Evidence-based treatment for acute spinal cord injury

OBJECTIVE： To formulate an evidence-based treatment for one patient with acute spinal cord injury and summarize evidence for evaluating acute spinal cord injury treatment. METHODS： Studies related to the treatment for acute spinal cord injury were identified via a search of National Guideline Clearinghouse （NGC, 2000 11）, the Cochrane Library （Issue 1,2011）, TRIP Database （2000 11）, and PubMed （1966-2011）. Treatment strategies were formulated according to three basic principles： best evidence, doctor＇s professional experience, and wishes of the patient. RESULTS： A total of 34 articles were selected, including 1 NGC guideline, 22 systematic reviews, and 11 randomized controlled trials. Based on our review, we arrived at the following recommendations： no clinical evidence exists definitively to recommend the use of any of neuroprotective pharmaceuticals; surgery should be undertaken early; mechanical compression devices and low-molecular weight heparin should be employed to prevent thrombosis; respiratory muscle training is beneficial for pulmonary function and quality of life; and functional electrical stimulation and acupuncture can promote functional recovery. The patient accordingly underwent surgery 6 hours after trauma without receiving any neuroprotective pharmaceuticals; low-molecular weight heparin and intermittent pneumatic compression were applied to prevent thrombosis. He also underwent respiratory muscle training daily for 8 weeks and received functional electrical stimulation for 15 minutes and acupuncture for 30 minutes every day. After follow-up for 3 months, the above therapeutic regimen was confirmed efficacious for acute spinal cord injury. CONCLUSION： Evidence-based medicine provides an individualized treatment protocol for acute spinal cord injury, which can significantly improve the therapeutic effect and prognosis.

Morphological evolution of γ'precipitates in a nickel-based superalloy during various solution treatments

The morphological evolution of the γ' phase in nickel-based superalloy жc6y during various solution heat treatments was investigated. The significant changes of the γ' precipitates were observed in the solution-treated samples. The coarsening and dissolution of γ' phase simulta-neously occurred at intermediate temperatures. In some areas, the primary precipitates became blunt and the adjacent ones were intercon-nected with each other via a diffuse neck, indicating a coarsening process of the primary γ' population. The coarsening was dominated by the precipitate agglomeration mechanism (PAM) rather than by the well-known Ostwald ripening mechanism. In other areas, the partial dissolu-tion of the γ' precipitates began to occur, spreading gradually from dendrite cores to interdendritic regions. In addition, a flower-like γ' struc-ture was developed during the subsolvus solution treatments. The observable long filaments composed of erraticly shaped precipitates were caused by the heterogeneous nucleation of the cooling precipitates during water quenching.

INVESTIGATION OF MULTI-STEP THERMO-MECHANICALTREATMENT OF CAN-FORGED TiAl-BASED ALLOY

The effects of a new technology, multi-step thermo-mechanical treatment, on the microstructure, deformation substructure and mechanical properties at ambient and elevated tempemture of can-forged Ti-33 Al-3 Cr-0.5Mo (wt%) Alloy were investigated.The results show that, after multi-step thermo-mechanical treatment of can-forged specimens, homogeneous, fine microstructures can be obtained in the whole TiAl-based alloy specimens. Furthermore, the specimen with homogeneous and fine full lamellae microstructure demonstrutes excellent comprehensive mechanical properties at ambient and elevated temperature.

High-temperature tribological behaviors of Ti_2AlNb-based alloys by plasma surface duplex treatment

Plasma tungstening followed by carburization(W-C duplex treatment)was performed on the Ti2AlNb-based(O phase) alloy by using the double glow plasma process to enhance its wear resistance.The microstructure and high-temperature tribological behaviors of the un-treated and W-C duplex-treated samples were investigated.The results show that the duplex-treated layer is mainly composed of W2C or W6C2.54 phases and the contents of W and C elements in the alloyed layer change gradually along the depth by surface plasma duplex treatment.The diffusion depth of W is about 12μm,while the carbon atoms most exist in the depth more than 12μm.High temperature tribometer tests indicate that the friction coefficient of the W-C duplex-treated layer is approximately 1/6 that of substrate.The wear rate of the duplex-treated layer is about 28%that of the untreated one.So,plasma surface W-C duplex treatment can obviously improve the high-temperature tribological resistance of Ti2AlNb-based alloy.The tribological mechanism of the duplex-treated layer is discussed by dividing the friction process of the duplex-treated layer into three fluctuate stages.The first stage is the formation of oxide film between W-C duplex-treated layer and counterface.The second stage is the detachment of oxide film,acting as "the third body" .The last stage is the period that the friction and wear occur between the compact particle layer and counterface.

Effects of electric-field treatment on a Ni-base superalloy

The effects of electric-field treatment on the microstructure and deformation behavior of a nickel-base superalloy were summarized.The results show that the electric-field treatment increases the ductility of the superalloy but has no evident influence on its static strength at both room and elevated temperatures,while,the strength increases but elongation changes weekly with the increasing tensile strain rate.It is found that the direction of microcrack propagation can be changed by the presence of the annealing twins during the tensile deformation,and it causes the increasing of the plastic deformation energy and delay of the fracture,which is considered as the reason for the increasing the ductility.

Morphology and quantitative analysis of O phase during heat treatment of hot-deformed Ti_2AlNb-based alloy

A 1040°C-hot-deformed Ti_2AlNb-based alloy solution-treated at 950°C and aged at different temperatures was quantitatively investigated. The microstructure, size of the phase, and microhardness of the deformed alloys were measured. The results indicated that the microstructure of the deformed Ti_2AlNb-based alloy specimens comprise coarse O lath, fine O lath, equiaxed O/α_2, and acicular O phase. More O phase was generated in the deformed alloy after heat treatment because the acicular O phase was more likely to nucleate and grow along the deformation-induced crystal defects such as dislocations and subgrain boundaries. After deformation and subsequent heat treatment, the acicular O phase of the resultant alloy became finer compared to that of the undeformed alloy, and the acicular O phase became coarser and longer with the elevated aging temperature, while the width of the O lath exhibited unobvious variations. The hot deformation facilitated the dissolution of the O lath but accelerated the precipitation of the acicular O phase. When the 950°C-solution-treated deformed Ti_2AlNb-based alloy was then aged at 750°C for different periods, the phase content was nearly invariable, O and B2 phases eventually reached equilibrium, and the microstructure became stable and homogeneous.

Effect of heat treatment on microstructure and high temperature tensile properties of cast nickel-base superalloy with high W, Mo and Nb contents

The microstructural features and high temperature tensile properties of M963 superalloy at as cast, as solutioned and as aged conditions were investigated in detail. The results show that the solution treatment at 1?220?℃ for 4?h, AC causes an increase in high temperature yield strength but a drastic drop in high temperature ductility due to the precipitation of both the secondary carbide M 6C along grain boundaries and at the interdendritic regions and very fine γ ′ particles in the dendrite cores. Aging treatment following the solution treatment can improve the high temperature tensile properties of M963 superalloy due to the coarsing of the γ′ precipitate. One stage aging at 850?℃ for 16?h following the solution treatment causes an increase in both strength and ductility of alloy M963, and two stage aging of 1?089?℃ / 2?h, AC plus 850?℃ / 16?h, AC following the solution treatment further increases the ductility of alloy M963 but slightly decreases its strength.

Research on the treatment based on syndrome differentiation of COVID-19 according to the theory of Guangwenyilun

COVID-19 is highly infectious and epidemic,which belongs to the"plague"disease of traditional Chinese medicine and seriously endangers the safety of human life.Based on the theory of Guangwenyilun combined with the treatment experience of COVID-19 in TCM,syndrome differentiation-based treatment and the clinical characteristic of COVID-19 is being deeply analysed.COVID-19 began because of the"epidemic pathogenic factors",and the pathogenesis is that the dampness and heat generated toxin which blocked the qi movement.The early onset of this disease is in the pleurodiaphragmatic interspace,and its transmission can be divided into sequential transmission and reverse transmission.Regardless of the direction of its transmission,grasping the transmission of"epidemic pathogenic factors"on the diagnosis and treatment combined with"five distinguishing thought,exterior and interior,accompanying symptoms"theory will be of great importance to help to improve the effect of treatment.At the same time,this clinical approach will also provide reference for the diagnosis and treatment of any possible new diseases.

Effect of heat treatment on the microstructure and hardness of C-Cr-W-Mo-V-RE Fe-based hardfacing layer

After different heat treatment processes, the metal compound, the microstructure and the hardness of the C-Cr-W- Mo-V-RE Fe-based hardfacing layers are investigated by means of metallographic microscope, X-ray diffraction （ XRD ）, energy dispersive spectrum（ EDS ）, transmission electron microscope（TEM） and hardness tester. The results show that the hardfacing layers have higher tempering stability and secondary hardening property. After quenching at 820 ℃ ,the hardness value（ HRC37 ） and the microstructure of the layers are similar to that normalized at 820 - 1 000 ℃. The tempering stability and the hardness increases with increasing quench temperature, which is attributed to the amount of the alloy element in the matrix. These results are very helpful for improving the mechanical properties of the hardfacing layers.

Discussion on the thinking innovation of the “Treatment based on syndromedifferentiation” according to “Precision medical”

Based on the concept of ＂precision medicine＂, this paper is to probe into the thinking innovation thought anddevelopment direction of ＂dialectical theory＂ of TCM, and to compare the development prospects of ＂syndromedifferentiation＂ and ＂genetic constitution＂. It points out that the dialectical concept of ＂syndrome differentiation andtreatment＂ is combined with the concept of high and new technology of ＂precision medicine＂ to further clarify thescientific connotation of traditional Chinese medicine.

Application of Stone Needle Therapy Based on Blood Stasis Theory in the Treatment of 36 Cases of Knee Osteoarthritis in Early and Middle Stage

Objective:To evaluate the clinical efficacy of stone needle therapy based on blood stasis theory for different traditional Chinese medicine(TCM)syndrome types of patients with knee osteoarthritis in early and middle stage.Methods:Totally 36 patients with knee osteoarthritis were enrolled in the orthopaedic ward between March 2016 and December 2017,and diagnosed as qi stagnation and blood stasis syndrome,cold dampness and stasis syndrome,or phlegm and stasis syndrome according to TCM syndrome differentiation.After treatment,stone needle was used for ironing on the different meridian acupoints according to different syndrome.The efficacy of patients with the above three syndromes was respectively evaluated,and the visual analogue scale(VAS)score and western ontario and mcMaster universities arthritis Index(WOMAC)score of the three groups were calculated before treatment,2 weeks,and 4 weeks after treatment.Results:The effective rates of the three groups were 86.67%,81.82%,and 80.00%,respectively.After 2 weeks and 4 weeks of treatment,the VAS and WOMAC scores of the three groups decreased significantly compared to treatment before(P<0.05).Conclusion:Stone needle therapy for ironing on the acupoints around the knee joint has a good therapeutic effect on knee osteoarthritis of different syndrome types,which is worthy of further application.

Effect of Heat Treatment Temperature on Properties of Chinese Calcined Flint Clay Based Plastic Refractories

Effects of different heat treatment temperatures on properties of Chinese calcined flint clay based plastic refractories were investigated using Chinese calcined flint clay as starting material, aluminum sulfate and fireclay as binding system. The results showed that with temperature rising, Chinese calcined flint clay based plastic refractories shrinked firstly and then expanded. The modulus of rupture （MOR） and the cold crushing strength （CCS） inereased firstly and then decreased from 110 ℃ to 600 ℃ , then increased obviously. Thermal expansion coefficient increased from 110 ℃ to 760 ℃, decreased from 760 ℃ to 1 300 ℃ , and increased from 1 300 ℃ to1500 ℃.

Microstructural evolution of a forged TiAl based alloy during heat treatment at subtransus temperature

Microstructural evolution of a forged TiAl based alloy during heat treatment from 1 180 ℃ to 1 300 ℃ was investigated. The grain sizes of the alpha phases as well as the sizes and the volume fractions of the gamma phases were evaluated as a function of heat treatment temperature and time. When the alloys are isothermally heat treated at subtransus temperatures, the sizes of gamma phases(D γ) increase slightly with heat treatment temperature and time and those of alpha phases(D α) and the volume fractions of gamma phases(φ γ) vary significantly with holding time in the early stages of heat treatments, but after heat treatments for 2 h, φ γ reveal little variations with holding times and D α approach limits, which can be described by D α0 =0.65D γ/φ γ. Besides, it has been found that the alpha phases in the specimens heat treated at 1 260 ℃ and 1 300 ℃ contain lamellar structures, at low temperatures, however, appear featureless.

Kinetic study on deep dephosphorization treatment of liquid steel by BaO-based fluxes

Laboratory study was carried out on deep dephosphorization of liquid steel byBaO-based fluxes at 1600°C to achieve ultra low phosphorus level in the steel. A dynamic model ofdephosphorization of Liquid steel by BaO-based fluxes was established. According to the model, thecontrolling step of dephosphorization by BaO-based fluxes was the mass-transfer of phosphorus insteel phase under the condition of low phosphorus liquid steel. It is estimated that the apparentrate constant of dephosphorization by BaO-based fluxes was 0.4xl0^(-3)-8.2xl0^(-3) g/(cm^2 centre tos) and the mass-transfer coefficient of phosphorus in bulk steel was 0.025-0.04 cm/s.

Progress of traditional Chinese Medicine on ADHD Treatment Based on Syndrome Differentiation

Attention-Deficit Hyperactivity Disorder(ADHD)is a common neurodevelopmental disorder in childhood.Syndrome differentiation for ADHD in traditional Chinese medicine is complex without common uniform,it is important to propose unified standards.Based on the principle of syndrome differentiation,this article focused on the different names of different syndrome differentiation methods but the same essence,and summarized Chinese medicine compounds according to syndrome factors.By collecting relevant literature on ADHD treatment with Chinese herbal compound in recent years,ADHD is classified into 7 different syndrome types,and Chinese herbal compound is classified correspondingly for reference and selection of clinical treatment of ADHD.

A NEW HEAT TREATMENT PROCESSING FOR TiAl BASED ALLOY

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Effect of Heat-Treatment Process on Properties of Rare Earth Mg-Based System Hydrogen Storage Alloys with AB_3-Type

The effect of heat-treatment process on the properties of Mm0.8Mg0.2(NiCoAlMn)3.5 hydrogen storage alloy was discussed . The electrochemical properties such as cycling stability, activation property, and the plateau voltage of the alloy which was heat-treated in various temperatures and times had different changes during the cycle process, the optimum heat-treatment conditions of this alloy were determined by this work.

Effectiveness of Family-Based Behavioral Treatment Based on Medication Behavior Barkley Compared with Drug Therapy in Reducing the Symptoms of Children with Attention Deficit Disorder-Hyperactivity

Children with attention deficit and hyper activity disorder have various problems such as low academic performance, social and communication problems, anxiety, depression, aggression, conduct disorder and delinquency, and also when they become adults, they have problems in social relationships that these problems can increase or decrease in dealing with family. Hence, this study was performed in order to examine the impact of family-based behavioral treatment compared with Barkley behavior therapy in reducing symptoms of children with attention deficit disorder—ADHD. To meet the aim, 20 of children with age range of 7 to 12 years old with attention deficit disorder—hyperactivity were selected in both experimental and control groups, and exposed to the treatment of behavioral family therapy groups and changes in behavior Barkley. Before and after the treatment, they were evaluated according to the scale of the Conner’s Parent Rating Scale-Revised Short Form (CPRS-R: S). Results of multivariate analysis of covariance indicated that there were significant differences between the experimental group who had received family-based behavioral treatments based on changes in behavior Barkley and a control group who had received drug treatment in variables, including conduct problems, learning problems, psychosomatic symptoms, and signs of impulsive hyperactivity, anxiety and hyperactivity (p < 0.01). These results could be guidance for counsel or sand therapists for children with attention deficit disorder—ADHD.

论基于“病、证、征结合”方剂的主治表述

目前对方剂主治的规范性研究较少,通过对方剂主治源流的梳理并分析《方剂学》教材中方剂主治描述中存在的问题,提出“病、证、征结合”3个层次的方剂主治描述规范,从而有利于临证依法用方、规范教材和规范方剂的科学研究。