慢性乙型肝炎合并非酒精性脂肪性肝病患者体质量指数与血脂水平的研究

目的研究慢性乙型肝炎(CHb)合并非酒精性脂肪性肝病(nAfld)患者体质量指数(bMI)和血脂与其发病的关系。方法选取经临床和病理确诊的CHb并nAfld患者80例为病例组,另选取同期住院的47例CHb患者为对照组;测量身高、体质量,同时检测两组患者的总胆固醇(TC)、甘油三酯(Tg),采用病例对照研究的方法,lOgISTIC回归分析bMI、TC、Tg与CHb并nAfld的相关性。结果两组患者的bMI、TC、Tg水平的差异有统计学意义(P<0.05);bMI、TC及Tg均为CHb并nAfld的危险因素(P<0.05);经lOgISTIC回归分析,bMI、Tg与CHb并nAfld有相关性(P<0.01)。结论 TC对CHb并nAfld的发病无明显影响,bMI和Tg均为CHb并nAfld的独立影响因子;Tg在预测CHb并nAfld的发生上比bMI更具有优势。福建省漳州市科技计划资助项目(Z04094);09军区面上B类(09MB131

Challenge by Head Transplant

范瑞平：诸位好!受《中国医学伦理学》杂志王明旭主编所托,组织一篇＂换头术的挑战＂争鸣笔谈,特邀各位参与。请踊跃发表意见,观点不拘,长短不限,畅所欲言,各抒己见,若能针对已发观点形成争论,则更能增加读者兴趣

博斯腾湖水环境现状研究

课题旨在通过对博斯腾湖湖水、沉积物以及水生生物的分析，出、入湖河流水系水质现状的监测，结合湖区工业废水、农业灌溉废水和城镇生活废水的分析，确定博斯腾湖湖水化学特征、水环境质量及流域的水污染现状和发展趋势，为博斯腾湖流域水资源的规划、开发利用和水功能区域的规划、管理提供基础数据和科学依据。课题取得的成果不仅对博斯腾湖整体生态环境的保护和促进博斯腾湖生态系统的良性循环有非常重要的科学价值，而且可对博斯腾湖的环境管理提供科学的依据，最终实现数字化管理的目标。根据巴音郭楞蒙古自治州政府和有关部门的要求，经协商，由巴州环保局、监测站、南京大学联合成立博斯腾湖水环境现状研究课题组。经过课题组的共同努力，于2003年12完成了实地调查和室内分析测试工作，2004年8月完成了课题报告

西藏羌塘盆地鸭湖地区天然气水合物成藏条件

近年来中国陆域冻土区天然气水合物调查研究结果表明，气源条件是制约羌塘盆地天然气水合物找矿突破的关键因素。为明确鸭湖地区天然气水合物成藏潜力，基于近年来的钻探调查成果，从陆域冻土区天然气水合物成藏系统理论出发，系统分析了影响天然气水合物成藏的冻土、气源、储集、构造等地质因素。分析结果显示，鸭湖地区局部具有较好的冻土、地温、气源、储集、构造及水源条件，具备一定的天然气水合物成藏潜力，继续寻找充足的烃类气源是下一步天然气水合物调查的主要方向。同时，选取钻探调查获取的地温梯度、气体组分等参数，结合音频大地电磁测深（AMT）冻土厚度调查成果，对鸭湖地区天然气水合物稳定带的厚度和底界深度进行了预测。结果显示，当甲烷为85%、乙烷为9%、丙烷为6%时，天然气水合物稳定带厚度与冻土厚度分布变化基本一致，稳定带厚度400~630m，底界深度400~680m。当甲烷为98%、乙烷为2%时，天然气水合物稳定带厚度急剧减薄，大部分地区仅有0~30m，最厚仅有150m，局部地区稳定带底界最深仅为240m。结合气测录井结果，认为渐新世唢呐湖组比上三叠统土门格拉组更具备天然气水合物成藏潜力，土门格拉组自身具备较强的生排烃能力，可作为寻找常规油气或页岩气的一个重要层位

Aripiprazole versus other atypical antipsychotics for schizophrenia

BACKGROUND: In most western industrialised countries, second generation (atypical) antipsychotics are recommended as first line drug treatments for people with schizophrenia. In this review we specifically examine how the efficacy and tolerability of one such agent - aripiprazole - differs from that of other comparable second generation antipsychotics. OBJECTIVES: To evaluate the effects of aripiprazole compared with other atypical antipsychotics for people with schizophrenia and schizophrenia-like psychoses. SEARCH METHODS: We searched the Cochrane Schizophrenia Group Trials Register (November 2011), inspected references of all identified studies for further trials, and contacted relevant pharmaceutical companies, drug approval agencies and authors of trials for additional information. SELECTION CRITERIA: We included all randomised clinical trials (RCTs) comparing aripiprazole (oral) with oral and parenteral forms of amisulpride, clozapine, olanzapine, quetiapine, risperidone, sertindole, ziprasidone or zotepine for people with schizophrenia or schizophrenia-like psychoses. DATA COLLECTION AND ANALYSIS: We extracted data independently. For dichotomous data we calculated risk ratios (RR) and their 95% confidence intervals (CI) on an intention-to-treat basis based on a random-effects model. Where possible, we calculated illustrative comparative risks for primary outcomes. For continuous data, we calculated mean differences (MD), again based on a random-effects model. We assessed risk of bias for each included study. MAIN RESULTS: We included 12 trials involving 6389 patients. Aripiprazole was compared to olanzapine, risperidone and ziprasidone. All trials were sponsored by an interested drug manufacturer. The overall number of participants leaving studies early was 30% to 40%, limiting validity (no differences between groups).When compared with olanzapine no differences were apparent for global state (no clinically important change: n = 703, 1 RCT, RR short-term 1.00 95% CI 0.81 to 1.22; n = 317, 1 RCT, RR medium-term 1.08 95% CI 0.95 to 1.22) but mental state tended to favour olanzapine (n = 1360, 3 RCTs, MD total Positive and Negative Syndrome Scale (PANSS) 4.68 95% CI 2.21 to 7.16). There was no significant difference in extrapyramidal symptoms (n = 529, 2 RCTs, RR 0.99 95% CI 0.62 to 1.59) but fewer in the aripiprazole group had increased cholesterol levels (n = 223, 1 RCT, RR 0.32 95% CI 0.19 to 0.54) or weight gain of 7% or more of total body weight (n = 1095, 3 RCTs, RR 0.39 95% CI 0.28 to 0.54).When compared with risperidone, aripiprazole showed no advantage in terms of global state (n = 384, 2 RCTs, RR no important improvement 1.14 95% CI 0.81 to 1.60) or mental state (n = 372, 2 RCTs, MD total PANSS 1.50 95% CI -2.96 to 5.96).One study compared aripiprazole with ziprasidone (n = 247) and both the groups reported similar change in the global state (n = 247, 1 RCT, MD average change in Clinical Global Impression-Severity (CGI-S) score -0.03 95% CI -0.28 to 0.22) and mental state (n = 247, 1 RCT, MD change PANSS -3.00 95% CI -7.29 to 1.29).When compared with any one of several new generation antipsychotic drugs the aripiprazole group showed improvement in global state in energy (n = 523, 1 RCT, RR 0.69 95% CI 0.56 to 0.84), mood (n = 523, 1 RCT, RR 0.77 95% CI 0.65 to 0.92), negative symptoms (n = 523, 1 RCT, RR 0.82 95% CI 0.68 to 0.99), somnolence (n = 523, 1 RCT, RR 0.80 95% CI 0.69 to 0.93) and weight gain (n = 523, 1 RCT, RR 0.84 95% CI 0.76 to 0.94). Significantly more people given aripiprazole reported symptoms of nausea (n = 2881, 3 RCTs, RR 3.13 95% CI 2.12 to 4.61) but weight gain (7% or more of total body weight) was less common in people allocated aripiprazole (n = 330, 1 RCT, RR 0.35 95% CI 0.19 to 0.64). Aripiprazole may have value in aggression but data are limited. This will be the focus of another review. AUTHORS' CONCLUSIONS: Information on all comparisons are of limited quality, are incomplete and problematic to apply clinically. Aripiprazole is an antipsychotic drug with a variant but not absent adverse effect profile. Long-term data are sparse and there is considerable scope for another update of this review as new data emerges from the many Chinese studies as well as from ongoing larger, independent pragmatic trials

JUNO Sensitivity on Proton Decay p→νˉK+p\to \bar\nu K^+ Searches

The Jiangmen Underground Neutrino Observatory (JUNO) is a large liquid scintillator detector designed to explore many topics in fundamental physics. In this paper, the potential on searching for proton decay in $p\to \bar\nu K^+$ mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification. Moreover, the excellent energy resolution of JUNO permits to suppress the sizable background caused by other delayed signals. Based on these advantages, the detection efficiency for the proton decay via $p\to \bar\nu K^+$ is 36.9% with a background level of 0.2 events after 10 years of data taking. The estimated sensitivity based on 200 kton-years exposure is $9.6 \times 10^{33}$ years, competitive with the current best limits on the proton lifetime in this channel