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分层渐进教学模式在儿科住院医师心电图培训中的应用实践
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作者 赵鎏丹 陈笋 +1 位作者 赵鹏军 孙晶 《中国医学教育技术》 2024年第6期821-826,共6页
目的 探讨分层渐进的教学模式在儿科住院医师心电图培训中的应用效果。方法 选取2019年8月—2023年8月在上海交通大学医学院附属新华医院儿科住院医师规范化培训基地心血管专业轮转的45名住院医师作为研究对象。教学团队于2021年12月起... 目的 探讨分层渐进的教学模式在儿科住院医师心电图培训中的应用效果。方法 选取2019年8月—2023年8月在上海交通大学医学院附属新华医院儿科住院医师规范化培训基地心血管专业轮转的45名住院医师作为研究对象。教学团队于2021年12月起在轮转的住院医师中开展心电图分层教学法。在此之前轮转医师为对照组,共27名,一次性连续轮转心血管科室,采用传统教学方法;在此之后轮转医师为试验组,共18名,分别在低年级(第一阶段)、高年级(第二阶段)分层轮转心血管科室,采用分层渐进教学方法。教学结束后,比较两组医师的考核成绩和教学满意度。结果 试验组医师在接受第二阶段培训后,其心电图考核总分和理论成绩与对照组医师相比差异无统计学意义(P>0.05),但病例判读分析得分高于对照组[(57.17±4.64)分vs.(53.37±6.74)分,P=0.039]。试验组在心腔结构异常的心电图判读正确率较对照组显著提高(81.25%vs. 44.00%,P=0.018)。试验组医师认为分层渐进的心电图教学方法在提升医师解决临床实际问题能力方面效果较好,教学满意度达标率较对照组高(88.90%vs. 51.90%,χ^(2)=6.668,P=0.007)。结论 分层渐进教学可以提高儿科住院医师的心电图判读技能,是一种更优化且受欢迎的培训模式。 展开更多
关键词 分层渐进 儿科住院医师规范化培训 心电图 教学
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基于MRI影像组学模型术前预测垂体神经内分泌瘤血供
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作者 吴莉莉 孙陈 +3 位作者 何天洪 吴树剑 范莉芳 陈基明 《中国肿瘤临床》 CAS CSCD 北大核心 2024年第8期406-412,共7页
目的:探讨基于MRI影像组学特征的机器学习模型在术前预测垂体神经内分泌瘤血供的价值。方法:回顾性分析2013年4月至2023年4月皖南医学院第一附属弋矶山医院136例经病理确诊的垂体神经内分泌瘤(直径>10 mm)患者的临床和影像资料。根... 目的:探讨基于MRI影像组学特征的机器学习模型在术前预测垂体神经内分泌瘤血供的价值。方法:回顾性分析2013年4月至2023年4月皖南医学院第一附属弋矶山医院136例经病理确诊的垂体神经内分泌瘤(直径>10 mm)患者的临床和影像资料。根据术中所见将其分为血供丰富组50例和血供一般组86例。按照完全随机的方法将所有患者以7∶3的比例分为训练组96例和验证组40例。采用多因素Logistic回归(LR)、随机森林(RF)、支持向量机(SVM)三种机器学习算法分别建立影像组学预测模型。绘制受试者工作特征曲线(ROC)评价模型的诊断效能,并绘制决策曲线分析(DCA)评估模型的临床净收益。结果:临床模型在训练组和验证组中的曲线下面积(AUC)为0.74、0.82;T1WI、T2WI、T1WI增强及联合序列影像组学模型在训练组中AUC分别为0.80、0.84、0.82、0.84,在验证组中分别为0.82、0.80、0.85、0.83;LR、RF、SVM模型在训练组中的AUC分别为0.85、0.87、0.84,验证组中分别为0.85、0.85、0.83。影像组学各模型均优于临床模型的诊断效能。DCA显示联合序列模型、LR及SVM模型均获得较好的临床净收益,LR模型最优。结论:MRI影像组学的机器学习各模型均具有较高的预测价值,优于临床医生肉眼观察MRI图像的判断,且具有较好的临床净收益,能够为临床决策提供有效指导作用。 展开更多
关键词 垂体神经内分泌瘤 血供 机器学习 影像组学 磁共振成像
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A Survey on an Emerging Safety Challenge for Autonomous Vehicles:Safety of the Intended Functionality
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作者 Hong Wang Wenbo Shao +3 位作者 chen sun Kai Yang Dongpu Cao Jun Li 《Engineering》 SCIE EI CAS CSCD 2024年第2期17-34,共18页
As the complexity of autonomous vehicles(AVs)continues to increase and artificial intelligence algorithms are becoming increasingly ubiquitous,a novel safety concern known as the safety of the intended functionality(S... As the complexity of autonomous vehicles(AVs)continues to increase and artificial intelligence algorithms are becoming increasingly ubiquitous,a novel safety concern known as the safety of the intended functionality(SOTIF)has emerged,presenting significant challenges to the widespread deployment of AVs.SOTIF focuses on issues arising from the functional insufficiencies of the AVs’intended functionality or its implementation,apart from conventional safety considerations.From the systems engineering standpoint,this study offers a comprehensive exploration of the SOTIF landscape by reviewing academic research,practical activities,challenges,and perspectives across the development,verification,validation,and operation phases.Academic research encompasses system-level SOTIF studies and algorithm-related SOTIF issues and solutions.Moreover,it encapsulates practical SOTIF activities undertaken by corporations,government entities,and academic institutions spanning international and Chinese contexts,focusing on the overarching methodologies and practices in different phases.Finally,the paper presents future challenges and outlook pertaining to the development,verification,validation,and operation phases,motivating stakeholders to address the remaining obstacles and challenges. 展开更多
关键词 Safety of the intended functionality Autonomous vehicles Artificial intelligence UNCERTAINTY Verification Validation
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Presence of a long nuclear-localization signal sequence in homeodomain transcription factor Nkx 1.2
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作者 Xinyi LI Lihui chen +4 位作者 Xinyuan WANG chen sun Guangdong JI Guobin HU Zhenhui LIU 《Journal of Oceanology and Limnology》 SCIE CAS CSCD 2024年第2期620-626,共7页
Homeodomains,a 60-amino acid sequence encoded by 180 nucleotides,are highly conserved DNA-binding motifs that are present in a variety of transcription factors in species ranging from yeast to humans.The NKX proteins ... Homeodomains,a 60-amino acid sequence encoded by 180 nucleotides,are highly conserved DNA-binding motifs that are present in a variety of transcription factors in species ranging from yeast to humans.The NKX proteins belong to the homeodomain(HD)-containing transcription factor family.They play vital roles in the regulation of morphogenesis.NKX1-2 is one member of the NKX subfamily.At present,information about its nuclear localization signal(NLS)sequence is limited.We studied the NLS sequence of zebrafish Nkx1.2 by introducing sequence changes such as deletion,mutation,and truncation,and identified an NLS motif(QNRRTKWKKQ)that is localized at the C-terminus of the homeodomain.Moreover,the deletion of two amino acid residues(RR)in this NLS motif prevents Nkx1.2 from entering the nucleus,indicating that the two amino acids are essential for Nkx1.2 nuclear localization.However,the NLS motif alone is unable to target cytoplasmic protein glutathione S-transferase(GST)to the nucleus.An intact homeodomain is necessary for mediating the complete nuclear transport of cytoplasmic protein.Unlike most nuclear import proteins with short NLS sequences,a long NLS is present in zebrafish Nkx1.2.We also demonstrated that the sequences of homeodomain of NKX1.2 are well conserved among different species.This study is informative to verify the function of the NKX1.2 protein. 展开更多
关键词 NKX1.2 NKX protein HOMEODOMAIN nuclear localization signal(NLS) nuclear transport
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Investigation of high-quality-factor aluminum nitride MEMS cantilever resonators
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作者 Shuai Shi Qingrui Yang +5 位作者 Yi Yuan Haolin Li Pengfei Niu Wenlan Guo chen sun Wei Pang 《Nanotechnology and Precision Engineering》 EI CAS CSCD 2024年第1期32-43,共12页
This paper presents the design,fabrication,and characterization of cantilever-type resonators with a novel stacked structure.Aluminum nitride is adopted as the material for both the structural layer and the piezoelect... This paper presents the design,fabrication,and characterization of cantilever-type resonators with a novel stacked structure.Aluminum nitride is adopted as the material for both the structural layer and the piezoelectric layer;this simplifies the fabrication process and improves the quality factor of the resonator.Both in-plane and out-of-planeflexural modes were investigated.The effect of the structural dimensions and electrode patterns on the resonator’s performance were also studied.Finite-element simulations and experiments examining anchor loss and thermoelastic damping,which are the main loss mechanisms affecting the quality factor of these resonators,were carried out.The optimal structural dimensions and electrode patterns of the cantilever-type resonators are presented.A quality factor of 7922 with a motional impedance of 88.52 kΩand a quality factor of 8851 with a motional impedance of 67.03 kΩwere achieved for the in-plane and out-of-planeflexural-mode resonators,respectively.The proposed resonator design will contribute to the development of high-performance devices such as accelerometers,gyroscopes,and pressure sensors. 展开更多
关键词 MEMS Cantilever-type micro-resonator ALN Finite-element simulation
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Impact of open hepatectomy on postoperative bile leakage in patients with biliary tract cancer
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作者 Gang Wu Wen-Ying Li +2 位作者 Yu-Xing Gong Feng Lin chen sun 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第1期67-75,共9页
BACKGROUND Bile leakage is a common and serious complication of open hepatectomy for the treatment of biliary tract cancer.AIM To evaluate the incidence,risk factors,and management of bile leakage after open hepatecto... BACKGROUND Bile leakage is a common and serious complication of open hepatectomy for the treatment of biliary tract cancer.AIM To evaluate the incidence,risk factors,and management of bile leakage after open hepatectomy in patients with biliary tract cancer.METHODS We retrospectively analyzed 120 patients who underwent open hepatectomy for biliary tract cancer from February 2018 to February 2023.Bile leak was defined as bile drainage from the surgical site or drain or the presence of a biloma on imaging.The incidence,severity,timing,location,and treatment of the bile leaks were recorded.The risk factors for bile leakage were analyzed using univariate and multivariate logistic regression analyses.RESULTS The incidence of bile leak was 16.7%(20/120),and most cases were grade A(75%,15/20)according to the International Study Group of Liver Surgery classification.The median time of onset was 5 d(range,1-14 d),and the median duration was 7 d(range,2-28 d).The most common location of bile leakage was the cut surface of the liver(70%,14/20),followed by the anastomosis site(25%,5/20)and the cystic duct stump(5%,1/20).Most bile leaks were treated conservatively with drainage,antibiotics,and nutritional support(85%,17/20),whereas some required endoscopic retrograde cholangiopancreatography with stenting(10%,2/20)or percutaneous transhepatic cholangiography with drainage(5%,1/20).Risk factors for bile leakage include male sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood transfusion.CONCLUSION Bile leakage is a frequent complication of open hepatectomy for biliary tract cancer.However,most cases are mild and can be conservatively managed.Male sex,hepatocellular carcinoma,major hepatectomy,blood loss,and blood transfusion were associated with an increased risk of bile leak. 展开更多
关键词 Open hepatectomy Bile leak Biliary tract cancer Risk factors Management COMPLICATION
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支气管肺发育不良极早产儿合并肺静脉狭窄2例报告
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作者 王丽平 尤优 +3 位作者 殷张华 王依闻 陈笋 夏红萍 《临床儿科杂志》 CAS CSCD 北大核心 2023年第4期289-293,共5页
目的探讨支气管肺发育不良极早产儿合并肺静脉狭窄(PVS)的临床特征和治疗结局。方法回顾性分析两例支气管肺发育不良合并PVS极早产儿的临床资料,并复习相关文献。结果两例极早产儿,胎龄分别为30+1周和28+2周,均为小于胎龄儿,诊断为支气... 目的探讨支气管肺发育不良极早产儿合并肺静脉狭窄(PVS)的临床特征和治疗结局。方法回顾性分析两例支气管肺发育不良合并PVS极早产儿的临床资料,并复习相关文献。结果两例极早产儿,胎龄分别为30+1周和28+2周,均为小于胎龄儿,诊断为支气管肺发育不良伴肺动脉高压。病例1生后4月20天发现左侧PVS,经药物治疗无效后死亡。病例2生后3月发现左侧PVS,生后5月15天右上肺静脉也狭窄,行肺静脉球囊扩张介入术后肺动脉压下降出院;1月余后,患儿肺高压反复,心胸外科行肺静脉狭窄纠治术,术后肺静脉再次狭窄,家属放弃治疗后死亡。结论合并支气管肺发育不良伴肺动脉高压的极早产儿,动态复查心彩超时应特别注意评估肺静脉情况。PVS患儿扩肺血管药物治疗无效时,可尝试介入或外科手术干预,但总体死亡率较高。 展开更多
关键词 极早产儿 肺静脉狭窄 支气管肺发育不良 肺动脉高压
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Unveiling and Alleviating Chemical“Crosstalk”of Succinonitrile Molecules in Hierarchical Electrolyte for High-Voltage Solid-State Lithium Metal Batteries 被引量:2
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作者 Fang Fu Ying Liu +4 位作者 chen sun Lina Cong Yulong Liu Liqun sun Haiming Xie 《Energy & Environmental Materials》 SCIE EI CAS CSCD 2023年第3期107-116,共10页
Succinonitrile-based plastic crystal electrolytes have emerged for high-energy-density Li metal batteries in terms of their superior ambient ionic conductivity,low flammability,and benign compatibility with high volta... Succinonitrile-based plastic crystal electrolytes have emerged for high-energy-density Li metal batteries in terms of their superior ambient ionic conductivity,low flammability,and benign compatibility with high voltage cathode,but are hampered by inherent instabilities toward Li anodes.Constructing hierarchical solid electrolytes structure is a fundamental approach to protect Li anode from succinonitrile attacks,with succinonitrile-based oxidation-resistance layer facing high voltage cathode and reduction-tolerant layer contacting Li anode.However,free succinonitrile molecules in succinonitrile-based electrolyte layer can diffuse across the electrolyte/electrolyte interface and further reach Li anode surface during the battery cycle.This chemical“crosstalk”cause reduction-tolerant electrolyte layer to fail to protect the Li anode from the attacks of free succinonitrile molecules.Nano Li_(6.4)La_(3)Zr_(1.4)Ta_(0.6)O_(12)is introduced creatively into succinonitrile-based electrolyte layer.By taking advantage of the complexation between La atoms in Li_(6.4)La_(3)Zr_(1.4)Ta_(0.6)O_(12)and N atoms in succinonitrile,the free succinonitrile molecules are successfully immobilized in succinonitrile-based electrolyte layer.The resulting low resistance and highly durable solid electrolyte interphase and cathode electrolyte interphase endow NCM622||Li batteries with remarkable cycle stability.Our research provides a new idea for the real application of plastic crystal electrolytes in high voltage solid-state lithium metal batteries. 展开更多
关键词 hierarchical solid electrolytes high voltage interface lithium metal plastic crystal
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Detection and quantification of Pb and Cr in oysters using laser-induced breakdown spectroscopy
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作者 闫清霞 田野 +7 位作者 李颖 林洪 贾自文 卢渊 俞进 孙琛 白雪石 Vincent DETALLE 《Plasma Science and Technology》 SCIE EI CAS CSCD 2023年第4期195-203,共9页
The quantitative determination of heavy metals in aquatic products is of great importance for food security issues.Laser-induced breakdown spectroscopy(LIBS)has been used in a variety of foodstuff analysis,but is stil... The quantitative determination of heavy metals in aquatic products is of great importance for food security issues.Laser-induced breakdown spectroscopy(LIBS)has been used in a variety of foodstuff analysis,but is still limited by its low sensitivity when targeting trace heavy metals.In this work,we compare three sample enrichment methods,namely drying,carbonization,and ashing,for increasing detection sensitivity by LIBS analysis for Pb and Cr in oyster samples.The results demonstrate that carbonization can remove a significant amount of the contributions of organic elements C,H,N and O;meanwhile,the signals of the metallic elements such as Cu,Pb,Sr,Ca,Cr and Mg are enhanced by3–6 times after carbonization,and further enhanced by 5–9 times after ashing.Such enhancement is not only due to the more concentrated metallic elements in the sample compared to the dried ones,but also the unifying of the matter in carbonized and ashed samples from which higher plasma temperature and electron density are observed.This condition favors the detection of trace elements.According to the calibration curves with univariate and multivariate analysis,the ashing method is considered to be the best choice.The limits of detection of the ashing method are 0.52 mg kg-1 for Pb and0.08 mg kg-1 for Cr,which can detect the presence of heavy metals in the oysters exceeding the maximum limits of Pb and Cr required by the Chinese national standard.This method provides a promising application for the heavy metal contamination monitoring in the aquatic product industry. 展开更多
关键词 laser-induced breakdown spectroscopy(LIBS) heavy metal detection signal enhancement sample preparation method quantification OYSTERS
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Tunable microfluidic chip for single-cell deformation study
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作者 Ruiyun Zhang Xuexin Duan +3 位作者 Shuaihua Zhang Wenlan Guo chen sun Ziyu Han 《Nanotechnology and Precision Engineering》 EI CAS CSCD 2023年第2期25-32,共8页
Microfluidic phenotyping methods have been of vital importance for cellular characterization,especially for evaluating single cells.In order to study the deformability of a single cell,we devised and tested a tunable ... Microfluidic phenotyping methods have been of vital importance for cellular characterization,especially for evaluating single cells.In order to study the deformability of a single cell,we devised and tested a tunable microfluidic chip-based method.A pneumatic polymer polydimethylsiloxane(PDMS)membrane was designed and fabricated abutting a single-cell trapping structure,so the cell could be squeezed controllably in a lateral direction.Cell contour changes under increasing pressure were recorded,enabling the deformation degree of different types of single cell to be analyzed and compared using computer vision.This provides a new perspective for studying mechanical properties of cells at the single cell level. 展开更多
关键词 MICROFLUIDICS Cell deformation Single cell Computer vision
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Exact solution of slow quench dynamics and nonadiabatic characterization of topological phases
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作者 邬睿 房盼攀 +1 位作者 孙辰 李福祥 《Chinese Physics B》 SCIE EI CAS CSCD 2023年第8期171-180,共10页
Previous studies have shown that the bulk topology of single-particle systems can be captured by the band inversion surface or by the spin inversion surface emerging on the time-averaged spin polarization.Most of the ... Previous studies have shown that the bulk topology of single-particle systems can be captured by the band inversion surface or by the spin inversion surface emerging on the time-averaged spin polarization.Most of the studies,however,are based on the single-particle picture even though the systems are fermionic and multi-bands.Here,we study the slow quench dynamics of topological systems with all the valence bands fully occupied,and show that the concepts of band inversion surface and spin inversion surface are still valid.More importantly,the many-particle nonadiabatic quench dynamics is shown to be reduced to a new and nontrivial three-level Landau-Zener model.This nontrivial three-level Landau-Zener problem is then solved analytically by applying the integrability condition and symmetry considerations,and thus adds a new member to the few models that are exactly solvable.Based on the analytical results,the topological spin texture revealed by the time-averaged spin polarization can be applied to characterize the bulk topology and thus provides a direct comparison for future experiments. 展开更多
关键词 Landau-Zener slow quench NONADIABATIC
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时间-空间关联成像技术评估圆锥动脉干畸形胎儿心功能 被引量:5
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作者 应倩 武育蓉 +1 位作者 陈笋 孙锟 《中国医学影像技术》 CSCD 北大核心 2018年第9期1284-1288,共5页
目的应用时间-空间关联成像(STIC)技术评价圆锥动脉干畸形(CTD)胎儿心功能。方法选取经胎儿超声心动图诊断的39胎CTD胎儿(CTD组)和39胎正常胎儿(对照组)。采用STIC技术评估2组胎儿的心功能,包括肺动脉(PA)内径、左心室舒张末期内径(LVDD... 目的应用时间-空间关联成像(STIC)技术评价圆锥动脉干畸形(CTD)胎儿心功能。方法选取经胎儿超声心动图诊断的39胎CTD胎儿(CTD组)和39胎正常胎儿(对照组)。采用STIC技术评估2组胎儿的心功能,包括肺动脉(PA)内径、左心室舒张末期内径(LVDD)和右心室舒张末期内径(RVDD)、左心室收缩末期内径(LVDS)、右心室收缩末期内径(RVDS)、缩短分数(FS)、左心室舒张末期容积(LVEDV)、右心室舒张末期容积(RVEDV)、左心室收缩末期容积(LVESV)、右心室收缩末期容积(RVESV)、每搏输出量(SV)和射血分数(EF)等指标,并比较2组间的差异。结果与对照组比较,CTD组胎儿PA内径及PA/AO均减小(P均<0.001),LVDD、LVDS、RVDD、RVDS、LVEDV、LVESV、RVEDV及RVESV差异均无统计学意义(P均>0.05),左、右心室FS、EF及SV均降低(P均<0.05),LVDD/RVDD明显升高(P均<0.01)。CTD组中,RVEDV高于LVEDV(P<0.05),左心室SV及EF均低于右心室(P均<0.05)。结论CTD在产前即可对胎儿心功能造成影响,右心室功能有代偿性增强表现,而右心扩大不明显。 展开更多
关键词 时间-空间关联成像技术 圆锥动脉干畸形 胎儿 心功能
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糖尿病孕妇转诊胎儿超声心动图的最小成本分析 被引量:1
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作者 孟卓 王鉴 +2 位作者 武育蓉 陈笋 孙锟 《临床儿科杂志》 CAS CSCD 北大核心 2020年第8期626-630,共5页
目的评估糖尿病孕妇胎儿心脏筛查策略的成本与效果。方法对199例因孕母糖尿病转诊胎儿超声心动图检查的孕妇进行理论最小成本分析,评估此类孕妇进行常规筛查和胎儿超声心动图筛查的成本与效果。结果199例糖尿病孕妇最终筛查出9例先天性... 目的评估糖尿病孕妇胎儿心脏筛查策略的成本与效果。方法对199例因孕母糖尿病转诊胎儿超声心动图检查的孕妇进行理论最小成本分析,评估此类孕妇进行常规筛查和胎儿超声心动图筛查的成本与效果。结果199例糖尿病孕妇最终筛查出9例先天性心脏病患儿。目前的筛查策略是对所有糖尿病孕妇进行孕中期胎儿畸形筛查和胎儿超声心动图检查,以及对产前发现先天性心脏病或即使只有良性发现的病例均进行生后超声心动图检查,每产前检出一例先天性心脏病的费用为13045.67元;若筛查策略仅对拥有其他转诊因素的糖尿病孕妇进行胎儿超声心动图检查,且仅对有产前发现先天性心脏病或其他良性发现的病例进行生后超声心动图检查,每产前检出一例先天性心脏病的费用会降低至8475.22元。结论在完成孕中期胎儿畸形筛查后,对伴有其他转诊指征的糖尿病孕妇行选择性的胎儿超声心动图检查,并对有产前心脏异常的病例选择性进行生后超声心动图检查的心脏筛查策略相比其他筛查策略性价比更高。 展开更多
关键词 胎儿超声心动图 转诊指征 糖尿病
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故事疗法延缓轻中度认知障碍老年人认知衰退的最佳证据总结 被引量:3
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作者 孙晨 拜争刚 《医学新知》 CAS 2022年第6期453-462,共10页
目的评价总结故事疗法对延缓轻中度认知障碍老年人认知衰退的最佳证据。方法计算机检索UpToDate、SIGN、NZGG、Cochrane Library、医脉通、Embase、PubMed、中国知网(CNKI)、万方、维普数据库中关于故事疗法延缓轻中度认知障碍老年人认... 目的评价总结故事疗法对延缓轻中度认知障碍老年人认知衰退的最佳证据。方法计算机检索UpToDate、SIGN、NZGG、Cochrane Library、医脉通、Embase、PubMed、中国知网(CNKI)、万方、维普数据库中关于故事疗法延缓轻中度认知障碍老年人认知衰退的所有指南、证据总结、最佳实践信息册、推荐实践、系统评价、专家意见、随机对照试验和准实验研究等。检索时限为2010年1月1日至2022年2月25日。采用相应的质量评价工具评价纳入的文献,总结有关故事疗法对延缓轻中度认知障碍老年人认知衰退的最佳证据。结果共纳入16篇文献,其中4篇系统评价、9篇随机对照试验、3篇准实验研究。经过评价,共总结了故事疗法类型、活动形式、场所选择、材料准备、干预时间、干预过程、注意事项、推广应用8个方面有关延缓轻中度认知障碍老年人认知衰退的33条最佳证据。结论本研究总结了目前关于故事疗法对延缓轻中度认知障碍老年人认知衰退的最佳证据,为轻中度认知障碍的非药物干预提供可操作性的参考意见。 展开更多
关键词 故事疗法 认知障碍 认知衰退 最佳证据
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2009—2015年丹阳市蚊蝇密度监测 被引量:1
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作者 郭礼梁 陈隼 王凯 《中华卫生杀虫药械》 CAS 2019年第2期156-159,共4页
目的了解丹阳市蚊蝇种群构成和季节消长情况,为蚊蝇的科学防治提供依据。方法蚊密度监测采用诱蚊灯法,蝇密度监测采用笼诱法。结果 2009—2015年共捕获成蚊7 350只,平均蚊密度为0.44只/(灯·h),淡色库蚊为优势种,占90.11%。不同年... 目的了解丹阳市蚊蝇种群构成和季节消长情况,为蚊蝇的科学防治提供依据。方法蚊密度监测采用诱蚊灯法,蝇密度监测采用笼诱法。结果 2009—2015年共捕获成蚊7 350只,平均蚊密度为0.44只/(灯·h),淡色库蚊为优势种,占90.11%。不同年份蚊密度差异无统计学意义,全年消长呈双峰型,活动高峰出现在7月和10月;共捕获蝇1 879只,平均蝇密度为2.68只/笼;家蝇和麻蝇为优势种,分别占27.35%和26.98%。自2009年,蝇密度逐年升高,至2013年出现高峰,此后密度下降,全年消长呈单峰型,活动高峰出现在7月。结论 2009—2015年,丹阳市蚊蝇密度整体均处于较低水平,但蝇密度在个别年份存在反弹现象,提示应充分利用蚊蝇密度监测结果,科学指导蚊蝇防治工作,并逐步建立和完善蚊蝇防治长效机制。 展开更多
关键词 病媒生物 蚊密度 蝇密度 监测 季节消长
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miRNA对Fontan术后血小板活化程度及血栓形成影响的精确预测价值 被引量:1
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作者 赵鹏军 吴兰萍 +5 位作者 崔艳 孙晶 沈加 白凯 陈笋 张海波 《精准医学杂志》 2018年第5期414-417,421,共5页
目的探讨微小核糖核酸(miRNA)对Fontan术后血小板活化程度及血栓形成影响的精确预测价值。方法选取单心室行Fontan术后病儿6例作为实验组(TG组),体检正常儿童6例作为对照组(CG组),分别提取两组血清、血小板和白细胞内miRNA;选取和心血... 目的探讨微小核糖核酸(miRNA)对Fontan术后血小板活化程度及血栓形成影响的精确预测价值。方法选取单心室行Fontan术后病儿6例作为实验组(TG组),体检正常儿童6例作为对照组(CG组),分别提取两组血清、血小板和白细胞内miRNA;选取和心血管病相关的miRNA(miR-126、miR-150、miR-197、miR-223及miR-21),通过qRT-PCR检测其表达情况;通过流式细胞仪检测血小板活化程度;通过Western Blot方法检测经慢病毒转染抑制miR-223表达后对细胞核因子κB(NF-κB)信号通路蛋白表达的影响。结果 CG组和TG组血清中miR-126、miR-223表达水平比较,差异有显著性(t=3.22、3.45,P<0.05)。两组外周血血小板和白细胞中miR-223表达水平比较,差异有显著性(t=5.62、4.32,P<0.05)。流式细胞仪检测结果显示,TG组血小板中CD62p、CD41a的表达率较CG组显著升高(t=17.57、87.78,P<0.01);Western Blot检测结果显示,TG+病毒无转录抑制因子组(TC组)白细胞Iκb蛋白表达下调,p-p65蛋白表达上调;CG+病毒含转录抑制因子组(CI组)白细胞中Iκb蛋白表达上调,p-p65蛋白表达下调;与CI组组比较,TG+病毒含转录抑制因子组(TI组)白细胞中Iκb蛋白表达下调,p-p65蛋白表达上调;Ikkb和NF-κB蛋白表达在不同处理组间无明显变化。结论 Fontan术后病儿血清中miR-223表达水平升高,血小板活化率增加;miR-223表达升高后可能通过NF-κB信号路径来促进血小板活化和血管内皮损伤,从而影响血栓形成。 展开更多
关键词 单心室 FONTAN手术 微RNAS 血栓形成 NF-κB 儿童
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CITED2基因在内脏反位患者中的突变分析 被引量:6
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作者 刘思捷 李婷婷 +3 位作者 陈笋 李奋 孙锟 徐让 《上海交通大学学报(医学版)》 CAS CSCD 北大核心 2019年第5期500-504,共5页
目的·研究CITED2 基因突变与内脏反位的关系。方法·选取24 例内脏反位的患者和100 名健康儿童对照,从外周血提取基因组DNA,使用PCR 扩增技术和Sanger 测序技术来检测CITED2 的外显子区域;通过软件Sift、PolyPhen-2、PROVEAN ... 目的·研究CITED2 基因突变与内脏反位的关系。方法·选取24 例内脏反位的患者和100 名健康儿童对照,从外周血提取基因组DNA,使用PCR 扩增技术和Sanger 测序技术来检测CITED2 的外显子区域;通过软件Sift、PolyPhen-2、PROVEAN 和MutationTaster 预测突变是否存在致病性;使用Y. Zhang 实验室服务器构建蛋白质的三维结构,导入SWISS-PdbViewer 查看突变对蛋白质结构的影响。结果·在1 例内脏反位的患者中发现了1 个新发的杂合错义突变c.418C>T(p.P140S),此突变在对照组中未发现。软件SIFT 和Mutation Taster 预测此突变具有致病性。SWISS-PdbViewer 显示,第140 位脯氨酸突变为丝氨酸后,第137 位天冬氨酸上的3个氢键全部断开,第140 位丝氨酸和第142 位丙氨酸重新建立了一个异常弱氢键。结论· CITED2 基因c.418C>T(p.P140S)突变可能影响CITED2 的生物学活性,与内脏反位的发生有关。 展开更多
关键词 内脏反位 CITED2基因 基因突变
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内脏异位综合征患儿中DNAI1和DNAH5基因编码区突变分析 被引量:2
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作者 徐蒙蒙 徐月娟 +2 位作者 陈笋 李奋 孙锟 《临床儿科杂志》 CAS CSCD 北大核心 2019年第7期494-499,共6页
目的 筛查中国汉族内脏异位综合征患儿DNAI1和DNAH5基因编码区突变情况。方法 临床招募确诊内脏异位综合征患儿及健康体检儿童,提取外周血DNA行全外显子组测序,检测DNAI1及DNAH5基因编码区核苷酸变异;Sanger测序验证外显子测序发现的突... 目的 筛查中国汉族内脏异位综合征患儿DNAI1和DNAH5基因编码区突变情况。方法 临床招募确诊内脏异位综合征患儿及健康体检儿童,提取外周血DNA行全外显子组测序,检测DNAI1及DNAH5基因编码区核苷酸变异;Sanger测序验证外显子测序发现的突变位点;以生物信息学软件Mutationtaster、SIFT、PolyPhen-2分析位点变异对蛋白功能的影响。结果 81例内脏异位综合征患儿及89例健康儿童的外显子测序结果可用于后续分析。在81例内脏异位综合征患儿中发现存在3个DNAI1及3个DNAH5基因的编码区突变位点,4例(4.94%)患儿携带DNAI1基因突变,2例(2.50%)患儿携带DNAH5基因突变;突变位点在89例健康儿童中均未发现。生物信息学分析提示上述突变位点可能破坏蛋白质功能。结论 中国汉族内脏异位综合征患儿DNAI1和DNAH5基因突变发生率分别为4.94%和2.50%,DNAI1和DNAH5基因突变可能与中国汉族儿童内脏异位发生相关。 展开更多
关键词 内脏异位 先天性心脏病 DNAI1基因 DNAH5基因 突变
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环境影响DNA甲基化及导致先天性心脏病发生的研究进展 被引量:6
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作者 周双 石鑫 +2 位作者 陈笋 于昱 孙锟 《临床儿科杂志》 CAS CSCD 北大核心 2018年第8期630-633,共4页
先天性心脏病的病因目前国际公认主要是遗传和环境因素共同作用的结果。环境诱发的表观遗传学变化可能是疾病发展起源的关键因素,具有重要的临床意义,而DNA甲基化是一种主要的表观遗传学机制。文章综述某些环境因素与DNA甲基化及先天性... 先天性心脏病的病因目前国际公认主要是遗传和环境因素共同作用的结果。环境诱发的表观遗传学变化可能是疾病发展起源的关键因素,具有重要的临床意义,而DNA甲基化是一种主要的表观遗传学机制。文章综述某些环境因素与DNA甲基化及先天性心脏病关系的研究进展,以便更好地了解先天性心脏病的发病机制,有利于早诊断、早治疗。 展开更多
关键词 环境因素 DNA甲基化 先天性心脏病
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基于产前诊断的不同侧别先天性膈疝患者临床特征与心脏结构特点研究 被引量:1
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作者 王雪瑶 潘伟华 +3 位作者 谢伟 陈笋 汤笑妤 王俊 《临床小儿外科杂志》 CAS CSCD 2021年第9期825-831,共7页
目的对不同侧别先天性膈疝(congenital diaphragmatic hernia,CDH)患者的临床特征和心脏结构进行对比分析。方法以2009年4月至2019年12月上海交通大学医学院附属新华医院小儿外科收治的产前诊断为CDH的179例患者为研究对象,所有患者采... 目的对不同侧别先天性膈疝(congenital diaphragmatic hernia,CDH)患者的临床特征和心脏结构进行对比分析。方法以2009年4月至2019年12月上海交通大学医学院附属新华医院小儿外科收治的产前诊断为CDH的179例患者为研究对象,所有患者采用“产前-产时-产后”程序化多学科综合诊疗模式。对不同侧别CDH患者的产前指标、产时新生儿临床结果、手术相关参数、临床结局以及产前超声心动图上心脏结构参数进行比较。结果179例中,左侧膈疝(left CDH,LCDH)139例(77.7%),归入LCDH组;右侧膈疝(right CDH,RCDH)40例(22.3%),归入RCDH组。179例总体存活率为68.7%(123/179)。RCDH组死亡率高于LCDH组(20.9%vs.45.0%,P=0.034)。RCDH组早产发生率更高(P=0.024),入院1 h内血pH更低(P=0.001)、PaCO_(2)值更高(P=0.002)。LCDH组中,B类缺损占比最多,RCDH组中D类缺损占比最多,两组不同缺损类型占比差异有统计学意义(P=0.007)。41例行产前超声心动图检查的CDH患者中,LCDH患者左心室标准化内径更小[(-2.58±0.77)vs.(-1.60±0.79),P=0.009]、右心室/左心室内径值更大[(1.09±0.09)vs.(0.99±0.07),P=0.015]。LCDH患者中,有肝脏疝入的胎儿右心室/左心室内径值更大[(1.15±0.11)vs.(1.06±0.07),P=0.027]。LCDH患者的左肺动脉标准化内径明显小于右肺动脉标准化内径[(-3.06±1.61)vs.(-2.40±1.43),P=0.041];而在RCDH患者中,上述两项指标差异无统计学意义(P>0.05)。结论产前诊断为RCDH的患者产时情况更危急,膈肌缺损更严重,存活率更低;产前诊断为LCDH的患者左心结构较RCDH患者小,肝脏疝入对左心结构可能有影响。 展开更多
关键词 产前诊断/方法 横膈 先天性/诊断 横膈 先天性/死亡率 超声检查 产前 心脏/解剖学和组织学
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