Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patien...Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.展开更多
Introduction: In Burkina Faso, undernutrition is a public health problem associated with more than 40% of infant and child mortality. Undernutrition management is complex, and there is often a risk of treatment abando...Introduction: In Burkina Faso, undernutrition is a public health problem associated with more than 40% of infant and child mortality. Undernutrition management is complex, and there is often a risk of treatment abandonment. Studies on this topic have not explored the influence of environmental and therapeutic factors on parental compliance. This study proposes an analysis of factors influencing the abandonment of nutritional recovery by parents of malnourished children aged 6 to 59 months in ambulatory care. Methods: This was a descriptive and exploratory qualitative study. Data collection took place in February 2020. Data were collected from seventeen (17) participants via in-depth interviews (IDI) and direct observation. The IDIs were transcribed verbatim and thematically analyzed using Nvivo software. Results: The results revealed that factors related to the physical environment, such as geographical inaccessibility, pastoral occupation, displacement at auriferous sites, and insecurity, are important causes of nutritional recovery abandonment. They also prove that factors related to the social environment, such as lack of family and social support, feelings of shame, stigmatization, occupation of the mother, and social events, lead to this abandonment. In addition, therapeutic factors such as interruptions of supplies of Ready to Use Therapeutic Food (RUTF), feeling of improvement or worsening of the state of health, recourse to traditional medicine, and ignorance of undernutrition are also associated with this issue. Conclusion: This study highlighted barriers to the abandonment of nutritional recovery among parents of severely malnourished children aged 6 to 59 months in the health district of Titao, Burkina Faso. It is more important to consider these different factors when evaluating care protocols so that policies to reduce child undernutrition can considerably impact the targets.展开更多
BACKGROUND Laparoscopic hernia repair is a minimally invasive surgery,but patients may experience emergence agitation(EA)during the post-anesthesia recovery period,which can increase pain and lead to complications suc...BACKGROUND Laparoscopic hernia repair is a minimally invasive surgery,but patients may experience emergence agitation(EA)during the post-anesthesia recovery period,which can increase pain and lead to complications such as wound reopening and bleeding.There is limited research on the risk factors for this agitation,and few effective tools exist to predict it.Therefore,by integrating clinical data,we have developed nomograms and random forest predictive models to help clinicians predict and potentially prevent EA.AIM To establish a risk nomogram prediction model for EA in patients undergoing laparoscopic hernia surgery under total inhalation combined with sacral block anesthesia.METHODS Based on the clinical information of 300 patients who underwent laparoscopic hernia surgery in the Nanning Tenth People’s Hospital,Guangxi,from January 2020 to June 2023,the patients were divided into two groups according to their sedation-agitation scale score,i.e.,the EA group(≥5 points)and the non-EA group(≤4 points),during anesthesia recovery.Least absolute shrinkage and selection operator regression was used to select the key features that predict EA,and incorporating them into logistic regression analysis to obtain potential pre-dictive factors and establish EA nomogram and random forest risk prediction models through R software.RESULTS Out of the 300 patients,72 had agitation during anesthesia recovery,with an incidence of 24.0%.American Society of Anesthesiologists classification,preoperative anxiety,solid food fasting time,clear liquid fasting time,indwelling catheter,and pain level upon awakening are key predictors of EA in patients undergoing laparoscopic hernia surgery with total intravenous anesthesia and caudal block anesthesia.The nomogram predicts EA with an area under the receiver operating characteristic curve(AUC)of 0.947,a sensi-tivity of 0.917,and a specificity of 0.877,whereas the random forest model has an AUC of 0.923,a sensitivity of 0.912,and a specificity of 0.877.Delong’s test shows no significant difference in AUC between the two models.Clinical decision curve analysis indicates that both models have good net benefits in predicting EA,with the nomogram effective within the threshold of 0.02 to 0.96 and the random forest model within 0.03 to 0.90.In the external model validation of 50 cases of laparoscopic hernia surgery,both models predicted EA.The nomogram model had a sensitivity of 83.33%,specificity of 86.84%,and accuracy of 86.00%,while the random forest model had a sensitivity of 75.00%,specificity of 78.95%,and accuracy of 78.00%,suggesting that the nomogram model performs better in predicting EA.CONCLUSION Independent predictors of EA in patients undergoing laparoscopic hernia repair with total intravenous anesthesia combined with caudal block include American Society of Anesthesiologists classification,preoperative anxiety,duration of solid food fasting,duration of clear liquid fasting,presence of an indwelling catheter,and pain level upon waking.The nomogram and random forest models based on these factors can help tailor clinical decisions in the future.展开更多
Suspended sediment concentrations in the Middle Yangtze River(MYR)reduced greatly after the Three Gorges Project operation,causing the composition of bed material to coarsen continuously.However,little is known about ...Suspended sediment concentrations in the Middle Yangtze River(MYR)reduced greatly after the Three Gorges Project operation,causing the composition of bed material to coarsen continuously.However,little is known about the non-equilibrium transport of graded suspended sediment owing to different bed material compositions(BMCs)along the MYR,and it is necessary to determine the magnitude of recovery factor.Using the Markov stochastic process in conjunction with the hiding-exposure effect of non-uniform bed-material,a new formula is proposed for calculating the recovery factor including the effect of different BMCs,and it is incorporated into the non-equilibrium transport equation to simulate the recovery processes of suspended load in both sand-gravel bed and sand bed reaches of the MYR.The results show that:(i)the recovery rate of graded sediment concentrations at Zhicheng was slower than that at Shashi during the period 2003-2007;(ii)the mean recovery factors of the coarse,medium,and fine sediment fractions in the ZhichengShashi reach were 0.152,0.0012,and 0.0005,respectively,and the coarse sediment recovered up to the maximum sediment concentration of 0.138 kg/m3over a distance of 15 km;and(iii)the results of the new formula that can consider the effect of bed material composition are in general agreement with the field observations,and the spatial and temporal delay effects are inversely related to particle size and BMC.Consequently,the BMC effect on the nonequilibrium sediment transport in different reaches of the MYR needs to be considered for higher simulation accuracy.展开更多
Brain functional impairment after stroke is common;however,the molecular mechanisms of post-stroke recovery remain unclear.It is well-recognized that age is the most important independent predictor of poor outcomes af...Brain functional impairment after stroke is common;however,the molecular mechanisms of post-stroke recovery remain unclear.It is well-recognized that age is the most important independent predictor of poor outcomes after stroke as older patients show poorer functional outcomes following stroke.Mounting evidence suggests that axonal regeneration and angiogenesis,the major forms of brain plasticity responsible for post-stroke recovery,diminished with advanced age.Previous studies suggest that Ras-related C3 botulinum toxin substrate(Rac)1 enhances stroke recovery as activation of Rac1 improved behavior recovery in a young mice stroke model.Here,we investigated the role of Rac1 signaling in long-term functional recovery and brain plasticity in an aged(male,18 to 22 months old C57BL/6J)brain after ischemic stroke.We found that as mice aged,Rac1 expression declined in the brain.Delayed overexpression of Rac1,using lentivirus encoding Rac1 injected day 1 after ischemic stroke,promoted cognitive(assessed using novel object recognition test)and sensorimotor(assessed using adhesive removal tests)recovery on days 14–28.This was accompanied by the increase of neurite and proliferative endothelial cells in the periinfarct zone assessed by immunostaining.In a reverse approach,pharmacological inhibition of Rac1 by intraperitoneal injection of Rac1 inhibitor NSC23766 for 14 successive days after ischemic stroke worsened the outcome with the reduction of neurite and proliferative endothelial cells.Furthermore,Rac1 inhibition reduced the activation of p21-activated kinase 1,the protein level of brain-derived neurotrophic factor,and increased the protein level of glial fibrillary acidic protein in the ischemic brain on day 28 after stroke.Our work provided insight into the mechanisms behind the diminished plasticity after cerebral ischemia in aged brains and identified Rac1 as a potential therapeutic target for improving functional recovery in the older adults after stroke.展开更多
BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,...BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.展开更多
Attempts have been made to use cell transplantation and biomaterials to promote cell proliferation,differentiation,migration,and survival,as well as angiogenesis,in the context of brain injury.However,whether bioactiv...Attempts have been made to use cell transplantation and biomaterials to promote cell proliferation,differentiation,migration,and survival,as well as angiogenesis,in the context of brain injury.However,whether bioactive materials can repair the damage caused by ischemic stroke by activating endogenous neurogenesis and angiogenesis is still unknown.In this study,we applied chitosan gel loaded with basic fibroblast growth factor to the stroke cavity 7 days after ischemic stroke in rats.The gel slowly released basic fibroblast growth factor,which improved the local microenvironment,activated endogenous neural stem/progenitor cells,and recruited these cells to migrate toward the penumbra and stroke cavity and subsequently differentiate into neurons,while enhancing angiogenesis in the penumbra and stroke cavity and ultimately leading to partial functional recovery.This study revealed the mechanism by which bioactive materials repair ischemic strokes,thus providing a new strategy for the clinical application of bioactive materials in the treatment of ischemic stroke.展开更多
Recent studies have mostly focused on engraftment of cells at the lesioned spinal cord,with the expectation that differentiated neurons facilitate recovery.Only a few studies have attempted to use transplanted cells a...Recent studies have mostly focused on engraftment of cells at the lesioned spinal cord,with the expectation that differentiated neurons facilitate recovery.Only a few studies have attempted to use transplanted cells and/or biomaterials as major modulators of the spinal cord injury microenvironment.Here,we aimed to investigate the role of microenvironment modulation by cell graft on functional recovery after spinal cord injury.Induced neural stem cells reprogrammed from human peripheral blood mononuclear cells,and/or thrombin plus fibrinogen,were transplanted into the lesion site of an immunosuppressed rat spinal cord injury model.Basso,Beattie and Bresnahan score,electrophysiological function,and immunofluorescence/histological analyses showed that transplantation facilitates motor and electrophysiological function,reduces lesion volume,and promotes axonal neurofilament expression at the lesion core.Examination of the graft and niche components revealed that although the graft only survived for a relatively short period(up to 15 days),it still had a crucial impact on the microenvironment.Altogether,induced neural stem cells and human fibrin reduced the number of infiltrated immune cells,biased microglia towards a regenerative M2 phenotype,and changed the cytokine expression profile at the lesion site.Graft-induced changes of the microenvironment during the acute and subacute stages might have disrupted the inflammatory cascade chain reactions,which may have exerted a long-term impact on the functional recovery of spinal cord injury rats.展开更多
Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expe...Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.展开更多
Emulsification is one of the important mechanisms of surfactant flooding. To improve oil recovery for low permeability reservoirs, a highly efficient emulsification oil flooding system consisting of anionic surfactant...Emulsification is one of the important mechanisms of surfactant flooding. To improve oil recovery for low permeability reservoirs, a highly efficient emulsification oil flooding system consisting of anionic surfactant sodium alkyl glucosyl hydroxypropyl sulfonate(APGSHS) and zwitterionic surfactant octadecyl betaine(BS-18) is proposed. The performance of APGSHS/BS-18 mixed surfactant system was evaluated in terms of interfacial tension, emulsification capability, emulsion size and distribution, wettability alteration, temperature-resistance and salt-resistance. The emulsification speed was used to evaluate the emulsification ability of surfactant systems, and the results show that mixed surfactant systems can completely emulsify the crude oil into emulsions droplets even under low energy conditions. Meanwhile,the system exhibits good temperature and salt resistance. Finally, the best oil recovery of 25.45% is achieved for low permeability core by the mixed surfactant system with a total concentration of 0.3 wt%while the molar ratio of APGSHS:BS-18 is 4:6. The current study indicates that the anionic/zwitterionic mixed surfactant system can improve the oil flooding efficiency and is potential candidate for application in low permeability reservoirs.展开更多
Post-disaster reconstruction is a topic of global concern,and traditional villages have special heritage attributes and need to face more requirements and obstacles in post-disaster reconstruction.This paper summarize...Post-disaster reconstruction is a topic of global concern,and traditional villages have special heritage attributes and need to face more requirements and obstacles in post-disaster reconstruction.This paper summarizes four concepts based on the research on post-disaster reconstruction both domestically and internationally,as well as the recovery and reconstruction of cultural heritage.Through a field survey of traditional villages in the Ms 6.8 Luding earthquake-stricken area,it is found that there are problems such as insufficient awareness of heritage value,misalignment of scientific reconstruction technology,and insufficient protection of reconstruction elements during the reconstruction process.Traditional villages face the risk of declining or even loss of heritage value.In order to effectively protect traditional villages and inherit the carrier of regional culture,four targeted reconstruction response strategies are proposed,i.e.,to"establish special planning for traditional village preservation","emphasize recovery of the authenticity of village heritage","ensure elements for village heritage recovery"and"promote the activation and utilization of village heritage",based on the problems discovered during the survey and the four concepts summarized in the research on post-disaster reconstruction of traditional villages.The research results hope to provide useful reference for ancient cultural areas affected by earthquakes on how to protect cultural heritage during the post-disaster reconstruction process.展开更多
For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein th...For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.展开更多
BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate ...BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.展开更多
This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the probl...This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the problems of EOR methods,and proposes the relevant research prospects.The basic research means for oilfield development include in-situ acquisition of formation rock/fluid samples and non-destructive testing.The EOR methods for conventional and shale oil development are classified as improved water flooding(e.g.nano-water flooding),chemical flooding(e.g.low-concentration middle-phase micro-emulsion flooding),gas flooding(e.g.micro/nano bubble flooding),thermal recovery(e.g.air injection thermal-aided miscible flooding),and multi-cluster uniform fracturing/water-free fracturing,which are discussed in this paper for their mechanisms,approaches,and key technique researches and field tests.These methods have been studied with remarkable progress,and some achieved ideal results in field tests.Nonetheless,some problems still exist,such as inadequate research on mechanisms,imperfect matching technologies,and incomplete industrial chains.It is proposed to further strengthen the basic researches and expand the field tests,thereby driving the formation,promotion and application of new technologies.展开更多
A significant portion of the national water supply can be attributed to de facto or unplanned potable reuse, though the extent of its contribution is difficult to estimate. Fortunately, the contribution of Water Resou...A significant portion of the national water supply can be attributed to de facto or unplanned potable reuse, though the extent of its contribution is difficult to estimate. Fortunately, the contribution of Water Resource Recovery Facility (WRRF) effluent to waters that supply drinking water treatment plants has been documented by some communities. In the United States (US), among the top 25 most impacted drinking water treatment plants by upstream WRRF, 16% of the influent flow to the drinking water treatment plant under average streamflow and up to 100% under low-flow conditions is WRRF effluent. Currently, the full extent of de facto reuse in the US may be much higher because of population growth. The scenario is no different for Beaufort-Jasper Water and Sewer Authority (BJWSA) in South Carolina, US, with contributions to the Savannah River originating from numerous WRRF and other upstream dischargers. South Carolina coastal utilities such as BJSWA are considering direct and indirect potable reuse options, driven by disposal limitations and challenges. Currently, South Carolina does not have a framework, guidelines, or regulations for reuse, but discussions have started among the regulated community. In addition to understanding the extent of de facto reuse, the state will need to develop standards and best practices to enable future adoption of planned potable reuse solutions to water resources challenges. Such guidance should address human health risk management and technical considerations regarding treatment in addition to other factors, including source control, storage, fail-safe operation, monitoring, non-cost factors, and public acceptance. This study conducted a mapping assessment specific to BJWSA, sampled at four locations on Savannah River, and observed that de facto reuse is approximately 4.6% to 5.9% during low-flow months and is within the range generally observed nationwide. When coupled with evidence that planned potable reuse can improve human health and environmental risks, this practice is a meaningful option in the water supply portfolio for many utilities.展开更多
Laboratory experiments,numerical simulations and fracturing technology were combined to address the problems in shale oil recovery by CO_(2)injection.The laboratory experiments were conducted to investigate the displa...Laboratory experiments,numerical simulations and fracturing technology were combined to address the problems in shale oil recovery by CO_(2)injection.The laboratory experiments were conducted to investigate the displacement mechanisms of shale oil extraction by CO_(2)injection,and the influences of CO_(2)pre-pad on shale mechanical properties.Numerical simulations were performed about influences of CO_(2)pre-pad fracturing and puff-n-huff for energy replenishment on the recovery efficiency.The findings obtained were applied to the field tests of CO_(2)pre-pad fracturing and single well puff-n-huff.The results show that the efficiency of CO_(2)puff-n-huff is affected by micro-and nano-scale effect,kerogen,adsorbed oil and so on,and a longer soaking time in a reasonable range leads to a higher exploitation degree of shale oil.In the"injection+soaking"stage,the exploitation degree of heavy hydrocarbons is enhanced by CO_(2)through its effects of solubility-diffusion and mass-transfer.In the"huff"stage,crude oil in large pores is displaced by CO_(2)to surrounding larger pores or bedding fractures and finally flows to the production well.The injection of CO_(2)pre-pad is conducive to keeping the rock brittle and reducing the fracture breakdown pressure,and the CO_(2)is liable to filter along the bedding surface,thereby creating a more complex fracture.Increasing the volume of CO_(2)pre-pad can improve the energizing effect,and enhance the replenishment of formation energy.Moreover,the oil recovery is more enhanced by CO_(2)huff-n-puff with the lower shale matrix permeability,the lower formation pressure,and the larger heavy hydrocarbon content.The field tests demonstrate a good performance with the pressure maintained well after CO_(2)pre-pad fracturing,the formation energy replenished effectively after CO_(2)huff-n-puff in a single well,and the well productivity improved.展开更多
Selective electrodialysis(SED)has surfaced as a highly promising membrane separation technique in the realm of acid recovery owing to its ability to effectively separate monovalent ions through the utilization of a po...Selective electrodialysis(SED)has surfaced as a highly promising membrane separation technique in the realm of acid recovery owing to its ability to effectively separate monovalent ions through the utilization of a potential difference.However,the current SED process is limited by conventional commercial monovalent cation permselective membranes(MCPMs).This study systematically investigates the use of an independently developed MCPM in the SED process for acid recovery.Various factors such as current density,volume ratio,initial ion concentration,and waste acid systems are considered.The independently developed MCPM offers several advantages over the commercial monovalent selective cation-exchange membrane(CIMS),including higher recovered acid concentration,better ion flux ratio,improved acid recovery efficiency,increased recovered acid purity,and higher current efficiency.The SED process with the MCPM achieves a recovered acid of 95.9%and a concentration of 2.3 mol·L^(–1) in the HCl/FeCl_(2) system,when a current density of 20 mA·cm^(-2) and a volume ratio of 1:2 are applied.Similarly,in the H_(2)SO_(4)/FeSO_(4) system,a purity of over 99%and a concentration of 2.1 mol·L^(–1) can be achieved in the recovered acid.This study thoroughly examines the impact of operation conditions on acid recovery performance in the SED process.The independently developed MCPM demonstrates outstanding acid recovery performance,highlighting its potential for future commercial utilization.展开更多
Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed...Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects.展开更多
The burning of fossil fuels in industry results in significant carbon emissions,and the heat generated is often not fully utilized.For high-temperature industries,thermophotovoltaics(TPVs)is an effective method for wa...The burning of fossil fuels in industry results in significant carbon emissions,and the heat generated is often not fully utilized.For high-temperature industries,thermophotovoltaics(TPVs)is an effective method for waste heat recovery.This review covers two aspects of high-efficiency TPV systems and industrial waste heat applications.At the system level,representative results of TPV complete the systems,while selective emitters and photovoltaic cells in the last decade are compiled.The key points of components to improve the energy conversion efficiency are further analyzed,and the related micro/nano-fabrication methods are introduced.At the application level,the feasibility of TPV applications in high-temperature industries is shown from the world waste heat utilization situation.The potential of TPV in waste heat recovery and carbon neutrality is illustrated with the steel industry as an example.展开更多
Complex networked systems,which range from biological systems in the natural world to infrastructure systems in the human-made world,can exhibit spontaneous recovery after a failure;for example,a brain may spontaneous...Complex networked systems,which range from biological systems in the natural world to infrastructure systems in the human-made world,can exhibit spontaneous recovery after a failure;for example,a brain may spontaneously return to normal after a seizure,and traffic flow can become smooth again after a jam.Previous studies on the spontaneous recovery of dynamical networks have been limited to undirected networks.However,most real-world networks are directed.To fill this gap,we build a model in which nodes may alternately fail and recover,and we develop a theoretical tool to analyze the recovery properties of directed dynamical networks.We find that the tool can accurately predict the final fraction of active nodes,and the prediction accuracy decreases as the fraction of bidirectional links in the network increases,which emphasizes the importance of directionality in network dynamics.Due to different initial states,directed dynamical networks may show alternative stable states under the same control parameter,exhibiting hysteresis behavior.In addition,for networks with finite sizes,the fraction of active nodes may jump back and forth between high and low states,mimicking repetitive failure-recovery processes.These findings could help clarify the system recovery mechanism and enable better design of networked systems with high resilience.展开更多
文摘Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.
文摘Introduction: In Burkina Faso, undernutrition is a public health problem associated with more than 40% of infant and child mortality. Undernutrition management is complex, and there is often a risk of treatment abandonment. Studies on this topic have not explored the influence of environmental and therapeutic factors on parental compliance. This study proposes an analysis of factors influencing the abandonment of nutritional recovery by parents of malnourished children aged 6 to 59 months in ambulatory care. Methods: This was a descriptive and exploratory qualitative study. Data collection took place in February 2020. Data were collected from seventeen (17) participants via in-depth interviews (IDI) and direct observation. The IDIs were transcribed verbatim and thematically analyzed using Nvivo software. Results: The results revealed that factors related to the physical environment, such as geographical inaccessibility, pastoral occupation, displacement at auriferous sites, and insecurity, are important causes of nutritional recovery abandonment. They also prove that factors related to the social environment, such as lack of family and social support, feelings of shame, stigmatization, occupation of the mother, and social events, lead to this abandonment. In addition, therapeutic factors such as interruptions of supplies of Ready to Use Therapeutic Food (RUTF), feeling of improvement or worsening of the state of health, recourse to traditional medicine, and ignorance of undernutrition are also associated with this issue. Conclusion: This study highlighted barriers to the abandonment of nutritional recovery among parents of severely malnourished children aged 6 to 59 months in the health district of Titao, Burkina Faso. It is more important to consider these different factors when evaluating care protocols so that policies to reduce child undernutrition can considerably impact the targets.
文摘BACKGROUND Laparoscopic hernia repair is a minimally invasive surgery,but patients may experience emergence agitation(EA)during the post-anesthesia recovery period,which can increase pain and lead to complications such as wound reopening and bleeding.There is limited research on the risk factors for this agitation,and few effective tools exist to predict it.Therefore,by integrating clinical data,we have developed nomograms and random forest predictive models to help clinicians predict and potentially prevent EA.AIM To establish a risk nomogram prediction model for EA in patients undergoing laparoscopic hernia surgery under total inhalation combined with sacral block anesthesia.METHODS Based on the clinical information of 300 patients who underwent laparoscopic hernia surgery in the Nanning Tenth People’s Hospital,Guangxi,from January 2020 to June 2023,the patients were divided into two groups according to their sedation-agitation scale score,i.e.,the EA group(≥5 points)and the non-EA group(≤4 points),during anesthesia recovery.Least absolute shrinkage and selection operator regression was used to select the key features that predict EA,and incorporating them into logistic regression analysis to obtain potential pre-dictive factors and establish EA nomogram and random forest risk prediction models through R software.RESULTS Out of the 300 patients,72 had agitation during anesthesia recovery,with an incidence of 24.0%.American Society of Anesthesiologists classification,preoperative anxiety,solid food fasting time,clear liquid fasting time,indwelling catheter,and pain level upon awakening are key predictors of EA in patients undergoing laparoscopic hernia surgery with total intravenous anesthesia and caudal block anesthesia.The nomogram predicts EA with an area under the receiver operating characteristic curve(AUC)of 0.947,a sensi-tivity of 0.917,and a specificity of 0.877,whereas the random forest model has an AUC of 0.923,a sensitivity of 0.912,and a specificity of 0.877.Delong’s test shows no significant difference in AUC between the two models.Clinical decision curve analysis indicates that both models have good net benefits in predicting EA,with the nomogram effective within the threshold of 0.02 to 0.96 and the random forest model within 0.03 to 0.90.In the external model validation of 50 cases of laparoscopic hernia surgery,both models predicted EA.The nomogram model had a sensitivity of 83.33%,specificity of 86.84%,and accuracy of 86.00%,while the random forest model had a sensitivity of 75.00%,specificity of 78.95%,and accuracy of 78.00%,suggesting that the nomogram model performs better in predicting EA.CONCLUSION Independent predictors of EA in patients undergoing laparoscopic hernia repair with total intravenous anesthesia combined with caudal block include American Society of Anesthesiologists classification,preoperative anxiety,duration of solid food fasting,duration of clear liquid fasting,presence of an indwelling catheter,and pain level upon waking.The nomogram and random forest models based on these factors can help tailor clinical decisions in the future.
基金the National Natural Science Foundation of China(Grant Nos.51725902,52009095,U2040215,U2240206,and 52109098)supported partly by the Postdoctoral Research Foundation of China(Grant No.BX2021228)Natural Science Foundation of Hubei Province(Grant No.2021CFA029)。
文摘Suspended sediment concentrations in the Middle Yangtze River(MYR)reduced greatly after the Three Gorges Project operation,causing the composition of bed material to coarsen continuously.However,little is known about the non-equilibrium transport of graded suspended sediment owing to different bed material compositions(BMCs)along the MYR,and it is necessary to determine the magnitude of recovery factor.Using the Markov stochastic process in conjunction with the hiding-exposure effect of non-uniform bed-material,a new formula is proposed for calculating the recovery factor including the effect of different BMCs,and it is incorporated into the non-equilibrium transport equation to simulate the recovery processes of suspended load in both sand-gravel bed and sand bed reaches of the MYR.The results show that:(i)the recovery rate of graded sediment concentrations at Zhicheng was slower than that at Shashi during the period 2003-2007;(ii)the mean recovery factors of the coarse,medium,and fine sediment fractions in the ZhichengShashi reach were 0.152,0.0012,and 0.0005,respectively,and the coarse sediment recovered up to the maximum sediment concentration of 0.138 kg/m3over a distance of 15 km;and(iii)the results of the new formula that can consider the effect of bed material composition are in general agreement with the field observations,and the spatial and temporal delay effects are inversely related to particle size and BMC.Consequently,the BMC effect on the nonequilibrium sediment transport in different reaches of the MYR needs to be considered for higher simulation accuracy.
基金supported by NIH grants RF1 AG069466(to JL and LDM),R01 NS099628(to JL),and AG069466(to JL and LDM)the American Heart Association award 20POST35180172(to FB)。
文摘Brain functional impairment after stroke is common;however,the molecular mechanisms of post-stroke recovery remain unclear.It is well-recognized that age is the most important independent predictor of poor outcomes after stroke as older patients show poorer functional outcomes following stroke.Mounting evidence suggests that axonal regeneration and angiogenesis,the major forms of brain plasticity responsible for post-stroke recovery,diminished with advanced age.Previous studies suggest that Ras-related C3 botulinum toxin substrate(Rac)1 enhances stroke recovery as activation of Rac1 improved behavior recovery in a young mice stroke model.Here,we investigated the role of Rac1 signaling in long-term functional recovery and brain plasticity in an aged(male,18 to 22 months old C57BL/6J)brain after ischemic stroke.We found that as mice aged,Rac1 expression declined in the brain.Delayed overexpression of Rac1,using lentivirus encoding Rac1 injected day 1 after ischemic stroke,promoted cognitive(assessed using novel object recognition test)and sensorimotor(assessed using adhesive removal tests)recovery on days 14–28.This was accompanied by the increase of neurite and proliferative endothelial cells in the periinfarct zone assessed by immunostaining.In a reverse approach,pharmacological inhibition of Rac1 by intraperitoneal injection of Rac1 inhibitor NSC23766 for 14 successive days after ischemic stroke worsened the outcome with the reduction of neurite and proliferative endothelial cells.Furthermore,Rac1 inhibition reduced the activation of p21-activated kinase 1,the protein level of brain-derived neurotrophic factor,and increased the protein level of glial fibrillary acidic protein in the ischemic brain on day 28 after stroke.Our work provided insight into the mechanisms behind the diminished plasticity after cerebral ischemia in aged brains and identified Rac1 as a potential therapeutic target for improving functional recovery in the older adults after stroke.
基金Supported by Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0190.
文摘BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.
基金supported by the National Natural Science Foundation of China,Nos.81941011(to XL),31771053(to HD),31730030(to XL),31971279(to ZY),31900749(to PH),31650001(to XL),31320103903(to XL),31670988(to ZY)the Natural Science Foundation of Beijing,Nos.7222004(to HD)+1 种基金a grant from Ministry of Science and Technology of China,Nos.2017YFC1104002(to ZY),2017YFC1104001(to XL)a grant from Beihang University,No.JKF-YG-22-B001(to FH)。
文摘Attempts have been made to use cell transplantation and biomaterials to promote cell proliferation,differentiation,migration,and survival,as well as angiogenesis,in the context of brain injury.However,whether bioactive materials can repair the damage caused by ischemic stroke by activating endogenous neurogenesis and angiogenesis is still unknown.In this study,we applied chitosan gel loaded with basic fibroblast growth factor to the stroke cavity 7 days after ischemic stroke in rats.The gel slowly released basic fibroblast growth factor,which improved the local microenvironment,activated endogenous neural stem/progenitor cells,and recruited these cells to migrate toward the penumbra and stroke cavity and subsequently differentiate into neurons,while enhancing angiogenesis in the penumbra and stroke cavity and ultimately leading to partial functional recovery.This study revealed the mechanism by which bioactive materials repair ischemic strokes,thus providing a new strategy for the clinical application of bioactive materials in the treatment of ischemic stroke.
基金supported by the Stem Cell and Translation National Key Project,No.2016YFA0101403(to ZC)the National Natural Science Foundation of China,Nos.82171250 and 81973351(to ZC)+6 种基金the Natural Science Foundation of Beijing,No.5142005(to ZC)Beijing Talents Foundation,No.2017000021223TD03(to ZC)Support Project of High-level Teachers in Beijing Municipal Universities in the Period of 13th Five-year Plan,No.CIT&TCD20180333(to ZC)Beijing Municipal Health Commission Fund,No.PXM2020_026283_000005(to ZC)Beijing One Hundred,Thousand,and Ten Thousand Talents Fund,No.2018A03(to ZC)the Royal Society-Newton Advanced Fellowship,No.NA150482(to ZC)the National Natural Science Foundation of China for Young Scientists,No.31900740(to SL)。
文摘Recent studies have mostly focused on engraftment of cells at the lesioned spinal cord,with the expectation that differentiated neurons facilitate recovery.Only a few studies have attempted to use transplanted cells and/or biomaterials as major modulators of the spinal cord injury microenvironment.Here,we aimed to investigate the role of microenvironment modulation by cell graft on functional recovery after spinal cord injury.Induced neural stem cells reprogrammed from human peripheral blood mononuclear cells,and/or thrombin plus fibrinogen,were transplanted into the lesion site of an immunosuppressed rat spinal cord injury model.Basso,Beattie and Bresnahan score,electrophysiological function,and immunofluorescence/histological analyses showed that transplantation facilitates motor and electrophysiological function,reduces lesion volume,and promotes axonal neurofilament expression at the lesion core.Examination of the graft and niche components revealed that although the graft only survived for a relatively short period(up to 15 days),it still had a crucial impact on the microenvironment.Altogether,induced neural stem cells and human fibrin reduced the number of infiltrated immune cells,biased microglia towards a regenerative M2 phenotype,and changed the cytokine expression profile at the lesion site.Graft-induced changes of the microenvironment during the acute and subacute stages might have disrupted the inflammatory cascade chain reactions,which may have exerted a long-term impact on the functional recovery of spinal cord injury rats.
文摘Knee osteoarthritis is a degenerative disorder of the knee,which leads to joint pain,stiffness,and inactivity and significantly affects the quality of life.With an increased prevalence of obesity and greater life expectancies,total knee arthroplasty(TKA)is now one of the major arthroplasty surgeries performed for knee osteoarthritis.When enhanced recovery after surgery(ERAS)was introduced in TKA,clinical outcomes were enhanced and the economic burden on the healthcare system was reduced.ERAS is an evidence-based scientific protocol aimed at ameliorating the surgical stress response.ERAS aims to enhance the recovery phase,which encompasses multidisciplinary strategies at every step of perioperative care,including the rehabilitation phase.Implementation of ERAS in TKA aids in reducing the length of hospital stay,improving pain management,reducing perioperative complications,and enhancing patient satisfaction.Multidisciplinary collaboration,integrating the expertise of anesthesiologists,orthopedic surgeons,nursing personnel,and other healthcare professionals,is the cornerstone of ERAS in patients undergoing TKA.
基金financially supported by National Natural Science Foundation of China(No.22302229)Beijing Municipal Excellent Talent Training Funds Youth Advanced Individual Project(No.2018000020124G163)。
文摘Emulsification is one of the important mechanisms of surfactant flooding. To improve oil recovery for low permeability reservoirs, a highly efficient emulsification oil flooding system consisting of anionic surfactant sodium alkyl glucosyl hydroxypropyl sulfonate(APGSHS) and zwitterionic surfactant octadecyl betaine(BS-18) is proposed. The performance of APGSHS/BS-18 mixed surfactant system was evaluated in terms of interfacial tension, emulsification capability, emulsion size and distribution, wettability alteration, temperature-resistance and salt-resistance. The emulsification speed was used to evaluate the emulsification ability of surfactant systems, and the results show that mixed surfactant systems can completely emulsify the crude oil into emulsions droplets even under low energy conditions. Meanwhile,the system exhibits good temperature and salt resistance. Finally, the best oil recovery of 25.45% is achieved for low permeability core by the mixed surfactant system with a total concentration of 0.3 wt%while the molar ratio of APGSHS:BS-18 is 4:6. The current study indicates that the anionic/zwitterionic mixed surfactant system can improve the oil flooding efficiency and is potential candidate for application in low permeability reservoirs.
基金funded by the National Natural Science Foundation of China under the project“Research on Urban Spatial Coupling Mechanism Between Urban Epidemic Spreading and Vulnerability and Planning Response in Chengdu-Chongqing Area”(Grant No.52078423)the Major Program of Sichuan Provincial Scientific Research under the Project“Research and Demonstration of Resilient Collaborative Planning and Design for Park Cities”(Grant No.2020YFS0054)the Sichuan Provincial Science and Technology Innovation Platform and Talent Plan"Research on the Construction and Development Strategies of Several Major Infrastructure Systems for New Smart Cities"(Grant No.2022JDR0356).
文摘Post-disaster reconstruction is a topic of global concern,and traditional villages have special heritage attributes and need to face more requirements and obstacles in post-disaster reconstruction.This paper summarizes four concepts based on the research on post-disaster reconstruction both domestically and internationally,as well as the recovery and reconstruction of cultural heritage.Through a field survey of traditional villages in the Ms 6.8 Luding earthquake-stricken area,it is found that there are problems such as insufficient awareness of heritage value,misalignment of scientific reconstruction technology,and insufficient protection of reconstruction elements during the reconstruction process.Traditional villages face the risk of declining or even loss of heritage value.In order to effectively protect traditional villages and inherit the carrier of regional culture,four targeted reconstruction response strategies are proposed,i.e.,to"establish special planning for traditional village preservation","emphasize recovery of the authenticity of village heritage","ensure elements for village heritage recovery"and"promote the activation and utilization of village heritage",based on the problems discovered during the survey and the four concepts summarized in the research on post-disaster reconstruction of traditional villages.The research results hope to provide useful reference for ancient cultural areas affected by earthquakes on how to protect cultural heritage during the post-disaster reconstruction process.
基金supported by Hong Kong Spinal Cord Injury Fund (HKSCIF),China (to HZ)。
文摘For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.
基金Supported by the Scientific Research Foundation of Peking University Shenzhen Hospital,No.KYQD2021096the National Natural Science Foundation of China,No.81972829Precision Medicine Research Program of Tsinghua University,No.2022ZLA006.
文摘BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.
基金Supported by the PetroChina Science and Technology Major Project(2023ZZ04,2023ZZ08)。
文摘This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the problems of EOR methods,and proposes the relevant research prospects.The basic research means for oilfield development include in-situ acquisition of formation rock/fluid samples and non-destructive testing.The EOR methods for conventional and shale oil development are classified as improved water flooding(e.g.nano-water flooding),chemical flooding(e.g.low-concentration middle-phase micro-emulsion flooding),gas flooding(e.g.micro/nano bubble flooding),thermal recovery(e.g.air injection thermal-aided miscible flooding),and multi-cluster uniform fracturing/water-free fracturing,which are discussed in this paper for their mechanisms,approaches,and key technique researches and field tests.These methods have been studied with remarkable progress,and some achieved ideal results in field tests.Nonetheless,some problems still exist,such as inadequate research on mechanisms,imperfect matching technologies,and incomplete industrial chains.It is proposed to further strengthen the basic researches and expand the field tests,thereby driving the formation,promotion and application of new technologies.
文摘A significant portion of the national water supply can be attributed to de facto or unplanned potable reuse, though the extent of its contribution is difficult to estimate. Fortunately, the contribution of Water Resource Recovery Facility (WRRF) effluent to waters that supply drinking water treatment plants has been documented by some communities. In the United States (US), among the top 25 most impacted drinking water treatment plants by upstream WRRF, 16% of the influent flow to the drinking water treatment plant under average streamflow and up to 100% under low-flow conditions is WRRF effluent. Currently, the full extent of de facto reuse in the US may be much higher because of population growth. The scenario is no different for Beaufort-Jasper Water and Sewer Authority (BJWSA) in South Carolina, US, with contributions to the Savannah River originating from numerous WRRF and other upstream dischargers. South Carolina coastal utilities such as BJSWA are considering direct and indirect potable reuse options, driven by disposal limitations and challenges. Currently, South Carolina does not have a framework, guidelines, or regulations for reuse, but discussions have started among the regulated community. In addition to understanding the extent of de facto reuse, the state will need to develop standards and best practices to enable future adoption of planned potable reuse solutions to water resources challenges. Such guidance should address human health risk management and technical considerations regarding treatment in addition to other factors, including source control, storage, fail-safe operation, monitoring, non-cost factors, and public acceptance. This study conducted a mapping assessment specific to BJWSA, sampled at four locations on Savannah River, and observed that de facto reuse is approximately 4.6% to 5.9% during low-flow months and is within the range generally observed nationwide. When coupled with evidence that planned potable reuse can improve human health and environmental risks, this practice is a meaningful option in the water supply portfolio for many utilities.
基金Supported by Basic and Forward-Looking Project of the Science and Technology Department of SINOPEC(P22213-4)。
文摘Laboratory experiments,numerical simulations and fracturing technology were combined to address the problems in shale oil recovery by CO_(2)injection.The laboratory experiments were conducted to investigate the displacement mechanisms of shale oil extraction by CO_(2)injection,and the influences of CO_(2)pre-pad on shale mechanical properties.Numerical simulations were performed about influences of CO_(2)pre-pad fracturing and puff-n-huff for energy replenishment on the recovery efficiency.The findings obtained were applied to the field tests of CO_(2)pre-pad fracturing and single well puff-n-huff.The results show that the efficiency of CO_(2)puff-n-huff is affected by micro-and nano-scale effect,kerogen,adsorbed oil and so on,and a longer soaking time in a reasonable range leads to a higher exploitation degree of shale oil.In the"injection+soaking"stage,the exploitation degree of heavy hydrocarbons is enhanced by CO_(2)through its effects of solubility-diffusion and mass-transfer.In the"huff"stage,crude oil in large pores is displaced by CO_(2)to surrounding larger pores or bedding fractures and finally flows to the production well.The injection of CO_(2)pre-pad is conducive to keeping the rock brittle and reducing the fracture breakdown pressure,and the CO_(2)is liable to filter along the bedding surface,thereby creating a more complex fracture.Increasing the volume of CO_(2)pre-pad can improve the energizing effect,and enhance the replenishment of formation energy.Moreover,the oil recovery is more enhanced by CO_(2)huff-n-puff with the lower shale matrix permeability,the lower formation pressure,and the larger heavy hydrocarbon content.The field tests demonstrate a good performance with the pressure maintained well after CO_(2)pre-pad fracturing,the formation energy replenished effectively after CO_(2)huff-n-puff in a single well,and the well productivity improved.
基金supported by the National Key Research and Development Program of China(2022YFB3805100)National Natural Science Foundation of China(22222812 and 22178330)+1 种基金Anhui Provincial Key Research and Development Plan(202104b11020030)Major Science and Technology Innovation Projects in Shandong Province(2022CXGC020415).
文摘Selective electrodialysis(SED)has surfaced as a highly promising membrane separation technique in the realm of acid recovery owing to its ability to effectively separate monovalent ions through the utilization of a potential difference.However,the current SED process is limited by conventional commercial monovalent cation permselective membranes(MCPMs).This study systematically investigates the use of an independently developed MCPM in the SED process for acid recovery.Various factors such as current density,volume ratio,initial ion concentration,and waste acid systems are considered.The independently developed MCPM offers several advantages over the commercial monovalent selective cation-exchange membrane(CIMS),including higher recovered acid concentration,better ion flux ratio,improved acid recovery efficiency,increased recovered acid purity,and higher current efficiency.The SED process with the MCPM achieves a recovered acid of 95.9%and a concentration of 2.3 mol·L^(–1) in the HCl/FeCl_(2) system,when a current density of 20 mA·cm^(-2) and a volume ratio of 1:2 are applied.Similarly,in the H_(2)SO_(4)/FeSO_(4) system,a purity of over 99%and a concentration of 2.1 mol·L^(–1) can be achieved in the recovered acid.This study thoroughly examines the impact of operation conditions on acid recovery performance in the SED process.The independently developed MCPM demonstrates outstanding acid recovery performance,highlighting its potential for future commercial utilization.
文摘Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects.
基金supported by the National Natural Science Foundation of China(No.52227813)China Postdoctoral Science Foundation(Nos.2023M740905,2023T160164)+3 种基金National Key ResearchDevelopment Program of China(No.2022YFE0210200)Natural Science Foundation of Heilongjiang Province(No.LH2023E043)the Fundamental Research Funds for the Central Universities(Nos.2022ZFJH04,HIT.OCEF.2021023)。
文摘The burning of fossil fuels in industry results in significant carbon emissions,and the heat generated is often not fully utilized.For high-temperature industries,thermophotovoltaics(TPVs)is an effective method for waste heat recovery.This review covers two aspects of high-efficiency TPV systems and industrial waste heat applications.At the system level,representative results of TPV complete the systems,while selective emitters and photovoltaic cells in the last decade are compiled.The key points of components to improve the energy conversion efficiency are further analyzed,and the related micro/nano-fabrication methods are introduced.At the application level,the feasibility of TPV applications in high-temperature industries is shown from the world waste heat utilization situation.The potential of TPV in waste heat recovery and carbon neutrality is illustrated with the steel industry as an example.
基金supported by the National Natural Science Foundation of China(62172170)the Science and Technology Project of the State Grid Corporation of China(5100-202199557A-0-5-ZN).
文摘Complex networked systems,which range from biological systems in the natural world to infrastructure systems in the human-made world,can exhibit spontaneous recovery after a failure;for example,a brain may spontaneously return to normal after a seizure,and traffic flow can become smooth again after a jam.Previous studies on the spontaneous recovery of dynamical networks have been limited to undirected networks.However,most real-world networks are directed.To fill this gap,we build a model in which nodes may alternately fail and recover,and we develop a theoretical tool to analyze the recovery properties of directed dynamical networks.We find that the tool can accurately predict the final fraction of active nodes,and the prediction accuracy decreases as the fraction of bidirectional links in the network increases,which emphasizes the importance of directionality in network dynamics.Due to different initial states,directed dynamical networks may show alternative stable states under the same control parameter,exhibiting hysteresis behavior.In addition,for networks with finite sizes,the fraction of active nodes may jump back and forth between high and low states,mimicking repetitive failure-recovery processes.These findings could help clarify the system recovery mechanism and enable better design of networked systems with high resilience.