全前循环脑梗死神经断联休克期1例护理

患男，72岁。因突发右侧肢体无力2d入院2d前患者清晨起床时感右肢体麻木无力，下床时跌倒，无外伤，未有头昏、头痛，发病后5h门诊就诊，血压24．0／13．3KPa。右侧肢体可在床上水平移动。即给予脱水降压，抗凝及脑保护治疗后病情继续加重，致右侧肢体完全不能活动入血栓科住院，病后无头痛、呕吐、抽搐及意识障碍，即往有高血压病史两年多，无明确糖尿病史。

特高压V形多联绝缘子断联冲击特性分析

特高压V形多联绝缘子串相较于其他电压等级的绝缘子串，呈现出细长比增加、柔性增强和结构更加复杂的特点，一旦发生断串其动力特性也更为复杂。通过考虑多联绝缘子串与导线的耦合效应，建立连续三档导线V形多联绝缘子串耦合非线性有限元模型。针对前串、后串和整联三种典型断串工况，研究绝缘子轴向力和各档中点位移等的冲击动力晌应，得到三种工况下绝缘子串动态冲击系数。对比导线覆冰前后多联绝缘子串断联冲击特性的变化规律。结果表明，单串断裂时的对线串耦合模型的动态冲击作用明显小于整联断裂。单串断裂时断串位置对耦合系统的动态冲击作用影响较小。同一断串工况下，覆冰对耦合系统的动态冲击响应的变化有显著影响。提供的方法和研究结果，为特高压多联绝缘子串的动载荷设计和优化提供了理论支撑。

“情境化断联”:青年“断亲”的媒介实践

从社会转型或现代化的相关理论出发,解释亲属关系出现疏离的“断亲”现象及其根源有其合理性,但难以描绘青年“断亲”的生动策略。因而本研究从青年的媒介实践出发,试图描绘“情境化断联”中“糊弄”、电子“认亲”与“断后重联”等亲缘图景。媒介技术为“断亲”议题提供表达空间的同时,也对当下亲属关系进行了革新。面对明显的青年视角和情绪化表达,“断亲”难题的纾解则需要多方合力,其背后是数字化生存状态下家庭社会关系网络的结构性重塑,相近的业缘、趣缘、利缘与价值观缘正在成为关系维系的关键。

特高压耐张复合绝缘子串断联冲击影响因素分析

为保证复合绝缘子作为耐张串应用于特高压工程的安全性,有必要对绝缘子串断联进行研究,尤其是对影响冲击系数的关键因素进行研究。设计复合绝缘子串断联试验系统,并制定实施方案。对两联耐张复合绝缘子串断联进行试验,用动态力测试系统记录试验过程中绝缘子串张力的变化情况,通过计算得到在不同张力条件下断联工况的绝缘子动力影响系数。对复合绝缘子串断联进行数值计算,用试验数据对数值计算进行验证。用数值计算方法研究联板结构高度、档距对冲击系数的影响,为进一步研究复合绝缘子的机械性能和制定相应的设计规范提供参考和依据。

500kV线路耐张复合绝缘子安全系数的选取

500kV线路的传统盘形瓷耐张绝缘子过于沉重、抗污闪性能不足、零值和经济性能差的问题越来越突出,需要采取新的技术措施。复合绝缘子以其重量轻、机械强度高、防污闪性能好等优点,已经在电力线路中的悬垂串中取得了良好的效果,解决其安全系数的选取问题是复合绝缘子应用于500kV线路耐张串上的关键问题。为此,从对比研究的思路出发,运用架空导线非线性动力学的分析方法,分析比较耐张复合绝缘子和悬垂复合绝缘子在动态力下的冲击系数。结果表明在断联、脱冰跳跃、舞动、台风等动态力作用下,耐张复合绝缘子的总体动态力冲击系数不大于悬垂复合绝缘子,得出结论:耐张复合绝缘子的安全系数与悬垂复合绝缘子一样取3是合适的。

立式钢琴击弦机结构与设计初探(上)

按照立式钢琴击弦机设计理念及实际工作中高精度的要求,在详尽分析立式钢琴击弦机将弹奏力转换为击弦力的结构形式,以及设计中较易被忽视而又影响较大的"断联"、四连杆结构的同时,提出合理的计算方法。用实验的方法解释和提出了四连杆结构的尺寸链计算公式。进而,提示专业设计、制作者注意到:立式钢琴击弦机的结构科学而精密,其任何一处尺寸的改变,都会影响整体的尺寸,而使整体结构发生变化,其计算、设计、制作的每一环节都需要高精准。

Insulation fault diagnosis based on group grey relational grade analysis method for power transformers

Utilising dissolved gases analysis, a new insulation fault diagnosis methodfor power transformers is proposed. This method is based on the group grey relational grade analysismethod. First, according to the fault type and grey reference sequence structure, some typicalfault samples are divided into several sets of grey reference sequences. These sets are structuredas one grey reference sequence group. Secondly, according to a new calculation method of the greyrelational coefficient, the individual relational coefficient and grade are computed. Then accordingto the given calculation method for the group grey relation grade, the group grey relational gradeis computed and the group grey relational grade matrix is structured. Finally, according to therelational sequence, the insulation fault is identified for power transformers. The results of alarge quantity of instant analyses show that the proposed method has higher diagnosis accuracy andreliability than the three-ratio method and the traditional grey relational method. It has goodclassified diagnosis ability and reliability.

钢琴击弦机构的两个重要指标

钢琴击弦机构中的两项性能指标,是在我们的设计、制作、维修中不容忽视的两个问题。一是弦槌击弦至距弦1～3mm处时,顶杆与凸轮脱开,弦槌靠惯性力击弦,即我们通常所说的“断联”尺寸;二是弦槌击弦后返回,被托木托住时,弦槌距弦的距离,这里我们暂且称“返回”尺寸。试对其尺寸的变化所造成的影响分析如下:

Forward and backward models for fault diagnosis based on parallel genetic algorithms

In this paper, a mathematical model consisting of forward and backward models is built on parallel genetic algorithms (PGAs) for fault diagnosis in a transmission power system. A new method to reduce the scale of fault sections is developed in the forward model and the message passing interface (MPI) approach is chosen to parallel the genetic algorithms by global sin-gle-population master-slave method (GPGAs). The proposed approach is applied to a sample system consisting of 28 sections, 84 protective relays and 40 circuit breakers. Simulation results show that the new model based on GPGAs can achieve very fast computation in online applications of large-scale power systems.

Combination of acoustic radiation force impulse imaging, serological indexes and contrast-enhanced ultrasound for diagnosis of liver lesions

AIM To assess the value of combined acoustic radiation force impulse(ARFI) imaging, serological indexes and contrast-enhanced ultrasound(CEUS) in distinguishing between benign and malignant liver lesions. METHODS Patients with liver lesions treated at our hospital were included in this study. The lesions were divided into either a malignant tumor group or a benign tumor group according to pathological or radiological findings. ARFI quantitative detection, serological testing and CEUS quantitative detection were performed and compared. A comparative analysis of the measured indexes was performed between these groups. Receiver operating characteristic(ROC) curves were constructed to compare the diagnostic accuracy of ARFI imaging, serological indexes and CEUS, alone or in different combinations, in identifying benign and malignant liver lesions. RESULTS A total of 112 liver lesions in 43 patients were included, of which 78 were malignant and 34 were benign. Shear wave velocity(SWV) value, serum alpha-fetoprotein(AFP) content and enhancement rate were significantly higher in the malignant tumor group than in the benign tumor group(2.39 ± 1.20 m/s vs 1.50 ± 0.49 m/s, 18.02 ± 5.01 ng/m L vs 15.96 ± 4.33 ng/m L, 2.14 ± 0.21 d B/s vs 2.01 ± 0.31 d B/s; P < 0.05). The ROC curve analysis revealed that the areas under the curves(AUCs) of SWV value alone, AFP content alone, enhancement rate alone, SWV value + AFP content, SWV value + enhancement rate, AFP content + enhancement rate and SWV value + AFP content + enhancement rate were 85.1%, 72.1%, 74.5%, 88.3%, 90.4%, 82.0% and 92.3%, respectively. The AUC of SWV value + AFP content + enhancement rate was higher than those of SWV value + AFP content and SWV value + enhancement rate, and significantly higher than those of any single parameter or the combination of any two of parameters.CONCLUSION The combination of SWV, AFP and enhancement rate had better diagnostic performance in distinguishing between benign and malignant liver lesions than the use of any single parameter or the combination of any two of parameters. It is expected that this would provide a tool for the differential diagnosis of benign and malignant liver lesions.

AN INTERNET-BASED REMOTE MONITORING SYSTEM FOR AUTOMOBILE TESTING SYSTEMS

Modern automobile testing systems are complexly computerized measure and control systems, and used in automobile vehicle design centers and assembly plants. Their performance is critical but difficult to be monitored efficiently and in real time. This paper introduces an Internet based remote monitoring system for automobile testing systems, and the design and the implementation using Web database and Socket techniques.

Clinical Intelligent Diagnosis Path Based on the Chief Complaint

Goals of traditional Chinese medicine(TCM)include precision,accuracy,and recognition by clinical practice.Establishment of a diagnosis and treatment system that closely conforms to the principle-method-recipe-medicines system and derivation of an accurate diagnosis and treatment plan should be considerations of TCM.Artificial intelligence research based on computer technology is one of the effective ways to solve this problem.In the research of intelligent diagnosis path,reflecting the characteristics of the overall view and dialectical treatment of TCM such as"Combination of four diagnostic methods""overall examination""combination of disease and syndrome"and"treatment individualized to patient,season and locality"are key for successful research of artificial intelligence in TCM diagnosis or recognition by clinical practice.

Expression characteristics and diagnostic value of annexin A2 in hepatocellular carcinoma

AIM： TO investigate the characteristics and diagnostic value of annexin A2 （ANXA2） expression in cancerous tissues and sera of patients with hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC）. METHODS： Levels of liver ANXA2 gene transcription or protein expression were analyzed in HCC-, their self- controlled precancerous-, and distant cancerous- tissues from 30 HCC. Serum levels of ANXA2 expression in 115 patients with HCC, 25 with metastatic liver can cer, 35 with chronic hepatitis, 28 with acute hepatitis, 38 with cirrhosis, and 30 healthy controls were deter- mined. Clinicopathological characteristics of circulating ANXA2 expression were analyzed, and its diagnostic efficiency and clinical values in HCC were evaluated. RESULTS： ANXA2 expression was localized in both cell membrane and cytoplasm in HCC tissue, mainly in the cytoplasm of matched adjacent cancerous tissue, and there was almost no positive staining in matched distant cancerous tissue. Abnormal expression of liver ANXA2 was present in HCC tissues compared with self-con- trolled adjacent- and distant-cancerous tissues at pro- tein or mRNA level. Circulating ANXA2 in HCC patients was significantly higher than that of other liver diseases （P 〈 0.01） except metastatic liver cancer. If the diag- nostic cutoff value of ANXA2 level was more than 18 ng/ mL, the incidence of serum ANXA2 was 86.96% in the HCC group, 80% in the metastatic liver cancer group, 31.58% in the liver cirrhosis group, none in the chronic hepatitis or acute hepatitis or normal control group, respectively. Serum ANXA2 expression in HCC patients was correlated with HBV infection （27.38 ± 5.67 ng/mL vs 18.58 ± 7.83 ng/mL, P 〈 0.01）, extrahepatic metas- tasis （26.11±5.43 ng/mL ys 22.79 ± 5.64 ng/mL, P 〈 0.01）, and portal vein thrombus （26.03 ± 5.99 ng/mL vs 23.06 ± 5.03 ng/mL, P 〈 0.01）, and was significantly higher （P 〈 0.01） in the moderately- （26.19±5.34 ng/ mL） or the poorly- differentiated group （27.05 ± 5.13 ng/mL） than in the well differentiated group （20.43 ± 4.97 ng/mL）, and in the tumor node metastasis stages Ⅲ-Ⅳ（P 〈 0.01） than in stages Ⅰ-Ⅱ. ANXA2 was not correlated with patient sex, age, size or α-fetoprotein （AFP） level. Area under the receiver operating charac- teristic curve for the whole range of sensitivities and specificities was 0.796 for ANXA2 and 0.782 for AFP. Combining detection of serum ANXA2 and AFP substan- tially improved the diagnostic efficiency （96.52%） and the neclative predictive value （＇96.61%） for HCC.of ANXA2 expression has good diagnostic potential for HCC diagnosis.

Experiences and benefits of positron emitted tomography-computed tomography (PET-CT) combined with video-assisted thoracoscopic surgery (VATS) in the diagnosis of Stage 1 sarcoidosis

Background： The purpose of this study was to describe our experiences and analyze the benefits of video-assisted thoracoscopic surgery （VATS） combined with positron emitted tomography （PET）-computed tomography （CT） in the diagnosis of patients with early （Stage 1） sarcoidosis. Methods： From 1995 to 2006, seven patients （two males, five females）, with ages ranging from 26 to 58 years, were impressed with Stage 1 sarcoidosis （mediastinal or hilar lymph nodes involvements without lung involvement） by histological examination of intrathoracic lymph nodes （LNs） and/or lung parenchyma taken＇from VATS biopsy. Three of them received PET or PET-CT evaluation. VATS was approached from the right and left side in one and six patients, respectively, according to the locations of their lesions. Results： All the VATS biopsied LNs or lung specimens were adequate for establishing diagnosis. Mediastinal LNs were taken from Groups 3, 4 in four, Group 7 in two, and Groups 5, 6 in one of them. Hilar LNs biopsies were performed in four cases. Lung biopsy was performed in all but two cases. All of them were expressed pathologically or radiologically as Stage 1 sarcoidosis. PET-CT revealed high emission signals over these affected LNs. These patients received oral steroid treatment or follow up only. All of them were followed up from 5 months to 11 years with satisfactory results. Conclusion： VATS biopsy is a minimally invasive, safe and effective procedure. It can be used as a diagnostic altermative of transbronchial lung biopsy （TBLB）, and can harvest larger and more areas of specimens than mediastinoscopy for staging patients with sarcoidosis. PET-CT can provide us more accurate information about the characteristics and localization of these lesions before biopsy. VATS combined with PET-CT can provide more accurate and earlier diagnosis of patients with unknown intrathoracic lesions, including the sarcoidosis.

Pre-diagnostic levels of adiponectin and soluble vascular cell adhesion molecule-1 are associated with colorectal cancer risk

AIM： To examine the relationships between pre-diag- nostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS： A nested case-control study was designed to include all first primary incident colorectal cancer cases diagnosed between inclusion in the SUpplemen- tation en VItamines et Min^raux AntioXydants cohort in 1994 and the end of follow-up in 2007. Cases （n = 50） were matched with two randomly selected con- trols （n = 100）. Conditional logistic regression models were used to investigate the associations between pre- diagnostic levels of hs-CRP, adiponectin, leptin, soluble vascular cell adhesion molecule-1 （sVCAM-1）, soluble intercellular adhesion molecule-I, E-selectin, monocyte chemoattractant protein-1 and colorectal cancer risk. Area under the receiver operating curves （AUC） and relative integrated discrimination improvement （RIDI） statistics were used to assess the discriminatory poten- tial of the models. RESULTS： Plasma adiponectin level was associated with decreased colorectal cancer risk （P for linear trend -- 0.03）. Quartiles of sVCAM-1 were associated with increased colorectal cancer risk （P for linear trend = 0.02）. No association was observed with any of the other biomarkers. Compared to standard models with known risk factors, those including both adiponectin and sVCAM-1 had substantially improved performance for colorectal cancer risk prediction （P for AUC improve- ment = 0.01, RIDI = 26.5%）. CONCLUSION： These results suggest that pre-diag- nostic plasma adiponectin and sVCAM-1 levels are as- sociated with decreased and increased colorectal cancer risk, respectively. These relationships must be confirmed in large validation studies.

Diagnosis and treatment of diverticulum of the uterus in pregnancy through hysteroscopy and methotrexate: a case report

A 27-year-old patient was diagnosed by hysteroscopy with uterine diverticulum in pregnancy and admitted to the hospital. Under the guidance of hysteroscopy combined with methotrexate, the scraping of the uterus was done and operation successfully completed. The management of this case showed that hysteroscopy was a kind of valuable approach to the diagnosis and treatment of uterine diverticulum and curettage of the uterus under hysteroscope combined with drug was a safe, effective and conservative treatment.

Long-term Effect of TCM Decoctions in Treatment of Nephrotic Syndrome

Fifty-seven cases of nephrotic syndrome were treated with TCM decoctions as accessory treatment for prednisone and cyclophosphamide, and the effects were observed in a follow-up period of 5-15 years. The long-term complete remission rate of 68.4% and recurrence rate of 26.3% in the treatment group were respectively higher and lower than those in the control group (P

Association between autoimmune pancreatitis and systemic autoimmune diseases

AIM: To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4). METHODS: The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment. Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and, in some cases, by computer tomography (CT). RESULTS: Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28%) of the 61 SAID patients. 10 patients had Sj gren's syndrome (SS) (IgG4: 590 ± 232 mg/L), 2 of them in association with Hashimoto's thyroiditis, and 7 patients (IgG4: 1388 ± 985.5 mg/L) had systemic lupus erythematosus (SLE). The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L). Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level. CONCLUSION: The serum IgG4 level may be elevated in SAIDs without the presence of AIP. The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.

Establishment of a Two-site ELISA for Detection of Chlamydia Trachomatis

Objective:To establish a rapid and simple assay for the diagnosis of Chlamydia trachomatis (CT) infection. Methods BALB/c mice were immunized with SDS-PAGE purified major outer membrane protein (MOMP) from CT and the monoclonal antibodies were obtained subsequently. Two-site ELISA was developed to detect CT infection. Results: The established assay was able to detect as low as 1.248ug/ml MOMP with interrun and inrun CV 6.9% and 3.1% respectively. 94% (34/36) of culture-positive samples were found to be positive in the current examination, indicating the high sensitivity of this assay. Conclusion: The assay is applicable for clinical diagnosis of CT infection.