BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasi...BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasis are unclear.AIM To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe AC.METHODS We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July 2023.The outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later,employing a propensity score(PS)frame-work.Our primary outcomes were intensive care unit(ICU)admission rates,ICU length of stay,and duration of antibiotic use.RESULTS In total,we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention:The urgent group(≤24 h,n=102)and the elective group(>24 h,n=152).Ninety-three pairs of patients with similar characteristics were selected by PS matching.The urgent ERCP group had more ICU admissions(34.4%vs 21.5%,P=0.05),shorter ICU stays(3 d vs 9 d,P<0.001),fewer antibiotic use(6 d vs 9 d,P<0.001),and shorter hospital stays(9 d vs 18.5 d,P<0.001).There were no significant differences observed in adverse events,in-hospital mortality,recurrent cholangitis occurrence,30-d readmission rate or 30-d mortality.CONCLUSION Urgent one-stage ERCP provides the advantages of a shorter ICU stay,a shorter duration of antibiotic use,and a shorter hospital stay.展开更多
目前数据中心网络(data center network,DCN)的负载均衡方法存在对大小流的调度缺乏全局实时检测等不足,部分大流会造成拥塞、负载不均衡和带宽碎片等问题.针对上述问题,提出了一种SDN网络流量负载均衡算法—DSA-D.首先,对流量进行分类...目前数据中心网络(data center network,DCN)的负载均衡方法存在对大小流的调度缺乏全局实时检测等不足,部分大流会造成拥塞、负载不均衡和带宽碎片等问题.针对上述问题,提出了一种SDN网络流量负载均衡算法—DSA-D.首先,对流量进行分类,为大流计算所有源至目的主机可达路径的最短跳数路径集;然后,根据LLDP和ECHO测量链路时延以求得时延最优路径集;最后,采用概率拟合算法分配路径,实现数据中心网络流量负载均衡.在相同场景下的实验结果表明,与ECMP、Hedera和DIFF算法相比,DSA-D算法具有更好的吞吐量、链路带宽利用率和平均往返时延.展开更多
基金The study was approved by the Ethics Committee(2019ZDSYLL094-P01).
文摘BACKGROUND During emergency endoscopic retrograde cholangiopancreatography(ERCP),the safety and feasibility of performing one-stage endoscopic treatment for patients with acute cholangitis(AC)due to choledocholithiasis are unclear.AIM To investigate the safety and feasibility of one-stage endoscopic treatment for moderate to severe AC.METHODS We enrolled all patients diagnosed with moderate to severe cholangitis due to common bile duct stones from January 2019 to July 2023.The outcomes were compared in this study between patients who underwent ERCP within 24 h and those who underwent ERCP 24 h later,employing a propensity score(PS)frame-work.Our primary outcomes were intensive care unit(ICU)admission rates,ICU length of stay,and duration of antibiotic use.RESULTS In total,we included 254 patients and categorized them into two groups based on the time elapsed between admission and intervention:The urgent group(≤24 h,n=102)and the elective group(>24 h,n=152).Ninety-three pairs of patients with similar characteristics were selected by PS matching.The urgent ERCP group had more ICU admissions(34.4%vs 21.5%,P=0.05),shorter ICU stays(3 d vs 9 d,P<0.001),fewer antibiotic use(6 d vs 9 d,P<0.001),and shorter hospital stays(9 d vs 18.5 d,P<0.001).There were no significant differences observed in adverse events,in-hospital mortality,recurrent cholangitis occurrence,30-d readmission rate or 30-d mortality.CONCLUSION Urgent one-stage ERCP provides the advantages of a shorter ICU stay,a shorter duration of antibiotic use,and a shorter hospital stay.
文摘目前数据中心网络(data center network,DCN)的负载均衡方法存在对大小流的调度缺乏全局实时检测等不足,部分大流会造成拥塞、负载不均衡和带宽碎片等问题.针对上述问题,提出了一种SDN网络流量负载均衡算法—DSA-D.首先,对流量进行分类,为大流计算所有源至目的主机可达路径的最短跳数路径集;然后,根据LLDP和ECHO测量链路时延以求得时延最优路径集;最后,采用概率拟合算法分配路径,实现数据中心网络流量负载均衡.在相同场景下的实验结果表明,与ECMP、Hedera和DIFF算法相比,DSA-D算法具有更好的吞吐量、链路带宽利用率和平均往返时延.
