This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relev...This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis", "cirrhosis", "chronic hepatitis", "chronic liver disease", "decompensated cirrhosis", "hepatic encephalopathy", "hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.展开更多
This paper presents a detailed investigation, via field experiment, into the mechanism of high-order polygonal wear of wheels of a new type of high-speed train. The investigation was carried out during the performance...This paper presents a detailed investigation, via field experiment, into the mechanism of high-order polygonal wear of wheels of a new type of high-speed train. The investigation was carried out during the performance acceptance test of the train and its initial commercial operation. The investigation covered the performance acceptance test of 150 000 km and the commercial operation of about 150 000 km. In the performance acceptance test of the first stage of about 70 000 km, at 200-250 km/h with full loading and sometimes overloading by 30%, the serious polygonal wear of 23-order took place on all the wheels of the train, and was measured and analyzed in detail. All the potygonized wheels were re-profiled because the polygonal wear had caused strong vibration and damage to the train parts. After re-profiling, the vibration of the train and track and the wear status of the wheels were measured and analyzed at different test mileages according to the polygonal wear situation of the wheels. The measured vibration of the train includes the accelerations at different positions of a motor car and a trail car. The vibration modes of the key parts of the bogies of the two cars were calculated. Meanwhile, the track resonant frequencies were investigated at the site. The purpose of the above tests and analysis is try to find the frequency of work mode matching the passing frequency of the high-order wheel polygon. The present investigation shows that one of the working models causes the formation and development of the high-order wheel polygonal wear. The growth of this wear was effectively reduced through the frequent changing of the running speed of the train operating on the way back and forth every day.展开更多
文摘This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: "ascites", "liver fibrosis", "cirrhosis", "chronic hepatitis", "chronic liver disease", "decompensated cirrhosis", "hepatic encephalopathy", "hypertransaminasemia", "liver transplantation" and "portal hypertension". Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis.
基金Project supported by the National Natural Science Foundation of China （No. U 1134202）
文摘This paper presents a detailed investigation, via field experiment, into the mechanism of high-order polygonal wear of wheels of a new type of high-speed train. The investigation was carried out during the performance acceptance test of the train and its initial commercial operation. The investigation covered the performance acceptance test of 150 000 km and the commercial operation of about 150 000 km. In the performance acceptance test of the first stage of about 70 000 km, at 200-250 km/h with full loading and sometimes overloading by 30%, the serious polygonal wear of 23-order took place on all the wheels of the train, and was measured and analyzed in detail. All the potygonized wheels were re-profiled because the polygonal wear had caused strong vibration and damage to the train parts. After re-profiling, the vibration of the train and track and the wear status of the wheels were measured and analyzed at different test mileages according to the polygonal wear situation of the wheels. The measured vibration of the train includes the accelerations at different positions of a motor car and a trail car. The vibration modes of the key parts of the bogies of the two cars were calculated. Meanwhile, the track resonant frequencies were investigated at the site. The purpose of the above tests and analysis is try to find the frequency of work mode matching the passing frequency of the high-order wheel polygon. The present investigation shows that one of the working models causes the formation and development of the high-order wheel polygonal wear. The growth of this wear was effectively reduced through the frequent changing of the running speed of the train operating on the way back and forth every day.
