Evolution mechanism and treatment timing of penetrating fissures

The Inner Mongolia mining area in western China are characterized by the development of numerous penetrating fissures,resulting in severe land damage.It is significant to reveal the underlying evolution mechanism and identify treatment timing for restoring the ecological environment.The Guanbanwusu mining subsidence area in Inner Mongolia,China was selected as the research case for this study.The evolution mechanism of different penetrating fissures was revealed by field measurement,physical simulation and theoretical analysis.The treatment timing prediction model for the mining subsidence area was established based on the enhanced Weibull time function.The results show that the ground fissures are mainly step-type and collapse-type fissures.The breaking form of overlying strata determines their vertical opening and horizontal dislocation.The high mining intensity in the western mining area results in a shortened period of dynamic fissure expansion and reduced closure degree.The damage extent of the overlying strata exhibits zoning characteristics both vertically and horizontally.The relative standard deviation of the prediction model is only 3.7%.Concurrently,the prediction model is employed to determine the optimal timing for treatment in the study area,estimated to be 259 days.Subsequently,once this threshold is reached,the study area undergoes treatment and restoration of its e cological environment.This study addresses the knowledge gap in this field by highlighting the interconnectedness between rock strata structure and evolution mechanism of penetrating fissures,thereby providing a method for determining the treatment timing in mining subsidence areas.

EFFECTS OF TREATMENT TIME ON CORROSION OF DIFFUSION-ALLOYED COATINGS OF PURE MAGNESIUM

The corrosion resistance of pure magnesium with surface alloying layer obtained by a solid diffusion alloying technique has been analyzed. To establish the optimum treatment time, the experiments were performed at 480℃ for different solid diffusion time （8, 16, and 24h）. The diffusion interaction effectiveness between Zn, Al mix powder and the sample surface, depending on the treatment time for diffusion at given temperatures, has an obvious influence on corrosion resistance and corrosion mechanism. Corrosion properties were studied using the constant immersion test （in 3.0% NaCl solution, temperature is （28±1）℃, and time is 96h）. Optical microscopy （OM） and EDS （energy dispersive spectrum） composition analysis were used to examine the cross-sectional microstructural characteristics of alloyed layer of treated samples. It is shown that in comparison with the untreated samples, the treated ones possess a better corrosion resistance. The Al5Mg11Zn4 phase, which formed as a continuous phase due to the diffusion of Al, Zn, and Mg elements and subsequent interaction on the outermost layer of diffusion alloying zones （especially the samples treated for 24h at 480℃）, was inert to the chloride solution compared with pure magnesium and acted as a corrosion barrier, and therefore the best corrosion resistance was obtained. This protective action of Al5Mg11Zn4 phase was found to change with its amount, which was controlled by the diffusion time at given temperature. It was concluded that the continuous Al5Mg11Zn4 phase （WP-zone） of the reacted layer in pure magnesium was beneficial from the point of view of corrosion resistance.

Effect of solution treatment time on plasticity and ductile fracture of 7075 aluminum alloy sheet in hot stamping process

The effect of solution treatment time on the post-formed plasticity and ductile fracture of 7075 aluminum alloy in the hot stamping process was studied.Tensile tests were conducted on the specimens subjected to the hot stamping process with different solution treatment time.The digital image correlation(DIC)analysis was used to obtain the strain of the specimen.Based on the experiments and modeling,the Yld2000-3d yield criterion and the DF2014 ductile fracture criterion were calibrated and used to characterize the anisotropy and fracture behavior of the metal,respectively.Furthermore,the microstructure of specimens was studied.The experimental and simulation results indicate that the 7075 aluminum alloy retains distinct anisotropy after the hot stamping process,and there is no obvious effect of extending the solution treatment time on the material anisotropy.However,it is found that a longer solution treatment time can increase the fracture strain of the aluminum alloy during the hot stamping process,which may be related to the decrease of the second-phase particles size.

Vitamin D and calcium are required at the time of denosumab administration during osteoporosis treatment

To evaluate the differences in outcomes of treatment with denosumab alone or denosumab combined with vitamin D and calcium supplementation in patients with primary osteoporosis. Patients were split into a denosumab monotherapy group （18 cases） or a denosumab plus vitamin D supplementation group （combination group; 23 cases）. We measured serum bone alkaline phosphatase （BAP）, tartrate-resistant acid phosphatase （TRACP）-5b and urinary N-terminal telopeptide of type-I collagen （NTX） at baseline, 1 week, as well as at I month and 2, 4, 8 and 12 months. We also measured bone mineral density （BMD） of L1-4 lumbar vertebrae （L）-BMD and bilateral hips （H）-BMD at baseline and at 4, 8 and 12 months. There was no significant difference in patient background. TRACP-5b and urinary NTX were significantly suppressed in both groups from I week to 12 months （except at 12 months for NTX）. In the combination group, TRACP-5b was significantly decreased compared with the denosumab monotherapy group at 2 and 4 months （P 〈 0.05）. BAP was significantly suppressed in both groups at 2-12 months. L-BMD significantly increased at 8 and 12 months （8.9%） in the combination group and at 4, 8 and 12 months （6.0%） in the denosumab monotherapy group, compared with those before treatment. H-BMD was significantly increased in the combination group （3.6%） compared with the denosumab group （1.2%） at 12 months （P 〈 0.05）. Compared with denosumab monotherapy, combination therapy of denosumab with vitamin D and calcium stopped the decrease in calcium caused by denosumab, inhibited bone metabolism to a greater extent, and increased BMD （especially at the hips）.

Determinants of Delay in Malaria Prompt Diagnosis and Timely Treatment among Under-Five Children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia: A Case Control Study

Background: Ensuring prompt diagnosis and timely malaria treatment will prevent most cases of uncomplicated malaria from progressing to severe and fatal illness. To avoid this progression, treatment must begin as soon as possible, generally within 24 hours after symptoms onset. The reason why mothers/caretakers delay in malaria prompt diagnosis and timely treatment for under-five is not well studied in the study area as well as in Ethiopia. Objective: To assess determinants of delay in malaria prompt diagnosis and timely treatment among under-five children in Shashogo Woreda, Hadiya Zone, Southern Ethiopia, 2013. Methods: An unmatched case control study was conducted from March 25-April 25, 2013. A total sample size of 302 with 151 cases and 151 controls were selected by systematic random sampling techniques. Cases were under-five children who had clinical malaria and sought treatment after 24 hours of symptoms onset, and controls were under-five children who had clinical malaria and sought treatment within 24 hours of symptoms onset. Both bivariate and multivariate logistic regressions were done to identify determinant of delay in malaria prompt diagnosis and timely treatment. Results: A total of 151 mothers/caretakers of cases and 151 mothers/caretakers of controls were interviewed. Illiterate mothers (AOR = 7.14;95%CI: 1.10, 46.39), monthly income ≤500 ETB (AOR = 5.49;95%CI: 2.09, 14.45), females sex (AOR = 3.45;95%CI: 1.62, 7.34), distance from health facility >5 km (AOR = 4.31;95%CI: 1.22, 15.23), absence of history of child death (AOR = 4.21;95%CI: 1.514, 11.68), side effects of antimalarial drugs (AOR = 2.91;95%CI: 1.15, 7.33) and khat chewing (AOR = 2.38;95%CI: 1.28, 5.79) were determinants of delay in malaria prompt diagnosis and timely treatment of under-five children. Conclusion: Mother’s education, monthly income, distance from health facility, absence of history of child death, complained about side effects of drugs and khat chewing were predictors of delay of prompt diagnosis and timely malaria treatment. Effective malaria control programs revision would be required to avoid delay of prompt diagnosis and timely treatment for under-five children.

Numerical Simulation of Vacuum Heat Treatment Thermal Hysteresis Time of GH4169 Superalloy Workpiece

A nonlinear finite element model of vacuum heat treatment process was developed. In this model, influence of many factors, such as nonlinear heat radiation, temperature-dependent thermal physical properties of material are considered. The temperature field of GH4169 alloy workpiece during vacuum heat treatment process was calculated using finite element software MSC.Marc, and the thermal hysteresis time of the workpiece was predicted. An experiment of vacuum heat treatment of GH4169 superalloy workpiece was carried out to verify the calculation. The experimental results of temperature profile agree well with the simulated results. This work lays a theoretical foundation for optimizing technical parameter of vacuum heat treatment process.

急性上消化道出血患者内镜检查时机的临床研究

为探讨分析急性上消化道出血(upper gastrointestinal hemorrhage,UGIB)患者消化内镜检查的最佳时机。回顾性分析2020年6月至2022年6月,就诊于北京友谊医院急诊科并接受消化内镜检查的736例急性UGIB患者。根据就诊后内镜检查时间分为急诊内镜组(12 h内)和择期内镜组(12 h后)。比较两组患者一般临床资料、内镜相关资料、介入栓塞率、外科手术率、输血量、30 d内的再出血率、死亡率和平均住院时间。本研究共纳入428名患者,其中326名患者进行了急诊内镜检查(76.2%)。与择期内镜组相比,急诊内镜组心率明显增加(Ρ=0.043)而收缩压降低(Ρ=0.061)。14例(3.3%)患者内镜治疗失败后请血管介入科行经动脉栓塞,6例(1.4%)患者转入普通外科行手术治疗,两组患者没有明显差异(Ρ=0.115,Ρ=0.561)。两组患者平均输血量和住院时间没有明显差异(Ρ=0.138,Ρ=0.799)。30 d内再出血率为10.0%(43/428),急诊内镜组为11.7%(38/326),择期内镜组为4.9%(5/102)(Ρ=0.048)。30 d总死亡率为6.8%(29/428),急诊内镜组和择期内镜组没有差异(7.7%和3.9%,Ρ=0.189)。UGIB患者择期内镜与急诊内镜相比,30 d再出血概率低,介入栓塞率、外科手术率、输血量、30 d死亡率和平均住院时间没有明显差别。UGIB患者在血液动力学稳定后,宜采用择期内镜。

内镜逆行性阑尾炎治疗在小儿阑尾炎中的应用价值

目的探讨内镜逆行性阑尾炎治疗(ERAT)在小儿阑尾炎的应用价值。方法选取2021年1月至2022年6月赣州市人民医院收治的60例急性单纯性阑尾炎患儿为对象,按照随机数表法分为试验组(n=30)和对照组(n=30)。对照组行抗生素治疗,试验组行ERAT治疗。比较两组相关时间指标、并发症发生率、治疗前后白细胞水平。结果试验组的症状缓解时间、白细胞恢复时间、体温恢复时间、住院时间短于对照组,差异有统计学意义(P<0.05);两组的并发症总发生率比较,差异无统计学意义(P>0.05);试验组治疗后1 d的白细胞水平低于对照组,差异有统计学意义(P<0.05);试验组的复发率低于对照组,差异有统计学意义(P<0.05)。结论内镜逆行性阑尾炎治疗方案在小儿单纯性阑尾炎治疗中的应用对促进患儿症状快速缓解、缩短患儿住院时间等均有显著效果,可有效降低患儿复发率。

介入栓塞时机对脑动脉瘤破裂患者效果及神经损伤的影响

目的:探究介入栓塞时机对脑动脉瘤破裂患者效果及神经损伤的影响。方法:选取2021年1月—2023年6月扬州市江都人民医院收治的80例脑动脉瘤破裂患者进行回顾性研究,根据治疗时机分为A组和B组。A组入院3 d后进行介入栓塞治疗,B组入院3 d内进行介入栓塞治疗。比较两组栓塞效果、并发症总发生率、治疗前后美国国立卫生研究院卒中量表(NIHSS)评分及血清神经损伤指标[神经元特异性烯醇化酶(NSE)、S100钙结合蛋白B(S100B)及髓鞘碱性蛋白(MBP)]。结果:B组栓塞效果显著优于A组,并发症总发生率显著低于A组,差异均有统计学意义(P<0.05)。治疗前两组NIHSS评分及血清神经损伤指标比较,差异均无统计学意义(P>0.05);治疗后1、3个月B组NIHSS评分均显著优于A组,治疗后3、7、14 d两组血清神经损伤指标均显著低于治疗前,且B组血清神经损伤指标均显著低于A组,差异均有统计学意义(P<0.05)。结论:早期介入栓塞治疗在脑动脉瘤破裂患者中的应用效果较好,更有助于改善神经功能,减少并发症发生。

支气管镜介入治疗对RMPP患儿的疗效及其对外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值的影响

目的探讨支气管镜介入治疗对难治性肺炎支原体肺炎(RMPP)患儿的疗效及其对外周血C反应蛋白(CRP)、铁蛋白(SF)、白细胞介素(IL)-8水平及CD4^(+)/CD8^(+)比值的影响。方法选取2020年12月至2022年12月河北省儿童医院收治的195例确诊为RMPP患儿作为研究对象,采用随机数字表法分为对照组和介入组(病程≥14 d归为晚期介入组、病程<14 d归为早期介入组)。根据临床疗效将130例接受支气管镜介入治疗的患儿分为有效组和无效组。对照组进行常规治疗,晚期介入组和早期介入组在对照组的基础上实施支气管镜介入治疗。比较对照组、晚期介入组和早期介入组临床疗效、临床症状与体征改善情况;检测并比较对照组、晚期介入组和早期介入组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值;比较对照组、晚期介入组和早期介入组不良反应发生率;比较有效组和无效组外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值。采用受试者工作特征(ROC)曲线分析外周血CRP、SF、IL-8、CD4^(+)/CD8^(+)比值对支气管镜介入治疗RMPP疗效的预测价值。结果早期介入组总有效率高于对照组和晚期介入组,差异均有统计学意义(P<0.05);对照组和晚期介入组总有效率比较,差异无统计学意义(P>0.05)。早期介入组咳嗽持续时间、发热持续时间、住院时间均短于对照组和晚期介入组,差异均有统计学意义(P<0.05)。对照组、晚期介入组和早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于治疗前,CRP、SF、IL-8水平均低于治疗前,差异均有统计学意义(P<0.05);早期介入组治疗后外周血CD4^(+)/CD8^(+)比值均高于对照组和晚期介入组,CRP、SF、IL-8水平均低于对照组和晚期介入组,差异均有统计学意义(P<0.05)。早期介入组出现不良反应8例,晚期介入组出现不良反应10例,均暂停灌洗操作后很快恢复。对照组未出现上述不良反应。无效组外周血CRP、SF、IL-8水平均高于有效组,CD4^(+)/CD8^(+)比值低于有效组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,CRP、SF、IL-8、CD4^(+)/CD8^(+)比值联合检测预测支气管镜介入治疗RMPP无效的曲线下面积、灵敏度、特异度分别为0.871、81.81%、83.80%。结论早期应用支气管镜介入治疗对RMPP的疗效较好,可改善患儿外周血CRP、SF、IL-8水平及CD4^(+)/CD8^(+)比值,且外周血CRP、SF、IL-8、CD4^(+)/CD8^(+)比值联合检测有助于预测支气管镜介入治疗RMPP的疗效。

2013—2023年滁州市输入性疟疾流行病学特征分析

目的了解滁州市输入性疟疾的流行特征,为下一步优化疟疾防控工作策略提供科学依据。方法通过寄生虫病防治信息管理系统和传染病监测系统收集2013年1月—2023年6月滁州市网报输入性疟疾病例的资料,运用Microsoft Excel软件对所有病例的时间分布、感染虫种、感染来源地和就诊情况等进行统计分析。结果滁州市2013年后10年间共网报输入性病例35例,其中恶性疟28例(80.00%)、间日疟2例(5.71%)、卵形疟4例(11.43%)和混合疟1例(2.86%);患者都是青壮年男性,无女性病例;初诊单位以地市级医疗机构和疾控中心为主(19例,54.29%),确诊单位以地市级医疗机构和县级疾控中心为主(26例,74.29%);常见的症状为发热、发冷、多汗和头痛乏力,部分患者出现食欲不振、呕吐和腹泻;诊断时间的算术平均数为5.67 d,最短诊断时间为2 h,最长为78 d;有4例(11.43%,4/35)病例在就诊前自行口服青蒿素类药物;所有病例达到100.00%的正规治疗率,无死亡病例且按照方案对全部间日疟和卵形疟病例进行了休止期根治。结论10年间,滁州市网报病例以境外输入性恶性疟为主,但卵形疟和混合疟病例数有所增加,所以防控输入是目前防控的主要任务,并着重提升乡镇及以下医疗机构的诊断和镜检能力,为防止输入性病例再传播、巩固好消除状态打下坚实的基础。

89例细菌性肝脓肿的临床特征及抗感染治疗分析

目的分析探讨细菌性肝脓肿的临床特征、抗菌药物合理使用情况和疗程。方法回顾青岛市第八人民医院2020年1月1日至2022年12月31日诊断为“细菌性肝脓肿”患者的临床资料,总结临床特征,制定评价标准对抗菌药物合理性进行评价,统计不同治疗结局抗菌药物的使用疗程。结果共89例患者纳入分析,平均年龄(62.0±15.6)岁,男性占61.8%,最常见合并症为糖尿病,占53.9%。59例(66.3%)脓液或血培养阳性患者中,肺炎克雷伯菌51例(57.3%)。经验和目标抗感染治疗中,分别有45例(50.6%)和17例(28.8%)抗菌药物使用不合理。痊愈抗感染疗程(17.0±7.6)d,临床实际抗感染疗程(21.1±7.3)d。结论糖尿病为细菌性肝脓肿的高危因素,以肺炎克雷伯菌感染为主。应加强抗菌药物的管理,探索适宜抗感染疗程,减少抗菌药物的过度使用。

急诊零停顿与急危重症患者一体化救治体系建设探讨

急危重症患者的救治体系是保障人民生命健康的关键环节,本文立足科技赋能,基于胸痛、卒中、创伤、危重孕产妇、危重儿童和新生儿急诊急救五大中心建设,提出急诊零停顿管理目标,从信息管理技术一体化、移动CT和移动卒中单元应用、院前急救即时超声应用、复合手术室应用以及新型急救技术及创新手术团队应用等方面探讨实现急诊零停顿的技术与措施,以提升急危重症患者的救治能力。

基于模式识别技术的光电探测器故障辨识研究

当前光电探测器故障辨识错误率高,为提升光电探测器故障辨识效果,设计了基于模式识别技术的光电探测器故障辨识方法。首先采集光电探测器状态信号,并从光电探测器状态信号中提取特征,然后利用主成分分析算法对特征进行降维处理,得到最优光电探测器状态辨识特征,最后将光电探测器状态特征作为支持向量机的输入,光电探测器状态作为支持向量机输出,通过支持向量机学习设计光电探测器状态辨识器,实验结果表明,本方法可以有效辨识光电探测器辨识故障,光电探测器故障辨识正确率超过了90%,光电探测器故障辨识时间控制在20 ms以内,为光电探测器状态分析提供了理论依据。

青榨槭种子发芽规律研究

为了解青榨槭种子发芽规律,通过种子不同处理,不同贮藏时间对种子进行发芽试验。结果表明:低温湿沙贮藏能显著提高种子的发芽率,种子的发芽率为15.42%,不同处理种子的发芽率存在显著性差异;不同贮藏时间种子发芽率存在显著差异,贮藏时间越长,种子的发芽率越高,随温度提高种子发芽率显著提高。该结果可为青榨槭种苗培育提供重要参考。

Time-resolved Microwave Conductivity Studies on the Chemical Treatment of the Nanocrystalline Porous TiO2 Films

Effect of Ti(iso-C3H7O)4 treatment on the photoinduced charge carrier kinetics of nanocrystalline porous TiO2 films is studied by time-resolved microwave conductivity measurements. Analysis of the transient photoconductivity decays indicates that Ti(iso-C3H7O)4 treatment leads to an increased concentration of photogenerated charge carriers and a fast interfacial transfer rate of holes via the surface modification of the freshly growing TiO2 nanocrystallites.

氯雷他定联合罗红霉素治疗肺炎支原体致上呼吸道感染后咳嗽的疗效

目的观察氯雷他定联合罗红霉素治疗肺炎支原体(MP)致上呼吸道感染后咳嗽的疗效。方法选取2020年1月—2022年12月苏州大学医院内科收治的MP致上呼吸道感染后咳嗽患者112例,按照简单信封随机法分为罗红霉素组与联合治疗组,每组56例。罗红霉素组患者予以罗红霉素,联合治疗组患者在罗红霉素组基础上联合氯雷他定,2组均连续用药5~7 d。比较2组临床疗效,临床相关指标,不良反应。结果联合治疗组治疗总有效率高于罗红霉素组(94.64%vs.71.43%,χ^(2)=10.712,P=0.001)。联合治疗组体温恢复正常时间、咳嗽缓解时间、咳嗽消失时间、住院时间短于罗红霉素组(P<0.05或P<0.01)。治疗期间,联合治疗组不良反应总发生率低于罗红霉素组(7.14%vs.21.43%,χ^(2)=4.667,P=0.031)。结论MP致上呼吸道感染后咳嗽患者采用氯雷他定联合罗红霉素治疗,可增强抗感染疗效,较快地改善咳嗽症状,且用药安全性较高。

内镜诊疗时机对急诊肝硬化食管胃底静脉曲张破裂出血患者救治效果及预后的影响

目的探讨内镜诊疗时机对急诊肝硬化食管胃底静脉曲张破裂出血(EGVB)患者救治效果及预后的影响。方法选取2018年10月至2023年2月河南中医药大学第一附属医院收治的高危急诊肝硬化EGVB患者96例进行回顾性分析和随访,根据内镜诊疗时机不同分为A组(35例,入院后0~6 h内行内镜诊疗)、B组(29例,入院后6~12 h内行内镜诊疗)和C组(32例,入院后12~24 h内行内镜诊疗),比较3组治疗情况(出血部位检出率、止血成功率、再出血率、死亡率)、输血量、住院时间、住院费用。并根据患者生存情况分为存活组(86例)和死亡组(10例),比较两组临床资料,采用多因素logistic回归分析影响高危急诊肝硬化EGVB患者预后的因素。结果A组和B组出血部位检出率高于C组(P<0.05);A组和B组比较,差异无统计学意义(P>0.05);B组止血成功率高于A组和C组(P<0.05);A组和C组比较,差异无统计学意义(P>0.05);3组再出血率和死亡率比较,差异无统计学意义(P>0.05)。3组输血量、住院时间、住院费用比较,差异无统计学意义(P>0.05)。存活组和死亡组腹水征、血钠、ALT、AST比较,差异有统计学意义(P<0.05);多因素logistic回归分析显示,腹水征、血钠降低是影响高危急诊肝硬化EGVB预后的危险因素(P<0.05)。结论高危急诊肝硬化EGVB患者于入院后6~12 h内行内镜诊疗可提高患者救治效果,但入院后0~6 h内行内镜诊疗需更多临床循证证据,且腹水征、血钠降低是影响患者预后的因素。

妊娠期口腔急症的临床考量

妊娠期是口腔疾病患病和治疗的特殊时期,妊娠期发生的口腔急症需得到恰当的处置。一方面,孕妇生理环境、个人习惯的改变增加了部分口腔疾病的易患性;另一方面,为了保证孕妇和胎儿安全,临床治疗策略局限。孕妇应掌握口腔健康知识、增强口腔保健意识。口腔医生应在“孕前预防,孕期治标,孕后治本”的原则下,根据不同的妊娠时期制定合适的治疗方案,以最安全、简单、有效的手段控制急症、防止疾病进展,避免对孕妇和胎儿的不良影响。防治结合,让孕妇和口腔医生共同维护妊娠期口腔健康。本文围绕妊娠期治疗原则,对妊娠期口腔急症治疗的时机选择、临床管理和不同疾病的治疗策略等进行了总结。

史锁芳治疗感染后咳嗽经验

史锁芳教授认为感染后咳嗽病位在肺,涉及肝脾,病理因素多责之于风、痰、火。临床治疗可根据病程分阶段论治:初期重在宣透,处方以三拗汤加质轻性浮之品;中期以清解郁热为主,辅以疏风散邪,常用桑叶、桑白皮、薄荷等;晚期清热养阴、润肺益气,处方可选麦门冬汤、沙参麦冬汤、清燥救肺汤加减。同时,史教授还善用“风四药”(桑叶、菊花、全蝎、僵蚕)疏风解痉止咳。对于难治性感染后咳嗽,史教授遵循因人制宜、因时制宜原则,因势利导,常获佳效。附验案2则。