Efficacy and safety analysis of continued nursing of complications in discharged patients after percutaneous transhepatic biliary drainage

BACKGROUND Percutaneous hepatobiliary drainage(PTCD)is an effective method for the treatment of biliary obstruction and other diseases,but postoperative complications are still one of the important problems faced by patients.Continuous nursing is a comprehensive nursing model that plays an important role in postoperative recovery.The purpose of this study was to investigate the effect of continuous nursing on the incidence of complications in patients after PTCD surgery through meta-analysis and to evaluate its efficacy and safety.AIM To evaluate the effect of extended nursing on the incidence of complications in discharged patients after percutaneous transhepatic biliary drainage(PTBD).METHODS Randomized controlled studies on PTBD postdischarge extended care were identified in the CNKI,Wanfang,VIP,CBM,PubMed,Cochrane Library,Embase,Web of Science,and other databases.The quality of the included studies was evaluated using the Joanna Briggs Institute of Australia literature quality evaluation tool,and a meta-analysis of the included studies was performed with RevMan 5.4 software.RESULTS Finally,9 studies were included,with a total sample size of 854 patients(425 patients in the control group and 429 patients in the intervention group).Meta-analysis revealed that extended care effectively reduced biliary tract infection(RR:0.42,95%CI:0.30-0.57),puncture wound infection(RR:0.19,95%CI:0.06-0.65),catheter protrusion or displacement in discharged patients after PTBD(RR:0.31,95%CI:0.18-0.54),catheter blockage(RR:0.23,95%CI:0.13-0.42),skin infection around the drainage tube(RR:0.30,95%CI:0.12-0.77),and catheter-related readmissions(RR:0.34,95%CI:0.18-0.65)(P<0.05).CONCLUSION Compared with conventional discharge care,extended care can effectively reduce the occurrence of complications such as biliary tract infection,puncture wound infection,catheter prolapse or displacement,catheter blockage,skin infection around the drainage tube,and catheter-related readmission in discharged patients after PTBD.

Effect of Continuous Double-Lumen Irrigation Drainage at Constant Temperature on the Control of Abdominal Infection After Surgery

Objective:To investigate the effect of continuous double-lumen irrigation drainage at constant temperature on the control of abdominal infection after surgery,providing a reference for clinical treatment.Methods:From December 2022 to August 2023,100 patients with abdominal infections after surgery were selected from Wendeng People's Hospital in Weihai.They were randomly divided into a control group(50 cases,using conventional single-hole rubber irrigation drainage)and an observation group(50 cases,using continuous double-lumen irrigation drainage at constant temperature).The inflammatory and immune indicators of the two groups were compared after different interventions,and the specific conditions of abdominal infection were statistically analyzed.Results:There was no significant difference in inflammatory indicators between the two groups before intervention(P>0.05).After the intervention,the inflammatory indicators of the observation group were significantly lower(P<0.05).There was no significant difference in immune function indicators between the two groups before intervention(P>0.05).After intervention,the immune function indicators of the observation group showed significant improvement(P<0.05).The control of abdominal infection in the observation group was better than in the control group(P<0.05).Conclusion:Continuous double-lumen rrigation drainage at constant temperature has a better effect on controlling abdominal infection after surgery,improving the infection condition,and enhancing the immune function of patients.

One-dimensional nonlinear consolidation analysis of soil with continuous drainage boundary

Following the assumptions proposed by MESRI and ROKHSAR,the one-dimensional nonlinear consolidation problem of soil under constant loading is studied by introducing continuous drainage boundary.The numerical solution is derived by using finite difference method and its correctness is assessed by comparing with existing analytical and numerical solutions.Based on the present solution,the effects of interface parameters,stress ratios(i.e.,final effective stress over initial effective stress,N_(σ))and the ratio c_(c)/c_(k)of compression index to permeability index on the consolidation behavior of soil are studied in detail.The results show that,the characteristics of one-dimensional nonlinear consolidation of soil are not only related to c_(c)/c_(k)and N_(σ),but also related to boundary conditions.In the engineering practice,the soil drainage rate of consolidation process can be designed by adjusting the values of interface parameters.

An online method to determine chlorine stable isotope composition by continuous flow isotope ratio mass spectrometry (CF-IRMS) coupled with a Gasbench Ⅱ

An online method using continuous flow isotope ratio mass spectrometry （CF-IRMS） interfaced with a Gasbench Ⅱ was presented to determine chlorine stable isotope composition. Silver chloride （AgCl） was quantitatively derived from chloride by using silver nitrate （AgNO3）, and then was reacted with iodomethane （CH3Ⅰ） to produce methyl chloride （CH3Cl）. A GasBench Ⅱ equipped with a PoraPlot Q column was used to separate CH3Cl from any other gas species. Finally, chlorine stable isotope analysis was carried out on CH3Cl introduced to the IRMS in a helium stream via an active open split. The minimum amount of Cl used in this method is of the order of 1.4 μmol. Inter-laboratory and inter-technique comparisons show that the total uncertainty incorporating both the precision and accuracy of this method is better than 0.007%. Furthermore, ten seawaters sampled from different locations have a narrow δ37Cl value range from -0.008% to 0.010%, with a mean value of （0.000±0.006）%. This supports the assumption that any seawater can be representative of standard mean ocean chloride （SMOC） and used as an international reference material.

STABLE AND UNSTABLE STATIONARY TRAJECTORIES

The stability of stationary trajectories of a particular autonomous system is studied.The proof of the result is based upon continuation methods.

STABILITY CONTROL AND ANALYSIS OF ASYMMETRIC CONTINUOUS NEURAL NETWORKS

A new method for analyzing dynamics of continuous neural networks is proposed,and the necessary convergence conditions for a class of associative networks are obtained. Basedon the stability criterion and the equations of equilibrium set of the network, synthesis of aclass of associative neural networks is given. The stability control model of asymmetric unstablenetworks is suggested, which is also a valid way for optimization and dynamic control of stableneural networks.

Analysis of one-dimensional consolidation of fractional viscoelastic saturated soils under continuous drainage boundary conditions

This paper presents the one-dimensional(1D)viscoelastic consolidation system of saturated clayey soil under continuous drainage boundaries.The fractional-derivative Merchant(FDM)model has been introduced into the consolidation system to simulate the viscoelasticity.Swartzendruber’s flow law is also introduced to describe the non-Darcian flow characteristics simultaneously.The generalized numerical solution of the 1D consolidation under continuous boundaries is given by the finite difference scheme.Furthermore,to illustrate the effectiveness of the numerical method,two simplified cases are compared against the current analytical and numerical results.Finally,the effects of boundary parameters and model parameters on the viscoelastic consolidation were illustrated and discussed.The results indicated that the boundary parameters have a significant influence on consolidation.The larger the values of boundary parameters,the faster the whole dissipation of the excess pore-water pressure and soils’settlement rate.Fractional-order and viscosity parameter have little effect on consolidation,which are primarily significant in the middle and late consolidation phases.With the increase of the modulus ratio,the whole consolidation process becomes faster.Moreover,considering Swartzendruber’s flow delays the consolidation rate of the soil layer.

Construction Technology and Quality Control of Double Layer Continuous Paving of Cement Stabilized Macadam Base

The construction method of continuous paving of the upper and lower base of the water stable macadam base can improve the construction efficiency,overcome the quality problems of the traditional layered paving of the upper and lower base,such as untimely curing,slow construction,poor interlayer bonding,contraction joint and interlayer,so as to ensure the construction quality of the water stable macadam.It is also the promotion and application of new technology.

ABSOLUTE CONTINUITIES OF EXIT MEASURES AND TOTAL WEIGHTED OCCUPATION TIME MEASURES FOR SUPER-α-STABLE PROCESSES

Suppose X is a super-α-stable process in R^d, （0 〈 α〈 2）, whose branching rate function is dr, and branching mechanism is of the form ψ（z） = z^1＋β （0 〈0 〈β ≤1）. Let Xγ and Yγ denote the exit measure and the total weighted occupation time measure of X in a bounded smooth domain D, respectively. The absolute continuities of Xγ and Yγ are discussed.

广义α-stable过程的自相交局部时

研究了N指标d维广义α stable过程自相交局部时的存在性和联合连续性,给出了其相交局部时平方可积和联合连续的一个充分条件,其结论推广了N指标d维α stable过程和N指标d维广义BrownianSheet的相应结果.

N指标d维广义α-stable过程的局部时

研究了一类新过程——广义α－ｓｔａｂｌｅ过程，它包含了Ｎ指标ｄ维α－ｓｔａｂｌｅ过程和Ｎ指标ｄ维广义布朗单．证明了该过程的局部时的存在性、联合连续性和可微性．

A LOWER BOUND OF STABLE STATIONARY TRAJECTORIES

It is proven that an autonomous system verifying some conditions has at least one stable stationary trajectory and it is also given a lower bound to the number of unstable stationary trajectorlies.

Clinical Analysis of Lumbar Pool Drainage Combined with Antibiotics in the Treatment of Intracranial Infection

Objective: To explore the clinical effect of lumbar pool drainage combined with antibiotics in the treatment of patients with intracranial infections, and to provide a reference basis for clinical treatment. Methods: To collect and select patients admitted to the First People’s Hospital of Jingzhou City for craniotomy from January 2016 to June 2022, the infected were 20 cases, and continuous drainage of the lumbar pool was used under the premise of systemic application of sensitive antibiotics. Results: Twenty cases in this group were discharged cured. Conclusion: Lumbar pool placement drainage combined with systemic application of antibiotics for intracranial infection is a safe and effective treatment method.

Local times of linear multifractional stable sheets

Let X^H(u)(u)={X^H(u)(u);u∈R^N+}be linear multifractional stable sheets with index functional H(u),where H(u)=(H1(u),…,HN(u))is a function with values in(0;1)N.Based on some assumptions of H(u),we obtain the existence of the local times of X^H(u)(u)and establish its joint continuity and the Holder regularity.These results generalize the corresponding results about fractional stable sheets to multifractional stable sheets.

不同负压引流方式联合氨甲环酸对颈椎后路单开门手术病人失血量、引流量及并发症的影响

目的探究不同负压引流方式联合氨甲环酸对颈椎后路单开门手术的多节段脊髓型颈椎病病人失血量、引流量及并发症的影响。方法按照研究目标设定的纳入、排除标准,将2018年10月至2020年10月沧州中西医结合医院接受颈椎后路单开门手术的多节段脊髓型颈椎病病人182例作为研究对象进行回顾性研究,根据负压引流情况分为A组(持续负压引流联合氨甲环酸,46例)、B组(间断负压引流联合氨甲环酸,46例)、C组(持续负压引流,不使用氨甲环酸,45例)及D组(间断负压引流,不使用氨甲环酸,45例)。对比四组病人手术时间、总失血量、术后引流量、术后72 h血红蛋白水平,生化指标[活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、纤维蛋白原(Fib)],术后疼痛视觉模拟评分(VAS)及日本骨科协会评估治疗分数(JOA)评分。结果手术后,四组手术时间、总失血量比较差异无统计学意义(P>0.05),四组术后24 h引流量[A组(191.21±22.38)mL、B组(175.34±17.85)mL、C组(205.62±20.78)mL、D组(210.43±20.14)mL]、术后隐性失血量[A组(275.37±30.12)mL、B组(251.42±26.12)mL、C组(321.47±35.62)mL、D组(296.78±32.14)mL]、引流管留置时间[A组(1.85±0.51)d、B组(1.45±0.42)d、C组(2.32±0.65)d、D组(2.78±0.78)d]比较差异有统计学意义(P<0.05),其中B组最优,其次为A组。四组术后72 h血红蛋白水平[A组(112.43±12.57)g/L、B组(120.53±17.85)g/L、C组(103.47±10.78)g/L、D组(102.58±11.12)g/L]均明显降低(P<0.05),但是B组下降最少,其次为A组。四组血清APTT、PT、Fib水平差值比较差异有统计学意义(P<0.05),其中A组各指标变化最明显,B组血清APTT水平变化最小;四组VAS评分与JOA评分比较差异无统计学意义(P>0.05);四组发热、脑脊液漏、血肿压迫脊髓、下肢深静脉血栓、心血管事件等并发症发生情况比较差异无统计学意义(P>0.05)。结论颈椎后路单开门手术中应用间断负压引流联合氨甲环酸利于手术时间缩短,并减少术后引流量及隐性失血量,改善血红蛋白水平。

基于分数低阶协方差的阵列式超声波测风方法

考虑到当前基于时差法的超声波测风方法是间歇式测量,并且在脉冲噪声背景下测风精度较差,提出一种基于分数低阶协方差的阵列式超声波连续测风方法。该方法采用由一个发射超声波换能器和4个接收换能器组成的超声波测风阵列结构,依托该阵列结构通过对其连续采样并进行分数低阶协方差运算处理以抑制脉冲冲击噪声的影响,然后结合多重信号分类算法即可实现风速风向的高精度连续测量。通过仿真对比实验和实际测量实验验证了所提方法的有效性及优越性,与其他超声波测风方法相比具有更强的噪声抑制能力及测风精度,在实测实验中风速和风向的测量误差分别为1.2%和2°,基本达到了超声波风速风向测量的精度要求。

煤层气L型水平井电潜螺杆泵井清防砂工艺技术创新及应用

套管完井压裂投产的煤层气L型水平井出砂严重,倒置式电潜螺杆泵举升工艺受压裂砂影响故障频繁,影响了连续稳定排采,因此确定了倒置式电潜螺杆泵排采过程中由于压裂砂导致的故障点,并针对性创新应用了井筒内、导流罩及泵内清砂工艺技术,同时优化防砂管柱设计,确保了连续稳定排采。

小切口切除术联合持续负压封闭引流对浆细胞性乳腺炎患者的影响

目的探究小切口切除术联合持续负压封闭引流对浆细胞性乳腺炎(PCM)患者疗效、乳房毁损率及换药次数的影响。方法选取2016年6月至2021年6月西安交通大学第二附属医院收治的PCM女性患者163例作为研究对象,随机将其分为试验组(75例)和对照组(88例)。对照组患者采用持续负压封闭引流进行治疗,试验组在对照组基础上联合使用小切口切除术,对比两组患者的临床疗效、乳房完整性、手术指标、不良反应及复发率情况。结果对照组总有效率(86.36%)低于试验组(97.33%)(P<0.05);乳房完整性比较,试验组优秀的占52.00%,差的占1.33%;对照组优秀的占31.82%,差的占11.36%,试验组乳房完整性优于对照组(P<0.05);试验组手术时间、切口长度和愈合时间均优于对照组(P<0.05);试验组不良反应发生率(4.00%)低于对照组(6.82%),差异无统计学意义(P>0.05);试验组复发率(2.67%)低于对照组(14.77%)(P<0.05)。结论小切口切除术联合持续负压封闭引流能提高PCM患者的临床疗效,降低乳房毁损率。

“互联网+”4C延续性护理模式对精神分裂症稳定期患者健康行为及生活质量的影响

目的:探究“互联网+”4C延续性护理模式对精神分裂症稳定期患者健康行为及生活质量的影响。方法:采用方便抽样法选取2022年9月—2023年9月临沂市精神卫生中心收治的80例精神分裂症稳定期患者作为研究对象。根据随机数表法将其分为对照组和观察组,各40例。对照组采取常规延续性护理,观察组采取“互联网+”4C延续性护理模式。比较两组护理前后不良情绪、生活质量及健康行为。结果:护理后,两组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均降低,观察组SAS评分、SDS评分均显著低于对照组,差异有统计学意义(P<0.05)。护理后,两组健康责任感、躯体活动、人际关系、压力管理、营养、心理健康评分均升高,观察组健康责任感、躯体活动、人际关系、压力管理、营养、心理健康评分均显著高于对照组,差异有统计学意义(P<0.05)。护理后,两组心理社会、动机/精力、症状/副反应评分均降低,观察组心理社会、动机/精力、症状/副反应评分均低于对照组,差异有统计学意义(P<0.05)。结论:对精神分裂症稳定期患者采取“互联网+”4C延续性护理模式能够提高患者生活质量,提高患者健康行为并减轻负面情绪。

腰池持续引流改善动脉瘤性蛛网膜下腔出血后急性脑积水患者的预后

目的 分析腰池引流量对动脉瘤性蛛网膜下腔出血(aneurysmal subarachnoid hemorrhage, aSAH)后急性脑积水(acute hydrocephalus, AHC)预后的影响。方法 纳入2017年1月至2022年1月就诊于重庆医科大学附属第一医院神经外科因动脉瘤性蛛网膜下腔出血发生AHC的患者82例。以出院半年后改良Rankin评分量表(modified Rankin scale, mRS)评分为预后结局,对人口学因素、入院时蛛网膜下腔出血(subarachnoid hemorrhage, SAH)严重程度、既往史、血管痉挛、腰池引流等数据进行单因素和多因素Logistic逐步回归分析,并构建列线图预测模型。结果 单因素分析发现WFNS、Hunt-Hess、mFisher、腰池引流时间、分流依赖、脑血管痉挛、腰池引流量可影响患者预后,进一步采用Logistic逐步回归分析,发现高评分WFNS(OR:3.25,95%CI:1.11~9.48)、mFisher高分级(OR:3.66, 95%CI:1.08~12.35)、发生分流依赖(OR:15.56,95%CI:1.22~198.57)与脑血管痉挛(OR:22.24,95%CI:3.08~160.68)是影响mRS的独立危险因素,腰池引流量(OR:0.57, 95%CI:0.40~0.82)是独立保护因素。ROC曲线面积显示模型具有良好的预测效果[AUC:0.898(95%CI:0.935~0.861)];通过Bootstrap方法进行内部验证,结果显示模型具很好的区分能力[C-index:0.950(95%CI:0.904~0.996);校正C-index:0.934]。结论 增加腰池引流量是aSAH术后发生AHC预后不良的独立保护因素,并可以改善SAH患者的预后。