AIM： To evaluate plasma levels of nitrite/nitrate （NOx）, soluble Pas （spas） antigen, tumor necrosis factor alpha （TNF-α） and interleukin-6 （IL-6） in patients with compensated and acute decompensated cirrhosi...AIM： To evaluate plasma levels of nitrite/nitrate （NOx）, soluble Pas （spas） antigen, tumor necrosis factor alpha （TNF-α） and interleukin-6 （IL-6） in patients with compensated and acute decompensated cirrhosis and to evaluate mediators causing acute decompensation in liver cirrhosis, METHODS： This prospective study was conducted in the medical intensive care unit of an academic tertiary center, Fifty-five patients with acute decompensation （gastrointestinal hemorrhage, encephalopathy, hydropic decompensation） and twenty-five patients with compensated liver drrhosis were included, Blood samples were taken for analyses of spas, Nox, IL-6, TNF-α, Liver enzymes and kidney functions were also tested, RESULTS： In patients with acute decompensation, plasma spas levels were higher than in non-decompensated patients （15305 ± 4646 vs 12458± 4322 pg/mL, P 〈 0.05）. This was also true for the subgroup of patients with alcoholic liver cirrhosis （P 〈 0.05）. The other mediators were not different and none of the parameters predicted survival, except for ALT （alanine-aminotransferase）. In patients with portal-hypertension-induced acute hemorrhage, NOx levels were significantly lower than in patients with other forms of decompensation （70.8 ± 48.3 vs 112.9 ± 74.9 pg/mL, P 〈 0.05）. When NOx levels were normalized to creatinine levels, the difference disappeared. IL-6, TNF-α and spas were not different between bleeders and non-bleeders. In decompensated patients spas, IL-6 and NOx levels correlated positively with creatinine levels, while IL-6 levels were dependent on Child class. CONCLUSION： In acute decompensated cirrhotic patients sPas is increased, suggesting a role of apoptosis in this process and patients with acute bleeding have lower NOx levels, However, in this acute complex clinical situation, kidney function seems to have a predominant influence on mediator levels,展开更多
A novel methodology is presented for simultaneously optimizing synthesis and cleaning schedule of flexible heat exchanger network(HEN)by genetic/simulated annealing algorithms(GA/SA).Through taking into account the ef...A novel methodology is presented for simultaneously optimizing synthesis and cleaning schedule of flexible heat exchanger network(HEN)by genetic/simulated annealing algorithms(GA/SA).Through taking into account the effect of fouling process on optimal network topology,a preliminary network structure possessing two-fold oversynthesis is obtained by means of pseudo-temperature enthalpy(T-H)diagram approach prior to simultaneous optimization.Thus,the computational complexity of this problem classified as NP(Non-deterministic Polynomial)-complete can be significantly reduced.The promising matches resulting from preliminary synthesis stage are further optimized in parallel with their heat exchange areas and cleaning schedule.In addition,a novel continu- ous time representation is introduced to subdivide the given time horizon into several variable-size intervals according to operating periods of heat exchangers,and then flexible HEN synthesis can be implemented in dynamic manner.A numerical example is provided to demonstrate that the presented strategy is feasible to decrease the total annual cost(TAC)and further improve network flexibility,but even more important,it may be applied to solve large-scale flexible HEN synthesis problems.展开更多
文摘AIM： To evaluate plasma levels of nitrite/nitrate （NOx）, soluble Pas （spas） antigen, tumor necrosis factor alpha （TNF-α） and interleukin-6 （IL-6） in patients with compensated and acute decompensated cirrhosis and to evaluate mediators causing acute decompensation in liver cirrhosis, METHODS： This prospective study was conducted in the medical intensive care unit of an academic tertiary center, Fifty-five patients with acute decompensation （gastrointestinal hemorrhage, encephalopathy, hydropic decompensation） and twenty-five patients with compensated liver drrhosis were included, Blood samples were taken for analyses of spas, Nox, IL-6, TNF-α, Liver enzymes and kidney functions were also tested, RESULTS： In patients with acute decompensation, plasma spas levels were higher than in non-decompensated patients （15305 ± 4646 vs 12458± 4322 pg/mL, P 〈 0.05）. This was also true for the subgroup of patients with alcoholic liver cirrhosis （P 〈 0.05）. The other mediators were not different and none of the parameters predicted survival, except for ALT （alanine-aminotransferase）. In patients with portal-hypertension-induced acute hemorrhage, NOx levels were significantly lower than in patients with other forms of decompensation （70.8 ± 48.3 vs 112.9 ± 74.9 pg/mL, P 〈 0.05）. When NOx levels were normalized to creatinine levels, the difference disappeared. IL-6, TNF-α and spas were not different between bleeders and non-bleeders. In decompensated patients spas, IL-6 and NOx levels correlated positively with creatinine levels, while IL-6 levels were dependent on Child class. CONCLUSION： In acute decompensated cirrhotic patients sPas is increased, suggesting a role of apoptosis in this process and patients with acute bleeding have lower NOx levels, However, in this acute complex clinical situation, kidney function seems to have a predominant influence on mediator levels,
基金Supported by the National Natural Science Foundation of China （20976022） and Dalian University of Technology for Constructing Interdiscipline ＇Energy＋X＇. ACKNOWLEDGEMENTS The authors gratefully acknowledge financial support from Lanzhou Petrochemical Company, PetroChina Company Limited.
文摘A novel methodology is presented for simultaneously optimizing synthesis and cleaning schedule of flexible heat exchanger network(HEN)by genetic/simulated annealing algorithms(GA/SA).Through taking into account the effect of fouling process on optimal network topology,a preliminary network structure possessing two-fold oversynthesis is obtained by means of pseudo-temperature enthalpy(T-H)diagram approach prior to simultaneous optimization.Thus,the computational complexity of this problem classified as NP(Non-deterministic Polynomial)-complete can be significantly reduced.The promising matches resulting from preliminary synthesis stage are further optimized in parallel with their heat exchange areas and cleaning schedule.In addition,a novel continu- ous time representation is introduced to subdivide the given time horizon into several variable-size intervals according to operating periods of heat exchangers,and then flexible HEN synthesis can be implemented in dynamic manner.A numerical example is provided to demonstrate that the presented strategy is feasible to decrease the total annual cost(TAC)and further improve network flexibility,but even more important,it may be applied to solve large-scale flexible HEN synthesis problems.
