BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT i...BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT in patients after PM resection for CRC.METHODS This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023.The primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication bias.Sur-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,respectively.ACT had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT groups.Multivariate analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved survival.CONCLUSION ACT does not improve survival after PM resection for CRC.Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.展开更多
The array laterolog is an important tool for complex formation logging evaluation due to its high resolution and large detection depth.However,its logging responses are seriously affected by leakage events due to the ...The array laterolog is an important tool for complex formation logging evaluation due to its high resolution and large detection depth.However,its logging responses are seriously affected by leakage events due to the surrounding rock and by mud invasion.These factors must be considered when inverting array lateral logging data,so that the inversion results reflect the true formation conditions as much as possible.The difficulties encountered in the inversion of array lateral logging data are:too many inversion parameters cause the calculation of the Jacobian matrix to be difficult and the time required to select the initial inversion values due to the slow forward-modeling speed.In this paper,we develop a fast processing method for array laterolog data.First,it is important to clearly define the main controlling factors for the array laterolog response,such as thickness,the surrounding rock,and invasion.Second,based on a depth-window technique,processing the array laterolog data for the entire well is transformed into multiple 2 D inversions of the layers using a series of continuous depth windows.For each formation in a depth window,combined with the1 D equivalent fast-forward algorithm,rapid extraction of the radial resistivity profile of the formation is achieved.Finally,the 1 D inversion result is used as the initial state to further eliminate the influence of surrounding rocks and layer thicknesses on the apparent resistivity response.Numerical simulation results show that the factors affecting the response of the array laterolog are the invasion properties,the layer thicknesses,and the surrounding rocks;the windowing technique greatly reduces the number of inversion parameters needed and improves the inversion speed.A real application of the method shows that 2 D inversion can rapidly reconstruct the actual resistivity distribution and improve the accuracy of reservoir saturation calculations.展开更多
Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine wal...Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri? balloon (Cook Medical Incorporated) in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description;and the first one in a third degree recurrent puerperal uterine inversion.展开更多
A bound state solution is a quantum state solution of a particle subjected to a potential such that the particle＇s energy is less than the potential at both negative and positive infinity. The particle＇s energy may ...A bound state solution is a quantum state solution of a particle subjected to a potential such that the particle＇s energy is less than the potential at both negative and positive infinity. The particle＇s energy may also be negative as the potential approaches zero at infinity. It is characterized by the discretized eigenvalues and eigenfunctions, which contain all the necessary information regarding the quantum systems under consideration. The bound state problems need to be extended using a more precise method and approximation scheme. This study focuses on the non-relativistic bound state solutions to the generalized inverse quadratic Yukawa potential. The expression for the non-relativistic energy eigenvalues and radial eigenfunctions are derived using proper quantization rule and formula method, respectively. The results reveal that both the ground and first excited energy eigenvalues depend largely on the angular momentum numbers, screening parameters, reduced mass, and the potential depth. The energy eigenvalues, angular momentum numbers, screening parameters, reduced mass, and the potential depth or potential coupling strength determine the nature of bound state of quantum particles. The explored model is also suitable for explaining both the bound and continuum states of quantum systems.展开更多
Recently, semiconductor quantum dot (QD) sensitized solar cells (QDSSCs) are expected to achieve higher conversion efficiency because of the large light absorption coefficient and multiple exciton generation in QDs. T...Recently, semiconductor quantum dot (QD) sensitized solar cells (QDSSCs) are expected to achieve higher conversion efficiency because of the large light absorption coefficient and multiple exciton generation in QDs. The morphology of TiO2 electrode is one of the most important factors in QDSSCs. Inverse opal (IO) TiO2 electrode, which has periodic mesoporous structure, is useful for QDSSCs because of better penetration of electrolyte than conventional nanoparticulate TiO2 electrode. In addition, the ordered three dimensional structure of IO-TiO2 would be better for electron transport. We have found that open circuit voltage Voc of QDSSCs with IO-TiO2 electrodes was much higher (0.2 V) than that with nanoparticulate TiO2 electrodes. But short circuit current density Jsc was lower in the case of IO-TiO2 electrodes because of the smaller surface area of IO-TiO2. In this study, for increasing surface area of IO-TiO2, we applied TiCl4 post treatment on IO-TiO2 and investigated the effect of the post treatment on photovoltaic properties of CdSe QD sensitized IO-TiO2 solar cells. It was found that Jsc could be enhanced due to TiCl4 post treatment, but decreased again for more than one cycle treatment, which indicates excess post treatment may lead to worse penetration of electrolyte. Our results indicate that the appropriate post treatment can improve the energy conversion efficiency of the QDSSCs.展开更多
The aim of this work was the determination of the optimal aerations, and more specifically the corresponding optimal air velocities uopt, at which the largest COD removals were achieved in treatment of industrial wast...The aim of this work was the determination of the optimal aerations, and more specifically the corresponding optimal air velocities uopt, at which the largest COD removals were achieved in treatment of industrial wastewaters of various strength conducted in the inverse fluidized bed biofilm reactor. The largest COD removals were achieved at the following air velocities uopt and retention times ts, and (Vb/VR) = 0.55: i) for CODo = 72,780 mg/l at uopt = 0.052 m/s and ts = 80 h;ii) for CODo = 62,070 mg/l at uopt = 0.042 m/s and ts = 65 h;iii) for CODo = 49,130 mg/l at uopt = 0.033 m/s and ts= 55 h;iv) for CODo = 41,170 mg/l at uopt = 0.028 m/s and ts = 45 h;v) for CODo = 35,460 mg/l at uopt = 0.025 m/s and ts = 27.5 h;and vi) for CODo = 26,470 mg/l at uopt= 0.014 m/s and ts = 22.5 h. In the treatment operation conducted in a reactor optimally controlled at the above values of uopt, ts and (Vb/VR), the following decreases in COD were obtained: i) from 72,780 to 5410 mg/l;ii) from 62,070 to 3730 mg/l;iii) from 49,130 to 2820 mg/l;iv) from 41,170 to 1820 mg/l;v) from 35,460 to 1600 mg/l;and vi) from 26,470 to 1180 mg/l, that is, approximately a 93%, 94%, 95%, 96%, 95% and 96% COD reduction was attained, respectively.展开更多
BACKGROUND Esophageal variceal bleeding is a severe complication associated with liver cirrhosis and typically necessitates endoscopic hemostasis.The current standard treatment is endoscopic variceal ligation(EVL),and...BACKGROUND Esophageal variceal bleeding is a severe complication associated with liver cirrhosis and typically necessitates endoscopic hemostasis.The current standard treatment is endoscopic variceal ligation(EVL),and Western guidelines recom-mend antibiotic prophylaxis following hemostasis.However,given the impro-vements in prognosis for variceal bleeding due to advancements in the management of bleeding and treatments of liver cirrhosis and the global concerns regarding the emergence of multidrug-resistant bacteria,there is a need to reassess the use of routine antibiotic prophylaxis after hemostasis.AIM To evaluate the effectiveness of antibiotic prophylaxis in patients treated for EVL.METHODS We conducted a 13-year observational study using the Tokushukai medical database across 46 hospitals.Patients were divided into the prophylaxis group(received antibiotics on admission or the next day)and the non-prophylaxis group(did not receive antibiotics within one day of admission).The primary outcome was composed of 6-wk mortality,4-wk rebleeding,and 4-wk spontaneous bacterial peritonitis(SBP).The secondary outcomes were each individual result and in-hospital mortality.A logistic regression with inverse probability of treatment weighting was used.A subgroup analysis was conducted based on the Child-Pugh classification to determine its influence on the primary outcome measures,while sensitivity analyses for antibiotic type and duration were also performed.RESULTS Among 980 patients,790 were included(prophylaxis:232,non-prophylaxis:558).Most patients were males under the age of 65 years with a median Child-Pugh score of 8.The composite primary outcomes occurred in 11.2%of patients in the prophylaxis group and 9.5%in the non-prophylaxis group.No significant differences in outcomes were observed between the groups(adjusted odds ratio,1.11;95%confidence interval,0.61-1.99;P=0.74).Individual outcomes such as 6-wk mortality,4-wk rebleeding,4-wk onset of SBP,and in-hospital mortality were not significantly different between the groups.The primary outcome did not differ between the Child-Pugh subgroups.Similar results were observed in the sensitivity analyses.CONCLUSION No significant benefit to antibiotic prophylaxis for esophageal variceal bleeding treated with EVL was detected in this study.Global reassessment of routine antibiotic prophylaxis is imperative.展开更多
目的基于双重稳健估计(Doubly robust,DR)方法估计非小细胞肺癌治疗过程对院内死亡的因果效应大小,为降低非小细胞肺癌院内死亡率提供参考依据。方法依据非小细胞肺癌治疗质量评价体系,计算治疗过程指标的使用率,以治疗过程质量均值得...目的基于双重稳健估计(Doubly robust,DR)方法估计非小细胞肺癌治疗过程对院内死亡的因果效应大小,为降低非小细胞肺癌院内死亡率提供参考依据。方法依据非小细胞肺癌治疗质量评价体系,计算治疗过程指标的使用率,以治疗过程质量均值得分为界限将患者划分为高质量组与低质量组。以院内死亡为结局指标,采用倾向性评分逆概率加权(Inverse probability of treatment weighting,IPTW)法校正的Kaplan-Meier法及Cox回归,分析治疗过程质量对非小细胞肺癌院内死亡的影响;结合DR估计治疗过程对院内死亡的因果效应大小。结果治疗过程指标使用率的中位数为66.88%,患者治疗过程质量得分为0.270±0.124,其中高质量组为0.358±0.069,低质量组为0.158±0.081。经过IPTW法加权后,患者基线特征标准化平均差(Standardized mean difference,SMD)减小;IPTW前后两组患者生存曲线间差异具有统计学意义(P<0.05),高质量组患者的预后优于低质量组患者(IPTW前:HR=0.367,95%CI:0.275~0.491;IPTW后:HR=0.228,95%CI:0.167~0.312)。与低质量组相比,高质量组患者治疗过程对院内死亡的平均因果效应大小为-0.026。结论DR可弥补logistic或IPTW的不足,规避模型出错的风险,可以获得治疗过程质量对院内死亡的因果效应。医疗实践中应提高治疗过程指标的使用率,从而改善患者预后;因果效应研究提示,除治疗过程外,影响院内死亡的其他因素也是不可忽略的。展开更多
Annual production output of poly(ethylene terephthalate)(PET) fiber has been over 15 million tons in China due to its good mechanical properties and processability,but the shortage of hydrophilic group of PET has impo...Annual production output of poly(ethylene terephthalate)(PET) fiber has been over 15 million tons in China due to its good mechanical properties and processability,but the shortage of hydrophilic group of PET has imposed many limitations to further extend its application.The PET fabrics were grafted with polyacrylic acid in inverse microemulsion after low pressure plasma treatment,and the microstructure and properties of the grafted fabrics were investigated with infrared spectroscopy,scanning electron microscope(SEM),hydrophilic and mechanical tests.The grafting yield was increased with the grafting time.The grafting polymer was in the granular form with its particle size ranging from a few micrometers to a dozen of micrometers,normally smaller than the fiber diameter.The moisture regain and water uptake increased while the air permeability of the grafted fabrics decreased with the increase of grafting yield.The bending rigidity and tensile properties show slightly complicated behaviors with grafting yield.The inverse emulsion grafting technique can be used to control the grafting polymer architecture.展开更多
The aim of this work was to investigate the aerobic degradation of high-strength industrial (refinery) wastewaters in the inverse fluidized bed biological reactor, in which polypropylene particles of density 910 kg/m3...The aim of this work was to investigate the aerobic degradation of high-strength industrial (refinery) wastewaters in the inverse fluidized bed biological reactor, in which polypropylene particles of density 910 kg/m3 were fluidized by an upward flow of gas through a bed. Measurements of chemical oxygen demand (COD) versus residence time t were performed for various ratios of settled bed volume to reactor volume (Vb/VR) and air velocities u. The largest COD reduction, namely, from 54,840 to 2,190 mg/l, i.e. a 96% COD decrease, was achieved when the reactor was operated at the ratio (Vb/VR) = 0.55, air velocity u = 0.046 m/s and t = 65 h. Thus, these values of (Vb/VR), u and t can be considered as the optimal operating parameters for a reactor when used in treatment of high-strength refinery wastewaters. In the treatment operation conducted in a reactor optimally controlled at (Vb/VR) = 0.55, u = 0.046 m/s and t = 65 h, the conversions obtained for all phenolic constituents of the wastewater were larger than 95%. The conversions of about 90% were attained for other hydrocarbons.展开更多
The appearance of lower hardness at the surface than at the core after through-hardening of steels is known as "inverse quench-hardening." Pioneering work was performed in the 1970s by establishing a simple ...The appearance of lower hardness at the surface than at the core after through-hardening of steels is known as "inverse quench-hardening." Pioneering work was performed in the 1970s by establishing a simple test procedure where cylindrical specimens were cooled by air and brine sequentially to produce the effect. This phenomenon was described in relation to the polymer quenching and its effect to the improvement in the fatigue strength of the steel in the 1990s. The hardening mechanism in the same specimens as the pioneering work was recently examined using a finite element simulation method. However, this work has not been completed for lack of experimental quenching cooling curves for the comparisons. In this study, the same experiments using 20mm diameter cylindrical specimens as those of the pioneering work were conducted to obtain cooling curves and hardness distributions for comparing simulated results. Experimental cooling curves showed a temperature recovery as predicted by the simulation. Also the inverse quench-hardening phenomena were found in the measured and simulated hardness distributions of the specimens.展开更多
基金Supported by the National Project for Clinical Key Specialty Development.
文摘BACKGROUND The benefit of adjuvant chemotherapy(ACT)for patients with no evidence of disease after pulmonary metastasis resection(PM)from colorectal cancer(CRC)remains controversial.AIM To assess the efficacy of ACT in patients after PM resection for CRC.METHODS This study included 96 patients who underwent pulmonary metastasectomy for CRC at a single institution between April 2008 and July 2023.The primary end-point was overall survival(OS);secondary endpoints included cancer-specific survival(CSS)and disease-free survival(DFS).An inverse probability of treat-ment-weighting(IPTW)analysis was conducted to address indication bias.Sur-vival outcomes compared using Kaplan-Meier curves,log-rank test,Cox regre-ssion and confirmed by propensity score-matching(PSM).RESULTS With a median follow-up of 27.5 months(range,18.3-50.4 months),the 5-year OS,CSS and DFS were 72.0%,74.4%and 51.3%,respectively.ACT had no significant effect on OS after PM resection from CRC[original cohort:P=0.08;IPTW:P=0.15].No differences were observed for CSS(P=0.12)and DFS(P=0.68)between the ACT and non-ACT groups.Multivariate analysis showed no association of ACT with better survival,while sublobar resection(HR=0.45;95%CI:0.20-1.00,P=0.049)and longer disease-free interval(HR=0.45;95%CI:0.20-0.98,P=0.044)were associated with improved survival.CONCLUSION ACT does not improve survival after PM resection for CRC.Further well-designed randomized controlled trials are needed to determine the optimal ACT regimen and duration.
基金supported by the National Science and Technology Major Project of China(NO.2017ZX05005-005-005,NO.2016ZX05014-002-001 and No.2016ZX05002-005-001)the Strategic Priority Research Program of the Chinese Academy of Sciences,Grant No.XDA14010204
文摘The array laterolog is an important tool for complex formation logging evaluation due to its high resolution and large detection depth.However,its logging responses are seriously affected by leakage events due to the surrounding rock and by mud invasion.These factors must be considered when inverting array lateral logging data,so that the inversion results reflect the true formation conditions as much as possible.The difficulties encountered in the inversion of array lateral logging data are:too many inversion parameters cause the calculation of the Jacobian matrix to be difficult and the time required to select the initial inversion values due to the slow forward-modeling speed.In this paper,we develop a fast processing method for array laterolog data.First,it is important to clearly define the main controlling factors for the array laterolog response,such as thickness,the surrounding rock,and invasion.Second,based on a depth-window technique,processing the array laterolog data for the entire well is transformed into multiple 2 D inversions of the layers using a series of continuous depth windows.For each formation in a depth window,combined with the1 D equivalent fast-forward algorithm,rapid extraction of the radial resistivity profile of the formation is achieved.Finally,the 1 D inversion result is used as the initial state to further eliminate the influence of surrounding rocks and layer thicknesses on the apparent resistivity response.Numerical simulation results show that the factors affecting the response of the array laterolog are the invasion properties,the layer thicknesses,and the surrounding rocks;the windowing technique greatly reduces the number of inversion parameters needed and improves the inversion speed.A real application of the method shows that 2 D inversion can rapidly reconstruct the actual resistivity distribution and improve the accuracy of reservoir saturation calculations.
文摘Puerperal Uterine Inversion (PUI) is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri? balloon (Cook Medical Incorporated) in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description;and the first one in a third degree recurrent puerperal uterine inversion.
文摘A bound state solution is a quantum state solution of a particle subjected to a potential such that the particle＇s energy is less than the potential at both negative and positive infinity. The particle＇s energy may also be negative as the potential approaches zero at infinity. It is characterized by the discretized eigenvalues and eigenfunctions, which contain all the necessary information regarding the quantum systems under consideration. The bound state problems need to be extended using a more precise method and approximation scheme. This study focuses on the non-relativistic bound state solutions to the generalized inverse quadratic Yukawa potential. The expression for the non-relativistic energy eigenvalues and radial eigenfunctions are derived using proper quantization rule and formula method, respectively. The results reveal that both the ground and first excited energy eigenvalues depend largely on the angular momentum numbers, screening parameters, reduced mass, and the potential depth. The energy eigenvalues, angular momentum numbers, screening parameters, reduced mass, and the potential depth or potential coupling strength determine the nature of bound state of quantum particles. The explored model is also suitable for explaining both the bound and continuum states of quantum systems.
文摘Recently, semiconductor quantum dot (QD) sensitized solar cells (QDSSCs) are expected to achieve higher conversion efficiency because of the large light absorption coefficient and multiple exciton generation in QDs. The morphology of TiO2 electrode is one of the most important factors in QDSSCs. Inverse opal (IO) TiO2 electrode, which has periodic mesoporous structure, is useful for QDSSCs because of better penetration of electrolyte than conventional nanoparticulate TiO2 electrode. In addition, the ordered three dimensional structure of IO-TiO2 would be better for electron transport. We have found that open circuit voltage Voc of QDSSCs with IO-TiO2 electrodes was much higher (0.2 V) than that with nanoparticulate TiO2 electrodes. But short circuit current density Jsc was lower in the case of IO-TiO2 electrodes because of the smaller surface area of IO-TiO2. In this study, for increasing surface area of IO-TiO2, we applied TiCl4 post treatment on IO-TiO2 and investigated the effect of the post treatment on photovoltaic properties of CdSe QD sensitized IO-TiO2 solar cells. It was found that Jsc could be enhanced due to TiCl4 post treatment, but decreased again for more than one cycle treatment, which indicates excess post treatment may lead to worse penetration of electrolyte. Our results indicate that the appropriate post treatment can improve the energy conversion efficiency of the QDSSCs.
文摘The aim of this work was the determination of the optimal aerations, and more specifically the corresponding optimal air velocities uopt, at which the largest COD removals were achieved in treatment of industrial wastewaters of various strength conducted in the inverse fluidized bed biofilm reactor. The largest COD removals were achieved at the following air velocities uopt and retention times ts, and (Vb/VR) = 0.55: i) for CODo = 72,780 mg/l at uopt = 0.052 m/s and ts = 80 h;ii) for CODo = 62,070 mg/l at uopt = 0.042 m/s and ts = 65 h;iii) for CODo = 49,130 mg/l at uopt = 0.033 m/s and ts= 55 h;iv) for CODo = 41,170 mg/l at uopt = 0.028 m/s and ts = 45 h;v) for CODo = 35,460 mg/l at uopt = 0.025 m/s and ts = 27.5 h;and vi) for CODo = 26,470 mg/l at uopt= 0.014 m/s and ts = 22.5 h. In the treatment operation conducted in a reactor optimally controlled at the above values of uopt, ts and (Vb/VR), the following decreases in COD were obtained: i) from 72,780 to 5410 mg/l;ii) from 62,070 to 3730 mg/l;iii) from 49,130 to 2820 mg/l;iv) from 41,170 to 1820 mg/l;v) from 35,460 to 1600 mg/l;and vi) from 26,470 to 1180 mg/l, that is, approximately a 93%, 94%, 95%, 96%, 95% and 96% COD reduction was attained, respectively.
基金approved by the Institutional Review Board of the Future Medical Research Centre Ethical Committee(Approval No.TGE02100-02).
文摘BACKGROUND Esophageal variceal bleeding is a severe complication associated with liver cirrhosis and typically necessitates endoscopic hemostasis.The current standard treatment is endoscopic variceal ligation(EVL),and Western guidelines recom-mend antibiotic prophylaxis following hemostasis.However,given the impro-vements in prognosis for variceal bleeding due to advancements in the management of bleeding and treatments of liver cirrhosis and the global concerns regarding the emergence of multidrug-resistant bacteria,there is a need to reassess the use of routine antibiotic prophylaxis after hemostasis.AIM To evaluate the effectiveness of antibiotic prophylaxis in patients treated for EVL.METHODS We conducted a 13-year observational study using the Tokushukai medical database across 46 hospitals.Patients were divided into the prophylaxis group(received antibiotics on admission or the next day)and the non-prophylaxis group(did not receive antibiotics within one day of admission).The primary outcome was composed of 6-wk mortality,4-wk rebleeding,and 4-wk spontaneous bacterial peritonitis(SBP).The secondary outcomes were each individual result and in-hospital mortality.A logistic regression with inverse probability of treatment weighting was used.A subgroup analysis was conducted based on the Child-Pugh classification to determine its influence on the primary outcome measures,while sensitivity analyses for antibiotic type and duration were also performed.RESULTS Among 980 patients,790 were included(prophylaxis:232,non-prophylaxis:558).Most patients were males under the age of 65 years with a median Child-Pugh score of 8.The composite primary outcomes occurred in 11.2%of patients in the prophylaxis group and 9.5%in the non-prophylaxis group.No significant differences in outcomes were observed between the groups(adjusted odds ratio,1.11;95%confidence interval,0.61-1.99;P=0.74).Individual outcomes such as 6-wk mortality,4-wk rebleeding,4-wk onset of SBP,and in-hospital mortality were not significantly different between the groups.The primary outcome did not differ between the Child-Pugh subgroups.Similar results were observed in the sensitivity analyses.CONCLUSION No significant benefit to antibiotic prophylaxis for esophageal variceal bleeding treated with EVL was detected in this study.Global reassessment of routine antibiotic prophylaxis is imperative.
文摘目的基于双重稳健估计(Doubly robust,DR)方法估计非小细胞肺癌治疗过程对院内死亡的因果效应大小,为降低非小细胞肺癌院内死亡率提供参考依据。方法依据非小细胞肺癌治疗质量评价体系,计算治疗过程指标的使用率,以治疗过程质量均值得分为界限将患者划分为高质量组与低质量组。以院内死亡为结局指标,采用倾向性评分逆概率加权(Inverse probability of treatment weighting,IPTW)法校正的Kaplan-Meier法及Cox回归,分析治疗过程质量对非小细胞肺癌院内死亡的影响;结合DR估计治疗过程对院内死亡的因果效应大小。结果治疗过程指标使用率的中位数为66.88%,患者治疗过程质量得分为0.270±0.124,其中高质量组为0.358±0.069,低质量组为0.158±0.081。经过IPTW法加权后,患者基线特征标准化平均差(Standardized mean difference,SMD)减小;IPTW前后两组患者生存曲线间差异具有统计学意义(P<0.05),高质量组患者的预后优于低质量组患者(IPTW前:HR=0.367,95%CI:0.275~0.491;IPTW后:HR=0.228,95%CI:0.167~0.312)。与低质量组相比,高质量组患者治疗过程对院内死亡的平均因果效应大小为-0.026。结论DR可弥补logistic或IPTW的不足,规避模型出错的风险,可以获得治疗过程质量对院内死亡的因果效应。医疗实践中应提高治疗过程指标的使用率,从而改善患者预后;因果效应研究提示,除治疗过程外,影响院内死亡的其他因素也是不可忽略的。
基金the First Phase of Jiangsu Universities' Distinctive Discipline Development Program for Textile Science and Engineering of Soochow University,China
文摘Annual production output of poly(ethylene terephthalate)(PET) fiber has been over 15 million tons in China due to its good mechanical properties and processability,but the shortage of hydrophilic group of PET has imposed many limitations to further extend its application.The PET fabrics were grafted with polyacrylic acid in inverse microemulsion after low pressure plasma treatment,and the microstructure and properties of the grafted fabrics were investigated with infrared spectroscopy,scanning electron microscope(SEM),hydrophilic and mechanical tests.The grafting yield was increased with the grafting time.The grafting polymer was in the granular form with its particle size ranging from a few micrometers to a dozen of micrometers,normally smaller than the fiber diameter.The moisture regain and water uptake increased while the air permeability of the grafted fabrics decreased with the increase of grafting yield.The bending rigidity and tensile properties show slightly complicated behaviors with grafting yield.The inverse emulsion grafting technique can be used to control the grafting polymer architecture.
文摘The aim of this work was to investigate the aerobic degradation of high-strength industrial (refinery) wastewaters in the inverse fluidized bed biological reactor, in which polypropylene particles of density 910 kg/m3 were fluidized by an upward flow of gas through a bed. Measurements of chemical oxygen demand (COD) versus residence time t were performed for various ratios of settled bed volume to reactor volume (Vb/VR) and air velocities u. The largest COD reduction, namely, from 54,840 to 2,190 mg/l, i.e. a 96% COD decrease, was achieved when the reactor was operated at the ratio (Vb/VR) = 0.55, air velocity u = 0.046 m/s and t = 65 h. Thus, these values of (Vb/VR), u and t can be considered as the optimal operating parameters for a reactor when used in treatment of high-strength refinery wastewaters. In the treatment operation conducted in a reactor optimally controlled at (Vb/VR) = 0.55, u = 0.046 m/s and t = 65 h, the conversions obtained for all phenolic constituents of the wastewater were larger than 95%. The conversions of about 90% were attained for other hydrocarbons.
文摘The appearance of lower hardness at the surface than at the core after through-hardening of steels is known as "inverse quench-hardening." Pioneering work was performed in the 1970s by establishing a simple test procedure where cylindrical specimens were cooled by air and brine sequentially to produce the effect. This phenomenon was described in relation to the polymer quenching and its effect to the improvement in the fatigue strength of the steel in the 1990s. The hardening mechanism in the same specimens as the pioneering work was recently examined using a finite element simulation method. However, this work has not been completed for lack of experimental quenching cooling curves for the comparisons. In this study, the same experiments using 20mm diameter cylindrical specimens as those of the pioneering work were conducted to obtain cooling curves and hardness distributions for comparing simulated results. Experimental cooling curves showed a temperature recovery as predicted by the simulation. Also the inverse quench-hardening phenomena were found in the measured and simulated hardness distributions of the specimens.
