Propofol sedation in routine endoscopy:A case series comparing target controlled infusion vs manually controlled bolus concept

BACKGROUND Many studies have addressed safety and effectiveness of non-anaesthesiologist propofol sedation(NAPS)for gastrointestinal(GI)endoscopy Target controlled infusion(TCI)is claimed to provide an optimal sedation regimen by avoiding under-or oversedation.AIM To assess safety and performance of propofol TCI sedation in comparison with nurse-administered bolus-sedation.METHODS Fouty-five patients undergoing endoscopy under TCI propofol sedation were prospectively included from November 2016 to May 2017 and compared to 87 patients retrospectively included that underwent endoscopy with NAPS.Patients were matched for age and endoscopic procedure.We recorded time of sedation and endoscopy,dosage of medication and adverse events.RESULTS There was a significant reduction in dose per time of propofol administered in the TCI group,compared to the NAPS group(8.2±2.7 mg/min vs 9.3±3.4 mg/min;P=0.046).The time needed to provide adequate sedation levels was slightly but significantly lower in the control group(5.3±2.7 min vs 7.7±3.3 min;P<0.001),nonetheless the total endoscopy time was similar in both groups.No differences between TCI and bolus-sedation was observed for mean total-dosage of propofol rate as well as adverse events.CONCLUSION This study indicates that sedation using TCI for GI endoscopy reduces the dose of propofol necessary per minute of endoscopy.This may translate into less adverse events.However,further and randomized trials need to confirm this trend.

Nonlocal multi-target controlled controlled gate using Greenberger–Horne–Zeilinger channel and qutrit catalysis

We present a scheme for implementing locally a nonlocal N-target controlled–controlled gate with unit probability of success by harnessing two（N＋1）-qubit Greenberger–Horne–Zeilinger（GHZ） states as quantum channel and N qutrits as catalyser. The quantum network that implements this nonlocal（N＋2）-body gate is built entirely of local single-body and two-body gates, and has only（3N＋2） two-body gates. This result suggests that both the computational depth of quantum network and the quantum resources required to perform this nonlocal gate might be significantly reduced. This scheme can be generalized straightforwardly to implement a nonlocal N-target and M-control qubits gate.

Application of Fuzzy Automata Decision-Making System in Target Control

In order to perform better in target control, this paper proposed a decision-making system method based on fuzzy automata. The decision-making system first preprocessed the signal and then performed a two-level decision on the target to achieve optimal control. The system consisted of four parts: signal preprocessing, contrast decision-making, comprehensive judgment of decision-making and decision-making result. These decision algorithms in target control were given. A concrete application of this decision-making system in target control was described. Being compared with other existing methods, this paper used both global features and local features of target, and used the decision-making system of fuzzy automata for the target control. Simulation results showed that the control effect based on the decision-making system was better than that of the other existing methods. Not only it was faster, but also its correct control rate was higher to be 95.18% for the target control. This research on the control system not only developed the FA theory, but also strengthened its application scope in the field of control engineering.

Clinical evaluation of target controlled infusion system for sufentanil administration

Background Sufentanil target controlled infusion （TCI） provides stable analgesia, better hemodynamic control than a bolus injection of intravenous anesthetics, anticipated recovery and improved quality of anesthesia during perioperative period. This study evaluated the accuracy and feasibility of TCI system for sufentanil at high concentrations in Chinese surgical patients. Methods Twelve low risk adult patients undergoing elective surgery under general anesthesia were included in this study. Sufentanil was administered with a specific TCI system incorporating the population pharmacokinetic data of sufentanil previously reported, using a target effect-site concentration of sufentanil 4 or 6 ng/ml. Sufentanil TCI duration was 30 minutes. Frequent arterial blood samples were taken during and up to 24 hours after sufentanil TCI for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry. The changes of circulatory system function during the procedure, recovery profile and adverse effects were recorded. Measured plasma sufentanil concentrations were compared with the values predicted by the TCI system. The bias （median performance error, MDPE）, precision （median absolute performance error, MDAPE） and wobble （variability of performance error） of the sufentanil TCI system were determined. Results All patients had stable cardiovascular variables during induction and maintenance of anesthesia. Time to eye opening and extubation were （5.6±1.7） minutes when TCI set to 4 ng/ml and （7.2±2.3） minutes when set to 6 ng/ml. There was no episode of agitation, muscle rigidity or intraoperative awareness. The bias （MDPE）, precision （MDAPE） and wobble of the sufentanil TCI system were -3.7%, 18.9% and 19.6% respectively during TCI, and the MDPE, MDAPE and wobble were -29.1%, 31.7% and 15.0% respectively after TCI （up to 8 hours）. Conclusions The TCI system programmed for sufentanil at 4 or 6 ng/ml was considered acceptable for clinical use in low risk Chinese surgical patients. But the relatively larger MDPE and MDAPE after TCI suggest improvements of the Dharmacokinetic model are needed.

Propofol Target-Controlled Infusion Modeling in Rabbits:Pharmacokinetic and Pharmacodynamic Analysis

This study aimed to establish a new propofol target-controlled infusion（TCI） model in animals so as to study the general anesthetic mechanism at multi-levels in vivo. Twenty Japanese white rabbits were enrolled and propofol（10 mg/kg） was administrated intravenously. Artery blood samples were collected at various time points after injection, and plasma concentrations of propofol were measured. Pharmacokinetic modeling was performed using Win Nonlin software. Propofol TCI within the acquired parameters integrated was conducted to achieve different anesthetic depths in rabbits, monitored by narcotrend. The pharmacodynamics was analyzed using a sigmoidal inhibitory maximal effect model for narcotrend index（NI） versus effect-site concentration. The results showed the pharmacokinetics of propofol in Japanese white rabbits was best described by a two-compartment model. The target plasma concentrations of propofol required at light anesthetic depth was 9.77±0.23 μg/m L, while 12.52±0.69 μg/m L at deep anesthetic depth. NI was 76.17±4.25 at light anesthetic depth, while 27.41±5.77 at deep anesthetic depth. The effect-site elimination rate constant（ke0） was 0.263/min, and the propofol dose required to achieve a 50% decrease in the NI value from baseline was 11.19 μg/m L（95% CI, 10.25–13.67）. Our results established a new propofol TCI animal model and proved the model controlled the anesthetic depth accurately and stably in rabbits. The study provides a powerful method for exploring general anesthetic mechanisms at different anesthetic depths in vivo.

Multi-rate tracking controller analysis and design for target tracking systems

As the sampling rates of the inner loop and the outer loop of the target tracking control system are different,a typical digital multi-rate control system was formed.If the traditional single-rate design method was applied,the low sampling rate loop will seriously impact the dynamical characteristic of the system.After analyzing and calculating the impact law of the low sampling rate loop to the bandwidth and the stability of the tracking system,a kind of multi-rate control system design method was introduced.Corresponding to the different sampling rates of the inner loop and the outer loop,the multi-rate control strategy was constituted by a high sampling rate sub-controller and a low sampling rate sub-controller.The two sub-controllers were designed separately and connected by means of the sampling rate converter.The low sampling rate controller determined the response rapidity of the system,while the high sampling rate controller applied additionally effective control outputs to the system during a sampling interval of the low sampling rate controller.With the introduced high and low sampling rates sub-controllers,the tracking control system can achieve the same performance as a single-rate controller with high sampling rate,yet it works under a much lower sampling rate.The simulation and experimental results show the effectiveness of the introduced multi-rate control design method.It reduces the settling time by 5 times and the over shoot by 4 times compared with the PID control.

Study of targeted and controlled release of 5-fluorouracil-loaded PLA nanoparticles and microspheres on treatment of gastric tumor

The aim of this paper was to evaluate controlled release behavior and the therapeutic efficacy of 5-FU-loaded Poly(lactic acid) (PLA)microspheres to human gastric cancer xenograft, and the targeting effect of VEGF/5-FU loaded PLA nanoparticles. 5-FU-loaded PLA microspheres were prepared by an emulsion evaporation method, and were characterized by scanning electron microscopy (SEM). 5-FU loaded PLA nanoparticles were characterized by (TEM), and particle size analyzer determined the distribution of nanoparticles size. The release performances of 5-FU microspheres in vitro were studied in PH 7.4 phosphate buffered saline. The therapeutic efficacy of 5-FU-loaded PLA microspheres in vivo were studied using MGC-803 (human stomach cancer) xenograft. 32 nude mice were divided into four groups (n =8), 5-FU loaded PLA microspheres were injected at tumor site. VEGF121 monoclonal antibody was connected with 5-FU loaded PLA nanoparticles through carbodimide. The targeted effect of VEGF 5-FU loaded nanoparticles in vivo were observed by single photon emission computed tomography (SPECT) after tail vein injection at 1 h and 2 h. SEM observation showed that microspheres were spherical, and the diameters of two kinds of microspheres were 1 μm and 5 μm respectively. The mean diameter of nanoparticles was 191.0 nm, and the index of polydispersity was 0.202. The drug was released following biphasic kinetics, initial burst and the following steady phase. 1 μm and 5 μm 5-FU-loaded microspheres both resulted in increased life span (1 μm microspheres median survival time=40.63 days, 5 μm microspheres median survival time=62.25 days), against 5-FU pure drug (median survival time=14.5 days). These results strongly suggest that 5-FU-loaded PLA microspheres increase life span of nude mice bearing MGC-803 tumors. After injection for 2 h, almost all the VEGF/5-FU loaded PLA nanoparticles could centralize at the human gastric cancer xenograft sites. That demonstrated VEGF monoclonal antibody remain its bioactivity after connection with nanoparticles, VEGF/5-FU loaded PLA nanoparticles had very exact targeting function for gastric tumor xenograft.

Grey Prediction Fuzzy Control of the Target Tracking System in a Robot Weapon

Grey modeling can be used to predict the behavioral development of a system and find out the lead control values of the system. By using fuzzy inference, PID parameters can be adjusted on line by the fuzzy controller with PID parameters self-tuning. According to the characteristics of target tracking system in a robot weapon, grey prediction theory and fuzzy PID control ideas are combined. A grey prediction mathematical model is constructed and a fuzzy PID controller with grey prediction was developed. Simulation result shows fuzzy PID control algorithm with grey prediction is an efficient method that can improve the control equality and robustness of traditional PID control and fuzzy PID control, and has much better performance for target tracking.

The law of anti-VCAM-1 targeted microbubbles adhesion to activated endothelial cells under controlled shear flow

Microbubbles can enhance the detection in noninvasive ultrasound imaging.Recently,targeted microbubbles have been developed to selectively adhere to specific and overexpressed p molecules in endothelial cells in some pathologic conditions.However,the law of

Robust attitude control for rapid multi-target tracking in spacecraft formation flying

A robust attitude tracking control scheme for spacecraft formation flying is presented. The leader spacecraft with a rapid mobile antenna and a camera is modeled. While the camera is tracking the ground target, the antenna is tracking the follower spacecraft. By an angular velocity constraint and an angular constraint, two methods are proposed to compute the reference attitude profiles of the camera and antenna, respectively. To simplify the control design problem, this paper first derives the desired inverse system （DIS）, which can convert the attitude tracking problem of 3D space into the regulator problem. Based on DIS and sliding mode control （SMC）, a robust attitude tracking controller is developed in the presence of mass parameter uncertainties and external disturbance. By Lyapunov stability theory, the closed loop system stability can be achieved. The numerical simulations show that the proposed robust control scheme exhibits significant advantages for the multi-target attitude tracking of a two-spacecraft formation.

Unified Modeling Approach of Kinematics, Dynamics and Control of a Free-Flying Space Robot Interacting with a Target Satellite

In this paper a unified control-oriented modeling approach is proposed to deal with the kinematics, linear and angular momentum, contact constraints and dynamics of a free-flying space robot interacting with a target satellite. This developed approach combines the dynamics of both systems in one structure along with holonomic and nonholonomic constraints in a single framework. Furthermore, this modeling allows consid-ering the generalized contact forces between the space robot end-effecter and the target satellite as internal forces rather than external forces. As a result of this approach, linear and angular momentum will form holonomic and nonholonomic constraints, respectively. Meanwhile, restricting the motion of the space robot end-effector on the surface of the target satellite will impose geometric constraints. The proposed momentum of the combined system under consideration is a generalization of the momentum model of a free-flying space robot. Based on this unified model, three reduced models are developed. The first reduced dynamics can be considered as a generalization of a free-flying robot without contact with a target satellite. In this re-duced model it is found that the Jacobian and inertia matrices can be considered as an extension of those of a free-flying space robot. Since control of the base attitude rather than its translation is preferred in certain cases, a second reduced model is obtained by eliminating the base linear motion dynamics. For the purpose of the controller development, a third reduced-order dynamical model is then obtained by finding a common solution of all constraints using the concept of orthogonal projection matrices. The objective of this approach is to design a controller to track motion trajectory while regulating the force interaction between the space robot and the target satellite. Many space missions can benefit from such a modeling system, for example, autonomous docking of satellites, rescuing satellites, and satellite servicing, where it is vital to limit the con-tact force during the robotic operation. Moreover, Inverse dynamics and adaptive inverse dynamics control-lers are designed to achieve the control objectives. Both controllers are found to be effective to meet the specifications and to overcome the un-actuation of the target satellite. Finally, simulation is demonstrated by to verify the analytical results.

老年髋关节置换术中实施丙泊酚闭环靶控输注麻醉的效果及对患者术后谵妄风险的影响

目的研究老年髋关节置换术中实施丙泊酚闭环靶控输注麻醉的效果及对术后谵妄风险的影响。方法回顾性选取2020年1月至2023年1月入安庆市第一人民医院接受治疗的90例髋关节骨折老年患者,择期行髋关节置换术。参考麻醉方式不同分为A组、B组和C组,每组各30例。A组给予丙泊酚闭环靶控持续输注麻醉,B组给予丙泊酚开环靶控持续输注麻醉,C组给予丙泊酚人工持续输注麻醉。比较3组患者的术中相关指标(麻醉时间、手术时间以及拔管时间)、麻醉相关指标(术中丙泊酚总计用量、术中维持泵调节次数)、血流动力学变化[麻醉诱导开始(T_(0))、插管(T_(1))、手术开始(T_(2))、手术结束(T_(3))、拔管(T_(4))的平均动脉压、心率以及脑电双频指数(BIS)值]情况、术后恢复情况及术后谵妄发生情况。结果(1)术中指标:3组患者麻醉时间、手术时间以及拔管时间比较,差异均无统计学意义(P>0.05)。(2)麻醉相关指标:A组患者术中丙泊酚总计用量、术中维持泵调节次数均明显低于B、C组,差异均有统计学意义(P<0.05);B组患者单位麻醉时间内丙泊酚用量、单位手术时间内丙泊酚用量均明显高于A、C组,差异均有统计学意义(P<0.05)。(3)血流动力学:A组T_(2)、T_(3)时平均动脉压均高于B组、C组,A组T_(4)时的平均动脉压更加接近于T_(0);3组患者不同时刻心率差异无统计学意义(P>0.05);A组T_(2)、T_(3)时BIS值均低于B组、C组,差异均有统计学意义(P<0.05)。(4)术后恢复情况:A组患者PACU停滞时间、自主呼吸恢复时间、指令反应恢复时间均明显低于B、C组,差异均有统计学意义(P<0.05)。(5)术后谵妄:A组患者术后谵妄发生率为16.67%,显著低于B、C组(40.00%、46.67%),差异均有统计学意义(P<0.05)。结论老年髋关节置换术中采用丙泊酚靶控输注麻醉可减少丙泊酚用量,术中生命体征更加平稳,可降低人工操作次数,术后麻醉苏醒更快,且术后谵妄发生率也更低,是老年患者首选的麻醉方案。

Overall Evaluation of the Control Schemes of Automobile Pollution and Its Multi-Target Decision

Various control schemes of automobile pollution are comprehensively evaluated by using the weighting and feyzzy methods, from which several feasible schemes are selected, and then mulit-target decision is made by using the minimum distance and hierarcby analysis methods, for determining the optimal control methods of automobile pollution.

煤矸石自燃的关键影响因素及治理方法研究现状

煤矸石作为煤炭的伴生产物,长期堆存过程中自燃现象频发,直接或间接产生生态污染、水体污染、地质灾害等诸多问题,造成巨大经济损失和人员伤亡。煤矸石从堆积初期到燃烧状态受诸多因素影响,包括自身性质、自燃条件和外部环境等,是一个复杂的物理化学反应过程。为提高煤矿矿区矸石自燃的防治能力,分析了煤矸石自燃理论的研究现状,系统总结了现阶段国内外学者对煤矸石自燃机理和治理方法的研究进展。围绕可燃物、氧气、温度3个影响煤矸石自燃的必要因素,提出了引发自燃的主要关键影响因素和作用过程机理。较全面介绍已有煤矸石山自燃防治的主要方法,对比分析了各种常规煤矸石自燃灭火手段以及治理技术的优缺点,指出了常规简单技术治理效果的局限性。针对煤矸石作为砂、石等替代材料,回填露天矿坑、采煤塌陷区等区域进行土地整治和生态修复,提出在防治过程中要明确自燃治理的控制对象,提升防灭火材料的特定性能,通过智能化设备提高辨识准确性进行精细化监控,并运用多种监测预警技术协同自燃防治材料多手段多方法运用综合治理,并提出了煤矸石自燃防治技术的未来发展和矿用防灭火材料的研究方向,为后续开展煤矸石自燃机理研究及自燃防治工程应用提供参考和理论支持。

艾司氯胺酮和丙泊酚在宫腔镜手术中的药效学相互作用

目的采用响应曲面法分析艾司氯胺酮和丙泊酚在宫腔镜手术中的药效学相互作用。方法选择择期行宫腔镜手术患者45例,年龄18~64岁,BMI 18.5~28.0 kg/m^(2),ASAⅠ或Ⅱ级。选择不同血浆药物浓度的艾司氯胺酮(0、0.1、0.2、0.3、0.4、0.5、0.6、0.7、0.8μg/ml)复合丙泊酚靶控输注,术中维持艾司氯胺酮的血浆药物浓度不变,阶梯式增加丙泊酚的血浆药物浓度。评估扩张宫颈引起的体动反应。采用响应曲面模型分析艾司氯胺酮与丙泊酚的药效学相互作用。结果艾司氯胺酮(0~0.8μg/ml)与丙泊酚(1.0~7.0μg/ml)相互作用的三维响应曲面显示,两者抑制扩张宫颈引起的体动反应方面具有相加作用。抑制扩张宫颈引起的体动反应的艾司氯胺酮半数有效浓度(EC_(50))为0.61μg/ml(95%CI 0.41~0.81μg/ml),丙泊酚EC_(50)为4.69μg/ml(95%CI 3.17~6.21μg/ml)。结论响应曲面法可以定性和定量地分析艾司氯胺酮和丙泊酚的药效学相互作用规律,在抑制扩张宫颈引起的体动反应上,艾司氯胺酮和丙泊酚具有相加作用。

右美托咪定与利多卡因靶控输注在无痛胃肠镜麻醉中的相互作用和配伍方案优化

目的:探究右美托咪定与利多卡因靶控输注在无痛胃肠镜麻醉中的相互作用和配伍方案优化。方法:选择进行无痛胃肠镜检查的患者92例为研究对象,随机分为A、B、C、D四组,每组23例。比较四组麻醉时(T_(1))、无痛胃肠镜置入时(T_(2))、无痛胃肠镜检查第5 min时(T_(3))疼痛视觉模拟量表(VAS)评分、拉姆赛(Ramsay)镇静评分、心率(HR)、平均动脉压(MAP)、脉搏氧饱和度(SpO_(2))、麻醉满意度以及不良反应方式情况。采用等辐射法分析右美托咪定与利多卡因在脑电双频谱指数(BIS)为50时的相互作用。结果:A组患者T_(2)和T_(3)时Ramsay镇静评分高于其他三组(均P<0.05);T_(3)时HR、MAP低于其他三组,SpO_(2)高于其他三组(均P<0.05)。A组麻醉诱导时间长于其他三组,麻醉满意度低于其他三组(均P<0.05)。D组苏醒时间和离院时间长于其他三组,恶心呕吐和嗜睡发生率高于其他三组(均P<0.05)。等辐射法分析结果显示,右美托咪定和利多卡因在无痛胃肠镜麻醉中有协同作用。结论:右美托咪定和利多卡因在麻醉作用上有协同作用。0.50μg/kg右美托咪定+0.80 mg/kg利多卡因与0.60μg/kg右美托咪定+0.60 mg/kg利多卡因靶控输注在无痛胃肠镜麻醉中麻醉效果和血流动力学指标稳定性更好,不良反应发生率更低,麻醉满意度更高。

基于嵌入式技术的运动目标控制与自动追踪系统设计

针对目前移动机器人运动目标定位不准确和追踪过程中容易丢失的问题,设计了一种基于嵌入式技术的运动目标控制与自动追踪系统。本系统以光斑模拟运动目标,通过算法编程不但可以实现目标的运动轨迹控制,还可对其运动轨迹进行自动追踪。本设计以嵌入式芯片STM32F103为核心,通过OpenMV进行图像数据处理,并由PID精确算法调节舵机,从而控制光斑在屏幕上按照设定程序进行移动和追踪。经测试,该系统能够准确地完成运动目标的控制和自动追踪任务,反应灵敏,性价比高,可广泛应用于运动目标追踪等智能控制设备中。

基于WGAN-GP-CNN的海面小目标检测

针对传统基于统计理论的海面小目标检测方法在复杂海面环境中性能不高的问题,该文提出了一种改进的检测方法。首先通过分析海杂波和目标回波的特征,将检测问题转化为特征空间的分类任务。鉴于海面小目标样本数量有限,存在样本不平衡的问题,该文引入了一种基于梯度惩罚的沃瑟斯坦生成对抗网络(Wasserstein Generative Adversarial Network with Gradient Penalty,WGAN-GP)来增强目标数据,从而在数量上平衡目标样本与海杂波样本。同时,对原始WGAN-GP网络的损失函数进行了改进,引入相位损失以确保生成数据能够反映真实数据的相位信息。基于这些数据,进一步提取了生成目标和海杂波的高维特征,并将其送入卷积神经网络(Convolutional Neural Network,CNN)进行训练。为了应对高维特征空间中虚警概率难以控制的问题,对CNN算法进行了改进,通过设置Softmax分类器的阈值,实现了虚警概率可控。最后,借助公开的IPIX雷达数据集进行实验验证,所提的WGAN-GP-CNN检测器在积累时间为1.024 s,虚警概率为0.001时,平均检测概率达到0.8683,具有良好的检测效果。

一种靶弹多功能控制器设计与实现

靶弹是模拟敌方来袭导弹技战术特性的实体空中靶标;针对退役导弹改装靶弹中面临的改装线路复杂、对动目标供靶精度不足等实际问题,对靶弹飞行控制规律和改装设计方法进行了研究探索,创新了靶弹制导控制方法,综合采用靶弹飞行控制回路状态转换、动目标供靶航路精确控制、靶弹功能扩展等关键技术,设计研制了集电气改装、接口转换、目标导引、安全控制等功能于一体的靶弹多功能控制器,实现了退役飞航导弹到多用途靶弹的通用化、标准化改装,探索了一种经济而有效的靶弹开发方法;试验结果表明,该多功能控制器具备简便可靠、工作量小、通用性好、弹道控制灵活等突出特点,较好地解决了靶弹改装难题,满足了防空武器系统试验训练的需要。