某椭球形采光顶支承结构稳定性与抗震性能分析

单层网壳兼具薄壳结构及杆系结构的力学特征,属于缺陷敏感型结构,结构稳定性起主要控制作用。以某椭球形三向网格型单层网壳玻璃采光顶支承结构为研究对象,对其进行弹塑性全过程稳定分析,建模求解椭球形单层网壳在长、短轴半跨及满跨活载工况下结构整体稳定性系数,通过数值分析得出椭球形单层网壳在满跨活载工况下整体失稳的风险高于半跨活载工况,结构整体稳定性对荷载不对称分布不敏感;鉴于本工程的重要性,在不同烈度下的结构抗震能力分析中,结构的抗震设防目标需提高到大震不屈服。

Resilience to structural and molecular changes in excitatory synapses in the hippocampus contributes to cognitive function recovery in Tg2576 mice

Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function.Unraveling the factors that lead to this cognitive resilience to AD offers promising prospects for identifying new therapeutic targets.Our hypothesis focuses on the contribution of resilience to changes in excitatory synapses at the structural and molecular levels,which may underlie healthy cognitive performance in aged AD animals.Utilizing the Morris Water Maze test,we selected resilient(asymptomatic)and cognitively impaired aged Tg2576 mice.While the enzyme-linked immunosorbent assay showed similar levels of Aβ42 in both experimental groups,western blot analysis revealed differences in tau pathology in the pre-synaptic supernatant fraction.To further investigate the density of synapses in the hippocampus of 16-18 month-old Tg2576 mice,we employed stereological and electron microscopic methods.Our findings indicated a decrease in the density of excitatory synapses in the stratum radiatum of the hippocampal CA1 in cognitively impaired Tg2576 mice compared with age-matched resilient Tg2576 and non-transgenic controls.Intriguingly,through quantitative immunoelectron microscopy in the hippocampus of impaired and resilient Tg2576 transgenic AD mice,we uncovered differences in the subcellular localization of glutamate receptors.Specifically,the density of GluA1,GluA2/3,and mGlu5 in spines and dendritic shafts of CA1 pyramidal cells in impaired Tg2576 mice was significantly reduced compared with age-matched resilient Tg2576 and non-transgenic controls.Notably,the density of GluA2/3 in resilient Tg2576 mice was significantly increased in spines but not in dendritic shafts compared with impaired Tg2576 and non-transgenic mice.These subcellular findings strongly support the hypothesis that dendritic spine plasticity and synaptic machinery in the hippocampus play crucial roles in the mechanisms of cognitive resilience in Tg2576 mice.

CIMA“绿卡”打造财会金领

企业对财务的要求越来越向管理靠拢,财务将不再是简单的记账及报表的工作,而是将作为商业合作伙伴参与企业的价值创造。财务的工作将更加多姿多彩,也更加富有挑战。

Sleeve Gastrectomy Associated with Antral Lesion Resection and Roux-en-Y Antrojejunal Reconstruction

Obesity has been growing worldwide, reaching epidemic proportions. Bariatric surgery is the most effective and durable treatment for severe obesity and related diseases. Roux-en-Y Gastric Bypass (RYGB) and Sleeve Gastrectomy (SG) are the most frequently performed bariatric operations, with long-term good results, in terms of weight loss and comorbidities control. Gastroesophageal Reflux Disease (GERD) is commonly associated with obesity. In general, it precludes the indication of sleeve gastrectomy, since this technique has a refluxogenic potential, as shown in many studies. In such cases, RYGB is considered the best surgery, reaching good weight loss and gastroesophageal reflux disease control. The drawback of this technique is that it leaves the remnant stomach, the duodenum, and the proximal part of the jejunum inaccessible. Besides, RYGB makes transoral endoscopic access to the biliary tree impossible. For all these reasons, this bariatric technique is not indicated in cases of gastric polyposis, gastric dysplasia, or strong family history of cancer, among others. We report a case of a morbidly obese patient with intense GERD, for whom a RYGB was precluded due to her strong family history of cancer, even knowing that it would be the best choice for reflux disease control. Instead, SG was chosen, even knowing it could worsen the gastroesophageal reflux disease. The patient signed an informed consent, after being fully enlightened about the risks. During the surgery, a small subserosal whitish lesion was detected, near the pylorus, on the anterior wall of the antrum. Thinking in a Gastrointestinal Stromal Tumor (GIST), it was resected, with a 2 cm safety margin, leaving a 4 to 5 cm hole on the gastric wall. The decision to maintain the proposed sleeve gastrectomy was made, to avoid leaving a remnant stomach, in a patient with such a strong family history of cancer. In the area of the resected lesion, an intraoperative decision was made not to just close the big gastric hole, being afraid of causing some anatomic or functional disturbance in gastric emptying. Instead, we decided to use the gastric opening to construct a Roux-en-Y antrotrojejunal anastomosis, with a 50 cm alimentary limb and a 200 cm biliopancreatic limb. Accordingly, it was performed a sleeve gastrectomy, associated with an antrojejunostomy in a Roux-en-Y fashion. The patient had an uneventful postoperative course. In the second year, she achieved normal weight and good nutritional status, without gastroesophageal reflux symptoms complaints. Seriography study shows that most of the contrast material passes through the antrojejunal anastomosis, instead of the pylorus, while the duodenum is endoscopically patent. This case report shows an unexpected surgical finding that led to a tactic of adding a Roux-en-Y gastric bypass in the antrum, associated with a sleeve gastrectomy, a strategy that may be adopted in cases of morbidly obese patients with important GERD, for whom gastrointestinal exclusions are contraindicated. To confirm this hypothesis, controlled studies are needed.

Cholangiocyte anion exchange and biliary bicarbonate excretion

主要小管胆汁沿着被几个因素包括荷尔蒙， innervation/neuropeptides，和胆汁的成分影响的胆道经历使液化和硷化的一个过程。在 canaliculi 和胆汁管的酸式碳酸盐的排泄是到所谓的胆汁盐独立人士流动的产生的一个重要贡献者。酸式碳酸盐通过经由 AE2/SLC4A2-mediated Cl-/HCO3- 交换通过 Cl- 隧道，和进一步的酸式碳酸盐分泌物的激活包含氯化物流出的平行机制从 hepatocytes 和 cholangiocytes 被分泌。高血糖素和分泌素是似乎在他们的目标房间(为前者的 hepatocytes 和为后者的 cholangiocytes ) 很同样行动的二相关荷尔蒙。这些荷尔蒙与他们的特定的 G 联合蛋白质的受体交往，引起营地的细胞内部的层次和营地依赖者 Cl- 和 HCO3- 的激活的增加能分泌的机制。hepatocytes 和 cholangiocytes 看起来有在的营地应答的细胞内部的泡有房间 specific Cl- 隧道的 AE2/SLC4A2 colocalizes (在 cholangiocytes 并且还没的 CFTR 在 hepatocytes 决定了) 并且 aquaporins (在 hepatocytes 的 AQP8 和在 cholangiocytes 的 AQP1 ) 。到小管或 cholangiocyte lumenal 膜和进一步的 exocytosis 的这些泡的导致营地的协调交通国王与网导致水的增加的渗透的力量和被运动充满酸式碳酸盐的胆液排泄增多。

Initial clinical presentation of Takotsubo cardiomyopathy with-a focus on electrocardiographic changes: A literature review of cases

AIM: To review the initial presentation and demonstrate the importance of Takotsubo cardiomyopathy. METHODS: A PubMed search using the terms "Takotsubo cardiomyopathy (TC)" and "apical ballooning syndrome" yield 211 publications. Only those that were relevant were fully reviewed. The gender, age, precipitating stressor, main complaint at presentation, electrocardiogram (ECG) at admission and serum cardiac markers of patients diagnosed with TC, were extracted as available. The data were organized in tables and graphics, and the incidence of the disorder was calculated and analyzed. RESULTS: A total of 250 clinical cases were examined. The predominant gender that was affected was female, with a prevalence of 87.5%. The mean age of presentation was 64±14 years. The cases were divided by age into 10-year intervals. The age interval of 60-69 years showed the highest frequency of TC, accounting for 79 cases. The most common precipitating stressor was physical (50% of cases). Chest pain wasthe primary complaint at presentation (58.8% of cases) followed by dyspnea (30% of cases). The ST segment changes category was the most common (60%), followed by T wave changes (39.6%). Of the 60% of cases with ST segment changes, 12% had concomitant T wave changes. This means that for 27.6% of the cases, the primary abnormality in the ECG was T wave changes; 87.6% of cases with TC had a change in the ST segment, in the T wave or in both. The percentage of ECGs presenting with changes in the anterior wall was 54.4% (35.6% of ST segment elevation +1.6% of ST segment depression +17.2% of T wave inversion). The percentage of patients presenting with changes in the lateral segment of the heart was 46.8%, while the percentage of patients with changes in the inferior heart was 21.6% and the percentage of patients with changes in the apical region was only 16%. The prevalence of elevated creatinine kinase and/or troponin on initial presentation was 89.3%. CONCLUSION: It is essential that every physician consider Takotsubo cardiomyopathy as a possible differential diagnosis when a patient is classified with acute coronary syndrome. To do so, it is necessary to know the clinical presentation of this syndrome in its early stages.

Therapy of cancer by cytokines mediated by gene therapy approach

基因治疗为癌症的治疗提供一条新途径。编码 immunostimulatory cytokines 的基因的转移与显著成功被使用了在动物消除癌症。然而，在有这策略的病人的临床的试用限制了功效。因此，基因转移向量系统的改进是必要的。混合病毒的向量，与鼠科的 IL-12 或记者 LacZ 基因由 SFV replicon 组成，被构造。这混合向量在 vitro 并且在 vivo 在 HCC 显示出表示的特性和高水平。在一个老鼠 orthotropic 肝肿瘤模型，没有伴随毒性，由有 mIL-12 基因的混合向量的确定的肿瘤的治疗导致了一项强壮的反肿瘤活动。随后，助手依赖者侵入人体气管粘膜的病菌包含 mifepristone (RU486 ) 的向量可诱导的系统被构造为控制并且人的 interleukin 的肝特定的表示 12 (hIL-12 )(HD-Ad/RUhIL-12 ) 并且鼠标 IL-12 (mIL-12 )(HD-Ad/RUmIL-12 ) 。数据证明 hIL-12 的高、支撑的浆液层次能被继续 RU486 的管理达到每 12 或 24 h。hIL-12 的重复正式就职能被获得在上，至少在 HD-Ad/RUhIL-12 的单个注射以后的 48 个星期的一个时期。肝转移与的处理 HD-Ad/RUmIL-12，正 RU846 在所有动物导致了完全的肿瘤回归。然后，不同 cytokine 基因被插入到有条件的 replicative 侵入人体气管粘膜的病菌向量(也叫的 oncolytic 侵入人体气管粘膜的病菌) 。在肿瘤房间的侵入人体气管粘膜的病菌的复制将杀死肿瘤房间和版本病毒，它感染包围肿瘤房间。由 oncolytic 侵入人体气管粘膜的病菌的 cytopathic 效果和 transgene 的生物效果的联合将施加强壮的反肿瘤活动。向量的这些新类型可以为癌症基因治疗提供一个有势力和安全工具。

Wilson's disease: A review of what we have learned

Wilson's disease(WD), which results from the defective ATP7 B protein product, is characterized by impaired copper metabolism and its clinical consequences vary from an asymptomatic state to fulminant hepatic failure, chronic liver disease with or without cirrhosis, neurological, and psychiatric manifestations. A high grade of suspicion is warranted to not miss cases of WD, especially less florid cases with only mild elevation of transaminases, or isolated neuropsychiatric involvement. Screening in first and second relatives of index cases is mandatory, and treatment must commence upon establishment of diagnosis. Treatment strategies include chelators such as D-penicillamine and trientine, while zinc salts act as inductors of methallothioneins, which favor a negative copper balance and a reduction of free plasmatic copper. As an orphan disease, research is lacking in this field, especially regarding therapeutic strategies which are associated with better patient compliance and which could eventually also reverse established injury.

Impairment of pre-mRNA splicing in liver disease: Mechanisms and consequences

Pre-mRNA splicing is an essential step in the process of gene expression in eukaryotes and consists of the removal ofintrons and the linking of exons to generate mature mRNAs. This is a highly regulated mechanism that allows the alternative usage of exons, the retention ofintronic sequences and the generation of exonic sequences of variable length. Most human genes undergo splicing events, and disruptions of this process have been associated with a variety of diseases, including cancer. Hepatocellular carcinoma (HCC) is a molecularly heterogeneous type of tumor that usually develops in a cirrhotic liver. Alterations in pre-mRNA splicing of some genes have been observed in liver cancer, and although still scarce, the available data suggest that splicing defects may have a role in hepatocarcinogenesis. Here we briefly review the general mechanisms that regulatepre-mRNA splicing, and discuss some examples that illustrate how this process is impaired in liver tumorigenesis, and may contribute to HCC development. We believe that a more thorough examination of pre-mRNA splicing is still needed to accurately draw the molecular portrait of liver cancer. This will surely contribute to a better understanding of the disease and to the development of new effective therapies.

Characterization of hepatitis B virus X gene quasispecies complexity in mono-infection and hepatitis delta virus superinfection

Hepatitis delta virus(HDV) seems to strongly suppress hepatitis B virus(HBV)replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution of mutants, resulting in viral quasispecies. Next-generation sequencing is a viable approach for analyzing the composition of these mutant spectra. As the regulatory hepatitis B X protein(HBx) is essential for HBV replication, determination of HBV X gene(HBX)quasispecies complexity in HBV/HDV infection compared to HBV monoinfection may provide information on the interactions between these two viruses.AIM To compare HBV quasispecies complexity in the HBX 5' region between chronic hepatitis delta(CHD) and chronic HBV mono-infected patients.METHODS Twenty-four untreated patients were included: 7/24(29.2%) with HBeAgnegative chronic HBV infection(CI, previously termed inactive carriers), 8/24(33.3%) with HBeAg-negative chronic hepatitis B(CHB) and 9/24(37.5%) with CHD. A serum sample from each patient was first tested for HBV DNA levels.The HBX 5' region [nucleotides(nt) 1255-1611] was then PCR-amplified for subsequent next-generation sequencing(MiSeq, Illumina, United States). HBV quasispecies complexity in the region analyzed was evaluated using incidencebased indices(number of haplotypes and number of mutations), abundancebased indices(Hill numbers of order 1 and 2), and functional indices(mutation frequency and nucleotide diversity). We also evaluated the pattern of nucleotide changes to investigate which of them could be the cause of the quasispecies complexity.RESULTS CHB patients showed higher median HBV-DNA levels [5.4 logIU/mL,interquartile range(IQR) 3.5-7.9] than CHD(3.4 logIU/mL, IQR 3-7.6)(P = n.s.)or CI(3.2 logIU/mL, IQR 2.3-3.5)(P < 0.01) patients. The incidence and abundance indices indicated that HBV quasispecies complexity was significantly greater in CI than CHB. A similar trend was observed in CHD patients, although only Hill numbers of order 2 showed statistically significant differences(CHB2.81, IQR 1.11-4.57 vs CHD 8.87, 6.56-11.18, P = 0.038). There were no significant differences in the functional indices, but CI and CHD patients also showed a trend towards greater complexity than CHB. No differences were found for any HBV quasispecies complexity indices between CHD and CI patients. G-to-A and C-to-T nucleotide changes, characteristic of APOBEC3 G, were higher in CHD and CI than in CHB in genotype A haplotypes, but not in genotype D. The proportion of nt G-to-A vs A-to-G changes and C-to-T vs T-to-C changes in genotype A and D haplotypes in CHD patients showed no significant differences. In CHB and CI the results of these comparisons were dependent on HBV genotype.CONCLUSION The lower-replication CHD and CI groups show a trend to higher quasispecies complexity than the higher-replication CHB group. The mechanisms associated with this greater complexity require elucidation.

解密海尔财务升级

主持人：青岛市人力资源协会副会长、海尔集团人力资源总监王筱楠讨论嘉宾：海尔集团高级副总裁。

财务转型

本文是Martin Fahy博士为本刊撰写的专稿,其观点主要取自作者之前分别刊登在《Financial Management》2005年 6月和10月中关于财务未来的两篇文章。

Are assemblages of the fireworm Hermodice carunculata enhanced in sediments beneath offshore fish cages?

Abundances of the fireworm Hermodice carunculata were counted through a monitoring assessment study of fish cages in Barranco Hondo（NE Tenerife）. Seven campaigns were conducted from November 2007 to June 2010 and temporal variations were found, as well as differences among sampling stations. The polychaete H. carunculata obtained its highest abundance in sediments beneath fish cages throughout the study period. Thus, the assemblages of this omnivorous species were favoured by the presence of fish cages.

Epidermal growth factor receptor inhibitors in colorectal cancer treatment: What's new?

Colorectal cancer constitutes one of the most common malignancies and the second leading cause of death from cancer in the western world representing one million new cases and half a million deaths annually worldwide. The treatment of patients with metastatic colon cancer comprises different regimens of chemotherapeutic compounds (fluoropyrimidines, irinotecan and oxaliplatin) and new targeted therapies. Interestingly, most recent trials that attempt to expose patients to all five-drug classes (fluoropyrimidines, irinotecan, oxaliplatin, bevacizumab and cetuximab) achieve an overall survival well over 2 years. In this review we will focus on the main epidermal growth factor receptor inhibitors demonstrating clinical benefit for colorectal cancer mainly cetuximab, panitumumab, erlotinib and gefitinib. We will also describe briefly the molecular steps that lie beneath them and the different clinical or molecular mechanisms that are reported for resistance and response.

第四届中国护理信息学大会暨第四届CMIA护理信息学专委会全体委员大会第一次会议会议通知

2016年9月 中国厦门 由中国医药信息学会护理信息学专业委员会：（China Medical Informatics Association- Nursing Informatics Community,CMIA-NI）主办的第四届中国护理信息学大会将于2016年9月5-7日在中国厦门召开，

From China’s Heavy Precipitation in 2020 to a “Glocal” Hydrometeorological Solution for Flood Risk Prediction

The prolonged mei-yu/baiu system with anomalous precipitation in the year 2020 has swollen many rivers and lakes,caused flash flooding,urban flooding and landslides,and consistently wreaked havoc across large swathes of China,particularly in the Yangtze River basin.Significant precipitation and flooding anomalies have already been seen in magnitude and extension so far this year,which have been exerting much higher pressure on emergency responses in flood control and mitigation than in other years,even though a rainy season with multiple ongoing serious flood events in different provinces is not that uncommon in China.Instead of delving into the causes of the uniqueness of this year’s extreme precipitation-flooding situation,which certainly warrants in-depth exploration,in this article we provide a short view toward a more general hydrometeorological solution to this annual nationwide problem.A“glocal”(global to local)hydrometeorological solution for floods(GHS-F)is considered to be critical for better preparedness,mitigation,and management of different types of significant precipitation-caused flooding,which happen extensively almost every year in many countries such as China,India and the United States.Such a GHS-F model is necessary from both scientific and operational perspectives,with the strength in providing spatially consistent flood definitions and spatially distributed flood risk classification considering the heterogeneity in vulnerability and resilience across the entire domain.Priorities in the development of such a GHS-F are suggested,emphasizing the user’s requirements and needs according to practical experiences with various flood response agencies.

Confounding response of macrofauna from a confluence of impacts: brine and sewage pollution

Throughout the shores of the world, a confluence of different sources of pollution is common, e.g., through outlets releasing brine, industrial, and domestic sewage. In this study, we assessed whether a combined disposal of domestic sewage and brine altered the patterns of abundance and assemblage structure of sub- tidal macrofauna inhabiting sandy seabeds on the south coast of Gran Canaria （Canary Islands, NE Atlantic Ocean）. Samples were collected in two surveys （May 2008 and January 2009） at three distances （0, 15, and 30 m） away from the discharge point. Macrofaunal abundances showed different patterns with varying proximity from the disposal point in the two surveys. In May 2008, lower abundances were observed at 0 m （53.89±46.82 ind.） than at 15 m （120±91.7 ind.） and 30 m （283.89±189.33 ind.） away from the dis- posal point. In January 2009, however, higher abundances were observed at 0 m （131.33±58.69 ind.） than at 30 m （100±24.44 ind.） and 15 m （84.78±58.39 ind.） away from the disposal point. Significant differ- ences in macrofaunal assemblage structure were found with varying proximity from the discharge point in both surveys. The effect of proximity from the disposal point was confounded by changes in sedimen- tary composition between surveys, which contributed to explain differences in macrofaunal abundances and assemblage structure with varying proximity from the discharge point. As a result, confounding driver- s of macrofaunal assemblage structure, here, changes in sediment composition, accounted for changes in macrofaunal abundances and assemblage structure with varying proximity from a combined disposal point of brine and sewage.

Temporal dynamics of shallow subtidal meiobenthos from a beach in Tenerife (Canary Islands, northeast Atlantic Ocean)

A shallow subtidal （3 m deep） meiofaunal assemblage in Los Abrigos Bay, Tenerife, Canary Islands was sam- pled during May 2000-April 2001. The main aims were to （1） find temporal variations in meiofaunal assem- blage structure and overall abundance, as well as in the most abundant meiofaunal species throughout the study period, and （2） identify environmental variables （sedimentary composition, organic matter content, and total nitrogen） that better explain meiofaunal assemblage structure during the study year. The most abundant species were the nematodes Siphonolaimus sp. 2 and Catanema sp., which represented 46.2% of the overall meiofaunal abundances and varied significantly throughout the study duration. Overall meio- faunal abundance and the most abundant taxonomic groups （nematodes, copepods, and oligochaetes） showed significant temporal variations during the study period. Nematodes overwhelmingly dominated during the study period, ranging from 78% in May to 97.34% in February. Multivariate analyses showed seasonality in meiofaunal community structure during the study year, with the lowest abundances in May. Keywords： Meiofauna, assemblage structure, subtidal, Canary Islands, Atlantic Ocean

Macrofaunal communities of threatened subtidal maёrl seabeds on Tenerife (Canary Islands, north-east Atlantic Ocean) in summer

This study contributes with the first data on physical and taxonomical structure of macrofaunal assemblages of maerl beds from the Canary Islands. Maerl beds and Cymodocea nodosa meadows of the Canary Islands are considered biodiversity hot-spots in terms of taxonomic and functional biodiversity with a broad geographical and depth ranges. The authors have studied the structure of the macrofaunal assemblages on different habitat types （Cymodocea, Caulerpa, sabellid field, garden eel and maerl beds）. Samples were taken at a range of depths between 14 and 46 m. Correlations were performed among abiotic variables （granulometry, organic matter, nitrogen and phosphates） and the most abundant taxa. Similarity analysis was performed to explore the patchiness of seabeds at a local scale. Significant differences were found in macrofaunal assemblages among seabed types, with highest abundances and lowest biodiversity in sabellid fields, where the sabellid Bispira viola dominated. The polychaetes Aponuphis bilineata and Chone filicauda and the mollusc Turritella brochii were the most abundant taxa on maerl beds. The mosaic of granulometric conditions would explain the associated macroinfaunal community structure and contribute to the creation of diversity on these relatively well preserved seabeds at a local scale.