Laparoscopic-assisted catheter insertion for continuous ambulatory peritoneal dialysis:A case report of simple technique for optimal placement

A 40-year-old male underwent tube placement surgery for continuous ambulatory peritoneal dialysis(CAPD).A2-cm skin incision was made,and the peritoneum was reflected enough to perform secure fixation.A swannecked,double-felted silicone CAPD catheter was inserted,and the felt cuff was sutured to the peritoneum to avoid postoperative leakage.An adequate gradient for tube fixation to the abdominal wall was confirmed.The CAPD tube was passed through a subcutaneous tunnel.Aeroperitoneum was induced to confirm that there was no air leakage from the sites of CAPD insertion.Two trocars were placed,and we confirmed that the CAPD tube led to the rectovesical pouch.Tip position was reliably observed laparoscopically.Optimal patency of the CAPD tube was confirmed during surgery.Placement of CAPD catheters by laparoscopic-assisted surgery has clear advantages in simplicity,safety,flexibility,and certainty.Laparoscopic technique should be considered the first choice for CAPD tube insertion.

Novel Formula for Calculation of the Optimal Insertion Depth for Cuffed Endotracheal Tubes in Pediatric Major Surgery

Background: Accurate determination of the optimal insertion depth of a pediatric endotracheal tube (ETT) is quite important. The aim of this study was to create an easily available formula that can be used to determine the optimal insertion depth for a cuffed ETT even without depth marking with clear definitions of the upper and lower limits for the tip of ETT in the trachea in clinical practice. Methods: Eighty children under 12 years of age were enrolled. The depth marking of the cuffed ETT was placed at the vocal cords and both lungs were then auscultated using a stethoscope. The upper limit was radiographically defined as the position of the tip of the cuffed ETT being between the clavicles. The lower limit was defined as a distance of 5 mm above the carina. The relationship between the insertion depth and patient characteristics was analyzed to create a formula for optimal ETT insertion depth. Results: Sixty-nine ETTs were optimally placed in the trachea. There were good correlations between the optimal insertion depth of ETTs and patients characteristics (height (R = 0.92);BSA (R = 0.92);weight (R = 0.91);age (R = 0.88)). Using these patient characteristics, we created the following three formulas for calculation of the optimal insertion depth for pediatric cuffed ETTs: insertion depth (cm) = height (cm)/11 + 5.5, weight (kg)/3 + 9.5 or 11 + 3/4 × age (years). The rates of appropriate tube placement of both pediatric cuffed ETTs were 87.5% (Hi-Contour) and 85.0% (Microcuff). Conclusions: Our formula and graphs may be easy to determine the optimal insertion depth of cuffed ETT even without depth marking in clinical practice.

Deformation behaviors of 21-6-9 stainless steel tube numerical control bending under different friction conditions

For contact dominated numerical control(NC) bending process of tube, the effect of friction on bending deformation behaviors should be focused on to achieve precision bending forming. A three dimensional(3D) elastic-plastic finite element(FE) model of NC bending process was established under ABAQUS/Explicit platform, and its reliability was validated by the experiment. Then, numerical study on bending deformation behaviors under different frictions between tube and various dies was explored from multiple aspects such as wrinkling, wall thickness change and cross section deformation. The results show that the large friction of wiper die-tube reduces the wrinkling wave ratio η and cross section deformation degree ΔD and increases the wall thinning degree Δt. The large friction of mandrel-tube causes large η, Δt and ΔD, and the onset of wrinkling near clamp die. The large friction of pressure die-tube reduces Δt and ΔD, and the friction on this interface has little effect on η. The large friction of bending die-tube reduces η and ΔD, and the friction on this interface has little effect on Δt. The reasonable friction coefficients on wiper die-tube, mandrel-tube, pressure die-tube and bending die-tube of 21-6-9(0Cr21Ni6Mn9N) stainless steel tube in NC bending are 0.05-0.15, 0.05-0.15, 0.25-0.35 and 0.25-0.35, respectively. The results can provide a guideline for applying the friction conditions to establish the robust bending environment for stable and precise bending deformation of tube bending.

Reverse Solution and Parametric Design of the Conjugate Cam Weft Insertion Mechanism Based on VB.NET and UG

In order to realize the parametric design of the conjugate cam weft insertion mechanism,according to the necessary parameters of weft insertion process,ideal kinematic curves of the weft insertion mechanism were given,and the mathematical model of reverse solution for this mechanism was established.The parameters of this mechanism were obtained by reverse solution on the basis of the given ideal kinematic curves and kinematic requirements.The parametric design platform which was integrated with the functions of parametric reverse solution,motion simulation,three-dimensional modeling and virtual assembly was developed based on VB.NET and Unigraphics(UG) NX.After entering the technological parameters of weft insertion process and essential structural parameters by users,three-dimensional drawing of the main parts such as the conjugate cam and shaft,can be obtained by this platform,also the processing data of the cam can be calculated.This platform provides a rapid approach for parametric design of weft insertion mechanism.

A novel technique to insert nasogastric tube for the anesthetized patients during cervical esophageal reconstruction

We are describing a novel technique to insert nasogastric tube （NGT） in the anesthetized patients dur- ing cervical esophageal reconstruction. Methods： Forty patients with mid and upper esophageal tumor enrolled into this study were randomly allocated into two groups （the control group, group C and the novel method group, group N）. All the patients were applied mechanical anastomosis to finish the cervical esophageal reconstruction. The procedure of NGT insertion for group C use the conventional method; well, the group N use the novel technique. Results： All the patients in group N had been finished the NGT insertion in the first attempt, and the total time for insertion was （5.05 ＋ 1.15） mins; on the contrary, for the group C, duration of insertion （min） was （24.45 ± 5.23） mins, and the successful rate of NGT insertion in the first attempt was 40% （P〈 0.05）; no one in group N had coiling/kinking, and 6/20 （30%） in group C had it （P= 0.020）. The complication rate of bleeding between the two group had no significant difference. Conclusion： For the patient with mid and upper esophageal tumor who need cervical esophageal reconstruction, this novel method can save the NGT insertion time, and make it easier with higher successful rate.

Air-flow Analysis for BCF Texturing Tube

In this paper,the Reynolds number,velocity,pressureand kinetic energy of the BCF processing hot air-floware analyzed with the help of the aero-dynamic theory,and their distributions inside the texturing tube are ob-tained by pressure measuring.

内置扭带管Cu-水纳米流体的流动和传热特性

为了研究纳米流体在内置扭带管表面传热特性及流动特性,设计并建立一套纳米流体表面传热实验系统,Reynolds数(Re)在2 000-7 000的范围内,分别对质量分数为0.1%,0.3%和0.5%的Cu-水纳米流体在不同扭转比的内置扭带管中的传热特性进行实验研究。结果表明:随着Re增加,Cu-水纳米流体和去离子水的沿程阻力系数均减少;水的沿程阻力系数小于Cu-水纳米流体,内置扭带管的沿程阻力大于光管,且随着扭转比的增大而减少;Nusselt数(Nu)随Re和纳米颗粒质量分数的增大而增大;Cu-水纳米流体的Nu比水高,质量分数为0.5%的Cu-水纳米流体在Y=3.5与Y=5.5的内置扭带管的增强幅度分别为2.29与2.14;内置扭带管的Nu比光管大,且随扭转比增大而减少。

一种真耳-耦合腔差值(RECD)测量方法的有效性研究

目的考察一种新的真耳-耦合腔差值（real-ear-to-coupler difference，RECD）测量方法——探管固定同步介入法（tube fixation and synchronous insertion method,TFSI）的可行性和有效性。方法对20例（40耳）受试者（成人和儿童各10例）分别应用传统方法和TFSI方法进行RECD测量，考察两种方法测量结果的一致性；对13例受试者（26耳）运用TFSI方法进行两次RECD测量，考察两次测量结果的一致性。结果采用传统方法和TFSI方法测得的RECD值差异不显著（P〉0．05）；采用TFSI方法先后两次测得的RECD值差异不显著（P〉0．05）；TFSI方法耗时（平均2．15分钟）明显少于传统方法（平均6．03分钟）（P〈0．05）。结论TFSI方法可以准确、有效测量RECD，其耗时较短、可重复性好。

优选前胶辊为NFR-W0358型纺制CJ 5.8 tex纱的分析

通过优选NFR-W0358型铝衬管表面不处理胶辊为纺特细号纱所使用的前胶辊的生产实践,说明其具有优良的抗绕性,良好的耐磨性,硬度稳定性好,可作为纺CJ 5.8 tex以上特细号纱的首选前胶辊。

Intraoperative Gastric Tube Intubation: A Summary of Case Studies and Review of the Literature

Study Objective: Establish complications and risk factors that are associated with blind tube insertion, evaluate the validity of correct placement verification methods, establish the rationales supporting its employment by anesthesia providers, and describe various deployment facilitators described in current literature. Measurements: An exhaustive literature review of the databases Medline, CINAHL, Cochrane Collaboration, Scopus, and Google Scholar was performed applying the search terms “gastric tube”, “complications”, “decompression”, “blind insertion”, “perioperative”, “intraoperative” in various order sequences. A five-year limit was applied to limit the number and timeliness of articles selected. Main Results: Patients are exposed to potentially serious morbidity and mortality from blindly inserted gastric tubes. Risk factors associated with malposition include blind insertion, the presence of endotracheal tubes, altered sensorium, and previous tube misplacements. Pulmonary aspiration risk prevention remains the only indication for anesthesia-related intraoperative use. There are no singularly effective tools that predict or verify the proper placement of blindly inserted gastric tubes. Current placement facilitation techniques are perpetuated through anecdotal experience and technique variability warrants further study. Conclusion: In the absence of aspiration risk factors or the need for surgical decompression in ASA classification I & II patients, a moratorium should be instituted on the elective use of gastric tubes.

Influence of Thermal Load on Mechanical Property of Cemented Carbide Material and Heavy Cemented Carbide Inserts Life

A large amount of cutting heat is produced during the heavy cutting process,and insert life is restricted by the effect of thermal load.The thermal load experiment of cemented carbide SCS,WF and YT15 is carried out,and the results show that the bending strength and fracture toughness of cemented carbide material decrease obviously under cyclic thermal load,while in the cooling process,the material mechanical property changes worse suddenly.The high-temperature mechanical property of SCS is the most stable,and that of YT15 is the worst.Further,a relation model among cutting temperature,cutting parameters and insert life is established.Finally,the measures to improve heavy cemented carbide inserts life are summarized from the aspects of cutting parameters selection,insert optimization design and TiCN,Al2O3,TiN complex insert coating.The research results are expected to provide support and reference for heavy cutting technology and insert technology.

Advanced glycation end products induce neural tube defects through elevating oxidative stress in mice

Our previous study showed an association between advanced glycation end products （AGEs） and neural tube defects （NTDs）. To understand the molecular mechanisms underlying the effect of AGEs on neural tube development, C57BL/6 female mice were fed for 4 weeks with com- mercial food containing 3% advanced glycation end product bovine serum albumin （AGE-BSA） or 3% bovine serum albumin （BSA） as a control. After mating mice, oxidative stress markers including malondialdehyde and H202 were measured at embryonic day 7.5 （E7.5） of ges- tation, and the level of intracellular reactive oxygen species （ROS） in embryonic cells was determined at E8.5. In addition to evaluating NTDs, an enzyme-linked immunosorbent assay was used to determine the effect of embryonic protein administration on the N-（carboxymethyl） lysine reactivity of acid and carboxyethyl lysine antibodies at E10.5. The results showed a remarkable increase in the incidence of NTDs at El0.5 in embryos of mice fed with AGE-BSA （no hyperglycemia） compared with control mice. Moreover, embryonic protein administration resulted in a noticeable increase in the reactivity of N-（carboxymethyl） lysine and N（ε）-（carboxyethyl） lysine antibodies. Malondialdehyde and H2O2 levels in embryonic cells were increased at E7.5, followed by increased intracellular ROS levels at E8.5. Vitamin E supplementation could partially recover these phenomena. Collectively, these results suggest that AGE-BSA could induce NTDs in the absence of hyperglycemia by an underlying mechanism that is at least partially associated with its capacity to increase embryonic oxidative stress levels.

Application of color structured light pattern to measurement of large out-of-plane deformation

Measurement of out-of-plane deformation is significant to understanding of the deflection mechanisms of the plate and tube structures.In this study,a new surface contouring technique with color structured light is applied to measure the out-of-plane deformation of structures with one-shot projection.Through color fringe recognizing,decoding and triangulation processing for the captured images corresponding to each deformation state,the feasibility of the method is testified by the measurement of elastic deflections of a flexible square plate,showing good agreement with those from the calibrated displacement driver.The plastic deformation of two alloy aluminum rectangular tubes is measured to show the technique application to surface topographic evaluation of the buckling structures with large displacements.

基于GT-Power某MPV进气噪声优化设计

文章对某MPV进气系统进行优化,通过试验和分析该段噪声的特性及产生的机理,通过对空滤器出气管出气管的优化设计降低这显著噪声,改善了整车NVH性能,提高了产品竞争力。

Effect of abrasive blasting on the internal surface of L80-13Cr tubing and casing

In this study,two sandblasting textures,namely,quartz and high-chromium(Cr)stainless steel sands,were used for sandblasting of the internal surface L80-13Cr tubing and casing.The contrastive analysis on the properties of the pipes before and after abrasive blasting was conducted,including the metallographic phase detection of the internal surface,simulating accelerated corrosion tests,and residual stress tests for the pipe after abrasive blasting.Based on the analysis results,it is explained why the API standard requires that no scale appears on the internal surface of L80-13Cr and iron contamination when internal sandblasting media are applied.The results show that abrasive blasting can effectively remove scales on the internal surface of L80-13Cr tubing and casing and improve corrosion resistance.The abrasive blasting process does not produce obvious residual stress on the internal surface of the tubing and casing.Also,the de-rusting effect of stainless sand is better than that of quartz sand,and the former does not produce iron contamination.

Qualitative study on influencing factors of refusal of gastric tube placement in stroke patients with dysphagia

Objective:To explore the influencing factors of patients with dysphagia after stroke who refuse to accept gastric tube implantation,and to provide intervention basis for improving the compliance of patients with gastric tube implantation.Methods:Asemi-structured interview method was used to conduct in-depth interviews with 11 patients who refused gastric tube placement,and the interview data were analyzed by Colaizzi analysis method.Results:The influencing factors of patients with dysphagia after stroke can be summarized into the following three themes:patient factors(patient's cognition of disease,patient's subjective pain perception and fear),family factors(patient's caregiver's cognition of disease,economic conditions)and medical factors(trust in medical staff,medical education methods).Conclusion:Medical staff should understand the influencing factors of dysphagia after stroke and take positive measures to improve the compliance of patients with gastric tube placement and ensure the treatment effect.

HX-9812三层胶管的研制和应用

介绍了三层复合结构的HX 9812胶管的主要技术性能和试纺情况。通过与天津、无锡、美国等胶辊的纺纱对比 ,证明该胶管适纺性强 ,改善条干CV %值效果明显 。

重氮试验在盲插鼻肠管时末端位置判断中的应用效果研究

目的探讨重氮试验在盲插鼻肠管后末端位置判断的应用效果。方法采用便利抽样法,选取2021年9月至2022年1月山东省某三级甲等医院重症监护病房(intensive care unit,ICU)进行盲插鼻肠管术的216名患者为研究对象。采用重氮试验、测pH值、观察回抽液性质三种方式预测鼻肠管末端位置,以X线摄片为判定的金标准,确认鼻肠管末端位置。比较重氮试验及其他两种方式预测的准确率、敏感度、特异度、阳性结果预测值(positive predictive value,PPV)、阴性结果预测值(negative predictive value,NPV)、阳性似然比(positive likelihood ratio,PLR)、阴性似然比(negative likelihood ratio,NLR)等指标。结果pH值判断的敏感度为97.7%、NPV为84.0%、NLR为0.045;回抽液性质判断的特异度为82.9%、PPV为95.5%、PLR为4.912;重氮试验方式的准确率为92.6%、Kappa系数为0.755;受试者操作特征曲线下面积最大为0.870,95%CI(0.793,0.947)。结论重氮试验判断盲插鼻肠管末端位置的准确率、一致性较好,具有较高的临床预测价值。

无相变液-液换热设备的优化设计和强化技术(Ⅰ)

介绍无相变液-液换热设备的优化设计方法以及强化传热技术。强化技术包括扩面强化管的应用、折流杆换热器和流化床换热器的应用以及管内插入物强化和静态混合器技术。

HM-JL740型短车全自动集体落纱装置使用体会

为了解决细纱短车落纱工序劳动强度大、用工多等问题,分析目前纺织行业用工现状及存在问题,介绍HM-JL740型短车全自动集体落纱装置特点及改造注意事项,并对1.5万锭纺精梳18.2tex纱改造后与人工落纱的成本及效果进行对比。指出:该装置运行稳定可靠,各项指标均达到预期水平,在落纱过程能全自动完成操作,缩短落纱时间,提高管纱质量,并省去空纱管整理程序、满纱人工落纱及空管插入时间,提高劳动生产率,减轻劳动强度,减少用工数量,降低生产成本。