临路淤泥塘基坑施工技术探讨

本工程基坑临路,存在大量淤泥,周围环境比较复杂。针对基坑开挖对道路安全的影响和行车动荷载对基坑稳定性的影响,本工程提出了相应的技术措施。监测数据表明,本工程采取的基坑开挖与支护方式得到极好的实施效果,整个施工过程达到了有效、安全的目标,可为相似工程提供一定的参考。

内蒙古高速公路临路综合服务体系开发建设研究

在分析内蒙古高速公路特点和资源的基础上,提出了内蒙古高速公路发展临路综合服务体系的意义和路径以及相应的开发建设思路,包括“以点带面,率先开展分布式发电示范工程建设”、“因地制宜,深入研究完善交通旅游产业和第三方仓储物流业务”、“保障先行,积极使用金融工具推动整体建设”,有助于内蒙古高速公路产业可持续发展。

历经苦难 痴心不改——谈李白《临路歌》的深层内蕴

李白的诗歌多以高度浓缩的笔法来概括时间跨度较大的事件。《临路歌》就以短短六句诗概括了他一生的追求和经历。李白用自己的诗歌为自己雕刻了一座千古不朽的崇高的悲剧性的大鹏形象。

浅谈对新建改建公路临路违法建筑的控制

要认真做好新建改建公路临路违法建筑的控制工作，就必须从公路的规划、划线、验收工作做起，提高群众养路爱路意识，对公路实行综合管理。

临路型村庄环境整治规划研究——以沭阳县沂涛镇二圩村为例

临路型村庄指临近交通干道或被交通干道穿越的村庄,具有重要的形象展示意义,但长期以来由于缺乏重视,村庄的环境质量不佳。沭阳县沂涛镇二圩村是被S326省道东西向穿越的村庄。本次规划根据二圩村的实际情况,从挖掘地域特色、优化空间结构、提升村容村貌三个角度出发,对村庄标志、沿线景观、道路空间、街道商业、公共节点五项内容进行规划设计,制定面向实施的整治措施,形成便于操作的成果,对未来同类型村庄环境整治规划提供一定参考价值。

内蒙古高速公路风光发电业务探索性研究

为推动内蒙古自治区高速公路临路经济绿色发展,通过实证研究法分析了依托高速公路现有土地资源开展风光互补发电业务的可行性和必要性,梳理了国家及行业对绿色能源发展应用的政策指引,在借鉴相似成功案例的基础上,开展内蒙古自治区高速公路风光发电技术方案设计。

Critical load position for cavities beneath CRCP slab under vehicle loading

In order to study the critical load position that causes cavities beneath the continuously reinforced concrete pavement（ CRCP） slab under vehicle loading, the elliptical load is translated into the square load based on the equivalence principle.The CRCP slab is analyzed to determine the cavity position beneath the slab under vehicle loading. The influences of cavity size on the CRCP slab＇s stress and vertical displacement are investigated. The study results showthat the formation of the cavity is unavoidable under traffic loading, and the cavity is located at the edge of the longitudinal crack and the slab corner.The cavity size exerts an obvious influence on the largest horizontal tensile stress and vertical displacement. The slab corner is the critical load position of the CRCP slab. The results can be used to assist the design of CRCP in avoiding cavities beneath slabs subject to vehicle loading.

Clinical course of ulcerative colitis patients who develop acute pancreatitis

To investigate the clinical course of ulcerative colitis (UC) patients who develop acute pancreatitis.METHODSWe analyzed 3307 UC patients from the inflammatory bowel disease registry at Asan Medical Center from June 1989 to May 2015. The clinical course of UC patients who developed acute pancreatitis was compared with that of non-pancreatitis UC patients.RESULTSAmong 51 patients who developed acute pancreatitis, 13 (0.40%) had autoimmune, 10 (0.30%) had aminosalicylate-induced, and 13 (1.73%) had thiopurine-induced pancreatitis. All 13 patients with autoimmune pancreatitis (AIP) had type 2 AIP. Two (15.4%) patients had pre-existing AIP, and three (23.1%) patients developed AIP and UC simultaneously. Compared to non-pancreatitis patients, AIP patients had UC diagnosed at a significantly younger age (median, 22.9 years vs 36.4 years; P = 0.001). AIP and aminosalicylate-induced pancreatitis patients had more extensive UC compared to non-pancreatitis patients. All patients with pancreatitis recovered uneventfully, and there were no recurrences. Biologics were used more frequently in aminosalicylate- and thiopurine-induced pancreatitis patients compared to non-pancreatitis patients [adjusted OR (95%CI), 5.16 (1.42-18.67) and 6.90 (1.83-25.98), respectively]. Biologic utilization rate was similar among AIP and non-pancreatitis patients [OR (95%CI), 0.84 (0.11-6.66)]. Colectomy rates for autoimmune, aminosalicylate-induced, and thiopurine-induced pancreatitis, and for non-pancreatitis patients were 15.4% (2/13), 20% (2/10), 15.4% (2/13), and 7.3% (239/3256), respectively; the rates were not significantly different after adjusting for baseline disease extent.CONCLUSIONPancreatitis patients show a non-significant increase in colectomy, after adjusting for baseline disease extent.

A Parallel-based Lifting Algorithm and VLSI Architecture for DWT

A novel Parallel-Based Lifting Algorithm （PBLA） for Discrete Wavelet Transform （DWT）, exploiting the parallelism of arithmetic operations in all lifting steps, is proposed in this paper. It leads to reduce the critical path latency of computation, and to reduce the complexity of hardware implementation as well. The detailed derivation on the proposed algorithm, as well as the resulting Very Large Scale Integration （VLSI） architecture, is introduced, taking the 9/7 DWT as an example but without loss of generality. In comparison with the Conventional Lifting Algorithm Based Implementation （CLABI）, the critical path latency of the proposed architecture is reduced by more than half from （4Tm ＋ 8Ta）to Tm ＋ 4Ta, and is competitive to that of Convolution-Based Implementation （CBI）, but the new implementation will save significantly in hardware. The experimental results demonstrate that the proposed architecture has good performance in both increasing working frequency and reducing area.

Updates on therapies for chronic prostatitis/chronic pelvic pain syndrome

Prostatitis comprises of a group of syndromes that affect almost 50% of men at least once in their lifetime and makeup the majority of visits to the Urology Clinics.After much debate, it has been divided into four distinct categories by National Institutes of Health namely(1) acute bacterial prostatitis;(2) chronic bacterial prostatitis;(3) chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS) which is further divided into inflammatory and non-inflammatory CP/CPPS; and(4)asymptomatic inflammatory prostatitis. CP/CPPS has been a cause of great concern for both patients and physicians because of the lack of presence of thoroughinformation about the etiological factors along with the difficult-to-treat nature of the syndrome. For the presented manuscript an extensive search on PubM ed was conducted for CP/CPPS aimed to present an updated review on the evaluation and treatment options available for patients with CP/CPPS. Several diagnostic criteria's have been established to diagnose CP/CPPS, with prostatic/pelvic pain for at least 3 mo being the major classifying symptom along with the presence of lower urinary tract symptoms and/or ejaculatory pain. Diagnostic tests can help differentiate CP/CPPS from other syndromes that come under the heading of prostatitis by ruling out active urinary tract infection and/or prostatic infection with uropathogen by performing urine cultures, Meares-Stamey Four Glass Test, Preand Post-Massage Two Glass Test. Asymptomatic inflammatory prostatitis is confirmed through prostate biopsy done for elevated serum prostate-specific antigen levels or abnormal digital rectal examination. Researchers have been unable to link a single etiological factor to the pathogenesis of CP/CPPS, instead a cluster of potential etiologies including atypical bacterial or nanobacterial infection, autoimmunity, neurological dysfunction and pelvic floor muscle dysfunction are most commonly implicated. Initially monotherapy with anti-biotics and alpha adrenergic-blockers can be tried, but its success has only been observed in treatment nave population. Other pharmacotherapies including phytotherapy, neuromodulatory drugs and anti-inflammatories achieved limited success in trials. Complementary and interventional therapies including acupuncture, myofascial trigger point release and pelvic floor biofeedback have been employed. This review points towards the fact that treatment should be tailored individually for patients based on their symptoms. Patients can be stratified phenotypically based on the UPOINT system constituting of Urinary, Psychosocial, Organ-specific, Infectious, Neurologic/Systemic and symptoms of muscular Tenderness and the treatment algorithm should be proposed accordingly. Treatment of CP/CPPS should be aimed towards treating local aswell as central factors causing the symptoms. Surgical intervention can cause significant morbidity and should only be reserved for treatment-refractory patients that have previously failed to respond to multiple drug therapies.

Appropriate kidney stone size for ureteroscopic lithotripsy:When to switch to a percutaneous approach

Flexible ureteroscopy(f URS) has become a more effective and safer treatment for whole upper urinary tract stones. Percutaneous nephrolithotomy(PNL) is currently the first-line recommended treatment for large kidney stones ≥ 20 mm and it has an excellent stone-free rate for large kidney stones. However, its invasiveness is not negligible considering its major complication rates. Staged f URS is a practical treatmentfor such large kidney stones because f URS has a minimal blood transfusion risk, short hospitalization and few restrictions on daily routines. However, as the stone size becomes larger, the stone-free rate decreases, and the number of operations required increases. Therefore, in our opinion, staged f URS is a practical option for kidney stones 20 to 40 mm. Miniaturized PNL combined with f URS should be considered to be a preferred option for stones larger than 40 mm. Moreover, URS is an effective treatment for multiple upper urinary tract stones. Especially for patients with a stone burden < 20 mm, URS is a favorable option that promises a high stone-free rate after a single session either unilaterally or bilaterally. However, for patients with a stone burden ≥ 20 mm, a staged operation should be considered to achieve stone-free status.

Upper tract urothelial carcinoma: Paradigm shift towards nephron sparing management

Upper tract urothelial carcinoma （UTUC） is relatively rare compared to urothelial carcinoma of the lower tract, comprising only 5%-10% of all urothelial cancers. Although both entities share histologic properties, UTUC tends to be more invasive at diagnosis and portend a worse prognosis, with a 5 year overall mortality of 23%. To date, the gold standard management of UTUC has been radical nephroureterectomy （RNU）, with nephron sparing techniques reserved for solitary kidneys or cases where the patient could not tolerate radical surgery. Limited data from these series, as well as select series where nephron-sparing endoscopic management has been offered to a broader patient base, suggest that minimally invasive, nephron sparing techniques can offer comparable oncologic and survival outcomes to RNU in appropriately selected patients. We review the current literature on the topic and discuss long term outcomes and sequelae of the gold standard treatment, RNU. We also discuss the oncologic outcomes of minimally invasive, endoscopic management of UTUC. Our goal is to provide the reader a comprehensive overview of the current state of the feld in order to inform and guide their treatment decisions.

Pediatric primary urolithiasis: Symptoms, medical management and prevention strategies

In the past few decades pediatric urolithiasis has become more frequent. The reason for this increase is not completely clear but has been attributed to changes in climate, nutritional habits and possibly other environ-mental factors. Although less frequent than adult stone disease, urolithiasis in the pediatric age group is also related to significant morbidity, particularly since stones tend to recur, and, thus, should not be underestimated. Most children with idiopathic stone disease have an underlying metabolic abnormality substantiating the importance of metabolic evaluation already following initial diagnosis of urolithiasis. Identification of the metabolic abnormality allows for more specifc prescription of non pharmacological and pharmacological interventions aimed at preventing recurrent stone formation. A better understanding of the causes of kidney stone disease will provide better strategies for stone prevention in children.

Identification and characteristics analysis of bottlenecks on urban expressways based on floating car data

Identifying bottlenecks and analyzing their characteristics are important tasks to city traffic management authorities.Although the speed difference was proposed for the bottleneck identification in the existing research,the use of a secondary indicator has not been fully discussed.This paper strived to develop a method to identify the bottleneck on expressways by using the massive floating car data(FCD)in Beijing.First,the speed characteristics of bottlenecks on expressway were analyzed based on the speed contour map.The results indicated that there was a significant difference between speeds on the bottleneck and downstream links when a bottleneck was observed.The speed difference could indeed be used as the primary indicator to identify the bottleneck.However,it was also shown that a sufficiently large speed difference does not necessitate an activation of a bottleneck.The speed-at-capacity was then used as the secondary indicator to distinguish the real bottleneck from the non-bottleneck speed difference.Second,a practical method for identifying the bottleneck on expressways was developed based on the speed difference and the speed-at-capacity.Finally,the method was applied to identifying the bottlenecks of the 3rd Outer Ring Expressway in Beijing.The duration,affected distance,delay and cause were used to evaluate and analyze the bottlenecks.

Retrograde intrarenal surgery in pediatric patients

Urinary tract stone disease is seen at a level of 1%-2% in childhood(< 18 years).In recent years,however,there has been a marked increased in pediatric stone disease,particularly in adolescence.A carbohydrateand salt-heavy diet and a more sedentary lifestyle are implicated in this increase.Although stone disease is rare in childhood,its presence is frequently associated with metabolic or anatomical disorders or infectious conditions,for which reason there is a high possibility of post-therapeutic recurrence.Factors such as a high possibility of recurrence and increasing incidence further enhance the importance of minimally invasive therapeutic options in children,with their expectations of a long life.In children in whom active stone removal is decided on,the way to achieve the highest level of success with the least morbidity is to select the most appropriate treatment modality.Thanks to today's advanced technology,renal stones that were once treated only by surgery can now be treated with minimally in-vasive techniques,from invasion of the urinary system in an antegrade(percutaneous nephrolithotomy) or retrograde(retrograde intrarenal surgery) manner or shock wave lithotripsy to laparoscopic stone surgery.This compilation study examined studies involving the RIRS procedure,the latest minimally invasive technique,in children and compared the results of those studies with those from other techniques.

Are phosphodiesterase type 5 inhibitors effective for the management of lower urinary symptoms suggestive of benign prostatic hyperplasia?

AIM: To review the efficacy of phosphodiesterase type 5 inhibitors(PDE5-Is) in lower urinary tract symptoms(LUTS) suggestive of benign prostate hyperplasia(LUTS/BPH). METHODS: A comprehensive research was conducted to identify all publications relating to benign prostate hyperplasia and treatment with sildenafil, vardenafil and tadalafil. To assess the efficacy, the changes in total international prostate symptom score(IPSS), IPSS subscore including voiding, storage and quality of life(Qo L), Benign prostatic hyperplasia Impact Index(BII), maximum urinary flow rate(Qmax) and the International Index of Erectile Function(IIEF) were extracted. A meta-analytical technique was used for the analysis of integrated data from the included studies to evaluate the mean difference in the results. RESULTS: Total IPSS score, IIEF and BII showed a significant improvement in trials in which LUTS/BPH with or without erectile dysfunction(ED) were compared with the placebo. For LUTS/BPH, the mean differences of total IPSS score, IIEF and BII are-2.17, 4.88 and-0.43, P < 0.00001, respectively. For LUTS/BPH with comorbid ED, the mean difference are-1.97, 4.54 and-0.52, P < 0.00001, respectively. PDE5-Is appear to improve IPSS storage, voiding and Qo L subscore(mean difference =-0.71,-1.23 and-0.33, P < 0.00001, respectively). Although four doses of tadalafil(2.5, 5, 10 and 20 mg) failed to reach significance in Qmax(mean difference = 0.22, P = 0.10), the 5 mg dose of tadalafil significantly improved the Qmax(mean difference = 0.33, P = 0.03).CONCLUSION: PED5-Is demonstrated efficacy for improving LUTS in BPH patients with or without ED and could be considered to be the first line treatment for LUTS/BPH.

Bone disease in pediatric idiopathic hypercalciuria

Idiopathic hypercalciuria （IH） is the leading metabolic risk factor for urolithiasis and affects all age groups without gender or race predominance. IH has a high morbidity with or without lithiasis and reduced bone mineral density （BMD）, as described previously in pe-diatric patients as well as in adults. The pathogenesis of IH is complex and not completely understood, given that urinary excretion of calcium is the end result of an interplay between three organs （gut, bone and kidney）, which is further orchestrated by hormones, such as 1,25 dihydroxyvitamin D, parathyroid hormone, calcitonin and fosfatonins （i.e., fbroblast growth-factor-23）. Usu-ally, a primary defect in one organ induces compensa-tory mechanisms in the remaining two organs, such as increased absorption of calcium in the gut secondary toa primary renal loss. Thus, IH is a systemic abnormality of calcium homeostasis with changes in cellular trans-port of this ion in intestines, kidneys and bones. Re-duced BMD has been demonstrated in pediatric patients diagnosed with IH. However, the precise mechanisms of bone loss or failure of adequate bone mass gain are still unknown. The largest accumulation of bone mass occurs during childhood and adolescence, peaking atthe end of the second decade of life. This accumulation should occur without interference to achieve the peak of optimal bone mass. Any interference may be a risk factor for the reduction of bone mass with increased risk of fractures in adulthood. This review will address the pathogenesis of IH and its consequence in bone mass.

Laparoscopic surgical repair of pelvic organ prolapse and female stress urinary incontinence

Pelvic organ prolapse(POP) occurs in a relatively big population of women which is continuously increasing and is associated with a variety of urinary bowel and sexual symptoms. As this problem magnifi es, the need for surgical repair is increasing relatively. The main goals of surgical repair for POP include: no anatomic prolapse, no functional symptoms, patient satisfaction and avoidance of complications, goals that cannot always be fully achieved. The decision for the type of surgery depends of various factors such as patient characteristics and prolapsed compartment but also by the surgeon expertise. The laparoscopic approach is already the gold standard procedure for many urologic procedures and can also be used for the treatment of POP and stress urinary incontinence. Herein, we review the literature about the available data concerning laparoscopic surgery techniques for treating POP.

Laparoscopic Burch urethropexy at time of mesh sling removal: A cohort study evaluating functional outcomes and quality of life

AIM： To theorize that performing a laparoscopic Burch urethropexy at time of sling removal would signifcantly decrease subjective symptoms of stress urinary incon-tinence （SUI） and improve patient satisfaction.METHODS： Women who underwent a combined sling removal and laparoscopic Burch procedure between 2009 and 2014 were matched via age and sling-type in a 1：2 ratio to women who only underwent a sling removal. Those who underwent surgery within 6 mo of data collection were excluded from the study, as were women who underwent multi-stage surgery. Preoperative assessment for both groups included a focused clinical exam with or without functional testing and questionnaires including urogenital distress inventory-6 （UDI-6） and incontinence impact ques-tionnaire-7 （IIQ-7） per the standard clinical practice. All non-exempt women were sent a questionnaire that included UDI-6 and IIQ-7 in addition to standard follow-up questions. Research staff contacted participants via email, mail, and telephone using the same questionnaire template and script. Data was analyzed by using c2 test for categorical data, and Student’s t test and Wilcoxon Rank Sum test for continuous data. The measure of effect was determined by logistic regression analysis.RESULTS： A total of 48 women out of 146 selected patients were successfully recruited with n = 22 in the Burch cohort and n = 26 in the control cohort. The mean age was 54.7 ± 7.8 years and mean body mass index was 22.0 ± 13.9 kg/m2. The majority of patients were Caucasian （73.3%）, postmenopausal （91.1%）, non-smokers （57.9%）, with a history of hysterectomy （81.4%）. Six nineteen point six percent of women presented after at least 2 years from placement, which was signifcantly more common in the Burch cohort. Pain was the most common chief complaint （64.4%） in both groups at the time of initial presentation, and 78.9% of women reported concomitant urinary incontinence. There was no signifcant difference in pre-operative UDI-6 and IIQ-7 scores between the two cohorts. However, the change in UDI-6 score postoperatively was significantly improved in the Burch cohort with an average drop in score of 28.41 points compared to a decrease of 4.01 points in the control group （P = 0.02, 95%CI： 3.84 to 44.97）.Although not statistically significant, the Burch cohort was 58% more likely to show an overall improvement in their score after surgery and 40% more likely to meet the minimal important difference of 11 points （RR = 1.58, 95%CI： 0.97 to 2.57; RR 1.40, 95%CI： 0.79 to 2.46）. The difference in IIQ scores was nonsignificant. There was no signifcant difference in blood loss, complications, or postoperative pain or dyspareunia.CONCLUSION： Performing a Burch urethropexy during sling removal does not increase complication rates and results in a significant change in validated symptom-related quality of life scores.

Strategies to optimizeshockwavelithotripsy outcome:Patient selection and treatment parameters

Shock wave lithotripsy(SWL) was introduced in 1980, modernizing the treatment of upper urinary tract stones, and quickly became the most commonly utilized technique to treat kidney stones. Over the past 5-10 years, however, use of SWL has been declining because it is not as reliably effective as more modern technology. SWL success rates vary considerably and there is abundant literature predicting outcome based on patient- and stone-specific parameters. Herein we discuss the ways to optimize SWL outcomes by reviewing proper patient selection utilizing stone characteristics and patient features. Stone size, number, location, density, composition, and patient body habitus and renal anatomy are all discussed. We also review the technical parameters during SWL that can be controlled to improve results further, including type of anesthesia, coupling, shock wave rate, focal zones, pressures, and active monitoring. Following these basic principles and selection criteria will help maximize success rate.