Treatment of malignant digestive tract obstruction by combined intraluminal stent installation and intra-arterial drug infusion

AIM: To study the palliative treatment of malignant obstruction of digestive tract with placement of intraluminal stent combined with intra-arterial infusion of chemotherapeutic drugs. METHODS: A total of 281 cases of digestive tract malignant obstruction were given per oral (esophagus, stomach, duodenum and jejunum), per anal (colon and rectum) and percutaneous transhepatic (biliary) installation of metallic stent. Among them, 203 cases received drug infusion by cannulation of tumor supplying artery with Seldinger's technique. RESULTS: Altogether 350 stents were installed in 281 cases, obstructive symptoms were relieved or ameliorated after installation. Occurrence of restenotic obstruction was 8-43 weeks among those with intra-arterial drug infusion, which was later than 4-26 weeks in the group with only stent installation. The average survival time of the former group was 43 (3-105) weeks, which was significantly longer than 13 (3-24) weeks of the latter group. CONCLUSION: Intraluminal placement of stent combined with intra-arterial infusion chemotherapy is one of the effective palliative therapies for malignant obstruction of the digestive tract with symptomatic as well as etiological treatment.

A NEW HEAT-TREATMENT PROCESS FOR 2014 ALUMINUM ALLOY AND ITS MECHANISM

The plan of heat-treatment process for 2014Al alloy is designed using orthogonal method, the heat-treatment experiments are made and the mechanical properties are tested according to the designed plan. The effect of solid solution temperature, ageing temperature, ageing time on microscopic mechanism of the mechanical properties of the 2014Al alloy is studied using microscope, transmission electron microscope. The best heat treatment process of the 2014Al alloy is developed. The experimental results indicate that the strength σb, yield stress σ0.2, percentage elongation δ of the alloy reach separately 490～500 MPa, 450～490 MPa, 10～12％ adopting the new heat treatment process. Compared with GB, the strength increases 20～30％, the percentage elongation increases 30～40％. The mechanism of the new heat-treatment process is also discussed.

GIS Based Landslide Susceptibility Mapping with Application of Analytical Hierarchy Process in District Ghizer, Gilgit Baltistan Pakistan

District Ghizer is a rugged mountainous territory which experiences several landslides each year. There are 16 major landslide areas and 53 villages that are at high risk to hazards. Keeping in view the severity of natural hazards, the present study was designed to generate landslide susceptibility map based on twelve causative factors viz., slope, aspect, elevation, drainage network, Stream Power Index (SPI), Topographic Wetness Index (TWI), lithological units, fault lines, rainfall, road network, land cover and soil texture. Soil texture was determined by particle size analysis and data for other factors were acquired from freely available sources. Analytical Hierarchy Process (AHP) was employed to identify major landslide causative factors in the district Ghizer. Further, a temporal assessment from 1999 till 2015 was generated to assess the impact of land cover change on landslides. It indicated that the barren soil/ exposed rocks and glaciers have reduced while the vegetation and water classes have shown increment. The total area that lies in moderate to very high landslide susceptible zones was 74.38%, while slope is the main landslide causative factor in the district Ghizer. Validation of the susceptibility map showed 88.1% of the landslides in the study area had occurred in the moderate to very high susceptible zones.

Current situation and consideration of small splint in the treatment of distal radius fracture complicated with ulnar styloid process fracture

Objective:The incidence of distal radius fracture combined with ulnar styloid process fracture is increasing,which seriously affects the quality of life of patients.Small splint therapy of Traditional Chinese Medicine is a reliable method for the treatment of such fractures.It not only has good clinical efficacy,but also has fewer complications and high safety.However,the traditional small splint fixation does not cover the styloid process of the ulna,and the fracture of the styloid process of the ulna is closely related to the stability of the wrist joint,which has an important impact on the prognosis of the fracture.Based on this,we believe that the ulnar elongation splint can better improve the wrist function,and further prospects for related issues,in order to guide clinical practice.

CLASSIFICATION, PROGRESSIVE STAGE AND COMBINED TREATMENT OF PERIPHERAL FACIAL PARALYSIS

A combined method using acupuncture,Chinese herbs and Western medicine inthe treatment of peripheral facial paralysis is formulated from the author’s clinical experience duringmore than 20 years period.Two stages and four types are divided separately according to the develop-ment of the disorder and the lesion level of the facial nerve。which are different from the classificationsin the common textbooks.Out of the whole series of 718 cases,99.58％of the patients got cured andno one had been treated ineffectively.

Pharmacologic approaches to treatment resistant depression:Evidences and personal experience

AIM: To review evidence supporting pharmacological treatments for treatment-resistant depression(TRD) and to discuss them according to personal clinical experience.METHODS: Original studies, clinical trials, systematic reviews, and meta-analyses addressing pharmacological treatment for TRD in adult patients published from 1990 to 2013 were identified by data base queries(Pub Med, Google Scholar e Quertle Searches) using terms: "treatment resistant depression", "treatment refractory depression", "partial response depression", "non responder depression", "optimization strategy", "switching strategy", "combination strategy", "augmentation strategy", selective serotonin reuptake inhibitors antidepressants(SSRI), tricyclic antidepressants(TCA), serotonin norepinephrine reuptake inhibitors antidepressants, mirtazapine, mianserine, bupropione, monoamine oxidase inhibitor antidepressant(MAOI), lithium, thyroid hormones, second generation antipsychotics(SGA), dopamine agonists, lamotrigine, psychostimulants, dextromethorphan, dextrorphan, ketamine, omega-3 fatty acids, S-adenosil-L-metionine, methylfolat, pindolol, sex steroids, glucocorticoid agents. Other citations of interest were further identified from references reported in the accessed articles. Selected publications were grouped by treatment strategy:(1) switching from an ineffective antidepressant(AD) to a new AD from a similar or different class;(2) combining the current AD regimen with a second AD from a different class; and(3) augmenting the current AD regimen with a second agent not thought to be an antidepressant itself.RESULTS: Switching from a TCA to another TCA provides only a modest advantage(response rate 9%-27%), while switching from a SSRI to another SSRI is more advantageous(response rate up to 75%). Evidence supports the usefulness of switching from SSRI to venlafaxine(5 positive trials out 6), TCA(2 positive trials out 3), and MAOI(2 positive trials out 2) but not from SSRI to bupropione, duloxetine and mirtazapine. Three reviews demonstrated that the benefits of intraand cross-class switch do not significantly differ. Data on combination strategy are controversial regarding TCA-SSRI combination(positive results in old studies, negative in more recent study) and bupropion-SSRI combination(three open series studies but not three controlled trails support the useful of this combination) and positive regard mirtazapine(or its analogue mianserine) combination with ADs of different classes. As regards the augmentation strategy, available evidences supported the efficacy of TCA augmentation with lithium salts and thyroid hormone(T3), but are conflicting regard the SSRI augmentation with these two drugs(1 positive trial out of 4 for lithium and 3 out of 5 for thyroid hormone). Double-blind controlled studies showed the efficacy of AD augmentation with aripiprazole(5 positive trials out 5), quetiapine(3 positive trials out 3) and, at less extent, of fluoxetine augmentation with olanzapine(3 positive trials out 6), so these drugs received the FDA indication for the acute treatment of TRD. Results on AD augmentation with risperidone are conflicting(2 short term positive trials, 1 short-term and 1 long-term negative trials). Case series and open-label trials showed that AD augmentation with pramipexole or ropinirole, two dopamine agonists, could be an effective treatment for TRD(response rate to pramipexole 48%-74%, to ropinirole 40%-44%) although one recent double-blind placebo-controlled study does not support the superiority of pramipexole over placebo. Evidences do not justify the use of psychostimulants, omega-3 fatty acids, S-adenosil-Lmetionine, methylfolate, pindolol, lamotrigine, and sex hormone as AD augmentation for TRD. Combining the available evidences with our experience we suggest treating non-responders to one SSRI bupropion or mirtazapine trial by switching to venlafaxine, and nonresponders to one venlafaxine trial by switching to a TCA or, if TCA are not tolerated, combining mirtazapine with SSRI or venlafaxine. In non-responders to two or more ADs(including at least one TCA if tolerated) current AD regimen could be augmented with lithium salts(mainly in patients with bipolar depression or suicidality), SGAs(mostly aripiprazole) or DA-agonists(mostly pramipexole). In patients with severe TRD, i.e., non-responders to combination and augmentation strategies as well as to electroconvulsive therapy if workable, we suggest to try a combination plus augmentation strategy.CONCLUSION: Our study identifies alternative effective treatment strategies for TRD. Further studies are needed to compare the efficacy of different strategies in more homogeneous subpopulations.

Effects of Fillerwire Composition along with Different Pre- and Post-Heat Treatment on Mechanical Properties of AISI 4130 Welded by the GTAW Process

This research intends to find out the optimal mechanical properties of AISI 4130 steel welded by the GTAW process. Six test plates were joined by two types of filler wire with similar chemical composition to the base metal, and with lower carbon content and slightly higher alloy elements content compared to the first one. Test plates then exerted three different pre-heat and post-heat treatments on both groups. The three types of heat treatments were alternatively without pre-heat and post-heat, with pre-heat only, and finally with pre-heat and post-heat. Tensile, side bends and impact tests (for weld zone and HAZ) have been conducted. Results show that using low-carbon filler wire along with pre- and post-heat resulted in outstanding mechanical properties.

Induction Heating in the Processing of Ti &Zr

Induction heating has important applications in science and industry. The method of induction heating can be successfully used for melting and heat treatment of titanium and zirconium alloys. Different applications using induction precise heating before plastic deformation are discussed in this paper. For alloys of many metals such as titanium, zirconium, niobium, tantalum, etc., it is important to provide precision heating with a high degree of homogeneity of the temperature field and strict adherence to the condition of heating. This is explained by polymorphism of the alloys based on these metals, their chemical activity at high temperatures and the specific thermal and electrical properties. It is very important for induction heating to define the extreme achievable unevenness of the temperature field. For special alloys it is necessary to use resistance furnaces for homogenization of billets’ temperature after heating in the inductors. Optimal control can be used for massive billets to reduce significantly the heating time, energy expenses and to improve the quality of the temperature field distribution. Optimization of induction heating process can be achieved by synchronous solution of the problem of optimal control and design with specially developed models.

Analysis of Combined Therapy and Treatment Effect of Localized Ultraviolet Irradiation and Shengji Yuhong Cream on Diabetic Foot

Objective:To investigate the treatment effect of combined application of localized ultraviolet irradiation and Shengji Yuhong Cream on diabetic foot patients.Methods:Diabetic foot patients in the control group were treated with localized ultraviolet irradiation on the basis of conventional treatment.The study group was added with Shengji Yuhong Cream on top of the localized ultraviolet irradiation on the basis of conventional treatment.Results:The results of ankle brachial index and dorsal foot skin temperature of that two groups before treatment were compared,P>0.05.After treatment,the ankle brachial index and dorsal foot skin temperature of the study group were better than those of the control group.The comparison between the groups and within the group was P<0.05.The total effective rate of the study group(95.65%)was higher than that of the control group(71.11%),P<0.05.Conclusion:The application of localized ultraviolet irradiation and Shengji Yuhong Cream in the treatment of diabetic foot is effective.

The study on the mechanism of Sodium aescinate combined with Xuesaitong for cerebral thrombosis treatment

Objective:To observe the mechanism of Sodium aescinate combined with Xuesaitong for cerebral thrombosis treatment and offer clinical help to cerebral thrombosis treatment. Methods:A total of 92 patients with cerebral thrombosis were selected and randomly divided into groups: the observation group (46 people) and the control group (46 people).The patient in the control group were treated with conventional therapy and the patients in the observation group were treated with Sodium aescinate combined with Xuesaitong on the basis of conventional therapy. Inflammatory factors (IL-6, IL-10, TNF-α and CRP), Nerve cell factor (NSE, NGF and NTF) and blood rheology indexes (Fg, BVH, BVL and PV) were detected and analyzed before and after treatment.Results:The comparison of inflammatory factors, Nerve cell factor and blood rheology indexes in the two groups before treatment were not statistically significant. Inflammatory factors (IL-6, TNF-α and CRP), Nerve cell factor (NSE) and blood rheology indexes (Fg, BVH, BVL and PV) in both groups after treatment significantly decreased compared with that before treatment. Inflammatory factors (IL-10), Nerve cell factor (GF and NTF) in both groups after treatment significantly increased compared with that before treatment. The changes were statistically significant. Inflammatory factors (IL-6, TNF-α and CRP), Nerve cell factor (NSE) and blood rheology indexes (Fg, BVH, BVL and PV) in observation group after treatment decreased more significantly than that in control group, and inflammatory factors (IL-10), Nerve cell factor (GF and NTF) increased more significantly than that in control group. The difference between two groups was considered statistically significant.Conclusion:Sodium aescinate combined with Xuesaitong could inhibit the inflammatory reaction, improve the blood flow condition and promote rehabilitation in patients with cerebral thrombosis. So it has a very important clinical significance of the treatment to cerebral hemorrhage.

Optimization and Characterization of Combined Degumming Process of Typha angustata L. Stem Fibers

Plant derived natural fibers have been widely investigated as alternatives to synthetic fibers in reinforcing polymers.Researchers over the years have explored many plant fibers using different extraction processes to study their physical,chemical,and mechanical properties.In this context,the present study relates to the extraction,characterization,and optimization of Typha angustata L.stem fibers.For this purpose,desirability functions and response surface methodology were applied to simultaneously optimize the diameter(D),linear density(LD);yield(Y),lignin fraction(L),and tenacity(T)of Typha stem fibers.Typha stems have been subjected to both alkali(NaOH)and enzymatic(pectinex ultra-SPL)treatments.Three levels of process variables including enzyme concentration(10,15,and 20 ml/L)and treatment duration(10,15,and 20 days)were used to design the experiments according to the factorial design.Experimental results were examined by analysis of variance and fitted to second order polynomial model using multiple regression analysis.The Derringer’s desirability function released that the values of process variables generating optimized diameter,linear density,yield,lignin ratio and tenacity are 20 ml/L and 20 days for concentration of pectinex ultra-SPL enzyme and treatment duration,respectively.Confirmation was performed and high degree of correlation was found between the experimental and statistical values.Moreover,the morphological structure has been investigated by the scanning electron microscope,showing a crenelated structure of ultimate fiber bundles of cellulose composing the Typha fiber.Compared to Typha stem non-treated fibers(TSNTF),Typha stem combined treated fibers(TSCTF),brings to improve mechanical properties.This change in mechanical properties is affected by modifying the fiber structure showing alpha cellulose of(66.86%)and lignin ratio of(10.83%)with a crystallinity index of(58.47%).

Acupuncture Combined with Massage for Treatment of 200 cases of Scapulohumeral Periarthritis

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Pressure stimulated current in progressive failure process of combined coal-rock under uniaxial compression:Response and mechanism

Effective monitoring of the structural health of combined coal-rock under complex geological conditions by pressure stimulated currents(PSCs)has great potential for the understanding of dynamic disasters in underground engineering.To reveal the effect of this way,the uniaxial compression experiments with PSC monitoring were conducted on three types of coal-rock combination samples with different strength combinations.The mechanism explanation of PSCs are investigated by resistivity test,atomic force microscopy(AFM)and computed tomography(CT)methods,and a PSC flow model based on progressive failure process is proposed.The influence of strength combinations on PSCs in the progressive failure process are emphasized.The results show the PSC responses between rock part,coal part and the two components are different,which are affected by multi-scale fracture characteristics and electrical properties.As the rock strength decreases,the progressive failure process changes obviously with the influence range of interface constraint effect decreasing,resulting in the different responses of PSC strength and direction in different parts to fracture behaviors.The PSC flow model is initially validated by the relationship between the accumulated charges of different parts.The results are expected to provide a new reference and method for mining design and roadway quality assessment.

Acupuncture Combined with Plucking Muscle Method for Treatment of 48 Cases of Acute Lumbar Sprain

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The Business of Managing Risk and Network Security:An Exploration of Knowledge Transfer Issues within the Context of Data Security and Countermeasure Trade Offs

The contemporary environment within which command,control,communications,computers and intelligence (C4I platforms exist, have a number of characteristics. These characteristics may be most obviously identified as interconnectivity, international networking, speed of data transfer, the compact nature of electronic information and rapidly changing technology. Information security professionals employ a variety of approaches in order to counter risks within this complex and fluid environment. The gamut of potential security activities ranges form access control through a variety of auditing techniques to secure data communications. This field is broad and well documented. Indeed, the discipline of network risk management and data security is both well developed and sophisticated.This paper addresses twin themes:i.The fundamental issue of the method by which specific approaches are employed. This is a precursor to the adoption of an eventual strategy.ii.The crucial issues revolving around the

Optimization of continuous electrocoagulation-adsorption combined process for the treatment of a textile effluent

The aims of this study is to design and optimize the functioning of a full continuous combined process based on electrocoagulaion-adsorption on crude Tunisian clay to treat a real textile effluent.The clay characterization shows that the used clay is a rich-smectite clay.The response surface methodology(RSM)technique based on Box-Behnken design(BBD)was used to optimize the process.At optimum conditions which are initial pH solution of 8.24,effluent flow rate of 0.5 L·min^(-1),voltage of 70 V,and added suspension of clay flow rate of 100 ml·min^(-1) the achieved color,chemical oxygen demand(COD)and total suspended solid(TSS)removal efficiencies were respectively 96.87%,89.77%and 84.46%with0.75 USD·m^(-3) as total cost.The additional laboratory experiments at optimum conditions agree with the predicted results,which confirm the accuracy and the capability of RSM to predict results in the defined space.Finally the designed process could be a good eco-friendly alternative to treat and reuse wastewater in industrial process with reasonable cost.

Tribology properties of composite layer of CrMoCu alloy cast iron by combined treatment of ion nitrocarburizing and sulphurizing

Composite layer with nitrocarbonide and sulfide was made on the surface of CrMoCu alloy cast iron by combined treatment of ion nitrocarburizing and sulphurizing. The composite layer is composed of sulfide layer, nitrocarbonide hypo-surface layer and its diffusing layer, the size of sulfide globular grains distributing equably on the surface is in nano-micron-scale, and the phase structure of the composite layer is composed of FeS, FeS1-x, Fe2C and Fe3N. Under oil lubrication, sulphurized surface shows good scuffing-resistance only under low velocity, and nitrocarburized and sulphurized surface greatly improves the scuffing-resistance and wear-resistance of CrMoCu alloy cast iron, its integrated friction and wear properties are better than those of the plain and sulphurized surfaces under all the velocities.

Source,Process and End Treatment Technology of Volatile Organic Compounds in Oil Storage

Oil storage is a source of volatile organic compounds( VOCs). Volatile organic compounds can cause different damages to the environment,animals and plants. Therefore, it is important to control the discharge of VOCs in oil storage. In this paper,the control technology of sources of VOCs pollution in oil storage was analyzed from the source,process and end treatment,and measures for the prevention and control of VOCs pollution in oil storage were proposed.

Reducing Efficiencies of the Commonly Used Heat Treatment Methods and Fermentation Processes on Aflatoxin M1 in Naturally Contaminated Fresh Cow Milk

The reducing efficiencies of the commonly used heat treatment methods and fermentation processes on aflatoxin M1 (AFM1) in Nigeria were investigated. Seventy samples of fresh cow milk from both conventional and traditional dairy cattle herds were collected and analyzed for the determination of AFM1 using Cobra-cell incorporated high performance liquid chromatography. Of these analyzed samples, 56 (80.0%) tested positive for AFM1 out of which 3 milk samples with high AFM1 concentrations were selectively pooled and subjected to varied conditions of heat treatments and fermentation processes using both indigenized and exotic strains of lactic acid bacteria (Lactobacillus bulgaricus + Streptococcus thermophilus and L. rhamnosus and L. plantarum) as starter cultures respectively. Both processes used either singly or combined, demonstrated high degrees of reducing effects on AFM1 levels. Sterilization of the milk at 121?C and 80?C under the same condition of time (15 - 20) min showed significant reduction of up to 58.8% (p 0.05) in the level of AFM1 when compared with the initial mean AFM1 concentration of the untreated fresh milk. The situation was however different around the boiling temperature of 100?C at which point the level of AFM1 reduction was found to be inconsistent. The indigenized combined strains showed some slight margins of AFM1 reduction in the proportions of (20.5, 30.8 and 43.9)% over and above that of the exotic strains (17.4, 30.0 and 41.1)% in 12 h, 48 h and 72 h of fermentation respectively. Generally, fermentation alone showed lower reduction of AFM1 in milk from 24.5% to 43.9% compared with the reducing activities of (35.4 to 58.8)% when heat-treated milk samples were subsequently subjected to varied fermentation conditions.

Improving Prediction Accuracy of a Rate-Based Model of an MEA-BasedCarbon Capture Process for Large-Scale Commercial Deployment

Carbon capture and storage （CCS） technology will play a critical role in reducing anthropogenic carbondioxide （CO2） emission from fossil-fired power plants and other energy-intensive processes. However, theincrement of energy cost caused by equipping a carbon capture process is the main barrier to its commer-cial deployment. To reduce the capital and operating costs of carbon capture, great efforts have been madeto achieve optimal design and operation through process modeling, simulation, and optimization. Accuratemodels form an essential foundation for this purpose. This paper presents a study on developing a moreaccurate rate-based model in Aspen Plus for the monoethanolamine （MEA）-based carbon capture processby multistage model validations. The modeling framework for this process was established first. The steady-state process model was then developed and validated at three stages, which included a thermodynamicmodel, physical properties calculations, and a process model at the pilot plant scale, covering a wide rangeof pressures, temperatures, and CO2 loadings. The calculation correlations of liquid density and interfacialarea were updated by coding Fortran subroutines in Aspen Plus. The validation results show that the cor-relation combination for the thermodynamic model used in this study has higher accuracy than those ofthree other key publications and the model prediction of the process model has a good agreement with thepilot plant experimental data. A case study was carried out for carbon capture from a 250 MWe combinedcycle gas turbine （CCGT） power plant. Shorter packing height and lower specific duty were achieved usingthis accurate model.