Effects of combined spinal-epidural anesthesia on anxiety,labor analgesia and motor blocks in women during natural delivery

BACKGROUND The background of this study was analgesia in natural delivery.The combined spinal-epidural anesthesia has obvious analgesic effect on the parturients in natural labor,and combined spinal-epidural anesthesia has been widely used in anesthesia for various diseases.AIM To study the effects of combined spinal-epidural anesthesia on anxiety,labor analgesia,and motor blocks in parturients during natural delivery.METHODS A total of 120 women who gave birth at Changning District Maternal and Child Health Hospital between December 2021 to December 2022 were included;a random number table approach was employed to divide the women into a control group and a joint group,with each group consisting of 60 women.The control group was given epidural anesthesia,while the joint group was given combined spinal-epidural anesthesia.The visual analog scale(VAS)was used to evaluate the degree of maternal pain.Comparisons were made between the two groups’conditions of childbirth and the duration of labor.Apgar scores were used to evaluate the status of the newborns at birth;Self-rating Anxiety Scale(SAS)and General Self-Efficacy Scale(GSES)scores,umbilical artery blood gas analysis indices and stress indices were compared between the two groups;and the frequencies of motor block and postpartum complications were analyzed.RESULTS In comparison to the control group,in the joint group,the VAS scores for the first,second,and third stages of labor were lower(P<0.05).The rates of conversion to cesarean section and postpartum blood loss in the joint group were lower than those in the control group(P<0.05).No significant differences were observed in the Apgar score,the duration of the first stage of labor,or the total duration of labor between the two groups(P>0.05).The second and third stages of labor in the joint group were shorter than those in the control group(P<0.05).When compared to the control group,the postpartum SAS score of the joint group was lower,while the GSES score was greater(P<0.05).Between the control group and the joint group,the differences observed in pH,arterial carbon dioxide partial pressure,arterial oxygen partial pressure,or arterial hydrogen ion concentration were not significant(P>0.05).Nitric oxide,cortisol,and adrenaline levels were lower in the joint group than in the control group(P<0.05).There were no substantial differences in Bromage grade or rate of complications between the two groups(P>0.05).CONCLUSION For parturients during natural delivery,combined spinal-epidural anesthesia can reduce anxiety,provide labor analgesia,shorten labor time,and reduce postoperative stress levels but did not result in a motor block.

Pneumocephalus Following Combined Spinal-Epidural Anesthesia: A Case Report Analysis

Background: Combined spinal-epidural anesthesia (CSEA) is widely used in clinical anesthesia due to its rapid onset, reliable anesthetic effect, and strong controllability. Although advancements in technique have reduced the frequency and severity of common complications, reports of rare and serious complications such as pneumocephalus, remain scarce. Case Report: This article presents a case of pneumocephalus following CSEA in a middle-aged female patient undergoing surgery for an intrauterine space-occupying lesion. The patient experienced severe headache postoperatively, and imaging confirmed the presence of intracranial air. After receiving active symptomatic treatment, the patient recovered and was discharged. Conclusion: This case underscores the importance of adhering to standard anesthesia protocols and increasing awareness of rare CSEA complications, particularly the risk of pneumocephalus. Early recognition and timely management are crucial. There is a need to further enhance training and research in anesthetic procedures to improve clinical anesthesia quality and ensure patient safety.

分组密码算法uBlock积分攻击的改进

积分攻击是由Daemen等人(doi:10.1007/BFb0052343)于1997年提出的一种密码分析方法,是继差分分析和线性分析之后最有效的密码分析方法之一。作为2018年全国密码算法设计竞赛分组算法的获胜算法,uB-lock抵抗积分攻击的能力受到较多的关注。为了重新评估uBlock家族密码算法抵抗积分攻击的安全性,该文利用单项式传播技术,结合混合整数线性规划(MILP)工具搜索积分区分器,并利用部分和技术进行密钥恢复攻击。对于uBlock-128/128和uBlock-128/256,基于搜索到的9轮积分区分器分别进行了首个11轮和12轮攻击,数据复杂度为2~(127)选择明文,时间复杂度分别为2~(127.06)和2~(224)次加密,存储复杂度分别为2~(44.58)和2~(138)字节;对于uBlock-256/256,基于搜索到的10轮积分区分器进行了首个12轮攻击,数据复杂度为2~(253)选择明文,时间复杂度为2~(253.06)次加密,存储复杂度为2~(44.46)字节。与之前uBlock的最优积分攻击结果相比,uBlock-128/128和uBlock-256/256的攻击轮数分别提高2轮,uBlock-128/256的攻击轮数提高3轮。本文的攻击说明,uBlock针对积分攻击依然有足够的安全冗余。

螺旋扩弓器联合Twin-block矫治器早期矫治在青少年下颌后缩中的应用效果及对气道形态的影响研究

目的探讨螺旋扩弓器联合Twin-block矫治器早期矫治在青少年下颌后缩中的应用效果及对气道形态的影响研究。方法将河南大学赛思口腔医院2021年5月至2022年5月收治的63例青少年下颌后缩患者,根按照随机数字表法分为两组,对照组(32例)、观察组(31例),对照组早期给予Twin-block矫治器治疗,观察组早期给予螺旋扩弓器联合Twin-block矫治器矫治治疗,观察两组牙齿角度相关指标、气道形态指标及舌骨位置变化。结果矫治前,两组上下齿槽座角(ANB)、颅底-下齿槽座角(SNB)、前下中切牙下颌平面(T-MP)、颅底-上齿槽座角(SNA)比较差异无统计学意义(P>0.05),矫治后3个月,观察组ANB、SNB、T-MP、SNA均大于对照组(P<0.05);矫治前,两组后鼻脊-咽顶点距(PNS-R)、软腭后-软腭后咽壁距(SPP-SPPW)、后鼻脊-上咽壁距(PNS-UPW)、会厌骨-下咽壁距(V-LPW)比较差异无统计学意义(P>0.05),矫治后3个月,观察组PNS-R、SPP-SPPW、PNS-UPW、V-LPW均大于对照组(P<0.05);矫治前,两组舌骨-眶耳平面距(H-FH)、舌骨-下颌平面距(H-MP)、舌骨-颈椎前平面距(H-VL)、舌骨-颅底平面距(H-S)比较差异无统计学意义(P>0.05),矫治后3个月,观察组H-FH、H-MP、H-VL、H-S均大于对照组(P<0.05)。结论螺旋扩弓器联合Twin-block矫治器早期矫治可以有效改善青少年下颌后缩患者牙齿角度、气道形态,纠正舌骨的位置,改善通气功能。

Twin-block在骨性Ⅱ类错[牙合]下颌后缩患儿中的应用

目的:探讨Twin-block在骨性Ⅱ类错[牙合]下颌后缩患儿中的应用效果。方法:选取2019年1月-2021年1月笔者医院接收的84例骨性Ⅱ类错[牙合]下颌后缩患儿设置为研究对象,按随机抽签法分为对照组、研究组,各42例,对照组采用直丝弓矫治器,研究组采用Twin-block矫治器。比较两组治疗前后咀嚼功能、牙齿咬合力、下颌骨变化、软组织面型变化、上气道矢状径,并统计家属治疗满意度。结果:治疗后,研究组咀嚼功能、牙齿咬合力、下颌骨变化指标、软组织面型变化指标均优于对照组(P<0.05);治疗后,研究组上气道矢状径高于对照组(P<0.05);研究组家属治疗满意度(95.24%)明显高于对照组(73.81%)(P<0.05)。结论:Twin-block应用于骨性Ⅱ类错[牙合]下颌后缩患儿治疗中,能改善咀嚼功能,增强牙齿咬合力,促进下颌骨生长,提高面型美观度,扩大上气道矢状径,利于改善呼吸功能,获得家属对治疗效果的高度评价。

Twin-Block双期矫治与单纯直丝弓矫正技术在早期下颌后缩矫正患儿中的疗效对比

目的探讨Twin-Block双期矫治与单纯直丝弓矫正技术在替牙及恒牙早期错(牙合)畸形矫正患儿中的疗效对比。方法选取我院2020年9月到2023年9月收治的60例恒牙早期错(牙合)畸形患儿作为研究对象,按照治疗方法不同分为观察组与对照组,各组均为30例。所有患儿均采取矫正治疗,对照组患儿采取直丝弓矫正技术进行治疗,观察组患儿采取Twin-Block矫治器及直丝弓矫治技术进行双期治疗。对比两组患儿临床疗效,及矫治时间,治疗前头影测量及关节改建情况,采用口腔锥形束扫描成像进行检测两组患儿关节窝宽径、关节前间隙、关节后间隙、关节上间隙、髁突前后径、髁突高度相关参数表达水平,最后对比两组患儿治疗前后上下齿槽座(ANB)角、下齿槽座(SNB)角、上齿槽座(SNA)角、下颌平面角(Mp-SN)、下颌综合长度(Ar-Po)、下颌升支高度(Ar-Go)、下颌体长(Go-Gn)、上中切牙-SN平面角(U1-SN)、下中切牙-下颌平面角(L1-Mp)、上唇审美平面距(Ls-E)、下唇审美平面距(Li-E)、鼻唇角。结果观察组治疗总有效率96.67%明显高于对照组76.67%(P<0.05);治疗后,观察组矫治时间长于对照组(P<0.05);治疗前,两组患儿关节窝宽径、关节前间隙、关节后间隙、关节上间隙、髁突前后径、髁突高度对比无明显差异(P>0.05),治疗后,两组患儿关节窝宽径对比无明显差异,关节前间隙减小,观察组(1.21±0.28)mm高于对照组,关节后间隙、关节上间隙、髁突前后径、髁突高度均增加,且观察组高于对照组(P<0.05);治疗前,两组患儿ANB角、SNB角、SNA角、Mp-SN、Ar-Po、Ar-Go、Go-Gn、U1-SN、L1-Mp、Ls-E、Li-E、鼻唇角对比无明显差异(P>0.05),治疗后,两组患儿SNB、Mp-SN、Ar-Po、Ar-Go、Go-Gn、鼻唇角均增大,ANB、U1-SN、L1-Mp、Li-E、Ls-E减小,且观察组变化大于对照组(P<0.05)。结论Twin-Block矫治器配合直丝弓矫治技术双期矫治器与单纯直丝弓矫正技术相比治疗替牙及恒牙早期错(牙合)畸形疗效显著,可作为儿童恒牙早期错(牙合)畸形的首选治疗方案。

基于Group-Res2Block的智能合成语音说话人确认方法

针对现有说话人确认任务基于自然语音条件下并不适用于智能合成语音的问题,提出一种基于Group-Res2Block的智能合成语音说话人确认方法。首先,设计了Group-Res2Block结构,在Res2Block的基础上将当前分组与相邻前后分组进行合并形成新的分组,以增强说话人局部特征的上下文联系;其次,设计了并行结构的多尺度通道注意力特征融合机制,利用不同大小卷积核实现同一层级的特征在通道维度的特征选择,以获取更具表现力的说话人特征,避免信息冗余;最后,设计了串行结构的多尺度层注意力特征融合机制,构建层结构,将深浅层特征整体进行融合并赋予不同权重,以获取最优的特征表达。为验证所提出特征提取网络的有效性,构建了中英文两种智能合成语音数据集进行消融实验和对比实验。结果表明本文方法在该任务的评价指标精确度(accuracy,ACC)、等错误率(equal error rate,EER)和最小检测代价函数(minimum detection cost function,minDCF)上是最优的。此外,通过对模型泛化性能进行测试,验证了本文方法对未知智能语音算法的适用性。

Investigation of the block toppling evolution of a layered model slope by centrifuge test and discrete element modeling

Primary toppling usually occurs in layered rock slopes with large anti-dip angles.In this paper,the block toppling evolution was explored using a large-scale centrifuge system.Each block column in the layered model slope was made of cement mortar.Some artificial cracks perpendicular to the block column were prefabricated.Strain gages,displacement gages,and high-speed camera measurements were employed to monitor the deformation and failure processes of the model slope.The centrifuge test results show that the block toppling evolution can be divided into seven stages,i.e.layer compression,formation of major tensile crack,reverse bending of the block column,closure of major tensile crack,strong bending of the block column,formation of failure zone,and complete failure.Block toppling is characterized by sudden large deformation and occurs in stages.The wedge-shaped cracks in the model incline towards the slope.Experimental observations show that block toppling is mainly caused by bending failure rather than by shear failure.The tensile strength also plays a key factor in the evolution of block toppling.The simulation results from discrete element method(DEM)is in line with the testing results.Tensile stress exists at the backside of rock column during toppling deformation.Stress concentration results in the fragmented rock column and its degree is the most significant at the slope toe.

Greatly enhanced corrosion/wear resistances of epoxy coating for Mg alloy through a synergistic effect between functionalized graphene and insulated blocking layer

The poor corrosion and wear resistances of Mg alloys seriously limit their potential applications in various industries.The conventional epoxy coating easily forms many intrinsic defects during the solidification process,which cannot provide sufficient protection.In the current study,we design a double-layer epoxy composite coating on Mg alloy with enhanced anti-corrosion/wear properties,via the spin-assisted assembly technique.The outer layer is functionalized graphene(FG)in waterborne epoxy resin(WEP)and the inner layer is Ce-based conversion(Ce)film.The FG sheets can be homogeneously dispersed within the epoxy matrix to fill the intrinsic defects and improve the barrier capability.The Ce film connects the outer layer with the substrate,showing the transition effect.The corrosion rate of Ce/WEP/FG composite coating is 2131 times lower than that of bare Mg alloy,and the wear rate is decreased by~90%.The improved corrosion resistance is attributed to the labyrinth effect(hindering the penetration of corrosive medium)and the obstruction of galvanic coupling behavior.The synergistic effect derived from the FG sheet and blocking layer exhibits great potential in realizing the improvement of multi-functional integration,which will open up a new avenue for the development of novel composite protection coatings of Mg alloys.

Novel approach of ultrasound-guided lateral recess block for a patient with lateral recess stenosis: A case report

BACKGROUND Ultrasound guide technology,which can provide real-time visualization of the needle tip and tissues and avoid many adverse events,is widely used in mini-mally invasive therapy.However,the studies on ultrasound-guided Lateral recess block(LRB)are limited,this is probably because there is no recognized standard method for ultrasound scanning.This study aimed to evaluate the effect of ultrasound-guided LRB in patients with lateral recess stenosis(LRS).CASE SUMMARY A 65-year-old patient complained of low back pain accompanied occasionally by pain and numbness in the left lower limb.Physical examination showed ten-derness on the spinous process and paraspinal muscles from L1 to S1,extensor hallucis longus and tibialis anterior weakness(muscle strength:4-),and a positive straight leg raising test in the left lower limb(60°).Magnetic resonance imaging showed L4–L5 disc degeneration with left LRS and nerve root entrapment.Subsequently,the patient was diagnosed with LRS.This patient was treated with a novel ultrasound-guided LRB approach.The patient’s symptoms significantly improved without any complications at 1 wk postoperatively and at the 3-month follow-up.CONCLUSION This is the first report on the LRS treatment with ultrasound-guided LRB from the contralateral spinous process along the inner side of the articular process by out-plane technique.Further studies are expected to investigate the efficacy and safety of ultrasound-guided LRB for patients with LRS.

THE STABLE RECONSTRUCTION OF STRONGLY-DECAYING BLOCK SPARSE SIGNALS

In this paper,we reconstruct strongly-decaying block sparse signals by the block generalized orthogonal matching pursuit(BgOMP)algorithm in the l2-bounded noise case.Under some restraints on the minimum magnitude of the nonzero elements of the strongly-decaying block sparse signal,if the sensing matrix satisfies the the block restricted isometry property(block-RIP),then arbitrary strongly-decaying block sparse signals can be accurately and steadily reconstructed by the BgOMP algorithm in iterations.Furthermore,we conjecture that this condition is sharp.

Correction to:Production and test of sPHENIX W/SciFiber electromagnetic calorimeter blocks in China

Correction to:Nuclear Science and Techniques(2024)35:145 https://doi.org/10.1007/s41365-024-01517-y In this article the author’s name Wan-Bing He was incorrectly written as Wan-Bin He.The original article has been corrected.

Misinterpretation of sleep-induced second-degree atrioventricular block

A number of publications have claimed that Mobitz type Ⅱ atrioventricular block(AVB)may occur during sleep.None of the reports defined type Ⅱ AVB and representative electrocardiograms were either misinterpreted or missing.Relatively benign Wenckebach type Ⅰ AVB is often misdiagnosed as Mobitz type Ⅱ which is an indication for a pacemaker.Review of the published reports indicates that Mobitz type II AVB does not occur during sleep when it is absent in the awake state.Conclusion:There is no proof that sleep is associated with Mobitz type Ⅱ AVB.

A nanobody-based blocking enzyme-linked immunosorbent assay for detecting antibodies against pseudorabies virus glycoprotein E

Pseudorabies(PR)is an acute infectious disease of pigs caused by the PR virus(PRV)and results in great economic losses to the pig industry worldwide.PRV glycoprotein E(gE)-based enzyme-linked immunosorbent assay(ELISA)has been used to distinguish gE-deleted vaccine-immunized pigs from wild-type virus-infected pigs to eradicate PR in some countries.Nanobody has the advantages of small size and easy genetic engineering and has been a promising diagnostic reagent.However,there were few reports about developing nanobody-based ELISA for detecting anti-PRV-gE antibodies.In the present study,the recombinant PRV-gE was expressed with a bacterial system and used to immunize the Bactrian camel.Then,two nanobodies against PRV-gE were screened from the immunized camel by phage display technique.Subsequently,two nanobody-HRP fusion proteins were expressed with HEK293T cells.The PRV-gE-Nb36-HRP fusion protein was selected as the probe for developing the blocking ELISA(bELISA)to detect anti-PRV-gE antibodies.Through optimizing the conditions of bELISA,the amount of coated antigen was 200 ng per well,and dilutions of the fusion protein and tested pig sera were separately 1:320 and 1:5.The cut-off value of bELISA was 24.20%,and the sensitivity and specificity were 96.43 and 92.63%,respectively.By detecting 233 clinical pig sera with the developed bELISA and a commercial kit,the results showed that the coincidence rate of two assays was 93.99%.Additionallly,epitope mapping showed that PRV-gE-Nb36 recognized a conserved conformational epitope in different reference PRV strains.Simple,great stability and low-cost nanobody-based bELISA for detecting anti-PRV-gE antibodies were developed.The bELISA could be used for monitoring and eradicating PR.

Electrical Resistivity Structures of the Beishan Block,NW China,and Tectonic Implications

The Central Asian Orogenic Belt(CAOB)is a giant orogenic belt located between the Siberian Plate,the Tarim Plate,and the North China Plate,which records the longterm and complex geologic evolution of the Paleo-Asian Ocean from the Early Neoproterozoic(ca.1000 Ma)to the Late Paleoproterozoic(ca.250 Ma)process.The Beishan Block is located in the middle and southern edge of the Central Asian orogenic belt,at the intersection of the Tarim plate,the Siberian Plate and the Kazakhstan Plate.

Ultrasound-guided sphenopalatine ganglion block for effective analgesia during awake fiberoptic nasotracheal intubation: A case report

BACKGROUND Awake fiberoptic nasotracheal intubation(AFNI)is the preferred airway ma-nagement strategy for patients with difficult airways.However,this procedure can cause significant physical and psychological distress.This case report explores the application of a sphenopalatine ganglion(SPG)block as an alternative anal-gesic modality to mitigate the discomfort associated with AFNI.CASE SUMMARY A 63-year-old female with a history of right maxillary osteosarcoma underwent craniotomy for a suspected malignant brain lesion.The patient’s medical history included prior surgery,chemotherapy,and radiation therapy,resulting in signi-ficant jaw impairment and limited neck mobility.Considering the anticipated air-way challenges,AFNI was planned.A SPG block was performed under real-time ultrasound guidance,providing effective analgesia during nasotracheal intuba-tion.CONCLUSION The SPG block represents a promising analgesic approach in AFNI,offering po-tential benefits in alleviating pain involving the nasal and nasopharyngeal regions as well as improving patient cooperation.

Rheological Evidence of the Lithospheric Destruction of the Eastern Block of the North China Craton

The Eastern Block of the North China Craton(NCC)(Fig.1)has undergone severe lithospheric destruction,with crustal thinning down to 100 km depth(Chen et al.,2009),contrasting sharply with the stable Kalahari and Rae cratons.However,there remains controversy over the destruction pattern(e.g.,Zhu et al.,2017).During the Early Mesozoic,crustal thickening occurred in the Xuhuai and Qinling orogens,followed by lithospheric delamination leading to crustal thinning(Chen et al.,2023).The middle and upper crustal thinning in the Yanshan and Taihang uplifts was induced by mafic magma underplating(Ji et al.,2009).

General Method of Combining Grover and Simon for Attacking Block Ciphers

The compatibility of different quantum algorithms should be considered when these algorithms are combined.In this paper,the method of combining Grover and Simon is studied for the first time,under some preconditions or assumptions.First,we give two preconditions of applying Grover’s algorithm,which ensure that the success probability of finding the marked element is close to 1.Then,based on these two preconditions,it is found out that the success probability of the quantum algorithm for FXconstruction is far less than 1.Furthermore,we give the design method of the Oracle function,and then present the general method of combining Grover and Simon algorithm for attacking block ciphers,with success probability close to 1.

Quantum block coherence with respect to projective measurements

Quantum coherence serves as a defining characteristic of quantum mechanics,finding extensive applications in quantum computing and quantum communication processing.This study explores quantum block coherence in the context of projective measurements,focusing on the quantification of such coherence.Firstly,we define the correlation function between the two general projective measurements P and Q,and analyze the connection between sets of block incoherent states related to two compatible projective measurements P and Q.Secondly,we discuss the measure of quantum block coherence with respect to projective measurements.Based on a given measure of quantum block coherence,we characterize the existence of maximal block coherent states through projective measurements.This research integrates the compatibility of projective measurements with the framework of quantum block coherence,contributing to the advancement of block coherence measurement theory.

The Lithosphere Structure and its Implication for Different Metallogenic Belts beneath the Eastern South China Block

The South China Block(SCB)was formed through the Neoproterozoic amalgamation of the Yangtze Block(YB),the Cathaysia Block(CB),and the accreted components of the Jiangnan orogenic belt(JNO),it is bounded by the Jiangshan–Shaoxing–Pingxiang fault(JSPF)and the Jiujiang–Shitai–Jishou fault(JSJF)(Yao et al.,2019).The SCB has undergone a series of complex geological events,including Paleozoic orogeny,Mesozoic collisions with the North China Craton(NCC)and the Indochina Block,as well as the intracontinental orogeny,leading to extensive lithospheric modifications and magmatic activities(Zhang H J et al.,2023;Fig.1).