王安忆小说的女性意识

王安忆的小说一以贯之地强调女性柔弱而绵长的旺盛生命力,她以细腻的笔法、悲悯的情怀娓娓叙说着一个个女性的令人感慨的命运与灵魂,其愈来愈独特、越来越成熟的创作,成功地表达着女性意识。     

从淡淡的哀愁到竭力的批判——20世纪二三十年代乡土小说比较研究

乡土小说的兴盛,是20世纪20年代中国文学的一个突出现象。20年代的乡土小说主要呈现忧郁、哀伤、凄婉的格调,蕴涵着淡淡的哀愁,而20世纪30年代的乡土小说由于时代的变迁和作家主观认识度的加深,较20世纪20年代的乡土小说更具有力度,更多地体现出一种社会性和民族性,对现存的社会现状充满竭力的批判。     

关注欧盟新资源食品法规提案

文章从新资源食品的定义（包括影响到食品的新技术）和新资源食品法规的范围、对来自第三方国家的传统食品的要求、新资源食品的审批和授权,以及激励创新4个方面对提案进行了剖析,并对我国食品出口企业如何规避这一新的技术性贸易壁垒提出对策建议。     

Clinical and economic benefits of extended treatment with apixaban for the treatment and prevention of recurrent venous thromboembolism in Canada

Background and objective Venous thromboembolism (VTE) is associated with long-term clinical and economic burden. Clinical guidelines generally recommend at least 3 months of anticoagulation, but, in clinical practice, concerns over bleeding risk often limit extended treatment. Apixaban was studied for extended VTE treatment in the AMPLIFY-EXT trial, demonstrating superiority to placebo in VTE reduction without increasing risk of major bleeding. This study assessed the long-term clinical and economic benefits of extending treatment with apixaban when clinical equipoise exists compared to standard of care with enoxaparin/warfarin and other novel oral anti-coagulants (NOACs) for the treatment and prevention of recurrent VTE in Canada.

Methods A Markov model was developed to follow patients with VTE over their lifetimes. Efficacy and safety for apixaban and enoxaparin/warfarin were based on AMPLIFY and AMPLIFY-EXT, while relative efficacy to other NOACs was synthesized by network meta-analysis (NMA). Dosages for NOACs and enoxaparin/warfarin were based on their respective trials and were given up to 18 months and up to 6 months, followed by no treatment, respectively. Patient quality adjusted life years (QALYs) were based on published studies, and costs for resource utilization were from a Ministry of Health perspective, expressed as 2014 CAD ($).

Results Extended treatment with apixaban compared to enoxaparin/warfarin resulted in fewer recurrent VTEs, VTE-related deaths, and bleeding events, but at slightly increased cost. The incremental cost-effectiveness ratio was $4828 per QALY gained. Compared to other NOACs, apixaban had the fewest bleeding events, similar recurrent VTE events, and the lowest overall cost, which was driven by the strong bleeding profile. In scenario analyses of acute and lifetime treatments, apixaban was cost-effective against all strategies.

Conclusions Extended treatment with apixaban can offer substantial clinical benefits and is a cost-effective alternative to enoxaparin/warfarin and other NOACs.     

Impact of novel agents on patient-relevant outcomes in patients with previously untreated chronic lymphocytic leukemia who are not eligible for fludarabine-based therapy

Background: Chronic lymphocytic leukemia (CLL) is an orphan disease that primarily affects the elderly. The majority of symptomatic patients eligible for frontline treatment are unfit for fludarabine based chemoimmunotherapy. Historical treatment includes chlorambucil (Chl), bendamustine/rituximab (BR), and chlorambucil/rituximab/ChlR combination. Clinical guidelines now recommend the use of novel agents, such as ibrutinib (Ibr), in both frontline and relapse settings and other novel agents, such as idelalisib (with rituximab), in relapse settings. Despite compelling clinical results for novel agents, follow-up in clinical trials is relatively short and, thus, the comparative long-term benefits are still unknown.

Materials and methods: The authors developed a simulation model to generate treatment specific lifetime estimates of Overall Survival (OS) and Quality Adjusted Life Years (QALYs) for treatment with BR, Chl, ChlR, and Ibr. Two potential clinical scenarios were modelled: with and without novel agents for treating CLL. The model was based on health states relating to first- and second-line progression-free survival (PFS), post-progression survival, and death.

Results: Where novel agents were assumed unavailable, mean OS ranged from 5.4–8.5 years and QALYs from 3.5–6.1. Where novel agents were available, the mean OS increased to 10.0 years, with a corresponding increase in QALYs to 7.6. Frontline Ibr use followed by Physician’s Choice, including novel agents at relapse, resulted in projected increase in OS of between 18% (1.5 years) and 85% (4.6 years), corresponding to a 25–117% increase in QALYs, compared with currently available traditional therapies.

Limitations: The limitations of this analysis include immature OS data and the assumption of equivalent efficacy across all novel agents in terms of their impact on PFS and OS.

Conclusions: The use of novel agents is predicted to yield substantive gains in predicted lifetime OS and QALY improvements compared to traditional therapies in CLL patients who are ineligible for fludarabine-based chemoimmunotherapy.     

以小说的方式言说文化：文化悬念小说价值阐释——兼评宋耀良《西夏谜城》

与传统悬念小说不同,新悬念小说包括知识悬疑小说和文化悬念小说,在满足读者的解谜欲之外,更多地着眼于人的求知欲,激发人的好奇心。这种类型小说中的文化悬念小说是国外知识悬疑小说中国化后引入的一个概念,传承了＂文以载道＂的传统,以小说的方式言说文化。宋耀良的《西夏谜城》在文化悬念小说作品中颇具代表性。作品以小说的形式来解谜一个消失的王朝———西夏,让被称为＂东方金字塔＂的西夏王陵、拥有过＂中世纪图书馆＂的黑城遗址和＂乍视字皆可识,熟识无一字可识＂的西夏文字等诸多西夏之谜在普通人的眼里绽放出生命的＂音容笑貌、歌舞哀哭＂。     

老舍小说中的文化意识

老舍在小说中以犀利的笔触揭示了民族的恶习,严肃批判了传统文化中存在的弊端。只有从愚昧麻木的状态变成积极主动的现代人,改变落后的社会心理状态,中华民族的优秀传统文化才能在传承中进化前行。     

温庭筠与《干■子》的创作

温庭筠是晚唐著名的诗人和词人,在文学史上有着重要的地位。才华使温庭筠负有盛名,然而,由于他士行尘杂,不修边幅,酣醉终日,由是累年不第。最后竟落得为当涂者所薄,名宦不进,坎坷终身的悲惨境遇。温庭筠的小说创作和当时的社会风气有关。温庭筠创作《干■子》的动机一是能悦众心;二是能抒己心。《干子》问世于晚唐时期,原书已不存,今人可从《太平广记》、《类说》、《绀珠集》等旧籍搜罗佚文。《太平广记》录佚文33篇,王汝涛编校的《全唐小说》共收有33篇。     

亦真亦幻的错综世界——白先勇小说《游园惊梦》新探

关于白先勇的小说《游园惊梦》,前人评论已经不少,著名的评论家有欧阳子、隐地、刘俊等,脱口而出的有悲天悯人的情怀、传统文化的眷恋、王谢堂前燕的今昔之感等等,这篇文章是在前人评论的基础上,通过文本细读的方法,从新的角度探索其艺术特点,探索作者的用意。     

多层螺旋CT薄层图像与多平面重组图像在真菌性肺炎患者诊断中的应用价值

目的：探讨多层螺旋CT薄层图像与多平面重组（MPR）图像在真菌性肺炎患者诊断中的应用价值。方法选取河南省郑州市中医院肺病科接受治疗的50例真菌性肺炎患者，分别采用多层螺旋CT薄层图像与MPR图像方法进行诊断，分析两种检测方法各种征象的显示结果情况及各种真菌感染病变的累及情况。结果采用两种方法进行检测后，白色念珠菌、放线菌以及曲菌3种细菌感染肺部的累及情况比较，差异无统计学意义（P＞0.05）。分别采用两种方法对50例真菌性肺炎患者进行检测后，MIR图像各种征象的显示结果明显高于多层螺旋CT薄层图像的各种征象的显示结果，差异统计有学意义（P＜0.05）。结论多层螺旋CT薄层图像与MPR图像在诊断真菌性肺炎中的临床价值明显，而MPR图像的检测结果更为准确，但同时联合应用两种方法更能有效对病变的情况进行检测。