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Antibiotic Resistance Profile of Salmonella Strains Isolated at the National Clinical Biology and Public Health Laboratory in Bangui, Central African Republic
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作者 Marceline Djeintote Ernest Lango-Yaya +6 位作者 Zéphirin-Dalengat Vogbia Clotaire Donatien Rafaï Augustin Balekouzou Henri Saint-Claver Djemer Wilfried Sylvain Nambei Boniface Koffi Gérard Gresenguet 《Health》 2024年第2期160-171,共12页
In Africa, each year, there are estimated to be more than 91 million cases of salmonellosis and 137,000 cases of death. The problem of antibiotic resistance in Salmonella strains is a threat to public health. The obje... In Africa, each year, there are estimated to be more than 91 million cases of salmonellosis and 137,000 cases of death. The problem of antibiotic resistance in Salmonella strains is a threat to public health. The objective of this study is to evaluate the antibiotic resistance profile of Salmonella strains isolated in biological products analyzed at the National Laboratory of Clinical Biology and Public Health (NLCBPH) in Bangui. This is, therefore, a cross-sectional study with a descriptive aim, running from January to December 2022. It focused on the strains of Salmonella isolated and identified in stools, urines, and blood samples. For each strain of Salmonella isolated, an antibiogram was carried out following the recommendations of the French Society of Microbiology (CASFM, 2022). A total of 93 strains of Salmonella have been recorded. The age group 0 - 9 years was 29% and that of >50 years was 11%. The median age of patients was 30 years with a minimum of 1 and a maximum of 78 years. The female gender was more represented at 52.69% than the male gender at 47.31%, i.e. a sex ratio of 0.89 (M/F). Salmonella strains were much more isolated in stools at 62% followed by urines at 29% and blood at 6%. Salmonella arizonae strains were more represented with 52%. Salmonella strains have a resistance rate to Tetracycline of 62.37% followed by Penicillins of 50%. The rate of multi-antibiotic resistance of the Salmonella strains isolated represented 48.38%. Salmonella spp. strains were multi-resistant at 58.69% followed by Salmonella arizonae strains at 47.91%. There is a significant association between the different families of antibiotics and Salmonella strains (p < 0.05). According to the results obtained, Penicillins, Phenicoles, and Cyclins had a high rate of resistance on Salmonella strains. No strain-producing Broad Spectrum Beta-lactamase has been isolated. Salmonella strains represent a zoonotic health danger, constitute a public health problem and remain a current subject. This germ is resistant to the antibiotics used. It is, therefore, essential to emphasize monitoring the resistance of these germs in the Central African Republic (CAR) to improve the health of the population. 展开更多
关键词 SALMONELLA Resistance ANTIBIOTICS central African Republic
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Epidemiological and Clinical Aspects of Male Infertility in Patients Consulting at the Urology Department of the Yaounde Central Hospital
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作者 Achile Aurele Mbassi Florent Ymele Fouelifack +2 位作者 Fatoumata Touda Dehukwe Maguira Roosvelt Dongmo Tiodjou Magloire Sida Biwole 《Open Journal of Obstetrics and Gynecology》 2024年第3期348-358,共11页
Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and cl... Introduction: About 10 to 15% of couples in the world and 20 to 30% in Cameroon consult for infertility problems. Infertility is of male origin in 40% of cases. Our objective was to evaluate the epidemiological and clinical aspects of male infertility in our setting. Methods: This was a cross-sectional and descriptive study, with retrospective data collection from the files of patients received for male infertility, over 5 years and 6 months (from January 1<sup>st</sup>, 2016 to April 30<sup>th</sup>, 2021) at the Urology Department of the Yaounde Central Hospital. Phone calls were made to patients with incomplete records for completion following a verbal consent. Data reported on data collection forms were entered into a data entry form designed on CSPro software version 7.2. The database was later exported for descriptive statistics using the IBM SPSS software version 23. Qualitative variables were summarized in frequencies and percentages while quantitative variables were summarized in means with their standard deviations for normally distributed data, or medians and interquartile ranges otherwise. Results: Out of 110 patients whose records were analyzed, the median age was 37.0 years, with an interquartile range of 8.3, with 55.5% in the age group 30 to 39 years. Of these 95 (86.4%) were married, 58 (52.7%) were from the West region, 76 (69.1%) were employed. Past history was dominated by mumps 40 (36.4%), varicocele surgery 25 (22.7%), alcoholism 87 (79.1%) and smoking 15 (13.6%). A disorder of spermatogenesis was found in all our patients: 37 (33.6%) azoospermia, 27 (24.6%) asthenospermia and 26 (23.7%) oligospermia patients. Paraclinical evidence of chlamydia and gonococcal infections were found respectively in 38 (34.5%) and 14 (12.7%) patients, varicocele and testicular dystrophy respectively in 95 (86.4%) and 38 (34.5%) patients. Infertility was primary in 67 (60.9%) patients. Conclusion: Most patients with infertility were in their thirties, had risky social habits and comorbidities. An early start of health promotion activities, comorbidities prevention and early detection of spermogram abnormalities would make it possible to reduce the frequency of male infertility. 展开更多
关键词 Epidemiology Clinical Male Infertility central Hospital Yaounde
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Contribution to the Study of Fungal Strains Contaminating Peanut Pastes in Bangui (Central African Republic)
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作者 Romaric Lebon Bondom Ernest Lango-Yaya +6 位作者 Mireille Morissi Denissio Clotaire Donatien Rafai Alban Thibaut Moulo-Oli Zéphirin Vogbia Dalenga Marceline Djeintote Mossoro-Kpindé   Boniface Koffi 《Journal of Biomedical Science and Engineering》 2024年第5期97-106,共10页
Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contam... Introduction: Peanut pastes are food products resulting from artisanal or industrial processing, used in cooking in Africa in general and in Central African Republic in particular. These peanut pastes are often contaminated by molds and filamentous fungi involved in the degradation of hygienic and organoleptic or even toxicological quality. This study aims to determine the epidemiological profile of molds contaminating peanut pastes sold on the Central African market. Methodology: This was a cross-sectional study carried out from June to September 2023. Samples of peanut pastes sold on Central African market were taken and analyzed at the National Laboratory of Clinical Biology and Public Health using the conventional microbiology method according to ISO 7954 standards. The data obtained were collected in the ODK 2023.3.1 application and analyzed with the Epi Info 7 software. A multivariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Penicillium sp.;11.25% of Mucor sp.;10.63% of Aspergillus terrei;3.13% of Aspergillus niger;1.25% of Aspergillus medullans;28.13% of Aspergillus flavus;2.50% of Aspergillus fumigatus. Peanut pastes stored beyond three days were more contaminated (94.19%). Conclusion: The results of this study made it possible to highlight strains of mold that impact the hygienic and organoleptic quality of peanut pastes sold at the Central African market. Most of the isolated strains were the Aspergillus flavus species which is recognized by its toxigenic effects. This species is much more incriminated in the contamination of foodstuffs with the production of the toxin which causes underlying pulmonary pathologies in humans. 展开更多
关键词 Peanut Pastes FUNGAL CONTAMINATION central African Republic
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Contribution to the Study of the Incidence of Post-Streptococcal Complications in Republic Central African Republic from 2015 to 2018
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作者 Zéphirin Dalengat Vogbia Ernest Lango Yaya +7 位作者 Jean De Dieu Longo Augustin Balekouzou Gaspard Tekpa Christian Maucler Pamaticka Stéphanie Judith N’Yetobouko Maurel Anicet Adonis Ouoko Fatigbia Christian Diamant Mossoro Kpindet Gérard Gresenguet 《Open Journal of Epidemiology》 2024年第1期110-121,共12页
Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present stud... Introduction: Acute rheumatic fever (AAR) is a non-suppurative complication of late infection by group A. Infections due to streptococci remain a public health problem in the Central African Republic. The present study aims to determine the incidence rate of AAR cases and its complications. Methodology: This was a retrospective and analytical study over a period of 4 years (from January 2015 to December 2018) at the National Laboratory of Clinical Biology and Public Health (LNBCSP) in Bangui. It focused on samples concerning the diagnosis of AAR and patient files seen in consultation in the capital’s reference health establishments. Laboratory registers and patient consultation files were used to collect data. They were entered into Excel 2010 to be analyzed with Epi Info 7. A univariate analysis by logistic regression, Ficher’s exact test, and chi<sup>2</sup> at the 5% threshold (p Results: We analyzed 94 cases meeting Jones’s criteria. The ages of the patients ranged from 18 to 85 years (mean age 52 years and mode 45 years). The incidence rate of AAR for the female sex was higher than that of the male sex during the study period (p > 0.05). It went from 166.6 in 2015 to 200 in 2016 and 2018 cases of AAR per 1000 people per year. The average incidence rate was 296.18 cases of AAR per 1000 people per year. The average incidence rate was 223.5 cases of AAR per 1000 people per year for joint damage. Joint damage represented 80.85% (RR = 0.62;Chi<sup>2</sup> = 4.88;95% CI [0.39-0.97];p Conclusion: The study allowed data on the impact rate and complications of the AAR in Bangui. Special attention to data management will help produce a complete result on the problem. Joint complications predominated. Sustaining an effective surveillance system and preventing infection would help reduce the risk of AAR occurrence. 展开更多
关键词 INCIDENCE Acute Joint Rheumatism central African Republic
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Contribution of Genomic Surveillance in the Detection and Monitoring of SARS-CoV-2 Variants during the 6 Pandemic Waves in the Central African Republic from 2020 to 2023
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作者 Clotaire Donatien Rafaï Ernest Lango-Yaya +6 位作者 Marie Roseline Darnicka Belizaire Ouoko Fa-Ti-Gbia Maurel Annicet Adonis Marcel Mbeko Simaleko Jean-Baptiste Roungou Oscar Senzongo Karl G. Njuwa Fai Boniface Koffi 《Journal of Tuberculosis Research》 2024年第3期151-164,共14页
Objective: The COVID-19 pandemic has highlighted the need to strengthen diagnosis and genomic surveillance capacities. In 2021, Central African managed five waves of COVID-19 by integrating genomic surveillance into t... Objective: The COVID-19 pandemic has highlighted the need to strengthen diagnosis and genomic surveillance capacities. In 2021, Central African managed five waves of COVID-19 by integrating genomic surveillance into their health monitoring system. This study sought to report surveillance data from the National Laboratory of Clinical Biology and Public Health and describe the circulation of SARS-CoV-2 variants. Materials and Methods: This retrospective, descriptive observational study spans three years, from April 2020 to November 2023. It was conducted on a population of consenting volunteers from across the Central African Republic, who were tested using RT-PCR on nasopharyngeal samples. Data with sufficient information were obtained from the National Laboratory of Clinical Biology and Public Health (LNBCSP) databases. Sequencing was largely carried out at the National Institute of Biomedical Research (INRB) in Kinshasa until May 2023, and subsequently at the LNBCSP. Results and Discussion: Out of 97,864 RT-PCR tests performed, 9,764 were positive, resulting in a prevalence of 9.98%. The average age of the patients was 39.97 years ± 13.76, and the male-to-female sex ratio was 2.12. RT-PCR test positivity was significantly associated with age (p = 0.001), sex (p = 0.013) and clinical manifestations. Ten variants circulated during the five recorded waves, with Omicron (B.1.1.529), Delta (B.1.617.2) variants being predominant. Notably, the B.1.620 and B.640 variants were prominent during the second wave. Conclusion: This retrospective study provides key insights into the COVID-19 pandemic in the CAR. It identifies risk factors and details the circulation of various SARS-CoV-2 variants. Enhancing national genomic surveillance capacities would enable the country to better respond to future pandemic challenges. 展开更多
关键词 SARS-CoV-2 VARIANTS central African Republic RT-PCR
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Caulerpa J. V. Lamouroux (1809) (Chlorophyta: Bryopsidales) Species and Sites in Eastern Samar, Central Philippines
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作者 Ma. Natalia A. Ciasico 《Open Journal of Ecology》 2024年第10期747-753,共7页
A descriptive survey was conducted in Eastern Samar to identify the Caulerpa species, sites where these species exhibit massive populations, and the most preferred edible species. Results revealed that only four of th... A descriptive survey was conducted in Eastern Samar to identify the Caulerpa species, sites where these species exhibit massive populations, and the most preferred edible species. Results revealed that only four of the eleven species, C. racemosa, C. lentillifera, C. chemnitzia var. peltata, and C. cylindracea, have massive populations;The four Caulerpa sites are the municipalities of Arteche, Guiuan, Salcedo (Matarinao Bay) and Quinapondan, and species C. racemosa, C. lentillifera, and C. chemnitzia var. peltata are most preferred edible species which are considered in the local diet. The study concludes that the distribution of Caulerpa in Eastern Samar is area-specific and should therefore be considered in resource planning and management, particularly in relation to aquaculture. 展开更多
关键词 Caulerpa Species Caulerpa Sites Caulerpa Massive Populations Edible Species central Philippines
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Prevalence of Gender-Based Violence among Sex Workers in Bangui, Central African Republic (CAR)
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作者 D. Mossoro-Kpinde Hermione S. C. Diemer Henri +2 位作者 R. Tende Nzengou Richard S. Siki Francis J. D. D. Tekpa Bertrand 《Advances in Sexual Medicine》 2024年第2期13-20,共8页
Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a majo... Background: Violence against women has become an international public health and human rights issue in recent decades. The violence suffered by sex workers is of little interest for research, yet it constitutes a major health and safety problem. We propose to assess the extent of the phenomenon of gender-based violence (GBV) among sex workers (SWs) in the city of Bangui in the CAR. Methodology: This is a descriptive cross-sectional epidemiological study covering the period from July to October 2021 carried out among SWs in Bangui, the capital of the CAR. Given that the SWs association had only 159 members in Bangui, an exhaustive sampling was retained. Were included in the study, any SW present during the data collection period and having given their written consent. The parameters studied were socio-demographic characteristics: age, sex, residence, level of education, marital status, and characteristics linked to violence: the notion of violence during their professional activity, the type of violence, the declaration and the declaration if necessary, the response and management of this violence. The data collected was analyzed using Epi info version 7 software. Results: Of the 159 SWs that counted the association, 108 had been included. The average age was 27.0 years with extremes of 14 and 46 years. The age groups of 25 to 34 years were the most represented (43.5%). Fifty-six SWs (51.9%) had reached the secondary level. Unemployed SWs were in the majority at 74.1%;Sixty-six (66) SWs in our sample (61.1%) had already been victims of violence during the exercise of their activity Sexual violence was the most represented (28.5%) followed by verbal violence (22.4%). Sixty-eight (62.9%) wanted to stop the professional activity of SWs and 93.1% would accept another income-generating activity in place of sex work. Conclusion: It is necessary to supervise SWs and protect them within the framework of respect for human rights, rather than criminalizing them and the exploiters flouting their human dignity and putting their lives in danger. . 展开更多
关键词 Female Sex Workers Gender-Based Violence central African Republic
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Epidemiological Profile of Men Who Have Sex with Men: First Data about Male Sex Workers in Central African Republic (CAR)
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作者 Hermione Dahlia Mossoro-Kpinde Balekouzou Augustin +1 位作者 Paola Julienne Demba Henri Saint Calvaire Diemer 《Advances in Sexual Medicine》 2024年第1期1-11,共11页
Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex wor... Objectives: Sex work is not well documented among African men. The aim of this study was to describe the epidemiological profile of men who have sex with men (MSM) and eventually to determine the proportion of sex workers (SW) among them, as well as the proportion of MSM who have been victims of gender-based violence (GBV). Material and Methods: A cross-sectional study coordinated by the Direction de la Médecine du Travail was carried out at the headquarters of the association ALTERNATIVES in Bangui Bangui from July 1 to October 31, 2021. Consenting MSM present during the study period were systematically included. Sociodemographic variables, those relating to the future vision of the activity and to GBV were collected and analyzed using Epi-Info version 7 software. Results: Forty MSM with an average age of 23 years and mainly secondary education (75.0%) were included. The vast majority of MSM were unemployed (85.0%). 45.0% had been victims of GBV and wanted to stop working as an MSM (47.5%), and almost 2/3 (65.0%) would accept another income-generating activity in exchange for the MSM. Violence was sexual (32.5%), economic (22.5%), physical (20.0%), verbal (12.5%) and psychological (12.5%). Conclusion: The MSM were mainly young, poorly educated, unemployed, and almost half were victims of GBV. The desire to change MSM activity to another income-generating activity alongside that of MSM shows that many of them are SW, workers in the informal sector. This must be taken into account in prevention activities, even if the data needs to be confirmed on a much larger sample. 展开更多
关键词 Men Who Have Sex with Men Sex Workers Gender-Based Violence Informal Sector central Africa
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Designing a Protection Scheme in Micro-Grid Systems with DG Using Central Protection Unite and Multiple Setting Group Protection Relays
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作者 Mostafa I. Saleh Gaber El-Saady +1 位作者 Ali M. Yousef El-Noby A. Ibrahim 《Journal of Power and Energy Engineering》 2024年第9期37-49,共13页
Distributed generators now is widely used in electrical power networks, in some cases it works seasonally, and some types works at special weather conditions like photo voltaic systems and wind energy, and due to this... Distributed generators now is widely used in electrical power networks, in some cases it works seasonally, and some types works at special weather conditions like photo voltaic systems and wind energy, and due to this continuous changes in generation condition, the fault current level in network will be affected, this changes in fault current level will affect in the coordination between protection relays and to keep the coordination at right way, an adaptive protection system is required that can adaptive its setting according to generation changes, the fault current level in each case is evaluated using ETAP software, and the required relay setting in each case is also evaluated using Grey Wolf Optimizer (GWO) algorithm, and to select suitable setting which required in each condition, to select the active setting group of protection relay according to generation capacity, central protection unite can be used, and to improve protection stability and minimizing relays tripping time, a proposed method for selecting suitable backup relay is used, which leads to decrease relays tripping time and increase system stability, output settings for relays in all cases achieved our constrains. 展开更多
关键词 Directional Overcurrent Relay Protection Coordination Distributed Generators central Protection Unite Multiple Setting Group Protection Relay
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Class Central慕课课程How to Write an Essay教学设计分析
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作者 张春芳 冯建雯 《常州信息职业技术学院学报》 2023年第3期71-73,78,共4页
调研了美国Class Central网站发布的“2023年250门全球最受欢迎在线课程榜”19门英语写作类MOOC课程。How to Write an Essay被列为250门全球最受欢迎MOOC课程之一,源于其优质的教学设计:世界顶尖大学及其丰富的在线课程经验、优秀师资... 调研了美国Class Central网站发布的“2023年250门全球最受欢迎在线课程榜”19门英语写作类MOOC课程。How to Write an Essay被列为250门全球最受欢迎MOOC课程之一,源于其优质的教学设计:世界顶尖大学及其丰富的在线课程经验、优秀师资,教学目标注重培养学习者技能、终身学习理念以及抛锚式教学模式,这对于在线课程建设和教学具有借鉴意义。 展开更多
关键词 Class central MOOC How to Write an Essay 教学设计 抛锚式教学模式
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肉苁蓉的药理作用及其在中枢神经系统疾病中的研究进展 被引量:6
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作者 王璐 吴丽娥 贾建新 《中华中医药学刊》 CAS 北大核心 2024年第3期50-54,共5页
肉苁蓉(Cistanches)是列当科植物肉苁蓉的肉质茎,又名金笋、地精、大芸。肉苁蓉的提取物主要包括肉苁蓉总苷、苯乙醇苷类、环烯醚萜类、挥发性成分、木脂素类、多糖、生物碱等。肉苁蓉的传统中药作用有补肾壮阳、润肠通便、女子不孕、... 肉苁蓉(Cistanches)是列当科植物肉苁蓉的肉质茎,又名金笋、地精、大芸。肉苁蓉的提取物主要包括肉苁蓉总苷、苯乙醇苷类、环烯醚萜类、挥发性成分、木脂素类、多糖、生物碱等。肉苁蓉的传统中药作用有补肾壮阳、润肠通便、女子不孕、滋补强身等;现代药理作用包括抗氧化、抗凋亡、调控自噬、增强体力和抗疲劳、改善学习认知功能。相关研究表明肉苁蓉对中枢神经系统疾病具有良好的治疗效果。脑缺血再灌注损伤(Cerebral ischemia reperfusion injury,CIRI)发生常伴随着脑水肿、血脑屏障的破坏、神经炎症、神经元凋亡,肉苁蓉提取物肉苁蓉总苷可抑制神经细胞炎症及凋亡,减少脑梗死面积,对CIRI模型大鼠具有神经保护作用。肉苁蓉通过减少自由基堆积、抑制氧化应激和炎症反应,提高阿尔茨海默病(Alzheimer’s disease,AD)和血管性痴呆(Vascular dementia,Va D)模型大鼠的学习记忆能力。肉苁蓉可以改善帕金森病(Parkinson’s disease,PD)小鼠运动行为异常,发挥神经保护作用。肉苁蓉能够抑制肌萎缩侧索硬化症(Amyotrophic lateral sclerosis,ALS)兴奋性氨基酸的水平,减轻神经毒性作用,改变星形胶质细胞功能,提高神经细胞存活率。目前肉苁蓉对于中枢神经系统疾病的应用越来越广泛,就其药理作用及其在中枢神经系统疾病中的研究进展进行综述,以期为肉苁蓉的开发和利用提供新的思路。 展开更多
关键词 肉苁蓉 中枢神经系统疾病 脑血管病 神经系统变性病
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中西非裂谷系富油凹陷石油地质特征与勘探方向 被引量:1
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作者 窦立荣 史忠生 +1 位作者 庞文珠 马峰 《石油勘探与开发》 EI CSCD 北大核心 2024年第1期1-13,共13页
基于地震、钻井、烃源岩测试分析等资料,对中西非裂谷系主要盆地富油凹陷石油地质特征进行研究,并探讨未来油气勘探方向。研究表明:中非裂谷系发育下白垩统湖相优质烃源岩,西非裂谷系发育上白垩统陆源海相优质烃源岩,两类烃源岩为中西... 基于地震、钻井、烃源岩测试分析等资料,对中西非裂谷系主要盆地富油凹陷石油地质特征进行研究,并探讨未来油气勘探方向。研究表明:中非裂谷系发育下白垩统湖相优质烃源岩,西非裂谷系发育上白垩统陆源海相优质烃源岩,两类烃源岩为中西非裂谷系油气富集提供了物质基础。中西非裂谷系发育包括基岩在内的多套储集层,并存在下白垩统、上白垩统和古近系3套区域盖层。晚中生代以来,受中非剪切带右旋走滑作用等地球动力学因素的影响,中西非裂谷系不同方向的盆地在裂谷作用期次、区域盖层发育层段、圈闭类型及成藏模式等方面存在差异。其中,北东—南西向盆地主要保存了早白垩世一期裂谷层序,区域盖层位于下白垩统裂陷期地层内,形成反转背斜、花状构造及基岩潜山等圈闭类型,发育“源储一体、源内成藏”及“源上储下、源下成藏”两种成藏模式;北西—南东向盆地具有多期裂谷叠置特征,发育上白垩统和古近系区域盖层,形成披覆背斜、断背斜、反向断块等圈闭类型,以“源下储上、源上成藏”为主要成藏模式。多期叠置裂谷盆地的源内成藏组合、强反转盆地的源内岩性油藏及页岩油是中西非裂谷系盆地未来勘探的重要领域。 展开更多
关键词 烃源岩 区域盖层 圈闭类型 成藏模式 富油凹陷 中非剪切带 中西非裂谷系
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奥布替尼联合利妥昔单抗及大剂量甲氨蝶呤治疗初治原发中枢神经系统淋巴瘤的疗效分析 被引量:1
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作者 闻淑娟 朱琳 +1 位作者 吴梅 李姗 《肿瘤药学》 CAS 2024年第1期30-35,共6页
目的通过回顾性研究分析奥布替尼联合利妥昔单抗及大剂量甲氨蝶呤(RMO方案)治疗新诊断原发中枢神经系统淋巴瘤(PCNSL)患者的临床疗效和安全性。方法收集2021年1月—2023年1月在我院治疗的初治PCNSL患者资料。所有患者均接受RMO方案治疗... 目的通过回顾性研究分析奥布替尼联合利妥昔单抗及大剂量甲氨蝶呤(RMO方案)治疗新诊断原发中枢神经系统淋巴瘤(PCNSL)患者的临床疗效和安全性。方法收集2021年1月—2023年1月在我院治疗的初治PCNSL患者资料。所有患者均接受RMO方案治疗:奥布替尼片150 mg口服,1次/d,d1~21;利妥昔单抗375mg·m^(-2)静脉滴注,d1;甲氨蝶呤注射液3.5 g·m^(-2)静脉滴注3 h,d2;21 d为1个治疗周期。所有患者均治疗6个周期,每2个周期后进行疗效评估,6个周期治疗结束后行PET-CT及脑核磁评估疗效。治疗结束后,符合移植条件者行自体造血干细胞移植巩固治疗,有条件者进行奥布替尼维持治疗。观察患者的临床疗效及不良反应。结果共纳入12例患者,中位年龄58(45~74)岁,病理类型均为CD20阳性弥漫大B细胞淋巴瘤。治疗4个周期后疗效评估为完全缓解(CR)4例、部分缓解(PR)7例、疾病进展(PD)1例,CR率为33.3%,客观缓解率(ORR)为91.7%。治疗6个周期后疗效评估为CR 8例、PR 2例、PD 2例,CR率为66.6%,ORR为83.3%。中位无进展生存期(mPFS)未达到,中位总生存期(mOS)未达到,6个月PFS率为83.3%,6个月OS率为100%,12个月PFS率为64.8%,12个月OS率为80.8%。有8例患者接受基因突变检测,其中MCD型7例、A53型1例。7例MCD型患者接受治疗后ORR为100%,CRR为85.7%。主要不良反应为疲劳(25.0%),仅有1例不良反应≥3级,最常见的血液学毒性为白细胞减少(16.7%),所有患者均未发生房颤及肾功能衰竭。结论RMO方案对于初治PCNSL患者是安全、有效的治疗方案。 展开更多
关键词 奥布替尼 原发中枢神经系统淋巴瘤 疗效 安全性
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人工关节集采对DRG IC29组病例住院费用的影响分析 被引量:4
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作者 荣惠英 史舒 +2 位作者 高永莲 陈萍 任庆文 《卫生软科学》 2024年第1期70-73,共4页
[目的]研究集中带量采购对人工关节置换术患者住院费用的影响,为深化高值耗材持续改革提供依据。[方法]收集某三级医院集采前后DRG分组IC29组病例的DRG结算数据和医保信息系统的相关信息,进行倾向得分匹配后,采用描述性分析、非参数检... [目的]研究集中带量采购对人工关节置换术患者住院费用的影响,为深化高值耗材持续改革提供依据。[方法]收集某三级医院集采前后DRG分组IC29组病例的DRG结算数据和医保信息系统的相关信息,进行倾向得分匹配后,采用描述性分析、非参数检验、结构变动度进行费用变化分析。[结果]集采政策实施后的各项费用中位数显示,IC29组病例次均费用下降了33445元,其中材料费下降了34835元;DRG统筹金额下降了13705元,个人自付金额下降了24550元。集采前后的结构变动度为60.52%,材料费呈负向变动,医疗服务费、检查化验费、药品费及其他费呈正向变动。结构变动贡献率前三位为材料费50.00%、医疗服务费26.04%、检查化验费16.36%。[结论]集采后IC29组病例的次均费用、材料费、医保支付和个人负担费用均明显降低,费用结构得到优化,人工关节集中带量采购成效明显。建议持续进行高值耗材集采工作,并协同推进医疗服务价格和医院薪酬制度等其他医改配套政策。 展开更多
关键词 集中带量采购 人工关节 住院费用 DRG 结构变动度
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党的二十届三中全会全面深化改革系统推进中国式现代化的逻辑进路 被引量:10
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作者 蒲清平 马睿 《西南大学学报(社会科学版)》 北大核心 2024年第4期1-10,共10页
全面深化改革推进中国式现代化是一个系统工程,党的二十届三中全会指出,目前我国已实现改革由局部探索、破冰突围到系统集成、全面深化的转变。进一步全面深化改革、推进中国式现代化,要增强改革系统性、整体性、协同性,解决中国式现代... 全面深化改革推进中国式现代化是一个系统工程,党的二十届三中全会指出,目前我国已实现改革由局部探索、破冰突围到系统集成、全面深化的转变。进一步全面深化改革、推进中国式现代化,要增强改革系统性、整体性、协同性,解决中国式现代化系统中的结构性矛盾、层次性矛盾、派生性矛盾,要求全面深化改革必须是整体性、协同性和渐进性相统一的改革。当前和今后一个时期是以中国式现代化全面推进强国建设、实现民族复兴伟业的关键时期,但改革过程中暴露出的改革设计拟合欠佳、改革布局协同弱化、改革环节衔接梗阻等难点问题,制约了中国式现代化的系统推进。破解上述难点问题,必须坚持党的领导强化改革顶层设计的总体擘画,坚持新发展理念增进改革布局间的协同耦合,坚持问题导向和目标导向促进改革有机衔接,坚持守正创新在关键领域改革取得重大突破,开创进一步全面深化改革推进中国式现代化的新局面。 展开更多
关键词 全面深化改革开放 中国式现代化 系统观念 党的二十届三中全会精神 新质生产力
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颈静脉、锁骨下静脉汇入无名静脉区的影像解剖分型研究及其在中心静脉置管中的应用 被引量:1
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作者 徐志宾 徐远 王鑫 《海南医学》 2024年第2期258-261,共4页
目的 研究双侧颈静脉、锁骨下静脉汇入无名静脉“三岔口”区的局部影像解剖并进行分型,初步探讨其在中心静脉置管中的应用。方法 河南科技大学第一附属医院2020年10月至2022年11月中心静脉置管病例389例,根据锁骨下静脉、颈静脉汇入无... 目的 研究双侧颈静脉、锁骨下静脉汇入无名静脉“三岔口”区的局部影像解剖并进行分型,初步探讨其在中心静脉置管中的应用。方法 河南科技大学第一附属医院2020年10月至2022年11月中心静脉置管病例389例,根据锁骨下静脉、颈静脉汇入无名静脉区局部影像解剖特点进行分型,右侧分为5型,左侧分为4型,结合置管后胸部X线片、CT检查、腔内心电及超声等资料明确中心静脉管位置,采用统计学方法分析“三岔口”区影像解剖分型与中心静脉导管异位的关系。结果 389例病例右侧“三岔口”区影像解剖分型中Ⅰ型占44.7%、Ⅱ型占24.7%、Ⅲ型占10.3%、Ⅳ型占17.2%、Ⅴ型占3.1%;左侧“三岔口”区影像解剖分型中Ⅰ型占29.3%、Ⅱ型占59.9%、Ⅲ型占9.8%、Ⅳ型占1.0%。经外周置入中心静脉导管(PICC)共271例,右侧入路180例中导管异位共24例,其中Ⅰ型3例、Ⅱ型5例、Ⅲ型4例、Ⅳ型7例、Ⅴ型5例,左侧入路91例中导管异位共3例,其中Ⅱ型2例、Ⅲ型1例;中心静脉导管异位发生率PICC右侧入路各型比较差异有统计学意义(χ^(2)=11.796,P=0.019),左侧入路各型比较差异无统计学意义(χ^(2)=2.073,P=0.557)。CVC置管118例,右侧入路104例中导管异位5例,其中Ⅱ型2例、Ⅲ型2例、Ⅳ型1例,左侧入路14例中导管异位3例,其中Ⅱ型2例、Ⅳ型1例,中心静脉导管异位发生率CVC右侧入路各型比较差异无统计学意义(χ^(2)=7.403,P=0.116),左侧入路各型比较差异无统计学意义(χ^(2)=4.497,P=0.213)。结论 颈静脉、锁骨下静脉汇入无名静脉区的影像解剖分型右侧Ⅰ型最多见,左侧Ⅱ型最多见,局部影像解剖分型与中心静脉导管异位存在一定关系。 展开更多
关键词 颈静脉 锁骨下静脉 无名静脉 影像解剖 经外周置入中心静脉导管 颈内静脉穿刺置入中心静脉导管
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纵向监管、地方选择性供地与产业结构绿色转型 被引量:1
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作者 周玉龙 刘玉海 宋悦 《经济理论与经济管理》 北大核心 2024年第2期1-16,共16页
地方政府的有效执行是中国式分权下提升中央发展战略实施绩效的关键,而中央政府对地方政府治理行为的有效监督则是其中至关重要的环节。本文基于2007—2019年中国微观工业用地供应以及中央环保督察的通报结果数据,采用广义双重差分法实... 地方政府的有效执行是中国式分权下提升中央发展战略实施绩效的关键,而中央政府对地方政府治理行为的有效监督则是其中至关重要的环节。本文基于2007—2019年中国微观工业用地供应以及中央环保督察的通报结果数据,采用广义双重差分法实证考察中央环保督察对地方政府选择性供地策略的影响及其机制。研究表明,中央环保督察促使地方政府降低污染密集型工业用地供应,增加清洁型工业用地供应,从而推动地区产业结构的绿色转型。机制分析发现,中央环保督察通过地方领导人职业发展激励机制以及产业转型能力机制对不同特征的城市工业土地供应结构策略产生异质性影响。本文结论对高质量发展背景下的央地互动关系与地方利用土地偏向性供给推动产业结构绿色转型具有政策启示。 展开更多
关键词 中央环保督察 地方选择性供地 产业结构绿色转型 纵向监管
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滇中地区主要森林凋落物有效截留量及其影响因素 被引量:2
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作者 王平 李璐杉 +1 位作者 丁智强 李玉辉 《水土保持研究》 CSCD 北大核心 2024年第3期213-221,229,共10页
[目的]研究滇中地区主要森林类型凋落物有效截留量差异及其影响因素,为该地未来植被恢复和森林管理提供科学支撑。[方法]利用样方调查法、烘干法和浸泡法分析了昆明市双河—磨南德水源林自然保护区内的地带性次生常绿阔叶林(SF)、针阔... [目的]研究滇中地区主要森林类型凋落物有效截留量差异及其影响因素,为该地未来植被恢复和森林管理提供科学支撑。[方法]利用样方调查法、烘干法和浸泡法分析了昆明市双河—磨南德水源林自然保护区内的地带性次生常绿阔叶林(SF)、针阔混交林(TF)、旱冬瓜林(ACF)、华山松林(PA)、成熟云南松林(OPY)、幼龄云南松林(YPY)、银荆林(AD)7种主要森林类型凋落物未分解层(OL)和半分解层(OF)的有效截留量及其影响因素。[结果](1) 7种森林类型凋落物厚度为2.06~7.57 cm,其中OL层1.10~4.30 cm, OF层0.83~3.93 cm,凋落物层厚度排序为TF>ACF>PA>OPY>SF>AD>YPY,凋落物蓄积量为4.75~17.45 t/hm^(2),其中OL层占比为32.02%~62.48%,OF层占比为37.52%~67.98%,凋落物层蓄积量排序为TF>PA>SF>OPY>ACF>AD>YPY。(2)凋落物最大持水率为115.3%~170.7%,初始吸水速率为3.65~5.62 g/(g·h),凋落物持水率和浸水时间的关系可用对数函数y=aln(x)+b表示,吸水速率与浸水时间可用幂函数y=kt~n表示。(3)凋落物最大持水量为7.05~32.19 t/hm^(2),排序为PA>TF>SF>OPY>ACF>AD>YPY,有效截留量为5.45~25.34 t/hm^(2),以TF最高(25.34t/hm^(2)),PA(24.99 t/hm^(2))和SF(24.62 t/hm^(2))次之,YPY最低(5.45t/hm^(2)),影响有效截留量的场地特征主要为蓄积量、自然含水率、分解强度以及厚度,影响有效截留量的水动力过程主要是最大失水量、前6.0 h平均吸水速率和前2.0 h平均吸水速率。[结论]滇中地区未来植树造林应以针阔混交林为主,注重对地带性次生常绿阔叶林的保育,采取辅助自然更新的措施促进人工纯林向混交林演化,同时减少踩踏、收集凋落物等人类活动的干扰,从而增加森林生态系统凋落物的水源涵养能力。 展开更多
关键词 凋落物 主要森林类型 持水特性 有效截留量 滇中地区
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三部配穴法针刺治疗慢性中心性浆液性脉络膜视网膜病变的临床效果 被引量:1
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作者 刘鹏 张必萌 +4 位作者 张开勇 蒋会茹 寿崟 徐斯伟 赵娜 《中国医药导报》 CAS 2024年第3期131-134,共4页
目的 观察三部配穴法针刺治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的临床效果。方法 将2022年1月至12月于上海市第一人民医院就诊的84例慢性CSC患者按随机数字表法分为对照组(42例)与治疗组(42例),对照组予维生素B1片、肌苷片、三磷... 目的 观察三部配穴法针刺治疗慢性中心性浆液性脉络膜视网膜病变(CSC)的临床效果。方法 将2022年1月至12月于上海市第一人民医院就诊的84例慢性CSC患者按随机数字表法分为对照组(42例)与治疗组(42例),对照组予维生素B1片、肌苷片、三磷酸腺苷二钠片的基础治疗(40 d),治疗组在对照组的基础上联合三部配穴法针刺,隔天针刺1次,共20次(40 d)。比较两组临床疗效,比较两组治疗前后美国国立眼科研究院视功能问卷-25(NEI-VFQ-25)、中医症状证候量表、最佳矫正视力(BCVA)变化。结果 对照组脱落3例,治疗组脱落4例。治疗组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组NEI-VFQ-25评分、BCVA均高于治疗前,且治疗组高于对照组,差异有统计学意义(P<0.05)。治疗后,治疗组中医症状证候量表评分低于本组治疗前及对照组,差异有统计学意义(P<0.05)。结论 三部配穴法针刺联合基础治疗慢性CSC效果显著,具有较高的临床推广及应用价值。 展开更多
关键词 三部配穴法 针刺 慢性中心性浆液性脉络膜视网膜病变 临床研究
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分布式训练系统及其优化算法综述 被引量:3
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作者 王恩东 闫瑞栋 +1 位作者 郭振华 赵雅倩 《计算机学报》 EI CAS CSCD 北大核心 2024年第1期1-28,共28页
人工智能利用各种优化技术从海量训练样本中学习关键特征或知识以提高解的质量,这对训练方法提出了更高要求.然而,传统单机训练无法满足存储与计算性能等方面的需求.因此,利用多个计算节点协同的分布式训练系统成为热点研究方向之一.本... 人工智能利用各种优化技术从海量训练样本中学习关键特征或知识以提高解的质量,这对训练方法提出了更高要求.然而,传统单机训练无法满足存储与计算性能等方面的需求.因此,利用多个计算节点协同的分布式训练系统成为热点研究方向之一.本文首先阐述了单机训练面临的主要挑战.其次,分析了分布式训练系统亟需解决的三个关键问题.基于上述问题归纳了分布式训练系统的通用框架与四个核心组件.围绕各个组件涉及的技术,梳理了代表性研究成果.在此基础之上,总结了基于并行随机梯度下降算法的中心化与去中心化架构研究分支,并对各研究分支优化算法与应用进行综述.最后,提出了未来可能的研究方向. 展开更多
关键词 分布式训练系统 (去)中心化架构 中心化架构算法 (异)同步算法 并行随机梯度下降 收敛速率
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