Effect of a disposable endoscope precleaning kit in the cleaning procedure of gastrointestinal endoscope:A multi-center observational study

BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.

Theoretical study of(e,2e) triple differential cross section of 1b3g orbital of ethylene by vibrational multi-center distorted-wave method

The vibrational motions are usually neglected when calculating(e,2e) triple differential cross sections(TDCSs) of molecules. Here, multi-center distorted-wave method(MCDW) has been modified by including molecular vibrations. This vibrational MCDW method is employed to calculate the TDCSs of 1b3gorbital of ethylene at low(100 eV) and medium(250 eV) incident electron energies in coplanar asymmetric kinematic condition. The results show that molecular vibrations significantly influence the angular distributions of the TDCSs, especially in the binary region along momentum transfer near the Bethe ridge.

CLINICAL REPORT ON MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF TREATMENT OF MIGRAINE BY ELECTRO-ACUPUNCTURE AT QI■X■(丘墟GB40)

Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.

Probing the structure of multi-center molecules with odd–even high harmonics

We study high-order harmonic generation(HHG)from multi-center asymmetric linear molecules numerically and analytically.Our simulations show that odd and even HHG spectra of the asymmetric multi-center system respond differently to the change of the molecular structure.Specifically,when the internuclear distances between these nuclei of the molecule have a small change,the odd spectra usually do not change basically,but the even spectra differ remarkably.Based on this phenomenon,a simple procedure is proposed to probe the positions of these nuclei with odd–even HHG.Our results shed light on attosecond probing of the structure of multi-center molecules using HHG.

Minimum MSE Weights of Adjusted Summary Estimator of Risk Difference in Multi-Center Studies

The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a treatment effect in multi-center studies, we propose minimum MSE (mean square error) weights of an adjusted summary estimate of risk difference under the assumption of a constant of common risk difference over all centers. To evaluate the performance of the proposed weights, we compare not only in terms of estimation based on bias, variance, and MSE with two other conventional weights, such as the Cochran-Mantel-Haenszel weights and the inverse variance (weighted least square) weights, but also we compare the potential tests based on the type I error probability and the power of test in a variety of situations. The results illustrate that the proposed weights in terms of point estimation and hypothesis testing perform well and should be recommended to use as an alternative choice. Finally, two applications are illustrated for the practical use.

Multi-Order and Multi-Center Metallogenic Zoning of Yinshan Cu-Au Polymetallic Ore Deposit,Jiangxi Province,China

Yinshan anticline is the product of tectono-dynamic deformation - metamorphism .Along the axis of the anticline exists a brittle-ductile shearing zone which obviously controls the ore-formation . Mineralization occurs along the axis of the anticline in a width of about 1000m .In the mining area .volcano- subvolcanic rocks of Early Yanshan period are divided into three cycles :Ⅰ intermediate acidic dacite lava and dacite porphyry ;Ⅱ acidic amphibole liparite and quartz porphyry;Ⅲ intermediate andesite porphyrite . Among them activities of ⅠandⅡ cycles are more intensive and are intimately related to the mineralization . Yinshan ore deposit is the result of combinative processes of tectono -dynamic and volcano -magmatic hydrothermal fluids, so that mere are two centers of metallogenic zoning, one being the axial strain zone of Yinshan anticline which is the center of first order, and the other being porphyry stock , 2nd order.

Theoretical study of (e,2e) triple differential cross sections of pyrimidine and tetrahydrofurfuryl alcohol molecules using multi-center distorted-wave method

We report theoretical studies of electron impact triple differential cross sections of two bio-molecules,pyrimidine and tetrahydrofurfuryl alcohol,in the coplanar asymmetric kinematic conditions with the impact energy of 250 eV and ejected electron energy of 20 eV at three scattering angles of-5°,-10°,and-15°.Present multi-center distorted-wave method well describes the experimental data,which was obtained by performing(e,2e)experiment.The calculations show that the secondary electron produced by the primary impact electron is strongly influenced by the molecular ionic multi-center potential,which must be considered when the low energy electron interacts with DNA analogues.

The Volume Effect and Safety of 6% Hydroxyethyl Starch 130/0.4 in Patients Undergoing Major Elective Surgery: An Uncontrolled, Open-Labeled, Multi-Center Study

Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven&#174) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4;for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.

Xi-Feng-Hua-Shi granules for diarrhea-predominant irritable bowel syndrome:protocol for a randomized,double-blind,placebo-controlled multi-center clinical trial

Background:Irritable bowel syndrome(IBS)is a common functional bowel disorder that can severely affect the quality of life of patients.Limited drugs have been reported for modern medical IBS treatment.The advantages of traditional Chinese medicine(TCM)treatment are gradually becoming prominent.Xi-Feng-Hua-Shi granules have been clinically used for diarrhea-predominant IBS(IBS-D)treatment for many years in TCM practice.Thus,this study aimed to further verify the effectiveness and safety of Xi-Feng-Hua-Shi(XFHS)granules in IBS-D treatment through a randomized,double-blind,placebo-controlled multi-center clinical trial and provide high-quality evidence for its effectiveness and safety in treatment,as well as provide a basis for clinical rational drug use and explore new clinical IBS-D treatment plans.Methods:A randomized,double-blind,placebo-controlled multi-center clinical trial will be performed in 23 hospitals.A total of 300 participants will be randomly divided into the experimental group(prescribed with XFHS granules)and the control group(prescribed with the placebo granules),with 150 participants in each group.The appearance,shape,color,and taste of the placebo granules are the same as those of XFHS granules.All participants will receive a 4-week treatment and a 6-month follow-up.The primary outcome is the overall clinical efficacy;the secondary outcomes are the IBS-Symptom Severity Score(IBS-SSS),TCM Syndrome Evaluation,and the IBS-Quality of Life(IBS-QoL)score,mental state assessment,and recurrence rate.Outcome measures(including primary and secondary outcome measures)are collected at baseline,as well as 2,4,16,and 28 weeks post-intervention.Discussion:This randomized,placebo-controlled,multi-center trial may provide high-quality evidence for the clinical XFHS granule efficacy in IBS-D treatment.Additionally,this study will conduct safety evaluations to provide a basis for clinical rational drug use.

Minimally invasive perventricular VSD closure without cardiopulmonary bypass mid-term results from multi-centers

Objective Transesophageal echocardiography (TEE) guided,minimally invasive perventricular device occlusion of ventricular septal defects (VSDs) without cardiopulmonary bypass (CPB) has been applied in multiple centers. We reported experiences and the mid-term results. Methods Four hundred and thirty-two cases from 4 cardiac centers were involved in the study. There were 235 maled and 197 females,aged from 3 months to 15 years,with a body weight varying from 4.0 to 26.0 kg.

Generating attosecond pulses with controllable polarization from cyclic H_(3)^(2+) molecules by bichromatic circular fields

We investigate the polarization properties of harmonics from the cyclic H_(3)^(2+) molecular ions in tailored bichromatic counter-rotating circularly polarized(BCCP)fields by solving the time-dependent Schrödinger equation.The allowed harmonics and their helicities are associated with the symmetry compatibility of the field-target systems,and large intensity difference between adjacent harmonics with opposite helicities appears in a wide spectral range when the BCCP field is at certain rotation angles.We try to explain the intensity difference by using a recombination model based on the quantum-orbit theory and by analyzing the ionization pathways.Moreover,to synthesize attosecond pulse trains with tunable polarization,the intensity difference is manipulated by introducing a seed XUV field,and by changing the relative amplitude ratio as well as the helicity of BCCP fields.

多GPU系统的高速互联技术与拓扑发展现状研究

多GPU系统通过横向扩展实现性能提升,以满足人工智能日趋复杂的算法和持续激增的数据所带来的不断增长的计算需求。对于多GPU系统而言,处理器间的互联带宽以及系统的拓扑是决定系统性能的关键因素。在传统的基于PCIe的多GPU系统中,PCIe带宽是限制系统性能的瓶颈。当前,面向GPU的高速互联技术成为解决多GPU系统带宽限制问题的有效方法。本文首先介绍了传统多GPU系统所采用的PCIe互联技术及其典型拓扑,然后以Nvidia NVLink、AMD Infinity Fabric Link、Intel X^(e) Link、壁仞科技BLink为例,对国内外代表性GPU厂商的面向GPU的高速互联技术及其拓扑进行了梳理分析,最后讨论了关于互联技术的研究启示。

A Study on the Relationship Between Skin Sensitivity and Lifestyle, Skin Conditions

Investigate the self-assessment of the skin sensitivity degree of Chinese cosmetic consumers,and explore the differences in lifestyle and skin conditions among consumers with different degrees of skin sensitivity.The study selected 716 female participants from different cities,and collected relevant data through questionnaire surveys,instrument tests,and other methods.The results found that the participants who self-assessed as having sensitive skin had a lower average age,frequency of skin care,frequency of makeup,and years of makeup.The proportion of choosing medical cosmetology and staying up late was higher,the skin was more elastic,the skin tone was more biased towards red,there were more red areas,and the skin texture was better(p<0.05).The research results can be used to guide the development of cosmetics to meet the needs of consumers with different degrees of skin sensitivity.

综合考虑内外生不确定性的绿色数据中心多域资源协同规划方法

数字经济下,发展以“高能源效率、低环境影响”为主要特征的绿色数据中心(green data center,GDC)是应对碳中和挑战和促进社会可持续发展的重要举措。如何科学配置供需侧资源,在满足服务质量约束的前提下,充分利用数据用户的互动响应潜力促进系统提质增效,是未来公有型GDC规划面临的难点。为此,该文基于信息-物理-社会耦合视角,在深入分析不同类型数据负载运行特性的基础上,引入后悔度匹配方法模拟数据用户参与GDC需求响应(GDC demand response,GDC-DR)意愿的中长期动态演化。基于动态预想场景,综合考虑数据用户参与GDC-DR意愿等内生不确定性和可再生能源发电出力、数据负载需求等外生不确定性的影响,提出一种GDC多域资源协同规划模型。模型以系统综合效益最大化为目标,同时考虑设备运行、服务质量等多域约束,通过对GDC设备容量、需求响应激励价格以及各预想场景下系统运行策略进行协同优化,以充分发掘数据负载灵活性潜力,实现系统经济性和碳中和效益的综合趋优。算例仿真结果验证了该文所提模型和方法的有效性。

数据中心间接蒸发冷却热管多联的应用研究

数据中心在信息时代扮演着至关重要的角色。然而,随着运算复杂性的提升和设备数量的增长,能源消耗和散热问题日益凸显。文章深入分析了数据中心领域中间接蒸发冷却热管多联系统的应用,详细剖析其技术原理、运行机制以及实际应用表现。经过系统的构建和实际应用验证,该技术在提高数据中心散热效率、实现节能降耗以及模块化搭建方面展现出卓越的特性。

REDCap系统APP功能部署及实践研究

随着移动应用技术服务的普及与发展,队列研究中使用手机作为媒介越来越普遍,由于调查研究现场情况复杂、传统的纸质问卷难以满足后期多维数据分析的需求,容易产生调查对象依从性差、随访追踪困难等问题,REDCap(Research Electronic Data Capture)系统APP(Application)能够以极低成本建立本地及多中心手机应用服务、快速建立调查队列、网络故障问卷数据本地暂存、安全等级高、最大限度保护调查对象隐私等方面解决多中心队列研究的问题,本文介绍了REDCap系统APP如何部署及其实践应用介绍。

考虑数据中心用能时空可调的多区域能源站协同规划

数字经济背景下,数据中心用能规模日益增长,数据中心用能在时间、空间尺度上的灵活性引起了广泛关注。为充分挖掘数据中心用能灵活性资源、促进综合能源系统资源优化配置,文中在计及电、气、热、冷多能转换互补、多区域互联互济、能量流-数据流深度耦合的基础上,提出了一种考虑数据中心用能时空可调的多区域能源站协同规划模型。首先,对数据负载及数据中心能耗进行建模,并分析了数据中心用能的时空可调特性。然后,以总成本最小为目标构建了考虑数据中心用能时空可调的多区域能源站规划模型。最后,根据是否考虑数据中心用能时空可调特性设置了3个场景进行对比分析,基于中国天津市某实际算例验证了考虑数据中心用能时空可调特性在提高设备利用率、降低投资成本等方面的积极作用。

城市体系结构演变、产业动态集聚与空间效率优化协同

随着城市化水平提升和城市集群化发展,优化城市体系空间结构成为释放我国区域效率潜能的重要动力。经过学术史梳理可以发现,处于不同国家、不同区位的城市体系,其空间结构效率存在明显差异,因此并不能断定究竟单中心还是多中心结构更有利于效率提升。文章认为,脱离产业动态调整过程来静态评价城市体系的空间效率是片面的。原因在于,对于产业净流出的区域,无论何种空间结构,其效率损失的概率更高。因此,文章将企业进入和退出某地区的过程融入产业动态集聚指标构建,同时在对折旧率和资本存量重新测算的基础上对城市生产率进行测算,并采用空间计量模型对影响城市体系空间效率的作用机制进行检验。研究发现,扁平化的多中心结构更有利于地区生产率提升,但需要兼顾产业集聚动态变化的影响,该结果进一步说明忽略企业进入和退出某地区的过程可能导致结果是有偏的,同时缺乏解释力。进一步研究表明,多中心结构使城市规模效率得到显著改善,却不利于技术进步率和技术效率的改进。研究还发现,京津冀和长江中游城市群的多中心特征偏弱,且空间效率尚待进一步优化。相比之下,长三角和珠三角城市群的多中心结构与产业动态集聚形成了良好的协同效应。此外,考虑产业可能在城市体系内部动态调整,从而产生城市间生产率的不均衡分布。研究表明,多中心结构与产业动态集聚有利于城市生产率协同,但同时发现其更有利于大规模城市的效率提升,反而限制了小城市的发展。该结果影射出在多中心结构形成的过程中,大规模城市依然是利益最大攫取者。尽管空间计量模型可以弱化内生效应,但为降低结果偏误,文章参照现有研究分别采用城市地表粗糙度和区域河流密度作为产业集聚和城市体系的工具变量,其结果并未出现根本性变化。文章同时采用调整赫芬达尔指数、变换首位度指数和人均GDP进行稳健性检验,以增强研究结论的可信度。影响机制检验结果表明,产业在各城市集聚的过程加速了多中心城市体系结构的形成,而市场一体化又有效释放了多中心结构的空间效率。因此,应当深化城市体系结构演进与产业动态集聚的耦合协同关系,推进市场一体化以进一步释放效率潜能。同时,在突出中心城市主导地位的同时,更加注重中小城市协调发展,在双循环的发展框架下促进城市体系内部的良性循环。

A Study on The Factors Influencing the Facial Apparent Age of Chinese Cosmetic Consumers

To investigate the apparent age of Chinese cosmetic consumers and its influencing factors.The subjects’skin conditions in all dimensions were collected using professional instruments and clinical expert assessment,subjects’lifestyles,skin care and makeup habits were obtained through questionnaire.The apparent age of the subjects was obtained based on the visual perception of photos judged by observers and then averaged.The association between apparent age and skin characteristics,the association between the difference between apparent age and actual age and the subjects'lifestyle and its difference among cities were investigated.The results showed that apparent age had a high correlation with skin tone and severity of skin problems.The model of multiple regression analysis obtained a high resolution(R2=0.704).The use of skin care products may help to delay the apparent aging of the skin.The results of the study have some guiding significance for the development of anti-aging products and the evaluation of anti-aging efficacy and is informative for lifestyle choices to maintain youthfulness.

基于多中心疾病登记系统的膜性肾病中医主要证型分布特征分析

【目的】分析特发性膜性肾病(IMN)患者临床诊疗数据,探讨IMN患者中医证型分布特征及影响因素,以期丰富对IMN中医证型的认识,为研究IMN的主要病机和中医临床诊治提供一定依据。【方法】基于IMN临床研究电子数据采集系统,采用横断面调查方法,分析多中心来源的187例IMN患者的临床诊疗数据,归纳其中医证型分布规律;根据IMN的危险分层将患者分为低风险组、中风险组、高风险组3组,并根据地域将患者分为广东组和黑龙江组2组,分析不同IMN的危险分层及地域对中医证型分布特征的影响。【结果】(1)中医证候分布情况:187例患者中,分布频率居前3位的分别为:小便混浊或有明显泡沫尿167例(89.30%),舌苔腻、舌胖大或齿痕158例(84.49%),水肿134例(71.65%);中医证型分布情况:湿阻证频次最高,共169例(90.37%),其次为气虚证165例(88.24%)、血瘀证89例(47.59%)。(2)分组情况:187例患者中,低风险组102例(54.54%)、中风险组54例(28.88%)、高风险组31例(16.58%);广东组147例(78.61%),黑龙江组40例(21.39%)。(3)IMN证型分布的影响因素中,在IMN的危险分层方面,低风险组患者中湿阻证的占比为83.33%(85/102),中风险组为98.15%(53/54),高风险组为100.00%(31/31),3组患者的湿阻证比例比较,差异有统计学意义(P=0.002);在地域方面,广东组和黑龙江组的瘀血证比例分别为55.10%(81/147)和20.00%(8/40),不同地域的血瘀证比例比较,差异有统计学意义(P<0.001);在兼夹证型方面,高风险组的气虚血瘀湿阻证比例[64.52%(20/31)]明显高于低风险组和中风险组的34.31%(35/102)、38.89%(21/54);广东组的气虚血瘀湿阻证比例[46.94%(69/147)]明显高于黑龙江组的17.50%(7/40),而气虚湿阻证比例[31.97%(47/147)]明显低于黑龙江组的60.00%(24/40),差异均有统计学意义(P<0.05)。【结论】本研究归纳和分析了IMN患者的中医证候、中医证型分布规律及其影响因素,探讨了湿证在IMN疾病发生中的关键作用,这对于进一步揭示湿证内涵、促进IMN中医证候研究具有重要意义。