Prevalence of Congenital Heart Disease at Extremely High Altitudes in Tibet and the Establishment of a New Free Treatment Model

Background: This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas (over 4000 m to even 5000 m above sea level) and explore an aid model for early diagnosis and treatmentfor the Tibetan population. Methods: A total of 2242 students from different schools in Ngamring County,Xigaze City, Tibet from September 2019 to September 2020 were selected for screening. The students were examinedthrough the inquiry of their current medical history and family history, cardiac auscultation and a physicalexamination, in order to screen out the suspected cases of CHD, and then the suspected cases were confirmed bycardiac color ultrasound examinations. After that, positive patients were be transferred to Shandong Province forfree treatment. Results: The prevalence of CHD among children in Ngamring County was 3.70% (83 cases),which is the highest incidence rate ever reported. The most common type of CHD was patent ductus arteriosus(PDA), accounting for 55.42% of the total number of cases screened, followed by atrial septal defect (ASD) andventricular septal defect (VSD), accounting for 28.92% and 12.05%, respectively. The prevalence of CHD in childrenat high altitude was significantly higher than that in children at low altitude. The children with CHD weretransferred to Shandong Province for surgery, the operations were successful and their recoveries went well.Conclusions: The results show that high altitude is closely related to the prevalence of CHD, and the incidencein Ngamring County is much higher than that in previous reports.

Mathematical Modeling of HIV Investigating the Effect of Inconsistent Treatment

HIV is a retrovirus that infects and impairs the cells and functions of the immune system. It has caused a great challenge to global public health systems and leads to Acquired Immunodeficiency Syndrome (AIDS), if not attended to in good time. Antiretroviral therapy is used for managing the virus in a patient’s lifetime. Some of the symptoms of the disease include lean body mass and many opportunistic infections. This study has developed a SIAT mathematical model to investigate the impact of inconsistency in treatment of the disease. The arising non-linear differential equations have been obtained and analyzed. The DFE and its stability have been obtained and the study found that it is locally asymptotically stable when the basic reproduction number is less than unity. The endemic equilibrium has been obtained and found to be globally asymptotically stable when the basic reproduction number is greater than unity. Numerical solutions have been obtained and analyzed to give the trends in the spread dynamics. The inconsistency in treatment uptake has been analyzed through the numerical solutions. The study found that when the treatment rate of those infected increases, it leads to an increase in treatment population, which slows down the spread of HIV and vice versa. An increase in the rate of treatment of those with AIDS leads to a decrease in the AIDS population, the reverse happens when this rate decreases. The study recommends that the community involvement in advocating for consistent treatment of HIV to curb the spread of the disease.

Mathematical Modeling of the Co-Infection Dynamics of HIV and Tuberculosis Incorporating Inconsistency in HIV Treatment

A non-linear HIV-TB co-infection has been formulated and analyzed. The positivity and invariant region has been established. The disease free equilibrium and its stability has been determined. The local stability was determined and found to be stable under given conditions. The basic reproduction number was obtained and according to findings, co-infection diminishes when this number is less than unity, and persists when the number is greater than unity. The global stability of the endemic equilibrium was calculated. The impact of HIV on TB was established as well as the impact of TB on HIV. Numerical solution was also done and the findings indicate that when the rate of HIV treatment increases the latent TB increases while the co-infected population decreases. When the rate of HIV treatment decreases the latent TB population decreases and the co-infected population increases. Encouraging communities to prioritize the consistent treatment of HIV infected individuals must be emphasized in order to reduce the scourge of HIV-TB co-infection.

Impact of extended nursing model after multi-disciplinary treatment on young patient with post-stroke

BACKGROUND Stroke has become one of the most serious life-threatening diseases due to its high morbidity,disability,recurrence and mortality rates.AIM To explore the intervention effect of multi-disciplinary treatment(MDT)extended nursing model on negative emotions and quality of life of young patients with post-stroke.METHODS A total of 60 young stroke patients who were hospitalized in the neurology department of our hospital from January 2020 to December 2021 were selected and randomly divided into a control group and an experimental group,with 30 patients in each group.The control group used the conventional care model and the experimental group used the MDT extended nursing model.After the inhospital and 3-mo post-discharge interventions,the differences in negative emotions and quality of life scores between the two groups were evaluated and analyzed at the time of admission,at the time of discharge and after discharge,respectively.RESULTS There are no statistically significant differences in the negative emotions scores between the two groups at admission,while there are statistically significant differences in the negative emotions scores within each group at admission and discharge,at discharge and post-discharge,and at discharge and post-discharge.In addition,the negative emotions scores were all statistically significant at discharge and after discharge when compared between the two groups.There was no statistically significant difference in quality of life scores at the time of admission between the two groups,and the difference between quality of life scores at the time of admission and discharge,at the time of discharge and post-discharge,and at the time of admission and post-discharge for each group of patients was statistically significant.CONCLUSION The MDT extended nursing mode can improve the negative emotion of patients and improve their quality of life.Therefore,it can be applied in future clinical practice and is worthy of promotion.

Risk Prediction Model for Surgical Treatment of Ruptured Corpus Luteum in the Ovary

Objective: To explore the related factors of surgical treatment of patients with corpus luteum rupture and establish a risk prediction model of surgical treatment of corpus luteum rupture. Methods: 222 patients with corpus luteum rupture treated in Jingzhou First People’s Hospital from January 2015 to March 2022 were analyzed retrospectively, including 45 cases of surgery and 177 cases of conservative treatment. The training set and validation set were randomly assigned according to 7:3. We collected the basic information, laboratory and ultrasonic examination data of 222 patients. Logistic regression analysis was used to determine the independent risk factors and combined predictors of surgical treatment of corpus luteum rupture. The risk prediction model was established and the nomogram was drawn. The discrimination and calibration of the prediction model were verified and evaluated by receiver operating characteristic (ROC) curve, calibration curve and Hosmer-Lemeshow goodness of fit test;Decision curve analysis (DCA) was used to evaluate the clinical effectiveness of the prediction model. Results: Univariate logistic regression showed that whole abdominal pain (OR: 2.314, 95% CI: 1.090 - 4.912), abdominal muscle tension (OR: 2.379, 95% CI: 1.112 - 5.089), adnexal mass ≥ 4 cm (OR: 3.926, 95% CI: 1.771 - 8.266), hemoglobin Conclusion: The nomogram prediction model containing three predictive variables (hemoglobin, depth of pelvic effusion under ultrasound and cervical lifting pain) can be used to predict the risk of surgical treatment in patients with corpus luteum rupture.

The Effectiveness of a Multidisciplinary Collaborative Model for the Diagnosis and Treatment of Vertigo

Objective:To investigate the effectiveness of applying a multidisciplinary collaborative model for the diagnosis and treatment of patients with vertigo.Methods:The study was carried out in Xianyang Hospital of Yan’an University,in which 100 patients with vertigo were selected from April 2021 to April 2022 and were divided into two groups:the control group was under the single diagnosis and treatment model,whereas the experimental group was under the multidisciplinary collaborative diagnosis and treatment model,with 50 cases in each group.The diagnostic effects of the two groups were compared.Results:The diagnostic and therapeutic efficiency of the patients in the experimental group were 94%and 98%,respectively,while those of the patients in the control group were 78%and 82%,respectively,with a significant difference between the two groups(p<0.05).The balance scores of the patients in both groups were low before the treatment,in which the difference was not significant(p>0.05);after the treatment,the scores improved,with those of the patients in the experimental group being significantly higher than those in the control group(p<0.05).Moreover,the satisfaction rate of patients in the experimental group(98%)was significantly higher than that of the control group(80%)(p<0.05).Conclusion:The application of the multidisciplinary collaborative diagnosis and treatment model in the diagnosis of patients with vertigo is effective.The multidisciplinary model can improve clinical diagnosis,enhance the treatment effect,improve the clinical symptoms of patients,and increase the satisfaction of patient care.Hence,it is of high clinical application value.

Current Problems of the Diagnostics and Treatment of Sepsis and Burn Injuries: The Modified Pathogenetic Concept

Background: The deep understanding of pathogenesis is a key moment in the formation of the modern strategy of modern medicine. We conducted the thorough analysis of the microscopic processes occurring in the bodies of patients with purulent-septic complications. The modified pathogenetic concept of the diagnostic and treatment model of diseases with septic complications is presented. The obtained information about the mechanisms of origin and development of these diseases is fundamentally important for finding the modern effective methods of treating patients. The aim of the research is to modify treatment tactics for patients with sepsis and burn injuries based on the modified pathogenetic concept using modern diagnostics, i.e. the method of fluorescence spectroscopy (MFS) and biomarkers. Materials and Methods: The proposed modified pathogenetic concept of the diagnostic and treatment model of diseases with purulent-septic complications along with standard methods was used successfully for effective treatment of 15 patients with sepsis and 25 with burn injuries. Results: 3 main scenarios of behaviour of spectral-fluorescence characteristics of patients with sepsis are illustrated. Spectral-fluorescence markers of sepsis were studied, which are informative 24 to 48 hours before the appearance of obvious clinical and laboratory signs of significant changes in the general somatic status of patients. Conclusions: The proposed diagnostic and therapeutic approach is new and fundamentally important for diagnostics and monitoring of the process of treatment of patients with purulent-septic diseases and burn injuries. An in-depth understanding of the dynamics of septic complications and the corresponding changes of the main markers of these diseases during treatment is especially relevant. The use of infusion therapy with solutions of donor albumin as an effective pathogenetic treatment is scientifically justified.

Mathematical Model of Heat Treatment and Its Computer Simulation

Computer simulation on heat treatment is the foundation of intelligent heat treatment. The simulations of temperature field, phase transformation, stress/strain complicate quenching operation were realized by using the model of three dimensional non linear finite element method and the treatment methods of abruptly changing interface conditions. The simulation results basically fit those measured in experiments. The intelligent sealed multipurpose furnace production line has been developed based on the combination of computer simulation on gaseous carburizing and computer control technology. More than 3000 batches of workpieces have been processed on this production line, and all are up to standard. The application of computer simulation technology can significantly improve the loading ability and relia bility of nitriding and carburizing workpieces, reduce heat treatment distortion, and shorten carburizing duration. It is recommended that the reliable product design without redundancy should be performed with the combination of the CAD of mechanical products, the CAE of materials selection and heat treatment, and the dynamic evaluation technology of product reliability.

The Trends and Tasks of Modeling and Simulation for Reduction of Heat Treatment Distortion

The development of simulation model and benchmark work have expanded in the past decade and many models and soft ware are introduced. The leading software "Hearts’ developed by Prof Inoue[1] and several other have proved the effectiveness as the pre-production simulation work at many part of heat treatment processes[2-10]. Although, numerous other models and simulation studies dealt with many fundamental factors are reported at many conferences except very few models have not completed three dimensional computation methods, or lack of validation work to evaluate their tools exactly. In this paper, several distortion case studies will be introduced and the needs of fundamental study of distortion and internationally collaborative program on model evaluation and construction of materials database are proposed.

Modeling and Simulation of Heat Transfer in Loaded Continuous Heat Treatment Furnace

Continuous furnaces are widely used in the heat treatment of mass-produced parts. However, the heating up process of parts in continuous furnace is still decided by experience. In this paper the heat transfer in the continuous furnace is formulated firstly. The heat balance in each zone is discussed and equations are given. Coupled with the model for heat transfer between workpieces and furnace and the heat transfer in the workload as well presented in the former developed CHT-6/ for batch furnaces, a program CHT- for continuous furnaces was developed. The model deals with two typical movements of parts: continuous or step by step. The moving speed of parts and load pattern can be optimized based on the calculated temperature distributions and curves, especially, the fastest heated and slowest-heated temperature-distance profiles. A case study is carried out for the heat treatment of a kind of hook-shaped part. The calculated results are analyzed and in good agreement with the measured ones.

Technological Options to Ameliorate Waste Treatment of Intensive Pig Production in China:An Analysis Based on Bio-Economic Model

Ameliorating waste treatment by technological improvements affects the economic and the ecological-environment benefits of intensive pig production. The objective of the research was to develop and test a method to determine the technical optimization to ameliorate waste treatment methods and gain insight into the relationship between technological options and the economic and ecological effects. We developed an integrated bio-economic model which incorporates the farming production and waste disposal systems to simulate the impact of technological improvements in pig manure treatment on economic and environmental benefits for the case of a pilot farm in Beijing, China. Based on different waste treatment technology options, three scenarios are applied for the simulation analysis of the model. The simulation results reveal that the economic-environmental benefits of the livestock farm could be improved by reducing the cropland manure application and increasing the composting production with the current technologies. Nevertheless, the technical efficiency, the waste treatment capacity and the economic benefits could be further improved by the introduction of new technologies. It implies that technological and economic support policies should be implemented comprehensively on waste disposal and resource utilization to promote sustainable development in intensive livestock production in China.

Improved Monitoring Protocol for Evaluating the Performance of a Sewage Treatment Works Based on Sensitivity Analysis of Mathematical Modelling

Extensive historical data of a sewage treatment works are required by numerical models in order to simulate the biological processes accurately. However, the data are recorded mostly for daily operational purpose. They are basically not comprehensive enough to meet the modelling’s requirements. A comprehensive sampling protocol to accurately characterise the influent is required in order to determine all model components, which is very time-consuming and expensive. In a project of evaluating a sewage treatment works in Chongqing by using BioWin 4.1 for mathematical modelling, sensitivity analysis was conducted to determine the most critical parameters for process monitoring. It was found that influent characteristics, wasted sludge flow rate, water temperatures, DO levels of the biological tanks and five bio-kinetic parameters were the most influential parameters governing the plant performance. Therefore, apart from monitoring the effluent quality, regular checking of the afore-mentioned influential parameters can help examine the performance of a sewage treatment works. Moreover, operators of the sewage treatment works can conduct “what-if” analysis to determine how these most influential parameters can be adjusted to improve the treatment performance of the sewage treatment works.

Modelling spatial variation in the treatment costs of nonpoint source pollution in mountainous regions of southwest China

Non-point source(NPS) pollution is considered to be one of the main threats of the aquatic environment. Mountainous regions are particularly important water sources for urban areas. The various driving factors of NPS pollution such as terrain, precipitation, and vegetation type in mountainous regions show clear spatial heterogeneity. Consequently, the management systems required for NPS pollution in mountainous regions are complex. In this study, we developed a framework to estimate and map the treatment costs for NPS pollution in mountainous regions and applied this method in Baoxing County, a typical mountainous county in Sichuan Province of southwest China. The export levels of total nitrogen(TN) and total phosphorus(TP) in Baoxing County were estimated using the water purification model in InVEST(Itegrated Valuation of Ecosystem Services and Tradeoffs) tool. NPS pollutant treatment costs were calculated based on the level of pollutants exports, water yield, water quality targets, and treatment costs of NPS pollutants per unit mass. The results show that at the watershed level the amounts of TN and TP exported in Baoxing County were below threshold limits. However, at the sub-watershed level, TN and TP excesses of 291.64 and 2.96 tons per year were found, respectively, with mean TN and TP treatment costs of 6.58 US$/hm^2 and 0.35 US$/hm^2. Appraising pollution treatment cost intuitively reflects the overall expenditure in NPS pollution reduction from an economic perspective. This study provides a foundation for the implementation of Payment for Ecosystem Service(PES) and the prevention and control of NPS pollution.

Global Dynamic Analysis of a Vector-Borne Plant Disease Model with Discontinuous Treatment

This paper proposes a vector-borne plant disease model with discontinuous treatment strategies. Constructing Lyapunov function and applying non-smooth theory to analyze discontinuous differential equations, the basic reproductive number R0 is proved, which determines whether the plant disease will be extinct or not. If R0 R0 > 1 , there exists a unique endemic equilibrium which is globally stable. The numerical simulations are provided to verify our theoretical results, which indicate that after infective individuals reach some level, strengthening treatment measures is proved to be beneficial in controlling disease transmission.

Process Optimization and Modeling by Response Surface Methodology of Nitrite Electro-Reduction by Ti/RuO2 + IrO2 Electrode

Electrochemical reduction is one of the most suitable methods for the treatment of highly nitrate-contaminated solutions. This work focuses on the optimization of parameters influencing the electrochemical denitrification of water by the Ti/RuO2 + IrO2 electrode. The methodological approach used consists in carrying out a series of electrolysis by scrutinizing the reaction selectivity according to the experimental conditions. For this study, the ions concentrations before and after electrolysis were determined by UV-vis absorption spectroscopy. The results of the process optimization showed that the electrochemical reduction ofis efficient at neutral pH after 120 mn of electrolysis at -100 mA. In contrast to works found in the literature, this study highlighted the process modeling that could open interesting perspectives to develop new treatment methods of polluted waters.

Mathematical Model of Decarburization of Ultra Low Carbon Steel during RH Treatment

According to the balance of carbon and oxygen, a decarburization model for the RH treatment has been developed. in which the influence of the mass transfer of carbon and oxygen in the liquid steel and the stirring energy (ε) in the vacuum vessel on decarburization rate has been considered. The conclusion that the volumetric coefficients of the mass transfer of carbon is proportional to ε(1.5) is drawn. Industrical experiment proves this model is reliable. The influence of some factors on decarburization rate has been obtained. which can provide directions for RH treatment The decarburization behavior of steel with RH-OB treatment is also studied. The OB-or-not curve, the optimized OB time and OB amount are discussed.

基于态靶辨治代谢疾病智能辅助诊疗系统的研究与设计

目的:基于“态靶辨证”中医诊疗思维,利用人工智能技术为代谢病中医辅助诊疗提供智能化支持。方法:通过自然语言处理技术,对医学文献和专家经验进行信息抽取和实体识别,构建包含疾病状态、治疗靶点及相关辨证规则的术语知识库。在此基础上,利用图数据库和深度学习算法,构建态靶辨证知识图谱,表达不同疾病状态与治疗靶点之间的复杂关系。结果:通过模型训练和知识推理,结合病例的具体症状和体质,推荐相应的中医治疗方案,提高了代谢病辅助诊疗的准确性和效率。结论:本研究为中医辨证施治提供了新的方法和思路,不断迭代优化算法,拓展临床应用,推动中医药辅助诊疗的发展和完善,为中医药传承创新奠定良好的技术基础。

基于演化博弈的我国分级诊疗策略分析

目的在分级诊疗制度中涉及政府、医院和患者之间的利益关系,探讨三方动态博弈策略,有利于完善分级诊疗的理论范式和政策逻辑。方法构建政府、医院和患者三方模型,分析其策略选择及演化路径,求解三方演化博弈的稳定策略,探究如何进行利益平衡和合作以实现三方共赢。另外,利用Matlab R2018b对模型进行仿真,进一步分析三方主体的演化路径以及不同策略选择对分级诊疗制度推广的影响。结果政府、医院和患者3个主体的决策行为之间相互影响,最终将演化至点(1,1,1)的理想稳定状态。增大政府补贴会加速医院和患者的初始参与概率值收敛至1,但过多的补贴会使政府逐渐背离鼓励分级诊疗的策略。结论政府应在成本范围内加大对医院优质医疗资源下沉的专家补贴力度,并加强政府监管。大型医院和基层医疗卫生机构重要的是实现医生资源的自由流动和合理分布。患者还需转变固有的就医观念,才能最终实现有序就医。

氯盐环境下UHPC-NC界面黏结性能试验研究

氯盐环境作为一种较为常见的化学侵蚀环境,研究其对超高性能混凝土(ultra-high performance concrete,UHPC)和普通混凝土(normal concrete,NC)界面耐久性能的影响对于UHPC加固混凝土结构和UHPC-NC组合结构的工程应用均具有重大的现实意义.基于此,通过在常规环境以及氯盐环境下的推出试验,获得了干湿循环次数(0次、25次、50次)、氯盐浸泡天数(0 d、50 d、100 d)及界面处理方式(钢丝刷刷毛、高压水射流冲毛、表面缓凝处理)对UHPC-NC界面黏结强度、界面黏结刚度及界面黏结滑移曲线的影响.结果表明:在100 d试验周期内,干湿循环及氯盐浸泡作用造成的界面黏结强度损失率不超过20%;氯盐环境作用时长的增加会导致界面黏结刚度的降低;随着界面粗糙度的增加,UHPC-NC试件的界面黏结强度以及界面黏结刚度均会增加;界面粗糙度的提高有助于界面抗氯盐侵蚀能力的提升.受到界面处理方法的影响,UHPC-NC试件经历干湿循环及氯盐浸泡后,荷载滑移曲线呈现2种不同的形式,分别对应光滑界面(钢丝刷刷毛界面)和其他界面(高压水射流冲毛界面和缓凝剂处理界面).各组试件的黏结滑移曲线在荷载到达峰值前趋于一致;荷载到达峰值后,前者存在荷载骤降段及持荷段,后者则随着滑移量的增加荷载不断降低.根据UHPC-NC黏结滑移曲线特征,提出了黏结滑移建议模型.

基于AQUATOX模拟的小球藻处理水产养殖废水试验

目的 为实现低碳快捷处理水产养殖废水,探究利用小球藻处理废水的最优方案。方法 以某鲅鱼养殖基地水体为对象,利用AQUATOX软件建立水生态环境模型,根据不同的水产养殖废水浓度、水力停留时间和流量建立5个试验组,稀释后投加5 mg/L的小球藻藻种,模拟分析小球藻的处理效果,并将结果与实测数据进行对比。结果 投加小球藻的最适比例为:ρ(小球藻)∶ρ(TN)∶ρ(NH_(3)-N)∶ρ(TP)∶ρ(CODcr)=1∶16.8∶3.2∶0.8∶40;最适投加比例的小球藻对废水中的TN、TP、NH_(3)-N、CODCr的处理效率分别达到了73%、72.5%、94%、75%;藻生物量也达到了初始值的26倍。结论 应用AQUATOX模型可以快速实现小球藻处理水产养殖废水方案优化,TN、TP、NH_(3)-N和CODcr质量浓度模拟结果的平均相对误差分别为0.32%、2.52%、4.83%和0.10%。