The Research Progress of Cognitive Reserve and Cognitive Disorders

认知储备能（CR）可以理解为不同个体预防认知功能障碍或痴呆发病的能力,有助于理解在认知功能障碍或痴呆发病过程中,认知功能下降的差异性。CR主要分为不可塑性认知储备假说和可塑性认知储备假说,除了脑容量、民族、遗传等不可调控CR外,生活方式、受教育程度、语言学习、移民以及收入等,均是后天能够影响CR的可调控因素。在充分认识CR性质的前提下,通过可增加CR的方法,可以在一定程度上预防认知功能障碍的发生或延缓此类疾病的进展。文中主要从CR的概念、分类、影响因素、评价方法等方面进行综述。 Cognitive reserve（CR） might be thought one ability which delays the morbidity of cognitive disorders, it can help us understanding the variety of reserve decline in the development process of different diseases. CR concept, classification, impact factors, evaluation methods, their effects on diseases and other aspects were systematically reviewed. The idea of reserve stems from the repeated observation has been proposed, which mainly divided into passive models and active models. A variety of environmental factors such as education level, reading ability, emigration and income and so on have impacts on the reserve. Furthermore, lots of methods that have been used to quantify reserve were summed up. CR plays a significant role in these diseases, it might be an effective tool to prevent and treat these serious diseases.</p

黄土塬区长期不同耕作、覆盖措施对表层土壤 理化性状和玉米产量的影响

【目的】研究不同耕作、覆盖措施对土壤理化性质及对作物农艺性状的影响，为选择适合黄土高原沟壑 区最佳耕作、覆盖措施提供参考。【方法】田间定位试验设置 12 个处理，分别为传统耕作、传统耕作 + 膜上 种植、传统耕作 + 秸秆覆盖、传统耕作 + 膜侧种植、传统耕作 + 全膜覆盖、传统耕作 + 秸秆覆盖 + 地膜覆盖、 隔年耕作、免耕、免耕 + 地膜覆盖、免耕 + 秸秆覆盖、免耕 + 生草覆盖、免耕 + 秸秆覆盖 + 地膜覆盖，每个处 理 3 个重复。于 2014 年对已持续 12 年的不同耕作、覆盖措施土壤理化性质与农艺指标进行测定与分析。 【结果】免耕处理降低了土壤容重，提高了土壤饱和导水率和 4 月下旬至 10 月上旬表层土壤含水量，降低了作 物出苗期温度，降低了成熟期土壤全磷与速效磷含量，降低了株高、叶面积指数和产量。相反，地膜覆盖极显 著增加了土壤容重 (P &lt; 0.01)，显著降低了土壤饱和导水率 (P &lt; 0.05)，降低了成熟期土壤有机质、全氮含量， 有较为明显的保持和调节温度的作用，不同类型的地膜覆盖均能极显著提高玉米株高和叶面积指数进而提高产 量 (P &lt; 0.01)。秸秆覆盖对土壤容重和含水量的影响与耕作方式有关，翻耕条件下，秸秆覆盖增加了土壤容重； 免耕条件下，降低了土壤容重且均不显著。翻耕 + 秸秆覆盖土壤表层含水量最高；免耕 + 秸秆覆盖处理的土壤 含水量最低。但秸秆覆盖下土壤有机质含量、全氮含量、作物株高、叶面积指数和产量与未覆盖时相比均有增 加，影响皆达到显著水平 (P &lt; 0.05)，且均有降低地表温度的作用。【结论】免耕虽有利于改良土壤物理性状， 却较传统耕作降低了作物产量。免耕条件下秸秆 + 地膜处理显著提高作物产量和土壤全氮、有机质含量 (P &lt; 0.05)，是免耕处理组中最优选择。不同类型的地膜覆盖均可显著提高作物产量 (P &lt; 0.05)，而且秸秆 + 地膜双覆 盖增产效果最显著，并显著提高土壤全氮、有机质含量，是黄土塬区最适宜的覆盖措施。</p

硫酸钾对浑水滴灌滴头堵塞的影响

【Objective】 In order to provide reference for the implementation of water and fertilizer integrated drip irrigation, this study evaluated the effects of potassium sulfate on the clogging of the drip in fertigation with muddy water such as the Yellow River water. 【Method】Three kinds of sediment content（1.0，1.5 and 2.0 g/L） and three kinds of potassium sulfate mass concentration（10，20 and 30 g/L）were arranged. A kind of intermittent irrigation clogging experiment was designed, the changes of average relative flow rate and coefficient of uniformity of the drip were calculated. After that period, the siltation&rsquo;s characteristics and structure of the runner block had been analyzed by field emission scanning electron microscopy. Lastly, the dripper output sediment and deposition sediment were collected and analyzed. 【Result】Adding potassium sulfate into muddy water accelerates the clogging of dripper, and the higher potassium sulfate mass concentration was, the more obvious the effect of accelerating the clogging was. When potassium sulfate mass concentration was 30 g/L, the effective irrigation times of different sediment content, which were 1.0, 1.5 and 2.0 g/L, reduced by 4 times, 9 times and 8 times respectively and the clogging rate increased by 30%&mdash;35%. Potassium sulfate increased the conductivity significantly, the conductivity of muddy water was 0.16 ms.cm-1 when there was no fertilization, and however the conductivity which potassium sulfate mass concentration of 30 g/L was about 25 ms/cm. The potassium sulfate mass concentration has a certain effect on the clogging position of the dripper, which has little effect on the inlet&#39;s clogging and has a great effect on the channel block. The potassium sulfate mass concentration was 10, 20and 30 g/L, and the total number of blocked flow blockage was increased by 7, 18 and 17 respectively than without fertilizer. Potassium sulfate changes the conductivity of irrigation water, affecting sulfate precipitation and resulting in dripper clogging. After the application of potassium sulfate, the sediment in the water is easy to adsorb K+, which increases the agglomeration between the sediment particles, resulting in the increase of the complexity of surface structure of the clogging and the compactness and stability of the clogging material. After applying potassium sulfate in muddy water, the proportion of silt and clay in the output sediment is larger than that in the capillary, and the proportion of sand is less than the deposition sediment in the pipe. The fractal dimension of siltation sediment was negatively correlated with the relative flow rate.【Conclusion】If using the potassium sulfate fertilizer for drip irrigation, people should reduce the potassium sulfate concentration below 10 g/L, in order to slow the dripper clogging.;【目的】分析引黄灌溉过程中肥料硫酸钾对滴头堵塞的影响，为水肥一体化滴灌的实施提供参考。【方法】分别配置了3种含沙量（1.0，1.5和2.0 g/L）和3种硫酸钾质量浓度（10，20和30 g/L）进行间歇灌水堵塞试验，计算滴头的平均相对流量和灌水均匀度，利用场发射扫描电镜分析流道堵塞物结构，收集并分析滴头输出泥沙和毛管淤积泥沙的机械组成。【结果】施加硫酸钾后浑水滴灌滴头堵塞出现加速现象，硫酸钾质量浓度越大，加速堵塞作用越明显。当硫酸钾质量浓度为30 g/L时，含沙量为1.0，1.5和2.0 g/L处理的有效灌水次数分别较未施肥处理减少4，9和8次，滴头堵塞率较未施肥处理增加30%~35%；施加硫酸钾显著增大了水的电导率，未施加硫酸钾的浑水电导率约为0.16 ms/cm，硫酸钾质量浓度为30 g/L时，含钾浑水的电导率为25.19 ms/cm。硫酸钾质量浓度对滴头堵塞的位置有一定影响，对滴头进水口堵塞影响较小，对滴头流道堵塞影响较大,当硫酸钾质量浓度为10，20和30 g/L时，流道堵塞滴头数比未施肥处理分别增加了7、18和17个。硫酸钾改变了灌溉水的电导率，易产生硫酸盐沉淀而造成滴头堵塞。施加硫酸钾肥后，浑水中泥沙颗粒易吸附K+，增加了泥沙颗粒之间的团聚，导致堵塞物表面结构复杂程度提高，堵塞物致密性和稳定性增强；浑水中施加硫酸钾肥后，输出泥沙中粉砂和黏粒比例较毛管淤积泥沙大，砂粒比例则较毛管淤积泥沙少，淤积泥沙的分形维数与平均相对流量呈显著负相关。【结论】选用硫酸钾滴灌时，硫酸钾质量浓度应小于10 g/L，以减缓其对滴头堵塞的影响。</p

晋陕蒙接壤区露天矿层状土壤水分入渗特征与模拟

分析4种不同结构层状土水分入渗规律，为晋陕蒙接壤区露天矿排土场建设筛选合适的 层状土体。设置沙土、砒砂岩、黄绵土和红黏土4种均质土柱以及黄-沙-红、黄-红-沙、沙-黄-砒、 黄-砒-沙4种层状土，借助室内土柱自动观测系统测定矿区土壤的入渗过程，通过入渗速率、累积入渗 量、湿润锋运移、剖面含水量变化分析不同结构层状土入渗特征，结合晋陕蒙接壤区自然条件，评价 适合排土场建设的层状土体。结果表明：黄-沙-红、沙-黄-砒型层状土在短时间内能储存大量水分， 且第三层土体阻水作用强，黄-沙-红型层状土下层红黏土阻水效果尤其显著，这两种层状土体是矿区 排土场较理想的新土体结构。但是，黄-红-沙型层状土入渗速率慢，在强降雨条件下不能使水分迅速 入渗。黄-砒-沙型层状土湿润锋到达第三层土体后运移速率仍很快，阻水效果差，水分容易渗漏到深 层土壤，这两种层状土结构不宜应用到晋陕蒙矿区排土场建设中。最后探讨了H Y D R U S-1D 对入渗过 程的模拟，利用均质土剖面含水量反演土壤水力参数模拟4种层状土的入渗过程，得到较好的模拟效 果。本文对4种层状土入渗特征的测定与模拟，对于指导露天矿区排土场新土体构筑有一定的理论和现 实意义。</p

Design and Implementation of an HL7/CDA Standard Document Format Transfer Service System for Physical Examination Reports

[[abstract]]健康檢查報告是個人健康歷的一部分，和電子病歷一樣都有交換的需求，必須要遵循標準的格式才能進行交換。我國目前使用的電子病歷資料交換標準是以臨床文件架構(CDA)為主，之前雖曾經制定過健康檢查報告的單張和交換標準格式的規範書草案，但是各醫院所製作的健檢報告，卻很少看到實際採用 CDA 格式，究其原因在於健康檢查報告的項目繁多，有些項目不容易找到標準代碼，增加標準編碼系統開發的困難度，另一方面也因為代碼不一致的情形，而無法進行交換。為了解決健康檢查報告資料互通的問題，本研究探討國內外現有健康檢查報告標準的文獻，並收集國內常見的健康檢查報告之檢查項目，找出每一種檢查項目的標準代碼，並且將產生標準文件所需的資料，如檢查項目的方法和參考值等，都建立到資料庫中，然後撰寫CDA 的編碼程式，開發健康檢查報告標準編碼系統雛型。使用者可以使用編碼範例產生工具，選擇某一種檢查項目，輸入一個檢驗值後，產生該檢驗的CDA區段編碼，也可以將全部的健康檢查結果值上傳到系統後，自動產生完整的檢驗報告標準文件。為了方便使用者閱讀健檢報告文件，本系統也採用可擴充性樣式語言(XSL)的技術，製作健檢報告資料呈現模板，提供使用者選擇所需的樣式，並呈現在適合的終端設備。雛型系統建置完成後，相信對於檢驗報告的交換及個人健康歷的推動將會有幫助。 Physical examination reports are included in the personal health records. Similar to medical records, physical examination reports also have an exchange requirement and need to follow a standard format. The Ministry of Health and Welfare proposed the Clinical Document Architecture (CDA) as the standard format for medical information exchange in the country. The standard profile of physical examination reports has been defined and declared for several years, but has not been followed by any institution given the complexity of physical examination items and the difficulty in finding a consistent code for CDA encoding of such items. In order to solve the interoperability problems of physical examination reports and determine the deficiencies, we reviewed related literatures, discussed with experts, gathered local and common physical examination reports, and tried to redefine a new standard profile that satisfies the requirements of most medical institutions. We aimed at determining the standard code for each examination item such as method and reference value while establishing a physical examination item database. We implemented a CDA encoding prototyping system that could allow users to generate CDA section sample code by entering an examination value. Users could also transfer examination results to the system to automatically generate a complete examination document in CDA format. To help a user read a medical document easily; we would provide a presentation format with an extensible style-sheet language (XSL). The prototyping system is under development and would significantly help promote the exchange of physical examination reports and personal health records in the near future

中国脑血管病临床管理指南（第2版）（节选）——第3章 脑血管病高危人群管理 Chinese Stroke Association Guidelines for Clinical Management of Cerebrovascular Diseases (Second Edition) (Except) ——Chapter Three Management of Patients at Hige-risk of Cerebrovascular Diseases

针对脑血管病的危险因素积极进行早期干预管理是减少脑血管病危害最有效的方法。本章节介绍脑血管病高危人群管理的推荐意见，包括对不可干预和可干预血管危险因素的控制，阿司匹林在缺血性卒中一级预防中的应用以及首次卒中风险评估等方面。 Abstract: Early intervention to manage the risk factors of cerebrovascular disease is the most effective way to reduce the harm of cerebrovascular diseases. This chapter presents recommendations for the management of populations at high risk for cerebrovascular disease, including control of non-interventionable and interventionable vascular risk factors, the use of aspirin in the primary prevention of ischaemic stroke, and the risk assessment of first-time stroke