OBJECTIVE： To determine the distribution of Tradi- tional Chinese Medicine （TCM） patterns in hepatitis B-related acute-on-chronic liver failure （HB-ACLF） in different stages for guiding clinical prescriptions and...OBJECTIVE： To determine the distribution of Tradi- tional Chinese Medicine （TCM） patterns in hepatitis B-related acute-on-chronic liver failure （HB-ACLF） in different stages for guiding clinical prescriptions and treatments. METHODS： A prospective, cross-sectional survey method was used in this study. A total of 324 cases with HB-ACLF in China were involved. RESULTS： The general frequency of TCM patterns in HB-ACLF were as follows： Heat Toxin Stagnation Pattern （134/324, 41.36%）, Damp-heat Obstruction Pattern （66/324, 20.37% ）, Yong Qi Deficiency Pat- tern （52/324, 16.05%）, and Liver and Kidney Yin De- ficiency Pattern （26/324, 8.02%）. In the early stage of HB-ACLE there was a remarkably higher percent- age of excessive patterns than those in the middle and late stage. The incidence of Heat Toxin Stagna- tion reached 58.57% （82/140） in the early stage, while it was 33.96% （36/106） in the middle stage and 20.51% （16/78） in the late stage. In the early stage of HB-ACLF, excessive patterns, such as the Heat Toxin Stagnation Pattern, were more preva- lent than those in the middle and late stages （P〈a＇= 0.003）. However, in the late stage of HB-ACLE defi- cient patterns, such as the Yang Qi Deficiency Pat- tern, were more prevalent than those in the early and middle stages. The Yang Qi Deficiency Pattern had a higher rate of 41.03% （32/78） in the late stage compared with that of 20.75% （22/106） in the middle stage and 8.57% （12/140, P〈a＇ =0.003） in the early stage. The distribution of the other pat- terns was not significant between the three stages （P〉0.003）. CONCLUSIONS： There are four major patterns of HI3-ACLF, including the Heat Toxin Stagnation Pat- tern, the Damp-heat Obstruction Pattern, the Yang Qi Deficiency Pattern, and the Liver and Kidney Yin Deficiency Pattern. The Heat Toxin Stagnation and Yang Qi Deficiency Patterns are the representative patterns in the early and late stages of HB-ACLF. In the middle stage of HB-ACLF, the TCM patterns vary in a complicated manner, with no significant differ- ence among the patterns. Treatment for HB-ACLF should vary with the different representative pat- terns in the early and late stages.展开更多
The first wall of the fusion reactor is a plasma-facing component and is a key link to maintain the integrity of structure during thermal shock induced by plasma disruptions. Be and W/Cu functionally graded materials ...The first wall of the fusion reactor is a plasma-facing component and is a key link to maintain the integrity of structure during thermal shock induced by plasma disruptions. Be and W/Cu functionally graded materials are two kinds of important plas- ma-facing materials （PFM） of first wall in fusion reactor currently. Previous researches seldom comparatively evaluated the normal servicing and heat shock resistance performance of first walls with those two kinds of PFMs. And also there lacks cou- pled thermal/mechanical analysis on the heat shock process in consideration of multiple thermal/mechanical phenomena, such as material melting, solidification, evaporation, etc., which is significant to further understand the heat shock damage mecha- nism of the first wall with different PFMs. With the aim of learning more detailed mechanical mechanism of thermal shock damage and then improving the thermal shock resistance performance of different first wall designs, the coupled ther- mal/mechanical response of two typical ITER-like first walls with PFM of Be and functionally graded W-Cu respectively un- der the heat shock of 1 2 GW/m2 are computed by the finite element method. Special considerations of elastic-plastic defor- mation, material melting, and solidification are included in numerical models and methods. The mechanical response behaviors of different structures and materials under the normal servicing operation as well as plasma disruption conditions are analyzed and investigated comparatively. The results reveal that heat is mainly deposited on the PFM layer in thc high energy shock pulse induced by plasma disruptions, resulting in complex thermal stress change as well as mechanical itTeversible damage of thermal elastic and plastic expansion, contraction and yielding. Compared with the first wall with Be PFM, which mitigates the damages from heat shock at most only in the PFM layer with cost of whole PFM layer plastic yielding, the first wall with graded W-Cu PFM is demonstrated to be possessed both of higher heat shock resistance performance and normal servicing performance, provided its material gradient and cooling capacity are well optimized under practical loading conditions.展开更多
基金Supported by the National Science and Technology Major Project of the Ministry of Science and Technology of China (No.2008ZX1005)
文摘OBJECTIVE： To determine the distribution of Tradi- tional Chinese Medicine （TCM） patterns in hepatitis B-related acute-on-chronic liver failure （HB-ACLF） in different stages for guiding clinical prescriptions and treatments. METHODS： A prospective, cross-sectional survey method was used in this study. A total of 324 cases with HB-ACLF in China were involved. RESULTS： The general frequency of TCM patterns in HB-ACLF were as follows： Heat Toxin Stagnation Pattern （134/324, 41.36%）, Damp-heat Obstruction Pattern （66/324, 20.37% ）, Yong Qi Deficiency Pat- tern （52/324, 16.05%）, and Liver and Kidney Yin De- ficiency Pattern （26/324, 8.02%）. In the early stage of HB-ACLE there was a remarkably higher percent- age of excessive patterns than those in the middle and late stage. The incidence of Heat Toxin Stagna- tion reached 58.57% （82/140） in the early stage, while it was 33.96% （36/106） in the middle stage and 20.51% （16/78） in the late stage. In the early stage of HB-ACLF, excessive patterns, such as the Heat Toxin Stagnation Pattern, were more preva- lent than those in the middle and late stages （P〈a＇= 0.003）. However, in the late stage of HB-ACLE defi- cient patterns, such as the Yang Qi Deficiency Pat- tern, were more prevalent than those in the early and middle stages. The Yang Qi Deficiency Pattern had a higher rate of 41.03% （32/78） in the late stage compared with that of 20.75% （22/106） in the middle stage and 8.57% （12/140, P〈a＇ =0.003） in the early stage. The distribution of the other pat- terns was not significant between the three stages （P〉0.003）. CONCLUSIONS： There are four major patterns of HI3-ACLF, including the Heat Toxin Stagnation Pat- tern, the Damp-heat Obstruction Pattern, the Yang Qi Deficiency Pattern, and the Liver and Kidney Yin Deficiency Pattern. The Heat Toxin Stagnation and Yang Qi Deficiency Patterns are the representative patterns in the early and late stages of HB-ACLF. In the middle stage of HB-ACLF, the TCM patterns vary in a complicated manner, with no significant differ- ence among the patterns. Treatment for HB-ACLF should vary with the different representative pat- terns in the early and late stages.
基金supported by the National Magnetic Confinement Fusion Science Program of China(Grant Nos.2015GB121007&2013GB113004)
文摘The first wall of the fusion reactor is a plasma-facing component and is a key link to maintain the integrity of structure during thermal shock induced by plasma disruptions. Be and W/Cu functionally graded materials are two kinds of important plas- ma-facing materials （PFM） of first wall in fusion reactor currently. Previous researches seldom comparatively evaluated the normal servicing and heat shock resistance performance of first walls with those two kinds of PFMs. And also there lacks cou- pled thermal/mechanical analysis on the heat shock process in consideration of multiple thermal/mechanical phenomena, such as material melting, solidification, evaporation, etc., which is significant to further understand the heat shock damage mecha- nism of the first wall with different PFMs. With the aim of learning more detailed mechanical mechanism of thermal shock damage and then improving the thermal shock resistance performance of different first wall designs, the coupled ther- mal/mechanical response of two typical ITER-like first walls with PFM of Be and functionally graded W-Cu respectively un- der the heat shock of 1 2 GW/m2 are computed by the finite element method. Special considerations of elastic-plastic defor- mation, material melting, and solidification are included in numerical models and methods. The mechanical response behaviors of different structures and materials under the normal servicing operation as well as plasma disruption conditions are analyzed and investigated comparatively. The results reveal that heat is mainly deposited on the PFM layer in thc high energy shock pulse induced by plasma disruptions, resulting in complex thermal stress change as well as mechanical itTeversible damage of thermal elastic and plastic expansion, contraction and yielding. Compared with the first wall with Be PFM, which mitigates the damages from heat shock at most only in the PFM layer with cost of whole PFM layer plastic yielding, the first wall with graded W-Cu PFM is demonstrated to be possessed both of higher heat shock resistance performance and normal servicing performance, provided its material gradient and cooling capacity are well optimized under practical loading conditions.
