Comparative Analysis of Continuous versus Intermittent Proton Pump Inhibitor Therapy in Patients with Upper Gastrointestinal Bleeding Due to Ulcers

Upper gastrointestinal bleeding (UGIB) presents as a prevalent clinical challenge, with annual incidence rates ranging from 80 to 150 cases per 100,000 individuals. Guidelines for managing patients with UGIB due to bleeding ulcers recommend a continuous infusion of proton pump inhibitors (PPI). However, studies comparing intermittent dosing of PPI therapy show that this regimen achieves similar clinical benefits. If the clinical efficacy remains equivalent, intermittent dosing will be more cost-effective for patients and the health care system. Our research study aims to analyze the comparative effectiveness of intermittent versus continuous PPI therapy after endoscopic treatment in patients with UGIB, focusing on such endpoints as rebleeding risk at 3-and 7-day mortality rates. Methods: Resources searched included MEDLINE, EMBASE, PUBMED, and the Cochrane Central Register of Controlled Trials databases from January 2010 through December 2023 with the inclusion of meta-analysis, systematic review, review, or ACG guideline recommendations. Results of the analysis show how recommendations regarding high vs. low PPI regimen changed over time: from no difference in regimen in 2010 to recommending continuous regimen in 2012 to declaring insufficient evidence between choosing one regimen over another in 2013 to determine that both regimens were comparable to each other in 2014-2018 and finally to recommending both regimens in 2021. To conclude, our review shows that in patients with bleeding ulcers and high-risk endoscopic findings, intermittent PPI therapy is non-inferior to continuous PPI infusion for three days, seven days bleeding risk or mortality rates;however, it remains challenging to determine the most optimal intermittent regimen due to heterogeneity of RCTs included in meta-analyses, and further trials will need to be performed.

Safe upper limit of intermittent hepatic inflow occlusion for liver resection in cirrhotic rats

AIM To evaluate the effects of varying ischemic durations on cirrhotic liver and to determine the safe upper limit of repeated intermittent hepatic inflow occlusion.``METHODS Hepatic ischemia in cirrhotic rats was induced by clamping the common pedicle of left and median lobes after non-ischemic lobes resection. The cirrhotic rats were divided into six groups according to the duration and form of vascular clamping: sham occlusion (SO),intermittent occlusion for 10 (IO-10), 15(IO-15). 20(IO-20)and 30(IO-30) minutes with 5 minutes of refiow andcontinuous occlusion for 60 minutes (CO-60). All animals received a total duration of 60 minutes of hepatic inflow occlusion. Liver viability was investigated in relation of hepatic adenylate energy charge ( EC ).Triphenyltetrazollum chloride (TTC) reduction activities were assayed to qualitatively evaluate the degree of irreversible hepatocellular injury. The biochemical and morphological changes were also assessed and a 7-day mortality was observed.``RESULTS At 60 minutes after reperfusion following atotal of 60 minutes of hepatic inflow occlusion, EC values in lO-L0 (0.749±:0.012) and IO-15 (0.699 ±0.002) groups were rapidly restored to that in SO group (0. 748± 0.016).TTC reduction activities remained in high levels (0. 144 ±0.002 mg/mg protein, 0. 139 + 0.003 mg/mg protein and 0.121 ± 0.003 mg/mg protein in SO, IO-10 and IO-15groups, respectively). But in IO-20 and IO-30 groups, EC levels were partly restored (0.457 ± 0.023 and 0.534 ±0.027) accompanying with a significantly decreased TTCreduction activities (0.070 ± 0.005 mg/mg protein and 0.061 ±0.003 rng/mg protein). No recovery in EC values , i).228 ± 0.004) and a progressive decrease in TTC reduction activities ( 0.03.3 ± 0.002 mg/mg protein) were shown in CO-60 group. Although not significantly different, the activities of the serum aspartate aminotransferase (AST) on the third postoperative day (POD3 ) and POD7 and of the serum alanineaminotransferase (ALT) on POD3 in CO-60 group remained higher than that in intermittent occlusion groups.Moreover, a 60% animal mortality rate and more severe morphological alterations were also shown in CO-60group.``CONCLUSION Hepatic inflow occlusion during 60 minutes for liver resection in cirrhotic rats resulted in less hepatocellular injury when occlusion was intermittent rather than continuous. Each period of 15 minutes was the safe upper limit of repeated intermittent vascular occlusion that the cirrhotic liver could tolerate without undergoing irreversible hepatocellular injury.

Criteria for intermittent and continuous disturbance transition of ERA interaction with shaped charge jet

There are two interaction mechanisms between shaped charge jet and thin flying plate driven by explosion, that is, the intermittent and continuous disturbance. Determination of the transition criteria for the intermittent and continuous disturbance is of importance for the penetration calculation of the escaping jet and the design of ERA(explosive reactive armour). In this paper a new criteria was presented based on the analysis of interaction process, and the effects of NATO angle and thickness of flying plate on the disturbance frequency were discussed. It is shown that the critical shaped charge jet velocity increases with the plate thickness and NATO angle, especially increases drastically between 45° and 60°.

Research on Energy-Saving Performance of Intermittent Heating for Rooms in Hot Summer&ColdWinter Zone

In the hot summer&cold winter zone in China,intermittent heating space for rooms is widely used.However,in comparison with continuous space heating,the energy-saving performance of intermittent space heating has not been sufficiently investigated.This paper studied the factors influencing the energy performance of intermittent heating for the representativeoffice inhot summer&coldwinter zone.Basedon theheatbalancemethod,adynamic thermalmodel of the intermittent heating roomwas built and tested by experiments.And then,it analyzed the total space heating load,the amount of energy saving and energy saving ratio of the intermittent heating under different preheating hours,occupation hours,required roomtemperatures,air change rates,overall heat transfer coefficients(U-value)of windows and wall materials.If the adjacent rooms were not heated,for a typical room occupied about 10 h a day,the energy-saving ratio of intermittent heating was about 30%compared with continuous heating.But the preheating power was higher than two times of continuous heating.The results also indicated that the occupation hours had a significant effect on energy saving amount and ratio,it should be noted that the energy saving ratio by intermittent heating was much lower than the unoccupied period ratio.Relative to other factors,the heating temperatures,room air change rates and U-value of windows,and room envelope materials had little effect on energy efficiency.If the adjacent rooms were heated in the same manner as the roomin question,the energy-saving ratio of the total load of intermittent heating was heavily reduced to 8.46%.

Meta-analysis of the effects of high-intensity intermittent exercise on cardiopulmonary function rehabilitation in patients with stroke

Objective:Systematically evaluate the rehabilitation effect of high-intensity intermittent exercise(HIIT)on cardiovascular function in stroke patients,in order to provide a basis for selecting the best rehabilitation plan for stroke patients.Methods:Computer retrieval of CNKI,WanFang Data,VIP,CBM,Pubmed,EMbase,Web of science,The Cochrane Library databases was conducted from the establishment of the database until March 2023.Randomized controlled trials on HIIT improving cardiovascular function in stroke patients were included,and the included literature was screened,data extracted,and bias risk evaluated.Then,metaanalysis was conducted using RevMan 5.4 software and Stata17.0 software.Results:In the end,9 articles met the research criteria,with a total of 428 patients.The meta-analysis results showed that compared with the control group,HIIT had significant effects on peak oxygen uptake(VO2peak)[MD=3.87,95%CI(3.43,4.31),P<0.00001],minute ventilation(VE)[MD=7.14,95%CI(4.34,9.94),P<0.00001],peak power(WRpeak)[MD=17.13,95%CI(13.7320.54),P<0.00001],6-minute walking distance(6MWD)[MD=43.82,95%CI(16.08,71.56),P=0.002],The intervention effect of the 10 meter walking test(10MWT)[MD=-2.00,95%CI(-2.91,-1.08),P<0.0001]was better than that of the control group.Conclusion:The current analysis results show that compared to conventional rehabilitation therapy or continuous aerobic exercise,HIIT has more advantages in improving the cardiopulmonary function of stroke patients.

Impact of continuous positive airway pressure therapy for nonalcoholic fatty liver disease in patients with obstructive sleep apnea

BACKGROUND Obstructive sleep apnea(OSA)has been suggested as an independent risk factor for nonalcoholic fatty liver disease(NAFLD),and continuous positive airway pressure(CPAP)is the first-line therapy for OSA.AIM To clarify the efficacy of effective CPAP therapy on NAFLD of OSA patients by serum markers and transient elastography(TE)using FibroScan®(Echosens,Paris,France).METHODS We prospectively enrolled 123 consecutive patients with OSA who met the indications for CPAP.Liver fibrosis and steatosis were assessed using TE.Before and after 6 mo of CPAP therapy,serum markers and TE were assessed for all patients.The mean usage rate of CPAP therapy for 6 mo was arbitrarily calculated in each patient and expressed as“mean compliance index”(m-CI).RESULTS In 50 OSA patients with NAFLD,both aspartate aminotransferase(AST)and alanine aminotransferase(ALT)levels were significantly decreased after 6 mo of CPAP therapy.Univariate analysis showed that decreased body weight(BW),decreased body mass index(BMI),decreased AST level,decreased hemoglobin A1c,and high m-CI were significantly related with improved ALT level.In multivariate regression model adjusted for quantities of BW change during 6 mo of CPAP therapy,high m-CI tended to improve ALT level(P=0.051).All 17 OSA patients with NAFLD,high m-CI and no BMI changes showed significant improvements in AST and ALT levels.Meanwhile,no significant changes in TE data or serum fibrosis markers were seen.CONCLUSION Some NAFLD could be associated with chronic intermittent hypoxia due to OSA independent of BW changes.In those cases,adequate reoxygenation from effective CPAP therapy may improve NAFLD.

A Retrospective Study of Continuous Renal Therapy and Anticoagulation in Patients with Hemorrhagic Fever with Renal Syndrome

Objective To observe the application of continuous renal replacement therapy(CRRT) and heparin anticoagulation in patients with HFRS, and to explore a more suitable anticoagulant strategy. Methods Eighty-five severe-type patients(severe group) and 71 critical-type patients(critical group) were enrolled in this study. The frequency of CRRT was compared between the two groups; the frequency of CRRT treated with and without heparin anticoagulation and the frequency of hemorrhage and channel blood clotting induced by the two anticoagulant strategies were observed. Results The frequency of CRRT in the critical group was higher than that in the severe group(P < 0.001). The frequency of CRRT initiated during the overlapping phases in the critical group was significantly higher than that of the severe group(P = 0.032). The total times of CRRT was 103, and 70 of them were treated with heparin anticoagulation. The frequencies of hemorrhage induced by heparin anticoagulation and no heparinization were 16 and 0, respectively, and the frequencies of channel blood clotting were 2 and 4, respectively. Conclusions CRRT has been used extensively in the critical-type patients with HFRS. The heparin anticoagulation and no anticoagulant strategies should be used more rationally in patients treated with CRRT, according to the clinical characteristics of the disease.

Intermittent androgen deprivation therapy in patients with prostate cancer: Connecting the dots

Intermittent androgen deprivation therapy(IADT)is now being increasingly opted by the treating physicians and patients with prostate cancer.The most common reason driving this is the availability of an off-treatment period to the patients that provides some relief from treatment-related side-effects,and reduced treatment costs.IADT may also delay the progression to castration-resistant prostate cancer.However,the use of IADT in the setting of prostate cancer has not been strongly substantiated by data from clinical trials.Multiple factors seem to contribute towards this inadequacy of supportive data for the use of IADT in patients with prostate cancer,e.g.,population characteristics(both demographic and clinical),study design,treatment regimen,on-and off-treatment criteria,duration of active treatment,endpoints,and analysis.The present review article focuses on seven clinical trials that evaluated the efficacy of IADT vs.continuous androgen deprivation therapy for the treatment of prostate cancer.The results from these clinical trials have been discussed in light of the factors that may impact the treatment outcomes,especially the disease(tumor)burden.Based on evidence,potential candidate population for IADT has been suggested along with recommendations for the use of IADT in patients with prostate cancer.

Clinical characteristics and outcomes associated with nasal intermittent mandatory ventilation in acute pediatric respiratory failure

AIM To characterize the clinical course and outcomes of nasal intermittent mandatory ventilation(NIMV) use in acute pediatric respiratory failure.METHODS We identified all patients treated with NIMV in the pediatric intensive care unit(PICU) or inpatient general pediatrics between January 2013 and December 2015 at two academic centers.Patients who utilized NIMV with other modes of noninvasive ventilation during the same admission were included.Data included demographics,vital signs on admission and prior to initiation of NIMV,pediatric risk of mortality Ⅲ(PRIsM-Ⅲ) scores,complications,respiratory support characteristics,PICU and hospital length of stays,duration of respiratory support,and complications.Patients who did not require escalation to mechanical ventilation were defined as NIMV responders;those who required escalation to mechanical ventilation(MV) were defined as NIMV nonresponders.NIMV responders were compared to NIMV non-responders.RESULTS Forty-two patients met study criteria.six(14%) failed treatment and required MV.The majority of the patients(74%) had a primary diagnosis of bronchiolitis.The median age of these 42 patients was 4 mo(range 0.5-28.1 mo,IQR 7,P = 0.69).No significant difference was measured in other baseline demographics and vitals on initiation of NIMV;these included age,temperature,respiratory rate,O2 saturation,heart rate,systolic blood pressure,diastolic blood pressure,and PRIsM-Ⅲ scores.The duration of NIMV was shorter in the NIMV nonresponder vs NIMV responder group(6.5 h vs 65 h,P < 0.0005).Otherwise,NIMV failure was not associated with significant differences in PICU length of stay(LOs),hospital LOs,or total duration of respiratory support.No patients had aspiration pneumonia,pneumothorax,or skin breakdown.CONCLUSION Most of our patients responded to NIMV.NIMV failure is not associated with differences in hospital LOs,PICU LOs,or duration of respiratory support.

A Simple Combined Antegrade Radiological and Retrograde Endoscopic Procedure to Recanalise Fibrotic Hypopharyngo-Oesophageal Occlusions: Technical Description and Lessons from Clinical Outcome in Three Cases

Background: Complete hypopharyngo-oesophageal occlusion is a rare complication of head and neck radiotherapy and a range of other conditions. Absolute dysphagia is accompanied by aspiration and dependence on gastrostomy feeding. The condition presents a substantial management challenge. Surgical approaches to re-establish pharyngo-oesophageal continuity are varied, highly invasive and are associated with unpredictable outcomes. Minimally invasive techniques employing endoscopic and radiological techniques are emerging. This report describes a multidisciplinary approach which translates two interventional radiology techniques used in the management of central venous occlusions and biliary strictures to the management of three cases of complete hypopharyngo-oesophageal occlusion. Methods: Three cases with different underlying aetiologies had treatment initiated between 2009 and 2011. Antegrade pharyngoscopic access to the occlusions was accompanied by retrograde endoscopic access via a small gastrostomy. Luminal continuity was re-established by the interventional radiology technique of “sharp recanalisation” followed by passage of a wide bore nasogastric tube which was maintained in situ for 4-6 months, a duration of treatment analogous to that applied in the radiological management of fibrotic biliary strictures. After treatment a radiological contrast swallows examination was performed to gauge the calibre of the re-established lumen, assess functionality and to rule out aspiration. Results: Pharyngo-oesophageal continuity was re-established in all three cases on the first attempt. No complications occurred as a result of the procedures. In two cases, the excellent swallowing function was re-established, although one of these required prolonged post-treatment adjuvant interventions. In one case no swallowing function resulted, despite apparently successful re-establishment of luminal continuity. Conclusions: Complete fibrotic occlusion of the hypopharyngo-oesophageal lumen is rare and presents a substantial management challenge. A minimally invasive treatment combining antegrade radiological and retrograde endoscopic approaches resulted in successful re-establishment of luminal continuity in three cases of complete fibrotic occlusion of the hypopharyngo-oesophageal lumen. However variable responses to treatment suggest that both the underlying aetiology and the chronicity of the occlusion may influence the likelihood of a successful functional outcome. Until definitive management guidelines are established, we suggest that such cases are managed only by motivated multidisciplinary teams keen to develop their expertise in this area.

Occupancy-aided ventilation for airborne infection risk control:Continuously or intermittently reduced occupancies?

Ventilation is an important engineering measure to control the airborne infection risk of acute respiratory diseases,e.g.,Corona Virus Disease 2019(COVID-19).Occupancy-aided ventilation methods can effectively improve the airborne infection risk control performance with a sacrifice of decreasing working productivity because of the reduced occupancy.This study evaluates the effectiveness of two occupancy-aided ventilation methods,i.e.,the continuously reduced occupancy method and the intermittently reduced occupancy method.The continuously reduced occupancy method is determined by the steady equation of the mass conservation law of the indoor contaminant,and the intermittently reduced occupancy method is determined by a genetic algorithm-based optimization.A two-scenarios-based evaluation framework is developed,i.e.,one with targeted airborne infection risk control performance(indicated by the mean rebreathed fraction)and the other with targeted working productivity(indicated by the accumulated occupancy).The results show that the improvement in the airborne infection risk control performance linearly and quadratically increases with the reduction in the working productivity for the continuously reduced occupancy method and the intermittently reduced occupancy method respectively.At a given targeted airborne infection risk control performance,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the working productivity by up to 92%.At a given targeted working productivity,the intermittently reduced occupancy method outperforms the continuously reduced occupancy method by improving the airborne infection risk control performance by up to 38%.

滨海核电厂液态流出物间歇排放数值模拟分析

应用非结构化网格MIKE 21水动力模型及对流扩散模块,针对某滨海核电厂工程海域建立液态流出物排放数学模型,对核电厂运营期间液态流出物中核素在等浓度排放条件下4种不同典型潮时(涨憩、落急、落憩、涨急)起始的间歇排放进行数值模拟,并与连续排放进行比较,给出了不同工况下液态流出物在环境水域中全潮平均相对浓度分布及影响范围、不同半径海域内核素的平均相对浓度以及取水相对浓度特征值。对比分析显示,滨海核电液态流出物在受纳水体中的输移、扩散主要受潮流影响。落急时刻起始的间歇排放方式总体上在环境影响和取水浓度方面均具有显著优势。计算结果可为核电厂液态流出物排放方式的优化及海洋环境影响评价提供了依据。

基本型间歇性外斜视患儿单眼遮盖试验前后斜视度的变化

目的:比较单眼遮盖试验前后基本型间歇性外斜视患儿斜视度的变化。方法:前瞻性临床研究。选取2021-07/2022-09在我院行斜视矫正术的基本型间歇性外斜视患儿258例,其中男122例,女136例,年龄5-12(平均8.0±3.1)岁。术前均采用三棱镜加交替遮盖法进行视远(6 m)及视近(33 cm)的斜视度的测量,然后遮盖患儿非主导眼40 min后再次测量视远及视近斜视度,遮盖期间患儿不能闭眼及视近,打开遮盖眼之前需遮盖另眼,再交替遮盖测量斜视度。结果:单眼遮盖试验前后看远(6 m)斜视度分别为28.23^(△)±10.79^(△)、29.79^(△)±10.85^(△)(t=-0.903,P=0.368),看近(33 cm)斜视度分别为33.14^(△)±8.89^(△)、36.90^(△)±10.76^(△)(t=-2.377,P=0.019)。结论:基本型间歇性外斜视患儿术前单眼遮盖试验对视近斜视度影响大,可以暴露最大斜视度,降低斜视术后欠矫率,为斜视手术方案提供更可靠的依据。

不同强度运动抑制糖尿病大鼠肾脏PI3K/AKT/mTOR信号通路改善自噬的比较

背景:2型糖尿病损害肾功能。研究表明运动干预可以保护肾脏;鸢尾素可以通过抑制磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路恢复自噬,保护糖尿病肾病患者的肾功能。目的:探讨运动能否通过抑制肾脏磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路过度激活来恢复自噬,改善肾损伤,以及分析不同方式运动产生影响的差异。方法:将6周龄的SD大鼠随机分为空白对照组(正常大鼠)和糖尿病组,其中糖尿病组大鼠经过高脂高糖喂养加腹腔注射低剂量1%链脲佐菌素(30 mg/kg)建立2型糖尿病模型。造模成功后再将糖尿病组大鼠随机分成糖尿病模型组、中强度持续运动组和高强度间歇运动组。两个运动组大鼠分别进行8周不同强度运动干预。取材后采用葡萄糖氧化酶法检测大鼠空腹血糖,使用试剂盒检测糖化血红蛋白水平,Elisa法检测血清胰岛素浓度,计算胰岛素抵抗指数,RT-PCR检测肾组织磷脂酰肌醇3-激酶、蛋白激酶B、雷帕霉素靶蛋白、Beclin-1、podocin、nephrin的基因表达量,Western Blot检测肾组织雷帕霉素靶蛋白及自噬标记蛋白LC3-1、LC3-2、Beclin-1的蛋白表达量。结果与结论:①2型糖尿病大鼠空腹血糖和糖化血红蛋白水平极显著性升高,胰岛素抵抗水平显著上升,胰岛素水平显著下降;两种运动均能使2型糖尿病大鼠空腹血糖和糖化血红蛋白水平极显著下降,胰岛素抵抗水平显著下降,胰岛素水平显著上升;与中强度持续运动组相比,高强度间歇运动组胰岛素水平显著上升。②2型糖尿病大鼠podocin、nephrin基因表达量显著降低;两种不同形式运动均能显著提高其表达;与高强度间歇运动组相比,中等强度持续性运动组足细胞相关蛋白基因表达有进一步上升趋势,但无显著性差异。③2型糖尿病大鼠肾组织磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及蛋白的表达量显著增加,自噬标志蛋白Beclin-1、LC3-2表达量以及LC3-2/LC3-1显著降低;两种不同形式运动均能使肾组织磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及雷帕霉素靶蛋白蛋白的表达量显著降低,自噬标志蛋白Beclin-1、LC3-2以及LC3-2/LC3-1显著升高;与中等强度持续性运动组相比,高强度间歇运动的磷脂酰肌醇3-激酶、蛋白激酶B、mTORC1的mRNA及雷帕霉素靶蛋白的蛋白表达量有进一步下降的趋势,Beclin-1、LC3-2以及LC3-2/LC3-1有进一步升高的趋势,但仅Beclin-1有显著性差异。④结果说明2型糖尿病肾脏足细胞损伤,自噬受到抑制,与磷脂酰肌醇3-激酶/蛋白激酶B/mTORC1信号通路被异常激活密切相关。高强度间歇运动和中等强度持续性运动可以保护糖尿病肾脏,减少足细胞损伤,促进自噬恢复,这可能与运动抑制磷脂酰肌醇3-激酶/蛋白激酶B/雷帕霉素靶蛋白信号通路过度激活有关。与中等强度持续性运动相比,高强度间歇运动恢复自噬的效果呈更优趋势,但足细胞蛋白表达稍有下降。

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。

不同无创通气联合枸橼酸咖啡因治疗早产儿呼吸暂停疗效分析

目的通过分析不同无创辅助通气模式联合枸橼酸咖啡因在早产儿呼吸暂停中的治疗效果,探讨治疗早产儿呼吸暂停的优化方案。方法选择2019年10月~2022年8月蚌埠医学院第二附属医院新生儿重症监护病房收治的90例胎龄≤34周的呼吸暂停患儿作为研究对象,回顾性分析患儿的病例资料,将患儿分为NCPAP联合枸橼酸咖啡因组(n=44)和NIPPV序贯NCPAP联合枸橼酸咖啡因组(n=46)。采用t检验、χ2检验、Mann-Whitney检验等,对两组患儿一般临床资料、呼吸暂停疗效、治疗时间及不良反应发生情况,进行统计学比较。结果NIPPV序贯NCPAP联合枸橼酸咖啡因组治疗早产儿呼吸暂停总有效率为91.30%,高于NCPAP联合枸橼酸咖啡因组的86.36%,差异有统计学意义(P<0.05);两组无创通气失败及相关治疗时间比较,差异有统计学意义(P<0.05);两组在喂养不耐受、鼻损伤发生情况比较,差异有统计学意义(P<0.05)。结论早期采用NIPPV序贯NCPAP的通气模式,较传统单用NCPAP治疗早产儿呼吸暂停,可以取得更好的临床效果,缩短治疗及住院时间,不良反应相对更少,值得临床推广。

连续性与间歇性降雨下土壤结皮与入渗的关系模拟

[目的]为探究连续性和间歇性降雨条件下土壤结皮与入渗性能间的变化关系。[方法]选取3种典型耕作层黄土,通过室内模拟降雨试验,分析不同降雨条件下土壤结皮强度和黏结力与入渗性能的关系。[结果](1)入渗性能随连续性降雨历时及间歇性降雨场次的增加而减小;同等降雨历时和降雨强度下,间歇性降雨的减渗效应高于连续性降雨。(2)土壤结皮强度和黏结力随连续性降雨历时和间歇性降雨场次的增加而增加;褐土和黑垆土的入渗性能与结皮强度和黏结力呈显著线性相关(p<0.05),连续性降雨历时越长、间歇性降雨场次的越多,土壤结皮强度、黏结力以及减渗效应越大;沙壤土的入渗性能与结皮强度和黏结力则呈显著的非线性相关(p<0.05)。(3)结皮的MWD和GMD越小,入渗性能越差,减渗效应越大;关联度分析结果显示,间歇性降雨对入渗性能的影响较高。[结论]相同雨强条件下,间歇性降雨下能形成更坚实的结皮,对土壤入渗性能的削弱能力更强。研究结果可为黄土高原防治水土流失、有效利用水资源提供参考依据。

我国刨花板工业技术进步回顾与展望

回顾总结我国刨花板工业发展与技术进步历程,分析当前我国刨花板工业现状和发展机遇,剖析刨花板产业发展存在的问题和面临的挑战,探讨我国刨花板产业发展趋势,旨在为我国刨花板产业技术创新和产业健康可持续发展提供思路,并为其他人造板技术改造和产业升级提供参考与借鉴。

负压封闭引流不同冲洗方式对创面愈合影响的Meta分析

目的系统评价负压封闭引流(VSD)不同冲洗方式对创面愈合的影响。方法检索中国期刊全文数据库(中国知网)、中文科技期刊数据库(维普)、中国学术期刊数据库(万方)、中国临床试验中心、中国生物医学文献数据库(CBM)、PubMed、ScienceDirect、Embase、The Cochrane Library等数据库建库至2022年4月27日公开发表的VSD间歇冲洗与持续冲洗治疗创面的相关文献,并根据纳入与排除标准对文献进行筛选、评价和数据提取,采用RevMan 5.3软件对纳入文献进行Meta分析。结果最终纳入符合标准文献6篇,文献质量均为B级;Meta分析结果显示,与VSD持续冲洗相比,VSD间歇冲洗更有利于提高创面愈合效果、缩短创面愈合时间及VSD平均使用时间、减轻创面疼痛(合并效应量为3.52、-3.68、-1.60、-1.85,95%CI为1.06~11.69、-5.10~-2.25、-2.09~-1.11、-2.29~-1.41,P=0.040、P<0.001、P<0.001、P<0.001),但堵管发生率较高(合并效应量为3.15,95%CI为1.24~8.01,P=0.020)。结论与VSD持续冲洗相比,VSD间歇冲洗更有利于促进创面愈合,缩短VSD平均使用时间,缓解创面疼痛,临床应用价值更高,但堵管发生风险较高。

寒冷地区农村居住建筑供暖能耗计算方法研究

分析了主要文献对多智能体的定义及其特征,对建筑环境与能源控制领域的多智能体控制系统应用的标准、常用框架和语言进行了综述和介绍,并对多智能体控制系统的不同系统架构、协调机制、优化算法进行了对比分析。针对建筑设备系统优化控制、单体建筑能源与环境优化控制、建筑与外部能源网络交互优化控制、建筑群与外部能源网络优化控制等不同层次的多智能体控制应用研究进行了综述,并对多智能体控制系统在建筑能源和环境领域应用中存在的时间序列优化、在线学习、计算不确定性、稳定性与收敛性等重要问题进行了讨论。