输尿管通道鞘状态与鞘内流速变化分析

目的探讨输尿管通道鞘(UAS)的不同状态与鞘内灌注液流出速度的变化关系,了解限压150 mmHg Wolf泵灌注时肾盂内的压力。方法 18例输尿管软镜手术患者根据UAS(F12/14)的3种状态分成A、B和C 3组,各6例,分别测定URF-P5软镜进入肾盂寻找结石时和置入200μm光纤碎石时UAS鞘内灌注液的流出速度,C组患者采用"鞘内导丝法"提高鞘内流速,对其中1例有肾瘘管的患者进行肾盂内压力测定。结果限压150 mmHg Wolf泵灌注下,URF-P5软镜进入肾盂寻找结石时,3组鞘内流速分别为(54.22±2.14)、(47.32±2.39)和(25.01±2.54)ml/min;置入200μm光纤碎石时,鞘内流速分别为(32.68±2.23)、(30.44±2.58)和(24.15±2.22)ml/min;鞘内放置导丝后,C组的流速为(28.64±2.18)ml/min,与放置导丝前相比,流速增加13.0%～21.0%,平均流速增加18.6%。测压患者静息状态下肾盂内压为11 mmHg;软镜进入肾盂后,肾盂内压28～51 mmHg,中位值38 mmHg;钬激光碎石时肾盂内压55～72 mmHg,中位值68 mmHg;鞘内置入导丝后肾盂内压下降至38～61 mmHg,中位值50 mmHg。结论 UAS的不同状态导致了不同的鞘内灌注液的流出速度,通过观察鞘内流速的变化,可以间接判断肾盂内的压力情况;使用F12/14 UAS、URF-P5软镜和Wolf泵灌注限压150 mmHg是相对安全的;当UAS的状态评估不满意时,术者应控制手术时间,可以采用"鞘内导丝法"增加鞘内流速,降低肾盂内压力。

3D打印输尿管通道鞘鞘后装置在≥2.0 cm肾结石手术中的应用研究

目的探讨3D打印输尿管通道鞘(UAS)鞘后装置的有效性。方法选择2019年1月-2020年12月该院使用输尿管软镜治疗≥2.0 cm肾结石的72例患者,采用随机数表法分成A组(n=34)和B组(n=38),A组为常规手术组,UAS后方自然出水,B组UAS后方连接3D打印装置,将负压传导至肾内,按需调节负压大小。比较两组患者灌注液使用量、术后发热率、手术时间、Ⅱ期手术率和结石清除率。结果两组患者均成功置鞘并完成手术;B组灌注液使用量为(1388.00±363.00)mL,较A组的(1016.00±231.00)mL增加了36.6%,两组比较,差异有统计学意义(P=0.000);B组患者术后24 h发热率(T≥37.5℃)为2.6%(1/38),与A组的23.5%(8/34)比较,差异有统计学意义(P=0.011);两组患者手术时间、Ⅱ期手术率和结石清除率比较,差异均无统计学意义(P>0.05)。结论3D打印的UAS鞘后装置能将负压吸力传递入肾盂,实现主动调节和按需调节,能提高灌注液流出速度,增加灌注流量,带走激光产生的热量,吸出部分粉尘,降低肾盂内压力,使输尿管软镜手术更安全。

A sample of metal-poor galaxies identified from the LAMOST spectral survey

We present a sample of 48 metal-poor galaxies at z 〈 0.14 selected from 92 510 galaxies in the LAMOST survey. These galaxies are identified by their detection of the auroral emission line[OⅢ]λ4363 above the 3σ level, which allows a direct measurement of electron temperature and oxygen abundance. The emission line fluxes are corrected for internal dust extinction using the Balmer decrement method. With electron temperature derived from [OⅢ]λλ4959, 5007/[OⅢ]λ4363 and electron density from [SⅡ]λ6731/[SⅡ]λ6717, we obtain the oxygen abundances in our sample which range from 12 ＋ log（O/H） = 7.63（0.09 Z_⊙） to 8.46（0.6 Z_⊙）. We find an extremely metal-poor galaxy with 12 ＋ log（O/H） = 7.63 ± 0.01. With multiband photometric data from FUV to NIR and Hαmeasurements, we also determine the stellar masses and star formation rates, based on the spectral energy distribution fitting and Hα luminosity, respectively. We find that our galaxies have low and intermediate stellar masses with 6.39 ≤ log（M/M_⊙） ≤ 9.27, and high star formation rates（SFRs） with-2.18 ≤ log（SFR/M_⊙yr^（-1）） ≤ 1.95. We also find that the metallicities of our galaxies are consistent with the local T_e-based mass-metallicity relation, while the scatter is about 0.28 dex. Additionally,assuming the coefficient of α = 0.66, we find most of our galaxies follow the local mass-metallicity-SFR relation, but a scatter of about 0.24 dex exists, suggesting the mass-metallicity relation is weakly dependent on SFR for those metal-poor galaxies.

Recent Progress in Networked Control Systems——A Survey

For the past decades,networked control systems(NCSs),as an interdisciplinary subject,have been one of the main research highlights and many fruitful results from different aspects have been achieved.With these growing research trends,it is significant to consolidate the latest knowledge and information to keep up with the research needs.In this paper,the results of different aspects of NCSs,such as quantization,estimation,fault detection and networked predictive control,are summarized.In addition,with the development of cloud technique,cloud control systems are proposed for the further development of NCSs.

Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease

Background:Coronary artery disease(CAD)in octogenarians(age of>80 years)has a high risk of mortality and high expenses.Research shows that the prevalence of CAD is higher among octogenarians than that among younger people,but few such patients undergo percutaneous coronary intervention(PCI)or coronary artery bypass grafting(CABG).This study aimed to evaluate different treatments w让h respect to their clinical effects and impacts on quality of life of octogenarians with CAD.Methods:Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital,Capital Medical University(Beijing,China)from January 2010 to January 2016 were collected in this study.The patients were categorized into three groups based on the treatments they received:the PCI group(n=292),CABG group(n=110),and medical treatment group(n=117).The followings were recorded during follow-up:clinical data,death(all-cause and cardiovascular-related),re-hospitalization time,Seattle Angina Questionnaire(SAQ)score,and occurrence of hemorrhagic events(cerebral bleeding,gastrointestinal bleeding,and dermal ecchymosis).Results:The median follow-up duration was 25.0(25th,75th percentile:17.0,55.5)months among 417 patients.The all-cause death rates(28.2%vs.12.0%and 14.6%,respectively)and cardiovascular-related death rates(15.4%us.3.8%and 6.4%,respectively)were significantly higher in the medical treatment group than those in the PCI group and CABG group(all P<0.05).The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group(3.8%vs.12.8%and 14.9%,respectively)(x^2=8.23&P=0.018).The SAQ scores of physical limitation,angina frequency,treatment satisfaction,and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group(all P<0.05).No significant difference in the angina stability score was observed among the three groups(F=3.179,P=0.204).Conclusion:PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD.

Unfractionated Heparin with Sequential Enoxaparin in Patients with Complex Coronary Artery Lesions during Percutaneous Coronary Intervention

Background： Unfractionated heparin （UFH）, despite its limitations, has been used as the primary anticoagulant alternative during the percutaneous coronary intervention （PCI）. Some studies indicated that intravenous enoxaparin could be an effective and safe option. Our team used enoxaparin alone at one time according to the guidelines （Class IIA） and found a little catheter thrombosis during PCI. We recommend a new anticoagulation strategy using enoxaparin in combination with UFH. Enoxaparin has a more predictable anticoagulant response with no need of repeatedly monitoring anticoagulation during PCI. This retrospective study aimed to evaluate the efficacy and safety of using enoxaparin in combination with UFH in PCI patients with complex coronary artery disease. Methods： Between January 2015 and April 2017, 600 PCI patients who received intravenous UFH at an initial dose of 3000 U plus intravenous enoxaparin at a dose of 0.75 mg/kg （observation group） and 600 PCI patients who received UFH at a dose of 100 U/kg （control group） were consecutively included in this retrospective study. The endpoints were postoperative 48-h thrombolysis in myocardial infarction （TIMI） bleeding and transfusion and 30-day and l-year major adverse cardio-cerebrovascular events （MACCE）. Results： Baseline clinical, angiographic, and procedural characteristics were similar between groups, except there was less stent implantation per patient in the observation group （2.13 vs. 2.25 in the control group, P = 0.002）. TIMI bleeding （3.3% vs. 4.7%） showed no significant difference between the observation group and control group. During the 30-day follow-up, the rate of MACCE was 0.9% in the observation group and 1.5% in the control group. There was no significant difference in the rates of MACCE, death, myocardial infarction, target vessel revascularization, cerebrovascular event, and angina within 30 days and 1 year after PC1 between groups as well as in the subgroup analysis of transfemoral approach. Conclusions： UFH with sequential enoxaparin has similar anticoagulant effect and safety as UFH in PCI of complex coronary artery disease.

An efficient TILLING platform for cultivated tobacco

Targeting-induced local lesions in genomes(TILLING)is a powerful reverse-genetics tool that enables high-throughput screening of genomic variations in plants.Although TILLING has been developed for many diploid plants,the technology has been used in very few polyploid species due to their genomic complexity.Here,we established an efficient capillary electrophoresis-based TILLING platform for allotetraploid cultivated tobacco(Nicotiana tabacum L.)using an ethyl methanesulfonate(EMS)-mutagenized population of 1,536 individuals.We optimized the procedures for endonuclease preparation,leaf tissue sampling,DNA extraction,normalization,pooling,PCR amplification,heteroduplex formation,and capillary electrophoresis.In a test screen using seven target genes with eight PCR fragments,we obtained 118 mutants.The mutation density was estimated to be approximately one mutation per 106kb on average.Phenotypic analyses showed that mutations in two heavy metal transporter genes,HMA2S and HMA4T,led to reduced accumulation of cadmium and zinc,which was confirmed independently using CRISPR/Cas9 to generate knockout mutants.Our results demonstrate that this powerful TILLING platform(available at http://www.croptilling.org)can be used in tobacco to facilitate functional genomics applications.

Effect of Ti and rare earth on microsegregation and large-sized precipitates of H13 steel

Large-sized precipitates are fatal to the thermal fatigue of H13 hot work die steel.Different amounts of Ti and/or rare earth(RE)were added in H13 steel during electroslag remelting to improve the element segregation and refine the large-sized precipitates.The results show that as Ti content increases from 0.0032 to 0.057 wt.%,the segregation of Cr,Mo and V becomes more severe.V-rich M(C,N)carbides are shorter,and their branches are denser in 3D observation.Moreover,the number density of V-rich M(C,N)carbides with a size less than 2μm increases and that with other sizes decreases.In addition,Ti-rich MN nitrides with the size greater than 4μm increases significantly at high Ti content.When RE content increases from 0.0051 to 0.036 wt.%,the segregation of main alloying elements is first weakened and then aggravated.Compared with that in RE-free H13 steel,V-rich M(C,N)carbides are less developed in 3D observation,and the change in number density is similar to that of Ti-modified alloys.After composite modification of 0.024 wt.%Ti and 0.011 wt.%RE,the segregation of alloying element and V-rich M(C,N)carbides are not significantly improved.