Kinetic equilibrium reconstruction with internal safety factor profile constraints on EAST tokamak

Reconstruction of plasma equilibrium plays an important role in the analysis and simulation of plasma experiments. The kinetic equilibrium reconstruction with pressure and edge current constraints has been employed on EAST tokamak. However, the internal safety factor(q) profile is not accurate. This paper proposes a new way of incorporating q profile constraints into kinetic equilibrium reconstruction. The q profile is yielded from the Polarimeter Interferometer(POINT)reconstruction. Virtual probes containing information on q profile constraints are added to inputs of the kinetic equilibrium reconstruction program to obtain the final equilibrium. The new equilibrium produces a more accurate internal q profile. This improved method would help analyze EAST experiments.

First results of CO_(2) dispersion interferometer on EAST tokamak

A dispersion interferometer(DI)has been installed and operates on the Experimental Advanced Superconducting Tokamak(EAST).This DI system utilizes a continuous-wave 9.3μm CO_(2)laser source to measure line-averaged electron densities accurately.In contrast to conventional interferometers,the DI does not require substantial vibration isolations or compensating systems to reduce the impact of vibrations in the optical path.It also employs a ratio of modulation amplitudes,ensuring it remains immune to the variations in detected intensities.Without a variation compensation system,the DI system on EAST reaches a density resolution of less than1.8×10^(-2)πrad and a temporal resolution of 20μs.The measurements made by the POlarimeterINTerferometer(POINT)system and the far-infrared hydrogen cyanide(HCN)interferometer are remarkably consistent with the DI’s results.The possibility of fringe jumps and the impact of refraction in high-density discharge can be significantly decreased using a shorter wavelength laser source.A rapid density change of 3×10^(19)m^(-3)during 0.15 s has been measured accurately in shot No.114755 of EAST.Additionally,the DI system demonstrates dependability and stability under 305 s long-pulse discharges in shot No.122054.

BILL Strategy:Points to Consider During the Performance and Interpretation of Critical Care Echocardiography

The growing utilization of critical care echocardiography(CCE)by clinicians necessitates a meticulous review of clinical conditions in critically ill patients,both before and during the examination.The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings.This article proposes a comprehensive strategy,namely BILL strategy to integrated into the CCE protocol,where“B”represents baseline respiratory and hemodynamic support,“I”signifies information gleaned from invasive monitoring,including central venous pressure and thermodilution-derived cardiac output,the first“L”denotes laboratory results such as central venous oxygen saturation,troponin,and brain natriuretic peptide,and the second“L”refers to lung ultrasound data.xx Combining the BILL strategy with CCE enhances a more comprehensive understanding of critical illness,potentially leading to improved diagnostic accuracy and patient outcomes.

鼻内镜下方形软骨即刻修复复杂性鼻中隔偏曲矫正术中穿孔的临床效果分析

目的 探讨鼻中隔方形软骨应用于复杂性鼻中隔偏曲矫正术中穿孔的临床疗效及安全性。方法 回顾性分析2015年1月-2021年12月因鼻中隔偏曲于中国医科大学附属第一医院耳鼻咽喉科行鼻内镜下鼻中隔偏曲矫正术患者的临床资料,术前经鼻窦CT和鼻内镜检查确认为复杂性鼻中隔偏曲且术中发生鼻中隔黏膜穿孔,同时应用局部方形软骨修补黏膜穿孔的61例患者,观察患者术后并发症及相关不良反应。结果 与术前相比较,所有入组患者鼻塞症状均得到明显改善。术后复查见绝大部分患者(58/61)鼻中隔偏曲矫正效果良好,鼻内镜下术区恢复理想;随访半年,无鼻中隔穿孔、鼻梁塌陷等严重并发症出现。结论 采用鼻中隔方形软骨修补复杂性鼻中隔偏曲术中黏膜穿孔效果良好,对临床有一定的指导意义,值得推广。

14例儿童耳后骨膜下脓肿临床分析

目的探讨儿童耳后骨膜下脓肿的临床特点及治疗方案。方法回顾性分析2013年9月~2018年2月行手术治疗的14例儿童耳后骨膜下脓肿患者的临床资料。结果学龄前儿童9例,学龄期儿童5例,均继发于急性中耳炎。与学龄期儿童相比,学龄前儿童病程短、炎症重、进展快。所有患者均行完壁式乳突开放术+上鼓室开放术±鼓膜切开术/鼓膜置管术。随访期间均未复发。结论儿童耳后骨膜下脓肿常继发于急性中耳炎,好发于学龄前儿童。完壁式乳突开放术+上鼓室开放术+鼓膜切开术/鼓膜置管术是有效的治疗方式。

自发性脑脊液耳漏4例临床分析

目的探讨自发性脑脊液耳漏的临床特点及治疗。方法回顾性分析2015年7月—2016年12月手术治疗的4例自发性脑脊液耳漏患者的临床病例资料,4例患者均有细菌性脑膜炎病史,2例为内耳畸形(内耳不完全分隔Ⅰ型),漏点均位于镫骨足板;行耳后切口鼓室探查术,术中见镫骨足板缺损有清亮液体涌出,去除镫骨及砧骨,以颞肌筋膜、耳廓软骨及纤维蛋白胶封堵前庭窗。另2例漏点位于后颅窝硬脑膜,其中1例位于弓状隆起至总角水平,1例位于圆窗至外耳道下壁水平;此2例患者均行完壁式乳突开放术,显露后颅窝骨质缺损处,可见脑脊液流出,以颞肌筋膜、耳廓软骨、乳突皮质骨骨粉及纤维蛋白胶封堵缺损。结果4例患者术后随访23~39个月,脑脊液耳漏及脑膜炎均无复发。结论自发性脑脊液耳漏发病率低,容易漏诊、误诊,以致脑膜炎反复发作。听力下降伴脑膜炎的患者应高度怀疑自发性脑脊液耳漏的可能。

耳源性脑脓肿14例临床分析

目的探讨耳源性脑脓肿的临床特点及治疗。方法回顾性分析2011年8月~2017年9月于中国医科大学附属第一医院收治的耳源性脑脓肿患者的临床病例资料,总结其临床特点及治疗。结果所有患者中3例脑脓肿经抗炎治疗治愈,8例行开颅脑脓肿切除术,3例行钻孔引流术。13例行耳部手术。14例患者中13例患者治愈,治愈率92.9%,随访10个月~3年,未出现脑脓肿及耳部疾病复发。1例患者脑脓肿术后病情加重转回当地治疗失访。结论耳源性脑脓肿好发于颞骨胆脂瘤。对于有中耳炎急性发作病史,持续头痛,影像学提示骨质破坏的病例应高度怀疑脑脓肿等颅内并发症的可能。尽早发现脑脓肿并针对性的治疗是治愈的关键。

PBL联合PAL教学模式在耳鼻咽喉科留学生教学中的应用研究

目的探讨PBL(Problem-based Learning,以问题为基础的学习)联合PAL(Peer-assisted Learning,同伴互助学习)教学模式在耳鼻咽喉科本科留学生教学中的应用效果。方法以中国医科大学99名临床医学本科留学生为研究对象,随机分为实验组(50人)和对照组(49人)。对照组采用PBL教学模式,实验组在对照组基础上联合应用PAL教学模式。教学结束后通过问卷调查和阶段考试进行学习效果评价。结果实验组留学生课外学习时间多于对照组,阶段考试成绩显著高于对照组,组间差异具有统计学意义(P<0.01)。与对照组教学模式相比,实验组的PBL联合PAL教学模式更有利于培养留学生的团队协作能力、交流沟通能力及临床思维能力,提高学习兴趣,加强对知识体系的掌握并获得同伴的支持与帮助(P<0.01)。结论 PBL联合PAL教学模式可以有效提升留学生耳鼻咽喉科教学效果,提高学习热情和满意度,值得在临床教学中推广应用。

保留杓状软骨在喉次全切除环舌根会厌吻合术中的应用

目的探讨保留杓状软骨在喉次全切除环舌根会厌吻合术中的应用及疗效。方法回顾性收集我院1998年1月至2013年12月216例声门型喉癌行喉次全切除环舌根会厌吻合术患者的临床资料。按照是否保留杓状软骨分为未保留杓状软骨组和保留杓状软骨组。采用Kaplan-Meier法行生存率统计,采用log-rank检验行生存率差异比较。结果216例患者的随访率为91.5%,3年总生存率为84.9%,5年总生存率为72.3%,未保留杓状软骨组的3年和5年生存率分别为82.5%和70.3%,保留杓状软骨组的3年和5年生存率分别为85.8%和75.3%。所有患者术后发音均恢复。拔管率为94.5%。误咽率为8.3%。结论喉次全切除环舌根会厌吻合术是保留喉发音、呼吸和吞咽功能的有效手术方法,最常见的并发症是误咽。保留单侧或双侧杓状软骨不仅可有效降低误咽率,还可提高患者术后的生存率,因此该手术方法值得推广。

Restrictive Cardiomyopathy Resulting from a Troponin Ⅰ Type 3 Mutation in a Chinese Family

Objective To identify the pathogenic variant responsible for restrictive cardiomyopathy （RCM） in aChinese family.Methods Next generation sequencing was used for detecting the mutation and results verified bysequencing. We used restriction enzyme digestion to test the mutation in the family members and 200 unrelatednormal subjects without any cardiac inherited diseases when the mutation was identified.Results Five individuals died from cardiac diseases, two of whom suffered from sudden cardiacdeath. Two individuals have suffered from chronic cardiac disorders. Mutation analysis revealed a novelmissense mutation in exon 7 of troponin I type 3 （TNNI3）, resulting in substitution of serine （S） withproline （P） at amino acid position 150, which cosegregated with the disease in the family, which is predictedto be probably damaging using PolyPhen-2. The mutation was not detected in the 200 unrelated subjectswe tested.Conclusion Using next generation sequencing, which has very recently been shown to be successfulin identifying novel causative mutations of rare Mendelian disorders, we found a novel mutation of TNNI3 in aChinese family with RCM.

Experimental observation of reverse-sheared Alfvén eigenmodes(RSAEs) in ELMy H-mode plasma on the EAST tokamak

Reverse-sheared Alfv6n eigenmodes （RSAEs） have been observed by using an interferometer and ECE diagnostics in NBI heated ELMy H-mode plasma on EAST tokamak. A typical feature of these modes is a fast frequency sweeping upward from -80 kHz to -110 kHz in hundred milliseconds during which the plasma temperature, density and rotation keeps no change. Only core channels of the interferometer can observe these modes, implying a core localized mode. The ECE measurement further showed that these modes located at about ρ = 0.37-0.46, just around the position of qmin with ρ -0.4. These core localized modes are very weak in the magnetic fluctuations measured by mirnov probes mounted at the machine vacuum vessel. A multiple frequency fluctuation component, seemingly the so-called ＇grand cascades＇, was also clearly observed on the ECE signal at ρ = 0.46. During the phase, a transient internal transport barrier （ITB） in ion temperature and toroidal rotation was observed and the ITB foot was just close to the position of qmin. A modulation of RSAE frequency by ELM event was observed and this modulation could be attributed to rotation decrease or qmin increase due to ELM. Further study of these modes in EAST can provide valuable constraints for the q profile measurement and will be important for the long pulse operation.

Experimental study of density pump-out on EAST

In the experimental advanced superconducting tokamak,density pump-out phenomena were observed by using a multi-channel polarimeter-interferometer system under different heating schemes of ion cyclotron resonant heating,electron cyclotron resonance heating,and neutral beam injection.The density pump-out was also induced with application of resonant magnetic perturbation,accompanied with a degradation of particle confinement.For the comparison analysis in all heating schemes,the typical plasma parameters are plasma current 400 k A,toroidal field 2 T,and line average density 2×10^19m^-3.The experimental results show that the degree of pump-out is concerned with electron density and heating power.Low density deuterium low confinement（L-mode） plasmas（〈3.5×10^19m^-3） show strong pump-out effects.The density pump-out correlated with a significant drop of particle confinement.

Spontaneous current relaxation in NBI heated plasmas on EAST

We report on current profile evolution in EAST NBI driven plasmas where two neutral beams are injected,one during the current ramp phase and the second during flattop.At the end of the current ramp phase,it is found that a flat q profile with q0-1 is achieved with low magnetic shear in the core.It is observed that plasma current and density both relax much faster than resistive time,even in the absence of sawtooth activity when H-L transition occurs.Density fluctuations associated with magnetic perturbations（3/2） as a precursor to the H-L transition are observed.It is likely that these modes play a role in fast current transport.

Magnetohydrodynamic effect of internal transport barrier on EAST tokamak

An internal transport barrier(ITB)can be formed on EAST in exploring high-parameter operation.Previous studies show that safety factor(q)profiles,Shafranov shift and magnetohydrodynamic behaviors could be helpful in ITB formation by suppressing anomalous transport.Recently,electron density evolution with high resolution demonstrates that fishbone could be dominant in electron density ITB formation and sustainment.The power threshold is low in the fishbone condition and the electron density profile is determined by traits of fishbone.Simulation shows that the low-k ion mode is suppressed by fishbone.Direct measurement of turbulence in the inner region shows that the internal kink mode could sustain an electron temperature ITB by suppressing the trapped electron mode.The multi-scale interaction between the kink mode and turbulence by current could be key in sustaining high-electron-temperature long-pulse operation.

沈阳地区AR患者血清过敏原分布及主要变应原IgE水平多因素分析

目的:探讨沈阳地区IgE水平因素,为该地区变应性鼻炎(AR)的预防提供科学依据。方法:将749例症状符合AR的患者进行体外血IgE检测,按年龄分成5组,并对患者进行问卷调查,分析患者血清过敏原分布及主要过敏原IgE水平多因素分析。结果:首要变应原为屋尘螨或粉尘螨,各年龄组屋尘螨或粉尘螨变应原亦处于首位,榆树、真菌、猫毛/狗毛、蟑螂、豚草阳性率比较差异有统计学意义(P<0.01或P<0.05)。7~14岁组、15~35岁组食入性变应原排序分布与总体一致,≤6岁组前三位依次为芒果菠萝、牛羊肉、虾蟹,36~60岁组、61~65岁组芒果菠萝和牛奶并列第1位,鸡蛋第2位,牛羊肉第3位,芒果菠萝、牛羊肉、蟹和坚果阳性率比较差异有统计学意义(P<0.01或P<0.05)。蟑螂作为反应原IgE水平受到患者的过敏史及家中养殖花草和饲养动物的影响。真菌作为反应原IgE水平受到患者性别、过敏史及家中饲养动物和家具更新的影响。艾蒿作为反应原IgE水平受到过敏史和哮喘史的影响。花生作为反应原IgE水平受到年龄和过敏史的影响。鸡蛋作为反应原IgE水平受到饮食过敏史,家中养殖花草和饲养动物的影响。蟹作为反应原IgE水平受到过敏史和家中饲养动物的影响。结论:AR各年龄组主要吸入性变应原为屋尘螨或粉尘螨,食入性变应原各年龄组有所不同,为避免食入性过敏提供参考依据。主要变应原IgE水平影响因素不同为患者日后除避免接触过敏原,每一种危险因素成为患者的防控重点,为AR患者的防治提供较大帮助。

Transarterial chemoembolization combined with sorafenib and iodine-125 seed brachytherapy for hepatocellular carcinoma with portal vein tumor thrombus:a retrospective controlled study

To the Editor:Portal vein tumor thrombus(PVTT)is present in 10%to 40%of patients with hepatocellular carcinoma(HCC)at diagnosis and has a profound adverse effect on progno-sis.[1]Sorafenib is recommended as the first-line treatment for patients with advanced HCC,including those who have PVTT.However,its efficacy is modest.[1,2]A combination of transarterial chemoembolization(TACE)and sorafenib(TACE-S)has been reported to be associated with improved outcomes.[1,3]But unfortunately,its efficacy in controlling PVTT remained limited,with an objective response rate(ORR)of only 9.7%.[3]Previous studies have demonstrated that iodine-125(125I)seed brachytherapy targeting PVTT can lead to a significant reduction in tumor thrombus with few complications.[4,5]We hypothesized that TACE-S combined with 125I seed brachytherapy(TACE-S-I)could improve the control of PVTT and confer a greater survival benefit.Therefore,we conducted this study to evaluate the efficacy and safety of TACE-S-I compared with TACE-S in HCC patients with PVTT.This study was approved by our institutional review board(No.2020-hg-ks-03).