依达拉奉辅助治疗脑卒中后继发性癫痫临床效果观察

目的探讨依达拉奉辅助治疗脑卒中继发性癫痫的临床效果。方法选择2008年2月—2013年9月我院收治的36例脑卒中继发性癫痫患者,随机分为对照组和观察组,对照组给予常规治疗,观察组在常规治疗基础上加用依达拉奉,比较2组患者癫痫控制效果及不良反应发生情况。结果观察组患者临床显效9例(50%)、有效7例(38.9%),总有效率88.9%;对照组临床显效7例(38.9%)、有效6例(33.3%),总有效率72.2%;观察组总有效率优于对照组,组间比较差异显著(P<0.05)。2组患者均无明显不良反应发生。结论依达拉奉辅助治疗脑卒中继发性癫痫可有效提高临床疗效,无明显不良反应发生,临床应用安全、有效。

Simulation of Start-Up Process of Turbofan Engine Based on Full-State Characteristics of Fan

Difficulties in obtaining component characteristics in the sub-idle state of rotor constrain the simulation capabilities of ground and windmill start-up processes for turbofan engines.This paper proposes a backbone feature method based on conventional characteristics parameters to derive the full-state characteristics of fan.The application of the fan’s full-state characteristics in component-level model of turbofan engine enables zero-speed iterative simulation for ground start-up process and windmill simulation for windmill start-up process,thereby improving the simulation capability of sub-idle state during turbofan engine start-up.

思密达联合山莨菪碱治疗小儿病毒性腹泻临床分析

目的 :观察思密达联合山莨菪碱治疗小儿病毒性腹泻的有效性与安全性。方法 :采用随机对照方法对思密达联合山莨菪碱与思密达单用进行上市后再评价。结果 :共纳入受试者 15 8例 ,实验组 85例 ,对照组 73例 ,试验组的有效率为 97 6 % ,对照组为 72 6 % ,有显著性差异 ,加用山莨菪碱组有部分病例出现一过性不良反应。结论 :思密达联合山莨菪碱治疗小儿病毒性腹泻较思密达单用更有效 ,但应注意山莨菪碱的不良反应。

CAUSALITY DIAGRAM BASED SAFETY ANALYSIS OF MICRO TURBOJET ENGINE

An improved safety analysis based on the causality diagram for the complex system of micro aero-engines is presented.The study is examined by using the causality diagram in analytical failure cases due to rupture or pentration in the receiver of micro turbojet engine casing,and the comparisons are also made with the results from the traditional fault tree analysis.Experimental results show two main advantages：（1）Quantitative analysis which is more reliable for the failure analysis in jet engines can be produced by the causality diagram analysis;（2）Graphical representation of causality diagram is easier to apply in real test cases and more effective for the safety assessment.

Clinical Features of Renal Insufficiency due to Multiple Myeloma and Related Risk Factors

Objective: To study clinical features of the patients with multiple myeloma(MM) accompanied by renal insufficiency and investigate the related risk factors of renalimpairment. Methods: A control study of clinical characteristics was performed between 91 patientswith renal insufficiency due to MM and 165 patients with normal renal function in MM during the sameperiod. The data were statistically analyzed by chi-square test and logistic regression analysis.Results: Renal insufficiency was the initial presentation in 48 (52.7%) of the 91 patients, and 30(62.5%) of the 48 patients were misdiagnosed. The prognosis of group with renal insufficiency wassignificantly poorer than that of group with normal renal function: mortality in 3 months, 3months-1 year was 26/91 vs 14/165 (P 【 0.0001), 14/91 vs 12/165 (P 【 0.05) respectively, andpatients survived 】 1 year was 18/91 vs 95/165 (P 【 0.0001). The incidence of hypercalcemia,hyperuricemic, severe anemia, high serum M-protein concentration and lytic bone lesions weresignificantly higher in renal insufficiency group than those in control group (P 【 0.05). Logisticregression analysis identified 5 risk factors of renal impairment, including, severe anemia(Exp(β)=13.819, P 【 0.0001), use of nephrotoxic drugs (Exp(β)=6.217, P = 0.001), high serumM-protein concentration (Exp(β) = 5.026, P = 0.001), male (Exp(β)=3.745, P=0.006), andhypercalcemia (Exp(β)=3A72, P=0.006), but age, serum density of uric acid, type of serum M-protein,and Bence Jones proteinuria were not significantly associated with renal insufficiency. Conclusion:Renal insufficiency was a common early complication of MM, which often resulted in misdiagnosis.The status of these patients tended to be very bad, with many other complications, when MM wasdiagnosed, so their prognosis was poor. The occurrence of renal insufficiency in patients with MMand hypercalcemia, severe anemia, high serum M-protein concentration, especially use of nephrotoxicdrugs should be alert.

Transcatheter to Close the Patent Duetus Arteriosus and Atrial Septal Defects in Children

Objective: To evaluate the therapeutic effect, safety and complications oftranscathetering Amplatzer device in the closure of patent ductus arteriosus (PDA) and atrial septaldefects (ASD) in children. Methods: Patients with PDA (n = 25) and ASD ( n = 16), confirmed byechocardiography, were treated by transcatheterization. Amplatzer occluder device was placed by thetranscatheterization with the image support of X-ray and transthoracic echocardiography ( TTE) . TheTTE, ECG and X-ray examination were engaged to evaluate the therapeutic results on the time pointsof 24 h , 1, 3 , 6, 12 months after the operation, and all these cases were engaged to the follow-upexamination. Results: The cardioangiographic diameter was 13.0-28.0 mm ([19.3+-4.9] mm) in ASD and2.0-7.7 mm ([3.9+-1.5] mm) in PDA . The diameter of the Amplatzer occluder selected were 13.0-30.0mm ( [20.6+-5.1] mm) in ASD and 4.0-12.0 mm ([6.6+-1.9] mm) in PDA , respectively. All the Amplatzeroccluders were placed successfully. There were no complications during and after the operation.Very small residual shunt was still found soon after the operation in 10 cases , and there were noresidual or recanalization after three months of the operation. The pulmonary artery pressure andheart size were significantly decreased in follow-up examination . Conclusion: Transcatheteringclosure with Amplatzer device is an effective, simple and safe technique in the treatment of ASD andPDA in children.

Control of In Vitro Regeneration of Individual Reproductive and Vegetative Organs in Dracaena fragrans cv. massangeana Hort. Regularities of the Direct Regenerationof Individual Organs In Vitro

Various individual organs (tepal, flower bud, inflorescence branch, inflorescence, adult vegetative bud and juvenile vegetative bud) were directly regenerated respectively by callus in Dracaena fragrans cv. massangeana Hort. During the regeneration of these individual organs some regularity phenomena were observed. Firstly, the kind range of the individual organs, which are directly regenerated in vitro, is in close relationship to the differentiated stages of the organs used for explant excision during plant ontogeny. The explants excised from the epigeous organ that is differentiated at some stage (stage A) during plant ontogeny must be able to separately regenerate all of those individual epigeous organs: ones differentiated slightly later than the stage A, ones differentiated at the stage A and all ones differentiated earlier than the stage A. Secondly, within this range which kind of organ is regenerated depends on the exogenous auxin concentrations in medium. With the gradual increase of 2,4-D concentration from 0.005 mg/L to 0.5 mg/L, the kinds of regenerated organs will change by the order as follows: vegetative bud, inflorescence, inflorescence branch, flower bud, tepal. These regularities will be able to be used for inducing the direct regeneration of a given epigeous organ in angiosperms.

Differences in biological features of gastric dysplasia, indefinite dysplasia, reactive hyperplasia and discriminant analysis of these lesions

AIM: To investigate the differences in biological features of gastric dysplasia (Dys), indefinite dysplasia (IDys) and reactive hyperplasia (RH) by studying the biomarker alterations in cell proliferation, cell differentiation, cell cycle control and the expression of house-keeping genes, and further to search for markers which could be used in guiding the pathological diagnosis of three lesions. METHODS: Expressions of MUC5AC, MUC6, adenomatous polyposis coli (APC), p53, Ki-67, proliferation cell nuclear antigen (PCNA) and EGFR were studied by immunohistochemistry with a standard Envision technique in formalinfixed and paraffin-embedded specimens from 43 RH, 35 IDys, 35 Dys and 36 intestinal type gastric carcinomas (IGC). In addition, Bayes discriminant analysis was used to investigate the value of markers studied in differential diagnosis of RH, IDys, Dys and IGC. RESULTS: The MUC5AC and MUC6 antigen expressions in RH, IDys, Dys and IGC decreased gradually (MUC5AC:86.04%, 77.14%, 28.57%, 6.67%; MUC6: 65.15%, 54.29%, 20.00%, 25.00%, respectively). The expressions of the two markers had no significant difference between RH and IDys, but were all significantly higher than those ofthe other two lesions (MUC5AC: x2 = 27.607, 38.027 and 17.33, 26.092; MUC6: x2= 16.54, 12.665 and 9.282, 6.737, P＜0.01). There was no significant differencebetween RH and IDys, Dys and IGC in MUC6 expression. The APC gene expression in the four lesions had a similar decreasing tendency (RH 69.76%, IDys 68.57%, Dys39.39%, IGC 22.86%), and it was significantly higher in the first two lesions than in the last two (x2 = 7.011,16.995 and 14.737, 19.817, P＜0.05). The p53 expressionin RH, IDys, Dys and IGC was 6.98%, 20%, 57.14% and 50%, respectively. There was no significant differencebetween RH and IDys or Dys and IGC, but the p53 expression in RH and IDys was significantly lower than that in Dys and IGC (x2 = 7.011, 16.995 and 14.737, 19.817, P＜0.01).The Ki-67 label index was significantly different among four lesions (RH: 0.298±8.92%, IDys: 0.358±9.25%,Dys: 0.498±9.03%, IGC: 0.620±10.8%, P＜0.001). Positive immunostaining of PCNA was though observed in all specimens, significant differences were detected among four lesions (F= 95.318, P＜0.01). In addition, we used Bayes discriminant analysis to investigate molecular pathological classification of the lesions, and obtained the best result with the combination of MUC5AC, Ki-67 and PCNA. The overall rate of correct classification was67.4% (RH), 68.6% (IDys), 70.6% (Dys) and 84.8% (IGC), respectively.CONCLUSION: Dys has neoplastic biological characteristics, while RH and IDys display hyperplastic characteristics. MUC5AC and proliferation-related biomarkers (Ki-67, PCNA) are more specific in distinguishing Dys from RH and IDys.

Hemi-semi Laminectomy Approach for the Microsurgical Treatment of Spinal Schwannomas

Objective To evaluate the safety and efficiency of hemi-semi laminectomy approach for the micro- surgical treatment of spinal schwannomas. Methods A total of 22 patients underwent hemi-semi laminectomy for the microsurgical removal of spinal schwannomas during a period of 2009 and 2011 in Affiliated Hospital of Nantong University. We ret- rospectively analyzed the clinical outcomes of these patients. Results Of them, 5 cases were diagnosed with cervical schwannomas, 9 with thoracic schwarmomas, and 8 with lumbar schwannomas. All the tumors including two dumbbell schwannomas were totally removed without major complications. Postoperatively, all patients were followed up from 6 to 36 months. The symp- toms and signs were obviously improved, and no tumor recurrence or spinal deformity occurred. Conclusion Hemi-semi laminectomy is a safe and effective method for resection of spinal schwan- nomas

GLOBALIZATION AND RESPONSE OF LARGE STATED-OWNED ENTERPRISES IN AGRICULTURAL RELATED INDUS-TRIES: COMPANY CASE STUDIES FROM CENTRAL CHINA

By using interview data from three large state-owned enterprises (SOEs) in agriculture related industries, this paper reveals that SOEs in inland area are much slow in response to globalization. Although they pursued some strategies to adjust themselves, they are far behind the position to utilize the opportunities generated by economic globalization. Most of them are still out of the networks of transnational corporations. The strategies they adopted are quite different from SOEs in the coastal area. They overlook the importance of information infrastructure, well-educated personnel, and collaboration with the competitive leaders in their industries. The lagging situation is related to isolated location, traditional culture, and slow progress in enterprise reform. International comparison shows that the case companies did follow the general patterns that globalization promotes extension of company′s networks of linkages but in a rather slow phase. The decision makers should encourage intra-regional linkages between SOEs, between SOEs and private, foreign owned companies, as well as inter-regional linkages among them. The latter appears particularly important given the enlarging gaps between coastal and inland areas.

Donor safety in adult living donor liver transplantation using the right lobe: Single center experience in China

AIM: To evaluate the safety of donors in adult living donor liver transplantation (LDLT) using the right lobe in a single liver transplantation center in China. METHODS: We investigated retrospectively 52 living donor liver resections performed from October 2003 to July 2006. All patients were evaluated by blood tests and abdominal CT. The mean donor age was 28.2 ± 7.4 years. Residual liver volume was 42.1% ± 4.7%. Mean operative time was 420 ± 76.2 min; mean ICU stay, less than 36 h; mean hospital stay, 16.4 ± 8.6 d; and mean follow-up period, 6 mo. RESULTS: There was no mortality. The overall complication rate was 40% (21 donors). Major complications included biliary leak in two, and pneumonia in 2 donors. Minor complications included mild pleural effusion in 12 donors, transient ascites in 6, mild depression in 4, intra-abdominal collections in 2, and wound infections in 1 donor. Residual liver volume did not affect the complication rate. None required re- operation. Return to pre-donation activity occurred within 5-8 wk. CONCLUSION: Right hemi-hepatectomy can be performed safely with minimal risk in cases of careful donor selection. Major complications occurred in only 7.7% of our series.

Agenesis of the dorsal pancreas

During the last 100 years in medical literature,there are only 54 reports,including the report of Pasaoglu et al(World J Gastroenterol 2008;14:2915-2916),with clinical descriptions of agenesis of the dorsal pancreas in humans.Agenesis of the dorsal pancreas,a rare congenital pancreatic malformation,is associated with some other medical conditions such as hyperglycemia,abdominal pain,pancreatitis and a few other diseases.In approximately 50% of reported patients with this congenital malformation,hyperglycemia was demonstrated.Evaluation of hyperglycemia and diabetes mellitus in all patients with agenesis of the dorsal pancreas including description of fasting blood glucose,oral glucose tolerance test,glycated hemoglobin and medical treatment would be a future goal.Since autosomal dominant transmission has been suggested in single families,more family studies including imaging technologies with demonstration of the pancreatic duct system are needed for evaluation of this disease.With this letter to the editor,we aim to increase available information for the better understanding of this rare disease.

Clinical study on safety of adult-to-adult living donor liver transplantation in both donors and recipients

AIM： TO investigate the safety of adult-to-adult living donor liver transplantation （A-A LDLT） in both donors and recipients. METHODS： From January 2002 to July 2006, 50 cases of A-A LDLT were performed at West China Hospital, Sichuan University, consisting of 47 cases using right lobe graft without middle hepatic vein （HHV）, and 3 cases using dual grafts （one case using two left lobe, 2 using one right lobe and one left lobe）. The most common diagnoses were hepatitis B liver cirrosis, 30 （60%） cases; and hepatocellular carcinoma, 15 （30%） cases in adult recipients. Among them, 10 cases had the model of end-stage liver disease （HELD） with a score of more than 25. Donor screening consisted of reconstruction of the hepatic blood vessels and biliary system with 3-dimension computed tomography and volumetry of whole liver and right liver volume. Various improved surgical techniques were adopted in the procedures for both donors and recipients. RESULTS： Forty-nine right lobes and 3 left lobes （2 left lobe grafts for 1 recipient, 1 left lobe graft for 1 recipient who had received right lobe graft donated by relative living donor） were obtained from 52 living donors. The 49 right lobe grafts, without HHV, weighed 400 g-850 g （media 550 g）, and the ratio of graft volume to recipient standard liver volume （GV/SLV） ranged from 31.74% to 71.68% （mean 45.35%）. All donors＇ remnant liver volume was over 35% of the whole liver volume. There was no donor mortality. With a follow- up of 2-52 mo （media 9 too）, among 50 adult recipients, complications occurred in 13 （26%） cases and 4 （8%） died postoperatively within 3 mo. Their 1-year actual survival rate was 92%.CONCLUSION： When preoperative CT volumetry shows volume of remnant liver is more than 350, the ratio of right lobe graft to recipients standard liver volume exceeding 40%, A-A LDLT using right lobe graft without MHV should be a very safe procedure for both donors and recipients, otherwise dual grafts liver transplantation should be considered.

CLINICAL COMPLICATIONS AND SAFETY OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY:A REPORT OF 1552 EXAMINATIONS

Method Fifteen hundred and fifty two patients with heart disease were examined with monoplane, biplane and omniplane TEE probe(including male 727, female 825;9～76 years old) During the same period, 113 307 precordial echocardiographic examinations were performed in our laboratory The ratio between TEE and transthoracic Echo examines was 1:73 Result All different kinds of complication were occurred during TEE examination, including vomiting, minor mucus bleeding, laryngospasm, mandibular dislocation, angina pectoris, arrhythmia, even ventricular fibrillation and death The article suggested that there were five steps must be improved during TEE examination including instrument and patients preparation, local anesthesia, manipulation technique and TEE probes pattern Conclusion Although TEE is a semiinvasive technique and can cause some kinds of complication, it is a safe technique if the five steps are improved

Pure red cell aplasia due to parvovirus B19 infection after liver transplantation:A case report and review of the literature

Pure red cell aplasia （PRCA） due to parvovirus B19 （PVB19） infectiori after solid organ transplantation has been rarely reported and most of the cases were renal transplant recipients, Few have been described after liver transplantation. Moreover, little information on the management of this easily recurring disease is available at present. We describe the first case of a Chinese liver transplant recipient with PVB19-induced PRCA during immunosuppressive therapy. The patient suffered from progressive anemia with the lowest hemoglobin level of 21 g/L. Bone marrow biopsy showed selectively inhibited erythropoiesis with giant pronormoblasts. Detection of PVB19-DNA in serum with quantitative polymerase chain reaction （PCR） revealed a high level of viral load. After 2 courses of intravenous immunoglobulin （IVIG） therapy, bone marrow erythropoiesis recovered with his hemoglobin level increased to 123 g/L. He had a lowlevel PVB19 load for a 5-too follow-up period without recurrence of PRCA, and finally the virus was cleared. Our case indicates that clearance of PVB19 by IVIG in transplant recipients might be delayed after recovery of anemia.

Work safety and sustainable development in enterprise

The nature of work safety and the way insisting on sustainable development in enterprise were analyzed. It indicates that problem of work safety in enterprise is closely related to the public’s consciousness, to the development of science and tech- nology, and to the weakening of safety management during the economic transition pe- riod. However, it is the people’s questions concerned in the final analysis for the forming and development of the problem of work safety. Therefore, in order to solve the problem of work safety radically, the most basic way of insisting on the sustainable development in safety administration is to do a good job of every aspect about people. We should im- prove all people quality in science and culture and strengthen their safety and legal consciousness to form correct safety value concept. We should fortify safety legislation and bring close attention to approach and apply new safety technology.

Chronic hepatitis C infection in a patient with bone marrow hypoplasia

Chronic hepatitis C virus(HCV) infection is associated with multifarious extra-hepatic manifestations;the most described and discussed being mixed cryoglob-ulinemia which is strongly related to B-cell lympho-proliferative disorders(LPDs).We present a case of chronic HCV infection and mixed cryoglobulinemia,with minimal liver involvement.The case is a 53-year-old patient who was diagnosed as having bone marrow hypoplasia at the age of three.She received several blood transfusions to normalize her haemoglobin.At the age of 31,she was diagnosed with rheumatoid ar-thritis on account of her diffuse joint pain and inflam-mation,elevated rheumatoid factor(RF) and Raynaud's phenomenon.Twenty years later,monoclonal gam-mopathy of IgG Lambda(one year later,changed to IgM Kappa) was detected during a routine examina-tion.A bone marrow biopsy showed hypoplasia,Kappa positive B-lymphocytes and low-grade malignant lym-phoma cells.PCR of the bone marrow aspirate was not contributory.No treatment was initiated owing to herpoor bone marrow function and she is under regular follow-up.

A Multivariate Public Key Cryptographic Scheme

This paper presents a multivariate public key cryptographic scheme over a finite field with odd prime characteristic.The idea of embedding and layering is manifested in its construction.The security of the scheme is analyzed in detail,and this paper indicates that the scheme can withstand the up to date differential cryptanalysis.We give heuristic arguments to show that this scheme resists all known attacks.

Metastases of esophageal carcinoma to skeletal muscle:Single center experience

Metastases of esophageal carcinoma to the skeletal muscle are rare,but the incidence may be increasing because of better diagnosis resulting from widespread use of positron emission tomography/computed tomography(PET/CT).A cohort of 205 patients with esophageal carcinoma treated at our center who had PET/CT between 2006 and 2010 was retrospectively evaluated for the presence of skeletal muscle metastases.Four patients had skeletal muscle metastases of esophageal carcinoma,including two patients with squamous cell carcinoma.In another patient with squamous cell carcinoma of the esophagus and synchronous skeletal muscle metastases,muscle metastases were subsequently shown to be related to second primary pancreatic adenocarcinoma.In all cases,skeletal muscle metastases were the first manifestation of systemic disease.In three patients palliation was obtained with the combination of external beam radiation therapy,systemic chemotherapy or surgical resection.Skeletal muscle metastases are a rare complication of esophageal carcinoma.

Energy Security in the European Union

According to the European Commission, the three challenges that Europe must face related to energy are sustainability, security of supply and reaching an effective competitiveness in the internal energy market. To meet these three challenges, the Commission deems necessary to implement a common energy policy. To this end, it proposed an action plan based on the effective creation of an internal energy market, the solidarity between Member States and security of supply for oil, gas and electricity, Therefore energy security is one of the main concerns, and so one of the priorities, of the new European energy policy proposed by the Commission. This paper tries to show that even though energy has been on the basis of what we call today European Union, it has been extremely complicated to get a common energy policy. Bearing this in mind, energy security has been one of the main areas of consensus that has led EU to the mentioned Commission proposal, and we can see now the first steps of the so much wanted common energy policy.