Application of Etiology List in Differential Diagnosis of Acute Abdominal Pain^#

Objective: To use the etiology list of abdominal pain to help identify acute abdominal pain. Methods: to design a list of causes of acute abdominal pain as per the concept of system thinking, determine the five differential diagnosis directions of “local organ disease, adjacent organ disease, systemic disease, psychogenic disease, and female reproductive system disease”, and elaborate the application effect of the checklist in the diagnosis of acute abdominal pain by virtue of the analysis of one case of acute abdominal pain. Results: according to the list of causes of abdominal pain, the causes of acute abdominal pain were screened, and patients suffering from acute renal infarction (ARI) who presented with simple abdominal pain were diagnosed and treated timely. Conclusion: the etiology list is helpful to guide the diagnosis direction of acute abdominal pain, and make a rapid clinical diagnosis, so as to form a systematic thinking mode.

Value of Real-Time Bedside Ultrasonography in the Etiologic Diagnosis of Acute Dyspnea

Objective: To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea. Methods: Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. Results: Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). Conclusion: Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.

Can Be Done Better for the Diagnosis of Non-Differentiated Diseases in Community Hospital?

General Practice is a comprehensive subject with a wide spectrum of diseases. It is challenging to make a more correct diagnosis timely and reasonable treatment with the least instrument examination for the diagnosis of medically unexplained physical symptoms (MUPS). This article reviews the case report of a patient who presented to a community hospital with a one-month history of constant diffuse abdominal pain and underwent eight weeks of examinations, finally experienced deterioration of their condition. Based on this case, this article discusses the problems in the diagnosis of abdominal pain in a community hospital, and according to the clinical thinking mode and checklist of abdominal pain, the diagnostic process of abdominal pain can be improved, and the diagnosis of non-differentiated diseases can be done better, the harm caused by delayed diagnosis may be reduced.

农用车身双相钢板拉弯成形中的韧性断裂准则研究

由于农业机械车辆的轻量化,高强度双相钢大量用于农用车车身,为提高农业用车身双相钢板在拉弯成形中的成型性,提出一种参数利于标定且能准确预测农用车车身钢板DP780断裂的韧性断裂准则,通过建立其Hill'48本构模型,利用数值模拟单拉及剪切过程获得断裂极限阈值为0.16,试验验证该断裂准则在模具凸模圆角为15 mm时,钢板拉弯深度为32 mm,仿真结果和试验一致性较好。该研究可以提高冲压成形成功率,节约成本,未知参数易于标定,方便工程应用,有很好的工程应用价值。

Construction of mechanically robust superamphiphobic surfaces on fiber using large particles

Superamphiphobic surfaces have attracted the attention of researchers because of their broad application prospects.Currently,superamphiphobicity is primarily achieved by minimizing the solid-liquid contact area.Over the past few decades,researchers have primarily focused on using physical deposition methods to construct superamphiphobic surfaces using fine-sized nanoparticles(<100 nm).However,porous hollow SiO_(2)particles(PH-SiO_(2)),which aretypically large spheres,have a highly hierarchical structure and can provide lower solid-liquid contact fractions than those provided byfine-sized particles.In this study,we used PH-SiO_(2)as building blocks and combined them with poly(dimethylsiloxane)to construct a mechanically robust coating on fiber by spray-coating.After chemical vapordeposition treatment,the coating exhibited excellent superamphiphobicity and could repel various liquids,covering a wide rangeof surfacetensions(27.4-72.0mN-m^(-1)).

Controlled synthesis of Pt-loaded yolk-shell TiO_(2)@SiO_(2) nanoreactors as effective photocatalysts for hydrogen generation

Yolk-shell and hollow structures are powerful platforms for controlled release,confined nanocatalysis,and optical and electronic applications.This contribution describes a fabrication strategy for a yolk-shell nanoreactor(NR)using a post decoration approach.The widely studied yolk-shell structure of silica-coated TiO_(2)(TiO_(2)@SiO_(2))was used as a model.At first,anatase TiO_(2) spheres were prepared,and subsequently were given a continuous coating of carbonaceous and silica layers.Finally,the carbonaceous layer was removed to produce a yolk-shell structure TiO_(2)@SiO_(2).By using an in-situ photodeposition method,Pt-encased spheres(Pt-TiO_(2)@SiO_(2))were synthesized with Pt nanoparticles grown on the surface of the TiO_(2) core,which contained void spaces suitable for use as NRs.The NR showed enhanced hydrogen production with a rate of 24.56 mmol·g^(-1)·h^(-1) in the presence of a sacrificial agent under simulated sunlight.This strategy holds the potential to be extended for the synthesis of other yolk-shell photocatalytic NRs with different metal oxides.