美托洛尔对舒张性心力衰竭兔神经内分泌系统的影响

目的研究美托洛尔对舒张性心力衰竭兔神经内分泌系统的影响。方法雄性新西兰兔30只随机分为3组：手术组在右侧肾动脉上1cm处行腹主动脉缩窄术;手术治疗组从术后第1天起应用美托洛尔治疗;假手术组作为对照组。术后观察心衰的临床表现,定期复查超声心动图,并监测全身和心肌局部AngⅡ、ET-1、NE和NT—proBNP变化。结果手术治疗组的心衰发生率明显低于手术组,心室结构和功能达到显著改善,血清AngⅡ（25．57vs38．16,P〈0．01）、ET-1（21．14vs35．96,P〈0．01）和血清与心肌NE（97．90vs128．51,P〈0．01;11．77vs17．28,P〈0．05）、NT—proBNP（221．92vs305．76,P〈0．01;24．33vs30．53,P〈0．05）显著降低。结论美托洛尔可有效抑制DHF兔的全身和心肌局部神经内分泌系统激活.     

麻醉诱导气管插管对动脉粥样硬化危险因素者动脉舒张功能的影响

目的：通过肱动脉内皮依赖性扩张功能（Endotheliud—dependent dilation,EDD）的检则,探讨静脉麻醉药物诱导和气管插管与动脉粥样硬化危险因素患者动脉内皮舒张功能的关系。方法：采用B型超声检测合并动脉粥样硬化危险因素的全静脉麻醉手术患者61名,测定麻醉诱导前和诱导插管后肱动脉内皮依赖性扩张功能。结果：诱导插管后,肱动脉内皮依赖性扩张功能为6．23％±1．16％,较诱导前7．05％±1．48％有统计学差异（P〈0．01）。结论：麻醉秀导期合并有动脉粥样硬化危险因素的患者动脉内皮功能显著降低。     

计算机辅助肝脏三维重建技术在肝癌患者围手术期健康教育中的应用研究

目的：探讨计算机辅助肝脏三维重建技术在肝癌患者围手术期健康教育中的应用效果方法将84例行肝癌切除术的患者随机分为实验组（43例）与对照组（41例）。对照组采用常规方式进行围手术期健康教育,实验组应用计算机辅助肝脏三维重建技术辅助进行围手术期健康教育。人院时及出院时,分别测评两组患者肝癌围手术期知识掌握度,术前测定两组患者焦虑值,出院时分别测定两组患者及家属对围手术期健康教育的满意度。结果两组患者的肝癌围手术期知识掌握度,人院时差异无统计学意义（P〉0．1）,而出院时,差异具有统计学意义（P〈0．05）。两组患者术前焦虑评分差异显著（P〈0．05）。患者及家属对围手术期健康教育满意度,出院时两组差异具有统计学意义（P〈0．05）。结论计算机辅助肝脏三维重建技术在肝癌患者的围手术期健康教育中的确能起到明显的效果,值得推广应用。     

血管回声跟踪技术评价糖尿病患者颈动脉弹性与下肢动脉粥样硬化的相关性

目的：利用血管回声跟踪技术（ET）研究糖尿病（DM）患者颈动脉弹性与下肢动脉粥样硬化病变的相关性。方法：选择116例糖尿病患者分别进行颈动脉弹性检查和下肢血管彩超检查,根据血管彩超检查结果分为无下肢动脉粥样硬化病变组（对照组A）和下肢动脉粥样硬化病变组,下肢动脉粥样硬化病变组又根据下肢动脉血管的狭窄程度由轻至重依次分为B、C、D、E四组。分析比较各组间应用髓检查获得的颈动脉弹性参数,即压力应变弹性系数（Ep）、僵硬度（β）、顺应性（AC）、增大指数（AI）、脉冲波传导速度（PWVβ）。结果：下肢动脉粥样硬化病变组Ep取PWvp值较对照组明显增高,Ac值较对照组明显降低,差异有统计学意义（P〈0．01或P〈0．05）,随着各组间下肢动脉病变程度的不断加重,Ep取Pw邯值增加明显,差异有统计学意义（P〈0．01或P〈0．05）,参数AI在各组间差异无统计学意义（P〉0．05）。结论：血管回声跟踪技术能揭示糖尿病患者颈动脉弹性参数与下肢动脉粥样硬化病变程度的相关性,是评价糖尿病下肢动脉粥样硬化病变的有效方法。     

CKDⅣ—Ⅴ期的2型糖尿病患者的临床特征分析

目的：探讨GKDⅣ-Ⅴ期的2型糖尿病患者的临床特点。方法：回顾性分析了67例Ⅳ-Ⅴ期的2型糖尿病患者的临床表现,血常规、肝、肾功并根据肾功计算有效肾小球滤过率（eGFR）,及B型超声检查肾脏大小。结果：①CKD第1Ⅴ期与Ⅴ期2型糖尿病患者两者盆血程度夫显著性差异（P〉0.05）。②不同程度水肿的患者间比较,CKDⅣ-Ⅴ期的2型糖尿病患者其血清Alb水平无显著性差异（P〉0.05）,但水肿越重的患者,其心衰的发生率越高（P〈0.05）。③全部CKD Ⅳ-Ⅴ期的2型糖尿病患者肾脏大小正常者占80.60＆,但其血肌酐466.26±277,80μmol/L,而肾脏缩小者仅占19.40%。④全部CKD Ⅳ-Ⅴ期的2型糖尿病继发糖尿病慢性并发症如糖尿病视网膜病变41例（61.19%）,糖尿病周围神经病变22例（32.84%）,合并高血压58例（86.57%）,脑血管意外10例（14.93%）,心血管疾病56例（83.58%）,感染42例（62.69%）。结论：CKD Ⅳ-Ⅴ期的2型糖尿病患者贫血和水肿较重,而大部分患者肾脏体积不缩小。此外,CKD Ⅳ-Ⅴ期的2型糖尿病患者心脑血管并发症、及感染的发生率明显增多,可能是影响患者预后的重要因素。     

5-杂氮-2’-脱氧胞苷调控UCHL1基因表达对人前列腺癌PC-3细胞增殖及凋亡的影响

目的：探讨5-杂氮-2’-脱氧胞苷（5-Aza—CdR）对人前列腺癌细胞（PC-3）株增殖和凋亡的影响及其可能机制。方法以2．5、5．0、10．0kenol／L的5-Aza—CAR作用于PC-3细胞48h后,采用流式细胞术（FCM）检测细胞凋亡率;逆转录聚合酶链式反应（tiT—PcR）检测UCHL1 mRNA表达;甲基化测序聚合酶链反应（BsP）检测UCHLlCpG岛的甲基化状态;蛋白质印迹法（Western Blot）检测UCHL1蛋白的表达。结果：5-Aza—CAR对PC-3细胞生长有抑制作用;与对照组相比细胞凋亡率明显增高（P〈0．01）;5-Aza—CdR处理细胞后UCHL1的启动子甲基化水平明显降低（P〈0．01）;UCHL1 mRNA表达水平显著上调（P〈0．01）;UCHL1蛋白表达水平上升（P〈0．01）。结论：5-Aza—CAR能诱导前列腺癌PC-3细胞株凋亡的作用,其机制可能是5-Aza—CdR能逆转PC-3细胞UCHLl启动子CpG岛的异常甲基化,诱导mRNA转录和蛋白的表达。     

基于深度学习的自闭症谱系障碍fMRI数据分类研究

与健康儿童对照相比，自闭症谱系障碍（ASD）患者的脑结构和功能存在显著异常，因此文中采用脑影像的方法实现ASD的辅助诊断。由于基于传统的脑图谱构建脑网络节点依赖于人为的先验知识和假设，因此将由受试者的数据通过数据驱动的方法即独立成分分析（ICA）进行全脑独立成分（ICs）分析，并将提取的ICs作为感兴趣区域（ROI）提取时间序列，随后用计算得到的相关性矩阵构建脑网络并通过Node2vec方法将脑网络的节点向量化以生成节点特征，最后通过图卷积网络（GCN）刻画脑网络连接水平状态，并通过多层感知机（MLP）实现对ASD的识别。所用方法 ICA+GCN在79名ASD患者和105名典型对照组中取得了86.1%的分类精度。综上，文中所用方法有望用于ASD辅助诊断。     

舒芬太尼和芬太尼分别联合咪唑安定对烧伤植皮术后的镇痛镇静疗效及其对多器官功能的影响

目的：比较舒芬太尼和芬太尼分别联合咪唑安定对烧伤植皮术后患者镇痛镇静的临床疗效及其对多器官功能的影响。方法：将60例烧伤植皮术后患者随机分入舒芬太尼联合咪唑安定组和芬太尼联合咪唑安定组。两组患者均分别采用舒芬太尼和芬太尼联合咪唑安定进行术后镇静镇痛治疗。比较两种治疗方案的镇静镇痛临床疗效、不良反应和对患者肝肾功能、心功能和呼吸功能变化。结果镇痛治疗后6h和12h时,舒芬太尼组的VAS评分显著低于芬太尼组;其中12h时,舒芬太尼组的RSS分值亦显著低于芬太尼组,差异均具有统计学意义（P〈0．05）。且芬太尼组出现恶心、呕吐和嗜睡的发生率明显高于舒芬太尼组（P〈0．05）。此外,两组患者的心、肝、肺功能指标比较无明显差异（P〉0．05）,而舒芬太尼联合咪唑安定对于改善肾功能相关指标的效果则优于芬太尼（P〈0．05）。结论舒芬太尼联合咪唑安定方案对烧伤植皮术后患者进行镇静镇痛的临床疗效和肾功能恢复方面由于芬太尼联合咪唑安定方案。     

钬激光剜除术治疗良性前列腺增生症疗效及安全性的Meta分析

目的：评价钬激光前列腺剜除术（HoLKP）治疗良性前列腺增生症的疗效及安全性。方法：通过检索PubMed、Ovid、Cochrane library、EMBASE、万方、维普、中国知网等数据库,收集有关比较钬激光前列腺剜除术（HoLEP）与经尿道前列腺电切术（TURP）治疗良性前列腺增生症的随机对照研究（RCT）。按Coehranee系统评价的方法对纳入的研究进行质量评价,采用专业系统评价软件RevMan5．0进行meta分析。结果：经筛选,共纳入7个研究,HoLEP组有317例,TURP组有313例。Meta分析结果：与TURP组比较,HoLEP组的平均手术时间长17．25min（P=O．0001）,而住院时间和术后带尿管时间分别缩短26．2小时（P〈0．001301）、23．15小时（P〈0．00001）,血红蛋白丢失量少（P=0．01）。而两组切除前列腺的重量无统计学差异（P=0．95）。HoLEP组在术后12月时IPSS、Qmax的改善要优于TURP组（P=0．02;P〈0．00001）,而两组间QOL评分无统计学差异（P：0．21）。两组在术后尿失禁、尿道狭窄的发生率无统计学差异（P=0．81;P=0．21）,而HoLEP组术后输血的风险低于TURP组（P=0．03）。结论HoLEP是一种有效、安全的治疗BPH的于术方式,具有住院时间短、术后保留尿管时间短、失血少、输血率低等优点,且远期疗效要优于TURP。     

趋化因子配体18与鼻咽癌相关性研究及意义

目的：探讨趋化因子配体18（CCL18）在鼻咽癌患者血浆中的表达水平及检测在体外对人鼻咽癌细胞株增殖和迁移能力的影响。方法：收集到重庆医科大学附属第二医院就诊并病理诊断为鼻咽癌患者37例,在未接受任何治疗前留取血液标本,另取20例健康体检者外周血液标本作为正常人群对照。以酶联免疫吸附测定（ELIAS）方法检测血浆中CCL18的表达水平。体外实验以人鼻咽癌细胞株HNE-1为研究对象,用噻唑蓝（MTT）比色法检测重组CCL18对细胞增殖能力的影响,用Transwe11体外迁移系统检测CCL18对鼻咽癌细胞的趋化作用。结果：鼻咽癌患者血浆中CCL18的表达水平明显高于健康体检者（P〈0．0001）,伴有颈部淋巴结转移的鼻咽癌患者较未发生颈部淋巴结转移者血浆中CCL18的表达水平显著升高（P〈0．05）。CCL18因子在体外对鼻咽癌细胞无明显促进增殖作用（P〉0．05）。CCL18对鼻咽癌细胞具有明显促进迁移趋化作用,并呈现浓度依赖性。结论：CCL18是鼻咽癌的生物学标志物,其表达与鼻咽癌的侵袭转移相关,对鼻咽癌的诊断和预后判断有一定临床意义。     

Effects of losartan on blood pressure, oxidative stress, and nitrate/nitrite levels in the nitric oxide deficient hypertensive rats

Losartan, an angiotensin II type-1 receptor (AT1) antagonist, was used to investigate whether it can offer protection against the sustained hypertension, cardiac hypertrophy, and renal damage induced by chronic inhibition of nitric oxide (NO) by Nomega-nitro-L-arginine methyl ester (L-NAME). We studied the involvement of both NO metabolism and oxidative stress in L-NAME-induced hypertension, and how AT1 receptor antagonism may interact. Male Wistar albino rats were subjected to NO synthesis inhibition by the use of L-NAME (60 mg/kg/day), and the effects of losartan (10 mg/kg/day) in drinking water for six weeks were observed. After six weeks, animals were subjected to the measurements for systolic, mean, and diastolic blood pressure (BPs, BPm, and BPd, respectively). Under light ether anesthesia blood was withdrawn for ACE activity, NOx and creatinine determinations. Heart and kidneys were weighed, and organ indices were calculated comparing to their body weights. These tissues were immediately preserved for GSH, MDA, NOx estimations. Chronic L-NAME treatment raised BPs, BPm, and BPd, respectively, above the normal. Treatment also increased NOx in plasma, significantly decreased it in the heart, and tended to increase it in kidney. L-NAME caused GSH depletion in the heart and kidney tissues with a concomitant increase in MDA contents in both the tissues. Plasma creatinine doubled in L-NAME-treated animals. Plasma ACE activity showed a nonsignificant decrease below control. Concurrent treatment with losartan almost completely inhibited any rise in blood pressure. Losartan replenished the partly depleted cardiac and renal antioxidant GSH and ameliorated the increase of oxidative stress damage index, MDA. However, losartan alone did not change appreciably the plasma level or cardiac and renal contents of NO,. Losartan plus L-NAME treatment caused an increase in plasma ACE activity above control. Furthermore, losartan ameliorated the L-NAME induced increase in creatinine back to value nonsignificantly different from control.     

Bayesian statistics as applied to hypertension diagnosis

The Bayesian approach was applied to a specific case of medical diagnosis, i.e. essential hypertension and five types of secondary hypertension (fibrodysplasic renal artery stenosis, atheromatous renal artery stenosis, Conn's syndrome, renal cystic disease, and pheochromocytoma). Only blood pressures, general information and general biochemical data are taken into account. Nineteen items were finally selected through statistical investigation of the experimental data as being both discriminative and independent. The marginal density distributions of every item, and then joint density distribution functions were determined within six types of hypertension. The frequency of a given hypertension type within the hypertensive patients was used as prior probability of this state. The loss matrix was established by medical arguments. The expected loss corresponding to six possible decisions was calculated for all cases. Both the ratio of secondary hypertensions that could be inferred from this set of data (not including the results of complementary tests) and that of correct essential hypertension diagnosis provided to be satisfactory     

Spatial Velocity Distributions in the Ascending Aorta of Healthy Humans and Cardiac Patients

Blood velocity profiles in the human ascending aorta were assessed with the aid of ultrasonic Doppler echocardiography. To this end, the transducer was placed in the suprasternal notch, and the spatial velocity profiles along an axis passing through the center of the aortic cross section were recorded by a multigate Doppler instrument. The profiles are analyzed with respect to characteristics independent of the angle of incidence and the cross sectional area. Data from 10 healthy individuals, 10 patients with hypertrophic obstructive cardiomyopathy (HOCM), and 10 patients with severe aortic insufficiency (AI) are compared. Five instantaneous profiles recorded at different times during systole and the temporal average of all profiles recorded during the entire cardiac cycle at 16 ms intervals are examined. Considerable differences between the three groups of subjects are observed visually as well as quantitatively in terms of specific parameters. The representation of the velocity maps in the form of contour graphs is particularly incisive. The results demonstrate that the temporal velocity patterns measured depend, in general, on both the disease and the location of the sampling volume within the aortic lumen. Reliable aortic volume flow rate measurements may have to be based on a method which takes into account the velocity at every point of the entire vascular cross section of patients with HOCM or AI.     

开放式办公室声场评价指标研究

针对国内开放式办公室的评价目标、评价指标问题，开展了问卷调查和主观试验，证明了利用清晰度指数A，描述语言私密度的可行性，然后给出了A，的建模计算方法，对三个开放式办公室进行了计算，最后通过相关分析和回归分析，研究了A，与典型室内声学指标之间的关系。     

急性冠脉综合征、肾动脉狭窄、急性左心衰三联征的临床研究

目的提高对急性冠脉综合征、肾动脉狭窄、急性左心衰三联征的诊治率。方法回顾性分析25例急性冠脉综合征、肾动脉狭窄、急性左心衰三联征患者的临床资料,分析基线资料与预后的关系。结果高血压、陈旧性心梗、陈旧性脑梗、高脂血症、糖尿病、吸烟、周围血管病等危险因素的发生率分别为100%、54.0%、60.0%、40.0%、48.0%、36%;出现典型心绞痛症状至冠心病确诊(发生心梗/冠脉造影/冠脉CT确诊)平均为5.3年,冠心病确诊-肾动脉狭窄确诊约6.2年,心绞痛症状至肾动脉狭窄确诊约11.5年。造影结果13例为双侧肾动脉狭窄,平均冠脉病变为2.6支,确诊后所有患者进行了冠脉和(或)肾动脉介入或冠脉搭桥术。2例治疗无效死亡,其余23例好转出院,其中3例肾功能较入院时恶化。2年随访期内12例病情好转或稳定,4例死亡,7例发生次级终点事件;因小样本及选择偏倚,无基线资料与预后相关。结论三联征术后及两年预后较差,早期诊断、治疗才能减少发病率及改善预后。     

实验性缺氧性肺动脉高压肺腺泡内动脉的超微结构观察

目的:观察实验性缺氧性肺动脉高压肺腺泡内动脉的超微结构变化并探讨其发生机理。方法:将Wistar大鼠随机分成对照组(n=9)及肺动脉高压组(n=9)。以右心导管法测定肺动脉平均压力(mPAP)。用透射电镜观察肺腺泡内动脉超微结构。结果:肺动脉高压组大鼠mPAP较对照组明显增高(P<0 01)。超微结构观察,肺动脉高压组大鼠肺腺泡内动脉内皮细胞增生、变性。内弹力膜厚薄不均。呼吸性细支气管水平小动脉中层平滑肌细胞增生;呼吸性细支气管水平及肺泡水平小动脉肌化。中间型细胞及血管周细胞增生。胶原原纤维增多。结论:肺腺泡内动脉平滑肌细胞增生及动脉肌化是缺氧性肺动脉高压特征性的超微结构变化。肺血管结构重建是缺氧性肺动脉高压形成的病理基础。     

HELLP综合征合并急性肾功能衰竭10例分析

目的探讨HELLP综合征合并急性肾功能衰竭(ARF)的临床特点、诊断、治疗和孕产妇及新生儿预后。方法对我院2005年1月-2008年12月以来HELLP综合征合并ARF的10例患者临床资料进行回顾性分析。结果多为妊娠期高血压疾病的并发症,以血压升高、恶心、呕吐、水肿、皮下淤斑或黏膜出血、少尿或无尿为特点,乳酸脱氢酶、转氨酶、血小板、血肌酐等均为诊断及监测疾病变化及预后的指标;在常规治疗HELLP的基础上及时终止妊娠、行血液净化治疗,是防止病情恶化降低孕产妇及围产儿死亡率的关键。结论HELLP综合征合并ARF发病急而凶险,早期诊断、综合治疗、及时终止妊娠及血液净化治疗是改善孕产妇及新生儿预后的关键。     

Application research of optical communication network based on artificial intelligence technique

The applications of artificial intelligence (AI) technique in optical communication networks were explored.Some representative AI applications and potential risks due to the failure of the AI technique were discussed.To address these risks,methods including systematic AI modeling through unitizing and miniaturizing sub-systems and cooperation with traditional network modeling and planning methods were proposed,which were expected to help improve the effectiveness and practicality of the application of the AI technique.Finally,to recover a system from the failure of its employed AI technique or attacks,some protection strategies were proposed.     

Performance Criteria for Spread Spectrum Communications

The criteria for antijam (AJ) and anti-intercept (AI) systems are described, in terms of the appropriate action taken by the jammer or interceptor. Avoiding pseudonoise (PN) sequences which can be partially or totally predicted is a foremost criteria, especially for AJ, and use of nonlinear feedforward logic (NFFL) with long-period linear maximal sequences appears attractive. A frequency-hopping (FH) system must anticipate a multitone jamming signal, and an error-control code is necessary. A novel method for generating a multitone signal using repeating maximal sequences is described. PN systems must anticipate a tone jammer, and now an errorcontrol code may be needed to assure that sporadic PN sequence correlation with the tone does not reduce the processing gain. Any AI system must anticipate that the interceptor may, if advantageous, integrate his decision energy over many communicator symbols (up to the message length). Now spreading both in frequency and in time may be valuable. Finally, the use of an automatic adaptive data rate is suggested to realize flexibly either AJ or AI objectives.