摘要：从患者、家属、医生三方参与医疗决策的理论依据出发,对医患共同决策过程中决策权利配置的公平与效率问题进行了探讨。首先对三方决策权的主要争议进行了辨析,然后设计出权责对等和社会关照等可操作的医疗服务决策权配置原则,进而提出明确权利行使顺序、规范权利制衡机制、提高医疗决策能力等优化医疗服务决策权配置的对策。认为患者最佳利益的第一守护者是患者本人,家属和医生是居于补充地位的第二守护者,而公权力的执掌者是居于最后一道防线的第三守护者。

摘要：目的:评价羌月乳膏治疗儿童亚急性和慢性湿疹的临床有效性及安全性。方法:采用多中心、分层区组随机、双盲、安慰剂平行对照的设计方法。以中心为分层因素,计划入选240例,按1∶1随机分为试验组和对照组。试验组采用羌月乳膏,对照组采用基质乳膏,均涂敷于患处,每日3次,疗程4周。以靶皮损形态疗效、面积疗效、瘙痒疗效的有效率为主要有效性评价指标。结果:治疗2周及4周后,试验组靶皮损形态的有效率(46.96%、60.87%)均高于对照组(29.66%、44.91%);试验组靶皮损面积有效率(37.39%、55.65%)均高于对照组(22.03%、38.14%);试验组瘙痒疗效的有效率(48.65%、67.57%)均高于对照组(42.24%、51.72%),2组比较差异均有统计学意义(P0.05)。结论:羌月乳膏局部治疗儿童亚急性和慢性湿疹,能显著改善皮损形态,缩小皮损面积,缓解瘙痒症状,且复发率低,具有较好的疗效和安全性。

摘要：体育产业集群品牌的建设正逐步成为集群内体育企业提高市场竞争力的重要途径,但同时由于其自身公共物品属性,体育产业集群品牌培育也蕴含着风险。通过运用博弈论工具以及经济学基础分析双重途径,推导出体育产业集群品牌风险的形成机理。同时结合现状,对我国体育产业集群品牌建设过程中的现实风险进行深层梳理。在归因分析的基础上,提出了"激励—扶持—保障—监督"四环一线式的体育产业集群风险规避路径,以促进体育产业集群经济更好地发展。

摘要：We report on the ability to create complex 3D flower-like SiO2 in vitro via CaCO3 micropar- icles supported by polyethyleneimine mediated biosilicification under experimentally altered chemical influences. The morphology, structure, composition of the product have been inves- tigated with the X-ray photoelectron spectrum, scanning electron microscope, transmission electron microscope, and energy-dispersive spectroscopy. Tile overall morphologies could be controlled to shift from a characteristic network of flower-like silica sphere to a sheet-like structure by adjusting physical adsorption of different amount of polyethyleneimine onto the surface of the CaCO3 microparticles.

摘要：目的探讨虫草素(cordycepin,COR)减轻庆大霉素(gentamicin,GEN)肾毒性的作用及其抑制GEN诱导的氧化应激和细胞铁死亡的分子机制。方法将SD大鼠分为对照组、GEN组与GEN+COR组3组,动物模型构建成功后,检测各组大鼠血清肌酐和尿素氮水平,HE染色评价肾脏组织损伤程度。另外,检测各组SD大鼠肾脏组织中丙二醛和谷胱甘肽含量,并通过Western blot的方法分析细胞铁死亡标志蛋白GPX4、SLC7A11表达。结果与对照组相比,GEN组大鼠血清肌酐、尿素氮明显升高(P<0.01),同时给予50 mg·kg-1 COR后有效降低肌酐与尿素氮水平,HE结果也显示COR能够缓解GEN造成的肾脏组织损伤;COR可逆转GEN造成的大鼠肾脏组织中丙二醛水平升高与谷胱甘肽水平下降。同时,COR能够恢复GEN诱导的GPX4、SLC7A11蛋白水平下降。结论COR能够通过减轻细胞氧化应激与铁死亡缓解GEN造成的肾损伤。

摘要：本试验选用24只3-3.5月龄的波德代(♂)×蒙古羊(♀)和陶赛特(♂6)×蒙古羊(♀)杂交一代羔羊,按2×2×2因子设计,研究了两个营养水平下以高果胶的甜菜粕取代小麦的全混合颗粒饲料对两种羔羊瘤胃pH值的影响。结果表明,低营养水平组的pH值显著高于高营养水平组(P=0.015);食后4 h(P-0.019)、6 h(P=0.009)的pH值在营养水平和饲料间存在互作,高营养水平组,小麦组羔羊的瘤胃液pH高于甜菜粕组,而低营养水平组、甜菜粕组的pH高于小麦组;羊品种对pH值无影响。

摘要：As an emerging technology to promote the combination of medicine and industry,the three-dimensional(3D)printing has developed rapidly in the fields of orthopedics,while its unique advantages in improving precise treatment still need to be further *** this report,our team have exhibited several classic cases of integrating 3D printing into orthopedic clinical application,thereby further elaborating thoughts and opinions on the significance of 3D printing in the orthopedic clinical application,technical advantages,existing main problems and coping strategies.

摘要：本文基于第3代非支配排序遗传算法(NSGA-Ⅲ)开展了多目标屏蔽智能优化方法研究。以乏燃料运输船舶为对象,采用多目标智能优化程序建立一维离散纵标计算模型,针对舱盖上方区域屏蔽结构(混凝土和聚乙烯厚度)进行优化设计,最终得到1组优化的屏蔽方案。基于优化后的屏蔽方案,建立真实的三维蒙特卡罗计算模型,和基于混凝土、聚乙烯或含硼硅树脂的方案进行对比,评估优化方案的屏蔽效果。评价指标包括屏蔽厚度、重量、总剂量率和价格等。结果显示,基于所开发的多目标屏蔽智能优化方法优化得到的方案各有特点,包含了多个优选的方案,为设计者提供了更丰富的选择。

摘要：The interaction between Amyloid β(Aβ) peptide and acetylcholine receptor is the key for our understanding of how Aβ fragments block the ion channels within the synapses and thus induce Alzheimer’s ***,molecular docking and molecular dynamics(MD)simulations were performed for the structural dynamics of the docking complex consisting of Aβ and α7-n ACh R(α7 nicotinic acetylcholine receptor),and the inter-molecular interactions between ligand and receptor were *** results show that Aβ_(25-35) is bound toα7-n ACh R through hydrogen bonds and complementary shape,and the Aβ_(25-35) fragments would easily assemble in the ion channel of α7-n ACh R,then block the ion transfer process and induce neuronal *** simulated amide-I band of Aβ_(25-35) in the complex is located at 1650.5 cm^(-1),indicating the backbone of Aβ_(25-35) tends to present random coil conformation,which is consistent with the result obtained from cluster *** existing drugs were used as templates for virtual screening,eight new drugs were designed and semi-flexible docking was performed for their *** results show that,the interactions between new drugs and α7-n ACh R are strong enough to inhibit the aggregation of Aβ_(25-35) fragments in the ion channel,and also be of great potential in the treatment of Alzheimer’s disease.

摘要：针对顾客需求不确定和部分设施节点失效情况下闭环供应链网络设计问题,考虑网络结构复杂度,以最小化闭环供应链运营成本和维护成本为优化目标,构建非线性混合整数规划模型.采用鲁棒对等式理论处理需求不确定性,采用情景分析方法处理单一设施节点中断不确定性;采用信息熵理论量化网络结构复杂度并采用分段线性逼近方法进行结构复杂度线性重构,构建混合不确定因素影响下的鲁棒优化模型,利用Gurobi求解进行节点开放及流量分配决策.针对算例,将鲁棒优化模型与随机规划模型进行对比,结果显示,考虑网络结构复杂度进行网络设计,与随机规划模型相比,鲁棒优化模型的目标函数值在不确定情景下的波动幅度显著减小,表明模型具有较好的抵抗外部风险的能力.