目的探讨食管闭锁术后经鼻胃管进行高能量密度的早期肠内营养模式对术后恢复的影响。方法收集2016年1月至2022年12月在天津市儿童医院一期食管吻合手术治疗的Ⅲb型先天性食管闭锁36例患儿的资料,所有患儿均于术后早期经鼻胃管进行肠内营...目的探讨食管闭锁术后经鼻胃管进行高能量密度的早期肠内营养模式对术后恢复的影响。方法收集2016年1月至2022年12月在天津市儿童医院一期食管吻合手术治疗的Ⅲb型先天性食管闭锁36例患儿的资料,所有患儿均于术后早期经鼻胃管进行肠内营养(enteral nutrition,EN)。根据所使用配方奶能量密度分为两组:一组为早期微量EN组17例,其中男11例,女6例,胎龄为(38.8±1.3)周,出生体重为(2.6±0.3)kg,术后早期给予深度水解配方奶微量喂养;另一组早期强化EN组19例,其中男13例,女6例,胎龄为(38.5±1.8)周,出生体重为(2.8±0.4)kg,术后早期给予高能量密度深度水解配方奶喂养。两组均根据胃肠道耐受情况,逐步增加肠内营养量,最终过渡至完全经口喂养。采用IBM SPSS Statistics 26软件处理所有数据,符合正态分布的定量资料用独立样本t检验,非正态分布用非参数检验。结果两组在术前一般指标、手术方式、喂养不耐受、术后首次排便时间、术后14 d血清前白蛋白水平及术后1个月年龄别体重Z值(weight for age z score,WAZ)方面差异无统计学意义(P>0.05);早期强化EN组术后7 d血清前白蛋白水平、日均体重增长、达到全肠内营养时间、住院时长、住院总费用方面明显优于早期微量EN组,差异均有统计学意义(P<0.05)。结论新生儿食管闭锁术后早期高能量密度的肠内营养有助于改善围手术期营养状态,缩短住院时间及减少医疗花费,值得临床推广。展开更多
Combustion instability of pilot flame has been investigated in a model pilot bluff body stabilized combustor by running the pilot flame only. The primary objectives are to investigate the pilot flame dynamics and to p...Combustion instability of pilot flame has been investigated in a model pilot bluff body stabilized combustor by running the pilot flame only. The primary objectives are to investigate the pilot flame dynamics and to provide bases for the study of the interaction mechanisms between the pilot flame and the main flame. Dynamic pressures are measured by dynamic pressure transduc- ers. A high speed camera with CH* bandpass filter is used to capture the pilot flame dynamics. The proper orthogonal decomposition (POD) is used to further analyze the high speed images. With the increase of the pilot fuel mass flow rate, the pilot flame changes from stable to unstable state grad- ually. The combustion instability frequency is 136 Hz when the pilot flame is unstable. Numerical simulation results show that the equivalence ratios in both the shear layer and the recirculation zone increase as the pilot fuel mass flow rate increases. The mechanism of the instability of the pilot flame can be attributed to the coupling between the second order acoustic mode and the unsteady heat release due to symmetric vortex shedding. These results illustrate that the pilot fuel mass flow rate has significant influences on the dynamic stability of the pilot flame.展开更多
文摘目的探讨食管闭锁术后经鼻胃管进行高能量密度的早期肠内营养模式对术后恢复的影响。方法收集2016年1月至2022年12月在天津市儿童医院一期食管吻合手术治疗的Ⅲb型先天性食管闭锁36例患儿的资料,所有患儿均于术后早期经鼻胃管进行肠内营养(enteral nutrition,EN)。根据所使用配方奶能量密度分为两组:一组为早期微量EN组17例,其中男11例,女6例,胎龄为(38.8±1.3)周,出生体重为(2.6±0.3)kg,术后早期给予深度水解配方奶微量喂养;另一组早期强化EN组19例,其中男13例,女6例,胎龄为(38.5±1.8)周,出生体重为(2.8±0.4)kg,术后早期给予高能量密度深度水解配方奶喂养。两组均根据胃肠道耐受情况,逐步增加肠内营养量,最终过渡至完全经口喂养。采用IBM SPSS Statistics 26软件处理所有数据,符合正态分布的定量资料用独立样本t检验,非正态分布用非参数检验。结果两组在术前一般指标、手术方式、喂养不耐受、术后首次排便时间、术后14 d血清前白蛋白水平及术后1个月年龄别体重Z值(weight for age z score,WAZ)方面差异无统计学意义(P>0.05);早期强化EN组术后7 d血清前白蛋白水平、日均体重增长、达到全肠内营养时间、住院时长、住院总费用方面明显优于早期微量EN组,差异均有统计学意义(P<0.05)。结论新生儿食管闭锁术后早期高能量密度的肠内营养有助于改善围手术期营养状态,缩短住院时间及减少医疗花费,值得临床推广。
文摘Combustion instability of pilot flame has been investigated in a model pilot bluff body stabilized combustor by running the pilot flame only. The primary objectives are to investigate the pilot flame dynamics and to provide bases for the study of the interaction mechanisms between the pilot flame and the main flame. Dynamic pressures are measured by dynamic pressure transduc- ers. A high speed camera with CH* bandpass filter is used to capture the pilot flame dynamics. The proper orthogonal decomposition (POD) is used to further analyze the high speed images. With the increase of the pilot fuel mass flow rate, the pilot flame changes from stable to unstable state grad- ually. The combustion instability frequency is 136 Hz when the pilot flame is unstable. Numerical simulation results show that the equivalence ratios in both the shear layer and the recirculation zone increase as the pilot fuel mass flow rate increases. The mechanism of the instability of the pilot flame can be attributed to the coupling between the second order acoustic mode and the unsteady heat release due to symmetric vortex shedding. These results illustrate that the pilot fuel mass flow rate has significant influences on the dynamic stability of the pilot flame.