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防治危岩落石桥梁棚洞一体化结构设计防护能级划分标准研究

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铁道技术标准（中英文） 2024年第4期6卷 47-52页

作者：苏昶国家铁路局规划与标准研究院技术标准所北京100055

基于铁路工程建设运营安全需求,尤其是中西部山区危岩落石易发的实际情况,分析国内外防治危岩落石防护柔性和刚性棚洞应用现状,对比防护网、明洞、棚洞不同结构类型情况下防护方式的防护能级范围,梳理目前国内铁路典型棚洞设计能级指标... 详细信息

基于铁路工程建设运营安全需求,尤其是中西部山区危岩落石易发的实际情况,分析国内外防治危岩落石防护柔性和刚性棚洞应用现状,对比防护网、明洞、棚洞不同结构类型情况下防护方式的防护能级范围,梳理目前国内铁路典型棚洞设计能级指标实际,针对桥梁棚洞一体化结构特点、常见落石计算防护能级和200、500、1000 kJ 3种防护能级在主梁、棚洞使用钢筋、混凝土用量的经济性比较,提出我国铁路工程防治危岩落石桥梁棚洞一体化结构设计防护能级划分标准建议。

关键词：铁路安全危岩落石桥梁棚洞一体化结构标准防护能级

Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action(EQIA)study:a national cohort study in China from 2017 to 2019

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Frontiers of Medicine 2024年第2期18卷 315-326页

作者： Wei Cheng Jieqing Chen Xudong Ma Jialu sun Sifa Gao Ye Wang Longxiang su Lu Wang Wei Du Huaiwu He Yujie Chen Zunzhu Li Qi Li Jianhua sun Hongbo Luo Jinbang Liu Guangliang Shan Bing Du Yanhong Guo Dawei Liu chang Yin Xiang Zhou on behalf of the China National Critical Care Quality Control Center-the ECMO quality improvement action(EQIA)study Department of Critical Care Medicine State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijing100730China Information Center Department/Department of Information Management State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalPeking Union Medical College&Chinese Academy of Medical SciencesBeijing100730China Department of Medical Administration National Health Commission of the People’s Republic of ChinaBeijing100044China School of Population Medicine and Public Health Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100730China Department of Epidemiology and Biostatistics Institute of Basic Medicine SciencesChinese Academy of Medical Sciences(CAMS)&School of Basic MedicinePeking Union Medical CollegeBeijing100730China National Institute of Hospital Administration National Health Commission of the People’s Republic of ChinaBeijing100044China 不详

This cohort study was performed to explore the influence of intensive care unit(ICU)quality on in-hospital mortality of veno-venous(V-V)extracorporeal membrane oxygenation(ECMO)-supported patients in China.The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019,using data from the National Clinical Improvement System and China National Critical Care Quality Control Center.ICU quality was assessed by quality control indicators and capacity parameters.Among the 2563 V-V ECMO-supported patients in 318 hospitals,a significant correlation was found between ECMO-related complications and prognosis.The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients(cutoff:1.5%and 7.0%;95%confidence interval:1.05–1.48 and 1.04–1.45;odds ratios:1.25 and 1.23;P=0.012 and P=0.015,respectively).Meanwhile,the V-V ECMO center volume was a protective factor(cutoff of≥50 cases within the 3-year study period;95%confidence interval:0.57–0.83,odds ratio:0.69,P=0.0001).The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings.Thus,ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation in-hospital mortality high-volume centers quality control intensive care unit capacity parameters

早期免疫抑制治疗在预防眼肌型重症肌无力向全身型转化中的作用

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西安交通大学学报（医学版） 2024年第2期45卷 312-319页

作者：阮哲宁凡苏悦常婷屈秋民西安交通大学第一附属医院神经内科陕西西安710061 空军军医大学第二附属医院神经内科陕西西安710038

目的比较眼肌型重症肌无力(OMG)患者接受或不接受免疫抑制治疗的全身转化风险。方法回顾了2015年1月1日至2019年5月1日在空军军医大学唐都医院注册登记的OMG患者的资料,按照是否接受免疫抑制治疗将患者分为治疗组和对照组,使用多因素Co... 详细信息

目的比较眼肌型重症肌无力(OMG)患者接受或不接受免疫抑制治疗的全身转化风险。方法回顾了2015年1月1日至2019年5月1日在空军军医大学唐都医院注册登记的OMG患者的资料,按照是否接受免疫抑制治疗将患者分为治疗组和对照组,使用多因素Cox比例风险回归模型分析比较了发病后2年内两组患者的疾病转化风险。通过敏感性分析,评估了免疫抑制治疗时程以及不同免疫治疗方案下的转化风险;使用分层分析,评价了不同亚组因子水平下主要结果的一致性。结果共收集702例以眼肌症状起病的重症肌无力(MG)患者的信息,367例(52.3%)患者被纳入治疗组,平均发病年龄为(50.54±15.1)岁,其中159例(43.3%)为女性。335例(47.7%)患者被纳入对照组,平均年龄(49.1±14.6)岁,159例(47.5%)为女性。治疗组中28例(7.7%),对照组中106例(31.6%)患者在观察期内转化为全身型重症肌无力(GMG)。经多变量校正的Cox模型分析后发现,与对照组相比,接受免疫抑制治疗的患者全身转化风险明显降低(HR=0.24;95%CI:0.15~0.37;P<0.001)。敏感性分析发现,免疫抑制持续时间越长,转化风险越低(HR=0.88;95%CI:0.85~0.91;P<0.001)。分层分析显示,不同亚组中患者接受免疫抑制治疗均可降低转化风险。结论早期接受免疫抑制治疗可以显著降低OMG患者向全身型转化的风险。

关键词：眼肌型重症肌无力(OMG) 全身型重症肌无力(GMG) 全身转化免疫治疗

Risk Factors Associated with Unsuccessful Vaginal Birth after One Cesarean (VBAC-1) in Puerto Rico

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 888-902页

作者： Irazú Guinan Marjorie suárez Fabiola Angulo Luis Mayol Paula suárez Lisandris Dominicci Nathalie chang Saribel Torres Antonio Rodríguez Raymond L. Tremblay Maricarmen Colón-Díaz Department of Physiology and Pathology San Juan Bautista School of Medicine Caguas USA

Background: Cesarean section (CS) has increased steadily over the last decade, with an estimated one-third of women delivering by cesarean section worldwide. Objective: Our study aimed to investigate the demographic and associated factors influencing vaginal birth after one cesarean (VBAC-1) success focusing on variables like pre-pregnancy BMI, diabetes, hypertension, education, and smoking. Study Design and Methods: In this retrospective study, we analyzed 285 cases (81 unsuccessful VBAC-1, 204 successful VBAC-1) from San Juan City Hospital (Puerto Rico) between January 1, 2019, and December 31, 2020. We used odds ratios and model selection comparison to assess the impact of variables on successful VBAC-1, using a significance threshold of 95% CI. Model selection assessed binomial model combinations using a generalized linear approach to identify key risk factors. Results: Unsuccessful VBAC-1 (a repeat cesarean), was associated with diabetes (OR: 0.376, p = 0.086), hypertension (OR: 0.23, p = 0.006), and university-educated women (OR: 1.372, p = 0.711). High school-educated women had an OR of 3.966 (p = 0.105), while overweight women were 0.481 times more likely to have unsuccessful VBAC-1 (p = 0.041). Significant associations were not found with obesity (OR: 0.574, p = 0.122), underweight/normal (OR: 1.01, p = 0.810), or smoking (OR: 1.227, p = 0.990). Conclusion: Results revealed women with higher education levels, hypertension, or diabetes are less likely to have a successful VBAC-1. Understanding the complex interactions affecting these outcomes is aimed at establishing guidelines for healthcare professionals to conduct systematic risk/benefit assessments. This study lays a foundation for evidence-based practices and policies, offering initial insights into VBAC-1 success factors in Puerto Rico.

关键词： Diabetes Hypertension Obesity Trial of Labor Vaginal Birth after Cesarean

Microbiota enterotoxigenic Bacteroides fragilis-secreted BFT-1 promotes breast cancer cell stemness and chemoresistance through its functional receptor NOD1

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Protein & Cell 2024年第6期15卷 419-440页

作者： Wei Ma Lu Zhang Weilong Chen Zhaoxia chang Juchuanli Tu Yuanyuan Qin Yuwen Yao Mengxue Dong Jiajun Ding Siqin Li Fengkai Li Qiaodan Deng Yifei Yang Tingting Feng Fanrong Zhang Xiying Shao Xueyan He Lixing Zhang Guohong Hu Quentin Liu Yi-Zhou Jiang Shu Zhu Zhi Xiao Dan su Tong Liu suling Liu Fudan University Shanghai Cancer Center & Institutes of Biomedical Sciences State Key Laboratory of Genetic EngineeringCancer InstitutesDepartment of OncologyKey Laboratory of Breast Cancer in ShanghaiThe Shanghai Key Laboratory of Medical EpigeneticsShanghai Key Laboratory of Radiation OncologyThe International Co-laboratory of Medical Epigenetics and MetabolismMinistry of Science and TechnologyShanghai Medical CollegeFudan UniversityShanghai 200032China Intelligent Pathology Institute and Department of Pathology The First Affiliated Hospital of USTCDivision of Life Sciences and MedicineUniversity of Science and Technology of ChinaHefei 230071China Department of Thyroid Breast and Vascular SurgeryXijing HospitalFourth Military Medical UniversityXi’an 710032China Institute of Immunology CAS Key Laboratory of Innate Immunity and Chronic DiseaseSchool of Basic Medical SciencesDivision of Life Science and MedicineUniversity of Science and Technology of ChinaHefei 230027China Department of Pathology The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)Institute of Basic Medicine and Cancer (IBMC)Chinese Academy of SciencesHangzhou 310022China Department of Breast surgery The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)Institute of Basic Medicine and Cancer (IBMC)Chinese Academy of SciencesHangzhou 310022China Department of Breast Medical Oncology The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital)Institute of Basic Medicine and Cancer (IBMC)Chinese Academy of SciencesHangzhou 310022China Shanghai Institute of Nutrition and Health University of Chinese Academy of SciencesChinese Academy of SciencesShanghai 200031China sun Yat-sen University Cancer Center State Key Laboratory of Oncology in South ChinaGuangzhou 510060China Department of Breast surgery Xiangya HospitalChangsha 410008China Department of Breast surgery Tumor Hospital of Harbin Medic

Tumor-resident microbiota in breast cancer promotes cancer initiation and malignant progression.However,targeting microbiota to improve the effects of breast cancer therapy has not been investigated in detail.Here,we evaluated the microbiota composition of breast tumors and found that enterotoxigenic Bacteroides fragilis(ETBF)was highly enriched in the tumors of patients who did not respond to taxane-based neoadjuvant chemotherapy.ETBF,albeit at low biomass,secreted the toxic protein BFT-1 to promote breast cancer cell stemness and chemoresistance.Mechanistic studies showed that BFT-1 directly bound to NOD1 and stabilized NOD1 protein.NOD1 was highly expressed on ALDH+breast cancer stem cells(BCSCs)and cooperated with GAK to phosphorylate NUMB and promote its lysosomal degradation,thereby activating the NOTCH1-HEY1 signaling pathway to increase BCSCs.NOD1 inhibition and ETBF clearance increase the chemosensitivity of breast cancer by impairing BCSCs.

关键词： NOD1 breast chemotherapy

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下穿铁路框架桥的基坑设计及安全分析

山西建筑 2024年第7期50卷 89-93页

作者：苏昶中铁第四勘察设计院集团有限公司湖北武汉430063

基坑在工程建设中较为常见,基坑开挖安全分析在每一个特定工程中都具有其重要意义,以杭州市萧山区彩虹快速路下穿沪昆铁路的建设工程为研究对象,介绍了下穿铁路线的框架桥及其深基坑的设计、施工方案,并基于现场监控和数值模拟的手段分... 详细信息

基坑在工程建设中较为常见,基坑开挖安全分析在每一个特定工程中都具有其重要意义,以杭州市萧山区彩虹快速路下穿沪昆铁路的建设工程为研究对象,介绍了下穿铁路线的框架桥及其深基坑的设计、施工方案,并基于现场监控和数值模拟的手段分析了基坑施工过程中围护结构的变形情况及周边地表的沉降情况。结果表明,相较于预制框架顶进施工法,明挖基坑现浇框架法更易保证其施工安全性,且对既有铁路线的运营影响更小;该基坑施工过程中,围护结构最大水平变形22 mm、最大沉降3.0 mm,立柱桩最大沉降15 mm,基坑结构具有很好的安全稳定性;然而,基坑周边地表沉降最大可达18 mm,且影响范围处于距离基坑边缘2 m~25 m范围内,应尤其注意该距离范围内既有铁路线的维护与检修,并适当降低铁路运营速度。

关键词：框架桥深基坑地表沉降围护结构变形现场监控数值模拟安全评估

原油市场不确定风险、油价周期与中国金融周期的交互时变溢出效应

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金融与经济 2024年第1期 3-17页

作者：苏鹏刘术东郭畅新疆大学经济与管理学院新疆创新管理研究中心新疆大学商学院

首先基于Beveridge-Nelson分解(B-N)从油价序列中提取原油市场不确定性风险和油价周期成分,进而构建二者与中国金融周期的时变参数向量自回归模型以及动态溢出指数予以分析。研究发现,三者间交互脉冲响应具有显著的时变特征;不确定性风... 详细信息

首先基于Beveridge-Nelson分解(B-N)从油价序列中提取原油市场不确定性风险和油价周期成分,进而构建二者与中国金融周期的时变参数向量自回归模型以及动态溢出指数予以分析。研究发现,三者间交互脉冲响应具有显著的时变特征;不确定性风险引致油价周期性波动中有很大的投机因素;金融周期在不确定性风险和油价周期性波动增强情况下更容易趋于紧缩,具体影响特征与中国石油对外依存度、金融开放度和市场运行状况以及投机因素相关。就三者构成的交互系统内部而言,不确定性风险是主要的冲击发动者,金融周期在2008年之前是主要的冲击接收者,之后金融周期对油价周期具有正的净溢出效应,而油价周期成为系统冲击的接收对象,这源于中国经济实力的增强和原油市场竞争格局的改变。

关键词：不确定风险油价周期金融周期时变溢出

油画技法与纸张工艺的结合对艺术品市场的影响

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鞋类工艺与设计 2024年第9期4卷 97-99页

作者：苏畅集美大学福建厦门361000

油画技法与纸张工艺的结合对艺术品市场产生了深远的影响,不仅催生了新的市场需求,推动了艺术品市场的结构性变革,还促进了艺术品价格的变动和市场结构的调整。油画技法在纸张上的创新应用为消费者带来了前所未有的艺术体验,能满足其个... 详细信息

油画技法与纸张工艺的结合对艺术品市场产生了深远的影响,不仅催生了新的市场需求,推动了艺术品市场的结构性变革,还促进了艺术品价格的变动和市场结构的调整。油画技法在纸张上的创新应用为消费者带来了前所未有的艺术体验,能满足其个性化、多样化的需求,而纸张的广泛应用降低了艺术品的门槛,使更多人能够接触和购买油画作品。本文将深入探讨这种结合对艺术品市场的影响以及它如何推动市场的创新和变革,以期丰富艺术品的种类和风格,并为艺术品市场带来新的增长点。

关键词：油画技法纸张工艺艺术品市场

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如通苏湖城际铁路主跨240m斜拉桥设计

铁道勘测与设计 2024年第3期 40-44页

作者：苏昶中铁第四勘察设计院集团有限公司桥梁院武汉430063

新建如通苏湖城际铁路长兴特大桥主桥采用(51+94+240+94+51)m双塔双索面斜拉桥,主梁采用预应力混凝土箱形截面,桥塔采用倒Y形混凝土索塔,空间双索面,半漂浮体系,斜拉索的索塔锚固端采用钢锚箱,斜拉索的主梁锚固端采用混凝土锚槽。结合... 详细信息

新建如通苏湖城际铁路长兴特大桥主桥采用(51+94+240+94+51)m双塔双索面斜拉桥,主梁采用预应力混凝土箱形截面,桥塔采用倒Y形混凝土索塔,空间双索面,半漂浮体系,斜拉索的索塔锚固端采用钢锚箱,斜拉索的主梁锚固端采用混凝土锚槽。结合工程实际,本文介绍了技术标准、主桥总体布置、主要结构设计,并对主桥的静力性能及抗风、抗震、车桥耦合等动力性能进行了计算分析。结果表明:该桥结构受力合理,在合适的成桥索力作用下,主桥静动力计算结果均满足规范要求,主梁后期收缩徐变变形值较小,斜拉桥桥型适用于城际铁路大跨度桥梁结构。

关键词：城际铁路混凝土斜拉桥静动力性能收缩徐变结构设计