One Case of Primary Thrombocythemia with Concealed Hypokalemia Complicated by Acute Myocardial Infarction

Medical history summary: Male, 47 years old, was admitted to the hospital due to “dizziness accompanied by chest tightness and pain for more than 8 days”. One week ago, the patient experienced chest tightness, chest pain accompanied by profuse sweating for 3 hours and underwent emergency percutaneous coronary intervention (PCI) at a local hospital. The procedure revealed left main stem occlusion with subsequent left main stem to left anterior descending artery percutaneous transluminal coronary angioplasty (PTCA). After the procedure, the patient experienced hemodynamic instability, recurrent ventricular fibrillation, and critical condition, thus transferred to our hospital for further treatment. Symptoms and signs: The patient is in a comatose state, unresponsive to stimuli, with bilateral dilated pupils measuring 2.0 mm, exhibiting reduced sensitivity to light reflex, and recurrent fever. Coarse breath sounds can be heard in both lungs, with audible moist rales. Irregular breathing pattern is observed, and heart sounds vary in intensity. No pathological murmurs are auscultated in any valve auscultation area. Diagnostic methods: Coronary angiography results at the local hospital showed complete occlusion of the left main stem, and left main stem to left anterior descending artery percutaneous transluminal coronary angioplasty (PTCA) was performed. However, the distal guidewire did not pass through. After admission, blood tests showed a Troponin T level of 1.44 ng/ml and a Myoglobin level of 312 ng/ml. The platelet count was 1390 × 109/L. Von Willebrand factor (vWF) activity was measured at 201.9%. Bone marrow aspiration biopsy showed active bone marrow proliferation and platelet clustering. The peripheral blood smear also showed platelet clustering. JAK-2 gene testing was positive, confirming the diagnosis of primary thrombocytosis. Treatment methods: The patient is assisted with mechanical ventilation and intra-aortic balloon counterpulsation to improve coronary blood flow. Electrolyte levels are closely monitored, especially maintaining plasma potassium levels between 4.0 and 4.5 mmol/l. Hydroxyurea 500 mg is administered for platelet reduction. Anticoagulants and antiplatelet agents are used rationally to prevent further infarction or bleeding. Antiarrhythmic, lipid-lowering, gastroprotective, hepatoprotective, and heart failure treatment are also provided. Clinical outcome: The family members chose to withdraw treatment and signed for discharge due to a combination of reasons, including economic constraints and uncertainty about the prognosis due to the long disease course. Acute myocardial infarction has gradually become one of the leading causes of death in our country. As a “green channel” disease, corresponding diagnostic and treatment protocols have been established in China, and significant progress has been made in emergency care. There are strict regulations for the time taken from the catheterization lab to the cardiac intensive care unit, and standardized treatments are provided to patients once they enter the intensive care unit. Research results show that the incidence of acute myocardial infarction in patients with primary thrombocythemia within 10 years is 9.4%. This type of disease is rare and difficult to cure, posing significant challenges to medical and nursing professionals. In order to benefit future patients, we have documented individual cases of treatment and nursing care for these patients. The research results show that these patients exhibit resistance to traditional oral anticoagulant drugs and require alternative anticoagulants. Additionally, there are significant differences in serum and plasma potassium levels among patients. Therefore, when making clinical diagnoses, it is necessary to carefully distinguish between the two. Particularly, nursing personnel should possess dialectical thinking when supplementing potassium levels in patients in order to reduce the incidence of malignant arrhythmias and mortality rates.

Application of geophysical methods in fine detection of urban concealed karst:A case study of Wuhan City,China

The construction of modern livable cities faces challenges in karst areas,including ground collapse and engineering problems.Wuhan,with a population of 13.74×10^(6) and approximately 1161 km^(2)of soluble rocks in the urban area of 8569.15 km^(2),predominantly consists of concealed karst areas where occasional ground collapse events occur,posing significant threats to underground engineering projects.To address these challenges,a comprehensive geological survey was conducted in Wuhan,focusing on major karstrelated issues.Geophysical methods offer advantages over drilling in detecting concealed karst areas due to their efficiency,non-destructiveness,and flexibility.This paper reviewed the karst geological characteristics in Wuhan and the geophysical exploration methods for karst,selected eight effective geophysical methods for field experimentation,evaluated their suitability,and proposed method combinations for different karst scenarios.The results show that different geophysical methods have varying applicability for karst detection in Wuhan,and combining multiple methods enhances detection effectiveness.The specific recommendations for method combinations provided in this study serve as a valuable reference for karst detection in Wuhan.

Technique of Error Concealment for Block-Based Image Coding Using Genetic Algorithm

Since real world communication channels are not error free, the coded data transmitted on them may be corrupted, and block based image coding systems are vulnerable to transmission impairment. So the best neighborhood match method using genetic algorithm is used to conceal the error blocks. Experimental results show that the searching space can be greatly reduced by using genetic algorithm compared with exhaustive searching method, and good image quality is achieved. The peak signal noise ratios(PSNRs) of the restored images are increased greatly.

An error resilient scheme for H.264 video coding based on distortion estimated mode decision and nearest neighbor error concealment

Although H.264 video coding standard provides several error resilience tools, the damage caused by error propagation may still be tremendous. This work is aimed at developing a robust and standard-compliant error resilient coding scheme for H.264and uses techniques of mode decision, data hiding, and error concealment to reduce the damage from error propagation. This paper proposes a system with two error resilience techniques that can improve the robustness of H.264 in noisy channels. The first technique is Nearest Neighbor motion compensated Error Concealment (NNEC) that chooses the nearest neighbors in the reference frames for error concealment. The second technique is Distortion Estimated Mode Decision (DEMD) that selects an optimal mode based on stochastically distorted frames. Observed simulation results showed that the rate-distortion performances of the proposed algorithms are better than those of the compared algorithms.

Frame erasure concealment in wideband speech coding based on large hidden Markov model

Frame erasure concealment is studied to solve the problem of rapid speech quality reduction due to the loss of speech parameters during speech transmission. A large hidden Markov model is applied to model the immittance spectral frequency （ISF） parameters in AMR-WB codec to optimally estimate the lost ISFs based on the minimum mean square error （MMSE） rule. The estimated ISFs are weighted with the ones of their previous neighbors to smooth the speech, resulting in the actual concealed ISF vectors. They are used instead of the lost ISFs in the speech synthesis on the receiver. Comparison is made between the speech concealed by this algorithm and by Annex I of G. 722. 2 specification, and simulation shows that the proposed concealment algorithm can lead to better performance in terms of frequency-weighted spectral distortion and signal-to-noise ratio compared to the baseline method, with an increase of 2.41 dB in signal-to-noise ratio （SNR） and a reduction of 0. 885 dB in frequency-weighted spectral distortion.

Frame loss error concealment for SVC

Scalable video coding (SVC), as the Scalable Extension of H.264/AVC, is an ongoing international video coding standard designed for network adaptive or device adaptive applications and also offers high coding efficiency. However, packet losses often occur over unreliable networks even for base layer of SVC and have severe impact on the playback quality of compressed video. Until now, no literature has discussed error concealment support for standard SVC bit-stream. In this paper, we provide robust and effective error concealment techniques for SVC with spatial scalability. Experimental results showed that the proposed methods provide substantial improvement, both subjectively and objectively, without a significant complexity overhead.

Error concealment in pixel based Wyner-Ziv video coding

In the Wyner-Ziv(WZ) video coding paradigm, a virtual correlation channel is assumed between the quantized source and the side information(SI) at the decoder, and channel coding is applied to achieve compression. In this paper, errors caused by the virtual correlation channel are addressed and an error concealment approach is proposed for pixel-based WZ video coding. In the approach, errors after decoding are classified into two types. Type 1 errors are caused by residual bit errors after channel decoding, while type 2 errors are due to low quality of SI in part of a frame which causes SI not lying within the quantization bin of a decoded quantized pixel value. Two separate strategies are respectively designed to detect and conceal the two types of errors. Simulations are carried out and results are presented to demonstrate the effectiveness of the proposed approach.

Analysis and application of error concealment tools in AVS-M decoder

Audio Video coding Standard (AVS) is the latest audio and video coding standard of China. AVS Part 7 (also known as AVS-M) targets mobility applications where error concealment is of great importance. This paper first briefly introduces the general concept of error concealment. Then two error concealment schemes are proposed and implemented on AVS-M decoder under different test conditions. Simulation results of the schemes and suggestions on how to use these tools are also provided.

Content-adaptive robust error concealment for packet-lossy H.264 video streaming

In this paper, we present a spatio-temporal post-processing error concealment (EC) algorithm designed initially for a H.264 video-streaming scheme over packet-lossy networks. It aims at optimizing the subjective quality of the restored video under the constraints of low delay and computational complexity, which are critical to real-time applications and portable devices having limited resources. Specifically, it takes into consideration the physical property of motion field in order to achieve more meaningful perceptual video quality, in addition to the improved objective PSNR. Further, a simple bilinear spatial interpolation approach is combined with the improved boundary-match (B-M) based temporal EC approach according to texture and motion activity analysis. Finally, we propose a low complexity temporal EC method based on motion vector interpolation as a replacement of the B-M based approach in the scheme under low-computation requirement, or as a complement to further improve the scheme's performance in applications having enough computation resources. Extensive experiments demonstrated that the proposal features not only better reconstruction, objectively and subjectively, than JM benchmark, but also robustness to different video sequences.

Temporal Shape Error Concealment for Video Objects

A novel temporal shape error concealment technique is proposed, which can he used in the context of object-based video coding schemes. In order to reduce the effect of the shape variations of a video object, the curvature scale space （CSS） technique is adopted to extract features, and then these features are used for boundary matching between the current frame and the previous frame. Because the temporal, spatial and sta- tistical video contour information are all considered, the proposed method can find the optimal matching, which is used to replace the damaged contours. The simulation results show that the proposed algorithm achieves better subjective, objective qualities and higher efficiency than those previously developed methods.

A NOVEL TEMPORAL ERROR CONCEALMENT METHOD BASED ON FUZZY REASONING FOR H.264

In this paper,a fuzzy reasoning based temporal error concealment method is proposed. The basic temporal error concealment is implemented by estimating Motion Vector (MV) of the lost MacroBlock (MB) from its neighboring MVs. Which MV is the most proper one is evaluated by some criteria. Generally,two criteria are widely used,namely Side Match Distortion (SMD) and Sum of Absolute Difference (SAD) of corresponding MV. However,each criterion could only partly describe the status of lost block. To accomplish the judgement more accurately,the two measures are considered together. Thus a refined measure based on fuzzy reasoning is adopted to balance the effects of SMD and SAD. Terms SMD and SAD are regarded as fuzzy input and the term ‘similarity’ as output to complete fuzzy reasoning. Result of fuzzy reasoning represents how the tested MV is similar to the original one. And k-means clustering technique is performed to define the membership function of input fuzzy sets adaptively. According to the experimental results,the concealment based on new measure achieves better performance.

Temporal Error Concealment Technique for MPEG-4 Video Streams

Concerning inter4v mode employed widely in MPEG-4 video, a new temporal error concealment scheme for MPEG-4 video sequences is proposed, which can selectively interpolate one or four motion vectors （MVs） for the missing macroblock （ MB ） according to the estimated MB coding mode. Performance of the proposed scheme is compared with the existing schemes with multiple testing sequences at different bit error rates. Experimental results show that the proposed algorithm can mask the impairments caused by transmission errors more efficiently than 0 MV and average MV methods by consuming more time for different bit error rates. It has an acceptable image quality close to that obtained by the selective motion vector matching （ SMVM ） algorithm, while taking less than half of cycles of operations. The proposed concealment scheme is suitable for low complexity video real-time implementations.

A MODIFIED EDGE-ORIENTED SPATIAL INTERPOLATION ALGORITHM FOR CONSECUTIVE BLOCKS ERROR CONCEALMENT

This paper proposes a low-complexity spatial-domain Error Concealment (EC) algorithm for recovering consecutive blocks error in still images or Intra-coded (I) frames of video sequences. The proposed algorithm works with the following steps. Firstly the Sobel operator is performed on the top and bottom adjacent pixels to detect the most likely edge direction of current block area. After that one-Dimensional (1D) matching is used on the available block boundaries. Displacement between edge direction candidate and most likely edge direction is taken into consideration as an important factor to improve stability of 1D boundary matching. Then the corrupted pixels are recovered by linear weighting interpolation along the estimated edge direction. Finally the interpolated values are merged to get last recovered picture. Simulation results demonstrate that the proposed algorithms obtain good subjective quality and higher Peak Signal-to-Noise Ratio (PSNR) than the methods in literatures for most images.

SPATIAL ERROR CONCEALMENT BASED ON MOJETTE TRANSFORM

This letter presents a novel spatial error concealment algorithm for the H.264 video coding. The error concealment algorithm is based on directional interpolation. Mojette transform is used to estimate the orientation features of the damaged blocks,and the image is interpolated in the appro-priate directions. The proposed method is compared with bilinear interpolation algorithm in the ref-erence implementation of H.264 and all directional interpolation. Experimental results prove that the proposed algorithm has better subjective and objective image reconstruction quality.

Network-aware perceptual error concealment method for H.264 video with side information

In order to improve the video quality of transmission with data loss,a spatial and temporal error concealment method was proposed,which considered both the state information of the network and the perceptual weight of the video content.The proposed method dynamically changed the reliability weight of the neighboring macroblock,which was used to conceal the lost macroblocks according to the packet loss rate of the current channel state.The perceptual weight map was utilized as side information to do weighted pixel interpolation and side-match based motion compensation for spatial and temporal error concealment,respectively.And the perceptual weight of the neighboring macroblocks was adaptively modified according to the perceptual weight of the lost macroblocks.Compared with the method used in H.264 joint model,experiment results show that the proposed method performs well both in subjective video quality and objective video quality,and increases the average peak signal-to-noise ratio(PSNR) of the whole frame by about 0.4 dB when the video bitstreams are transmitted with packets loss.

Reawakened Sexual Interest: The Result of Surgical Correction of Concealed Penis

Concealed penis (CP) is a developmental anomaly in which the penis is hidden in the skin of the abdomen, thigh or scrotum. As a result of this, the penis appears shortened in length. It was first described by Keyes Jr. E.L. in 1919. It can be associated with voiding problem and in adults, sexual issues, among others. Objective: To show that surgery can reverse celibacy induced by CP and highlight the need for an interdisciplinary approach to correction of this anomaly. Patient and Method: A thirty-one-year male patient who had a surgical release of his buried penis by two surgeons in 2019 in a private hospital. The case note was reviewed, the data obtained analyzed and the results including photographs, were presented. The patient was followed up. Result: A 10 cm length of penis and a hundred percent (100%) take of sheet of split skin graft used to resurface the denuded penis were achieved using combined spinal and epidural anesthesia. The patient, his mother and the surgeons were satisfied with the outcome. Consequently, he resolved to marry a wife after all. Conclusion: Concealed penis can now be regarded as a known cause of celibacy and surgical correction can reverse the celibate state.

顶部隐伏溶洞对隧道围岩变形特征影响分析——以齐岳山高速公路隧道为例

齐岳山高速公路岩溶隧址区强致灾性隐伏溶洞较为发育,为研究隐伏溶洞对隧道围岩位移影响的变化规律,选取围岩等级、隧道埋深2个地质因素,对溶洞大小、溶洞与隧道的距离2个形态因素开展数值试验,讨论支护对围岩位移的影响,分析顶部隐伏溶洞对隧道围岩不同方向变形的影响,系统研究不同因素对顶部溶洞作用效果的影响规律。得到如下研究结果:1)顶部溶洞对围岩变形在垂直方向和水平方向的作用效果是相反的,在垂直方向,顶部溶洞减缓拱顶和拱底的收敛效果;在水平方向,顶部溶洞加剧拱腰的收敛效果,且对拱顶、拱底、拱腰位移变化的影响依次减小。2)随着围岩级别提高、隧道埋深增大、溶洞尺寸增大、溶洞与隧道距离减小,顶部溶洞对隧道围岩变形影响的作用效果增强;在因素设计范围内,各因素对顶部溶洞作用效果的影响差异明显。

热液脉型萤石矿床隐伏矿体定位预测综合技术方法

萤石是国家战略性新兴产业发展中不可或缺的关键支撑原材料,被国际社会普遍列为“关键矿产”,随着萤石露头矿的发现殆尽,急需开展隐伏矿体的深部定位预测研究。文章简要论述了断裂构造控制的热液脉型萤石矿床地质特征、分带模式和成矿规律,评述了萤石找矿中常用的勘查技术方法。结合找矿标志和控矿要素分析,总结了隐伏-半隐伏萤石矿体定位预测的找矿模型,提出了“分带型”和“掩埋型”两种类型隐伏萤石矿体及相应的找矿技术方法组合。笔者建立了隐伏萤石矿体定位预测的地质-物探-化探-遥感综合找矿模型及其四步勘查技术流程,这对指导隐伏萤石矿床(体)的找矿勘查具有重要的理论和实践意义。

基于断层量化隐伏型煤矿基岩含水层水化学空间演化机制研究

地质构造是控制地下水化学场形成的关键因子,但由于其类型、性质和组合方式存在较大差异,致使定量表征地质构造对含水层水化学空间演化是个难点问题,亟待解决。本文以典型隐伏型煤田——淮北煤田袁店一矿的二叠系主采煤层砂岩裂隙含水层(简称“煤系”)和石炭系太原组灰岩岩溶裂隙含水层(简称“太灰”)为研究对象,基于主成分分析和离子比例分析,阐明控制含水层水化学空间演化的关键因素,利用断层复杂系数量化地质构造对地下含水层水-岩作用的影响,揭示袁店一矿水化学空间演化机制。研究结果表明,袁店一矿煤系主要水-岩作用为阳离子交替吸附与脱硫酸,太灰主要水-岩作用为碳酸盐溶解与黄铁矿氧化。袁店一矿东部断层复杂系数平均值为0.56,中部为0.61,西部为0.71。随着断层复杂系数平均值的增加,断层愈发育,煤系在袁店一矿主要水-岩作用阳离子交替吸附与脱硫酸有向非碳酸盐溶解转变的趋势;太灰在袁店一矿主要水-岩作用碳酸盐溶解与黄铁矿氧化有进一步增强的趋势。研究成果为研究华北隐伏型煤田地下水化学演化的构造控制机制提供了新思路,奠定了良好的理论基础。

湘南坪宝矿田岩浆热液成矿系统深部探测与地球化学约束

湘南是我国乃至世界最重要的钨锡多金属矿集区之一,发育了坪宝、柿竹园、骑田岭等多个大型矿床(田)。随着浅部资源逐渐枯竭,成矿系统深延与探测成为找矿突破的重点,尤其是覆盖层下隐伏成矿岩体、流体运移通道与矿体赋存空间的准确识别。本文以湘南坪宝矿田为例,采用广域电磁、构造解析与地球化学等方法揭示了成矿系统的空间结构与物质组成:(1)矿田深部(<5 km)存在4个隐伏的燕山期花岗岩体,包括宝山、黄沙坪、大坊、野鹅塘,岩体呈现不规则形态;(2)岩体侵位受NNE走向、NE走向与NW走向的区域断裂交汇联合控制,其岩体接触带与次级断裂为主要的控矿构造;(3)断层破碎带中方解石、石英、赤铁矿等热液矿物为成矿流体活动留下的痕迹,可用来识别成矿流体的源区与路径;(4)科学钻探证实了矿体与成矿运移通道深延稳定,且可能与深部隐伏岩体导通;(5)宝山矿区西部、黄沙坪矿区东部、大坊与野鹅塘矿区深部应为该区未来找矿勘查的重点。通过广域电磁、构造解析与矿物地球化学分析可以深入认识隐伏岩体的空间形态与形成时代,构建成矿物质与流体的“源-运-储”模型,开展成矿系统的深部探测与成矿潜力评价。