科创中国

进入21世纪,信息新技术的涌现让许多人热血沸腾.不过,作为信息服务业的主导者,运营商却一度徘徊在一个茫然的十字路口.他们憧憬着能全方位满足人们的通信需要,打造一个包容了各种技术手段和服务方式的强大平台,但谁也不清楚这样的平台是什么样的以及如何去实现.运营商能做什么?要做什么?变革、创新、竞争、矛盾、彷徨……在种种的未知与不确定面前,中国电信用"一去两化新三者"转型战略作答.

随着移动互联网蓬勃发展,电信消费和行业结构正在发生着从语音通信向数据通信、从桌面互联网向移动互联网、从量变走向质变的巨大转变,这种转变对运营商而言是巨大的机遇,更是前所未有的挑战.与此同时,智能终端和无线网络带宽的扩展,正在逐步改变网络发展的格局,有线网络将逐步被光网络以及无线网络替代.从全球4G的发展来看,利用4G、WiMAX等技术发展移动宽带替代对有线宽带的需求,已成为一种重要的发展趋势.移动互联网正在考量着电信运营商的思维方式、商业模式及运营机制等.

目的 系统评价红霉素用于提高成年危重患者肠内营养(EN)耐受性的有效性和安全性.方法 检索美国国立医学图书馆PubMed数据库、荷兰医学文摘EMbase数据库、Cochrane临床试验数据库、中国知网CNKI和万方数据库,查找从建库至2013年6月有关成年危重患者使用红霉素提高EN耐受性或提高EN置管成功率的随机对照临床试验(RCT).由2位研究人员独立筛选文献、提取资料和评价质量后,采用RevMan 5.2软件进行荟萃分析(Meta分析).结果 最终纳入16个RCT,其中改善EN耐受性的研究10个,共668例患者;提高胃肠置管成功率的研究6个,共353例患者.Meta分析结果显示:红霉素与安慰剂相比能显著提高鼻肠管幽门后置管成功率[相对危险度(RR)=1.82,95%可信区间(95%CI)为1.40~2.37,P<0.000 01],而与甲氧氯普胺相比则差异无统计学意义(RR=1.04,95%CI为0.79~ 1.36,P=0.799).对需要进行早期EN的患者,红霉素组试验5d时胃内喂养成功率较安慰剂或空白对照组明显升高(RR=1.89,95%CI为1.19 ~3.00,P=0.007).对EN不耐受的患者,红霉素较甲氧氯普胺可显著增加24 h胃内喂养成功率(RR=1.30,95%CI为1.02~ 1.66,P=0.03)、72 h胃内喂养成功率(RR=1.57,95%CI为1.15 ~2.14,P=0.005)、144 h胃内喂养成功率(RR=2.04,95% CI为1.23~3.37,P=0.006);红霉素组喂养失败的中位时间晚于甲氧氯普胺组.5个研究进行了不良反应的报告,除了红霉素与甲氧氯普胺联合治疗组腹泻发生率明显高于红霉素单药治疗外,其他差异均无统计学意义.结论 红霉素能显著提高危重患者幽门后营养管置管成功率,可以成为床旁无引导条件下置管前的一种辅助手段.目前的证据支持对EN不耐受的危重患者静脉给予小剂量(3 mg/kg)红霉素治疗.

目的 分析探讨儿童颅内感染的临床药物治疗.方法 以88例颅内感染患儿为研究对象,主要采取静脉应用抗菌药物的同时增加鞘内给予新型的抗菌药物万古霉素、头孢他啶、拉氧头孢等联合治疗.结果 参与本次临床调查诊治的88例患儿中,3例死亡,其余85例均治愈且后期随访效果良好.结论 临床治疗儿童颅内细菌感染,应采取早诊断早治疗的原则,应用鞘内给予抗菌药物可有效治疗神经外科的颅内感染,降低临床致死致残率,疗程短起效快,经济安全,值得临床推广应用.

Human activity has been shown to influence how animals assess the risk of predation, but we know little about the spatial scale of such impacts. We quantified how vigilance and flight behavior in mule deer Odocoileus hemionus varied with distance from an area of concentrated human activity--a subalpine field station. An observer walked trails at various distances away from the station looking for deer. Upon encounter, the observer walked toward the focal animal and noted the distance at which it alerted and directed its attention to the approaching human (Alert Distance; AD), and the distance at which it fled (Flight Initiation Distance;. FID). AD and FID both increased nonlinearly with distance from the center of the field station, reaching pla- teaus around 250 m and 750 m, respectively. Deer also tended to flee by stotting or running, rather than by walking, when far from the station but they walked away when near the station. These results indicate that deer perceive lower risk near a focused area of human activity, and that vigilance and flight behaviors respond on somewhat different spatial scales. The concept of a spatial "human footprint" on behavior may be useful for understanding how human activities affect wildlife

上颌窦囊肿在鼻窦囊肿中最为常见,分为黏膜囊肿和黏液囊肿,多见于其底壁及内壁.传统的手术方式为柯-陆氏手术切除囊肿,随着功能性鼻内镜外科的开展,已逐步被鼻内镜手术所替代.本文回顾分析我科2003年1月-2011年1月期间,根据术前鼻窦CT冠状位及轴位检查对囊肿进行定位,

目的:通过开展"品管圈"活动降低门诊药房药品调剂内差,提高药事服务质量,提升工作人员工作积极性以及参与管理的意识和解决问题的能力.方法:在门诊药房开展"品管圈"活动,以圈员自愿参与的方式,运用多种统计学方法,按照"品管圈"的十大步骤进行计划、实施、确认和处置.结果:"品管圈"活动开展以来,门诊药房调剂内差由原来的每周28.4件下降至每周13.0件,下降54.23%;圈员能力评分由平均1~3分上升到4~5分.结论:"品管圈"活动可以显著降低门诊药房调剂内差,提高药事服务质量,保证儿童用药的安全、有效.

目的 改良眼眶内肿瘤摘除方法,更好的达到肿瘤摘除,减少外观畸形的效果.方法 外侧壁开眶术治疗球后肿瘤,并微型钛钉钛板内固定,积极做好围手术期护理.结果 手术完整摘除肿瘤26例,其中海绵状血管瘤14例,泪腺腺样囊性癌4例、泪腺多形性腺瘤4例、黄色肉芽肿4例.不全摘除18例,泪腺腺样囊癌4例、纤维瘤样增生5例、神经纤维瘤5例、梭形细胞瘤4例,全部手术顺利进行,无一倒发生严重并发症.结论 眼眶内肿瘤摘除并微型钛钉钛板内固定具有安全、方便、减少外观畸形的特点.严格执行操作流程,密切观察病情变化及时处理不良反应,防止并发症发生是治疗成功的关健.

Recursion?by?herbivores?is?the?repeated?use?of?the?same?site?or?plants.?Recursion?by?wild?animals?is?rarely?investigated?but?may?be?ubiquitous.?Optimal?foraging?theory?predicts?site?recursion?as?a?function?of?the?quality?of?the?site,?extent?of?its?last?use,?and?time?since?its?last?use?because?these?influence?site?resource?status?and?recovery.?We?used?GPS?collars,?behaviour?and?site?sampling?to?investigate?recursion?to?foraging?sites?for?two?elephant?Elephas?maximus?borneensis?herds?in?the?Lower?Kinabatangan?Wildlife?Sanctuary,?Borneo,?over?a?12?month?period.?Recursion?occurred?to?48?out?of?87?foraging?sites?and?was?most?common?within?48?hours?or?between?151-250?days,?indicating?two?different?types?ofrecursion.?Recursion?was?more?likely?to?occur?if?the?site?had?previously?been?occupied?for?longer.?Moreover,?the?time?spent?at?a?site?at?recursion?was?the?same?as?the?time?spent?at?the?site?on?the?first?occasion.?The?number?of?days?that?had?passed?between?the?first?visit?and?recursion?was?also?positively?correlated?with?how?much?time?was?spent?at?the?site?at?recursion.?Habitat?type?also?influenced?the?intensity?of?site-use,?with?more?time?spent?at?recursion?within?riverine/open?grass?areas?along?forest?margins?compared?to?other?habitat?types.?Recursion?is?a?common?behaviour?used?by?the?elephants?and?its?pattern?suggests?it?may?be?a?foraging?strategy?for?revisiting?areas?of?greater?value.?The?qualities?of?recursion?sites?might?usefully?be?incorporated?into?landscape?management?strategies?for?elephant?conservation?in?the?area?[Current?Zoology?60?(4):?551-559,?2014].

Fear?and?anxiety?may?be?adaptive?responses?to?life-threatening?situations,?and?animals?may?communicate?fear?to?others?vocally.?A?fundamental?understanding?of?fear?inducing?sounds?is?important?for?both?wildlife?conservation?and?management?because?it?helps?us?understand?how?to?design?repellents?and?also?how?(and?why)?animals?may?be?negatively?impacted?by?anthropogenic?sounds.?Nonlinear?phenomena--sounds?produced?by?the?desynchronization?of?vibrations?in?a?sound?production?system-are?commonly?found?in?stress-induced?animal?vocalizations,?such?as?in?alarm?calls,?mobbing?calls,?and?fear?screams.?There?are?several?functional?hypotheses?for?these?nonlinear?phenomena.?One?specific?hypothesis?is?the?unpredictability?hypothesis,?which?suggests?that?because?nonlinear?phenomena?are?more?variable?and?somewhat?unpredictable,?animals?are?less?likely?to?habituate?to?them.?Animals?should,?therefore,?have?a?prolonged?response?to?sounds?with?nonlinear?phenomena?than?sounds?without?them.?Most?of?the?studies?involving?nonlinear?phenomena?have?used?mammalian?subjects?and?conspecific?stimuli.?Our?study?fo-?cused?on?white-crowned?sparrows?(Zonotrichia?leucophrys?ssp.?oriantha)?and?used?synthesized?acoustic?stimuli?to?investigate?behavioral?responses?to?stimuli?with?and?without?nonlinear?phenomena.?We?predicted?that?birds?would?be?less?relaxed?after?hearing?a?stimulus?with?a?nonlinear?component.?We?calculated?the?difference?from?baseline?of?proportion?of?time?spent?in?relaxed?behaviors?and?performed?pair-wise?comparisons?between?a?pure?tone?control?stimulus?and?each?of?three?experimental?stimuli,?including?a?frequency?jump?up,?a?frequency?jump?down,?and?white?noise.?These?comparisons?showed?that?in?the?30q50?s?after?the?playback?experiment,?birds?were?significantly?less?relaxed?after?hearing?noise?or?an?abrupt?frequency?jump?down?an?octave?but?not?an?abrupt?frequency?jump?up?an?octave?or?a?pure?tone.?Nonlinear?phenomena,?therefore,?may?be?generally?arousing?to?animals?and?may?explain?why?these?acoustic?properties?are?commonly?fou