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广东省2019—2023年耐万古霉素屎肠球菌检出率升高的时空变迀研究

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中国感染控制杂志 2024年第4期23卷 397-402页

作者：卓楚越林烨欣王译靖陈嘉康郭颖异姚丽康杨旭李嘉慧陈杨进何南豪赵雅婷李明欣肖书念卓超广州医科大学附属第一医院(广东省耐药菌监测和质量控制中心)广州呼吸健康研究院广东广州510030 广州医科大学呼吸疾病全国重点实验室广东广州510030

目的分析近年广东省耐万古霉素屎肠球菌(VR-Efm)临床分离株的时空分布,探寻VR-Efm检出率上升的原因。方法回顾性分析2019—2023年广东省4个区域(珠三角、粤东、粤西、粤北)的38所医疗机构上报至广东省细菌耐药监测系统中VR-Efm检出情况... 详细信息

目的分析近年广东省耐万古霉素屎肠球菌(VR-Efm)临床分离株的时空分布,探寻VR-Efm检出率上升的原因。方法回顾性分析2019—2023年广东省4个区域(珠三角、粤东、粤西、粤北)的38所医疗机构上报至广东省细菌耐药监测系统中VR-Efm检出情况、患者人口学特征及科室和标本分布等资料,同步分析世界卫生组织重点关注的ESKAPE中其他5种细菌的检出情况。结果广东省VR-Efm检出率从2019年1.4%(63/4543)上升至2023年21.3%(1351/6345),呈明显上升趋势,2023年44.7%(17所)的医疗机构VR-Efm检出率>20%;广东省4个区域VR-Efm检出率普遍上升,以珠三角地区为中心向周围辐射增长。ESKAPE整体由2019年10.1%升至2023年10.8%,其余5种病原体中,耐碳青霉烯类肺炎克雷伯菌检出率从2019年8.0%上升至2023年15.0%,耐碳青霉烯类鲍曼不动杆菌、耐甲氧西林金黄色葡萄球菌、耐碳青霉烯类铜绿假单胞菌和耐碳青霉烯类肠杆菌属检出率分别从2019年的61.6%、34.4%、21.2%、7.9%下降至2023年的58.2%、31.9%、21.0%、7.6%,皆有不同程度下降。ICU VR-Efm检出率(12.2%)高于门急诊(9.4%)、内科(9.2%)和外科(7.0%)等非ICU科室(均P9.4%,P<0.05)。结论近5年广东省VR-Efm检出率明显上升,可能与社区和医院获得的优势克隆传播有关。有条件的医疗机构应对入院患者开展VR-Efm的筛查,并对检出VR-Efm的患者采取有效防控措施,以遏制VR-Efm检出率在该区域的上升。

关键词：耐万古霉素屎肠球菌屎肠球菌耐药细菌耐药监测耐药性变迁

Ultrasound-guided serratus anterior plane block enhances postoperative analgesia and recovery in thoracoscopic surgery

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World Journal of Clinical Cases 2024年第19期12卷 3717-3724页

作者： Jing-Jing Zhang Shao-lin Wang Lei He Ding-Dong yang Wei Qian Ying Zhao Department of Anaesthesiology The Second People’s Hospital of WuhuWuhu 241000Anhui ProvinceChina

BACKGROUND The serratus anterior muscle,located in the lateral aspect of the thorax,plays a crucial role in shoulder movement and *** surgery,while minimally invasive,often results in significant postoperative pain,complicating patient recovery and potentially extending hospital *** anesthesia methods may not adequately address this pain,leading to increased complications such as agitation due to inadequate pain *** To evaluate the application value of ultrasound-guided serratus anterior plane block(SAPB)in patients undergoing thoracoscopic surgery,focusing on its effects on postoperative analgesia and *** Eighty patients undergoing thoracoscopic surgery between August 2021 and December 2022 were randomly divided into two groups:An observation group receiving ultrasound-guided SAPB and a control group receiving standard care without *** groups underwent general anesthesia and were monitored for blood pressure,heart rate(HR),oxygen saturation,and *** primary outcomes measured included mean arterial pressure(MAP),HR,postoperative visual analogue scale(VAS)scores for pain,supplemental analgesic use,and incidence of *** The observation group showed significantly lower cortisol and glucose concentrations at various time points post-operation compared to the control group,indicating reduced stress ***,MAP and HR levels were lower in the observation group during and after *** scores were significantly lower in the observation group at 1 h,4 h,6 h,and 12 h post-surgery,and the rates of analgesic supplementation and agitation were significantly reduced compared to the control *** Ultrasound-guided SAPB significantly improves postoperative analgesia and reduces agitation in patients undergoing thoracoscopic *** technique stabilizes perioperative vital signs,decreases the need for supplemental analgesics,and minimizes postoperative pain and str

关键词： Ultrasonic guidance Serserus anterior plane block Thoracoscopic surgery Postoperative analgesia

基于深度学习的锥形束CT影像金属伪影去除研究

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中华口腔医学杂志 2024年第1期59卷 71-79页

作者：贾泠卉林泓磊郑松炜林秀娇张栋于皓福建医科大学口腔医学院·附属口腔医院口腔修复科、福建省口腔疾病研究重点实验室、福建省口腔生物材料工程技术研究中心、福建省高校口腔医学重点实验室、福建医科大学口腔医学研究院、福建医科大学口腔生物力学及美学研究中心福州350002 福州大学计算机与大数据学院福州350108

目的建立基于深度学习的金属伪影去除系统(MARS),评估其对锥形束CT影像中不同厚度金属产生的伪影的去除效果。方法采用三维打印的光敏树脂制作标准牙列模型(60mm×75mm×110mm),设计目标牙位(上颌、下颌双侧第一和第二前磨牙)为可拆卸... 详细信息

目的建立基于深度学习的金属伪影去除系统(MARS),评估其对锥形束CT影像中不同厚度金属产生的伪影的去除效果。方法采用三维打印的光敏树脂制作标准牙列模型(60mm×75mm×110mm),设计目标牙位(上颌、下颌双侧第一和第二前磨牙)为可拆卸替换牙位,通过置入不同厚度(轴面及面厚度分别均为1.0、1.5、2.0mm,即A、B、C组)的钴铬合金全冠试件,获得完全配对的含有或不含有金属伪影的锥形束CT影像,并通过结构相似度(SSIM)及峰值信噪比(PSNR)评估不同厚度钴铬合金全冠试件产生伪影的范围。建立基于卷积神经网络(CNN)与U型网络(U-net)的MARS(CNN-MARS及U-net-MARS),检验CNN-MARS和U-net-MARS两种系统去伪影前后图像的SSIM值和PSNR值,评估其去伪影效果;通过可视化方式分析两种系统去除锥形束CT影像中金属伪影的效果。采用单因素方差分析分别对两种系统的SSIM值和PSNR值进行统计分析,检验水准为双侧α=0.05。结果A、B、C组钴铬合金全冠试件的SSIM值(分别为0.916±0.019、0.873±0.010、0.833±0.010)和PSNR值(分别为20.834±1.176、17.002±0.427、14.673±0.429)差异均有统计学意义(F=447.89,P<0.001;F=796.51,P<0.001)。并且随着钴铬合金全冠试件厚度增加,其SSIM及PSNR值均显著增加(P<0.05)。对含有同一厚度钴铬合金全冠试件的图像,采用CNN-MARS与U-net-MARS去伪影后的SSIM和PSNR值均显著高于伪影去除前(均P<0.05)。使用CNN-MARS去U-net-MARS伪影后,含不同厚度钴铬合金全冠试件图像的SSIM值和PSNR值差异均无统计学意义(CNN-MARS:F=2.22,P=0.112;F=0.54,P=0.585;U-net-MARS:F=0.24,P=0.788;F=0.07,P=0.929)。CNN-MARS与U-net-MARS去伪影后图像与原始图像的相似度较高;相比U-net-MARS,CNN-MARS去伪影后仍可见较清晰的金属边缘,目标区域的组织结构恢复更完整。结论本研究构建的锥形束CT图像金属伪影消除CNN-MARS与U-net-MARS模型,均可有效去除金属伪影的干扰,提升图像质量,且去伪影效果不受金属厚度的影响。相比于U-net-MARS,CNN-MARS对恢复伪影周围组织结构具有显著优势。

关键词：锥束计算机体层摄影术卷积神经网络 U型网络金属伪影去伪影

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青藏高原盐湖反风化作用与关键元素循环

地球学报 2024年第5期45卷 777-790页

作者：林勇杰郑绵平中国地质科学院矿产资源研究所、自然资源部盐湖资源与环境重点实验室北京100037

盐湖环境中的反风化(reverse weathering,又称逆风化)是指逆向的化学风化作用,通常指盐湖内部自生黏土矿物或碳酸盐矿物的形成过程,是控制盐湖关键元素地球化学循环的重要机制。青藏高原是地球上关键的盐湖区,既是内陆生态系统重要的碳... 详细信息

盐湖环境中的反风化(reverse weathering,又称逆风化)是指逆向的化学风化作用,通常指盐湖内部自生黏土矿物或碳酸盐矿物的形成过程,是控制盐湖关键元素地球化学循环的重要机制。青藏高原是地球上关键的盐湖区,既是内陆生态系统重要的碳库,又富含锂、钾、铷、铯等关键矿产资源。青藏高原盐湖的水化学类型多样,包括碳酸盐型、硫酸盐型和氯化物型,不同的水化学特征决定了盐类和黏土矿物的种类及其形成机制的差异。本文综述了盐湖环境中硅酸盐和碳酸盐反风化作用的研究进展,并探讨青藏高原盐湖反风化作用对关键元素地球化学循环的影响。青藏高原盐湖中自生黏土矿物的形成(如伊利石)是对盐湖卤水锂、钾、铷、铯等关键元素最重要的消耗机制;而碳酸盐的形成对关键金属元素消耗影响很小,除非形成含关键金属元素的独立矿物,如扎布耶石。自生黏土矿物和碳酸盐的形成均会显著影响湖泊的无机碳循环。目前,盐湖反风化作用程度的量化、控制因素解析和对关键元素损耗的影响程度是盐湖矿产资源研究的关键问题。当前非传统稳定同位素技术的快速发展为盐湖反风化研究提供了新机遇。青藏高原盐湖是反风化研究的天然实验室,开展盐湖反风化研究不仅可以深入理解青藏高原盐湖的关键金属元素成矿作用及碳循环过程,而且有助于丰富反风化理论。

关键词：盐湖反风化作用关键金属元素循环碳循环青藏高原

以全国统一大市场应对国际税改:全球最低税率计划的理论与实践

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社会科学战线 2024年第1期 54-61,281页

作者：陈林王佳莹暨南大学产业经济研究院广东广州510632 暨南大学学报编辑部广东广州510632

全球最低税率计划意在通过统一的最低企业税率标准重构数字时代国际资本流动新格局。这一美欧政治博弈下的合谋结果,对同为世界数字经济大国和出口大国的中国施压意图明显,若无法有效应对此次挑战,将严重阻碍中国经济高质量发展。面对... 详细信息

全球最低税率计划意在通过统一的最低企业税率标准重构数字时代国际资本流动新格局。这一美欧政治博弈下的合谋结果,对同为世界数字经济大国和出口大国的中国施压意图明显,若无法有效应对此次挑战,将严重阻碍中国经济高质量发展。面对以全球最低税率计划为主要内容的国际税收改革,如何以国内大循环和全国统一大市场为支撑,有效吸收和利用全球要素和市场资源,强化参与国际税收秩序重构,将成为新国际形势下中国构建更高水平对外开放新格局亟待解决的关键问题。文章通过梳理全球最低税率计划的提出背景与具体内容,分析此次税改对中国的影响,并基于市场经济、制度优势等理论视角,解释了以全国统一大市场建设应对全球最低税率计划的有效性与现实意义。

关键词：全国统一大市场全球最低税率计划国内大循环高水平对外开放市场经济

Shear mechanical properties and frictional sliding responses of rough joint surfaces under dynamic normal displacement conditions

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Journal of Central South University 2024年第7期31卷 2393-2410页

作者： ZHU Qiang YIN Qian TAO Zhi-gang HE Man-chao ZHENG Bo-wen JING Hong-wen REN Shu-lin ZHANG Qiang MENG Bo BAI Dong-feng WU Sai-sai WU Jiang-yu State Key Laboratory of Intelligent Construction and Healthy Operation and Maintenance of Deep Underground Engineering Xuzhou 221116China State Key Laboratory for Geomechanics&Deep Underground Engineering China University of Mining and Technology(Beijing)Beijing 100083China Key Laboratory of Shale Gas and Geoengineering Institute of Geology and GeophysicsChinese Academy of SciencesBeijing 100029China CCCC First Highway Survey and Design Research Institute Co. Ltd.Xi’an 710075China

A comprehensive understanding of the dynamic frictional characteristics in rock joints under high normal load and strong confinement is essential for ensuring the safety of deep engineering construction and mitigating geological *** study conducted shear experiments on rough rock joints under displacement-controlled dynamic normal loads,investigating the shear behaviors of joints across varying initial normal loads,normal loading frequencies,and normal loading *** results showed that the peak/valley shear force values increased with initial normal loads and normal loading frequencies but showed an initial increase followed by a decrease with normal loading *** normal loading can either increase or decrease shear strength,while this study demonstrates that higher frequencies lead to enhanced *** initial normal loading and normal loading frequency result in a gradual decrease in joint roughness coefficient(JRC)values of joint surfaces after *** correlations existed between frictional energy dissipation and peak shear forces,while post-shear joint surface roughness exhibited a negative correlation with peak shear forces through linear regression *** study contributes to a better understanding of the sliding responses and shear mechanical characteristics of rock joints under dynamic disturbances.

关键词： dynamic normal displacement shear strength variations phase lag phenomenon stick-slip

不设院系的跨学科组织创新——以新加坡科技设计大学为例

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现代大学教育 2024年第4期40卷 38-48,112页

作者：林杰刘业青北京师范大学国际与比较教育研究院北京100875

新加坡科技设计大学是世界上第一所完全采用跨学科组织模式的大学。该校不设传统的院系,改设跨学科的四大支柱,以及多学科组成的两大集群,突破了传统大学采用院系与跨学科机构并行的矩阵模式。新加坡科技设计大学的模式有利于资源的灵... 详细信息

新加坡科技设计大学是世界上第一所完全采用跨学科组织模式的大学。该校不设传统的院系,改设跨学科的四大支柱,以及多学科组成的两大集群,突破了传统大学采用院系与跨学科机构并行的矩阵模式。新加坡科技设计大学的模式有利于资源的灵活配置,因应新兴产业需求,通过协同创新解决复杂的重大现实问题。该校基于互补性,构建起同质组织网络,减少因学校规模类型而对跨学科产生的不利影响。新加坡科技设计大学的跨学科模式重树了技术环境的重要性,消融了固定的组织边界,打破了学科的等级制,有利于实现大学的共同治理以及创立跨学科的组织文化。

关键词：新加坡科技设计大学跨学科支柱集群组织创新组织间网络

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Cellular metabolism: A key player in cancer ferroptosis

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Cancer Communications 2024年第2期44卷 185-204页

作者： Xianjie Jiang Qiu Peng Mingjing Peng linda Oyang Honghan Wang Qiang Liu Xuemeng Xu Nayiyuan Wu Shiming Tan Wenjuan yang yaqian Han Jinguan lin Longzheng Xia ya.ya. Tang Xia Luo Jie Dai Yujuan Zhou Qianjin Liao Hunan Key Laboratory of Cancer Metabolism Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangshaHunanP.R.China Public Service Platform of Tumor Organoids Technology ChangshaHunanP.R.China Department of Head and Neck Surgery Hunan Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of MedicineCentral South UniversityChangshaHunanP.R.China Hengyang Medical School University of South ChinaHengyangHunanP.R.China

Cellular metabolism is the fundamental process by which cells maintain growth and *** produces energy,furnishes raw materials,and intermedi-ates for biomolecule synthesis,and modulates enzyme activity to sustain normal cellular *** metabolism is the foundation of cellular life processes and plays a regulatory role in various biological functions,including pro-grammed cell *** is a recently discovered form of iron-dependent programmed cell *** inhibition of ferroptosis plays a crucial role in tumorigenesis and tumor ***,the role of cellular metabolism,particularly glucose and amino acid metabolism,in cancer ferroptosis is not well ***,we reviewed glucose,lipid,amino acid,iron and sele-nium metabolism involvement in cancer cell ferroptosis to elucidate the impact of different metabolic pathways on this ***,we provided a detailed overview of agents used to induce cancer *** explained that the metabolism of tumor cells plays a crucial role in maintaining intracellu-lar redox homeostasis and that disrupting the normal metabolic processes in these cells renders them more susceptible to iron-induced cell death,resulting in enhanced tumor cell *** combination of ferroptosis inducers and cel-lular metabolism inhibitors may be a novel approach to future cancer therapy and an important strategy to advance the development of treatments.

关键词： cancer therapy cellular metabolism ferroptosis inducer ferroptosis

Research trends in pharmacogenomics of immune diseases:A bibliometric study

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Clinical Research Communications 2024年第3期7卷 13-22页

作者： Xue-Ting Mao Hong-Ting Nie Guan-Ru Chen Xiao-ling Wang Xiao-lin Xu Department of Pharmacy Beijing Children's HospitalCapital Medical UniversityNational Center for Children’s HealthBeijing 100045China. Department of Clinical Pharmacology School of Pharmaceutical SciencesCapital Medical UniversityBeijing 100069China. Department of Clinical Pharmacy Anhui Provincial Children's HospitalHefei 230000China.

Background:Numerous academic studies have explored the utilization of pharmacogenomics in the context of immunologic diseases in recent *** this,there is a notable absence of scientometric analyses focusing on the literature within this ***:This study employs bibliometric methods to systematically categorize the literature pertaining to pharmacogenomics in the context of immune diseases,with the aim of identifying research trends,key areas of interest,and prominent research institutions in this ***:Scientometric analysis compared 812 international publications with 71 Chinese publications,finding that the prevailing international research focus is on the precise dosing and therapy of immunosuppressants like mercaptopurine,a topic more extensively explored than in Chinese ***:It is found that the research focus is centered on precision medication and therapy,with a particular emphasis on the utilization of different immunosuppressants like mercaptopurine and ***,it is anticipated that precision dosing of emerging immunosuppressants like sirolimus will be a significant are a of future research.

关键词： pharmacogenomics immunization American Science Citation Index Online Edition bibliometrics analysis CiteSpace