目的 应用高分辨率固态测压技术(HRM)检测Passy-Muir说话瓣膜(PMV)对脑卒中气管切开患者吞咽生物力学的作用,探讨利用咽腔与食管上括约肌(UES)压力参数评估PMV治疗效果的应用价值。方法 2020年1月至2024年1月,新疆维吾尔自治区人民医院...目的 应用高分辨率固态测压技术(HRM)检测Passy-Muir说话瓣膜(PMV)对脑卒中气管切开患者吞咽生物力学的作用,探讨利用咽腔与食管上括约肌(UES)压力参数评估PMV治疗效果的应用价值。方法 2020年1月至2024年1月,新疆维吾尔自治区人民医院100例脑卒中气管切开患者随机分为对照组(n=50)和PMV组(n=50),对照组给予常规吞咽康复,PMV组在此基础上佩戴PMV,共2周。治疗前后,采用改良曼恩吞咽能力评估量表(MMASA)进行临床吞咽功能评估;并进行HRM检查,收集腭咽收缩压力峰值、腭咽收缩时长、UES松弛残余压和UES松弛时间等数据。将PMV组治疗后的MMASA评分与HRM压力参数值进行相关性分析。结果 两组各脱落4例。治疗后,两组UES松弛残余压显著降低(t> 47.403, P <0.001),MMASA评分、腭咽收缩压力峰值、腭咽收缩时长和UES松弛时间均显著增加(t> 19.621, P <0.001);PMV组均优于对照组(t>2.050, P <0.05)。治疗后PMV组腭咽收缩压力峰值(r=0.924, P <0.001)、腭咽收缩时长(r=0.948, P <0.001)和UES松弛残余时间(r=0.954, P <0.001)与MMASA评分呈正相关,UES松弛残余压与MMASA评分呈负相关(r=-0.939, P <0.001)。结论 佩戴PMV治疗能增强脑卒中气管切开患者的吞咽功能,提高咽腔和UES区域的吞咽生物力学水平。利用咽腔和UES区域的压力参数可预测佩戴PMV治疗后患者吞咽功能的改善情况。展开更多
Faced with the problems of natural resources and ecological environment caused by the early modernization in the late 19^th and early 20^th centuries,John Muir combined the natural science knowledge as well as the obs...Faced with the problems of natural resources and ecological environment caused by the early modernization in the late 19^th and early 20^th centuries,John Muir combined the natural science knowledge as well as the observation and perception of nature,constructed the preservation thoughts which advocated the overall preservation concept by highlighting the aesthetics value,spiritual value and intrinsic value of nature,and perfected the cognition of the natural multi-value system and the relationship between man and nature.At the same time,the preservationists like Muir actively put preservation into practice,promoted the establishment of Yosemite and other national parks,contributing to the construction of the U.S.national park system.However,in the process of the management of national parks and forest reserves,it was difficult to really implement preservation because there existed the tension between it and the mainstream values such as the concept of development and progress.展开更多
As the basic of a deeper investigation on the turbulent transport, the fluctuation property in the boundary of the newly-reconstructed Joint Texas Experimental Tokamak （J- TEXT） is studied experimentally using the r...As the basic of a deeper investigation on the turbulent transport, the fluctuation property in the boundary of the newly-reconstructed Joint Texas Experimental Tokamak （J- TEXT） is studied experimentally using the reciprocating Langmuir four-tip probe, which has been built and operated as the primary diagnostic tool in the boundary of J-TEXT tokamak. In this paper, spatial profiles of the plasma-edge parameters are obtained, such as electron temperature, plasma density, plasma potential, poloidal electric field and their fluctuations. The results indicate the existence of a Er ×BT shear layer at the vicinity of last closed flux surface （LCFS）, with the fluctuations suppressed in varying degrees. The turbulence-induced particle and energy fluxes can be calculated by the local plasma parameters above. Convection dominates the cross-field turbulent transport in boundary plasma. Electrostatic fluctuations properties are also studied in detail with the help of numerical analysis. Statistical analysis on density fluctuation shows that, the intermittency can affect the turbulence in the scrape-off layer （SOL）.展开更多
文摘目的 应用高分辨率固态测压技术(HRM)检测Passy-Muir说话瓣膜(PMV)对脑卒中气管切开患者吞咽生物力学的作用,探讨利用咽腔与食管上括约肌(UES)压力参数评估PMV治疗效果的应用价值。方法 2020年1月至2024年1月,新疆维吾尔自治区人民医院100例脑卒中气管切开患者随机分为对照组(n=50)和PMV组(n=50),对照组给予常规吞咽康复,PMV组在此基础上佩戴PMV,共2周。治疗前后,采用改良曼恩吞咽能力评估量表(MMASA)进行临床吞咽功能评估;并进行HRM检查,收集腭咽收缩压力峰值、腭咽收缩时长、UES松弛残余压和UES松弛时间等数据。将PMV组治疗后的MMASA评分与HRM压力参数值进行相关性分析。结果 两组各脱落4例。治疗后,两组UES松弛残余压显著降低(t> 47.403, P <0.001),MMASA评分、腭咽收缩压力峰值、腭咽收缩时长和UES松弛时间均显著增加(t> 19.621, P <0.001);PMV组均优于对照组(t>2.050, P <0.05)。治疗后PMV组腭咽收缩压力峰值(r=0.924, P <0.001)、腭咽收缩时长(r=0.948, P <0.001)和UES松弛残余时间(r=0.954, P <0.001)与MMASA评分呈正相关,UES松弛残余压与MMASA评分呈负相关(r=-0.939, P <0.001)。结论 佩戴PMV治疗能增强脑卒中气管切开患者的吞咽功能,提高咽腔和UES区域的吞咽生物力学水平。利用咽腔和UES区域的压力参数可预测佩戴PMV治疗后患者吞咽功能的改善情况。
基金the support from the National Social Science Fund of China(Project No.17CSS022).
文摘Faced with the problems of natural resources and ecological environment caused by the early modernization in the late 19^th and early 20^th centuries,John Muir combined the natural science knowledge as well as the observation and perception of nature,constructed the preservation thoughts which advocated the overall preservation concept by highlighting the aesthetics value,spiritual value and intrinsic value of nature,and perfected the cognition of the natural multi-value system and the relationship between man and nature.At the same time,the preservationists like Muir actively put preservation into practice,promoted the establishment of Yosemite and other national parks,contributing to the construction of the U.S.national park system.However,in the process of the management of national parks and forest reserves,it was difficult to really implement preservation because there existed the tension between it and the mainstream values such as the concept of development and progress.
基金supported by Open Research Program from Key Laboratory of Geospace Environment, Chinese Academy of Sciences
文摘As the basic of a deeper investigation on the turbulent transport, the fluctuation property in the boundary of the newly-reconstructed Joint Texas Experimental Tokamak （J- TEXT） is studied experimentally using the reciprocating Langmuir four-tip probe, which has been built and operated as the primary diagnostic tool in the boundary of J-TEXT tokamak. In this paper, spatial profiles of the plasma-edge parameters are obtained, such as electron temperature, plasma density, plasma potential, poloidal electric field and their fluctuations. The results indicate the existence of a Er ×BT shear layer at the vicinity of last closed flux surface （LCFS）, with the fluctuations suppressed in varying degrees. The turbulence-induced particle and energy fluxes can be calculated by the local plasma parameters above. Convection dominates the cross-field turbulent transport in boundary plasma. Electrostatic fluctuations properties are also studied in detail with the help of numerical analysis. Statistical analysis on density fluctuation shows that, the intermittency can affect the turbulence in the scrape-off layer （SOL）.
