Coupling Relationship between Transport Superiority Degree and Urbanization in Sichuan,China

Relationship between transport superiority degree and urbanization is not quantified enough in recent researches.Combined with coupling model and coupling coordination model,the spatial analysis technique was applied to quantitatively analyzing the relationship between transport superiority degree and comprehensive urbanization in eighteen prefecture-level cities in Sichuan from 2000 to 2011. An evaluation index system was constructed,and index weights were obtained using the variation coefficient method. The traffic volume was found to be the main factor contributing to transport superiority degree, and space urbanization was the primary factor influencing comprehensive urbanization. The coupling degree between transport superiority degree and urbanization( CU) was generally higher than the coupling coordination degree( DU) in 2000-2011. DUvaried more significantly than CU. In 2011, Sichuan was divided into five regional types. Based on the above observations, targeted recommendations were developed.

A Tragedy of Reason Superiority——An Analysis of “The Most Dangerous Game” in Textism

The Most Dangerous Game is a highly-trimmed short story,with well-knitted plot,deep-carved characters,suspense,symbols,ironies,etc.Beyond its elaborate form,it conveys far-reaching social and cultural values.This paper is an attempt to appreciate the story inside out,in which structural approach and cultural approach are employed.Parallels and contrasts in structure and the unique shifts and gaps in its narration are highlighted to explore the tradition of reason superiority in western culture and the doom it has brought to the world and to the people concerned.The First World War is the fighting between rational beings.Rationality,when brought to extremes,may lead to irrationality.The image of General Zaroff is a reflection of modern westerner who boasts to be rational being while killing his fellow beings in bloody wars.

Interactive Effect and Spatial Characteristics of Agricultural Development Level and Transport Superiority Degree in Main Grain-producing Areas of the Central Jilin Province,China

To investigate the spatial synergy between agricultural development level and transport superiority degree in grain-producing areas of the central Jilin Province and the driving mechanism between them,22 counties in the central Jilin Province were used as the research units to calculate agricultural development level and transport superiority degree using the entropy weighting method,weighted travel time and raster cost distance.The spatial econometric model was used to analyze the mechanism of the mutual influence between the two.The main conclusions are as follows.1)Agricultural development level around Changchun,the provincial capital city,and in the areas of Changchun-Jilin and Changchun-Gongzhuling is high,whereas the development level of the counties in the southwest is low.2)Transport superiority degree of each county has improved,the overall connectivity of the road networks has been optimized,and the level of transportation accessibility has shown the development trend of‘centralization’,exhibiting the characteristics of proximity diffusion.3)Locally,there is spatial heterogeneity in the mutual driving effects of the two,with six main patterns.4)The theoretical conditions of von Thunen’s agricultural location have changed under the conditions of market economy due to the improvement of the transport networks,the new model of agricultural development,and the changes of the market system.

Drug combination therapy:providing evidence of significant superiority of a combination of drugs compared to the single agents

Based on Jun-Chen-Zuo-Shi,traditional Chinese medicine has used mixtures of naturally occurring herbs for more than 2000 years.Since the last century,advances in omics and cell biology have greatly impacted on the increasing use of drug combination in modern medicine.The enhanced understanding of the biology of a disease as a disturbed system of interconnected molecular pathways which are more susceptible to the simultaneous action of several drugs,provides new opportunities for the rational development of combination therapies.Combination therapies exploit the chances for better efficacy,decreased toxicity,and reduced development of drug resistance and owing to these advantages,have become a standard for the treatment of several diseases and continue to represent a promising approach in indications of unmet medical need.

Evaluation on Terrain-Climate Superiority Degree at County Level in Yunnan Province

Terrain slope and climate zone(heat zone)are important factors affecting land use zoning and agricultural production layout in mountainous areas.Using"weight grade method",a quantitative index of comprehensively evaluating terrain slope and climatic(thermal)conditions in mountainous areas was proposed:terrain-climate superiority degree(TCSD),and TCSD,terrain superiority degree(TSD),and climate superiority degree(CSD)in 129 counties(cities and districts)of Yunnan Province were measured and analyzed.The results showed that TCSD in 50.39%of counties of Yunnan Province was relatively better(levels I and II),and TCSD in 38.76%of counties was moderate(level III),while TCSD in 10.85%of counties was relatively poorer(levels IV and V).

Efficacy of Zhumian Tang formula granules(助眠汤配方颗粒)combined with eszopiclone for the treatment of poor sleep quality:a multi-center,randomized controlled,superiority trial

OBJECTIVE:To evaluate the efficacy and safety of Zhumian Tang formula granules(助眠汤配方颗粒)combined with eszopiclone for treating poor sleep quality.METHODS:This multi-center,dynamic blockrandomized,parallel-group superiority clinical trial included 130 patients.The combined treatment group received Zhumian Tang formula granules combined with eszopiclone treatment,and the control group received eszopiclone treatment only.The group allocation ratio was 1∶1.The duration of treatment was 2 weeks.Participants were asked to complete questionnaires before treatment,after 1 week of the intervention,after 2 weeks of the intervention,and at the follow-up on week 3.The primary outcomes were the Pittsburgh Sleep Quality Index(PSQI)score and the total effective rate of treatment.The secondary outcome was the rate of adverse effects.RESULTS:Compared with the eszopiclone treatment group,the PSQI score of the combined treatment group was significantly lower after 2 weeks of the intervention(6.98 vs 8.26,P<0.05).However,there was no significant difference in the mean PSQI score after 1 week of the intervention(9.89 vs 9.15,P=0.124).After the follow-up on week 3,the PSQI score of the combined treatment group remained significantly lower than that of the eszopiclone treatment group(6.12 vs 8.31,P<0.001).The total effective rates of treatment of the combined group and the eszopiclone group were 36.92%vs 35.38%(Z=0.033,P=0.855)after 1 week of the intervention,83.08%vs 58.46%(Z=9.519,P<0.05)after 2 weeks of the intervention,and 83.08%vs 61.54%(Z=7.530,P<0.05)and after the follow-up on week 3,respectively.There was no significant difference in the overall rate of adverse reactions between the combined and eszopiclone treatment groups(21.53%vs 31.8%,P=0.318).CONCLUSION:The combination of Zhumian Tang formula granules with eszopiclone was found to be safe and more effective in improving sleep quality than eszopiclone alone.Traditional Chinese medicine can enhance the effectiveness of Western medicine in the treatment of insomnia.

颈部挫伤并发甲状腺上动脉破裂致咽喉后壁血肿1例

1临床资料患者,男,65岁,因“颈部闭合性损伤1 h”急诊收治入院,就诊时呈渐近性呼吸困难加重,伴有咽痛明显,无明显声嘶发作。查体:颈部肿胀明显,皮下有少许淤血样改变,颈部皮肤完整。3~4度阻塞性呼吸困难,不能平卧位。相关科室除外颅脑、胸腹并发伤后,急诊坐位下行气管切开术,术后呼吸有改善,但效果不明显。术前颈动脉血管造影发现左侧甲状腺上动脉破裂(图1A),颈部CT示血肿上至第2颈椎水平,下至第1胸椎水平(图1B、1C),咽喉后壁巨大血肿约500 ml,术前介入科行血管栓塞术。

Superior rectus/levator complex in acquired anophthalmic socket repaired with spheric implant—a computed tomography scan and topographic study

AIM:To determine whether the levator palpebrae superioris(LPS)/superior rectus(SR)muscle complex,can influence the position of the upper lid and fornix in acquired anophthalmic sockets.METHODS:This comparative non-randomized and non-interventional study included retrospective data of 21 patients with unilateral acquired anophthalmic sockets repaired with spheric implants.High-resolution computed tomography(CT)measurements of the LPM/SR muscle complex and clinical topographic position of the upper lid,superior and inferior fornix depth in primary gaze position were evaluated.Demographic data were presented as frequency and percentage proportions and quantitative variables comparing the socket measurements with the normal contralateral orbit was statistically analyzed using non-parametric tests considering P<0.05.RESULTS:The anophthalmic orbits had a significantly shorter LPS length(P=0.01)and significantly thicker SR(P=0.02)than the normal orbit.Lagophthalmos was present in anophthalmic sockets but not in normal orbits(P=0.002),while levator function was normal in both(P>0.05,all comparisons).The superior fornix depth was similar in the anophthalmic socket and the contralateral normal orbit(P=0.192)as well the inferior fornix depth(P=0.351).CONCLUSION:Acquired anophthalmic sockets repaired with spheric implants have shorter LPS,thicker SR,and more lagophthalmos than normal orbits.The relationship of the LPS and SR with other orbital structures,associated with passive or active forces acting in the final position of the lids and external ocular prosthesis should be further investigated.

Dynamic ultrasonography for optimizing treatment position in superior mesenteric artery syndrome:Two case reports and review of literature

BACKGROUND Superior mesenteric artery(SMA)syndrome is a rare cause of duodenal obstruction by extrinsic compression between the SMA and the aorta(SMA-Ao).Although the left lateral recumbent position is considered effective in the treatment of SMA syndrome,individual variations in the optimal patient position have been noted.In this report,we present two elderly cases of SMA syndrome that exhibited rapid recovery due to ultrasonographic dynamic evaluation of the optimal position for each patient.CASE SUMMARY Case 1:A 90-year-old man with nausea and vomiting.Following diagnosis of SMA syndrome by computed tomography(CT),ultrasonography(US)revealed the SMA-Ao distance in the supine position(4 mm),which slightly improved in the lateral position(5.7–7.0 mm)without the passage of duodenal contents.However,in the sitting position,the SMA-Ao distance was increased to 15 mm accompanied by improved content passage.Additionally,US indicated enhanced passage upon abdominal massage on the right side.By day 2,the patient could eat comfortably with the optimal position and massage.Case 2:An 87-year-old woman with vomiting.After the diagnosis of SMA syndrome and aspiration pneumonia by CT,dynamic US confirmed the optimal position(SMA-Ao distance was improved to 7 mm in forward-bent position,whereas it remained at 5 mm in the supine position).By day 7 when her pneumonia recovered,she could eat with the optimal position.CONCLUSION The optimal position for SMA syndrome varies among individuals.Dynamic US appears to be a valuable tool in improving patient outcomes.

Tuning the crystalline and electronic structure of ZrO_(2)via oxygen vacancies and nano-structuring for polysulfides conversion in lithium-sulfur batteries

The recent emergence of tetragonal phases zirconium dioxide(ZrO_(2))with vacancies has generated significant interest as a highly efficient and stable electrocatalyst with potential applications in trapping polysulfides and facilitating rapid conversion in lithium-sulfur batteries(LSBs).However,the reduction of ZrO_(2)is challenging,even under strong reducing atmospheres at high temperatures and pressures.Consequently,the limited presence of oxygen vacancies results in insufficient active sites and reaction interfaces,thereby hindering practical implementation.Herein,we successfully introduced abundant oxygen vacancies into ZrO_(2)at the nanoscale with the help of carbon nanotubes(CNTs-OH)through hydrogen-etching at lower temperatures and pressures.The introduced oxygen vacancies on ZrO_(2-x)/CNTs-OH can effectively rearrange charge distribution,enhance sulfiphilicity and increase active sites,contributing to high ionic and electronic transfer kinetics,strong binding energy and low redox barriers between polysulfides and ZrO_(2-x).These findings have been experimentally validated and supported by theory calculations.As a result,LSBs assembled with the ZrO_(2-x)/CNTs-OH modified separators demonstrate excellent rate performance,superior cycling stability,and ultra-high sulfur utilization.Especially,at high sulfur loading of 6 mg cm^(-2),the area capacity is still up to 6.3 mA h cm^(-2).This work provides valuable insights into the structural and functional optimization of electrocatalysts for batteries.

Lateral clavicle fracture-plating options and considerations

Clavicle fractures are among the most prevalent types of fractures with numerous treatment strategies that have evolved over time.In the realm of lateral-third clavicle fracture management,several surgical methods are available,with plate and screw constructs being one of the most frequently employed options.Within this construct,numerous choices exist for fixing the fracture.This editorial provides an overview of the common plate options utilized in the management of distal third clavicle fractures underscoring the critical considerations and approaches that guide clinicians in selecting the most appropriate fixation techniques,considering the complex landscape of clavicle fractures and their challenging management.

Accidental placement of venous return catheter in the superior vena cava during venovenous extracorporeal membrane oxygenation for severe pneumonia: A case report

BACKGROUND Venovenous extracorporeal membrane oxygenation(V-V ECMO)has become an important treatment for severe pneumonia,but there are various complications during the treatment.This article describes a case with severe pneumonia success-fully treated by V-V ECMO,but during treatment,the retrovenous catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.The ECMO was safely withdrawn after multidiscip-linary consultation.Our experience with this case is expected to provide a reference for colleagues who will encounter similar situations.CASE SUMMARY A 64-year-old man had severe pulmonary infection and respiratory failure.He was admitted to our hospital and was given ventilation support(fraction of inspired oxygen 100%).The respiratory failure was not improved and he was treated by V-V ECMO,during which the venous return catheter,which was supposed to be in the right internal vein,entered the superior vena cava directly in the mediastinum.There was a risk of massive mediastinal bleeding if the catheter was removed directly when the ECMO was withdrawn.Finally,the patient underwent vena cava angiography+balloon attachment+ECMO with-drawal in the operating room(prepared for conversion to thoracotomy for vascular exploration and repair at any time during surgery)after multidiscip-linary consultation.ECMO was safely withdrawn,and the patient recovered and was discharged.CONCLUSION Patients may have different vascular conditions.Multidisciplinary cooperation can ensure patient safety.Our experience will provide a reference for similar cases.

Emergency rescue of a patient with hemorrhagic shock caused by superior mesenteric artery rupture:A case report

BACKGROUND Superior mesenteric artery(SMA)injuries rarely occur during blunt abdominal injuries,with an incidence of<1%.The clinical manifestations mainly include abdominal hemorrhage and peritoneal irritation,which progress rapidly and are easily misdiagnosed.Quick and accurate diagnosis and timely effective treatment are greatly significant in managing emergent cases.This report describes emergency rescue by a multidisciplinary team of a patient with hemorrhagic shock caused by SMA rupture.CASE SUMMARY A 55-year-old man with hemorrhagic shock presented with SMA rupture.On admission,he showed extremely unstable vital signs and was unconscious with a laceration on his head,heart rate of 143 beats/min,shallow and fast breathing(frequency>35 beats/min),and blood pressure as low as 20/10 mmHg(1 mmHg=0.133 kPa).Computed tomography revealed abdominal and pelvic hematocele effusion,suggesting active bleeding.The patient was suspected of partial rupture of the distal SMA branch.The patient underwent emergency mesenteric artery ligation,scalp suture,and liver laceration closure.In view of conditions with acute onset,rapid progression,and high bleeding volume,key points of nursing were conducted,including activating emergency protocol,opening of the green channel,and arranging relevant examinations with various medical staff for quick diagnosis.The seamless collaboration of the multidisciplinary team helped shorten the preoperative preparation time.Emergency laparotomy exploration and mesenteric artery ligation were performed to mitigate hemorrhagic shock while establishing efficient venous accesses and closely monitoring the patient’s condition to ensure hemodynamic stability.Strict measures were taken to avoid intraoperative hypothermia and infection.CONCLUSION After 3.5 h of emergency rescue and medical care,bleeding was successfully controlled,and the patient’s condition was stabilized.Subsequently,the patient was transferred to the intensive care unit for continuous monitoring and treatment.On the sixth day,the patient was weaned off the ventilator,extubated,and relocated to a specialized ward.Through diligent medical intervention and attentive nursing,the patient made a full recovery and was discharged on day 22.The follow-up visit confirmed the patient’s successful recovery.

Preservation of superior rectal artery in laparoscopic colectomy:The best choice for slow transit constipation?

Laparoscopic colectomy with ileorectal anastomosis may be beneficial for patients with slow transit constipation who do not respond to conservative treatment,particularly if the superior rectal artery(SRA)is preserved.Several important concerns have been addressed in this commentary.It is important to first go over the definition of surgical procedure as it is used in this text.Second,the current study lacked a control group that had SRA preservation.Thirdly,it would be best to use a prospective,randomized controlled study.Lastly,a description of the mesenteric defect’s state following a laparoscopic colectomy is necessary.

Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein:A case report

BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.

No-touch isolation technique in emergency pancreaticoduodenectomy for neoplastic hemorrhage: Two case reports and review of literature

BACKGROUND Emergency pancreaticoduodenectomy(EPD)is a rare event for complex periam-pullary etiology.Increased intraoperative blood loss is correlated with poor post-operative outcomes.CASE SUMMARY Two patients underwent EPD using a no-touch isolation technique,in which all arteries supplying the pancreatic head region were ligated and divided before manipulation of the pancreatic head and duodenum.The operative times were 220 and 239 min,and the blood loss was 70 and 270 g,respectively.The patients were discharged on the 14^(th) and 10^(th) postoperative day,respectively.Thirty-two patients underwent EPD for the treatment of neoplastic bleeding.The mean operative time was 361.6 min,and the mean blood loss was 747.3 g.The comp-lication rate was 37.5%.The in-hospital mortality rate was 9.38%.CONCLUSION The no-touch isolation technique is feasible,safe,and effective for reducing intraoperative blood loss in EPD.

Comprehensive Evaluation of Flower Border Application Value of New and Superior Plants in Hefei Area

An analytic hierarchy process(AHP)was employed to assess the applicability of 18 new and superior varieties of flowers in Hefei City flower border applications.A total of 12 indicators were selected from three distinct aspects of adaptability,ornamental characteristics and use traits,in order to establish a comprehensive evaluation model.The results demonstrate that grade I(J≥2.685)exhibits excellent application value,encompassing six species of plants,such asHydrangeamacrophylla‘Endless Summer’;grade II(2.684≤J≤2.420)is also of notable application value,encompassing five species of plants,such asCallistemonrigidus;grade III(2.419≤J≤2.615)is of average application value,including five species of plants,such asCrocosmiacrocosmiflora;grade IV(J≤2.16)is of relatively poor application value.The evaluation results may be utilized as a theoretical reference for the promotion of new and superior varieties in the flower border of Hefei.