Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravasc...Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravascular hypothermic groups (IVT) and traditional moderate hypothermia groups(HT) . Inclusion criteria included a Glasgow Coma Scale(GCS) score ≤8 and time from injury to admission must be within 12 hours.展开更多
Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well k...Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well know. The objective of this study is to examine whether hypothermia protects the spinal cord by preventing apoptosis of nerve cell and also investigate a possible mechanism involved in hypothermia neuroprotection. Cell apoptosis with necrosis was evident in the spinal cord 24 h after 30 min of ischemia. Moderate hypothermia decreased the incidence of apoptotic nerve cells. Both cell apoptosis and necrosis were attenuated by hypothermia. p53 expression increased and bcl-2 expression declined after ischemia, while hypothermia mitigated these changes. This study suggests that apoptosis contributes to cell death after spinal cord ischemia, and that moderate hypothermia can prevent nerve cell apoptosis by a mechanism associated with bcl-2 and p53 genes.展开更多
BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxyge...BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03± 1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.展开更多
The purpose of this work is to investigate the effect of moderate hypothermia on intercellular adhesion molecule-1 (ICAM-1) expression in lung tissue in a rat model of lipopolysaccharide-induced acute lung injury (ALI...The purpose of this work is to investigate the effect of moderate hypothermia on intercellular adhesion molecule-1 (ICAM-1) expression in lung tissue in a rat model of lipopolysaccharide-induced acute lung injury (ALI). A rat model of ALI was established by intratracheal instillation of lipopolysaccharide (1.5?mg/kg, 0.5?mL, LPS) 16?h after LPS (1.0? mg/kg ) intraperitoneal administration. Thirty-four male Sprague Dawley rats were randomly divided into 4 groups: control group, receiving saline only; LPS group, receiving LPS; hypothermia group, treated with hypothermia without receiving LPS; LPS+hypothermia group, treated with LPS and cooled to 32.5-33.0℃ when PaO 2/FiO 2 was below 300?mmHg. Hemodynamics and blood gases were recorded every hour. Rats were killed 4?h after ALI, and lungs were taken out for histology and for ICAM-1 immunohistostaining. A visual count of neutrophils per 10 high-power fields (10?hpf) was performed in 10 randomly selected fields per sample in a blinded fashion by light microscopy. PaO 2/FiO 2 was significantly decreased and PaCO 2 was increased in the LPS group as compared with their baseline values. Treatment with hypothermia inhibited the increase in PaCO 2 but had no effect on PaO 2/FiO 2 in the presence of LPS. It was demonstrated that light microscopy of lung samples of animals in the LPS group had significantly higher neutrophil counts when compared with those in the control group ( P <0.01), but moderate hypothermia significantly reduced the neutrophil counts ( P <0.01). In addition, hypothermia reduced the expression of ICAM-1 in lung tissues. Hypothermia significantly inhibits pulmonary neutrophil accumulation and ICAM-1 expression on vascular endothelial cells in the rat model of lipopolysaccharide-induced ALI, which attenuates the lung injuries.展开更多
Objective To investigate the role of moderate h.vpothennia in the lung inflammation of rat acute lung injury induced by lipopolysaccharide(LPS). Methods A rat model of acute lung injury (ALl) was established by in-tin...Objective To investigate the role of moderate h.vpothennia in the lung inflammation of rat acute lung injury induced by lipopolysaccharide(LPS). Methods A rat model of acute lung injury (ALl) was established by in-tin-tracheal instillation of lipopolysaccharide ( 1.5 mg/kg, 0.5 ml) at 16 h after LPS ( 1.0 mg/kg) intraperitoneal adrninis-tmtion. Thirty-four male Sprague Dawley rats were randomly divided into four groups: control group, receiving saline only;LPS group, receiving LPS; hypothennia group, treated with hypothennia without LPS; LPS + hypothennia group, treated with LPS and cooled to 32.5℃-33.0℃ as PaO2/FiO2. was below 300 mmHg. Hemodynamics and blood gases were record-ed every hour throughout the study. Rats were killed 4 h after ALl, and lung lavage was performed to measure the tumor ne-crosis factor α(TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) concentrations in bronchoalveolar lavage fluid (BALF) by using enzyme-linked immunosorbent assay (ELISA). Results PaO2/FiO2 was significantly decreased and PaCO2 was increased in the LPS group as compared to their baseline values( P＜0.01). Treatment with hypothermia inhib-ited the increase in PaCO2( P＜0.05) but had no effect on PaO2/FiO2 in the presence of LPS. The administration of LPS significantly increased the concentrations of TNF-α, IL-6 and IL-10 in BALF as compared to the control experiment( P＜0.05, P＜0.01 ). Moderate hypothermia reduced the expressions of TNF-α and IL-6 ( P＜0.01 ) but had no effect on the production of IL-10 ( P＞0.05). Conclusion Moderate hypothermia significantly inhibits proinflammatory cytokine ex-pressions in lipopolysaccharide-induced acute lung injury.展开更多
To investigate the effect of moderate hypothermia on respon ses of axonal cytoskeleton to axonal injury in the acute stage of injury. Methods: Of fifteen adult guinea pigs, twelve animals were subj ected to stretch in...To investigate the effect of moderate hypothermia on respon ses of axonal cytoskeleton to axonal injury in the acute stage of injury. Methods: Of fifteen adult guinea pigs, twelve animals were subj ected to stretch injury to the right optic nerves and divided into the normother mic group (n=6) in which the animals core temperature was maintained at 36.0 37.5℃ and the hypothermia group (n=6) in which the core temperature was red uced to 32.0 32.5℃ after stretch injury. Remaining three animals sustained no injury to the right optic nerves and served as control group. Half of injure d animals (n=3) of either normothermic group or hypothermic group were killed at either 2 hours or 4 hours after injury. The ultrastructural changes of axonal c ytoskeleton of the right optic nerve fibers from the animals were examined under a transmission electron microscope and analyzed by quantitative analysis with a computer image analysis system. Results: At 2 hours after stretch injury, there was a significa nt reduction in the mean number of microtubules (P< 0.001 ), and a significant increase in the mean intermicrotubule spacing (P< 0.05 or P< 0.01 ) in axons of all siz es in normothermic animals. The mean number of neurofilaments also decreased sta tistically (P< 0.01 ) in large and medium subgroups of a xons in the same experimental group at 2 hours. By 4 hours, the large subgroup o f axons in normothermic animals still demonstrated a significant decline in the mean number of microtubules (P< 0.01 ) and an increase i n the mean intermicrotubule spacing (P< 0.05 ), while th e medium and small subgroups of axons displayed a significant increase in the me an number of neurofilaments (P< 0.05 ) and reduction in the mean interneurofilament spacing (P< 0.05 ). On the c ontrary, either the mean number of microtubules and the mean intermicrotubule sp acing, or the mean number of neurofilaments and interneurofilament spacing in ax ons of all sizes in hypothermic stretch injured animals was not significant dif ferent from the mean values of sham operated animals. Conclusions: Posttraumatic moderate hypothermia induced immedia tely after axonal injury results in substantial protection of axonal cytoskeleto n and ameliorates axonal damage.展开更多
To explore the variant processes of cell apoptosis and the inhibiting effect of moderate hypothermia on cell apoptosis after diffuse brain injury. Methods: Models of diffuse brain injury were induced by the trauma dev...To explore the variant processes of cell apoptosis and the inhibiting effect of moderate hypothermia on cell apoptosis after diffuse brain injury. Methods: Models of diffuse brain injury were induced by the trauma device reported by Marmarou. 1 A total of 128 Wistar rats were divided into 4 groups: the uninjured group (Group A, n=8), the severely injured group (Group B, n=60), the mildly injured group (Group C, n=30) and the mild hypothermia group (Group D, n=30). In Group D, the severely injured rats were treated with moderate hypothermia to keep the rectal temperature at 32℃ (standard deviation for 0.1 ℃) for 6 hours. Then the morphosis, the characteristics and the quantity of apoptotic cells in the cerebral cortex and in the hippocampus regions after different severities of craniocerebral injuries were observed and compared under an electronic microscope, with terminal deoxynucleotidyl nick end labeling (TUNEL) in DNA fragmentation and with agarose gel electrophoresis. Results: TUNEL showed apoptotic cells increased according to the injury severity, and they peaked at 48 hours after injury and then declined. In Group C, apoptosis was located in the CA 2 and CA 3 areas of the hippocampus. And in Group B, apoptosis increased evidently, and located in the whole hippocampus and in the frontal and parietal cortex regions. The hypothermia treated rats had some apoptotic cells, too. However, even at 24, 48 and 72 hours after injury there were significantly fewer apoptotic cells in the cortex and in the hippocampus in Group D than that in the non treated groups. Electron microscopy showed that the apoptotic cells were round and shrunken in morphology and the nuclei were round and condensed at 24 and 48 hours after injury. And the apoptosis at 48 hours was more severe than that at 24 hours. The hypothermia treated rats had no apoptotic cells. Gel electrophoresis showed that characteristic DNA “ladders” were observed in the cortex and in the hippocampus at 48 hours after severe injury. But there was no DNA “ladder” at other time points in the severely injured group, in the mildly injured group and in the hypothermia treated group. Conclusions: It suggests that apoptosis occurs after diffuse brain injury and apoptotic cells increase with the injury severity. Moderate hypothermia has a specific inhibiting effect on cell apoptosis after diffuse brain injury in rats.展开更多
Objective: To evaluate the effect and safety of early moderate hypothermia therapy (MHT) on patients with head injury by using parallel control test. Methods: Thirty patients with severe head injury within 6 hours aft...Objective: To evaluate the effect and safety of early moderate hypothermia therapy (MHT) on patients with head injury by using parallel control test. Methods: Thirty patients with severe head injury within 6 hours after accidents were treated by MHT generally for 4 10 days. The other 30 patients with similar head injury treated routinely were enrolled for a parallel control test. The mortality, morbidity and changes of some neuro functional indexes as Glasgow Coma Scores, and Glasgow Outcome Scale, levels of endothelin and some other factors of neurobiochemistry in blood plasma were observed. Meanwhile, the dynamic monitoring by transcranial Doppler ultrasonography was conducted in these patients. Results: The mortality in MHT group was significantly lower than that in control group. MHT not only reduced endothelin but also increased the brain biochemical factors, which were helpful to the protection of neurons in the early brain ischemia after head injury. Conclusions: Early MHT can help reduce mortality and morbidity in patients with acute head injury.展开更多
The electrolyte integrated with lithium metal anodes is subjected to the issues of interfacial compatibility and stability,which strongly influence the performances of high-energy lithium metal batteries.Here,we repor...The electrolyte integrated with lithium metal anodes is subjected to the issues of interfacial compatibility and stability,which strongly influence the performances of high-energy lithium metal batteries.Here,we report a new electrolyte recipe viz.a moderately concentrated electrolyte comprising of 2.4 M lithium bis(fluorosulfonyl)imide(LiFSI)in a cosolvent mixture of fluorinated ethylene carbonate(FEC)and dimethyl carbonate(DMC)with relatively high ion conductivity.Owing to the preferential decomposition of LiFSI and FEC,an inorganic-rich interphase with abundant Li_(2)O and LiF nanocrystals is formed on lithium metal with improved robustness and ion transfer kinetics,enabling lithium plating/stripping with an extremely low overpotential of~8 mV and the average CE of 97%.When tested in Li||LiFePO_(4) cell,this electrolyte provides long-term cycling with a capacity retention of 98.3%after 1000 cycles at 1 C and an excellent rate performance of 20 C,as well as an areal capacity of 1.35 mA h cm^(-2)at the cathode areal loading of 9 mg cm^(-2).Moreover,the Li||LiFePO_(4) cell exhibits excellent wide-temperature performances(-40~60℃),including long-term cycling stability over 2600 cycles without visible capacity fading at 0℃,as well as extremely high average CEs of 99.6%and 99.8% over 400 cycles under-20℃ and 45℃.展开更多
Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on...Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .展开更多
Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriche...Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.展开更多
BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patien...BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.展开更多
Voltage scaling has been extensively used in industry for decades to reduce power consumption.In recent years,exploring digital circuit operation in moderate inversion has created an interest among researchers due to ...Voltage scaling has been extensively used in industry for decades to reduce power consumption.In recent years,exploring digital circuit operation in moderate inversion has created an interest among researchers due to its immense capability to provide a perfect tradeoff between high performance and low energy operation.But circuits operating in moderate inversion are susceptible to process variations and variability.To compute variability,statistical parameters such as the probability density function(PDF)and cumulative distribution function(CDF)are required.This paper presents an analytical model framework for delay calculations utilizing log skew normal distribution for ultradeep submicron technology nodes up to 22 nm.The CDF of the proposed model is utilized to calculate minimum and maximum delays with 3σ-accuracy providing better accuracy than the conventional methods.The obtained results are also compared with Monte Carlo simulations with errors lying within the acceptable range of 2%-4%.展开更多
The natural and economic conditions of agricultural resources vary greatly in China,especially in hilly and mountainous areas.The phenomenon of land fragmentation has become increasingly prominent,so that large-scale ...The natural and economic conditions of agricultural resources vary greatly in China,especially in hilly and mountainous areas.The phenomenon of land fragmentation has become increasingly prominent,so that large-scale operations cannot be fully achieved in a short period of time,and the centralized and continuous scale of operations cannot be realized in China.In addition,with increasingly strict farmland protection and agricultural land use control systems,the issues of nongrain production and nonagricultural cultivated land use have become increasingly restricted.Thus,it is quite necessary to determine the appropriate scale of operations and the means to achieve moderately scaled operations for the new business entities.On the basis of microsurvey data for 108 new citrus-planting business entities in the modern agricultural park in the Chongqing's Jiangjin District,an area with long citrus-planting history,we measured the moderate scale of new citrus-planting business entities to maximize profit using a translog growth model.According to the projection pursuit model,we evaluated the suitability conditions of citrus planting in garden land,woodland,grassland,and general cultivated land in the study area.We then explored the potential for new moderate-scale business entities within different farming radii.The results showed that large-scale planting conditions of citrus in garden land,forest land,grassland,and general cultivated land in the study area were suitable,and the proportion of high-suitable and mediumsuitable land was 73.42%.Under the existing social and economic conditions,the moderate scale of new citrus-planting business entities in the study area was 1.8–2.7 hm^(2).In particular,its rankings from large to small were agricultural enterprises(17.19–25.78 hm^(2)),farmer cooperatives(16.88–25.33 hm^(2)),big growers and breeders(6.39–9.59 hm^(2)),and family farms(5.02–7.53 hm^(2)).In the sample of 108 households,only 47.22%of the entities achieved moderate-scale operation,of which 25%of the entities achieved a scale greater than moderate operation.However,52.78%of the entities achieved a scale of less than moderate operation.These entities would have to transfer the surrounding adjacent garden land,forest land,grassland,or general cultivated land to achieve largescale land management.The land area of the adjacent gardens in a 1000 m farming radius could meet the moderate-scale operation demand of the vast majority of new business entities.For the vast majority of new business entities,the land area of the adjacent woodland,grassland,and general cultivated land could supplement the garden land to achieve moderate-scale operation in a 500 m farming radius.If the land area with moderate suitability and high suitability is prioritized,the land area in the adjacent gardens in the 1000 m farming radius could meet the moderate-scale operation demand for the vast majority of new business entities.Within the 500 m farming radius,the vast majority of new business entities have achieved moderate-scale operations if the land area adjacent to forest land,grassland,and general arable land was supplemented by gardens;however,a few entities could not achieve moderate-scale operations.From the village perspective,gardens were prioritized.Sixteen villages had planting areas and planting suitability that exceeded the average level of the study area,accounting for 23.53%.If combined with the reserve potential of the garden land,eight villages could improve their potential,accounting for 11.76%.Therefore,the conditions of large-scale citrus planting in the study area should be further improved,and the scale expansion of new citrus-planting business entities should receive additional scientific guidance.展开更多
文摘Objective To study difference between intravascular cooling system and traditional moderate hypothermia in patients with severe traumatic brain injury. Methods Eighty sTBI patients were randomly divided into intravascular hypothermic groups (IVT) and traditional moderate hypothermia groups(HT) . Inclusion criteria included a Glasgow Coma Scale(GCS) score ≤8 and time from injury to admission must be within 12 hours.
基金This work was supported in part by National Natural Science Foundation of China(90208011,30300174,30470856 and 30421005)National Basic Research Program(973 Program)(2002CB713802)Shanghai Key Project of Ba-sic Science Research(04DZ14005 and 04DZ05608).
文摘Paraplegia is a disastrous complication after operations of descending and thoracoabdominal aortic aneurysm. Re- gional hypothermia protects against spinal cord ischemia although the protective mechanism is not well know. The objective of this study is to examine whether hypothermia protects the spinal cord by preventing apoptosis of nerve cell and also investigate a possible mechanism involved in hypothermia neuroprotection. Cell apoptosis with necrosis was evident in the spinal cord 24 h after 30 min of ischemia. Moderate hypothermia decreased the incidence of apoptotic nerve cells. Both cell apoptosis and necrosis were attenuated by hypothermia. p53 expression increased and bcl-2 expression declined after ischemia, while hypothermia mitigated these changes. This study suggests that apoptosis contributes to cell death after spinal cord ischemia, and that moderate hypothermia can prevent nerve cell apoptosis by a mechanism associated with bcl-2 and p53 genes.
文摘BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03± 1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.
基金This work was supported by Jiangsu Province Education Ministry (No.K2096)
文摘The purpose of this work is to investigate the effect of moderate hypothermia on intercellular adhesion molecule-1 (ICAM-1) expression in lung tissue in a rat model of lipopolysaccharide-induced acute lung injury (ALI). A rat model of ALI was established by intratracheal instillation of lipopolysaccharide (1.5?mg/kg, 0.5?mL, LPS) 16?h after LPS (1.0? mg/kg ) intraperitoneal administration. Thirty-four male Sprague Dawley rats were randomly divided into 4 groups: control group, receiving saline only; LPS group, receiving LPS; hypothermia group, treated with hypothermia without receiving LPS; LPS+hypothermia group, treated with LPS and cooled to 32.5-33.0℃ when PaO 2/FiO 2 was below 300?mmHg. Hemodynamics and blood gases were recorded every hour. Rats were killed 4?h after ALI, and lungs were taken out for histology and for ICAM-1 immunohistostaining. A visual count of neutrophils per 10 high-power fields (10?hpf) was performed in 10 randomly selected fields per sample in a blinded fashion by light microscopy. PaO 2/FiO 2 was significantly decreased and PaCO 2 was increased in the LPS group as compared with their baseline values. Treatment with hypothermia inhibited the increase in PaCO 2 but had no effect on PaO 2/FiO 2 in the presence of LPS. It was demonstrated that light microscopy of lung samples of animals in the LPS group had significantly higher neutrophil counts when compared with those in the control group ( P <0.01), but moderate hypothermia significantly reduced the neutrophil counts ( P <0.01). In addition, hypothermia reduced the expression of ICAM-1 in lung tissues. Hypothermia significantly inhibits pulmonary neutrophil accumulation and ICAM-1 expression on vascular endothelial cells in the rat model of lipopolysaccharide-induced ALI, which attenuates the lung injuries.
文摘Objective To investigate the role of moderate h.vpothennia in the lung inflammation of rat acute lung injury induced by lipopolysaccharide(LPS). Methods A rat model of acute lung injury (ALl) was established by in-tin-tracheal instillation of lipopolysaccharide ( 1.5 mg/kg, 0.5 ml) at 16 h after LPS ( 1.0 mg/kg) intraperitoneal adrninis-tmtion. Thirty-four male Sprague Dawley rats were randomly divided into four groups: control group, receiving saline only;LPS group, receiving LPS; hypothennia group, treated with hypothennia without LPS; LPS + hypothennia group, treated with LPS and cooled to 32.5℃-33.0℃ as PaO2/FiO2. was below 300 mmHg. Hemodynamics and blood gases were record-ed every hour throughout the study. Rats were killed 4 h after ALl, and lung lavage was performed to measure the tumor ne-crosis factor α(TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10) concentrations in bronchoalveolar lavage fluid (BALF) by using enzyme-linked immunosorbent assay (ELISA). Results PaO2/FiO2 was significantly decreased and PaCO2 was increased in the LPS group as compared to their baseline values( P＜0.01). Treatment with hypothermia inhib-ited the increase in PaCO2( P＜0.05) but had no effect on PaO2/FiO2 in the presence of LPS. The administration of LPS significantly increased the concentrations of TNF-α, IL-6 and IL-10 in BALF as compared to the control experiment( P＜0.05, P＜0.01 ). Moderate hypothermia reduced the expressions of TNF-α and IL-6 ( P＜0.01 ) but had no effect on the production of IL-10 ( P＞0.05). Conclusion Moderate hypothermia significantly inhibits proinflammatory cytokine ex-pressions in lipopolysaccharide-induced acute lung injury.
文摘To investigate the effect of moderate hypothermia on respon ses of axonal cytoskeleton to axonal injury in the acute stage of injury. Methods: Of fifteen adult guinea pigs, twelve animals were subj ected to stretch injury to the right optic nerves and divided into the normother mic group (n=6) in which the animals core temperature was maintained at 36.0 37.5℃ and the hypothermia group (n=6) in which the core temperature was red uced to 32.0 32.5℃ after stretch injury. Remaining three animals sustained no injury to the right optic nerves and served as control group. Half of injure d animals (n=3) of either normothermic group or hypothermic group were killed at either 2 hours or 4 hours after injury. The ultrastructural changes of axonal c ytoskeleton of the right optic nerve fibers from the animals were examined under a transmission electron microscope and analyzed by quantitative analysis with a computer image analysis system. Results: At 2 hours after stretch injury, there was a significa nt reduction in the mean number of microtubules (P< 0.001 ), and a significant increase in the mean intermicrotubule spacing (P< 0.05 or P< 0.01 ) in axons of all siz es in normothermic animals. The mean number of neurofilaments also decreased sta tistically (P< 0.01 ) in large and medium subgroups of a xons in the same experimental group at 2 hours. By 4 hours, the large subgroup o f axons in normothermic animals still demonstrated a significant decline in the mean number of microtubules (P< 0.01 ) and an increase i n the mean intermicrotubule spacing (P< 0.05 ), while th e medium and small subgroups of axons displayed a significant increase in the me an number of neurofilaments (P< 0.05 ) and reduction in the mean interneurofilament spacing (P< 0.05 ). On the c ontrary, either the mean number of microtubules and the mean intermicrotubule sp acing, or the mean number of neurofilaments and interneurofilament spacing in ax ons of all sizes in hypothermic stretch injured animals was not significant dif ferent from the mean values of sham operated animals. Conclusions: Posttraumatic moderate hypothermia induced immedia tely after axonal injury results in substantial protection of axonal cytoskeleto n and ameliorates axonal damage.
文摘To explore the variant processes of cell apoptosis and the inhibiting effect of moderate hypothermia on cell apoptosis after diffuse brain injury. Methods: Models of diffuse brain injury were induced by the trauma device reported by Marmarou. 1 A total of 128 Wistar rats were divided into 4 groups: the uninjured group (Group A, n=8), the severely injured group (Group B, n=60), the mildly injured group (Group C, n=30) and the mild hypothermia group (Group D, n=30). In Group D, the severely injured rats were treated with moderate hypothermia to keep the rectal temperature at 32℃ (standard deviation for 0.1 ℃) for 6 hours. Then the morphosis, the characteristics and the quantity of apoptotic cells in the cerebral cortex and in the hippocampus regions after different severities of craniocerebral injuries were observed and compared under an electronic microscope, with terminal deoxynucleotidyl nick end labeling (TUNEL) in DNA fragmentation and with agarose gel electrophoresis. Results: TUNEL showed apoptotic cells increased according to the injury severity, and they peaked at 48 hours after injury and then declined. In Group C, apoptosis was located in the CA 2 and CA 3 areas of the hippocampus. And in Group B, apoptosis increased evidently, and located in the whole hippocampus and in the frontal and parietal cortex regions. The hypothermia treated rats had some apoptotic cells, too. However, even at 24, 48 and 72 hours after injury there were significantly fewer apoptotic cells in the cortex and in the hippocampus in Group D than that in the non treated groups. Electron microscopy showed that the apoptotic cells were round and shrunken in morphology and the nuclei were round and condensed at 24 and 48 hours after injury. And the apoptosis at 48 hours was more severe than that at 24 hours. The hypothermia treated rats had no apoptotic cells. Gel electrophoresis showed that characteristic DNA “ladders” were observed in the cortex and in the hippocampus at 48 hours after severe injury. But there was no DNA “ladder” at other time points in the severely injured group, in the mildly injured group and in the hypothermia treated group. Conclusions: It suggests that apoptosis occurs after diffuse brain injury and apoptotic cells increase with the injury severity. Moderate hypothermia has a specific inhibiting effect on cell apoptosis after diffuse brain injury in rats.
文摘Objective: To evaluate the effect and safety of early moderate hypothermia therapy (MHT) on patients with head injury by using parallel control test. Methods: Thirty patients with severe head injury within 6 hours after accidents were treated by MHT generally for 4 10 days. The other 30 patients with similar head injury treated routinely were enrolled for a parallel control test. The mortality, morbidity and changes of some neuro functional indexes as Glasgow Coma Scores, and Glasgow Outcome Scale, levels of endothelin and some other factors of neurobiochemistry in blood plasma were observed. Meanwhile, the dynamic monitoring by transcranial Doppler ultrasonography was conducted in these patients. Results: The mortality in MHT group was significantly lower than that in control group. MHT not only reduced endothelin but also increased the brain biochemical factors, which were helpful to the protection of neurons in the early brain ischemia after head injury. Conclusions: Early MHT can help reduce mortality and morbidity in patients with acute head injury.
基金the Innovation-Driven Project of Central South University(2019CX033)the National Natural Science Foundation of China(51904344 and 52172264)the Natural Science Foundation of Hunan Province of China(2021JJ10060 and 2022GK2033)。
文摘The electrolyte integrated with lithium metal anodes is subjected to the issues of interfacial compatibility and stability,which strongly influence the performances of high-energy lithium metal batteries.Here,we report a new electrolyte recipe viz.a moderately concentrated electrolyte comprising of 2.4 M lithium bis(fluorosulfonyl)imide(LiFSI)in a cosolvent mixture of fluorinated ethylene carbonate(FEC)and dimethyl carbonate(DMC)with relatively high ion conductivity.Owing to the preferential decomposition of LiFSI and FEC,an inorganic-rich interphase with abundant Li_(2)O and LiF nanocrystals is formed on lithium metal with improved robustness and ion transfer kinetics,enabling lithium plating/stripping with an extremely low overpotential of~8 mV and the average CE of 97%.When tested in Li||LiFePO_(4) cell,this electrolyte provides long-term cycling with a capacity retention of 98.3%after 1000 cycles at 1 C and an excellent rate performance of 20 C,as well as an areal capacity of 1.35 mA h cm^(-2)at the cathode areal loading of 9 mg cm^(-2).Moreover,the Li||LiFePO_(4) cell exhibits excellent wide-temperature performances(-40~60℃),including long-term cycling stability over 2600 cycles without visible capacity fading at 0℃,as well as extremely high average CEs of 99.6%and 99.8% over 400 cycles under-20℃ and 45℃.
文摘Background: Moderate to severe hypoxic-ischemic encephalopathy (HIE) in neonates is often treated with hypothermia. However, some neonates may experience epileptic seizures during therapeutic hypothermia (TH). Data on the electrophysiologic and evolutionary aspects of these seizures are scarce in African countries. Objectives: To determine the types of epileptic seizures caused by HIE in neonates in Brazzaville;to describe the evolution of background EEG activities during TH and rewarming;to report the evolution of epileptic seizures. Methods: This was a cross-sectional, descriptive study conducted from January 2020 to July 2022. It took place in Brazzaville in the Neonatology Department of the Blanche Gomez Mother and Child Hospital. It focused on term neonates suffering from moderate or severe HIE. They were treated with hypothermia combined with phenobarbital for 72 hours. Results: Among 36 neonates meeting inclusion criteria, there were 18 boys and 18 girls. Thirty-one (86.1%) neonates had grade 2 and 5 (13.9%) grade 3 HIE. In our neonates, HIE had induced isolated electrographic seizures (n = 11;30.6%), electroclinical seizures (n = 25;69.4%), and 6 types of background EEG activity. During TH and rewarming, there were 52.8% of patients with improved background EEG activity, 41.7% of patients with unchanged background EEG activity, and 5.5% of patients with worsened background EEG activity. At the end of rewarming, only 9 (25%) patients still had seizures. Conclusion: Isolated electrographic and electroclinical seizures are the only pathological entities found in our studied population. In neonates with moderate HIE, the applied therapeutic strategy positively influences the evolution of both seizures and background EEG activity. On the other hand, in neonates with severe HIE, the same therapeutic strategy is ineffective. .
文摘Introduction: In Chad, malnutrition is a silent emergency. Yet the use of local products in the fight against malnutrition is essential. The purpose of this study was to compare the efficacy of locally sourced enriched flour in the recovery of children 6 to 59 months of moderate acute malnourishment compared to Ready-to-Use Therapeutic Foods (Plumpy’ Sup) in the city of Abéché-Chad. Methodology: This study took place from 1 October 2021 to 31 January 2022 in the city of Abéché, capital of the province of Ouaddaï. It was conducted in eight (8) urban health centers in the city of Abéché and concerned eighty (80) children with moderate acute malnutrition. It was based on a consumption assessment of two complementary foods by two groups of children. The assessment of nutritional status was made through anthropometric data such as weight, height and brachial perimeter. Results: All 80 children were tested for moderate acute malnutrition. Two complementary foods have been used which are locally produced flour and the Ready-to-Use Therapeutic Food. The study showed that the group 1 who consumed the locally produced flour had an average weight gain of 1100 g and the group 2 who consumed the Plumpy sup had an average weight gain of 400 g. Conclusion: The present study carried out in Abéché allowed us to compare the effectiveness of locally produced weaning flours with Ready-to-Use Therapeutic Foods on moderate malnourished child weight growth in the nutritional units of the town of Abéché.
基金The study was approved by the Institutional review board of The Affiliated Hospital of Southwest Medical University,No.KY2023184.
文摘BACKGROUND Perioperative hypothermia(PH)negatively affects the physical and mental health of patients to varying degrees.Currently,there is no effective multidisciplinary team(MDT)intervention for gynecological patients with PH.AIM To apply the best evidence on the prevention and management of PH in gynecological patients,improve the quality of perioperative evidence-based care based on treatment by an MDT for gynecological patients and analyze the effect of MDT-and evidence-based practice(EBP)projects on the psychological status and cognitive function of gynecological patients with PH.METHODS Under the guidance of knowledge translation and combined with the opinions of involved stakeholders and clinical experts,the best evidence for PH prevention and management in gynecological patients was selected and adjusted to suit the practice setting.Based on the evidence,the practice plan was developed,and the MDT intervention was carried out in the preoperative ward,the preoperative preparation room,the intraoperative operating room,the postanesthesia care unit,and the 24-hour postoperative gynecological ward through the EBP program.The incidence of hypothermia,the nurses’awareness,the implementation rate of examination indicators,and the thermal comfort level,psychological status and cognitive function of patients were compared before and after the implementation of the program.RESULTS The incidence of PH in gynecological patients decreased from 43.33%to 13.33%after the implementation of the scheme.The implementation rate of examination indicators 6-10,12,14,16-18,21,and 22 reached 100%,and that of other indicators was above 90%,except for examination indicators 5 and 13,which was 66.67%;the indices were significantly improved compared with the baseline(before evidence application)(P<0.05).The score of nurses'awareness of PH prevention and management in gynecological patients increased from 60.96±9.70 to 88.08±8.96,and the difference was statistically significant(P<0.001).The total score of the perioperative thermal comfort level of patients undergoing gynecological surgery was 27.97±2.04,which was significantly increased compared with the score of 21.27±1.57 observed by researchers at baseline(P<0.001).The perioperative Hamilton Depression Scale and Hamilton Anxiety Scale scores of patients undergoing gynecological surgery decreased from 15.03±3.16 and 13.93±2.64 to 4.30±1.15 and 3.53±0.78,respectively,with statistically significant differences(P<0.001).The perioperative Montreal Cognitive Assessment Scale score of the gynecological surgery patients increased from 23.17±1.68 to 26.93±1.11,also with statistical significance(P<0.001).CONCLUSION MDT-based EBP for PH prevention and management in gynecological patients during the perioperative period can standardize nursing operations,improve nurses'awareness and behavioral compliance with gynecological hypothermia management,and reduce the occurrence of PH in gynecological patients while playing a positive role in reducing patients’negative emotions and enhancing their cognitive function.
文摘Voltage scaling has been extensively used in industry for decades to reduce power consumption.In recent years,exploring digital circuit operation in moderate inversion has created an interest among researchers due to its immense capability to provide a perfect tradeoff between high performance and low energy operation.But circuits operating in moderate inversion are susceptible to process variations and variability.To compute variability,statistical parameters such as the probability density function(PDF)and cumulative distribution function(CDF)are required.This paper presents an analytical model framework for delay calculations utilizing log skew normal distribution for ultradeep submicron technology nodes up to 22 nm.The CDF of the proposed model is utilized to calculate minimum and maximum delays with 3σ-accuracy providing better accuracy than the conventional methods.The obtained results are also compared with Monte Carlo simulations with errors lying within the acceptable range of 2%-4%.
基金supported by National Natural Science Foundation of China(No.41971244)National Natural Science Foundation of China(No.41501104)Natural Science Foundation of Chongqing Municipal Science and Technology Commission(cstc2021jcyj-msxm X0696)。
文摘The natural and economic conditions of agricultural resources vary greatly in China,especially in hilly and mountainous areas.The phenomenon of land fragmentation has become increasingly prominent,so that large-scale operations cannot be fully achieved in a short period of time,and the centralized and continuous scale of operations cannot be realized in China.In addition,with increasingly strict farmland protection and agricultural land use control systems,the issues of nongrain production and nonagricultural cultivated land use have become increasingly restricted.Thus,it is quite necessary to determine the appropriate scale of operations and the means to achieve moderately scaled operations for the new business entities.On the basis of microsurvey data for 108 new citrus-planting business entities in the modern agricultural park in the Chongqing's Jiangjin District,an area with long citrus-planting history,we measured the moderate scale of new citrus-planting business entities to maximize profit using a translog growth model.According to the projection pursuit model,we evaluated the suitability conditions of citrus planting in garden land,woodland,grassland,and general cultivated land in the study area.We then explored the potential for new moderate-scale business entities within different farming radii.The results showed that large-scale planting conditions of citrus in garden land,forest land,grassland,and general cultivated land in the study area were suitable,and the proportion of high-suitable and mediumsuitable land was 73.42%.Under the existing social and economic conditions,the moderate scale of new citrus-planting business entities in the study area was 1.8–2.7 hm^(2).In particular,its rankings from large to small were agricultural enterprises(17.19–25.78 hm^(2)),farmer cooperatives(16.88–25.33 hm^(2)),big growers and breeders(6.39–9.59 hm^(2)),and family farms(5.02–7.53 hm^(2)).In the sample of 108 households,only 47.22%of the entities achieved moderate-scale operation,of which 25%of the entities achieved a scale greater than moderate operation.However,52.78%of the entities achieved a scale of less than moderate operation.These entities would have to transfer the surrounding adjacent garden land,forest land,grassland,or general cultivated land to achieve largescale land management.The land area of the adjacent gardens in a 1000 m farming radius could meet the moderate-scale operation demand of the vast majority of new business entities.For the vast majority of new business entities,the land area of the adjacent woodland,grassland,and general cultivated land could supplement the garden land to achieve moderate-scale operation in a 500 m farming radius.If the land area with moderate suitability and high suitability is prioritized,the land area in the adjacent gardens in the 1000 m farming radius could meet the moderate-scale operation demand for the vast majority of new business entities.Within the 500 m farming radius,the vast majority of new business entities have achieved moderate-scale operations if the land area adjacent to forest land,grassland,and general arable land was supplemented by gardens;however,a few entities could not achieve moderate-scale operations.From the village perspective,gardens were prioritized.Sixteen villages had planting areas and planting suitability that exceeded the average level of the study area,accounting for 23.53%.If combined with the reserve potential of the garden land,eight villages could improve their potential,accounting for 11.76%.Therefore,the conditions of large-scale citrus planting in the study area should be further improved,and the scale expansion of new citrus-planting business entities should receive additional scientific guidance.
