紫杉醇药物涂层球囊治疗老年冠状动脉小血管病变的效果分析

目的 分析紫杉醇药物涂层球囊对老年冠状动脉小血管病变患者的治疗效果,为临床提供参考。方法 回顾性分析2021年1月至2022年1月北京市仁和医院收治的88例行经皮冠状动脉介入治疗(PCI)术的老年冠状动脉小血管病变患者的临床资料。根据术中介入治疗方案不同分为药物涂层球囊(DCB)组(49例,给予紫杉醇药物涂层球囊治疗)与药物洗脱支架(DES)组(39例,给予雷帕霉素支架治疗)。比较两组患者治疗效果、造影结果、主要心脏不良事件(MACE)发生情况及出血情况。结果 DCB组患者整体疗效优于DES组,且总有效率高于DES组(P<0.05)。术后即刻,两组患者最小血管直径大于术前、血管狭窄程度小于术前,且DCB组最小血管直径大于DES组、血管狭窄程度小于DES组(P<0.05);术后8个月,DCB组的晚期管腔丢失(LLL)水平低于DES组(P<0.05)。术后12个月,两组患者MACE总发生率比较,差异无统计学意义(P>0.05)。术后12个月,DCB组患者出血总发生率低于DES组(P<0.05)。结论 PCI中予紫杉醇药物涂层球囊治疗老年冠状动脉小血管病变患者,可有效预防患者二次狭窄,保障治疗效果与安全性。

内观认知疗法对医学生焦虑水平、自我效能感和应对方式的干预及机制

目的:探究内观认知疗法对医学生焦虑水平、自我效能感和应对方式的影响,并考察医学生内观认知疗法干预、自我效能感、应对方式和焦虑水平间的关系,以期为医学生心理健康教育工作和NCT疗法的作用机制研究提供理论支持。方法:采用随机数字表法将70名符合筛选标准的研究对象随机分配到内观认知疗法组和心理健康教育组,每组35人。内观认知疗法组接受为期7天的内观认知疗法干预,心理健康教育组接受相同时间的常规心理健康教育,最终共68人完成试验(内观认知疗法组34人,心理健康教育组34人)。干预前后使用SAS、GSES、SCSQ量表对两组研究对象进行测评。结果:①干预前,内观认知疗法组与心理健康教育组在焦虑,自我效能感,积极和消极应对方式得分上均不存在显著差异。②干预后,内观认知疗法组焦虑得分显著降低(t=5.835;P<0.01),自我效能感和积极应对方式得分均显著升高(t=2.289,4.668;P<0.05),消极应对方式得分不存在显著差异,干预前后心理健康教育组在上述所有量表得分中均不存在显著差异。③干预后,内观认知疗法组自我效能感和积极应对方式得分显著高于心理健康教育组(t=2.653,3.122;P<0.01),焦虑得分显著低于心理健康组(t=2.562;P<0.05)。④中介效应检验方面,内观认知疗法既可以直接影响医学生焦虑水平(β=-0.293,95%CI=-3.755~0.008),也可以通过自我效能感的中介作用(β=-0.307,95%CI=-0.612~-0.028)、积极应对方式的中介作用(β=0.140,95%CI=-0.293~-0.004)及自我效能感和积极应对方式的链式中介作用(β=0.222,95%CI=-0.553~-0.022)间接影响医学生焦虑水平。结论:内观认知疗法是一种能够有效降低医学生焦虑水平的干预手段,既能直接缓解焦虑,也能通过提高医学生自我效能感水平,改善积极应对方式间接降低医学生焦虑水平。

BILL Strategy:Points to Consider During the Performance and Interpretation of Critical Care Echocardiography

The growing utilization of critical care echocardiography(CCE) by clinicians necessitates a meticulous review of clinical conditions in critically ill patients, both before and during the examination. The reviewing process of clinical conditions minimizes the risk of overlooking or misinterpreting crucial findings. This article proposes a comprehensive strategy, namely BILL strategy, to integrate into the CCE protocol, where "B" represents baseline respiratory and hemodynamic support, "I" signifies information gleaned from invasive monitoring, including central venous pressure and thermodilution-derived cardiac output, the first "L" denotes laboratory results such as central venous oxygen saturation, troponin, and brain natriuretic peptide, and the second "L" refers to lung ultrasound data. Combining the BILL strategy with CCE can enhance comprehensive understanding of critical conditions, potentially leading to improved diagnostic accuracy and patient outcomes.

Prediction and critical transition mechanism for granite fracture:Insights from critical slowing down theory

Rock fracture warning is one of the significant challenges in rock mechanics.Many true triaxial and synchronous acoustic emission(AE)tests were conducted on granite samples.The investigation focused on the characteristics of AE signals preceding granite fracture,based on the critical slowing down(CSD)theory.The granite undergoes a transition from the stable phase to the fracture phase and exhibits a clear CSD phenomenon,characterized by a pronounced increase in variance and autocorrelation coefficient.The variance mutation points were found to be more identifiable and suitable as the primary criterion for predicting precursor information related to granite fracture,compared to the autocorrelation coefficient.It is noteworthy to emphasize that the CSD factor holds greater potential in elucidating the underlying mechanisms responsible for the critical transition of granite fracture,in comparison to the AE timing parameters.Furthermore,a novel multi-parameter collaborative prediction method for rock fracture was developed by comprehensively analyzing predictive information,including abnormal variation modes and the CSD factor of AE characteristic parameters.This method enhances the understanding and prediction of rock fracture-related geohazards.

Vascular Calcification:Where is the Cure?

With the progress of aging,the incidence of vascular calcification(VC)gradually increases,which is correlated with cardiovascular events and all-cause death,aggravating global clinical burden.Over the past several decades,accumulating approaches targeting the underlying pathogenesis of VC have provided some possibilities for the treatment of VC.Unfortunately,none of the current interventions have achieved clinical effectiveness on reversing or curing VC.The purpose of this review is to make a summary of novel perspectives on the interventions of VC and provide reference for clinical decision-making.

Cryogenic springback of 2219-W aluminum alloy sheet through V-shaped bending

A V-shaped bending device was established to evaluate the effects of temperature and bending fillet radius on springback behavior of 2219-W aluminum alloy at cryogenic temperatures.The cryogenic springback mechanism was elucidated through mechanical analyses and numerical simulations.The results indicated that the springback angle at cryogenic temperatures was greater than that at room temperature.The springback angle increased further as the temperature returned to ambient conditions,attributed to the combined effects of the “dual enhancement effect” and thermal expansion.Notably,a critical fillet radius made the springback angle zero for 90° V-shaped bending.The critical fillet radius at cryogenic temperatures was smaller than that at room temperature,owing to the influence of temperature variations on the bending moment ratio between the forward bending section at the fillet and the reverse bending section of the straight arm.

Effects of temperature, particle size, and air humidity on sensibility of typical high-energetic explosives

The production and utilization of high-energetic explosives often pose a range of safety hazards,with sensitivity being a key factor in evaluating these risks.To investigate how temperature,particle size,and air humidity affect the responsiveness of commonly used high-energetic explosives,a series of BAM(Bundesanstalt für Materialforschung und-prüfung)impact and friction sensitivity tests were carried out to determine the critical impact energy and critical load pressure of four representative high-energetic explosives(RDX,HMX,PETN and CL-20)under different temperatures,particle sizes,and air humidity conditions.The experimental findings facilitated an examination of temperature and particle size affecting the sensitivity of high-energetic explosives,along with an assessment of the influence of air humidity on sensitivity testing.The results clearly indicate that high-energetic explosives display a substantial decline in critical reaction energy when subjected to micrometre-sized particles and an air humidity level of 45%at a temperature of 90℃.Furthermore,it was noted that the critical reaction energy of high-energetic explosives diminishes with an increase in temperature within 25℃−90℃.In the same vein,as the particle sizes of high-energetic explosives increase,so does the critical reaction energy for micrometre-sized particles.High air humidity significantly affects the sensitivity testing of high-energetic explosives,emphasizing the importance of refraining from conducting sensitivity tests in such conditions.

Witnessing quantum phase transition in a non-Hermitian trapped ion system via quantum Fisher information

Quantum Fisher information is used to witness the quantum phase transition in a non-Hermitian trapped ion system with balanced gain and loss,from the viewpoint of quantum parameter estimation.We formulate a general non-unitary dynamic of any two-level non-Hermitian system in the form of state vector.The sudden change in the dynamics of quantum Fisher information occurs at an exceptional point characterizing quantum criticality.The dynamical behaviors of quantum Fisher information are classified into two different ways which depends on whether the system is located in symmetry unbroken or broken phase regimes.In the phase regime where parity and time reversal symmetry are unbroken,the oscillatory evolution of quantum Fisher information is presented,achieving better quantum measurement precision.In the broken phase regime,quantum Fisher information undergoes the monotonically decreasing behavior.The maximum value of quantum estimation precision is obtained at the exceptional point.It is found that the two distinct kinds of behaviors can be verified by quantum entropy and coherence.Utilizing quantum Fisher information to witness phase transition in the non-Hermitian system is emphasized.The results may have potential applications to non-Hermitian quantum information technology.

Analysis on flutter performance of flexible photovoltaic support based on full-order method

Taking a three-cable flexible photovoltaic(PV)support structure as the research subject,a finite element model was established.Utilizing a full-order flutter analysis method,the flutter critical wind speed and flutter frequency of the flexible PV support structure at a tilt angle of 0°were calculated.The results showed good agreement with wind tunnel test data.Further analysis examined the pretension effects in the load-bearing and stabilizing cables on the natural frequency and flutter critical wind speed of the flexible PV support structure.The research findings indicate increasing the pretension in the load-bearing cables significantly raises the natural frequencies of the first four modes.Specifically,as the pretension in the load-bearing cables increases from 22 to 102 kN,the flutter critical wind speed rises from 17.1 to 21.6 m/s.By contrast,the pretension in the stabilizing cable has a smaller effect on the natural frequency and flutter critical wind speed of the flexible PV support structure.When the pretension in the stabilizing cable increased from 22 to 102 kN,the flutter critical wind speed increased from 17.1 to 17.7 m/s.For wind-resistant design of flexible PV support structures,it is recommended to prioritize increasing the pretension in the load-bearing cables to enhance the structural flutter performance.

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing,China:A cross-sectional study

Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

Zinc-modified Pt/SAPO-11 for improving the isomerization selectivity to dibranched alkanes

Zinc-modified Pt/SAPO-11 catalysts were prepared by incipient wetness impregnation and assessed in the hydroisomerization of n-octane.Their physicochemical properties were investigated using powder X-ray diffraction,scanning electron microscopy,nitrogen adsorption-desorption,pyridine-adsorbed infrared spectroscopy,temperature-programmed desorption of NH3,temperature-programmed reduction of hydrogen,temperature-programmed desorption of hydrogen,transmission electron microscopy,and X-ray photoelectron spectroscopy.The addition of zinc resulted in high dispersion of platinum.Zinc acted as a competitive adsorbent,changed the location of platinum.The catalyst with a zinc loading of 0.5%gave the highest selectivity to dimethylhexanes,but the conversion was lower than those achieved with the other catalysts.Dimethylhexanes have large molecular diameters,and therefore their diffusion may be difficult.This weakens the catalytic activity of the zinc-modified catalysts and lowers the n-octane conversion.

Relationship between Al(OH)_3 solubility and particle size in synthetic Bayer liquors

Surface tension of sodium aluminate solution and the contact angle between Al（OH）3 particles and aluminate solution were measured, then the dependence of Al（OH）3 solubility on its particle size was calculated and thus the variation of the critical nucleus sizes was determined based on the Ostwald ripening formula. The results show that the Al（OH）3 solubility in sodium aluminate solution decreases with the increment of particle size, and the critical nucleus sizes increase with the rise of alkali concentration, caustic ratio and precipitation temperature. The results also imply that the presence of small particles in seeded precipitation system is an important factor to limit the depth of precipitation.

Research Advances in Pharmacological Action and Clinical Application of Periplaneta americana

Researches on pharmacological action and drug development of Periplane- ta americana have demonstrated that it has wide medicinal value, low side effects and rich resources, having good application prospects in medicine field. This article reviewed the researches on pharmacological action and clinical application of Periplaneta americana in order to provide references for the further research and devel- opment of Periplaneta americana medicines.

A New Method to Retrieve Proximity Effect Parameters in Electron-Beam Lithography

A new method for determining proximity parameters α,β ,and η in electron beam lithography is introduced on the assumption that the point exposure spread function is composed of two Gaussians.A single line is used as test pattern to determine proximity effect parameters and the normalization approach is adopted in experimental data transaction in order to eliminate the need of measuring exposure clearing dose of the resist.Furthermore,the parameters acquired by this method are successfully used for proximity effect correction in electron beam lithography on the same experimental conditions.

Characterization of Fertility Alteration in 8 Environment-sensitive Genic Male-sterile Lines of indica Rice

Eight indica ( Oryza sativa L.) environment-sensitive genic male-sterile (EGMS) lines, 2-2S, K1405S, F131S, 2136S, Pei-Ai 64S, 1290S, GD-IS and N17S, were sequentially seeded with 10-15 d interval at three sites, Wuhan in 1997, Guiyang in 1997 and Sanya in 1997 and 1998, China. The results of investigations on self-sterilities showed that all of eight EGMS lines had stable sterile periods of longer than 30 d at Wuhan. They can be used for seed production of two-line hybrid rice, but can not reproduce themselves. Their stable sterile periods were shorter than 30 d at Guiyang, they can reproduce themselves and can not be used for hybrid seed production. In Sanya, their stable sterile periods were longer than 150 d, all of eight lines can be used for seed production in summer and autumn and reproduce themselves in winter. The fertility of all eight lines were sensitive to temperature. The sensitive stages, sensitive duration and critical point of temperatures (CPT) of fertility alteration in various lines were different. The sensitive stages of 2-2S and K1405S were from 18 d to 9 d before heading, the sensitive durations were 7-10 d and the CPTs were 23.7-24.5 degreesC. The sensitive stage, sensitive duration and CPT of F131S were from 17 to 5 d before heading, 13 d and 24.3-24.7 degreesC, respectively. The sensitive stage, sensitive duration and CPT of 2136S were from 18 to 12 d before heading, 7 d and 24.6-25.1 degreesC:, respectively. The sensitive stages, sensitive durations of Pei-Ai 64S, 1290S, N17S and GD-1S were from 24 to 13 d before heading and 10-13 d. And their CPTs were 24.6-25.1 degreesC, 25.5-26.2 degreesC, 25.4-26.1 degreesC,, and 24.1-24.7 degreesC, respectively.

Overview of Pharmacological & Ecological Research of Scirpus tabernaemontani Gmel

On the basis of extensive literature search, the species, ingredients, pharmacology, clinical applications, ecological value and cultivation techniques of Scirpus tabemaemontani Gmel have been reviewed, to provide scientific data for further research ＆ development.

心血管外科临床见习的教学探讨

本文对如何进行心血管外科临床见习生的教学进行了探讨,目的是培养学生的临床思维能力和提高实践操作技能,进而提高临床见习的教学效果。

CLINICAL RESEARCH OF JIAJI(夹脊EX-B2) IN TREATMENT OF SPASTIC CEREBRAL PALSY WITH ACUPUNCTURE

Objective To observe the clinical therapeutic effects of Jiájǐ（夹脊EX-B2） on spastic cerebral palsy （SOP） with acupuncture.Methods 62 cases of SOP were randomized into two groups,named treat- ment group with acupuncture on Jiájǐ（夹脊EX-B2）,and control group with sham-acupuncture.The treatment was applied once a day,10 times made a course,totally 6 courses were required.Modified Ashworth scale and FIM grade were used to observe and assess the results of treatment.Results The total effective rate was 84.4 % in treatment group and was 63.3 % in control group,indicating significant difference （P〈0.01）. Conclusion Acupuncture on Jiájǐ（夹脊EX-B2） achieves good clinical therapeutic effects on SCP.

Supercritical Fluid Extraction of Essential Oil from Dry Rhizome of Ligusticum chuanxiong Hort and Their Characterization by GC/MS

Supercritical fluid extraction (SFE) of essential oil from dry rhizome ofLigusticum chuanxiong Hort was developed. GC/MS was used for the determination of the composition ofessential oil. Forty-four compounds were identified. The conventional extraction method wasconducted in parallel for comparison. The extracts were qualitatively compared by GC/MS. The yieldsof SFE and steam distillation-extraction were 4.16 % ( v/w) and 0.8 % ( v/w), respectively.Application of SFE of zessential oil from dry rhizome of Ligustiaan chuanxiong Hort was preferable.

Rigorous back analysis of shear strength parameters of landslide slip

A rigorous back analysis of shear strength parameters of landslide slip was presented. Kinematical element method was adopted to determine factor of safety and critical failure surface, which overcomes the disadvantage of limit equilibrium method. The theoretical relationship between the combination of shear strength parameters and stability state was studied. The results show that the location of critical slip surface, F/tan f and F/c depend only on the value of c/tan f. The failure surface moves towards the inside of slope as c/tan f increases. According to the information involving factor of safety and critical failure surface in a specific cross-section, strength parameters can be back calculated based on the above findings. Three examples were given for demonstrating the validity of the present method. The shear strength parameters obtained by back analysis are almost consistent with their correct solutions or test results.