静脉渗出分级护理对静脉置管行静脉高营养患者的应用效果观察

目的探析肝胆科接受静脉置管行静脉高营养患者实施静脉渗出分级护理的临床效果。方法选取2019年5月~2020年11月内蒙古自治区人民医院肝胆科收治的82例接受静脉置管行静脉高营养患者为研究对象,采用随机数表法分为对照组与干预组,每组41例。对照组患者实施常规护理干预,干预组患者实施静脉渗出分级护理,对比两组患者的组间数据差异。结果干预组患者静脉Ⅲ级以上渗出发生率低于对照组,差异有统计学意义(P<0.05);干预组患者对护理服务质量评分中,护理方案、护理态度、护理内容以及护理细节的评分高于对照组,差异有统计学意义(P<0.05)。结论肝胆科患者实施输入静脉高营养干预期间,静脉渗出分级护理能够有效地根据患者的静脉渗出状况及生理状况完成护理干预,促进患者生理状态有效改善,临床应用价值显著。

深静脉置管行血液净化治疗相关感染的护理要点分析

探讨分析深静脉置管血液净化治疗中感染的护理要点。方法 共选取100例患者作为研究目标,患者皆来自2022年11月到2023年10月时期,患者均接受了深静脉导管的血液净化治疗。这些患者被平均分为两组,每组各50人。观察组接受了标准护理加上针对感染因素的预防性护理,而对照组仅接受了常规护理。通过比较这两种护理方法,评估它们对患者感染控制的效果。结果 与对照组相比,观察组相关感染发生率得到了更有效的遏制(P<0.05)。结论 对感染因素进行预防性护理,可有效避免深静脉导管血液净化治疗中感染的发生,对降低感染发生率、提高患者康复安全性具有重要的实用价值。

从“管心”与“管行”研究高职生的管理

加强学生管理，是高职学院维护校园秩序，提高人才培养质量，造就高素质社会需求人才的需要。学生管理，不仅要用心，更要“管心”，以“管心”促进“管行”，不断提高管理水平。

承钢360m^2烧结机机尾除尘系统改造

承钢烧结机机尾除尘系统原采用静电除尘器,排放浓度不达标。对除尘器结构形式、进出风方式、管路附件、布袋清灰系统和控制系统进行了改造,特别是在布袋清灰系统使用了无管行喷专利技术。改造后既满足环保排放的要求,又节约了项目投资。

An Overview of Coilia ectenes in Jiangsu Section of the Yangtze River

Anchovies are migratory fish and adult individuals migrate in group from the sea into the river every year because of reproductive needs. TheYangtze River is the largest river in China, with rich food and fish species, hence, the Yangtze River would be an ideal habitat for growth and reproduction of anchovy. In this pa- per, based on fishing log data of anchovy in Jiangsu section of the Yangtze River, realted analysis was conducted in digital map using statistical software and GIS. From 2008 to 2011, the number of anchovy fishing vessels and fishing days in Jiangsu section remained stable, but the fishing volume and economic profit of single-vessel fluctuated constantly. This study provides references and advices for plan and management of anchovy fishery resource to administrative department.

ENERGY STATE APPROACH TO THE INTEGRATED FLIGHT PERFORMANCE MANAGEMENT OF COMMERCIAL AIRCRAFT

The integrated aircraft flight performance management techniques are discussed in this paper based on the point-mass energy state approximation principle. The flight performance optimization algorithms, developed with energy state approximation approach, are first introduced, the functionally integrated flight path/speed control system, so called total energy control system (TECS), is then discussed, and the guidance technique and algorithms, which relate the performance optimization results directly with the TECS, are analyzed and developed. Digital simulation results for a specific transport aircraft model demonstrate the satisfactory performances of the resulted flight performance management system.

Reform Dividends and Economic Convenience

Reform dividends refer to the improvements in certain economic actors under the new, reformed institutional system as compared against the original system. Reform leads to greater economic growth potential by changing the institutional environment, which in turn increases the vibrancy and innovation of economic actors. The most economically convenient system is also in actuality the most effective market economic system. Reform based on public and collective actions should be based on the following principle： if institutional reform is evolving towards the enhancement of economic convenience, then we can be sure that reform is embarking on the path of releasing dividends.

Retrograde Hepatectomy for Difficultly Resected Liver Cancer: A Report of 244 Cases

Objective To report our experience of retrograde hepatectomy in 244 cases of difficultly resected liver cancer. Methods Large, poor-exposure and inferior vena cava (IVC)-involving liver cancers that were difficult to remove by classical hepatectomy, have been resected successfully by retrograde hepatectomy combined with vascular surgical techniques in 244 patients (group A). Thirty one patients with similar circumstances undergoing classical hepatectomy duing the same period served as controls (group B). Results There were no perioperative mortalities in both groups. The comparison between group A and group B, the estimated intraoperative blood loss was 1290±998 ml versus 2286±1363 ml, post-operative pleural effusions occurred in 26/244 versus 10/31, ascites in 72/244 versus 19/31, moderate to severe jaundice in 14/244 versus 5/31, effusion in the operative area in 17/244 versus 7/31, subphrenic infection in 3/244 versus 1/31, bile leakage in 2/244 versus 1/31, wound infection in 3/244 versus 1/31, respectively. The time until ALT normalizaton in the groups A and B was 13.8±5.1 days and 18.9±8.9 days respectively. The difference between the two groups were statistically significant (P<0.01). Conclusion Retrograde hepatectomy is a safe and effective method for difficultly resected liver cancer. Key words cancer - liver - liver surgery - retrograde

FLIGHT CONFLICT DETECTION AND RESOLUTION

The air traffic control (ATC) systems are facing more and more serious congestive because of the increasing of air traffic flow in China. One of the most available ways to solve the problem is 'free flight' that the pilots may choose the air route and flight speed suitable for them. But this will lead to the difficulties for the controllers. This paper presents how ATC genetic algorithms can be used to detect and to solve air traffic control conflicts in free flight. And it also shows that this algorithm perfectly suits for solving flight conflicts resolution because of its short computing time.

360m^2烧结机机尾除尘系统改造

烧结机机尾除尘原为静电除尘,排放浓度不达标,通过对除尘器结构形式、进出风方式、管路附件、布袋清灰系统和控制系统进行改造,特别是在布袋清灰系统使用了无管行喷专利技术,改造后既满足环保排放的要求,又节约了项目投资。

Management of acute nonvariceal upper gastrointestinal bleeding:Current policies and future perspectives

Acute upper gastrointestinal bleeding(UGIB) is a gastroenterological emergency with a mortality of 6%-13%.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB,and is recommended within 24 h of presentation.Proton pump inhibitor(PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy,but has no effect on rebleeding,mortality and need for surgery.Endoscopic therapy should be undertaken for ulcers with high-risk stigmata,to reduce the risk of rebleeding.This can be done with a variety of modalities.High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality,particularly in patients with high-risk stigmata.

Risk factors for gastroesophageal reflux disease,reflux esophagitis and non-erosive reflux disease among Chinese patients undergoing upper gastrointestinal endoscopic examination

AIM: To analyze the spectrum and risk factors of gastroesophageal reflux disease (GERD) based on presenting symptoms and endoscopic f indings. METHODS: A cross-sectional survey in a cluster random sample was conducted from November 2004 to June 2005 using a validated Chinese version Reflux Disease Questionnaire (RDQ) and other items recording the demographic characteristics and potential risk factors for GERD. Subjects were def ined as having GERD symptoms according to the RDQ score (> 12). All subjects were endoscopied and the def inition and severity of erosive esophagitis were evaluated by Los Angeles classif ication. The statistical analysis was performed with SPSS13.0 programs. RESULTS: Of 2231 recruited participants, 701 (31.40%) patients were diagnosed as having GERD while 464 (20.80%) patients had objective findings of reflux esophagitis (RE). Of those 464 patients, only 291 (13.00%) were reported as subjects with GERD symptoms. A total of 528 (23.70%) patients were found to have GERD symptoms, including 19.50% patients with grade A or B reflux esophagitis, 0.90% with grade C and 0.40% with grade D. On multivariate analysis, old age, male, moderate working burden, divorced/widowed and strong tea drinking remained as signif icant independent risk factors for erosive esophagitis. Meanwhile, routine usage of greasy food and constipation were considered as significant independent risk factors for non-erosive reflux disease (NERD). CONCLUSION: GERD is one of the common GI diseaseswith a high occurrence rate in China and its main associated factors include sex, anthropometrical variables and sociopsychological characteristics.

Portal vein thrombosis:Prevalence,patient characteristics and lifetime risk:A population study based on 23796 consecutive autopsies

AIM： TO assess the lifetime cumulative incidence of portal venous thrombosis （PVT） in the general population. METHODS： Between 1970 and 1982, 23 796 autopsies, representing 84% of all in-hospital deaths in the Malmo city population, were performed, using a standardised protocol including examination of the portal vein. PVT patients were characterised and the PVT prevalence at autopsy, an expression of life-time cumulative incidence, assessed in high-risk disease categories and expressed in terms of odds ratios and 95% CI. RESULTS： The population prevalence of PVT was 1.0%. Of the 254 patients with PVT 28% had cirrhosis, 23% primary and 44% secondary hepatobiliary malignancy, 10% major abdominal infectious or inflammatory disease and 3% had a myeloproliferative disorder. Patients with both cirrhosis and hepatic carcinoma had the highest PVT risk, OR 17.1 （95% CI 11.1-26.4）. In 14% no cause was found; only a minority of them had developed portal-hypertension-related complications. CONCLUSION： In this population-based study, PVT was found to be more common than indicated by previous clinical series. The markedly excess risk in cirrhosis and hepatic carcinoma should warrant an increased awareness in these patients for whom prospective studies of directed intervention might be considered.

Prevalence of Barrett's esophagus in patients with moderate to severe erosive esophagitis

AIM: To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation. METHODS: Patients with EE of Los Angeles (LA) class B, C and D who underwent follow-up endoscopy documenting complete mucosal healing. RESULTS: A total of 86/169 patients were suspected of having BE (38 before healing and 48 after healing of EE) and, 46/86 eventually had the histological confirmation. At index esophago-gastro-duodenoscopy (EGD), BE was suspected in 38/169 (22%), and ultimately, histologically confirmed in 20 of these. In 11 patients where biopsies were performed in the presence of inflammation, BE was detected in 2 and missed in 5 (including 2 dysplasias). In 131/169 patients (77.5%), BE was not suspected at index EGD. After healing of EE though, 48 patients had suspicion of BE who underwent biopsies, and in 26 of these histology was positive for BE. The length of inflammation had a linear correlation with the length of BE (P = 0.01). Out of multiple variables to predict BE, only the suspicion at index endoscopy was statistically significant (P = 0.01). CONCLUSION: BE was seen in 46/169 (27%) patients with EE of LA class B, C and D. The length of EE can predict the length of underlying BE segment.Even when suspected, BE and associated dysplasia can be missed in the presence of inflammation; therefore, repeat evaluation should be considered after complete healing of esophagitis.

Type D personality negatively associated with self-care in Chinese heart failure patients

Background Little is known about the association between type D personality and self-care behaviors in heart failure （HF） patients. We examined the effect of type D personality on self-care behaviors and self-efficacy among Chinese HF patients. Methods A cross-sectional study with a convenience sample was conducted. All participants completed the questionnaires of the self-care of HF index （V6） and type D personality scale. Demographic and clinical variables were obtained from medical records and patient interviews. The me- thods used for data analysis included descriptive analysis, independent-sample t-test, Z2 test, and multiple linear regression. Results A total of 127 HF patients were included and 61.4% of them were male. The average age for this study sample was 64.9± 12.34 years. The majority of the participants were in a New York Heart Association class III or IV （87%）, and the average length of living with HF was 38.24 ± 41.1 months. A total of 33.1% of the participants were identified as having type D personality. No significant differences were determined in the demographic and clinical variables between type D and non-type D patients, except for the mean age and the length of living with HF. Type D patients were younger and had a shorter time of living with HF than their non-type D counterparts. Multiple regression demonstrated significant associations between type D personality and self-care maintenance and self-efficacy after adjusting the demographic and clinical factors. However, type D personality was not significantly associated with self-care management behaviors. Conclusions Type D personality was negatively related to self-care maintenance and self-efficacy in Chinese HF patients. Future study is warranted to develop a tailored intervention to improve engagement in self-care behaviors in HF patients with type D personality.

Clinical features and management of primary biliary cirrhosis

Primary biliary cirrhosis(PBC),which is characterised by progressive destruction of intrahepatic bile ducts,is not a rare disease since both prevalence and incidence are increasing during the last years mainly due to the improvement of case finding strategies.The prognosis of the disease has improved due to both the recognition of earlier and indolent cases,and to the wide use of ursodeoxycholic acid(UDCA).New indicators of prog-nosis are available that will be useful especially for the growing number of patients with less severe disease.Most patients are asymptomatic at presentation.Pruri-tus may represent the most distressing symptom and,when UDCA is ineffective,cholestyramine represents the mainstay of treatment.Complications of long-standing cholestasis may be clinically relevant only in very ad-vanced stages.Available data on the effects of UDCA on clinically relevant end points clearly indicate that the drug is able to slow but not to halt the progression of the disease while,in advanced stages,the only thera-peutic option remains liver transplantation.

Endosonography with linear array instead of endoscopic retrograde cholangiography as the diagnostic tool in patients with moderate suspicion of common bile duct stones

AIM: To evaluate the diagnostic efficiency of endoscopic ultrasound (EUS) as the main imaging modality in patients with moderate suspicion of common bile duct stones (CBDS).METHODS: 55 patients with moderate clinical suspicion of CBDS were prospectively included to the study and evaluated with EUS. This study was done in single blind method in the clinical and biochemical data of patients. EUS was done with echo-endoscope Pentax FG 32-UA (f=5-7,5 MHz) and Hitachi EUB 405 ultrasound machine. Patients diagnosed with CBDS by EUS were excluded from this study and treated with ERC. All the other patients were included to the follow up study obtained by mail every 6 months for clinical evaluation (need of ERC or surgery).RESULTS: CBDS was found in 4 patients by EUS. Diagnosis was confirmed in all cases on ERC. The remaining 51 patients without CBDS on EUS were followed up for 6-26 months (meanly 13 months) There were: 40 women, 42cholecystectomized patients, aged: 55 (mean). Biochemical values (mean values) were as follows: bilirubin: 14,9 μmol.L-1,alkaline phosphatase: 95 IU.L-,1 γ-GTP: 131 IU.L-1, ALT: 50IU.L-1, AST: 49 IU.L-1, Only 1 patient was lost for follow up.In the remaining 50 patients with follow up, there was only 1 (2 %) patient with persistent biliary symptoms in whom CBDS was finally diagnosed by ERC with ES. All other patients remained symptoms free on follow up and did not require ERC or biliary surgery.CONCLUSION: Vast majority of patients with moderate suspicion of CBDS and no stones on EUS with linear array can avoid invasive evaluation of biliary tree with ERC.

Wrinkling behavior of magnesium alloy tube in warm hydroforming

In tube hydroforming with axial feeding,under the effect of coupled internal pressure and axial stress,wrinkles often occur and affect the forming results.Wrinkling behavior of an AZ31B magnesium alloy tube was experimentally investigated with different loading paths at different temperatures.Features of wrinkles,including shape,radius and width,were acquired from the experiments,as well as the thickness distribution.Numerical simulations were carried out to reveal the stress state during warm hydroforming,and then the strain history of material at the top and bottom of the wrinkles were analyzed according to the stress tracks and yielding ellipse.Finally,effects of loading paths on expansion ratio limit of warm hydroforming were analyzed.It is verified that at a certain temperature,expansion ratio limit can be increased obviously by applying a proper loading path and realizing enough axial feeding.

Effect of Application of Pipe Roof Method by Using Pipe Jacking on Behavior of Surrounding Soil

Tunnels in an urban area, in many cases, are constructed in soft ground which contains underground water, near existing facilities and structures. Structural stability for the tunnel and also the nearby structures and facilities is vital in this kind of work. Slurry pipe jacking was firmly established as a special method for the non-disruptive construction of underground pipelines of sewage systems. This method utilizes mud slurry that is formed around the pipes in order to stabilize the surrounding soil. In the pipe roof method the tubing elements that are constructed by slurry pipe jacking are near each other longitudinally, and create a rigid and stable lining before the excavation of the main tunnel. This paper discusses ＇the application of a slurry pipe jacking system on ＇the pipe roof method by means of numerical analysis. Because of the rigid behavior of the lining, the results show little subsidence, making this method a reliable method of constructing large tunnels with small cover in an urban area.

Shape and Mechanical Behavior of Geotextile Tubes

Nowadays, geotextile tubes hydraulically filled with dredged materials have been used in the application of cofferdam, sea reclamation and deepwater channel regulation in China. The shape and mechanical behaviors during the process of filling, consolidation and stacked are one of the main problems concemed by designers and researchers.This paper uses the method of elliptic integrals to study the behaviors of filling and deduces the regressive formulas of shape features and circumferential tension. The results show that the proposal regressive formulas are only the function of pressure at bottom; they are very convenient and suitable for the filling design. When the filling materials are sandy, the shape and mechanical behaviors nearly remain during the process of consolidation. The behaviors of stacked geotextile tubes are very complex, because they are involved in the properties of the filling material, geotextile and foundation.Using the commercial finite element analysis program ABAQUS, this paper establishes the entire 2- D finite element load model to investigate, which include the part of filling material, geotextile and foundation. The numerical results suggest that the maximun circumferential tension varies with the properties of filling materials and foundations, whereas the largest tensile force occurs during the filling process.