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简介：AbstractBackground:The End Tuberculosis (TB) Strategy of the World Health Organization highlights the need for patient-centered care and social protection measures that alleviate the financial hardships faced by many TB patients. In China, TB treatments are paid for by earmarked government funds, social health insurance, medical assistance for the poor, and out-of-pocket payments from patients. As part of Phase III of the China-Gates TB project, this paper introduces multi-source financing of TB treatment in the three provinces of China and analyzes the challenges of moving towards universal coverage and its implications of multi-sectoral engagement for TB care.Main text:The new financing policies for TB treatment in the three provinces include increased reimbursement for TB outpatient care, linkage of TB treatment with local poverty alleviation programs, and use of local government funds to cover some costs to reduce out-of-pocket expenses. However, there are several challenges in reducing the financial burdens faced by TB patients. First, medical costs must be contained by reducing the profit-maximizing behaviors of hospitals. Second, treatment for TB and multi-drug resistant TB (MDR-TB) is only available at county hospitals and city or provincial hospitals, respectively, and these hospitals have low reimbursement rates and high co-payments. Third, many patients with TB and MDR-TB are at the edge of poverty, and therefore ineligible for medical assistance, which targets extremely poor individuals. In addition, the local governments of less developed provinces often face fiscal difficulties, making it challenging to use of local government funds to provide financial support for TB patients. We suggest that stakeholders at multiple sectors should engage in transparent and responsive communications, coordinate policy developments, and integrate resources to improve the integration of social protection schemes.Conclusions:The Chinese government is examining the establishment of multi-source financing for TB treatment by mobilization of funds from the government and social protection schemes. These efforts require strengthening the cooperation of multiple sectors and improving the accountability of different government agencies. All key stakeholders must take concrete actions in the near future to assure significant progress toward the goal of alleviating the financial burden faced by TB and MDR-TB patients.

简介：摘要：本文采用密度泛函理论计算了压力下CrSi2的声子谱、电子结构、弹性常数和弹性各向异性。结果表明，CrSi2的晶体结构参数随着压力的增加而减小。声子色散曲线在不同外加压力下没有出现虚频，说明它们都是动力稳定的。弹性常数也符合Born准则，表明机械学稳定性。CrSi2的弹性常数、体积模量、剪切模量、杨氏模量、泊松比和B/G都随压力的增加而增加，表明适当的外界压力可以加强CrSi2的延展性，从而让其在工业应用上有望成为具有良好前景的可塑性金属合金的备选材料。热容量随着压力的增大而轻微的减小。

简介：AbstractBackground:The global prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing. The pathogenesis of NAFLD is multifaceted, and the underlying mechanisms are elusive. We conducted data mining analysis to gain a better insight into the disease and to identify the hub genes associated with the progression of NAFLD.Methods:The dataset GSE49541, containing the profile of 40 samples representing mild stages of NAFLD and 32 samples representing advanced stages of NAFLD, was acquired from the Gene Expression Omnibus database. Differentially expressed genes (DEGs) were identified using the R programming language. The Database for Annotation, Visualization and Integrated Discovery (DAVID) online tool and Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database were used to perform the enrichment analysis and construct protein-protein interaction (PPI) networks, respectively. Subsequently, transcription factor networks and key modules were identified. The hub genes were validated in a mice model of high fat diet (HFD)-induced NAFLD and in cultured HepG2 cells by real-time quantitative PCR.Results:Based on the GSE49541 dataset, 57 DEGs were selected and enriched in chemokine activity and cellular component, including the extracellular region. Twelve transcription factors associated with DEGs were indicated from PPI analysis. Upregulated expression of five hub genes (SOX9, CCL20, CXCL1, CD24, and CHST4), which were identified from the dataset, was also observed in the livers of HFD-induced NAFLD mice and in HepG2 cells exposed to palmitic acid or advanced glycation end products.Conclusion:The hub genes SOX9, CCL20, CXCL1, CD24, and CHST4 are involved in the aggravation of NAFLD. Our results offer new insights into the underlying mechanism of NAFLD progression.

简介：摘要目的通过文献回顾，探讨癌症患者家庭弹性的概念，为癌症患者开展家庭弹性护理及干预提供参考。方法检索中国知网、万方、维普等中文数据库及PubMed、Medline、Web of Science、EBSCO等英文数据库，采用Walker-Avant的概念分析法进行分析。结果了解家庭弹性在国内外文献应用现状，明确概念定义属性，分析前因及后果，总结分析实证测评指标。结论癌症患者家庭弹性具有自身的独特性和发展趋势，通过此概念的分析有助于概念的深入了解，为后期家庭弹性的研究提供支持。

简介：摘要：水轮发电机组的推力轴承承担着机组转动部分的全部重量和水的轴向推力，在检修过程中需要对推力轴承弹性油箱的受力进行调整，一方面使各个弹性油箱受力均匀，另一方面又要保证镜板水平符合要求。传统调整方法的调整精度及效率都极低，受力调整与水平调整难以兼顾甚至可能出现两者调整方向相互矛盾的情况。本文所述调整方法的创新性在于：建立了测量值与每个弹性油箱应该调整量之间的精确数学关系，理论上可一次调整成功，且达到最高调整精度。填补了推力轴承受力调整方法缺乏理论指导的空白，对于全面提高水轮发电机组的安装与检修质量具有重要意义。关键词：弹性油箱 压缩值 平衡力系 受力调整 自由高度

简介：摘要目的通过文献回顾，探讨癌症患者家庭弹性的概念，为癌症患者开展家庭弹性护理及干预提供参考。方法检索中国知网、万方、维普等中文数据库及PubMed、Medline、Web of Science、EBSCO等英文数据库，采用Walker-Avant的概念分析法进行分析。结果了解家庭弹性在国内外文献应用现状，明确概念定义属性，分析前因及后果，总结分析实证测评指标。结论癌症患者家庭弹性具有自身的独特性和发展趋势，通过此概念的分析有助于概念的深入了解，为后期家庭弹性的研究提供支持。

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简介：摘要：聚氨酯弹性体(PUE)又称聚氨基甲酸酯弹性体或聚氨酯橡胶，简称PUE，是一种大分子主链中含有重复氨酯基的嵌段共聚物。作为一种综合性能优异的聚氨酯(PU)制品，聚氨酯弹性体已被广泛应用于人们生产和生活的方方面面。本文介绍了聚氨酯弹性体的特点、结构与性能的关系、合成方法及其在一些重要领域的应用，并对其未来发展趋势进行了展望。

简介：摘要：新课程强调“以学生发展为本”的教育教学思想，注重满足学生成长、发展的需求，注重培养学生终身学习的能力。家庭作业是学生巩固基础知识，提高学习能力的重要途径。本文从传统作业中存在的问题和现行新课标下科学弹性作业设计等两个方面进行探讨。

简介：摘要目的观察情绪弹性疗法对重症监护室（ICU）护士共情疲劳和心理弹性的影响。方法将70例ICU护士随机分为试验组和对照组各35例，对照组给予常规心理辅导干预，试验组实施为期8周的情绪弹性疗法。干预前后采用中文版同情疲劳量表、心理弹性量表对效果进行评价。结果干预后试验组共情满意、继发性创伤应激得分和共情疲劳总分为（26.46 ± 4.99）、（17.80 ± 4.05）、（69.14 ± 5.70）分，明显低于对照组的（28.86 ± 4.14）、（20.11 ± 4.38）、（75.51 ± 10.32）分，差异有统计学意义（t值为2.190、2.296、3.197，P<0.05）。干预后试验组坚韧、力量、乐观维度得分和心理弹性总分为（34.23 ± 6.06）、（25.77 ± 5.01）、（14.31 ± 3.22）分和（74.31 ± 9.55）分，明显高于对照组的（30.86 ± 6.23）、（23.31 ± 3.29）、（12.11 ± 2.04）分和（66.29 ± 7.28）分，差异有统计学意义（t值为2.295~3.956，P<0.05）。结论情绪弹力疗法可缓解ICU护士的共情疲劳和增强其心理弹性水平。

简介：摘要目的观察情绪弹性疗法对重症监护室（ICU）护士共情疲劳和心理弹性的影响。方法将70例ICU护士随机分为试验组和对照组各35例，对照组给予常规心理辅导干预，试验组实施为期8周的情绪弹性疗法。干预前后采用中文版同情疲劳量表、心理弹性量表对效果进行评价。结果干预后试验组共情满意、继发性创伤应激得分和共情疲劳总分为（26.46 ± 4.99）、（17.80 ± 4.05）、（69.14 ± 5.70）分，明显低于对照组的（28.86 ± 4.14）、（20.11 ± 4.38）、（75.51 ± 10.32）分，差异有统计学意义（t值为2.190、2.296、3.197，P<0.05）。干预后试验组坚韧、力量、乐观维度得分和心理弹性总分为（34.23 ± 6.06）、（25.77 ± 5.01）、（14.31 ± 3.22）分和（74.31 ± 9.55）分，明显高于对照组的（30.86 ± 6.23）、（23.31 ± 3.29）、（12.11 ± 2.04）分和（66.29 ± 7.28）分，差异有统计学意义（t值为2.295~3.956，P<0.05）。结论情绪弹力疗法可缓解ICU护士的共情疲劳和增强其心理弹性水平。

简介：摘要：目的：分析情绪弹性疗法对重症监护室护士共情疲劳和心理弹性的干预效果。方法：采取调查统计分析的方式，包括共情疲劳简短量表、心理弹性量表等，并对数据进行分析。结果：58例重症监护室护士的共情疲劳程度得分和心理弹性得分，分别为（48.75±12.16）、（42.87±13.45）；护士共情疲劳程度得分为（36.56±9.87）、心理弹性得分为（66.89±16.45），较比干预前，数据对比差异显著（P＜0.05）。结论：重症监护室护士工作压力大，在情绪弹性疗法干预下，增强了护士的心理建设，营造了良好的工作氛围，提高护士心理弹性。

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简介：摘要：目前国内大量超/超超临界火电机组在运行，随着锅炉设计运行参数的逐步升高，锅炉受热面管道氧化皮脱落导致的锅炉爆管机组非停事故越来越多。由于锅炉受热面管道氧化皮脱落严重威胁锅炉安全经济运行，锅炉爆管产生的经济损失很大，因此，如何减缓超临界机组氧化皮脱落速度，进一步提高锅炉的安全性是目前亟待解决的关键性技术难点。本文对锅炉受热面管道氧化皮的生成、脱落的原因进行分析，并结合工作实际如何减缓氧化皮脱落提供一些建议。

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简介：AbstractObjective:This survey was designed to understand the misconceptions about labor epidurals.Methods:This voluntary and anonymous online survey on wenjuan.com was conducted from September 1st, 2015 to January 1st, 2016 via mainly WeChat groups dedicated to perinatal healthcare providers in China. The questionnaire included items inquiring the knowledge and opinions about labor epidural analgesia related to maternal complications, baby safety, and effect on laboring. Incomplete surveys were excluded from the data analysis. The data was presented as percentages and a Chi-square test or Fisher’s exact test, as appreciate, was used to quantitatively compare the results.Results:A total of 1412 respondents completed surveys with 42.9% (606/1412) of them being anesthesiologists, 35.1% (495/1412) being obstetricians, 11.8% (167/1412) being midwives, 3.7% (52/1412) being labor and delivery nurses, and 6.5% (92/1412) being hospital administrators and unspecified. The study revealed a lack of knowledge in labor pain control. Although 82.4% (1164/1412) of respondents were familiar with labor epidural analgesia, 8.9% (126/1412) did not know how it works, and 1.1% (15/1412) never heard it in a multiple-choice question. The three main groups (anesthesiologists, obstetricians, and midwives/labor and delivery nurses) were chosen for comparisons. Opinions among these three groups concerning five questions in the three main concerns were evaluated using a statistical significance of P<0.05.Conclusion:The results in our survey indicated an urgent need of continuing medical education to multidisciplinary specialties to improve evidence-based medical practices as these misconceptions have existed for over 10 years in the medical professionals. Lack of public awareness fueled by misconceptions related to labor epidural analgesia may be associated with a lack of professional knowledge. Correct knowledge in professionals needs to be disseminated to the public in order to dispel possible misconceptions and rumors about labor epidural analgesia. This would not only enhance patient understanding of their care but also improve maternal, fetal, and neonatal outcomes.