2nd International Symposium on Imprecise Probabilities and Their Applications, Ithaca, New

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SGLT2_抑制剂联合二甲双胍治疗对糖尿病肾病患者血糖及疗效的影响

SGLT2_抑制剂联合二甲双胍治疗对糖尿病肾病患者血糖及疗效的影响

SGLT2抑制剂联合二甲双胍治疗对糖尿病肾病患者血糖及疗效的影响郑秋娥,程秋敏,刘江建福建省立医院药学部,福建福州350001[摘要]目的分析钠-葡萄糖共转运蛋白2(sodium-dependent glucose transporters 2, SGLT2)抑制剂联合二甲双胍治疗对糖尿病肾病患者血糖及疗效的影响。

方法选取2021年1月—2023年1月福建省立医院接诊的108例糖尿病肾病患者,按照随机数表法分为对照组与研究组,各54例。

对照组接受二甲双胍+百令胶囊治疗,研究组联合SGLT2抑制剂治疗,分析对比两组患者血糖指标、临床总有效率、肾功能指标及血清炎症指标。

结果与对照组相比,研究组治疗后的空腹血糖、餐后2 h血糖及糖化血红蛋白水平更低,差异有统计学意义(P<0.05)。

与对照组对比,研究组临床总有效率更高,差异有统计学意义(P<0.05)。

与对照组对比,研究组治疗后的血肌酐、尿素氮及尿白蛋白排泄率更低,差异有统计学意义(P<0.05)。

结论SGLT2抑制剂联合二甲双胍治疗糖尿病肾病可降低血糖水平,改善肾功能,减轻机体炎症反应,提高临床总效率。

[关键词] SGLT2抑制剂;二甲双胍;糖尿病肾病;血糖[中图分类号] R4 [文献标识码] A [文章编号] 1672-4062(2023)10(b)-0076-04Effect of SGLT2 Inhibitor Combined with Metformin Treatment on Blood Glucose and Curative Effect in Patients with Diabetic NephropathyZHENG Qiu'e, CHENG Qiumin, LIU JiangjianDepartment of Pharmacy, Fujian Provincial Hospital, Fuzhou, Fujian Province, 350001 China[Abstract] Objective To analyze the effects of sodium-dependent glucose transporters 2 (SGLT2) inhibitor combined with metformin treatment on blood glucose and curative effect in patients with diabetic nephropathy.Methods 108 pa⁃tients with diabetes nephropathy who were treated in Fujian Provincial Hospital from January 2021 to January 2023 were selected and divided into the control group and the study group according to the random number table, with 54 patients in each group. The control group received treatment with metformin and Bailing capsules, while the study group received treatment with SGLT2 inhibitors. The blood glucose indicators, clinical total efficiency, renal function indicators, and serum inflammation indicators were analyzed and compared between the two groups.Results Compared with the control group, the study group had lower levels of FPG, 2 hPG, and HbA1c after treatment, the difference was statistically significant (P<0.05). Compared with the control group, the total clinical efficiency of the study group was higher, and the difference was statistically significant (P<0.05). Compared with the control group, the study group had lower Scr, BUN, and UAER after treatment, the difference was statistically significant (P<0.05).Conclusion SGLT2 in⁃hibitor combined with metformin in the treatment of diabetic nephropathy can reduce blood glucose level, improve re⁃nal function, reduce the inflammatory response of the body, and improve the overall clinical efficiency.[Key words] SGLT2 inhibitor; Metformin; Diabetic nephropathy; Blood glucose糖尿病肾病是糖尿病并发症之一,也是引发终末期肾衰竭的主要原因,近十年来随着糖尿病发病率的增高,糖尿病肾病发病率增加2倍以上[1]。

第二届国际生物质催化炼制大会(CatBior 2013)第一轮通知

第二届国际生物质催化炼制大会(CatBior 2013)第一轮通知

( 第二届 国际生物质催化炼制大会 组委会)
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发展. 二 、会 议 主 题 及 征 稿 范 围 本 次 大 会 主 题 是 生 物 质 催 化 转 化 过 程 的基 础 和 应 用 问 题研 究, 征 稿 范 围 包 括 以下 几个 议题 :
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个 与学 界交流 的契机, 从 而推动 生物质 能源产业 可持 续
大会组委会副主席: 王 爱 琴
4 .生物质热转化及 生物 油精制; 5 .其它生物质催化转化过程 . 三 、投稿要求及 日期
大会组委 会热诚欢迎 从事生物质转化 研究与技术开发
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前列腺不典型小腺泡增生

前列腺不典型小腺泡增生
2 A SA P与前列腺微小癌鉴别指标
ASAP与前列腺微小癌 (m inimal volume p rostatic adeno2 carcinoma,癌占活检组织总量的 5%以下 )之间的鉴别标准 中 ,腺泡数目和病灶大小是最主要的一条 , ASAP腺泡的数目 是癌腺泡数目的 2 /3 (11、17) , ASAP病灶比癌性病灶小一半 (014 mm、018 mm ) 。核增大 、明显的核仁 、核分裂象 、腔内蓝 色黏液及并存 P IN等形态特征在前列腺微小癌中更明显 ,但 核深染及中 ~重度萎缩在 ASAP 比癌中更为常见 (分别为 44%、9%和 59%、35% ) 。 100%前列腺微小癌呈浸润性生 长 ,但浸润性的生长方式也存在于 75%的 ASAP病例中 。嗜 酸性颗粒性分泌物与类晶体在两者无明显差异 [12 ] 。
前列腺癌占男性恶性肿瘤的第 2位 ,在发达国家 ,前列 腺癌占全部恶性肿瘤的 19% ,在发展中国家为 513% [1 ] 。前 列腺穿刺活检是发现和确诊前列腺癌的重要手段 ,但穿刺标 本中经常会遇到少量不典型腺泡 ,疑似癌却又不能确定为 癌 ,这便是前列腺不典型小腺泡增生 ( atyp ical small acinar p roliferation, ASAP) 。现将 ASAP形态特征 、诊断标准 、发病 率 、临床意义以及对发现前列腺癌的预测价值等作一综述 。
1 A SA P的病理特征及应用现状
ASAP也称不典型腺体 ( atyp ia / atyp ical glands) [2 ] ,是由 Bostw ick等 [3 ]于 1993年首次提出的一个描述不典型腺样前 列腺增生的诊断术语 。4 年后这一诊断的临床意义得到首 次阐述 [4 ] 。
ASAP为不典型腺泡病变 ,表现为排列紧密的灶性增生 的小腺泡集落 。这些小腺泡被覆一层几近透明的分泌细胞 上皮 ,而基底细胞呈断片状或消失 (可经 34βE12 免疫组化 证实 ) 。组织特点为 : ①有限数量的腺体 ; ② 极少腺体出现 细胞不典型性 ,包括核增大 、核仁增大 ; ③ 组织异型 :缺乏核 异型的小腺泡杂乱无章地排列 ; ④ 腔内可见蓝色黏液 、结晶 体或粉红色蛋白样分泌物 [5 ] 。这些腺泡的结构形态和 /或细 胞形态类似于分化较好的前列腺癌 ,但数量太少 ,只是怀疑 为癌但不能明确诊断 。不足以诊断为癌而做出 ASAP这一 诊断主要见于两种情况 [6 ] : ①质的方面 ,缺乏足够的前列腺 癌细胞和组织结构特点 。例如一个病灶可能包括 12 个腺 泡 ,腺泡缺乏基底细胞层 ,呈浸润性生长 ,但细胞形态和组织 结构上尚未达到癌的诊断标准 (如缺少明显的核仁和明显 的核增大 ) ; ②量的方面 ,包含的腺泡数量太少 ,腺泡的细胞 和组织结构方面已经达到癌的诊断标准 ,但病灶的大小是其 主要限制 (如 1~3个腺泡 ) 。

纽储非妇产科

纽储非妇产科
次氯酸在临床灭菌消毒方面的应用得到进一步扩大验证。 Kim HJ[5]发现次氯酸(HOCl)不仅杀细菌,还杀真菌、病毒,烟曲霉、米根霉、人流 感病毒A。
低浓度的纯次氯酸伤口清洁敷料——纽储非面世。
这是世上首个也是目前唯一一个利用复杂工艺将低浓度的纯次氯酸应用于临床治疗 上的创新产品。
纽储非® :理想的伤口清洁产品
[1] SAM DUKAN,et al. Hypochlorous Acid Stress in Escherichia coli: Resistance, DNA Damage, and Comparison with Hydrogen Peroxide Stress. 1996;178(21):6145-6150
首次证实人体先天免疫中产生次氯酸(HOCl)杀菌。 John E. Harrison [1]在白细胞氧化爆发过程中证明次氯酸存在,并证明次氯酸 有着明显的杀菌作用。
次氯酸的杀菌机理得到进一步揭示。 Thomas EL[2]发现次氯酸(HOCl)通过损坏细菌DNA、蛋白(硫醇、硫醚和氨 基)、酶失活作用,包括切割肽键和氧化细菌成分巯基。
同时人体细胞中存在一种天然的 非必需氨基酸-牛磺酸,作为次 氯酸的清道夫,防止附带损害。
次氯酸盐: 控制1841年维也纳产褥热
塞麦尔韦斯 (Semmel-Weiss,1818~1865),现代医院流行病学之父 在19世纪中叶,时任奥地利维也纳大学附属医学院的产科医师塞麦尔韦斯注意 到,由医师负责的产科病房产褥热的发生率比助产士负责的病房高9倍,前者 的病死率高达10%以上,经过调查,该感染是通过医生的手扩散的,是由于做 过尸体解剖的医师未经洗手消毒,就去处理产科患者造成的。通过实行严格的 漂白粉液洗手措施后,产褥热的传播得到了明显的控制,病死率减少到1.0% 以下。他应用系统的流行病学调查方法,控制了该医院产褥热的流行爆发。

2型糖尿病非胰岛素类新型药物临床应

2型糖尿病非胰岛素类新型药物临床应

·综述·糖尿病新世界2022年10月2型糖尿病非胰岛素类新型药物临床应用研究新进展蒋一凡,王科斯,张新盘锦辽油宝石花医院内分泌科,辽宁盘锦124099[摘要]2型糖尿病是我国糖尿病患者发病最广分型,其发病率逐年升高,并呈现出发病人群年轻化、多种病变并发症等特点,为患者和社会带来沉重的医疗负担。

传统糖尿病治疗方案主要为胰岛素治疗,然而胰岛素治疗通常伴有低血糖、胰岛素过敏、水肿等不良反应。

在此背景下,基于靶点作用机制的非胰岛素类药物的研究开发为2型糖尿病患者提供了新的治疗选择方案。

相关研究表明:新型非胰岛素类药物除高效降糖效果外,兼具心肾保护作用,对糖尿病并发症具有显著预防作用。

鉴于此,本文在梳理2型糖尿病的发病机理的基础上,对非胰岛素类降糖药物的近期临床研究进展开展综述,以期为广大医务工作者、药物研发人员提供有益参考。

[关键词]2型糖尿病;非胰岛素类药物;降糖;心肾保护;获益效应[中图分类号]R587.1[文献标识码]A[文章编号]1672-4062(2022)10(a)-0190-06New Progress in Clinical Application of New Non-insulin Drugs for Type2 DiabetesJIANG Yifan,WANG Kesi,ZHANG XinDepartment of Endocrinology,Liaoyou Gem Flower Hospital,Panjin,Liaoning Province,124099China[Abstract]Type2diabetes is the most common type of diabetes in our country,and its incidence rate is increasing year by year,and it presents the characteristics of younger onset population and multiple disease complications,which brings a heavy medical burden to patients and society.The traditional treatment of diabetes is mainly insulin treat‐ment,but insulin treatment is usually accompanied by adverse reactions such as hypoglycemia,insulin allergy,and edema.In this context,the research and development of non-insulin drugs based on the target mechanism of action provides new treatment options for patients with type2diabetes.Relevant studies have shown that the new non-insulin drugs not only have high hypoglycemic effects,and have a significant preventive effect on diabetic complica‐tions.In view of this,this paper reviews the recent clinical research progress of non-insulin hypoglycemic drugs on the basis of sorting out the pathogenesis of type2diabetes,in order to provide useful reference for the majority of medical workers and drug research and development personnel.[Key words]Type2diabetes;Non-insulin drugs;Hypoglycemic;Cardio-renal protection;Benefit effect根据国际糖尿病联盟在2021年发布的最新全球糖尿病地图,2021年全球约有5.37亿成年人患有糖尿病。

美国导管相关血流感染预防与控制技术指南的分析

美国导管相关血流感染预防与控制技术指南的分析
• Rupp, et al. Ann Intern Med, 2005 (CHG/SS vs Control CVC)
– 393例CVC导管定植的发生率:锁骨下为5%,颈内 为19%,股静脉为39%
• Raad, et al. Ann Intern Med, 1997
– 266例CVC导管定植的让步比:锁骨下VS 颈内为 0.39(p=0.02);锁骨下VS股静脉为0.28(p=0.002)
3. 手卫生和无菌操作
1.在触摸插管部位前、后,以及插入、重置、触碰、维护 导管及更换敷料前、后时,均应严格执行手卫生程序 ,可以是传统的皂液和水,或者用酒精擦手液。在对 插管部位进行消毒处理后,不应再触摸该部位,除非 采用无菌操作。(ⅠB)
2.在进行插管和维护操作时须无菌操作。(ⅠB) 3.进行周围静脉置管时,若对插管部位进行皮肤消毒后不
教育项目的效果
• 外科ICU • 为ICU护士制定的10页
自学模块材料 • 总体的BSI发生率
– 教育前:10.8/1000 导管 日
– 教育后:3.7/1000导管日
Coopersmith CM, et al. Critical Care Med, 2002
病人/护士比率和人员水平
• 在SICU内,中心 静脉导管相关BSI 爆发与病人数与护 士数比例有关
病学上的研究或理论依据 • 未解决的问题.代表一个尚未解决的争议性措施,因为
没有充分的实证或目前无法判断其实施的效果性
推荐程度总结
• Total 103 recommendations 所有103项推荐
– 21 IA – 37 IB – 3 IC – 31 II – 11项为未解决的问题
1.教育、培训与人员配备

世界卫生组织儿童标准处方集

世界卫生组织儿童标准处方集

WHO Model Formulary for ChildrenBased on the Second Model List of Essential Medicines for Children 2009世界卫生组织儿童标准处方集基于2009年儿童基本用药的第二个标准目录WHO Library Cataloguing-in-Publication Data:WHO model formulary for children 2010.Based on the second model list of essential medicines for children 2009.1.Essential drugs.2.Formularies.3.Pharmaceutical preparations.4.Child.5.Drug utilization. I.World Health Organization.ISBN 978 92 4 159932 0 (NLM classification: QV 55)世界卫生组织实验室出版数据目录:世界卫生组织儿童标准处方集基于2009年儿童基本用药的第二个标准处方集1.基本药物 2.处方一览表 3.药品制备 4儿童 5.药物ISBN 978 92 4 159932 0 (美国国立医学图书馆分类:QV55)World Health Organization 2010All rights reserved. Publications of the World Health Organization can be obtained fromWHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: ******************). Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the aboveaddress(fax:+41227914806;e-mail:*******************).世界卫生组织2010版权所有。

monoclonal gammopathies单克隆免疫球蛋白病

monoclonal gammopathies单克隆免疫球蛋白病

MM – etiopathogenesis of multiple myeloma II
MM – etiology and pathogenesis (2) • chromosome abnormalities were found in ~ 90% or patients with FISH and microarray techniques − deletion of chromosome 13 and hypodiploidy have been shown to be associated with poor survival as have t(4;14), t(14;16) − c-Myc RNA and protein overexpression, N- and K-RAS mutations (~ 50%) − mutations and deletions in the retinoblastoma and the p53 tumor suppressor genes in malignant plasma cells − muldidrug resistance (MDR) gene • cytokines are involved − IL-6 is an autocrine growth factor − IL-1 and TNF- • elevation of proliferation rate and low apoptosis rate of myeloma cells → accumulation of myeloma cells • contact with marrow stromal cells appears to be required for the complete expression of the malignant repertoire of myeloma cells

2024版:《治疗性血液成分双采技术标准》专家共识(第2版)英文版

2024版:《治疗性血液成分双采技术标准》专家共识(第2版)英文版

2024版:《治疗性血液成分双采技术标准》专家共识(第2版)英文版2024 Edition: Expert Consensus on Therapeutic Blood Component Double Collection Technology Standards (2nd Edition)In the ever-evolving field of medicine, the importance of establishing and adhering to standardized procedures cannot be emphasized enough. The 2024 edition of the expert consensus on therapeutic blood component double collection technology standards serves as a vital tool for healthcare professionals worldwide.This document outlines the best practices and guidelines for the collection of blood components, emphasizing the importance of precision and accuracy in the process. By following these standardized protocols, healthcare providers can ensure the safety and efficacy of blood transfusions, ultimately improving patient outcomes.The expert consensus was developed by a panel of leading experts in the field, pooling their knowledge and experience to create a comprehensive and up-to-date guide for healthcare professionals. Through a collaborative effort, the second edition of the standards has been refined and expanded to address the latest advancements and challenges in therapeutic blood component double collection technology.Key areas covered in the document include the proper techniques for collecting blood components, ensuring the quality and integrity of the samples, and minimizing the risk of contamination. By following these guidelines, healthcare providers can optimize the collection process and enhance the overall quality of care for patients.In addition to technical guidelines, the expert consensus also addresses ethical considerations and patient safety concerns related to blood component collection. By prioritizing patient welfare and upholding the highest standards of care, healthcare providers can build trust and confidence with their patients.Overall, the 2024 edition of the expert consensus on therapeutic blood component double collection technology standards is a valuable resource for healthcare professionals seeking to improve their practices and enhance patient care. By adhering to these guidelines, healthcare providers can ensure the safe and effective collection of blood components, ultimately benefiting the health and well-being of their patients.。

基于miR-139

基于miR-139

郭瑾,王梓仪,张倩,孟骊冲,胡志希*湖南中医药大学,湖南长沙410208〔收稿日期〕2023-07-12〔基金项目〕国家自然科学基金项目(82274412);广东省重点领域研发项目(2020B1111100001);湖南省教育厅项目(21A0230,21B0361)。

〔通信作者〕*胡志希,男,医学博士,教授,博士研究生导师,E-mail:****************。

〔摘要〕目的探讨参附注射液对盐酸异丙肾上腺素(isoprenaline hydrochloride ,ISO )诱导的慢性心力衰竭(chronic heart fail⁃ure ,CHF )大鼠心肌纤维化的作用与机制。

方法采用随机数字表法将45只SD 大鼠随机分为正常组9只,造模组36只,采用ISO 背部皮下多点注射14天制备CHF 大鼠模型,再正常饲养14d 通过模型验证和评价,期间死亡大鼠5只,未成模大鼠4只。

将造模成功的27只大鼠按随机数字表法分为3组:模型组(腹腔注射6mL ·kg -1氯化钠注射液+灌胃10mL ·kg -1蒸馏水)、参附注射液组(腹腔注射6mL ·kg -1参附注射液+灌胃10mL ·kg -1蒸馏水)、卡托普利组(腹腔注射6mL ·kg -1生理盐水+灌胃10mL ·kg -1蒸馏水,蒸馏水含8.8mg ·kg -1卡托普利,相当于临床等效量)。

药物干预15d 后,检测各组大鼠心功能及心肌纤维化的相关指标:超声心动图、体质量、心脏质量指数及左心室质量指数;ELISA 法检测氨基末端脑钠肽前体(N-terminal pro brain natriuretic peptide ,NT-proBNP );HE 染色、Masson 染色检测心肌组织病理形态及纤维化状态;RT-qPCR 检测心肌组织中miR-139、Wnt 家族成员3a (Wnt family member 3a ,Wnt3a )、β-连环蛋白(β-catenin )、糖原合成酶激酶3β(glycogen synthase kinase 3β,GSK3β)、Ⅰ型胶原蛋白(typeⅠcollagen ,Col-Ⅰ)、Ⅲ型胶原蛋白(typeⅢcollagen ,Col-Ⅲ)及α-平滑肌肌动蛋白(α-smooth muscle actin ,α-SMA)、基质金属蛋白酶-2(matrix metalloproteinase-2,MMP-2)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)mRNA 的表达;Western blot 检测心肌组织中Wnt3a 、β-catenin 、GSK3β、Col-Ⅰ、Col-Ⅲ、α-SMA 、MMP-2、MMP-9蛋白表达。

背根神经节脉冲射频联合银质针治疗带状疱疹后遗神经痛临床研究

背根神经节脉冲射频联合银质针治疗带状疱疹后遗神经痛临床研究

背根神经节脉冲射频联合银质针治疗带状疱疹后遗神经痛临床研究李新巧1,阚厚铭2,徐元玙1,范后宝1,温雨婷1(1.徐州医科大学第二附属医院,江苏徐州221000;2.徐州医科大学江苏省麻醉学重点实验室,江苏徐州221004) [摘要]遗神经痛(PNH )的临床疗效及安全性。

将2019年2月—2020年6月在徐州医科大学第二附属医院治疗的带状疱疹后遗神经痛患者随机分为3组,在药物治疗的基础上,银质针组、脉冲射频组、脉冲射频联合银质针组分别给予银质针治疗、背根神经节脉冲射频治疗、背根神经节脉冲射频联合银质针治疗,对比3组患者治疗前后疼痛视觉模拟评分(VAS )、匹兹堡睡眠质量指数(PSQI )、医院焦虑抑郁量表(HADS -A 、HADS -D )评分、加巴喷丁使用量和盐酸曲马多使用率,记录不良反应和并发症发生情况。

3组患者治疗1周、1个月、3个月、6个月后,VAS 、PSQI 、HADS -A 、HADS -D 评分均较治疗前明显降低(P 均<0.05);脉冲射频联合银质针治疗组治疗1周、1个月、3个月、6个月后VAS 、PSQI 、HADS -A 评分均明显低于银质针治疗组和脉冲射频治疗组(P 均<0.05);脉冲射频联合银质针治疗组治疗后3个月、6个月后HADS -D 评分均明显低于银质针治疗组和脉冲射频治疗组(P 均<0.05);3组患者治疗后加巴喷丁使用量和曲马多使用率均较治疗前明显下降(P 均<0.05),组间比较差异均无统计学意义(P 均>0.05);3(P 均>0.05);3组患者均无严重并发症发生。

背根神经节脉冲射频联合银质针治疗带状疱疹后遗神经痛效果优于单独使用脉冲射频和银质针治疗,且该方法安全。

[关键词] 带状疱疹后遗神经痛;脉冲射频;银质针doi :10.3969/j.issn.1008-8849.2021.36.007[中图分类号] R752.12 [文献标识码] A [文章编号] 1008-8849(2021)36-4023-07[作者简介] 李新巧,女,副主任医师,擅长治疗软组织相关性疾病及脊椎相关性疾病、神经病理痛。

抗紧密连接蛋白3单克隆抗体以及使用该抗体的癌症的治疗和诊断[发明专利]

抗紧密连接蛋白3单克隆抗体以及使用该抗体的癌症的治疗和诊断[发明专利]

专利名称:抗紧密连接蛋白3单克隆抗体以及使用该抗体的癌症的治疗和诊断
专利类型:发明专利
发明人:吉田贤二
申请号:CN200780051336.9
申请日:20071214
公开号:CN101663322A
公开日:
20100303
专利内容由知识产权出版社提供
摘要:本发明提供与在细胞表面上表达的紧密连接蛋白3特异性结合的单克隆抗体。

本发明的抗体可用作卵巢癌、前列腺癌、乳腺癌、子宫癌、肝癌、肺癌、胰腺癌、胃癌、膀胱癌和结肠癌等紧密连接蛋白3表达亢进的癌症的诊断。

本发明还提供对这些癌症细胞显示细胞毒作用的单克隆抗体。

即,公开了使表达紧密连接蛋白3的细胞同与紧密连接蛋白3结合的抗体接触,对表达紧密连接蛋白3的细胞引发细胞毒的方法,以及抑制表达紧密连接蛋白3的细胞增殖的方法。

并且本发明还公开了癌症的诊断或治疗方法。

申请人:株式会社未来创药研究所
地址:日本东京都
国籍:JP
代理机构:中国专利代理(香港)有限公司
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参芪扶正注射液联合经动脉化疗栓塞治疗中晚期肝癌患者的效果及安全性

参芪扶正注射液联合经动脉化疗栓塞治疗中晚期肝癌患者的效果及安全性

- 105 -*基金项目:广州市卫生健康科技项目(20211A010005)①广州市第一人民医院 广东 广州 510180通信作者:陈国东参芪扶正注射液联合经动脉化疗栓塞治疗中晚期肝癌患者的效果及安全性*李西山① 陈国东①【摘要】 目的:分析参芪扶正注射液联合经动脉化疗栓塞(TACE)治疗中晚期肝癌患者的效果和安全性。

方法:选择2021年1月—2022年12月于广州市第一人民医院接受治疗的98例中晚期肝癌患者为研究对象,采用随机数表法均分为研究组和对照组,各49例。

对照组仅予以TACE 治疗,研究组在TACE 的基础上予以静脉参芪扶正注射液联合治疗。

比较两组的临床有效率、肝功能指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)]、免疫学指标(CD3+、CD4+、CD8+和CD4+/CD8+)、不良反应发生率和生活质量。

结果:研究组临床总有效率为79.59%,高于对照组的63.27%,差异有统计学意义(P <0.05)。

术后2周,两组ALT、AST 均低于术前1 d,且研究组上述指标均低于对照组,差异有统计学意义(P <0.05)。

术后2周,研究组CD3+、CD4+和CD4+/CD8+高于术前1 d 和对照组,而CD8+水平低于术前1 d 和对照组,差异有统计学意义(P <0.05)。

研究组不良反应总发生率为30.61%,低于对照组的57.14%,差异有统计学意义(P <0.05)。

研究组生活质量改善率为91.84%,高于对照组的65.31%,差异有统计学意义(P <0.05)。

结论:参芪扶正注射液联合TACE 治疗能够提高中晚期肝癌患者的临床有效率,保护患者的肝功能,减少患者TACE 后不良反应,提高患者的免疫学水平和临床生活质量。

【关键词】 肝癌 参芪扶正注射液 经动脉化疗栓塞 疗效 不良反应 doi:10.14033/ki.cfmr.2024.02.027 文献标识码 B 文章编号 1674-6805(2024)02-0105-04 Efficacy and Safety of Shenqi Fuzheng Injection Combined with Transarterial Chemoembolization in the Treatment of Patients with Middle and Advanced Liver Cancer/LI Xishan, CHEN Guodong. //Chinese and Foreign Medical Research, 2024, 22(2): 105-108 [Abstract] Objective: To analyze the efficacy and safety of Shenqi Fuzheng Injection combined with transarterial chemoembolization (TACE) in the treatment of patients with middle and advanced liver cancer. Method: A total of 98 patients with middle and advanced liver cancer who received treatment in Guangzhou First People's Hospital from January 2021 to December 2022 were selected as the study objects, and they were divided into study group and control group by random number table method, with 49 cases in each group. The control group was treated with TACE only, while the study group was treated with intravenous Shenqi Fuzheng Injection on the basis of TACE. The clinical effective rate, liver function indexes [alanine aminotransferase (ALT), aspartate aminotransferase (AST)], immunological indexes (CD3+, CD4+, CD8+ and CD4+/CD8+), incidence of adverse reactions and quality of life of the two groups were compared. Result: The total clinical effective rate of the study group was 79.59%, which was higher than 63.27% of the control group, the difference was statistically significant (P <0.05). At 2 weeks after surgery, ALT and AST in both groups were lower than those 1 d before surgery, and the above indexes in the study group were lower than those in the control group, the differences were statistically significant (P <0.05). At 2 weeks after surgery, the levels of CD3+, CD4+ and CD4+/CD8+ in the study group were higher than those 1 d before surgery and control group, while CD8+ levels were lower than those 1 d before treatment and control group, the differences were statistically significant (P <0.05). The total incidence of adverse reactions in the study group was 30.61%, which was lower than 57.14% in the control group, and the difference was statistically significant (P <0.05). The improvement rate of quality of life in the study group was 91.84%, which was higher than 65.31% in the control group, and the difference was statistically significant (P <0.05). Conclusion: Shenqi Fuzheng Injection combined with TACE can improve the clinical effective rate of patients with middle and advanced liver cancer, protect the liver function of patients, reduce the adverse reactions after TACE, and improve the immunological level and clinical quality of life. [Key words] Liver cancer Shenqi Fuzheng Injection Transarterial chemoembolization Efficacy Adverse reactions First-author's address: Guangzhou First People's Hospital, Guangzhou 510180, China 肝癌是世界上癌症相关死亡的最常见原因之一,我国超过80%的肝癌患者在确诊时已为中晚期[1]。

二氟尼柳美国药典

二氟尼柳美国药典

Diflunisal Tablets» Diflunisal Tablets contain not less than 90.0 percent and not more than 110.0 percent of the labeled amount of C13H8F2O3.Packaging and storage— Preserve in well-closed containers.USP Reference standards 11—USP Diflunisal RS.Identification—A: The retention time of the major peak in the chromatogram of the Assay preparation corresponds to that of the Standard preparation, obtained as directed in the Assay.B: Transfer a quantity of finely ground Tablets, equivalent to about 100 mg of diflunisal, to a 10-mL volumetric flask, add 2 mL of water, and sonicate for 5 minutes. Dilute with methanol to volume, sonicate for an additional 5 minutes, mix, and filter. Separately apply 10 µL each of the filtrate and a Standard solution of USP Diflunisal RS in methanol solution (4 in 5) containing 10 mg per mL to a thin-layer chromatographic plate (see Chromatography 62) coated with a 0.25-mm layer of chromatographic silica gel mixture.Develop the chromatogram in a solvent system consisting of n-hexane, glacial acetic acid, and chloroform (17:3:2) until the solvent front has moved aboutthree-fourths of the length of the plate. Remove the plate from the chamber, air-dry, and examine under long-wavelength UV light: the RF value of the principal spot in the chromatogram of the test solution corresponds to that obtained from the Standard solution.Dissolution 71—pH 7.20, 0.1 M Tris buffer— Dissolve 121 g of tris (hydroxymethyl) aminome thane (THAM) in 9 liters of water. Adjust the solution with a 7 in 100 solution of anhydrous citric acid in water to a pH of 7.45, at 25. Dliters, equilibrate to 37, a H of 7.20, if necessary.Medium: pH 7.20, 0.1 M Tris buffer; 900 mL.Apparatus 2: 50 rpm.Time: 30 minutes.Procedure— Determine the amount of C13H8F2O3 dissolved from UV absorbances at the wavelength of maximum absorbance at about 306 nm of filtered portions of the solution under test, suitably diluted with pH 7.20, 0.1 M Tris buffer, in comparison with a Standard solution having a known concentration of USP Diflunisal RS in the same Medium.Tolerances— Not less than 80% (Q) of the labeled amount of C13H8F2O3 is dissolved in 30 minutes.Uniformity of dosage units 90: mProcedure for content uniformity—Transfer 1 finely powdered Tablet to a200-mL volumetric flask, add 50 mL of water, shake by mechanical means for 30 minutes, and sonicate for 2 minutes. Add 100 mL of alcohol to the flask, shake by mechanical means for 15 minutes, and sonicate for 2 minutes. Dilute with alcohol to volume, mix, and centrifuge a portion of the solution. Quantitatively dilute an accurately measured volume of the resultant clear supernatant with alcohol, if necessary, to obtain a test solution containing about 1.25 mg per mL. Transfer about 125 mg of USP Diflunisal RS, accurately weighed, to a 100-mL volumetric flask, add 75 mL of alcohol to dissolve, dilute with water to volume, and mix to obtain the Standard solution. Transfer 3.0 mL each of the Standard solution and the test solution to separate 50-mL volumetric flasks. To each flask add 5.0 mL of a solution containing 1 g of ferric nitrate in 100 mL of 0.08 N nitric acid, dilute with water to volume, and mix. Concomitantly determine the absorbances of the solutions at the wavelength of maximum absorbance at about 550 nm, with a suitable spectrophotometer, using water as the blank. Calculate the quantity, in mg, of C13H8F2O3 in the Tablet by the formula:(TC / D)(AU / AS)in which T is the labeled quantity, in mg, of diflunisal in the Tablet; C is the concentration, in µg per mL, of USP Diflunisal RS in the Standard solution; D is the concentration, in µg per mL, of diflunisal in the test solution, based uponthe labeled quantity per Tablet and the extent of dilution; and AU and AS are the absorbances of the solutions from the test solution and the Standard solution, respectively.Assay—Mobile phase—Prepare a suitable degassed mixture of water, methanol, acetonitrile, and glacial acetic acid (45:40:17:6) such that the retention time of diflunisal is about 8 minutes.Standard preparation— Dissolve a suitable quantity of USP Diflunisal RS in a mixture of acetonitrile and water (60:40) to obtain a solution having a known concentration of about 1.0 mg per mL.Assay preparation—Weigh and finely powder not fewer than 20 Tablets. Transfer an accurately weighed portion of the powder, equivalent to about 100 mg of diflunisal, to a 100-mL volumetric flask containing about 5 mL of water. Sonicate for 5 minutes, add 60.0 mL of acetonitrile, sonicate for an additional 5 minutes, dilute with water to volume, mix, and filter.Chromatographic system (see Chromatography 62)—The liquid chromatograph is equipped with a 254-nm detector and a 3.9-mm × 30-cm column that contains packing L1.The flow rate is about 2.0 mL per minute. Chromatograph the Standard preparation, and record the peak responses as directed for Procedure: the tailing factor for the analyte peak is not more than 2.0, and the relative standard deviation for replicate injections is not more than 2.0%.Procedure— Separately inject equal volumes (about 20 µL) of the Standard preparation and the Assay preparation into the chromatograph, record the chromatograms, and measure the responses for the major peaks. Calculate the quantity, in mg, of diflunisal (C13H8F2O3) in the portion of Tablets taken by the formula:100C(rU / rS)in which C is the concentration, in mg per mL, of USP Diflunisal RS in the Standard preparation; and rU and rS are the peak responses obtained from the Assay preparation and the Standard preparation, respectively.。

中国缺血性脑卒中和短暂性脑缺血发作二级预防指南

中国缺血性脑卒中和短暂性脑缺血发作二级预防指南

中国缺血性脑卒中和短暂性脑缺血发作二级预防指南2010_中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组_|中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组|中华医学会神经病学分会脑血管病学组缺血性脑卒中二级预防指南撰写组|_脑血管网心脑血管站点群:大中小文章号:W056326关键字:缺血性脑卒中短暂性脑缺血指南目前脑血管病已成为我国城市和农村人口的第一位致残和死亡原因,且发病有逐年增多的趋势。

流行病学研究表明,中国每年有150万~200万新发脑卒中的病例,校正年龄后的年脑卒中发病率为(116~219)/10万人口,年脑卒中死亡率为(58~142)/10万人口。

目前我国现存脑血管病患者700余万人,其中约70%为缺血性脑卒中,有相当的比例伴有多种危险因素,是复发性脑卒中的高危个体。

随着人口老龄化和经济水平的快速发展及生活方式的变化,缺血性脑卒中发病率明显上升,提示以动脉粥样硬化为基础的缺血性脑血管病[包括短暂性脑缺血发作(TIA)]发病率正在增长。

近10年来随着大量的有关脑血管病二级预防的随机对照试验(RCT)研究结果的公布,脑血管病的治疗有了充分的证据,许多国家都出台了相应的治疗指南。

尽管国外大量的研究资料为我们提供了具有重要参考价值的信息,但考虑到西方人群与中国人群在种族、身体条件、用药习惯、价值取向、文化背景、法律法规、社会福利体系等诸多方面还存在着很多的差异,出台适合中国国情的有中国特色的指南十分必要,也十分迫切。

由此而制订的指南更应切合我国的实际情况而不是盲目套用其他国家的指南。

为此,2008年7月成立了中国缺血性脑血管病二级预防指南撰写专家组,汇集了神经内科、心内科、内分泌科、重症监护病房、呼吸科、介入科、流行病学等多个学科的专家编写此指南。

在写作过程中,强调在循证医学原则指导下,参考国际规范,结合中国国情和临床可操作性制定,在有充分可靠证据时使用证据,无可依靠的证据时,则采用当前最好证据或经验达成的共识。

nerocomputing文献缩写参考格式

nerocomputing文献缩写参考格式

nerocomputing文献缩写参考格式[1] J. van der Geer, J.A.J. Hanraads, R.A. Lupton, The art of writing a scientific article, J. Sci. Commun. 163 (2010) 51–59.Reference to a book:[2] W. Strunk Jr., E.B. White, The Elements of Style, fourth ed., Longman, New York, 2000. Reference to a chapter in an edited book:[3] G.R. Mettam, L.B. Adams, How to prepare an electronic version of your article, in: B.S. Jones, R.Z. Smith (Eds.), Introduction to the Electronic Age, E-Publishing Inc., New York, 2009, pp. 281–304.标准格式Vukobratovic M, Juricic D. Contribution to the Synthesis of Biped Gait[J]. IEEE Transactions on Biomedical Engineering, 1969, bme-16(1):1-6.IEEE Trans. Biomed. EngAmin K, Angelini E D, Carlier S G, et al. A state-of-the-art review on segmentation algorithms in intravascular ultrasound (IVUS) images.[J]. Information Technology in Biomedicine IEEE Transactions on, 2012, 16(5):823-834.IEEE Trans. Inf. Technol. BiomedWein W, Roper B, Navab N. Integrating diagnostic B-mode ultrasonography into CT-based radiation treatment planning.[J]. Medical Imaging IEEE Transactions on, 2007, 26(6):866-879.IEEE Trans. Med. Imaging 26 (6) (2007) 866–879Oralkan O, Ergun A S, Johnson J A, et al. Capacitive micromachined ultrasonic transducers: next-generation arrays for acoustic imaging?[J]. Ultrasonics Ferroelectrics & Frequency Control IEEE Transactions on, 2002, 49(11):1596-1610.IEEE Trans. Ultrason. Ferroelectr. Freq. Control 49 (11) (2002) 1596–1610.Vegas A F, Meineri M M. Three-Dimensional Transesophageal Echocardiography Is a Major Advance for Intraoperative Clinical Management of Patients Undergoing Cardiac Surgery: A Core Review[J]. Anesthesia & Analgesia, 2010, 110(6):1548-1573.Vegas, M. Meineri, Core review: three-dimensional transesophageal echocardiography is a major advance for intraoperative clinical management of patients undergoing cardiac surgery: a core review, Anesth. Analg. 110 (6) (2010) 1548–1573.IEEE Transactions on Instrumentation and MeasurementIEEE Trans.Instrum.measIEEE Transactions on Ultrasonics Ferroelectrics and Frequency ControlIEEE Trans. Ultrason. Ferroelectr. Freq. Control会议格式:A.K. Jumaat, W.E.Z.W.A. Rahman, A. Ibbrahim, R. Mahmud, Comparison of balloon snake and GVF snake in segmenting masses from breast ultrasound images, in: The 2010 IEEE Second International Conference on Computer Research and Development, 2010, pp. 505–509.[1]R. Jansohn, M. Schickert. Objective interpretation of ultrasonic concrete images,in: Proc. 7th European Conference on Non-Destructive Testing (ECNDT), Denmark, 3(12)1998, pp. 808–815.[2]L. Angrisani, R.S.L. Moriello, Estimating ultrasonic time-of-flight throughquadrature demodulation, IEEE Transactions on Instrumentation and Measurement, 55(1) (2006) 54–62.IEEE Trans. Instrum. MeasMeas. Sci. Technol.IEEE Transactions on Image ProcessingIEEE Trans.ImagIEEE Trans. Image Process.IEEE Transactions on Pattern Analysis and Machine IntelligenceIEEE Trans. Pattern Anal. Mach. Intell.M. Wright, E. Harks, S. Deladi, S. Fokkenrood, F. Zuo, S. Knecht, M. Hocini, M. Haissaguerre, P. Jais, Real-time catheter assessment of endocardial rf ablation lesions: comparison of integrated ultrasound and electrogram amplitude, in: Heart Rhythm Conference, 2011.Y. Gao, S. Gao, C. Ding, L. Rao, D. Khoury, Semi-automatic segmentation of the endocardial boundary in intracardiac echocardiographic images, in: Conference Proceedings: IEEE Engineering in Medicine and Biology Society, vol. 3, 2004, pp. 1911–1913.D. Ilea, P. Whelan, C. Brown, A. Stanton, An automatic 2d cad algorithm for the segmentation of the imt in ultrasound carotid artery images, in: Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC 2009), 2009, pp. 515–519.Y. Li and. X.Lu, The viscous resistance calculation for the trimarans based on the boundary layer theory, in: International Conference of the IEEE Optoelectronics and Image Processing (ICOIP 2010), 2010, pp. 657–661J. Shah, N. Patel, Hiral Tandel, A hybrid approach for edge detection using fuzzy logic and canny method, International Journal of Engineering Research & Technology, 2(3) (2013) 1-6.Int J. Eng. Res.TechnolIEEE Transactions on Instrumentation & Measurement IEEE Trans.。

06年4月欧洲批准和上市的新产品

06年4月欧洲批准和上市的新产品

06年4月欧洲批准和上市的新产品
刘敏(摘)
【期刊名称】《国外药讯》
【年(卷),期】2006(000)007
【摘要】获准新产品 Roche/GSK公司的三个月给药一次的Bonviva(ibandroni cacid,依班膦酸)3mg静脉注射剂获欧洲医药管理部门批准,用于停经期后妇女骨质疏松的治疗。

这是欧盟批准用于停经期后妇女骨质疏松治疗的这类药物的头一个注射剂。

批准的依据是一项为期两年的DIVA(静脉内给药)临床试验结果。

DIVA比较了它与一天给药一次Bonviva口、服配方的疗效、安全性和耐受性。

结果显示,它高度有效且耐受性良好。

接受静注给药的病人其腰椎骨矿物质密度增加较高,为6.3%对4.8%。

【总页数】3页(P9-11)
【作者】刘敏(摘)
【作者单位】无
【正文语种】中文
【中图分类】R95
【相关文献】
1.2010年4月份欧洲批准和上市的新产品 [J], 无
2.2009年4月份欧洲批准和上市的新产品 [J], 无
3.07年4月份欧洲批准和上市的新产品 [J], 刘敏(摘)
4.2005年3~4月份欧洲批准和上市的新产品 [J], 刘敏
5.2004年3-4月欧洲批准和上市的新产品 [J], 刘敏
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2nd International Symposium on Imprecise Probabilities and Their Applications,Ithaca,New York,2001 Confidence as Higher-Order UncertaintyPei WangCenter for Research on Concepts and Cognition,Indiana Universitypwang@/farg/peiwang/AbstractWith conflicting evidence,a reasoning system derives uncertain conclusions.If the system is open to new evidence,it faces additionally a higher-order uncer-tainty,because thefirst-order uncertainty evaluations are uncertain themselves—they can be changed by future evidence.A new measurement,confidence,is introduced for this higher-order uncertainty.It is de-fined in terms of the amount of available evidence, and interpreted and processed as the relative stabil-ity of thefirst-order uncertainty evaluation.Its rela-tion with other approaches of“reasoning with uncer-tainty”is also discussed.Keywords.confidence,evidence,frequency interval, revision,inference,deduction,induction,abduction. 1IntroductionIn this paper,we discuss the representation and pro-cessing of uncertainty in an adaptive reasoning sys-tem,whose knowledge and resources are insufficient with respect to the questions to be answered. NARS(for Non-Axiomatic Reasoning System,see[26] for details)is a reasoning system that accepts knowl-edge and questions from its user in a formal lan-guage,and answers the questions according to avail-able knowledge.No restriction is imposed on the con-tents of the knowledge and questions the system may encounter,as long as they are expressible in the for-mal language.Therefore,new knowledge may come from time to time,and may conflict with previous knowledge.Also,questions may go beyond the sys-tem’s current knowledge scope.We want the system to be adaptive,that is,to be-have according to its experience(available knowl-edge/evidence).In such a situation,the system’s an-swers are usually uncertain,since the input knowledge is not necessarily conflict-free,and the system needs to make plausible inferences when the available knowl-edge is insufficient to answer a question with absolute certainty.As a result,for a given question,NARS usually cannotfind a unique“correct”or“optimal”answer,but only a“reasonable”answer that is best supported by its experience,and can be found or con-structed under the current time-space constraint.In the following sections,we explain why in NARS the representation of uncertainty needs two num-bers.A new measurement,confidence,is introduced, and some operations on this measurement are dis-cussed.Finally,this approach is compared with other probability-based measurements of higher-order un-certainty.Since a comprehensive introduction to NARS is far beyond the capacity of this paper,we will focus on the confidence issue,and for the other aspects of the sys-tem(such as knowledge representation language,se-mantics,inference rules,truth value functions,mem-ory management,inference control,and so on),we only mention the directly relevant parts.Papers and an on-line demonstration of NARS are available at the author’s web-page.2Evidence and ConfidenceIn NARS,the basic form of knowledge is an inher-itance relation between two terms,“S⊂P”.Intu-itively,it indicates that S is a specialization of P,and P is a generalization of S.It roughly corresponds to “S is a kind of P”in English.In its ideal form,Inheritance is reflexive and tran-sitive.In NARS,the extension and intension of a term T are defined as sets of terms:E T={x|x⊂T}and I T={x|T⊂x}.Intuitively,they include all known specialization(instances)and generalizations (properties)of T,respectively.It can be proven that(S⊂P)⇐⇒(E S⊆E P)⇐⇒(I P⊆I S),where thefirst relation is an Inheritance relation between two terms,while the last two aresubset relations between two sets(extensions and in-tensions of terms).Therefore,S⊂P indicates that S inherits the intension of P,and P inherits the ex-tension of S.Given the assumption of insufficient knowledge and the requirement of being adaptive,the uncertainty of S⊂P is defined according to available evidence in the system.For a statement S⊂P and a term M,if M is in the extensions of both S and P,it is positive evidence for the statement;if it is in the extensions of S but not the extension of P,it is negative evidence. Symmetrically,if M is in the intensions of both P and S,it is positive evidence for the statement;if it is in the intension of P but not the intension of S,it is negative evidence.Therefore,the amount of positive evidence is w+=|E S∩E P|+|I P∩I S|,the amount of negative evidence is w−=|E S−E P|+|I P−I S|, and the amount of all evidence is w=w++w−= |E S|+|I P|.For example,an observed black crow is a piece of positive evidence for“Crow is a kind of black thing”(w=w+=1),and an observed non-black crow is a piece of negative evidence for it(w=w−=1).Here we assume the observations have no uncertainty.To measure the amount(or weight)of evidence is not a new idea at all[10,15].For instance,Keynes said that“As the relevant evidence at our disposal increases,the magnitude of the probability of the ar-gument may either decrease or increase,according as the new knowledge strengthens the unfavorable or the favorable evidence;but something seems to have in-creased in either case,—we have a more substantial basis upon which to rest our conclusion.”[10] Though we do not always make a judgment by directly counting pieces of evidence,the concept of amount of evidence can be used as an idealized meter-stick by which uncertainty is measured—I can say that my belief on a sentence is“as strong as I have tested the sentence w times,and the tests succeeded w+times, but failed w−times”,even though I did not really test the sentence in this way.For how to apply this measurement to a formal language,see[25,26]. Because all the operations in the system are based on available evidence,w+and w−contain all the infor-mation about the uncertainty of the sentence.How-ever,when represented in this way,the information is inconvenient for certain purposes.When compar-ing competing options and deriving new conclusions, we usually prefer relative measurements to absolute measurements.The most often used relative measurement for uncer-tainty is the frequency,or proportion,of positive ev-idence among all available evidence.In the follow-ing,let us define the“frequency”of a sentence as f=w+/w.If the system has observed100crows, and95of them are black,but the remaining5are not,the system sets f=0.95for“Crow is a kind of black thing”.Although f is a natural and useful measurement,it is not enough for our current purpose.Intuitively, we have the feeling that the uncertainty evaluation f=0.95is uncertain itself.For a simple example, let us consider the following two situations:(1)the system only knows one crow,and it is black,and(2) the system knows10000crows,and all of them are black.Though in both situations we have f=1, thefirst case is obviously“more uncertain”than the second.Because here the uncertainty is about the sentence“The frequency for crows to be black is1”, we are facing a higher-order uncertainty,which is the uncertainty of an evaluation about uncertainty.As mentioned at the beginning of the paper,in NARS the uncertainty in a sentence appears as the result of insufficient knowledge.Specially,thefirst-order un-certainty,measured by frequency,is caused by known negative evidence,and the higher-order uncertainty is caused by potential negative evidence.As discussed previously,the most simple and natural measurement of the higher-order uncertainty is the amount of evidence,w.However,we have reasons to introduce a relative measurement,whose advantages will be apparent later.Intuitively,we are looking for a function of w,call it c for confidence,that satisfies the following conditions: 1.Confidence c is a continuous and monotonicallyincreasing function of w.(More evidence,higher confidence.)2.When w=0,c=0.(Without any evidence,confidence is minimum.)3.When w goes to infinity,c converges to1.(Withinfinite evidence,confidence is maximum.) There are infinite functions satisfying the above re-quirements,therefore we need more intuition to pick up a specific one.Many functions with value range[0,1]can be natu-rally interpreted as a ratio.Following this path,we might want to define c as the ratio of“the amount of evidence the system has known”to“the amount of evidence the system will know”.Obviously,the first item is w,but for a system that is always open to new evidence,the second item is infinity,thereforethe ratio is always0.When compared with an infi-nite“future,”the difference among the variousfinite “past”cannot be perceived.For an adaptive system, though past experience is never sufficient to predict future situations,the amount of evidence does matter for the system’s decision,and the behaviors based on more evidence should be preferred.Because confidence is supposed to be a relative mea-surement defined onfinite evidence,a natural idea is to compare the amount of current evidence with the amount of evidence the system will know in the near future.By“near future,”we mean“until the coming of a constant amount of new evidence”.Now we get the definition of confidence that we want to introduce in this paper:c=w/(w+k),where k is a positive constant indicating the“near future”. Defined in this way,the frequency and confidence of a sentence are independent to each other,in the sense that,from the value of one,the other’s value cannot be determined,or even estimated or bounded(except the trivial case where c=0indicates that f has an undefined value).Obviously,this function satisfies the three require-ments.For a specific system,k should remain un-changed to make the system’s behaviors consistent, but different systems can have different values for k. In this paper,the default value of k is1(and we will discuss the choice of k later).Under such a definition, confidence indicates the ratio of the current amount of evidence(for the piece of knowledge under con-sideration)to the amount of evidence the system will have after it gets new evidence with a unit amount(or weight).The more the system already knows,the less the new evidence will contribute(relatively),therefore the more confident,or the less ignorant,the system is,with respect to the given relation.When w=1, c=0.5,and the new evidence will double the amount of available evidence;When w=999,c=0.999,and the new evidence will have little effect on the system’s belief.For empirical knowledge,c can never reach1,so the knowledge is always(more or less)revisible.In NARS,c=1is reserved for analytical knowledge,such as mathematical knowledge.This kind of knowledge is not a direct summary of experience,but a conven-tion that is not directly revisible by evidence(we will return to this issue later).We can interpret confidence in another way.As de-fined previously,the current frequency of positive ev-idence is f=w+/w.After getting a piece of new evidence with weight k,where will the new f be?Ob-viously,if the new evidence is completely negative,f will be w+/(w+k);if the new evidence is completely positive,f will be(w++k)/(w+k).Therefore,no matter what content the new evidence has,the fre-quency will stay in the interval[w+/(w+k),(w++ k)/(w+k)]in the near future.Let us call the lower bound and the upper bound of the interval“lower frequency”and“upper frequency”,respectively.The width of the interval,k/(w+k),provides a measure-ment for the ignorance(or susceptibility)of the sys-tem on the statement,which is a higher-order uncer-tainty,and its complement(to1),w/(w+k),provides a measurement for the confidence(or stability)of the judgment.Now we have three functionally identical ways to rep-resent the uncertainty of a statement:by two of the three amounts of evidence(w+,w−,and w),by the two ratios(frequency and confidence),or by the lower–upper frequency interval.From the above def-initions,it is not difficult to get the one-to-one map-pings among the three representations[25,26].No matter which form is used,we need two numbers to represent the uncertainty of a statement.Is this kind of information available to the system? Even Bayesian network and fuzzy logic,which require the users to assign a single number to each statement, have difficulty in getting the numbers.How can we now expect users to provide a pair of numbers for each statement?To us,the hardness of value assignments comes mainly from the unclear interpretation about what are measured by these values.Our approach at-tempts to be more user friendly by unifying differ-ent uncertainty representations.This clarifies the as-signment process for the users.They can even mix different forms of uncertainty,in terms of amount of evidence,frequency,confidence,ignorance,frequency interval,and so on,in the knowledge they provide. Though c is defined as a function of w,which is intuitively understood as“amount of available evi-dence,”the system does not simply count the num-ber of pieces of evidence,and treat each of them as equally-weighted.Instead,it interprets evidence as equivalent to(“as strong as”)that from such a simple counting.If a statement has a confidence c=0.9, which corresponds to w=9when k=1,it does not mean that the system really has found9pieces of(ideal)evidence,but that the system believes the statement to such an extent,as if it has found9pieces of ideal evidence for the statement[26].3Confidence-related OperationsIn the following,we show how confidence is processed in the major inference operations of NARS.3.1RevisionIn NARS,revision indicates the process by which ev-idence from different sources is combined.For exam-ple,assuming the system’s previous uncertainty for “Crows are black”is<9/10,10/11>(we know that it corresponds to“Ten crows observed,and nine of them are black”when k=1),now a piece of new knowledge comes,which is“Crows are black<3/4,4/5>”(so it corresponds to“Four crows are observed,and three of them are black”).If the system can determine that no evidence is repeatedly counted in the two sources (see[25,26]for how this is defined and checked), then the uncertainty of the revised judgment should be<6/7,14/15>(corresponding to“Fourteen crows observed,and twelve of them are black”). Formally,revision is the rule that merges<f1,c1> and<f2,c2>into<f,c>for the same S⊂P.From the conversion that the amount of evidence is additive during revision and the definition of frequency and confidence in terms of evidence,we get the following uncertainty function for the revision rule:f=f1c1(1−c2)+f2c2(1−c1)c1(1−c2)+c2(1−c1)c=c1(1−c2)+c2(1−c1)c1(1−c2)+c2(1−c1)+(1−c1)(1−c2)where<f1,c1>and<f2,c2>are the uncertainty of the two premises,and<f,c>is the uncertainty of the conclusion.This function has the following properties:1.The order of the premises does not matter.2.As a weighted average of f1and f2,f is usuallya“compromise”of them,and is closer to the one that is supported by more evidence.3.c is never smaller than either c1or c2,that is,theconclusion is supported by no less evidence than either premise.4.If c1=0,then f=f2and c=c2,that is,a judg-ment supported by null evidence cannot revise another judgment.5.If c1=1and c2<1,then f=f1and c=c1,thatis,a definition(supported by complete evidence) cannot be modified by empirical evidence.6.If c1=c2=1but f1=f2,then f and c areundefined,that is,there are two conflicting defi-nitions in the system,from which nothing can be derived.This definition is compatible with our intuition about evidence and revision—revision is nothing but to reevaluate the uncertainty of a statement by taking new evidence into account.Revision is not updat-ing,where old evidence is thrown away.A high w means that the system already has much evidence for the statement,therefore its confidence is high and its ignorance is low(on this issue).It follows that the statement is relatively insensitive to new evidence.All these properties are independent to the decisions on how w is divided into w+and w−,as well as to how they are actually measured(so these decisions may change from situation to situation without invalidat-ing the revision rule).It needs to be clarified that here“revision”refers to the operation by which the system summarize two (maybe conflicting)beliefs.In this operation the con-clusion always has a higher confidence.However,gen-erally speaking,in NARS it is possible for the system to loss its confidence on a belief.This can be caused by the“forgetting”or“explaining away”of previously available evidence.This issue is related to the mem-ory management and control mechanism of the system [26],and thus is beyond the scope of this paper.3.2ChoiceWhat will happen if the evidence of the two premises are“correlated”,that is,some evidence are used by both of them?Ideally,we would like to merge the ev-idence without repeatedly counting the overlapping part.However,with insufficient resources(which is assumed in NARS),it is simply impossible to distin-guish the contribution of each piece of evidence to the uncertainty of the judgment.Therefore,when NARS recognizes that two premises are based on correlated evidence(for how this can be done,see[26]),it chooses the premise with a higher confidence,because it is supported by more evidence.This is exactly what we expect from an adaptive system whose behaviors are based on its experience.Another type of choice happens when the competing statements have different contents.For example,the system needs to decide which one of two statements S1⊂P<f1,c1>and S2⊂P<f2,c2>is more likely to be confirmed in the next time they are tested (i.e.,which of S1and S2is a better candidate if a spe-cialization of P is needed).For an adaptive system, such a decision is only based on available evidence about the two statements,represented by their un-certainty.This problem is similar to the decision-making prob-lem studied by the Bayesian school,where the system simply takes the option that has a higher probabil-ity(when they have the same utility).What makes things complex in NARS is the fact that here the un-certainty of a statement is represented by a pair of real numbers,and both numbers influence the system’s preferences,but in different ways.When the compet-ing statements have the same confidence,the system takes the one with a higher frequency as more likely to be confirmed.When the competing statements have the same frequency,the statement with a higher con-fidence is“stronger.”For example,if f1=f2=1, c1=1/2,and c2=10/11,the second statement is stronger,because it is supported by more evidence. In this case,the one with a higher confidence is more likely to be confirmed in the future.On the contrary, if f1=f2=0,the one with a higher confidence is still “stronger”,but less likely to be confirmed,because it has more negative evidence.In general,we need to combine f and c into a single measurement e,indicating the system’s expectation on how likely the statement will be confirmed again in the future.Intuitively,this measurement is similar to “probability”under subjective interpretation,which is derived from preference in decision making[1].In other words,e indicates the system’s betting quotient on the statement,when the only alternative is the negation of the statement(that is,abstention is not allowed).To avoid a sure lose(“Dutch book”),the e value of a statement and the e value of the negation of the statement should sum to1.As defined previously,c=0means no evidence,there-fore e is1/2,since the system is indifferent to the statement and its negation.When c=1,the system has known the limit of frequency,which is used as e. In other cases,f is“squashed”by c to the“indiffer-ence”point1/2to become e,showing a“conservative”tendency by taking the possible variations of f into consideration.Consequently,we obtaine=c(f−1/2)+1/2.When representing e directly as a function of the weight of evidence,we gete=w++k/2 w+kwhere k is the constant defined previously.With the same evidence,a system with a larger k has an e closer to the indifference point,that is,it accepts a smaller betting quotient—the system is more prudent than a system with a smaller k.We call the k a“personal-ity parameter,”because it shows a systematic bias in the system’s preferences.Everyone prefers an option that has both a high frequency and a high confidence. However,when the two qualities cannot be achieved at the same time(i.e.,one option has a higher fre-quency,but the other one has a higher confidence),different people balance the two differently.There is no“optimum value”for this parameter,as far as our current discussion concerns.The expectation value also happen to be the middle point of the frequency interval[w+w+k,w++kw+k]3.3InferencesThe major inference rules in NARS are the syllogistic rules for deduction,abduction,and induction,listed in the following.Each rule takes a pair of premises that share a common term,and derives a conclusion between the other two terms.Each rule includes a truth value function calculating the uncertainty of the conclusion from those of the premises.DeductionM⊂P<f1,c1>S⊂M<f2,c2>————————S⊂P<f,c>AbductionP⊂M<f1,c1>S⊂M<f2,c2>————————S⊂P<f,c>InductionM⊂P<f1,c1>M⊂S<f2,c2>————————S⊂P<f,c>A detailed discussion of the rules is beyond the scope of this paper,and such discussions can be found in [25,26].In the following,we only summarize the pro-cedure by which the above functions is determined. By definition,frequency f and confidence c take their values in the interval[0,1],and so does the amount of evidence w when the evidence under consideration is at most of unit amount.Under this condition,we can carry out the task in the following steps:1.Treat all the involved variables as Boolean,that is,have values in{0,1}(i.e.,either0or1).Conse-quently,each premise is fully positive(f=1,c=1), fully negative(f=0,c=1),or fully unknown (c=0).2.Study each value combination of the premises,and decide the corresponding values for the conclusion ac-cording to the semantics of the language and the def-inition of the uncertainty measurements.For deduction,the Boolean truth value function is given by the transitivity of ideal Inheritance and the principle that from two pure negative Inheritance re-lations,no conclusion can be derived.There are the following situations:•When<f1,c1>and<f2,c2>are both<1,1>, so is<f,c>.•When<f1,c1>and<f2,c2>are<1,1>and <0,1>(no matter which is which),<f,c>is <0,1>.•When<f1,c1>and<f2,c2>are both<0,1>,c is0.•When c1or c2is0,c is0.For abduction and induction,the confidence of the conclusion cannot be1,therefore it is not fruitful to directly represent<f,c>as Boolean function of the truth values of the premises.Instead,the previous definition of evidence is used,so that the amount of evidence of the conclusion is represented as Boolean function:•When<f1,c1>and<f2,c2>are both<1,1>, M is positive evidence,i.e.,w=w+=1.•When in abduction<f1,c1>is<1,1>and <f2,c2>is<0,1>,or in induction<f1,c1>is <0,1>and<f2,c2>is<1,1>,M is negative evidence,i.e.,w=1and w+=0.•When in abduction<f1,c1>is<0,1>,or in induction<f2,c2>is<0,1>,M is no evidence,i.e.,w=0.•When c1or c2is0,M is no evidence,i.e.,w=0.3.Represent the uncertainty of the conclusion as Boolean functions of those of the premises,under the constraint provided by the previous u-ally there is more than one function satisfying the requirement,and we use the one that is simple and has a natural interpretation.What we get are:DeductionAND(f,c)=AND(f1,c1,f2,c2)c=AND(c1,c2,OR(f1,f2))Abductionw+=AND(f1,c1,f2,c2)w=AND(f1,c1,c2)Inductionw+=AND(f1,c1,f2,c2)w=AND(c1,f2,c2)4.Extend the Boolean operators AND,OR,and NOT from{0,1}to[0,1],according to the study of T-norm and T-conorm[2,6,17].The extended Boolean operators in NARS are:AND(x,y)=x∗yOR(x,y)=x+y−x∗yNOT(x)=1−xwhere thefirst two are applied only when x and y are independent to each other,meaning that the value of one provides no information on the value of the other. When these operators are applied to the truth value functions obtained previously,we get the truth value function of NARS:Deductionf=f1f2/(f1+f2−f1f2)c=c1c2(f1+f2−f1f2)Abductionf=f2c=f1c1c2/(f1c1c2+1)Inductionf=f1c=f2c1c2/(f2c1c2+1)The above inference rules,plus the revision rule and the choice rule introduced previously,are the ma-jor operations on confidence in NARS.By comparing them,we can see the following:•Both frequency and confidence contribute to in-ference and decision making,but in different ways.•Revision is the only rule where the confidence of the conclusion may be higher than those of the premises.•The confidence of a syllogistic conclusion is never higher than the confidence of either premise,that is,confidence“declines”in syllogistic inference.•Confidence declines much slower in deduction than in induction and abduction.In deduction, if both premises have a confidence value of1,the conclusion may also have a confidence value of1 (so it is a derived definition or convention).In induction and abduction,on the contrary,the confidence of the conclusion has an upper bound which is far less than1.So,by saying that“In-duction and abduction are more uncertain when compared with deduction”,what is referred to is not the“first-order uncertainty”,f(inductive and abductive conclusions can have a frequency of1when all available evidence is positive),but the“higher-order uncertainty”,c.4Compared with Other Approaches 4.1Bayesian approachFor reasoning under uncertainty,the most popular re-search paradigm is the Bayesian approach,which has the following major features:[1,4,14,20]1.The probability of a proposition is interpreted asthe system’s degree of belief on the proposition, according to available evidence.2.The system’s beliefs,or knowledge,are repre-sented by a(consistent)probability distribution on a proposition space.3.When the system needs make a choice amongcompeting uncertain answers,it always prefer the one that has the highest probability(when utility is the same).4.The inferences in the proposition space preciselyfollow probability theory.5.When new evidence comes,the beliefs are revisedaccording to Bayes’theorem,According to this approach,when“probability”is identified with“degree of belief”,which indicates a system’s preference among possible choices,and prob-ability theory is used as a normative theory for how the system should behave to maintain a consistent belief space,a probability distribution on a proposi-tion space is capable of representing the uncertainty involved in the above operations,because no matter what is the origin of uncertainty,its effects eventually appears in the system’s preference among possible op-tions in making a choice.This argument is valid if we only consider the choice and the inference operations defined above.However, if we carefully analyze the revision operation,a limit of Bayesian approach can be found.A detailed dis-cussion of this issue is in[23],and here we only briefly summarize the argument.In the Bayesian approach,learning of new evidence is mainly carried out by conditionalization according to Bayesian Theorem,that is,if new evidence is E,then the probability of an arbitrary statement S is changed from time T0to time T1as P T1(S)=P T0(S|E).The problem in this method is:the knowledge that can be put into the system a priori(in P T0)cannot always be learned a posteriori as E.In general,to revise the background knowledge of a probability distribution, to know the distribution itself is not enough.The confidence measurement introduced in this paper can be seen as an attempt to measure the knowledge be-hind a probabilistic judgment.To use two(or more)numbers to represent the un-certainty of a statement is not a new idea.The previous problem(or similar problems)is the origin of many alternative approaches which challenge the dominant position of the Bayesian approach in the field.The advocates of these new approaches claim that the Bayesian approach cannot properly represent and process this kind of uncertainty,and various new measurements have been proposed.Some of them are discussed in the following.4.2Higher-order probabilitySeveral new measurements are proposed under the assumption that thefirst-order uncertainty measure-ment(call it“probability”or“degree of belief”)is an approximation of a“real”or“objective”probability. Under the frequentist interpretation,the probability of a statement is the limit of frequency,therefore all estimations of it based onfinite evidence are not accu-rate.Even if we take probability as degree of belief,it can still be argued that such a degree should converge to the objective probability if it exists.If thefirst-order probability assignment is only an approximation of an unknown value,the need for a higher-order measurement follows naturally—we want to know how good the approximation is,in ad-dition to the approximated value itself.One natural idea is to apply probability theory once again,which leads to the concepts like“probability of probability,”“second order probability,”“higher order probability,”and so on[7,8,13].In this way, we can assign probability to a probability assignment, to represent how good an approximation it is to the real probability.However,there are problems in how to interpret the second value,and whether it is really useful[12,14]. For our current purpose,under the assumption of in-sufficient knowledge,it makes little sense to talk about the“probability”that“the frequency is an accurate estimate of an objectivefirst-order probability”.Since NARS is always open to new evidence,it is simply impossible to decide whether the frequency of a judg-ment will converge to a point in the infinite future,not to mention where the point will be.If we say that the second-order probability is an approximation itself, then a third-order probability follows for the same reason—we are facing an infinite regression[16]. Since second-order probability is not introduced as a function of available evidence alone,it does not represent ignorance.“P(P(A)=p)=0”means。

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