Design and Analysis for Enlarging Mechanism of Air Cylinder Stroke

In this paper,a new type of machinery which can enlarge the stroke of air cylinder is introduced. It is very useful when the original stroke of air cylinder cannot satisfy the work requirement.According to design requirements,its multi-objective mathematic model with constrained conditions is built. In order to solve this model, some methods are discussed and used such as penalty function method,variable metric method,Newton tangent method and bisection method. Based on the optimal result,motion curves of enlarging stroke mechanism are obtained. Results show that the motion characteristic of enlarging stroke of air cylinder mechanism is satisfying. In addition,we also consider the influence of different initial values of link length to optimal results and two important laws are got in this paper on the basis of optimal results.

Planning Method of Eco-environment Restoration Based on Enlarging Terrace and De-farming in Loess Hilly Region——A Case Study of Yangou Catchment

After expatiating the guiding ideology,contents,standards and principles of eco-environment restoration based on enlarging terrace and de-farming,this paper discussed the planning method and technical flow of enlarging terrace and garden plot in a small catchment of loess hilly region by means of GIS spatial analysis technology,and then the planning method was applied in Yangou catchment.The result showed that it is practicabl,and the areas of newly-built terrace and garden plot in Yangou catchment are at least 295.06 and 4.61 hm2,so that the areas of basic farmland and garden plot reach 359.23 and 622.69 hm2.After the land use structure is regulated,the forest coverage is 48.87%,and the permanent vegetation coverage is about 75% in Yangou catchment,while sediment reduction benefit is above 80% in slope land.In agricultural development,Yangou catchment can yield 1 645.13 tons of food supplies,above 9 340 tons of apples,and can feed 7 500 sheep every year.

Plea to radiologists:Please consider Mahvash disease when encountering an enlarged pancreas

Radiologists play a key role in establishing an early and accurate diagnosis,especially for rare diseases.Mahvash disease(OMIM 619290)is an autosomal recessive hereditary disease caused by inactivating mutations of the glucagon receptor and its main clinical consequences are pancreatic neuroendocrine tumors and in some cases,porto-sinusoidal vascular disease and portal hypertension.Untreated Mahvash disease can be lethal.The diagnosis of Mahvash disease has almost always been delayed in the past due to radiologists’unawareness of or unfamiliarity with the unique imaging features of Mahvash disease which are moderately to enormously enlarge pancreas with preserved pancreas contour and parenchyma without vascular involvement or lymphadenopathy.These features help differentiate Mahvash disease from other etiologies of diffusely enlarged pancreas such as diffuse pancreatic ductal carcinoma,diffuse pancreatic lymphoma,and autoimmune pancreatitis.Invoking Mahvash disease in the differential diagnosis of an enlarged pancreas has recently been shown to facilitate early diagnosis.To prevent missing the diagnosis of this significant disease,I sincerely ask radiologists to consider Mahvash disease in their differential diagnoses of diffusely enlarged pancreas.

Enlarging Flower Display Vital for Cross-fertilized Alpine Herb

Primula tibetica is an inconspicuous herb distributed in the Himalayas where lacks pollinators.The species may undergo severe pollen limitation in the field,and makes an ideal model system for studying whether pollen limitation selects on the traits that increase the floral display in a case in which a small,inconspicuous plant undergoes

基于定量脑电图及经颅多普勒的多模脑功能监测评估急性高血压性脑出血血肿扩大及预后的价值

目的评估定量脑电图(QEEG)和经颅多普勒(TCD)的多模脑功能监测在预测急性高血压性脑出血患者血肿扩大及预后的价值。方法回顾性分析2019年10月至2022年10月120例急性高血压性脑出血患者的临床资料。所有患者在入院24 h内接受QEEG和TCD检查,并根据血肿是否扩大将患者分为血肿扩大组(79例)和血肿稳定组(41例)。通过对比两组间QEEG和TCD的参数差异,探究这些监测指标与血肿扩大及患者预后之间的关联。结果血肿扩大组的患者年龄较高,且吸烟比例也较高,血肿扩大组患者的初始神经功能损伤更严重,血肿扩大组在脑出血后不同时间点的DAR和DTABR值均高于续血肿稳定组(P<0.05)。相关性分析显示DAR、DTABR和P1与血肿扩大呈正相关,其中DAR和DTABR的相关性尤其强(r值分别为0.774和0.738,P<0.05),P1的相关性相对较弱(r=0.213,P<0.05)。ROC曲线分析显示DAR、DTABR和P1参数在预测血肿扩大方面具有高灵敏度和特异度,DAR的AUC值高达0.970。随访期间,血肿稳定组的MRS评分在所有时间点上优于血肿扩大组(P<0.05)。结论QEEG和TCD有助于早期识别高风险患者,从而实施更有针对性的治疗措施,改善患者的临床结果。

膝关节镜下活瓣扩大切除联合囊壁切除术对腘窝囊肿患者疼痛及囊肿残存情况的影响

目的观察膝关节镜下活瓣扩大切除(AEVR)联合囊壁切除术(CWR)治疗腘窝囊肿的效果。方法回顾性分析2022年6月-2023年6月该院收治的80例腘窝囊肿患者的临床资料,根据术式不同分为两组,A组(39例)行传统开放囊肿切除术(TOC),B组(41例)行AEVR-CWR。比较两组患者围手术期指标、住院时间、疼痛情况、膝关节功能、膝关节活动范围、腘窝囊肿分级、术后并发症和囊肿残存情况。结果B组术中出血量明显少于A组,术后并发症总发生率和术后6个月时囊肿残存率明显低于A组,切口长度和住院时间明显短于A组,手术时间明显长于A组,差异均有统计学意义(P<0.05);两组患者术后视觉模拟评分法(VAS)评分明显低于术前,且B组明显低于A组,差异均有统计学意义(P<0.05);两组患者术后Lysholm评分明显高于术前,且B组明显高于A组,膝关节活动范围明显大于术前,且B组明显大于A组,差异均有统计学意义(P<0.05);两组患者术后Rauschning-Lindgren分级较术前明显改善,且B组优于A组,差异均有统计学意义(P<0.05)。结论AEVR-CWR可减少腘窝囊肿手术出血量,缩短切口长度和住院时间,减轻患者疼痛,扩大膝关节活动范围,改善膝关节功能和腘窝囊肿分级,降低术后并发症总发生率和术后6个月时囊肿残存率,但手术时间会延长。

标准护理流程在数字化截骨导板辅助下颌角截骨术患者中的应用

目的:探讨标准护理流程在数字化截骨导板辅助下颌角截骨术患者中的应用效果。方法:选取2020年1月-2023年6月笔者医院收治的数字化截骨导板辅助下颌角截骨术的158例下颌角肥大就医者,按照不同护理干预模式进行分组。将2020年1月-2021年9月收治的79例就医者纳入对照组,行常规护理;2021年10月-2023年6月收治的79例就医者纳入研究组,按照标准护理流程实施干预。比较两组术前准备完整率、并发症情况、焦虑评分及护理满意度。结果:研究组术前准备完整率为98.73%,显著高于对照组的72.15%(P<0.05);研究组并发症发生率为3.80%,低于对照组的13.92%(P<0.05);研究组干预后焦虑自评量表(Self-rating anxiety scale,SAS)评分低于对照组(P<0.05);研究组护理满意度为97.47%,明显高于对照组的82.28%(P<0.05)。结论:在数字化截骨导板辅助下颌角截骨术患者中实施标准护理流程,可提高术前准备完整率,降低并发症发生风险,在改善患者焦虑的同时提高了满意度,值得临床推广。

Hematoma enlargement-related factors in hypertensive cerebral hemorrhage

BACKGROUND：Continuous hemorrhage or hematoma enlargement often occurs following cerebral hemorrhage attacks. OBJECTIVE： To retrospectively analyze the influential factors for hematoma enlargement in patients with hypertensive cerebral hemorrhage prior to minimally invasive surgery. DESIGN, TIME AND SETTING： A comparative analysis of 90 patients with cerebral hemorrhage undergoing minimally invasive surgery at the Department of Neurology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology between April 2005 and February 2007. PARTICIPANTS： Fifty-eight males and thirty-one females aged （52.7 ± 5.23） years （range, 28-73 years）. METHODS： Cranial CT was performed twice to objectively identify hematoma enlargement. Patients with hematoma enlargement prior to surgery were selected as the observation group （n = 30）, and those with no obvious hematoma changes served as the control group （n = 60）. Following cranial CT localization, the two groups underwent minimally invasive hematoma aspiration and drainage, according to Standardized Treatment Guidelines for Micro-invasive Aspiration and Drainage of Intracranial Hematoma. MAIN OUTCOME MEASURES： Hemorrhage site, coagulation function, diabetes history, and clinical symptoms. RESULTS： There were no significant differences in hemorrhage sites between the two groups （χ2 = 2.262, P 〉 0.05）. The percent of intemperance patients in the observation group was significantly larger than the control group （χ2 = 6.923, P 〈 0.01）. No significant differences in terms of percent of coagulation dysfunction or diabetes were determined between the two groups （χ2 = 0.03, 0.08, P 〉 0.05）. The percent of patients with clinical deterioration was significantly higher in the observation group, compared to the control group （χ2 = 25.57, P 〈 0.01）. CONCLUSION： Intemperance and preoperative clinical deterioration may increase incidence of hematoma enlargement prior to minimally invasive surgery in patients with hypertensive cerebral hemorrhage.

Clinical treatment considerationsin the intensity-modulated radiotherapy era for patients with NO-category nasopharyngeal carcinoma and enlarged neck lymph nodes

Background:Nasopharyngeal carcinoma(NPC) shows a high proportion of lymph node metastasis,and treatment guidelines have been developed for positive nodes.However,no irradiation guidelines have been proposed for patients with enlarged neck lymph nodes(ENLNs) that do not meet the radiological criteria of 10 mm in diameter for positive lymph nodes.This study aimed to determine the prognostic value and radiation dose for ENLNs in NO-category NPC patients treated with intensity-modulated radiotherapy(IMRT).Methods:We reviewed the medical data of 251 patients with non-metastatic,NO-category NPC treated with IMRT.Receiver operating characteristic curves were used to calculate the cut-off value of the ENLN diameter for the prediction of disease failure.The biological equivalent dose(BED) for ENLNs was calculated.Patient survival was compared between the small and large ENLN groups.Independent prognostic factors were identified using the Cox proportional hazards model.Results:The estimated 4-year regional relapse-free survival rate was higher in patients with ENLNs ≥5.5 mm than in those with ENLNs <5.5 mm(100%vs.98.8%,P=0.049),whereas disease-free,overall,and distant metastasis-free survival rates were similar between the two groups.After adjusting for various factors,ENLN diameter was not identified as an independent prognostic factor(P > 0.05 for all survival rates).In the subgroup analysis,patients receiving BED ≥72 Gy had a similar prognosis as patients receiving BED <72 Gy in both the small and large ENLN groups.The multivariate analysis also confirmed that BED≥72 Gy was not associated with significantly improved prognosis in patients with NO-category NPC.Conclusions:A BED of 72 Gy to ENLNs is considerably sufficient to provide a clinical benefit to patients with NO-category NPC.Prospective studies are warranted to validate the findings in the present study.

Optimizing CT for the evaluation of vestibular aqueduct enlargement:Inter-rater reproducibility and predictive value of reformatted CT measurements

Enlarged vestibular aqueduct(EVA), the most frequent identifiable cause of congenital hearing loss, is evaluated with high-definition multidetector CT in the axial plane. Our purpose was to determine which reformatted CT measurements are most reproducible. Seven multiplanar reformatted images were created for each of the 64 temporal bones in patients with EVA. Intraclass correlation coefficients(ICC) were used to assess inter-observer variability, and both linear regression and ROC analyses were used to compare the measurements with severity of hearing loss, as assessed by pure tone audiometry. All seven measurements had excellent inter-observer variability, with average-measure ICC ranging from 0.92 to 0.98. There was no statistically significant correlation between the radiologic degree of aqueduct enlargement and severity of hearing loss using any of the seven measurements; ROC analyses revealed areas under the curves ranging from 0.57 to 0.73. Optimal accuracy was obtained with a threshold of 1.75 mm as measured at the aqueductal aperture in the P€oschl plane, with sensitivity of 0.75 and specificity of0.63. Although the radiologic measurement may not serve as a reliable tool for assessing severity of EVA, P€oschl plane reformatting has proven to be better than conventional axial acquisition plane for identifying patients with clinically significant hearing loss.

Risk factors of distal segment aortic enlargement after complicated type B aortic dissection

Objectives:Distal segment aortic enlargement(DSAE)is a common complication that influences the long-term prognosis of type B aortic dissection(TBAD)after thoracic endovascular aortic repair(TEVAR).In this study,a multivariate analysis was performed to find potential factors predictive of DSAE.Methods:A single-center retrospective study was performed from 1999 to 2016.Included in the study were complicated TBAD patients who underwent TEVAR with uncovered residual tears.Based on the diameter of the distal segment of the uncovered aorta,we assigned patients to an enlargement group and a non-enlargement group.Data extracted from the medical records included demographic and clinical characteristics and followup computed tomography angiography data.The primary endpoints were the all-cause mortality and the presumably aortic-related events that required reintervention during the follow-up period.Results:For the 333 patients,all-cause mortality was 38(11.41%),and 76(22.82%)patients underwent reintervention.A total of 70(21.02%)patients experienced DSAE,among them were 2 patients who died of aortic rupture and 58 patients who accepted reintervention.Multivariate analysis reviewed independent risk factors of postoperative DSAE,including current smoking,the residual length of the patent false lumen,the postoperative number of dissection tears in the thoracic aorta and type III aortic arch;as well as protective factors,including the application of a restrictive bare stent(RBS),the length of covered stent in the descending thoracic aorta,and the distance from the residual first tear to the left subclavian artery(LSA).Conclusion:DSAE after TEVAR for patients with a complicated TBAD can be influenced by their current smoking habit,the residual length of patent false lumen,the postoperative number of dissection tears in the thoracic aorta and the aortic arch type.Meanwhile,RBS usage,the length of the covered stent in the descending thoracic aorta and the distance from the residual first tear to the LSA could have positive effect on the prognosis.

Influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel

The influence of enlarged section parameters on pressure transients of high-speed train passing through a tunnel was investigated by numerical simulation.The calculation results obtained by the structured and unstructured grid and the experimental results of smooth wall tunnel were verified.Numerical simulation studies were conducted on three tunnel enlarged section parameters,the enlarged section distribution along circumferential direction,the enlarged section area and the enlarged section distribution along tunnel length direction.The calculation results show that the influence of the different enlarged section distributions along tunnel circumferential direction on pressure transients in the tunnel is basically consistent.There is an optimal enlarged section area for the minimum value of the pressure variation amplitude and the average pressure variation in the tunnel.The law of the pressure variation amplitude and the average pressure variation of the enlarged section distribution along tunnel length direction are obtained.

AN ENLARGEMENT OF FILTRATION FOR BROWNIAN MOTION

Let Bt be an Ft Brownian motion and Gt be an enlargement of filtration of Ft from some Gaussian random variables. We obtain equations for ht such that Bt ht is a Gt-Brownian motion.

Ring Enlargement of Alkaloids

The procedure for the ring enlargement of N-heterocycles with the net result of CH2 insertion was successfully carried out with certain alkaloids such as tetrahydroberberine and strychnine.

Patterns and Experience of China's Four Decades of Opening-Up

China＇s four decades of opening-up coincided with the trend of the world economy, and contributed to its own economic development. With a gradualist approach, China achieved opening-up without causing economic and social repercussions, and unleashed institutional dividends that facilitated its reform and development. This approach has breathed lasting momentum and vitality into China＇s economic growth and structural transition, and improved China＇s industrial competitiveness and status in the international division of labor. As a basic national strategy and one of the country＇s five development concepts, opening-up is essential for China to pursue peaceful development and stand proudly in the family of nations. Facing new changes in domestic and international environments in the new era, particularly increasing competition among major countries such as China and the United States, China should proactively explore a new model of opening-up, refocus opening-up from policy supply to capacity building, and form a new pattern of opening-up on all fronts for high-quality economic development.

Uniform stable conformal convolutional perfectly matched layer for enlarged cell technique conformal finite-difference time-domain method

Based on conformal construction of physical model in a three-dimensional Cartesian grid,an integral-based conformal convolutional perfectly matched layer（CPML） is given for solving the truncation problem of the open port when the enlarged cell technique conformal finite-difference time-domain（ECT-CFDTD） method is used to simulate the wave propagation inside a perfect electric conductor（PEC） waveguide.The algorithm has the same numerical stability as the ECT-CFDTD method.For the long-time propagation problems of an evanescent wave in a waveguide,several numerical simulations are performed to analyze the reflection error by sweeping the constitutive parameters of the integral-based conformal CPML.Our numerical results show that the integral-based conformal CPML can be used to efficiently truncate the open port of the waveguide.

Clinical correlates of enlarged prostate size in subjects with sexual dysfunction

Digito-rectal examination （DRE） of the prostate provides useful information on the state of prostate growth and on the presence of suspected peripheral nodules. The aim of this study is to describe the clinical and biochemical correlates of finding an enlarged prostate size at DRE in subjects with sexual dysfunction （SD）. A consecutive series of 2379 patients was retrospectively studied. The analysis was focused on a subset of subjects （n = 1823; mean age 54.7± 11.4） selected for being free from overt prostatic diseases. Several parameters were investigated. After adjusting for confounders, the presence of an enlarged prostate size at DRE was associated with a higher risk of metabolic syndrome （HR = 1.346 （1,129-1.759）; P = 0.030）, type 2 diabetes mellitus （HR = 1.489 （1.120-1.980）; P = 0.006）, increased LDL cholesterol （〉100mgdl^-1; HR = 1.354 （1.018-1.801）; P = 0.037） and increased mean blood pressure （BP） values （HR = 1.017 （1.007-1.027） for each mmHg increment; P = 0.001）. Accordingly, enlarged prostate size was also associated with a higher risk of arteriogenic erectile dysfunction （ED）, as well as with other andrological conditions, such as varicocele and premature ejaculation （PE）. PSA levels were significantly higher in subjects with enlarged prostate size when compared to the rest of the sample （HR = 3.318 （2.304; 4.799） for each log unit increment in PSA levels; P 〈 0.0001）. Arteriogenic ED, according to different criteria, was also associated with increased PSA levels. In conclusion, our data support the need to examine prostate size either by clinical （DRE） or biochemical （PSA） inspection in subjects with SD, in order to have insights into the nature of the SD and the metabolic and cardiovascular （CV） background of the patient.

An intelligent system for calculating the scale of rational,enlarged production of an underground non-ferrous metal mine

The enlarged production scale of underground non-ferrous metal mines is affected by many uncertain factors difficult to describe mathematically with any level of accuracy.The problem can be solved by a synthesis of artificial intelligence.Based on the analysis of the major factors affecting the scale of enlarged production,we first interpreted in detail the design principles and structure of the intelligent system.Secondly,we introduced an ANN subsystem.In order to ensure technological and scale efficien- cies of the training samples for ANN,we filtrated the samples with a DEA method.Finally,we trained the intelligent system,which was proved to be very efficient.

Image of tumor metastasis and inflammatory lymph node enlargement by contrast-enhanced ultrasonography

AIM:To compare the difference between tumorinduced lymph node enlargement and inflammation-induced lymph node enlargement by contrast-enhanced ultrasonography and pathological findings. METHODS:A model of tumor-induced lymph node metastasis was prepared by embedding a VX2 tumor into the hind paws of white rabbits.A model of inflammation-induced enlargement was prepared by injecting a suspension of Escherichia coli into separate hind paws of white rabbits.Then,a solution of SonazoidTM(GE Healthcare,Oslo,Norway)was injected subcutaneously in the proximity of the lesion followed by contrast-enhanced ultrasonography of the enlarged popliteal lymph nodes. RESULTS:In the contrast-enhanced ultrasonography of the tumor-induced metastasis model,the sentinel lymph node was imaged.An area of filling defect was observed in that enlarged lymph node.In the histology examination,the area of filling defect corresponded to the metastatic lesion of the tumor.Contrast-enhanced ultrasonography of the model on inflammation-induced lymph node enlargement,and that of the acute inflam-mation model performed 3-7 d later,revealed dense staining that was comparatively uniform.The pathological findings showed acute lymphadenitis mainly due to infiltration of inflammatory cells.Contrast-enhanced ultrasonography that was performed 28 d post-infection in the acute inflammation model showed speckled staining.Inflammation-induced cell infiltration and fiberization,which are findings of chronic lymphadenitis, were seen in the pathological findings. CONCLUSION:Sentinel lymph node imaging was made possible by subcutaneous injection of SonazoidTM.Contrast-enhanced ultrasonography was suggested to be useful in differentiating tumor-induced enlargement and inflammation-induced enlargement of lymph nodes.

Enlarged folds on endoscopic gastritis as a predictor for submucosal invasion of gastric cancers

BACKGROUND Accurate diagnosis of the depth of gastric cancer invasion is crucial in clinical practice.The diagnosis of gastric cancer depth is often made using endoscopic characteristics of the tumor and its margins;however,evaluating invasion depth based on endoscopic background gastritis remains unclear.AIM To investigate predicting submucosal invasion using the endoscopy-based Kyoto classification of gastritis.METHODS Patients with gastric cancer detected on esophagogastroduodenoscopy at Toyoshima Endoscopy Clinic were enrolled.We analyzed the effects of patient and tumor characteristics,including age,sex,body mass index,surveillance endoscopy within 2 years,current Helicobacter pylori infection,the Kyoto classification,and Lauren’s tumor type,on submucosal tumor invasion and curative endoscopic resection.The Kyoto classification included atrophy,intestinal metaplasia,enlarged folds,nodularity,and diffuse redness.Atrophy was characterized by non-reddish and low mucosa.Intestinal metaplasia was detected as patchy whitish or grayish-white flat elevations,forming an irregular uneven surface.An enlarged fold referred to a fold width≥5 mm in the greater curvature of the corpus.Nodularity was characterized by goosebump-like multiple nodules in the antrum.Diffuse redness was characterized by uniform reddish nonatrophic mucosa in the greater curvature of the corpus.RESULTS A total of 266 gastric cancer patients(mean age,66.7 years;male sex,58.6%;mean body mass index,22.8 kg/m2)were enrolled.Ninety-three patients underwent esophagogastroduodenoscopy for surveillance within 2 years,and 140 had current Helicobacter pylori infection.The mean Kyoto score was 4.54.Fifty-eight cancers were diffuse-type,and 87 cancers had invaded the submucosa.Multivariate analysis revealed that low body mass index(odds ratio 0.88,P=0.02),no surveillance esophagogastroduodenoscopy within 2 years(odds ratio 0.15,P<0.001),endoscopic enlarged folds of gastritis(odds ratio 3.39,P=0.001),and Lauren’s diffuse-type(odds ratio 5.09,P<0.001)were independently associated with submucosal invasion.Similar results were obtained with curative endoscopic resection.Among cancer patients with enlarged folds,severely enlarged folds(width≥10 mm)were more related to submucosal invasion than mildly enlarged folds(width 5-9 mm,P<0.001).CONCLUSION Enlarged folds of gastritis were associated with submucosal invasion.Endoscopic observation of background gastritis as well as the lesion itself may help diagnose the depth of cancer invasion.