针对县域水利工程全生命周期过程档案不全、无法实现闭环管理的难题,通过数据仓库、数据接口、一码通管理等技术的研发应用实现闭环管理,并在苍南县进行了应用。县域水利工程数字档案馆采用NoSQL和MPP NewSQL相结合的方法建设数据仓,以...针对县域水利工程全生命周期过程档案不全、无法实现闭环管理的难题,通过数据仓库、数据接口、一码通管理等技术的研发应用实现闭环管理,并在苍南县进行了应用。县域水利工程数字档案馆采用NoSQL和MPP NewSQL相结合的方法建设数据仓,以解决数字档案馆的多元化数据存储问题;采用API和XML Web Service接口融合方法,解决了内部局域网系统和外部其他云系统的接口对接问题;开发了基于工作流引擎技术的SPARK分布式组件库,实现了水利局各个科室的业务协同与数据共享;采用一码通三色督查技术建立了三阶段数字档案健康评价指标体系,实现了“绿、黄、红”一码督查的管理档案;采用全链透析档案串并联技术,实现了水利工程整个全生命周期过程的数据分析。展开更多
As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the time...As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the times.From the perspective of narratology,this paper considers that the writer uses narrative techniques such as non-linear narration and embedded structure to express multi-level narrative voices through a first-person narrator,Sheona.These narrative techniques help to fully reflect the theme of the work and endow the work with great aesthetic and ideological value.展开更多
Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes...Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.展开更多
Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN m...Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.展开更多
文摘针对县域水利工程全生命周期过程档案不全、无法实现闭环管理的难题,通过数据仓库、数据接口、一码通管理等技术的研发应用实现闭环管理,并在苍南县进行了应用。县域水利工程数字档案馆采用NoSQL和MPP NewSQL相结合的方法建设数据仓,以解决数字档案馆的多元化数据存储问题;采用API和XML Web Service接口融合方法,解决了内部局域网系统和外部其他云系统的接口对接问题;开发了基于工作流引擎技术的SPARK分布式组件库,实现了水利局各个科室的业务协同与数据共享;采用一码通三色督查技术建立了三阶段数字档案健康评价指标体系,实现了“绿、黄、红”一码督查的管理档案;采用全链透析档案串并联技术,实现了水利工程整个全生命周期过程的数据分析。
文摘As the opening work of“Fishing the Sloe-Black River Stories,”Irish-American writer Colum McCann’s short story“Sisters”has attracted scholars’interest with its profuse historical background and themes of the times.From the perspective of narratology,this paper considers that the writer uses narrative techniques such as non-linear narration and embedded structure to express multi-level narrative voices through a first-person narrator,Sheona.These narrative techniques help to fully reflect the theme of the work and endow the work with great aesthetic and ideological value.
基金supported by grants from the National Natural Science Foundation of China (82070665 and 81900592)
文摘Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.
文摘Approximately 20%-30%of patients with acute necrotizing pancreatitis develop infected pancreatic necrosis(IPN),a highly morbid and potentially lethal complication.Early identification of patients at high risk of IPN may facilitate appropriate preventive measures to improve clinical outcomes.In the past two decades,several markers and predictive tools have been proposed and evaluated for this purpose.Conventional biomarkers like C-reactive protein,procalcitonin,lymphocyte count,interleukin-6,and interleukin-8,and newly developed biomarkers like angiopoietin-2 all showed significant association with IPN.On the other hand,scoring systems like the Acute Physiology and Chronic Health Evaluation II and Pancreatitis Activity Scoring System have also been tested,and the results showed that they may provide better accuracy.For early prevention of IPN,several new therapies were tested,including early enteral nutrition,anti-biotics,probiotics,immune enhancement,etc.,but the results varied.Taken together,several evidence-supported predictive markers and scoring systems are readily available for predicting IPN.However,effective treatments to reduce the incidence of IPN are still lacking apart from early enteral nutrition.In this editorial,we summarize evidence concerning early prediction and prevention of IPN,providing insights into future practice and study design.A more homo-geneous patient population with reliable risk-stratification tools may help find effective treatments to reduce the risk of IPN,thereby achieving individualized treatment.
