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英国文学课件--Crossing-the-Bar精选全文

英国文学课件--Crossing-the-Bar精选全文

Rereading/Analyzing the Text
• What does Tennyson want to do after crossing the bar?
• What is the literal voyage described? • What DOESN’T the speaker want
Tennyson, the man (continued)
• In 1850 he published in Memoriam, an elegy that tells the story of his own recovery of faith in the immortality of the soul and the harmony of creations – despite the new, unsettling discoveries of science and his deep sense of the unfairness of death.
Questions for Crossing the Bar
What do you predict the images of harbor, bar (sandbar), and sea in this poem will symbolize?
A bar is a sandbar at the mouth of a harbor. Beyond the bar is deep sea.
Rereading/Analyzing the Text
eread the first stanza.
From whom do you think the speaker receives this “one clear call”

IND560 weighing terminal和Fill-560应用软件商品说明书

IND560 weighing terminal和Fill-560应用软件商品说明书

2Industrial Weighing and MeasuringDairy & CheeseNewsIncrease productivitywith efficient filling processesThe new IND560 weighing terminal enables you to boost speed and precision during the filling process. Choose from a wide range of scales and weigh modules to connect to the terminal.The versatile IND560 excels in control-ling filling and dosing applications, delivering best-in-class performance for fast and precise results in manual, semi-automatic or fully automatic operations. For more advanced filling, the Fill-560 application software adds additional sequences and component inputs. Without complex and costly programming you can quickly con-figure standard filling sequences, or create custom filling and blending applications for up to four compo-nents, that prompt operators for action and reduce errors.Ergonomic design Reducing operator errors is achieved through the large graphic display which provides visual signals.SmartTrac ™, the METTLER TOLEDO graphical display mode for manual operations, which clearly indicate sta-tus of the current weight in relation to the target value, helps operators to reach the fill target faster and more accurately.Connectivity and reliabilityMultiple connectivity options are offered to integrate applications into your con-trol system, e.g. Allen-Bradley ® RIO, Profibus ®DP or DeviceNet ™. Even in difficult vibrating environments, the TraxDSP ™ filtering system ensures fast and precise weighing results. High reli-ability and increased uptime are met through predictive maintenance with TraxEMT ™ Embedded MaintenanceTechnician.METTLER TOLEDO Dairy & Cheese News 22Speed up manual operations with flexible checkweighingB e n c h & F l o o r S c a l e sHygienic design, fast display readouts and the cutting-edge color backlight of the new BBA4x9 check scales and IND4x9 terminals set the standard for more efficient manual weigh-ing processes.Flexibility through customizationFor optimal static checkweighing the software modules ‘check’ and‘check+’ are the right solutions. They allow customization of the BBA4x9 and the IND4x9 for individual activi-ties and needs, e.g. manual portion-ing or over/under control. Flexibility is increased with the optional battery which permits mobility. Hygienic design Easy-to-clean equipment is vital in food production environments. Both the BBA4x9 scale and the IND4x9 ter-minal are designed after the EHEDGand NSF guidelines for use in hygi-enically sensitive areas.Even the back side of the scale stand has a smooth and closed surfacewhich protects from dirt and allowstrouble-free cleaning.Fast and preciseThe colorWeight ® display with a colored backlight gives fast, clear indication when the weight is with-in, below or above the tolerance.The color of the backlight can be chosen (any mixture of red, greenand blue) as well as the condition itrefers to (e.g. below tolerance). The ergonomic design enables operators to work more efficiently due to less exhaustion.Short stability time, typically between 0.5s and 0.8s, ensures high through-put and increased productivity.PublisherMettler-Toledo GmbH IndustrialSonnenbergstrasse 72CH-8603 Schwerzenbach SwitzerlandProductionMarCom IndustrialCH-8603 Schwerzenbach Switzerland MTSI 44099754Subject to technical changes © 06/2006 Mettler-Toledo GmbH Printed in SwitzerlandYellow – weight above toleranceGreen – weight within toleranceRed – weight below toleranceYour benefits• Fast and precise results and operations • Higher profitability• Ergonomic design, simple to operate • Mobility up to 13h due to optional batteryFast facts BBA4x9 and IND4x9• 6kgx1g, 15kgx2g, 30kgx5g (2x3000d), for higher capacity scales: IND4x9 terminal • Weights and measures approved versions 2x3000e • Functions: simple weighing, static checkweighing, dispensing • Color backlight, bar graph • Tolerances in weight or %• 99 Memory locations • Optional WLAN, battery• Meets the IP69k protection standardsagainst high-pressure and steam cleaning • Complete stainless steel construction Immediate checkweighing resultswith color Weight®EHEDGThe colored backlight of the LC display provides easy-to- recognize indication whether the weight is within the tolerancelimits or not.WLANMETTLER TOLEDO Dairy & Cheese News 23HACCP programs, GMP (Good Manufacturing Practice), pathogen monitoring and good cleaning practices are essential for effective food safety plans. Our scales are constructed for compliance with the latest hygienic design guidelines.Hygienic design to improve food safetyMETTLER TOLEDO supports you in complying with the latest food safety standards like BRC, IFS or ISO 22000 by offering solutions which are:• Compliant with EHEDG (European Hygienic Engineering & Design Group) and NSF (National Sanitation Foundation) guidelines • Full V2A stainless steel construc-tions, optional V4A load plates • Smooth surface (ra < 0.8μm)• Easy-to-clean construction, no exposed holes • Radius of inside corners > 3mm• Ingress protection rating up to IP69k• Hermetically sealed loadcellsYour benefits• Reduce biological and chemical contamination risks • Fast and thorough cleaning procedures • Fulfillment of hygiene regulations • Long equipment life thanks to rugged designGuaranteed serviceKeep your business runningAvoid unnecessary downtime with our wide range of service packages.With a range of innovative service solutions offering regulatory compli-ance, equipment calibration, train-ing, routine service and breakdown assistance, you can profit from sus-tained uptime, together with ongoing performance verification and long life of equipment. There is a range of contract options designed to comple-ment your existing quality systems. Each one offers its own unique set of benefits depending on the equipment and its application.4/serviceFast facts PUA579 low profile scale • 300kgx0.05kg – 1500kgx0.2kg • Open design• Lifting device for easy cleaning • EHEDG conform(300 and 600kg models -CS/-FL)• Free size scale dimensions • Approach rampsExample:PUA579 first EHEDG conform floor scaleEHEDGW e i g h P r i c e L a b e l i n gChallenges faced in the packaging area are:• Responding quickly to retailer demands while improving margins • Improving pack presentation • Minimizing downtime and product giveawaysWith a complete offering of cutting-edge weighing technology, high-per-formance printing, and smart soft-ware solutions, we can help you tackle your labeling challenges whether they are very simple or highly demanding. Intuitive human-machine interfaceTouch-screen operator displays withgraphical icons guide the operator intuitively and reduce nearly every operation to just one or two key-strokes. This interface allows reduced operator training as well as increased operating efficiency.Advanced ergonomics and sani-tary designOur weigh-price labelers are made out of stainless steel for extensive pro-tection against food contamination. Careful attention to hygienic design requirements, with no dead spots and few horizontal parts, ensure that the labelers are easy to clean.Modular designOur product offering includes both manual and automatic weigh-price labelers constructed of flexible “build-ing blocks.” Different combinations and configurations can meet specific budget and operational requirements. METTLER TOLEDO will help you toselect the right:• Scale performance • Display technology • Memory capacity • IT connections • Degree of automation• Integration kitsA large range of options and peripher-als give flexibility for meeting unique requirements e.g. wireless network, hard disks, external keyboards, bar code scanners, RFID transponder, dynamic checkweighing, or metal detection.Weigh-price-labeling Ergonomic, modular, fastEtica 2300 standard manual labelerFor individual weight labeling of various products, high- speed weighing, smart printing and fast product changes are essential. METTLER TOLEDO offers static and automated solutions for both manual and high-speed prepack applica-tions. Choose from our Etica and PAS product range.METTLER TOLEDO Dairy & Cheese News 24Etica 2400i combination with automatic stretch wrappersEtica 2430G multi-conveyer weigh-price labeler rangeEfficient label applicatorsThe unique Etica label applicator (Etica G series) does not require an air compressor, allowing savings on initial equipment expense and ongo-ing maintenance costs. Labels are gently applied in any pre-memorized orientation.PAS systems provide motorized height adjustment and places the label in any corner of the package. Users will have a new degree of freedom in planning their case display layouts to maximize both product presentation and consumer impact.Smart label design tools Retailers want labels to carry clear, correct information, in accordance with their traceability and style requirements. Our solutions are equipped with labeldesign software tools which facili-tate the design of labels customizedfor retailers demands. A touch-screenallows the user to create specific labels– even with scanned elements such aslogos and graphics, pre-programmedlabel templates, or RFID.Versatile integration capabilitiesThe engineers at METTLER TOLEDOworked closely with Europe’s leadingautomatic stretch wrapper suppliersto design performance-enhancingand cost-effective weigh-wrap-labelsystem solutions. Achieving a smallsystem footprint means the systemsrequire only slightly more floor spacethan the wrapper alone.The PAS and Etica weigh-price label-ers can be integrated via TCP/IP ina METTLER TOLEDO scale network,in host computer systems and goodsmanagement systems.Etica weigh-price-labeling systems• Static and automatic weigh-price-labeling up to 55 pieces/min.• Operator displays:– 5.7” color back-lighted LCD (Etica 2300 series)– 10.4” high resolution touch screen (Etica 4400 series)• 3 inch graphic thermal printer (125 to 250mm/sec) withfully programmable label format (max. size 80x200mm)• Data memory:– 64 to 256 Mb RAM– 128 Mb to 10 Gb mass storage– Unlimited number of logo graphics and label descriptions• Interfaces:– 1 serial RS232 interface– Optional second RS232 + RS485 + Centronics port– Ethernet network communication interface(10baseT), TCP/IP, 2 USB ports (1)– Optional: hand-held bar code scanner for automatictraceability data processingGarvens PAS 3008/3012 price labelersEtica 4400METTLER TOLEDO Dairy & Cheese News 2FlexMount ® weigh moduleFast, reproducible and reliable batch-ing and filling are key success factors for your production process. Various factors can affect precision: foam can compromise optical/radar sensors, and solids do not distribute evenly in a tank or silo. Our weighing techno-logy is not affected by these condi-tions and provides direct, accurate and repeatable measurement of mass without media contact. In addition our range of terminals and transmit-ters/sensors enable easy connectivity to your control systems.Key customer benefits• Increased precision and consistencyof your material transfer processes• Faster batching process throughsupreme TraxDSP ™ noise and vibration filtering • Minimal maintenance cost Fast facts terminals/transmitters: PTPN and IND130• Exclusive TraxDSP ™ vibration rejection and superior noise filter-ing system • Easy data integration through a variety of interfaces, including Serial, Allen-Bradley ® RIO, Modbus Plus ®, Profibus ® and DeviceNET • IP65 stainless harsh versionsProcess terminal PTPN• Local display for weight indication and calibration checks • Panel-mount or stainless steel desk enclosureIND130 smart weight transmitter• Direct connectivity where no local display is required • Quick setup and run via PC tool • CalFREE ™ offers fast and easy cali-bration without test weights • DIN rail mounting versionPLCIND1306Tank and silo weighing solutions master your batching processesT a n k & S i l o W e i g h i n g S o l u t i o n sBoost your productivity and process uptime with reliable weighing equipment – improved batching speed and precision, maximum uptime at low maintenance cost.TraxDSP ™ ensures accurate results evenin difficult environments with vibrationPTPN process terminalMETTLER TOLEDO Dairy & Cheese News 27Quality data under control?We have the right solutionConsistently improving the quality of your products requires the ability of efficiently controlling product and package quality parameters in a fast-changing and highly competi-tive environment.Competition in the food industry –with high volumes but tight margins – causes demands for efficient quality assurance systems. Statistical Quality Control (SQC) systems for permanent online information and documenta-tion about your key quality para-meters convert into real cost savings.Our solutions for Statistical Quality Control (SQC) combine ease of opera-tion, quality data management and analysis functionality.• We offer mobile compact solutions with embedded SQC intelligence up to networked systems with an SQL database.• The systems are upgradeable and can be expanded and adapted to meet changing customer needs.• Simple and intuitive prompts guide the user through the sample proc-ess, reducing training costs as well as sampling errors.• Realtime analysis and alarms help to take immediate corrective measures and to save money by reducing overfilling.Throughout the manufacturing pro-cess, METTLER TOLEDO SQC solu-tions analyze your important product and package quality parameters andpresent them the way you want, help-ing to comply to legislation, to control and document your product qualityand your profitability.Metal detectionCheckweigher Sample check ® onlinequality data analysis/dairy-cheeseFor more informationMettler-Toledo GmbH CH-8606 Greifensee SwitzerlandTel. +41 44 944 22 11Fax +41 44 944 30 60Your METTLER TOLEDO contact:1. SevenGo ™ portable pH-meter2. In-line turbidity, pH and conductivity sensors3. DL22 Food and beverage analyzer4. Halogen moisture analyzersA wide range of solutions to improve processes1. Statistical Quality Control/Statistical Process Control2. Process weighing3. Predictive maintenance4. Methods of moisture content determinationShare our knowledgeLearn from our specialists – our knowledge and experience are at your disposal in print or online.Learn more about all of our solutions for the dairy and cheese industry at our website. You can find information on a wide range of topics to improve your processes, including case studies,application stories, return-on invest-ment calculators, plus all the product information you need to make aninformed decision.1 2 341423。

肝移植术后严重门静脉狭窄的三维可视化成像与门静脉支架植入术疗效分析

肝移植术后严重门静脉狭窄的三维可视化成像与门静脉支架植入术疗效分析

· 论著·肝移植术后严重门静脉狭窄的三维可视化成像与门静脉支架植入术疗效分析赵洪强 刘影 马建明 李昂 于里涵 童翾 吴广东 卢倩 张跃伟 汤睿【摘要】 目的 分析肝移植术后严重门静脉狭窄的三维成像特征与优势,评估门静脉支架植入术效果。

方法 回顾性分析10例肝移植术后因严重门静脉狭窄接受门静脉支架植入的患者的临床资料,分析严重门静脉狭窄的影像学特征、三维重建的成像优势及介入治疗效果。

结果 10例患者中狭窄类型包括向心性缩窄3例,曲折成角致狭窄2例,受压狭窄2例,长段狭窄和(或)血管闭塞3例。

三维重建图像在狭窄的准确判断、狭窄类型的辨别和狭窄累及长度判断方面具有优势。

所有患者均成功接受门静脉支架植入术,支架植入后门静脉最狭窄处直径较治疗前增加[(6.2±0.9)mm 比(2.6±1.7)mm ,P <0.05],吻合口流速较治疗前下降[(57±19)cm/s 比(128±27)cm/s ,P <0.05],近肝处门静脉主干流速较治疗前增加[(41±6)cm/s 比(18±6)cm/s ,P <0.05]。

1例患者因介入穿刺引起肝内血肿,经保守观察治疗后好转,其余患者均未出现相关并发症。

结论 三维可视化技术可以立体直观展示狭窄部位、特征与严重程度,有利于临床医师进行治疗决策和辅助介入操作。

及时的门静脉支架植入术可以有效逆转病变进程并改善门静脉血流。

【关键词】 肝移植;血管并发症;门静脉狭窄;介入治疗;三维可视化成像;门静脉支架;血流加速;门静脉高压【中图分类号】 R617, R543 【文献标志码】 A 【文章编号】 1674-7445(2024)01-0011-08Analysis of three-dimensional visualization imaging of severe portal vein stenosis after liver transplantation and clinical efficacy of portal vein stent implantation Zhao Hongqiang *, Liu Ying, Ma Jianming, Li Ang, Yu Lihan, Tong Xuan, Wu Guangdong,Lu Qian, Zhang Yuewei, Tang Rui. *Hepatopancreatobiliary Center , Beijing Tsinghua Changgung Hospital Affiliatal to Tsinghua University , Key Laboratory of Digital Intelligence Hepatology of Ministry of Education , School of Clinical Medicine , Tsinghua University , Beijing 102218, ChinaCorresponding author: Tang Rui, Email: ******************【Abstract 】 Objective To analyze three-dimensional imaging characteristics and advantages for severe portal vein stenosis after liver transplantation, and to evaluate clinical efficacy of portal vein stent implantation. Methods Clinical data of 10 patients who received portal vein stent implantation for severe portal vein stenosis after liver transplantation were retrospectively analyzed. Imaging characteristics of severe portal vein stenosis, and advantages of three-dimensional reconstruction imaging and interventional treatment efficacy for severe portal vein stenosis were analyzed.DOI: 10.3969/j.issn.1674-7445.2023201基金项目:国家自然科学基金重点项目(81930119);中国医学科学院医学与健康科技创新工程创新单元(2019-I2M-5-056);北京清华长庚医院青年启动基金资助项目(12019C1012)作者单位: 102218 北京,清华大学附属北京清华长庚医院肝胆胰中心 数智肝胆病学教育部重点实验室 清华大学临床医学院(赵洪强、刘影、李昂、于里涵、童翾、吴广东、卢倩、张跃伟、汤睿);拉萨市人民医院普外科(马建明、汤睿)作者简介:赵洪强(ORCID 0000-0002-8544-2865),博士,住院医师,研究方向为肝脏移植的临床与基础研究,Email :*************************通信作者:汤睿(ORCID 0000-0003-3118-3842),博士,副主任医师,研究方向为肝脏移植的临床与基础研究,Email :******************第 15 卷 第 1 期器官移植Vol. 15 No.1 2024 年 1 月Organ Transplantation Jan. 2024 Results Among 10 patients, 3 cases were diagnosed with centripetal stenosis, tortuosity angulation-induced stenosis in 2 cases, compression-induced stenosis in 2 cases, long-segment stenosis and/or vascular occlusion in 3 cases. Three-dimensional reconstruction images possessed advantages in accurate identification of stenosis, identification of stenosis types and measurement of stenosis length. All patients were successfully implanted with portal vein stents. After stent implantation, the diameter of the minimum diameter of portal vein was increased [(6.2±0.9) mm vs. (2.6±1.7) mm, P<0.05], the flow velocity at anastomotic site was decreased [(57±19) cm/s vs. (128±27) cm/s, P<0.05], and the flow velocity at the portal vein adjacent to the liver was increased [(41±6) cm/s vs. (18±6) cm/s, P<0.05]. One patient suffered from intrahepatic hematoma caused by interventional puncture, which was mitigated after conservative observation and treatment. The remaining patients did not experience relevant complications. Conclusions Three-dimensional visualization technique may visually display the location, characteristics and severity of stenosis, which is beneficial for clinicians to make treatment decisions and assist interventional procedures. Timely implantation of portal vein stent may effectively reverse pathological process and improve portal vein blood flow.【Key words】Liver transplantation; Vascular complication; Portal vein stenosis; Interventional therapy; Three-dimensional visualization imaging; Portal vein stent; Accelerated blood flow; Portal hypertension术后门静脉狭窄是肝移植主要的血管并发症之一,尽管发生率低,但可能造成移植物丢失、患者死亡等严重后果[1]。

乙型肝炎核心蛋白调节剂[发明专利]

乙型肝炎核心蛋白调节剂[发明专利]

专利名称:乙型肝炎核心蛋白调节剂
专利类型:发明专利
发明人:W.特纳,L.D.阿诺德,H.马格,M.布雷斯申请号:CN201680065137.2
申请日:20160915
公开号:CN108348529A
公开日:
20180731
专利内容由知识产权出版社提供
摘要:本公开在一些方面提供了针对乙型肝炎病毒Cp具有变构效应器性质的化合物。

本文中还提供了治疗病毒感染如乙型肝炎的方法,其包括向需要的患者给药公开的化合物。

申请人:组装生物科学股份有限公司,美国印第安纳大学研究和技术公司
地址:美国印第安纳州
国籍:US
代理机构:北京市柳沈律师事务所
更多信息请下载全文后查看。

circRNA在心肌纤维化中的研究进展

circRNA在心肌纤维化中的研究进展

circRNA在心肌纤维化中的研究进展作者:孙帅锋刘巍来源:《新医学》2020年第07期通信作者简介:刘巍,哈尔滨医科大学附属第四医院心血管内科主任医师、硕士研究生导师、教授、九三学社成员。

医学博士,生物学和病理学博士后。

曾赴美国Vermont大学留学。

自1998年起,从事心血管内科至今,擅长高血压病、冠状动脉粥样硬化性心脏病、心肌炎、心肌病及心力衰竭、心律失常等的诊断和治疗。

国家自然科学基金委员会评议专家。

2012年起担任中国医师协会高血压专业委员会委员,2013年担任高血壓青年委员会常委,2016年担任中华医学会心力衰竭专业委员会青年委员会委员。

获得发明专利1项。

2006年获得教育部科技进步二等奖,2007年获得中华医学三等奖,2003年、2009年及2015年分别获得黑龙江省政府科技进步二等奖3次。

发表SCI论文十余篇,目前主持国家自然科学基金课题2项,黑龙江省留学归国基金1项,黑龙江省教育厅海外学人重点项目1项,中国博士后特别资助项目1项,省级课题多项。

【摘要】环状RNA(circRNA)是一类不能正常编码蛋白质的共价闭合环状RNA分子。

circRNA涉及许多正常的生理过程和疾病的发病机制。

越来越多的研究表明心肌纤维化的发生和发展与circRNA的调节密切相关。

该文总结当前关于circRNA生物起源和功能的认识,进一步强调circRNA在心肌纤维化中的最新进展和作为新型生物标志物、治疗靶标的潜力。

【关键词】环状RNA;心肌纤维化;生物标志物;治疗靶标【Abstract】 Circular RNA (circRNA) are a category of covalently closed circRNA molecules that normally do not encode proteins. circRNA are involved in many physiological processes as well as the pathogenesis of diseases. A growing number of studies have reported that the incidence and development of cardiac fibrosis is closely associated with the regulation of circRNA. This review summarizes the current understanding of circRNA biogenesis and function, highlighting the recent updates regarding the involvement of circRNA in cardiac fibrosis, and their potential as novel biomarkers and therapeutic targets.【Key words】 Circular RNA;Cardiac fibrosis;Biomarker;Therapeutic target心血管疾病仍然是全球主要的公众健康问题,并且是全世界高发病率、高病死率的首要病因之一[1]。

Twin-block与肌激动器功能矫治安氏Ⅱ类下颌后缩的效果对比

Twin-block与肌激动器功能矫治安氏Ⅱ类下颌后缩的效果对比

Twin-block 与肌激动器功能矫治安氏Ⅱ类下颌后缩的效果对比刘清华林俊才陈东斌蓝建灵*(福建医科大学附属龙岩市第一医院,福建龙岩364000)Factors and Improvements in Diagnosis [J].Rev Diabet Stud ,2015,12(1-2):110-118.[5]WEI J ,ZHU A ,JI J S.A Comparison Study of Vitamin D Deficiency among Older Adults in China and the United States [J].Sci Rep ,2019,9(1):19713.[6]RAVANI P ,MALBERTI F ,TRIPEPI G ,et al.Vitamin D levels and patientoutcome in chronic kidney disease [J].Kidney Int ,2009,75(1):88-95.[7]GUO Y ,GUPTE M ,UMBARKAR P ,et al.Entanglement of GSK-3β,β-catenin and TGF-β1signaling network to regulate myocardial fibrosis [J].J Mol Cell Cardiol ,2017,1(10):109-120.[8]MU M ,ZUO S ,WU R M ,et al.Ferulic acid attenuates liver fibrosis and hepatic stellate cell activation via inhibition of TGF-β/Smad signaling pathway [J].Drug Des Devel Ther ,2018,4(12):4107-4115.[9]KIM K K ,SHEPPARD D ,CHPMAN H A.TGF-β1Signaling and Tissue Fibrosis [J].Cold Spring Harb Perspect Biol ,2018,10(4):a022293.[10]虞建新,周理兰,许仁炜.活性维生素D 3干预糖尿病肾病大鼠模型对肾脏TGF-β1/Smads 信号轴的影响[J].中国基层医药,2017,24(18):2760-2763.[11]ZHAO Y ,QIAO X ,TAN T K ,et al.Matrix metalloproteinase 9-dependent Notch signaling contributes to kidney fibrosis through peritubular endothelial-mesenchymal transition [J].Nephrol DialTransplant ,2017,32(5):781-791.[12]WANG Q ,MA A ,GAO T ,et al.Poor Vitamin D Status in Active Pulmonary Tuberculosis Patients and Its Correlation with Leptin and TNF-α[J].J Nutr Sci Vitaminol (Tokyo ),2019,65(5):390-398.[13]MAO X ,QIU J ,ZHAO L ,et al.Vitamin D and IL-10Deficiency in Preterm Neonates With Bronchopulmonary Dysplasia [J].Front Pediatr ,2018,6(11):246.[14]ALTIERI B ,GRANT W B ,DELLA CASA S ,et al.Vitamin D and pancreas :The role of sunshine vitamin in the pathogenesis of diabetes mellitus and pancreatic cancer [J].Crit Rev Food Sci Nutr ,2017,57(10):3472-3488.[15]SZYMCZAK-PAJOR I ,LIWI ńSKA A.Analysis of Association between Vitamin D Deficiency and Insulin Resistance [J].Nutrients ,2019,11(4):794.[16]MUSCOGIURI G ,CHAVEZ A O ,GASTALDELLI A ,et al.The crosstalkbetween insulin and renin-angiotensin-aldosterone signaling systems and its effect on glucose metabolism and diabetes prevention [J].Curr Vasc Pharmacol ,2008,6(4):301-312.[17]黄映珍.2型糖尿病患者糖尿病肾脏病进展的危险因素分析[D].南方医科大学,2018.[18]MELAMED M L ,THADHANI R I.Vitamin D therapy in chronic kidney disease and end stage renal disease [J].Clin J Am Soc Nephrol (CJASN ),2012,7(10):358-365.[19]MIZOBUCHI M ,MORRISSEY J ,FINCH J L ,et bination therapy with an angiotensin-converting enzyme inhibitor and a vitamin D analog suppresses the progression of renal insufficiency in uremic rats [J].J Am Soc Nephrol ,2007,18(6):1796-1806.[20]LIYANAGE P ,LEKAMWASAM S ,WEERARATHNA T P ,et al.Effect of Vitamin D therapy on urinary albumin excretion ,renal functions ,andplasmareninamong patientswithdiabeticnephropathy :A randomized ,double-blind clinical trial [J].J Postgrad Med ,2018,64(1):10-15.[21]石天闻,周迪夷,牟新.不同剂量的活性维生素D 治疗糖尿病肾病疗效的系统评价[J].浙江医学,2018,40(1):54-60.(收稿日期:2020-11-20)【摘要】目的对比Twin-block 与肌激动器功能矫治安氏Ⅱ类下颌后缩的效果。

基于机器学习的香豆素衍生物的建模研究

基于机器学习的香豆素衍生物的建模研究

基于机器学习的香豆素衍生物的建模研究作者:张培俭夏润泽高湛刘壮来源:《青岛大学学报(工程技术版)》2023年第04期摘要:為了筛选潜在药物治疗乳腺癌,本文采用机器学习方法对香豆素衍生物建立定量构效关系模型。

基于启发式方法筛选出3种香豆素衍生物的分子描述符,通过支持向量机、广义回归神经网络和K近邻方法建立3种机器学习预测模型,拟合57种香豆素衍生物对MCF-7乳腺癌细胞的抑制作用并作出预测。

预测结果表明,3种模型的预测结果与实测值吻合度较高,其中支持向量机的效果和鲁棒性最佳,通过网格搜索确定后的参数为C=1.43,γ= 499.768,其测试集的均方根误差为0.15。

该研究为设计新的乳腺癌药物分子提供研究方向以及活性预测。

关键词:乳腺癌;香豆素衍生物;定量构效关系;机器学习中图分类号:TP181文献标识码:A收稿日期:2023-04-10;修回日期:2023-09-18基金项目:山东省自然科学基金资助项目(ZR2019PF012);青岛大学国家级大学生创新训练项目(S202011065021)作者简介:张培俭(1974-),男,博士,副教授,主要研究方向为药物大数据分析。

Email:*****************乳腺癌是女性最常见的恶性肿瘤之一,也是女性癌症死亡的主要原因,其发病率随着年龄的增长急剧上升[1-2],全球癌症统计发现,2018年乳腺癌新发病例约208.9万例[3],其中包含死亡病例627 000例,约占全球女性癌症死亡总数的15%[4]。

自上世纪60年代,科学家研制出选择性雌激素调制器(SERM),首次被批准用于辅助治疗乳腺癌的SERM是他莫昔芬,该药物已为许多患者提供治疗。

虽然SERM改善了ERα阳性乳腺癌患者的症状,但其价格昂贵,且伴有诸多副作用,严重限制了其治疗效果[5],目前活性高但副作用低的SERM尚未发现。

近几年,香豆素发展成一种多功能的分子支架,广泛分布在自然界,具有多种药理及治疗作用,如抗细菌,抗真菌,抗疟疾和抗癌等[6]。

魏冬青教授简介

魏冬青教授简介

魏冬青教授简介魏冬青教授,1978-1985年河南师大(原新乡师院)学士,硕士(师从卢锦梭先生),1987年7月在美属波多黎各大学获化学物理学博士学位,1987年8月-1992年12月加拿大不列颠哥伦比亚大学做博士后研究,1993年1月-2006年2月加拿大计算及其应用研究中心,任研究员,1999-2000年北京大学教授,2000年8月-2006年2月蒙特利尔理工学院教授,院长,2003年1月-2006年1月,天津市及天津师大特聘教授(海河学者),天津大学博士生导师,天津生物信息与药物开发研究所所长,2006年2月起任上海交通大学教授,博士生导师,生物信息与生物统计系执行主任。

交叉科学杂志主编。

现任河南师范大学校友会上海分会会长,河南枫华种业股份有限公司董事长。

魏冬青教授,长期从事交叉科学领域的前沿研究,主要研究方向为计算微生物学,生物信息学、生物物理学以及高压物理学。

早期的科研工作集中在离子液体,极性液体以及液晶的统计力学理论研究,发展了广适的分子液体转动动力学和溶剂化动力学理论,有力推进了介电松弛理论和离子电导理论的发展。

首次从理论上证明了铁电液晶的存在,为寻找新型的铁电液晶材料指引了方向。

实现了硝基甲烷晶体的第一原理模拟,揭示了爆炸反应的机理,为新的含能材料的设计奠定了理论基础。

他领导的课题组自主开发了分子模拟和计算机辅助药物设计软件SAMM,构建了多个数据库工具,比如中药有效成分数据库,细胞色素P450酶多态性基因型-表型相关性数据库等。

利用多种统计以及人工智能方法构建了统计预测模型并应用到药物构效关系,药物代谢动力学和基因表型相关性的研究中。

将现代计算机药物设计方法和中药有效成分等数据库应用到药物设计和分子优化的实践中,病毒(SARS,HIV,H5N1, H1N1)和老年痴呆等疾病的药物设计。

通过虚拟筛选,发现花椒有效成分wgx-50(花椒素)有可能作为治疗阿尔兹海默症的候选药物。

大量实验证明wwx50小分子能够结合到目标蛋白α7烟碱乙酰胆碱受体(α7 nAChR)上,同时能够有效地抑制Aβ淀粉样蛋白(β-amyloid)诱导的神经胶质细胞的炎性因子的分泌,阻止细胞凋亡蛋白的表达,减少细胞凋亡,从而有效地保护神经细胞。

GInaFiT手册说明书

GInaFiT手册说明书

GInaFiTGeeraerd and Van Impe Inactivationmodel Fitting ToolDeveloped under the supervision ofAnnemie Geeraerdas support of a range ofmicrobial inactivation models published in Bigelow and Esty (1920), Cerf (1977), Geeraerd et al. (2000), Mafart et al. (2002), Albert and Mafart (2005),Geeraerd et al. (2005), Coroller et al. (2006) Version 1.7 – Office 365, 2016, 2013, 2010 & 2007November 2016Copyright © 2003-2017Katholieke Universiteit Leuven (Belgium)Disclaimer and SupportDisclaimerGInaFiT and this manual come without ANY WARRANTY and are provided “AS-IS”. The softwar e GInaFiT is copyrighted by the Katholieke Universiteit Leuven (KULeuven, Belgium). It is not permitted to include GInaFiT in any other application. The program is for research purposes only and should not be solely relied upon for any reason.AcknowledgementsOn publishing/presenting the results obtained with GInaFiT, you are kindly invited to refer to A.H. Geeraerd, V.P. Valdramidis, J.F. Van Impe, 2005. GInaFiT, a freeware tool to assess non-log-linear microbial survivor curves. International Journal of Food Microbiology, 102, 95-105 and to the original research publications for the model(s) you selected for your case-study (as provided in the Excel result-sheet(s) and this user manual).FeedbackIf you would have comments or suggestions regarding the installation, use or content of GInaFiT, or if you would be willing to provide a short user testimonial, please contact *****************************.be, associate professor at www.mebios.be. Your comments and user testimonials are highly appreciated.UpdatesPossible future updates will be accessible via the GInaFit homepage http://www.ginafit.be/ Compatibility with different Microsoft® Office Excel® versionsThe GInaFiT version that you have obtained together with this manual is compatible with Microsoft®Office Excel® 365, Microsoft® Office Excel® 2016, Microsoft® Office Excel® 2013, Microsoft®Office Excel® 2010 and Microsoft® Office Excel® 2007, and in principle it should work for any language (though we did obviously not test for every language). Installation instructions are provided below.Since Version 1.6 GInaFiT is not compatible anymore with Microsoft® Office Excel® 2003,also called Microsoft® Office Excel® XP. If you would be interested in receiving Version 1.5 (Version 1.7 contains bug fixes not implemented in Version 1.5) for Microsoft®Office Excel®2003/XP, please contact *****************************.be.Installation of GInaFiT Office365/2016/2013/2010For the installation instructions for GInaFiT Office 2007, please refer to page 11 of this manual.An essential requirementPlease carefully consider the following essential requirement before proceeding to the installation of GInaFiT in Office 365/2016/2013/2010: the MS-Excel Add-In “Solver” is installed.This requirement can be verified by looking under the Excel worksheet tab “Data”. Solver should be visible in the right corner, as indicated in the next figure.If the Solver is not appearing under the worksheet tab “Data”, it needs to be installed. This is to be performed by following this procedure:∙Click the File tab.∙The Microsoft Office Backstage view opens∙Click Options;∙The Options dialog box appears. Select Add-InsAt the bottom of the Add-Ins screen, select “Excel Add-Ins” und er the drop-down list next to “Manage”. It is likely (but not guaranteed) that “Excel Add-Ins” is already appearing here. Then proceed by hitting the button Go∙The item “Solver Add-in” has to be ticked in the list, i.e. the “v” should be visible before the Solver Add-In. Alternatively, it may be the case that the Solver name is indicated with its equivalent name in the language of your Windows version. If this is the case, select the Solver with this other name.∙Press OK∙The Solver should now be visible in the right corner under the Excel menu tab “Data”, as indicated in the next figure.Installation of GInaFiT.xlaIt is suggested to place the file GInaFiT.xla in the directoryc:\Program Files\Microsoft Office\Office14\ADDINSor in a similar directory for an Office version in a language different from English. Nevertheless, placing at any other location like, for example, C:\temp, is always possible.Start MS-Excel with a blank work sheet.∙Click the File tab.∙The Microsoft Office Backstage view opens∙Click Options;∙The Options dialog box appears. Select Add-Ins∙At the bottom of the Add-Ins screen, select “Excel Add-Ins” under the drop-down list next to “Manage”. It is likely (but not guaranteed) that “Excel Add-Ins” is already appearing here. Then proceed by hitting the button Go.∙In the Add-In screen tick the Add-In GInaFiT when present in the list or select the GInaFiT.xla file by browsing to the directory selected at the start of this installation procedure.∙Press OK and please read carefully the two screens appearing.∙From this moment on the button GInaFiT will be present in the Worksheet tab Add-Ins (last tab)How to remove GInaFiTStart MS-Excel with a blank work sheet.∙Click the File tab.∙The Microsoft Office Backstage view opens∙Click Options;∙The Options dialog box appears. Select Add-Ins∙At the bottom of the Add-Ins screen, select “Excel Add-Ins” under the drop-down list next to “manage”. It is likely (but not guaranteed) that “Ex cel Add-Ins” is already appearing here. Then proceed by hitting the button Go∙In the Add-In screen untick the Add-In GInaFiT.∙ A screen appears, press OK on that screen.∙Delete the GInaFiT.xla file from the directory selected at the start of the installation procedure.Installation of GInaFit Office 2007An essential requirementPlease carefully consider the following essential requirement before proceeding to the installation of GInaFiT Office 2007: the MS-Excel Add-In “Solver” is installed.This requirement can be verified by looking under the Excel worksheet tab “Data”. Solver should be visible in the right corner, as indicated in the next figure.If the Sol ver is not appearing under the worksheet tab “Data”, it needs to be installed. This is to be performed with the procedure∙Hit the Office Button (this is the Circle with the Office logo in the upper left corner of the Excel application)∙Hit the button “Excel Options”∙Select Add-Ins∙At the bottom of the Add-Ins screen, select “Excel Add-Ins” under the drop-down list next to “manage”. It is likely (but not guaranteed) that “Excel Add-Ins” is alreadyappearing here. Then proceed by hitting the button Go.∙The item “Solver Add-in” has to be ticked in the list, i.e. the “v” should be visible before the Solver Add-In. Alternatively, it may be the case that the Solver name is indicated with its equivalent name in the language of your Windows version. If this is the case, select the Solver with this other name.∙Press OK∙The Solver should now be visible in the right corner under the Excel menu tab “Data”, as indicated in the next figure.Installation of GInaFiT.xlaIt is suggested to place the file GInaFiT.xla in the directoryc:\Program Files\Microsoft Office\Office12\ADDINSor in a similar directory for an Office version in a language different from English. Nevertheless, placing at any other location like, for example, C:\temp, is always possible.Start MS-Excel with a blank work sheet.∙Hit the Office Button (this is the Circle with the Office logo in the upper left corner of the Excel application)∙Hit the button “Excel Options”∙Select Add-Ins∙At the bottom of the Add-Ins screen, select “Excel Add-Ins” under the drop-down list next to “manage”. It is likely (but not guaranteed) that “Excel Add-Ins” is already appearing here. Then proceed by hitting the button Go.∙In the Add-In screen tick the Add-In GInaFiT when present in the list or select the GInaFiT.xla file by browsing to the directory selected at the start of this installation procedure.∙Press OK and please read carefully the two screens appearing.∙From this moment on the button GInaFiT will be present in the Worksheet tab Add-Ins (last tab)How to remove GInaFiTStart MS-Excel with a blank work sheet.∙Hit the Office Button (this is the Circle with the Office logo in the upper left corner of the Excel application)∙Hit the button “Excel Options”∙Select Add-Ins∙At the bottom of the Add-Ins screen, select “Excel Add-Ins” under the drop-down list next to “manage”. It is likely (but not guaranteed) that “Excel Add-Ins” is already appearing here. Then proceed by hitting the button Go∙In the Add-In screen untick the Add-In GInaFiT.∙Delete the GInaFiT.xla file from the directory selected at the start of the installation procedure.How to use GInaFiT1.Select the data to be modelled in the Excel sheet. The first column should be time, the second columnshould be LOG10(N).2.Select the model to be applied out of the ten different models available as can be seen in the figurebelow.3. A new sheet is inserted with the same name as the name of the original sheet followed by the nameof the model selected, e.g., Sheet1 would result in Sheet1_Geeraerd_Shoulder_Tail. The result is demonstrated below.GInaFiT output when selecting the “Gee raerd et al., 2000: Log-Linear + Shoulder” Menu-Item for the case-study at hand.A short advice on the use of GInaFiTThe tool is useful for testing ten different types of microbial survival models on user-specific experimental data relating the evolution of the microbial population with time. The ten model types are: (i) classical log-linear curves, (ii) curves displaying a so-called shoulder before a log-linear decrease is apparent, (iii) curves displaying a so-called tail after a log-linear decrease, (iv) survival curves displaying both shoulder and tailing behavior, (v) concave curves, (vi) convex curves, (vii) convex/concave curves followed by tailing, (viii) biphasic inactivation kinetics, (ix) biphasic inactivation kinetics preceded by a shoulder, and (x) curves with a double concave/convex shape. The models were originally published as Bigelow and Esty (1920), Cerf (1977), Geeraerd et al. (2000), Mafart et al. (2002), Albert and Mafart (2005), Geeraerd et al. (2005) and Coroller et al. (2006).Next to the obtained parameter values, the following statistical measures are automatically reported: standard errors of the parameter values, the Sum of Squared Errors, the (Root) Mean Sum of Squared Errors, the R² and the adjusted R². In addition, t4D, the time needed for a 4 log reduction of the initial microbial population, as originally proposed by Buchanan et al. (1993), is also automatically reported (for data sets covering at least 4 decimal reductions).The tool can be used in two ways. On one hand, for end-users having already a qualitative idea of the general shape of their survival curves, the choice for one of the model types is obvious. On the other hand, if the end-user does not have a clear idea yet, two or more of the different model types available can be tested and compared. The time for a 4 decimal reduction can be useful to summarize the information present in a data set, for example, if a common survivor curve shape can not be selected for a range of different conditions tested.Additionally, the tool has some built-in features testing for mis-use, for example, when trying to identify a model with tailing on data not having a tail or when using a too limited number of data points (observations) in comparison with the number of parameters in the model type chosen (the number of parameters ranges from 2 to 5 for the ten model types available).Further illustration on the use of GInaFiT can be found in Geeraerd et al. (2005). If the use or interpretation of GInaFiT results would raise questions, please contact us at *****************************.be.ReferencesAlbert I. and P. Mafart 2005. “A modified Weibull model for bacterial inactivation”.International Journal of Food Microbiology, 100, 197-211Bigelow W.D. and J.R. Esty 1920. “The thermal death point in relation to typical thermophylic organisms”. Journal of Infectious Diseases, 27, 602Buchanan R.L., Golden M.H. and Whiting R.C. 1993. “Differentiation of the effects of pH and lactic or acetic acid concentration on the kinetics of Listeria monocytogenes inactivation”.Journal of Food Protection, 56, 474-478, 484.Cerf O. 1977. “A review. Tailing of surv ival curves of bacterial spores”. Journal of Applied Microbiology, 42, 1-19Coroller L., I. Leguerinel, E. Mettler, N. Savy and P. Mafart 2006. “General model, based on two mixed Weibull distributions of bacterial resistance, for describing various shapes of inactivation curves”. Applied and Environmental Microbiology, 72, 6493-6502.Geeraerd A.H., C.H. Herremans and J.F. Van Impe 2000. “Structural model requirements to describe microbial inactivation during a mild heat treatment”. International Journal of Food Microbiology, 59, 185-209Geeraerd A.H., V.P. Valdramidis and J.F. Van Impe 2005. “GInaFiT, a freeware tool to assess non-log-linear microbial survivor curves”. International Journal of Food Microbiology, 102, 95-105 Geeraerd A.H. and J.F. Van Impe 2007. “GinaFiT. Revealing the time-dependence of microbial survival under food processing, food preservation or environmental stress conditions”. In: Nychas, G.-J.E., Taoukis, P., Koutsoumanis, K., Van Impe, J. and Geeraerd, A. (Eds.), 5th International Conference Predictive Modelling in Foods - Conference Proceedings, 163-164, Agricultural University of Athens, Athens (ISBN 978-960-89313-7-4) [5th International Conference Predictive Modelling in Foods, Athens (Greece), 16-19 September, 2007]Mafart P., O. Couvert, S. Gaillard and I. Leguerinel 2002. “On calculating steril ity in thermal preservation methods: application of the Weibull frequency distribution model.” International Journal of Food Microbiology, 72, 107-113AcknowledgementsAnnemie Geeraerd is associate professor at the Division MeBioS –Mechatronics, Biostatistics and Sensors at the Biosystems Department at KULeuven –www.mebios.be. My colleagues Benny Depre, Maarten Hertog and Bram Van de Poel are gratefully acknowledged for their help in realizing this GInaFiT Version 1.6 and its manual. Dr. Vicente Gomez, CSIC, Spain is gratefully acknowledged for reporting a bug in Version 1.5.Mieke Janssen, Arnout Standaert, Vasilis Valdramidis and Karen Vereecken (at that time working at KULeuven/BioTeC, Department of Chemical Engineering) are gratefully acknowledged for their help in testing an earlier version of this tool, as well as Marie Cornu (who was affiliated with AFSSA, now ANSES in Paris) for her help to establish an earlier French version.Concerning the test phase of the language-independent version of GInaFiT (from Version 1.4.2 on), the following persons are especially to be acknowledged: Antonio Valero Díaz (Department of Food Science and Technology, University of Cordoba, Spain), Laurent Guillier (Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France), Philipp Hammer (Institute for Hygiene and Food Safety, Federal Research Center of Nutrition and Food, Kiel, Germany) and Xiaohe Wu (College of Food Science & Nutritional Engineering, China Agriculture University, Beijing, China).。

未分化结缔组织病相关肝纤维化1_例报告

未分化结缔组织病相关肝纤维化1_例报告

作者单位:200092上海市上海交通大学医学院附属新华医院消化内科第一作者:孙超,女,47岁,医学博士,副主任医师㊂主要从事慢性肝病防治研究㊂E-mail:csun7682@通讯作者:范建高,E-mail:fanjiangao@ ㊃病例报道㊃未分化结缔组织病相关肝纤维化1例报告孙超,段晓燕,葛文松,范建高㊀㊀ʌ关键词ɔ㊀结缔组织病;肝纤维化㊀㊀DOI:10.3969/j.issn.1672-5069.2024.03.038㊀㊀Undifferentiated connective tissue disease associated liver fibrosis:A case report㊀Sun Chao,Duan Xiaoyan,Ge Wensong, et al.Department of Gastroenterology,Xinhua Hospital Affiliated to Shanghai JiaoTong University School of Medicine,Shanghai 200092,China㊀㊀ʌKey wordsɔ㊀Undifferentiated connective tissue disease;Liver fibrosis㊀㊀结缔组织病(connective tissue disease,CTD)是风湿性疾病中的一大类,以血管和结缔组织慢性炎症性改变为主要发病基础,累及多个器官㊂未分化CTD(undifferentiated CTD,UCTD)是CTD的一种特殊类型,相对少见,可累及肝脏,引起肝损害,临床表现缺乏特异性,易漏诊误诊[1]㊂本文报道一例因反复肝功能异常为首发表现就诊消化科,伴有肝纤维化㊁间质性肺炎和亚临床甲状腺功能减退症,最终被诊断为UCTD及相关肝纤维化和间质性肺炎,给予皮质激素和羟氯喹治疗后患者肝功能指标恢复正常㊂现回顾性分析该例的诊疗过程并进行文献复习,供临床医师参考㊂1㊀病例摘要患者女性,54岁㊂因 发现反复肝功能异常4年 于2023年5月3日入院㊂4年前无明显诱因患者自觉双手指遇冷发白,偶有中上腹隐痛,每次持续约10分钟,进食后可好转,就诊当地医院,化验外周血发现丙氨酸氨基转移酶(alanine transaminase, ALT)为43U/L,天冬氨酸氨基转移酶(aspartate transaminase,AST)为46U/L,碱性磷酸酶(alkaline phosphatase,ALP)为184U/L,γ-谷氨酰转肽酶(γ-glutamyl transpeptadase,GGT)为260U/L,总胆红素(total bilirubin,TBIL)为19.5μmol/L㊂腹部超声提示肝脏形态大小正常,脾稍大㊂未予治疗㊂后多次复查肝功能,均提示ALT和AST轻度升高㊂2年前患者因左肩疼痛2月于当地医院住院,查血清ALT42U/L,AST85U/L,ALP163U/L,GGT196U/L㊂抗核抗体(antinuclear antibody,ANA)1:1000弱阳性㊂抗着丝粒蛋白B抗体阳性,抗双链DNA抗体阴性㊂诊断为 免疫性肝损害,左肩周炎 ,给予泼尼松㊁硫唑嘌呤㊁熊去氧胆酸等治疗1月,复查肝功能指标未见明显好转,自行停药㊂后未规律随访㊂今年2月患者再次在当地卫生院复查ALT38U/L,AST151 U/L,ALP205U/L,GGT294U/L,TBIL11.8μmol/L,直接胆红素(direct bilirubin,DBIL)3.6μmol/L,遂就诊我院㊂既往无饮酒史,无药物过敏史,10年前行子宫肌瘤切除术,5年前因胆囊结石行胆囊切除术㊂查体:体温36.3ħ,脉搏76次/分,呼吸18次/分,血压105/60mmHg㊂身高158cm,体质量65kg,体质指数26.03kg/m2,腰围81cm,臀围97cm㊂全身皮肤和巩膜无明显黄染,无肝掌㊁蜘蛛痣,心肺听诊无异常发现,腹部查体无特殊㊂查血常规㊁C反应蛋白正常,凝血酶原时间10.4s,血沉23mm/h㊂胆汁酸11.7μmol/L,ALT17U/L,AST108U/L,ALP176U/L, GGT186U/L,TBIL9.1μmol/L和白蛋白(albumin, ALB)40.5g/L㊂肾功能和尿蛋白正常㊂空腹血糖5.0mmol/L,糖基化血红蛋白5.3%,空腹胰岛素54.7pmol/L㊂稳态型评估法胰岛素抵抗指数1.8㊂血清总胆固醇正常,甘油三脂2.6mmol/L,高密度脂蛋白胆固醇0.1mmol/L,低密度脂蛋白胆固醇3.7mmol/L㊂肿瘤标志物正常㊂血清嗜肝病毒和EB病毒㊁巨细胞病毒标志物均为阴性,ANA(1:640)阳性,ANA(1:1280)弱阳性,抗着丝粒蛋白B抗体阳性,抗Ro-52阳性,类风湿因子㊁抗双链DNA抗体㊁抗Smith抗体㊁抗线粒体抗体-M2㊁抗平滑肌抗体㊁抗肝肾微粒体抗体㊁抗肝细胞溶质抗原1型抗体㊁抗可溶性肝抗原抗体㊁抗心磷脂抗体均为阴性㊂IgM4.8 g/L,IgG㊁IgA㊁IgE正常㊂IgG4正常㊂铜蓝蛋白正常㊂血清游离三碘甲状腺原氨酸4.6pmol/L,游离四碘甲状腺原氨酸14.3pmol/L,促甲状腺素5.9uIU/mL,抗促甲状腺激素受体抗体㊁抗甲状腺过氧化物酶抗体均正常㊂结核感染T细胞检测阴性㊂腹部超声示肝㊁胰㊁双肾未见明显异常,脾稍大㊂双侧甲状腺胶样结节,双侧甲状腺弥漫性病变㊂超声检查全身淋巴结无肿大㊂胸部CT平扫见肺多发磨玻璃结节,右肺上叶和中叶结节,两肺间质性炎症㊂腹部增强磁共振见肝门区数枚结节,考虑肿大的淋巴结,腹部脏器未见明显异常㊂在超声引导下肝穿刺活检术,病理学检查提示肝细胞部分气球样变,少数细胞脂肪变(<5%),可见点灶状坏死,局灶出血坏死,网状纤维塌陷,见少量淋巴细胞和中性粒细胞浸润,未见细胞内淤胆及胆栓㊂汇管区见中等量淋巴细胞和中性粒细胞浸润㊂局灶轻度界面炎,可见汇管区和窦周纤维化,个别汇管区小叶间静脉腔闭塞(图1)㊂免疫组化检查见胆管细胞角蛋白7阳性,细胞角蛋白19阳性㊂马松和网状纤维染色见汇管区和窦周纤维化,糖原染色阳性,提示慢性活动性肝炎(G2S2),不除外自身免疫性疾病可能㊂经风湿免疫科和呼吸科多学科会诊,临床诊断UCTD,间质性肺炎,亚临床甲状腺功能减退症,高脂血症,甲状腺结节㊂给予强的松30mg.d-1口服,羟氯喹200mg.d-1口服治疗㊂2个月后随访,患者肝功能恢复正常㊂图1㊀肝组织病理学表现(HE,400ˑ)2 讨论本文报道了一例UCTD引起的长期反复慢性肝损害,逐渐发展为肝纤维化,且伴间质性肺炎㊁亚临床甲状腺功能减退症等多系统表现㊂目前,UCTD的诊断标准尚不统一,但通常采用1999年Mosca提出的初步分类标准:包括至少一种CTD的临床表现,ANA阳性,至少三年的病程,但不符合任一确定CTD的分类标准[2]㊂研究发现仅30%UCTD患者在3~5年后进展为某种确定的CTD[3,4]㊂其中14%~20%患者最终发展为系统性红斑狼疮[5]㊂一项来自西班牙758例UTCD患者研究报道,随访11年,14%患者进展为确定的CTD,24%患者临床症状缓解,62%患者仍为UCTD[6]㊂因多数UCTD患者数十年后仍保持未分化状态,故目前多认为UCTD可能是CTD分类中一种独立的疾病㊂早期UCTD往往症状不明显,或仅有非特异性的临床表现,如乏力㊁低热㊁淋巴结肿大等㊂患者常先出现血清自身抗体阳性,再逐步出现临床症状㊂稳定期UCTD常见的症状有关节痛/关节炎㊁雷诺现象㊁皮疹㊁口腔溃疡㊁干眼症㊁白细胞减少㊁贫血和血小板减少㊁间质性肺炎,相对而言,浆膜炎(心包炎)㊁心脏病变(如心肌炎,心律失常)㊁消化系统(食管运动异常㊁吸收不良综合征)等症状不常见㊂肾脏疾病(膜性肾小球肾炎,肾病综合征)㊁神经系统损害(三叉神经痛㊁无菌性脑炎)及危及生命仅偶见报道[6,7]㊂该患者病程4年,反复肝功能异常,有雷诺现象,间质性肝炎,ANA高滴度,患者否认反复发热㊁口腔溃疡㊁明显口眼干,未见颜面皮疹㊁猖獗性龋齿,双手关节未见明显畸形,无确定CTD的典型症状和体征,符合UCTD的诊断㊂UCTD患者发生肝功能异常的原因包括UCTD 本身,也包含自身免疫性肝炎㊁原发性硬化性胆管炎㊁原发性胆汁性胆管炎㊁代谢相关脂肪性肝病㊁药物性肝损伤等其他肝脏本身的疾病[3]㊂临床上,区分UCTD肝脏受累和UCTD合并原发肝病具有一定的难度㊂该患者肝损害原因复杂,首先考虑UCTD 本身通过免疫介导引起的肝损害㊂此外,该患者ALT正常,IgG正常,肝组织只有局灶轻度界面炎,无大量浆细胞浸润,无玫瑰花环样结构和淋巴细胞穿入现象,使用国际自身免疫性肝炎诊断积分系统打分为13分,暂不考虑合并自身免疫性肝炎㊂虽有超重㊁血脂异常,但患者腰围正常,血糖正常,无胰岛素抵抗,腹部超声和MRI未提示脂肪肝,肝组织细胞脂肪变<5%,合并代谢相关脂肪性肝病也不考虑㊂综上所述,该患者肝损害主要还是由UCTD引起的㊂治疗UCTD的主要药物是皮质激素㊁羟氯喹和非甾体类抗炎药物,不到三分之一患者需要免疫抑制药物(硫唑嘌呤㊁甲氨蝶呤㊁吗替麦考酚酯等)治疗[1]㊂羟氯喹可以抑制多形核细胞的趋化性,抑制前列腺素合成,具有抗炎㊁调节免疫和抗凝作用㊂与糖皮质激素联合使用可以控制关节㊁皮肤粘膜和全身炎性症状[1]㊂若常规治疗效果差或严重器官受累时,加用免疫抑制剂是关键的治疗方法,可减轻与UCTD相关的炎症症状㊂该患者在确诊为UCTD时,予以皮质激素联合羟氯喹治疗后肝功能好转㊂多数UCTD患者预后良好,10a生存率达到90%以上[6]㊂患者的预后主要与其受累及的器官相关㊂虽然多数患者可能进展为确定的CTD,但多症状较轻,并发症发生少,预后相对较好[7]㊂即使UCTD患者疾病难以痊愈,多数病情保持稳定或自行缓解,很少恶化[8]㊂当然,该例患者将来是否仍为UCTD还是演变为确定的CTD需长期随访㊂总之,对于反复肝功能异常的患者,不仅需仔细排查肝脏本身的疾病,还需警惕结缔组织病的可能,特别是患者出现雷诺现象㊁多脏器功能异常等表现,且伴有自身抗体阳性时,更应及时进行相关检查,以尽早确立诊断和治疗㊂伦理学声明:本例患者已签署知情同意书㊂利益冲突声明:所有作者声明均不存在利益冲突㊂作者贡献声明:孙超负责收集临床资料和撰写论文;段晓燕和葛文松参与论文起草和修改;范建高修改文章关键内容㊂ʌ参考文献ɔ[1]Rubio J,Kyttaris VC.Undifferentiated connective tissue disease:comprehensive review.Connectivetissue sisease:Comprehensive re-view.Curr Rheumatol Rep,2023,25(5):98-106. [2]Mosca M,Neri R,Bombardieri S.Undifferentiated connectivetissue diseases(UCTD):a review of the literature and a proposal for preliminary classification criteria.Clin Exp Rheumatol,1999,17(5):615-620.[3]莫颖倩,严青,叶霜,等.未分化结缔组织病和混合性结缔组织病的诊疗规范.中华内科杂志,2022,61(10):1119-1127.[4]Radin M,Rubini E,Cecchi I,et al.Disease evolution in a long-term follow-up of104undifferentiated connective tissue disease pa-tients.Clin Exp Rheumatol,2022,40(3):575-580. [5]Drehmel KR,Erickson AR,England BR,et al.Applying SLICCand ACR/EULAR systemic lupus erythematosus classification criteria in a cohort of patients with undifferentiated connective tissue disease.Lupus,2021,30(2):280-284.[6]Sciascia S,Roccatello D,Radin M,et al.Differentiating betweenUCTD and early-stage SLE:from definitions to clinical approach.Nat Rev Rheumatol,2022,18(1):9-21.[7]Garcia-Gonzalez M,Rodriguez-Lozano B,Bustabad S,et al.Un-differentiated connective tissue disease:predictors of evolution into definite disease.Clin Exp Rheumatol,2017,35(5):739-745.[8]Radin M,Cecchi I,Barinotti A,et al.Identifying subsets of pa-tients with undifferentiated connective tissue disease:Results from a prospective,real-world experience using particle-based multi-ana-lyte technology.Autoimmun Rev,2023,22(5):103298.(收稿:2024-01-08)(本文编辑:陈从新)。

汤一苇

汤一苇

获上海复旦大学医学院医学学士和硕士学位,一九九五年获美国范德堡大学微生物学与免疫学博士学位。

曾先后在美国联邦疾病控制预防中心和美国梅约医学中心接受博士后或住院医师培训。

现任美国范德堡大学内科系和病理系双系副教授,病理系传染病分子生物学诊断室和内科系分子流行病室主任。

是美国医学微生物委员会资格认证的临床微生物学家。

二零零二年入选为美国微生物学会核心期刊<<临床微生物学杂志>>主编之一,二零零五年入选为美国微生物学院院士和美国感染病与艾滋病学会会士。

建立了四十余种体外核酸扩增诊断技术并用于传染病病原体的检测和定量。

拥有美国或中国专利局专利四份并发表相关论著、综述和著书章节逾百篇。

Dr. Yi-Wei Tang (汤一苇)美国范德堡大学医学中心分子传染病实验室主任Methicillin-Resistant Staphylococcus aureus Screening: State-of-the-ArtYi-Wei Tang, MD, PhD, FAAM, FIDSAAssociate Professor of Medicine and PathologyDirector, Molecular Infectious Disease LaboratoryBoucher & Corey.Clin. Infect. Dis. 46:S344-9, 2008Staphylococcus aureus Causes aVariety of Pus-forming Infectionsand Toxinoses in Humans♦Superficial skin lesions such as boils,styes and furunculosis♦Serious infections such as pneumonia, mastitis,phlebitis, meningitis, and urinary tract infections♦Deep-seated infections, such as osteomyelitis andendocarditis♦Food poisoning, toxic shock syndrome, necrotizingpneumonia♦Hospital acquired (nosocomial) infection ofsurgical wounds and infections associated withindwelling medical devicesStaphylococcus aureus: a Super Bug with Loaded Virulence determinantsLowy.N. Engl. J. Med. 339:520-32, 1998Virulence Factors E xpressed byStaphylococcus aureus♦Surface proteins that promote colonization of host tissues ♦Invasins that promote bacterial spread in tissues; leukocidin, kinases, hyaluronidase♦Surface factors that inhibit phagocytic engulfment: capsule, protein A♦Biochemical properties that enhance their survival in phagocytes: carotenoids, catalase♦Immunological disguises: protein A, coagulase, clotting factor♦Inherent and acquired resistance to antimicrobial agents♦Exotoxins that damage host tissues or otherwise provoke symptoms of disease: SEA-G, TSST, ET♦Membrane-damaging toxins that lyse eukaryotic cell membranes: hemolysins, leukotoxin(PVL), leukocidinEvolving “Milestones ”of Staphylococcus aureus: Resistance to Antibiotics♦PRSA: penicillin-resistant S. aureus ♦MRSA: methicillin-resistant S. aureus ♦VISA: vancomycin-intermediate S. aureus ♦VRSA: vancomycin-resistant S. aureus ♦CA-MRSA : community-acquired MRSA1960s 199820032005MRSA VISA VRSA CA-MRSA 1940sPRSAEmergency of CA-MRSA♦Dramatic emergence of new public health problem in recent years: infections with novel community-associated strains (CA-MRSA) in previously healthy individuals♦Most infections involve skin and skin structures ♦Unusual frequency of invasive and lethalinfectionsEpidemiology of CA-MRSA♦Increasing community-associated S. aureus infections are methicillin resistant: 2000-1 (56%), 2001-2 (57%), 2002-3 (78%)♦Risk factors included children, competitive athletes, prisoners, soldiers, native Americans, Pacific islanders, low socioeconomic status, IVDU, men who have sex with men♦Associated with unusually severe disease ♦Septic shock♦Necrotizing pneumonia♦Necrotizing fasciitisDrivers of Active Surveillance for MRSA♦Leading cause (8%) of nosocomial infections, especially surgical wound infections and pneumonia (28% each)♦19,000 deaths attributable to invasive MRSA infections in 2005, most associated with health care delivery♦~1.5% of US residents carry MRSA in anterior nareswho are at higher risk of infection than noncarriers♦~25% of patients that become colonized with MRSAduring hospital stay subsequently develop infection♦MRSA is readily transmitted in health-care settings and causes frequent outbreaks♦>$500 million excess health care expenditures annually Diekema and Climo, 2008, JAMA, 299:1190Nasal Swab Specimen Collection for MRSAScreeningLaboratory Techniques for MRSAScreening♦Conventional approaches♦Solid agar-based selective media♦Inhibitory substances: NaCl, tellurite, cefoxitin♦Chromogenic media: MRSA Select (Bio-Rad), CHROMagarMRSA (BioConnections), MRSA ID (bioMerieus)♦Enrichment broths♦Molecular methods♦BD GeneOhm(Infectio Diagnostic, Ste-Foy, Canada)♦GeneXpert(Cepheid, Sunnyvale, CA, USA)♦Directly from screening specimens♦Rapid procedure done within 5 hours♦Multiple genes covered in one single reaction♦Nasal-rectal “dual”swabs♦Simultaneous screening for MRSA and VRERapid and Simultaneous Screening of MRSA and VRE from Screening Clinical Specimens♦When: July 6 to November17, 2006♦Where: Waukesha Memorial Hospital, Wisconsin ♦What:♦307 swabs: ear (4), nares(234), rectum (7) and skin (62)♦Standard reference 1: routine culture (SBA and CAN)♦Standard reference 2: BD-Genom as tiebreaker for discrepant results between culture and MVPlex ♦MVPlex: Genaco Biomedial Products, Huntsville, ALStaphPlex Simultaneously Amplifies 18 Genes: How a Multiplex PCR Really WorksMVPlex Results and Interpretation♦Detection: Staphylococci, enterococci♦Identification: MRSA, VRE♦Speciation: 5 common CoNSSensitivity and Specificity of MVPlex in Comparison to CultureSensitivity, 93.7%; specificity, 89.9%Sensitivity and Specificity of MVPlex in Comparison to A Resolved StandardSensitivity, 84.4% (culture), 97.8% (MVPlex), p=0.002Specificity, 98.6% (culture), 95.8% (MVPlex), p>0.05In Additional toTechnique Availabilities (1)Conclusion A universal,rapid MRSA admissionscreening strategy did notreduce nosocomialMRSA infection in asurgical department withendemic MRSAprevalence but relativelylow rates of MRSAinfection.University of Geneva Hospitals, SwitzerlandIn Additional toTechnique Availabilities (2)Conclusion: Theintroduction ofuniversal admissionsurveillance for MRSAwas associated with alarge reduction inMRSA disease duringadmission and 30 daysafter discharge.Evanston Northwestern Hospital, ChicagoA 1,200-bed London teaching hospital, UKIn Additional to Technique Availabilities (3)Conclusion: A rapid test for MRSA led to the quickreceipt of results and had an impact on bed usage.No evidence was found of a significant reduction inMRSA acquisition and on these data it is unlikely thatthe increased costs of rapid tests can be justifiedcompared with alternative control measures againstMRSA.MRSA Screening in 2008♦Rapid and accurate techniques are available for MRSA screening ♦Controversial approach for prevention of MRSA nosocomial infections♦Lack appropriately controlled studies demonstrating consistent benefits♦Much of the supporting data derived from single hospitals using multiple intervention strategies without control groups♦Many potential adverse consequences including up to 5-fold increase in number of patients placed on contact precautions♦Costs for molecular screening is high and reimbursement is at large ♦Possible reduced attention from healthcare workers but increased emotional distress for patients♦Current CDC guidelines recommend against routine or mandated screening for MRSA controlWho Should Be Screened for MRSACarriage?♦Any patient with a previous admission to an acute care facility for a stay of from 12 to 48 hours during the last3 to 12 months as determined by the facility and thehealth authority♦Patients who have been recently incarcerated, live in shelters, dormitories or other group settings ♦Patients who have participated in contact sports or any sport activities using shared equipment♦Patients from long term care settings with known risk factors (examples: hemodialysis, chronic ventilation or skin breakdown)♦Patients admitted from areas with higher endemic rates (examples: ICUs, Burn units, and Oncology units)Chinese American Association for Clinical MicrobiologyFounded in 2003Taipei, First CAACM Symposium, 2004Beijing, Laboratory Medicine Forum, 2005Shanghai, Second CAACM Symposium, 2005Shenzhen, Third CAACM Symposium, 2006Hong Kong, First Asia Pacific Symposium on AMT, 2006Urumqi, HIV and Opportunistic Infection Symposium, 2007 Wuhan, First Clinical Virology Symposium, 2007Hangzhou, Fourth CAACM Symposium, 2008Chongqing, International CM Symposium, 2008Taipei, Fourth GCAMID Meeting, 2008Shanghai, Fifth CAACM Symposium, 2009。

不同脑小血管病负荷评分与伴无症状腔隙的脑小血管病患者认知功能的关系

不同脑小血管病负荷评分与伴无症状腔隙的脑小血管病患者认知功能的关系

不同脑小血管病负荷评分与伴无症状腔隙的脑小血管病患者认知功能的关系杜晓光,魏荣,刘琦慧,于力群,周丽摘要:目的 探讨不同脑小血管病(CSVD)负荷评分与伴无症状腔隙的CSVD患者认知功能的关系。

方法 纳入2021年7月—2023年10月就诊于潍坊市人民医院神经内科的128例伴无症状腔隙的CSVD患者,运用蒙特利尔量表(MoCA)、CSVD总负荷评分和改良负荷评分统计受试者的认知功能和CSVD负荷,分为认知障碍组(MoCA<26分)和无认知障碍组(MoCA≥26分),比较两组患者的人口社会学信息、血管病危险因素及CSVD负荷评分的差异。

采用线性回归分析MoCA评分与两种CSVD负荷评分的关系,采用趋势检验分析伴无症状腔隙的CSVD 患者认知障碍的发病趋势。

结果 研究共纳入伴无症状性腔隙的CSVD患者128例,其中认知障碍组68例(53.1%),无认知障碍组60例(46.9%),两组患者人口社会学信息及血管病危险因素差异无统计学意义(P>0.05)。

两组患者的CSVD总负荷评分和改良负荷评分比较均存在统计学差异(P<0.05)。

Spearman秩相关分析显示,CSVD 总负荷评分和改良负荷评分均与MoCA评分呈负相关(P<0.001)。

线性趋势χ2检验分析显示,伴无症状腔隙的CSVD患者认知障碍发病风险随CSVD改良负荷评分增加而增加(P trend<0.05),该发病风险与CSVD总负荷评分间趋势分析无统计学意义(P trend=0.069)。

结论 CSVD总负荷评分和改良负荷评分均可用于筛检伴无症状腔隙的CSVD认知障碍患者。

改良负荷评分可能在识别认知障碍高风险患者方面更具优势。

关键词:脑小血管病;认知;腔隙中图分类号:R743 文献标识码:ARelationship between cerebral small vessel disease burden scores and cognitive function in patients with cerebral small vessel disease with asymptomatic lacunes DU Xiaoguang,WEI Rong,LIU Qihui, et al.(Department of Neurol⁃ogy, Weifang People′s Hospital, Weifang 261000, China)Abstract:Objective To investigate the relationship between cerebral small vessel disease (CSVD) burden scores and cognitive function in patients with CSVD with asymptomatic lacunes.Methods A total of 128 patients with CSVD with asymptomatic lacunes who visited the Department of Neurology of Weifang People′s Hospital from July 2021 to October 2023 were included. All the patients were scored using the Montreal Cognitive Assessment (MoCA) for cognitive function and using the total CSVD score and the modified CSVD score for CSVD burden. They were divided into cognitive impairment group (MoCA score<26)and non-cognitive impairment group (MoCA score≥26).The demographic information,vascular disease risk factors, and the CSVD scores of the two groups were compared. A linear regression analysis was performed to as⁃sess the relationship between the MoCA score and the two CSVD scores. A trend analysis was conducted to analyze the trend of incidence of cognitive impairment in patients with CSVD with asymptomatic lacunes.Results Among the 128 patients with CSVD with asymptomatic lacunes, 68 (53.1%) were in the cognitive impairment group and 60 (46.9%) were in the non-cognitive impairment group. There were no significant differences in the demographic information and vascular disease risk factors between the two groups (P>0.05). The total CSVD score and the modified CSVD score differed significantly be⁃tween the two groups (P<0.05). The Spearman correlation analysis showed that the total and modified CSVD scores were sig⁃nificantly negatively correlated with the MoCA score (P<0.001). The chi-square test for linear trend revealed that the cogni⁃tive impairment risk increased significantly with the modified CSVD score in patients with CSVD with asymptomatic lacunes (P trend<0.05), but with no significance for the total CSVD score (P trend=0.069).Conclusion Both the total and modified CSVD scores are useful tools to detect cognitive impairment in patients with CSVD with asymptomatic lacunes, and the modi⁃fied CSVD score may be superior in identifying patients at high risk of cognitive impairment.Key words:Cerebral small vessel disease;Cognition;Lacune脑小血管病(cerebral small vessel disease,CSVD)是血管性认知障碍的主要原因[1]。

n-Widths in Approximation Theory

n-Widths in Approximation Theory
rass and Approximation Theory
Allan Pinkus
Abstract. We discuss and examine Weierstrass’ main contributions to approximation
theory.
§1. Weierstrass This is a story about Karl Wilhelm Theodor Weierstrass (Weierstraß), what he contributed to approximation theory (and why), and some of the consequences thereof. We start this story by relating a little about the man and his life. Karl Wilhelm Theodor Weierstrass was born on October 31, 1815 at Ostenfelde near M¨ unster into a liberal (in the political sense) Catholic family. He was the eldest of four children, none of whom married. Weierstrass was a very successful gymnasium student and was subsequently sent by his father to the University of Bonn to study commerce and law. His father seems to have had in mind a government post for his son. However neither commerce nor law was to his liking, and he “wasted” four years there, not graduating. Beer and fencing seem to have been fairly high on his priority list at the time. The young Weierstrass returned home, and after a period of “rest”, was sent to the Academy at M¨ unster where he obtained a teacher’s certificate. At the Academy he fortuitously came under the tutelage and personal guidance of C. Gudermann who was professor of mathematics at M¨ unster and whose basic mathematical love and interest was the subject of elliptic functions and power series. This interest he was successful in conveying to Weierstrass. In 1841 Weierstrass received his teacher’s certificate, and then spent the next 13 years as a teacher (for 6 years he was a teacher in a pregymnasium in the town of Deutsch-Krone (West Prussia), then for another 7 years in a gymnasium in Braunsberg (East Prussia)). During this period he continued learning mathematics, mainly by studying the work of Abel. He also published some mathematical papers. However these appeared in school journals and were quite naturally not discovered at that time by any who could understand or appreciate them. (Weierstrass’ collected works contain 7 papers from before 1854, the first of which On the development of modular functions (49 pp.) was written in 1840.) In 1854 Weierstrass published the paper On the theory of Abelian functions in Crelle’s Journal f¨ ur die Reine und Angewandte Mathematik (the first mathematical research journal, founded in 1826, and now referred to without Crelle’s name in the formal title). It created a sensation within the mathematical community. Here was a 39 year old school teacher whom no one within the mathematical community had heard of. And he had written a masterpiece, not only in its depth, but also in its mastery of an area. Recognition was

Nature子刊全基因组关联分析揭示肠道微生物群的改变有助于颅内未破裂动脉瘤的进展

Nature子刊全基因组关联分析揭示肠道微生物群的改变有助于颅内未破裂动脉瘤的进展

Nature子刊全基因组关联分析揭示肠道微生物群的改变有助于颅内未破裂动脉瘤的进展推荐:江舜尧编译:小鹿同学编辑:小菌菌中国医学科学院和北京协和医学院国家心血管疾病研究中心阜外医院心血管疾病国家重点实验室陈敬洲研究员等人于2020年6月25日在国际顶级期刊Nature Communications发表题目《Alterations of gut microbiota contribute to the progression of unruptured intracranial aneurysms》的文章,该研究对颅内未破裂动脉瘤(UIA)患者和健康对照者的粪便样品进行了全基因组关联研究,结合小鼠模型的粪便移植实验,研究者发现Hungatella hathewayi的丰度改变影响牛磺酸的循环水平,并与UIA的发生率增加相关。

文章摘要颅内未破裂动脉瘤(UIA)是一种威胁生命的脑血管疾病。

肠道微生物的组成变化是否参与了UIAs的发展尚不清楚。

研究者在国内UIA患者和健康对照者两个队列内以及接受人类供体粪便移植的小鼠中进行了一项病例对照的全基因组关联研究。

粪便移植后,UIA菌群足以在小鼠中诱发UIAs。

研究者确定了与UIA相关的肠道微生物物种与循环中牛磺酸的变化相关。

具体来说,人和动物体内Hungatella hathewayi的丰度明显降低,并且与牛磺酸循环中的浓度呈正相关。

与此结果一致地是,通过管饲法对小鼠施用H. hathewayi可以使其血清内牛磺酸的水平正常化,并保护小鼠免于颅内动脉瘤的形成和破裂。

牛磺酸的补充也可以逆转颅内动脉瘤的进展。

研究者的发现有助于深入了解H. hathewayi相关的牛磺酸消耗作为UIAs发病机理中关键因素的潜在作用。

文中重要图片说明图1 | UIA患者中肠道菌群的改变。

图2 | UIA患者中肠道微生物种类的改变。

图3 | 肠道微生物物种将UIA患者与健康对照者区分开。

2_型糖尿病缺血性脑卒中患者视网膜血管直径变化及其临床意义

2_型糖尿病缺血性脑卒中患者视网膜血管直径变化及其临床意义

2型糖尿病缺血性脑卒中患者视网膜血管直径变化及其临床意义王梅1,王媛媛2,杨洪涛2,裴存文21 昆明爱尔眼科医院,昆明650000;2 承德市中心医院眼科摘要:目的 观察有缺血性脑卒中病史的2型糖尿病(T2DM)患者视网膜血管直径变化,并分析其临床意义。

方法 T2DM患者480例,根据有无缺血性脑卒中病史分为缺血性脑卒中组73例、非缺血性脑卒中组407例,使用眼底照相机和半自动测量软件ARIA测量视网膜动脉和静脉直径,计算视网膜中央静脉等效值(CRVE)、视网膜中央动脉等效值(CRAE)、动静脉比值(AVR)。

收集患者的年龄、体质量指数(BMI)、吸烟史、饮酒史、高血压病史、糖尿病视网膜病变(DR)病史、糖尿病肾病(DN)病史等一般资料。

将研究对象分别按照CRVE、CRAE、AVR四分位数分为4组,作为等级变量纳入logistic回归分析模型进行趋势性检验,以缺血性脑卒中患病率为因变量,分析T2DM患者视网膜血管直径与缺血性脑卒中患病率的关系。

按年龄、性别、糖尿病病程、有无DR病史、有无DN病史、有无高血压病史进行分层,通过在logistic回归模型中包含交叉积交互项来检验CRAE、AVR与每个分层变量之间的交互作用,分析T2DM患者不同分层人群中视网膜血管直径与缺血性脑卒中患病率变化趋势的稳健性。

结果 缺血性脑卒中组患者CRVE、AVR均低于非缺血性脑卒中组(P均<0.05)。

与非缺血性脑卒中组相比,缺血性脑卒中组患者年龄更大,糖尿病病程更长,有高血压、DN、DR病史者更多,SBP、SCr、Cys-C水平更高,TC、LDL-C水平更低(P均<0.05)。

T2DM患者缺血性脑卒中的患病率随CRAE、AVR减小而增加(P for trend均<0.05),与CRVE无关(P fortrend>0.05)。

T2DM患者的CRAE和AVR与年龄、性别、糖尿病病程、有无DR病史、有无DN病史、有无高血压病史均无交互作用(P for interaction均>0.05)。

微小RNA与子宫内膜异位症

微小RNA与子宫内膜异位症

微小RNA与子宫内膜异位症魏薇【摘要】子宫内膜异位症(简称内异症)是生育年龄妇女的常见病,病因机制复杂.其病变广泛,极具侵袭性和复发性,呈现恶性临床行为.微小RNA(miRNA)在细胞增殖、分化和凋亡等多种细胞生长和发育过程中起重要的调控作用.其参与调控内异症黏附和侵袭、细胞生长和增殖及血管形成,在内异症恶性转化中具有重要作用.随着反义技术和基因治疗领域技术的发展,miRNA有望成为内异症诊断和治疗的新的切入点.%Endometriosis is a common disease of reproductive-age women, which has complex pathogene-sis. The lesions are extensive , highly invasive and recurrent, presenting malignant clinical behaviour. Micro R-NA( miRNA ) plays an important role in regulating cell proliferation, differentiation and apoptosis of cell growth and development process. miRJNA may involve in the regulation of adhesion, invasion, cell proliferation and angiogenesis, playing an important role in malignant transformation of endometriosis. With the development of antisense technology and gene therapy, miRNA is expected to become a new strategy in endometriosis diagnosis and treatment.【期刊名称】《医学综述》【年(卷),期】2013(019)008【总页数】3页(P1403-1405)【关键词】子宫内膜异位症;微小RNA;发病机制【作者】魏薇【作者单位】首都医科大学附属北京妇产医院妇科,北京,100026【正文语种】中文【中图分类】R711.71子宫内膜异位症(简称内异症)是指子宫内膜组织(腺体和间质)在子宫腔被覆内膜以外的部位生长、浸润[1]。

美国路易斯维尔大学招博后,NIH资助项目

美国路易斯维尔大学招博后,NIH资助项目

美国路易斯维尔大学招博后,NIH资助项目Postdoctoral associate positions are available in the laboratory of Dr. Huang-Ge Zhang in the Brown Cancer Center at the University of Louisville, Kentucky, USA.We are seeking a full-time post-doctoral researcher for a 5-year NIH-funded project aiming to develop edible plant exosomes like nanoparticles (ELNs) based immune therapy for cancer and autoimmune disease. The lab also explores the cellular and molecular mechanisms by which the ELNs inhibit cancer to advance and brain neurodegeneration, emphasizing gut microbiota metabolites mediated cancer metastasis, microglial mitochondrial pathology, metabolism, and immune response. We use a combination of in vitro cell culture, in vivo transgenic/knockout animal models.RequiredQualifications:A PhD or MD degree in immunology, biochemistry, molecular biology, microbiology or other medical research related fields is required. Previous working experience in mouse models, mitochondria, microbiome, and nanoparticles involving the brain, liver, lung or gutdisease is highly desired.Commensurate with experience. Provide competitive salary with excellent fringe benefits. The living cost in Louisville is very affordable.Interested individuals should send a cover letter, CV, and the names/phone numbers of three people who could provide letters of reference by email to:Huang-GeZhang,************************************************The major publications (selected) from 134 in Dr. Huang-Ge Zhang’s team•Gut Bacterial Isoamylamine Promotes Age-Related Cognitive Dysfunction by Promoting Microglial Cell Death. Cell Host & Microbe, 2022 June.•Exosome-like nanoparticles from Mulberry bark prevent DSS-induced colitis via the AhR/COPS8 pathway. EMBO report. 2022 Jan.•High-fat diet-induced upregulation of exosomal phosphatidylcholine contributes to insulin resistance, Nature Communications, 2021 Dec 12:213•Restoring Oat Nanoparticles Mediated Brain Memory Function of Mice Fed Alcohol by Sorting Inflammatory Dectin-1 Complex into Microglial Exosomes, Small, 2021 Dec 13;e2105385 •Plant-derived exosomal microRNAs shape the gut microbiota. Cell Host & Microbe, 2018, Volume 24, Issue 5, 637–652.•MVP-mediated exosomal sorting of miR-193a promotes colon cancer progression, Nature Communications, 2017 Feb 17;8:14448•Ginger- derived nanoparticles protect against alcohol-induced liver damage. J Extracell Vesicles. 2015 Nov 25;4:28713. doi: 10.3402/jev.v4.28713.•Intestinal mucus-derived nanoparticles mediate activation of Wnt/β-catenin signaling plays a role in induction of liver NKT cell anergy. Hepatology. 2013 57(3):1250-61.•Delivery of therapeutic agents by nanoparticles made of grapefruit-derived lipids. Nature Communications. 2013;4:1867. doi: 10.1038/ncomms2886.。

爱思唯尔中国医学网站开通

爱思唯尔中国医学网站开通

爱思唯尔中国医学网站开通
佚名
【期刊名称】《医学研究杂志》
【年(卷),期】2009(38)9
【总页数】1页(P49-49)
【关键词】医学网站;中国;新闻媒体;医学部
【正文语种】中文
【中图分类】R-39;R197.32
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4.我校尹衍升教授入围爱思唯尔2020中国高被引学者榜单 [J],
5.中国药科大学11名学者入选爱思唯尔2020年中国高被引学者榜单 [J], 无因版权原因,仅展示原文概要,查看原文内容请购买。

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Parallelized numerical methods for large systems of differential–algebraic equations in industrial applicationsJu¨rgen Borchardt,Friedrich Grund and Dietmar Horn,BerlinSummary.Based on a hierarchical modular modeling the large nonlinear systems of differen-tial algebraic equations arising from industrial applications in electric circuit simulation or in dynamic process simulation of chemical plants can be structured into subsystems.Parallelized numerical methods for solving such systems are considered at the level of nonlinear and linear equations.Merging subsystems to blocks and extending the systems of nonlinear equations resulting from backward differentiation formulas block–structured Newton–type methods can be used for their solution on parallel computers.A parallelized Gaussian elimination method using pseudo code techniques for the LU–factorization of the large sparse systems of linear equations is implemented.The methods are successfully used on parallel and vector com-puters for the time domain simulation of VLSI circuits as well as for the dynamic process simulation of complex chemical production plants.AMS Subject Classification:65Y05,65L05,65H10,65F50,80A30,92E20. Keywords:Systems of differential–algebraic equations;Block partitioned systems;Newton–type methods;Gaussian elimination;Sparse–matrix techniques;Parallelization;Electric cir-cuit simulation;Chemical process simulation.1IntroductionFor the time domain simulation in many industrial applications structural properties of the considered objects are used for a hierarchical modular modeling.Thus electronic circuits usually consist of identical repetitive subnetworks as inverter chains,adders, or NAND–and NOR–gates.Analogously,complex chemical production plants are networks of coupled process units as pumps,reboilers,condensers,or trays of dis-tillation columns.To each subcircuit or unit a mathematical model is assigned and they are linked to form the electric circuit or chemical plant respectively.For the time domain simulation this leads to initial value problems for large nonlinear systems of differential–algebraic equations(DAE’s)which are structured corresponding to the subcircuits or units into coupled subsystems(1)1with given vector valued parameter function and unknown function.In today’s applications the system of DAE’s can involve tens of thousands of equa-tions or more.For solving such large–scale problems we consider a two level hierar-chical structure of the system.Thefirst level of the structure is build by the subsys-tems of the DAE–system.To exploit this structure for parallelization,it is assumedthat for each subsystem the corresponding part of the function as well as the hy-perrows of the Jacobian,with integration constant(see[6]), can be computed independently of the other subsystems.The second level of the hi-erarchy is obtained by merging subsystems to blocks(2)There are different algorithms for generating a so called block partitioning(2).The algorithm used in this connection exploits only topological informations.It merges subsystems to nearly equal sized blocks while trying to minimize the number of cou-pling variables between blocks and to optimize the number of blocks in relation to the number of equations and the number of available concurrent processors.The imple-mented algorithm is reliable for general problems,it is of low complexity and there-fore it is fast.An algorithm to generate a block partitioning with numerically weakly coupled blocks is described in[12,13].In Section2it is described how the hierarchical structure of the DAE–system can be used to construct effective parallelizable block–structured Newton–type methods. These methods require to solve many linear systems with the same pattern structure of the matrices but with different right hand sides.For it the Gaussian elimination method with pseudo code techniques is used.How this method can be adapted advan-tageously to vector and parallel computers is described in Section3.Finally,results for large scale real life applications are given in Section4.2Block–structured Newton–type methodsBased on a block partitioning(2)we extend the system of nonlinear equations arising from backward differentiation formulas(BDF)[6]to use Block–structured Newton–type methods for its solution on parallel computers.The extension is done by de-termining the internal variables of the blocks,doubling of exter-nal couple variables,and appending linear identification equations ,yielding the extended system(3)where the nonlinear functions,corresponding to the blocks,have disjunctive arguments.We split each block function,with into by determining pivot elements in the dimensional matrix.Thus the pivot rows determine(see Fig.1)and it is ensured that is regular.2pivot columns(1)do parallel for all:(a)for new Jacobian:(i)compute the Jacobians andand do LU–factorization for(ii)solve:(9)(b)compute the function and solve:(10)enddo(2)do sequential(a)for new Jacobian:do LU–factorization of main system matrix(b)solve:(11)enddo(3)do parallel for all:enddo Both main parts of the computational amount,namely all the calculation of func-tions and Jacobians and most of the amount for the solution of the linear systems, are included together in one parallel loop(step1)resulting into a coarse grain paral-lelism.The bottleneck is the sequential part(step2)which is dominated by the LU–factorization of the main system matrix.To reduce this sequential amount of the algo-rithm and increase the efficiency of the implementation on parallel computers various modifications of the method can be considered.Atfirst,the main system factorization can be speeded up by eliminating zero elements (sparsing)from the dense computed submatrix blocks.For instance for a DAE system of a distillation plant with13436equations using14blocks the resulting1138 equations of the main system comprise67342matrix elements which can be reduced to24504nonzero elements.At second,by using multilevel Newton iteration techniques[3,17]it is possible to shift computational costs from the main system solution(outer iteration)to the solu-tion of the blocks by substituting step(1)(b)by an inner iteration loop: setdo:compute and solve:(12)and setenddoset and4At third,by formally extending the main system(11)with the last factorized block–diagonal matrix,a new factorization of the main system matrix can be avoided,in some cases,by using the following iterative scheme for solving the main system instead of step(2)(b):setdo:do parallel for all(13)enddo(14)enddosetStep(3)can then be replaced by:do parallel for all:enddo In(12)as well as in(13)and(14)only existing factorizations are used and the cor-rections in(13)can be computed in parallel for all blocks.The integer constants depend on the convergence properties of the method.3Gaussian elimination method with pseudo codeFor solving systems of linear equationswith unsymmetric and sparse matrices,we use the Gaussian elimination method(15)(16) is a lower triangular matrix and an upper triangular matrix.The row permutation matrix is used to provide numerical stability and the column permutation matrix is used to control sparsity.In the following,two cases for the determination of and are considered.5In thefirst case,we determine in each elimination step a permutation of and then a permutation of.With it also the columns are reordered dynamically.The permu-tation of is done by using thefirst column of the eliminated matrix with a minimal number of nonzero elements as the pivot column[13].For keeping the method nu-merically stable at stage of the elimination,the pivot is selected among those candidates satisfying the numerical threshold criterion(17) with a threshold parameter.In the second case,wefind the permutation matrix by minimum degree ordering of or of.Then,in a separate step we determine using the numerical threshold criterion(17).To perform several factorizations of into the product of and for matrices with the same pattern structure and the same pivot sequence as well as to solve and for several right hand sides,a pseudo code is generated. This code describes the operations that are necessary to refactorize with(15)and to resolve the linear systems(16).It can be formulated independently of a computer [12].For vectorization as well as for parallelization one has tofind elements of just as and respectively that can be computed independently of each ing the algorithm of Yamamoto and Takahashi[18]a level of independence is defined for each matrix element of in(15)and each vector element of and in(16),so that elements with the same level number can be computed concurrently.Based on this information,one can define vector statements for the pseudo code instructions(vec-torization)or spread the pseudo code instructions among different processors(paral-lelization).Let denote the nonzero elements in.Then for vector computers the following vector statements have been proven to be successful for the factorization:The array elements are addressed indirectly because of the representation of as a sparse matrix.For parallel computers we distribute the pseudo code for each level of independence to about equal parts on the processors.After the processors have executed their part of the pseudo code instructions of a level concurrently,a synchronization among the processors is needed,before the execution of the next level can be started.4ApplicationsBoth the nonlinear and the linear solver have been proven successfully for dynamic process simulation of real life chemical plants.They are now included in a block ori-ented process simulation code BOP using block partitioning algorithms and numerical6integration with BDF methods[6].It uses a structured data interface,which is cur-rently generated[15]out of the data supplied by the commercial process simulator SPEEDUP1[1].The interface describes the system of DAE’s structured into subsys-tems corresponding to the units of the plant and is usable for an independent evalua-tion of subsystem functions and Jacobian matrices.Our simulation code BOP is cur-rently implemented on moderate parallel computers Cray J90with up to32processors and on a SGI Origin2000with8processors.Carrying out dynamic process simula-tions for large–scale distillation plants of the Bayer AG Leverkusen have shown the potential parallelism of the methods realized in BOP(see Tables1and2).Table1.Dynamic simulation of plant bayer11(190subsystems,10226equations) Coupling variables0500500500500 CPU time(in seconds)694.90730.96855.37865.72839.65 Wall clock time(in seconds)701.37732.12245.33160.72116.21Table2.Dynamic simulation of plant bayer12(170subsystems,19558equations) Coupling variables0819819897897 CPU time(in seconds)1038.39934.311079.931059.011080.07 Wall clock time(in seconds)1040.60936.04230.31219.82175.96The times given in Table1and2are measured for whole simulation runs on non ded-icated machines Cray J90and include the times for sequential pre–and post–proces-sing,which are usually about5%of the overall CPU time.From a performance analy-sis using the Cray tool ATExpert it was found that for the dynamic simulation of plant bayer12using16processors and a16block partitioning a speedup factor of11.5is possible.For some large matrices arising from circuit simulation and chemical process simu-lation(Table3)our linear solver GSPAR has been compared with the solvers UMF-PACK[7]and SuperLU[8].Results for using GSPAR with dynamical column re-ordering and with minimum degree ordering of or,signed with and respectively,are given in Table4.In this table op LU denotes the number of oper-ations for the factorization,nz LU the number of nonzero elements in L+U,and strat the CPU time(in seconds)on a DEC AlphaServer with a EV5.6processor used for thefirst factorization including the analysis and the generation of pseudo code.Table3.Matrices for GSPAR,UMFPACK and SuperLU advice3388circuit338840545advice3776simulation377627590meg1290458142meg4596046842 Table4.GSPAR with dynamical column reordering and minimum degree ordering advice338831034849842 1.0339696550363 1.70 advice377635546553246 1.1038222453664 1.60 meg1796797985780.721245847117700 1.26 meg442079985626 1.30376324818500.78 bayer011003262192167247.9013860173109027915.70 bayer0459547184270889.266340579449103 4.72 bayer105992500322601 5.603953687298559 2.68GSPAR UMFPACK SuperLU Name with dco with mmdFor some large matrices arising from chemical process simulation we compared the vector version of our linear solver GSPAR with FAMP[19],the frontal method of SPEEDUP[1],and found that factorizations with GSPAR are up to two times faster on Cray vector computers[13].Thus using GSPAR alternatively to FAMP in SPEEDUP it was possible to reduce the CPU–time for the whole dynamic simulation of large distillation plants to up to62%.8The performance of the parallel version of GSPAR on a computer Cray T3D is shown in Table6.For this example the pseudo code is to large to distribute it among up to8 processors.Table6.Example bayer01:CPU time(in seconds)for refactorization on Cray T3D16 2.36set to1.0032 1.45 1.63640.95 2.47[12]Grund,F.,Borchardt,J.,Horn,D.,Michael,T.,Sandmann,H.:Differential–algebraicsystems in the chemical process simulation.In:Keil,F.,Mackens,W.,V oss,H., Werther,J.(eds.):Scientific Computing in Chemical Engineering,Springer–Verlag, Berlin,pp.68–74(1996).[13]Grund,F.,Michael,T.,Bru¨ll,L.,Hubbuch,F.,Zeller,R.,Borchardt,J.,Horn,D.,Sandmann,H.:Numerische Lo¨sung großer strukturierter DAE–Systeme in der chemis-chen Prozeßsimulation.In:Hoffmann,K.H.,Ja¨ger,W.,Lohmann,Th.,Schunk,H.(Hrsg.):Mathematik–Schlu¨sseltechnologie fu¨r die Zukunft,Springer–Verlag,Berlin Heidelberg,S.91–103(1997).[14]Gra¨b,R.,Gu¨nther,M.,Wever,U.,Zheng,Q.:Optimization of Parallel Multilevel–Newton Algorithms on Workstation Clusters.In:L.Bouge et al.(Eds.):Euro–Par96 Parallel Processing,Berlin,Lecture Notes in Computer Science1124,Springer-Verlag, Berlin Heidelberg,p.91–96(1996).[15]Horn,D.:Entwicklung einer Schnittstelle fu¨r einen DAE–Solver in der chemischenVerfahrenstechnik.In:Mackens,W.,Rump,S.M.(Hrsg.),:Software Engineering im Scientific Computing,Vieweg&Sohn Verlagsgesellschaft mbH,Braunschweig,S.249–255(1996).[16]Hoyer,W.,Schmidt,J.W.:Newton–Type Decomposition Methods for EquationsArising in Network Analysis,ZAMM64,No.9,pp.397–405(1984).[17]Rabbat,N.B.G.,Sangiovanni–Vincentelli,A.L.,Hsieh,H.Y.:A Multilevel NewtonAlgorithm with Macromodeling and Latency for the Analysis of Large-Scale Nonlinear Cirquits in the Time Domain,IEEE Transactions on CAD of Integrated Cicuits and Systems,vol.CAD–1,No.3,pp.131–145(1982).[18]Yamamoto,F.,Takahashi,S.:Vectorized LU decomposition algorithms for large–scalecircuit simulation,IEEE Transactions on Computer Aided Design of Integrated Cicuits and Systems,CAD–4,pp.231–239(1985).[19]Zitney,S.E.,Stadtherr,M.A.:Frontal algorithms for equation–based chemical processflowsheeting on vector and parallel computers,Computers&Chemical Engineering, 17,pp.319–338(1993).Authors’adress:J.Borchardt,F.Grund and D.Horn,Weierstrass Institute for Applied Anal-ysis and Stochastics,Mohrenstrasse39,D–10117Berlin,Federal Republic of Germany.10。

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