AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seve...AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions.展开更多
In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as d...In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as diastolic dysfunction, may cause endothelial dysfunction and affect pulmonary vasculature. Furthermore, older patients have certain differences in clinical characteristics and outcomes. In this article the special characteristics of aging in PAH patients have been reviewed, while the risk predictors of elderly patients are also discussed.展开更多
A best evidence topic was devised in light of a structured protocol. What is the advantage of （minl＂mally invasive） approach in （frail patients） undergoing （aortic valve replacement）？ In cardiac outpatient cl...A best evidence topic was devised in light of a structured protocol. What is the advantage of （minl＂mally invasive） approach in （frail patients） undergoing （aortic valve replacement）？ In cardiac outpatient clinic you review an 85-year old male with severe aortic valve stenosis, low left ventricular ejection fraction and creatinine clearance of less than 50 mL/min. Other comorbidities include treated pulmonary hypertension, mild cognitive impairment, marked limitation of ordinary physical activity and depression. You resolve to determine whether to recommend mim＇mally invasive or conventional aortic valve replacement （AVR） or transcathe- ter aortic valve implantation （TAVI）, however you are not sure of the differences of the impact of frailty on preopera- tive risk for each approach; hence you investigate the best evidence on the topic.展开更多
Objective:The present study was to evaluate the feasibility of using the multi-biomarker strategy for the prediction of sepsis-induced myocardial dysfunction(SIMD)and mortality in septic patients.Methods:Brain natriur...Objective:The present study was to evaluate the feasibility of using the multi-biomarker strategy for the prediction of sepsis-induced myocardial dysfunction(SIMD)and mortality in septic patients.Methods:Brain natriuretic peptide(BNP),cardiac troponin I(cTnI),and heart-type fatty acid-binding protein(h-FABP)in 147 septic patients were assayed within 6 h after admission.We also determined the plasma levels of myeloperoxidase(MPO)and pregnancyassociated plasma protein-A(PAPP-A).The receiver operating characteristic(ROC)curve was used to assess the best cutoff values of various single-biomarkers for the diagnosis of SIMD and the prediction of mortality.Also,the ROC curve,net reclassification improvement(NRI),and integrated discrimination improvement(IDI)indices were used to evaluate the feasibility of using multi-biomarkers to predict SIMD and mortality.Results:Our statistics revealed that only h-FABP independently predicted SIMD(P<0.05).The addition of MPO and cTnI to h-FABP for SIMD prediction provided an NRI of 18.7%(P=0.025)and IDI of 3.3%(P=0.033).However,the addition of MPO or cTnI to h-FABP did not significantly improve the predictive ability of h-FABP to SIMD,as evidenced by the area under the curve(AUC),NRI,and IDI(all P>0.05).A history of shock and MPO were independent predictors of mortality in septic patients(both P<0.05).The addition of PAPP-A and h-FABP to MPO resulted in a mortality prediction with NRI of 25.5%(P=0.013)and IDI of 2.9%(P=0.045).However,this study revealed that the addition of h-FABP or PAPP-A to MPO did not significantly improve the ability to predict mortality,as evidenced by the AUC,NRI,and IDI(all P>0.05).Conclusions:The findings of this study indicate that a sensitive and specific strategy for early diagnosis of SIMD and mortality prediction in sepsis should incorporate three biomarkers.展开更多
In many engineering applications,heat transfer enhancement techniques are of vital importance in order to ensure reliable thermal designs of convective heat transfer applications.This study examines experimentally the...In many engineering applications,heat transfer enhancement techniques are of vital importance in order to ensure reliable thermal designs of convective heat transfer applications.This study examines experimentally the heat transfer characteristics on the base plate around various surface mounted obstacles.Local convection coefficients are evaluated in the vicinity of each individual protruding body with great spatial resolution using the transient liquid crystal technique.Five different obstacles of constant height-to-hydraulic diameter ratio(~1.3) are considered.These include:a cylinder,a square,a triangle,a diamond and a vortex generator of delta wing shape design.The experiments were carried out over a range of freestream Reynolds numbers,based on the hydraulic diameter of each obstacle,varying from 4,000 to 13,000.The results indicate a negligible effect of the flow speed on the heat transfer topological structure and a considerable effect of the obstacle geometry on the level and distribution of heat transfer enhancement.展开更多
文摘AIM: To investigate the morbidity of functional bowel disorders (FBD) under military stress conditions in order to lay foundations for the prevention and treatment of this disease. METHODS: Four hundred and fifty-seven soldiers who were assigned to specified services and 471 soldiers who were assigned to routine services were enrolled using cluster sampling, with the latter as a control group. They were surveyed using the Rome Ⅲ FBD standard questionnaire. The FBD symptom question-naire included FBD-related symptoms, severity, dura- tion or attack time, and accompanying symptoms. RESULTS: The morbidity of the military stress group (14.6%) was significantly higher than in the control group (9.98%) ( 2 = 4.585, P < 0.05). The incidence of smoking, abdominal pain and acid regurgitation ( 2 = 4.761, P < 0.05) as well as the ZUNG anxiety/depression scores ( 2 = 7.982, P < 0.01) were also sig- nificantly higher in the military stress group compared with the control group. ZUNG anxiety ( 2 = 11.523, P < 0.01) and depression ( 2 = 5.149, P < 0.05) scores were higher in the FBD group compared with the non-FBD group. The differences in the ZUNG self-rated anxiety and depression scales between the 2 groups were statistically significant ( 2 = 14.482, P < 0.01 and 2 = 6.176, P < 0.05). CONCLUSION: The morbidity of FBD was higher under military stress conditions.
文摘In recent times, the prevalence of pulmonary arterial hypertension creased prevalence of hypertension, diabetes, obesity, arterial stiffness, （PAH） is more commonly seen among elderly populations. The inas well as diastolic dysfunction, may cause endothelial dysfunction and affect pulmonary vasculature. Furthermore, older patients have certain differences in clinical characteristics and outcomes. In this article the special characteristics of aging in PAH patients have been reviewed, while the risk predictors of elderly patients are also discussed.
文摘A best evidence topic was devised in light of a structured protocol. What is the advantage of （minl＂mally invasive） approach in （frail patients） undergoing （aortic valve replacement）？ In cardiac outpatient clinic you review an 85-year old male with severe aortic valve stenosis, low left ventricular ejection fraction and creatinine clearance of less than 50 mL/min. Other comorbidities include treated pulmonary hypertension, mild cognitive impairment, marked limitation of ordinary physical activity and depression. You resolve to determine whether to recommend mim＇mally invasive or conventional aortic valve replacement （AVR） or transcathe- ter aortic valve implantation （TAVI）, however you are not sure of the differences of the impact of frailty on preopera- tive risk for each approach; hence you investigate the best evidence on the topic.
基金Project supported by the Zhejiang Provincial Natural Science Foundation of China(No.LQ16H020003)the National Natural Science Foundation of China(Nos.81971860 and 81772110)。
文摘Objective:The present study was to evaluate the feasibility of using the multi-biomarker strategy for the prediction of sepsis-induced myocardial dysfunction(SIMD)and mortality in septic patients.Methods:Brain natriuretic peptide(BNP),cardiac troponin I(cTnI),and heart-type fatty acid-binding protein(h-FABP)in 147 septic patients were assayed within 6 h after admission.We also determined the plasma levels of myeloperoxidase(MPO)and pregnancyassociated plasma protein-A(PAPP-A).The receiver operating characteristic(ROC)curve was used to assess the best cutoff values of various single-biomarkers for the diagnosis of SIMD and the prediction of mortality.Also,the ROC curve,net reclassification improvement(NRI),and integrated discrimination improvement(IDI)indices were used to evaluate the feasibility of using multi-biomarkers to predict SIMD and mortality.Results:Our statistics revealed that only h-FABP independently predicted SIMD(P<0.05).The addition of MPO and cTnI to h-FABP for SIMD prediction provided an NRI of 18.7%(P=0.025)and IDI of 3.3%(P=0.033).However,the addition of MPO or cTnI to h-FABP did not significantly improve the predictive ability of h-FABP to SIMD,as evidenced by the area under the curve(AUC),NRI,and IDI(all P>0.05).A history of shock and MPO were independent predictors of mortality in septic patients(both P<0.05).The addition of PAPP-A and h-FABP to MPO resulted in a mortality prediction with NRI of 25.5%(P=0.013)and IDI of 2.9%(P=0.045).However,this study revealed that the addition of h-FABP or PAPP-A to MPO did not significantly improve the ability to predict mortality,as evidenced by the AUC,NRI,and IDI(all P>0.05).Conclusions:The findings of this study indicate that a sensitive and specific strategy for early diagnosis of SIMD and mortality prediction in sepsis should incorporate three biomarkers.
文摘In many engineering applications,heat transfer enhancement techniques are of vital importance in order to ensure reliable thermal designs of convective heat transfer applications.This study examines experimentally the heat transfer characteristics on the base plate around various surface mounted obstacles.Local convection coefficients are evaluated in the vicinity of each individual protruding body with great spatial resolution using the transient liquid crystal technique.Five different obstacles of constant height-to-hydraulic diameter ratio(~1.3) are considered.These include:a cylinder,a square,a triangle,a diamond and a vortex generator of delta wing shape design.The experiments were carried out over a range of freestream Reynolds numbers,based on the hydraulic diameter of each obstacle,varying from 4,000 to 13,000.The results indicate a negligible effect of the flow speed on the heat transfer topological structure and a considerable effect of the obstacle geometry on the level and distribution of heat transfer enhancement.
