目的检索并获取国内外慢性心力衰竭患者Ⅱ期心脏康复的最佳证据。方法检索BMJ Best Practice、UpToDate、国际指南协作网等指南网站,美国心脏协会等专业学会网站,PubMed、Web of Science、中国知网等数据库中有关慢性心力衰竭患者Ⅱ期...目的检索并获取国内外慢性心力衰竭患者Ⅱ期心脏康复的最佳证据。方法检索BMJ Best Practice、UpToDate、国际指南协作网等指南网站,美国心脏协会等专业学会网站,PubMed、Web of Science、中国知网等数据库中有关慢性心力衰竭患者Ⅱ期心脏康复的相关证据,证据类型包括临床决策、指南、专家共识、系统评价、最佳证据总结。由2名研究者对文献质量进行评价和资料提取。结果共纳入19篇文献,包括8篇指南、2篇临床决策、3篇专家共识、4篇系统评价和2篇证据总结。从多学科团队协作、场地及配置、评估、运动、药物、营养、心理、危险因素管理、健康教育、依从性监督10个方面形成30条最佳证据。结论该研究总结了慢性心力衰竭患者Ⅱ期心脏康复的最佳证据,可为临床医护人员制订慢性心力衰竭患者Ⅱ期心脏康复全面管理方案及开展高质量Ⅱ期心脏康复提供循证依据。展开更多
In this study,the dynamic stress concentration factors(DSCF)around a straight-wall arch tunnel(SWAT)were solved analytically utilizing the complex variable function methods and Duhamel’s integral.The effects of wavel...In this study,the dynamic stress concentration factors(DSCF)around a straight-wall arch tunnel(SWAT)were solved analytically utilizing the complex variable function methods and Duhamel’s integral.The effects of wavelength,incident angle,and blasting rising time on the DSCF distribution were analyzed.Theoretical results pointed out dynamic disturbances resulting in compressive stress concentration in the vertical direction and tensile stress in the incident direction.As the wavelength and rising time increased,there was a tendency for the amplitude of stress concentration to initially rise and then converge.Moreover,a series of 3D FEM models were established to evaluate the effect of different initial stress states on the dynamic failure of the tunnel surrounding rock.The results indicated that the failure of the surrounding rock was significantly influenced by the direction of the static maximum principal stress and the direction of the dynamic disturbance.Under the coupling of static and blasting loading,damage around the tunnel was more prone to occur in the dynamic and static stress concentration coincidence zone.Finally,the damage modes of rock tunnel under static stress and blasting disturbance from different directions were summarized and a proposed support system was presented.The results reveal the mechanisms of deep-buried rock tunnel destruction and dynamically triggered rockburst.展开更多
基金supported by the National Natural Science Foundation of China(No.12072376)the Fundamental Research Funds for the Central Universities of Central South University,China(No.2020zzts708).
基金supported by the National Natural Science Foundation of China(Nos.12072376,52174140)the Fundamental Research Funds for Central Universities of the Central South University,China(No.2020zzts195)。
文摘目的检索并获取国内外慢性心力衰竭患者Ⅱ期心脏康复的最佳证据。方法检索BMJ Best Practice、UpToDate、国际指南协作网等指南网站,美国心脏协会等专业学会网站,PubMed、Web of Science、中国知网等数据库中有关慢性心力衰竭患者Ⅱ期心脏康复的相关证据,证据类型包括临床决策、指南、专家共识、系统评价、最佳证据总结。由2名研究者对文献质量进行评价和资料提取。结果共纳入19篇文献,包括8篇指南、2篇临床决策、3篇专家共识、4篇系统评价和2篇证据总结。从多学科团队协作、场地及配置、评估、运动、药物、营养、心理、危险因素管理、健康教育、依从性监督10个方面形成30条最佳证据。结论该研究总结了慢性心力衰竭患者Ⅱ期心脏康复的最佳证据,可为临床医护人员制订慢性心力衰竭患者Ⅱ期心脏康复全面管理方案及开展高质量Ⅱ期心脏康复提供循证依据。
基金Project(12072376)supported by the National Natural Science Foundation of ChinaPoject(10533220215858)supported by the Fundamental Research Funds for the Central Universities,China。
文摘In this study,the dynamic stress concentration factors(DSCF)around a straight-wall arch tunnel(SWAT)were solved analytically utilizing the complex variable function methods and Duhamel’s integral.The effects of wavelength,incident angle,and blasting rising time on the DSCF distribution were analyzed.Theoretical results pointed out dynamic disturbances resulting in compressive stress concentration in the vertical direction and tensile stress in the incident direction.As the wavelength and rising time increased,there was a tendency for the amplitude of stress concentration to initially rise and then converge.Moreover,a series of 3D FEM models were established to evaluate the effect of different initial stress states on the dynamic failure of the tunnel surrounding rock.The results indicated that the failure of the surrounding rock was significantly influenced by the direction of the static maximum principal stress and the direction of the dynamic disturbance.Under the coupling of static and blasting loading,damage around the tunnel was more prone to occur in the dynamic and static stress concentration coincidence zone.Finally,the damage modes of rock tunnel under static stress and blasting disturbance from different directions were summarized and a proposed support system was presented.The results reveal the mechanisms of deep-buried rock tunnel destruction and dynamically triggered rockburst.
