Relative risk factors of in-hospital death due to aortic dissection

目的分析主动脉夹层(Ad)患者院内死亡的相关危险因素。方法回顾性分析厦门市心脏中心2002年1月至2011年10月确诊急性Ad患者175例的临床资料,其中男性129例,女性46例,平均年龄(56.8±12.1)岁。按住院期间是否死亡进行分组,分为存活组(n=141)及死亡组(n=34),分析年龄、性别、既往病史、血压水平、症状、并发症及实验室指标与死亡的相关性,并用lOgISTIC回归分析危险因素与病死率的关系。结果与存活组比较,死亡组d-二聚体水平升高,意识障碍和心包填塞比例增加,手术或支架治疗比例减少,差异有统计学意义(P均<0.05)。lOgISTIC回归分析结果表明,d-二聚体水平升高(Or=1.325,95%CI:1.436~1.973,P=0.004)、伴意识障碍(Or=2.481,95%CI:1.302~3.203,P=0.003)、心包填塞(Or=7.726,95%CI:1.762~34.003,P=0.008)为Ad患者住院死亡的独立危险因素,手术或介入治疗(Or=0.101,95%CI:1.762~34.003,P=0.044)为保护因素。结论 Ad患者中d-二聚体明显升高,并发意识障碍、心包填塞者病死率高,临床上应予高度重视,依据病情采取手术或介入治疗有利于降低Ad患者的病死率。Objective To analyze the relative risk factors of in-hospital death in patients with aortic dissection(AD).Methods The clinical materials of patients with acute AD [n=175, male 129, female 46 and average age was(56.8±12.1)] were analyzed retrospectively from Jan.2002 to Oct.2011, and all patients were divided into survival group(n=141) and death group(n=34).The correlation between age, sex, medical history, blood pressure level, symptoms, complications or laboratory indexes and death was analyzed, and the relatio level increased, and the percentage of patients with consciousness disorder and cardiac tamponade increased and percentage of patients with surgery or stenting decreased(all P<0.05).The results of Logistic regression analysis showed that increased D-dinship between risk factors and mortality was analyzed by using Logistic regression analysis.ResultsCompared with survival group, in death group D-dimermer level(OR=1.325, 95%CI: 1.436~1.973, P=0.004), consciousness disorder(OR=2.481, 95%CI: 1.302~3.203, P=0.003) and cardiac tamponade(OR=7.726, 95%CI: 1.762~34.003, P=0.008) were independent risk factors of in-hospital death, and surgery or interventional treatment(OR=0.101, 95%CI: 1.762~34.003, P=0.044) were protective factors in AD patients.Conclusion Mortality is higher in patients with increased D-dimer level or complicating consciousness disorder and cardiac tamponade.Surgery and interventional treatment can reduce the mortality

Analysis outcomes and complications of twin pregnancy by in vitro fertilization-embryotransfer and intracytoplasmic sperm injection

目的比较体外受精-胚胎移植(IVf-ET)与单精子卵胞浆内注射(ICSI)受孕双胎妊娠围生期并发症及结局。方法回顾性分析我院2004年2月~2011年5月437例IVf-ET、ICSI受孕双胎的并发症(如胎膜早破、胎盘早剥、妊娠期高血压疾病、妊娠期肝内胆汁淤积症)及妊娠结局(流产发生率)。结果 IVf-ET受孕双胎组胎膜早破及胎盘早剥发生率高于ICSI受孕双胎组(χ2=5.93,6.01;P0.05);IVf-ET受孕双胎组较ICSI受孕双胎组流产率高,差异有统计学差异(χ2=5.09;P0.05);Ratio of abortion in IVF-ET group was significant higher than that in ICSI group(χ2=5.09;P<0.05).Conclusion:The risk of twin pregnancy by IVF-ET is higher than by ICSI,IVF-ET and ICSI maybe are not the main cause of pregnancy-induced hypertension and intrahepatic cholestasis of pregnancy

动脉粥样硬化性肾动脉狭窄的早期发现

探讨冠状动脉造影同时行肾动脉造影的必要性及动脉粥样硬化性肾动脉狭窄的相关危险因素分析。共 4 91例临床疑似冠心病患者行冠状动脉造影同时行非选择性或选择性肾动脉造影 ,并对相关的临床因素进行评价 ,筛选出动脉粥样硬化性肾动脉狭窄的独立危险因素。冠心病组患者中动脉粥样硬化性肾动脉狭窄的发病率为2 0 % ,显著高于非冠心病组 (2 .6 % )。冠心病、外周血管疾病是动脉粥样硬化性肾动脉狭窄的独立危险因素 (多元Logistic回归分析示 ,P <0 .0 0 1、P =0 .0 0 3) ,是其早期发现的指标。对怀疑有冠心病的患者 ,在冠状动脉造影同时行肾动脉造影有助于动脉粥样硬化性肾动脉狭窄的早期发现

支架表面的光滑度对家兔髂动脉内膜增生的影响

目的研究金属支架表面的光滑程度对兔髂动脉模型内膜增生的影响,探讨动脉支架植入术后再狭窄的影响因素。方法选择30只家兔对侧髂动脉作为自身相互对照,随机在一侧髂动脉植入30枚表面光滑支架(组1),而在另一侧植入30枚表面粗糙的支架(组2)。术后5个月处死家兔,并将所有髂动脉取出,对支架部位进行形态学分析。结果组1兔髂动脉测量段内膜面积小于组2:0.69±0.30对1.48±0.32mm2(P<0.05)。组1的内膜及中层横截面积的比率小于组2,1.27±0.47对3.08±0.89(P<0.01)。结论粗糙的支架表面明显增加支架内的内膜增生

小剂量~(16)O~(8+)离子预辐射减轻大剂量辐射所致小鼠睾丸组织损伤(英文)

为了了解小剂量重离子辐射诱导小鼠睾丸结构的适应性反应,采用小剂量(0.05Gy)~(16)O~(8+)离子照射B6C3F_1雄性小鼠睾丸。4h后,再给予2Gy~(16)O~(8+)离子照射。照射后第35天取材在光镜下观察睾丸结构。结果显示,大剂量(2Gy)照射明显损伤睾丸组织,主要表现为曲精细管直径几乎减小一半,精管内各发育阶段的生殖细胞减少或消失,特别是精原细胞几乎完全消失。而Leydig细胞和Sertoli细胞仅有轻度核固缩及胞浆减少。提示睾丸生殖细胞的辐射敏感性明显高于其间质组织细胞。预先给予小剂量(0.05Gy)照射可明显减轻随后大剂量(2Gy)辐射对睾丸组织的损伤。提示小剂量重离子辐射可诱导小鼠睾丸结构明显的适应性反应

国内8款常用植物识别软件的识别能力评价

随着智能手机和人工智能技术的发展,以手机app为载体的植物识别软件慢慢走进公众生活、科普活动和科研活动的各个方面。植物识别app的识别正确率是决定其使用价值和用户体验的关键因素。目前,国内应用市场上有许多植物识别app,它们的开发目的和应用范围各异,软件本身的关注点、数据库来源、算法、硬件要求也存在很大差异。对于不同人群,植物识别app有不同的意义,如对于科研人员来说,识别能力强的app是提高效率的一大工具;对植物爱好者来说,具一定准确率的识别app可以作为入门的工具。因此,对各app的识别能力进行分析与评价显得尤为重要。本文选取了8款常用的app,分别对400张已准确鉴定的植物图片进行识别,其中干旱半干旱区、温带、热带和亚热带4个区各选取100张。这些图片共计122科164属340种,涵盖了乔木、灌木、草本、草质藤本和木质藤本5种生长型,包含23种国家级保护植物。种、属、科准确识别正确分别计4分、2分、1分,以此标准对软件识别能力按总得分进行排序,正确率得分由高到低依次为花帮主、百度识图、花伴侣、形色、花卉识别、植物识别、发现识花、微软识花

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

JUNO sensitivity on proton decay p → ν K + searches*

The Jiangmen Underground Neutrino Observatory (JUNO) is a large liquid scintillator detector designed to explore many topics in fundamental physics. In this study, the potential of searching for proton decay in the $p\to \bar{\nu} K^+$ 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 suppression of 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% ± 4.9% with a background level of $0.2\pm 0.05({\rm syst})\pm$$0.2({\rm stat})$ events after 10 years of data collection. The estimated sensitivity based on 200 kton-years of exposure is $9.6 \times 10^{33}$ years, which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies