Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes...Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.展开更多
We demonstrate an optical frequency comb(OFC)based on a turnkey mode-locked laser with a figure-9-shape structure and polarization-maintaining fibers,for the comparison of frequency among optical clocks with wavelengt...We demonstrate an optical frequency comb(OFC)based on a turnkey mode-locked laser with a figure-9-shape structure and polarization-maintaining fibers,for the comparison of frequency among optical clocks with wavelengths of 698 nm,729 nm,1068 nm,and 1156 nm.We adopt a multi-branch approach in order to produce high power OFC signals at these specific wavelengths,enabling the signal-to-noise ratio of the beatnotes between the OFC and the clock lasers to exceed30 d B at a resolution bandwidth of 300 k Hz.This approach makes the supercontinuum spectra much easier to be generated than a single branch OFC.However,more out-of-loop fibers degrade the long-term frequency instability due to thermal drift.To minimize the thermal drift effect,we set the fiber lengths of different branches to be similar,and we stabilize the temperature as well.The out-of-loop frequency instability of the OFC due to the incoherence of the multi-branch is about5.5×10^(19) for 4000 s,while the in-loop frequency instability of fceo and that of fbeat are 7.5×10^(18) for 1 s and 8.5×10^(18) for 1 s,respectively.The turnkey OFC meets the requirement for the comparison of frequency between the best optical clocks.展开更多
Central venous catheters （CVCs） are widely used in various puncture and drainage operations in intensive care units （ICUs） in recent years. Compared to conventional operating devices, CVC was welcomed by clinician...Central venous catheters （CVCs） are widely used in various puncture and drainage operations in intensive care units （ICUs） in recent years. Compared to conventional operating devices, CVC was welcomed by clinicians because of the advantages of easy use, less damage to the body and convenient fixation pro- cess. We came across a patient with severe acute pancreatitis （SAP） who developed cardiac arrest due to thoracic cavity massive bleeding 24 h after thoracoceotesis with CVC. Thoracotomy surgery was carried out immediately, which confirmed an intercostal artery injury. The patient was discharged from hospital without any neurological complications two months later. Here we report this case to remind all the emergency department and ICU physicians to pay more attention to the complication of thoracic cavity bleeding following thoracocentesis conducted by CVC.展开更多
基金supported by grants from the National Natural Science Foundation of China (82070665 and 81900592)
文摘Background:Early systemic anticoagulation(SAC)is a common practice in acute necrotizing pancreatitis(ANP),and its impact on in-hospital clinical outcomes had been assessed.However,whether it affects long-term outcomes is unknown.This study aimed to evaluate the effect of SAC on 90-day readmission and other long-term outcomes in ANP patients.Methods:During January 2013 and December 2018,ANP patients admitted within 7 days from the onset of abdominal pain were screened.The primary outcome was 90-day readmission after discharge.Cox proportional-hazards regression model and mediation analysis were used to define the relationship between early SAC and 90-day readmission.Results:A total of 241 ANP patients were enrolled,of whom 143 received early SAC during their hospitalization and 98 did not.Patients who received early SAC experienced a lower incidence of splanchnic venous thrombosis(SVT)[risk ratio(RR)=0.40,95%CI:0.26-0.60,P<0.01]and lower 90-day readmission with an RR of 0.61(95%CI:0.41-0.91,P=0.02)than those who did not.For the quality of life,patients who received early SAC had a significantly higher score in the subscale of vitality(P=0.03)while the other subscales were all comparable between the two groups.Multivariable Cox regression model showed that early SAC was an independent protective factor for 90-day readmission after adjusting for potential confounders with a hazard ratio of 0.57(95%CI:0.34-0.96,P=0.04).Mediation analysis showed that SVT mediated 37.0%of the early SAC-90-day readmission causality.Conclusions:The application of early SAC may reduce the risk of 90-day readmission in the survivors of ANP patients,and reduced SVT incidence might be the primary contributor.
基金Project supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB35030101)the National Natural Science Foundation of China(Grant No.61825505)+1 种基金the Quantum Control and Quantum Information of the National Key Research and Development Program of China(Grant No.2020YFA0309800)the Natural Science Basic Research Program of Shaanxi Province,China(Grant No.2020JQ434)。
文摘We demonstrate an optical frequency comb(OFC)based on a turnkey mode-locked laser with a figure-9-shape structure and polarization-maintaining fibers,for the comparison of frequency among optical clocks with wavelengths of 698 nm,729 nm,1068 nm,and 1156 nm.We adopt a multi-branch approach in order to produce high power OFC signals at these specific wavelengths,enabling the signal-to-noise ratio of the beatnotes between the OFC and the clock lasers to exceed30 d B at a resolution bandwidth of 300 k Hz.This approach makes the supercontinuum spectra much easier to be generated than a single branch OFC.However,more out-of-loop fibers degrade the long-term frequency instability due to thermal drift.To minimize the thermal drift effect,we set the fiber lengths of different branches to be similar,and we stabilize the temperature as well.The out-of-loop frequency instability of the OFC due to the incoherence of the multi-branch is about5.5×10^(19) for 4000 s,while the in-loop frequency instability of fceo and that of fbeat are 7.5×10^(18) for 1 s and 8.5×10^(18) for 1 s,respectively.The turnkey OFC meets the requirement for the comparison of frequency between the best optical clocks.
文摘Central venous catheters （CVCs） are widely used in various puncture and drainage operations in intensive care units （ICUs） in recent years. Compared to conventional operating devices, CVC was welcomed by clinicians because of the advantages of easy use, less damage to the body and convenient fixation pro- cess. We came across a patient with severe acute pancreatitis （SAP） who developed cardiac arrest due to thoracic cavity massive bleeding 24 h after thoracoceotesis with CVC. Thoracotomy surgery was carried out immediately, which confirmed an intercostal artery injury. The patient was discharged from hospital without any neurological complications two months later. Here we report this case to remind all the emergency department and ICU physicians to pay more attention to the complication of thoracic cavity bleeding following thoracocentesis conducted by CVC.
