双屏幕显示多功能药品计价机软件的研制

双屏幕显示多功能药品计价机软件的研制苏州市第四人民医院药剂科（２１５００１）钱汝宜苏州市第四人民医院信息科（２１５００１）陆伟我院是一所市级综合性医院，每天接收的门诊处方在１０００张以上，只有一个药品计价窗口，计价工作是十分繁忙、紧张的。随着改革开放...

Evaluation of inflammatory activity in Crohn's disease and ulcerative colitis

Crohn's disease and ulcerative colitis evolve with a relapsing and remitting course.Determination of inflammatory state is crucial for the assessment of disease activity and for tailoring therapy.However,no simple diagnostic test for monitoring intestinal inflammation is available.Noninvasive markers give only indirect assessments of disease activity.Histopathological or endoscopical examinations accurately assess inflammatory activity,but they are invasive,time consuming and expensive and therefore are unsuitable for routine use.Imaging procedures are not applicable for ulcerative colitis.The usefulness of ultrasound and Doppler imag-ing in assessing disease activity is still a matter of discussion for Crohn's disease,and an increased interest in computed tomography enterograph (CTE) has been seen,mainly because it can delineate the extent and severity of bowel wall inflammation,besides detecting extraluminal findings.Until now,the available data concerning the accuracy of magnetic resonance enterography in detecting disease activity is less than CTE.Due to this,clinical activity indices are still commonly used for both diseases.

Scheduling optimization problem considering time-of-use tariffs and piece-rate machine maintenance in EAF steelmaking

An operating schedule of the parallel electric arc furnaces(EAFs)considering both productivity and energy related criteria is investigated.A mathematical model is established to minimize the total completion time and the total electricity cost.This problem is proved to be an NP-hard problem,and an effective solution algorithm,longest processing time-genetic(LPT-gene)algorithm,is proposed.The impacts of varied processing energy consumption and electricity price on the optimal schedules are analyzed.The integrated influence of the different weight values and the variation between the peak price and the trough price on the optimal solution is studied.Computational experiments illustrate that considering the energy consumption costs in production has little influence on makespan;the computational performance of the proposed longest processing time-genetic algorithm is better than the genetic algorithm(GA)in the issue to be studied;considerable reductions in the energy consumption costs can be achieved by avoiding producing during high-energy price periods and reducing the machining energy consumption difference.The results can be a guidance for managers to improve productivity and to save energy costs under the time-of-use tariffs.

Multislice computed tomography angiography in the diagnosis of coronary artery disease

Multislice CT angiography represents one of the most exciting technological revolutions in cardiac imaging and it has been increasingly used in the diagnosis of coronary artery disease. Rapid improvements in multislice CT scanners over the last decade have allowed this technique to become a potentially effective alternative to invasive coronary angiography in patients with suspected coronary artery disease. High diagnostic value has been achieved with multislice CT angiography with use of 64- and more slice CT scanners. In addition, multislice CT angiography shows accurate detection and analysis of coronary calcium, characterization of coronary plaques, as well as prediction of the disease progression and major cardiac events. Thus, patients can benefit from multislice CT angiography that provides a rapid and accurate diagnosis while avoiding unnecessary invasive coronary angiography procedures. The aim of this article is present an overview of the clinical applications of multislice CT angiography in coronary artery disease with a focus on the diagnostic accuracy of coronary artery disease; prognostic value of coronary artery disease with regard to the prediction of major cardiac events; detection and quantification of coronary calcium and characterization of coronary plaques. Limitations of multislice CT angiography in coronary artery disease are also briefly discussed, and future directions are highlighted.

Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention

Objectives To evaluate the prognostic value of the coronary artery calcium （CAC） score in patients with stable angina pectoris （SAP） who underwent percutaneous coronary intervention （PCI）. Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography （MSCT） were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events （MACE） were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score〉300 （n=145） had significantly higher PCI complexity （13.1%vs. 5.8%, P=0.017） and rate of procedure-related complications （17.2%vs. 7.4%, P=0.005） than patients with a CAC score≤300 （n=189）. After a median follow-up of 22.5 months （4-72 months）, patients with a CAC score≤300 differ greatly than those patients with CAC score＆gt;300 in cumulative non-events survival rates （88.9 vs. 79.0%, Log rank 4.577, P=0.032）. After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio （HR）：4.3, 95%confidence inter-val （95%CI）：2.4-8.2, P=0.038] in patients with a CAC score〉300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

Optimal transmission lines assignment with maximal reliabilities in multi-source multi-sink multi-state computer network

The optimal transmission lines assignment with maximal reliabilities (OTLAMR) in the multi-source multi-sink multi-state computer network (MMMCN) was investigated. The OTLAMR problem contains two sub-problems: the MMMCN reliabilities evaluation and multi-objective transmission lines assignment optimization. First, a reliability evaluation with a transmission line assignment (RETLA) algorithm is proposed to calculate the MMMCN reliabilities under the cost constraint for a certain transmission lines configuration. Second, the non-dominated sorting genetic algorithm II (NSGA-II) is adopted to find the non-dominated set of the transmission lines assignments based on the reliabilities obtained from the RETLA algorithm. By combining the RETLA and the NSGA-II algorithms together, the RETLA-NSGA II algorithm is proposed to solve the OTLAMR problem. The experiments result show that the RETLA-NSGA II algorithm can provide efficient solutions in a reasonable time, from which the decision makers can choose the best solution based on their preferences and experiences.

Prognostic value of 18-fluorodeoxyglucose positron emission tomography-computed tomography in resectable colorectal cancer

AIM:To assess the prognostic value of preoperative 18 fluorodeoxyglucose positron emission tomography(FDG-PET)/computed tomography(CT) in patients with resectable colorectal cancer.METHODS:One hundred sixty-three patients with resectable colorectal cancer who underwent FDG-PET/CT before surgery were included.Patient data including pathologic stage at presentation,histology,treatment,disease-free survival and the maximum standardized uptake value(SUVmax) of the primary tumor on FDG-PET/CT were retrospectively analyzed.Median follow up duration was 756(range,419-1355).The primary end point was disease-free survival.RESULTS:Twenty-five of 163 patients(15.3%) had recurrences.The median SUVmax values of the recurrence and no-recurrence groups were 8.9(range,5-24) and 8.2(range,0-23,P = 0.998).Receiver operating characteristic(ROC) curve analysis showed no significant association between SUVmax and recurrence(area under the curve = 0.5,P = 0.998,95% CI:0.389-0.611).Because a statistically significant value was not found,SUVmax was dichotomized at its median of 8.6.The disease-free survival curve was analyzed using the median SUVmax(8.6) as the cut off.Univariate and multivariate analysis did not provide evidence that disease-free survival rates for the subgroups defined by the median SUVmax were significantly different(P = 0.52,P = 0.25).CONCLUSION:Our study suggests that the high FDG uptake of primary mass in resectable colorectal cancer doesn't have a significant relationship with tumor recurrence and disease-free survival.

Value of ^(99m)Tc-MDP SPECT/CT fusion imaging and CT in evaluating the extent of mandibular invasion by malignant tumor of oral cavity

Objective： The aim of our study was to compare the value of computed tomography （CT） and 99mTc-methylene- diphosphonate （MDP） SPECT （single photon emission computed tomography）/CT fusion imaging in determining the extent of mandibular invasion by malignant tumor of the oral cavity. Methods： This study had local ethical committee approval, and all patients gave written informed consent. Fifty-three patients were revealed mandibular invasion by malignant tumor of the oral cavity underwent CT and SPECT/CT. The patients were divided into two groups： group A （invasion-periphery-type） and group B （invasion-center- type）. Two radiologists assessed the CT images and two nuclear medicine physicians separately assessed the $PECT/CT images in consensus and without knowledge of the results of other imaging tests. The extent of bone involvement suggested with an imaging modality was compared with pathological findings in the surgical specimen. Results： With pathological findings as the standard of reference, Group A： The extent of mandibular invasion by malignant tumor under- went SPECT/CT was 1.02 _＋ 0.20 cm larger than that underwent pathological findings. And the extent of mandibular invasion underwent CT was 1.42 ＋ 0.35 cm smaller than that underwent pathological examination. There were significant difference among the three methods （P 〈 0.01）. Group B： The extent of mandibular invasion by malignant tumor underwent SPECT/CT was 1.3 ＋ 0.39 cm larger than that underwent pathological examination. The extent of mandibular invasion underwent CT was 2.55 ＋ 1.44 cm smaller than that underwent pathological findings. There were significant difference among the three methods （P 〈 0.01）. The extent of mandibular invasion underwent SPECT/CT was the extent which surgeon must excise to get clear margins. Conclusion： SPECT/CT fusion imaging has significant clinical value in determining the extent of mandibular inva- sion by malignant tumor of oral cavity.

Evaluation of sorafenib for hepatocellular carcinoma by contrast-enhanced ultrasonography:A pilot study

AIM:To determine the usefulness of arrival time parametric imaging(AtPI) using contrast-enhanced ultrasonography(CEUS) with Sonazoid in evaluating early response to sorafenib for hepatocellular carcinoma(HCC).METHODS:Fourteen advanced HCC patients who received sorafenib 400/800 mg/d for at least 4 wk and were followed up by CEUS were enrolled in this study.CEUS was performed before treatment and 2 and 4 wk after treatment,and images of the target lesion in the arterial phase were recorded for each patient.The images were analyzed by AtPI.Color mapping(CM) images obtained by AtPI were compared before and after the treatment.In these CM images,the mean arrival time of the contrast agent in the region of interest from the starting point [mean time(MT)] was calculated.In each patient,differences between MT before and MT 2 and 4 wk after the treatment were compared with responses evaluated 4-8 wk after the treatment by dynamic computed tomography(CT),and statistical analysis was performed.Modified response evaluation criteria in solid tumors was used for the response evaluation.RESULTS:In CM images both 2 and 4 wk after the treatment,delays in the arrival time of the contrast agent were noted in 8 of the 14 patients.In the other 6 patients,no color changes were observed in the tumor,or red and/or yellow increase,suggesting a decrease in blood flow velocity between images 2 and 4 wk after the treatment and those before the treatment.Dynamic CT could be performed 4-8 wk after the treatment in 13 of the 14 patients.Median differences in the MT were 1.13 s and 1.015 s,2 and 4 wk after the treatment,respectively,in the 8 patients who showed stable disease(SD)/partial response(PR) on dynamic CT.Median differences in the MT were-0.39 s and-0.95 s,2 and 4 wk after the treatment,respectively,in the 5 patients who showed progressive disease(PD).Differences in the median MT between SD/PR and PD groups were significant 2 and 4 wk after the treatment with P = 0.019 and P = 0.028,respectively.CONCLUSION:AtPI by CEUS using Sonazoid is suggested to be useful for evaluating early responses to sorafenib.

Model of Land Suitability Evaluation Based on Computational Intelligence

A novel model of land suitability evaluation is built based on computational intelligence (CI). A fuzzy neural network (FNN) is constructed by the integration of fuzzy logic and artificial neural network (ANN). The structure and process of this network is clear. Fuzzy rules (knowledge) are expressed in the model explicitly, and can be self-adjusted by learning from samples. Genetic algorithm (GA) is employed as the learning algorithm to train the network, and makes the training of the model efficient. This model is a self-learning and self-adaptive system with a rule set revised by training.

An Intelligent Approach to Sensory Evaluation: LVQ Neural Network

Converting between “fuzzy concept” and “numerical value” in computer aided assessment is rather difficult in many applications. This paper presents a LVQ neural network paradigm for sensory evaluation. This intelligent approach utilizes predefined class information for supervised learning in order to solve the converting problem and keep the fuzziness and imprecision of the whole sensory information. The method is validated by the experiment on stimulation evaluation of cigarette sensory.

Predictive value of ^(18)F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma

AIM： To investigate the correlation of 18F-fluorodeoxy- glucose （18F-FDG） positron emission tomography （PET） with clinical features and the prediction of treatment response. METHODS： A total of 83 hepatocellular carcinoma （HCC） patients undergoing 18F-FDG PET before transar- terial chemolipiodolization with systemic chemo-infusion between October, 2006 and May, 2009 were retrospec-tively enrolled. The patients included 68 men and 15 women （mean age, 60 ~ 10.7 years）. The effect of 18F- FDG-monitored PET uptake on clinical features and on the evaluated treatment response was ascertained with modified Response Evaluation Criteria in Solid Tumors. The PET parameters of maximal standardized uptake value of the tumor （Tsuvmax）, the ratio of the tumor maximal standardized uptake value （SUV） to the liver maximal SUV （Tsuvmax/Lsuwax） and the ratio of tumor maximal SUV to the liver mean SUV （msuvmax/LSUVrnean） were tested as predictive factors. RESULTS： Among the 3 SUV parameters, the TSUV- =maxdLsuvmean ratio （cutoff value of 1.90） was significantly associated with tumor burden including tumor size, tu- mor number, α-fetoprotein levels and tumor stage （P 〈 0.001, P = 0.008, P = 0.011, P 〈 0.001, respectively）. The objective response rates in patients with a high SUV ratio （≥ 1.90） were significantly better than those with a low SUV ratio （〈 1.90） （P = 0.020）. The overall survival rates of patients exhibiting a low Tsuvmax/Lsu- Vmean ratio （〈 1.90） and those with a high SUV ratio （≥1.90） was 38.2 and 10.3 mo, respectively （P 〈 0.01）. However, the time to progression showed no significant difference between the groups （P = 0.15）. CONCLUSION： 18F-FDG PET can be an important predictor of HCC treatment. In particular, the Tsuvmax/ Lsuwean ratio （cutoff value of 1.90） can provide useful information in treatment prognosis for HCC patients treated with Iocoregional therapy.

Peripheral bronchogenic carcinoma: Enhancement pattern evaluation on PACS and CT workstations

Objective: The aim of the study was to determine the efficiency and effectiveness of picture archiving and communication system(PACS) workstation in detecting enhancement pattern of peripheral bronchogenic carcinoma. Methods: The 62 patients with peripheral bronchogenic carcinoma underwent two-phase contrast material-enhanced multislices computed tomography(MSCT) of the chest in a single-breath-hold technique. Two spiral CT scans were obtained at 25 s and 90 s respectively after nonionic contrast material was administrated via the antecubital vein at a rate of 4 m L/s by using an autoinjector. Precontrast and postcontrast attenuation on every scan were measured on PACS and CT workstations respectively and peak height was calculated. Enhancement pattern was evaluated on the image obtained at 90 s after injection of contrast medium on PACS and CT workstations respectively. Results: No statistically significant difference in precontrast attenuation, postcontrast attenuation at 25 s and 90 s was found between these measured on a PACS workstation [(40.21 ± 7.03) HU;(55.53 ± 11.09) HU;(75.95 ± 13.45) HU] and those [(39.01 ± 8.95) HU;(56.01 ± 10.91) HU;(76.03 ± 11.95) HU] on a CT workstation(t = 1.140, P = 0.256 > 0.05; t = 1.580, P = 0.149 > 0.05; t = 1.505, P = 0.150﹥0.05). The peak height that calculated on a PACS workstation was 35.74 HU(20 HU). There was not statistically significant difference in peak height between that calculated on a PACS workstation and that on a CT workstation [(37.02 ± 12.05) HU; t = 2.001, P = 0.099 > 0.05]. The tumors showed same enhancement pattern on PACS workstation and CT workstation. Of the 62 cases, 38 showed homogeneous enhancement, 17 showed heterogeneous enhancement, five showed peripheral enhancement, two showed central enhancement, at 90 s. The enhancement pattern revealed on PACS workstation was consistent with feature of peripheral bronchogenic carcinoma. Conclusion: The efficiency and effectiveness of PACS workstation is as same as those of CT workstation in detecting enhancement pattern of peripheral bronchogenic carcinoma.

On stochastic optimal control of partially observable nonlinear quasi Hamiltonian systems

A stochastic optimal control strategy for partially observable nonlinear quasi Hamiltonian systems is proposed. The optimal control forces consist of two parts. The first part is determined by the conditions under which the stochastic optimal control problem of a partially observable nonlinear system is converted into that of a completely observable linear system. The second part is determined by solving the dynamical programming equation derived by applying the stochastic averaging method and stochastic dynamical programming principle to the completely observable linear control system. The response of the optimally controlled quasi Hamiltonian system is predicted by solving the averaged Fokker-Planck-Kolmogorov equation associated with the optimally controlled completely observable linear system and solving the Riccati equation for the estimated error of system states. An example is given to illustrate the procedure and effectiveness of the proposed control strategy.

Valuable Impulses and Successful Models of Gearbox Development from Practice

Gears play an important role in mechanical engineering because of their moment and speed transmission possibilities. Design and optimization of a complete gearbox provide many requirements to the designer. The complex gearbox model consists of many machine elements （shafts, gears, bearings, housing, seals, and shaft-hub connections）. The gearbox must be understood as a system with interactive parts. Next to the calculation of kinematics, load capacities and life times of single elements, aspects of load distribution and efficiency and noise excitation of gearboxes become important. The wide range of knowhow needed mostly cannot be covered by a small number of engineers. The development of automated calculation routines with understandable and comprehensive results is the goal for these research projects that lead to sottware-realizing solutions for engineers to efficiently design, calculate, optimize and verify gearboxes with minimal resources in terms of calculation experts and time.

Standards Education Programs' Strategic Value and CNIS Practice

This paper reviews the efforts made in educational programs on standardization by the CNIS. Based on their study and field practice, CNIS proposes that different types of programs have different aspects of strategic value for the standardization of academic and standard development institutions. The paper explains CNIS＇ strategy for educating institutions about standardization.

Institutions as Tools of Public Policy： A Comparative Evaluation of South East Asian-Sub-Saharan African Post War Development

In general, it can be argued that institutional framework a country or region designs plays a significant role in crafting, applying or even success of public policy. Drawing lessons from how Asia exploited the developmental state＇s concept by designing institutions which targeted key public policy areas such as education, health, domestic savings, and rural development, or aligned infrastructures such as roads, transport and ports, to drive economic development. The paper explores how this approach can be applied in sub-Saharan Africa （or individual countries）. The objective is to extricate constant factors impacting development both in ahistorical and atemporal terms. The investigation is guided by the key question： whether quality of institutions and institutional analysis can help explain development failures in Africa？ Hence, on one part, it probes institutions, institution-making, public policy making and what uniquely the Asian developmental state did that can help illuminate institutional role in policymaking and application. In pursuing this objective, the paper is cognisant of the question by Brousseau et al. asked, regarding generalizability of institutional capabilities, ＂If growth-enhancing institutions are identified in a specific country, can other countries learn from and transplant these＂. The investigation concludes that in public policy and development strategy-making institutions do matter as they delimit or even help create possibilities necessary for development and its sustenance, and to a certain extent, they are the vital constant （factors） that explains development differentiations in different geographic spaces or time periods.

Spectrum of mucin-producing neoplastic conditions of the abdomen and pelvis:Cross-sectional imaging evaluation

Various mucin-producing neoplasms originate in different abdominal and pelvic organs.Mucinous neoplasms differ from non-mucinous neoplasms because of the differences in clinical outcome and imaging appearance.Mucinous carcinoma,in which at least 50%of the tumor is composed of large pools of extracellular mucin and columns of malignant cells,is associated with a worse prognosis.Signet ring cell carcinoma is characterized by large intracytoplasmic mucin vacuoles that expand in the malignant cells with the nucleus displaced to the periphery.Its prognosis is also generally poor.In contrast,intraductal papillary mucinous neoplasm of the bile duct and pancreas,which is characterized by proliferation of ductal epithelium and variable mucin production,has a better prognosis than other malignancies in the pancreaticobiliary tree.Imaging modalities play a critical role in differentiating mucinous from non-mucinous neoplasms.Due to high water content,mucin has a similar appearance to water on ultrasound(US) ,computed tomography(CT) ,and magnetic resonance imaging,except when thick and proteinaceous,and then it tends to be hypoechoic with fine internal echoes or have complex echogenicity on US,hyperdense on CT,and hyperintense on T1and hypointense on T2-weighted images,compared to water.Therefore,knowledge of characteristic mucin imaging features is helpful to diagnose various mucinproducing neoplastic conditions and to facilitate appropriate treatment.

Research on the paperless test based on the computer elementary course

Compared with the traditional examinations, the paperless examination of the computer elementary course can not only realize the assessment of the theoretical knowledge, but also can carry out the assessment of the actual operations of some of the operational computer subjects, which can make it more comprehensive. Through the computer evaluation, we can make the results consistent, and get rid of the human interference as far as possible, and thus it can prevent the emergence of the human errors, to ensure fairness and justice of the tests. This issue is analyzed and discussed in the following.

Pattern Specialization Based on Partial Evaluation

Design pattern enables software architecture generality and reusability, but which depresses the high performance. The pattern specialization was built on partial evaluation technology to reduce the overheads of design pattern. The design patterns were classified to extract the common features, and the corresponding pattern specializations were constructed. In the pattern specialization, the optimization opportunities were identified, and the specialization methods and conditions were described. The syntax of binding time analysis was defined, and the semantic depicted the invariant of usage context. The virtual invocation and dispatch were eliminated, which enhances the running efficiency. This pattern specialization is a high-level specialization for improving the performance of software aimed at design level that is orthogonal with the low-level code optimization.