A longitudinal study of constipation and laxative use in a community-dwelling elderly population.
肠道菌群和自闭症
∙1a Department of Soil, Plant and Food Sciences , University of Bari Aldo Moro , Bari , Italy.AbstractThrough extensive microbial-mammalian co-metabolism, the intestinal microbiota have evolved to exert a marked influence on health and disease viagut-brain-microbiota interactions. In this addendum, wesummarize the findings of our recent study on the fecal microbiota and metabolomes of children with pervasive developmental disorder-not otherwise specified (PDD-NOS) or autism (AD) compared with healthy children (HC). Children with PDD-NOS or AD have altered fecal microbiota and metabolomes (including neurotransmitter molecules). We hypothesise that the degree of microbial alteration correlates with the severity of the disease since fecal microbiota and metabolomes alterations were higher inchildren with PDD-NOS and, especially, AD compared to HC. Our study indicates that the levels of free amino acids (FAA) and volatile organic compounds (VOC) differ in AD subjects compared to children with PDD-NOS, who are more similar to HC. Finally, we propose a new perspective on the implications for the interaction between intestinal microbiota and AD.∙1Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.∙2Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada ; Brain-Body Institute, St Joseph's Healthcare, Hamilton, ON, Canada.AbstractThe human intestine houses an astounding number and species of microorganisms, estimated at more than 10(14) gut microbiota and composed of over a thousand species. An individual's profileof microbiota is continually influenced by a variety of factors including but not limited to genetics, age, sex, diet, and lifestyle. Although each person's microbial profile is distinct, the relative abundance anddistribution of bacterial species is similar among healthy individuals, aiding in the maintenance of one's overall health. Consequently, the ability of gut microbiota to bidirectionally communicate with the brain, known as the gut-brain axis, in the modulation of human health is at the forefront of current research. At a basic level, the gutmicrobiota interacts with the human host in a mutualistic relationship - the hostintestine provides the bacteria with an environment to grow and the bacterium aids in governinghomeostasis within the host. Therefore, it is reasonable to think that the lack ofhealthy gut microbiota may also lead to a deterioration of these relationships and ultimately disease.Indeed, a dysfunction in the gut-brain axis has been elucidated by a multitude of studies linked toneuropsychological, metabolic, and gastrointestinal disorders. For instance, altered microbiota has been linked to neuropsychological disorders including depression and autism spectrum disorder, metabolic disorders such as obesity, and gastrointestinal disorders including inflammatory bowel disease andirritable bowel syndrome. Fortunately, studies have also indicated that gut microbiota may be modulated with the use of probiotics, antibiotics, and fecal microbiota transplants as a prospect for therapyin microbiota-associated diseases. This modulation of gutmicrobiota is currently a growing area ofresearch as it just might hold the key to treatment.∙1Department of Internal Medicine and Medical Specialties, University Sapienza, Rome (Marilia Carabotti, Annunziata Scirocco, Carola Severi), Italy.∙2Experimental Pharmacology Laboratory, Scientific Institute of Gastroenterology S. de Bellis, Castellana Grotte, Bari (Maria Antonietta Maselli), Italy.AbstractThe gut-brain axis (GBA) consists of bidirectional communication between the central and the enteric nervous system, linking emotional and cognitive centers of the brain with peripheral intestinal functions.Recent advances in research have described the importance of gut microbiota in influencing theseinteractions. This interaction between microbiota and GBA appears to be bidirectional, namely through signaling from gut-microbiota to brain and from brain to gut-microbiota by means of neural, endocrine, immune, and humoral links. In this review we summarize the available evidence supporting the existence of these interactions, as well as the possible pathophysiological mechanisms involved. Most of the data have been acquired using technical strategies consisting in germ-free animal models, probiotics,antibiotics, and infection studies. In clinical practice, evidence ofmicrobiota-GBA interactions comes from the association of dysbiosis with central nervous disorders (i.e. autism, anxiety-depressive behaviors) and functional gastrointestinal disorders. In particular, irritable bowel syndrome can be considered an example of the disruption of these complex relationships, and a better understanding of these alterations might provide new targeted therapies.∙1Alimentary Pharmabiotic Centre, University College, Cork, Ireland; Department of Psychiatry, University College Cork, Ireland. Electronic address: t.dinan@ucc.ie.∙2Alimentary Pharmabiotic Centre, University College, Cork, Ireland; Department of Anatomy and Neuroscience, University College Cork, Ireland.∙3Alimentary Pharmabiotic Centre, University College, Cork, Ireland; Department of Psychiatry, University College Cork, Ireland; Teagasc, Moorepark, Cork, Ireland.AbstractThe human gut harbors a dynamic and complex microbial ecosystem, consisting of approximately 1 kg of bacteria in the average adult, approximately the weight of the human brain. The evolutionary formation ofa complex gut microbiota in mammals has played an important role in enabling brain development andperhaps sophisticated social interaction. Genes within the human gut microbiota, termed the microbiome,significantly outnumber human genes in the body, and are capable of producing a myriad of neuroactive compounds. Gut microbes are part of the unconscious system regulating behavior. Recent investigations indicate that these microbes majorly impact on cognitive function and fundamental behavior patterns, such as social interaction and stress management. In the absence of microbes, underlyingneurochemistry is profoundly altered. Studies of gut microbes may play an important role in advancing understanding of disorders of cognitive functioning and social interaction, such as autism.∙1Swette Center for Environmental Biotechnology, Biodesign Institute, Arizona State University, Tempe, AZ, USA.∙2School of Sustainable Engineering and The Built Environment, Arizona State University, Tempe, AZ, USA; dr.rosy@.∙3Department of Medicine, University of Colorado-Denver, Aurora, CO, USA.∙4School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA.AbstractRecent studies suggest a role for the microbiota in autism spectrum disorders (ASD), potentially arising from their role in modulating the immune system and gastrointestinal (GI) function or from gut-brain interactions dependent or independent from the immune system. GI problems such as chronicconstipation and/or diarrhea are common in children with ASD, and significantly worsen their behavior and their quality of life. Here we first summarize previously published data supporting that GI dysfunction is common in individuals with ASD and the role of the microbiota in ASD. Second, by comparing with other publically available microbiome datasets, we provide some evidence that the shifted microbiota can be a result of westernization and that this shift could also be framing an altered immune system. Third, we explore the possibility that gut-brain interactions could also be a direct result of microbially produced metabolites.∙1BioFrontiers Institute, University of Colorado, Boulder, CO, USA.∙2Department of Computer Science, University of Colorado, Boulder, CO, USA.∙3Center for Infection and Immunity, Columbia University Mailman School of Public Health, New York, NY, USA.∙4Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.∙5Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA.∙6Department of Chemistry and Biochemistry, University of Colorado at Boulder, Boulder, CO, USA.∙7Institute for Genomic and Systems Biology, Argonne National Laboratory, Argonne, IL, USA.∙8Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA.∙9Marine Biological Laboratory, Woods Hole, MA, USA.∙10College of Environmental and Resource Sciences, Zhejiang University, Hangzhou, China;gilbertjack@.∙11Howard Hughes Medical Institute, Boulder, CO, USA.AbstractDifferences in the gut microbiota have been reported between individuals with autism spectrum disorders (ASD) and neurotypical controls, although direct evidence that changes in the microbiome contribute to causing ASD has been scarce to date. Here we summarize some considerations of experimental design that can help untangle causality in this complex system. In particular, large cross-sectional studies that can factor out important variables such as diet, prospective longitudinal studies that remove some of the influence of interpersonal variation in the microbiome (which is generally high, especially in children), and studies transferring microbial communities into germ-free mice may be especially useful. Controlling for the effects of technical variables, which have complicated efforts to combine existing studies, is critical when biological effect sizes are small. Large citizen-science studies with thousands of participants such as the American Gut Project have been effective at uncovering subtle microbiome effects in self-collected samples and with self-reported diet and behavior data, and may provide a useful complement to other types of traditionally funded and conducted studies in the case of ASD, especially in the hypothesis generation phase.J Clin Invest. 2015 Mar 2;125(3):926-38. doi: 10.1172/JCI76304. Epub 2015 Feb 17.Gut/brain axis and the microbiota.Mayer EA, Tillisch K, Gupta A.AbstractTremendous progress has been made in characterizing the bidirectional interactions between the central nervous system, the enteric nervous system, and the gastrointestinal tract. A series of provocativepreclinical studies have suggested a prominent role for the gut microbiota in these gut-brain interactions.Based on studies using rodents raised in a germ-free environment, the gut microbiota appears toinfluence the development of emotional behavior, stress- and pain-modulation systems, and brainneurotransmitter systems. Additionally, microbiota perturbations by probiotics and antibiotics exertmodulatory effects on some of these measures in adult animals. Current evidence suggests that multiple mechanisms, including endocrine and neurocrine pathways, may be involved in gut microbiota-to-brain signaling and that the brain can in turn alter microbial composition and behavior via the autonomicnervous system. Limited information is available on how these findings may translate to healthy humans or to disease states involving the brain or the gut/brain axis. Future research needs to focus on confirming that the rodent findings are translatable to human physiology and to diseases such as irritable bowel syndrome, autism, anxiety, depression, and Parkinson's disease.∙1Department of Biochemistry, Rush University Medical Center, Cohn Research Building, 1735 W.Harrison St., Room 506, Chicago, IL 60612, United States.∙2Department of Medicine, Knapp Center for Biomedical Discovery, University of Chicago, Chicago, IL 60637, United States.AbstractHumans have coevolved with their microbes over thousands of years, but this relationship, is now being dramatically affected by shifts in the collective human microbiome resulting from changes in theenvironment and societal norms. Resulting perturbations of intestinal host-microbe interactions can lead to miscues and altered host responses that increase the risk of pathogenic processes and promote"western" disorders such as inflammatory bowel diseases, cancers, obesity, diabetes, autism, andasthma. Given the current challenges and limitations in gene therapy, approaches that can reshapethe gut microbiome represent a reasonable strategy for restoring the balance between host and microbes.In this review and commentary, we highlight recent progress in our understanding of the intestinalmicrobiome in the context of health and diseases, focusing on mechanistic concepts that underlie the complex relationships between host and microbes. Despite these gains, many challenges lie ahead that make it difficult to close the gap between the basic sciences and clinical application. We will discuss the potential therapeutic strategies that can be used to manipulate the gutmicrobiota, recognizing that the promise of pharmabiotics ("bugs to drugs") is unlikely to be completely fulfilled without a greaterunderstanding of enteric microbiota and its impact on mammalian physiology. By leveraging theknowledge gained through these studies, we will be prepared to enter the era of personalized medicine where clinical inventions can be custom-tailored to individual patients to achieve better outcomes.∙1Department of Molecular and Cellular Biology, University of Guelph, Guelph, Canada.∙2Department of Molecular and Cellular Biology, University of Guelph, Guelph, Canada;eav@uoguelph.ca.AbstractThe human gut microbiota is a complex microbial ecosystem that contributes an important component towards the health of its host. This highly complex ecosystem has been underestimated in its importance until recently, when a realization of the enormous scope of gut microbiota function has been (andcontinues to be) revealed. One of the more striking of these discoveries is the finding thatthe gut microbiota and the brain are connected, and thus there is potential for the microbiota in the gut to influence behavior and mental health. In this short review, we outline the link between brainand gut microbiota and urge the reader to consider the gut microbiota as an ecosystem 'organ' rather than just as a collection of microbes filling a niche, using the hypothesized role ofthe gut microbiota in autism spectrum disorder to illustrate the concept.Ochratoxin A as possible factor trigging autism and its maleprevalence via epigenetic mechanism.Mezzelani A, Raggi ME, Marabotti A, Milanesi L.AbstractThe role of dysbiosis causing leaky gut with xenobiotic production and absorption is increasinglydemonstrated in autism spectrum disorder (ASD) pathogenesis. Among xenobiotics, we focused on ochratoxin A (one of the major food contaminating mycotoxin), that in vitro and in vivo exerts a male-specific neurotoxicity probably via microRNA modulation of a specific target gene. Among possible targets, we focused on neuroligin4X. Interestingly, this gene carries some SNPs already correlated with the disease and with illegitimate microRNA binding sites and, being located on X-chromosome, could explain the male prevalence. In conclusion, we propose a possible gene-environment interactiontriggering ASD explaining the epigenetic neurotoxic mechanism activated by ochratoxin A in genetically predisposed children. This mechanism offers a clue for male prevalence of the disease and may have an important impact on prevention and cure of ASD.∙1KU Leuven, Department of Microbiology and Immunology, Rega Institute, Herestraat 49, B-3000 Leuven, Belgium. VIB, Center for the Biology of Disease, Herestraat 49, B-3000 Leuven, Belgium.Microbiology Unit, Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium.∙2KU Leuven, Department of Microbiology and Immunology, Rega Institute, Herestraat 49, B-3000 Leuven, Belgium. VIB, Center for the Biology of Disease, Herestraat 49, B-3000 Leuven, Belgium.∙3KU Leuven, Department of Microbiology and Immunology, Rega Institute, Herestraat 49, B-3000 Leuven, Belgium. VIB, Center for the Biology of Disease, Herestraat 49, B-3000 Leuven, Belgium.Microbiology Unit, Faculty of Sciences and Bioengineering Sciences, Vrije Universiteit Brussel, Pleinlaan 2, B-1050 Brussels, Belgium. jeroen.raes@med.kuleuven.be.AbstractThe microbiota of the human gut is gaining broad attention owing to its association with a wide range of diseases, ranging from metabolic disorders (e.g. obesity and type 2 diabetes) to autoimmune diseases (such as inflammatory bowel disease and type 1 diabetes), cancer and even neurodevelopmentaldisorders (e.g. autism). Having been increasingly used in biomedical research, mice have become the model of choice for most studies in this emerging field. Mouse models allow perturbationsin gut microbiota to be studied in a controlled experimental setup, and thus help in assessing causality of the complex host-microbiota interactions and in developing mechanistic hypotheses. However, pitfalls should be considered when translating gut microbiome research results from mouse models to humans.In this Special Article, we discuss the intrinsic similarities and differences that exist between the two systems, and compare the human and murine core gut microbiota based on a meta-analysis of currently available datasets. Finally, we discuss the external factors that influence the capability of mouse models to recapitulate the gut microbiota shifts associated with human diseases, and investigate whichalternative model systems exist for gut microbiota research.。
大学教育对所有的东西都是有利的吗英语作文
大学教育对所有的东西都是有利的吗英语作文Is University Good For Everything?Hi there! My name is Jimmy and I'm 10 years old. I love learning about all sorts of things like science, math, reading, and more. My big sister just started university last year and it got me thinking - is going to university really good for every single subject?From what I can tell, university seems amazing for some topics but maybe not so great for others. Let me explain what I mean.The Awesome Stuff University Is Great ForThere are definitely areas where university makes total sense and can really help people become experts. Take something like medicine or engineering. To become a doctor or an engineer, you need advanced, specialized training over several years. You can't just read some books and call yourself a surgeon! The human body and building bridges are super complex. University is the perfect place to dive deep into these intricate fields in a hands-on way with guidance from professors who dedicate their lives to teaching this stuff.Same goes for other careers like law, accounting, architecture and more. These are disciplines that require extended study from people who have mastered the subject matter inside and out. You're just not going to get that level of comprehensive, immersive education without going to university.University also seems awesome for academics who want to spend their life pursuing knowledge and research in a particular domain. If you dream of making the next scientific breakthrough or philosophical insight, joining the university as a student and later professor is probably going to be your best path. They have the resources, colleagues, labs and academic environment to support those ambitions over decades of work.Creativity and Open-Ended LearningBut then there are areas where university feels less essential in my opinion. What about more open-ended creative fields? Do you need a formal university degree to become a brilliant artist, writer, musician or creator of any kind? Lots of hugely successful people in these areas have been self-taught talents who didn't get a relevant university credential.University is mainly structured around taking courses, following set curriculums, and getting graded on your retentionand mastery of that material. That conventional model works well for established fields. But what if you want to be a creative pioneer who charts their own path? Do you really need to spend four years and a bunch of money sitting in classes to find your artistic voice and vision? Couldn't you develop your skills and body of work in a more freeform, self-directed way?I'm sure university arts programs are enriching and provide great foundational knowledge. But formal education and restrictive curriculums aren't necessarily a prerequisite for thriving in creative mediums based on experimentation, intuition and developing your own authentic style over years of dedication.Practical Learning by DoingAnother area where university feels less critical is hands-on skilled labor. Things like plumbing, construction, mechanics, repair and the trades in general. For topics like these, the best form of education is simply doing the work under the guidance of an experienced mentor or apprenticeship program. You need hands-on repetition in real-world scenarios, not just book knowledge.I imagine a university could provide some relevant technical instruction. But learning a skilled trade is ultimately aboutphysically practicing the craft and accumulating on-the-job hours and experience. You can't just theorize your way into becoming an expert plumber or electrician! This type of work seems better suited for vocational schools or just starting as an apprentice to someone already doing the job professionally.Life Skills and Practical WisdomThere are also lots of super important parts of life that aren't necessarily tied to a formal university curriculum. Things like personal finance, entrepreneurship, leadership, decision making, emotional intelligence, conflict resolution and so on.Don't get me wrong, you could probably take some classes covering these topics at university if you wanted to. And universities often strive to instill certain values and soft skills in their students beyond just academic knowledge. But ultimately, much of this "practical wisdom" tends to get learned through lived experience, self-study, being mentored and putting yourself in real-world situations where you're forced to grow.For example, I'm sure having a university degree could be really helpful for starting a business. But I don't think it's an absolute requirement for entrepreneurial success. There are plenty of entrepreneurs who became tremendously prosperous by taking massive action, constantly educating themselves,developing relentless grit and using wise judgement they accumulated through the ups and downs of actually doing it.So in many ways, this type of essential "life mastery" comes from your own drive, experiences and ability to learn the lessons each day brings. The journey of becoming a well-rounded, capable human being isn't necessarily confined to university.A Balanced ApproachDon't get me wrong, I'm not bashing university by any means! Higher education plays an enormously important role in advancing humanity and there are clearly many areas where it is incredibly valuable or even indispensable depending on your goals.I just think it's an overgeneralization to say that university is 100% critical for all skills and knowledge under the sun. There are plenty of domains and types of learning where other approaches can be just as legitimate and effective, if not more so.The path isn't always university -> career -> retirement anymore. Careers are becoming more dynamic and youth entering the workforce should stay open-minded about all the possible roads available, including ones that divert from conventional university-streamed paths.At the end of the day, being a lifelong "master student" is vastly more important than what type of schooling you get or don't get. Feed your curiosities, chase your passions, always keep acquiring new knowledge and skillsets, and have the humility to recognize there is always more to learn no matter how many degrees you have.That constant pursuit of growth through whatever means work best for you and your goals? That's true higher education if you ask me!Phew, well that's my ten-year-old take on this whole university education debate! I'd love to hear what you all think as well. Am I being wise beyond my years here or just a naive kid? Let me know!。
高三英语学术研究方法单选题30题
高三英语学术研究方法单选题30题1. In a literature review, which of the following is the most important step?A. Collecting a large number of sourcesB. Selecting relevant and reliable sourcesC. Reading the sources quicklyD. Copying the content of the sources directly答案：B。
本题考查文献综述中最重要的步骤。
选项A 收集大量来源固然重要，但质量更关键；选项C 快速阅读来源可能会忽略重要信息；选项 D 直接复制来源内容是学术不端行为。
选项 B 选择相关可靠的来源是确保文献综述质量的关键步骤。
2. When conducting a literature review, how should you handle contradictory information from different sources?A. Ignore it and focus on the consistent informationB. Choose the information that supports your hypothesisC. Analyze and try to reconcile the differencesD. Just randomly pick one of the pieces of information答案：C。
在进行文献综述时，面对不同来源的矛盾信息，选项A 忽略它只关注一致信息可能会导致研究不全面；选项B 只选择支持假设的信息会使研究有偏差；选项 D 随机挑选信息是不科学的。
选项C 分析并尝试调和差异是正确的处理方式。
3. What is the purpose of citing sources in a literature review?A. To show off your knowledgeB. To increase the word count of your reviewC. To give credit to the original authors and support your argumentsD. To make the review look more complicated答案：C。
高一英语心理学知识单选题30题
高一英语心理学知识单选题30题1.Psychology is the scientific study of _____.A.behavior and mental processesnguage and communicationC.math and scienceD.history and culture答案：A。
心理学是对行为和心理过程的科学研究。
选项B 语言和交流不是心理学的主要研究对象；选项C 数学和科学也不是心理学的研究范畴；选项D 历史和文化也不属于心理学的研究内容。
2.Who is known as the father of psychology?A.Sigmund FreudB.William JamesC.John WatsonD.Ivan Pavlov答案：B。
威廉·詹姆斯被称为心理学之父。
西格蒙德·弗洛伊德是精神分析学派创始人；约翰·华生是行为主义心理学代表人物；伊万·巴甫洛夫以经典条件反射实验闻名。
3.The famous Stanford Prison Experiment was conducted by _____.gramB.ZimbardoC.AschD.Piaget答案：B。
著名的斯坦福监狱实验是由津巴多进行的。
米尔格拉姆进行了服从权威实验；阿希进行了从众实验；皮亚杰是儿童心理学家。
4.Psychologists who study how people think, learn, and remember are called _____.A.cognitive psychologistsB.social psychologistsC.developmental psychologistsD.clinical psychologists答案：A。
研究人们如何思考、学习和记忆的心理学家被称为认知心理学家。
社会心理学家研究人与人之间的互动；发展心理学家研究人的成长和发展；临床心理学家主要处理心理障碍。
雅思作文2018.1013
雅思作文2018.1013IELTS Essay: 2018.1013 The rapid advancements in technology have undoubtedly revolutionized numerous aspects of human life. However, there is an ongoing debate surrounding the overall impact of technology, with some arguing that it has made our lives easier while others contend that it has made them more complicated. This essay will delve into both sides of the argument, ultimately concluding that while technology has brought undeniable benefits, it has also introduced complexitiesthat must be carefully navigated. On the one hand, technology has undeniably simplified many aspects of daily life. Communication has been revolutionized bythe internet and smartphones, enabling instant connections across geographical boundaries. Social media platforms allow us to stay connected with friends and family regardless of distance. Online shopping platforms offer unparalleled convenience, enabling us to purchase goods and services from the comfort of our homes. Technological advancements in healthcare have led to improved diagnoses, treatments, and overall well-being. From scheduling appointments to accessing medical records, technology has streamlined the healthcare experience. Transportation has been similarly transformed, with ride-sharing apps and GPS navigation systems making travel more efficient and convenient. However, it is essential to acknowledge the complexities that technology has introduced. The overwhelming volume of information available online can lead to information overload and difficulty in discerning credible sources from misinformation. Social media, despite its ability to connect people, can also fuel social isolation and anxiety as individuals strive to portray idealized versions of themselves online. The constant connectivity fostered by smartphones can blur the boundaries between work and personal life, leading to burnout and decreased productivity. Furthermore, technological advancements in fields like artificial intelligence and automation raise concerns about job displacement and widening socioeconomic disparities. Navigating the digital world necessitates the development of new skills and literacies. Critical thinking is paramount to discerning the veracity of online information, while digital literacy is crucial for navigating the complexities of online platforms and applications. Moreover, ethical considerations must be at the forefront of technological development and implementation. Ensuring privacy anddata security is crucial in an increasingly interconnected world. Addressing the potential for algorithmic bias in areas like hiring and loan applications is essential for mitigating societal inequities. While technological advancements have undoubtedly brought immense benefits, it is crucial to approach them with a discerning eye. Embracing the advantages while mitigating the potential drawbacks necessitates a multifaceted approach. Education plays a critical role in equipping individuals with the skills and knowledge to navigate the digital landscape effectively. Fostering critical thinking, digital literacy, and ethical awareness are paramount. Furthermore, policymakers and industry leaders must proactively address concerns related to job displacement, data security, and algorithmic bias. The impact of technology on human life is multifaceted and complex. While it has simplified many aspects of our lives, it has also introduced new challenges. Ultimately, the key to harnessing the transformative power of technology lies in embracing its benefits while mitigating its potential drawbacks. By fosteringcritical thinking, digital literacy, and ethical awareness, and by addressing the societal implications of technological advancements, we can strive towards afuture where technology serves as a force for progress and betterment. In conclusion, the debate surrounding the impact of technology is likely to persistas technology continues to evolve at an unprecedented pace. However, byrecognizing both the benefits and complexities that technology presents, and by actively engaging in critical discourse and proactive solutions, we can harnessits power to create a more equitable, sustainable, and enriching future for all.。
197-Common Questons About Constipation
International Foundation for Functional Gastrointestinal DisordersIFFGD700 W. Virginia St., #201 Milwaukee, WI 53204Phone: 414-964-1799Toll-Free (In the U.S.): 888-964-2001Fax: 414-964-7176 Internet: (197)© Copyright 2005-2012 by the International Foundation for Functional Gastrointestinal DisordersCommon Questions About Constipation: Myths and MisconceptionsBy: Kenneth G. Mandel, Ph.D.In January 2005, Drs. Stefan Muller-Lissner of Germany, Michael Kamm of the U.K., CarmeloScarpignato of Italy, and Arnold Wald of the U.S., all noted gastroenterologists and experts on thetreatment of constipation, published a review article discussing various myths and misconceptions about constipation and its treatment.[1] Though most of the issues discussed in the article are well understood by the medical practice community, they persist among the general public and are still promoted by those who are uninformed. Hence, a brief discussion of the review article is relevant.Is there a danger from constipation that stool can remain for too long a time period in the colon? Can this cause other disease?Since ancient times there has been a belief that when stool resides in the colon for too long, “toxins” in the stool are released and can cause disease. This theory, which is referred to as “autointoxication” had a resurgence in the early 20th century, at which time the use of frequent enemas, cleansing purgatives, and even surgical removal of part or all of the colon were popular. Even today, colon cleansing with various purgative and enema procedures is promoted to maintain “colon health.” However, there is no foundation in science for this theory. No data have ever shown that toxins are generated in the colon to be absorbed and contribute to other diseases.Autointoxication is a myth. While surgical removal of the colon is used, though very rarely, as atreatment in extreme cases of chronic and untreatable constipation, it is only considered when constipation has proven unresponsive to all other means ofmedical treatment and the colon is proven to have a local neuromuscular disorder.Can changes in hormones cause constipation?Some studies have associated hormonal changes with constipation. For example, small studies show that women with severe idiopathic (of unknown cause) constipation have a reduction in sex hormone levels in the blood. Other small studies have reported a diminished release of gastrointestinal hormones in response to meals in chronically constipated patients. Despite such observational correlations, there is no evidence for a cause and effect relationship. Rather, it appears that changes in hormone responses are secondary to alterations in gut function or metabolism.Is constipation caused by low intake of fiber or fluid?There is a general concept that low intake of fiber or fluids may commonly cause constipation. Western diets often provide only about 1/3 of the daily levels of fiber intake recommended by nutritionists. Hence, fiber, often provided as supplements or over the counter drugs, is widely used to treat constipation. Fiber clearly increases stool bulk and frequency, and decreases transit time in healthy people, and may benefit individuals with relatively minor oroccasional constipation. However, the few studies in which dietary fiber has been used to treat chronic constipation have not demonstrated significant benefit. Thus, many conclude that low fiber intake cannot be a cause of chronic constipation, and that increasing fiber intake is unlikely to offer significant benefit for patients with more severe constipation. Nevertheless, a high fiber diet should be tried before embarking on long-term drug treatments or special testing.There is also a belief that constipation can occur from drinking insufficient liquid. Even small changes in stool water content can considerably alter stool consistency. Osmotic laxatives work by this rationale. These agents (e.g., milk of magnesia or lactulose) help retain water in the stool. Normally, the colon absorbs very large amounts of water –almost 90–95% of the water that enters it daily. Therefore, simply adding a small amount of fluid to one’s diet, say 1 or 2 additional glasses of liquid, will not have an effect on constipation. So far, research does not support increasing fluid intake to relieve constipation, but dehydration should be avoided.Is the long-term use of stimulant laxatives for constipation unhealthy or unsafe?Laxatives are among the most commonly used medications. Stimulant laxatives, though indicated for occasional or short-term use, have been associated with concerns about their safety –specifically that they damage the intestine, increase the risk for colorectal cancer, and produce dependency.The belief that chronic use of stimulant laxatives causes damage to the intestine and colon is based on uncontrolled human studies. Though damage to nerves and muscle was observed, it is impossible to assign any cause-effect relationship. The data cannot explain if damage was due to laxative use (which was not documented), or whether it was part of the ongoing disease and the reason for the laxatives in the first place.In the only controlled study conducted to date, constipated patients treated with stimulant laxatives did not develop damage to their colons when compared to controls who did not receive laxatives. Hence, it is unlikely that stimulant laxatives are harmful when used at recommended doses. Nevertheless, the use of excessive laxatives over long periods has led to some serious metabolic consequences, such as dangerously low serum potassium.Despite one study reporting an association of constipation and the use of stimulant laxatives with an increased risk for colorectal cancer, the association is weak, and is actually less than that imposed by dietary factors alone (e.g., fat, meat, alcohol, low-vegetable intake, low-fiber intake). Subsequent studies have demonstrated no such association.Are stimulant laxatives habit forming?Although tolerance to laxatives has not been well studied in humans, animal data do not support development of tolerance. In one human study, no tolerance was observed in patients with constipation due to spinal cord injury who used bisacodyl for up to 34 years. A few patients with severe chronic constipation may find that they respond less to laxatives after prolonged use and may require larger doses. However, this is relatively uncommon. There are no data that suggest that laxatives are addictive or habit forming. Clearly, individuals with chronic constipation may require continued therapy, and may relapse when it is discontinued. However, this is not a sign of addiction or habituation.Overall, the available data indicates that laxatives are safe and effective treatments for constipation. If patients with constipation find that their treatments are becoming less effective, then it is time to consult a doctor about alternatives.References:(1) Muller-Lissner SA, Kamm MA, Scarpignato C, WaldA. Myths and misconceptions about chronic constipation. American Journal of Gastroenterology 100: 232-242, 2005.[Kenneth G. Mandel, Ph.D. is the President of KGM Innovation Associates, Inc., a medicine technology consulting service located in Fairfield, OH]Opinions expressed are an author’s own and not necessarily t hose of the International Foundation for Functional Gastrointestinal Disorders (IFFGD). IFFGD does not guarantee or endorse any product in this publication nor any claim made by an author and disclaims all liability relating thereto.This article is in no way intended to replace the knowledge or diagnosis of your doctor. We advise seeing a physician whenever a health problem arises requiring an expert's care.IFFGD is a nonprofit education and research organization. Our mission is to inform, assist, and support people affected by gastrointestinal disorders. For more information, or permission to reprint this article, write to IFFGD, 700 W. Virginia St., #201, Milwaukee, WI 53204. Call toll-free (In the U.S.): 888-964-2001 or 414-964-1799. Visit our websites at: or.。
肠嗜铬细胞及其分泌的5-羟色胺在肠易激综合征中的作用
肠嗜铬细胞及其分泌的5-羟色胺在肠易激综合征中的作用熊慧珍;祝金泉【摘要】肠易激综合征（irritable bowel syndrome．IBS）是一组包括腹痛或腹部不适、排便习惯改变和大便性状异常．持续存在或间歇发作。
而又缺乏形态学和生化异常改变可资解释的症候群。
按症状大致可以分为腹泻为主型（diarrhea—predominant IBS．D—IBS）、便秘为主型（constipation—predominant IBS,C—IBS）、腹泻便秘交替型（alemating IBS,A—IBS）。
近十多年来。
人们已普遍公认IBS是一种感觉、动力紊乱所致的肠功能性疾病。
胃肠运动功能障碍、内脏高敏感性和精神心理因素是IBS最重要的病理生理特征。
目前观点认为IBS患者的腹痛、胃肠运动功能及大便习惯的改变主要是由于胃肠道系统（肠道神经系统）与脊髓及脑（中枢神经系统）之间双向交流的通路调控紊乱。
【期刊名称】《江西医药》【年(卷),期】2006(041)006【总页数】4页(P423-426)【关键词】肠易激综合征;肠嗜铬细胞;5-羟色胺【作者】熊慧珍;祝金泉【作者单位】南昌大学第一附属医院消化内科研究所,南昌,330006;南昌大学第一附属医院消化内科研究所,南昌,330006【正文语种】中文【中图分类】医药卫生江西医药 2006 年第 41 卷第 6 期• 423 • 肠嗜错细胞及其分泌的 5 －瓷色胶在肠易激综合征中的作用熊慧珍祝金泉（南昌大学第一附属医院消化内科研究所，南昌，330006)关键词肠易激综合征 i肠嗜铭细胞； 5－经色胶中图分类号： R574肠易激综合征（irritable bowelsyndrome,IBS ）是一组包括腹痛或腹部不适、排便习惯改变和大便性状异常，持续存在或间歇发作，而又缺乏形态学和生化异常改变可资解释的症候群。
按症状大致可以分为腹泻为主型（diarrhea-predominantIBS, D-IBS ）、便秘为主型（constipation-predominant IBS, C-IBS ）、腹泻便秘交替型（ alernating IBS, A-IBS ）。
专题05 阅读理解D篇 (解析+词汇) -2024年1月浙江首考英语卷深度解析及变式训练 (解析版)
《2024年1月浙江首考英语卷深度解析及变式训练》专题05 阅读理解D篇(解析+词汇+变式+技巧+模拟) 解析版养成良好的答题习惯，是决定高考英语成败的决定性因素之一。
做题前，要认真阅读题目要求、题干和选项，并对答案内容作出合理预测;答题时，切忌跟着感觉走，最好按照题目序号来做，不会的或存在疑问的，要做好标记，要善于发现，找到题目的题眼所在，规范答题,书写工整;答题完毕时，要认真检查，查漏补缺，纠正错误。
关键词：说明文, 人与社会, 棉花糖测试, 心理测试, 信息轰炸, 抵御诱惑The Stanford marshmallow (棉花糖) test was originally conducted by psychologist Walter Mischel in the late 1960s. Children aged four to six at a nursery school were placed in a room. A single sugary treat, selected by the child, was placed on a table. Each child was told if they waited for 15 minutes before eating the treat, they would be given a second treat. Then they were left alone in the room. Follow-up studies with the children later in life showed a connect ion between an ability to wait long enough to obtain a second treat and various forms of success.As adults we face a version of the marshmallow test every day. We’ re not tempted (诱惑) by sugary treats, but by our computers, phones, and tablets — all the devices that connect us to the global delivery system for various types of information that do to us what marshmallows do to preschoolers.We are tempted by sugary treats because our ancestors lived in a calorie-poor world, and our brains developed a response mechanism to these treats that reflected their value —a feeling of reward and satisfaction. But as we’ve reshaped the world around us, dramatically reducing the cost and effort involved in obtaining calories, we still have the same brains we had thousands of years ago, and this mismatch is at the heart of why so many of us struggle to resist tempting foods that we know we shouldn’t eat.A similar process is at work in our response to information. Our formative environment as a species was information-poor, so our brains developed a mechanism that prized new information. But global connectivity has greatly changed our information environment. We are now ceaselessly bombarded (轰炸) with new information. Therefore, just as we need to be more thoughtful about our caloric consumption, we also need to be more thoughtful about our information consumption, resisting the temptation of the mental “junk food” in order to manage our time most effectively.32. What did the children need to do to get a second treat in Mischel’s test?A. Take an examination alone.B. Show respect for the researchers.C. Share their treats with others.D. Delay eating for fifteen minutes.33. According to paragraph 3, there is a mismatch between_______.A. the calorie-poor world and our good appetitesB. the shortage of sugar and our nutritional needsC. the rich food supply and our unchanged brainsD. the tempting foods and our efforts to keep fit34. What does the author suggest readers do?A. Absorb new information readily.B. Be selective information consumers.C. Use diverse information sources.D. Protect the information environment.35. Which of the following is the best title for the text?A. Eat Less, Read MoreB. The Bitter Truth about Early HumansC. The Later, the BetterD. The Marshmallow Test for Grownups【答案】32. D33. C34. B35. D【解析】【导语】这是一篇说明文。
新视野大学英语(第三版)读写教程Book2-unit8-textA课文翻译
Unit 8 Section A Animals or children?—A scientist's choice动物还是孩子？——一位科学家的选择1 I am the enemy! I am one of those cursed, cruel physician scientists involved in animal research. These rumors sting, for I have never thought of myself as an evil person. I became a children's doctor because of my love for children and my supreme desire to keep them healthy. During medical school and residency, I saw many children die of cancer and bloodshed from injury —circumstances against which medicine has made great progress but still has a long way to go. More importantly, I also saw children healthy thanks to advances in medical science such as infant breathing support, powerful new medicines and surgical techniques and the entire field of organ transplantation. My desire to tip the scales in favor of healthy, happy children drew me to medical research.1 我就是那个敌人！我就是那些被人诅咒的、残忍的、搞动物实验的医生科学家之一。
乳果糖防治产后排便困难PMS分析报告
摸索出适合产后便秘的有效治疗方案
起始剂量25-30ml，前3天维持剂量为20ml，第1周后可以降到15ml，治疗 周期为2周
福建
广西 广东
3.1% 4.1%
8.2%
海南
1.0%
2.3%
Contents
乳果糖防治产后排便困难PMS
研究背景 研究设计 入组情况 研究结果 讨论
乳果糖用药剂量
研究结果
乳果糖治疗剂量需要自行调整，治疗后期逐渐减量
50
产妇占比（%）
多数患者的治疗从15ml 向10ml移动
40 30 20 10 0 0
吴嘉煌等 中华医学杂志 2009年
预防产后便秘的临床意义
便秘严重损害了女性患者的生活质量，对于慢性便秘应引起临床 医师，包括妇产科，消化科等的足够重视。 注意女性的孕产期及产后保健，避免便秘的易患因素，早期干 预，综合治疗，有利于产后康复，提高女性的生活质量，关爱女性健 康。
吴嘉煌等 中华医学杂志 2009年
50.5
64.5 55.8
29.1 18.2 11.1 2.9 1.4 1.6 2.2
0天 1天 2天 3天 7天 14 天 21 天 28 天
75.4 70.1 67.4
47.3 * 37.4 22.2
0天
1天
2天
3天
7天
1、2型
停乳果糖后 疗效仍保持
3、4型
14 天 21 天 28 天
停乳果糖后 疗效仍保持
产后便秘的危害
便秘是肛肠疾病最大的祸根
讨论
直肠内长期滞留有毒物质不仅可诱发直肠癌，且粪便堆积，影响血液循环。用 力解出干燥粪块，必然会使肛门承受较大压力，产生瘀血、胀肿、裂口。
大学英语六级作文要求英语
In contemporary society, higher education plays an instrumental role in shaping future professionals and leaders. The notion of 'high-quality university education' transcends mere academic excellence; it is a multifaceted construct that encompasses intellectual growth, personal development, ethical values, and practical skills. This essay aims to delve deeply into several key dimensions that contribute to defining and achieving this standard.Firstly, academic rigor is the cornerstone of high-quality university education. It involves not only imparting comprehensive knowledge but also fostering critical thinking and analytical abilities. Professors should lead engaging lectures and discussions, encouraging students to question, analyze, and synthesize information from multiple sources. Moreover, universities should provide challenging curricula that reflect the latest advancements in their respective fields, ensuring that graduates are equipped with cutting-edge knowledge and prepared for the dynamic global job market. Assessment methods must be rigorous and fair, promoting genuine learning rather than rote memorization.Secondly, practical application and experiential learning form another pivotal aspect. Universities need to integrate internships, research projects, and case studies to bridge the gap between theoretical knowledge and real-world applications. This hands-on approach allows students to develop problem-solving skills, adaptability, and innovation, which are highly valued by employers. Laboratories, workshops, and simulation exercises further enhance these experiences, offering students opportunities to apply classroom learning in practical scenarios.Thirdly, nurturing personal development and fostering a sense of social responsibility are equally crucial. Universities should cultivate environments where students can hone their interpersonal skills, emotional intelligence, leadership qualities, and cultural awareness through group activities, clubs, and community service. These extracurricular engagements instill values of teamwork, empathy, and civic engagement, contributing significantly to holisticdevelopment.Fourthly, emphasis on ethics and integrity is indispensable. Higher education institutions have the responsibility to embed moral and ethical principles into their teaching, research, and campus culture. This includes educating students about professional ethics, respect for diversity, and the importance of honesty and transparency in all aspects of life. By doing so, they prepare students to become responsible citizens who can make informed decisions and positively impact society.Lastly, the quality of faculty and resources is a decisive factor. Talented professors with industry experience and strong research backgrounds inspire students and offer valuable mentorship. Equally important are well-equipped libraries, state-of-the-art technology, and modern facilities that facilitate effective learning.In conclusion, a high-quality university education is a complex tapestry woven from threads of academic rigor, practical learning, personal development, ethical values, and top-notch resources. Each component is interconnected and complementary, working together to produce graduates who are intellectually robust, socially aware, ethically grounded, and professionally adept. Institutions of higher learning must strive continuously to refine and improve upon these standards, ensuring that they remain relevant and responsive to the ever-evolving needs of the society and the world at large.Note: This response serves as a blueprint or outline for a longer piece. An actual essay exceeding 1248 words would expand on each point, providing examples, evidence, and further discussion to substantiate the arguments presented.。
学位英语万能小作文
学位英语万能小作文Crafting a Compelling English Proficiency Dissertation.Introduction.In the realm of academia, a dissertation serves as a culmination of years of rigorous research and scholarly inquiry. For non-native English speakers pursuing doctoral degrees, the task of crafting a dissertation in English presents unique challenges that require meticulous planning and preparation. This article provides comprehensive guidance on how to approach this daunting endeavor,offering insights into language proficiency assessment, writing strategies, and essential steps to ensure a polished dissertation that meets the highest academic standards.1. Assessing Your English Proficiency.Before embarking on the dissertation writing journey,it is crucial to assess your English proficiency. This involves evaluating your command of grammar, vocabulary, and writing skills. Several standardized tests, such as the Test of English as a Foreign Language (TOEFL) or the International English Language Testing System (IELTS), provide reliable measures of English proficiency. Aim for a score that meets the minimum requirements of youruniversity or department.2. Establishing a Solid Writing Foundation.Once your language proficiency has been established, focus on strengthening your writing skills through consistent practice. Read academic literature extensively, paying attention to the structure, style, and vocabulary employed by renowned scholars in your field. Attend writing workshops and seek feedback from experienced professors or writing tutors to refine your writing style and eliminate any linguistic errors.3. Crafting a Dissertation Proposal.The dissertation proposal outlines the scope, objectives, and methodology of your research. This document should be written in clear and concise English, demonstrating your research skills and the significance of your chosen topic. Ensure that the language is precise, avoiding colloquialisms or informal expressions.4. Conducting Rigorous Research.The heart of your dissertation lies in the research you conduct. Design a research plan that is both feasible and relevant to your topic. Gather data ethically and analyzeit meticulously. Throughout the process, maintain detailed documentation and keep a research journal to track your progress and insights.5. Drafting the Dissertation.With research completed, it is time to embark on the actual dissertation writing. Divide the work into manageable sections, starting with the introduction, which provides context and background for your research. Proceedlogically through the body of the dissertation, presenting your findings and arguments in a well-structured manner. Conclude with a strong summary of your research, highlighting its implications and contributions to the field.6. Editing and Proofreading.Once the dissertation draft is complete, meticulous editing and proofreading are essential. Check for grammatical errors, spelling mistakes, and inconsistencies in style. Seek feedback from native English speakers, such as your supervisor or colleagues, to ensure that the language is clear and polished.7. Preparing for the Defense.After submitting your dissertation, you will likely need to defend your work before a panel of experts. Prepare for this oral defense by practicing your presentation and anticipating potential questions. Focus on presenting your research confidently and articulately, showcasing yourEnglish proficiency and the depth of your knowledge.8. Publishing and Disseminating Your Research.Upon successful defense, consider publishing your dissertation in an academic journal or presenting your findings at conferences. This not only disseminates your research but also demonstrates your ability to communicate effectively in English within the scholarly community.Conclusion.Crafting an English proficiency dissertation is a challenging but rewarding endeavor that requires a combination of linguistic proficiency, writing skills, and research expertise. By following these steps, non-native English speakers can overcome language barriers and produce dissertations that meet the highest academic standards. Remember, the process requires dedication, persistence, and a willingness to embrace feedback. With careful planning and relentless effort, you can overcome the challenges andshowcase your academic prowess through a polished and impactful dissertation written in impeccable English.。
Stressandhealth
STRESS AND HEALTHThomas P Carey Jr. RRT MPHProfessor of Allied HealthBerkshire Community CollegeStressed-Out? Welcome to the Club!▪A US News survey found 7 out of 10 people felt stress at some point on a typical weekday.▪Prevention Magazine, 54% of respondents feltthey had more stress in their lives than theirparents did.▪About 75% of those asked said that stress waspreventing them from enjoying their lives more.The American PsychologicalAssociation(APA) study,Stress in America 2012▪What’s causing stress in America?▪Money, work and the economy.▪As well as personal health and theirfamily’s health▪People experience more stress whenever they are subjected to a lot of change in ashort period of time.▪These days it is a excess of change ▪More uncertainty▪Often feeling threatened▪OverwhelmedGetting frazzled at work▪For most people, their jobs and careersare the biggest source of stress in theirlives.▪Heavier workloads▪A boss from hell▪Toxic coworkers▪Restructuring▪Lay offsFrazzled @ Home▪Meals have to be prepared▪The house cleaned▪Laundry to be done▪Bills paid▪Chores completed▪Lawn and garden tended▪Homework to be done▪Kids chauffeured▪Did I mention the dog?Money Malaise-lack of▪Mortgage▪College tuition▪Braces▪Camp▪Travel▪Taxes▪Savings for retirementThe little things add up! ▪Besides major stressors and moderatestressors there are micro-stressors.▪Obnoxious neighbors▪Wal-Mart (Hotel California)▪Long lines▪Cable TV repair only between 12-5▪Cell phones going off everywhereIdentifying the Effects of Stress▪About 50% of those surveyed said thatstress was affecting their health.▪21% said that stress was negativelyaffecting their friendships.▪19% said that stress was hurting theirmarriages.▪15% said that stress was affecting theirperformance at work.What is the biggest cause of stress in our lives.Answer: Its other people ▪Interaction withpeople is largelyresponsible for theamount of stress weexperienceStress in human relationships comes from a combination of failure to meet expectations of others and failure to get yours met.Defining Stress▪“Defining stress islike nailing Jell-o to atree”▪Its like defininghappiness. Stress is what you experience when you believe you cannot cope effectively with a threatening situation or…Stress is created when your mind overrides the body’s basic desire to choke the living sh*t out of some idiot who desperately deserves it. How This Whole Stress Thing Got StartedStress way back when was nature’s way of keeping you alive.The Autonomic Nervous System▪The Sympathetic Nervous System▪The fight, flight or Fright response▪The Parasympathetic Nervous System ▪The rest and digest responsePhysiologic Changesin the Fight or Flight Response▪Heart▪HR Increases, force of contraction increases ▪BP▪Increases▪Lungs▪RR increases, bronchodilation▪Blood Clotting▪Blood clots faster▪Blood flow to skin▪Redirected to the brain and skeletalmuscles▪Eyes-Pupil size▪Pupils dilate▪Fat Tissue▪Increased breakdown of stored fat▪Brain▪Increased blood flow and increasedmetabolism of glucose▪Liver▪Converts glycogen to glucose▪GI tract▪Decreased protein synthesis anddecreased salivationStress can convict you▪Stress is a well documented cause ofillness▪Mind body disease-any condition to bethe result of excess emotional arousal,maladaptive coping and chronic distress ▪Anxiety, anger, fear and frustration canincrease the body’s susceptibility todiseaseStress plays a major role in circulatory diseases▪Stress:▪Increases BP▪Constricts blood vessels▪Increases your cholesterol level▪Increases HR and rate of blood clotting ▪Triggers arrhythmias ▪Such as▪Coronary Artery Disease▪CVA’s▪Sudden Cardiac DeathStress is implicated in @ least 80% of illnesses Stress lowers the body’s resistanceto diseaseUp to 75% of all Dr’s visits are forcomplaints/conditions that are stress related Experiencing severe stress for more than 1 month but less than 6 monthsdoubled a person’s risk of coming down with a cold Stress linked to Obesityand Depression▪68% of adults are overwt, 34% areobese.▪1 in 10 American adults suffer fromdepression.▪Obesity and depression are oftenexacerbated by stress.Unhealthy behaviors due to stress: (APA)▪29% skipped a meal due to stress▪39% reported overeating or eatingunhealthy foods▪44% reported lying awake at nite.▪41% Lack of motivation(esp when itcomes to exercise)Caregiving and Stress (APA)▪Millions of Americans providing care foraging of chronically ill family members at home▪55% of caregivers say they feeloverwhelmed by the amount of care their aging or chronically ill family memberrequires.Asthma and Stress▪Lancet 2000▪“Severe events, both on their own and in conjunction with chronic stress,significantly increased the risk of newasthma attacks”Asthma and Stress▪The stress of schoolexaminations onotherwise healthyyoung collegestudents with mildasthma increasedthe number ofeosinophils in theblood and sputum.▪AJRCCM 2002; 165-171▪Stressful life events increase the likelihood of a new asthma attack in children, according to theresults of a prospective study published in the December issue ofThorax 2005▪Maternal stress during pregnancy is linked to a higher risk for asthma in the offspring, according to the results of a prospective study reported online March 18, 2010in the American Journal of Respiratory and Critical Care Medicine ▪Stress and violent crime can contribute to the severity of childhood asthma, according toa longitudinal study presented here at the American Academy ofAllergy, Asthma and Immunology (AAAAI) 2010 Annual MeetingStress and Cancer▪ABC News March 6, 2006▪“While the research is young, “inflammatorypathways activated by stress have beenimplicated in the development of tumors,metastasis of tumors, and resistance tochemotherapy”▪Apr 12, 2010 Journal of Clinical Investigationshowed that stress hormones, such asadrenaline, can directly support tumor growthand metastasisCan stress increase a person’s risk of developing cancer?▪Results of some studies have indicated a linkbetween various psychological factors and anincreased risk of developing cancer, a directcause-and-effect relationship has not beenproven.Midlife Psychological Stress and Risk of Dementia▪Lena Johansson and colleges published in Brain.2010;133(8):2217-2224found an association betweenpsychological stress in middle-agedwomen and development of dementia,especially Alzheimer's diseaseVent PtsDifficulty incommunication wasa positive predictor ofpatient’spsychologicaldistress.“Stress Can Be Good!”Stress Can Be:▪Motivating▪Energizing▪Exciting▪Fun▪Challenge us to greater endeavor Stress is often in the eyeof the beholder▪A situation might bestressful to you▪Might be a minorirritation to some oneelse▪Or not stressful at allto others▪Wally-World Physical Signs of Stress Arousal▪Muscle tension▪Tiredness, Fatigue▪Shakiness, tremors ▪Heartburn, indigestion ▪Diarrhea/constipation ▪Drug/ETOH abuse▪Overeating/loss of appetite▪Gum Disease▪Ulcers ▪Excessive sweating ▪Rashes/hives itching ▪Sleep disturbances ▪Nail bitingPsychological Signs▪Depression▪Anxiety▪Withdrawal▪Hostile/aggressive behavior▪Irritability▪Moodiness▪Intrusive racing thoughts ▪Memory Lapses▪Difficulty concentrating▪Lowered productivity ▪Feeling overwhelmed ▪Loss of sense of humorThe Emotional and Physical Toll of Stress Americans reported s/s of stress:▪Irritability or anger 42%▪Fatigue 37%▪Lack of interest/motivation 35%▪Headaches 32%▪Upset stomachs 24%▪Change in appetite 17%There are two kinds of stressors▪External▪Physical Env: noise, lights, heat▪Social-interaction with people▪Organizational-rules, regs, deadlines▪Major Life Events▪Daily Hassles ▪Internal▪Lifestyle choices: too much caffeine, notenough sleep▪Negative Self talk:pessimistic thinking▪Mind traps: unrealistic expectations▪Stressful personality traits-workaholicStress, which is now the 2nd highest work related disease in the US, accounts for 20-25% of all occupational claims.▪Downsizing▪Restructuring▪Mergers▪Job insecurity▪Culture of longer working hours▪Information overloadThe combination of high jobdemands and low control over the job put people in greaterrisk for heart disease, a risksimilar to that of smokers orthose with elevated serumcholesterol levels.Individual Stressors at Work▪Occupational frustration▪Lack of communication▪Discrimination/reverse discrimination▪Bureaucracy▪Technological change▪PromotionRetirement▪Forced to retire from a very rewarding job suffer from some of the following symptoms:▪Depression▪A sense of worthlessness and a loss of self esteem▪Decreased appetite▪Lack of motivation▪Increased in cardiovascular complaints Biological Factors in theWorkplace▪Shift work fatigue- trying to adjust to an unnatural pattern of sleeping▪Shift workers have a higher risk for CV disease, neurotic disorders, dysfunctional alterations in appetite and s/s of depression.▪Computers and Eyestrain STRESS MANAGEMENTUnderstanding Stress Is As Simple As ABC▪A is the activating event▪B is your beliefs, thoughts or perceptions about “A”▪C is the emotional Consequence orstress that results from holding thesebeliefsA potentially stressful situation►Your perceptions►Your stress (or lack of stress)Having to wait in line-My thoughts about waiting in linePotential stressOr At Work...▪Fairly busy workload and you get reportthat the ER is a “zoo”▪Your thoughts about the busy workload ▪Potential stressManaging Stress: AThree-Pronged Approach ▪Changing your “A” means modifying your environment▪Changing your “B” change the way youperceive the stressor▪You can change your “C” if you can’tchange “A” or “B” you can learn how torelax your body and quiet your mind Some Ways To Master StressChange Lifestyle Habits▪Decrease your intake sympathomimetic agentsMaintain a Well Balanced Diet▪Maintain a well balanced diet▪Increased adrenaline production causes thebody to step up the metabolism of proteins,fats and carbs.▪Causing the body to excrete AAs, K+, and P; to deplete Mg stored in muscle tissue, and tostore less Ca++▪The body does not absorb ingested nutrientswell under stress▪Stress promotes the formation of free radicalsand depletes B complex, C and D vitaminsEat slowlyAvoid junk foodTake a multivitamin Eat your colorsDrink plenty of water GET REGULAR EXCERISE!MANAGE TIME EFFICIENTLY▪Time Management is NOT▪Watching a clock▪Compiling schedules ▪Organizing ▪Its ABOUT:▪Planning your course in life▪Balancing multiple priorities▪Enjoying life▪Making decisions about the use of your timeTime management is your decision!If a To Do list is to work you mustkeep it short and PRIORITIZE itCreate a Stress FreeHome Environment▪Creating a peaceful room/corner can be aneffective stress buffer, color therapy▪Plan quiet time alone for you▪Leave the TV off▪Unplug the phone▪Your personal life-choose people who in youropinion have a low risk : benefit ratio▪Stay away from co-dependent energy drainersLeisure Time▪Do something foryourself everyday!▪Get a hobby▪Go for a quiet walkalone▪Do a mindlessactivityMonitor Your InternalConversations▪Use positive self talk▪Some therapist recommend shouting“GET OUT" (or any phrase you choose) immediately when a intrusive orunpleasant worries enter your thoughts Try To Get Enough Sleep Ventilation/ SupportSystem▪“a problem shared is a problem halved”▪Develop a support system of trusted friends or relatives ▪“When my life is going well, I live it. When it’s not going well I write it”▪Write the nastiest letter to the person you are pissed at then burn itLack of willpower is a problem.▪The A.P.A’s annual report onStress in America 2011, foundthat Americans cited lack ofwillpower as the biggestbarrier to adopting healthierbehavior.Altruism-giving to others ▪Pelletier(1994)conducted a 5yrstudy of 51prominent altruisticindividuals whoshowed an unusualability to cope withstress and to grow inspite of it.Have a good sense of humorDon’t worry about theunimportant stuff!▪A common source of stress is unrealistic expectations.▪“No expectations, no disappointments”▪Will it really matter a year from now.▪Don’t Sweat the Small Stuff!▪Be more patient▪Stay in the PRESENT“The secret of health for both mind and body is not to mourn for the past, worry about the future, or anticipate troubles, but to live in the present moment wisely and earnestly” BUDDHA▪Avoid losing your temper-angermanagement▪Stop and think before you react▪Practice deep breathing▪Try meditation▪Progressive relaxation▪Investigate aromatherapy▪Sex and intimacy can reduce stressIf you feel you cannot handle the stresses in your life , consider seeking outside help. Psychotropic medicationsfor emotional stress▪Some people may need medications forstress related symptoms, treatment fordepression and anxietySome helpful references▪Stress Management for Dummies by Elkin ▪Controlling Stress and Tension 8th ed byGirando▪The Precious Present by Spencer Johnson ▪Don’t Sweat The Small Stuff.. By RichardCarlson▪Don’t Sweat The Small Stuff Workbook byRichard CarlsonExercise #1List of 10 most stressful jobsAnswers ▪ 1. Enlisted Soldier▪ 2. Firefighter▪ 3. Airline Pilot▪ 4. Military General▪ 5. Police Officer▪ 6. Event Coordinator▪7. Public Relations Executive▪8. Senior Corporate Executive▪9. Photojournalist▪10. Taxi DriverExercise #2List the Top Ten StressorsAnswers Exercise #2 ▪ 1. Loss of a loved one▪ 2. Major illness or injury▪ 3. Divorce or separation▪ 4. Serious financial difficulties▪ 5. Loss of a job.▪ 6. Getting married▪7. Moving to a new place▪8. A serious falling out with a close friend ▪9. Birth of a child.▪10. RetirementJust How Stressed Are you?The simplest way to measure your stress is using a stress gauge. Exercise #3▪10▪9 I feel extremely stressed▪8▪7▪6 I feel a moderate amount of stress▪5▪4▪3 I feel only a little stress▪2▪1▪0 I don’t feel any stressThe Stress-Symptom Scale Exercise #4Knowing where your stress is coming from Exercise #5How Patient Are You?Exercise #6。
AnEmpiricalStudy...
II
摘要
摘要
翻译至今已有几千年的历史了，翻译研究在语言研究和文化研究中是个长期的 课题，这不仅仅因为其悠久的历史，更因为翻译是帮助不同文化之间相互理解、 是帮助不同人之间相互沟通的桥梁。因此，翻译学习对大学生是很重要的。作为 一种特殊的语言形式，习语充分反映了一个民族在语言、文化、思维方式等方面 的特点。几乎在任何一种语言中习语都是常见现象，习语翻译是翻译学习中不可 或缺的部分。但是正因为习语自身的特性，习语翻译对译者特别是对学生而言， 并不那么容易。众所周知，习语翻译教学是困难的，学生的习语翻译能力也需要 提高，但笔者发现很少有研究关注学生在习语翻译中所遇到的转换困难以及学生 在习语翻译中所遇转换困难的具体类型。此文试图从文化、语言和思维方式三个 方面来分析学生的这些转换困难，进而提出了如何有效进行习语翻译教学的一些 建议。笔者针对学生的作业数据和访谈结果进行了分析。文化方面选择的是社会 习俗、生活经验和文学，语言方面选择的是词的使用范围和句子结构，思维方式 上选择的是具体到抽象的转变以及模糊到精确的转变。
2018年英语专四作文
2018年英语专四作文英文回答：As a crucial element in international communication, English occupies a pivotal position in today's globalized world. Its significance extends beyond its status as alingua franca, permeating diverse spheres of human endeavor. From the realms of diplomacy and commerce to the frontiersof scientific research and technological advancement, English serves as a common language that facilitates cross-cultural understanding, fosters collaboration, and accelerates the dissemination of knowledge.The proliferation of English as a global language has been driven by a multitude of factors. One key catalyst has been the ascendancy of the United States as an economic and political superpower. The widespread use of English in American media, entertainment, and business has propelledits global reach, making it the de facto language of international trade and finance. Moreover, theproliferation of English-language education around the world has further contributed to its widespread adoption. Today, English is taught as a second or foreign language in over 100 countries, fostering a global community of English speakers who can communicate effectively across borders.The advantages of English as a global language are manifold. By facilitating communication between people from diverse linguistic backgrounds, English fosters cross-cultural understanding and empathy. It enables individuals to access information and knowledge from around the world, empowering them with a wider worldview and a deeper understanding of global issues. Moreover, the use of English in international business and diplomacy promotes economic growth and cooperation, creating opportunities for collaboration and fostering mutually beneficial relationships.However, it is important to acknowledge that the dominance of English as a global language also presents certain challenges. Some critics argue that it may lead to the marginalization or even extinction of minoritylanguages, which are essential for preserving cultural diversity and heritage. Others contend that the widespread use of English creates a linguistic hierarchy, with non-native speakers often facing barriers to full participation in international discourse.Despite these concerns, the advantages of English as a global language far outweigh its potential drawbacks. Its widespread adoption has fostered unprecedented global connectivity and cooperation, enabling people from all corners of the world to engage in meaningful交流 and pursue shared goals. As the world becomes increasingly interconnected, the importance of English as a global language will continue to grow, serving as a catalyst for progress, understanding, and collaboration.中文回答：英语作为全球语言的重要性。
创面血管内皮生长因子、血管内皮生长因子受体2水平表达与Ⅱ期肛裂患者术后创面愈合时间的关系研究
㊃论 著㊃[收稿日期]2023-03-05[基金项目]上海市卫生和计划生育委员会项目(Z Y (2018-2020)C C C X -1004);上海中医药大学附属曙光医院四明临床研究专项(S G K J L C -202028)[作者简介]陶一秋(1988-),女,上海人,上海中医药大学附属曙光医院主治医师,医学硕士,从事肛肠科疾病诊治研究㊂*通信作者㊂E -m a i l :2413774367@q q.c o m 创面血管内皮生长因子、血管内皮生长因子受体2水平表达与Ⅱ期肛裂患者术后创面愈合时间的关系研究陶一秋,张冬梅*,沈菲菲,杜佳琦(上海中医药大学附属曙光医院肛肠科,上海200021) [摘要] 目的探讨创面血管内皮生长因子(v a s c u l a r e n d o t h e l i a l g r o w t h f a c t o r ,V E G F )㊁血管内皮生长因子受体(v a s c u l a r e n d o t h e l i a l g r o w t h f a c t o r r e c e p t o r ,V E G F R )-2表达与Ⅱ期肛裂术后创面愈合时间的关系㊂方法选取在我院进行手术治疗的Ⅱ期肛裂患者104例为研究对象㊂术后1周换药时采集创缘肉芽组织检测V E G F ㊁V E G F R -2水平㊂统计患者术后创面愈合时间,根据患者术后创面愈合时间三分位数分3组,对比3组临床资料及创面V E G F ㊁V E G F R -2水平㊂分析V E G F ㊁V E G F R -2与术后创面愈合时间的相关性及术后创面愈合时间的影响因素㊂结果3组创面V E G F 及V E G F R -2水平比较,差异有统计学意义(P <0.05);创面V E G F ㊁V E G F R -2水平愈低,其创面愈合时间愈长(P <0.05);V E G F ㊁V E G F R -2与术后创面愈合时间呈负相关(P <0.05);便秘㊁手术时间㊁开放切口㊁创面纵径㊁创面横径为术后创面愈合时间的独立危险因素,V E G F ㊁V E G F R -2均术后创面愈合时间的独立保护因素(P <0.05)㊂结论创面V E G F ㊁V E G F R -2水平与Ⅱ期肛裂术后创面愈合时间呈负相关,可通过检测两指标水平判断患者创面愈合情况,为术后治疗方案的完善提供指导㊂[关键词] 肛裂;血管内皮生长因子受体2;治疗结果 d o i :10.3969/j .i s s n .1007-3205.2024.05.018 [中图分类号] R 657.14 [文献标志码] A [文章编号] 1007-3205(2024)05-0595-06R e l a t i o n s h i p o f t h e e x p r e s s i o no fV E G Fa n dV E G F R -2i nw o u n dw i t h p o s t o pe r a t i v e w o u n dh e a l i n g t i m e i n p a t i e n t sw i t h s t a g eⅡa n a lf i s s u r ew o u n d e x pr e s s i o no fV E G F a n dV E G F R -2a n dw o u n dh e a l i n g t i m e a f t e r s t a geⅡa n a l f i s s u r e T A O Y i -q i u ,Z H A N G D o n g -m e i *,S H E NF e i -f e i ,D UJ i a -qi (D e p a r t m e n t o f P r o c t o l o g y ,S h u g u a n g H o s p i t a lA f f i l i a t e d t oS h a n g h a iU n i v e r s i t y o fT r a d i t i o n a lC h i n e s eM e d i c i n e ,S h a n gh a i 200021,C h i n a )[A b s t r a c t ] O b je c t i v e T o i n v e s t i g a t e t h e r e l a t i o n s h i p of v a s c u l a r e n d o t h e l i a lg r o w th f a c t o r (V E G F )a n dv a s c u l a r e n d o t h e li a l g r o w t h f a c t o r r e c e p t o r -2(V E G F R -2)e x pr e s s i o no n t h ew o u n d s u r f a c ew i t h p o s t o p e r a t i v ew o u n dh e a l i n g t i m e i n p a t i e n t sw i t h s t a geⅡa n a l f i s s u r e .M e t h o d s A t o t a l o f 104p a t i e n t sw i t hs t a g eⅡa n a l f i s s u r ew h ou n d e r w e n t s u r g i c a l t r e a t m e n t i no u rh o s p i t a l w e r e s e l e c t e da st h er e s e a r c hs u b je c t s .T h el e v e l so fV E G Fa n d V E G F R -2c o l l e c t e df r o m t h eg r a n u l a t i o n t i s s u e o f th ew o u n d e d g ew e r e d e t e c t e d a t d r e s si n g c h a n g e a t o n ew e e ka f t e r s u r g e r y.T h e p o s t o p e r a t i v e w o u n dh e a l i n g t i m eo f p a t i e n t s w a ss t a t i s t i c a l l y a n a l y z e d ,a n dt h e p a t i e n t s w e r e d i v i d e d i n t ot h r e e g r o u p sa c c o r d i n g t ot h e t h i r d p e r c e n t i l eo f p o s t o p e r a t i v ew o u n dh e a l i n g ㊃595㊃第45卷第5期2024年5月河北医科大学学报J O U R N A L O F H E B E I M E D I C A L U N I V E R S I T YV o l .45 N o .5M a y2024t i m e o f p a t i e n t s.T h e c l i n i c a l d a t a a n d t h e l e v e l s o fV E G Fa n dV E G F R-2o n t h ew o u n d s u r f a c e i n t h e t h r e e g r o u p s w e r ec o m p a r e d.T h ec o r r e l a t i o no f V E G Fa n d V E G F R-2w i t h p o s t o p e r a t i v e w o u n dh e a l i n g t i m ea sw e l l a s t h e i n f l u e n c i n g f a c t o r so f p o s t o p e r a t i v ew o u n dh e a l i n g t i m ew a s a n a l y z e d.R e s u l t s T h e r ew e r es i g n i f i c a n td i f f e r e n c e s i n V E G Fa n dV E G F R-2l e v e l sa m o n g t h e t h r e e g r o u p s(P<0.05).T h e l o w e r t h e l e v e l s o fV E G Fa n dV E G F R-2o n t h ew o u n d s u r f a c e,t h e l o n g e r t h ew o u n dh e a l i n g t i m e(P<0.05).V E G Fa n dV E G F R-2w e r e n e g a t i v e l y c o r r e l a t e dw i t h p o s t o p e r a t i v ew o u n d h e a l i n g t i m e(P<0.05).C o n s t i p a t i o n,d u r a t i o n o f o p e r a t i o n,o p e n i n c i s i o n, w o u n d l o n g i t u d i n a ld i a m e t e ra n d w o u n dt r a n s v e r s ed i a m e t e rw e r e i n d e p e n d e n tr i s kf a c t o r sf o r p o s t o p e r a t i v ew o u n dh e a l i n g t i m e,a n dV E G Fa n dV E G F R-2w e r e i n d e p e n d e n t p r o t e c t i v e f a c t o r s f o r p o s t o p e r a t i v ew o u n d h e a l i n g t i m e(P<0.05).C o n c l u s i o n T h e l e v e l s o fV E G F a n dV E G F R-2 o n t h ew o u n ds u r f a c ea r en e g a t i v e l y c o r r e l a t e d w i t ht h e w o u n dh e a l i n g t i m ea f t e rs u r g e r y f o r s t a g eⅡa n a l f i s s u r e.T h e t w o i n d e x e s c a nb eu s e dt od e t e r m i n e t h ew o u n dh e a l i n g o f p a t i e n t s, t h u s p r o v i d i n gg u i d a n c e f o r t h e i m p r o v e m e n t o f p o s t o p e r a t i v e t r e a t m e n t p l a n s.[K e y w o r d s]a n a lf i s s u r e;v a s c u l a r e n d o t h e l i a l g r o w t h f a c t o r r e c e p t o r-2;t r e a t m e n t o u t c o m e肛裂是临床常见肛肠疾病,多发于中青年,发病率约为4%~6%[1]㊂肛裂具有一定自愈率,但Ⅱ期肛裂具有反复发作㊁缠绵难愈等特点,若经非手术治疗效果欠佳则需通过手术解除括约肌痉挛,促进创面愈合[2]㊂但由于Ⅱ期肛裂创缘不规则增厚,弹性差,部分患者术后创面愈合时间较长,而如何精准完善干预方案成为临床急需解决的问题之一㊂血管内皮生长因子(v a s c u l a re n d o t h e l i a l g r o w t hf a c t o r, V E G F)是目前已知最强的促血管新生因子[3]㊂另外,V E G F诸多生物学效应主要通过其特异性受体-血管内皮生长因子受体(v a s c u l a re n d o t h e l i a l g r o w t h f a c t o r r e c e p t o r,V E G F R)实现,其中V E G F R-2是V E G F的特异性受体,与同类受体相比,其更广泛的表达于新生血管的内皮细胞[4]㊂有研究表明,增加V E G F㊁V E G F R-2表达量对促进肛瘘术后创面愈合具有重要作用[5]㊂但创面V E G F㊁V E G F R-2表达与Ⅱ期肛裂患者术后创面愈合时间间是否存在相关性尚缺乏报道,本研究对此探讨,旨在为临床实现精准治疗提供参考㊂报告如下㊂1资料与方法1.1一般资料选取2020年10月 2022年10月在我院进行手术治疗的Ⅱ期肛裂患者104例为研究对象㊂纳入标准:根据‘肛肠病学“[6]诊断确诊,明确肛裂反复发作史,创缘不规则,增厚,弹性差,溃疡基底部紫红色或出现脓性分泌物;年龄ȡ18周岁;手术治疗者;无过敏史;知情本研究内容,签署同意书㊂排除标准:精神异常者;肿瘤者;合并其他肛肠疾病;哺乳㊁妊娠及经期女性;1年内有肛周手术史㊂男性80例,女性24例,年龄18~49岁,平均(31.17ʃ5.86)岁;病程3~12个月,平均(7.32ʃ1.49)个月;吸烟53例,饮酒62例,便秘63例,有肛肠手术史43例,合并高血压52例,合并糖尿病29例,贫血17例,营养不良17例;手术方式:切断括约肌38例,保留括约肌66例;手术时间<30m i n62例,ȡ30m i n 42例;切口类型:开放切口35例,半开放切口69例;创面纵径2.1~5.9c m,平均(3.94ʃ0.69)c m;创口横径1.3~3.6c m,平均(2.55ʃ0.40)c m;术后首次排便时间:<24h23例,24~48h58例,>48h 23例;术后切口感染5例㊂本研究经医院医学伦理委员会审批通过(2021-965-40-01)㊂1.2方法104例患者参照‘肛肠病学“[6]根据病情特征及患者意愿选取切断括约肌或保留括约肌术式治疗,术后均叮嘱多食富含纤维素食物,禁食辛辣刺激性食物,并常规进行抗感染干预㊂术后7d换药时用活检钳钳夹0.2c mˑ0.2c m创缘肉芽组织,甲醛溶液固定,常规脱水,浸蜡,包埋,连续切片,在400ˑ倍视野下观察V E G F㊁V E G F R-2阳性信号并计数(每张切片统计3个视野,取均值),并采用I m a g eP r o P l u s图像分析[7]软件对创面V E G F㊁V E G F R-2表达量进行半定量分析㊂赛默飞世尔中国提供免疫组化法试剂盒,均由相同资深检验科技师参照试剂盒说明书步骤规范完成㊂1.3观察指标①比较3组临床资料㊂②比较3组创面V E G F㊁V E G F R-2水平㊂③分析V E G F㊁V E G F R-2与术后创面愈合时间的相关性㊂④分析术后创面愈合时间的影响因素㊂㊃695㊃河北医科大学学报第45卷第5期1.4 统计学方法 应用S P S S25.0统计软件分析数据㊂计量资料采用单因素方差分析㊁S N K -q 检验㊁独立样本t 检验,计数资料采用χ2检验㊁秩和检验㊂P e a r s o n 分析V E G F ㊁V E G F R -2与术后创面愈合时间的相关性,有序多分类L o g i s t i c 回归分析校正混杂因素后V E G F ㊁V E G F R -2与术后创面愈合时间的关系㊂P <0.05为差异有统计学意义㊂2 结 果2.1 3组临床资料比较 104例患者术后创面愈合时间为13~29d ,平均(21.83ʃ2.71)d,根据术后创面愈合时间定量值三分位数分为<18d 组(34例)㊁18~24d 组(35例)㊁>24d 组(35例)㊂3组性别㊁年龄㊁吸烟㊁饮酒㊁合并高血压㊁合并糖尿病㊁贫血㊁营养不良㊁术后首次排便时间㊁术后切口感染发生率比较,差异无统计学意义(P >0.05)㊂3组病程㊁便秘㊁肛肠手术史㊁手术方式㊁手术时间㊁切口类型㊁创面纵径㊁创面横径比较差异有统计学意义(P <0.05)㊂见表1㊂表1 3组临床资料比较T a b l e 1 C o m p a r i s o no f c l i n i c a l d a t a i n t h e t h r e e g r o u ps 组别 例数性别(例数,%)男性女性年龄(x -ʃs ,岁)病程(x -ʃs ,月)吸烟(例数,%)创口横径(x -ʃs ,c m )<18d 组 3425(73.53)9(26.47)32.06ʃ6.116.82ʃ1.4615(44.11)2.39ʃ0.4118~24d 组3527(77.14)8(22.86)30.20ʃ5.787.32ʃ1.5818(51.43)2.56ʃ0.43>24d 组3528(80.00)7(20.00)31.27ʃ6.027.80ʃ1.41*20(57.14)2.69ʃ0.39*χ2/F /Z 值0.4080.8453.7701.1754.632P 值0.8150.4330.0260.5560.012组别例数饮酒(例数,%)便秘(例数,%)肛肠手术史(例数,%)合并高血压(例数,%)合并糖尿病(例数,%)术后切口感染(例数,%)<18d 组 3418(52.94)15(44.12)9(26.47)16(47.06)8(23.53)1(2.94)18~24d 组3520(57.14)21(60.00)14(40.00)17(48.57)10(28.57)1(5.71)>24d 组3522(62.86)27(77.14)*20(57.14)*19(54.29)11(31.43)3(8.57)χ2/F /Z 值0.7017.8846.7300.4030.5481.006P 值0.7040.0190.0350.8170.7610.605组别 例数贫血(例数,%)营养不良(例数,%)手术方式(例数,%)切断括约肌保留括约肌手术时间(例数,%)<30m i nȡ30m i n <18d 组 343(8.82)4(11.76)7(20.59)27(79.41)26(76.47)8(23.53)18~24d 组355(14.29)5(14.29)13(37.14)22(62.86)21(60.00)14(40.00)>24d 组359(25.71)8(22.86)18(51.43)*17(48.57)15(42.86)*20(57.14)χ2/F /Z 值3.7621.7167.0838.097P 值0.1520.4240.0290.017组别例数切口类型(例数,%)开放切口半开放切口术后首次排便时间(例数,%)<24h 24~48h>48h 创面纵径(x -ʃs ,c m )<18d 组 346(17.65)28(82.35)4(11.76)25(73.53)5(14.71)3.69ʃ0.7318~24d 组3512(34.29)23(65.71)8(22.86)19(54.29)8(22.86)3.91ʃ0.78>24d 组3517(48.57)*18(51.43)11(31.43)14(40.00)10(28.57)4.20ʃ0.68*χ2/F /Z 值7.3968.0384.228P 值0.0250.0900.017*P 值<0.05与<18d 组比较(S N K -q 检验或χ2检验)2.2 3组创面V E G F ㊁V E G F R -2水平比较 104例患者术后7d 创面V E G F ㊁V E G F R -2水平分别为(0.38ʃ0.03)㊁(0.40ʃ0.03)㊂3组创面V E G F ㊁V E G F R -2水平比较,差异有统计学意义(P <0.05);创面V E G F ㊁V E G F R -2水平愈低,其创面愈合时间愈长,差异有统计学意义(P <0.05)㊂见表2㊂2.3 V E G F ㊁V E G F R -2与术后创面愈合时间的相关性 V E G F (r =-0.656,P <0.001)㊁V E G F R -2(r =-0.618,P <0.001)与术后创面愈合时间呈负相关(P <0.05)㊂见图1,2㊂表2 3组创面V E G F ㊁V E G F R -2水平比较T a b l e 2 C o m pa r i s o no fV E G Fa n dV E G F R -2l e v e l s o n t h e w o u n d s u r f a c e i n t h e t h r e e g r o u ps (x -ʃs )组别例数V E G FV E G F R -2<18d 组340.40ʃ0.030.42ʃ0.0318~24d 组350.38ʃ0.02*0.40ʃ0.03*>24d 组 350.36ʃ0.02*#0.38ʃ0.02*#F 值 24.49218.858P 值<0.001<0.001*P 值<0.05与<18d 组比较 #P 值<0.05与18~24d 组比较(S N K -q 检验)㊃795㊃河北医科大学学报 第45卷 第5期图1V E G F与术后创面愈合时间的相关性F i g u r e1C o r r e l a t i o nb e t w e e nV EG Fa n d p o s t o p e r a t i v ew o u n d h e a l i n g t i m e图2V E G F R-2与术后创面愈合时间的相关性F i g u r e1C o r r e l a t i o n b e t w e e n V EG F R-2a n d p o s t o p e r a t i v e w o u n dh e a l i n g t i m e 2.4术后创面愈合时间的影响因素以术后创面愈合时间作为反应变量,以病程㊁便秘㊁肛肠手术史㊁手术方式㊁手术时间㊁切口类型㊁创面纵径㊁创面横径㊁V E G F㊁V E G F R-2作为解释变量,具体赋值见表3㊂以上因素纳入有序多分类L o g i s t i c回归模型,结果显示,便秘㊁手术时间㊁开放切口㊁创面纵径㊁创面横径为术后创面愈合时间的独立危险因素,V E G F㊁V E G F R-2均术后创面愈合时间的独立保护因素(P<0.05)㊂见表4㊂表3赋值T a b l e3A s s i g n m e n t变量赋值反应变量术后创面愈合时间<18d=1,18~24d=2,>24d=3解释变量病程实际值便秘无=0,有=1肛肠手术史无=0,有=1手术方式保留括约肌=1,切断括约肌=2手术时间<30m i n=1,ȡ30m i n=2切口类型半开放切口=1,开放切口=2创面纵径实际值创面横径实际值V E G F实际值V E G F R-2实际值表4术后创面愈合时间的有序多分类L o g i s t i c分析T a b l e4O r d e r e dm u l t i c l a s sL o g i s t i c a n a l y s i s o f p o s t o p e r a t i v ew o u n dh e a l i n g t i m e变量回归系数标准误W a l dχ2值P值O R值95%C I 反应变量18~24d1.0420.30911.371<0.001-- >24d1.5240.34119.973<0.001--解释变量病程0.3450.3021.3090.2531.4130.781~2.552便秘0.7960.3325.7470.0342.2161.156~4.249肛肠手术史0.3290.3271.0150.3141.3900.732~2.638手术方式0.3450.3251.1290.2881.4120.747~2.670手术时间0.8630.3715.0780.0242.3701.115~4.744切口类型1.0530.3489.1630.0022.8671.449~5.669创面纵径1.2240.3959.6020.0023.4011.568~7.376创面横径1.1760.3789.6710.0023.2401.545~6.800 V E G F-1.0940.31412.142<0.0010.3350.181~0.620 V E G F R-2-1.0130.30610.9580.0010.3630.199~0.6623讨论目前关于肛裂的发病机制尚未完全明确,治疗方案亦呈现多样化,其中Ⅱ期肛裂肛管已形成溃疡性裂口,非手术治疗后复发风险甚高,因此手术成为治疗Ⅱ期肛裂的重要方案之一㊂但由于肛门特殊的组织解剖结构及其相对复杂的生理功能,部分患者创面不易愈合[8-9]㊂目前虽然已有关于肛肠疾病术后创面愈合质量影响因素的相关研究[10-11],但个体化差异明显,如何根据生化指标变化指导临床治疗㊃895㊃河北医科大学学报第45卷第5期并促进患者术后恢复成为研究的重要方向之一㊂创面修复是一个复杂的生物学过程,以组织再生为主要表现,经历创面渗出期㊁肉芽生长期㊁上皮细胞生长期三个阶段,创面渗出期产生多种生长因子,诱导血管新生,促进成纤维细胞增殖分化㊁肉芽组织形成与重建,尽快完成肉芽生长期,之后进入上皮化期[12-13]㊂肉芽的主要成分为成纤维细胞及新生毛细血管床,V E G F是一种特异性血管生长因子,与内皮细胞表面特异性受体V E G F R-2结合并激活,促进血管内皮细胞增殖㊁迁移[14-16]㊂于泽洋等[17]在糖尿病足溃疡模型大鼠的实验中发现,经有效干预后创面组织V E G F㊁V E G F R2m R N A和蛋白表达上调,这可能是创面愈合的机制之一㊂目前V E G F㊁V E G F R-2在肛肠疾病术后创面愈合过程的变化已有相关报道,如聂桂宽㊁张明敏等[18-19]研究表明,混合痔外剥内扎术后患者经有效治疗后V E G F㊁V E G F R-2明显升高,创面缩小显著,创面愈合时间缩短;杨胜邦等[20]在肛肠病患者术后改进治疗方案后,创面肉芽组织中V E G F㊁V E G F R-2表达升高,且创面愈合时间更短;白景舒等[21]在肛裂患者术后给予其复方荆芥熏洗剂,术后7d创面V E G F㊁V E G F R-2的光密度值上升,对创面愈合具有积极意义㊂以上研究结果均表明创面V E G F㊁V E G F R-2表达与创面愈合时间密切相关,但尚未研究表明两指标与Ⅱ期肛裂术后患者创面愈合时间的确切关系㊂本研究结果发现,不同创面愈合时间患者创面V E G F㊁V E G F R-2水平比较差异有统计学意义,且创面V E G F㊁V E G F R-2水平愈低,其创面愈合时间愈长㊂分析主要是因V E G F/V E G F R-2作为调控血管生成的重要通路,V E G F㊁V E G F R-2表达升高可改变血管内皮细胞通透性,从而参与血管生长过程,加速创面愈合[22-23],同时还能诱导新生血管形成,为肉芽组织提供充足的营养支持,促进肉芽组织生长,加速新生上皮覆盖,从而缩短创面愈合时间[24-25]㊂上述研究说明,Ⅱ期肛裂术后患者创面V E G F㊁V E G F R-2水平可能与创面愈合时间有关㊂本研究进一步采用P e a r s o n相关系数分析发现,创面V E G F㊁V E G F R-2表达与术后创面愈合时间呈负相关,临床可根据术后创面V E G F㊁V E G F R-2表达情况初步判断创面愈合情况㊂但肛裂术后创面愈合情况受多种因素影响,如便秘患者排便时用力过度会导致肛门皮肤过度扩张㊁肛门括约肌反复收缩舒张,引起切口开裂㊁炎症性水肿㊁组织变脆,从而增加创面愈合时间;创面纵径㊁横径较大者愈合过程中所需肉芽更多,愈合时间更长㊂本研究经有序多分类L o g i s t i c分析V E G F㊁V E G F R-2均术后创面愈合时间的独立保护因素㊂分析是因创面愈合的关键步骤即是创面渗出期的血管生成,而V E G F作为生长因子家族内最强的促血管内皮细胞有丝分裂原,其与V E G F R-2结合后可有效发挥促血管生成的生物学功能,V E G F㊁V E G F R-2水平越高则越利于创面愈合㊂综上所述,创面V E G F㊁V E G F R-2水平与Ⅱ期肛裂术后创面愈合时间呈负相关,术后检测两指标水平可初步判断患者创面愈合情况,有利于临床及时调整治疗方案,促进创面愈合㊂[参考文献][1] A n d i c o e c h e aA g o r ríaA,D e l C a s a rL i z c a n o J M,B a r bónR e m i sE,e ta l.T r e a t m e n to fac h r o n i ca n a l f i s s u r e w i t hab o t u l i nt o x i nAi n j e c t i o na n d f i s s u r e c t o m y[J].R e vE s p E n f e r m D i g, 2019,111(9):672-676.[2] D'O 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经穴推拿联合脐灸治疗1例气虚便秘患者的中医护理体会
中西医结合护理Chinese Journal of Integrative Nursing 2023年第9卷第7期Vol.9， No.7，2023经穴推拿联合脐灸治疗1例气虚便秘患者的中医护理体会葛思楠1，王雪送2，余艳兰3（1.北京中医药大学附属护国寺中医医院针灸三病房，北京， 100035；2.北京中医药大学东方医院脑病二科，北京， 100078；3.湖南中医药大学第一附属医院护理部，湖南长沙， 410007）摘要：本文总结经穴推拿联合脐灸治疗1例气虚便秘患者中医护理体会。
根据护理评估以及辨证分型，在饮食指导、生活起居、情志护理等常规护理基础上给予经穴推拿联合脐灸的中医特色护理，有助于缓解患者便秘和气虚症状，有效促进疾病康复。
关键词：经穴推拿；脐灸；气虚；便秘；中医护理中图分类号：R 473.5文献标志码：A 文章编号：2709-1961（2023）07-0030-04Traditional Chinese medicine nursing of apatient with Qi-deficiency type constipationtreated by meridian acupoints massagecombined with umbilical moxibustionGE Sinan1，WANG Xuesong2，YU Yanlan3（1. Third Acupuncture Ward， Huguosi Traditional Chinese Medicine HospitalBeijing University of Chinese Medicine， Beijing，100035；2. Second Department of Encephalopathy， Dongfang Hospital Beijing University of Chinese Medicine，100078；3. Department of Nursing， The First Hospital of Hunan University ofChinese Medicine， Changsha， Hunan，410007）ABSTRACT： This paper summarized the experience of Traditional Chinese Medicine nursing for a patient with Qi-deficiency type constipation treated by meridian acupoints massage combined with umbilical moxibustion. According to syndrome differentiation of the patient， meridian acu⁃points massage combined with umbilical moxibustion was carried out to alleviate the symptoms of constipation and Qi-deficiency and improve the recovery of the patient.KEY WORDS：meridian acupoints massage；umbilical moxibustion；Qi-deficiency type；constipation； Traditional Chinese Medicine nursing便秘是指大肠传导功能异常而导致的大便秘结不通，欲排大便而排出艰涩不畅的一种疾病，通常表现为排便次数减少（每周少于3次）、粪便干硬和（或）排便困难［1-2］。
英语专业四级作文范文
英语专业四级作文范文英文回答：In the realm of academic endeavors, language holds a pivotal position as a conduit of knowledge, thought, and creativity. Particularly in the study of English at the university level, the ability to express oneselfeffectively in both written and spoken form is paramount. This essay will delve into the multifaceted importance of proficiency in the English language for students pursuing an English major at the university level.Foremost, English serves as the lingua franca of academia, facilitating communication and knowledge exchange among scholars from diverse linguistic backgrounds. The vast majority of academic literature, research findings, and theoretical frameworks are disseminated in English, making it indispensable for students to master the language to access and engage with this wealth of knowledge. Moreover, proficiency in English enables students toparticipate actively in academic discourse, present their research findings at conferences, and collaborate with international colleagues.Beyond its academic utility, English also plays a crucial role in fostering critical thinking and analytical skills. The English language is renowned for its richness and nuance, allowing for precise expression of complex ideas. Through the study of English literature, students develop a keen eye for detail, an appreciation forlinguistic patterns, and the ability to analyze and interpret texts critically. These skills are invaluable not only for literary analysis but also for understanding and evaluating arguments, conducting research, and communicating ideas effectively in any field of study.Furthermore, English proficiency is essential for effective communication in the professional world. Many multinational corporations, international organizations, and government agencies conduct their business in English. Students with strong English skills are highly sought after by employers as they can effectively communicate withclients, colleagues, and stakeholders from around the globe. Moreover, English proficiency opens doors to career opportunities in fields such as journalism, diplomacy, education, and international business.In addition to its practical benefits, the study of English also enriches students' cultural and intellectual horizons. Through exposure to a wide range of English-language texts, students gain insights into different cultures, perspectives, and historical contexts. They develop an appreciation for the diversity of human experience and learn to think critically about societal issues. Moreover, the study of English fosters creativity and imagination, as students are encouraged to express themselves through writing, speaking, and other creative endeavors.In conclusion, the English language is an indispensable tool for students pursuing an English major at theuniversity level. It facilitates access to academic knowledge, fosters critical thinking and analytical skills, enhances professional opportunities, and enriches culturaland intellectual horizons. Therefore, students shouldstrive to develop a high level of proficiency in both written and spoken English to fully reap the benefits of an English major and excel in their academic and professional endeavors.中文回答：英语专业四级作文的重要性。