Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-...Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.展开更多
BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria...BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.展开更多
Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve...Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve the expected economy.This paper constructs an operating simulation model of the park power grid operation considering demand response and proposes a multi-time scale operating simulation method that combines day-ahead optimization and model predictive control(MPC).In the day-ahead stage,an operating simulation plan that comprehensively considers the user’s side comfort and operating costs is proposed with a long-term time scale of 15 min.In order to cope with power fluctuations of photovoltaic,wind turbine and conventional load,MPC is used to track and roll correct the day-ahead operating simulation plan in the intra-day stage to meet the actual operating operation status of the park.Finally,the validity and economy of the operating simulation strategy are verified through the analysis of arithmetic examples.展开更多
Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for f...Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for fractured shale gas reservoirs is established,the optimization method of refracturing timing is proposed,and the influencing factors of refracturing timing are analyzed based on the data from shale gas well in Fuling of Sichuan Basin.The results show that due to the depletion of formation pressure,the percentage of the maximum horizontal principal stress reversal area in the total area increases and then decreases with time.The closer the area is to the hydraulic fracture,the shorter the time for the peak of the stress reversal area percentage curve to appear,and the shorter the time for the final zero return(to the initial state).The optimum time of refracturing is affected by matrix permeability,initial stress difference and natural fracture approach angle.The larger the matrix permeability and initial stress difference is,the shorter the time for stress reversal area percentage curve to reach peak and return to the initial state,and the earlier the time to take refracturing measures.The larger the natural fracture approach angle is,the more difficult it is for stress reversal to occur near the fracture,and the earlier the optimum refracturing time is.The more likely the stress reversal occurs at the far end of the artificial fracture,the later the optimal time of refracturing is.Reservoirs with low matrix permeability have a rapid decrease in single well productivity.To ensure economic efficiency,measures such as shut-in or gas injection can be taken to restore the stress,and refracturing can be implemented in advance.展开更多
BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to e...BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.展开更多
We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data ...We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975.展开更多
BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abd...BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.展开更多
This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather event...This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather events,and movement of tectonic plates.The proposed system is based on the Internet of Things and artificial intelligence identification technology.The monitoring system will cover various aspects of tunnel operations,such as the slope of the entrance,the structural safety of the cave body,toxic and harmful gases that may appear during operation,excessively high and low-temperature humidity,poor illumination,water leakage or road water accumulation caused by extreme weather,combustion and smoke caused by fires,and more.The system will enable comprehensive monitoring and early warning of fire protection systems,accident vehicles,and overheating vehicles.This will effectively improve safety during tunnel operation.展开更多
Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided...Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complic...BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complications such as bleeding and perforation,and the operation time is also longer.ESD operation time is closely related to bleeding and perforation.AIM To investigate the influencing factors associated with ESD operation time and postoperative delayed hemorrhage to provide a reference for early planning,early identification,and prevention of complications.METHODS We conducted a retrospective study based on the clinical data of 520 patients with early gastric cancer in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021.The baseline data,clinical features,and endoscopic and pathological characteristics of patients were collected.The multivariate linear regression model was used to investigate the influencing factors of ESD operation time.Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.RESULTS The multivariate analysis of ESD operation time showed that the maximum lesion diameter could affect 8.815%of ESD operation time when other influencing factors remained unchanged.The operation time increased by 3.766%or 10.247%if the lesion was mixed or concave.The operation time increased by 4.417%if combined with an ulcer or scar.The operation time increased by 3.692%if combined with perforation.If infiltrated into the submucosa,it increased by 2.536%.Multivariate analysis of delayed hemorrhage after ESD showed that the maximum diameter of the lesion,lesion morphology,and ESD operation time were independent influencing factors for delayed hemorrhage after ESD.Patients with lesion≥3.0 cm(OR=3.785,95%CI:1.165-4.277),lesion morphology-concave(OR=10.985,95%CI:2.133-35.381),and ESD operation time≥60 min(OR=2.958,95%CI:1.117-3.526)were prone to delayed hemorrhage after ESD.CONCLUSION If the maximum diameter of the lesion in patients with early gastric cancer is≥3.0 cm,and the shape of the lesion is concave,or accompanied by an ulcer or scar,combined with perforation,and infiltrates into the submucosa,the ESD operation will take a longer time.When the maximum diameter of the lesion is≥3.0 cm,the shape of the lesion is concave in patients and the operation time of ESD takes longer time,the risk of delayed hemorrhage after ESD is higher.展开更多
This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Tw...This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.展开更多
Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy o...Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.展开更多
This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure o...This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure of power systems under the integration of renewable energy. First, a linear model for the optimal operation of the HESS is established, which considers the different power-efficiency characteristics of the pumped storage system, electrochemical storage system, and a new type of liquid compressed air energy storage. Second, a TSOS simulation model for peak shaving is built to maximize the power entering the grid from the wind farms and HESS. Based on the proposed model, this study considers the transmission capacity of a TG. By adding the power-flow constraints of the TG, a TSOS-based HESS and TG combination model for peak shaving is established. Finally, the improved IEEE-39 and IEEE-118 bus systems were considered as examples to verify the effectiveness and feasibility of the proposed model.展开更多
With the rapid development of informatization,autonomy and intelligence,unmanned swarm formation intelligent operations will become the main combat mode of future wars.Typical unmanned swarm formations such as ground-...With the rapid development of informatization,autonomy and intelligence,unmanned swarm formation intelligent operations will become the main combat mode of future wars.Typical unmanned swarm formations such as ground-based directed energy weapon formations,space-based kinetic energy weapon formations,and sea-based carrier-based formations have become the trump card for winning future wars.In a complex confrontation environment,these sophisticated weapon formation systems can precisely strike mobile threat group targets,making them extreme deterrents in joint combat applications.Based on this,first,this paper provides a comprehensive summary of the outstanding advantages,strategic position and combat style of unmanned clusters in joint warfare to highlight their important position in future warfare.Second,a detailed analysis of the technological breakthroughs in four key areas,situational awareness,heterogeneous coordination,mixed combat,and intelligent assessment of typical unmanned aerial vehicle(UAV)swarms in joint warfare,is presented.An in-depth analysis of the UAV swarm communication networking operating mechanism during joint warfare is provided to lay the theoretical foundation for subsequent cooperative tracking and control.Then,an indepth analysis of the shut-in technology requirements of UAV clusters in joint warfare is provided to lay a theoretical foundation for subsequent cooperative tracking control.Finally,the technical requirements of UAV clusters in joint warfare are analysed in depth so the key technologies can form a closed-loop kill chain system and provide theoretical references for the study of intelligent command operations.展开更多
Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no othe...Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no other identifiable cause)stroke.The traditional approach has been to use a fluoroscopically guided blocking device,but this is contraindicated in patients with severe allergies to contrast media or inability to undergo angiography.With the advancements in technology,ultrasonic robotic systems have become available for medical procedures.In the current study,we reported a case of using the ultrasonic robotic teleoperation system to achieve closure of PFO at the Chinese PLA General Hospital,Beijing,China.展开更多
The Red-Thai Binh River system is an important water resource to the Northern Delta, serving the development of agriculture, people’s livelihood and other economic sectors through its upstream reservoirs and a system...The Red-Thai Binh River system is an important water resource to the Northern Delta, serving the development of agriculture, people’s livelihood and other economic sectors through its upstream reservoirs and a system of water abstraction works along the rivers. However, due to the impact of climate change and pressure from socio-economic development, the operation of the reservoir system according to Decision No. 740/QD-TTg was issued on June 17, 2019 by the Prime Minister of Government promulgating the Red-Thai Binh River system inter-reservoir operation rules (Operation rules 740) has some shortcomings that need adjustments for higher water use efficiency, meeting downstream water demand and power generation benefits. Through the results of water balance calculation and analysis of economic benefits from water use scenarios, this research proposed adjustment to the inter-reservoir operation during dry season in the Red River system. The result showed that an average water level of 1.0 - 1.7 m should be maintained at Hanoi during the increased release period.展开更多
Ergonomic reliability plays a significant role in the safe operation of devices.With the spread of infectious diseases around the world,in work environments with high loads and high infection rates,medical staff work ...Ergonomic reliability plays a significant role in the safe operation of devices.With the spread of infectious diseases around the world,in work environments with high loads and high infection rates,medical staff work in a state of high self-protection.The use of visual display terminal(VDT)for medical equipment has undergone fundamental changes,and the traditional medical equipment human-machine interface design needs to be improved.After the completion of design and development,a VDT design enters the experimental testing stage,which has significant limitations for simulating the work of medical staff in the high-load and high-infection environments.The testing cost is high,and subjects face harsh conditions;thus,an ergonomic reliability model that can predict the use of VDT in such special high-infection and high-load circumstances must be established.An ergonomic reliability model based on an improved backpropagation neural network(BPNN)and human cognition reliability(HCR)is proposed for predicting and evaluating operation flows according tomedical equipment VDTs.Firstly,a small data sample can be used to train BPNN to generate a network that can ensure suitable accuracy.To prevent the model from falling into local optimal solutions,the bat algorithm is introduced to improve the BPNN.Compared to a traditional BPNN,the superiority of the improved BPNN is clearly demonstrated.Secondly,the HCR method is used to analyze and highlight changes in the human factor reliability of VDTs for medical equipment in different time processes and operating processes according to BPNN prediction results,to provide a reference for selecting the optimalmethod.Finally,the validity and availability of the proposedmethod are verified through an eye tracker experiment and statistical analysis results.展开更多
Pipelines are widely used for transporting oil resources in the context of offshore oil exploitation.The pipeline stress-strength analysis is an important stage in related design and ensuing construction techniques.In...Pipelines are widely used for transporting oil resources in the context of offshore oil exploitation.The pipeline stress-strength analysis is an important stage in related design and ensuing construction techniques.In this study,assuming representative work environment parameters,pipeline lifting operations are investigated numerically.More specifically,a time-domain coupled dynamic analysis method is used to conduct a hydrodynamic analysis under different current velocities and wave heights.The results show that proper operation requires the lifting points are reasonably set in combination with the length of the pipeline and the position of the lifting device on the construction ship.The impact of waves on the pipeline is limited,however lifting operations under strong wind and waves should be avoided as far as possible.展开更多
Experimental and theoretical studies have reported that the precise firing of neurons is crucial for sensory representation.Autapse serves as a special synapse connecting neuron and itself,which has also been found to...Experimental and theoretical studies have reported that the precise firing of neurons is crucial for sensory representation.Autapse serves as a special synapse connecting neuron and itself,which has also been found to improve the accuracy of neuronal response.In current work,the effect of autaptic delay signal on the spike-timing precision is investigated on a single autaptic Hodgkin–Huxley neuron in the present of noise.The simulation results show that both excitatory and inhibitory autaptic signals can effectively adjust the precise spike time of neurons with noise by choosing the appropriate coupling strength g and time delay of autaptic signalτ.The g–τparameter space is divided into two regions:one is the region where the spike-timing precision is effectively regulated;the other is the region where the neuronal firing is almost not regulated.For the excitatory and inhibitory autapse,the range of parameters causing the accuracy of neuronal firing is different.Moreover,it is also found that the mechanisms of the spike-timing precision regulation are different for the two kinds of autaptic signals.展开更多
基金supported by the National Natural Science Foundation of China(82374493).
文摘Objective:To investigate the clinical efficacy and safety of percutaneous kyphoplasty at different surgical timings in the treatment of osteoporotic vertebral compression fracture(OVCF)based on the theory of“dynamic-static integration”.Methods:Patients with OVCF who underwent percutaneous kyphoplasty in our hospital were selected and divided into Groups A,B,and C for those undergoing surgery within 7,7—21,and>21 days of fracture occurrence.The variations in the amount of bone cement injected,pre-and post-operative pain levels,functional activity,deformity correction of the injured vertebrae,bone cement leakage,and vertebral body height loss were compared among the three groups.Results:Regarding pain relief and functional activity,the postoperative Visual Analog Scale and Oswestry Disability Index scores of the three groups significantly improved.Furthermore,the deformities of the injured vertebrae in the three groups were significantly corrected,with Groups A and B exhibiting superior correction compared to Group C.Moreover,the bone cement leakage rates in groups A and C were higher than that in Group B.At the 3-month follow-up,the loss of vertebral height in Group C was significantly higher than those in groups A and B.Conclusion:Kyphoplasty is effective for OVCF treatment.Early surgery can effectively restore the vertebral height of the injured vertebra,reduce kyphosis,and reduce height loss of the injured vertebra after surgery;nevertheless,treatment within 1—3 weeks of the fracture can reduce the occurrence of bone cement leakage,making the surgery safer.Therefore,surgical treatment within 1—3 weeks of fracture is safer and can achieve satisfactory therapeutic effects.From the perspective of traditional Chinese medicine,PKP surgery can transform the fracture end from a micromotion state to a fixed state,which fully embodies the theory of“dynamic-static integration”.
基金Taishan Scholar Foundation of Shandong Province,No.2018092901.
文摘BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.
基金supported by the Science and Technology Project of State Grid Shanxi Electric Power Research Institute:Research on Data-Driven New Power System Operation Simulation and Multi Agent Control Strategy(52053022000F).
文摘Due to the impact of source-load prediction power errors and uncertainties,the actual operation of the park will have a wide range of fluctuations compared with the expected state,resulting in its inability to achieve the expected economy.This paper constructs an operating simulation model of the park power grid operation considering demand response and proposes a multi-time scale operating simulation method that combines day-ahead optimization and model predictive control(MPC).In the day-ahead stage,an operating simulation plan that comprehensively considers the user’s side comfort and operating costs is proposed with a long-term time scale of 15 min.In order to cope with power fluctuations of photovoltaic,wind turbine and conventional load,MPC is used to track and roll correct the day-ahead operating simulation plan in the intra-day stage to meet the actual operating operation status of the park.Finally,the validity and economy of the operating simulation strategy are verified through the analysis of arithmetic examples.
基金Supported by National Natural Science Foundation Joint Fund Project(U21B2071)National Natural Science Foundation of China(52174033)National Natural Science Youth Foundation of China(52304041).
文摘Based on the elastic theory of porous media,embedded discrete fracture model and finite volume method,and considering the micro-seepage mechanism of shale gas,a fully coupled seepage-geomechanical model suitable for fractured shale gas reservoirs is established,the optimization method of refracturing timing is proposed,and the influencing factors of refracturing timing are analyzed based on the data from shale gas well in Fuling of Sichuan Basin.The results show that due to the depletion of formation pressure,the percentage of the maximum horizontal principal stress reversal area in the total area increases and then decreases with time.The closer the area is to the hydraulic fracture,the shorter the time for the peak of the stress reversal area percentage curve to appear,and the shorter the time for the final zero return(to the initial state).The optimum time of refracturing is affected by matrix permeability,initial stress difference and natural fracture approach angle.The larger the matrix permeability and initial stress difference is,the shorter the time for stress reversal area percentage curve to reach peak and return to the initial state,and the earlier the time to take refracturing measures.The larger the natural fracture approach angle is,the more difficult it is for stress reversal to occur near the fracture,and the earlier the optimum refracturing time is.The more likely the stress reversal occurs at the far end of the artificial fracture,the later the optimal time of refracturing is.Reservoirs with low matrix permeability have a rapid decrease in single well productivity.To ensure economic efficiency,measures such as shut-in or gas injection can be taken to restore the stress,and refracturing can be implemented in advance.
文摘BACKGROUND The comprehension and utilization of timing theory and behavior change can offer a more extensive and individualized provision of support and treatment alternatives for primipara.This has the potential to enhance the psychological well-being and overall quality of life for primipara,while also furnishing healthcare providers with efficacious interventions to tackle the psychological and physiological obstacles encountered during the stages of pregnancy and postpartum.AIM To explore the effect of timing theory combined with behavior change on selfefficacy,negative emotions and quality of life in patients with primipara.METHODS A total of 80 primipara cases were selected and admitted to our hospital between August 2020 and May 2022.These cases were divided into two groups,namely the observation group and the control group,with 40 cases in each group.The nursing interventions differed between the two groups,with the control group receiving routine nursing and the observation group receiving integrated nursing based on the timing theory and behavior change.The study aimed to compare the pre-and post-nursing scores of Chinese Perceived Stress Scale(CPSS),Edinburgh Postpartum Depression Scale(EPDS),Self-rating Anxiety Scale(SAS),breast milk knowledge,self-efficacy,and SF-36 quality of life in both groups.RESULTS After nursing,the CPSS,EPDS,and SAS scores of the two groups was significantly lower than that before nursing,and the CPSS,EPDS,and SAS scores of the observation group was significantly lower than that of the control group(P=0.002,P=0.011,and P=0.001 respectively).After nursing,the breastfeeding knowledge mastery,selfefficacy,and SF-36 quality of life scores was significantly higher than that before nursing,and the breastfeeding knowledge mastery(P=0.013),self-efficacy(P=0.008),and SF-36 quality of life(P=0.011)scores of the observation group was significantly higher than that of the control group.CONCLUSION The integration of timing theory and behavior change integrated theory has been found to be an effective approach in alleviating negative mood and stress experienced by primipara individuals,while also enhancing their selfefficacy and overall quality of life.This study focuses on the key concepts of timing theory,behavior change,primipara individuals,negative mood,and quality of life.
文摘We describe a 63-year-old male who appears to have undergone an early form of the arterial switch operation for D-transposition of the great arteries performed in the mid-1960s.We review the clinical and imaging data that support our conclusion.He had a diagnostic cardiac catheterization which demonstrated severe pulmonary hypertension responsive to epoprostenol and oxygen.Our case may represent one example of the experimental surgical work done prior to Dr.Adibe Jatene’s description of thefirst successful arterial switch performed in 1975.
文摘BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.
文摘This article proposes a comprehensive monitoring system for tunnel operation to address the risks associated with tunnel operations.These risks include safety control risks,increased traffic flow,extreme weather events,and movement of tectonic plates.The proposed system is based on the Internet of Things and artificial intelligence identification technology.The monitoring system will cover various aspects of tunnel operations,such as the slope of the entrance,the structural safety of the cave body,toxic and harmful gases that may appear during operation,excessively high and low-temperature humidity,poor illumination,water leakage or road water accumulation caused by extreme weather,combustion and smoke caused by fires,and more.The system will enable comprehensive monitoring and early warning of fire protection systems,accident vehicles,and overheating vehicles.This will effectively improve safety during tunnel operation.
文摘Objective:To explore the clinical benefits achieved by implementing the operating room nursing cooperation path for patients undergoing laparoscopic hysterectomy.Methods:64 laparoscopic hysterectomy cases were divided into groups according to the order of admission.The control group received routine perioperative care.The observation group implemented the nursing cooperation path in the operating room on the same basis as the control group.The two groups’physiological responses,stimulus indicators,anxiety,and complication rates were compared.Results:The heart rate,blood pressure 0.5 hours after surgery,anxiety scores 1 day before and 3 days after surgery,and the total number of complications in the observation group were all lower than those in the control group(P<0.05).Conclusion:The development of a nursing cooperation path in the operating room can help patients undergoing laparoscopic hysterectomy reduce heart rate,blood pressure,stress responses,and the risk of complications,and is worthy of promotion.
文摘BACKGROUND Endoscopic submucosal dissection(ESD)is a treatment for early gastric cancer with the advantages of small invasion,fewer complications,and a low local recurrence rate.However,there is a high risk of complications such as bleeding and perforation,and the operation time is also longer.ESD operation time is closely related to bleeding and perforation.AIM To investigate the influencing factors associated with ESD operation time and postoperative delayed hemorrhage to provide a reference for early planning,early identification,and prevention of complications.METHODS We conducted a retrospective study based on the clinical data of 520 patients with early gastric cancer in the Second Affiliated Hospital of Hainan Medical University from January 2019 to December 2021.The baseline data,clinical features,and endoscopic and pathological characteristics of patients were collected.The multivariate linear regression model was used to investigate the influencing factors of ESD operation time.Logistic regression analysis was carried out to evaluate the influencing factors of postoperative delayed hemorrhage.RESULTS The multivariate analysis of ESD operation time showed that the maximum lesion diameter could affect 8.815%of ESD operation time when other influencing factors remained unchanged.The operation time increased by 3.766%or 10.247%if the lesion was mixed or concave.The operation time increased by 4.417%if combined with an ulcer or scar.The operation time increased by 3.692%if combined with perforation.If infiltrated into the submucosa,it increased by 2.536%.Multivariate analysis of delayed hemorrhage after ESD showed that the maximum diameter of the lesion,lesion morphology,and ESD operation time were independent influencing factors for delayed hemorrhage after ESD.Patients with lesion≥3.0 cm(OR=3.785,95%CI:1.165-4.277),lesion morphology-concave(OR=10.985,95%CI:2.133-35.381),and ESD operation time≥60 min(OR=2.958,95%CI:1.117-3.526)were prone to delayed hemorrhage after ESD.CONCLUSION If the maximum diameter of the lesion in patients with early gastric cancer is≥3.0 cm,and the shape of the lesion is concave,or accompanied by an ulcer or scar,combined with perforation,and infiltrates into the submucosa,the ESD operation will take a longer time.When the maximum diameter of the lesion is≥3.0 cm,the shape of the lesion is concave in patients and the operation time of ESD takes longer time,the risk of delayed hemorrhage after ESD is higher.
基金Supported by the National Natural Science Foundation of China
文摘This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.
基金supported by a grant from the National Natural Science Foundation of China(31971249).
文摘Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.
基金supported by the State Grid Science and Technology Project (No.52999821N004)。
文摘This study proposes a combined hybrid energy storage system(HESS) and transmission grid(TG) model, and a corresponding time series operation simulation(TSOS) model is established to relieve the peak-shaving pressure of power systems under the integration of renewable energy. First, a linear model for the optimal operation of the HESS is established, which considers the different power-efficiency characteristics of the pumped storage system, electrochemical storage system, and a new type of liquid compressed air energy storage. Second, a TSOS simulation model for peak shaving is built to maximize the power entering the grid from the wind farms and HESS. Based on the proposed model, this study considers the transmission capacity of a TG. By adding the power-flow constraints of the TG, a TSOS-based HESS and TG combination model for peak shaving is established. Finally, the improved IEEE-39 and IEEE-118 bus systems were considered as examples to verify the effectiveness and feasibility of the proposed model.
基金the Natural Science Basic Research Program of Shaanxi(2023-JC-QN-0075,2022JM-395).
文摘With the rapid development of informatization,autonomy and intelligence,unmanned swarm formation intelligent operations will become the main combat mode of future wars.Typical unmanned swarm formations such as ground-based directed energy weapon formations,space-based kinetic energy weapon formations,and sea-based carrier-based formations have become the trump card for winning future wars.In a complex confrontation environment,these sophisticated weapon formation systems can precisely strike mobile threat group targets,making them extreme deterrents in joint combat applications.Based on this,first,this paper provides a comprehensive summary of the outstanding advantages,strategic position and combat style of unmanned clusters in joint warfare to highlight their important position in future warfare.Second,a detailed analysis of the technological breakthroughs in four key areas,situational awareness,heterogeneous coordination,mixed combat,and intelligent assessment of typical unmanned aerial vehicle(UAV)swarms in joint warfare,is presented.An in-depth analysis of the UAV swarm communication networking operating mechanism during joint warfare is provided to lay the theoretical foundation for subsequent cooperative tracking and control.Then,an indepth analysis of the shut-in technology requirements of UAV clusters in joint warfare is provided to lay a theoretical foundation for subsequent cooperative tracking control.Finally,the technical requirements of UAV clusters in joint warfare are analysed in depth so the key technologies can form a closed-loop kill chain system and provide theoretical references for the study of intelligent command operations.
基金the National Key Research and Development Program(2021YFC2501106)the Key Discipline Construction Project of Chinese PLA Medical College during the 13^(th) Five-Year Plan Period(A350109).
文摘Patent foramen ovale(PFO)is a remnant of normal fetal anatomy,which occurs in about 20%–25%of cases.Patients with PFO are at increased risk for migraine,acute limb ischemia secondary to emboli and cryptogenic(no other identifiable cause)stroke.The traditional approach has been to use a fluoroscopically guided blocking device,but this is contraindicated in patients with severe allergies to contrast media or inability to undergo angiography.With the advancements in technology,ultrasonic robotic systems have become available for medical procedures.In the current study,we reported a case of using the ultrasonic robotic teleoperation system to achieve closure of PFO at the Chinese PLA General Hospital,Beijing,China.
文摘The Red-Thai Binh River system is an important water resource to the Northern Delta, serving the development of agriculture, people’s livelihood and other economic sectors through its upstream reservoirs and a system of water abstraction works along the rivers. However, due to the impact of climate change and pressure from socio-economic development, the operation of the reservoir system according to Decision No. 740/QD-TTg was issued on June 17, 2019 by the Prime Minister of Government promulgating the Red-Thai Binh River system inter-reservoir operation rules (Operation rules 740) has some shortcomings that need adjustments for higher water use efficiency, meeting downstream water demand and power generation benefits. Through the results of water balance calculation and analysis of economic benefits from water use scenarios, this research proposed adjustment to the inter-reservoir operation during dry season in the Red River system. The result showed that an average water level of 1.0 - 1.7 m should be maintained at Hanoi during the increased release period.
基金supported by National Natural Science Foundation of China (No.51905116)Basic and Applied Basic Research Foundation of Guangdong Province (Item No.2020A1515111141)+3 种基金The 13th Five-Year Plan Youth Project of Philosophy and Social Science of Guangdong Province (GD20YYS03)Science and Technology Program of Guangzhou (No.201904010463)Youth Innovative Talent Projects from Ordinary University of Guangdong Province (2019WQNCX099)Innovation Training Program for College Students in Guangdong Province (S202111078058).
文摘Ergonomic reliability plays a significant role in the safe operation of devices.With the spread of infectious diseases around the world,in work environments with high loads and high infection rates,medical staff work in a state of high self-protection.The use of visual display terminal(VDT)for medical equipment has undergone fundamental changes,and the traditional medical equipment human-machine interface design needs to be improved.After the completion of design and development,a VDT design enters the experimental testing stage,which has significant limitations for simulating the work of medical staff in the high-load and high-infection environments.The testing cost is high,and subjects face harsh conditions;thus,an ergonomic reliability model that can predict the use of VDT in such special high-infection and high-load circumstances must be established.An ergonomic reliability model based on an improved backpropagation neural network(BPNN)and human cognition reliability(HCR)is proposed for predicting and evaluating operation flows according tomedical equipment VDTs.Firstly,a small data sample can be used to train BPNN to generate a network that can ensure suitable accuracy.To prevent the model from falling into local optimal solutions,the bat algorithm is introduced to improve the BPNN.Compared to a traditional BPNN,the superiority of the improved BPNN is clearly demonstrated.Secondly,the HCR method is used to analyze and highlight changes in the human factor reliability of VDTs for medical equipment in different time processes and operating processes according to BPNN prediction results,to provide a reference for selecting the optimalmethod.Finally,the validity and availability of the proposedmethod are verified through an eye tracker experiment and statistical analysis results.
基金This study was financially supported by the Program for Scientific Research Start-Up Funds of Guangdong Ocean University(060302072101)Comparative Study,and Optimization of Horizontal Lifting of Subsea Pipeline(2021E05011).
文摘Pipelines are widely used for transporting oil resources in the context of offshore oil exploitation.The pipeline stress-strength analysis is an important stage in related design and ensuing construction techniques.In this study,assuming representative work environment parameters,pipeline lifting operations are investigated numerically.More specifically,a time-domain coupled dynamic analysis method is used to conduct a hydrodynamic analysis under different current velocities and wave heights.The results show that proper operation requires the lifting points are reasonably set in combination with the length of the pipeline and the position of the lifting device on the construction ship.The impact of waves on the pipeline is limited,however lifting operations under strong wind and waves should be avoided as far as possible.
基金the Fundamental Research Funds for the Central Universities,China(Grant No.GK201903020)the National Natural Science Foundation of China(Grant No.12005006)Scientific research project of Education Department of Gansu Province,China(Grant No.2016A-049).
文摘Experimental and theoretical studies have reported that the precise firing of neurons is crucial for sensory representation.Autapse serves as a special synapse connecting neuron and itself,which has also been found to improve the accuracy of neuronal response.In current work,the effect of autaptic delay signal on the spike-timing precision is investigated on a single autaptic Hodgkin–Huxley neuron in the present of noise.The simulation results show that both excitatory and inhibitory autaptic signals can effectively adjust the precise spike time of neurons with noise by choosing the appropriate coupling strength g and time delay of autaptic signalτ.The g–τparameter space is divided into two regions:one is the region where the spike-timing precision is effectively regulated;the other is the region where the neuronal firing is almost not regulated.For the excitatory and inhibitory autapse,the range of parameters causing the accuracy of neuronal firing is different.Moreover,it is also found that the mechanisms of the spike-timing precision regulation are different for the two kinds of autaptic signals.
