BACKGROUND Among the most frequent hip fractures are trochanteric fractures,which usually occur from low-energy trauma like minor falls,especially in older people with osteoporotic bones.AIM To evaluate the treatment ...BACKGROUND Among the most frequent hip fractures are trochanteric fractures,which usually occur from low-energy trauma like minor falls,especially in older people with osteoporotic bones.AIM To evaluate the treatment efficacy of dynamic condylar screws(DCS)and proximal femoral nails(PFN)for unstable intertrochanteric fractures.METHODS To find pertinent randomized controlled trials and retrospective observational studies comparing PFN with DCS for the management of unstable femoral intertrochanteric fractures,a thorough search was carried out.For research studies published between January 1996 and April 2024,PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar were all searched.The complete texts of the papers were retrieved,vetted,and independently examined by two investigators.Disputes were settled by consensus,and any disagreements that persisted were arbitrated by a third author.RESULTS This study included six articles,comprising a total of 173 patients.Compared to the DCS,the PFN had a shorter operation time[mean difference(MD):-41.7 min,95%confidence interval(95%CI):-63.04 to-20.35,P=0.0001],higher success rates with closed reduction techniques[risk ratio(RR):34.05,95%CI:11.12-104.31,P<0.00001],and required less intraoperative blood transfusion(MD:-1.4 units,95%CI:-1.80 to-1.00,P<0.00001).Additionally,the PFN showed shorter fracture union time(MD:-6.92 wk,95%CI:-10.27 to-3.57,P<0.0001)and a lower incidence of reoperation(RR:0.37,95%CI:0.17-0.82,P=0.01).However,there was no discernible variation regarding hospital stay,implant-related complications,and infections.CONCLUSION Compared to DCS,PFN offers shorter operative times,reduces the blood transfusions requirements,achieves higher closed reduction success,enables faster fracture healing,and lowers reoperation incidence.展开更多
Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly p...Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.展开更多
Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few s...Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few scholars have explored the unstable evolution of railway slopes under the joint action of rainfall-vibration.Based on the model test of sandy soil slope,the unstable evolution process of slope under locomotive vibration,rainfall,and rainfall-vibration joint action conditions was simulated in this paper.By comparing and analyzing the variation trends of soil pressure and water content of slope under these conditions,the change laws of pore pressure under the influence of vibration and rainfall were explored.The main control factors affecting the stability of slope structure under the joint action conditions were further defined.Combined with the slope failure phenomena under these three conditions,the causes of slope instability resulting from each leading factor were clarified.Finally,according to the above conclusions,the unstable evolution of the slope under the rainfall-vibration joint action was determined.The test results show that the unstable evolution process of sandy soil slope,under the rainfall-vibration joint action,can be divided into:rainfall erosion cracking,vibration promotion penetrating,and slope instability sliding three stages.In the process of slope unstable evolution,rainfall and vibration play the roles of inducing and promoting slide respectively.In addition,the deep cracks,which are the premise for the formation of the sliding surface,and the violent irregular fluctuation of soil pressure,which reflects the near penetration of the sliding surface,constitute the instability characteristics of the railway slope together.This paper reveals the unstable evolution of sandy soil slopes under the joint action of rainfall-vibration,hoping to provide the theoretical basis for the early warning and prevention technology of railway slopes.展开更多
Central venous catheterization(CVC) is an invasive procedure for administering fluids,nutrients,and drugs;monitoring central venous pressure;performing pulmonary artery catheterization;and placing transvenous pacemake...Central venous catheterization(CVC) is an invasive procedure for administering fluids,nutrients,and drugs;monitoring central venous pressure;performing pulmonary artery catheterization;and placing transvenous pacemakers in intensive care units and all specialties,from anesthesia to emergency medicine,for the treatment of trauma and hemodynamically unstable pediatric and adult patients.[1,2]Complications have been observed in more than 15% of patients who underwent CVC.Mechanical,infectious,and thrombotic complications have been reported in 5%–19%,5%–26%,and 2%–26% of patients,respectively.[3] Malposition,on the other hand,is common in subclavian catheter insertion and is usually associated with an initially misplaced guidewire.[4]展开更多
Robotic percutaneous coronary intervention(R-PCI)is a novel technology in which operators can manipulate guidewires and catheter devices in interventional cardiology.This approach provides great benefits to interventi...Robotic percutaneous coronary intervention(R-PCI)is a novel technology in which operators can manipulate guidewires and catheter devices in interventional cardiology.This approach provides great benefits to interventional cardiologists in terms of reducing both radiation exposure and orthopedic injuries.Several large,high-quality cohort studies have confirmed the short-term safety and high technical success rate of R-PCI.However,randomized long-term data are still needed before adopting them as part of standard coronary interventions.Furthermore,tele-stenting for complex coronary lesions has significant potential for R-PCI.We need to overcome the present relevant challenges for its application such as inherent delays,bedside care for unstable patients from R-PCIs to manual PCIs(M-PCIs),incompatibility for a thrombus aspiration catheter and heavily calcified lesions.There is a great future in laboratory workflow teams,3D-printed anatomical models and multiple joint collaborative control algorithms.This narrative review summarizes the latest developments in R-PCI,with a focus on developments in robotic technology,and discusses the current and future potential use of R-PCI in clinical practice globally.展开更多
The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-...The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-conducting gases encapsulated in containers with no-slip boundaries and isothermal top and bottom walls.An initial linear temperature profile is assumed.A map of the possible convective modes is presented assuming the height of the region and the value of the temperature gradient as influential parameters.For a relatively small height,isobaric convection is found to take place,which is taken over by an adiabatic mode when the height exceeds the critical value,or by a super-adiabatic mode in case of a relatively high temperature gradient.In the adiabatic mode,convective flow develops due to adiabatic processes given a stable initial stratification.An analytic formula for the critical height of the region is derived taking into account and neglecting the dependence of the gas viscosity on the temperature.Moreover,an analytic formula is obtained for the upper boundary of the region of applicability of the Boussinesq approximation for incompressible gases.These models for compressible gases are relevant to practical situations such as the study of convective flows in spatially extended gas mixtures when dealing with safety issues related to hydrocarbons stored in gas stations.A dangerous situation arises when the tank is almost empty but some hydrocarbon is left at the bottom of the tank.In the presence of convective flows,the vaporized fuel is mixed with the oxidizer(air)forming a gas-vapor medium.However,if the volumetric concentration of fuel vapor(hydrocarbon)is in the interval between the lower and upper concentration limits of ignition,then the gas-vapor mixture becomes explosive and any accidental spark is sufficient to cause an emergency.展开更多
BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperativ...BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.展开更多
In 2023, momentous changes of a like not seen in a century accelerated across the globe. The world as a whole was in a period of turbulence and change: regional conflicts cropped up, major-country competition became m...In 2023, momentous changes of a like not seen in a century accelerated across the globe. The world as a whole was in a period of turbulence and change: regional conflicts cropped up, major-country competition became more complex, climate change deteriorated, and the scientific and technological revolution accelerated. The international security situation was worrisome, against which China demonstrated its sense of duty as a responsible country. Looking forward to 2024, in the face of an unstable, uncertain, and insecure external environment, China will advance its four global initiatives in a coordinated manner, contributing positive energy to the world.展开更多
At present,the growth momentum of the world economy is clearly insufficient,and faced with many unstable,uncertain and unpredictable factors,the world economy is generally on a downward path.From the perspective of tr...At present,the growth momentum of the world economy is clearly insufficient,and faced with many unstable,uncertain and unpredictable factors,the world economy is generally on a downward path.From the perspective of trend changes,the world economy will still be in the process of reshaping its growth momentum in 2024,with positive factors accumulating but downward pressure remaining.展开更多
Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) ...Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) from India. Our aim is to study the clinical and epidemiological profile of ACS PATIENTS presenting to our institute, including their angiographic features. Methods: This hospital-based observational, single tertiary care center, prospective study was conducted on patients admitted in the Department of Cardiology at a tertiary care center in Haryana. The study included 400 patients aged greater than 18 years who were admitted with the diagnosis of ACS, and it was carried out for 1 year. The epidemiological profile, clinical history, risk factors, electrocardiogram findings, and angiographic pattern were studied and analyzed with appropriate statistical tools. Results: The mean age of the study population was 55.12 ± 11.78 years. Male and female ratio was 2.4:1. The majority of the patients came from rural background (80%);24% of the patients were illiterate. Smoking was the most common risk factor (51.5%) in our study population followed by hypertension (40%) and diabetes (28%). Unstable angina was the most common type of ACS, which was found in 68.25% of patients. Premature CAD was found in 27.8% of patients and obstructive CAD was found in 63% of patients. Coronary angiography revealed that 39% had single vessel disease (SVD), 23.5% had double vessel disease (DVD), and 27.5% had triple vessel disease (TVD). LAD was more commonly involved, followed by RCA and LCX. Within the first 24 hours, 67% of patients sought medical assistance and only 38.5% received definitive treatment, suggesting a delay in seeking definitive treatment in our study population. Conclusion: The study suggests that unstable angina is the most common form of ACS in the study population, which is mostly of rural background with significant delay in seeking medical help. Smoking is the most common risk factor in the study population.展开更多
Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However...Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.展开更多
Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and ...Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and Conclusion The criteria for singular points, closed orbits and hyperbolic equilibrium points of a second order autonomous Birkhoff system are given. Moreover the stability of equilibria, stable manifolds and unstable manifolds are obtained.展开更多
A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Takin...A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Taking Ti-6.5Al-3.5Mo-1.5Zr-0.3Si alloy as the testing material, the thermomechnical parameter windows of the unstable deformation zones for the Ti-alloy are integrated into a commercial finite element simulation software platform. The distribution and variation of the unstable deformation zones of the alloy in hot compression process are simulated and predicted using the tailor-made finite element codes in the finite element platform. The simulation results tally with the physical experiments and the proposed method for simulation and prediction of the unstable deformation is thus verified and its efficiency is validated.展开更多
Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames...Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.展开更多
This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtai...This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtained.展开更多
An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, clo...An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, cloud data de-noising optimization, construction, display and operation of three-dimensional model, model editing, profile generation, calculation of goaf volume and roof area, Boolean calculation among models and interaction with the third party soft ware. Concerning this system with a concise interface, plentiful data input/output interfaces, it is featured with high integration, simple and convenient operations of applications. According to practice, in addition to being well-adapted, this system is favorably reliable and stable.展开更多
文摘BACKGROUND Among the most frequent hip fractures are trochanteric fractures,which usually occur from low-energy trauma like minor falls,especially in older people with osteoporotic bones.AIM To evaluate the treatment efficacy of dynamic condylar screws(DCS)and proximal femoral nails(PFN)for unstable intertrochanteric fractures.METHODS To find pertinent randomized controlled trials and retrospective observational studies comparing PFN with DCS for the management of unstable femoral intertrochanteric fractures,a thorough search was carried out.For research studies published between January 1996 and April 2024,PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar were all searched.The complete texts of the papers were retrieved,vetted,and independently examined by two investigators.Disputes were settled by consensus,and any disagreements that persisted were arbitrated by a third author.RESULTS This study included six articles,comprising a total of 173 patients.Compared to the DCS,the PFN had a shorter operation time[mean difference(MD):-41.7 min,95%confidence interval(95%CI):-63.04 to-20.35,P=0.0001],higher success rates with closed reduction techniques[risk ratio(RR):34.05,95%CI:11.12-104.31,P<0.00001],and required less intraoperative blood transfusion(MD:-1.4 units,95%CI:-1.80 to-1.00,P<0.00001).Additionally,the PFN showed shorter fracture union time(MD:-6.92 wk,95%CI:-10.27 to-3.57,P<0.0001)and a lower incidence of reoperation(RR:0.37,95%CI:0.17-0.82,P=0.01).However,there was no discernible variation regarding hospital stay,implant-related complications,and infections.CONCLUSION Compared to DCS,PFN offers shorter operative times,reduces the blood transfusions requirements,achieves higher closed reduction success,enables faster fracture healing,and lowers reoperation incidence.
文摘Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.
基金supported by the Major Research Plan of the National Natural Science Foundation of China(Grant No.42027806)the Key Programme of the Natural Science Foundation of China(Grant No.41630639)National Natural Science Foundation of China General Program(Grant No.42372324).
文摘Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few scholars have explored the unstable evolution of railway slopes under the joint action of rainfall-vibration.Based on the model test of sandy soil slope,the unstable evolution process of slope under locomotive vibration,rainfall,and rainfall-vibration joint action conditions was simulated in this paper.By comparing and analyzing the variation trends of soil pressure and water content of slope under these conditions,the change laws of pore pressure under the influence of vibration and rainfall were explored.The main control factors affecting the stability of slope structure under the joint action conditions were further defined.Combined with the slope failure phenomena under these three conditions,the causes of slope instability resulting from each leading factor were clarified.Finally,according to the above conclusions,the unstable evolution of the slope under the rainfall-vibration joint action was determined.The test results show that the unstable evolution process of sandy soil slope,under the rainfall-vibration joint action,can be divided into:rainfall erosion cracking,vibration promotion penetrating,and slope instability sliding three stages.In the process of slope unstable evolution,rainfall and vibration play the roles of inducing and promoting slide respectively.In addition,the deep cracks,which are the premise for the formation of the sliding surface,and the violent irregular fluctuation of soil pressure,which reflects the near penetration of the sliding surface,constitute the instability characteristics of the railway slope together.This paper reveals the unstable evolution of sandy soil slopes under the joint action of rainfall-vibration,hoping to provide the theoretical basis for the early warning and prevention technology of railway slopes.
文摘Central venous catheterization(CVC) is an invasive procedure for administering fluids,nutrients,and drugs;monitoring central venous pressure;performing pulmonary artery catheterization;and placing transvenous pacemakers in intensive care units and all specialties,from anesthesia to emergency medicine,for the treatment of trauma and hemodynamically unstable pediatric and adult patients.[1,2]Complications have been observed in more than 15% of patients who underwent CVC.Mechanical,infectious,and thrombotic complications have been reported in 5%–19%,5%–26%,and 2%–26% of patients,respectively.[3] Malposition,on the other hand,is common in subclavian catheter insertion and is usually associated with an initially misplaced guidewire.[4]
文摘Robotic percutaneous coronary intervention(R-PCI)is a novel technology in which operators can manipulate guidewires and catheter devices in interventional cardiology.This approach provides great benefits to interventional cardiologists in terms of reducing both radiation exposure and orthopedic injuries.Several large,high-quality cohort studies have confirmed the short-term safety and high technical success rate of R-PCI.However,randomized long-term data are still needed before adopting them as part of standard coronary interventions.Furthermore,tele-stenting for complex coronary lesions has significant potential for R-PCI.We need to overcome the present relevant challenges for its application such as inherent delays,bedside care for unstable patients from R-PCIs to manual PCIs(M-PCIs),incompatibility for a thrombus aspiration catheter and heavily calcified lesions.There is a great future in laboratory workflow teams,3D-printed anatomical models and multiple joint collaborative control algorithms.This narrative review summarizes the latest developments in R-PCI,with a focus on developments in robotic technology,and discusses the current and future potential use of R-PCI in clinical practice globally.
文摘The fully nonlinear equations of gas dynamics are solved in the framework of a numerical approach in order to study the stability of the steady mode of Rayleigh-Bénard convection in compressible,viscous and heat-conducting gases encapsulated in containers with no-slip boundaries and isothermal top and bottom walls.An initial linear temperature profile is assumed.A map of the possible convective modes is presented assuming the height of the region and the value of the temperature gradient as influential parameters.For a relatively small height,isobaric convection is found to take place,which is taken over by an adiabatic mode when the height exceeds the critical value,or by a super-adiabatic mode in case of a relatively high temperature gradient.In the adiabatic mode,convective flow develops due to adiabatic processes given a stable initial stratification.An analytic formula for the critical height of the region is derived taking into account and neglecting the dependence of the gas viscosity on the temperature.Moreover,an analytic formula is obtained for the upper boundary of the region of applicability of the Boussinesq approximation for incompressible gases.These models for compressible gases are relevant to practical situations such as the study of convective flows in spatially extended gas mixtures when dealing with safety issues related to hydrocarbons stored in gas stations.A dangerous situation arises when the tank is almost empty but some hydrocarbon is left at the bottom of the tank.In the presence of convective flows,the vaporized fuel is mixed with the oxidizer(air)forming a gas-vapor medium.However,if the volumetric concentration of fuel vapor(hydrocarbon)is in the interval between the lower and upper concentration limits of ignition,then the gas-vapor mixture becomes explosive and any accidental spark is sufficient to cause an emergency.
文摘BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.
文摘In 2023, momentous changes of a like not seen in a century accelerated across the globe. The world as a whole was in a period of turbulence and change: regional conflicts cropped up, major-country competition became more complex, climate change deteriorated, and the scientific and technological revolution accelerated. The international security situation was worrisome, against which China demonstrated its sense of duty as a responsible country. Looking forward to 2024, in the face of an unstable, uncertain, and insecure external environment, China will advance its four global initiatives in a coordinated manner, contributing positive energy to the world.
文摘At present,the growth momentum of the world economy is clearly insufficient,and faced with many unstable,uncertain and unpredictable factors,the world economy is generally on a downward path.From the perspective of trend changes,the world economy will still be in the process of reshaping its growth momentum in 2024,with positive factors accumulating but downward pressure remaining.
文摘Background: Cardiovascular diseases are the leading cause of death in India, with coronary artery disease (CAD) accounting for a majority of the deaths. There are few large registries on acute coronary syndrome (ACS) from India. Our aim is to study the clinical and epidemiological profile of ACS PATIENTS presenting to our institute, including their angiographic features. Methods: This hospital-based observational, single tertiary care center, prospective study was conducted on patients admitted in the Department of Cardiology at a tertiary care center in Haryana. The study included 400 patients aged greater than 18 years who were admitted with the diagnosis of ACS, and it was carried out for 1 year. The epidemiological profile, clinical history, risk factors, electrocardiogram findings, and angiographic pattern were studied and analyzed with appropriate statistical tools. Results: The mean age of the study population was 55.12 ± 11.78 years. Male and female ratio was 2.4:1. The majority of the patients came from rural background (80%);24% of the patients were illiterate. Smoking was the most common risk factor (51.5%) in our study population followed by hypertension (40%) and diabetes (28%). Unstable angina was the most common type of ACS, which was found in 68.25% of patients. Premature CAD was found in 27.8% of patients and obstructive CAD was found in 63% of patients. Coronary angiography revealed that 39% had single vessel disease (SVD), 23.5% had double vessel disease (DVD), and 27.5% had triple vessel disease (TVD). LAD was more commonly involved, followed by RCA and LCX. Within the first 24 hours, 67% of patients sought medical assistance and only 38.5% received definitive treatment, suggesting a delay in seeking definitive treatment in our study population. Conclusion: The study suggests that unstable angina is the most common form of ACS in the study population, which is mostly of rural background with significant delay in seeking medical help. Smoking is the most common risk factor in the study population.
文摘Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate.
文摘Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and Conclusion The criteria for singular points, closed orbits and hyperbolic equilibrium points of a second order autonomous Birkhoff system are given. Moreover the stability of equilibria, stable manifolds and unstable manifolds are obtained.
基金Project (51005112) supported by the National Natural Science Foundation of ChinaProject (GF200901008) supported by the Open Fund of National Defense Key Disciplines Laboratory of Light Alloy Processing Science and Technology,China
文摘A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Taking Ti-6.5Al-3.5Mo-1.5Zr-0.3Si alloy as the testing material, the thermomechnical parameter windows of the unstable deformation zones for the Ti-alloy are integrated into a commercial finite element simulation software platform. The distribution and variation of the unstable deformation zones of the alloy in hot compression process are simulated and predicted using the tailor-made finite element codes in the finite element platform. The simulation results tally with the physical experiments and the proposed method for simulation and prediction of the unstable deformation is thus verified and its efficiency is validated.
文摘Objective Compare the morphology of atherosclerotic plaquesmgiographically and histopathologically in acute myocardialmfarction m order to accumulate experience in recognizing plaquerupture and thrombus by angiogrames.Material and methods 16postmortem cases of acute myocardial infarction were studied.The coronary arteries were romoved en block,filled with barium the lumen and ridiographed.Then the arteries wereontinuously insetted and routin HE sections were made.Results 16 cases had plaque ruptures and thrombi.Among the total98 blocks,21 had plaque ruptures on which 20 thrombiccur(95.23%).while the other 777 unrupured blocks had only 2hrombi(0.25%).The difference was significant(p【0.001).Therupture mostly occur on unstable plaques.The ruptured plaqueswith thrombi had different angiographical morphology withunruptured plaques.The former had irregular borders andunraluminal lucencies;while the Iatter had smooth borders and nointraluminal lucencies.Conclusions Plaque ruprure withthrumbus was the major cause of acute myocardial infarction andthe ruptured plaques with thrombus had different angiographicalapperances with unruptured plaques.
文摘This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtained.
基金Project(51274250)supported by the National Natural Science Foundation of ChinaProject(2012BAK09B02-05)supported by the National Key Technology R&D Program during the 12th Five-year Plan of China
文摘An integration processing system of three-dimensional laser scanning information visualization in goaf was developed. It is provided with multiple functions, such as laser scanning information management for goaf, cloud data de-noising optimization, construction, display and operation of three-dimensional model, model editing, profile generation, calculation of goaf volume and roof area, Boolean calculation among models and interaction with the third party soft ware. Concerning this system with a concise interface, plentiful data input/output interfaces, it is featured with high integration, simple and convenient operations of applications. According to practice, in addition to being well-adapted, this system is favorably reliable and stable.