磁阻式旋转变压器解码系统设计

在高性能电机的闭环控制系统中,旋转变压器(简称旋变)常用于测量电机转子的位置与速度信息,设计了一种以专用旋变数字转换芯片为核心的磁阻式旋变解码系统,用于将旋变输出的正余弦信号解码为转子的位置信息。解码系统包括主芯片模块、旋变输入信号调理模块、励磁缓冲电路模块和电源模块等,将各功能模块集成在一块印刷电路板(PCB)上,并通过实验验证了设计方案的有效性。实验结果表明:设计的磁阻式旋变解码系统运行稳定,能实时准确地输出电机转子的位置与速度信息。

Study on Clinical Thinking of Traditional Chinese Medicine Based on Wang Yongyan＇s MedicalRecord Information System

运用医案信息系统工程技术将王永炎教授医案设定为总系统,并将其中的病、证、治、验分次建模,根据医家经验按照“问题一解”的程序将其组合,以此来研究王教授的治疗经验及其临床思维.

一种薄膜反射面天线型面精度主动控制方法

针对如何有效进行薄膜反射面天线型面精度主动控制的问题,提出了一种静电力和边界索力相结合的双向控制方法。推导了薄膜反射面和薄膜控制面间距发生变化时的静电力计算公式,并给出了静电力更新流程;以电极电压和边界索力为设计变量,以薄膜反射面型面精度为优化目标,建立了薄膜反射面天线型面精度主动控制模型;通过两种形式温度载荷作用下的薄膜反射面天线型面精度主动控制仿真算例,验证了控制方法的有效性。

Pretreatment with probiotics Enterococcus faecium NCIMB 11181 attenuated Salmonella Typhimurium-induced gut injury through modulating intestinal microbiome and immune responses with barrier function in broiler chickens

Background:Preventing Salmonella infection and colonization in young birds is key to improving poultry gut health and reducing Salmonella contamination of poultry products and decreasing salmonellosis for human consumption(poultry meat and eggs).Probiotics can improve poultry health.The present study was conducted to investigate the impact of a probiotics,Enterococcus faecium NCIMB 11181(E.faecium NCIMB 11181)on the intestinal mucosal immune responses,microbiome and barrier function in the presence or absence of Salmonella Typhimurium(S.Typh-imurium,ST)infection.Methods:Two hundred and forty 1-day-old Salmonella-free male broiler chickens(Arbor Acres AA+)were randomly allocated to four groups with 6 replicate cages of 10 birds each.The four experimental groups were follows:(1)nega-tive control(NC),(2)S.Typhimurium,challenged positive control(PC),(3)the E.faecium NCIMB 11181-treated group(EF),(4)the E.faecium NCIMB 11181-treated and S.Typhimurium-challenged group(PEF).Results:Results indicated that,although continuous feeding E.faecium NCIMB 11181 did not obviously alleviate growth depression caused by S.Typhimurium challenge(P>0.05),E.faecium NCIMB 11181 addition significantly blocked Salmonella intestinal colonization and translocation(P<0.05).Moreover,supplemental E.faecium NCIMB 11181 to the infected chickens remarkably attenuated gut morphological structure damage and intestinal cell apoptosis induced by S.Typhimurium infection,as evidenced by increasing gut villous height and reducing intes-tinal TUNEL-positive cell numbers(P<0.05).Also,E.faecium NCIMB 11181 administration notably promoting the production of anti-Salmonella antibodies in intestinal mucosa and serum of the infected birds(P<0.05).Addition-ally,16S rRNA sequencing analysis revealed that E.faecium NCIMB 11181 supplementation ameliorated S.Typhimu-rium infection-induced gut microbial dysbiosis by enriching Lachnospiracease and Alistipes levels,and suppressing Barnesiella abundance.Predicted function analysis indicated that the functional genes of cecal microbiome involved in C5-branched dibasic acid metabolism;valine,leucine and isoleucine biosynthesis;glycerolipid metabolism and lysine biosynthesis were enriched in the infected chickens given E.faecium NCIMB 11181.While alanine,asparate and glutamate metabolism;MAPK signal pathway-yeast;ubiquine and other terpenoid-quinore biosynthesis,protein processing in endoplasmic reticulum;as well as glutathione metabolism were suppressed by E.faecium NCIMB 11181 addition.Conclusion:Collectively,our data suggested that dietary E.faecium NCIBM 11181 supplementation could ameliorate S.Typhimurium infection-induced gut injury in broiler chickens.Our findings also suggest that E.faecium NCIMB 11181 may serve as an effective non-antibiotic feed additive for improving gut health and controlling Salmonella infection in broiler chickens.

Preoperative and postoperative complications as risk factors for delayed gastric emptying following pancreaticoduodenectomy: A single-center retrospective study

BACKGROUND Mortality rates after pancreaticoduodenectomy(PD)have significantly decreased in specialized centers.However,postoperative morbidity,particularly delayed gastric emptying(DGE),remains the most frequent complication following PD.AIM To identify risk factors associated with DGE after the PD procedure.METHODS In this retrospective,cross-sectional study,clinical data were collected from 114 patients who underwent PD between January 2015 and June 2018.Demographic factors,pre-and perioperative characteristics,and surgical complications were assessed.Univariate and multivariate analyses were performed to identify risk factors for post-PD DGE.RESULTS The study included 66 males(57.9%)and 48 females(42.1%),aged 33-83 years(mean:62.5),with a male-to-female ratio of approximately 1.4:1.There were 63 cases(55.3%)of PD and 51 cases(44.7%)of pylorus-preserving pancreatoduodenectomy.Among the 114 patients who underwent PD,33(28.9%)developed postoperative DGE.Univariate analysis revealed significant differences in four of the 14 clinical indexes observed:pylorus preservation,retrocolonic anastomosis,postoperative abdominal complications,and early postoperative albumin(ALB).Logistic regression analysis further identified postoperative abdominal complic-ations[odds ratio(OR)=4.768,P=0.002],preoperative systemic diseases(OR=2.516,P=0.049),and early postoperative ALB(OR=1.195,P=0.003)as significant risk factors.CONCLUSION Postoperative severe abdominal complications,preoperative systemic diseases,and early postoperative ALB are identified as risk factors for post-PD DGE.

“双减”政策的议程设置机制分析——基于多源流理论视角

2021年7月,中共中央办公厅、国务院办公厅印发《关于进一步减轻义务教育阶段学生作业负担和校外培训负担的意见》,该文件的出台对于解决学生学业负担重的问题具有重要指导意义。本研究基于多源流理论对学生减负问题是如何从众多的教育问题上升到教育政策议程进行分析。研究发现:中小学课业压力重和学科类校外辅导问题等形成了“双减”政策的问题源流;专家学者的政策建议构成了“双减”政策的政策源流;党和政府提高教育质量,落实立德树人根本任务的理念形成了“双减”政策的政治源流。在教培产业自身危机、学生和家长不堪重负、国家决心整治校外辅导等多方面因素的催化下,问题流、政策流、政治流三大源流实现汇合,从而实现了学生减负问题被提上政策议程及“双减”政策的出台。

循环流化床锅炉高温屏式过热器变形原因分析

某型循环流化床锅炉内部检验时发现炉膛高温屏式过热器均产生严重弯曲变形,测量其最大挠度约为800 mm。经现场检测,管材厚度、材质均没有明显变化。查阅锅炉技术资料和运行数据分析得出不合理的设计及运行工况是其产生屈曲和塑性变形的主要原因,并通过材料力学理论推导和有限元数值模拟给出了最大变形量的计算公式以及最小失稳应力值,最后提出了几点解决措施方案。

Effects of rearing system and antibiotic treatment on immune function,gut microbiota and metabolites of broiler chickens

Background:In China,cage systems with a high space utilization have gradually replaced ground litter systems,but the disease incidence of chickens in cages is higher.Broilers in the ground litter pens may be stimulated by more environmental microbes during the growth process and show strong immune function and status,but knowledge of which microbes and their metabolites play an immunomodulatory role is still limited.This study aimed to explore the differences and correlations in the immune function,gut microbiota and metabolites and the importance of gut microbiota of broilers raised in cages and ground litter pens.Methods:The experiment involved a 2×2 factorial arrangement,with rearing systems(cages or ground litter pens)and antibiotic treatment(with or without broad-spectrum antibiotics in drinking water)as factors.Results:The results showed that,compared with the cage group,the ground litter broilers had stronger nonspecific immune function(Macrophages%and NO in blood),humoral immune function(IgG in blood,LPS stimulation index in ileum)and cellular immune function(T%,Tc%,ConA stimulation index and cytokines in blood).Antibiotic(ABX)treat-ment significantly reduced nonspecific immune function(Macrophages%and NO in blood,iNOS and Mucin2 mRNA expression in ileum),humoral immune function(IgG in blood and sIgA in ileum)and cellular immune function(T%and cytokines in blood,Th and Tc ratio,TLRs and cytokines mRNA expression in ileum).Furthermore,the ground litter broil-ers had higherαdiversity of microbiota in ileum.The relative abundance of Staphylococcus,Jeotgalicoccus,Jeotgalibaca and Pediococcus in the ileum of ground litter broilers were higher.ABX treatment significantly reduced theαdiversity of ileal microbiota,with less Chloroplast and Mitochondria.In addition,the levels of acetic acid,isobutyric acid,kynurenic acid and allolithocholic acid in the ileum of ground litter broilers were higher.Spearman correlation analysis showed that Jeotgalibaca,Pediococcus,acetic acid,kynurenic acid and allolithocholic acid were related to the immune function.Conclusions:There were more potential pathogens,litter breeding bacteria,short-chain fatty acids,kynurenine,allolithocholic acid and tryptophan metabolites in the ileum of broilers in ground litter pens,which may be the reason for its stronger immune function and status.

Analysis of the effect of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts

Objective:To explore the efficacy,safety,and feasibility of holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts.Methods:From September 2012 to February 2019,a total of 18 patients,aged from 28 to 62(meanstandard deviation[SD]:46.50±9.14)years,were diagnosed with parapelvic renal cysts and treated by holmium laser flexible ureteroscopic intrapelvic drainage.There were 10 males and eight females.All of the parapelvic renal cysts were unilateral,and two cases were complicated with pyelolithiasis.The diameters of the cysts ranged from 4.1 cm to 8.2 cm.Results:All the patients completed the operation successfully in one stage without conversion to open surgery;in two cases,it was difficult to find the cysts during the operation,and the localization was completed by B-ultrasound and percutaneous injection of methylene blue.The mean operative time was 33.89(SD:9.68;range:22-54)min,and the mean hospitalization time was 2.67(SD:0.91;range:2-5)days.Three months and 6 months of follow-up were performed after surgery.The cysts disappeared in 13(72%)cases,and the diameter of the cysts in five(28%)cases decreased by more than 50%.Conclusion:Holmium laser flexible ureteroscopic intrapelvic drainage in the treatment of parapelvic renal cysts is simple,safe,and effective,and can be used as the first choice for the treatment of parapelvic renal cysts.

Dietary supplemental coated essential oils and organic acids mixture improves growth performance and gut health along with reduces Salmonella load of broiler chickens infected with Salmonella Enteritidis

Background Reducing Salmonella infection in broiler chickens by using effective and safe alternatives to antibiotics is vital to provide safer poultry meat and minimize the emergence of drug-resistant Salmonella and the spread of salmonellosis to humans.This study was to first evaluate the protective efficacy of feeding coated essential oils and organic acids mixture(EOA)on broiler chickens infected with Salmonella Enteritidis(S.Enteritidis,SE),and then its action mechanism was further explored.Methods A total of 4801-day-old Arbor Acres male chickens were randomly assigned into five treatments with six replicates,including non-challenged control fed with basal diet(A),SE-challenged control(B),and SE-infected birds fed a basal diet with 300 mg/kg of EOA(BL),500 mg/kg of EOA(BM)and 800 mg/kg of EOA(BH),respectively.All birds on challenged groups were infected with Salmonella Enteritidis on d 13.Results Feeding EOA showed a reversed ability on negative effects caused by SE infection,as evidenced by decreasing the feed conversion rate(FCR)and the ratio of villus height to crypt depth(VH/CD)(P<0.05),obviously decreasing intestinal and internal organs Salmonella load along with increasing cecal butyric acid-producing bacteria abundance(P<0.05).Moreover,supplemental different levels of EOA notably up-regulated claudin-1(CLDN-1),occludin(OCLN),zonula occludens-1(ZO-1),mucin-2(MUC-2),fatty acid binding protein-2(FABP-2),nuclear factor kappa-light-chainenhancer of activated B cells(NF-κB),myeloid differential protein-88(MyD88)and interleukin-6(IL-6)mRNA levels in the ileum of the infected chickens after challenge,whereas down-regulated toll-like receptor-4(TLR-4)mRNA levels(P<0.05).Linear discriminant analysis combined effect size measurements analysis(LEfSe)showed that the relative abundance of g_Butyricicoccus,g_Anaerotruncus and g_unclassified_f_Bacillaceae significantly was enriched in infected birds given EOA.Also,phylogenetic investigation of communities by reconstruction of unobserved states(PICRUSt)analysis showed that alpha-linolenic acid metabolism,fatty acid metabolism and biosynthesis of unsaturated fatty acids were significantly enriched in the EOA group.Conclusion Our data suggest that the essential oils and organic acids mixture can be used as an effective strategy to ameliorate and alleviate Salmonella Enteritidis infection in broilers.

Shaoma Zhijing granule for children with tic disorders: A rapid health technology assessment

Objective:To rapidly assess the effectiveness,safety,economy,and applicability of Shaoma Zhijing granule(SZG)for the treatment of children with tic disorders(TD),and provide currently available best evidence for decision-makers of health policies.Methods:We conducted a rapid health technology assessment(RHTA)to explore the value of SZG.A systematic literature search in eight literature databases and on three clinical trial registration platforms was performed.The literature was screened according to eligibility criteria.The screening process and data extraction were conducted by two reviewers,and the quality of the literature was also assessed.The results were summarized,analyzed,and presented in tables or figures.Results:A total of five randomized controlled trials(RCTs)were included in this study,of which one was published in English(in the Journal of Child Psychology and Psychiatry)and four in Chinese journals.The overall risk of bias for the five RCTs was evaluated as“some concerns.”SZG monotherapy or in combi-nation with tiapride was better than tiapride alone in improving traditional Chinese medicine(TCM)syndromes and tic symptoms,with a daily cost of¥67.50e107.22.Adverse events were mainly related to the digestive,respiratory,and neurological systems,but all were mild.Conclusion:Overall,the current RHTA of published,peer-reviewed literature has located a small body of evidence evaluating the use of SZG for the treatment of TD in children.SZG has effects on improving TCM syndromes and tic symptoms;the daily cost is¥67.50e107.22;and all adverse events are mild.High-quality studies with long-term follow-up should be conducted,so as to provide local evidence and consistently guide and improve scientific decision-making.

Cerebral proliferative angiopathy in pediatric age presenting as neurological disorders:A case report

BACKGROUND Cerebral proliferative angiopathy(CPA)is a rare subtype of arteriovenous malformation.It is extremely rare in pediatric patients and has serious implications for developing children.However,reports of these disorders worldwide are limited,and no uniform reference for diagnosis and treatment options exists.We report the case of a 6-year-old with CPA having predominantly neurological dysfunction and review the literature on pediatric CPA.CASE SUMMARY We report the case of a pediatric patient with CPA analyzed using digital subtraction angiography(DSA)who presented initially with a neurological disorder as the main manifestation.This case is the basis for further discussion of the clinical presentation,pathogenesis,diagnosis,and treatment of CPA in children.After the cerebral DSA,the patient was treated conservatively with sedation,fluid replacement,and blood anticoagulation.She could not cooperate with the followup magnetic resonance imaging examination because of her young age,and her family declined further treatment because of the surgery’s high risk.She was followed up for 3 months;her symptoms did not worsen.CONCLUSION This report of rare pediatric CPA can inform and advance clinical research on congenital cerebrovascular diseases.

Evaluation and treatment of altered mental status patients in the emergency department:Life in the fast lane

BACKGROUND:Altered mental status(AMS) is a very common emergency case,but the exact etiology of many AMS patients is unknown.Patients often manifest vague symptoms,thus,AMS diagnosis and treatment are highly challenging for emergency physicians.The aim of this study is to provide a framework for the assessment of AMS patients.This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS:This is a prospective cohort observational study.We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24months(June 2009 to June 2011).Demographic characteristics,clinical manifestations,assessment approaches,causative factors,emergency treatments and outcomes were collected prospectively.RESULTS:In 1934 patients with AMS recruited,accounting for 0.93%of all emergency department(ED) patients,1 026(53.1%) were male,and 908(46.9%) female.Their average age was 51.95±15.71 years.Etiologic factors were neurological(n=641;35.0%),pharmacological and toxicological(n=421;23.0%),systemic and organic(n=266;14.5%),infectious(n=167;9.1%),endocrine/metabolic(n=145;7.9%),psychiatric(n=71;3.9%),traumatic(n=38;2.1%),and gynecologic and obstetric(n=35;1.9%).Total mortality rate was 8.1%(n=156).The death rate was higher in elderly patients(≥60) than in younger patients(10.8%vs.6.9%,P=0.003).CONCLUSIONS:Patients with AMS pose a challenge for ED physicians.The most frequently encountered diagnostic categories causing AMS were primary CNS disorders,intoxication,organ system dysfunction,and endocrine/metabolic diseases.AMS has a high fatality rate in the ED.AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects.Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.

紫外老化对聚乳酸结晶及力学性能的影响

采用紫外老化试验仪对聚乳酸(PLA)进行加速老化处理,探究短周期紫外老化后,PLA试样表面与内部不同的老化行为,以及不同老化时间对PLA的结晶及力学性能的影响。结果表明,随老化时间的延长,PLA表面的C=O衍射强度变小,PLA内部C=O的衍射强度先减小后增大,同时,PLA表面区域的断面形貌比内部更加粗糙,且出现一定的交联现象。经老化处理24 h,48 h,72 h后,PLA表面的结晶度(X_c)依次增大至19.4%,32.7%,35.2%,PLA内部的X_c依次增大至15.0%,27.5%,32.6%;相同老化时间下,PLA表面的X_c总是大于PLA内部的,且随着老化时间的延长,这种趋势逐渐减小。相比于老化前,老化72 h的PLA拉伸强度、冲击强度、弹性模量分别提高了11.49%,38.38%,43.2%。

炼油厂燃料气回收液化气过程的设计与控制研究

以某炼油厂燃料气回收液化气(LPG)为对象,分别对3种LPG回收流程进行了研究。在稳态模拟的基础上,以年总费用为优化目标,优化了各流程的主要工艺参数。结果表明,隔壁塔流程较另外两种流程的年总费用分别降低37.66%和11.35%,表现出较大的经济优势。此外,对炼油厂燃料气回收LPG隔壁塔流程的动态特性进行了研究,提出的四点温度控制结构能够有效地抵抗进料扰动,具有良好的可控性。由此可见,隔壁塔在炼油厂燃料气回收LPG工艺中具有非常高的应用潜力。

Bt基因导入对侵染丛枝菌根真菌的玉米生长生理及磷转运基因表达的影响

为了分析Bt玉米与常规玉米对接种丛枝菌根真菌响应的异同,本文在接种摩西球囊霉(Funneliformis mosseae)和不接种的条件下,对比分析了两个Bt玉米品种‘5422Bt1’(Bt11)和‘5422CBCL’(Mon810)以及同源常规玉米品种‘5422’根系中丛枝菌根真菌侵染率、磷转运基因的表达量、生长和养分利用状况。结果表明:生长50 d和80 d时,Bt玉米‘5422Bt1’和‘5422CBCL’根系丛枝菌根真菌侵染率显著高于常规玉米‘5422’,分别比‘5422’高13.54%、11.24%和9.83%、6.70%;50 d取样时,接菌和不接菌处理玉米‘5422Bt1’、‘5422CBCL’和‘5422’根系内的磷转运基因表达量均没有显著差异;接菌和不接菌处理下玉米‘5422Bt1’的干重显著高于‘5422CBCL’相应的处理,而与‘5422’没有显著差异;80 d取样时,不接菌处理玉米‘5422Bt1’的根长、根表面积和根体积显著高于‘5422’和‘5422CBCL’不接菌处理。Bt基因的导入主要影响了两个Bt玉米品种(‘5422Bt1’和‘5422CBCL’)苗期(50 d)和成熟期(80 d)的氮素吸收利用,与常规玉米品种‘5422’相比,合成Bt蛋白消耗了部分氮素和磷;3个玉米品种对接种AMF的响应不同,接菌处理提高了‘5422Bt1’和‘5422CBCL’苗期(50 d)和成熟期(80 d)的氮素吸收利用。在磷养分条件满足玉米生长需要的条件下,接种丛枝菌根真菌对Bt玉米磷转运基因表达量和磷的吸收利用没有显著影响。Bt基因的导入以及接种F.mosseae对Bt玉米生长和养分利用的影响与不同转化事件形成的品种特性相关。

Effects of Bacillus coagulans supplementation on the growth performance and gut health of broiler chickens with Clostridium perfringens-induced necrotic enteritis

Background: The poultry industry is in need of effective antibiotic alternatives to control outbreaks of necrotic enteritis(NE) due to Clostridium perfringens.Methods: This study was conducted to investigate the effects of feeding Bacil us coagulans on the growth performance and gut health of broiler chickens with C. perfringens-induced NE. Two hundred and forty 1-day-old broiler chicks were randomly assigned to a 2 × 2 factorial arrangement with two dietary B. coagulans levels(0 or 4 × 109 CFU/kg of diet) and two disease chal enge statuses(control or NE chal enged).Results: NE-induced reduction in body weight gain was relieved by the addition of B. coagulans into broiler diets compared with the NE-infected birds. NE infection damaged intestinal morphological structure, promoted intestinal C.perfringens growth and liver invasion, and enhanced anti-C. perfringens specific sI gA concentrations in the gut and specific IgG levels in serum compared with the uninfected birds. NE infection significantly(P < 0.05) decreased mucin-2(at 14 d post-infection(DPI), tol-like receptor 2(TLR2, at 7 and 14 DPI), TLR4(at 7 and 14 DPI), tumor necrosis factor super family15(TNFSF15, at 7 and 14 DPI), lysozyme(LYZ, at 14 DPI) and fowlicidin-2(at 7 and 14 DPI) mR NA levels, whereas it dramatical y(P = 0.001) increased IFN-γ mR NA levels at 7 DPI. However, chal enged birds fed diets supplemented with B.coagulans showed a significant(P < 0.01) decrease in gut lesion scores, decreased C. perfringens numbers in the cecum and liver, and an increase in fowlicidin-2 mR NA levels in compared with the uninfected birds. In addition, compared with the non-supplemented group, dietary inclusion of B. coagulans improved intestinal barrier structure, further increased specific sI gA levels and alkaline phosphatase(IAP) activity in the jejunum, enhanced the expression of jejunum lysozyme mR NA, and inhibited the growth, colonization, and invasion of C. perfringens; in contrast, it reduced serum-specific IgG concentrations and jejunum IFN-γ mR NA levels.Conclusion: These results indicated that dietary B. coagulans supplementation appeared to be effective in preventing the occurrence and reducing the severity of C. perfringens-induced NE in broiler chickens.

Application of gemstone spectral imaging for efficacy evaluation in hepatocellular carcinoma after transarterial chemoembolization

AIM: To assess the value of gemstone spectral imaging(GSI) in efficacy evaluation in hepatocellular cancer(HCC) after transcatheter arterial chemoembolization(TACE) treatment.METHODS: Thirty patients with HCC underwent GSI, including nonenhanced, arterial, portalvenous and delayed phase scans, after TACE treatment. Arterial phase images were acquired with GSI for reconstruction of virtual nonenhanced images and color overlay images. Digital subtraction angiography(DSA) was performed in all these patients. Two blinded and independent readers evaluated the data in two reading sessions; standard nonenhanced, arterial, portalvenous, and delayed phase images were read in session A, and the optimal monochromatic images, iodine/water based images and spectrum features were read in session B. Sensitivity and specificity were calculated with the DSA data as the reference standard. The sensitivity and specificity were compared using the χ2 test.RESULTS: DSA revealed 154 lesions in 30 patients, and 100 of them had blood supply. Overall sensitivity and specificity were 72%( 72/100) and 77.8 %(42/54) for session A, and 97%(97/100) and 94.4%(51/54) for session B, respectively. The sensitivity and specificity of the two reading sessions were significantly different(χ2 = 23.04, χ2 = 7.11, P < 0.05).CONCLUSION: Compared with conventional CT, GSI could significantly improve the detection of small and multiple lesions without increasing the radiation dose. Based on spectrum features, GSI could assess tumor homogeneity and more accurately identify residual tumors and recurrent or metastatic lesions during efficacy evaluation and follow-up in HCC after TACE treatment.

Clinical practice guideline for transurethral plasmakinetic resection of prostate for benign prostatic hyperplasia(2021 Edition)

Benign prostatic hyperplasia (BPH) is highly prevalent among older men, impacting on their quality of life, sexual function, and genitourinary health, and has become an important global burden of disease. Transurethral plasmakinetic resection of prostate (TUPKP) is one of the foremost surgical procedures for the treatment of BPH. It has become well established in clinical practice with good efficacy and safety. In 2018, we issued the guideline “2018 Standard Edition”. However much new direct evidence has now emerged and this may change some of previous recommendations. The time is ripe to develop new evidence-based guidelines, so we formed a working group of clinical experts and methodologists. The steering group members posed 31 questions relevant to the management of TUPKP for BPH covering the following areas: questions relevant to the perioperative period (preoperative, intraoperative, and postoperative) of TUPKP in the treatment of BPH, postoperative complications and the level of surgeons’ surgical skill. We searched the literature for direct evidence on the management of TUPKP for BPH, and assessed its certainty generated recommendations using the grade criteria by the European Association of Urology. Recommendations were either strong or weak, or in the form of an ungraded consensus-based statement. Finally, we issued 36 statements. Among them, 23 carried strong recommendations, and 13 carried weak recommendations for the stated procedure. They covered questions relevant to the aforementioned three areas. The preoperative period for TUPKP in the treatment of BPH included indications and contraindications for TUPKP, precautions for preoperative preparation in patients with renal impairment and urinary tract infection due to urinary retention, and preoperative prophylactic use of antibiotics. Questions relevant to the intraoperative period incorporated surgical operation techniques and prevention and management of bladder explosion. The application to different populations incorporating the efficacy and safety of TUPKP in the treatment of normal volume (< 80 ml) and large-volume (≥ 80 ml) BPH compared with transurethral urethral resection prostate, transurethral plasmakinetic enucleation of prostate and open prostatectomy;the efficacy and safety of TUPKP in high-risk populations and among people taking anticoagulant (antithrombotic) drugs. Questions relevant to the postoperative period incorporated the time and speed of flushing, the time indwelling catheters are needed, principles of postoperative therapeutic use of antibiotics, follow-up time and follow-up content. Questions related to complications incorporated types of complications and their incidence, postoperative leukocyturia, the treatment measures for the perforation and extravasation of the capsule, transurethral resection syndrome, postoperative bleeding, urinary catheter blockage, bladder spasm, overactive bladder, urinary incontinence, urethral stricture, rectal injury during surgery, postoperative erectile dysfunction and retrograde ejaculation. Final questions were related to surgeons’ skills when performing TUPKP for the treatment of BPH. We hope these recommendations can help support healthcare workers caring for patients having TUPKP for the treatment of BPH.