超声联合血清标志物诊断慢性心力衰竭的价值

目的探讨心力衰竭超声指数联合血清半乳糖凝集素-3(Gal-3)、亲环素A 在慢性心力衰竭(CHF)诊断中的的价值。方法选取2015年1月—2018 年1月唐山市工人医院收治的312 例CHF 患者作为观察组。选取同期于该院体检的60例健康人群作为对照组。根据左室射血分数(LVEF)分为收缩性组和舒张性组。根据纽约心脏病学会心功能分级(NHYA)将患者分为NHYA Ⅰ、Ⅱ、Ⅲ及Ⅳ级组。检测不同组患者心力衰竭超声指数、血清Gal-3、亲环素A 水平,分析其与心功能的相关性。结果对照组和NYHA Ⅰ、Ⅱ、Ⅲ及Ⅳ级组患者的血清Gal-3、亲环素A、心力衰竭超声指数及LVEF 比较,差异有统计学意义(P <0.05),分级越高,Gal-3、亲环素A 和心力衰竭超声指数越高。收缩性心力衰竭患者血清Gal-3、亲环素A 和心力衰竭超声指数高于舒张性心力衰竭患者(P <0.05);血清Gal-3、亲环素A、心力衰竭超声指数与LVEF 呈负相关(r=-0.635、-0.622 和-0.628,均P <0.05),与心功能NHYA 分级呈正相关(r=0.745、0.834 和0.867,均P <0.05)。结论心力衰竭超声指数联合血清Gal-3、亲环素A 检测可进一步提高慢性心力衰竭的临床诊断水平,可作为评价患者心功能的重要指标.

A review on the critical challenges and progress of SiO_(x)-based anodes for lithium-ion batteries

With the advantages of abundant resources,high specific capacity,and relatively stable cycling performance,silicon suboxides(SiO_(x) ,x<2)have been recently suggested as promising anodes for next-generation lithium-ion batteries(LIBs).SiO_(x) exhibits superior storage capability because of the presence of silicon and smaller volume change upon charge/discharge than Si owing to the buffering effect of the initial lithiation products of inert lithium oxide and lithium silicates,enabling a stable cycle life of electrodes.However,significant improvements such as overcoming issues related to volume changes in cycling and initial irreversible capacity loss and enhancing the ionic and electronic charge transport in poorly conducting SiO_(x) electrodes,are still needed to achieve the satisfactory performance required for commercial applications.This review summarizes recent progress on the cycling performance and initial coulombic efficiency of SiO_(x) .Advances in the design of particle morphology and composite composition,prelithiation and prereduction methods,and usage of electrolyte additives and optimized electrode binders are discussed.Perspectives on the promising research directions that might lead to further improvement of the electrochemical properties of SiO_(x) -based anodes are noted.This paper can serve as a basis for the research and development of high-energy-density LIBs.

National guidelines for diagnosis and treatment of thyroid cancer 2022 in China(English version)

Contents 1. Overview 2. Diagnosis and management 2.1 Screening for high-risk group 2.2 Clinical manifestations 2.2.1 Symptoms 2.2.2 Signs 2.2.3 Invasion and metastasis 2.3 Laboratory examination 2.3.1 Routine examination 2.3.2 Special examination 2.4 Imaging 2.4.1 Ultrasonography 2.4.2 Computed tomography (CT)2.4.3 Magnetic resonance imaging (MRI)2.4.4 Positron emission tomography (PET)-CT。

Comments on National guidelines for diagnosis and treatment of thyroid cancer 2022 in China (English version)

Thyroid cancer (TC) is the most common endocrine system cancer, of note, the overall survival of TC in China is suboptimal when comparing with the developed countries such as US (84.3%vs.98.3%), posing a great challenge among professionals involved in this field.Standardization of its diagnosis and treatment not only provides the basis for all the care givers to promote the entire level of TC management, but also is helpful in shortening the distance between China and other developed countries. A multidisciplinary team (MDT)should be involved in the comprehensive clinical management of TC, particularly for those advanced or refractory TC, which needs cooperation among members from ultrasonography, radiology, pathology, surgery.

Clinical Engineering Benchmarking Comparison Between Zhejiang Province and American Hospitals

Clinical engineering(CE) has evolved rapidly over the last 25 years in China. Among the 34 provincial-level administrative units within China, the Zhejiang Province is one of the most advanced in terms of healthcare technology maintenance and management. In order to determine Zhejiang's current stage of development and opportunities for further improvement, a comparison of the performance of its CE departments was made against hospitals in the USA. Data were collected from 21 Zhejiang hospitals and compared to those from 270 acute-care hospitals in USA collected by Truven Health Analytics. The benchmarking comparison was made in three categories: operational, financial, and productivity. Within the operational category, the following metrics were compared: equipment inventory size/operating beds, annual repairs/inventory size, and annual scheduled maintenance/inventory size. Within the Financial category, the following metrics were compared: total CE expense/operating beds and total CE expense/total hospital expense. Within the Productivity category, the following metrics were compared: total CE full-time equivalent(FTE)/inventory size and total CE FTE/total hospital expense. These comparisons showed that:(1) While the equipment inventory in Zhejiang tends to be much smaller than USA for hospitals of comparable amount of operating beds, the numbers of repairs and scheduled maintenance per inventory size are similar;(2) The total CE expense/total hospital expense ratio is around 1% in both Zhejiang and USA; however, the total CE expense/operating beds and total CE expense/cost of equipment inventory are significantly lower in Zhejiang than USA;(3) The FTE amount in Zhejiang is significantly higher than in USA relative to both inventory size and total hospital operating expense, but significantly lower relative to the number of operating beds. The fact that repairs and scheduled maintenance are similar in Zhejiang and USA shows that CE leaders are managing equipment in comparable manner. Most of the differences found in the comparisons were traced to a few factors. First, the average length of stay in China is substantially higher than USA, which explains why hospitals in Zhejiang tend to have more operating beds but fewer pieces of equipment. Second, labor cost is significantly lower in China than USA, thus allowing Zhejiang hospitals to employ more workers than their American counterparts. Third, there is significantly difference in the cost of living between China and USA; Finally, being public entities Chinese hospitals are managed and operated in a different manner than American hospitals, which are mostly private, albeit nonprofit organizations. Nonetheless, it is interesting to note that hospitals in both areas spend roughly 1% of their total expenditure for CE. The results suggest that CE in Zhejiang is comparable to USA in terms of managerial excellence but there could be some room for improvement in financial management and productivity.

Anti-function solution of uniaxial anisotropic Stoner-Wohlfarth model

The anti-trigonometric function is used to strictly solve the uniaxial anisotropic Stoner-Wohlfarth(SW) model,which can obtain the relation of the angle α(θ) between the magnetization(the anisotropy field) and the applied magnetic field.Using this analytic solution,the hysteresis loops of uniaxial anisotropic SW particles magnetized in typical directions could be numerically calculated.Then,the hysteresis loops are obtained in randomly distributed SW particle ensembles while ignoring the dipole interaction among them with the analytic solution.Finally,the correctness of the analytic solution is verified by the exact solutions of remanence,switching field,and coercivity from the SW model.The analytic solution provides an important reference for understanding the magnetizing and magnetization reversal processes of magnetic materials.

Study on 3D Geological Model of Highway Tunnels Modeling Method

Geology is the base for highways and tunnels construction. With the fast development of national highway construction, highway tunnel construction project are more and more complex. The completeness and accuracy are essential for the planning, design and construction of projects, while the ground information is quite poor in systematic, reliable and timely aspects. Therefore, the development of underground road tunnels, and the implementation of informationized spatial information management is urgent for highway construction. 3D geological tunnel model is intuitive, high efficient and convenience which greatly facilitates the maintenance and security of highway tunnels construction and it will be the trend for the future highway tunnel development.

Pedestrian detection in driver assistance using SSD and PS-GAN

Pedestrian detection is a critical challenge in the field of general object detection,the performance of object detection has advanced with the development of deep learning.However,considerable improvement is still required for pedestrian detection,considering the differences in pedestrian wears,action,and posture.In the driver assistance system,it is necessary to further improve the intelligent pedestrian detection ability.We present a method based on the combination of SSD and GAN to improve the performance of pedestrian detection.Firstly,we assess the impact of different kinds of methods which can detect pedestrians based on SSD and optimize the detection for pedestrian characteristics.Secondly,we propose a novel network architecture,namely data synthesis PS-GAN to generate diverse pedestrian data for verifying the effectiveness of massive training data to SSD detector.Experimental results show that the proposed manners can improve the performance of pedestrian detection to some extent.At last,we use the pedestrian detector to simulate a specific application of motor vehicle assisted driving which would make the detector focus on specific pedestrians according to the velocity of the vehicle.The results establish the validity of the approach.

酚妥拉明对脓毒症心肌损伤患者心功能、心肌损伤指标及血流动力学的影响

目的:观察酚妥拉明治疗脓毒症心肌损伤(SMD)的效果,并分析其对患者心功能、心肌损伤指标及血流动力学的影响。方法:回顾性分析鄂东医疗集团黄石市中心医院2017年2月至2020年2月收治的SMD患者79例的临床资料,以是否联合酚妥拉明治疗分为对照组41例、观察组38例,比较两组临床效果及治疗前后心功能、心肌损伤指标及血流动力学指标。结果:两组28 d病死率差异无统计学意义(P>0.05)。观察组重症监护病房(ICU)入住时间、机械通气时间分别为(9.33±3.52)d、83.00(28.50,138.00)h,均显著短于对照组的(12.17±4.15)d、111.00(47.50,169.00)h(t=3.26,Z=-2.27,均P<0.05)。观察组有效率为81.58%(31/38),显著高于对照组的60.98%(25/41)(χ^(2)=4.05,P<0.05)。治疗后7 d,两组左心室射血分数(LVEF)均显著高于治疗前(均P<0.05),左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均显著低于治疗前(均P<0.05);观察组LVEF显著高于对照组(t=3.29,P<0.05),LVEDD、LVESD均显著低于对照组(t=5.94、11.21,均P<0.05)。两组患者N-末端原脑利钠肽(NT-proBNP)、心肌肌钙蛋白I(cTnI)均随着时间的延长而显著下降(均P<0.05);治疗后24 h、治疗后72 h、治疗后7 d,观察组NT-proBNP、cTnI水平均显著低于对照组(均P<0.05)。治疗后7 d,两组心率(HR)均显著低于治疗前(均P<0.05),平均动脉压(MAP)、心脏指数(CI)、每搏输出量指数(SVI)均显著高于治疗前(均P<0.05);观察组HR显著低于对照组(t=4.90,P<0.05),MAP、CI、SVI均显著高于对照组(t=4.37、3.23、6.01,均P<0.05)。结论:酚妥拉明可改善SMD患者血流动力学,减轻心肌损伤,提高心功能。

Optimizing strain response in lead-free(Bi_(0.5)Na_(0.5))TiO_(3)-BaTiO_(3)-NaNbO_(3)solid solutions via ferroelectric/(non-)ergodic relaxor phase boundary engineering

Lead-free bismuth sodium titanate(Bi_(0.5)Na_(0.5))TiO_(3)(BNT)and related solid solutions are potential piezoelectric materials for such applications as actuators and transducers if their excellent strain responses and piezoelectric properties can be optimized.In this work,a large strain response of 0.61%is achieved in lead-free(0.94-x%)(Bi_(0.5)Na_(0.5))TiO_(3)-0.06BaTiO_(3)-x%NaNbO_(3)(x=0 e6,BNT-6BT-xNN)ceramics with the composition of x=3.5 in a pseudo-cubic structure.Coexistence of ferroelectric(FE)and relaxor(RE)domain structures is observed in all the unpoled ceramics and the enhanced strain response is believed to be related to the evolution of the ergodic relaxor(ER)and non-ergodic(NR)states thanks to the substitution of antiferroelectric NN.BNT-6BT-3.5NN is a critical composition near the FE/NR/ER phase boundary close to room temperature(RT)and its high strain response arises from a synergistic combination of a reversible electric-field-induced phase transition and an active domain switching in the mixed NR/ER state.This work provides new insights into the dynamic interplay between mesoscopic domains and macroscopic electrical properties in the BNT-based piezoceramics.

Methods,progresses,and opportunities of materials informatics

As an implementation tool of data intensive scientific research methods,machine learning(ML)can effectively shorten the research and development(R&D)cycle of new materials by half or even more.ML shows great potential in the combination with other scientific research technologies,especially in the processing and classification of large amounts of material data from theoretical calculation and experimental characterization.It is very important to systematically understand the research ideas of material informatics to accelerate the exploration of new materials.Here,we provide a comprehensive introduction to the most commonly used ML modeling methods in material informatics with classic cases.Then,we review the latest progresses of prediction models,which focus on new processing–structure–properties–performance(PSPP)relationships in some popular material systems,such as perovskites,catalysts,alloys,two-dimensional materials,and polymers.In addition,we summarize the recent pioneering researches in innovation of material research technology,such as inverse design,ML interatomic potentials,and microtopography characterization assistance,as new research directions of material informatics.Finally,we comprehensively provide the most significant challenges and outlooks related to the future innovation and development in the field of material informatics.This review provides a critical and concise appraisal for the applications of material informatics,and a systematic and coherent guidance for material scientists to choose modeling methods based on required materials and technologies.

A modified 3D mean strain energy density criterion for predicting shale mixed-mode I/III fracture toughness

The fracture toughness of rocks is a critical fracturing parameter in geo-energy exploitation playing a significant role in fracture mechanics and hydraulic fracturing.The edge-notched disk bending(ENDB)specimens are employed to measure the entire range of mixed-modeⅠ/Ⅲfracture toughness of Longmaxi shale.To theoretically interpret the fracture mechanisms,this research first introduces the detailed derivations of three established fracture criteria.By distinguishing the volumetric and distortional strain energy densities,an improved three-dimensional mean strain energy density(MSED)criterion is proposed.As the critical volumetric to distortional MSED ratio decreases,the transition from tensiondominated fracture to shear-dominated fracture is observed.Our results indicate that both peak load and applied energy increase significantly with the transition from pure mode I(i.e.,tension)to pure modeⅢ(i.e.,torsion or tearing)since mode-Ⅲcracking happens in a twisted manner and mode-Ⅰcracking occurs in a coplanar manner.The macroscopic fracture signatures are consistent with those of triaxial hydraulic fracturing.The average ratio of pure mode-Ⅲfracture toughness to pure mode-Ⅰfracture toughness is 0.68,indicating that the obtained mode-Ⅲfracture resistance for a tensionbased loading system is apparent rather than true.Compared to the three mainstream fracture criteria,the present fracture criterion exhibits greater competitiveness and can successfully evaluate and predict mixed-modeⅠ/Ⅲfracture toughness of distinct materials and loading methods.

VO2·0.2H2O nanocuboids anchored onto graphene sheets as the cathode material for ultrahigh capacity aqueous zinc ion batteries

Aqueous Zinc-ion batteries(ZIBs),using zinc negative electrode and aqueous electrolyte,have attracted great attention in energy storage field due to the reliable safety and low-cost.A composite material comprised of VO2·0.2H2O nanocuboids anchored on graphene sheets(VOG)is synthesized through a facile and efficient microwave-assisted solvothermal strategy and is used as aqueous ZIBs cathode material.Owing to the synergistic effects between the high conductivity of graphene sheets and the desirable structural features of VO2·0.2H2O nanocuboids,the VOG electrode has excellent electronic and ionic transport ability,resulting in superior Zn ions storage performance.The Zn/VOG system delivers ultrahigh specific capacity of 423 mAh·g^−1 at 0.25 A·g^−1 and exhibits good cycling stability of up to 1,000 cycles at 8 A·g^−1 with 87%capacity retention.Systematical structural and elemental characterizations confirm that the interlayer space of VO2·0.2H2O nanocuboids can adapt to the reversible Zn ions insertion/extraction.The as-prepared VOG composite is a promising cathode material with remarkable electrochemical performance for low-cost and safe aqueous rechargeable ZIBs.

A NEUROENDOCRINE-INSPIRED BIONIC MANUFACTURING SYSTEM

Due to rapid changes of markets and pressures of competitions, the manufacturing companies are forced to adapt their production ways to support diversity of customer＇s needs and increase of new product developments. As biological organisms are quite capable of adapting to environmental changes and stimulus, bio-inspired concepts have been recognized much suitable for adaptive manufacturing system control. This paper, therefore, proposes a novel concept of NeuroEndocrine-Inspired Manufacturing System （NEIMS）. The proposed NEIMS control architecture is based on analogies with neuro-control and hormone-regulation principles. It has the capability to explicitly specify production control schemes including control points, material, information flow paths and logical operations, and to agilely deal with the frequent occurrence of unexpected disturbances at the shop floor level. From the cybernetics point of view, the control model of NEIMS indicates adaptive behavior to the changes in products demands due to external environment and malfunction of manufacturing cells as an intemal environment. Finally, a prototype system has been set up to enable the NEIMS simulation.

Au-catalysed free-standing wurtzite structured InAs nanosheets grown by molecular beam epitaxy

In this study,we report the growth of free-standing InAs nanosheets using Au catalysts in molecular beam epitaxy.Detailed structural characterizations suggest that wurtzite structured InAs nanosheets,with features of extensive{1120}surfaces,grown along the<1102>direction and adopted{0001}nanosheet/catalyst interfaces,are initiated from wurtzite structured[0001]nanowires as the inclined epitaxial growth due to relatively higher In concentrations in Au catalysts,and grown from these inclined nanostructures through catalyst-induced axial growth and their enhanced lateral growth under the high growth temperature.Based on the facts that the nanosheets contain large low energy{1120}surfaces and{0001}nanosheet/catalyst interfaces,the growth of our nanosheets is a thermodynamically driven process.This study provides new insights into fabricating free-standing Ⅲ-Ⅴ nanosheets for their applications in future nanoscale devices.

Tune the electronic structure of MoS_(2)homojunction for broadband photodetection

Due to the weak absorption and low light-matter interaction of MoS_(2),intrinsic MoS_(2)photodetector usually has low photoresponse,thus limiting its real application.Herein,MoS_(2)homojunction was constructed by using the chemical vapor deposition grown intrinsic MoS_(2)films and the Nb-doped MoS_(2)films.The results show that the Nb doping will induce p-type doping in MoS_(2),where the electron concentration will decrease by 2.08×10^(12)cm^(–2)after Nb doping.By investigating the photoelectric effect of MoS_(2)/Nb-doped MoS_(2)homojunction-based phototransistor,the tunability of the photoresponse,detectivity as the function of the external field,wavelength,and power of light have been studied in detail.The results show that the photoresponse and detectivity are strongly dependent on the gate voltage due to the external field tuned interlayer photoexcitation attributing to the band bending.The maximum of photoresponse can reach 51.4 A/W,the detectivity can reach 3.0×10^(12)Jones,which is two orders higher than that of intrinsic MoS_(2).Furthermore,by correlating the photoresponse and detectivity with the external field,it is found that the photodetection of MoS_(2)homojunction can be significantly tuned and exhibit well photodetection in infrared.This comprehensive work not only sheds light on the tunable photoexcitation mechanism but also offers a strategy to achieve a high-performance photodetector.

Mirror-twin induced bicrystalline InAs nanoleaves

In this study, leaf-like one-dimensional InAs nanostructures were grown by the metal-organic chemical vapor deposition method. Detailed structural charac- terization suggests that the nanoleaves contain relatively low-energy {122} or {133} mirror twins acting as their midribs and narrow sections connecting the nanoleaves and their underlying bases as petioles. Importantly, the mirror twins lead to identical lateral growth of the twinned structures in terms of crystallography and polarity, which is essential for the formation of lateral symmetrical nanoleaves. It has been found that the formation of nanoleaves is driven by catalyst energy minimization. This study provides a biomimic of leaf found in nature by fabricating a semiconductor nanoleaf.

Experiments and calculations of wave breaking and evolution of wave groups with high steepness

The evolution of the nonlinear wave groups in deep water is investigated through laboratory measurements and numerical analysis.Laboratory experiments are conducted in deep-water wave tank,focusing on the characteristics of breaking waves arising from the evolved wave train.Some quantitative results are obtained for the significant breaking wave train,including the surface elevation time series,the local geometry,and the energy dissipation.A nonlinear model for the evolution of the wave groups in deep water is developed by adding eddy viscosity dissipation terms in the High Level Irrotational Green-Naghdi(HLIGN)equations.The results of the simulation are compared with the laboratory measurements,and good agreement is observed for the evolved wave train.