外框架斜柱对框架结构受力性能的影响

为了研究外框架斜柱倾角变化对框架结构的受力性能影响,建立了一个采用竖直框架柱的钢筋混凝土框架结构计算模型和4个含有不同倾角的外框架斜柱的框架结构计算模型,通过对模型在不同工况下的内力变化进行对比分析,揭示外框架斜柱外倾角度对框架结构受力的影响。结果表明:斜柱外倾使框架梁受拉,且拉力随斜柱倾斜角度增大而增大,框架梁应按拉弯构件进行设计;在竖向荷载和组合工况下,框架柱均受压,且压力均随斜柱倾角增大而增大;但在地震作用下,斜柱所受拉力随倾角增大而减小,内直框架柱由受压逐渐变为受拉,且拉力随倾角增大而增大。

恶性肿瘤患者症状调查及患者日记工具可行性分析

[目的]分析肿瘤患者在入院时、住院期间及出院时的症状分布及患者日记管理工具在疾病管理中的可行性。[方法]选取全国17家医院的恶性肿瘤患者,向其发放患者日记,指导其如何填写,嘱其每日认真填写日记。通过第三方研究者问询获得并分析患者在住院时、住院期间及出院时的相关症状,通过患者对日记满意度调查与主管医生对日记认可度调查分析患者日记工具的可行性。[结果]共纳入符合要求的152例患者,调查发现肿瘤患者入院时排名前10位的症状分别是疲乏、食量下降(近1周)、疼痛、体重下降(近1个月)、睡眠不好、厌食、胸闷气短、便秘、咳嗽咳痰和心情郁闷;住院期间排名前10位的症状分别是便秘、恶心呕吐、厌食、食量下降(近1周)、腹胀、疼痛、睡眠不好、疲乏、腹泻和发热。出院时排名10位的症状分别是疲乏、便秘、睡眠不好、胸闷气短、疼痛、咳嗽咳痰、厌食、出汗、小便减少、心情郁闷。肿瘤疾病分期为Ⅳ期的患者,入院时的症状患病率明显高于非Ⅳ期患者。绝大部分患者(91.4%,139/152)认可患者日记,认为该患者日记能帮助医生更好的了解自己,65.1%(99/152)的患者表示自己出院后会继续填写该日记内容,82.2%(125/152)的患者表示填写日记不会造成负担。绝大部分主管医生(77.6%,118/152)认为患者日记设计合理,77.0%(117/152)的主管医生认可患者日记并愿意继续使用,75.7%(115/152)的主管医生认为患者日记实用性很强,72.4%(104/152)主管医生认为患者日记能够帮助自己全面了解患者症状,64.4%(98/152)的主管医生认为患者日记能够提高查房效率。[结论]Ⅳ期肿瘤患者相关症状发生率明显高于非Ⅳ期患者,需重点监测和管理。肿瘤患者临床症状在住院期间部分会得以改善,但治疗相关的不良反应使出院时症状又有升高,需要主管医生引起重视并加强出院后随访及症状管理。患者日记工具能够使患者重视肿瘤所有相关的症状的监测,能提高医护工作人员的查房效率,有助于患者及家属在出院后的疾病全程相关症状管理,值得进一步临床研究及使用。

Topical Delivery of Modified Da-Cheng-Qi Decoction(加味大承气汤) Using Low-Frequency Ultrasound Sonophoresis for Refractory Metastatic Malignant Bowel Obstruction:An Open-Label Single-Arm Clinical Trial

Objective:To evaluate the efficacy and safety of topical delivery of modified Da-Cheng-Qi Decoction(加味大承气汤,MDCQD)by low-frequency ultrasound sonophoresis(LFUS)in patients with refractory metastatic malignant bowel obstruction(MBO)using an objective performance criteria(OPC)design.Methods:Fifty patients with refractory metastatic MBO were enrolled in this open-label single-arm clinical trial.Alongside fasting,gastrointestinal decompression,glycerol enema,intravenous nutrition and antisecretory therapy,a 50 g dose of MDCQD(prepared as a hydrogel)was applied through topical delivery at the site of abodminal pain or Tianshu(S 25)using LFUS for 30 min,twice daily for 5 consecutive days.The overall outcomes were the remission of intestinal obstruction,improvement on abdominal pain,abdominal distention,nausea and vomiting scores.Indicators of safety evaluation included liver and renal function as well as blood coagulation indicators.Results:Among 50 patients,5 patients(10%)showed complete remission of intestinal obstruction and 21 patients(42%)showed improvement of intestinal obstruction.The overall remission rate of bowel obstruction was 52%.The results of the symptom score,based on the severity and frequency of the episode,were as follows:26 patients(52%)showed improvment on symptom scores,20 patients(40%)did not respond to treatment,and 4 patients(8%)discontinued treatment due to intolerance.No serious adverse effects or abnormal changes on liver and renal functions or blood coagulation were observed.Conclusion:Topical delivery of MDCQD at 100 g/day using LFUS can improve the treatment response in patients with refractory metastatic MBO.

Low-Frequency Sonophoresis of Chinese Medicine Formula Improves Efficacy of Malignant Pleural Effusion Treatment

Objective:To evaluate whether low-frequency ultrasound-facilitated transdermal delivery of a Chinese medicine(CM)formula could improve the efficacy of intrapleural administration of interleukin?2(IL-2)in treatment of malignant pleural effusion(MPE).Methods:A total of 110 eligible participants were randomized into the low-frequency sonophoresis(LFS)of CM(LSF/CM)group(55 cases)and the control group(55 cases)by simple randomization using a random number table.The control group was treated with an intrapleural administration of IL-2;and the LFS/CM group was treated with LFS of a CM gel formulation,combined with the same IL-2 injection as in the control group.The CM formula consisted of Semen Lepidii,Semen Sinapis,Flamulus Cinnamomi,Poriacocos,Herba Lycopi,and Radix Paeoniae Rubra.After 2-week treatment,the therapeutic outcome was determined by the change of the amount of MPE,which was evaluated by B-scan ultrasound and/or chest X-ray,and the change of quality of life(QOL)scores,which were evaluated by the Eastern Cooperative Oncology Group(ECOG)performance status.Results:A significantly higher objective remission rate(ORR)was obtained with intrapleural IL-2 plus LFS/CM than IL-2 treatment alone(P=0.049).In addition,more patients in the LFS/CM group than in the control group had an improved QOL score(P=0.048),and no patients in the LFS/CM group had a reduced QOL.Conclusion:LFS of CM formulation could effectively alleviate MPE and improve the QOL of cancer patients.