Efficacy and safety of endoscopic submucosal dissection for early gastric cancer and precancerous lesions in elderly patients

BACKGROUND With advancements in the development of endoscopic technologies,the endo-scopic submucosal dissection(ESD)has been one of the gold-standard therapies for early gastric cancer.AIM To investigate the efficacy and safety ESD in the treatment of early gastric cancer and precancerous lesions in the elderly patients.METHODS Seventy-eight elderly patients with early gastric cancer and precancerous lesions admitted to the Third Affiliated Hospital of Qiqihar Medical University were se-lected and classified into two groups according to the different surgical therapies they received between January 2021 and June 2022.Among them,39 patients treated with ESD were included in an experimental group,and 39 patients treated with endoscopic mucosal resection(EMR)were included in a control group.We compared the basic intraoperative conditions,postoperative short-term recovery,long-term recovery effects and functional status of gastric mucosa between the two groups;the basic intraoperative conditions included lesion resection,intra-operative bleeding and operation time;the postoperative short-term recovery assessment indexes were length of hospital stay and incidence of surgical complic-ations;and the long-term recovery assessment indexes were the recurrence rate at 1 year postoperatively and the survival situation at 1 year and 3 years postoper-atively;and we compared the preoperative and predischarge serum pepsinogen I(PG I)and PG II levels and PG I/PG II ratio in the two groups before surgery and discharge.RESULTS The curative resection rate and the rate of en bloc resection were higher in the experimental group than in the control group.The intraoperative bleeding volume was higher in the experimental group than in the control group.The operation time was longer in the experimental group than that in the control group,and the rate for base residual focus was lower in the experimental group than that of the control group,and the differences were all statistically significant(all P<0.05).The length of hospital stay was longer in the experi-mental group than in the control group,and the incidence of surgical complications,1-year postoperative recu-rrence rate and 3-year postoperative survival rate were lower in the experimental group than in the control group,and the differences were statistically significant(all P<0.05).However,the difference in the 1-year postoperative survival rate was not statistically significant between the two groups(P>0.05).Before discharge,PG I and PG I/PG II ratio were elevated in both groups compared with the preoperative period,and the above indexes were higher in the experimental group than those in the control group,and the differences were statistically significant(both P<0.05).Moreover,before discharge,PG II level was lower in both groups compared with the preoperative period,and the level was lower in the experimental group than in the control group,and the differences were all statistically significant(all P<0.05).CONCLUSION Compared with EMR,ESD surgery is more thorough.It reduces the rate of base residual focus,recurrence rate,surgical complications,and promotes the recovery of gastric cells and glandular function.It is safe and suitable for clinical application.

Clinical efficacy of laparoscopic cholecystectomy combined with endoscopic papillary balloon dilation in treatment of gallbladder stones with common bile duct stones: A retrospective study

BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.

Influence of underground space development mode on the groundwater flow field in Xiong’an new area

The degree and scale of underground space development are growing with the continuous advancement of urbanization in China.The lack of research on the change of the groundwater flow field before and after the development of underground space has led to various problems in the process of underground space development and operation.This paper took the key development zone of the Xiong’an New Area as the study area,and used the Groundwater modeling system software(GMS)to analyse the influence on the groundwater flow field under the point,line,and surface development modes.The main results showed that the underground space development would lead to the expansion and deepening of the cone of depression in the aquifer.The groundwater level on the upstream face of the underground structure would rise,while the water level on the downstream face would drop.The“line”concurrent development has the least impact on the groundwater flow field,and the maximum rise of water level on the upstream side of the underground structure is expected to be approximately 3.05 m.The“surface”development has the greatest impact on the groundwater flow field,and the maximum rise of water level is expected to be 7.17 m.

妊娠晚期糖尿病代谢和内皮损伤指标检测的临床意义

目的通过检测妊娠晚期糖尿病患者的血脂、血管内皮损伤标志物及骨代谢指标,探究其临床意义。方法选取2015年1月-2016年12月在该院就诊的110例妊娠晚期糖尿病患者,作为观察组;同期选取110例健康孕晚期孕妇作为对照组。于孕36周,采集所有孕妇的血液标本,检测子宫动脉搏动指数(UAPI)。比较两组血脂、血管内皮损伤标志物及骨代谢指标,分析妊娠晚期糖尿病患者UAPI、新生儿出生体重与血脂、血管内皮损伤标志物及骨代谢指标的相关性,以及血脂、血管内皮损伤标志物及骨代谢指标三者的相关性。结果观察组血糖、新生儿出生体重、三酰甘油(TG)、血管细胞黏附分子-1、骨钙素、总I型胶原氨基端延长肽及β-胶原降解产物水平高于对照组(P<0.05)。妊娠晚期糖尿病患者中,UAPI与TG呈正相关(P<0.05),与高密度胆固醇呈负相关(P<0.05);新生儿出生体重与TG呈正相关(P<0.05)。结论妊娠晚期糖尿病患者体内血脂和骨代谢水平升高,提示妊娠晚期糖尿病患者可能合并脂代谢异常、血管内皮损伤,且机体可代偿性地增强骨代谢。

Humanoid Based Intelligence Control Strategy of Plastic Cement Die Press Work-Piece Forming Process for Polymer Plastics

The plastic cement belongs to a sort of polymer material, the chemical composition is very complex, and the plastic cement work-piece is generally manufactured by die press forming. Aimed at being difficult to control in parameters of forming process, the paper explored the humanoid based intelligence control strategy. In the paper, it made the anatomy in control puzzle resulted in uncertainty such as chemical component of plastic cement etc., summarized up the characteristic of cybernetics in forming process, researched on the humanoid based intelligence control strategy, and constructed the control algorithm of forming process in plastic cement work-piece. Taking the process experiment of temperature and pressure control as an example, it validated the good dynamic and static control quality through simulation of control algorithm constructed in this paper. The experimental results show that the control algorithm explored in this paper is reasonably available.

天山乌鲁木齐河源1号冰川东支能量-物质平衡模拟研究

基于天山乌鲁木齐河源1号冰川东支海拔4025m处自动气象站的观测数据和同期物质平衡花杆观测数据,采用COSIMA模型,对该冰川东支2018年消融期单点能量-物质平衡进行了模拟。结果显示:物质平衡模拟值为(-0.67±0.03)m w.e.,与实测值有非常好的一致性,相关系数达0.96。造成冰川消融的能量来源于净短波辐射(84%)、感热通量(16%);冰川能量支出为净长波辐射(55%)、冰川消融耗热(32%)、潜热交换(7%)及地热通量(6%)。受能量收支影响,模拟物质平衡主要取决于表面消融和固态降水。与我国其他区域大陆型冰川研究结果比较发现,乌鲁木齐河源1号冰川物质损失较为显著,能量通量主要取决于海拔以及气候条件,再冻结和固态降水显著小于羌塘1号冰川和扎当冰川,推测与单条冰川所处的大气环流有关。

亚麻籽及亚麻籽油对围生期母羊生产性能的影响

为了研究亚麻籽及亚麻籽油对围生期母羊生产性能的影响,试验选取妊娠120 d的母羊60只,随机分成4组,每组15只,对照组饲喂基础日粮,试验组分别饲喂含有5.25%炒亚麻籽的日粮(炒亚麻籽组)、含有5.25%生亚麻籽的日粮(生亚麻籽组)和含有2.25%亚麻籽油的日粮(亚麻籽油组),试验期为60 d,其中预试期15 d,正试期45 d,测定分析了母羊的生产性能,并对各组的经济效益进行对比分析。结果表明:三个试验组羔羊死亡率平均为9.95%,比对照组低7.69百分点;三个试验组羔羊初生体重差异不显著(P>0.05),但均显著高于对照组(P<0.05),平均提高12.92百分点;各组间1月龄体重差异显著(P<0.05),其中炒亚麻籽组和亚麻籽油组均显著高于生亚麻籽组(P<0.05),而生亚麻籽组又显著高于对照组(P<0.05);炒亚麻籽组和亚麻籽油组1月龄日增重均显著高于生亚麻籽组和对照组(P<0.05),而炒亚麻籽组与亚麻籽油组,生亚麻籽组与对照组之间差异均不显著(P>0.05)。炒亚麻籽组、生亚麻籽组和亚麻籽油组每只母羊的毛利比对照组分别提高45.25元、42.97元和34.34元,差异十分明显。说明亚麻籽及其油可明显提高母羊产羔性能,效益十分明显。

Efficacy of Anshen Jieyu Decoction for Sub-healthy People with Insomnia

[Objectives]To investigate the efficacy of Anshen Jieyu decoction for sub-healthy people with insomnia.[Methods]A total of 80 sub-healthy insomnia patients admitted to Taihe Hospital of Shiyan City from January,2020 to December,2020 were selected as the research objects.All the patients were divided into observation group and control group according to a random number table.The control group was treated with conventional Western medicine,and the observation group was treated with Anshen Jieyu decoction.The clinical treatment effect of the two groups was compared.[Results]Before the intervention,there was no significant difference in Pittsburgh sleep quality index between the two groups.After the intervention,the scores of time required to fall asleep[(1.2±0.3)points],sleep time[(1.2±0.4)points],sleep disorder[(1.2±0.2)points],sleep efficiency[(1.4±0.3 points)],sleep quality[(0.9±0.2)points]and daytime dysfunction[(0.9±0.4)points]of the observation group were significantly lower than those of the control group.There was no significant difference in life quality between the two groups before the intervention.The scores of physical function[(92.3±3.3)points],social function[(91.7±4.1)points],mental health[(92.3±4.1)points]and emotional role[(92.8±5.2)points]after the intervention were significantly higher than those before the intervention.Before the intervention,there was no significant difference in the severity of insomnia between the two groups.After the intervention,the score of insomnia severity index was(10.3±3.0)points in the observation group and was(12.2±2.9)points in the control group.In terms of safety,there were 23 cases of level 1,15 cases of level 2 and 2 cases of level 3 in the observation group,and there were 20 cases of level 1,16 cases of level 2 and 4 cases of level 3 in the control group.No significant difference was observed in treatment safety between the two groups.[Conclusions]Anshen Jieyu decoction is effective in treating sub-healthy insomnia and is worthy of promotion.

Primary investigation of statistical correlation between changes in ice volume and area of glaciers

This study makes an attempt to investigate through statistical analysis the correlation between changes in ice volume and area of glaciers. Using data from nine sample glaciers in the Tian Shan, the results show that a linear relation exists between changes in ice volume and area, with a correlation coefficient of 0.700. However, the accuracy estimation is difficult due to the limited number of samples. The correlation was not improved after adding eleven glacier samples in other mountains. Two reference glaciers are then analyzed in more detail. The linear correlation coefficient is higher than 0.800 when using the observed changes in ice volume and area during different periods on Urumqi Glacier No. 1, which suggests that the linear relation is valid for one glacier for different periods if its shape does not change noticeably and also for other glaciers of the same shape during the same period. The relation between changes in ice volume and area of Qingbingtan Glacier No. 72 is different during different periods due to change in the shape of the glacier tongue and the influence of the debris cover. Moreover, errors in glacier-change monitoring and-volume estimation have an important influence on the correlation results. Therefore, further study needs to focus not only on the distinction between glacier types and between different periods but also on the accuracy of volume estimation.

Chemistry and environmental significance of aerosols collected in the eastern Tianshan

Aerosol samples were collected at altitudes from 584 m a.s.l.to 3,804 m a.s.l.at seven sites of the eastern Tianshan.The occurrence,distribution,and possible sources of 47 trace metals—including alkali metals and alkali earth metals,transition metals,lanthanoids,and heavy metals—were investigated.It was found that four sampling sites(Shuinichang,1,691 m a.s.l.;Urumqi City,809 m a.s.l.;Fu Kang Station,584 m a.s.l.;and Bogeda Glacier No.4,3,613 m a.s.l.)were contaminated mainly by heavy metals.Other three high-altitude sites(Urumqi Glacier No.1,3,804 m a.s.l.;Wang Feng road-maintenance station,3,039 m a.s.l.;and Tianshan Glaciology Station,2,135 m a.s.l.)were not polluted.The aerosol particles were clustered into two dominant types:crust-originated particles and pollution-derived particles.Aerosols from UG1,WF,and TGS were characterized by crust-originated particles such as clay,plagioclase,dolomite,alkali feldspar,and biotite;while those from SNC,Urumqi,FK,and BG4 were characterized by high content of Cl-rich particles,S-rich particles,and soot.The backward-trajectories results indicated that air masses arriving at SNC,Urumqi,FK,and BG4 were identified as the more polluted source,when compared to the short-range air mass transport from the North to UGI and WF.Relatively lower altitude,as well as terrain blocking,might be another important reason for the gradient difference in pollution influence among these seven places in the Urumqi River Basin.

医护人员对ICU物理环境因素认知的多中心调查

目的了解医护人员对ICU物理环境因素的知识和态度,探索其影响因素,为优化ICU物理环境因素提供参考依据。方法采用分层抽样的方法,使用自制问卷对福建省8所三级医院及14所二级医院的487名ICU医护人员进行问卷调查。结果调查对象对物理环境因素的知识、态度得分分别为(33.25±7.14)分、(42.17±3.26)分。多元线性回归分析结果显示,文化程度、医院等级是ICU医护人员对物理环境因素知识水平的影响因素(P<0.01),职称、行政职务和医院等级是ICU医护人员对物理环境因素态度的影响因素(P<0.01)。结论 ICU医护人员对ICU物理环境因素持积极态度,但相关知识有待提高。