Administration of Nebulised Ketamine for Managing Pain in the Intensive Care Unit of Obstetrics and Gynaecology

Introduction: The use of inhaled ketamine to manage a variety of painful conditions has been endorsed by the American College of Emergency Physicians and the American Academy of Emergency Medicine. Nebulized analgesia has multiple benefits, including rapid, effective and titratable analgesic delivery. The aim of our study is to assess the efficacy and safety of intranasal analgesic-dose ketamine compared to multimodal analgesia in patients presenting with acute postoperative pain or headache after a spinal anaesthetic in the intensive care unit of obstetrics and gynaecology. Materials and Methods: This was a prospective descriptive study, with hospital Ethics Committee approval and written informed consent from study participants. We compared the effect of nebulized ketamine and multimodal analgesia postoperatively in 120 patients belonging to the physical status I - II of the American Society of Anesthesiologists, in the intensive care unit of obstetrics and gynaecology, at the Ibn Rochd University Hospital Center in Casablanca from June 2021 to June 2022. Results: We included 120 patients in our study divided into two groups of 60 patients: the average age was 35 years, with extremes ranging from 18 to 45 years, All patients were hospitalized for postoperative care: all women underwent locoregional anaesthesia with a standard dose according to the service protocol (10 mg of bupivacaine, 25γ of fentanyl, 100γ of morphine), where pain was the common denominator. Among these patients, 59 were admitted for management of postpartum haemorrhage, 43 for postoperative monitoring, 15 for post-spinal anaesthesia headache and 3 for pelviperitonitis. The results of the pain assessment 30 minutes after the ketamine nebulization were marked by a request for analgesia in 12 patients, which is 20% of group A, including 5 patients, whose visual analogue scale (VAS) on admission was between 5 and 7, and 7 patients whose VAS at admission was ≥8;all these patients received a second dose of ketamine by nebulization;the evaluation 30 min after the second dose was marked by a request for analgesia in 4 patients, which is 7% of Group A;in all these patients the VAS at admission was ≥8. Of the total number of patients of Group A, only 4 received morphine when they were requested for analgesia after the second dose of nebulized ketamine. Conclusion: The primary outcome of nebulized ketamine use is a significant reduction in VAS pain score. We believe that nebulized ketamine has a potential effect of reducing pain in the intensive care unit of obstetrics and gynaecology;this may be an additional analgesic modality for clinicians to provide rapid, effective and non-invasive pain relief.

Using video imagery to reconstruct the 3D intertidal terrain along a beach with multiple cusps

A high-frequency,high-resolution shore-based video monitoring system(VMS)was installed on a macrotidal(tidal amplitude>4 m)beach with multiple cusps along the Quanzhou coast,China.Herein,we propose a video imagery-based method that is coupled with waterline and water level observations to reconstruct the terrain of the intertidal zone over one tidal cycle.Furthermore,the beach cusp system(BCS)was precisely processed and embedded into the digital elevation model(DEM)to more effectively express the microrelief and detailed characteristics of the intertidal zone.During a field experiment conducted in January 2022,the reconstructed DEM was deemed satisfactory.The DEM was verified by RTK-GPS and had an average vertical root mean square error along corresponding RTK-GPS-derived intertidal profiles and corresponding BCS points of 0.134 m and 0.065 m,respectively.The results suggest that VMSs are an effective tool for investigating coastal geomorphic processes.

Terrain-influenced wind flow of the Qitai radio telescope site

The wind environment of a site is one of the important factors affecting the observation performance of large aperture and high-performance radio telescopes.Exploring the relationship between the effects of different terrains on wind flow is important to optimize the wind environment of the site.The terrain of the Qitai radio telescope(QTT)site located in east Tianshan Mountains at an elevation of about 1800 m was used to study the wind flow in the adjacent zone of antenna based on numerical simulation.The area from 600m south to 600m north of the antenna is defined as the antenna adjacent zone,and three groups of boundaries with different terrains are set up upstream and downstream,respectively.Since the zone where the antenna is located is a slope terrain,in order to verify the influence of terrain on the wind flow and to clarify the relationship between the influence of boundary terrain on the wind flow,a control group of horizontal terrain is constructed.The simulation results show that the wind flow is mainly influenced by the terrain.The highest elevation of the upstream and downstream boundary terrains affects the basic wind speed.The upstream boundary terrain has a greater impact on wind flow than the downstream boundary terrain.In addition,the wind speed profile index obtained by numerical simulation is smaller than the actual index for the wind from south.Therefore,the wind speed at the upper level(about 100 m)obtained by inversion based on the measured wind speed at the bottom(about 10 m)is also smaller than the actual wind speed.

Single-element Anomaly Mapping from Stream Sediment Geochemical Landscapes Aided by Digital Terrain Analysis

The identification of anomalies within stream sediment geochemical data is one of the fastest developing areas in mineral exploration.The various means used to achieve this objective make use of either continuous or discrete field models of stream sediment geochemical data.To map anomalies in a discrete field model of such data,two corrections are required:background correction and downstream dilution correction.Topography and geomorphology are important factors in variations of element content in stream sediments.However,few studies have considered,through the use of digital terrain analysis,the influence of geomorphic features in downstream dilution correction of stream sediment geochemical data.This study proposes and demonstrates an improvement to the traditional downstream dilution correction equation,based on the use of digital terrain analysis to map single-element anomalies in stream sediment geochemical landscapes.Moreover,this study compares the results of analyses using discrete and continuous field models of stream sediment geochemical data from the Xincang area,Tibet.The efficiency of the proposed methodology was validated against known mineral occurrences.The results indicate that catchment-based analysis outperforms interpolation-based analysis of stream sediment geochemical data for anomaly mapping.Meanwhile,the proposed modified downstream dilution correction equation proved more effective than the original equation.However,further testing of this modified downstream dilution correction is needed in other areas,in order to investigate its efficiency further.

Correction of CMPAS Precipitation Products over Complex Terrain Areas with Machine Learning Models

Machine learning models were used to improve the accuracy of China Meteorological Administration Multisource Precipitation Analysis System(CMPAS)in complex terrain areas by combining rain gauge precipitation with topographic factors like altitude,slope,slope direction,slope variability,surface roughness,and meteorological factors like temperature and wind speed.The results of the correction demonstrated that the ensemble learning method has a considerably corrective effect and the three methods(Random Forest,AdaBoost,and Bagging)adopted in the study had similar results.The mean bias between CMPAS and 85%of automatic weather stations has dropped by more than 30%.The plateau region displays the largest accuracy increase,the winter season shows the greatest error reduction,and decreasing precipitation improves the correction outcome.Additionally,the heavy precipitation process’precision has improved to some degree.For individual stations,the revised CMPAS error fluctuation range is significantly reduced.

Strategies for Advancing Road Construction Slope Stability: Unveiling Innovative Techniques for Managing Unstable Terrain

This comprehensive review paper explores various aspects of geotechnical engineering, with a focus on the management of unstable terrains, numerical methods for solving complex soil and consolidation problems, rheological analysis of suspensions and muddy soils, and stability analysis of slopes. It begins by examining the unique physicochemical properties of cohesive sediments, including cohesion and specific surface area. The temporal evolution of deposit concentration and average bed concentration in unstable terrains is discussed, along with settling behavior of isolated particles and hindered settling using empirical equations. Key sedimentation theories, such as Kynch’s theory, and geotechnical consolidation theories, including Terzaghi’s consolidation equation and Gibson’s theory, are presented. The investigation interrelates these theories and principles to offer a holistic view of managing unstable terrains. It also addresses the challenges associated with experimental determination of constitutive relationships and presents alternative simplification methods proposed by researchers. Additionally, it delves into numerical methods for solving nonlinear partial differential equations governing soil behavior, emphasizing the need for numerical frameworks and discussing various techniques and associated challenges. The rheological analysis section covers material flow behavior, rheological behavior models, and the rheological properties of water and cohesive sediment mixtures. Fundamental geotechnical calculations, constitutive laws, and failure criteria are explained, highlighting their relevance in geotechnical engineering applications. This paper provides a multidimensional perspective on geotechnical engineering, offering valuable insights into soil properties, consolidation processes, numerical methods, rheological analysis, and slope stability assessment for professionals in the field.

The Effect of Nebulized Budesonide Inhalation in Treating Children with Asthma and its Influence on Immune Indexes

Objective:To explore and analyze the effect of nebulized budesonide inhalation on children with asthma and its influence on immune indexes.Methods:300 children who were with asthma admitted to the Pediatric Respiratory Department of our hospital from January 2021 to January 2023 were selected as the research subjects.The patients were divided into a nebulization group(n=150)and a reference group(n=150)by drawing lots.The nebulization group received routine treatment along with budesonide nebulization inhalation therapy,while the reference group only received routine treatment.The treatment effect,the immune indicators,the time taken for the disappearance of symptoms,and the pulmonary function indicators of both groups were compared.Results:The total efficacy of treatment received in the nebulization group was significantly higher than that in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the CD4^(+),CD8^(+),CD4^(+)/CD8^(+),between the two groups(P>0.05);after treatment,the nebulization group’s CD4^(+),CD8^(+),CD4^(+)/CD8^(+)and other immune indicators were significantly better than the reference group(P<0.05).The time taken for the disappearance of symptoms like wheezing,coughing,crackles,shortness of breath,and other symptoms in the nebulization group was significantly shorter than in the reference group(P<0.05).Before treatment,there was no statistically significant difference in the pulmonary function indexes such as FEV1,PEF,and FVC between the two groups(P>0.05);after treatment,the pulmonary function indexes of the patients in the nebulization group were significantly better than those in the reference group(P<0.05).Conclusion:Nebulized budesonide inhalation therapy has shown significant efficacy in the treatment of pediatric asthma,with notable improvements in immune indicators.Therefore,it is worthy of recommendation and further promotion.

Intensified haze formation and meteorological feedback by complex terrain in the North China Plain region

华北平原地区冬季雾霾污染频发,本研究结合地面观测,卫星反演和大气动力-化学耦合模拟发现,该地区复杂地形加剧了细颗粒物污染及其与大气边界层之间的相互作用.一方面,复杂地形导致污染在山麓平原积聚,加强迎风坡上升气流.在污染事件中,污染层易被抬升至1-2公里高度,高空较强的氧化能力利于二次气溶胶生成;另一方面,地形导致的污染层抬升和二次生成进一步加强气溶胶-边界层相互作用,削弱垂直扩散并加剧近地面大气污染.

六盘山地形及相对湿度对微波辐射计反演气温的影响

利用2018年4月至2019年11月的六盘山隆德站微波辐射计探测资料与平凉站探空资料,研究了微波辐射计反演温度(TM)对空气相对湿度的敏感性。首次提出湿度敏感性系数(HSR)和零度漂移度(ZDD)概念,利用这两个参量在不同高度层的分布特征,研究了六盘山地形对空气相对湿度和温度的影响,主要结论如下:(1)非降水天气条件下,空气相对湿度越大,HSR与1.0的差别越大,ZDD也越大。(2)六盘山地形对大气层的湿度垂直分布影响较大。爬坡气流或抬升气流明显增加了3 km以下气层湿度水平,晴天和阴天条件下空气相对湿度分别在山顶以上0.5 km气层和1.0~2.0 km气层达到最大,TM比实际温度最大能偏低2.7℃。(3)地形对气层湿度的影响进一步影响了空气温度的垂直分布,阴天条件下的大气逆辐射加热使得3 km以下气层平均升温2.3℃,因湿度敏感性产生的温度影响平均达到0.9℃,最高能达到1.7℃。

电大山区地物环境中电波传播的电磁计算

在无人驾驶与无人机等新兴行业中,信号覆盖范围的要求较高,不仅仅在城市,在人迹罕至的山地、沙漠、森林中也需要无线信号的覆盖才能真正完成远程操控,这些地区更多需要考虑的是地势变化对电磁传播所带来的影响。计算电磁学中的一致性几何绕射理论方法是分析电大环境电磁问题的有效方法,使用计算电磁学的方法研究电磁波在山区地物环境中的传播规律。给出了一种建立不规则地形模型的新方法,可以通过数字高程的网格数据生成电磁算法可用的三次多项式曲面,使用多个立方曲面对不规则地形进行拼接,使用平均均方根误差验证模型数据的准确性。基于所得的地形数据,完成了并行的几何光学算法,并对区域电磁场的分布进行了仿真计算。选取了实际山区地物环境进行了实地测量,测量结果与仿真结果对比趋势一致,验证了该方法在非规则地形中电磁波传播分析中的有效性。考虑环境电磁计算的规模,建立了相应的并行策略,100核测试的并行效率可以保持在80%以上。

止敏方口服联合雾化治疗过敏性结膜炎湿热夹风证的临床研究

目的观察止敏方口服联合雾化治疗湿热夹风证过敏性结膜炎(AC)的临床疗效。方法纳入2021年1月—2021年12月苏州市中医医院诊治的湿热夹风证AC患者90例(180只眼),随机分成联合组、雾化组和对照组,每组30例(60只眼)。联合组予止敏方口服及雾化,雾化组单予止敏方雾化,对照组予盐酸氮卓斯汀滴眼液滴眼,均治疗14 d。观察3组患者治疗前后的症状积分、体征积分、泪液免疫球蛋白E(Ig E)抗体值,评价临床疗效。结果3组治疗前症状、体征积分和泪液Ig E抗体比较,差异均无统计学意义(P>0.05)。(1)症状积分:治疗后3组症状积分均较治疗前降低,差异均有统计学意义(t_(联合组)=-18.199、t_(雾化组)=-15.715、t对照组=-13.739,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=8.594,P=0.000)。与对照组比较,联合组和雾化组症状积分均较低,差异均有统计学意义(t_(联合组)=-3.640,P=0.000;t_(雾化组)=-3.156,P=0.002),联合组与雾化组比较,差异无统计学意义(P>0.05)。(2)体征积分:治疗后3组体征积分均较治疗前降低,差异均有统计学意义(t_(联合组)=-18.887、t_(雾化组)=-17.742、t对照组=-15.556,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=16.959,P=0.000)。与对照组比较,联合组和雾化组体征积分均较低,差异均有统计学意义(t_(联合组)=-5.157,P=0.000;t_(雾化组)=-4.409,P=0.000),联合组与雾化组比较,差异无统计学意义(P>0.05)。(3)泪液Ig E抗体:治疗后3组Ig E抗体指标均较治疗前降低,差异均有统计学意义(t_(联合组)=-48.276、t_(雾化组)=-38.164、t对照组=-34.129,均P=0.000)。治疗后3组间比较,差异有统计学意义(F=1937.535,P=0.000)。与对照组比较,联合组和雾化组均较低(t_(联合组)=-56.682、t_(雾化组)=-21.667,均P=0.000)。联合组低于雾化组(t=-49.470,P=0.000),差异均有统计学意义。(4)临床疗效:3组临床疗效比较,差异有统计学意义(Z=14.887,P=0.001)。与联合组比较,雾化组和对照组均较低(Z_(雾化组)=-16.483,P=0.024;Z对照组=-23.267,P=0.001),差异均有统计学意义,雾化组和对照组比较,差异无统计学差异(P>0.05)。(5)复发率:3组复发率比较,差异有统计学意义(χ^(2)=22.816,P=0.000)。与对照组比较,联合组和雾化组均较低(χ^(2)_(联合组)=22.500,P=0.000;χ^(2)_(雾化组)=6.696,P=0.010),联合组低于雾化组(χ^(2)=5.963,P=0.015),差异均有统计学意义。结论止敏方口服加雾化的联合疗法治疗湿热夹风证AC有效,且较单一疗法优势显著。

中国典型复杂地形风能资源特性及其形成机制

为提高对复杂地形风资源特性及其形成机制的认识,改进复杂地形风场数值模拟方法,分别选取代表极大起伏山地与宽谷地形的藏南谷地、代表极大起伏山地与深谷地形的横断山区以及代表中、小起伏丘陵山地的山西高原开展风资源特性观测实验,分析不同典型复杂地形条件下天气背景风场、局地大气环流、地形动力强迫、地表摩擦与热力作用对风资源特性形成的贡献,结果表明:山西高原局地大气环流的作用较小;藏南谷地和横断山区的山谷风环流对其风能资源特性的形成起主要作用,尤其是横断山区还存在多尺度的局地大气环流,传统的风电场风资源CFD数值模拟不足以描述如此复杂的风场。因此,在局地大气环流作用明显的复杂地形地区,需要采用中尺度与CFD结合的风电场选址风资源数值模拟方法。

疏睑润目方雾化治疗MGD型干眼湿热蕴结证的疗效观察

目的观察疏睑润目方雾化治疗轻、中度MGD型干眼湿热蕴结证的临床疗效。方法纳入2021年7月—2022年6月苏州市中医医院诊治的轻、中度MGD型干眼患者60例(120只眼)。随机分为治疗组和对照组各30例(60只眼),证属湿热蕴结。对照组予睑缘清洁+0.9%氯化钠注射液雾化+睑板腺按摩+卡波姆眼用凝胶+双氯芬酸钠滴眼液治疗。治疗组将雾化药物换成疏睑润目方水煎液,余同对照组。2组均治疗30 d。分别在治疗前、后检测患者的泪膜破裂时间(BUT)、角膜荧光素染色(FL)评分、眼表疾病指数(OSDI)评分、有分泌力的睑板腺数量、睑板腺分泌物质量评分和泪液pH。结果2组治疗前BUT、FL评分、OSDI评分、有分泌力的睑板腺数量、睑板腺分泌物质量评分和泪液pH值比较,差异均无统计学意义(P>0.05)。(1)BUT:2组治疗后BUT均较治疗前延长,差异均有统计学意义(t_(治疗组)=26.000、t_(对照组)=15.480,均P=0.000)。治疗后治疗组BUT长于对照组,差异有统计学意义(t=9.936,P=0.000)。(2)FL评分:2组治疗后FL评分均较治疗前降低,差异均有统计学意义(t_(治疗组)=20.330、t_(对照组)=9.181,均P=0.000)。治疗后治疗组FL评分低于对照组,差异有统计学意义(t=5.543,P=0.000)。(3)OSDI评分:2组治疗后OSDI评分均较治疗前降低,差异均有统计学意义(t_(治疗组)=16.093、t_(对照组)=5.435,均P=0.000)。治疗后治疗组OSDI评分低于对照组,差异有统计学意义(t=3.440,P=0.001)。(4)有分泌力的睑板腺数量:2组治疗后有分泌力的睑板腺数量均较治疗前增加,差异均有统计学意义(t_(治疗组)=12.400、t_(对照组)=8.484,均P=0.000)。治疗后治疗组有分泌力的睑板腺数量多于对照组,差异有统计学意义(t=3.216,P=0.002)。(5)睑板腺分泌物质量评分:2组治疗后睑板腺分泌物质量评分均较治疗前降低,差异均有统计学意义(t_(治疗组)=8.510,P=0.000;t_(对照组)=2.100,P=0.038)。治疗后治疗组睑板腺分泌物质量评分低于对照组,差异有统计学意义(t=5.294,P=0.000)。(6)泪液pH值:2组治疗后泪液pH值均较治疗前降低,差异均有统计学意义(t_(治疗组)=26.602、t_(对照组)=16.763,均P=0.000)。治疗后治疗组泪液pH值低于对照组,差异有统计学意义(t=7.058,P=0.000)。结论疏睑润目方雾化疗法可改善轻、中度MGD型干眼湿热蕴结证患者的眼表症状,改善睑板腺功能。

基于机载多角度InSAR技术的复杂地形高精度DEM重建方法

干涉合成孔径雷达(Interferomtric Synthetic Aperture Radar,InSAR)是全天时、全天候获取三维地表信息重要的技术手段。机载InSAR系统具有机动灵活、多角度获取数据的优势,可以高效率、高精度获取数字高程模型(Digital Elevation Model,DEM)数据。但是,在地形复杂区域,InSAR侧视成像易在地形陡峭区域形成较大范围的阴影和严重的叠掩现象,阴影和叠掩区域在SAR图像上体现为信息的丢失,从而导致DEM数据大面积无效数据的存在,严重影响DEM数据的质量及应用。针对这一问题,本文提出了基于机载多角度InSAR技术的复杂地形高精度DEM重建方法,基于考虑地形起伏的机载多角度InSAR数据获取任务规划设计,最大程度的避免阴影和叠掩导致的无效数据;基于高精度InSAR数据处理,保证每个角度DEM数据精度的高度一致性;基于快速多角度DSM数据融合与滤波处理,实现多角度InSAR体制复杂地形DEM高精度重建。本文以四川省西部山区大坡度、非连续等复杂地形为例,基于本文提出的方法,利用3个角度InSAR数据融合处理,生成了高精度DEM数据,试验结果表明,本文提出的方法获取复杂地形DEM数据高程均方根误差为0.6 m,同时,数据有效率大于99%。

2022年8月四川盆地持续性极端高温特征及不同模式预报误差分析

本文基于2022年8月四川盆地104站逐时温度、降水数据和1971—2021年历史同期数据,及EC、CMA-GFS、CMA-MESO模式的2 m气温预报等数据,运用统计学相关方法分析了此次极端高温过程的特征及预报误差。结果表明:①2022年8月四川盆地极端高温过程范围大、强度强、持续时间长,有87.5%站最高气温超过该站历史同期极值,且高温最强盛时段较历史同期明显推后。②2022年8月最高气温分布为东高西低,最高气温与历史同期极值差分布则相反,其中最高气温随站点海拔增大而减小,而极值差则随站点海拔先增大再减小。另外,受热岛效应影响,极值差大值站点主要集中在龙泉山脉附近。③高温期间,最高、最低气温平均值高、距平大,且累计降水量和雨日数也明显低于历史同期。④相较而言,EC模式的预报优势主要在盆地低海拔地区。而CMA-MESO模式在盆地周边陡峭地形区域的平均绝对误差则更小。另外,EC模式预报的最高气温峰值出现时间更接近于实况,而CMA-MESO模式预报高温持续日数更接近实况。

基于激光SLAM多地形机器人的设计

为解决传统轮式机器人在复杂地形中受限与腿式机器人控制策略复杂的问题,提出一种多地形机器人。结合激光即时定位与地图构建(SLAM)方法和自适应式轮腿机构,将树莓派作为运算单元,搭载(ROS)机器人操作系统,应用激光SLAM技术实现环境地图构建和机器人导航,同时结合深度模型和摄像头完成图像任务。自适应式轮腿机械结构使机器人能够根据环境需求自动切换为轮式或腿式行进模式。底层控制器采用STM32F407,机器人通过PID算法能实现精准的移动和机械臂作业。结果表明:该多地形机器人控制方法简单高效,在坡地、草地、坑地、台阶障碍物等复杂地形中展现了灵活移动的能力,最大翻越障碍高度可达250 mm,爬坡角度可达45°,在稳定性和适应性方面具有显著优势。

沟谷地形下非均匀条带开采采场结构参数优化

沟谷地形下的缓倾斜矿层原岩应力场受地形影响较大,同一采区甚至盘区的采场所处的地应力环境有较大差异,采用与此种特殊地应力环境相匹配的采场结构参数对矿区的高效开采有重要意义。本文以宜昌晒旗河矿区为工程背景,提出非均匀条带开采方案,运用简支梁理论、弹塑性理论计算条带采留宽度,采用FLAC3D软件分别对采用均匀条带开采和非均匀条带开采的采场进行数值模拟,从应力、位移变化及塑性区分布规律等方面分析了采场稳定性特征。研究结果表明:相比于全部采场结构参数按矿体最大埋深计算的均匀条带开采方案,不同埋深采用不同采留宽度的非均匀条带开采方案使采场的应力分布更为均匀,在保证采场稳定的前提下,提升了生产能力,对沟谷地形下采场结构参数优化具有一定借鉴意义。

不同地形梯度下秦巴山区乡村振兴潜力及发展路径

我国山地丘陵地区在空间上相对孤立,乡村发展受到阻碍。开展不同地形梯度下乡村振兴潜力及发展路径研究,旨在为山区因地制宜推进乡村振兴提供理论与科学依据。基于陕南秦巴山区地形差异开展典型村域调研,构建评价指标体系测度乡村振兴潜力,结合相关性与障碍度模型,辨识不同地形梯度下乡村振兴的障碍因素,提出差异化发展建议。结果表明:①各地形梯度下乡村振兴综合潜力由大到小依次为低地形梯度、中低地形梯度、高地形梯度、中高地形梯度,地形梯度与秦巴山区乡村振兴综合潜力及区位条件、基础设施潜力成显著负相关关系;②随着地形梯度的上升,秦巴山区乡村主体、产业发展、人居环境、区位条件、基础设施潜力整体上呈减小趋势,资源禀赋潜力先减小后增大;③不同地形梯度下秦巴山区乡村振兴各维度潜力大小及其障碍因子皆存在明显差异。为优化山区乡村发展模式、全面推进乡村振兴,建议低地形梯度村庄重点防止人口、耕地等农业生产要素流失,中低地形梯度村庄优化基层组织、提升引领能力,中高梯度村庄加强基础设施建设、改善人居环境,高地形梯度村庄充分保护并合理利用林地资源,发展特色产业。

免疫调节剂联合吸入用复方异丙托溴铵溶液治疗慢性阻塞性肺疾病的效果

目的:探究免疫调节剂联合吸入用复方异丙托溴铵溶液治疗慢性阻塞性肺疾病(COPD)的效果。方法:选择2017年1月—2019年1月在山东省青州荣军医院呼吸内科治疗的COPD患者80例,应用随机数字表法将其分为对照组(吸入用复方异丙托溴铵溶液)及观察组(联合免疫调节剂),各40例,对比两组临床疗效、炎症因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)]、肺功能[最大呼气量(PEF)、最大自主通气量(MVV)、第1秒用力呼气容积占预计值的百分比(FEV_(1)%pred)]、气道黏液高分泌[Toll样受体4(TLR4)、痰液干湿比重、黏蛋白5AC(MUC5AC)]、不良反应发生率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗前,两组炎症因子比较,差异均无统计学意义(P>0.05);治疗后,两组hs-CRP、TNF-α、PCT均较治疗前降低,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗前,两组肺功能指标比较,差异均无统计学意义(P>0.05);治疗后,两组PEF、MVV、FEV_(1)%pred均较治疗前升高,且观察组均高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组气道黏液高分泌指标比较,差异均无统计学意义(P>0.05);治疗后,两组TLR4均降低,观察组低于对照组,差异均有统计学意义(P<0.05),痰液干湿比重、MUC5AC均降低,观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率与对照组比较,差异无统计意义(P>0.05)。结论:COPD采用免疫调节剂联合吸入用复方异丙托溴铵溶液治疗,效果显著,可改善患者肺功能,抑制炎症反应,缓解气道黏液高分泌状态,安全性较高。

山区公路有限空间施工安全评价方法

山区交通工程建设经常面临狭窄地形条件下斜坡、弃渣、桥桩相互影响带来的安全挑战,需要综合评价由此产生的工程稳定问题。为了研究山区公路施工安全评价方法,依托某山区公路斜坡路段,在广泛调研狭窄地形路段工程建设特点的基础上,提出狭窄地形公路工程建设面临的共性安全问题,构建此类工程施工安全评价方法及控制标准体系,并在实际工程中应用、检验及完善该方法及指标体系。主要结果为:提出包括地基承载安全、改变地形边坡稳定性和结构安全的山区公路有限空间施工安全评价方法和安全控制标准体系。在山区公路有限空间工程建设中,需要控制弃渣填筑高度,控制加载造成的竖向应力小于承载力安全标准,实现地基承载安全;通过填筑体内部滑移、填筑体与斜坡地形接触面滑移、填筑体与自然地形深大滑移等潜在风险复核,实现边坡稳定性的全面控制;通过对桩基内力复核,控制堆载造成的结构内力小于结构承载安全标准。