关键词： 重症肌无力   自身免疫性疾病   相关因素   治疗  

摘要： 重症肌无力(MG)是一种自身免疫性疾病,由针对神经-肌肉突触后膜的特异性自身抗体引起,常与许多自身免疫性疾病并存。MG治疗方案包括胆碱酯酶抑制剂、胸腺切除术、免疫抑制剂及血浆置换等。MG作为一种累及神经-肌肉接头的自身免疫性疾病,与其他自身免疫疾病共存时,可能使MG患者的疾病管理复杂化,干扰医疗护理,增加患者以及社会负担。文中就MG与其他常见的自身免疫性疾病伴发的相关机制、临床特征及综合治疗策略进行综述。

关键词： 正字   异体字   构造   变更   位置   代替   类型  

摘要： 此篇文章系基于本人已发表的“Causes of the formation of variant forms as a result of changed structure of character components(JCWS,2017.6)”第一章,弥补瑕疵、补充例子扩充而成,兹以表明之。汉字的异体字中有一些是由偏旁结构改变而成的异体字。这些异体字有的仅偏旁结构发生改变,而有的代替成其他字的同时,偏旁位置也发生改变,还有一些原本是两个偏旁的字,变为三个偏旁后,结构也随之改变。异体字的类型极其多样,本文考察并整理了这样的异体字的字形类型。

关键词： 庄子   重言   反复论辩   写作过程   思想进路   儒道会通  

摘要： 由于《庄子》的奇妙文体和不羁之思,加上历代的传抄、刻本亦不免讹误和异文,所以《庄子》还存在一些有待解决的语文问题,如历来训诂就对《知北游》中“汝唯莫必,无乎逃物”有误解,而《田子方》《庚桑楚》两篇也可能暗藏着错简。历来对《寓言》篇所谓“重言”也存在误断和误解。“重言”乃是著《庄子》者对其语言修辞和思想论辩特点的自我总结:《庄子》诸篇始终围绕着几个思想主题反复论辩、不断曼衍,所以全书就不能不“重意”而且“重言”了。《庄子》的这一特点,在儒家典籍《论语》《孟子》中也同样有所体现。理解了这个特点,有助于重新认识《庄子》文本逐渐曼衍的生成过程和反复推阐的思想进路以至于作者的归属。

关键词： 中古韵书   异体字   形声字   语音演变   声符替换  

摘要： 中古韵书中有些字的异体关系形成于语音演变。这些字通常为形声字。汉字读音改变,原有声符表音功能减弱,于是替换声符,新造字形。新字形和原字形在共时层面上互为异体字。本文考察“■”与“■”,“蝣”与“■”,“■”与“鲚”,“町”与“[田忝]”四组典型字例。该类现象的掘发可拓展汉字形音关系研究的角度和方法,丰富对异体字成因的认识。

关键词： 非物质文化遗产   民间文学   河西宝卷   翻译   文化构建  

摘要： 非物质文化遗产的翻译与传播是中国文化走出去的重要途径。宝卷作为民间文学类非物质文化遗产,主要包括河西宝卷、靖江宝卷、吴地宝卷等。河西宝卷是流传于甘肃省武威市、张掖市、酒泉市和嘉峪关市的传统民间说唱文学。民间文学蕴含着不同地域不同民族的文化基因,表达着各自不同的价值观念和审美情趣,如果在翻译中不注重文化的表达和传输,译文中就会出现晦涩难懂的句子,令目标语读者产生误解。要解决这一难题,促进非物质文化遗产的国际传播,翻译时必须弥补文化差异,避免误译、漏译等情况的发生。分析汉学家伊维德英译本《平天仙姑宝卷与其他河西宝卷》发现:民间文学翻译的文化构建可以从以下几方面来实现:在语言层面,采用文本对等理论;在结构方面,采用副文本策略;在技术路线方面,采用异化策略。

关键词： 重复保险   他保条款   责任   分摊  

摘要： 我国《保险法》第五十六条第二款允许当事人约定重复保险中各保险人的赔偿方式,但是多个其他保险条款竞合时如何处理则缺乏立法指引。解决该问题应当秉持“尽最大可能满足合同约定”和“遵循现行法体系”的原则。首先从社会性和强制性层面分出第一线责任承担者,其次在同一责任顺位中依约定初步确定各方应付保险金,总和超过被保险人应得保险金的,以实际保险金数额比例分担法确定最终赔偿责任;总和低于被保险人应得保险金的,不足部分依《保险法》第五十六条确定剩余赔偿责任。

关键词： RCEP   CPTPP   递归动态GTAP模型   区域贸易协定   对冲效应   贸易关税  

摘要： 采用递归动态GTA P模型,基于各国货物贸易实际关税减让承诺表确定各国彼此之间具体的关税减让程度,从宏观和微观角度定量预测模拟比较2021—2025年间RCE P与CPTPP对不同成员国产生的经济效应,评估RCEP对CPTPP所造成负面影响的对冲效果,发现RCEP与CPTPP对各自区域内成员国无论是宏观经济指标还是各行业产出较基准情形均有明显提升作用,但同时也会对非区域内成员国经济造成一定负面冲击;RCEP对CP T PP在宏观和微观经济方面所造成的不利影响有明显冲抵效果。针对模型运行结果,中国下一步需要积极消除非关税技术壁垒,充分做好加入CPTPP的各项准备工作,加快提升技术密集型产业的竞争优势,持续推动高技术产业升级优化。

关键词： 地质灾害   海洋灾害   地震灾害   水旱灾害   自然灾害   引发因素   气象灾害   森林火灾  

摘要： 地质灾害是指在自然或者人为因素的作用下形成的,对人类生命财产造成损失、对环境造成破坏的地质作用或地质现象。本文从气象灾害、水旱灾害、地震灾害、森林火灾、海洋灾害方面探讨了地质灾害与其的关系,可以说,其他自然灾害的动力作用常常成为地质灾害的引发因素。

关键词： hypospadias   pediatrics   testosterone   testosterone supplementation   glans diameter  

摘要： Purpose: Testosterone (T) administration prior to hypospadias surgery to increase glans size remains controversial. Understanding T's effect on glans width (GW) is essential to understanding its potential impact on surgical outcomes. We hypothesized that preoperative T in prepubertal boys significantly increases GW at the time of hypospadias surgery. Materials and Methods: Our single institutional database was queried to identify patients who underwent hypospadias surgery from 2016 to 2020, in which data for T administration and GW were available. Descriptive, nonparametric and categorical statistics were performed as indicated. Results: A total of 579 patients were eligible for analysis. Median age at surgery was 0.9 years (IQR 0.6-1.6). A total of 247/579 patients (42.7%) received T. The median GW at surgery was 15 mm (IQR 13-17). When comparing patients who had T administered to those who did not, we found a significant difference in GW at surgery (16 mm vs 14 mm, p <0.001). The median change in GW from the office to surgery was 4 mm for those receiving T vs 0 mm for those not receiving T (p <0.001). We identified a greater change in GW from preoperative to intraoperative measurements in patients who received 2 doses of T vs 1 dose (4 mm vs 2 mm, p <0.001). A histogram plot revealed the distribution of GW change at surgery. Conclusions: In our prospectively collected cohort of patients undergoing hypospadias surgery, we were able to quantitate the change in GW from preoperative T. Two doses of T resulted in a significant increase in GW vs 1 dose.

关键词： spectroscopy   near-infrared   brain mapping   urination   urodynamics  

摘要： Purpose: We explored the central pathogenesis of overactive bladder (OAB) and the central mechanism of action of sacral neuromodulation (SNM). Materials and Methods: We prospectively enrolled patients with OAB who chose SNM and healthy controls (HCs). At baseline, all subjects completed a 72-hour voiding diary, OAB symptom score and prefrontal cortex functional near-infrared spectroscopy scan synchronous urodynamic monitoring. All OAB patients were tested after implantation of the SNM electrode, and both success and failure groups were reevaluated. NIRS_KIT software was used to analyze prefrontal activity (p <0.05 and corrected by false discovery rate). SPSS(R) 22.0 was used to analyze clinical parameters, and p <0.05 was considered statistically significant. Results: A total of 16 HC and 20 OAB patients were enrolled. SNM treatment was successful in 18 OAB patients and failed in 2. The parameters of the voiding diary, OAB symptom score and urodynamic monitoring of OAB group were significantly improved after SNM treatment in success group, not in the failure group. Compared with HCs, Brodmann's area 9 (left dorsolateral prefrontal cortex [DLPFC]) was significantly deactivated in the preoperative OAB success group and significantly activated after SNM treatment. Before surgery, compared with the success group, the failure group showed significantly deactivated Brodmann's area 9 (left DLPFC). Conclusions: Our study provides novel neuroimaging evidence for the possible central pathogenesis of OAB (ie abnormal deactivation of the left DLPFC) and the possible central mechanism of action of SNM(ie restore activation of the left DLPFC).