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目的评价应用国产化冠状动脉CT血管造影（CTA）图像模拟的无创血流储备分数（FFRCT）对功能性心肌缺血的诊断价值。方法回顾性纳入2012年8月-2015年7月解放军总医院同期行冠脉CTA和FFRCT检查的39例患者,基于冠脉CTA图像通过流体力学原理模拟计算FFRCT值,以有创的FFR值为参考标准,分别从患者水平和血管水平计算FFRCT对功能性心肌缺血的诊断准确性、特异度、敏感度、阳性预测值和阴性预测值。结果在患者水平FFRCT的诊断准确性为82.05%,敏感度为83.33%,特异度为80.95%,阳性预测值为78.95%,阴性预测值为85.00%;在血管水平FFRCT的诊断准确性为76.79%,敏感度为69.57%,特异度为81.82%,阳性预测值为72.73%,阴性预测值为79.41%。在患者水平FFRCT的ROC曲线下面积为0.826;在血管水平FFRCT的ROC曲线下面积为0.786。在血管水平,FFRCT值与FFR值之间呈显著正相关（r=0.644,95%CI：0.458-0.775）。结论以FFR值作为参考标准,应用国产化无创FFRCT技术诊断功能性心肌缺血具有较高的准确率,临床应用前景较好。

目的探讨育龄期妇女月经紊乱症状与卵巢储备功能下降的关系。方法回顾分析2009年11月-2011年8月收治的282例育龄妇女的临床资料,其中对照组101例,均为月经正常者,月经紊乱组181例,均为近1年出现月经紊乱患者。月经紊乱组按月经紊乱持续时间长短分为3个亚组：A组（n=47）,月经紊乱持续1-4个月,B组（n=59）,月经紊乱持续5-8个月,C组（n=75）,月经紊乱持续9-12个月;按月经改变类型分为4个亚组：组1（n=62）,经量减少;组2（n=27）,经量增多;组3（n=35）,周期缩短;组4（n=57）,周期延长。比较对照组与月经紊乱组间,A、B、C 3个亚组之间年龄、血清卵泡刺激素（FSH）、血清促黄体生成素（LH）、血清雌二醇（E2）、FSH/LH比值和窦卵泡（AFC）数目,并比较组1、组2、组3、组4上述指标与对照组的差异。结果月经紊乱组的年龄、基础FSH水平、FSH/LH比值均明显高于对照组（P〈0.05）,AFC数目则低于对照组（P〈0.05）;月经紊乱组A、B、C 3个亚组的年龄、FSH值、LH值、FSH/LH比值、AFC数目比较差异均有统计学意义（P〈0.05）,且随着月经紊乱持续时间的延长,年龄、FSH值、FSH/LH比值呈上升趋势,LH值和AFC数目呈下降趋势;组1、组2、组4的FSH值与对照组比较均有统计学意义（P〈0.05）,4个亚组的FSH/LH比值与对照组比较均明显升高（P〈0.05）,而AFC数目均明显降低（P〈0.05）,以组3为最低。结论月经紊乱育龄期妇女卵巢储备功能可能已下降,月经紊乱持续时间及月经周期改变可作为育龄妇女卵巢储备功能下降的敏感信号。

目的 探讨D-山梨醇肝脏清除率（CLh-s）法补充吲哚箐绿15min潴留率（ICGR15）和Child-Pugh分级相结合评估肝硬化门脉高压患者肝储备功能的可行性。方法 41名肝硬化门脉高压患者分别给予Child-Pugh分级、ICGR15、CLh-s检测评估肝储备功能，对前两种评估方法出现交叉重叠的患者，进一步分析其CLh-s值与手术并发症的相关性。结果 Child-Pugh分级与ICGR15值（以40％为界）交错重叠主要集中在B级和C级之间。在Child-Pugh分级B级的18例患者中，〉40％的患者有5例，术后3例出现明显并发症（CLh-s分别为629．52、509．79、450．71mL／min），2例未出现明显并发症（CLh-s分别为784．49、779．36mL／min）；在Child-Pugh分级C级的13例患者中，有4例ICGR15〈40％的患者，2例行手术治疗，其中1例出现并发症（CLh-s为484．57mL／min）。1例未出现明显并发症（CLh-s为723．36mL／min）。概括之，CLh—s〉700mL／min者，手术并发症少；CLh-s〈700mL／min，者手术并发症多。结论 CLh-s与肝硬化门脉高压患者手术并发症有关。该法可对ICGR15和Child-Pugh分级联合评估肝储备功能时出现交叉重叠者进一步分类，使肝储备功能评估更为准确可靠。

目標：在高齡化人口中，伴隨老化而來的認知障礙益發受到重視。如何維持中老年人認知功能是一重要課題。本研究欲藉國內大型世代資料，分析台灣中老年人閱讀與認知衰退的關聯性。方法：本研究分析「台灣地區中老年身心社會生活狀況長期追蹤調查」2003及2007年資料。以2003年為基礎點，排除有認知功能缺損或不識字者，及非本人作答或資料不全者，得3,147位≥50歲之研究個案。以羅吉斯迴歸(logistic regression)控制社會人口學、健康狀況及健康行為等變項，分析高低閱讀頻率與四年後認知衰退之關聯。結果：若將閱讀活動保留在所有休閒活動(共十項)中，結果顯示高休閒參與者(≥3項/週)的認知衰退風險較低(OR=0.56, p＜0.001)。若將閱讀活動從休閒項目中個別獨立出來，結果顯示高休閒參與者的認知衰退風險雖仍較低(OR=0.73, p=0.050)，但關聯性較弱；而有高閱讀頻率者的衰退風險則明顯低於低閱讀頻率者(OR=0.51, p＜0.001)。另依教育程度分群分析，發現高休閒參與或高閱讀頻率(OR=0.57, 0.50;p＜0.01)皆對低受教育年數(0-6年)受訪者的認知衰退有延緩作用，但對高教育年數受訪者的影響則不明顯。結論：本研究凸顯閱讀對預防中老年人認知退的重要性。建議中老年人養成每週至少閱讀一次的習慣，以促進認知功能健康及延緩衰退。

ABSTRACT Land use change in prairie ecosystems is pervasive. Prairie obligate species may be affected by these changes, though many carnivore‐specific examples are unknown. We used 3 years (2018–2020) of camera‐trap (n = 381) data from Kansas, USA, to assess multiscale effects of landscape composition on habitat use by American badgers (badger, Taxidea taxus). We predicted that site occupancy and colonization would be positively associated with the amount of prairie surrounding sites. We also predicted that site occupancy and colonization would be negatively related to amounts of agriculture and the number of wind towers surrounding sites. Badgers were insensitive to amounts of prairie surrounding sites and likely to occupy and colonize sites surrounded by row‐crop agriculture. Badgers were also less likely to occupy sites farther from permanent water. Badgers may be exploiting agricultural areas because of increased prey densities or suitable burrowing substrates. Moreover, our study highlights the importance of water resources to badgers in arid regions.

Scientific site selection is the first step in constructing underground water-sealed petroleum storage depots, but no uniform standard and code for such activity has been established. Therefore, the main objective of this study is to propose an evaluation method for the site selection of an underground water-sealed petroleum storage depot. The first large underground water-sealed petroleum storage depot being built in China served as the background of this study. The following 12 indexes were used as evaluation factors based on comprehensive evaluation criteria and specifications for key project site selection: geographic structure development feature, topographic feature, lithostratic formation feature, crustal stress, strength of rock mass, joint development feature, hydrogeological conditions, long-term water sealing conditions, environmental/ecological vulnerability, regional stability, technical and economic conditions, and meteorological and hydrological conditions. The weight back analysis and power coefficient methods were also used to evaluate the site selected for the first underground water-sealed petroleum storage depot project. Petroleum site classification models based on the two aforementioned methods were established and used to verify the feasibility of the evaluation criteria and methods, and the evaluation results show the grade of the site selected for the underground water-sealed petroleum storage depot in Huangdao, China is good. The study results may be used as a reference for the site selection of future underground water-sealed petroleum storage depots.

This paper proposes an optimal dynamic reserve activation plan after the occurrence of an emergency situation (generator/transmission line outage, load increase or both). An optimal plan is developed to handle the emergency, using the coordinated action of fast and slow reserves, for secure operation with minimum overall cost. It considers the reserves supplied by the conventional thermal generators (spinning reserves), hydro power units and load demands (demand-side reserves). The optimal backing down of costly/fast reserves and bringing up of slow reserves in each sub-interval in an integrated manner is proposed. The proposed reserve activation approaches are solved using the genetic algorithm, and some of the simulation results are also compared using the Matlab optimization toolbox and the general algebraic modeling system (GAMS) software. The simulation studies are performed on the IEEE 30, 57 and 300 bus test systems. These results demonstrate the advantage of the proposed integrated/dynamic reserve activation plan over the conventional/sequential approach.

Objective：The objective was to delineate the current knowledge of fractional flow reserve （FFR） in terms of definition,features,clinical applications,and pitfalls of measurement of FFR.Data Sources：We searched database for primary studies published in English.The database of National Library of Medicine （NLM）,MEDLINE,and PubMed up to July 2014 was used to conduct a search using the keyword term ＂FFR＂.Study Selection：The articles about the definition,features,clinical application,and pitfalls of measurement of FFR were identified,retrieved,and reviewed.Results：Coronary pressure-derived FFR rapidly assesses the hemodynamic significance of individual coronary artery lesions and can readily be performed in the catheterization laboratory.The use of FFR has been shown to effectively guide coronary revascularization procedures leading to improved patient outcomes.Conclusions：FFR is a valuable tool to determine the functional significance of coronary stenosis.It combines physiological and anatomical information,and can be followed immediately by percutaneous coronary intervention （PCI） if necessary.The technique of FFR measurement can be performed easily,rapidly,and safely in the catheterization laboratory.By systematic use of FFR in dubious stenosis and multi-vessel disease,PCI can be made an even more effective and better treatment than it is currently.The current clinical evidence for FFR should encourage cardiologists to use this tool in the catheterization laboratory.

To the Editor： In one of the latest issues, Hu et al, carried out a national retrospective cohort study and investigated the clinical outcomes and cost of fractional flow reserve （FFR） guided percutaneous coronary intervention （PCI） in daily practice. FFR guided PCI was shown to improve the clinical outcomes with reduced cost, as demonstrated in the literature. We would like to expand the discussion part a little to figure out this issue more comprehensively.

Evaluating the effectiveness of protecting nature assets is a vital component of responsive, pro-active management of protected areas. It is important to protect reserves of geological （including fossils） assets as a means to also protect national and natural heritage. At the end of 2013, 2669 protected areas had been established in China and 123 of them are reserves for nature assets. This paper builds an evaluation framework for protection effectiveness of these assets. The current elements and characteristics for effective protection are analyzed, along with an analysis of existing problems so as to construct a scientific approach to protect these assets. The influencing elements and characteristics for effective protection of nature asset reserves are included in an index evaluation system for effective protection in such areas, which contains four parts-target layer, evaluation criteria, evaluation indexes, and evaluation parameters-based on related documents and files. For the target layer, it includes nature asset evaluation and management evaluation. In the end, it is discussed how to build a comprehensive evaluation model and achieve an effective quantitative evaluation.