变态背后的道德寓意--解读《泄密的心》中读者的参与?

读者是修辞叙事学中一个含义极广的概念。文本只有被读者阅读才有存在的意义，读者的阐释对作品的多样性解读有重要作用。以费伦的“四维读者观”为理论基础，以爱伦·坡《泄密的心》为例，分析叙述读者和作者的读者在解读文本中人物的变态和道德寓意时的参与性。     

Narrative constructs in modern clinical case reporting

Modern clinical case reporting takes the form of problem-solution narratives that redescribe symptoms in terms of disease categories. Authored almost always by those who have played a part in the medical assessment of the patient, reports historicise the salient details of an individual's illness as a complex effect of identifiable antecedent causes. Candidate hypotheses linking illness to pathological mechanisms are suggested by the patient’s experience, and by data that emerge from clinical examination and investigation. Observational and interpretive statements from these considerations are fitted into a temporally inflected account of the patient’s medical condition, configured from the vantage point of hindsight. Drawing on established forms of deferred telling, readers are invited to follow a story that drip-feeds a mixture of contingent and non-incidental information into the account, which engenders and frustrates curiosity, creates expectations, and challenges powers of reasoning and pattern recognition. Whereas case reporting once favoured memoir, the sentimental tale and eccentric biography as the means by which its historical narrative was cast, the preferred genres of contemporary case reporting include detective fiction, and puzzle and riddle narratives, formats that conceptualise the medical consultation in narrow problem-solution terms.     

非心肌梗死冠心病患者心率变异性分析

目的探讨非心肌梗死冠心病（NⅧcHD）患者在合并心力衰竭和／或合并非恶性室性心律失常情况下心率变异性的变化情况。方法39例NMICHD患者根据有无合并室性心律失常和有无合并心力衰竭分A、B、C、D4组,与30例健康志愿者的心率变异性进行分析对比。结果A、B、C组的SDNN较健康对照组降低（P〈0．05）,D组的SDNN、SDNNindex、rMSSD、PNN50与健康对照组比较差异无显著性（P〉0．05）;A或B组较C或D组的SDNN、SDNNindex、rMSSI）、PNN50皆豆著降低（P〈0．05）;A与B组之间,C与D组之间的SDNNindex、rMSSD、PNN50差异无显著性（P〉0．05）。结论在观察的心率变异性时域指标中,SDNN是反映非心肌梗死冠心病患者自主神经受损最敏感的指标。非心肌梗死冠心病患者合并心力衰竭较合并非恶性室性心律失常更易引起心率变异性下降,可能具有更高的危险性。     

Beagle犬部分生理指标测定

目的建立Beagle体温、呼吸、血压、心率、心电图等部分生理指标正常参考值范围,为国家制定标准提供参考依据和相关医学研究及应用提供参考基础数据。方法选用普通级健康beagle犬380只,采用肛表、多道生理记录仪、心电图仪分别测定Beagle犬体温（直肠温度）、呼吸、血压、心率、心电图。结果所有测定指标雌雄间比较差异不显著（P〉0.05）;只有呼吸指标高于相关报道,且差异显著（P〈0.05）。结论除呼吸指标外其它各项指标与国内相关报道基本相符合,具有较好的参考价值。     

基于非负矩阵分解技术探寻早期阿尔茨海默症基因表达调控网络

本文利用非负矩阵分解(NMF)技术,依据加强算法的稀疏性对患早期阿尔茨海默 症(Alzheimer’s Disease,AD)样本的基因表达数据进行了分析,提取了对疾病早期诊断具有重 要意义的显著基因,样本分类实验结果证明了算法的有效性。在此基础上,结合与炎症反应 有重要关系的 NF-κB 等基因初步建立了与早期 AD 密切相关的基因表达调控网络结构图, 为 AD 致病机理的探询、早期诊断与治疗等提供了有益的途径和方法。     

翠竹岭隧道病害整治方案

我国数量极大的高速公路隧道基本集中在约20年间建成，可以预见今后面临的维修整治任务将十分艰巨。本文详细介绍了翠竹岭隧道病害整治方案，可为其它隧道病害整治的设计和施工提供一定的参考。     

Association of cystatin C level and cardiovascular prognosis for patients with preexisting coronary heart disease： a meta-analysis

The association of circulating levels of cystatin C （CysC） and risk of recurrent cardiovascular events in patients with preexisting coronary heart disease are uncertain. To qualitatively and quantitatively address this issue, we performed a random meta-analysis of results from prospective studies on the topic. We searched elec- tronic and printed sources （up to 16 October 2011） using keywords and retrieved articles for seven prospective studies according to the selection criteria. Data were abstracted and meta-analysis was performed using the random-effects model （RevMan 5.0.23 software）. The cohorts involved 4,576 patients with preexisting coronary heart disease （CHD） and normal or mild chronic kidney disease, and follow-up ranged from 5.6 to 40.6 months. Highest versus lowest baseline CysC level was signifi- cantly associated with increased risk of cardiovascular events （OR 2.30, 95 % CI 1.80-2.94）, all-cause mortality （OR 5.69, 95 % CI 3.70-8.74）, but not with recurrent MI （OR 1.75, 95 % CI 0.77-4.00）. In heterogeneity testing for studies reporting cardiovascular events and all-cause mor- tality, no significant heterogeneity was found, and exclu- sion of any single study did not alter the overall finding. For risk of recurrent MI, significant heterogeneity was found among the five trials （Z2= 13.16, P=0.01, 12 = 70 %） and exclusion of the Taglieri et al. [12] study from the analysis resulted in a rise in relative risk （OR 2.36, 95 % CI 1.09-5.15）. In conclusion, for patients with established CHD, high baseline level of CysC is associated with increased risk of cardiovascular events and all-cause death during long-term follow-up.     

血清总胆红素与冠状动脉粥样硬化相关性的探讨

目的探讨血清总胆红素(TBIL)水平与冠状动脉粥样硬化的关系.方法根据178例冠状动脉造影的结果,将其分成正常组与疾病组,疾病组中依据冠状动脉狭窄程度和范围分成轻度狭窄组和重度狭窄组,根据临床、心肌酶学、心电图又将疾病组分为急性冠状动脉病变组和非急性冠状动脉病变组,将各组的血清TBIL进行比较分析.结果正常组血清总胆红素显著高于疾病组(P<0.01),血清TBIL水平与冠状动脉粥样硬化狭窄程度和范围呈负相关(P<0.01),急性冠状动脉病变患者血清总胆红素水平明显升高(P<0.01).结论血清总胆红素对冠状动脉可能有一定的保护作用.     

RACK1基因在急性冠脉综合征行PCI术患者外周血中的表达及意义

选取在我院行PCI术的急性冠脉综合征患者66例,用实时荧光定量PCR法分别测定PCI术前及术后3个月时患者外周血单个核细胞中RACK1基因的表达。40名健康者作为对照组。测定结果是:(1)急性冠脉综合征组患者外周血单个核细胞中RACK1 mRNA表达水平明显高于对照组(17.56±4.98 vs 3.11±1.24,P0.05);(2)急性冠脉综合征患者行PCI术3月后,外周血单个核细胞中RACK1 mRNA表达水平较术前明显降低(10.84±3.71 vs 17.56±4.98,P0.05),但仍高于健康者(10.84±3.71 vs 3.11±1.24,P0.05)。RACK1在急性冠脉综合征患者外周血中表达上调,其表达水平可能和病情进展相关。     

链霉菌S1的抑菌活性及其对植物病害的防治

摘要： 为了探明链霉菌S1的抑菌活性及其对植物病害的防控作用,通过抑菌圈法研究了链霉菌S1对不同病原菌的抑制作用并分析了菌株S1是否合成几丁质酶和葡聚糖酶,筛选了菌株S1的最佳发酵培养基、发酵时间和最佳接种量,进一步优化发酵培养条件。通过温室防效实验,研究了链霉菌S1发酵液对桃核腐病和番茄根结线虫的防治作用。结果表明：链霉菌S1对多种病原菌有较好的抑菌作用,其中对桃褐腐病原真菌（Monilinia fructicola）和平菇褐斑病原细菌（Pseudomonas tolaasii）的抑制效果最佳。菌株S1能够合成几丁质酶,不能合成葡聚糖酶。链霉菌S1的最佳发酵培养基为G117,最佳发酵时间为3 d,最佳接种量为8%。链霉菌S1的发酵上清液和发酵液对桃核腐病具有显著的防治作用,防效可到达80.66%。发酵代谢产物对番茄根结线虫的杀线活性最高可达90%,发酵原液对番茄根结线虫的防治效果最高到达71.02%。可见链霉菌S1具有较好的防治作用,为植物病害生物防治提供了优良的菌种资源。