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国家儿童区域医疗中心管理体制与运行机制的实践探索

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中华医院管理杂志 2024年第4期40卷 241-247页

作者：吴红燕张晓敏高静陈昊彬成怡冰罗淑颖于映映周崇臣郑州大学附属儿童医院/河南省儿童医院郑州儿童医院郑州450018 郑州大学附属儿童医院/河南省儿童医院郑州儿童医院区域中心办公室郑州450018 郑州大学附属儿童医院/河南省儿童医院郑州儿童医院院办公室郑州450018 郑州大学附属儿童医院/河南省儿童医院郑州儿童医院急诊科郑州450018 郑州大学附属儿童医院/河南省儿童医院郑州儿童医院科研办郑州450018

党的二十大报告对促进优质医疗资源扩容和区域均衡布局进行了重大部署,国家区域医疗中心建设是落实落地的重要举措。河南省儿童医院郑州儿童医院(北京儿童医院郑州医院)国家儿童区域医疗中心在"三个共建"建立的国家、省、市多重管理体制... 详细信息

党的二十大报告对促进优质医疗资源扩容和区域均衡布局进行了重大部署,国家区域医疗中心建设是落实落地的重要举措。河南省儿童医院郑州儿童医院(北京儿童医院郑州医院)国家儿童区域医疗中心在"三个共建"建立的国家、省、市多重管理体制下,系统梳理了中心的内外部议事决策机制,建立了管理、人才、学科、体系四大方面的管理体制和运行机制,并在人才引进培养、薪酬分配、双向交流、考核激励、学科建设、技术应用、科技创新共享评价、院校科教联动融合、分级诊疗体系构建等方面进行了探索。文章从因地制宜建设、加强内部协同、优化外部保障等方面提出建议,以期为其他国家区域医疗中心建设项目的深入推进提供实践参考。

关键词：医院,公立国家区域医疗中心医院,儿科管理体制运行机制

术前外周血炎症相关指标对肾透明细胞癌Fuhrman分级预测价值的研究

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临床外科杂志 2024年第5期32卷 532-536页

作者：李浩于莹莹宋祥伟张鹤骞滕立臣哈尔滨医科大学附属肿瘤医院泌尿外科 150081 黑龙江省齐齐哈尔市第一医院

目的探讨全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)、白蛋白与球蛋白比值(AGR)以及热休克蛋白90α(HSP90α)对肾透明细胞癌(ccRCC)Fuhr... 详细信息

目的探讨全身免疫炎症指数(SII)、全身炎症反应指数(SIRI)、中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)、血小板与淋巴细胞比值(PLR)、白蛋白与球蛋白比值(AGR)以及热休克蛋白90α(HSP90α)对肾透明细胞癌(ccRCC)Fuhrman分级的预测价值。方法2019年10月~2022年8月因ccRCC行手术治疗的病人212例,根据Fuhrman分级情况,分为低级别肿瘤组和高级别肿瘤组。通过单因素和多因素Logistic回归分析确定Fuhrman分级的独立影响因素,绘制受试者工作特征曲线(ROC)评估各炎症指标对Fuhrman分级的预测价值,构建列线图预测模型,并评估预测模型的有效性。结果术前SII、PLR、AGR、HSP90α水平和肿瘤最大径在高级别组与低级别组间比较,差异有统计学意义(P<0.05)。Logistic回归分析显示,肿瘤最大径、PLR、AGR和HSP90α是Furhman分级的独立影响因素。绘制ROC曲线发现,术前PLR、AGR和HSP90α预测Furhman分级的曲线下面积(AUC)分别为0.641、0.675和0.696。此外,Furhman分级列线图预测模型具备较好的预测能力,AUC为0.789(95%CI:0.717~0.862),敏感度为61.80%,特异度为85.40%。结论外周血炎症相关指标是ccRCC Furhman分级的影响因素,基于肿瘤最大径和外周血炎症指标构成的Furhman分级列线图预测模型具备较好的预测能力。

关键词：肾细胞癌炎症指标 Furhman分级预测价值

Fast Zn^(2+)mobility enabled by sucrose modified Zn^(2+)solvation structure for dendrite-free aqueous zinc battery

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Nano Research 2023年第3期16卷 3839-3846页

作者： yufang Cao Xiaohui Tang Linge Li Haifeng Tu yuzhen Hu yingying yu Shuang Cheng Hongzhen Lin Liwen Zhang Jiangtao Di Yongyi Zhang Meinan Liu School of Nano-Tech and Nano-Bionics University of Science and Technology of ChinaHefei 230026China Key Laboratory of Multifunctional Nanomaterials and Smart Systems Advanced Materials DivisionSuzhou Institute of Nano-Tech and Nano-BionicsChinese Academy of SciencesSuzhou 215123China Division of Nanomaterials and Jiangxi Key Lab of Carbonene Materials Jiangxi Institute of NanotechnologyNanchang 330200China

Aqueous zinc battery has been regarded as one of the most promising energy storage systems due to its low cost and environmental ***,the safety concern on Zn anodes caused by uncontrolled Zn dendrite growth in aqueous electrolyte hinders their ***,sucrose with multi-hydroxyl groups has been introduced into aqueous electrolyte to modify Zn^(2+)solvation environment and create a protection layer on Zn anode,thus effectively retarding the growth of zinc *** simulations and experiments confirm that sucrose molecules can enter into the solvation sheath of Zn^(2+),and the as-formed unique solvation structure enhances the mobility of Zn^(2+).Such fast Zn^(2+)kinetics in sucrose-modified electrolyte can successfully suppress the dendrite *** this sucrose-modified aqueous electrolyte,Zn/Zn symmetric cells present more stable cycle performance than those using pure aqueous electrolyte;Zn/C cells also deliver an impressive higher energy density of 129.7 Wh·kg^(−1)and improved stability,suggesting a great potential application of sucrose-modified electrolytes for future Zn batteries.

关键词： solvation structure Zn^(2+)mobility dendrite suppression sucrose

经颈静脉肝内门体静脉分流术降低门静脉高压对外周免疫细胞的影响及免疫变化与肝性脑病的关系

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传染病信息 2024年第2期37卷 124-131页

作者：左焱玫余滢滢潘仕达沈颖娟苏楠孟繁平解放军总医院第五医学中心生物损伤与救治科北京100039

目的本研究旨在分析经颈静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)降低门静脉高压对外周免疫细胞的影响及免疫变化与肝性脑病的关系。方法收集2020年10月—2022年10月在解放军总医院第五医学中心行T... 详细信息

目的本研究旨在分析经颈静脉肝内门体静脉分流术(transjugular intrahepatic portosystemic shunt,TIPS)降低门静脉高压对外周免疫细胞的影响及免疫变化与肝性脑病的关系。方法收集2020年10月—2022年10月在解放军总医院第五医学中心行TIPS治疗的39例肝硬化患者的临床资料,包括TIPS术前、术后1周及术后12周的实验室检查结果,以及肝性脑病的发生情况,分析外周免疫细胞的变化情况及其与肝性脑病的相关性。结果与基线相比,TIPS术后1周,白细胞(white blood cell,WBC)、中性粒细胞绝对值(absolute neutrophil cell,ANC)、单核细胞绝对值(absolute monocytes cell,AMC)、CD8+T细胞水平均升高,差异有统计学意义(P均<0.05);术后12周,WBC、CD8+T细胞、T淋巴细胞水平均升高,差异有统计学意义(P均<0.05)。单因素Logistic回归分析表明,年龄≥57岁(P=0.020)、TIPS术后1周丙氨酸氨基转移酶(alanine aminotransferase,ALT)≥1 ULN(正常上限值)(P=0.041)、TIPS前中度贫血(P=0.083)和TIPS术后1周ANC<1 ULN(P=0.051)可能是肝性脑病发生的危险因素。将上述因素纳入多因素Logistic回归分析,结果显示年龄≥57岁(OR=8.333,95%CI:1.474~47.114)、TIPS术后1周ALT≥1 ULN(OR=7.433,95%CI:1.257~43.949)是肝性脑病发生的风险因素,TIPS术后1周ANC<1 ULN(OR=0.140,95%CI:0.025~0.987)是肝性脑病发生的保护因素。使用受试者工作特征(receiver operatingcharacteristic,ROC)曲线评估预测准确性,结果提示TIPS术后1周ANC<1 ULN的ROC曲线下面积为0.835(95%CI:0.695~0.974,P=0.000),提示具有较显著的预测价值。结论WBC、CD8+T细胞水平在TIPS术后1周及12周增加;ANC、AMC水平在TIPS术后1周增加,术后12周恢复。中性粒细胞绝对值的早期变化可以预测肝性脑病的发生。

关键词：经颈静脉肝内门体静脉分流术免疫功能肝性脑病门静脉高压

Upper bounds on the capacity for optical intensity channels with AWGN

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Science China(Information Sciences) 2017年第2期60卷 165-176页

作者： yingying yu Zaichen ZHANG Liang WU Jian DANG National Mobile Communications Research Laboratory Southeast University

The channel capacity of the optical wireless communication(OWC) systems is still a problem that has not an optimal and close-form expression, in spite of OWC can be used to achieve high data rates. This paper presents novel upper bounds on the channel capacity of an optical intensity modulated and directed detection(IM/DD) system under peak-power and average-power constraints. The channel is modeled as an additive white Gaussian noise(AWGN) optical channel. The bounds are derived based on sphere-based signal space argument. Simulation results show the proposed bounds are tight at both high and low signal-to-noise ratios(SNRs). Compared to those reported bounds, the derived bounds are better at high SNRs region in particular, and the expressions are simpler and unique for the whole range of average-to-peak-power ratio.

关键词： channel capacity optical communication AWGN sphere-based signal space high signal-to-noise ratios(SNRs)

Development of Spectral Features for Monitoring Rice Bacterial Leaf Blight Disease Using Broad-Band Remote Sensing Systems

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Phyton-International Journal of Experimental Botany 2024年第4期93卷 745-762页

作者： Jingcheng Zhang Xingjian Zhou Dong Shen Qimeng yu Lin yuan yingying Dong College of Artificial Intelligence Hangzhou Dianzi UniversityHangzhou310018China School of Information Engineering Zhejiang University of Water Resources and Electric PowerHangzhou310018China Key Laboratory of Digital Earth Science Aerospace Information Research InstituteChinese Academy of SciencesBeijing100094China

As an important rice disease, rice bacterial leaf blight (RBLB, caused by the bacterium Xanthomonas oryzae ***), has become widespread in east China in recent years. Significant losses in rice yield occurred as a result ofthe disease’s epidemic, making it imperative to monitor RBLB at a large scale. With the development of remotesensing technology, the broad-band sensors equipped with red-edge channels over multiple spatial resolutionsoffer numerous available data for large-scale monitoring of rice diseases. However, RBLB is characterized by rapiddispersal under suitable conditions, making it difficult to track the disease at a regional scale with a single sensorin practice. Therefore, it is necessary to identify or construct features that are effective across different sensors formonitoring RBLB. To achieve this goal, the spectral response of RBLB was first analyzed based on the canopyhyperspectral data. Using the relative spectral response (RSR) functions of four representative satellite or UAVsensors (i.e., Sentinel-2, GF-6, Planet, and Rededge-M) and the hyperspectral data, the corresponding broad-bandspectral data was simulated. According to a thorough band combination and sensitivity analysis, two novel spectralindices for monitoring RBLB that can be effective across multiple sensors (i.e., RBBRI and RBBDI) weredeveloped. An optimal feature set that includes the two novel indices and a classical vegetation index was *** capability of such a feature set in monitoring RBLB was assessed via FLDA and SVM algorithms. The resultdemonstrated that both constructed novel indices exhibited high sensitivity to the disease across multiple ***, the feature set yielded an overall accuracy above 90% for all sensors, which indicates its cross-sensorgenerality in monitoring RBLB. The outcome of this research permits disease monitoring with different remotesensing data over a large scale.

关键词： Rice bacterial leaf blight analysis of spectral response multispectral data simulation vegetation indices cross-sensor disease monitoring

Making the Complicated Simple:A Minimizing Carrier Strategy on Innovative Nanopesticides

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Nano-Micro Letters 2024年第10期16卷 31-46页

作者： Wenjie Shangguan Qiliang Huang Huiping Chen yingying Zheng Pengyue Zhao Chong Cao Manli yu Yongsong Cao Lidong Cao State Key Laboratory for Biology of Plant Diseases and Insect Pests Institute of Plant ProtectionChinese Academy of Agricultural SciencesBeijing 100193People's Republic of China College of Plant Protection China Agricultural UniversityBeijing 100193People's Republic of China State Key Laboratory of Element-Organic Chemistry Department of Chemical BiologyCollege of ChemistryNankai UniversityTianjin 300071People's Republic of China

The flourishing progress in nanotechnology offers boundless opportunities for agriculture,particularly in the realm of nanopesticides research and ***,concerns have been raised regarding the human and environmental safety issues stemming from the unrestrained use of non-therapeutic nanomaterials in *** is also important to consider whether the current development strategy of nanopesticides based on nanocarriers can strike a balance between investment and return,and if the complex material composition genuinely improves the efficiency,safety,and circularity of ***,we introduced the concept of nanopesticides with minimizing carriers(NMC)prepared through prodrug design and molecular self-assembly emerging as practical tools to address the current limitations,and compared it with nanopesticides employing non-therapeutic nanomaterials as carriers(NNC).We further summarized the current development strategy of NMC and examined potential challenges in its preparation,performance,and ***,we asserted that the development of NMC systems can serve as the innovative driving force catalyzing a green and efficient revolution in nanopesticides,offering a way out of the current predicament.

关键词： Nanopesticides Green agrochemicals Self-assembly Nanomaterial safety Sustainable development strategies

Immune checkpoint inhibitors break whose heart? Perspectives from cardio-immuno-oncology

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Genes & Diseases 2024年第2期11卷 807-818页

作者： yingying He Hui yu Shuang Dai Miao He Ling Ma Zihan Xu Feng Luo Li Wang Oncology Department Deyang People's HospitalDeyangSichuan 618000China Department of Medical Oncology Lung Cancer CenterWest China HospitalSichuan UniversityChengduSichuan 610000China Cardiovascular Department Mianyang Central HospitalMianyangSichuan 621000China Department of Rheumatology and Immunology Deyang People's HospitalDeyangSichuan 618000China

Immune checkpoint inhibitors (ICIs) are monoclonal antibody antagonists,which can block cytotoxic T lymphocyte antigen-4 (CTLA-4),programmed death-1/ligand-1 (PD-1/PD-L1) pathways,and other molecules exploited by tumor cells to evade T cell-mediated immune *** have transformed the treatment landscape for various cancers due to their amazing *** anti-tumor therapies,including targeted therapy,radiotherapy,and chemotherapy,combine ICIs to make the treatment more ***,the off-target immune activation caused by ICIs may lead to a broad spectrum of immune-related adverse events (irAEs) affecting multiple organ *** irAEs,cardiotoxicity induced by ICIs,uncommon but fatal,has greatly offset survival benefits from ICIs,which is heartbreaking for both patients and ***,such cardiotoxicity requires special vigilance,and it has become a common challenge both for patients and *** article reviewed the clinical manifestations and influence of cardiotoxicity from the view of patients and clinicians,elaborated on the underlying mechanisms in conjunction with animal studies,and then attempted to propose management strategies from a cardio-immuno-oncology multidisciplinary perspective.

关键词： Cancer management Cardio-immuno-oncology multidisciplinary Cardiotoxicity Immune checkpoint inhibitors Immune tolerance

“省属县用”改革下助理全科规培基地“分层督导式”教学门诊的实践研究

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中国高等医学教育 2024年第5期 19-21页

作者：吴玲燕宋筱筱俞莹莹王卫华余馨妍刘倩倩王靓童钰铃浙江大学医学院附属第二医院浙江杭州310009 遂昌县人民医院浙江遂昌323300

目的:探讨“分层督导式”教学门诊提升指导医师的教学能力的实践效果。方法:在助理全科规培基地开展“分层督导式”教学门诊,比较培训前后指导医师的SOAP病历批改及门诊带教能力的差异。结果:培训后指导医师在SOAP病历批改及门诊带教能... 详细信息

目的:探讨“分层督导式”教学门诊提升指导医师的教学能力的实践效果。方法:在助理全科规培基地开展“分层督导式”教学门诊,比较培训前后指导医师的SOAP病历批改及门诊带教能力的差异。结果:培训后指导医师在SOAP病历批改及门诊带教能力上均有显著提升。结论:“分层督导式”教学门诊可提升指导医师的教学能力。

关键词：师资队伍建设省属县用教学门诊助理全科规培基地全科医生