背景:随着生物制剂种类的增加,治疗中重度克罗恩病(CD)和中重度溃疡性结肠炎(UC)的一线生物制剂需要更精准的定位。目的:系统性评价英夫利西单抗(IFX)和乌司奴单抗(UST)在中重度CD和中重度UC一线生物治疗中的疗效和安全性。方法:检索中...背景:随着生物制剂种类的增加,治疗中重度克罗恩病(CD)和中重度溃疡性结肠炎(UC)的一线生物制剂需要更精准的定位。目的:系统性评价英夫利西单抗(IFX)和乌司奴单抗(UST)在中重度CD和中重度UC一线生物治疗中的疗效和安全性。方法:检索中国知网、万方、维普、中国科学引文数据库、PubMed、Web of Science、Embase、ClinicalTrials、Cochrane Library等数据库中IFX和UST治疗中重度CD和UC的随机对照试验(RCT),检索时间为建库至2023年12月。采用间接meta分析比较IFX与UST治疗中重度CD和UC的疗效和安全性。结果:最终纳入11项RCT。IFX诱导和维持中重度CD的临床缓解率与UST相比差异无统计学意义(P>0.05),严重不良事件和严重感染发生率差异亦无统计学意义(P>0.05)。IFX诱导和维持中重度UC的临床缓解率与UST相比差异无统计学意义(P>0.05),严重不良事件和严重感染发生率差异亦无统计学意义(P>0.05)。结论:在中重度CD患者中,IFX和UST可作为一线生物治疗的平行选择,考虑到IFX可增加患者感染结核的风险,推荐UST作为首选疗法。在中重度UC患者中,IFX是有效、安全的一线生物制剂,UST可作为一线生物治疗的选择之一。展开更多
The scattering of plane harmonic P and SV waves by a pair of vertically overlapping lined tunnels buried in an elastic half space is solved using a semi-analytic indirect boundary integration equation method. Then the...The scattering of plane harmonic P and SV waves by a pair of vertically overlapping lined tunnels buried in an elastic half space is solved using a semi-analytic indirect boundary integration equation method. Then the effect of the distance between the two tunnels, the stiffness and density of the lining material, and the incident frequency on the seismic response of the tunnels is investigated. Numerical results demonstrate that the dynamic interaction between the twin tunnels cannot be ignored and the lower tunnel has a significant shielding effect on the upper tunnel for high-frequency incident waves, resulting in great decrease of the dynamic hoop stress in the upper tunnel; for the low-frequency incident waves, in contrast, the lower tunnel can lead to amplification effect on the upper tunnel. It also reveals that the frequency-spectrum characteristics of dynamic stress of the lower tunnel are significantly different from those of the upper tunnel. In addition, for incident P waves in low-frequency region, the soft lining tunnels have significant amplification effect on the surface displacement amplitude, which is slightly larger than that of the corresponding single tunnel.展开更多
The indirect boundary element method （IBEM） is developed to solve the scattering of plane SH-waves by a lined tunnel in elastic wedge space. According to the theory of single-layer potential, the scattered-wave fiel...The indirect boundary element method （IBEM） is developed to solve the scattering of plane SH-waves by a lined tunnel in elastic wedge space. According to the theory of single-layer potential, the scattered-wave field can be constructed by applying virtual uniform loads on the surface of lined tunnel and the nearby wedge surface. The densities of virtual loads can be solved by establishing equations through the continuity conditions on the interface and zero-traction conditions on free surfaces. The total wave field is obtained by the superposition of free field and scattered-wave field in elastic wedge space. Numerical results indicate that the IBEM can solve the diffraction of elastic wave in elastic wedge space accurately and effi- ciently. The wave motion feature strongly depends on the wedge angle, the angle of incidence, incident frequency, the location of lined tunnel, and material parameters. The waves interference and amplification effect around the tunnel in wedge space is more significant, causing the dynamic stress concentration factor on rigid tunnel and the displacement amplitude of flexible tunnel up to 50.0 and 17.0, respectively, more than double that of the case of half-space. Hence, considerable attention should be paid to seismic resistant or anti-explosion design of the tunnel built on a slope or hillside.展开更多
文摘背景:随着生物制剂种类的增加,治疗中重度克罗恩病(CD)和中重度溃疡性结肠炎(UC)的一线生物制剂需要更精准的定位。目的:系统性评价英夫利西单抗(IFX)和乌司奴单抗(UST)在中重度CD和中重度UC一线生物治疗中的疗效和安全性。方法:检索中国知网、万方、维普、中国科学引文数据库、PubMed、Web of Science、Embase、ClinicalTrials、Cochrane Library等数据库中IFX和UST治疗中重度CD和UC的随机对照试验(RCT),检索时间为建库至2023年12月。采用间接meta分析比较IFX与UST治疗中重度CD和UC的疗效和安全性。结果:最终纳入11项RCT。IFX诱导和维持中重度CD的临床缓解率与UST相比差异无统计学意义(P>0.05),严重不良事件和严重感染发生率差异亦无统计学意义(P>0.05)。IFX诱导和维持中重度UC的临床缓解率与UST相比差异无统计学意义(P>0.05),严重不良事件和严重感染发生率差异亦无统计学意义(P>0.05)。结论:在中重度CD患者中,IFX和UST可作为一线生物治疗的平行选择,考虑到IFX可增加患者感染结核的风险,推荐UST作为首选疗法。在中重度UC患者中,IFX是有效、安全的一线生物制剂,UST可作为一线生物治疗的选择之一。
基金supported by the Tianjin Research Program of Application Foundation Advanced Technology (14JCYBJC21900)the National Natural Science Foundation of China under grants 51278327
文摘The scattering of plane harmonic P and SV waves by a pair of vertically overlapping lined tunnels buried in an elastic half space is solved using a semi-analytic indirect boundary integration equation method. Then the effect of the distance between the two tunnels, the stiffness and density of the lining material, and the incident frequency on the seismic response of the tunnels is investigated. Numerical results demonstrate that the dynamic interaction between the twin tunnels cannot be ignored and the lower tunnel has a significant shielding effect on the upper tunnel for high-frequency incident waves, resulting in great decrease of the dynamic hoop stress in the upper tunnel; for the low-frequency incident waves, in contrast, the lower tunnel can lead to amplification effect on the upper tunnel. It also reveals that the frequency-spectrum characteristics of dynamic stress of the lower tunnel are significantly different from those of the upper tunnel. In addition, for incident P waves in low-frequency region, the soft lining tunnels have significant amplification effect on the surface displacement amplitude, which is slightly larger than that of the corresponding single tunnel.
基金National Natural Science Foundation of China under Grants (51278327)the Tianjin Research Program of Application Foundation and Advanced Technology (14JCYBJC21900)
文摘The indirect boundary element method （IBEM） is developed to solve the scattering of plane SH-waves by a lined tunnel in elastic wedge space. According to the theory of single-layer potential, the scattered-wave field can be constructed by applying virtual uniform loads on the surface of lined tunnel and the nearby wedge surface. The densities of virtual loads can be solved by establishing equations through the continuity conditions on the interface and zero-traction conditions on free surfaces. The total wave field is obtained by the superposition of free field and scattered-wave field in elastic wedge space. Numerical results indicate that the IBEM can solve the diffraction of elastic wave in elastic wedge space accurately and effi- ciently. The wave motion feature strongly depends on the wedge angle, the angle of incidence, incident frequency, the location of lined tunnel, and material parameters. The waves interference and amplification effect around the tunnel in wedge space is more significant, causing the dynamic stress concentration factor on rigid tunnel and the displacement amplitude of flexible tunnel up to 50.0 and 17.0, respectively, more than double that of the case of half-space. Hence, considerable attention should be paid to seismic resistant or anti-explosion design of the tunnel built on a slope or hillside.
