-Oriented BodyNets

In this study, aiming at the characteristics of randomness and dynamics in Wearable Audiooriented BodyNets （WA-BodyNets）, stochastic differential game theory is applied to the investigation of the problem of transmitted power control inconsumer electronic devices. First, astochastic differential game model is proposed for non-cooperative decentralized uplink power control with a wisdom regulation factor over WA-BodyNets with a onehop star topology.This model aims to minimize the cost associated with the novel payoff function of a player, for which two cost functions are defined： functions of inherent power radiation and accumulated power radiation darmge. Second, the feedback Nash equilibrium solution of the proposed model and the constraint of the Quality of Service （QoS） requirement of the player based on the SIR threshold are derived by solving the Fleming-Bellman-Isaacs partial differential equations. Furthermore, the Markov property of the optimal feedback strategies in this model is verified.The simulation results show that the proposed game model is effective and feasible for controlling the transmitted power of WA-BodyNets.

Breakage and separation mechanism of ZGM coal mill based on parameters optimization model

Sampling ports were firstly drilled on a ZGM95 coal mill in the power plant in China, and the coal samples from various points in the pulverizer were collected under the different operation conditions. The prop- erty of the sampling material from the mill was analyzed, applying the float-sink test, size distribution analysis, proximate analysis and so on. It was indicated that the ＋250 I^m fraction in the pulverized fuel accounted for only 0.02%, while it was 83.2% in the new feed. The circulating ratio and coal flow in the separator and the cone zone were calculated using the mass balance of the circulating load. So, the cir- culating ratio in the separator of the pulverizer was between 8 and 13, and the circulating ratio, the feed flow of separator and cone zone all raised with the increase of the air volume. Furthermore, the parameters of the separation functions were obtained based on the fitting method. It was shown that the mean value of the shape factor B was 0.7617, and the parameter D which is the particle size at 50% cumulative yield in the separator almost kept unchanged.

The Forming Mechanism of Foreign language Teachers＇ Professional Development Community

Learning community is an important approach to the professional development of foreign language teachers in colleges and universities. Based on the concept of professional development community, this paper analyzes the common connotation and classification of foreign language teachers＇ professional development community, and constructs the model and forming mechanism of foreign language teachers＇ professional development community, aiming at providing enlightenment and reference for the professional development of foreign language teachers in colleges and universities

Abnormal Earthquake Intensity Areas and Formation Mechanism of the Minxian-Zhangxian M_S6.6 Earthquake on July 22,2013,Gansu

On July 22, 2013, the Minxian-Zhangxian Ms6. 6 earthquake occurred on the east segment of Lintan-Dangchang fault. The analysis of digital elevation and remote sensing imaging shows that the east segment of Lintan-Dangchang fault is still active and the main thrust feature of the fault switches to left lateral slip. With the field research of intensity and damage, several abnormal areas of degree VIII spread in the isoseismal line of degree VII and some abnormal areas of degree VII spread in the isoseismal line of degree VI. These abnormal areas are distributed along the hanging wall of the fault in a width of 2km. The analysis based on the remote sensing and digital elevation model shows that the segment of the Lintan-Dangchang fault south of Minxian mainly slips in left literal. The fault movement made the soil soft in the fault zone. The earthquake motion propagated along the fault zone. Therefore the strong earthquake motion caused foundation failure in the soft soil along the fault zone and the abnormal intense areas of disaster formed.

The Design of Small Micro-UAV Formation of ＂Sub-mother＂ type

This paper aims to provide a design about a kind of low-cost ＂sub-mother＂ UAV small formation by using the low-cost micro-UAV as the platform. Combined with the current international situation in the UAV formation research, the modeling is based on the distributed control method and the behavior-based strategy. In this paper, some research to a few key issues has been carried out.