简介：系统科学和控制论在二次世界大战以后出现在年里。这些地创造了许多新途径到工程和管理并且贡献了新想法到存在的学术地。新地也越过地的一个范围识别了类似的概念并且开始创造了系统的一个一般理论。另外，系统科学为管理复杂系统创造了许多方法，例如后勤，运筹学和计算机模拟。在1970年代，关于人口和环境平衡有担心。当前与统治正在增加担心，后来，问题的表示的率似乎比我们的机构的能力很好管理他们。这篇论文将讨论系统科学的历史，控制论，提出的问题和答案求婚，困难在在当代的大学和现在在进行之中的研究的一些令人激动的线以内发现一个家遇到了。

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简介：数据是清楚的：人类正在面对一个全球社会经济的危机。全球身体在结束neoliberal寻找答案独占性，而非自由的市场，经济，并且在在社会责任的标签下面的全身的行为的介绍。支持这个努力，在这贡献被报导关于的研究，建议社会责任的全身的感觉引起滥用的结束，社会责任，并且合适的经济前提的提升的策略，由行动的几根线支持了，所有人能触发它。

简介：AbstractSystemic sclerosis (SSc) is characterized by immune dysfunction, vasculopathy, chronic fibrosis of skin and internal organs with complex etiology. With the rapid development and the application in biomedicine of epigenetics, accumulating evidence has shown that epigenetics plays an important role in the pathogenesis of SSc. Environmental factors via epigenetics are needed to trigger and maintain for the disease in the subjects with genetic predisposition to SSc. The role of epigenetics in the pathogenesis of SSc includes hypermethylation of the promoter region of nitric oxide synthase and bone morphogenetic protein receptors II, up-regulation of histone deacetylases 4 and 5 expression, and down-regulation of miR-193b and miR-152 in endothelial cells inducing vascular dysfunction; DNA hypermethylation and hypoacetylation of histone H3 and H4 in Friend leukemia virus integration 1 and Kruppel-like factor 5 genes, and the abnormal expression of miR-29, miR-129-5p and miR-135b in fibroblasts causing excessive fibrosis; DNA hypomethylation in the promoter regions of CD11a and CD70 genes in CD4+T cells resulting in immune dysfunction. Studies on the role of epigenetics in SSc are of great significance for better understanding the pathogenic machanism of SSc, which is helpful to find new molecular targets for treating SSc, and consequently, improve the prognosis of SSc.

简介：Theworldpost-9/11ischaracterisedbyuncertainty,fearandsuspicion.Psychologicalconfrontationsamplifiedbythemassmediahaveevencometodominatephysicalengagementsbetweenwarringparties.Dramatheoryprovidesapowerfulframeworkforunderstandingtheseinteractionsinmuchthewaythatgametheorywasabletosupportstrategymakingbyautonomousplayersinalessinter-connectedera.Amodelofthe'normal'processleadingtodramaticresolutionisanessentialfeatureofthedramatheoryapproachandisdescribedhere.Howeverthisprocesscanbederailedorfailinmanyways.Thispaperreviewsmanyofthesesystemicpathologiesandillustratessomeofthemthroughconsiderationofthreehigh-profilecases.Theconclusionisthatitisimportanttorecogniseandpossiblytousepathologicalbehaviorasanelementofacharacter'sinteractionstrategy.

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简介：AbstractSystemic lupus erythematosus (SLE) is an autoimmune disease with extreme heterogeneity and potentially involvement of any organ or system. Numerous unanswered questions and challenges in SLE always prompt further exploration. In 2019, great progress in various aspects of SLE emerged. Both the classification criteria and management recommendation for SLE were updated. New promising medications have been widely developed and tested, although subsequent clinical studies are warranted. As an emerging number of most notable studies in SLE were published in both clinical area and basic research in 2019, we aim to summarize the highest quality data on SLE regarding novel insights of pathogenesis, updated recommendations, hot-spot issues on clinical manifestations, new understanding of disease prognosis, and most importantly, the therapeutic advances in SLE in this review.

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简介：AbstractIntroduction:Primary systemic amyloidosis is characterized by clonal plasma cell disorder, and its signs and symptoms are various and complex, damage to the skin and mucous membrane is often more likely to attract attention.Here we reported a case of a 61-year-old male patient who presented with topical mucocutaneous lesion, as well unusual skin vegetations.Case presentation:A 61-year-old man was hospitalized due to repeated burning sensation on his back, multiple ecchymosis, and skin vegetations. Through a series of examinations (mainly including skin histopathology, bone marrow cytology, bone marrow flow cytometry, immunofixation electrophoresis), Primary systemic amyloidosis was diagnosed, but multiple myeloma could not be diagnosed. Subsequently, he received chemotherapy. In the half-year follow-up, there was no significant change in his symptoms and signs.Discussion:In this case, in addition to the typical skin damage of primary amyloidosis, the multiple skin vegetations in the buttocks, abdomen, and arms are particularly noteworthy. According to the histopathology and Immunohistochemistry of the skin vegetation, we infer that the formation mechanism of these skin vegetation is lymphatic obstruction caused by amyloid, which leads to lymphatic dilatation, lymph leakage, and dermal edema.Conclusion:Primary systemic amyloidosis is a rare disease, which is often difficult to diagnose. We should be alert to those atypical skin features so as not to delay diagnosis.

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简介：Inthecomingyearslifeexpectancyisexpectedtoincreaseandwiththisthepercentageofthepopulationaboveage65willgrow.Patientsabove65makeupmorethantwothirdsofthosecurrentlydiagnosedwithgastrointestinalmalignancies.Availableevidencebasedmedicinedoesnotfocusontheaveragepatient,abovetheage70,encounteredineverydaypractice.Mostguidelinesandclinicaltrialsarenotdesignedtotakeintoaccountthespecialconsiderationsneededwhentreatingtheelderlysuchasfunctionalstatus,comorbidities,polypharmacy,lifeexpectancy,andsocialsupport.Themajorityofavailabledataisbasedonretrospectivereviewsorsubsetanalysesoflargerstudieswheretheelderlyrepresentafractionofthestudiedpopulation.Thisreviewfocusesonthetoxicitiesandtolerabilityofcurrentstandardtherapiesfornoncolorectalgastrointestinalmalignancies,includinggastroesophageal,pancreatic,bileductandhepatocellularcancersintheelderly.Withcarefulpatientselectionandgeriatricassessmenttheelderlycansafelybenefitfromstandardtherapiesofferedtoyoungerpatients.

简介：AIM:Toestimatethepotentialsystemiceventsduringandafterretinopathyofprematurity（ROP）screening.METHODS:Aprospectiveanddescriptivedesignedstudywasconductedtodetectthephysiologicandpathologicalchanges24hbefore,during,and72hafterROPscreening.Controlbloodpressure（BP）,saturation,pulserate,andbodytemperaturewereroutinelytakenatvarioustimeinternalsbeforeandafterscreening.Adverseeffectspertaintocardiovascularsystem,respiratorysystem,gastricsystem,urinarysystemandnervoussystemwereretrospect0-72hafterROPscreeningata24-hourinterval.RESULTS:Totally1254prematuritybabiesreceivingROPscreeningduringJan.1st2013toDec.31th2013wereenrolledinoursurvey.Comparedtocontrolvitalsigndatatakenbeforetheexamination,therewasafluctuationinthediastolicBPwiththeincreased3.03mmHg（P=0.04）after3dosesofmydriaticdrops.Immediatelyaftertheexamination,therewasafurther12.64mmHg（P<0.01）increaseinsystolicBPanda7.24mmHg（P<0.01）indiastolicBP.Themeanpulserateduringexaminationwas22.4bpm（P<0.01）higherthanthe133.3±9.0bpmcontrollevel.Theoxygensaturationsharedanaveragedropof5%（P<0.01）duringscreening.Inprematuritywithpostconceptionalagelessthan31wk,theincidenceofapnea（23.5%）,necrotizingenterocolitis（NEC）（8.7%）,gastricresidual（25.4%）andupperdigestivetracthemorrhage（6.4%）alsodemonstratedasignificantrise（P<0.01）.CONCLUSION:Inourstudysample,ROPscreeningwasassociatedwithNEC,gastricresidualandupperdigestivetracthemorrhage.Thesegastrointestinalsideeffects,alongwithbreathactivitypatternchangeandvitalsignsindicatorsfluctuation,mayberesultsofadditionalstressresponses.

简介：Takingintoconsiderationthecharacteristicsofnowadayssociety,thispaperhasadvancedthesystemicthinkingonthebuildingofEnterprises'"ThreeCycle"IntegrationStructure.Afterpointingout,theprinciplesofoptimizationbetweentheoreticstructureandexecutivestructure,thispaperhasbroughtforwardtheEnterprises'"ThreeCycle"IntegrationStructureanditsinherentrelationshipamongeachcycle.

简介：全身的煽动性的反应症候群(先生)和得分系统的概念被骨头的杂志在1992定义。先生在四(发烧或降低体温，tachypnea，心悸亢进，和白细胞增多)被描述为二的出现或更多的临床的标准。Anearly在病人的全身的发炎的诊断和评价对治疗有用选举。这篇论文考察获得系统的先生的申请，它广泛地与严重损害和批评外科的疾病为批评照顾病人的大组被验证了。最近的研究在批评照顾病人作为不利结果的一个重要预兆的参数记录了先生分数。而且，一些研究也给我们上的一个建议岩山引出超载全身的反应。

简介：Hepaticinvolvementinaggressivesystemicmastocytosis(ASM)isrelativelycommon,andthemainclinicalfeaturesofthisdiseaseincludehepatomegaly,portalhypertension,ascites,andfibrosis.CirrhosisisarareASMsymptom.WereportanASMcasethatinitiallymimickedcirrhosisbasedonclinicalandradiographicanalyses.Theportaltractwasexpandedbymononuclearinflammatorycells,andanincreaseincollagenamountwasobservedinroutinehistologicalsectionsofthebiopsiedliver.Adiagnosisofsystemicmastocytosis(SM)wasmadeafterancillarytestsformastcellsusingbonemarrowaspirates.Extensiveinvolvementoftheliverandgastrointestinaltractwasobserved.CliniciansandpathologistsneedtoconsiderASMasadiagnosisordifferentialdiagnosisinaclinicalcaseofcirrhosiswithunknownetiology.Thediagnosiscanbeconfirmedordisregardedbyimmunohistochemicalstainingandmolecularanalysis.

简介：AutoreactiveB房间是在全身的豺狼座erythematosus(SLE)的致病被含有的关键有免疫力的房间之一。除了有害自身抗体(auto-Abs)的生产，B房间作为介绍抗原的房间告知autoreactiveT房间并且分泌大量支持inflammatorycytokines有autocrine和paracrine效果。调制B房间的代理人可能因此具有潜在的治疗学的价值。当前的策略包括指向B房间表面抗原，cytokines支持B房间生长和功能，和B房间和T房间相互作用。在这篇文章，我们在动物和人的研究在SLE考察B细胞的角色，并且我们检验为这个条件的处理作为有希望的策略支持B房间调整的以前的报告。另外，我们在场评估了在人的SLE反对CD20，CD22和B淋巴细胞激发器(BLyS)的代理人的治疗学的功效和安全的临床的试用上的更改。当这些研究的许多的结果仍然保持不确定时，belimumab，对BLyS的人的monoclonal抗体，显示出诺言并且最近被US食物药品管理局为病人作为显示的治疗同意了与对中等SLE温和。无疑，在B房间免疫学的进展将继续带我们到SLE致病的更好的理解和指向B房间的新奇特定的治疗的发展。

简介：BackgroundLeftventricularhypertrophy(LVH)inducedbysystemichypertensionrepresentsamaladaptiveresponsetotheincreasedoverload.HoweverantihypertensivetreatmentsarenotalwaysusefultoregressorpreventLVH.Thoroughlyunderstandingthemechanismswillhelptofindnewtherapeutictargetsthatpreventorreverseleftventricularhypertrophy.Anumberofregulatorsandmolecularsignalingpathwayshavebeenshowntobeinvolvedinthehypertrophicprocess,suchasangiotensinII,heatshockproteins90,microRNAs,TRPC,mTOR,HDACandPI3K/Aktsignalingpathways.Therefore,othertreatments,suchasG1cyclinantagonists,HSP90inhibitor,Rho-kinaseinhibitor,calcineurinblockers,CS866,statins,scutellarin,andaldosteroneantagonistcouldpreventleftventricularhypertrophy.