At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity...At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity liquid at normal temperature,but it can be solidified above 80℃.The plugging degree is up to 99%at 250℃.The sweep efficiency reaches 59.2%,which is 7.3%higher than pure steam injection.In addition,simultaneous injection of viscosity reducer and/or nitrogen foams can further enhance oil recovery.The mechanism of this technology depends on its strong plugging ability,which changes the flowing pattern of steam to effectively mobilize remaining oil.Viscosity reducer and nitrogen foams further expand the sweep range and extends the effective period.Therefore,thermal solidification agent can plug steam channeling paths and adjust steam flowing direction to significantly enhance oil recovery at high cycles of steam huff&puff.展开更多
This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion w...This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion with multi-cluster sand jetting perforation.The effects of temporary plugging agent(TPA)particle size,TPA concentration,single-cluster perforation number and cluster number on plugging pressure,multi-fracture diversion pattern and distribution of TPAs were investigated.A combination of TPAs with small particle sizes within the fracture and large particle sizes within the segment is conducive to increasing the plugging pressure and promoting the diversion of multi-fractures.The addition of fibers can quickly achieve ultra-high pressure,but it may lead to longitudinal fractures extending along the wellbore.The temporary plugging peak pressure increases with an increase in the concentration of the TPA,reaching a peak at a certain concentration,and further increases do not significantly improve the temporary plugging peak pressure.The breaking pressure and temporary plugging peak pressure show a decreasing trend with an increase in single-cluster perforation number.A lower number of single-cluster perforations is beneficial for increasing the breaking pressure and temporary plugging peak pressure,and it has a more significant control on the propagation of multi-cluster fractures.A lower number of clusters is not conducive to increasing the total number and complexity of artificial fractures,while a higher number of clusters makes it difficult to achieve effective plugging.The TPAs within the fracture is mainly concentrated in the complex fracture areas,especially at the intersections of fractures.Meanwhile,the TPAs within the segment are primarily distributed near the perforation cluster apertures which initiated complex fractures.展开更多
AIM:To investigated the incidence of diversion colitis(DC) and impact of DC symptoms on quality of life(QoL) after ileostomy reversal in rectal cancer.METHODS:We performed a prospective study with 30 patients who unde...AIM:To investigated the incidence of diversion colitis(DC) and impact of DC symptoms on quality of life(QoL) after ileostomy reversal in rectal cancer.METHODS:We performed a prospective study with 30 patients who underwent low anterior resection and the creation of a temporary ileostomy for the rectal cancer between January 2008 and July 2009 at the Department of Surgery,Korea University Anam Hospital.The participants totally underwent two rounds of the examinations.At first examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom were performed 3-4 mo after the ileostomy creations.At second examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom and QoL were performed 5-6 mo after the ileostomy reversals.Clinicopathological data were based on the histopathological reports and clinical records of the patients.RESULTS:At the first examination,all of the patients presented with inflammation,which was mild in 15(50%) patients,moderate in 11(36.7%) and severe in 4(13.3%) by endoscopy and mild in 14(46.7%) and moderate in 16(53.3%) by histology.At the second examination,only 11(36.7%) and 17(56.7%) patients had mild inflammation by endoscopy and histology,respectively.There was no significant difference in DC grade between the endoscopic and the histological findings at first or second examination.The symptoms detected on the first and second questionnaires were mucous discharge in 12(40%) and 5(17%) patients,bloody discharge in 5(17%) and 3(10%) patients,abdominal pain in 4(13%) and 2(7%) patients and tenesmus in 9(30%) and 5(17%) patients,respectively.We found no correlation between the endoscopic or histological findings and the symptoms such as mucous discharge,bleeding,abdominal pain and tenesmus in both time points.Diarrhea was detected in 9 patients at the second examination;this number correlated with the severity of DC(0%,0%,66.7%,33.3% vs 0%,71.4%,23.8%,4.8%,P = 0.001) and the symptom-related QoL(r =-0.791,P < 0.001).CONCLUSION:The severity of DC is related to diarrhea after an ileostomy reversal and may adversely affect QoL.展开更多
Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occ...Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.展开更多
We studied the flood, ebb and tidal averaged along (net) water diversion ratio (WDR) during dry season in the Changjiang (Yangtze) estuary, China, along with the effects of northerly wind, river discharge, tide and th...We studied the flood, ebb and tidal averaged along (net) water diversion ratio (WDR) during dry season in the Changjiang (Yangtze) estuary, China, along with the effects of northerly wind, river discharge, tide and their interactions on WDR using the improved version of three-dimensional numerical model ECOM. Using data for annual mean wind speed and river discharge during January, we determined that the flood, ebb, net WDR values in the North Branch of the estuary were 3.48%, 1.68%,-4.06% during spring tide, and 4.82%, 2.34%,-2.79% during neap tide, respectively. Negative net WDR values denote the transport of water from the North Branch into the South Branch. Using the same data, the corresponding ratios were 50.09%, 50.92%, 54.97%, and 52.33%, 50.15%, 43.86% in the North Channel and 38.56%, 44.78%, 103.96%, and 36.92%, 43.17%, 60.97% in the North Passage, respectively. When northerly wind speed increased, landward Ekman transport was enhanced in the North Branch, increasing the flood WDR, while the ebb WDR declined and the net WDR exhibited a significant decrease. Similarly, in the North Channel, the flood WDR is increased, the ebb WDR reduced, and the net WDR showed a marked decrease. In the North Passage, the flood WDR also increased while the ebb and net WDR declined. As the river discharge increased, the flood and ebb WDR of the North Branch increased slightly and the net WDR increased markedly. In the North Channel the flood and ebb WDR changed very slightly, while the net WDR declined during spring tides and increased during neap tides. The WDR in the North Passage changed slightly during flood and ebb tides while the net WDR showed a marked increase. The WDR values of different bifurcations and the responses to northerly wind, river discharge, and tide are discussed in comparison with variations in river topography, horizontal wind-induced circulation, and tidal-induced residual current.展开更多
One of the water source areas of the South-to-North Water Diversion Project is the Danjiangkou Reservoir (DJKR). To understand seasonal variation in phytoplankton composition, abundance and distribution in the DJKR ...One of the water source areas of the South-to-North Water Diversion Project is the Danjiangkou Reservoir (DJKR). To understand seasonal variation in phytoplankton composition, abundance and distribution in the DJKR area before water diversion, as well as to estimate potential risks of water quality after water diversion, we conducted an investigation on phytoplankton in the DJKR from August 2008 to May 2009. The investigation included 10 sampling sites, each with four depths of 0.5, 5, 10, and 20 m. In this study, 117 taxa belonging to 76 genera were identified, consisting of diatoms (39 taxa), green algae (47 taxa), blue-green algae (19 taxa), and others (12 taxa). Annual average phytoplankton abundance was 2.01×10^6 ind./L, and the highest value was 14.72 ×10^6 ind/L (at site 3 in August 2008). Phytoplankton abundance in front of the Danjiangkou Dam (DJKD) was higher than that of the Danjiang Reservoir Basin. Phytoplankton distribution showed a vertical declining trend from 0.5 m to 20 m at most sites in August 2008 (especially at sites of 1, 2, 4 and 10), but no distinct pattern in other sampling months. In December 2008 and March 2009, Stephanodiseus sp. was the most abundant species, amounting to 55.23% and 72.34%, respectively. We propose that high abundance ofStephanodiscus sp. may have contributed greatly to the frequent occurrence of Stephanodiscus sp. blooms in middle-low reaches of the Hanjiang River during the early spring of 2009. In comparison with previous studies conducted from 1992 to 2006, annual average phytoplankton density, green algae and blue-green algae species, as well as major nutrient concentrations increased, while phytoplankton diversity indices declined. This indicates a gradual decline in water quality. More research should be conducted and countermeasures taken to prevent further deterioration of water quality in the DJKR.展开更多
The south to the north project (WDP) on the saltwater intrusion in the Changjiang Estuary is studied by the improved three-dimensionai (3D) numerical model.The net unit width flux in the Changjiang Estuary as well as ...The south to the north project (WDP) on the saltwater intrusion in the Changjiang Estuary is studied by the improved three-dimensionai (3D) numerical model.The net unit width flux in the Changjiang Estuary as well as the sectional salt flux is calculated in the North Branch (NB),the South Branch (SB),the North Channel (NC),the South Channel (SC),the North Passage (NP) and the South Passage (SP),respectively.The net seaward water flux in the SB is reduced,and the net water flux spilling over from the NB to the SB is enhanced after the eastern WDP.Under the mean river discharge condition in the dry season,the net salt flux spilling over from the NB to the SB is increased by 2.09 t/s and 0.52 t/s during the spring and neap tides,respectively,due to the eastern WDP.The saltwater intrusion in the Changjiang Estuary is enhanced by the eastern WDP.Compared with that during the spring tide,the net water diversion ratio during the neap tide in the NC is smaller,and thus the enhancement of the saltwater intrusion by the eastern WDP is smaller in the NC,and larger in the NP and the SP.The tidally averaged surface salinity at the water intakes of the Dongfengxisha Reservoir,the Chenhang Reservoir and the Qingcaosha Reservoir rises both during the spring and neap tides.展开更多
AIM:To investigate the effect of plasmapheresis via the portal vein for"small-for-size"syndrome(SFSS)aided by extracorporeal continuous portal diversion(ECPD).METHODS:Extensive or total hepatectomy in the pi...AIM:To investigate the effect of plasmapheresis via the portal vein for"small-for-size"syndrome(SFSS)aided by extracorporeal continuous portal diversion(ECPD).METHODS:Extensive or total hepatectomy in the pig is usually adopted as a postoperative liver failure(PLF)or SFSS model.In this study,animals which underwent85%-90%hepatectomy were randomized into either the Systemic group(n=7)or the Portal group(n=7).In the Systemic group,all pigs received temporal plasmapheresis(PP)via the extracorporeal catheter circuit(systemic to systemic circulation)from 24 to 30 h posthepatectomy(PH);in the Portal group,all pigs received ECPD to divert partial portal vein flow(PVF)to the systemic circulation after hepatectomy,then converted to temporal PP from 24 to 30 h PH,and subsequently converted to ECPD again until 48 h PH.In the Portal group,the PVF was preserved at 3.0-3.3 times that of the baseline value,similar to that following 70%hepatectomy,which was regarded as the optimal PVF to the hypertrophic liver remnant.At 48 h PH,all pigs were re-opened and the portal vein pressure(PVP),PVF,and HAF(hepatic artery flow)were measured,and then diversion of the portal venous flow was terminated.After1 h the PVP,PVF,and HAF were re-measured.The portal hemodynamic changes,liver injury,liver regeneration and bacterial/lipopolysaccharide(LPS)translocation were evaluated in the two groups.RESULTS:The PVP in the Portal group was significantly lower than that in the Systemic group during the time period from 2 to 49 h PH(P<0.05).Serum alanine aminotransferase(ALT),total bilirubin(TB)and ammonia were significantly reduced in the Portal group compared with the Systemic group from 24 to 48 h PH(P<0.05).The Portal group may have attenuated sinusoidal endothelial injury and decreased the level of HA compared with the Systemic group.In the Systemic group,there was significant sinusoidal dilation,hydropic changes in hepatocytes and hemorrhage into the hepatic parenchyma,and the sinusoidal endothelial lining was partially destroyed and detached into the sinusoidal space.CD31immunostaining revealed significant destruction of the endothelial lining.In the Portal group,there was no intraparenchymal hemorrhage and the sinusoidal endothelial cells and hepatocytes were well preserved.CD31immunostaining was mild which indicated less destruction of the endothelial lining.HA was significantly decreased in the Portal group compared with the Systemic group from 2 to 48 h PH.The rate of liver remnant regeneration was elevated,while apoptosis was attenuated in the Portal group compared with the Systemic group.Thymidine kinase activity was much higher in the Portal group than in the Systemic group at 48 h PH.The PCNA index was significantly increased and the apoptotic index was significantly decreased in the Portal group compared with the Systemic group.Bacterial translocation and endotoxin,as well as the inflammatory response,were significantly attenuated in the Portal group compared with the Systemic group.LPS,tumor necrosis factor-and interleukin-6 levels were all significantly decreased in the Portal group compared with the Systemic group from 24 to48 h PH,while bacterial DNA level was significantly decreased from 2 to 48 h PH.CONCLUSION:PP plus ECPD via the portal vein can attenuate toxic load and hyperperfusion injury,and should be undertaken instead of PP via the systemic circulation in SFSS or PLF.展开更多
The proposals on entanglement diversion and quantum teleportation of entangled coherent states are presented. In these proposals, the entanglement between two coherent states, |α〉 and |-α〉, with the same amplitu...The proposals on entanglement diversion and quantum teleportation of entangled coherent states are presented. In these proposals, the entanglement between two coherent states, |α〉 and |-α〉, with the same amplitude but a phase difference of π is utilized as a quantum channel. The processes of the entanglement diversion and the teleportation are achieved by using the 50/50 symmctric beam splitters, the phase shifters and the photodetectors with the help of classical information.展开更多
According to site-specific environments such as high water pressures, high in-situ stresses and strong rockbursts, the design scheme of the long and deep diversion tunnels at Jinping II hydropower station was optimize...According to site-specific environments such as high water pressures, high in-situ stresses and strong rockbursts, the design scheme of the long and deep diversion tunnels at Jinping II hydropower station was optimized to ensure construction safety. New drainage tunnels were considered. Furthermore, lining structures and grouting pressures were modified during the excavation of tunnels. The construction scheme was updated dynamically based on the complex geological conditions. For instances, the diversion tunnels were first excavated by drilling and blasting method at the first stage of construction, and then by the combination method of tunnel boring machine (TBM) and drilling and blasting, and finally by drilling and blasting method. Through optimized scheme and updated construction scheme, the excavation of diversion tunnel #1 was successfully completed in June, 2011. This paper summarizes the key issues in rock mechanics associated with the construction of the long and deep diversion tunnels at Jinping II hydropower station. The experiences of design and construction obtained from this project could provide reference to similar projects.展开更多
AIM: To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity. METHODS: Fifty-nine symptomatic adults with chronic anal fissure developed af...AIM: To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity. METHODS: Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study. The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment. All data were analyzed in univariate and multivariate analysis. RESULTS: Two months after treatment, 65.4% of the patients had a healing scar. Only one patient had mild incontinence to flatus that lasted 3 wk after treatment, but this disappeared spontaneously. In the multivariate analysis of the data, two registered months after the treatment, sex (P = 0.01), baseline resting anal pressure (P = 0.02) and resting anal pressure 2 mo after treatment (P < 0.0001) were significantly related to healing rate.CONCLUSION: Botulinum toxin, despite worse results than in non-obese individuals, appears the best alternative to surgery for this group of patients with a high risk of incontinence.展开更多
Objective:To review the most used intracorporeal orthotopic ileal neobladder(ICONB)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent ima...Objective:To review the most used intracorporeal orthotopic ileal neobladder(ICONB)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images.Methods:We performed a non-systematic review of the literature with the keywords“bladder cancer”,“urinary diversion”,“radical cystectomy”,and“neobladder”.Results:Forty studies were included in the analysis.The most frequent type of ICONB was the modified Studer“U”neobladder(70%)followed by the Hautmann“W”modified neobladder(7.5%),the“Y”neobladder(5%),and the Padua neobladder(5%).The operative time to perform a urinary diversion ranged from 124 to 553 min.The total estimated blood loss ranged from 200 to 900 mL.The rate of positive surgical margins ranged from 0%to 8.1%.Early minor and major complication rates ranged from 0%to 100%and from 0%to 33%,respectively.Late minor and major complication rates ranged from 0%to 70%and from 0%to 25%,respectively.Conclusion:The most frequent types of ICONB are Studer“U”neobladder,Hautmann“W”neobladder,“Y”neobladder,and the Padua neobladder.Randomized studies comparing the performance of the different types of ICONB,the performance in an intra or extracorporeal manner,or the performance of an ICONB versus ICIC are lacking in the literature.To this day,there are not sufficient quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used ICONB with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images of each technique.展开更多
A combination of the rainfall-runoff module of the Xin’anjiang model, the Muskingum routing method, the water stage simulating hydrologic method, the diffusion wave nonlinear water stage method, and the real-time err...A combination of the rainfall-runoff module of the Xin’anjiang model, the Muskingum routing method, the water stage simulating hydrologic method, the diffusion wave nonlinear water stage method, and the real-time error correction method is applied to the real-time flood forecasting and regulation of the Huai River with flood diversion and retarding areas. The Xin’anjiang model is used to forecast the flood discharge hydrograph of the upstream and tributary. The flood routing of the main channel and flood diversion areas is based on the Muskingum method. The water stage of the downstream boundary condition is calculated with the water stage simulating hydrologic method and the water stages of each cross section are calculated from downstream to upstream with the diffusion wave nonlinear water stage method. The input flood discharge hydrograph from the main channel to the flood diversion area is estimated with the fixed split ratio of the main channel discharge. The flood flow inside the flood retarding area is calculated as a reservoir with the water balance method. The faded-memory forgetting factor least square of error series is used as the real-time error correction method for forecasting discharge and water stage. As an example, the combined models were applied to flood forecasting and regulation of the upper reaches of the Huai River above Lutaizi during the 2007 flood season. The forecast achieves a high accuracy and the results show that the combined models provide a scientific way of flood forecasting and regulation for a complex watershed with flood diversion and retarding areas.展开更多
For a water supply system with long-distance diversion pipelines, in addition to the water hammer problems that occur beyond pumps, the safety of the water diversion pipeline in front of pumps also deserves attention....For a water supply system with long-distance diversion pipelines, in addition to the water hammer problems that occur beyond pumps, the safety of the water diversion pipeline in front of pumps also deserves attention. In this study, a water hammer protection scheme combined with an overflow surge tank and a regulating valve was developed. A mathematical model of the overflow surge tank was developed, and an analytical formula for the height of the overflow surge tank was derived. Furthermore, a practical water supply project was used to evaluate the feasibility of the combined protection scheme and analyze the sensitivity of valve regulation rules. The results showed that the combined protection scheme effectively reduced the height of the surge tank, lessened the difficulties related to construction, and reduced the necessary financial investment for the project. The two-stage closing rule articulated as fast first and then slow could minimize the overflow volume of the surge tank when the power failure occurred, while the two-stage opening rule articulated as slow first and then fast could be more conducive to the safety of the water supply system when the pump started up.展开更多
Objective:To review the most used robot-assisted cutaneous urinary diversion(CUD)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent image...Objective:To review the most used robot-assisted cutaneous urinary diversion(CUD)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images Methods:A non-systematic review of the literature with the keywords“bladder cancer”,“cutaneous urinary diversion”,and“radical cystectomy”was performed.Results:Twenty-four studies of intracorporeal ileal conduit(ICIC)and two of intracorporeal Indiana pouch(ICIP)were included in the analysis.Regarding ICIC,the patients’age ranged from 60 to 76 years.The operative time to perform a urinary diversion ranged from 60 to 133 min.The total estimated blood loss ranged from 200 to 1117 mL.The rate of positive surgical margins ranged from 0%to 14.3%.Early minor and major complication rates ranged from 0%to 71.4%and from 0%to 53.4%,respectively.Late minor and major complication rates ranged from 0%to 66%and from 0%to 32%,respectively.Totally ICIP data are limited to one case report and one clinical series.Conclusion:The most frequent type of CUD is ICIC.Randomized studies comparing the performance of the different types of CUD,the performance in an intra-or extracorporeal manner,or the performance of a CUD versus orthotopic ileal neobladder are lacking in the literature.To this day,there are not enough quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used CUD with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images for each technique.展开更多
The South-to-North Water Diversion (SNWD) Project is a significant engineering project meant to solve water shortage problems in North China. Faced with market operations management of the water diversion system, th...The South-to-North Water Diversion (SNWD) Project is a significant engineering project meant to solve water shortage problems in North China. Faced with market operations management of the water diversion system, this study defined the supply chain system for the SNWD Project, considering the actual project conditions, built a decentralized decision model and a centralized decision model with strategic customer behavior (SCB) using a floating pricing mechanism (FPM), and constructed a coordination mechanism via a revenue-sharing contract. The results suggest the following: (1) owing to water shortage supplements and the excess water sale policy provided by the FPM, the optimal ordering quantity of water resources is less than that without the FPM, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without the FPM; (2) wholesale pricing and supplementary wholesale pricing with SCB are higher than those without SCB, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without SCB; and (3) considering SCB and introducing the FPM help increase the optimal profits of the whole supply chain, supplier, and external distributor, and improve the efficiency of water resources usage.展开更多
To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading ...To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading to severe BSEP deficiency in two unrelated patients were identified by genomic sequencing. Native liver biopsies and transiently transfected human embryonic kidney (HEK) 293 cells expressing either wild-type or mutated BSEP were subjected to immunofluorescence analysis to assess BSEP transporter localization. Bile acid profiles of patient and control bile samples were generated by ultra-performance liquid chromatography-tandem mass spectrometry. Wild-type and mutant BSEP transport of [<sup>3</sup>H]-labeled taurocholate (TC) and taurochenodeoxycholate (TCDC) was assessed by vesicular transport assays. RESULTSA girl (at 2 mo) presented with pruritus, jaundice and elevated serum bile salts (BS). PEBD stabilized liver function and prevented liver transplantation. She was heterozygous for the BSEP deletion p.T919del and the nonsense mutation p.R1235X. At the age of 17 years relative amounts of conjugated BS in her bile were normal, while total BS were less than 3% as compared to controls. An unrelated boy (age 1.5 years) presenting with severe pruritus and elevated serum BS was heterozygous for the same nonsense and another missense mutation, p.G1032R. PEBD failed to alleviate pruritus, eventually necessitating liver transplantation. BS concentration in bile was about 5% of controls. BS were mainly unconjugated with an unusual low amount of chenodeoxycholate derivatives (< 5%). The patients’ native liver biopsies showed canalicular BSEP expression. Both BSEP p.T919del and p.G1032R were localized in the plasma membrane in HEK293 cells. In vitro transport assays showed drastic reduction of transport by both mutations. Using purified recombinant BSEP as quantifiable reference, per-molecule transport rates for TC and TCDC were determined to be 3 and 2 BS molecules per wild-type BSEP transporter per minute, respectively. CONCLUSIONIn summary, our findings suggest that residual function of BSEP as well as substrate specificity influence the therapeutic effectiveness of PEBD in progressive familial intrahepatic cholestasis type 2 (PFIC-2).展开更多
The Middle Route of the South-to-North Water Diversion Project(MR-SNWDP)in China,with construction beginning in 2003,diverts water from Danjiangkou Reservoir to North China for residential,agriculture and industrial u...The Middle Route of the South-to-North Water Diversion Project(MR-SNWDP)in China,with construction beginning in 2003,diverts water from Danjiangkou Reservoir to North China for residential,agriculture and industrial use.The water source area of the MR-SNWDP is the region that is most sensitive to and most affected by the construction of this water diversion project.In this study,we used Landsat Thematic Mapper(TM)and HJ-1 A/B images from 2000 to 2015 by an object-based approach with a hierarchical classification method for mapping land cover in the water source area.The changes in land cover were illuminated by transfer matrixes,single dynamic degree,slope zones and fractional vegetation cover(FVC).The results indicated that the area of cropland decreased by 31%and was replaced mainly by shrub over the past 15 years,whereas forest and settlements showed continuous increases of 29.2% and 77.7%,respectively.The changes in cropland were obvious in all slope zones and decreased most remarkably(–43.8%)in the slope zone above 25°.Compared to the FVC of forest and shrub,significant improvement was exhibited in the FVC of grassland,with a growth rate of 16.6%.We concluded that local policies,including economic development,water conservation and immigration resulting from the construction of the MR-SNWDP,were the main drivers of land cover changes;notably,they stimulated the substantial and rapid expansion of settlements,doubled the wetlands and drove the transformation from cropland to settlements in immigration areas.展开更多
In most studies of tunnel boring machine(TBM)tunnelling, the groundwater pressure was not considered, or was simplified and exerted on the boundary of lining structure. Meanwhile, the leakage, which mainly occurs in t...In most studies of tunnel boring machine(TBM)tunnelling, the groundwater pressure was not considered, or was simplified and exerted on the boundary of lining structure. Meanwhile, the leakage, which mainly occurs in the segment joints, was often ignored in the relevant studies of TBM tunnelling. Additionally, the geological models in these studies were simplified to different extents, and mostly were simplified as homogenous bodies. Considering the deficiencies above, a 3D refined model of the surrounding rock of a tunnel is firstly established using NURBS-TIN-BRe P hybrid data structure in this paper. Then the seepage field of the surrounding rock considering the leakage in the segment joints is simulated. Finally, the stability of TBM water diversion tunnel is studied coupled with the seepage simulation, to analyze the stress-strain conditions, the axial force and the bending moment of tunnel segment considering the leakage in the segment joints. The results illustrate that the maximum radial displacement, the minimum principal stress, the maximum principal stress and the axial force of segment lining considering the seepage effect are all larger than those disregarding the seepage effect.展开更多
In arid regions, large-scale water diversion from rivers leads to significant changes in river flow regimes, which may have large impacts on ecological water uses of river-dependent ecosystems, such as river, lake, we...In arid regions, large-scale water diversion from rivers leads to significant changes in river flow regimes, which may have large impacts on ecological water uses of river-dependent ecosystems, such as river, lake, wetland, and riparian ecosystems. To assess the integrated impact of water diversion on ecological water uses, we proposed a hierarchy evaluation model composed of four layers representing the evaluation goal, sub-areas of the influenced region, evaluation criteria, and water diversion schemes, respectively. The evaluation criteria for different types of ecological water uses were proposed, and the analytical hierarchy process was used for the integrated assessment. For a river ecosystem, the percentage of mean annual flow was used to define the grade of environmental flow. For a lake ecosystem, water recharge to the lake to compensate the lake water losses was used to assess the ecological water use of a lake. The flooding level of the wetland and the groundwater level in the riparian plain were used to assess the wetland and riparian ecological water uses, respectively. The proposed model was applied to a basin in northern Xinjiang in northwest China, where both water diversion and inter-basin water transfer projects were planned to be carried out. Based on assessment results for the whole study area and two sub-areas, an appropriate scheme was recommended from four planning schemes. With the recommended scheme, ecological water uses of the influenced ecosystems can be maintained at an acceptable level. Meanwhile, economical water requirements can be met to a great extent.展开更多
基金supported by National Natural Science Foundation of China(52074321)Natural Science Foundation of Beijing Municipality,China(3192026)。
文摘At high cycles of steam huff&puff,oil distribution in reservoirs becomes stronger heterogeneity due to steam channeling.Thermal solidification agent can be used to solve this problem.Its solution is a lowviscosity liquid at normal temperature,but it can be solidified above 80℃.The plugging degree is up to 99%at 250℃.The sweep efficiency reaches 59.2%,which is 7.3%higher than pure steam injection.In addition,simultaneous injection of viscosity reducer and/or nitrogen foams can further enhance oil recovery.The mechanism of this technology depends on its strong plugging ability,which changes the flowing pattern of steam to effectively mobilize remaining oil.Viscosity reducer and nitrogen foams further expand the sweep range and extends the effective period.Therefore,thermal solidification agent can plug steam channeling paths and adjust steam flowing direction to significantly enhance oil recovery at high cycles of steam huff&puff.
基金Supported by the National Natural Science Foundation of China(51974332).
文摘This study conducted temporary plugging and diversion fracturing(TPDF)experiments using a true triaxial fracturing simulation system within a laboratory setting that replicated a lab-based horizontal well completion with multi-cluster sand jetting perforation.The effects of temporary plugging agent(TPA)particle size,TPA concentration,single-cluster perforation number and cluster number on plugging pressure,multi-fracture diversion pattern and distribution of TPAs were investigated.A combination of TPAs with small particle sizes within the fracture and large particle sizes within the segment is conducive to increasing the plugging pressure and promoting the diversion of multi-fractures.The addition of fibers can quickly achieve ultra-high pressure,but it may lead to longitudinal fractures extending along the wellbore.The temporary plugging peak pressure increases with an increase in the concentration of the TPA,reaching a peak at a certain concentration,and further increases do not significantly improve the temporary plugging peak pressure.The breaking pressure and temporary plugging peak pressure show a decreasing trend with an increase in single-cluster perforation number.A lower number of single-cluster perforations is beneficial for increasing the breaking pressure and temporary plugging peak pressure,and it has a more significant control on the propagation of multi-cluster fractures.A lower number of clusters is not conducive to increasing the total number and complexity of artificial fractures,while a higher number of clusters makes it difficult to achieve effective plugging.The TPAs within the fracture is mainly concentrated in the complex fracture areas,especially at the intersections of fractures.Meanwhile,the TPAs within the segment are primarily distributed near the perforation cluster apertures which initiated complex fractures.
基金Supported by The 2007 SK Chemical Grant of the Korean Society of Gastroenterology
文摘AIM:To investigated the incidence of diversion colitis(DC) and impact of DC symptoms on quality of life(QoL) after ileostomy reversal in rectal cancer.METHODS:We performed a prospective study with 30 patients who underwent low anterior resection and the creation of a temporary ileostomy for the rectal cancer between January 2008 and July 2009 at the Department of Surgery,Korea University Anam Hospital.The participants totally underwent two rounds of the examinations.At first examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom were performed 3-4 mo after the ileostomy creations.At second examination,endoscopies,tissue biopsies,and questionnaire survey about the symptom and QoL were performed 5-6 mo after the ileostomy reversals.Clinicopathological data were based on the histopathological reports and clinical records of the patients.RESULTS:At the first examination,all of the patients presented with inflammation,which was mild in 15(50%) patients,moderate in 11(36.7%) and severe in 4(13.3%) by endoscopy and mild in 14(46.7%) and moderate in 16(53.3%) by histology.At the second examination,only 11(36.7%) and 17(56.7%) patients had mild inflammation by endoscopy and histology,respectively.There was no significant difference in DC grade between the endoscopic and the histological findings at first or second examination.The symptoms detected on the first and second questionnaires were mucous discharge in 12(40%) and 5(17%) patients,bloody discharge in 5(17%) and 3(10%) patients,abdominal pain in 4(13%) and 2(7%) patients and tenesmus in 9(30%) and 5(17%) patients,respectively.We found no correlation between the endoscopic or histological findings and the symptoms such as mucous discharge,bleeding,abdominal pain and tenesmus in both time points.Diarrhea was detected in 9 patients at the second examination;this number correlated with the severity of DC(0%,0%,66.7%,33.3% vs 0%,71.4%,23.8%,4.8%,P = 0.001) and the symptom-related QoL(r =-0.791,P < 0.001).CONCLUSION:The severity of DC is related to diarrhea after an ileostomy reversal and may adversely affect QoL.
文摘Diversion colitis is characterized by inflammation of the mucosa in the defunctioned segment of the colon after colostomy or ileostomy. Similar to diversion colitis, diversion pouchitis is an inflammatory disorder occurring in the ileal pouch, resulting from the exclusion of the fecal stream and a subsequent lack of nutrients from luminal bacteria. Although the vast majority of patients with surgically-diverted gastrointestinal tracts remain asymptomatic, it has been reported that diversion colitis and pouchitis might occur in almost all patients with diversion. Surgical closure of the stoma, with reestablishment of gut continuity, is the only curative intervention available for patients with diversion disease. Pharmacologic treatments using short-chain fatty acids, mesalamine, or corticosteroids are reportedly effective for those who are not candidates for surgical reestablishment; however, there are no established assessment criteria for determining the severity of diversion colitis, and no management strategies to date. Therefore, in this mini-review, we summarize and review various recently-reported treatments for diversion disease. We are hopeful that the information summarized here will assist physicians who treat patients with diversion colitis and pouchitis, leading to better case management.
基金Supported by the Funds for Creative Research Groups of China (No. 40721004)the National Natural Science Foundation of China (Nos. 40776012, 40976056)the Special Funds of the State Key Laboratory of Estuarine and Coastal Research (No. 2008KYYW03)
文摘We studied the flood, ebb and tidal averaged along (net) water diversion ratio (WDR) during dry season in the Changjiang (Yangtze) estuary, China, along with the effects of northerly wind, river discharge, tide and their interactions on WDR using the improved version of three-dimensional numerical model ECOM. Using data for annual mean wind speed and river discharge during January, we determined that the flood, ebb, net WDR values in the North Branch of the estuary were 3.48%, 1.68%,-4.06% during spring tide, and 4.82%, 2.34%,-2.79% during neap tide, respectively. Negative net WDR values denote the transport of water from the North Branch into the South Branch. Using the same data, the corresponding ratios were 50.09%, 50.92%, 54.97%, and 52.33%, 50.15%, 43.86% in the North Channel and 38.56%, 44.78%, 103.96%, and 36.92%, 43.17%, 60.97% in the North Passage, respectively. When northerly wind speed increased, landward Ekman transport was enhanced in the North Branch, increasing the flood WDR, while the ebb WDR declined and the net WDR exhibited a significant decrease. Similarly, in the North Channel, the flood WDR is increased, the ebb WDR reduced, and the net WDR showed a marked decrease. In the North Passage, the flood WDR also increased while the ebb and net WDR declined. As the river discharge increased, the flood and ebb WDR of the North Branch increased slightly and the net WDR increased markedly. In the North Channel the flood and ebb WDR changed very slightly, while the net WDR declined during spring tides and increased during neap tides. The WDR in the North Passage changed slightly during flood and ebb tides while the net WDR showed a marked increase. The WDR values of different bifurcations and the responses to northerly wind, river discharge, and tide are discussed in comparison with variations in river topography, horizontal wind-induced circulation, and tidal-induced residual current.
基金Supported by the National Basic Research Program of China (973 Program) (No. 2008CB418006)the Knowledge Innovation Program of Chinese Academy of Sciences (No. KZCX-YW-14-1)
文摘One of the water source areas of the South-to-North Water Diversion Project is the Danjiangkou Reservoir (DJKR). To understand seasonal variation in phytoplankton composition, abundance and distribution in the DJKR area before water diversion, as well as to estimate potential risks of water quality after water diversion, we conducted an investigation on phytoplankton in the DJKR from August 2008 to May 2009. The investigation included 10 sampling sites, each with four depths of 0.5, 5, 10, and 20 m. In this study, 117 taxa belonging to 76 genera were identified, consisting of diatoms (39 taxa), green algae (47 taxa), blue-green algae (19 taxa), and others (12 taxa). Annual average phytoplankton abundance was 2.01×10^6 ind./L, and the highest value was 14.72 ×10^6 ind/L (at site 3 in August 2008). Phytoplankton abundance in front of the Danjiangkou Dam (DJKD) was higher than that of the Danjiang Reservoir Basin. Phytoplankton distribution showed a vertical declining trend from 0.5 m to 20 m at most sites in August 2008 (especially at sites of 1, 2, 4 and 10), but no distinct pattern in other sampling months. In December 2008 and March 2009, Stephanodiseus sp. was the most abundant species, amounting to 55.23% and 72.34%, respectively. We propose that high abundance ofStephanodiscus sp. may have contributed greatly to the frequent occurrence of Stephanodiscus sp. blooms in middle-low reaches of the Hanjiang River during the early spring of 2009. In comparison with previous studies conducted from 1992 to 2006, annual average phytoplankton density, green algae and blue-green algae species, as well as major nutrient concentrations increased, while phytoplankton diversity indices declined. This indicates a gradual decline in water quality. More research should be conducted and countermeasures taken to prevent further deterioration of water quality in the DJKR.
基金The National Basic Science Research Program of Global Change Research of China under contract No.2010CB951201the Funds for Creative Research Groups of China under contract No. 41021064the National Natural Science Foundation of China under contract No. 40976056
文摘The south to the north project (WDP) on the saltwater intrusion in the Changjiang Estuary is studied by the improved three-dimensionai (3D) numerical model.The net unit width flux in the Changjiang Estuary as well as the sectional salt flux is calculated in the North Branch (NB),the South Branch (SB),the North Channel (NC),the South Channel (SC),the North Passage (NP) and the South Passage (SP),respectively.The net seaward water flux in the SB is reduced,and the net water flux spilling over from the NB to the SB is enhanced after the eastern WDP.Under the mean river discharge condition in the dry season,the net salt flux spilling over from the NB to the SB is increased by 2.09 t/s and 0.52 t/s during the spring and neap tides,respectively,due to the eastern WDP.The saltwater intrusion in the Changjiang Estuary is enhanced by the eastern WDP.Compared with that during the spring tide,the net water diversion ratio during the neap tide in the NC is smaller,and thus the enhancement of the saltwater intrusion by the eastern WDP is smaller in the NC,and larger in the NP and the SP.The tidally averaged surface salinity at the water intakes of the Dongfengxisha Reservoir,the Chenhang Reservoir and the Qingcaosha Reservoir rises both during the spring and neap tides.
文摘AIM:To investigate the effect of plasmapheresis via the portal vein for"small-for-size"syndrome(SFSS)aided by extracorporeal continuous portal diversion(ECPD).METHODS:Extensive or total hepatectomy in the pig is usually adopted as a postoperative liver failure(PLF)or SFSS model.In this study,animals which underwent85%-90%hepatectomy were randomized into either the Systemic group(n=7)or the Portal group(n=7).In the Systemic group,all pigs received temporal plasmapheresis(PP)via the extracorporeal catheter circuit(systemic to systemic circulation)from 24 to 30 h posthepatectomy(PH);in the Portal group,all pigs received ECPD to divert partial portal vein flow(PVF)to the systemic circulation after hepatectomy,then converted to temporal PP from 24 to 30 h PH,and subsequently converted to ECPD again until 48 h PH.In the Portal group,the PVF was preserved at 3.0-3.3 times that of the baseline value,similar to that following 70%hepatectomy,which was regarded as the optimal PVF to the hypertrophic liver remnant.At 48 h PH,all pigs were re-opened and the portal vein pressure(PVP),PVF,and HAF(hepatic artery flow)were measured,and then diversion of the portal venous flow was terminated.After1 h the PVP,PVF,and HAF were re-measured.The portal hemodynamic changes,liver injury,liver regeneration and bacterial/lipopolysaccharide(LPS)translocation were evaluated in the two groups.RESULTS:The PVP in the Portal group was significantly lower than that in the Systemic group during the time period from 2 to 49 h PH(P<0.05).Serum alanine aminotransferase(ALT),total bilirubin(TB)and ammonia were significantly reduced in the Portal group compared with the Systemic group from 24 to 48 h PH(P<0.05).The Portal group may have attenuated sinusoidal endothelial injury and decreased the level of HA compared with the Systemic group.In the Systemic group,there was significant sinusoidal dilation,hydropic changes in hepatocytes and hemorrhage into the hepatic parenchyma,and the sinusoidal endothelial lining was partially destroyed and detached into the sinusoidal space.CD31immunostaining revealed significant destruction of the endothelial lining.In the Portal group,there was no intraparenchymal hemorrhage and the sinusoidal endothelial cells and hepatocytes were well preserved.CD31immunostaining was mild which indicated less destruction of the endothelial lining.HA was significantly decreased in the Portal group compared with the Systemic group from 2 to 48 h PH.The rate of liver remnant regeneration was elevated,while apoptosis was attenuated in the Portal group compared with the Systemic group.Thymidine kinase activity was much higher in the Portal group than in the Systemic group at 48 h PH.The PCNA index was significantly increased and the apoptotic index was significantly decreased in the Portal group compared with the Systemic group.Bacterial translocation and endotoxin,as well as the inflammatory response,were significantly attenuated in the Portal group compared with the Systemic group.LPS,tumor necrosis factor-and interleukin-6 levels were all significantly decreased in the Portal group compared with the Systemic group from 24 to48 h PH,while bacterial DNA level was significantly decreased from 2 to 48 h PH.CONCLUSION:PP plus ECPD via the portal vein can attenuate toxic load and hyperperfusion injury,and should be undertaken instead of PP via the systemic circulation in SFSS or PLF.
文摘The proposals on entanglement diversion and quantum teleportation of entangled coherent states are presented. In these proposals, the entanglement between two coherent states, |α〉 and |-α〉, with the same amplitude but a phase difference of π is utilized as a quantum channel. The processes of the entanglement diversion and the teleportation are achieved by using the 50/50 symmctric beam splitters, the phase shifters and the photodetectors with the help of classical information.
文摘According to site-specific environments such as high water pressures, high in-situ stresses and strong rockbursts, the design scheme of the long and deep diversion tunnels at Jinping II hydropower station was optimized to ensure construction safety. New drainage tunnels were considered. Furthermore, lining structures and grouting pressures were modified during the excavation of tunnels. The construction scheme was updated dynamically based on the complex geological conditions. For instances, the diversion tunnels were first excavated by drilling and blasting method at the first stage of construction, and then by the combination method of tunnel boring machine (TBM) and drilling and blasting, and finally by drilling and blasting method. Through optimized scheme and updated construction scheme, the excavation of diversion tunnel #1 was successfully completed in June, 2011. This paper summarizes the key issues in rock mechanics associated with the construction of the long and deep diversion tunnels at Jinping II hydropower station. The experiences of design and construction obtained from this project could provide reference to similar projects.
文摘AIM: To study the effect of botulinum toxin in patients with chronic anal fissure after biliopancreatic diversion (BPD) for severe obesity. METHODS: Fifty-nine symptomatic adults with chronic anal fissure developed after BPD were enrolled in an open label study. The outcome was evaluated clinically and by comparing the pressure of the anal sphincters before and after treatment. All data were analyzed in univariate and multivariate analysis. RESULTS: Two months after treatment, 65.4% of the patients had a healing scar. Only one patient had mild incontinence to flatus that lasted 3 wk after treatment, but this disappeared spontaneously. In the multivariate analysis of the data, two registered months after the treatment, sex (P = 0.01), baseline resting anal pressure (P = 0.02) and resting anal pressure 2 mo after treatment (P < 0.0001) were significantly related to healing rate.CONCLUSION: Botulinum toxin, despite worse results than in non-obese individuals, appears the best alternative to surgery for this group of patients with a high risk of incontinence.
文摘Objective:To review the most used intracorporeal orthotopic ileal neobladder(ICONB)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images.Methods:We performed a non-systematic review of the literature with the keywords“bladder cancer”,“urinary diversion”,“radical cystectomy”,and“neobladder”.Results:Forty studies were included in the analysis.The most frequent type of ICONB was the modified Studer“U”neobladder(70%)followed by the Hautmann“W”modified neobladder(7.5%),the“Y”neobladder(5%),and the Padua neobladder(5%).The operative time to perform a urinary diversion ranged from 124 to 553 min.The total estimated blood loss ranged from 200 to 900 mL.The rate of positive surgical margins ranged from 0%to 8.1%.Early minor and major complication rates ranged from 0%to 100%and from 0%to 33%,respectively.Late minor and major complication rates ranged from 0%to 70%and from 0%to 25%,respectively.Conclusion:The most frequent types of ICONB are Studer“U”neobladder,Hautmann“W”neobladder,“Y”neobladder,and the Padua neobladder.Randomized studies comparing the performance of the different types of ICONB,the performance in an intra or extracorporeal manner,or the performance of an ICONB versus ICIC are lacking in the literature.To this day,there are not sufficient quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used ICONB with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images of each technique.
基金supported by the National Natural Science Foundation of China (Grant No 50479017)the Program for Changjiang Scholars and Innovative Research Teams in Universities (Grant No IRT071)
文摘A combination of the rainfall-runoff module of the Xin’anjiang model, the Muskingum routing method, the water stage simulating hydrologic method, the diffusion wave nonlinear water stage method, and the real-time error correction method is applied to the real-time flood forecasting and regulation of the Huai River with flood diversion and retarding areas. The Xin’anjiang model is used to forecast the flood discharge hydrograph of the upstream and tributary. The flood routing of the main channel and flood diversion areas is based on the Muskingum method. The water stage of the downstream boundary condition is calculated with the water stage simulating hydrologic method and the water stages of each cross section are calculated from downstream to upstream with the diffusion wave nonlinear water stage method. The input flood discharge hydrograph from the main channel to the flood diversion area is estimated with the fixed split ratio of the main channel discharge. The flood flow inside the flood retarding area is calculated as a reservoir with the water balance method. The faded-memory forgetting factor least square of error series is used as the real-time error correction method for forecasting discharge and water stage. As an example, the combined models were applied to flood forecasting and regulation of the upper reaches of the Huai River above Lutaizi during the 2007 flood season. The forecast achieves a high accuracy and the results show that the combined models provide a scientific way of flood forecasting and regulation for a complex watershed with flood diversion and retarding areas.
基金supported by the National Natural Science Foundation of China(Grants No.52179062 and 51879087).
文摘For a water supply system with long-distance diversion pipelines, in addition to the water hammer problems that occur beyond pumps, the safety of the water diversion pipeline in front of pumps also deserves attention. In this study, a water hammer protection scheme combined with an overflow surge tank and a regulating valve was developed. A mathematical model of the overflow surge tank was developed, and an analytical formula for the height of the overflow surge tank was derived. Furthermore, a practical water supply project was used to evaluate the feasibility of the combined protection scheme and analyze the sensitivity of valve regulation rules. The results showed that the combined protection scheme effectively reduced the height of the surge tank, lessened the difficulties related to construction, and reduced the necessary financial investment for the project. The two-stage closing rule articulated as fast first and then slow could minimize the overflow volume of the surge tank when the power failure occurred, while the two-stage opening rule articulated as slow first and then fast could be more conducive to the safety of the water supply system when the pump started up.
文摘Objective:To review the most used robot-assisted cutaneous urinary diversion(CUD)after radical cystectomy for bladder cancer and create a unified compendium of the different alternatives,including new consistent images Methods:A non-systematic review of the literature with the keywords“bladder cancer”,“cutaneous urinary diversion”,and“radical cystectomy”was performed.Results:Twenty-four studies of intracorporeal ileal conduit(ICIC)and two of intracorporeal Indiana pouch(ICIP)were included in the analysis.Regarding ICIC,the patients’age ranged from 60 to 76 years.The operative time to perform a urinary diversion ranged from 60 to 133 min.The total estimated blood loss ranged from 200 to 1117 mL.The rate of positive surgical margins ranged from 0%to 14.3%.Early minor and major complication rates ranged from 0%to 71.4%and from 0%to 53.4%,respectively.Late minor and major complication rates ranged from 0%to 66%and from 0%to 32%,respectively.Totally ICIP data are limited to one case report and one clinical series.Conclusion:The most frequent type of CUD is ICIC.Randomized studies comparing the performance of the different types of CUD,the performance in an intra-or extracorporeal manner,or the performance of a CUD versus orthotopic ileal neobladder are lacking in the literature.To this day,there are not enough quality data to determine the supremacy of one technique.This manuscript represents a compendium of the most used CUD with detailed descriptions of the technical aspects,operative and perioperative outcomes,and new consistent images for each technique.
基金supported by the National Natural Science Foundation of China(Grants No.50379009,90924027and41101509)the National Social Science Foundation of China(Grant No.10AJY005)the Research Innovation Program for College Graduates of Jiangsu Province of 2009(Grant No.CX09B_057R)
文摘The South-to-North Water Diversion (SNWD) Project is a significant engineering project meant to solve water shortage problems in North China. Faced with market operations management of the water diversion system, this study defined the supply chain system for the SNWD Project, considering the actual project conditions, built a decentralized decision model and a centralized decision model with strategic customer behavior (SCB) using a floating pricing mechanism (FPM), and constructed a coordination mechanism via a revenue-sharing contract. The results suggest the following: (1) owing to water shortage supplements and the excess water sale policy provided by the FPM, the optimal ordering quantity of water resources is less than that without the FPM, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without the FPM; (2) wholesale pricing and supplementary wholesale pricing with SCB are higher than those without SCB, and the optimal profits of the whole supply chain, supplier, and external distributor are higher than they would be without SCB; and (3) considering SCB and introducing the FPM help increase the optimal profits of the whole supply chain, supplier, and external distributor, and improve the efficiency of water resources usage.
基金Supported by the German -Research Foun-dation-through the Clin-ical Research Group KFO217“Hepatobiliary tran-sport an-d liver diseases”the Collaborative Research Cen-tre 974“Commun-ication-an-d Systemic Relevan-ce in-Liver Damage an-d Regen-eration-”
文摘To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading to severe BSEP deficiency in two unrelated patients were identified by genomic sequencing. Native liver biopsies and transiently transfected human embryonic kidney (HEK) 293 cells expressing either wild-type or mutated BSEP were subjected to immunofluorescence analysis to assess BSEP transporter localization. Bile acid profiles of patient and control bile samples were generated by ultra-performance liquid chromatography-tandem mass spectrometry. Wild-type and mutant BSEP transport of [<sup>3</sup>H]-labeled taurocholate (TC) and taurochenodeoxycholate (TCDC) was assessed by vesicular transport assays. RESULTSA girl (at 2 mo) presented with pruritus, jaundice and elevated serum bile salts (BS). PEBD stabilized liver function and prevented liver transplantation. She was heterozygous for the BSEP deletion p.T919del and the nonsense mutation p.R1235X. At the age of 17 years relative amounts of conjugated BS in her bile were normal, while total BS were less than 3% as compared to controls. An unrelated boy (age 1.5 years) presenting with severe pruritus and elevated serum BS was heterozygous for the same nonsense and another missense mutation, p.G1032R. PEBD failed to alleviate pruritus, eventually necessitating liver transplantation. BS concentration in bile was about 5% of controls. BS were mainly unconjugated with an unusual low amount of chenodeoxycholate derivatives (< 5%). The patients’ native liver biopsies showed canalicular BSEP expression. Both BSEP p.T919del and p.G1032R were localized in the plasma membrane in HEK293 cells. In vitro transport assays showed drastic reduction of transport by both mutations. Using purified recombinant BSEP as quantifiable reference, per-molecule transport rates for TC and TCDC were determined to be 3 and 2 BS molecules per wild-type BSEP transporter per minute, respectively. CONCLUSIONIn summary, our findings suggest that residual function of BSEP as well as substrate specificity influence the therapeutic effectiveness of PEBD in progressive familial intrahepatic cholestasis type 2 (PFIC-2).
基金Under the auspices of the National Key Research and Development Program of China(No.2016YFC0500201-01)National Natural Science Foundation of China(No.41671365,41771464)the Annual Project of the Office of the South-to-North Water Diversion Project(No.2018-21)
文摘The Middle Route of the South-to-North Water Diversion Project(MR-SNWDP)in China,with construction beginning in 2003,diverts water from Danjiangkou Reservoir to North China for residential,agriculture and industrial use.The water source area of the MR-SNWDP is the region that is most sensitive to and most affected by the construction of this water diversion project.In this study,we used Landsat Thematic Mapper(TM)and HJ-1 A/B images from 2000 to 2015 by an object-based approach with a hierarchical classification method for mapping land cover in the water source area.The changes in land cover were illuminated by transfer matrixes,single dynamic degree,slope zones and fractional vegetation cover(FVC).The results indicated that the area of cropland decreased by 31%and was replaced mainly by shrub over the past 15 years,whereas forest and settlements showed continuous increases of 29.2% and 77.7%,respectively.The changes in cropland were obvious in all slope zones and decreased most remarkably(–43.8%)in the slope zone above 25°.Compared to the FVC of forest and shrub,significant improvement was exhibited in the FVC of grassland,with a growth rate of 16.6%.We concluded that local policies,including economic development,water conservation and immigration resulting from the construction of the MR-SNWDP,were the main drivers of land cover changes;notably,they stimulated the substantial and rapid expansion of settlements,doubled the wetlands and drove the transformation from cropland to settlements in immigration areas.
基金Supported by the Foundation for Innovation Research Groups of the National Natural Science Foundation of China(No.51321065)Tianjin Research Program of Application Foundation and Advanced Technology(No.12JCZDJC29200)Tianjin Natural Science Foundation(No.13JCYBJC19500)
文摘In most studies of tunnel boring machine(TBM)tunnelling, the groundwater pressure was not considered, or was simplified and exerted on the boundary of lining structure. Meanwhile, the leakage, which mainly occurs in the segment joints, was often ignored in the relevant studies of TBM tunnelling. Additionally, the geological models in these studies were simplified to different extents, and mostly were simplified as homogenous bodies. Considering the deficiencies above, a 3D refined model of the surrounding rock of a tunnel is firstly established using NURBS-TIN-BRe P hybrid data structure in this paper. Then the seepage field of the surrounding rock considering the leakage in the segment joints is simulated. Finally, the stability of TBM water diversion tunnel is studied coupled with the seepage simulation, to analyze the stress-strain conditions, the axial force and the bending moment of tunnel segment considering the leakage in the segment joints. The results illustrate that the maximum radial displacement, the minimum principal stress, the maximum principal stress and the axial force of segment lining considering the seepage effect are all larger than those disregarding the seepage effect.
基金supported by the National Natural Science Foundation of China (Grant No. 50879041)
文摘In arid regions, large-scale water diversion from rivers leads to significant changes in river flow regimes, which may have large impacts on ecological water uses of river-dependent ecosystems, such as river, lake, wetland, and riparian ecosystems. To assess the integrated impact of water diversion on ecological water uses, we proposed a hierarchy evaluation model composed of four layers representing the evaluation goal, sub-areas of the influenced region, evaluation criteria, and water diversion schemes, respectively. The evaluation criteria for different types of ecological water uses were proposed, and the analytical hierarchy process was used for the integrated assessment. For a river ecosystem, the percentage of mean annual flow was used to define the grade of environmental flow. For a lake ecosystem, water recharge to the lake to compensate the lake water losses was used to assess the ecological water use of a lake. The flooding level of the wetland and the groundwater level in the riparian plain were used to assess the wetland and riparian ecological water uses, respectively. The proposed model was applied to a basin in northern Xinjiang in northwest China, where both water diversion and inter-basin water transfer projects were planned to be carried out. Based on assessment results for the whole study area and two sub-areas, an appropriate scheme was recommended from four planning schemes. With the recommended scheme, ecological water uses of the influenced ecosystems can be maintained at an acceptable level. Meanwhile, economical water requirements can be met to a great extent.