We reported a case of severe anemia in a patient with end-stage kidney disease (ESKD) on dialysis. The anemia developed when the patient is switched from hemodialysis (HD) to peritoneal dialysis (PD) when the intra-ve...We reported a case of severe anemia in a patient with end-stage kidney disease (ESKD) on dialysis. The anemia developed when the patient is switched from hemodialysis (HD) to peritoneal dialysis (PD) when the intra-venous erythropoietin stimulating agent (ESA, Epogen) was changed into subcutaneous injection of darbepoetin. The patient’s hemoglobin dropped 2 grams in about two months during this period. Extensive work-up including, bleeding disorders, hemolysis, iron deficiency, infections including CMV, Epstein-Bar virus, parvo-19 virus infection were unrevealing The anti-Epogen neutralizing antibodies were not measured due to unavailability. Bone marrow biopsy and aspirate were negative for infiltrations or myelodysplastic syndrome (MDS). The leukocyte and platelet counts were normal. Even though anti-ESA antibodies were not measured in this case, all tentative causes of his anemia were excluded by laboratory investigations. The patient’s anemia was treated symptomatically with blood transfusion and discontinuation of the ESA treatment. He made a remarkable recovery.展开更多
为进一步提高中点电压钳制(neutral point clamped,NPC)H桥级联五电平逆变器的动态响应、降低控制器计算负担的同时确保装置低损耗运行,文中在电压矢量矩形区域分类的基础上,提出一种以满足动态响应和降低开关损耗为目标的两级优化模型...为进一步提高中点电压钳制(neutral point clamped,NPC)H桥级联五电平逆变器的动态响应、降低控制器计算负担的同时确保装置低损耗运行,文中在电压矢量矩形区域分类的基础上,提出一种以满足动态响应和降低开关损耗为目标的两级优化模型预测电压控制策略。首先根据逆变器数学模型和期望电流进行目标电压矢量计算、修正,接着基于矩形区域分类对目标电压矢量进行定位;并以定位后的候选矢量为基础,设计了两级优化目标函数以输出满足要求的最优矢量。仿真和实验结果验证了该方法的有效性,与空间矢量脉宽调制以及传统模型预测电流、电压控制策略相比,该文所研究的两级优化模型预测电压控制策略,在确保逆变器动态响应的前提下既能降低控制器计算负担,还能有效减少器件开关损耗。展开更多
文摘We reported a case of severe anemia in a patient with end-stage kidney disease (ESKD) on dialysis. The anemia developed when the patient is switched from hemodialysis (HD) to peritoneal dialysis (PD) when the intra-venous erythropoietin stimulating agent (ESA, Epogen) was changed into subcutaneous injection of darbepoetin. The patient’s hemoglobin dropped 2 grams in about two months during this period. Extensive work-up including, bleeding disorders, hemolysis, iron deficiency, infections including CMV, Epstein-Bar virus, parvo-19 virus infection were unrevealing The anti-Epogen neutralizing antibodies were not measured due to unavailability. Bone marrow biopsy and aspirate were negative for infiltrations or myelodysplastic syndrome (MDS). The leukocyte and platelet counts were normal. Even though anti-ESA antibodies were not measured in this case, all tentative causes of his anemia were excluded by laboratory investigations. The patient’s anemia was treated symptomatically with blood transfusion and discontinuation of the ESA treatment. He made a remarkable recovery.
文摘为进一步提高中点电压钳制(neutral point clamped,NPC)H桥级联五电平逆变器的动态响应、降低控制器计算负担的同时确保装置低损耗运行,文中在电压矢量矩形区域分类的基础上,提出一种以满足动态响应和降低开关损耗为目标的两级优化模型预测电压控制策略。首先根据逆变器数学模型和期望电流进行目标电压矢量计算、修正,接着基于矩形区域分类对目标电压矢量进行定位;并以定位后的候选矢量为基础,设计了两级优化目标函数以输出满足要求的最优矢量。仿真和实验结果验证了该方法的有效性,与空间矢量脉宽调制以及传统模型预测电流、电压控制策略相比,该文所研究的两级优化模型预测电压控制策略,在确保逆变器动态响应的前提下既能降低控制器计算负担,还能有效减少器件开关损耗。
