简介:Over20yearsofresearchhasledtothenowwidelyacceptedroleofcardiacresynchronizationtherapy(CRT)inmedicallyrefractory,mildtoseveresystolicheartfailure(HF)withincreasedQRSduration.Inadditiontoconferringamortalitybenefit,CRThasbeenshowntoreduceHFhospitalizationratesandimprovefunctionalstatusinthispopulation.However,notallpatientsconsistentlydemonstrateapositiveresponsetoCRT.EffortstoimproveresponsetoCRThavefocusedonimprovingpatientselectionandoptimizingdeviceimplantationandfollow-up,therebycorrectingelectricalandmechanicaldyssynchrony.Inthisarticlewereviewthepathobiologyofcardiacdyssynchrony,therationalefortheuseofCRT,thehistoryandthestateoftheartofCRT,andguidelinesandrecommendationsforCRT,whilealsofocusingontheareasofcontroversyandpotentialfutureapplications.
简介:Earthquakeengineeringresearchanddevelopmenthavereceivedmuchattentionsincethefirsthalfofthetwentiethcentury.Thisvaluableresearchpresentedahugestepforwardinunderstandingearthquakehazardmitigation,whichresultedinappreciablereductionoftheeffectsofpastearthquakes.Nevertheless,the2011Tohokuearthquakeandthesubsequenttsunamiresultedinmajordamage.Thispaperpresentsthetimelineofearthquakemitigationandrecovery,asseenbytheauthors.Possibleresearchdirectionswheretheauthorsthinkthatmanyopenquestionsstillremainareidentified.Theseareprimarilybasedontheimportantlessonslearnedfromthe2011Tohokuearthquake.
简介:摘要Corona virus disease 2019 (COVID-19) is a new disease characterized by lung damage and involvement in multiple tissues and organs in the whole body. Some of the patients may have long-term impairment and dysfunctions, including pulmonary fibrosis, heart, liver, kidney, nerve and immune system. Rehabilitation has certain beneficial effect in the acute stage, and especially in the recovery stage, including improving respiratory function, exercise endurance, self-care in daily living activities, as well as psychological support, etc. Rehabilitation is not offside or absent. A reasonable rehabilitation program needs scientific research to avoid arbitrary conclusions.
简介:FromtheUSNewEnergyPlan,personnelappointment,anddiplomaticactivities,etc.,wecanseethatUSisnowonthewaytoreturningtothenegotiationtableandundertakingtheleadershipinaddressingclimatechange.WhatUShasdoneputstremendouschallengesonChina,whichemitslargeamountofgreenhousegasintotheatmosphere.However,differentfromUS,Chinaisundergoingrapiddevelopment,andhugeenergyconsumptionisunavoidable.Chinahastomakeabalancebetweendevelopingeconomyandaddressingclimatechange.ThispaperfocusesontheUSclimatechangepoliciesanditsgreenhousegasemissions,anditsinfluencesonChinaclimatechangepolicy.ChinagreenhousegasemissionsandrelativepoliciesarealsoanalyzedtoseewhatsituationChinaisin,andwhatchallengesthatChinaisfacing.Consequently,combingChina'slocalsituation,weproposeseveralsolutionsforChinatoaddressclimatechange,i.e.movingtowardsalowcarboneconomy,strugglingforemittingmore,enhancingChina-UScooperation,andimplementingdifferentclimatechangepoliciesbasedonlocalsituation.Meanwhile,theachievementsthatChinahasmadearealsointroduced.
简介:AbstractMalaria was once one of the most serious public health problems in China, with more than 30 million malaria cases annually before 1949. However, the disease burden has sharply declined and the epidemic areas has shrunken after the implementation of an integrated malaria control and elimination strategy, especially since 2000. Till now, China has successfully scaled up its efforts to become malaria-free and is currently being evaluated for malaria-free certification by the WHO. In the battle against malaria, China’s efforts have spanned generations, reducing from an incidence high of 122.9/10 000 (6.97 million cases) in 1954 to 0.06/10 000 (7855 cases) in 2010. In 2017, for the first time, China reached zero indigenous case of malaria, putting the country on track to record three consecutive years of zero transmission by 2020, accoding to the National Malaria Elimination Action Plan (2010-2020). China’s efforts to eliminate malaria is impressive, and the country is dedicated to sharing its lessons learned in malaria elimination-including, but not limited to, the application of novel genetics-based approaches—with other nations through new initiatives. China will promote international relationships and establish collaborative platforms on a wide range of topics in roughly 65 countries, including 20 African nations. China’s experience in applying innovative genetics-based approaches and tools to characterize malaria parasite populations, including surveillance of markers related to drug resistance, categorization of cases as indigenous or imported, and objective identification of the likely sources of infections to inform efforts towards malaria control and elimination in Africa could offer game-changing results when applied to settings with ongoing transmission.
简介:Noise-inducedhearinglossisacommoncauseofacquiredhearinglossintheadultpopulation.Acousticoverstimulationcausescochleardamagethroughmechanicalstresstothetissue.Consequently,complexmolec-ularchangesareinitiated,andthesechangesleadtomorphologicalandbiologicalalterationsinthecochlea,whichinturncompromisethecochlearfunctionandcausehearingloss.Inthepast10years,therehavebeensignificantadvancesinourunderstandingofthemolecularmechanismsofnoise-inducedhearingloss.Theseadvancesareattributed,inpart,tothedevelopmentofhigh-throughputtechnologiesfortheglobalanalysesofmolecularchanges.Inthisreview,webrieflydescribethenewlydevelopedmethodsforinvestigatingthemo-lecularresponsesofthecochleatoacoustictraumaandtheknowledgegeneratedfromthesestudies.Wealsodiscussthestrengthsandlimitationsofeachtechniqueandthemajorchallengestoinvestigatecochleardegen-erationfollowingacousticinjury.
简介:AbstractAlthough the natural history of recurrence/progression in patients with intraductal papillary mucinous neoplasms (IPMN) of the pancreas has not been studied thoroughly, the three principal mechanisms have been identified: (a) presence of residual disease at the transection margin, (b) presence of intraductal/intraparenchymal metastases and (c) development of new primary lesions. Mechanisms (a) and (b) result in metastatic lesions that are genetically related to the primary, while new primary lesions (mechanism c) are genetically distinct. Interestingly, recurrence/progression in IPMN displays conceptual parallels with the well-established paradigm of disease recurrence in patients with hepatocellular carcinoma (HCC). Specifically, patients with HCC may also develop recurrent tumors due to microscopic residual disease/intrahepatic metastasis which are genetically similar to the primary while the development of genetically unrelated, de novo HCC after curative-intent resection is also common. The latter has been attributed to the presence of a widespread genetic abnormality ( "field defect" ) in the liver (ie, cirrhosis). Given the conceptual similarities between IPMN and HCC, a pancreatic "field defect" may also be hypothesized to exist. This review does not suggest that HCC and IPMN have identical pathogeneses, but rather that they have conceptual similarities in tumor recurrence/progression; thus, lessons learned from HCC could be applied to IPMN research and subsequent management. Conceptual similarities in tumor progression and recurrence may also be observed between IPMN and other malignancies. However, HCC was selected because it is well studied and can serve as a paradigm.
简介:摘要:自发布“中国学生发展核心素养总体框架”,中国学生的教育就由“三维目标”向“全面发展”的目标迈进。培养学生的核心素养就明确了促进学生的全面发展,即除了发展学生的语言能力外,还要注重学生的学习能力、思维品质和文化意识的培养,从而帮助他们更好地去适应将来的社会和生活。自此,课程改革的目标就由“能力”向“素养”的转变。在高中英语教学中,阅读是最重要的一个环节,能够促进学生的核心素养的养成,促进他们的全面发展。但是,面对英语学科核心素养,一线教师在进行阅读教学时,所展现的教师教学素养对学生“核心素养”的养成形成了直接的影响。对此,笔者进行了一些思考。