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Acta Mathematica Scientia 2020年第2期40卷 470-502页

作者：袁海荣赵勤 School of Mathematical Sciences and Shanghai Key Laboratory of Pure Mathematics and Mathematical PracticeEast China Normal UniversityShanghai 200241China Department of Mathematics School of ScienceWuhan University of TechnologyWuhan 430070China

Transonic shocks play a pivotal role in designation of supersonic inlets and *** the three-dimensional steady non-isentropic compressible Euler system with frictions,we constructe a family of transonic shock solutions in rectilinear ducts with square *** this article,we are devoted to proving rigorously that a large class of these transonic shock solutions are stable,under multidimensional small perturbations of the upcoming supersonic flows and back pressures at the exits of ducts in suitable function *** manifests that frictions have a stabilization effect on transonic shocks in ducts,in consideration of previous works which shown that transonic shocks in purely steady Euler flows are not stable in such *** its implications to applications,because frictions lead to a stronger coupling between the elliptic and hyperbolic parts of the three-dimensional steady subsonic Euler system,we develop the framework established in previous works to study more complex and interesting Venttsel problems of nonlocal elliptic equations.

关键词： Stability transonic shocks Fanno flow three-dimensional Euler system frictions decomposition nonlocal elliptic problem Venttsel boundary condition elliptic-hyperbolic mixed-composite tpe

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The process of transprofessional collaboration:how caregivers integrated the perspectives of rehabilitation through working with a physical therapist

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family Medicine and Community Health 2020年第4期8卷 20-27页

作者： Ryohei Goto Junji Haruta Department of family Medicine General Practice and Community HealthFaculty of MedicineUniversity of TsukubaTsukubaJapan Medical Education Center Keio UniversityTokyoJapan

Objectives To clarify the process of how caregivers in a nursing home integrate the perspectives of rehabilitation into their responsibilities through working with a physical *** This study was conducted under an action research *** The target facility was a nursing home located in *** researcher,a physical therapist,worked at the nursing home once a week from April 2016 to March *** the study period,he created field notes focused on the dialogue and action of caregivers regarding care,responses of caregivers to the physical therapist and reflections as a physical *** were also given a short informal interview about their relationship with the nursing home *** data analysis,two researchers discussed the content based on the field notes,consolidating the *** The participants were caregivers who worked at the target ***-eight caregivers agreed to *** age was 39.6±11.1 years,14(37%)were male and average caregiver experience was 9.8 *** Two cycles of action research were conducted during the study *** were four stages in the process of how caregivers in the nursing home integrated the perspectives of rehabilitation through their work with the physical ***,caregivers resisted having the rehabilitation programme carried out in the unit because they perceived that rehabilitation performed by a physical therapist was a special process and not under their ***,the caregivers were given a shared perspective on rehabilitation by the physical therapist,which helped them to understand the meaning of care to adapt the residents’abilities to their daily *** practised resident-centred care on a trial basis,although with a sense of conflict between their new and previous role,which emphasised the safety of residents’lives and *** caregivers increased their self-efficacy as their knowledge and skills were su

关键词： process rehabilitation approval

Therapeutic targets in the pancreatic adenocarcinoma microenvironment: past challenges and opportunities for the future

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Journal of Cancer Metastasis and Treatment 2021年第1期7卷 448-465页

作者： Erica S.Tsang Margaret A.Tempero Helen Diller family Comprehensive Cancer Center University of California San FranciscoSan FranciscoCA 94158USA

Pancreatic ductal adenocarcinoma(PDAC)remains a leading cause of cancer-related mortality,with cytotoxic chemotherapy still the mainstay of *** effective therapeutic agents alone,successful drug delivery is *** PDAC,the tumor microenvironment represents a physical barrier that limits in vivo drug delivery and *** this review,we highlight therapeutic targets in the tumor microenvironment,focusing on past challenges and opportunities for the *** discussed include the Hedgehog pathway,angiogenesis,hyaluronic acid,cancer-associated fibroblasts and associated cytokines,among *** the obstacles in successfully recapitulating promising lab results to practice-changing clinical results,many important lessons have been learned to improve clinical trial design within a highly engaged and motivated scientific *** collaborative efforts and the collective optimism will continue to propel the momentum forward to overcome these barriers and ultimately improve patient outcomes.

关键词： Pancreatic cancer PDAC tumor microenvironment pancreatic stroma

Primary care for cancers at diagnosis and follow-up:a narrative review

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family Medicine and Community Health 2013年第1期1卷 56-67页

作者： CHEW BOON HOW SRI WAHYU TAHER Department of family Medicine Universiti Putra MalaysiaMalaysia Klinik Kesihatan Simpang Kuala Alor SetarKedahMalaysia

This paper is concerned about the family physician’s role in early cancer diagnosis and follow-up with his/hers patients who have just been diagnosed with cancer;treatment modalities for cancer;and family physician continuous roles for patients who are under definitive cancer treatment,experiencing side-effects of cancer treatment;some of the effective means to reduce these side-effects during cancer treatment and management of oncologic *** some knowledge on the current cancer therapies would undoubtedly help family physicians to follow up patients with cancer more confidently,to appreciate their side-effects,symptomatic treatment,recognize the limit of primary care and be even useful for counseling and consultation with patients or their family members with a family history of *** searches with terms comprised“cancer”,“malignancy”,“primary care”,“general practice”,“cancer AND diagnosis”and“cancer AND follow-up”were done in the major databases such as Pubmed,ScienceDirect and *** employed selective searches with the above terms and their combination in some of the major journal such as The Lancet Oncology,The Lancet,New England Journal of Medicine,*** were followed by snowballing the relevant articles from the citation of references in those selected *** goal of this narrative review is not to provide exhaustive documentation of sound evidence for practice of primary care for cancer patients at diagnosis and *** mainly aims to provide specific evidence-based information and suggestions that are thought to be relevant for primary care professionals and policymakers.

关键词： Cancers Primary care General practice Office visits Diagnosis Survivors

Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women

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Chinese Medical Journal 2007年第10期120卷 868-870页

作者： LI Wei QIU Yi Department of Health Statistics Fourth Military Medical University Xi＇an 710032 China Key Laboratory for Improving Birth Outcome Technique Shandong Institute for Family Planning Jinan 250002 China

Background Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery. Methods A questionnaire was used to obtain data from 101 breasffeeding mothers. The following elements were analyzed： age, education level, breasffeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature （BBT） measurement. Results By ultrasonography, 53 of the 101 women （52.5%） had the first ovulation （follicle 〉1.8 cm in diameter） within 154 days after delivery on average, among whom 11 （10.9%, 11/101） had restoration of ovulation within 4 months and 42 （41.6%, 42/101） had it after 4 months. In women with follicles 〉1.8 cm in diameter （n=53）, the menstruation resumed （138±84） days after delivery, and the supplementary feeding was started at （4.0±1.1） months, which were significantly earlier than those in the women with follicular diameter 〈1.7 cm （n=48; （293±88） days, （5.1±1.3） months; t=9.003, P〈0.01 and t=4.566, P〈0.01）. In the women with follicles 〉1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter 〈1.7 cm had menstrual resumption at the same time （χ^2=16.91, P〈0.01）. The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation （n=100, r=0.4764, P〈0.01） and first ovulation after delivery （n=53, r=0.5554, P〈0.01）. In this series, no woman had pregnancy within 18 months postpartum. Conclusion Supplementary feeding can affect the restoration of menstrua

关键词： postpartum period menstruation ovulation

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Diabetes and hepatocellular carcinoma risks in patients with nonalcoholic steatohepatitis related cirrhosis

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Hepatobiliary Surgery and Nutrition 2020年第3期9卷 357-359页

作者： Chien-Hsieh Chiang Kuo-Chin Huang Department of family Medicine National Taiwan University Hospital&College of MedicineTaipei Department of Community and family Medicine National Taiwan University Hospital Yunlin BranchYunlin Graduate Institute of Pharmacology National Taiwan University College of MedicineTaipei Hepatitis Research Center National Taiwan University HospitalTaipei

Hepatocellular carcinoma(HCC)oncogenesis in the absence of alcoholic liver disease and chronic viral hepatitis has aroused growing clinical concern in clinical practice.

关键词： clinical hepatitis Diabetes

Tunneled peritoneal catheters for the palliative therapy of malignant ascites

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family Medicine and Community Health 2013年第1期1卷 17-22页

作者： YVONNE RYAN KAREN LYONS JOHN HANSEN AISLING O’GORMAN North Eastern General practice Training Scheme Department of Radiology Beaumont HospitalDublin Our Lady of Lourdes Hospital DroghedaCo.Louth

Objective:Malignant ascites presents difficult management issues in the palliative care population and results in distressing symptoms and recurrent hospital *** palliative care services in Our Lady of Lourdes Hospital have been using radiologically guided tunneled peritoneal catheters for the palliative therapy of troublesome malignant *** conducted a review of this management ***:There were 10 catheters inserted in 9 patients between May 2007 and June 2011 in patients with malignant ***:There were no procedural related mortalities or major *** catheter life was 98.9 *** catheter re-hospitalization rate was 1.55 times per *** patient survival post insertion was 140 *** eight percent of patients achieved death at ***:We conclude that this is a safe and useful strategy in the management of malignant ascites in a palliative care population.

关键词： Tunneled peritoneal catheter Palliative therapy Malignant ascites

Analysis on influencing factors of patients experience in community health centers of Shenzhen,China

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中西医结合护理（中英文） 2019年第1期5卷 224-230页

作者： CHANG Feifei CHEN Xianhui HUANG Hong WANG Qiang Department of General practice Pingshan District People's Hospital

Objective To investigate the patients experience in community health centers( CHCs) and explore its associated factors. Methods A cross-sectional study was conducted among 330 patients who visited CHCs in Shenzhen,China from January to March 2018. Dependent variable was patient experience. Key descriptive variables were age,gender,marital status,working status groups,visits frequency for the past 6 months,whether patients had signed a family doctor,whether trusted in family doctor,whether had chronic diseases. Results Questionnaires for 300 patients were assessed. In the univariate analysis,patients experience total score was significantly associated with marital status( P family doctor( P family doctor( P family doctor( P = 0. 023,OR = 0. 44,95% CI: 0. 22-0. 85) were more likely to get a higher score. Conclusions Findings of this study showed a medium-level score of patients experience in the community. Patients had a quite good experience and more interventions should be focused upon the influence factors to improve patients experience.

关键词： patients experience influencing factors community health centers family doctor chronic disease

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INTEGRATION OF A LONGITUDINAL CURRICULUM IN MEDICAL ACUPUNCTURE WITH RESIDENCY TRAINING IN family MEDICINE

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Journal of Integrative Medicine 2014年第3期 314-315页

作者： Richard Hobbs Maine-Dartmouth family Medicine Residency

Objective: To demonstrate that a residency-based model for training physicians in acupuncture is feasible and results in competence, as measured by the certification process of the American Board of Medical ***: The Maine-Dartmouth family Medicine Residency, which is affiliated with the Geisel School of Medicine at Dartmouth College, has for the past five years required all residents to participate in a 300-hour integrative medicine curriculum, as part of a pilot project developed at the University of Arizona Integrative Medicine *** the beginning, an introduction to medical acupuncture has been offered as an approved elective in the integrative medicine *** 2010, a three-year, elective, longitudinal curriculum in medical acupuncture was developed and approved by the Curriculum Committee of the residency *** curriculum was also presented to the American Board of Medical Acupuncture and was accepted as an alternative route for satisfying board *** of the MaineDartmouth longitudinal curriculum include:(a) principles oftraditional Chinese medicine;(b) development of skills in point location, needling, cupping and moxibustion;(c) modern paradigms, including electroacupuncture, French energetics, neuroanatomical approaches, balance methods and microsystems;(d) classical diagnostic methods;(e) reiterative instruction in differentiation of syndromes and treatment planning;(f) Chinese dietary therapy, Tuina, Qigong and other treatment modalities;(g) clinical ***: In 2013, the first resident to complete the program passed the certification examination of the American Board of Medical ***: Benefits of acupuncture training during residency include:(a) a reiterative process as opposed to linear learning;(b) enhanced opportunities for supervised clinical practice as part of acupuncture training;(c) preparation for seamless integration of acupuncture into a primary care practice.

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Peptic ulcer and childhood adversities experienced by working-aged people

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World Journal of Gastroenterology 2009年第27期15卷 3405-3410页

作者： Markku PT Sumanen Markku J Koskenvuo Lauri H Sillanmki Kari J Mattila Kangasala Health Center and Medical School University of TampereFI 33014 Finland Department of Public Health University of HelsinkiFI 00014 Finland Department of General practice University of Tampere Medical School and Hospital District of PirkanmaaFI 33014 Finland

AIM: To study the association between self-reported peptic ulcer and childhood ***: The Health and Social Support Study (HeS-Sup) population consisted of a stratif ied random sample drawn from the Finnish Population Register in four age groups: 20-24, 30-34, 40-44 and 50-54. The survey was carried out by postal questionnaire during 1998, with a response rate of 40.0%. A follow-up questionnaire was sent during 2003 to all those who responded to the f irst. Altogether 19 626 individuals returned the follow-up questionnaire; a response rate of 75.8%. The subjects were asked whether a doctor had told them that they have or have had peptic ulcer. The analyses covered those who responded aff irmatively to both the baseline and the follow-up enquiries (n = 718). Those not re-porting a peptic ulcer in either of the two questionnaires (n = 17 677) were taken as controls. The subjects were further requested (through six questions) to think about their childhood ***: The most common adversities mentioned were long-lasting financial difficulties in the family, serious conflicts in the family, and a family member seriously or chronically ill. All the adversities reported, except parental divorce, were more common among peptic ulcer patients than among controls (P values varied between < 0.001 and 0.003). Age- and sex-adjusted odds ratios (OR) of childhood adversities in the multivariate logistic analysis for self-reported pep-tic ulcer varied between 1.45 and 2.01. Adjusting for smoking, heavy drinking, stress and nonsteroidal anti-inflammatory drug use had no further influence (ORs between 1.22 and 1.73).CONCLUSION: Our findings suggest that childhood adversities maintain a connection with and have a predictive role in the development of peptic ulcer.

关键词：消化性溃疡工作经验老年人逆境童年