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CBL联合线上教学在风湿免疫科住院医师规范化培训中的应用研究

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中华医学教育探索杂志 2023年第11期22卷 1705-1708页

作者：景嵘月徐蕾徐长松徐媚媚郭亮陈月月朱亚梅徐波南京中医药大学附属南京中医院风湿病科南京210000

目的探讨以病例为基础的学习(case based learning,CBL)联合线上教学在风湿免疫科住院医师规范化培训中的效果。方法纳入2019年6月至2020年8月本院风湿免疫科参加住院医师规范化培训的人员78人,分为观察组与对照组。对照组采用传统教学... 详细信息

目的探讨以病例为基础的学习(case based learning,CBL)联合线上教学在风湿免疫科住院医师规范化培训中的效果。方法纳入2019年6月至2020年8月本院风湿免疫科参加住院医师规范化培训的人员78人,分为观察组与对照组。对照组采用传统教学,观察组采用CBL联合线上教学。通过理论考试、临床操作技能考核、带教教师评分对住院医师规范化培训医师进行评价;同时开展对带教教师教学满意度、教学方式满意度及课堂学习氛围的评价。结果观察组理论考试成绩[(94.10±2.01)分]、临床操作技能考核成绩[(90.44±1.57)分]与对照组相比明显提高(P<0.05),观察组对带教教师评分(89.36±1.33)也优于对照组,差异具有统计学意义(P<0.05)。观察组对教学满意度评价(3.79±0.41)、教学方式满意度评价(3.92±0.27)以及课堂学习氛围评价(3.90±0.31)均高于对照组,差异具有统计学意义(P<0.05)。结论CBL联合线上教学更有助于提高住培学员的学习效率、激发学习热情、拓展临床思维、促使教学相长、形成良性循环,值得进一步探讨。

关键词：以病例为基础的学习线上教学风湿免疫住院医师规范化培训

被动抬腿试验和停止超滤对血液透析患者透析相关性低血压的影响

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实用临床医药杂志 2021年第7期25卷 111-114页

作者：许贤荣马逊朱亚梅杨莉杨家慧俞香宝毛慧娟邢昌赢南京医科大学第一附属医院/江苏省人民医院肾内科江苏南京210029

目的观察被动抬腿(PLR)试验和停止超滤对血液透析相关低血压患者的影响。方法采用随机自身交叉对照研究设计,记录并比较52例血液透析低血压患者PLR、停止超滤的血压变化和超滤目标情况。结果所有患者在实施PLR、停止超滤前的血液透析时... 详细信息

目的观察被动抬腿(PLR)试验和停止超滤对血液透析相关低血压患者的影响。方法采用随机自身交叉对照研究设计,记录并比较52例血液透析低血压患者PLR、停止超滤的血压变化和超滤目标情况。结果所有患者在实施PLR、停止超滤前的血液透析时收缩压(SBP)、舒张压(DBP)、心率比较,差异无统计学意义(P> 0.05)。发生低血压时,PLR与停止超滤均可升高血压,在实施10 min后均可明显升高SBP,差异有统计学意义(P <0.05)。采用PLR 10、20、30 min时,DBP升高的差异有统计学意义(P <0.05或P <0.01),停止超滤对DBP无影响。PLR与停止超滤均可以接近达成血液透析净脱水目标,但实际超滤量均较预设超滤量减少,差异有统计学意义(P <0.05)。结论血液透析患者发生低血压时,可以采取PLR和停止超滤升高血压。PLR既能升高血压,也能达到目标超滤量。

关键词：血液透析透析中低血压被动抬腿试验停止超滤

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LTCC生瓷带缺陷分析与改善对策

电子工艺技术 2024年第4期45卷 59-62页

作者：吴纪锐张志伟陈樱琳朱思新林亚梅深圳振华富电子有限公司广东深圳518000

针对低温共烧陶瓷10~40μm生瓷带生产过程中遇到的缺陷问题,从材料、工艺等多个方面做了详细的分析与验证,确定了导致缺陷的根本原因。提出了通过优化材料形貌、调整浆料配方、控制流延工艺等措施,改善了生瓷带的生产缺陷。

关键词：生瓷带缺陷分析缺陷改善

心血管手术相关急性肾损伤患者行连续性肾脏替代治疗后的预后因素分析

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中华肾病研究电子杂志 2020年第4期9卷 159-165页

作者：刘珊邬步云刘康俞香宝朱亚梅邵永丰赵胜邢昌赢毛慧娟南京医科大学第一附属医院肾内科 210029 连云港市第二人民医院肾内科 222000 南京医科大学第一附属医院心脏大血管外科 210029

目的探讨心血管手术相关急性肾损伤患者行连续性肾脏替代治疗后不同预后的相关因素。方法本研究纳入2015年1月至2018年12月在南京医科大学第一附属医院住院行心血管手术治疗且接受连续性肾脏替代治疗的患者,按90 d是否死亡和90 d内RRT... 详细信息

目的探讨心血管手术相关急性肾损伤患者行连续性肾脏替代治疗后不同预后的相关因素。方法本研究纳入2015年1月至2018年12月在南京医科大学第一附属医院住院行心血管手术治疗且接受连续性肾脏替代治疗的患者,按90 d是否死亡和90 d内RRT治疗天数(≤14 d,15~90 d,>90 d)将患者分为4组,分析90 d死亡、90 d透析依赖、90 d延迟摆脱透析的相关影响因素。结果本研究共纳入210例患者,平均随访400 d。其中90 d死亡114例,90 d生存且14 d内摆脱透析37例,90 d生存15~90 d内摆脱透析46例,90 d生存且透析依赖13例。多因素Cox回归显示:90 d死亡的独立危险因素包括高龄(HR=1.029,95%CI:1.013~1.045,P<0.001)、术前血清肌酐低(HR=0.993,95%CI:0.987~0.998,P=0.008)、CRRT前APACHEⅡ高评分(HR=1.043,95%CI:1.004~1.084,P=0.028)、CRRT前SOFA评分高(HR=1.130,95%CI:1.052~1.213,P<0.001)、CRRT前脓毒症(HR=2.327,95%CI:1.591~3.403,P<0.001)、CRRT前过低的舒张压(HR=0.979,95%CI:0.963~0.996,P=0.013)。90 d存活患者透析依赖的独立危险因素包括术前较低的eGFR(HR=0.962,95%CI:0.940~0.984,P<0.001)。90 d存活患者中延迟摆脱透析的危险因素有血清白蛋白低(OR=0.837,95%CI:0.717~0.977,P=0.024)、机械通气时间长(OR=1.434,95%CI:1.175~1.749,P<0.001)、CRRT前尿量少(OR=0.739,95%CI:0.623~0.876,P<0.001)。结论心血管手术相关急性肾损伤并行连续性肾脏替代治疗患者中,90 d死亡与高龄、CRRT前疾病的严重程度、脓毒症和过低的舒张压有关;90 d存活患者透析依赖与患者术前较差的肾功能有关;90 d存活患者延迟摆脱透析与血清白蛋白低、机械通气时间长、CRRT前尿量少有关。

关键词：心血管手术相关急性肾损伤连续性肾脏替代治疗预后

Comparative analysis of plastomes in Oxalidaceae:Phylogenetic relationships and potential molecular markers

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Plant Diversity 2021年第4期43卷 281-291页

作者： Xiaoping Li yamei Zhao Xiongde Tu Chengru Li Yating zhu Hui Zhong Zhong-Jian Liu Shasha Wu Junwen Zhai Key Laboratory of National Forestry and Grassland Administration for Orchid Conservation and Utilization at College of Landscape Architecture Fujian Agriculture and Forestry UniversityFuzhou 350002China

The wood sorrel family,Oxalidaceae,is mainly composed of annual or perennial herbs,a few shrubs,and trees distributed from temperate to tropical *** of Oxalidaceae are of high medicinal,ornamental,and economic *** the rich diversity and value of Oxalidaceae,few molecular markers or plastomes are available for phylogenetic analysis of the ***,we reported four new whole plastomes of Oxalidaceae and compared them with plastomes of three species in the family,as well as the plastome of Rourea microphylla in the closely related family *** eight plastomes ranged in length from 150,673 bp(Biophytum sensitivum)to 156,609 bp(***).Genome annotations revealed a total of 129e131 genes,including 83e84 protein-coding genes,eight rRNA genes,37 tRNA genes,and two to three *** analyses showed that the plastomes of these species have minor variations at the gene *** smaller plastomes of herbs *** and three Oxalis species are associated with variations in IR region sizes,intergenic region variation,and gene or intron *** identified sequences with high variation that may serve as molecular markers in taxonomic studies of *** phylogenetic trees of selected superrosid representatives based on 76 protein-coding genes corroborated the Oxalidaceae position in Oxalidales and supported it as a sister to *** research also supported the monophyly of the COM(Celastrales,Oxalidales,and Malpighiales)clade.

关键词： Oxalidaceae Plastome Oxalidales Gene loss COM clade Phylogeny

达芬奇机器人辅助下肝癌根治术的临床疗效及围手术期护理路径的构建

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机器人外科学杂志（中英文） 2024年第3期5卷 392-398页

作者：刘竹曾月薇谭洁陈秋蓉骆阳阳杨亚梅德阳市人民医院肝胆外科四川德阳618000 成都市第三人民医院普外科四川成都610014 四川大学华西第二医院血液肿瘤科四川成都610041 四川省医学科学院·四川省人民医院肝胆外科四川成都610000

目的:探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。方法:选取2020年1月—2022年12月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治术的80例患者,采用随机数字表法将其分... 详细信息

目的:探究达芬奇机器人辅助下肝癌根治术的临床疗效以及护理路径在患者围手术期的应用效果。方法:选取2020年1月—2022年12月在四川省人民医院和成都市第三人民医院接受达芬奇机器人辅助下肝癌根治术的80例患者,采用随机数字表法将其分为研究组和对照组,各40例。对照组给予常规护理干预,研究组给予临床护理路径(CNP)。对比两组临床疗效、肝功能指标、生活质量评分、心理状态评分及住院指标。结果:所有手术均顺利完成,仅有1例胆漏,3例肝断面积液,经保守治疗后相关患者症状均消失;随访6~36个月所有患者均无复发或死亡;比较两组术后肝功能指标、各项生活质量评分、心理状态评分,差异具有统计学意义(P>0.05);出院前,两组肝功能指标和心理状态评分均明显降低,两组各项生活质量评分均明显升高,且研究组明显优于对照组,差异具有统计学意义(P<0.05);研究组卧床时间、住院时间、住院费用明显低于对照组,差异具有统计学意义(P<0.05)。结论:达芬奇机器人辅助下肝癌根治术能够取得良好的手术效果。同时与传统护理干预措施相比,临床护理路径构建的标准化护理流程能够改善患者肝功能、提高生活质量、调节不良情绪,具有较高的临床应用和推广价值。

关键词：机器人辅助手术肝癌根治术临床护理路径标准化护理流程

Determining antimicrobial resistance profiles and identifying novel mutations of Neisseria gonorrhoeae genomes obtained by multiplexed MinION sequencing

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Science China(Life Sciences) 2020年第7期63卷 1063-1070页

作者： Chi Zhang Feng Wang Cansheng zhu Leshan Xiu yamei Li Li Li Bo Liu Yizhun Li Yaling Zeng Boyang Guo Junping Peng NHC Key Laboratory'of Systems Biology of Pathogens Institute of Pathogen BiologyChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100176China Shenzhen Center for Chronic Disease Control Shenzhen 518020China Department of STD Laboratory Shaanxi Provincial Institute for Skin Disease and STD ControlXi'an 710003China

Gonorrhea is one of the most common sexually transmitted diseases worldwide. To cure infection and prevent transmission,timely and appropriate antimicrobial therapy is necessary. Unfortunately, Neisseria gonorrhoeae, the etiological agent of gonorrhea, has acquired nearly all known mechanisms of antimicrobial resistance(AMR), thereby compromising the efficacy of antimicrobial therapy. Treatment failure resulting from AMR has become a global public health concern. Whole-genome sequencing is an effective method to determine the AMR characteristics of N. gonorrhoeae. Compared with next-generation sequencing, the MinION sequencer(Oxford Nanopore Technologies(ONT)) has the advantages of long read length and portability. Based on a pilot study using MinION to sequence the genome of N. gonorrhoeae, we optimized the workflow of sequencing and data analysis in the current study. Here we sequenced nine isolates within one flow cell using a multiplexed sequencing strategy. After hybrid assembly with Illumina reads, nine integral circular chromosomes were obtained. By using the online tool Pathogenwatch and a BLAST-based workflow, we acquired complete AMR profiles related to seven classes of antibiotics. We also evaluated the performance of ONT-only assemblies. Most AMR determinants identified by ONT-only assemblies were the same as those identified by hybrid assemblies. Moreover, one of the nine assemblies indicated a potentially novel antimicrobial-related mutation located in mtrR which results in a frame-shift, premature stop codon, and truncated *** addition, this is the first study using the MinION sequencer to obtain complete genome sequences of N. gonorrhoeae strains which are epidemic in China. This study shows that complete genome sequences and antimicrobial characteristics of *** can be obtained using the MinION sequencer in a simple and cost-effective manner, with hardly any knowledge of bioinformatics required. More importantly, this strategy provid

关键词： nanopore sequencing MinION sequencer Neisseria gonorrhoeae whole-genome sequencing antimicrobial resistance

Morphological and skeletal comparison and ecological adaptability of Mandarin fish Siniperca chuatsi and big-eye Mandarin fish Siniperca kneri

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Aquaculture and Fisheries 2021年第5期6卷 455-464页

作者： XiaoYing Cao JinLiang Zhao ChenHong Li ShuQin zhu YueYue Hao yamei Cheng HongYan Wu Key Laboratory of Freshwater Aquatic Genetic Resources Ministry of AgricultureShanghai Ocean UniversityShanghaiChina Shanghai Collaborative Innovation for Aquatic Animal Genetics and Breeding Shanghai Ocean UniversityShanghaiChina National Demonstration Center for Experimental Fisheries Science Education Shanghai Ocean UniversityShanghaiChina

Most of the closely related fish species are similar in appearance,with slight *** study evaluated 35 morphological characteristic parameters and the number,shape,and spatial location of bones in the skull and vertebrae of the mandarin fish Siniperca chuatsi and big-eye mandarin fish Siniperca *** can understand their ecological adaptability,compare their morphological and skeletal differences,and elucidate the relationship between their phenotypic trait differences and skeletal *** results were as follows:*** Student’s t-test results revealed significant differences between *** and *** in terms of head depth,head back length,snout length,interorbital distance,distance of the eyes from the oral fissure,and width between the posterior trunk and base of the caudal *** component and discriminant analysis showed that the main morphological differences between *** and *** were in the eye position,head hump and body *** was no significant difference in the number and shape of the skull and vertebrae between *** and ***,but they differed in spatial *** terminus of the maxilla in *** is located at the lower border of the postorbital bone,but at the anterior in *** size of head hump is closely related to the spatial location of the splanchnocranium in *** and *** angles between the caudal vertebrae centrum and each of the following:the neural arch and spine;haemal arch and spine of *** are larger than those of *** conclusion,the morphological differences between *** and *** are closely related to the spatial position of *** phenotypic differences reflect the ecological adaptation of mandarin fish to different natural environments.

关键词： Siniperca chuatsi Siniperca kneri Morphology Skeleton Ecological adaptability

组织瓣环运动位移评价心室肥厚患者左室收缩功能

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临床医学研究与实践 2024年第10期9卷 85-89页

作者：贾玄慧亢春苗沈亚梅马盼盼朱媛陕西省人民医院超声诊断中心陕西西安710068

目的探讨组织瓣环运动位移(TMAD)自动追踪技术定量评价心室肥厚患者左室收缩功能的应用价值。方法纳入60例心室肥厚患者,原发性高血压亚组30例,尿毒症亚组30例,纳入35例健康体检者作为对照组。应用二维斑点追踪技术自动获取心尖四腔心... 详细信息

目的探讨组织瓣环运动位移(TMAD)自动追踪技术定量评价心室肥厚患者左室收缩功能的应用价值。方法纳入60例心室肥厚患者,原发性高血压亚组30例,尿毒症亚组30例,纳入35例健康体检者作为对照组。应用二维斑点追踪技术自动获取心尖四腔心切面、心尖两腔心切面二尖瓣环四个位点TMAD值、左心室整体纵向应变(LVGLS)及左室整体圆周应变(LVGCS),应用Bland-Altman法检验TMAD参数一致性及绘制受试者工作特性(ROC)曲线评价TMAD参数的诊断效能。结果原发性高血压亚组和尿毒症亚组的收缩压(SBP)、舒张压(DBP)明显高于对照组(P<0.05);尿毒症亚组的心率(HR)高于原发性高血压亚组及对照组(P<0.05)。尿毒症亚组的TMAD参数及应变参数均明显低于对照组(P<0.05)。原发性高血压亚组的LVGLS、T-AP4sep、T-AP4mid%、T-AP2int、T-AP2ant及T-AP2mid%低于对照组(P<0.05)。ROC曲线结果显示,TMAD各参数对心室肥厚患者左室收缩功能降低具有中等预测价值。结论TMAD可以定量评价心室肥厚患者的左室收缩功能,且可重复性好。

关键词：组织瓣环运动位移心室肥厚尿毒症原发性高血压左室收缩功能斑点追踪技术