The primary objective of emergency pre-examination and triage is to provide the most appropriate clinical service to patients with acute and critical illnesses while ensuring the optimal utilization of limited medical...The primary objective of emergency pre-examination and triage is to provide the most appropriate clinical service to patients with acute and critical illnesses while ensuring the optimal utilization of limited medical resources.With the advancement of medical information technology,mobile technology,and information management,these features have been gradually incorporated into emergency pre-examination and triage and have shown promising outcomes.In this article,the benefits of implementing mobile technology and the current status of integrated information management to provide a reference for the future development and enhancement of emergency pre-examination and triage are reviewed.展开更多
Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical outcomes.Therefore,we aimed to evaluat...Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical outcomes.Therefore,we aimed to evaluate the predictive value of liver stiffness for the regression of liver fibrosis.Methods:In this study,we collected data from a clinical cohort of patients who are received anti-virus therapies for 48 weeks.180 naive chronic hepatitis B(CHB)patients,who received paired LSM and liver biopsy with pre-and post-treatments were analyzed.Two methods(FibroScan and iLivTouch)test LSM.Result:The area under the receiver operating characteristics curve(AUROC)of changing LSM for fibrosis regression is higher in advanced fibrosis patients(F5/6)than in moderate fibrosis patients(F3/4)in both FibroScan(0.719,95%CI,0.590–0.848;P=0.003;vs 0.617,95%CI,0.379–0.856,P=0.282)and iLivTouch(0.707,95%CI,0.567–0.847;P=0.011;vs 0.583,95%CI,0.422–0.744;P=0.377).A higher kappa value was received in advanced stage than in moderate stage both in FibroScan(0.392,P=0.001 vs 0.265,P=0.053)and iLivTouch(0.326,P=0.019 vs 0.030,P=0.833).Cut-off set as 4.10 kPa(sen,69.4%;spe,73.9%)in FibroScan,as 4.25 kPa(sen,56.8%;spe,72.2%)in iLivTouch.Conclusion:The changing LSM can be used for predicting the liver fibrosis regression in advanced stage of CHB patients.展开更多
Background: Neonatal hyperbilirubinemia is indeed common. However, severe nerve injuries and bilirubin encephalopathy are rare and only occur in the unusual cases of extreme hyperbilirubinemia. Objectives: To investig...Background: Neonatal hyperbilirubinemia is indeed common. However, severe nerve injuries and bilirubin encephalopathy are rare and only occur in the unusual cases of extreme hyperbilirubinemia. Objectives: To investigate brain magnetic resonance imaging (MRI) changes and their correlations with perinatal predisposing factors in neonates with indirect hyperbilirubinemia, via regions of interest (ROIs) analysis. Methods: Seventy-six neonates with a gestational age of ≥35 weeks diagnosed with neonatal indirect hyperbilirubinemia or bilirubin encephalopathy all underwent brain MRI during hospitalization. Depending on peak total serum bilirubin (TSB), they were assigned to group A (<221 μmol/L), B (≥221 μmol/L μmol/L), C (≥42 μmol/L μmol/L), or D (≥428 μmol/L). The globus pallidus and the white matter around the anterior horn of the lateral ventricle and posterior horn of the lateral ventricle were selected as the ROIs. Average optical densities (AODs) of the ROIs and the cerebrospinal fluid region were measured. The ratio between the AODs was designated as the relative optical density (ROD), and used to determine relative signal intensity. Results: RODs of the globus pallidus were significantly lower in group D than in all other groups. TSB and the ratio of TSB to serum albumin concentration (B/A) was significantly negatively correlated with ROD in theglobus pallidus. Corrected age was significantly negatively correlated with the ROD of the ROIs. Conclusions: Semi-quantitative image analysis is a feasible method to assess conventional brain MRI for neonatal indirect hyperbilirubinemia. The signal intensity of the globus pallidus in T1-weighted images was significantly correlated with TSB level and B/A.展开更多
为提高黄土高原东部河谷平原春玉米水分利用效率,探究最适宜该地区春玉米种植的地表覆盖措施,基于连续7年长期定位试验,于2021—2022年开展田间试验,共选取无覆盖(CK)、地膜覆盖(plastic film mulching,FM)以及秸秆覆盖(straw mulching,...为提高黄土高原东部河谷平原春玉米水分利用效率,探究最适宜该地区春玉米种植的地表覆盖措施,基于连续7年长期定位试验,于2021—2022年开展田间试验,共选取无覆盖(CK)、地膜覆盖(plastic film mulching,FM)以及秸秆覆盖(straw mulching,SM)3个处理,研究不同覆盖措施对土壤水热状况及春玉米产量和水分利用效率的影响,系统分析了2年试验期土壤水分与温度动态变化及春玉米各阶段水分生产力,为该地区春玉米水肥高效提供利于农业可持续发展的科学管理措施。结果表明:与无覆盖处理相比,地膜覆盖具有增温效应,2年内土壤温度提高0.72~2.63℃;秸秆覆盖具有降温效应,2年内土壤温度降低0.20~1.51℃。与无覆盖处理相比,地膜与秸秆覆盖处理均可改善春玉米生长前期土壤含水量,并驱动土壤“湿干交替”现象促进水分吸收,提高水分利用效率,实现增产。虽然地膜覆盖处理改善了前期土壤含水量,促进春玉米前期生长发育,但会导致根系生长过浅,不利于生长后期水分利用,甚至植株存在倒伏风险(2021年倒伏率高达72.14%),影响产量形成。与地膜覆盖处理相比,秸秆覆盖处理驱动土壤“湿干交替”时表现出更强水分缓冲力,协调春玉米各阶段生长发育,生长后期水分利用效率显著提高25.17%~34.71%,并降低倒伏风险。2年平均数据显示,与地膜覆盖处理相比,秸秆覆盖处理产量与水分利用效率显著提高8.55%和10.23%,经济效益显著提高12.57%。综上所述,秸秆覆盖可作为该地区春玉米水肥高效可持续利用的科学管理措施。展开更多
H-steel all-bolted connection steel frame structures with heat preservation and decoration composite wall boards were investigated and the seismic performances of three scaled specimens were studied.The failure modes,...H-steel all-bolted connection steel frame structures with heat preservation and decoration composite wall boards were investigated and the seismic performances of three scaled specimens were studied.The failure modes,hysteresis curves,bearing capacity,ductility,energy dissipation capacity,stiffness degradation and strain distribution were discussed.The calculation method of structural theoretical internal force was presented.The results showed that the overall structural seismic performance was better,and the structural ductility met the demands of elastic-plastic inter-story drift angle for seismic design.The H-steel weak-axis connection structure obtained better energy dissipation capacity,and its bearing capacity and stiffness were slightly different from the strong-axis connection.The heat preservation and decoration performance of composite wallboard and the all-bolted connection of the steel frame realized prefabrication during the whole construction period.The plastic hinge of the steel beam can be moved outwards because of the L-angles,which effectively avoids stress concentration in joint areas and expands the plastic hinge range.The errors between the theoretical structural capacity calculated by the plastic analysis method and the test results were within 2.44%.In addition,structural failure mechanisms and bearing capacities were verified by the finite element(FE)analysis,and the effects of the main parameters on the structures were investigated.The FE verification results were the same as in the test.The research results provide theoretical support and technical guidance for the application of thermal insulation and decorative composite wall panels in H-shaped steel all-bolted steel frames.展开更多
文摘The primary objective of emergency pre-examination and triage is to provide the most appropriate clinical service to patients with acute and critical illnesses while ensuring the optimal utilization of limited medical resources.With the advancement of medical information technology,mobile technology,and information management,these features have been gradually incorporated into emergency pre-examination and triage and have shown promising outcomes.In this article,the benefits of implementing mobile technology and the current status of integrated information management to provide a reference for the future development and enhancement of emergency pre-examination and triage are reviewed.
基金supported by the National Science and Technology Major Project,The People’s Republic of China(2018ZX10302204,2014ZX10005001)the National Natural Science Foundation of China(81730109,82274305)。
文摘Background and objective:Liver stiffness measurement(LSM)may effectively correlate to the presence of liver fibrosis,but it is controversial to use for the prediction of clinical outcomes.Therefore,we aimed to evaluate the predictive value of liver stiffness for the regression of liver fibrosis.Methods:In this study,we collected data from a clinical cohort of patients who are received anti-virus therapies for 48 weeks.180 naive chronic hepatitis B(CHB)patients,who received paired LSM and liver biopsy with pre-and post-treatments were analyzed.Two methods(FibroScan and iLivTouch)test LSM.Result:The area under the receiver operating characteristics curve(AUROC)of changing LSM for fibrosis regression is higher in advanced fibrosis patients(F5/6)than in moderate fibrosis patients(F3/4)in both FibroScan(0.719,95%CI,0.590–0.848;P=0.003;vs 0.617,95%CI,0.379–0.856,P=0.282)and iLivTouch(0.707,95%CI,0.567–0.847;P=0.011;vs 0.583,95%CI,0.422–0.744;P=0.377).A higher kappa value was received in advanced stage than in moderate stage both in FibroScan(0.392,P=0.001 vs 0.265,P=0.053)and iLivTouch(0.326,P=0.019 vs 0.030,P=0.833).Cut-off set as 4.10 kPa(sen,69.4%;spe,73.9%)in FibroScan,as 4.25 kPa(sen,56.8%;spe,72.2%)in iLivTouch.Conclusion:The changing LSM can be used for predicting the liver fibrosis regression in advanced stage of CHB patients.
文摘Background: Neonatal hyperbilirubinemia is indeed common. However, severe nerve injuries and bilirubin encephalopathy are rare and only occur in the unusual cases of extreme hyperbilirubinemia. Objectives: To investigate brain magnetic resonance imaging (MRI) changes and their correlations with perinatal predisposing factors in neonates with indirect hyperbilirubinemia, via regions of interest (ROIs) analysis. Methods: Seventy-six neonates with a gestational age of ≥35 weeks diagnosed with neonatal indirect hyperbilirubinemia or bilirubin encephalopathy all underwent brain MRI during hospitalization. Depending on peak total serum bilirubin (TSB), they were assigned to group A (<221 μmol/L), B (≥221 μmol/L μmol/L), C (≥42 μmol/L μmol/L), or D (≥428 μmol/L). The globus pallidus and the white matter around the anterior horn of the lateral ventricle and posterior horn of the lateral ventricle were selected as the ROIs. Average optical densities (AODs) of the ROIs and the cerebrospinal fluid region were measured. The ratio between the AODs was designated as the relative optical density (ROD), and used to determine relative signal intensity. Results: RODs of the globus pallidus were significantly lower in group D than in all other groups. TSB and the ratio of TSB to serum albumin concentration (B/A) was significantly negatively correlated with ROD in theglobus pallidus. Corrected age was significantly negatively correlated with the ROD of the ROIs. Conclusions: Semi-quantitative image analysis is a feasible method to assess conventional brain MRI for neonatal indirect hyperbilirubinemia. The signal intensity of the globus pallidus in T1-weighted images was significantly correlated with TSB level and B/A.
文摘为提高黄土高原东部河谷平原春玉米水分利用效率,探究最适宜该地区春玉米种植的地表覆盖措施,基于连续7年长期定位试验,于2021—2022年开展田间试验,共选取无覆盖(CK)、地膜覆盖(plastic film mulching,FM)以及秸秆覆盖(straw mulching,SM)3个处理,研究不同覆盖措施对土壤水热状况及春玉米产量和水分利用效率的影响,系统分析了2年试验期土壤水分与温度动态变化及春玉米各阶段水分生产力,为该地区春玉米水肥高效提供利于农业可持续发展的科学管理措施。结果表明:与无覆盖处理相比,地膜覆盖具有增温效应,2年内土壤温度提高0.72~2.63℃;秸秆覆盖具有降温效应,2年内土壤温度降低0.20~1.51℃。与无覆盖处理相比,地膜与秸秆覆盖处理均可改善春玉米生长前期土壤含水量,并驱动土壤“湿干交替”现象促进水分吸收,提高水分利用效率,实现增产。虽然地膜覆盖处理改善了前期土壤含水量,促进春玉米前期生长发育,但会导致根系生长过浅,不利于生长后期水分利用,甚至植株存在倒伏风险(2021年倒伏率高达72.14%),影响产量形成。与地膜覆盖处理相比,秸秆覆盖处理驱动土壤“湿干交替”时表现出更强水分缓冲力,协调春玉米各阶段生长发育,生长后期水分利用效率显著提高25.17%~34.71%,并降低倒伏风险。2年平均数据显示,与地膜覆盖处理相比,秸秆覆盖处理产量与水分利用效率显著提高8.55%和10.23%,经济效益显著提高12.57%。综上所述,秸秆覆盖可作为该地区春玉米水肥高效可持续利用的科学管理措施。
文摘H-steel all-bolted connection steel frame structures with heat preservation and decoration composite wall boards were investigated and the seismic performances of three scaled specimens were studied.The failure modes,hysteresis curves,bearing capacity,ductility,energy dissipation capacity,stiffness degradation and strain distribution were discussed.The calculation method of structural theoretical internal force was presented.The results showed that the overall structural seismic performance was better,and the structural ductility met the demands of elastic-plastic inter-story drift angle for seismic design.The H-steel weak-axis connection structure obtained better energy dissipation capacity,and its bearing capacity and stiffness were slightly different from the strong-axis connection.The heat preservation and decoration performance of composite wallboard and the all-bolted connection of the steel frame realized prefabrication during the whole construction period.The plastic hinge of the steel beam can be moved outwards because of the L-angles,which effectively avoids stress concentration in joint areas and expands the plastic hinge range.The errors between the theoretical structural capacity calculated by the plastic analysis method and the test results were within 2.44%.In addition,structural failure mechanisms and bearing capacities were verified by the finite element(FE)analysis,and the effects of the main parameters on the structures were investigated.The FE verification results were the same as in the test.The research results provide theoretical support and technical guidance for the application of thermal insulation and decorative composite wall panels in H-shaped steel all-bolted steel frames.
