Effect of a systemic intervention combined with a psychological intervention in stroke patients with oropharyngeal dysfunction

BACKGROUND Stroke frequently results in oropharyngeal dysfunction(OD),leading to difficulties in swallowing and eating,as well as triggering negative emotions,malnutrition,and aspiration pneumonia,which can be detrimental to patients.However,routine nursing interventions often fail to address these issues adequately.Systemic and psychological interventions can improve dysphagia symptoms,relieve negative emotions,and improve quality of life.However,there are few clinical reports of systemic interventions combined with psychological interventions for stroke patients with OD.AIM To explore the effects of combining systemic and psychological interventions in stroke patients with OD.METHODS This retrospective study included 90 stroke patients with OD,admitted to the Second Affiliated Hospital of Qiqihar Medical College(January 2022–December 2023),who were divided into two groups:regular and coalition.Swallowing function grading(using a water swallow test),swallowing function[using the standardized swallowing assessment(SSA)],negative emotions[using the selfrating anxiety scale(SAS)and self-rating depression scale(SDS)],and quality of life(SWAL-QOL)were compared between groups before and after the intervention;aspiration pneumonia incidence was recorded.RESULTS Post-intervention,the coalition group had a greater number of patients with grade 1 swallowing function compared to the regular group,while the number of patients with grade 5 swallowing function was lower than that in the regular group(P<0.05).Post-intervention,the SSA,SAS,and SDS scores of both groups decreased,with a more significant decrease observed in the coalition group(P<0.05).Additionally,the total SWAL-QOL score in both groups increased,with a more significant increase observed in the coalition group(P<0.05).During the intervention period,the total incidence of aspiration and aspiration pneumonia in the coalition group was lower than that in the control group(4.44%vs 20.00%;P<0.05).CONCLUSION Systemic intervention combined with psychological intervention can improve dysphagia symptoms,alleviate negative emotions,enhance quality of life,and reduce the incidence of aspiration pneumonia in patients with OD.

LASIK术后20年患者远期视力效果与安全性

目的:评估准分子激光原位角膜磨镶术(LASIK)术后20a患者远期视力效果与安全性。方法:回顾性研究。收集1998-01/2001-12在我院准分子治疗中心接受LASIK手术治疗的患者资料。采用电话通知患者至门诊复查的方式,进行调查研究。收集的数据包括人口统计学特征(性别和年龄)、LASIK术前裸眼视力(UCVA)及最佳矫正视力(BCVA)、术前屈光度数、术中角膜瓣厚度及术中角膜基质层残余厚度。主要观察指标:长期疗效指数、安全性指数、UCVA、BCVA、角膜厚度及眼轴长度。同时进行裂隙灯、眼底及OCT检查。结果:本研究纳入95例190眼,术后末次复查时,71例142眼(74.7%)UCVA≥1.0;82例164眼(86.3%)BCVA≥1.0。其中2眼分别因黄斑劈裂及青光眼,导致BCVA不良(≤0.6),其余患者BCVA为0.8。术后20a患者UCVA及BCVA与手术时年龄、术前屈光度数、角膜厚度均无明显相关性(P>0.05),而与眼轴增长值存在负相关性(r=-0.32、-0.31,均P<0.05)。术后末次复查时UCVA及BCVA与剩余角膜基质层厚度(RST)相关(P<0.05)。LASIK术后20a的安全性和有效性指数分别为1.00±0.10和0.83±0.27。本组随访期间,未发现患者存在角膜扩张及角膜瓣相关并发症,也无二次增效手术患者。裂隙灯检查,未见明显角膜干燥病变患者。结论:LASIK术后20a显现出良好的安全性及有效性。

Application of video-assisted thoracic surgery in the standard operation for thoracic tumors

Objective: To evaluate the short-term outcomes of video-assisted thoracic surgery (VATS) for thoracic tumors. Methods: The data of 1,790 consecutive patients were retrospectively reviewed. These patients underwent VATS pulmonary resections, VATS esophagectomies, and VATS resections of mediastinal tumors or biopsies at the Cancer Institute & Hospital, Chinese Academy of Medical Sciences between January 2009 and January 2012. Results: There were 33 patients converted to open thoracotomy (OT, 1.84%). The overall morbidity and mortality rate was 2.79% (50/1790) and 0.28% (5/1790), respectively. The overall hospitalization and chest tube duration were shorter in the VATS lobectomy group (n=949) than in the open thoracotomy (OT) lobectomy group (n=753). There were no significant differences in morbidity rate, mortality rate and operation time between the two groups. In the esophageal cancer patients, no significant difference was found in the number of nodal dissection, chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS esophagectomy group (n=81) and open esophagectomy group (n=81). However, the operation time was longer in the VATS esophagectomy group. In the thymoma patients, there was no significant difference in the chest tube duration, morbidity rate, mortality rate, and hospital length of stay between the VATS thymectomy group (n=41) and open thymectomy group (n=41). However, the operation time was longer in the VATS group. The median tumor size in the VATS thymectomy group was comparable with that in the OT group. Conclusions: In early-stage (I/II) non-small cell lung cancer patients who underwent lobectomies, VATS is comparable with the OT approach with similar short-term outcomes. In patients with resectable esophageal cancer, VATS esophagectomy is comparable with OT esophagectomy with similar morbidity and mortality. VATS thymectomy for Masaoka stage I and II thymoma is feasible and safe, and tumor size is not contraindicated. Longer follow-ups are needed to determine the oncologic equivalency of VATS lobectomy, esophagectomy, and thymectomy for thymoma vs. OT.

Updated experiences with minimally invasive Mc Keown esophagectomy for esophageal cancer

AIM: To update our experiences with minimally invasive Mc Keown esophagectomy for esophageal cancer.METHODS: we retrospectively reviewed the medical records of 445 consecutive patients who underwent minimally invasive Mc Keown esophagectomy between January 2009 and July 2015 at the Cancer Hospital of Chinese Academy of Medical Sciences and used 103 patients who underwent open Mc Keown esophagectomy in the same period as controls. Among 375 patients who underwent total minimally invasive Mc Keown esophagectomy, 180 in the early period were chosen for the study of learning curve of total minimally invasive Mc Keown esophagectomy. These 180 minimally invasive Mc Keown esophagectomies performed by five surgeons were divided into three groups according to time sequence as group 1(n = 60), group 2(n = 60) and group 3(n = 60).RESULTS: Patients who underwent total minimally invasive Mc Keown esophagectomy had significantly less intraoperative blood loss than patients who underwent hybrid minimally invasive Mc Keown esophagectomy or open Mc Keown esophagectomy(100 ml vs 300 ml vs 200 ml, P = 0.001). However, there were no significant differences in operation time, number of harvested lymph nodes, or postoperative morbidity includingincidence of pulmonary complication and anastomotic leak between total minimally invasive Mc Keown esophagectomy, hybrid minimally invasive Mc Keown esophagectomy and open Mc Keown esophagectomy groups. There were no significant differences in 5-year survival between these three groups(60.5% vs 47.9% vs 35.6%, P = 0.735). Patients in group 1 had significantly longer duration of operation than those in groups 2 and 3. There were no significant differences in intraoperative blood loss, number of harvested lymph nodes, or postoperative morbidity including incidence of pulmonary complication and anastomotic leak between groups 1, 2 and 3.CONCLUSION: Total minimally invasive Mc Keown esophagectomy was associated with reduced intraoperative blood loss and comparable short term and long term survival compared with hybrid minimally invasive Mc Keown esophagectomy or open Mckeown esophagectomy. At least 12 cases are needed to master total minimally invasive Mc Keown esophagectomy in a high volume center.

Long.term outcomes of 307 patients after complete thymoma resection

Background: Thymoma is an uncommon tumor without a widely accepted standard care to date. We aimed to investigate the clinicopathologic variables of patients with thymoma and identify possible predictors of survival and recurrence after initial resection.Methods: We retrospectively selected 307 patients with thymoma who underwent complete resection at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College(Beijing, China) between January 2003 and December 2014. The associations of patients' clinical characteristics with prognosis were estimated using Cox regression and Kaplan–Meier survival analyses.Results: During follow?up(median, 86 months; range, 24–160 months), the 5? and 10?year disease?free survival(DFS) rates were 84.0% and 73.0%, respectively, and the 5? and 10?year overall survival(OS) rates were 91.0% and 74.0%, respectively. Masaoka stage(P < 0.001), World Health Organization(WHO) histological classification(P < 0.001), and postoperative radiotherapy after initial resection(P = 0.006) were associated with recurrence(52/307, 16.9%). Multivariate analysis revealed that, after initial resection, WHO histological classification and Masaoka stage were independent predictors of DFS and OS. The pleura(25/52, 48.0%) were the most common site of recurrence, and locoregional recurrence(41/52, 79.0%) was the most common recurrence pattern. The recurrence pattern was an independent predictor of post?recurrence survival. Patients with recurrent thymoma who underwent repeated resec?tion had increased post?recurrence survival rates compared with those who underwent therapies other than surgery(P = 0.017).Conclusions: Masaoka stage and WHO histological classification were independent prognostic factors of thymoma after initial complete resection. The recurrence pattern was an independent predictor of post?recurrence survival. Locoregional recurrence and repeated resection of the recurrent tumor were associated with favorable prognosis.

Development of alpha surface contamination monitor based on THGEM for contamination distribution

In cases of high radiation emergencies,we propose a surface contamination monitor(SCM)that can quickly measure and pinpoint the contamination distribution in the affected population.Thick gaseous electron multiplier(THGEM)has several advantages,including fast response time and good spatial resolution.Based on new THGEMs,a two-dimensional imaging detector was developed for alpha detection,with a position resolution greater than 3 mm.The detector design and test results are described in this paper.Fast radiation imaging SCMs,with a 40mm×40 mm sensitive area,are currently under development.

Influence of Re-Ti modification on the high impact wear resistance of high Si bainitic cast steel

The effect of rare earth （Re） and titanium （Ti） multi-modification on the impact wear behavior of Mn-B high-Si bainitic cast steel was investigated systematically. The experiments show that the impact wear resistance can be improved greatly with the addition of Re and Ti. Its wear loss is only about 1/3-1/2 as large as that of the unmodified bainitic cast steel. By the Re/Ti modification, coarse dendrite grains and bainitic/martensite duplex structure have been refined effectively, and the impact toughness of the bainitic cast steel is nearly tripled （10 mm×10 mm×55 mm, with unnotched sample）. Consequently, the modified bainitic cast steel possesses good wear resistance under high im- pact. For both modified and unmodified bainitic cast steels, high hardness white layer and deformed zone are developed beneath the worn surface under the high impact wear, but the formation and propagation of cracks are different for these bainitic casting steels. Different mod- els for the formation and propagation of cracks for both modified and unmodified bainitic cast steels under high impact wear are proposed.

Quantum phase transition of the Jaynes-Cummings model

Herein,we propose an experimentally feasible scheme to show the quantum phase transition of the Jaynes-Cummings(JC)model by modulating the transition frequency of a two-level system in a quantum Rabi model with strong coupling.By tuning the modulation frequency and amplitude,the ratio of the effective coupling strength of the rotating terms to the effective cavity(atomic transition)frequency can enter the deep-strong coupling regime,while the counter-rotating terms can be neglected.Thus,a deep-strong JC model is obtained.The ratio of the coupling strength to resonance frequencies in the deep-strong JC model is two orders of magnitude larger than the corresponding ratio in the original quantum Rabi model.Our scheme can be employed in atom-cavity resonance and off-resonance cases,and it is valid over a broad range.The nonzero average cavity photons of the ground state indicate the emergence of a quantum phase transition.Further,we demonstrate the dependence of the phase diagram on the atom-cavity detuning and modulation parameters.All the parameters used in our scheme are within the reach of current experimental technology.Our scheme provides a new mechanism for investigating the critical phenomena of finite-sized systems without requiring classical field limits,thereby opening a door for studying fundamental quantum phenomena occurring in the ultrastrong and even deep-strong coupling regimes.

Deterministic generation of multi-photon bundles in a quantum Rabi model

Multi-photon bundle states are crucial for a broad range of applications such as quantum metrology,quantum lithography,quantum communication,and quantum biology.Here we propose a scheme that generates multi-photon bundles via virtual excitations in a quantum Rabi model.Our approach utilizes a Ξ-type three-level atom,where the upper two levels are coupled to a cavity field to form a quantum Rabi model with ultrastrong coupling,and the transition between the lower two levels is driven by two sequences of Gaussian pulses.We show that the driving pulses induce deterministic emission of multiple photons from the eigenstates of the quantum Rabi model via the stimulated Raman adiabatic passage technique,and hence can create bundles of multiple photons on-demand in the cavity output field.We calculate the generalized second-order correlation functions of the output photons,which reveal that the emitted photons form antibunched multi-photon bundles.

Spectral Characterization of Couplings in a Mixed Optomechanical Model

We study the spectrum of single-photon emission and scattering in a mixed optomechanical model which consists of both linear and quadratic optomechanical interactions.The spectra are calculated based on the exact longtime solutions of the single-photon emission and scattering processes in this system.We find that there exist some phonon sideband peaks in the spectra and there are some sub peaks around the phonon sideband peaks under proper parameter conditions.The correspondence between the spectral features and the optomechanical interactions is confirmed, and the optomechanical coupling strengths can be inferred by analyzing the resonance peaks and dips in the spectra.

Hybrid Copolymerization via the Combination of Proton Transfer and Ring-opening Polymerization

Phosphazene base,t-BuP2,was employed to catalyze the proton transfer polymerization(PTP)of 2-hydroxyethyl acrylate(HEA),and PTP was further combined with ring-opening polymerization(ROP)to exploit a new type of hybrid copolymerization.The studies on homopolymerization showed that t-BuP2 was a particularly efficient catalyst for the polymerization of HEA at room temperature,giving an excellent monomer conversion.Throughout the polymerization,transesterification reactions were unavoidable,which increased the randomness in the structures of the resulting polymers.The studies on copolymerization showed that t-BuP2 could simultaneously catalyze the hybrid copolymerization via the combination of PTP and ROP at 25°C.During copolymerization,HEA not only provided hydroxyl groups to initiate the ROP ofε-caprolactone(CL)but also participated in the polymerization as a monomer for PTP.The copolymer composition was approximately equal to the feed ratio,demonstrating the possibility to adjust the polymeric structure by simply changing the monomer feed ratio.This copolymerization reaction provides a simple method for synthesizing degradable functional copolymers from commercially available materials.Hence,it is important not only in polymer chemistry but also in environmental and biomedical engineering.

Coherent excitation transfer via the dark-state channel in a bionic system

Light absorption and energy transfer were studied in a bionic system with donors and an acceptor.In the optimal case of uniform couplings,this seemingly complicated system was reduced to a three-level L-type system.With this observation,we showed that the efficiency of energy transfer through a dark-state channel,which is free of the spontaneous decay of the donors,was dramatically improved.After the overall average transfer time was evaluated,it was revealed that the time required for transfer through this channel was not optimal.To find the optimal parameters for the present system,we defined a new quantity,output power,which characterizes the average mean output of the whole transfer process.We estimated the optimal parameters of the system to achieve the maximum output power.The splitting behaviour of the maximum power may be used to explain the phenomenon of photosynthetic systems primarily absorbing two colours of light.

Hot Deformation Behavior and Processing Map of Spray Formed M3∶ 2 High Speed Steel

Hot deformation behavior of a new type of M3∶ 2 high speed steel with niobium addition made by spray forming was investigated based on compression tests in the temperature range of 950-1 150 ℃ and strain rate of 0. 001-10 s^（-1）. A comprehensive constitutive equation was obtained,which could be used to predict the flow stress at different strains. Processing map was developed on the basis of the flow stress data using the principles of dynamic material model. The results showed that the flow curves were in fair agreement with the dynamic recrystallization model. The flow stresses,which were calculated by the comprehensive constitutive equation,agreed well with the test data at low strain rates（ ≤1 s^（-1））. The material constant（ α）,stress exponent（ n） and the hot deformation activation energy（ Q_（HW）） of the new steel were 0. 006 15 MPa^（-1）,4. 81 and 546 kJ·mol^（-1）,respectively. Analysis of the processing map with an observation of microstructures revealed that hot working processes of the steel could be carried out safely in the domain（ T = 1 050-1 150 ℃,ε = 0. 01- 0. 1 s^（-1））with about 33% peak efficiency of power dissipation（ η）. Cracks was expected in two domains at either lower temperatures（ 〈 1 000 ℃） or low strain rates（ 0. 001 s^（-1）） with different cracking mechanisms. Flow localization occurred when the strain rates exceeded 1 s^（-1） at all testing temperatures.

Vitamin K3 Regulates Reactive Oxygen Species and Extracellular-Regulated Protein Kinase in Differentiated PC-12 Cells within a Safe Dose Range

Objective:Acupuncture can relieve pain by acting on the mitogen-activated protein kinase(MAPK)signal pathway,which plays a critical role in the balance between hyperalgesia and inflammation.Our previous studies have suggested that acupoint injection of Vitamin K3(Vit K3)had an intensive analgesic effect on primary dyspareunia.However,the mechanism by which Vit K3 worked on nerve cells has not been elucidated.Methods:Cell apoptosis,mitochondrial membrane potential(MMP),and reactive oxygen species(ROS)changes of PC-12 cells with Vit K3 treatment,for which the concentration gradient was 0,5,10,20,40,and 60μmol/L,were quantified by flow cytometry.The expression and phosphorylation of c-Jun N-terminal kinase,p38,and extracellular-regulated protein kinase(ERK),the three critical molecules of the MAPK pathway,were further assessed using Western blotting.Results:The level of ROS first decreased and then increased with Vit K3 at 20μmol/L,but no change in neither apoptosis nor MMP was evident.In addition,only ERK level decreased at 20μmol/L and the relative phosphorylation level increased.Changes in ROS were negatively correlated with the expression of ERK.Conclusions:The rapid analgesic effect of Vit K3 acupoint injection may be through the reduction of ROS in nerve cells with a small dose of Vit K3 or by influencing the expression of ERK but without damaging the nerve cells themselves.