慢性肺心病继发消化道出血24例临床分析

目的:探讨慢性肺心病继发消化道出血防治。方法:回顾分析24例慢性肺心病继发消化道出血的表现。结果:慢性肺心病继发消化道出血死亡率很高,本文通过对24例患者的观察,死亡率为72.5％,其中因窒息死亡率为53.33％。结论:慢性肺心病继发消化道出血患者早期预防和治疗是减少死亡率的关键。     

Concurrent pulmonary thrombosis with systemic embolism: a case report

Based on different mechanisms of blood coagulation, coexistence of venous thromboembolism and arterial thrombosis in a single individual is extremely rare in clinical practice. Both antiplatelet and anticoagulation therapy should be adopted for patients with arteriovenous embolism. Balancing the risk of ischemia and hemorrhage is especially challenging in these patients in order to achieve an optimal clinical benefit. We report on a 55-year-old female with acute pulmonary embolism (PE), subsequently diagnosed as having acute myocardial infarction (AMI) and a cerebral infarction. Examinations had been carried out, excluding potential arteriovenous shunts, cancer, antiphospholipid syndrome and other common hypercoagulable states. A combination of an anticoagulant drug (rivaroxaban, an Xa inhibitor) and an antiplatelet agent (clopidogrel, an ADP receptor inhibitor) was prescribed with a β-blocker and atorvastatin. The embolus was gradually shrunk during the next 10 months, and then it turned back into expanding. During the 16 months’ follow-up, an aneurysm of left ventricular apex was found through an echocardiogram and an angiotensin-converting enzyme inhibitor was administered. We conclude that combined anticoagulation and antiplatelet therapy significantly relieved the symptoms and improved the prognosis in patients suffering from arteriovenous embolism without any major clinical bleeding events.     

Molecular hydrogen is a promising therapeutic agent for pulmonary disease

Molecular hydrogen exerts biological effects on nearly all organs. It has anti-oxidative, anti-inflammatory, and anti-aging effects and contributes to the regulation of autophagy and cell death. As the primary organ for gas exchange, the lungs are constantly exposed to various harmful environmental irritants. Short- or long-term exposure to these harmful substances often results in lung injury, causing respiratory and lung diseases. Acute and chronic respiratory diseases have high rates of morbidity and mortality and have become a major public health concern worldwide. For example, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic. An increasing number of studies have revealed that hydrogen may protect the lungs from diverse diseases, including acute lung injury, chronic obstructive pulmonary disease, asthma, lung cancer, pulmonary arterial hypertension, and pulmonary fibrosis. In this review, we highlight the multiple functions of hydrogen and the mechanisms underlying its protective effects in various lung diseases, with a focus on its roles in disease pathogenesis and clinical significance.     

肺结核X线诊断分类500例探讨

目的旨在明确肺结核X线分类中两型合并的分类.方法本文收集经临床、肺结核细菌学和常规胸片确诊的肺结核500例,进行X线分类的探讨.结果X线分类,原发型167例,合并胸膜炎的6例;血型播散型70例,合并胸膜炎22例;继发型306例,合并胸膜炎74例.Ⅰ～Ⅲ型肺结核合并胸膜炎102例,占总病例数的20.4%.结论依据病因、发病机理、中国结核病分类法(1998),按原发型肺结核合并结核性胸膜炎、血行散型肺结核合并结核性胸膜炎、继发型肺结核合并结核性胸膜炎,进行X线分型.     

A case study of reading difficulty

Baseline assessment is well established, and generally regarded positively by teachers. However, it is used for different purposes, including identification of special educational needs and value added analyses of schools. The results of an evaluation of the national arrangements indicate variation in content and implementation of schemes. The implications of current evidence for the future development of baseline assessment are considered.     

A case study of scientific reasoning

Concern is increasingly being expressed about the teaching of higher order thinking skills in schools and the levels of understanding of scientific concepts by students. Metaphors for the improvement of science education have included science as exploration and science as process skills for experimentation. As a result of a series of studies on how children relate evidence to their theories or beliefs, Kuhn (1993a) has suggested that changing the metaphor to science as argument may be a fruitful way to increase the development of higher order thinking skills and understanding in science instruction. This report is of a case study into the coordination of evidence and theories by a grade 7 primary school student. This student was not able to coordinate these elements in a way that would enable her to rationally consider evidence in relation to her theories. It appeared that the thinking skills associated with science as argument were similar for her in different domains of knowledge and context. Specializations: science learning, scientific reasoning, learning environments, science teacher education. Specializations: cognition, reasoning in science and mathermatics.     

旅游客观真实性实证研究

利用旅游客观真实性和旅游动机等相关理论,在对国内七大类著名代表性景区进行调查分析的基础上,得出我国旅游者的旅游客观真实性结构情况以及旅游客观真实性与旅游动机的相关性研究结论。研究发现,七类不同类型景区的旅游者对客观旅游真实性的认可方面,文化类景区和自然类景区高于海滩度假景区,说明在自然景区和大多文化景区,多数旅游者对旅游客体的关注较高,对旅游客体的客观真实性很在意,而度假型景区的旅游者更多关注旅游者自身的身体放松和主观体验。另外,客观真实性与旅游动机的相关性表现为客观真实性旅游者更注重知识功能动机,对自尊动机、最小化惩罚动机、奖励最大化动机和自我实现动机则反应平淡。     

论法学教学中的案例教学法

由于各国法律在形式上的特点及法律文化历史传统方面的差异,两大法系国家的法学教学方法大有不同。在英美法系国家的法学教学中占据主导地位的是案例教学法,而大陆法系国家的法学教学则采用以讲授法为主的教学方法。近些年来,法学教育界开始提倡案例教学法。但我国法学教学切不可照搬英美法系国家的案例教学法,而应根据我国的实际,采用改进的案例教学法。     

重症监护病房脑出血并发肺部感染病原学研究

对重症监护病房（ICU）123例脑出血合并肺部感染患者的痰培养及药敏结果进行分析,结果显示,123例检出151株致病菌,其中革兰阴性菌（G^-菌）占65．6％,革兰阳性菌（G^＋菌）占25．1％;G^＋菌对多粘菌素B、亚安培南敏感,G^＋菌对万古霉素敏感,G^-菌及G^＋菌对三代头孢菌素具有普遍耐药性。ICU内脑出血合并肺部感染病原菌以G^-菌为主,应重视对耐药性的监测及对抗生素的合理应用。     

Developing Progress Files: A case study

This paper reports the development of a progress file, a tool to promote learning, planning and the recording of achievement, for dental therapists in training and professional practice. Progress files are to become obligatory in higher education in the United Kingdom. The aims of the file, its development and the naturalistic approach taken to evaluation are described; the outcomes are analysed. A number of potential challenges posed by progress files for teaching, learning, assessment, curriculum and policy development in the United Kingdom, and for researching these challenges, are highlighted. Issues relating to employment, self-appraisal, lifelong learning and reflection in learning are considered. The desirability of a discipline or professionally-based file, and for acceptance of flexibility in intent, length and usage of such devices is posited.     

数形结合信息选择题分类例析

数形结合信息选择题形式简洁、条件隐藏,是高考的重点.常见于直线、二次函数、幂函数和指数函数当中.     

NIDDM合并肺部感染患者的免疫功能变化研究

[目的]通过对免疫球蛋白(IgA、IgG、IgM),补体(C3、C4),T淋巴细胞亚群(CD3、CD4、CD8),可溶性白细胞介素2受体(SIL-2R)的检测,研究这些免疫指标与NIDDM(非胰岛素依赖性糖尿病)合并肺部感染患者的关系.[方法]采用双抗夹心法测SIL-2R,速率散射比浊法测免疫球蛋白和补体,单克隆法测淋巴细胞亚群等免疫指标.[结果]①糖尿病及其合并感染组SIL-2R显著高于正常对照组(P<0.01).CD4/CD8显著低于正常对照组(P<0.05);②合并感染组较正常对照组IgG、IgA、C3、C4显著升高(P<0.05、P<0.01、P<0.05、P<0.05),IgM无显著变化(P<0.05).[结论]NIDDM合并肺部感染可加重糖尿病及机体免疫功能低下,NIDDM合并肺部感染T淋巴细胞亚群(CD3、CD4、CD8),补体(C3、C4)免疫球蛋白(IgA、IgG)可溶性白细胞介素2受体(SIL-2R)的检测,可作为糖尿病及其合并感染者的病情变化的客观指标.     

A case study of two exemplary biology teachers

Research has indicated that most science classrooms are not intellectually demanding and place little emphasis on small group discussions and laboratory activities. However, successful science programs and competent science teaching that can provide models for other science teachers do exist. This study sought to document the teaching practices of two exemplary biology teachers of grades 11 and 12 by means of an interpretive research methodology. Both teachers had a thorough and comprehensive knowledge of the content they were to teach and had a range of teaching strategies that could be used without a great deal of thought. Their expectations for student performance were high, consistent, and firm. Students were expected to complete a high level of academic work in discussions, in problem work, and in laboratory activities, and were encouraged to take responsibility for their own learning. A distinctive feature of these biology classes was the high level of managerial efficiency, where lessons were busy occasions for both teacher and students; students had little opportunity for off-task behavior. Both teachers actively monitored the behavior of both high- and low-ability students by moving around the room and speaking with individuals, while still maintaining control of the entire class. By manipulating questioning and the social environment, both teachers encouraged students to engage in work, gave effective praise to the whole class and to individuals, encouraged student input by referring to it, helped students to effectively use their time, and gave marks for completion of set work. Compared to research with less-successful teachers, these teaching behaviors contributed to exemplary practice.     

A case study of learning styles in biology

Two intervention programmes ‐ ‘limited’ (using instructional materials only) and ‘full’ (using instructional materials, student and parent programmes, role models and field trips) ‐ were implemented in two rural high schools in the United States with two male teachers. A similar school and teacher served as a control site. Student attitudes, confidence and experiences were assessed, and demographic, enrolment, and achievement data were collected. In addition, trained observers collected qualitative impressions. The results suggest that a combination of quantitative and qualitative methodologies may enable researchers to interpret results more appropriately, since social desirability may affect data obtained by quantitative methods. In addition, the impact of student achievement level on student attitudes toward, confidence in and perceived ability for science has been assessed. Last, a more refined intervention model is described, based on the results of the Science Career Options for Rural Environment Students (scores) project.     

小而精的学府何以也成功——对加州理学院崛起的分析

如何通过跨越式发展为世界一流大学,是当前我国高等教育发展迫切需要解决的重大课题。本文通过对一所后发的小型学府－加州理工学院的专题分析,揭示了一所大学跨越式发展背后的内外动因、特色及其管理特征,最后结合我国大学发展的实际提出了若干结论与建议,特别强调了学术自由与大学自治对于我国高等教育发展的重要意义。     

一例多功能一体化监控系统分析

根据某部仓库日常安全管理和安全监控要求,设计了一套适于仓库需要的安全防范系统.该系统由上平台、下平台和总线层组成.其视频信道可实现处理选择、显示选择、网络发布以及对摄像机视角、焦距进行控制;以平面图方式显示各监控点工作状态及报警位置;实时处理各工作站信息,调整设备工作状态,并记录、备份,自动处理异情和警情.系统以自动运行为主,部分操作可进行人工干预.系统交付使用后,运行稳定可靠,在仓库的规范管理及安全防范方面发挥了重要作用.     

A Specification—Based Case Study from Test Class Framework

Testing is a standard method for verification of software performance.Producing efficinet and appropriate test case is an important aspect in testing.Specification-based testing presents a method to derive test data from software specification.Because of the precision and concision of specification.the test data derived from specification can test the software efficiently and entirely.This paper demonstrates a test class framework(TCF) on a file reading case study,specifiec using Z notation,This class framework defines test case sets,providing structure to the testing process.Flexbility is preserved so that many testing strategies can be used.     

The difficulties of defining development:A case study

In the current climate of change and expansion within higher education in the UK, there are various drivers for change in the way the curriculum is designed and delivered. In the recent past, within the UK, the QAA has presented a Code of Practice with respect to HE provision for students with disabilities and changes in the legislation relating to access to higher education for students with disabilities. These developments have prompted funding councils to resource major projects relating to accessibility. Such is the complexity of terms such as 'curriculum', 'accessibility' and 'disability', that these funded projects require a multidisciplinary approach. However, questions arise as to whether the key players in these multidisciplinary projects actually fully understand each other and have a shared understanding of the terms of reference. This case study highlights some of the difficulties experienced within a multidisciplinary team that did not ensure a shared conception of the complexities of the change management project in which it was engaged. What comes to the foreground is the problematic concept of academic development and how it is understood outside of its own community.