Enhancing lead-free photovoltaic performance:Minimizing buried surface voids in tin perovskite films through weakly polar solvent pre-treatment strategy

Buried interfacial voids have always been a notorious phenomenon observed in the fabrication of lead perovskite films. The existence of interfacial voids at the buried interface will capture the carrier, suppress carrier transport efficiencies, and affect the stability of photovoltaic devices. However, the impact of these buried interfacial voids on tin perovskites, a promising avenue for advancing lead-free photovoltaics, has been largely overlooked. Here, we utilize an innovative weakly polar solvent pretreatment strategy(WPSPS) to mitigate buried interfacial voids of tin perovskites. Our investigation reveals the presence of numerous voids in tin perovskites during annealing, attributed to trapped dimethyl sulfoxide(DMSO) used in film formation. The WPSPS method facilitates accelerated DMSO evaporation, effectively reducing residual DMSO. Interestingly, the WPSPS shifts the energy level of PEDOT:PSS downward, making it more aligned with the perovskite. This alignment enhances the efficiency of charge carrier transport. As the result, tin perovskite film quality is significantly improved,achieving a maximum power conversion efficiency approaching 12% with only an 8.3% efficiency loss after 1700 h of stability tests, which compares well with the state-of-the-art stability of tin-based perovskite solar cells.

Research and Application of Bedside Rhetorical Teaching Method in Teaching Nursing Interns

Objective:To observe and analyze the application of the bedside rhetorical teaching method in teaching nursing interns.Methods:A total of 64 nursing interns in the gastroenterology department of our hospital from July 2022 to May 2023 were randomly divided into two groups,32 cases in the control group and 32 cases in the intervention group.The control group was given conventional teaching methods,and the intervention group was given the bedside rhetorical teaching method on the basis of the conventional teaching.The differences in the methods of teaching between the two groups were compared after the end of the internship,and there was a statistically significant difference with P<0.05.Results:The scores of the interns in the intervention group were significantly better than those of the control group in theoretical knowledge,communication skills,and case analysis items(P<0.05).Conclusion:The bedside rhetorical teaching method transforms classroom education into bedside teaching,which enables the interns to apply the theoretical knowledge to clinical practice,and has a higher improvement in the three aspects of disease knowledge,communication skills,and case analysis,cultivates the interns’comprehensive clinical skills,and lays a good foundation for the future entry into the nursing field.

High corrosion resistance of electroless Ni-P with chromium-free conversion pre-treatments on AZ91D magnesium alloy

Phosphate-manganese, tannic acid and vanadium conversion coatings were proposed as an effective pre-treatment layer between electroless Ni-P coating and AZ91D magnesium alloy substrate to replace the traditional chromate plus HF pre-treatment. The electrochemical results show that the chrome-free coatings plus electroless Ni-P coating on the magnesium alloy has the lowest corrosion current density and most positive corrosion potential compared with chromate plus electroless Ni-P coating on the magnesium alloy. These proposed pre-treatment layers on the substrate reduce the corrosion of magnesium during plating process, and reduce the potential difference between the matrix and the second phase. Thus, an electroless Ni-P coating with fine crystalline and dense structure was obtained, with preferential phosphorus content, low porosity, good corrosion-resistance and strengthened adhesion than the chromate plus electroless Ni-P.

Comparison of pre-treatment and post-treatment use of selenium in retinal ischemia reperfusion injury

AIM: To investigate the effects of selenium in rat retinal ischemia reperfusion(IR) model and compare pretreatment and post-treatment use.METHODS: Selenium pre-treatment group(n =8) was treated with intraperitoneal(i.p.) selenium 0.5 mg/kg for7 d and terminated 24 h after the IR injury. Selenium posttreatment group( n = 8) was treated with i. p. selenium0.5 mg/kg for 7d after the IR injury with termination at the end of the 7d period. Sham group(n =8) received i.p.saline injections identical to the selenium volume for 7d with termination 24 h after the IR injury. Control group(n =8) received no intervention. Main outcome measures were retina superoxide dismutase(SOD), glutathione(GSH),total antioxidant status(TAS), malondialdehyde(MDA),DNA fragmentation levels, and immunohistological apoptosis evaluation.RESULTS: Compared to the Sham group, selenium pre-treatment had a statistical difference in all parameters except SOD. Post-treatment selenium also resulted in statistical differences in all parameters except the MDA levels. When comparing selenium groups, the pre-treatment selenium group had a statistically higher success in reduction of markers of cell damage such as MDA and DNA fragmentation. In contrast, the post-selenium treatment group had resulted in statisticallyhigher levels of GSH. Histologically both selenium groups succeeded to limit retinal thickening and apoptosis. Pre-treatment use was statistically more successful in decreasing apoptosis in ganglion cell layer compared to post-treatment use.CONCLUSION: Selenium was successful in retinal protection in IR injuries. Pre-treatment efficacy was superior in terms of prevention of tissue damage and apoptosis.

Effect of Cross-flow Velocity on the Critical Flux of Ceramic Membrane Filtration as a Pre-treatment for Seawater Desalination

Pre-treatment, which supplies a stable, high-quality feed for reverse osmosis （RO） membranes, is a criti- cal step for successful operation in a seawater reverse osmosis plant. In this study, ceramic membrane systems were employed as pre-treatment for seawater desalination. A laboratory experiment was performed to investigate the effect of the cross-flow velocity on the critical flux and consequently to optimize the permeate flux. Then a pilot test was performed to investigate the long-term performance. The result shows that there is no significant effect of the cross-flow velocity on the critical flux when the cross-flow velocity varies in laminar flow region only or in turbulent flow region only, but the effect is distinct when the cross-flow velocity varies in the transition region. The membrane fouling is slight at the permeate flux of 150 L·m^-2·h^-1 and the system is stable, producing a high-quality feed （the turbidity and silt density index are less than 0.1 NTU and 3.0, respectively） for RO to run for 2922.4 h without chemical cleaning. Thus the ceramic membranes are suitable to filtrate seawater as the pre-treatment for RO.

Bedside ultrasound in the diagnosis of nonalcoholic fatty liver disease

Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease in the United States.While the American Association for the Study of Liver Diseases guidelines define NAFLD as hepatic steatosis detected either on histology or imaging without a secondary cause of abnormal hepatic fat accumulation,no imaging modality is recommended as standard of care for screening or diagnosis.Bedside ultrasound has been evaluated as a non-invasive method of diagnosing NAFLD with the presence of characteristic sonographic findings.Prior studies suggest characteristic sonographic findings for NAFLD include bright hepatic echoes,increased hepatorenal echogenicity,vascular blurring of portal or hepatic vein and subcutaneous tissue thickness.These sonographic characteristics have not been shown to aid bedside clinicians easily identify potential cases of NAFLD.While sonographic findings such as attenuation of image,diffuse echogenicity,uniform heterogeneous liver,thick subcutaneous depth,and enlarged liver filling of the entire field could be identifiedby clinicians from bedside ultrasound.The accessibility,ease of use,and low-side effect profile of ultrasound make bedside ultrasound an appealing imaging modality in the detection of hepatic steatosis.When used with appropriate clinical risk factors and steatosis involves greater than 33%of the liver,ultrasound can reliably diagnose NAFLD.Despite the ability of ultrasound in detecting moderate hepatic steatosis,it cannot replace liver biopsy in staging the degree of fibrosis.The purpose of this review is to examine the diagnostic accuracy,utility,and limitations of ultrasound in the diagnosis of NAFLD and its potential use by clinicians in routine practices.

Application of scoring systems with point-of-care ultrasonography for bedside diagnosis of appendicitis

BACKGROUND: Appendicitis is a common disease requiring surgery. Bedside ultrasound(BUS) is a core technique for emergency medicine(EM). The Alvarado score is a well-studied diagnostic tool for appendicitis. This study aimed to investigate the relationship between patients' symptoms, Alvarado score and ultrasound(US) findings, as performed by emergency physicians(EPs) and radiologists, of patients with suspected appendicitis.METHODS: Three EM specialists underwent the BUS course and core course for appendicitis assessment. Patients suspected of having appendicitis were selected and their Alvarado and modif ied(m) Alvarado scores calculated. The specialists performed the BUS. Then, patients were given a formal US and surgery consultation if necessary. Preliminary diagnoses, admission or discharge from the emergency department(ED) and fi nal diagnosis were documented. The patients were also followed up after discharge from the hospital.RESULTS: The determined cut-off value was 2 for Alvarado and 3 for m Alvarado scores. The sensitivities of the two scores were 100%. Each score was used to rule out appendicitis. The results of EP-performed BUS were as follows: accuracy 70%, sensitivity 0.733, specifi city 0.673, + LR 2.24, and – LR 0.40(95%CI). Radiologists were better than EPs at diagnosing appendicitis and radiologists and EPs were equally strong at ruling out appendicitis by US. When US was combined with Alvarado and m Alvarado scores, EP US+Alvarado/m Alvarado scores ≤3 and radiology US+Alvarado/m Alvarado scores ≤4 perfectly ruled out appendicitis.CONCLUSION: BUS performed by EPs is moderately useful in detecting appendicitis. Combined with scoring systems, BUS may be a perfect tool for ruling out decisions in EDs.

Effect of microwave pre-treatment on physical quality,bioactive compounds,safety risk factor,and storage stability of peanut butter

Microwave,as a new heat treatment technology,has the characteristics of uniform and fast heating speed.It is an energy-saving technology known for improving oilseed product quality.Its efficiency mainly depends on the roasting power and time.However,the production of high-quality peanut butter using short-time roasting con-ditions are limited.Herein,we determined an appropriate microwave roasting power and time for peanuts and evaluated its impacts on the quality of peanut butter.Different roasting powers(400 W,800 W and 1200 W)and times(4,4.5,5,and 5.5 min)were preliminarily tested.Among them,800 W at 5 min was the most suitable.The roasting efficiency was further evaluated using color,sensory,bioactive compounds,storage stability,and safety risk factors of peanut butter produced from four peanut cultivars(Silihong,Baisha-1016,Yuanza-9102,and Yuhua-9414).The pre-treated butter obtained from three cultivars(Silihong,Yuanza-9102,and Yuhua-9414)with moisture content between 5%and 7.2%had a similar sensory score(6-7)as the commercial on a 9-point hedonic scale compare to the other.The color of the pre-treated peanut butter varies statistically with the commercial but remained in the recommended range of Hunter L*values of 51-52,respectively,for high initial moisture peanut cultivars.The total polyphenol(35.20-31.59±0.59μmol GAE/g)and tocopherol(19.05±0.35 mg/100 g)content in the butter obtained from three cultivars(Yuahua-9102,Yuhua,and Baisha-1016)and Silihong respectively,were significantly(P<0.05)higher than those in the commercial butter.The induction times of all pre-treated butter(19.80±0.99-7.84±0.07 h)were significantly(P<0.05)longer during storage at accelerated temperature than commercial samples.In addition,no benzo[a]pyrene was found in the pre-treated samples.Collectively,the microwave pretreated peanut butter was superior to the commercial one.These findings provided data support and a reference basis to promote microwave use for peanut butter production.

A feasibility study to determine if minimally trained medical students can identify markers of chronic parasitic infection using bedside ultrasound in rural Tanzania

BACKGROUND: Parasitic infections pose a significant health risk in developing nations and are a major cause of morbidity and mortality worldwide. In the Republic of Tanzania, the CDC estimates that 51.5% of the population is infected with one or more intestinal parasites. If diagnosed early, the consequences of chronic parasitic infection can potentially be avoided.METHODS: Six first-year medical students were recruited to enroll patients in the study. They underwent ten hours of formal, hands-on, ultrasound which included basic cardiac, hepatobiliary, renal, pulmonary and FAST scan ultrasound. A World Health Organization protocol with published grading scales was adapted and used to assess for pathology in each patient's liver, bladder, kidneys, and spleen.RESULTS: A total of 59 patients were enrolled in the study. Students reported a sensitivity of 96% and specificity of 100% for the presence of a dome shaped bladder, a sensitivity and specificity of 100% for bladder thickening, a sensitivity and specificity of 100% for portal hypertension and ascites. The sensitivity was 81% with a specificity of 100% for presence of portal vein distention. The sensitivity was 100% with a specificity of 90% for dilated bowel.CONCLUSIONS: Ultrasound has shown a promise at helping to identify pathology in rural communities with limited resources such as Tanzania. Our data suggest that minimally trained first year medical students are able to perform basic ultrasound scans that can identify ultrasonographic markers of parasitic infections.

Effects of thrombopoietin pre-treatment on peri-liver transplantation thrombocytopenia in a mouse model of cirrhosis with hypersplenism

BACKGROUND During cirrhosis,the liver is impaired and unable to synthesize and clear thrombopoietin properly.At the same time,the spleen assumes the function of hemofiltration and storage due to liver dysfunction,resulting in hypersplenism and excessive removal of platelets in the spleen,further reducing platelet count.When liver function is decompensated in cirrhotic patients,the decrease of thrombopoietin(TPO)synthesis is the main reason for the decrease of new platelet production.This change of TPO leads to thrombocytopenia and bleeding tendency in cirrhotic patients with hypersplenism.AIM To investigate the clinical efficacy of recombinant human TPO(rhTPO)in the treatment of perioperative thrombocytopenia during liver transplantation in cirrhotic mice with hypersplenism.METHODS C57BL/6J mice and TPO receptor-deficient mice were used to establish models of cirrhosis with hypersplenism.Subsequently,these mice underwent orthotopic liver transplantation(OLT).The mice in the experimental group were given rhTPO treatment for 3 consecutive days before surgery and 5 consecutive days after surgery,while the mice in the control group received the same dose of saline at the same frequency.Differences in liver function and platelet counts were determined between the experimental and control groups.Enzyme-linked immunosorbent assay was used to assess the expression of TPO and TPO receptor(c-Mpl)in the blood.RESULTS Preoperative administration of rhTPO significantly improved peri-OLT thrombocytopenia in mice with cirrhosis and hypersplenism.Blocking the expression of TPO receptors exacerbated peri-OLT thrombocytopenia.The concentration of TPO decreased while the concentration of c-Mpl increased in compensation in the mouse model of cirrhosis with hypersplenism.TPO pre-treatment significantly increased the postoperative TPO concentration in mice,which in turn led to a decrease in the c-Mpl concentration.TPO pre-treatment also significantly enhanced the Janus kinase(Jak)/signal transducers and activators of transcription pathway protein expressions in bone marrow stem cells of the C57BL/6J mice.Moreover,the administration of TPO,both before and after surgery,regulated the levels of biochemical indicators,such as alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase in the C57BL/6J mice.CONCLUSION Pre-treatment with TPO not only exhibited therapeutic effects on perioperative thrombocytopenia in the mice with cirrhosis and hypersplenism,who underwent liver transplantation but also significantly enhanced the perioperative liver function.

Artificial neural network approach for rheological characteristics of coal-water slurry using microwave pre-treatment

Detailed experimental investigations were carried out for microwave pre-treatment of high ash Indian coal at high power level(900 W) in microwave oven. The microwave exposure times were fixed at60 s and 120 s. A rheology characteristic for microwave pre-treatment of coal-water slurry(CWS) was performed in an online Bohlin viscometer. The non-Newtonian character of the slurry follows the rheological model of Ostwald de Waele. The values of n and k vary from 0.31 to 0.64 and 0.19 to 0.81 Pa·sn,respectively. This paper presents an artificial neural network(ANN) model to predict the effects of operational parameters on apparent viscosity of CWS. A 4-2-1 topology with Levenberg-Marquardt training algorithm(trainlm) was selected as the controlled ANN. Mean squared error(MSE) of 0.002 and coefficient of multiple determinations(R^2) of 0.99 were obtained for the outperforming model. The promising values of correlation coefficient further confirm the robustness and satisfactory performance of the proposed ANN model.

Tree-ring δ^(15)N of Qinghai spruce in the central Qilian Mountains of China:Is pre-treatment of wood samples necessary?

A knowledge of the tree-ring stable nitrogen isotope ratio(δ^(15)N)can deepen our understanding of forest ecosystem dynamics by indicating the long-term availability,cycling and sources of nitrogen(N).However,the radial mobility of N blurs the interannual variations in the long-term N records.Previous studies of the chemical extraction of tree rings before analysis had produced inconsistent results and it is still unclear whether it is necessary to pre-treat wood samples from specific tree species to remove soluble N compounds before determining theδ^(15)N values.We compared the effects of pre-treatment with organic solvents and hot ultrapure water on the N concentration andδ^(15)N of tree rings from endemic Qinghai spruce(Picea crassifolia)growing in the interior of the central Qilian Mountains,China,during the last 60 a.We assessed the effects of different preparation protocols on the removal of the labile N compounds and investigated the need to pre-treat wood samples before determining theδ^(15)N values of tree rings.Increasing trends of the tree-ring N concentration were consistently observed in both the extracted and unextracted wood samples.The total N removed by extraction with organic solvents was about 17.60%,with a significantly higher amount in the sapwood section(P<0.01).Theδ^(15)N values of tree rings decreased consistently from 1960 to 2019 in both the extracted and unextracted wood samples.Extraction with organic solvents increased theδ^(15)N values markedly by about 5.2‰and reduced the variations in theδ^(15)N series.However,extraction with hot ultrapure water had little effect,with only a slight decrease in theδ^(15)N values of about 0.5‰.Our results showed that the radial pattern in the inter-ring movement of N in Qinghai spruce was not minimized by extraction with either organic solvents or hot ultrapure water.It is unnecessary to conduct hot ultrapure water extraction for the wood samples from Qinghai spruce because of its negligible effect on the removal of the labile N.Theδ^(15)N variation trend of tree rings in the unextracted wood samples was not influenced by the heartwood-sapwood transition zone.We suggest that theδ^(15)N values of the unextracted wood samples of the climate-sensitive Qinghai spruce could be used to explore the ecophysiological dynamics while focusing on the long-term variations.

The Observation on Risk of Ventilator Failure Weaning by Ultrasound bedside Monitoring of Inferior Vena Cava and Lung B Line

Objective: This study was designed to investigate risk of ventilator weaning by ultrasound bedside monitoring of the width of inferior vena cava (IVC) and the number of lung B-lines (B-lines). Methods: This study was conducted on 106 patients from January 2019 to January 2020 who had mechanical ventilation for more than 48 hours in an emergency care unit. They were clinically stable and had the criteria for weaning from the ventilator. Before Spontaneous Breathing Test (SBT) and 30 min or 120 min after SBT, the width of IVC and the number of B-lines in patients were monitored via bedside ultrasound. There were 87 cases of successful weaning as a control group and 19 cases of ventilator failure weaning as a study group. Changes of the width of IVC and the number of B-lines were compared in the different stages of SBT. Results: A total of 106 patients were included in this study. There were 87 cases of ventilator successful weaning and 19 cases failure weaning. The weaning success rate was 82.08%. The width of IVC and the number of B-lines in the study group were higher than those in the control group in same stage of SBT, the difference was statistically significant (P < 0.05), and which increased significantly with time. There was no significant difference in the width of IVC and the number of B-lines on the different stage of SBT in the control group (P > 0.05), and significant difference in the study group. Conclusion: The width of IVC and the number of B-lines monitored by bedside ultrasound can assess the risk of ventilator weaning, it may be caused by cardiopulmonary interaction.

Pre-treatment to Enhance Biogas Yield from Pulp and Paper Mill Sludge

The purpose of this work was to study the potential to enhance biogas production from pulp and paper mill sludge by the use of thermal pre-treatment in combination with chemical pre-treatment. Biogas from waste is a renewable fuel with very low emissions during combustion. To further reduce the use of fossil fuels, more biogas substrates are necessary. Pulp and paper mill sludge is a large untapped reservoir of potential biogas. Pulp and paper mill sludge was collected from a mill that produces both pulp and paper and has a modified waste activated sludge system as part of its wastewater treatment. Pre-treatments were chosen heat （70 ~C or 140℃） combined with either acid （pH 2 or pH 4） or base （pH 9 or pH 11, obtained with Ca（OH）2 or NaOH）. Biogas potential was tested by anaerobic digestion batch assays under mesophilic conditions. All pre-treatments were tested in six replicates. Biogas volume was measured with a gas-tight syringe and methane concentration was measured with a gas chromatograph. The methane yield from sludge subjected to thermal pre-treatment at 70℃ did not differ from the untreated sludge, but thermal pre-treatment at 140℃ had a positive effect. Within the 70℃ thermal pre-treatment group, the pH 2 acid was the most successful chemical pre-treatment, and Ca（OH）2 pH 9 had the least effect with no measurable improvement in methane yield. For the 140 ℃ thermal pre-treatment group, acid and NaOH impacted methane production negatively, while the Ca（OH）2-treated sludge did not differ from sludge with no chemical pre-treatment. In conclusion, thermal pre-treatment at 70℃ showed no effect, whereas, pre-treatment at 140℃ improved methane yield with 170%, and for this sludge additional, chemical pre-treatments are unnecessary.

Value of Real-Time Bedside Ultrasonography in the Etiologic Diagnosis of Acute Dyspnea

Objective: To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea. Methods: Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. Results: Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). Conclusion: Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.

The Role of Bedside Troponin T Test for Identification of High Risk Patients With Acute Chest Pain

Objectives Evaluation of patients with acute chest pain when they admitted is time-consuming. We prospectively investigated the role of bedside troponin T test for predicting the risk of death and acute heart failure of patients with acute chest pain.Methods and Results 502 consecutive patients with chest pain for less than 24 hours were determined by troponin T test at bedside and quantitative troponin I test in lab. For bedside troponin T tests, there were 160 patients in positive and 323 in negative. During 30 days of followed-up. Myocardial infarction evolved in 139 patients among 160 patients in positive troponin T test, only 7 patients in negative one. Acute heart failure occurred in 51 patients among the positive group, but 37 occurred it at negative group. The odds ratio of acute heart failure of positive group vs. negative group was 3.6. Patients died 39 in positive group, 15 in negative group, the all-cause death odds ratio of positive group vs. negative group was 6.7; 31 patients died with cardiac event in positive group, 5 in negative group only. Conclusions Bedside Troponin T test is a powerful and independent predictor of death and acute heart failure for patients with acute chest pain.

风险管理联合细节干预对行床旁气管镜检查肺结核患者并发症的影响

目的探讨风险管理联合细节干预对行床旁气管镜检查肺结核患者并发症的影响。方法选择2019年7月至2020年12月接诊的80例行床旁气管镜技术检查的肺结核患者为研究对象,将其随机分为对照组和观察组,每组40例。对照组患者给予常规干预,观察组患者给予风险管理联合细节干预措施,比较2组患者的干预效果。结果观察组护理技能、文书书写、健康教育和服务态度等临床干预服务质量评分高于对照组(P<0.05)。观察组物质生活、生理健康、社会功能和心理状态等的生活质量评分优于对照组(P<0.05)。观察组的自我护理能力实施量表(ESCA)评分高于对照组(P<0.05)。观察组的护理满意度、治疗依从性高于对照组(P<0.05)。结论风险管理联合细节干预能有效降低行床旁气管镜技术检查肺结核患者的并发症发生率,提高临床服务质量。

床旁超声评估早期新生儿的脊髓和椎管发育

目的探讨床旁超声在早期新生儿脊髓和椎管发育中的临床价值。方法收集2022年1月—8月兰州大学第二医院125例新生儿的临床资料,包括母亲的分娩次数、分娩方式、新生儿的胎龄、性别、出生天数、身高、体重、头围、胸围,并用床旁超声测量颈、胸、腰椎脊髓和椎管前后径。按其胎龄分为早产儿组(32~36^(+6)周,30例)、早期足月儿组(37~38^(+6)周,39例)和完全足月儿组(39~40^(+6)周,56例)。比较脊髓和椎管前后径的组间差异及与临床资料的相关性,进一步观察脊髓和椎管前后径随胎龄变化的规律。结果完全足月儿组、早期足月儿组的脊髓和椎管前后径均大于早产儿组(P<0.05)。早期新生儿的脊髓和椎管前后径与胎龄、身高、体重、头围、胸围呈正相关,尤其早产儿组与胎龄明显相关(P<0.05)。脊髓和椎管发育无性别差异。结论床旁超声可以显示早期新生儿的脊髓和椎管前后径随胎龄而变化,其参考值将有助于评估新生儿的脊髓损伤。

床旁健康教育视频联合PDCA循环健康教育在经皮肾镜取石术患者中的应用效果及对治疗依从性的影响

目的探讨床旁健康教育视频联合PDCA循环健康教育在经皮肾镜取石术(PCNL)患者中的应用效果及对治疗依从性的影响。方法选取2021年6月至9月行PCNL的46例肾结石患者为参考组,另选择同年10月至12月行PCNL的46例肾结石患者为干预组。参考组予以常规健康教育,干预组予以床旁健康教育视频联合PDCA循环健康教育。比较两组的干预效果。结果干预组的首次下床时间、肛门排气时间、住院时间短于参考组,术后不良事件总发生率低于参考组,差异具有统计学意义(P<0.05)。干预组的术后饮食、术后服药、术后下床活动依从率高于参考组,结石复发率低于参考组,差异具有统计学意义(P<0.05)。干预组的中文版威斯康星州肾结石生活质量量表(WISQOL)各维度评分均高于参考组,差异具有统计学意义(P<0.05)。结论床旁健康教育视频联合PDCA循环健康教育能够提高PCNL患者的治疗依从性,加速术后康复,降低结石复发率,提高生活质量。

急诊床旁超声心动图在反向型Takotsubo综合征诊治中的应用价值

目的探讨急诊床旁超声心动图(EB-Echo)在反向型Takotsubo综合征(r-TTS)诊治中的临床应用价值。方法采用回顾性研究方法,选择2014年1月至2021年12月郑州人民医院重症医学科收治的10例已确诊为r-TTS患者的EB-Echo影像学资料及临床资料作为r-TTS组;选择同期收治的33例经典型TTS患者的临床资料作为经典型TTS组。比较两组患者EB-Echo检出率、EB-Echo诊断时间、心脏功能指标〔左室射血分数(LVEF)、左心室每搏量(LVSV)〕、血容量指标〔下腔静脉直径(IVCD)、下腔静脉塌陷度(cIVC)〕及并发症〔急性左室流出道梗阻(ALVOTO)、急性二尖瓣反流(AMR)、肺动脉高压(PH)〕发生率及预后的差异。结果r-TTS组EB-Echo检出率明显高于经典型TTS组〔100.0%(10/10)比66.7%(22/33),P<0.05〕,且诊断时间较经典型TTS组明显缩短(min:26.80±3.77比41.18±6.61,P<0.05)。在心脏功能指标方面,r-TTS组LVEF和LVSV均明显低于经典型TTS组〔LVEF:0.36±0.05比0.41±0.04,LVSV(mL):36.43±4.30比40.65±5.09,均P<0.05〕,而r-TTS组和经典型TTS组容量指标(IVCD和cIVC)比较差异无统计学意义〔IVCD(mm):15.02±1.88比14.94±1.75,cIVC:(0.43±0.06)%比(0.44±0.07)%,均P>0.05〕。并发症方面,r-TTS组ALVOTO发生率略低于经典型TTS组〔0%(0/10)比21.2%(7/33),P>0.05〕,AMR和PH发生率与经典型TTS组相近〔AMR发生率:40.0%(4/10)比24.2%(8/33),PH发生率:30.0%(3/10)比18.2%(6/33),均P>0.05〕。随访6个月至3年,r-TTS组无死亡病例,经典型TTS组死亡1例,两组病死率比较差异无统计学意义。结论EB-Echo在r-TTS早期诊断、指导治疗、改善预后方面有重要的临床应用价值。