加速康复外科(enhanced recovery after surgery,ERAS)理念的实施有益于外科患者术后加速康复,LEER模式[少痛(less pain)、早动(early move)、早食(early eat)、安心(reassuring)]下的ERAS体系则是为临床更好实施ERAS理念建立的系统、...加速康复外科(enhanced recovery after surgery,ERAS)理念的实施有益于外科患者术后加速康复,LEER模式[少痛(less pain)、早动(early move)、早食(early eat)、安心(reassuring)]下的ERAS体系则是为临床更好实施ERAS理念建立的系统、规范和标准化的工作方法与工作流程。经临床外科和外科联合具有综合属性的全科医学科建立的加速康复All in One病房的初期探索及应用取得了一系列有益结果,均证明LEER模式ERAS不仅能系统、全面、规范地执行ERAS措施,也可以将LEER-ERAS理念拓展应用到加速康复All in One病房共同协助外科患者围手术期的治疗及管理促进患者加速康复。在前期工作取得的成效基础上,将有益于患者治疗后加速康复的ERAS理念延伸、拓展成加速康复医学(enhanced recovery after treatment,ERAT)理念来拓宽加速康复All in One病房的应用范围,包括应用到临床所有的非外科专业科室,其目的是探索和研究如何应用ERAT理念构建医院ERAT临床应用体系来促进患者康复。展开更多
In this work, a study involving the fully coupled Euler and Navier-Stokes reactive equations is performed. These equations, in conservative and finite volume contexts, employing structured spatial discretization, on a...In this work, a study involving the fully coupled Euler and Navier-Stokes reactive equations is performed. These equations, in conservative and finite volume contexts, employing structured spatial discretization, on a condition of thermochemical non-equilibrium, are analyzed. High-order studies are accomplished using the Spectral method of Streett, Zang, and Hussaini. The high enthalpy hypersonic flows around a circumference, around a reentry capsule, along a blunt body, and along a double ellipse in two-dimensions are simulated. The Van Leer, Liou and Steffen Jr., and Steger and Warming flux vector splitting algorithms are applied to execute the numerical experiments. Three temperatures, which are the translational-rotational temperature, the vibrational temperature, and the electron temperature, are used to accomplish the numerical comparisons. Excellent results were obtained with minimum errors inferior to 6.0%. The key contribution of this work is the correct implementation of a three temperature model coupled with the implementation of three algorithms to perform the numerical simulations, as well the description of energy exchange mechanisms to perform more realistic simulations.展开更多
基于多学科团队(multi-disciplinary team,MDT)参与的加速康复外科(enhanced recovery after surgery,ERAS)(ERAS-MDT)构架下建立的All in One(AO)病房,通过外科联合具有综合属性的内科协助外科治疗作为AO病房的主体病房,纳入在专业治...基于多学科团队(multi-disciplinary team,MDT)参与的加速康复外科(enhanced recovery after surgery,ERAS)(ERAS-MDT)构架下建立的All in One(AO)病房,通过外科联合具有综合属性的内科协助外科治疗作为AO病房的主体病房,纳入在专业治疗上需要进行深度介入干预的相应专业组成的辅助病房以及协助外科完成治疗工作的相关专业组成的支持治疗病房,组成综合性独立单元体,其目标是探索多学科协同促进外科患者围手术期加速康复的策略。通过在加速康复AO病房实施LEER模式工作流程(即“少痛”“早动”“早食”“安心”)来实现患者术后加速康复这一共同目标。通过AO病房的治疗,期望增加老年、危重症患者的手术率,减少术后并发症的发生率,缩短外科患者平均住院时间,加快外科病房周转,节约有限的医疗资源,并拓展ERAS的应用领域。从形式和内容上创新了MDT,不仅有利于医院通过内部资源整合为外科纾困解难,也为进一步探索和深化慢病管理和临床专业协同工作模式提供了一种有益借鉴。展开更多
A high-resolution, 1-D numerical model has been developed in the discontinuous Galerkin framework to simulate 1-D flow behavior, sediment transport, and morphological evaluation under unsteady flow conditions. The flo...A high-resolution, 1-D numerical model has been developed in the discontinuous Galerkin framework to simulate 1-D flow behavior, sediment transport, and morphological evaluation under unsteady flow conditions. The flow and sediment concentration variables are computed based on the one-dimensional shallow water flow equations, while empirical equations are used for entrainment and deposition processes. The sediment transport model includes the bed load and suspended load components. New formulations for Harten-Lax-van Leer （HLL） and Harten-Lax-van Contact （HLLC） are presented for shallow water flow equations that include the bed load and suspended load fluxes. The computational results for the flow and morphological changes after two dam break events are compared with the physical model tests. Results show that the modified HLL and HLLC formulations are robust and can accurately predict morphological changes in highly unsteady flows.展开更多
文摘加速康复外科(enhanced recovery after surgery,ERAS)理念的实施有益于外科患者术后加速康复,LEER模式[少痛(less pain)、早动(early move)、早食(early eat)、安心(reassuring)]下的ERAS体系则是为临床更好实施ERAS理念建立的系统、规范和标准化的工作方法与工作流程。经临床外科和外科联合具有综合属性的全科医学科建立的加速康复All in One病房的初期探索及应用取得了一系列有益结果,均证明LEER模式ERAS不仅能系统、全面、规范地执行ERAS措施,也可以将LEER-ERAS理念拓展应用到加速康复All in One病房共同协助外科患者围手术期的治疗及管理促进患者加速康复。在前期工作取得的成效基础上,将有益于患者治疗后加速康复的ERAS理念延伸、拓展成加速康复医学(enhanced recovery after treatment,ERAT)理念来拓宽加速康复All in One病房的应用范围,包括应用到临床所有的非外科专业科室,其目的是探索和研究如何应用ERAT理念构建医院ERAT临床应用体系来促进患者康复。
文摘In this work, a study involving the fully coupled Euler and Navier-Stokes reactive equations is performed. These equations, in conservative and finite volume contexts, employing structured spatial discretization, on a condition of thermochemical non-equilibrium, are analyzed. High-order studies are accomplished using the Spectral method of Streett, Zang, and Hussaini. The high enthalpy hypersonic flows around a circumference, around a reentry capsule, along a blunt body, and along a double ellipse in two-dimensions are simulated. The Van Leer, Liou and Steffen Jr., and Steger and Warming flux vector splitting algorithms are applied to execute the numerical experiments. Three temperatures, which are the translational-rotational temperature, the vibrational temperature, and the electron temperature, are used to accomplish the numerical comparisons. Excellent results were obtained with minimum errors inferior to 6.0%. The key contribution of this work is the correct implementation of a three temperature model coupled with the implementation of three algorithms to perform the numerical simulations, as well the description of energy exchange mechanisms to perform more realistic simulations.
文摘基于多学科团队(multi-disciplinary team,MDT)参与的加速康复外科(enhanced recovery after surgery,ERAS)(ERAS-MDT)构架下建立的All in One(AO)病房,通过外科联合具有综合属性的内科协助外科治疗作为AO病房的主体病房,纳入在专业治疗上需要进行深度介入干预的相应专业组成的辅助病房以及协助外科完成治疗工作的相关专业组成的支持治疗病房,组成综合性独立单元体,其目标是探索多学科协同促进外科患者围手术期加速康复的策略。通过在加速康复AO病房实施LEER模式工作流程(即“少痛”“早动”“早食”“安心”)来实现患者术后加速康复这一共同目标。通过AO病房的治疗,期望增加老年、危重症患者的手术率,减少术后并发症的发生率,缩短外科患者平均住院时间,加快外科病房周转,节约有限的医疗资源,并拓展ERAS的应用领域。从形式和内容上创新了MDT,不仅有利于医院通过内部资源整合为外科纾困解难,也为进一步探索和深化慢病管理和临床专业协同工作模式提供了一种有益借鉴。
文摘A high-resolution, 1-D numerical model has been developed in the discontinuous Galerkin framework to simulate 1-D flow behavior, sediment transport, and morphological evaluation under unsteady flow conditions. The flow and sediment concentration variables are computed based on the one-dimensional shallow water flow equations, while empirical equations are used for entrainment and deposition processes. The sediment transport model includes the bed load and suspended load components. New formulations for Harten-Lax-van Leer （HLL） and Harten-Lax-van Contact （HLLC） are presented for shallow water flow equations that include the bed load and suspended load fluxes. The computational results for the flow and morphological changes after two dam break events are compared with the physical model tests. Results show that the modified HLL and HLLC formulations are robust and can accurately predict morphological changes in highly unsteady flows.
