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目的初步探究鞘内注射2R， 6R-羟化去甲氯胺酮（2R， 6R-HNK）对慢性神经病理性疼痛（CNP）的镇痛作用及其机制。方法采用坐骨神经选择性损伤（SNI）诱导的CNP模型。将雌性小鼠随机分不同组：假手术或SNI术后3 周或术前30 min/1 d给予溶剂、2R， 6R-HNK、S-ketamine（10 mg/kg腹腔注射或7、21 μmol/L鞘内注射）（每组3 ~ 7只）。采用机械缩足阈值（PWT）和镇痛效率评估2R， 6R-HNK的治疗或预防效果。再用免疫荧光和RT-PCR方法检测背根神经节（DRG）和脊髓背角中蛋白转录及表达水平，并探讨其可能的作用机制。结果鞘内注射2R， 6R-HNK剂量依赖地缓解雌性小鼠SNI建模3 周的双侧机械痛敏；其中21 μmol/L 2R， 6R-HNK的镇痛效率达峰时间为2 d，峰值为（75.32±7.69）%。预先鞘内2R， 6R-HNK还能延迟SNI诱导双侧机械痛敏产生2 ~ 3 d。机制上，2R， 6R-HNK预处理不仅显著抑制SNI引起的双侧DRG和脊髓背角浅层神经元异常兴奋，还下调DRG内降钙素基因相关肽（CGRP）及脑源性神经生长因子（BDNF）的高表达。结论鞘内注射2R， 6R-HNK通过抑制上行痛觉通路神经元异常兴奋并下调DRG神经元CGRP和BDNF表达从而对CNP产生镇痛作用。

【目的】探讨铜体外抗低钾诱导大鼠小脑颗粒神经元（CGNs）凋亡作用及其机制。【方法】体外培养乳鼠的CGNs并用去极化诱导凋亡模型；噻唑兰（MTT）法检测细胞存活率；相差显微镜及Hoechst 33258染色分别观察细胞及其核形态学变化；流式细胞仪（FCM）检测亚二倍体峰。【结果】1~40 μmol/L的铜可抗低钾所致的大鼠CGNs凋亡，明显提高CGNs的存活率。铜（20 μmol/L）显著减少低钾所致的大鼠CGNs胞体皱缩、细胞核固缩和亚二倍体峰等凋亡特征。铜的神经保护作用可以持续72 h以上。磷脂酰肌醇3-激酶（phosphatidylinositol-3-kinane，PI3-K）抑制剂LY294002可阻断铜的保护作用。【结论】首次发现，一定浓度范围的铜对低钾所致的大鼠CGNs凋亡有保护作用，PI3-K/ Akt信号传导通路可能参与其保护作用。

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Objective To analyze the clinical value of oxygen saturation related diffusion index for monitoring oxygen and status in patients with acute respiratory distress syndrome(ARDS). Methods The enrolled cases were 130 patients with ARDS treated in the hospital from May 2017 to January 2020. The oxygen saturation related diffusion indexes were assessed and compared between patients with mild, moderate and severe ARDS. Results Of the 130 patients with ARDS, 38 were mild, accounting for 29. 23%; 55 were moderate, accounting for 42. 31%; and 37 were severe, accounting for 28. 46%. Refers to oxygen saturation-related diffusion index, mild ARDS patients were significantly higher than moderate patients, moderate patients were significantly higher than severe patients(P＜0. 05). Conclusion Finger oxygen saturation-related diffusion index has a negative correlation with the condition of patients with ARDS. Strengthening the monitoring of finger oxygen saturation-related diffusion index is of great significance for assessing the condition, treatment effect and prognosis of ARDS patients. (目的 分析应用指氧饱和度相关弥散指数监测急性呼吸窘迫综合征(ARDS)患者氧合状态的临床价值。方法 选取医院2017年5月—2020年1月收治的130例ARDS患者为研究对象, 对比轻度、中度、重度ARDS患者指氧饱和度相关弥散指数。结果 130例ARDS患者中38(29. 23%)例轻度, 55(42. 31%)例中度, 37(28. 46%)例重度。指氧饱和度相关弥散指数: 轻度ARDS患者明显高于中度患者, 中度患者明显高于重度患者, 差异有统计学意义(P

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[Objective] The multi-fractal characteristics of water erosion factors such as elevation, slope, land use and vegetation coverage are explored in order to deeply understand the water erosion mechanism of the Loess Plateau. [Methods] The watersheds in tow typical regions（Wangdonggou Watershed of Changwu County and Nihegou Watershed of Chunhua County, Quanjiagou Watershed of Mizhi County and Zhifanggou Watershed of Ansai County which are located in the highland and gully region and hilly and gully region, respectively） were taken as examples. The multifractal spectrum of the water erosion factor and its main parameters were calculated and analyzed by the multifractal method. The multifractal characteristics of the water erosion factor were discussed. [Results] The singulation index Δα values of the slope and land use were 0.817 and 0.310, respectively, while the largest difference in vegetation coverage was observed in the Quanjiagou Watershed, where the vegetation cover was Δα=1.309, the elevation of the loess hilly gully area was Δf（α）＜0, and Δα and Δf（α） of the slope of the loess highland and gully area was greater than that of the hilly ravine. That was, the relative undulations of hilly and ravines were greater, the surface of the landform was sharper, the land use fragmentation was more serious, and the complexity of vegetation coverage areas was high. [Conclusion] The relative relief degree and land use fragmentation were greater in Wangdonggou Basin, and the complexity of vegetation cover in Quanjiagou Basin was the highest, which was consistent with the actual situation. It was feasible to carry out multi-fractal characteristics analysis of water erosion factors quantification in the region. [ABSTRACT FROM AUTHOR]

装备物资保障是开展地震灾害救援的重要前提和物质基础。结合消防救援队伍战勤保障特点，就地震灾害救 援中的装备物资保障开展研究，从我国地震灾害救援装备物资保障的特点、地震灾害救援装备物资保障的现状、地 震灾害救援装备物资保障能力提升措施等方面进行了分析，旨在主动适应"全灾种、大应急"的加快转型和"主力 军、国家队"的工作需要，建立健全消防救援队伍应急装备物资保障体系. [ABSTRACT FROM AUTHOR]

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目的　总结宫颈腺样囊性癌的临床、病理特点及诊断方法。方法　回顾性分析1例宫颈腺样囊性癌的临 床资料。结果　患者女，40岁，“以性生活阴道出血2 + 月”入院。外院HPV检测显示HPV16型阳。核磁提示宫颈 外口少许异常强化灶，专科查体宫颈肥大，余触诊未见异常。镜下肿瘤组织由导管腺上皮和变异肌上皮这两种细胞 组成。肿瘤细胞巢呈圆形、椭圆形，有的细胞巢周围呈栅栏样排列，可见明显的粉刺样坏死。免疫表型 P16、CK7、 CD117、Bcl2弥漫阳性，P63、P40、CEA、CK5/6部分阳，Syn、CgA阴性，Ki-67指数热点区 80% + 。结论　宫颈腺样囊 性癌主要表现为阴道出血，但缺乏特异性表现，具有易复发及远处转移的特点，肿物可通过阴道镜检查发现，大体上 与其他宫颈肿瘤不易区分，明确诊断需行病理检查；病理检查显示肿瘤细胞巢呈圆形、椭圆形，有的细胞巢周围呈栅 栏样排列，可见明显的粉刺样坏死，免疫表型P16、CK7、CD117、Bcl2弥漫阳性及P63、P40、CEA、CK5/6部分阳性；通 过病理组织学及免疫组化P16、CD117等可以明确诊断，但应与腺样基底细胞癌、基底样鳞状细胞癌、神经内分泌癌 进行鉴别。宫颈腺样囊性癌作为十分罕见的肿瘤，相关的临床资料少，目前没有形成统一的治疗方案共识，但多数 临床上还是彻底的手术切除，并结合术后放化疗的方法。 [ABSTRACT FROM AUTHOR]