OBJECTIVE:To evaluate the efficacy and safety of Zhumian Tang formula granules(助眠汤配方颗粒)combined with eszopiclone for treating poor sleep quality.METHODS:This multi-center,dynamic blockrandomized,parallel-group ...OBJECTIVE:To evaluate the efficacy and safety of Zhumian Tang formula granules(助眠汤配方颗粒)combined with eszopiclone for treating poor sleep quality.METHODS:This multi-center,dynamic blockrandomized,parallel-group superiority clinical trial included 130 patients.The combined treatment group received Zhumian Tang formula granules combined with eszopiclone treatment,and the control group received eszopiclone treatment only.The group allocation ratio was 1∶1.The duration of treatment was 2 weeks.Participants were asked to complete questionnaires before treatment,after 1 week of the intervention,after 2 weeks of the intervention,and at the follow-up on week 3.The primary outcomes were the Pittsburgh Sleep Quality Index(PSQI)score and the total effective rate of treatment.The secondary outcome was the rate of adverse effects.RESULTS:Compared with the eszopiclone treatment group,the PSQI score of the combined treatment group was significantly lower after 2 weeks of the intervention(6.98 vs 8.26,P<0.05).However,there was no significant difference in the mean PSQI score after 1 week of the intervention(9.89 vs 9.15,P=0.124).After the follow-up on week 3,the PSQI score of the combined treatment group remained significantly lower than that of the eszopiclone treatment group(6.12 vs 8.31,P<0.001).The total effective rates of treatment of the combined group and the eszopiclone group were 36.92%vs 35.38%(Z=0.033,P=0.855)after 1 week of the intervention,83.08%vs 58.46%(Z=9.519,P<0.05)after 2 weeks of the intervention,and 83.08%vs 61.54%(Z=7.530,P<0.05)and after the follow-up on week 3,respectively.There was no significant difference in the overall rate of adverse reactions between the combined and eszopiclone treatment groups(21.53%vs 31.8%,P=0.318).CONCLUSION:The combination of Zhumian Tang formula granules with eszopiclone was found to be safe and more effective in improving sleep quality than eszopiclone alone.Traditional Chinese medicine can enhance the effectiveness of Western medicine in the treatment of insomnia.展开更多
In the wheat-cotton intercropping system, total 6 sowing rates （187.5, 225.0, 262.5, 300.0, 337.5 and 375.0 kg/hm2） were arranged, and the effects of sowing rate on marginal superiority and yield of wheat were inves...In the wheat-cotton intercropping system, total 6 sowing rates （187.5, 225.0, 262.5, 300.0, 337.5 and 375.0 kg/hm2） were arranged, and the effects of sowing rate on marginal superiority and yield of wheat were investigated. The re- sults showed that the effect of sowing rate on inner-line wheat was greater than that on side-line wheat; with the increased sowing rate, the marginal superiority of panicle number was reduced in overall, and the difference in panicle number be- tween inner and side lines was decreased from 9.0×10^5/hm2 （sowing rate of 187.5 kg/hm2） to 7.8×10^5/hm2 （sowing rate of 375.0 kg/hm2）; the marginal superiority of grains per spike was increased first and then reduced, and the largest difference in grains per spike between the inner and side lines reached 4.6 under the sowing rate of 300.0 kg/hm2; the marginal superiority of 1 000-grain weight and yield was gradually increased, and the largest difference in 1 000-grain weight between the inner and side lines reached 3.9 g under the sowing rate of 337.5 kg/hm2, and in yield reached 3 136.5 kg/hm2under the sowing rate of 375.0 kg/hm2. The effects of sowing rate on the three yield factors of intercropped wheat ranked as panicle number 〉 grains per spike 〉 1 000-grain weight. The appropriate sowing rate of wheat was 225.0-262.0 kg/hm2 in the wheat-cotton intercropping system.展开更多
In wheat-cotton intercropping system,the spike number per unit area,grains per spike,thousand-grain weight and yield of side line and inner line were investigated in six wheat varieties to study the marginal superiori...In wheat-cotton intercropping system,the spike number per unit area,grains per spike,thousand-grain weight and yield of side line and inner line were investigated in six wheat varieties to study the marginal superiority and select suitable wheat varieties intercropped with cotton.The results showed that Xingmai No.4had obvious marginal superiority with the yield of 6 919.0 kg/hm2,so it was the suitable variety for wheat-cotton intercropping system.展开更多
With F1 of self pollinated Eucalyptus urophylla, F1 of inter tree pollinated E.urophylla, F1of open pollinated E.urophylla and F1 of E.urophylla×grandis as materials,inbreeding depression and hy...With F1 of self pollinated Eucalyptus urophylla, F1 of inter tree pollinated E.urophylla, F1of open pollinated E.urophylla and F1 of E.urophylla×grandis as materials,inbreeding depression and hybrid superiority in growth and wood traits are analyzed and discussed.The results are as follows.①There was a regularity for E.urophylla that F1 of self pollinated was subjected to more intense depression than F1 of open pollinated,and growth traits showed more signifcant depression than wood traits.②As to F1 of self pollinated E.urophylla, height,DBH and volume showed significant or extremely significant depression,while water content of green wood,wood density and bark thickness showed no significant depression.③As to F1 of open pollinated E.urophylla, height,DBH and volume showed depression to a certain degree,but not significant;Here again,water content of green wood,wood density and bark thickness showed no significant depression.④F1 of E.urophylla×grandis showed significant hybrid superiority in height,DBH and volume,but the hybrid superiority percentage of different cross pairs varied greatly;It showed no hybrid superiority in water content of green wood,wood density and fiber length;Its bark thickness and content of 1% NaOH extractives decreased evidently.展开更多
To investigate the spatial synergy between agricultural development level and transport superiority degree in grain-producing areas of the central Jilin Province and the driving mechanism between them,22 counties in t...To investigate the spatial synergy between agricultural development level and transport superiority degree in grain-producing areas of the central Jilin Province and the driving mechanism between them,22 counties in the central Jilin Province were used as the research units to calculate agricultural development level and transport superiority degree using the entropy weighting method,weighted travel time and raster cost distance.The spatial econometric model was used to analyze the mechanism of the mutual influence between the two.The main conclusions are as follows.1)Agricultural development level around Changchun,the provincial capital city,and in the areas of Changchun-Jilin and Changchun-Gongzhuling is high,whereas the development level of the counties in the southwest is low.2)Transport superiority degree of each county has improved,the overall connectivity of the road networks has been optimized,and the level of transportation accessibility has shown the development trend of‘centralization’,exhibiting the characteristics of proximity diffusion.3)Locally,there is spatial heterogeneity in the mutual driving effects of the two,with six main patterns.4)The theoretical conditions of von Thunen’s agricultural location have changed under the conditions of market economy due to the improvement of the transport networks,the new model of agricultural development,and the changes of the market system.展开更多
Relationship between transport superiority degree and urbanization is not quantified enough in recent researches.Combined with coupling model and coupling coordination model,the spatial analysis technique was applied ...Relationship between transport superiority degree and urbanization is not quantified enough in recent researches.Combined with coupling model and coupling coordination model,the spatial analysis technique was applied to quantitatively analyzing the relationship between transport superiority degree and comprehensive urbanization in eighteen prefecture-level cities in Sichuan from 2000 to 2011. An evaluation index system was constructed,and index weights were obtained using the variation coefficient method. The traffic volume was found to be the main factor contributing to transport superiority degree, and space urbanization was the primary factor influencing comprehensive urbanization. The coupling degree between transport superiority degree and urbanization( CU) was generally higher than the coupling coordination degree( DU) in 2000-2011. DUvaried more significantly than CU. In 2011, Sichuan was divided into five regional types. Based on the above observations, targeted recommendations were developed.展开更多
The Most Dangerous Game is a highly-trimmed short story,with well-knitted plot,deep-carved characters,suspense,symbols,ironies,etc.Beyond its elaborate form,it conveys far-reaching social and cultural values.This pape...The Most Dangerous Game is a highly-trimmed short story,with well-knitted plot,deep-carved characters,suspense,symbols,ironies,etc.Beyond its elaborate form,it conveys far-reaching social and cultural values.This paper is an attempt to appreciate the story inside out,in which structural approach and cultural approach are employed.Parallels and contrasts in structure and the unique shifts and gaps in its narration are highlighted to explore the tradition of reason superiority in western culture and the doom it has brought to the world and to the people concerned.The First World War is the fighting between rational beings.Rationality,when brought to extremes,may lead to irrationality.The image of General Zaroff is a reflection of modern westerner who boasts to be rational being while killing his fellow beings in bloody wars.展开更多
Based on Jun-Chen-Zuo-Shi,traditional Chinese medicine has used mixtures of naturally occurring herbs for more than 2000 years.Since the last century,advances in omics and cell biology have greatly impacted on the inc...Based on Jun-Chen-Zuo-Shi,traditional Chinese medicine has used mixtures of naturally occurring herbs for more than 2000 years.Since the last century,advances in omics and cell biology have greatly impacted on the increasing use of drug combination in modern medicine.The enhanced understanding of the biology of a disease as a disturbed system of interconnected molecular pathways which are more susceptible to the simultaneous action of several drugs,provides new opportunities for the rational development of combination therapies.Combination therapies exploit the chances for better efficacy,decreased toxicity,and reduced development of drug resistance and owing to these advantages,have become a standard for the treatment of several diseases and continue to represent a promising approach in indications of unmet medical need.展开更多
Terrain slope and climate zone(heat zone)are important factors affecting land use zoning and agricultural production layout in mountainous areas.Using"weight grade method",a quantitative index of comprehensi...Terrain slope and climate zone(heat zone)are important factors affecting land use zoning and agricultural production layout in mountainous areas.Using"weight grade method",a quantitative index of comprehensively evaluating terrain slope and climatic(thermal)conditions in mountainous areas was proposed:terrain-climate superiority degree(TCSD),and TCSD,terrain superiority degree(TSD),and climate superiority degree(CSD)in 129 counties(cities and districts)of Yunnan Province were measured and analyzed.The results showed that TCSD in 50.39%of counties of Yunnan Province was relatively better(levels I and II),and TCSD in 38.76%of counties was moderate(level III),while TCSD in 10.85%of counties was relatively poorer(levels IV and V).展开更多
Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,...Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.展开更多
BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of ...BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.展开更多
The market share between China Mobile and China Unicom has stabilized since 2002. It is found that China Mobile has the superiority in the competition, for example, the scissors movement between its revenue and cost i...The market share between China Mobile and China Unicom has stabilized since 2002. It is found that China Mobile has the superiority in the competition, for example, the scissors movement between its revenue and cost indicates that it has a strong profit generating ability and there is enough room for it to reduce the price. The ratio between its price （marginal income） and marginal cost indicates that there is a very distant limit for it to reduce the price. Its demand is obviously flexible with the price, but it does not use the price weapon abundantly. The reason for the stabilization of the market is that China Mobile withdrew from the competition.展开更多
Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a ra...Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a rare phenomenon.In the general population,the incidence of this condition is reported to be between 0.3%and 2.1%.[1]While this anatomical variation is often asymptomatic and discovered incidentally,it becomes relevant in certain clinical scenarios.Indeed,the presence of a PLSVC and double superior vena cava can pose challenges as incorrect positioning and result in failure.展开更多
To the editor:The superior semicircular canal dehiscence was first described by Minor et all in 1998 as a condition in which the superior semicircular canal lacks a bony covering and has gained constantly increasing i...To the editor:The superior semicircular canal dehiscence was first described by Minor et all in 1998 as a condition in which the superior semicircular canal lacks a bony covering and has gained constantly increasing interest since its discovery.2 The symptoms are varied but specific what is known as Minor syndrome or‘third mobile window’syndrome,'as patients may experience autophony with abnormally loud sounds like footsteps,chewing,breathing,eye movement,echoing voice,distortion of environmental sounds and pulsatile tinnitus.展开更多
The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imag...The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imaging(MRI)which is also to measure the blood flow in the superior mesenteric vein(SMV)in pediatric patients over the traditional method.The study focuses on assessing the potential of SMV and superior mesenteric artery(SMA)flow quantification in children utilizing 4D flow MRI.It included 9 pediatric patients aged 18 years and below where 5 were male and 4 were female patients,on whom magnetic resonance enterorrhaphy(MRE)with 4D flow MRI protocol was used.Statistical analysis was performed using MedCalc.Measurements of SMV and SMA between two readers were calculated using Bland-Altman analysis.The results stated that six patients showed no MRE evidence of active inflammatory bowel disease,two patients showed unmarkable bowel appearance on MRI and one patient showed normal MRE without endoscopy performed at the same timeframe.The study utilized available 4D flow MRI sequences in this study aiming to show the feasibility of 4D flow quantitation of SMA and SMV flow in pediatric patients.The study also discovered good agreement for both peak velocity and peak speed measurements of SMA and SMV.展开更多
BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for as...BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for assessment of bowel disease in children has not been previously described.AIM To determine feasibility of superior mesenteric venous and arterial flow quantitation in pediatric patients using 4D flow MRI.METHODS Nine pediatric patients(7-14 years old,5 male and 4 female)with history or suspicion of bowel pathology,who underwent magnetic resonance(MR)enterography with 4D flow MR protocol from November 2022 to October 2023.Field strength/sequence:3T MRI using 4D flow MR protocol.Flow velocity and peak speed measurements were performed by two diagnostic radiologists placing the region of interest in perpendicular plane to blood flow on each cross section of superior mesenteric artery(SMA)and superior mesenteric vein(SMV)at three predetermined levels.Bland-Altman analysis,showed good agreement of flow velocity and peak speed measurements of SMV and SMA between two readers.RESULTS Mean SMV flow velocity increased from proximal to mid to distal(0.14 L/minute,0.17 L/minute,0.22 L/minute respectively).Mean SMA flow velocity decreased from proximal to mid to distal(0.35 L/minute,0.27 L/minute,0.21 L/minute respectively).Observed agreement was good for flow velocity measurements of SMV(mean bias-0.01 L/minute and 95%limits of agreement,-0.09 to 0.08 L/minute)and SMA(mean bias-0.03 L/minute and 95%limits of agreement,-0.23 to 0.17 L/minute)between two readers.Good agreement for peak speed measurements of SMV(mean bias-1.2 cm/second and 95%limits of agreement,-9.4 to 7.0 cm/second)and SMA(mean bias-3.2 cm/second and 95%limits of agreement,-31.4 to 24.9 cm/second).CONCLUSION Flow quantitation using 4D Flow is feasible to provide hemodynamic information for SMV and SMA in children.展开更多
基金Supported by Sichuan Province Central Guided Local Science and Technology Development Special Project:a Study of the Chinese and Western Medicine Clinical Consensus Program for People with Poor Sleep Quality(No.2021ZYD0109)Natural Science Foundation of Sichuan Province:Study on the Efficacy and Mechanism of Acupuncture in Treating Drug-dependent Insomnia from the Liver based on Multi-modal f MRI Technology(No.2022NSFSC0858)。
文摘OBJECTIVE:To evaluate the efficacy and safety of Zhumian Tang formula granules(助眠汤配方颗粒)combined with eszopiclone for treating poor sleep quality.METHODS:This multi-center,dynamic blockrandomized,parallel-group superiority clinical trial included 130 patients.The combined treatment group received Zhumian Tang formula granules combined with eszopiclone treatment,and the control group received eszopiclone treatment only.The group allocation ratio was 1∶1.The duration of treatment was 2 weeks.Participants were asked to complete questionnaires before treatment,after 1 week of the intervention,after 2 weeks of the intervention,and at the follow-up on week 3.The primary outcomes were the Pittsburgh Sleep Quality Index(PSQI)score and the total effective rate of treatment.The secondary outcome was the rate of adverse effects.RESULTS:Compared with the eszopiclone treatment group,the PSQI score of the combined treatment group was significantly lower after 2 weeks of the intervention(6.98 vs 8.26,P<0.05).However,there was no significant difference in the mean PSQI score after 1 week of the intervention(9.89 vs 9.15,P=0.124).After the follow-up on week 3,the PSQI score of the combined treatment group remained significantly lower than that of the eszopiclone treatment group(6.12 vs 8.31,P<0.001).The total effective rates of treatment of the combined group and the eszopiclone group were 36.92%vs 35.38%(Z=0.033,P=0.855)after 1 week of the intervention,83.08%vs 58.46%(Z=9.519,P<0.05)after 2 weeks of the intervention,and 83.08%vs 61.54%(Z=7.530,P<0.05)and after the follow-up on week 3,respectively.There was no significant difference in the overall rate of adverse reactions between the combined and eszopiclone treatment groups(21.53%vs 31.8%,P=0.318).CONCLUSION:The combination of Zhumian Tang formula granules with eszopiclone was found to be safe and more effective in improving sleep quality than eszopiclone alone.Traditional Chinese medicine can enhance the effectiveness of Western medicine in the treatment of insomnia.
基金Supported by National Key Technology Research and Development Program(2013BAD05B00)~~
文摘In the wheat-cotton intercropping system, total 6 sowing rates （187.5, 225.0, 262.5, 300.0, 337.5 and 375.0 kg/hm2） were arranged, and the effects of sowing rate on marginal superiority and yield of wheat were investigated. The re- sults showed that the effect of sowing rate on inner-line wheat was greater than that on side-line wheat; with the increased sowing rate, the marginal superiority of panicle number was reduced in overall, and the difference in panicle number be- tween inner and side lines was decreased from 9.0×10^5/hm2 （sowing rate of 187.5 kg/hm2） to 7.8×10^5/hm2 （sowing rate of 375.0 kg/hm2）; the marginal superiority of grains per spike was increased first and then reduced, and the largest difference in grains per spike between the inner and side lines reached 4.6 under the sowing rate of 300.0 kg/hm2; the marginal superiority of 1 000-grain weight and yield was gradually increased, and the largest difference in 1 000-grain weight between the inner and side lines reached 3.9 g under the sowing rate of 337.5 kg/hm2, and in yield reached 3 136.5 kg/hm2under the sowing rate of 375.0 kg/hm2. The effects of sowing rate on the three yield factors of intercropped wheat ranked as panicle number 〉 grains per spike 〉 1 000-grain weight. The appropriate sowing rate of wheat was 225.0-262.0 kg/hm2 in the wheat-cotton intercropping system.
文摘In wheat-cotton intercropping system,the spike number per unit area,grains per spike,thousand-grain weight and yield of side line and inner line were investigated in six wheat varieties to study the marginal superiority and select suitable wheat varieties intercropped with cotton.The results showed that Xingmai No.4had obvious marginal superiority with the yield of 6 919.0 kg/hm2,so it was the suitable variety for wheat-cotton intercropping system.
文摘With F1 of self pollinated Eucalyptus urophylla, F1 of inter tree pollinated E.urophylla, F1of open pollinated E.urophylla and F1 of E.urophylla×grandis as materials,inbreeding depression and hybrid superiority in growth and wood traits are analyzed and discussed.The results are as follows.①There was a regularity for E.urophylla that F1 of self pollinated was subjected to more intense depression than F1 of open pollinated,and growth traits showed more signifcant depression than wood traits.②As to F1 of self pollinated E.urophylla, height,DBH and volume showed significant or extremely significant depression,while water content of green wood,wood density and bark thickness showed no significant depression.③As to F1 of open pollinated E.urophylla, height,DBH and volume showed depression to a certain degree,but not significant;Here again,water content of green wood,wood density and bark thickness showed no significant depression.④F1 of E.urophylla×grandis showed significant hybrid superiority in height,DBH and volume,but the hybrid superiority percentage of different cross pairs varied greatly;It showed no hybrid superiority in water content of green wood,wood density and fiber length;Its bark thickness and content of 1% NaOH extractives decreased evidently.
基金Under the auspices of Strategic Priority Research Program of the Chinese Academy of Sciences(No.XDA19040500)。
文摘To investigate the spatial synergy between agricultural development level and transport superiority degree in grain-producing areas of the central Jilin Province and the driving mechanism between them,22 counties in the central Jilin Province were used as the research units to calculate agricultural development level and transport superiority degree using the entropy weighting method,weighted travel time and raster cost distance.The spatial econometric model was used to analyze the mechanism of the mutual influence between the two.The main conclusions are as follows.1)Agricultural development level around Changchun,the provincial capital city,and in the areas of Changchun-Jilin and Changchun-Gongzhuling is high,whereas the development level of the counties in the southwest is low.2)Transport superiority degree of each county has improved,the overall connectivity of the road networks has been optimized,and the level of transportation accessibility has shown the development trend of‘centralization’,exhibiting the characteristics of proximity diffusion.3)Locally,there is spatial heterogeneity in the mutual driving effects of the two,with six main patterns.4)The theoretical conditions of von Thunen’s agricultural location have changed under the conditions of market economy due to the improvement of the transport networks,the new model of agricultural development,and the changes of the market system.
基金Knowledge Innovation Program of Chinese Academy of Sciences(No.KZCX2-EW-317)Directional Project of Institute of Mountain Hazards and Environment of Chinese Academy of Sciences(No.SDS-135-1204-04)
文摘Relationship between transport superiority degree and urbanization is not quantified enough in recent researches.Combined with coupling model and coupling coordination model,the spatial analysis technique was applied to quantitatively analyzing the relationship between transport superiority degree and comprehensive urbanization in eighteen prefecture-level cities in Sichuan from 2000 to 2011. An evaluation index system was constructed,and index weights were obtained using the variation coefficient method. The traffic volume was found to be the main factor contributing to transport superiority degree, and space urbanization was the primary factor influencing comprehensive urbanization. The coupling degree between transport superiority degree and urbanization( CU) was generally higher than the coupling coordination degree( DU) in 2000-2011. DUvaried more significantly than CU. In 2011, Sichuan was divided into five regional types. Based on the above observations, targeted recommendations were developed.
文摘The Most Dangerous Game is a highly-trimmed short story,with well-knitted plot,deep-carved characters,suspense,symbols,ironies,etc.Beyond its elaborate form,it conveys far-reaching social and cultural values.This paper is an attempt to appreciate the story inside out,in which structural approach and cultural approach are employed.Parallels and contrasts in structure and the unique shifts and gaps in its narration are highlighted to explore the tradition of reason superiority in western culture and the doom it has brought to the world and to the people concerned.The First World War is the fighting between rational beings.Rationality,when brought to extremes,may lead to irrationality.The image of General Zaroff is a reflection of modern westerner who boasts to be rational being while killing his fellow beings in bloody wars.
文摘Based on Jun-Chen-Zuo-Shi,traditional Chinese medicine has used mixtures of naturally occurring herbs for more than 2000 years.Since the last century,advances in omics and cell biology have greatly impacted on the increasing use of drug combination in modern medicine.The enhanced understanding of the biology of a disease as a disturbed system of interconnected molecular pathways which are more susceptible to the simultaneous action of several drugs,provides new opportunities for the rational development of combination therapies.Combination therapies exploit the chances for better efficacy,decreased toxicity,and reduced development of drug resistance and owing to these advantages,have become a standard for the treatment of several diseases and continue to represent a promising approach in indications of unmet medical need.
基金Graduate Program from Science Research Fund of Yunnan Department of Education(2021Y547).
文摘Terrain slope and climate zone(heat zone)are important factors affecting land use zoning and agricultural production layout in mountainous areas.Using"weight grade method",a quantitative index of comprehensively evaluating terrain slope and climatic(thermal)conditions in mountainous areas was proposed:terrain-climate superiority degree(TCSD),and TCSD,terrain superiority degree(TSD),and climate superiority degree(CSD)in 129 counties(cities and districts)of Yunnan Province were measured and analyzed.The results showed that TCSD in 50.39%of counties of Yunnan Province was relatively better(levels I and II),and TCSD in 38.76%of counties was moderate(level III),while TCSD in 10.85%of counties was relatively poorer(levels IV and V).
文摘Background:Whether lactated Ringer's solution is clinically superior to normal saline for routine intravenous administration of fluids is uncertain.Methods:In an open-label,two-period,two-sequence,cross-sectional,cluster-randomized,crossover trial,we assigned hospitals in Ontario,Canada,to use either lactated Ringer's solution or normal saline hospital-wide for a period of 12 weeks.
文摘BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely impacting outcome.
文摘The market share between China Mobile and China Unicom has stabilized since 2002. It is found that China Mobile has the superiority in the competition, for example, the scissors movement between its revenue and cost indicates that it has a strong profit generating ability and there is enough room for it to reduce the price. The ratio between its price （marginal income） and marginal cost indicates that there is a very distant limit for it to reduce the price. Its demand is obviously flexible with the price, but it does not use the price weapon abundantly. The reason for the stabilization of the market is that China Mobile withdrew from the competition.
文摘Persistent left superior vena cava(PLSVC)is a congenital anomaly where the left-sided vena cava,which usually regresses during fetal development,persists.Double superior vena cava resulting from a PLSVC is indeed a rare phenomenon.In the general population,the incidence of this condition is reported to be between 0.3%and 2.1%.[1]While this anatomical variation is often asymptomatic and discovered incidentally,it becomes relevant in certain clinical scenarios.Indeed,the presence of a PLSVC and double superior vena cava can pose challenges as incorrect positioning and result in failure.
文摘To the editor:The superior semicircular canal dehiscence was first described by Minor et all in 1998 as a condition in which the superior semicircular canal lacks a bony covering and has gained constantly increasing interest since its discovery.2 The symptoms are varied but specific what is known as Minor syndrome or‘third mobile window’syndrome,'as patients may experience autophony with abnormally loud sounds like footsteps,chewing,breathing,eye movement,echoing voice,distortion of environmental sounds and pulsatile tinnitus.
文摘The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imaging(MRI)which is also to measure the blood flow in the superior mesenteric vein(SMV)in pediatric patients over the traditional method.The study focuses on assessing the potential of SMV and superior mesenteric artery(SMA)flow quantification in children utilizing 4D flow MRI.It included 9 pediatric patients aged 18 years and below where 5 were male and 4 were female patients,on whom magnetic resonance enterorrhaphy(MRE)with 4D flow MRI protocol was used.Statistical analysis was performed using MedCalc.Measurements of SMV and SMA between two readers were calculated using Bland-Altman analysis.The results stated that six patients showed no MRE evidence of active inflammatory bowel disease,two patients showed unmarkable bowel appearance on MRI and one patient showed normal MRE without endoscopy performed at the same timeframe.The study utilized available 4D flow MRI sequences in this study aiming to show the feasibility of 4D flow quantitation of SMA and SMV flow in pediatric patients.The study also discovered good agreement for both peak velocity and peak speed measurements of SMA and SMV.
文摘BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for assessment of bowel disease in children has not been previously described.AIM To determine feasibility of superior mesenteric venous and arterial flow quantitation in pediatric patients using 4D flow MRI.METHODS Nine pediatric patients(7-14 years old,5 male and 4 female)with history or suspicion of bowel pathology,who underwent magnetic resonance(MR)enterography with 4D flow MR protocol from November 2022 to October 2023.Field strength/sequence:3T MRI using 4D flow MR protocol.Flow velocity and peak speed measurements were performed by two diagnostic radiologists placing the region of interest in perpendicular plane to blood flow on each cross section of superior mesenteric artery(SMA)and superior mesenteric vein(SMV)at three predetermined levels.Bland-Altman analysis,showed good agreement of flow velocity and peak speed measurements of SMV and SMA between two readers.RESULTS Mean SMV flow velocity increased from proximal to mid to distal(0.14 L/minute,0.17 L/minute,0.22 L/minute respectively).Mean SMA flow velocity decreased from proximal to mid to distal(0.35 L/minute,0.27 L/minute,0.21 L/minute respectively).Observed agreement was good for flow velocity measurements of SMV(mean bias-0.01 L/minute and 95%limits of agreement,-0.09 to 0.08 L/minute)and SMA(mean bias-0.03 L/minute and 95%limits of agreement,-0.23 to 0.17 L/minute)between two readers.Good agreement for peak speed measurements of SMV(mean bias-1.2 cm/second and 95%limits of agreement,-9.4 to 7.0 cm/second)and SMA(mean bias-3.2 cm/second and 95%limits of agreement,-31.4 to 24.9 cm/second).CONCLUSION Flow quantitation using 4D Flow is feasible to provide hemodynamic information for SMV and SMA in children.
