Study of intra-abdominal hypertension prevalence and awareness level among experienced ICU medical staff

Background:Intra-abdominal hypertension(IAH) is a disease with high morbidity and mortality among critically ill patients.The study's objectives were to explore the prevalence of IAH and physicians' awareness of the 2013 World Society of Abdominal Compartment Syndrome(WSACS) guidelines in Chinese intensive care units(ICUs).Methods:A cross-sectional study of four ICUs in Southwestern China was conducted from June 17 to August 2,2014.Adult patients admitted to the ICU for more than 24 h,with bladder catheter but without obvious intravesical pressure(IVP) measurement contraindications,were recruited.Intensivists with more than 5 years of ICU working experience were also recruited.Epidemiological information,potential IAH risk factors,IVP measurements and questionnaire results were recorded.Results:Forty-one patients were selected.Fifteen(36.59%) had IVP?12mm Hg.SOFA(Sequential Organ Failure Assessment) hepatic and neurological sub-scores were utilized as independent predictors for IAH via logistic backward analysis.Thirty-seven intensivists participated in the survey(response rate:80.43%).The average score of each center was less than 35 points.All physicians believed the IAH prevalence in their departments was no more than 20.00%.A significant negative correlation was observed between the intensivists' awareness of the 2013 WSACS guidelines and the IAH prevalence in each center(r=-0.975,P=0.025).Conclusion:The prevalence and independent predictors of IAH among the surveyed population are similar to the reports in the literature.Intensivists generally have a low awareness of the 2013 WSACS guidelines.A systematic guideline training program is vital for improving the efficiency of the diagnosis and treatment of IAH.

The effect of increased intra-abdominal pressure on orbital subarachnoid space width and intraocular pressure

In accordance with the trans-lamina cribrosa pressure difference theory, decreasing the trans-lamina cribrosa pressure difference can re- lieve glaucomatous optic neuropathy. Increased intracranial pressure can also reduce optic nerve damage in glaucoma patients, and a safe, effective and noninvasive way to achieve this is by increasing the intra-abdominal pressure. The purpose of this study was to observe the changes in orbital subarachnoid space width and intraocular pressure at elevated intra-abdominal pressure. An inflatable abdominal belt was tied to each of 15 healthy volunteers, aged 22-30 years （12 females and 3 males）, at the navel level, without applying pressure to the abdomen, before they laid in the magnetic resonance imaging machine. The baseline orbital subarachnoid space width around the optic nerve was measured by magnetic resonance imaging at 1, 3, 9, and 15 mm behind the globe. The abdominal belt was inflated to increase the pressure to 40 mmHg （1 mmHg = 0.133 kPa）, then the orbital subarachnoid space width was measured every 10 minutes for 2 hours. After removal of the pressure, the measurement was repeated 10 and 20 minutes later. In a separate trial, the intraocular pressure was measured for all the subjects at the same time points, before, during and after elevated intra-abdominal pressure. Results showed that the baseline mean orbital subarachnoid space width was 0.88 ＋ 0.1 mm （range： 0.77-1.05 mm）, 0.77 ＋ 0.11 mm （range： 0.60-0.94 mm）, 0.70 ＋ 0.08 mm （range： 0.62-0.80 ram）, and 0.68 _＋ 0.08 mm （range： 0.57-0.77 mm） at 1, 3, 9, and 15 mm behind the globe, respectively. During the elevated intra-abdominal pressure, the orbital subarachnoid space width increased from the baseline and dilation of the optic nerve sheath was significant at 1, 3 and 9 mm behind the globe. After decompression of the abdominal pressure, the orbital subarachnoid space width normalized and returned to the baseline value. There was no significant difference in the intraocular pressure before, during and after the intra-abdominal pressure elevation. These results verified that the increased intra-abdominal pressure widens the orbital subarachnoid space in this acute trial, but does not alter the intraocular pressure, indicating that intraocular pressure is not affected by rapid increased in- tra-abdominal pressure. This study was registered in the Chinese Clinical Trial Registry （registration number： ChiCTR-ONRC-14004947）.

基于Intra Web的B/S架构的开发

本文首先介绍了B/S开发的几种模式 ,然后在此基础上重点分析了运用Asp等脚本技术开发B S所存在的问题。接着介绍了IntraWeb开发B/S架构的网站应用的优点及其一般流程 ,并结合一个登陆模块给出了具体代码实现 。

A novel intra refresh scheme for wireless video transmission

The burst error of wireless channels and the two-state Markov wireless model are analyzed. Based on this model and the coding modes of the video encoder,the channel distortion of inter-coding and intra-coding due to burst error is deduced. Then we propose a novel intra refresh scheme in rate-distortion (R-D) framework. This scheme optimizes the error resilience and coding efficiency of wireless video transmission system. It can also stop error propagation and reduce channel distortion effectively. Simulations under different channel conditions verify the improvements of the proposed scheme with respect to error resilience for wireless video communication.

基于Intranet的医院成本费用核算与控制的实现方法

通过对以海尔、澳柯玛等企业成本费用控制模式的介绍,探讨在大型医院实现基于Intranet(内部互联网)平台,以成本项目为中心,通过制作年预算和月预算方式实现事前、事中、事后全过程成本费用精细化控制的基本方法,并以责任中心为基点,实现业绩评价。

Effect of intra-abdominal volume increment on kidneys in minipigs with intra-abdominal hypertension after hemorrhagic shock and resuscitation

Background: To investigate the effect of intra-abdominal volume increment(IAVI) on intra-abdominal hypertension(IAH) in the kidneys.Methods: Eight minipigs were successfully established as IAH models and were randomly divided into two groups: the IAVI group and the sham-operated group. The intravesical pressure, inferior vena cava pressure and urine volume were measured before shock, 2 h after IAH, and 22 h after surgery, respectively. The following indices were measured: serum creatinine, urea nitrogen, renal cortical thickness, ratio of abdominal anteroposterior diameter/transverse diameter, renal thickness, diameter of the renal sinus and the wet/dry ratio of renal tissues.Results: The intravesical pressure(IVP) of the 8 minipig IAH models was calculated to be 21.16±4.63 mmHg. There was a significant increase in the abdominal anteroposterior diameter/transverse diameter ratio. The minipigs in the IAVI group survived during the observational period, whereas 2 minipigs died at 18 h and 20 h in the sham-operated group. Twenty-two hours after surgery, the animals in the IAVI group displayed increased urinary volume(UV) and decreased Cr and Ur and remarkable decreases of VP and IVCP. After IAH, the renal cortical thickness and the renal thickness increased significantly. The renal wet/dry ratio in the sham-operated group was higher than that in the IAVI group.Conclusion: IAVI helps to control renal dysfunction after IAH, which may be related to lowering the intra-abdominal pressure, thus alleviating renal edema and blood stasis.

Intraweb开发框架体系结构剖析

本文阐述了WEB应用的形式,并讨论了当前WEB应用开发存在的一些问题。Intraweb开发框架是解决上述问题较好的一个方案。首先深入分析了Intraweb开发框架基本结构和原理,然后主要阐述了动态网页控制技术,以及如何在常规应用程序开发环境中实现可视化组件式WEB应用开发的原理。最后对该开发框架从技术角度进行了特性分析。

Early and long-term postoperative management following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

Peritoneal surface malignancies have been traditionally regarded as end-stage conditions amenable to merely palliative options. The combination of aggressive cytoreductive surgery (CRS), involving peritonectomy procedures and multivisceral resections, with intra-operative hyperthermic intra-peritoneal chemotherapy (HIPEC) and/or early postoperative intra-peritoneal chemotherapy (EPIC) to treat the microscopic residual tumor is a new concept. In recent years, promising results have been reported for peritoneal mesothelioma and carcinomatosis of gastrointestinal and gynaecologic origin treated by this combined protocol. However, CRS with HIPEC and/or EPIC is a complex procedure associated with high rates of potentially life-threatening complications. Furthermore, disease progression following comprehensive treatment is not uncommon and represents a relevant cause of treatment failure. The present paper reviews the available information on early postoperative management and long-term follow-up in patients treated with CRS and intraperitoneal chemotherapy. The peculiar clinical and biological alterations that can be expected during an uncomplicated postoperative course, as compared to standard digestive surgery, are discussed. Early recognition and appropriate management of the most common adverse events are addressed, in order to minimize the impact of treatment-related morbidity on survival and quality of life results. Since re-operative surgery with additional HIPEC, has proven to be useful in selected patients with recurrent disease, long-term surveillance aiming at early detection of postoperative disease progression has become a relevant issue. Current results on follow-up investigations are presented.

Combined intra-arterial chemotherapy and intravitreal melphalan for the treatment of advanced unilateral retinoblastoma

●AIM:To evaluate the efficacy and safety of combined intraarterial chemotherapy(IAC)and intravitreal melphalan(IVM)for the treatment of advanced unilateral retinoblastoma.●METHODS:This retrospective study involved 30 consecutive eyes from 30 Chinese patients with advanced unilateral retinoblastoma.All patients were initially treated with IAC combined with IVM.The clinical status and complications were recorded at each visit.●RESULTS:The International Intraocular Retinoblastoma Classification groups were D in 23 eyes and E in 7 eyes.All eyes showed severe cloud vitreous seeds at the first visit.The mean number of IAC cycles and intravitreal injections was 3.2(range,3-4)and 6(range,1-14),respectively.The median follow-up time was 29 mo(range,7-36 mo).Treatment success with regression of the retinal tumor and vitreous seeds was achieved in 29 of 30 eyes(96.7%).Globe salvage was attained in 93.3%(28/30)eyes,and enucleation(n=2)was per formed due to neovascular glaucoma and persistent vitreous hemorrhage.Complications included retinal pigment epithelium(RPE)atrophy(n=13;43%),mild lens opacity(n=7;23%),vitreous hemorrhage(n=5;17%)and rhegmatogenous retinal detachment(n=1;3%).No extraocular tumor extension or metastasis occurred.●CONCLUSION:Combined IAC and IVM is effective and safe for the treatment of advanced unilateral retinoblastoma.

Research on the Low-carbon-high-value Agriculture Technology in the Comprehensive Improvement of Intra-county Environment Pollution——Taking the Development of Cultivation and Breeding Industry in the Ecological Cyclic Agricultural Garden in Shaoshan Irri

The comprehensive improvement strategy of intra-county environment pollution in the city and countryside was searched.By the research method which combined the microscopic view,the macroscopic view with the dynamic perspective,the seriousness of rural water quality,soil and atmospheric pollution in Xiangxiang,Xiangtan and the surrounding areas in Shaoshan irrigated area was revealed.The control measure which was 'four-dimensional pollution in the city and countryside'—— low-carbon-high-value agriculture and the technology innovation was proposed.The low-carbon-high-value technology innovation industrialization demonstration in three parts which included the pre-production,mid-production and post-production deep-processing of cultivation and breeding industry in the ecological cyclic agricultural garden in Shaoshan irrigated area was the driving force.We tried to propel the low-carbon ecological cultivation and breeding industry which included the paddy rice,grass,tree,medicinal herbs and pig,cow,chick,duck,fish.We wanted to relieve the structural unbalance of previous cultivation and breeding industry,'cheap grain hurting the farmers' and the short-leg problem of social-economic-ecological benefit.The results showed that the low-carbon-high-value agricultural system was a poly-generation technology system which promoted the multi-level and grading utilization,saved the energy,reduced the consumption and cleaned the production based on the ecology.

Efficacy of second-course intra-arterial chemotherapy in children for advanced retinoblastoma recurrence after intra-arterial chemotherapy

Purpose: The present study determined the efficacy and toxicity of second-course intra-arterial chemotherapy(IAC) in advanced retinoblastoma(RB) recurrence in children following failed initial IAC. Materials and Methods: A total of 24 child patients with unilateral or bilateral intra-ocular advanced RB(IIRC Group D and Group E) undergoing second-course IAC treatment after initial intra-arterial chemotherapy between September 2011 and November 2016 were enrolled. Global salvage, ocular adverse events, and systemic adverse events were assessed. Results: Following second-course IAC, 15(62.5%) showed complete control at 34 months follow-up, while 8 cases(33.3%) failed the treatment and 1 patient with metastatic disease(4.2%) eventually died of brain metastasis after refusing treatment. Ocular adverse events included eyelid edema(n=12), ptosis(n=5), forehead erythema(n-5), enophthalmos(n=3), and cataract(n=2). None of the patients had systemic adverse events, such as stroke or sepsis. Also, no secondary neoplasms and technical complications were observed. Conclusion: Second-course IAC is a potential alternative to enucleation in children with advanced RB, who fail an initial course of IAC. However, patients with advanced RB should be managed at experienced centers in order to consider all the alternatives before enucleation.

基于Intraweb和FMS的教学播客系统设计

在当今这个充分发挥自我个性的时代,继博客迅速崛起之后,最近两年又出现了一个新的名词:播客。极大程度上满足了大众的表现欲望以及对其他人发出自己声音的愿望。利用Intraweb技术结合FMS进行教学视频播客系统的设计研究,并以期更新和升级传统的视频点播系统在教学中的应用。

Y-Shaped Intra-Scleral Fixated Lens versus Retro-Pupillary Iris Claw Lens in the Treatment of Aphakia

Background: Many reasons can lead to an aphakia without adequate capsular support for implantation of a posterior chamber intraocular lens (IOL), such as intraoperative unintentional rupture of posterior capsule during phacoemulsification, planned intracapsular cataract extraction, ocular trauma and lens dislocation due to congenital and acquired causes. Purpose: To compare Y-shaped intra-scleral fixation of a posterior chamber IOL with retro pupillary fixation of an iris-claw intraocular lens (IOL) for Aphakic eyes without sufficient capsular support as respects safety, visual recovery and complications of both methods. Patients and Methods: One hundred Aphakic eyes were arbitrarily distributed between two groups. Group A included 50 eyes treated with retropupillary fixation of iris claw lens and group B included 50 eyes treated with Y-shaped intra-scleral fixation technique. Preoperative, intraoperative and postoperative data were analysed including best corrected visual acuity (BCVA), intraocular pressure (IOP), surgical time, intraoperative problems, IOL malposition and postoperative complications. Following up on patients was carried out for at least six months. Results: The mean duration of surgery was 21 ± 5.3 min in group A and was 53.4 ± 6.9 min in group B (p-value 0.05). IOL tilt was found in 0 (0%) eyes in group A and in 5 (10%) eyes in group B (p 0.05). Conclusion: The results of our study indicated that both methods are satisfactory in correcting aphakia without sufficient capsular support as regards postoperative best corrected visual acuity (BCVA);however the surgical technique of retropupillary iris claw lens is easier, shorter, with low intra- and postoperative complications and safer than those used for intra-scleral fixation of IOL. But for eyes which lack both iris and capsular support, a scleral fixation of a posterior chamber IOL remains the only option.

南苏门答腊盆地J区块中新统Intra-Gumai组三角洲前缘砂体精细描述

以地质背景为基础,结合单井、地震等资料,通过地震相以及沉积相的研究,将南苏门答腊盆地J区块始新统-中新统划分为6个三级层序,其中Intra-Gumai组位于SQ4的高位体系域。研究区SQ4高位体系域发育5种类型沉积相:三角洲平原、三角洲前缘、前三角洲、浊积体及浅海陆棚。分析认为三角洲前缘砂体为Intra-Gumai组的主要勘探目标,发育水下分流河道、河口坝、水下分流间湾等有利储集体。

Intra Web开发模式及其实现

要 :IntraWeb是一个创建基于Web应用程序的新方法 ,它提供了一个高速简单创建Internet、Intranet以及Extranet应用程序的杰出工具。IntraWeb支持两种不同的Web站点开发方式 :应用程序模式和页面模式。在介绍IntraWeb的基础上 ,主要阐述了它的这两种开发模式 ,最后通过实例演示如何创建这两种开发模式的应用程序。

Intradural Disc Herniation Can Be Intra-Arachnoid or Extra-Arachnoid: 2 Case Reports with MRI Diagnosis and Non-Surgical Management

Intradural disc herniation is rare and often diagnosed during surgery. We present two patients with the disease, one with an intra-arachnoid type, the other with an extra-arachnoid location. The teaching point of those cases is that this very frequent pathology can take a variety of forms, depending on the structures that are infiltrated. The key point in correctly diagnosing the intradural disc herniation is to look at the angle between the fragment and the dura. Is it pushing it (as in the usual disc herniation), embedded in it (those with the extra-arachnoid type) or does it go through to fall into the CSF (In the intra-arachnoid type)? It could be diagnosed on MRI preoperatively. Contrary to many published cases of intradural disc herniation, the two patients could be managed non-surgically.

An <i>In-Vivo</i>Study during Combined Intracavitary and Interstitial Brachytherapy of Gynaecological Malignancies Using microMOSFET

Aim: To analyze the inter-fraction, intra-fraction uncertainties and to verify the delivered total dose with planned dose in the combined intracavitary-interstitial brachytherapy of gynaecological cancer patients using microMOSFET in-vivo dosimeter. Materials and Methods: Between May 2014 and March 2016, 22 patients who underwent brachytherapy treatments with an applicator combination of CT/MR compatible tandem, ring and Syed-Neblett template-guided rigid needles were included in this study. Specially designed microMOSFET, after calibration, was used to analyze the variations in dosimetry of combined intracavitary-interstitial application. Results: The standard deviation for Inter-fraction variation among 22 combined intracavitary interstitial applications ranged between 0.86% and 10.92%. When compared with the first fraction dose, the minimum and maximum dose variations were &minus;9.5% and 26.36%, respectively. However, the mean doses varied between &minus;5.95% and 14.49%. Intra-fraction variation, which is the difference of TPS calculated dose with first fraction microMOSFET-measured dose ranges from &minus;6.77% to 8.68%. The variations in the delivered total mean dose in 66 sessions with planned doses were &minus;3.09% to 10.83%. Conclusions: It is found that there was a gradual increase in microMOSFET measured doses as compared to the first fraction with that of subsequent fractions in 19 out of 22 applications. Tumor deformation and edema may be the influencing factors, but the applicator movements played a major role for the variations. We find that the microMOSFET is an easy and reliable system for independent verification of uncertainties during ICBT-ISBT treatments.

Intra-Arterial Chemotherapy for Retinoblastoma

The management of retinoblastoma is challenging and complex. Preservation of the eyeball as well as vision, with minimum morbidity, is the aim in the initial stages. This has been made possible by the use of chemotherapy that is targeted to the eye in the form of selective intravitreal and intra-arterial chemotherapy which has shown promising results. The efficacy and safety of intra- arterial chemotherapy have been reported by many specialized centers. The aim of this article was to review the role of intraarterial chemotherapy in the management of retinoblastoma and its clinical outcomes. In addition, we will review the possible complications of the procedure. We were able to collect articles relevant to our research objectives by reviewing the title and abstract of each article. Irrelevant articles and those that did not meet the inclusion criteria were excluded. This yielded a total of 19 studies. The results indicated that intraarterial chemotherapy is an effective and new modality of treatment for retinoblastoma to salvage the eyeball and helps in the prevention of enucleation with minimal local and systemic complications that are mostly transient. For future work, we recommend conducting more prospective studies with large samples and the long duration of follow-up. Also, we recommend future studies focusing on assessing visual acuity, as most of the currently available studies did not assess the visual acuity, making the judgment on vision preservation with IAC difficult.

一种基于H.264 Intra帧的差错隐藏方法

为了充分利用H.264新特性带来的冗余信息对视频传输中的错误进行隐藏,提出了一种新的基于Intra帧的差错隐藏方法,根据丢失块周围子块的预测模式推断出丢失块中各子块的预测模式,再根据推断的预测模式重建丢失块.试验表明,这种方法能很好地预测出丢失块的预测模式,并能适应不同内容类型的图像,差错隐藏的效果明显.

Effects of dietary Bacillus amyloliquefaciens supplementation on growth performance,intestinal morphology, inflammatory response, and microbiota of intra-uterine growth retarded weanling piglets

Background: The focus of recent research has been directed toward the probiotic potential of Bacillus amyloliquefaciens(BA) on the gut health of animals. However, little is known about BA's effects on piglets with intra-uterine growth retardation(IUGR). Therefore, this study investigated the effects of BA supplementation on the growth performance,intestinal morphology, inflammatory response, and microbiota of IUGR piglets.Methods: Eighteen litters of newborn piglets were selected at birth, with one normal birth weight(NBW) and two IUGR piglets in each litter(i.e., 18 NBW and 36 IUGR piglets in total). At weaning, the NBW piglet and one of the IUGR piglets were assigned to groups fed a control diet(i.e., the NBW-CON and IUGR-CON groups). The other IUGR piglet was assigned to a group fed the control diet supplemented with 2.0 g BA per kg of diet(i.e., IUGR-BA group). The piglets were thus distributed across three groups for a four-week period.Results: IUGR reduced the growth performance of the IUGR-CON piglets compared with the NBW-CON piglets. It was also associated with decreased vil us sizes, increased apoptosis rates, reduced goblet cel numbers, and an imbalance between pro-and anti-inflammatory cytokines in the smal intestine. Supplementation with BA improved the average daily weight gain and the feed efficiency of the IUGR-BA group compared with the IUGR-CON group(P < 0.05). The IUGR-BA group exhibited increases in the ratio of jejunal vil us height to crypt depth, in ileal vil us height, and in ileal goblet cel density. They also exhibited decreases in the numbers of jejunal and ileal apoptotic cel s and ileal proliferative cel s(P < 0.05). Supplementation with BA increased interleukin 10 content, but it decreased tumor necrosis factor alpha level in the smal intestines of the IUGR-BA piglets(P < 0.05). Furthermore, compared with the IUGR-CON piglets, the IUGR-BA piglets had less Escherichia coli in their jejunal digesta, but more Lactobacil us and Bifidobacterium in their ileal digesta(P < 0.05).Conclusions: Dietary supplementation with BA improves morphology, decreases inflammatory response, and regulates microbiota in the smal intestines of IUGR piglets, which may contribute to improved growth performance during early life.