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军事医学伦理中的友谊、群体和关怀

医学与哲学（A） 2013年第7期34卷 26-30,33页

作者： Michael l.gross 李阳杨放海法大学政治科学学院以色列海法31905 第二军医大学人文社科部上海200433

医学伦理禁止医务人员将患者划分等级。然而,在军事中,特别是战争境遇下,由于医疗资源匮乏,其医学伦理却要求首先救助同胞士兵。社群主义者、关怀伦理提出了针对同盟者、朋友和家人的特殊责任:在小群体成员有医疗关怀需求时,不管谁的伤... 详细信息

医学伦理禁止医务人员将患者划分等级。然而,在军事中,特别是战争境遇下,由于医疗资源匮乏,其医学伦理却要求首先救助同胞士兵。社群主义者、关怀伦理提出了针对同盟者、朋友和家人的特殊责任:在小群体成员有医疗关怀需求时,不管谁的伤势更重,道德都会要求优先治疗同胞士兵,而后才是同盟或敌方士兵。

关键词：军事医学伦理分配正义日内瓦公约公平社群主义中立

Effect of pneumatic compression therapy on lymph movement in lymphedema-affected extremities,as assessed by near-infrared fuorescence lymphatic imaging.

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Journal of Innovative Optical Health Sciences 2017年第2期10卷 110-123页

作者： Melissa B.Aldrich Deborah gross John Rodney Morrow caroline E.Fife John C.Rasmussen Center for Molecular Imaging The Brown Institute for Molecular Medicine UTHealth HoustonTexasUSA Mego Afek/lympha Press USA Freehold New JerseyUSA CHI St.luke's Health The Woodlands Hospital The Woodlands TexasUSA

Previous studies have shown cost effectiveness and quality-of-life benefit of pneumatic compression therapy(PCT)for lymphedema(lE).Insurers,such as the Centers for Medicare/Medicaid(CMS),however,desire visual proof that PCT moves lymph.Near infrared fuorescence lymphatic imaging(NIRFlI)was used to visualize lymphatic anatomy and function in four subjects with primary and cancer treatment-related lE of the lower extremities before,during,and after PCT.Optically transparent and windowed PCT garments allowed visualization of lymph movement during single,1h PCT treatment sessions.Visualization revealed significant extravascular and lymphatic vascular movement of intradermally injected dye in all subjects.In one subject with sufficient patent lymphatic vessels to allow quantification of lymph pumping velocities and frequencies,these values were significantly increased during and after PCT as compared to pre-treatment values.lymphatic contractile activity in patent lymphatic vessels occurred in concert with the sequential cycling of PCT.Direct visualization revealed increased lymphatic function,during and after PCT therapy,in all lE-affected extremities.Further studies are warranted to assess the effects of PCT pressure and sequences on lymph uptake and movement.

关键词： lymphedema pneumatic compression therapy near-infrared fAuorescence

二甲双胍单药控制不佳的2型糖尿病患者联合达格列净治疗的长期有效性

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二甲双胍单药控制不佳的2型糖尿病患者联合达格列净治疗的长期有...

中华医学会糖尿病学分会第十六次全国学术会议

作者： Clifford J.Bailey Jorge l.gross Delphine Hennicken Nayyar Iqbal Traci A.Mansfield James F.list life and Health Sciences Aston UniversityBirminghamUK Endocrine Division Universidade Federal do Rio Grande do SulPorto AlegreBrazil

目的达格列净(DAPA)是选择性2型钠-葡萄糖协同转运蛋白(SGlT2)抑制剂,通过增加肾脏的葡萄糖清除这一非胰岛素依赖方式来降低血糖。先前已报道了二甲双胍(MET)单药控制欠佳的2型糖尿病患者(n=546)加用DAPA[主要终点:第24周的糖化血红蛋白...

目的达格列净(DAPA)是选择性2型钠-葡萄糖协同转运蛋白(SGlT2)抑制剂,通过增加肾脏的葡萄糖清除这一非胰岛素依赖方式来降低血糖。先前已报道了二甲双胍(MET)单药控制欠佳的2型糖尿病患者(n=546)加用DAPA[主要终点:第24周的糖化血红蛋白(HbA1c)水平]的随机、双盲、安慰剂对照试验(MB102014)的24周的短期治疗效果;而本研究将报道扩展治疗至102周的结果。

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慢性疾病康复进展:改善健康预后和功能水平

英国医学杂志中文版 2020年第1期23卷 29-42页

作者： caroline R Richardson Barry Franklin Marilyn l Moy Elizabeth A Jackson (译) 莫云凌(审校) Department of Family Medicine University of MichiganAnn ArborMI 48104USA Oakland University WilliamBeaumont School of MedicineRochesterMIUSA Harvard Medical School BostonMAUSA University of Alabama BirminghamALUSA The university of Bristol 航空医学研究所附属医院

医疗保健系统的大量负担与慢性疾病如心血管疾病和慢性阻塞性肺疾病的管理有关。虽然常规门诊心肺康复计划显著降低了慢性疾病患者的发病率和病死率,改善了患者的功能水平以及与健康相关的生活质量,但康复计划并没有得到充分利用。阻止... 详细信息

医疗保健系统的大量负担与慢性疾病如心血管疾病和慢性阻塞性肺疾病的管理有关。虽然常规门诊心肺康复计划显著降低了慢性疾病患者的发病率和病死率,改善了患者的功能水平以及与健康相关的生活质量,但康复计划并没有得到充分利用。阻止患者参加康复计划的障碍来自多个方面,包括未能向患者推荐这些服务、没有把患者转诊到这些项目;关于康复计划的潜在益处没有和患者沟通清楚;患者自身因素使其难以参加以设施为基础的康复计划,这些因素具体包括后勤障碍、财政困难、合并症和相互竞争的需求。康复计划的最新进展涉及远程交付技术(remotely delivered technology),这有助于向更多可能受益的人提供服务。最近的临床试验研究了以家庭为基础的康复计划在强度、依从性和安全性方面存在的问题,正在进行更大规模的推广和实施试验。本文总结了参加心肺康复计划对患者有益的证据,对下述有关新进展的文献进行了综述:如为降低成本、改善可及性开发的家庭远程遥控锻炼计划、心脏康复中的高强度间歇训练,以及针对慢性阻塞性肺疾病患者的替代疗法,如太极拳和瑜伽等。

关键词：康复计划临床试验研究慢性疾病患者心脏康复慢性阻塞性肺疾病心血管疾病远程遥控依从性

Chitin-glucan improves important pathophysiological features of irritable bowel syndrome

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World Journal of Gastroenterology 2024年第16期30卷 2258-2271页

作者： caroline Valibouze caroline Dubuquoy Philippe Chavatte Michaël Genin Veronique Maquet Salvatore Modica Pierre Desreumaux Christel Rousseaux Department of Digestive Surgery and Transplantation Lille UniversityLille 59037France Intestinal Biotech Development Facultéde MédicineLille 59045France U1286-INFINITE-Institute for Translational Research in Inflammation Universitéde LilleLille 59000France UlR 2694-METRICS Évaluation des Technologies de santéet des Pratiques MédicalesUniversity of LilleLille 59000France KitoZyme SA Institution SociétéAnonymeZone 2Parc des Hauts SartsRue de MilmortHerstal 4040Belgium Hepato-Gastroenterology Department Lille University HospitalLille 59037France

BACKGROUND Irritable bowel syndrome(IBS)is one of the most frequent and debilitating conditions leading to gastroenterological referrals.However,recommended treatments remain limited,yielding only limited therapeutic gains.Chitin-glucan(CG)is a novel dietary prebiotic classically used in humans at a dosage of 1.5-3.0 g/d and is considered a safe food ingredient by the European Food Safety Authority.To provide an alternative approach to managing patients with IBS,we performed preclinical molecular,cellular,and animal studies to evaluate the role of chitin-glucan in the main pathophysiological mechanisms involved in IBS.AIM To evaluate the roles of CG in visceral analgesia,intestinal inflammation,barrier function,and to develop computational molecular models.METHODS Visceral pain was recorded through colorectal distension(CRD)in a model of long-lasting colon hypersensitivity induced by an intra-rectal administration of TNBS[15 milligrams(mg)/kilogram(kg)]in 33 Sprague-Dawley rats.Intracolonic pressure was regularly assessed during the 9 wk-experiment(weeks 0,3,5,and 7)in animals receiving CG(n=14)at a human equivalent dose(HED)of 1.5 g/d or 3.0 g/d and compared to negative control(tap water,n=11)and positive control(phloroglucinol at 1.5 g/d HED,n=8)groups.The anti-inflammatory effect of CG was evaluated using clinical and histological scores in 30 C57bl6 male mice with colitis induced by dextran sodium sulfate(DSS)administered in their drinking water during 14 d.HT-29 cells under basal conditions and after stimulation with lipopolysaccharide(lPS)were treated with CG to evaluate changes in pathways related to analgesia μ-opioid receptor(MOR),cannabinoid receptor 2(CB2),peroxisome proliferator-activated receptor alpha,inflammation[interleukin(Il)-10,Il-1b,and Il-8]and barrier function[mucin 2-5AC,claudin-2,zonula occludens(ZO)-1,ZO-2]using the real-time PCR method.Molecular modelling of CG,lPS,lipoteichoic acid(lTA),and phospholipomannan(PlM)was developed,and the ability of CG to chelate microbial pathogenic lipids

关键词： Chitin-glucan Irritable bowel syndrome Abdominal pain Inflammation Intestinal barrier Molecular modelling Microbial cell walls chelation

Saccharomyces cerevisiae prevents postoperative recurrence of Crohn's disease modeled by ileocecal resection in HlA-B27 transgenic rats

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World Journal of Gastroenterology 2023年第5期29卷 851-866页

作者： caroline Valibouze Silvia Speca caroline Dubuquoy Florian Mourey lena M'Ba lucil Schneider Marie Titecat Benoît Foligné Michaël Genin Christel Neut Philippe Zerbib Pierre Desreumaux Department of Digestive Surgery and Transplantation Lille University HospitalLille 59037France U1286-INFINITE-Institute for Translational Research in Inflammation Univ.LilleInsermCHU LilleLille 59000France Intestinal Biotech Development Lille 59045France Department of Research and Applications Gnosis by LesaffreLesaffre GroupMarcq-en-Baroeul 59700France UlR 2694-METRICS:Évaluation des Technologies de Santéet des Pratiques Médicales University of LilleLille University HospitalLille 59000France Department of Hepato-Gastroenterology Lille University HospitalLille 59037France

BACKGROUND Postoperative recurrence(POR)after ileocecal resection(ICR)affects most Crohn's disease patients within 3-5 years after surgery.Adherent-invasive Escherichia coli(AIEC)typified by the lF82 strain are pathobionts that are frequently detected in POR of Crohn's disease and have a potential role in the early stages of the disease pathogenesis.Saccharomyces cerevisiae CNCM I-3856 is a probiotic yeast reported to inhibit AIEC adhesion to intestinal epithelial cells and to favor their elimination from the gut.AIM To evaluate the efficacy of CNCM I-3856 in preventing POR induced by lF82 in an HlA-B27 transgenic(TgB27)rat model.METHODS Sixty-four rats[strain F344,38 TgB27,26 control non-Tg(nTg)]underwent an ICR at the 12th wk(W12)of life and were sacrificed at the 18th wk(W18)of life.TgB27 rats were challenged daily with oral administration of lF82(109 colony forming units(CFUs)/day(d),n=8),PBS(n=5),CNCM I-3856(109 CFUs/d,n=7)or a combination of lF82 and CNCM I-3856(n=18).nTg rats receiving lF82(n=5),PBS(n=5),CNCM I-3856(n=7)or CNCM I-3856 and lF82(n=9)under the same conditions were used as controls.POR was analyzed using macroscopic(from 0 to 4)and histologic(from 0 to 6)scores.luminal lF82 quantifications were performed weekly for each animal.Adherent lF82 and inflammatory/regulatory cytokines were quantified in biopsies at W12 and W18.Data are expressed as the median with the interquartile range.RESUlTS nTg animals did not develop POR.A total of 7/8(87%)of the TgB27 rats receiving lF82 alone had POR(macroscopic score≥2),which was significantly prevented by CNCM I-3856 administration[6/18(33%)TgB27 rats,P=0.01].Macroscopic lesions were located 2 cm above the anastomosis in the TgB27 rats receiving lF82 alone and consisted of ulcerations with a score of 3.5(2-4).Seven out of 18 TgB27 rats(39%)receiving CNCM I-3856 and lF82 had no macroscopic lesions.Compared to untreated TgB27 animals receiving lF82 alone,coadministration of CNCM I-3856 and lF82 significantly reduced the macroscopic[3.5(2-4)vs 1(0-3),P=0.002]a

关键词： Crohn's disease Recurrence Escherichia coli Probiotic Saccharomyces cerevisiae Colorectal surgery

自由探索行为中海马—前额叶神经网络振荡特征

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Science Bulletin 2021年第21期66卷 2238-2250,M0004页

作者：董文秀陈宏标 Timothy Sit 韩业超宋非 Alexei l.Vyssotski Cornelius T.gross 斯白露詹阳 Guangdong Provincial Key laboratory of Brain Connectome and Behavior CAS Key Laboratory of Brain Connectome and Manipulationthe Brain Cognition and Brain Disease Institute(BCBDI)Shenzhen Key Laboratory of Translational Research for Brain DiseasesShenzhen Institutes of Advanced TechnologyChinese Academy of SciencesShenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research InstitutionsShenzhen 518055China State Key laboratory of Robotics Shenyang Institute of AutomationChinese Academy of SciencesShenyang 110016China Institutes for Robotics and Intelligent Manufacturing Chinese Academy of SciencesShenyang 110169 University of Chinese Academy of Sciences Beijing 100049China Institute of Neuroinformatics the University of Zürich and Swiss Federal Institute of Technology(ETH)Zurich CH-8057Switzerland European Molecular Biology laboratory(EMBl) Monterotondo 00015Italy School of Systems Science Beijing Normal UniversityBeijing 100875China

生物体探索未知环境的轨迹呈现出规律性,这反映了个体的探索模式和适应策略.然而,探索过程的轨迹动态变化特征以及神经机制尚不清楚.本研究利用探索大范围旷场环境的行为范式,开发了用于度量探索行为轨迹的计算方法,并且记录了小鼠大脑... 详细信息

生物体探索未知环境的轨迹呈现出规律性,这反映了个体的探索模式和适应策略.然而,探索过程的轨迹动态变化特征以及神经机制尚不清楚.本研究利用探索大范围旷场环境的行为范式,开发了用于度量探索行为轨迹的计算方法,并且记录了小鼠大脑的场电位信号.开发的累积熵和短时熵方法可以分别表征累积探索行为和短时探索行为.局部场电位分析表明背侧海马的theta频段的功率与短时熵高度相关.机器学习的分析结果表明,利用背侧海马体和前额叶皮层的神经振荡可以准确地预测多种探索行为.探索行为出现时,前额叶和背侧海马体theta频段的功率分别上升和下降.因此,在探索未知区域时背侧海马体和前额叶可以通过协同调节theta频段的神经活动来影响自由探索行为.

关键词：自由探索行为轨迹前额叶皮层神经活动机器学习行为范式神经网络探索行为

Human Performance in Critical Scenarios as a Benchmark for Highly Automated Vehicles

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Automotive Innovation 2021年第3期4卷 274-283页

作者： laura Quante Meng Zhang Katharina Preuk caroline Schießl Institute of Transportation Systems German Aerospace Center(DLR e.V.)Lilienthalplatz 738108 BraunschweigGermany

Before highly automated vehicles(HAVs)become part of everyday traffic,their safety has to be proven.The use of human performance as a benchmark represents a promising approach,but appropriate methods to quantify and compare human and HAV performance are rare.By adapting the method of constant stimuli,a scenario-based approach to quantify the limit of(human)performance is developed.The method is applied to a driving simulator study,in which participants are repeatedly confronted with a cut-in manoeuvre on a highway.By systematically manipulating the criticality of the manoeuvre in terms of time to collision,humans’collision avoidance performance is measured.The limit of human performance is then identified by means of logistic regression.The calculated regression curve and its inflection point can be used for direct comparison of human and HAV performance.Accordingly,the presented approach represents one means by which HAVs’safety performance could be proven.

关键词： Highly automated vehicles Automated driving Proof of safety Human performance Driving performance

Tracing the origin of large respiratory droplets by their deposition characteristics inside the respiratory tract during speech

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Building Simulation 2023年第5期16卷 781-794页

作者： Yihan Wang Jianjian Wei caroline X.Gao Tao Jin li liu Institute of Refrigeration and Cryogenics Key Laboratory of Refrigeration and Cryogenic Technology of Zhejiang ProvinceZhejiang UniversityHangzhou 310000China Public Health and Preventive Medicine Monash UniversityMelbourneVIC3004Australia Department of Building Science Tsinghua UniversityBeijing 100084China

Origin of differently sized respiratory droplets is fundamental for clarifying their viral loads and the sequential transmission mechanism of SARS-CoV-2 in indoor environments.Transient talking activities characterized by low(0.2 l/s),medium(0.9 l/s),and high(1.6 l/s)airflow rates of monosyllabic and successive syllabic vocalizations were investigated by computational fluid dynamics(CFD)simulations based on a real human airway model.SST k-ωmodel was chosen to predict the airflow field,and the discrete phase model(DPM)was used to calculate the trajectories of droplets within the respiratory tract.The results showed that flow field in the respiratory tract during speech is characterized by a significant laryngeal jet,and bronchi,larynx,and pharynx-larynx junction were main deposition sites for droplets released from the lower respiratory tract or around the vocal cords,and among which,over 90%of droplets over 5μm released from vocal cords deposited at the larynx and pharynx-larynx junction.Generally,droplets’deposition fraction increased with their size,and the maximum size of droplets that were able to escape into external environment decreased with the airflow rate.This threshold size for droplets released from the vocal folds was 10-20μm,while that for droplets released from the bronchi was 5-20μm under various airflow rates.Besides,successive syllables pronounced at low airflow rates promoted the escape of small droplets,but do not significantly affect the droplet threshold diameter.This study indicates that droplets larger than 20μm may entirely originate from the oral cavity,where viral loads are lower;it provides a reference for evaluating the relative importance of large-droplet spray and airborne transmission route of COVID-19 and other respiratory infections.

关键词： respiratory droplets deposition viral load airborne transmission COVID-19