超声测量联合LEMON法在阻塞性睡眠呼吸暂停低通气综合征患者困难气道评估中的应用研究

目的:分析使用超声测量联合LEMON法评估阻塞性睡眠呼吸暂停低通气综合征(Obstructive sleep apnea hypopnea syndrome,OSAHS)患者困难气道的准确性。方法:选择择期全麻气管插管下行改良腭咽成形术OSAHS患者46例,根据插管时Cormack-Lehane分级分为两组:Ⅰ、Ⅱ级为非喉镜暴露困难组27例,Ⅲ、Ⅳ级为喉镜暴露困难组19例。麻醉前测量张口度、甲颏距离,评估改良Mallampati分级,患者麻醉后在相同体位下行气管插管。比较常规评估气道方法和超声测量联合LEMON法与喉镜显露困难的关系,采用受试者工作特征曲线(Receiver operating characteristic curve,ROC)分析各指标预测困难气道的效能。结果:喉镜暴露困难组超声测量数据、LEMON法评分、改良Mallampati分级高于非喉镜暴露困难组(P<0.05)。超声测量联合LEMON法的曲线下面积(Area under curve,AUC)为0.990(95%CI 0.969~1.000),高于单独应用超声测量或LEMON法的AUC值。结论:超声测量和LEMON法均可有效对OSAHS患者困难气道进行评估,其中超声测量预测OSAHS患者困难气道具有较好的效果,超声测量联合使用LEMON法可提高评估OSAHS患者困难气道的准确性。

LEMON法预测困难气道的有效性

困难气道是麻醉中常遇到的紧迫而危险的境况,许多严重麻醉并发症和死亡的发生由困难气道管理失当引起^（[1-3]）。对未预料的困难气道,后果更为严重。虽然可视喉镜的应用使气管插管变得容易,插管困难的发生率也明显降低^（[1^4]）,但对全麻患者气道评估和对困难气道的处理是麻醉医师的临床基本技能,需要熟练掌握和应用,况且传统喉镜仍为目前的主要工具。

LEMON法预测患者困难气道的临床效果

目的评价LEMON法预测困难气道的临床效果。方法选择择期行全身麻醉下喉镜暴露气管插管的手术患者1 528例,男680例,女848例,年龄18~83岁,ASAⅠ或Ⅱ级。麻醉前进行LEMON法评分,采用受试者工作特征曲线(receiver operating characteristic curve,ROC)及曲线下面积(area under the curve,AUC)评价LEMON法预测困难气道的临床效果。结果困难气管插管患者37例,发生率为2.4%。困难喉镜暴露患者106例,发生率为6.9%。LEMON法预测困难喉镜暴露及困难气管插管的AUC分别为0.884(95%CI 0.867~0.899)和0.934(95%CI 0.921~0.946)。结论LEMON法在患者困难气道预测中有较好的临床效果。

输出假设理论指导下的多模态lemon英语写作教学体系初探

本文给出输出假设理论指导下的多模态lemon英语写作教学体系的定义,简述国内外的研究情况,分析研究的必要性,分析研究的意义和创新之处,给出研究的方法和具体的教学环节,对创新理论,丰富外语教学方法和提高学生的写作水平有重要的指导意义。

Reprogramming of a defense signaling pathway in rough lemon and sweet orange is a critical element of the early response to‘Candidatus Liberibacter asiaticus’

Huanglongbing(HLB)in citrus infected by Candidatus Liberibacter asiaticus(CLas)has caused tremendous losses to the citrus industry.No resistant genotypes have been identified in citrus species or close relatives.Among citrus varieties,rough lemon(Citrus jambhiri)has been considered tolerant due to its ability to produce a healthy flush of new growth after infection.The difference between tolerance and susceptibility is often defined by the speed and intensity of a plant’s response to a pathogen,especially early defense responses.RNA-seq data were collected from three biological replicates of CLas-and mock-inoculated rough lemon and sweet orange at week 0 and 7 following infection.Functional analysis of the differentially expressed genes(DEGs)indicated that genes involved in the mitogen activated protein kinase(MAPK)signaling pathway were highly upregulated in rough lemon.MAPK induces the transcription of WRKY and other transcription factors which potentially turn on multiple defense-related genes.A Subnetwork Enrichment Analysis further revealed different patterns of regulation of several functional categories,suggesting DEGs with different functions were subjected to reprogramming.In general,the amplitude of the expression of defense-related genes is much greater in rough lemon than in sweet orange.A quantitative disease resistance response may contribute to the durable tolerance level to HLB observed in rough lemon.

Synthesis of highly fluorescent carbon dots from lemon and onion juices for determination of riboflavin in multivitamin/mineral supplements

In this work, lemon and onion biomasses commonly found in street markets are for the first time used to develop a facile, fast and low-cost one-step microwave-assisted carbonization method for synthesis of highly fluorescent carbon dots (CDs). The structure and optical properties of CDs were investigated by TEM, XRD, XRF, UV-Vis, FTIR, and fluorescence spectroscopy. CDs displayed satisfactory optical pro-prieties, a high quantum yield of 23.6%, and excellent water solubility, and the particle size was 4.23-8.22 nm with an average diameter of 6.15 nm. An efficient fluorescent resonance energy transfer (FRET) between the CDs and riboflavin was achieved with CDs acting as donor and riboflavin as acceptor. A linear relationship between FRET and the riboflavin concentration from 0.10 to 3.0 μg/mL was observed, allowing the development of an accurate and fast analytical method to determine this vitamin in multivitamin/mineral supplements. Despite the potential interferences in these supplements, CDs were selective for riboflavin under optimized conditions. A paired t-test at a 95% confidence level indicated no statistically significant difference between the proposed and the reference methods. Recovery test presented values ranged from 96.0% to 101.4%. The limit of detection and relative standard deviation were estimated at 1.0 ng/mL and <2.6% (n = 3), respectively. CDs were successfully synthesized in a domestic microwave oven (1450 W, 6 min), presenting satisfactory parameters when compared with results of other studies reported in the literature, suggesting that the proposed method is a potentially useful method for the synthesis of CDs and determination of riboflavin.

Chemical and Biological Comparative <i>in Vitro</i>Studies of Cinnamon Bark and Lemon Peel Essential Oils

Cinnamon and lemon are the oldest plants which possess a rising popularity due to their therapeutic potential from centuries. Cinnamomum zeylanicum and lemon (Citrus lemon L.) have been subjected to extensive research. Their essential oils were extracted by steam distillation from selected plants and their chemical compositions were determined by the GC-MS system. Cinnamon and lemon essential oils were examined for antioxidant activity by ABTS method which showed the ability to inhibit lipid per-oxidation. On the other hand, in antimicrobial investigations, cinnamon and lemon essential oils have inhibitory effect against Gram positive bacteria (Staphylococcus aureus) and Gram negative bacteria (Escherichia coli) using Muller Hinton agar medium. The essential oils of cinnamon and lemon showed antifungal effects which were tested against (Candida albicans). The volatile oil of cinnamon bark has been found to be highly effective against all the tested bacteria and fungi. However, lemon peel essential oil has shown medium inhibition for Gram positive bacteria (Staphylococcus aureus). On the other hand, the cytotoxic activities of the essential oils were tested on hepatocellular carcinoma and colorectal carcinoma. Essential oils have shown good activities on the cell lines. Essential oil of cinnamon showed more inhibition rate than essential oil of lemon. This study reported the importance of both cinnamon and lemon volatile oils and recommends that cinnamon and lemon can be used as an active therapy for humans.

Consumer Behavior Analysis under the "Lemon Dilemma" in the Market of Agricultural Products

Based on the introduction of the connotation of "lemon market" and the phenomenon of "lemon" in the market of agricultural products,the consumers' behaviors in the "lemon market" of agricultural products are analyzed.Firstly,consumers feel unfair in their minds in the process of negotiation;secondly,the purchase decision rule tends to be simplified in the "lemon market" of agricultural products;thirdly,the consumers tend to follow the masses in the "lemon market" of agricultural products.The economics significance of the impact of "lemon dilemma" of agricultural products on consumers is analyzed.The causes of the impact are analyzed from two aspects the uncertainty of collecting the information of agricultural information and the uncertainty of using the agricultural information.The suggestions and countermeasures are put forward in order to solve the "lemon" problems in agricultural market.In the first place,the excellent mechanism for producing the information of agricultural products should be constructed;in the second place,the government should encourage the multi-channel,multi-form and multi-level operation mode of agricultural products,to promote the optimization of market functions;in the third place,the government should widen the channel of information dissemination for agricultural products and establish the high efficiency feedback path;in the fourth place,the traditional thought pattern of consumers should be changed,so as to promote the healthy,orderly and benign development of agricultural products market.

Dietary bioactives and essential oils of lemon and lime fruits

Human beings have consumed lemon(Citrus limon)and lime(Citrus aurantifolia or Citrus latiflia)for thousands of years.Among the variety of citrus families,lemon and lime are originated from the hybridization of citron with primitive papeda,hence they are similar from the nutritional and organoleptic standpoints,whereas very different from other citrus species such as orange and mandarin.Except for fresh produce,a signifi cant percentage of lemon and lime are processed and separated as juice,essential oils,pulps and other products.Lemon and lime juice or fruit itself is rich in vitamins,minerals and flavonoids which are rich sources for human nutrition.Consumption of lemon and lime fruit or juice are benefi cial for human health in the scope of urinary citrate increase,oxidative stress relief,improvement in lipid profi les and infl ammation markers,neuroprotective effects among others.These beneficial effects of lemon and lime are not only because of their high vitamin C content but also other bioactive micronutrients such as fl avonoids.Essential oils from lemon and lime have fresh and zesty aroma for perfumery and flavor applications for centuries.Compared with orange or mandarin,the integrated review for lemon and lime dietary bioactive compounds and essential oils is scarce.Therefore,in this review,we introduced the historical cultivation,consumption and process of lemon and lime,discussed the chemical and biological activities of phytochemicals in lemon and lime fruits and juice,and summarized volatile and non-volatile components in lemon and lime oil.This review may provide a comprehensive perspective for entire lemon and lime industry as well as their scientifi c values.

改良LEMON评分与创伤急诊手术患者气管插管困难的相关性研究

目的探讨改良LEMON评分与创伤急诊手术患者气管插管困难的相关性,明确改良LEMON评估法预测困难气道的独立危险因素。方法纳入300例气管插管全麻的创伤急诊手术患者,术前给予改良LEMON评估及麻醉诱导气管插管,并进行困难气管插管量表(IDS)评分。根据IDS评分将300例患者分为气管插管困难组(D组,IDS评分≥5分)和非气管插管困难组(ND组,IDS评分<5分)。分析改良LEMON评分与IDS评分的相关性;采用多因素Logistic回归分析探讨改良LEMON评估法预测困难气道的独立危险因素。结果D组的改良LEMON评分、IDS评分及张口度<3指、舌甲间距<2指及颈部活动受限的患者占比均高于ND组(P<0.05)。改良LEMON评分与IDS评分呈显著正相关(r=0.590,P<0.05)。多因素Logistic回归分析结果显示,张口度<3指、舌甲间距<2指及颈部活动受限均为预测创伤急诊手术患者困难气道的独立危险因素(P<0.05)。结论改良LEMON评分与创伤急诊手术患者气管插管困难呈显著相关性,张口度<3指、舌甲间距<2指及颈部活动受限均为预测困难气道的独立危险因素。

Effects of Lemon Beverages on Bone Metabolism and Bone Mineral Density in Postmenopausal Women: A Double-Blind, Controlled Intervention Study with Ca-Supplemented and Unsupplemented Lemon Beverages

The aim of the present study was to elucidate how bone metabolism and bone mineral density are affected by the consumption of a lemon juice-containing calcium (Ca)-enriched beverage. The efficacy of this investigational product was evaluated in postmenopausal women during five months of continuous intake (intervention). This was a randomized, controlled trial. Eighty-three subjects were assigned to three groups. Using a double-blind format, the first two groups received a Ca-supplemented lemon-juice (lemon) beverage (LECA) or a Ca-unsupplemented lemon-juice (lemon) beverage (LE). The third group (control) received no intervention. Each subject in the LECA and LE groups consumed one bottle (290 mL) of their assigned investigational product every day for five consecutive months. After five months of intervention, the gain in bone mineral density at the lumbar spine was significantly larger in the LECA and LE groups than in the control group. In the femur, subjects in the LECA group gained significantly more bone mineral density than the control subjects. The largest gain in bone mineral density at the lumbar spine was observed in the LECA group. As for the concentrations of the bone resorption marker tartrate-resistant acid phosphatase 5b (TRACP-5b), subjects in the LECA group had significantly lower values than those in the control group. Similarly, when compared with the LE and control groups, a significant decrease was detected in the LECA group in the concentrations of the bone formation markers, bone alkaline phosphatase (BAP) and osteocalcin (OC). In postmenopausal women, continuous consumption of Ca-supplemented lemon beverages improved the absorption of Ca and inhibited bone resorption. This likely blocked the function of osteoblasts and led to the suppression of bone formation, resulting in the attenuation of high-turnover bone metabolism.

Optimization of Headspace Solid-Phase Microextraction Conditions for the Identification of Volatiles Compounds from the Whole Fruit of Lemon, Lime, Mandarin and Orange

An optimum method has been developed for extracting volatile organic compounds (VOCs) which contribute to the aroma of different species of citrus fruit (orange, lemon, lime, and mandarin). Headspace solid phase microextraction (HS-SPME) combined with gas chromatography (GC) coupled with flame ionization detection (FID) is used as a very simple, efficient and non-destructive extraction method. A three phase 50/30 μm PDV/DVB/CAR fibre was used for the extraction process. The optimal sealing time for volatiles reaching equilibrium from whole fruit in the headspace of the chamber was 20, 16, 8 and 16 hours for lemon, lime, mandarin, and orange respectively. Optimum fibre exposure times for whole fruit were 2, 4, 2 and 2 hours for lemon, lime, mandarin, and orange respectively. Three chamber volumes (500, 1000 and 2000 ml) were evaluated for the collection of VOCs with the 500 ml chamber being selected. The 500ml chamber produced the highest quality peak areas and quantity of extracted volatiles. As a result of fruit respiration, the percentage of oxygen (O2) of all citrus fruit species in 500 ml chamber decreased from 21.8% to 18.8% in the 20 hours sealing time, while carbon dioxide (CO2) contents increased to 2.9% also in the 20 hours sealing time. The results of this study showed the feasibility of this technique for identifying VOCs from four of the citrus fruit species and its potential as a routine method for physiological studies on citrus fruit or on other fruit species.

Lemon Effect of Green Agricultural Products and Its Marketing Strategy

The paper introduces the lemon effect of green agricultural products,analyzes the formation reasons of the lemon effect of green agricul-tural products and summarizes problems brought by the effect,such as malicious deception and high price.The paper proposes countermeasures toavoid the lemon effect of green agricultural products from a perspective of marketing.The first is to strengthen the quality supervision of green agri-cultural products,upgrade the quality of products,and build up branded products.The government should foster the main body of the products andguide the main body to realize the importance of brand construction and management.The second is to construct a sales channel system of greenagricultural products,making use of the trading center of modern green agricultural products to sell products,developing a long term partnershipwith processing industries,big supermarket and restaurants,making use of internet and selling products online and offline.The third is to propagatethe products.Make a good use of advertisement,personal sales,propagation and public relations to accelerate the healthy development of greenagricultural market.

Phenolic Contents and Antioxidant Activities of Green Tea with and without Lemon

Tea is the most widely consumed beverage throughout the world, after water and is considered as a good antioxidant nutrient against free radical reactions. Lemons are citrus fruits that are very common in many parts of the world and are well known for their health benefits. In this study, different assays were used to evaluate total phenolic content and antioxidant activities of green tea with and without lemon. Our results showed that green tea with lemon has higher phenolic content, stronger reducing power than green tea without lemon;and exhibits a significant inhibition of 2,2-Diphenyl-1-picrylhydrazyl (DPPH) and hydrogen peroxide (H2O2). However, both samples exhibited high ferrous chelating activity with no significant difference among each other indicating a good antioxidant potential for both. This is a comparative study between green tea and green tea supplemented with lemon. The study contributes to a better understanding about how the addition of supplements like lemon might influence the antioxidant activity of tea.

A Study on‘the Market for Lemons’and the Strategy of‘Unification’in Booking Systems:A Case Study on the FAHSYSU Simulation T System of the Training Center for Clinical Skills of the First Affiliated Hospital of Sun Yat-sen University

Based on the blueprint of the training center for clinical skills of our hospital,this paper discusses the effect of‘the market for lemons’in its booking system from the perspective of economics of information,uses the law of large numbers and the central limit theorem to model to carry out the case study of FAHSYSU Simulation T,and takes measures of offsetting adverse selections to increase booking efficiency.The paper also analyzes how to apply the ancient Chinese theory that man is an integral part of nature to wipe out‘the market for lemons’.

Agrobacterium-Mediated Transfer of Arabidopsis ICE1 Gene into Lemon (Citrus Limon (L.) Burm. F. cv. Eureka)

The Arabidopsis ICE1 (inducer of CBF expression 1) gene was cloned through RT-PCR of Arabidopsis cDNAs and introduced into the lemon (Citrus Limon (L.) Burm. F. cv. Eureka) genome using Agrobacterium-mediated transformation method. Epicotyl segments from in vitro grown lemon seedlings were co-cultivated with A. tumefaciens strain EHA 105 carrying the binary plasmid pMVICE1, whose T-DNA region contain ICE1 gene driven by 35S CaMV promoter. Among 320 epicotyl segments inoculated, 71 explants responded and regenerated 51 elongated shoots. These shoots were subjected to an extra month of kanamycin exposure. In this way, the number of escapes reduced. Thirteen of 31 survived shoots formed roots and 7 were tested positive using PCR technique. Southern blot analyses confirmed PCR results and demonstrated that more than two copies of the ICE1 gene were integrated into the lemon genome.

The Meteorological Prediction Model of Lemon Production in Anyue County Based on Correlation

Using the meteorological data during 1971- 2013 and lemon growth and yield data during 2003- 2013 in Anyue,the suitability problem of lemon growth and correlation problem between meteorological factors and lemon growth in Anyue area were studied. According to relevance between the selected meteorological factors and yield of lemon,meteorological prediction model of lemon yield was established in Anyue,and the prediction accuracy was higher. The research had certain guiding significance for management work of lemon production in Anyue area.