目的运用Meta分析评价增强型体外反搏治疗慢性心力衰竭患者的临床疗效。方法检索中文(中国知网、万方、维普、SinoMed)和英文(Cochrane Library、Embase、Web of Science、PubMed)数据库,收集增强型体外反搏治疗慢性心力衰竭的随机对照...目的运用Meta分析评价增强型体外反搏治疗慢性心力衰竭患者的临床疗效。方法检索中文(中国知网、万方、维普、SinoMed)和英文(Cochrane Library、Embase、Web of Science、PubMed)数据库,收集增强型体外反搏治疗慢性心力衰竭的随机对照试验(RCTs),筛选文献、提取数据后,采用Revman 5.4软件进行Meta分析,对数据采用亚组分析和敏感性分析,发表偏倚采用漏斗图评价。结果共纳入14篇RCTs,共1300例患者;依据不同疗程增强型体外反搏治疗慢性心力衰竭的临床疗效显示,与对照组相比,观察组患者治疗后的6分钟步行距离(6MWD)更远[MD(95%CI)=56.24(44.48~68.00),P<0.01]、N末端B型利钠肽原(NT-proBNP)水平更低[MD(95%CI)=-371.29(-642.63~-99.95),P<0.01]、左心室射血分数(LVEF)水平更高[MD(95%CI)=3.75(2.50~5.01),P<0.01],两组患者不良反应差异无统计学意义[OR(95%CI)=1.62(0.69~3.76),P>0.05]。结论增强型体外反搏治疗慢性心力衰竭患者的临床疗效较好,且安全可靠。展开更多
目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP...目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。展开更多
Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately ...Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 deaths.The 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and distribution.Squamous cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local population.Conversely,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United States.The role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of controversy.The effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated topic.The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses.In areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive treatments.These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality.Early screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.展开更多
In an experiment performed on the Shenguang-III prototype laser facility, collective Thomson scattering (TS) is used to study the spatialgrowth of stimulated Brillouin scattering (SBS) in a gas-filled hohlraum by dete...In an experiment performed on the Shenguang-III prototype laser facility, collective Thomson scattering (TS) is used to study the spatialgrowth of stimulated Brillouin scattering (SBS) in a gas-filled hohlraum by detecting the SBS-driven ion acoustic wave. High-quality timeresolved SBS and TS spectra are obtained simultaneously in the experiment, and these are analyzed by a steady-state code based on theray-tracing model. The analysis indicates that ion–ion collisions may play an important role in suppressing SBS growth in the Au plasma;as aresult, the SBS excited in the filled gas region is dominant. In the early phase of the laser pulse, SBS originates primarily from the high-densityplasma at the edges of the interaction beam channel, which is piled up by the heating of the interaction beam. Throughout the duration of thelaser pulse, the presence of the TS probe beam might mitigate SBS by perturbing the density distribution around the region overlapping withthe interaction beam.展开更多
Extrapolation of implosion performance between different laser energy scales is investigated for indirect drive through a semi-hydroequivalent design.Since radiation transport is non-hydro-equivalent,the peak radiatio...Extrapolation of implosion performance between different laser energy scales is investigated for indirect drive through a semi-hydroequivalent design.Since radiation transport is non-hydro-equivalent,the peak radiation temperature of the hohlraum and the ablation velocity of the capsule ablator are not scale-invariant when the sizes of the hohlraum and the capsule are scale-varied.A semi-hydro-equivalent design method that keeps the implosion velocity V_(i),adiabat α_(F),and P_(L)/R_(hc)^(2) (where P_(L) is the laser power and R_(hc) is the hohlraum and capsule scale length)scale-invariant,is proposed to create hydrodynamically similar implosions.The semi-hydro-equivalent design and the scaled implosion performance are investigated for the 100 kJ Laser Facility(100 kJ-scale)and the National Ignition Facility(NIF-scale)with about 2 MJ laser energy.It is found that the one-dimensional implosion performance is approximately hydro-equivalent when V_(i) and α_(F) are kept the same.Owing to the non-hydro-equivalent radiation transport,the yield-over-clean without α-particle heating(YOC_(noα))is slightly lower at 100 kJ-scale than at NIF-scale for the same scaled radiation asymmetry or the same initial perturbation of the hydrodynamic instability.The overall scaled two-dimensional implosion performance is slightly lower at 100 kJ-scale.The general Lawson criterion factor scales asχ_(noα) ^(2D)∼S^(1.06±0.04)(where S is the scale-variation factor)for the semi-hydro-equivalent implosion design with a moderate YOC_(noα).Our study indicates that χ_(noα)≈0.379 is the minimum requirement for the 100 kJ-scale implosion to demonstrate the ability to achieve marginal ignition at NIF-scale.展开更多
This paper discussed the experimental results of the performance of an organic Rankine cycle(ORC)system with an ultra-low temperature heat source.The low boiling point working medium R134a was adopted in the system.Th...This paper discussed the experimental results of the performance of an organic Rankine cycle(ORC)system with an ultra-low temperature heat source.The low boiling point working medium R134a was adopted in the system.The simulated heat source temperature(SHST)in this work was set from 39.51°C to 48.60°C by the simulated heat source module.The influence of load percentage of simulated heat source(LPSHS)between 50%and 70%,the rotary valve opening(RVO)between 20%and 100%,the resistive load between 36Ωand 180Ωor the no-load of the generator,as well as the autumn and winter ambient temperature on the system performance were studied.The results showed that the stability of the system was promoted when the generator had a resistive load.The power generation(PG)and generator speed(GS)of the system in autumn were better than in winter,but the expander pressure ratio(EPR)was lower than in winter.Keep RVO unchanged,the SHST,the mass flow rate(MFR)of the working medium,GS,and the PG of the system increased with the increasing of LPSHS for different generator resistance load values.When the RVO was 60%,LPSHS was 70%,the SHST was 44.15°C and the resistive load was 72Ω,the highest PG reached 15.11 W.Finally,a simulation formula was obtained for LPSHS,resistance load,and PG,and its correlation coefficient was between 0.9818 and 0.9901.The formula can accurately predict the PG.The experimental results showed that the standard deviation between the experimental and simulated values was below 0.0792,and the relative error was within±5%.展开更多
文摘目的运用Meta分析评价增强型体外反搏治疗慢性心力衰竭患者的临床疗效。方法检索中文(中国知网、万方、维普、SinoMed)和英文(Cochrane Library、Embase、Web of Science、PubMed)数据库,收集增强型体外反搏治疗慢性心力衰竭的随机对照试验(RCTs),筛选文献、提取数据后,采用Revman 5.4软件进行Meta分析,对数据采用亚组分析和敏感性分析,发表偏倚采用漏斗图评价。结果共纳入14篇RCTs,共1300例患者;依据不同疗程增强型体外反搏治疗慢性心力衰竭的临床疗效显示,与对照组相比,观察组患者治疗后的6分钟步行距离(6MWD)更远[MD(95%CI)=56.24(44.48~68.00),P<0.01]、N末端B型利钠肽原(NT-proBNP)水平更低[MD(95%CI)=-371.29(-642.63~-99.95),P<0.01]、左心室射血分数(LVEF)水平更高[MD(95%CI)=3.75(2.50~5.01),P<0.01],两组患者不良反应差异无统计学意义[OR(95%CI)=1.62(0.69~3.76),P>0.05]。结论增强型体外反搏治疗慢性心力衰竭患者的临床疗效较好,且安全可靠。
文摘目的直接动脉血压(arterial blood pressure,ABP)连续监测是侵入式的,传统袖带式的间接血压测量法无法实现连续监测。既往利用光学体积描记术(photoplethysmography,PPG)实现了连续无创血压监测,但其为收缩压和舒张压的离散值,而非ABP波的连续值,本研究期望基于卷积神经网络-长短期记忆神经网络(CNN-LSTM)利用PPG信号波重建ABP波信号,实现连续无创血压监测。方法构建CNN-LSTM混合神经网络模型,利用重症监护医学信息集(medical information mart for intensive care,MIMIC)中的PPG与ABP波同步记录信号数据,将PPG信号波经预处理降噪、归一化、滑窗分割后输入该模型,重建与之同步对应的ABP波信号。结果使用窗口长度312的CNN-LSTM神经网络时,重建ABP值与实际ABP值间误差最小,平均绝对误差(mean absolute error,MAE)和均方根误差(root mean square error,RMSE)分别为2.79 mmHg和4.24 mmHg,余弦相似度最大,重建ABP值与实际ABP值一致性和相关性情况良好,符合美国医疗器械促进协会(Association for the Advancement of Medical Instrumentation,AAMI)标准。结论CNN-LSTM混合神经网络可利用PPG信号波重建ABP波信号,实现连续无创血压监测。
基金Supported by Shandong Province Medical and Health Science and Technology Development Plan Project,No.202203030713Clinical Research Funding of Shandong Medical Association-Qilu Specialization,No.YXH2022ZX02031Science and Technology Program of Yantai Affiliated Hospital of Binzhou Medical University,No.YTFY2022KYQD06.
文摘Esophageal cancer ranks among the most prevalent malignant tumors globally,primarily due to its highly aggressive nature and poor survival rates.According to the 2020 global cancer statistics,there were approximately 604000 new cases of esophageal cancer,resulting in 544000 deaths.The 5-year survival rate hovers around a mere 15%-25%.Notably,distinct variations exist in the risk factors associated with the two primary histological types,influencing their worldwide incidence and distribution.Squamous cell carcinoma displays a high incidence in specific regions,such as certain areas in China,where it meets the cost-effect-iveness criteria for widespread endoscopy-based early diagnosis within the local population.Conversely,adenocarcinoma(EAC)represents the most common histological subtype of esophageal cancer in Europe and the United States.The role of early diagnosis in cases of EAC originating from Barrett's esophagus(BE)remains a subject of controversy.The effectiveness of early detection for EAC,particularly those arising from BE,continues to be a debated topic.The variations in how early-stage esophageal carcinoma is treated in different regions are largely due to the differing rates of early-stage cancer diagnoses.In areas with higher incidences,such as China and Japan,early diagnosis is more common,which has led to the advancement of endoscopic methods as definitive treatments.These techniques have demonstrated remarkable efficacy with minimal complications while preserving esophageal functionality.Early screening,prompt diagnosis,and timely treatment are key strategies that can significantly lower both the occurrence and death rates associated with esophageal cancer.
基金supported by the Natural Science Foundation of China(Grant Nos.11905204,11975215,12105270,12205272,12205274,12275032,12275251,and 12035002)the Laser Fusion Research Center Funds for Young Talents(Grant No.RCFPD3-2019-6).
文摘In an experiment performed on the Shenguang-III prototype laser facility, collective Thomson scattering (TS) is used to study the spatialgrowth of stimulated Brillouin scattering (SBS) in a gas-filled hohlraum by detecting the SBS-driven ion acoustic wave. High-quality timeresolved SBS and TS spectra are obtained simultaneously in the experiment, and these are analyzed by a steady-state code based on theray-tracing model. The analysis indicates that ion–ion collisions may play an important role in suppressing SBS growth in the Au plasma;as aresult, the SBS excited in the filled gas region is dominant. In the early phase of the laser pulse, SBS originates primarily from the high-densityplasma at the edges of the interaction beam channel, which is piled up by the heating of the interaction beam. Throughout the duration of thelaser pulse, the presence of the TS probe beam might mitigate SBS by perturbing the density distribution around the region overlapping withthe interaction beam.
基金funded by the National Natural Science Foundation of China(NSFC)under Grant No.11975056Science Challenge Project(SCP)No.TZ2016005。
文摘Extrapolation of implosion performance between different laser energy scales is investigated for indirect drive through a semi-hydroequivalent design.Since radiation transport is non-hydro-equivalent,the peak radiation temperature of the hohlraum and the ablation velocity of the capsule ablator are not scale-invariant when the sizes of the hohlraum and the capsule are scale-varied.A semi-hydro-equivalent design method that keeps the implosion velocity V_(i),adiabat α_(F),and P_(L)/R_(hc)^(2) (where P_(L) is the laser power and R_(hc) is the hohlraum and capsule scale length)scale-invariant,is proposed to create hydrodynamically similar implosions.The semi-hydro-equivalent design and the scaled implosion performance are investigated for the 100 kJ Laser Facility(100 kJ-scale)and the National Ignition Facility(NIF-scale)with about 2 MJ laser energy.It is found that the one-dimensional implosion performance is approximately hydro-equivalent when V_(i) and α_(F) are kept the same.Owing to the non-hydro-equivalent radiation transport,the yield-over-clean without α-particle heating(YOC_(noα))is slightly lower at 100 kJ-scale than at NIF-scale for the same scaled radiation asymmetry or the same initial perturbation of the hydrodynamic instability.The overall scaled two-dimensional implosion performance is slightly lower at 100 kJ-scale.The general Lawson criterion factor scales asχ_(noα) ^(2D)∼S^(1.06±0.04)(where S is the scale-variation factor)for the semi-hydro-equivalent implosion design with a moderate YOC_(noα).Our study indicates that χ_(noα)≈0.379 is the minimum requirement for the 100 kJ-scale implosion to demonstrate the ability to achieve marginal ignition at NIF-scale.
基金This work was supported by Tianjin Natural Science Foundation(No.21JCZDJC00750).
文摘This paper discussed the experimental results of the performance of an organic Rankine cycle(ORC)system with an ultra-low temperature heat source.The low boiling point working medium R134a was adopted in the system.The simulated heat source temperature(SHST)in this work was set from 39.51°C to 48.60°C by the simulated heat source module.The influence of load percentage of simulated heat source(LPSHS)between 50%and 70%,the rotary valve opening(RVO)between 20%and 100%,the resistive load between 36Ωand 180Ωor the no-load of the generator,as well as the autumn and winter ambient temperature on the system performance were studied.The results showed that the stability of the system was promoted when the generator had a resistive load.The power generation(PG)and generator speed(GS)of the system in autumn were better than in winter,but the expander pressure ratio(EPR)was lower than in winter.Keep RVO unchanged,the SHST,the mass flow rate(MFR)of the working medium,GS,and the PG of the system increased with the increasing of LPSHS for different generator resistance load values.When the RVO was 60%,LPSHS was 70%,the SHST was 44.15°C and the resistive load was 72Ω,the highest PG reached 15.11 W.Finally,a simulation formula was obtained for LPSHS,resistance load,and PG,and its correlation coefficient was between 0.9818 and 0.9901.The formula can accurately predict the PG.The experimental results showed that the standard deviation between the experimental and simulated values was below 0.0792,and the relative error was within±5%.
