Objective To observe the clinical efficacy of the needling method for regulating wei qi and strengthening brain on insomnia.Method Two hundred patients with insomnia were randomly divided into a group of regulating we...Objective To observe the clinical efficacy of the needling method for regulating wei qi and strengthening brain on insomnia.Method Two hundred patients with insomnia were randomly divided into a group of regulating wei qi and strengthening brain（group A） and a group of normal acupuncture（group B）through random number table method,with 100 cases in each group.In group A,Baihui（百会 GV20）,Dazhui（大椎 GV 14）,Shenmai（申脉 BL62）,Zhaohai（照海 KI 6） and auricular points Yuanzhong（缘中 AT 2,3,4i）,and Shenmen（神门TF 4） were selected;and in group B,Sishencong（四神聪 EX-HN 1）,Shenmen（神门 HT 7）,and Sanyinjiao（三阴交 SP 6） were selected.Acupuncture was given on these points once daily for 15 days.Pittsburgh sleep quality index（PSQI） was used for scoring and curative effect was evaluated before and after treatment.Results The total effective rate was 89.0%（89/100） in group A and 65.0%（65/100） in group B with a very significant difference between the two groups（P〈0.01）;the difference of PSQI scores before and after treatment was（-9.15±5.68）in group A and（-5.64±5.73）in group B,with a very significant difference before and after treatment in the two groups（P〈0.01）.Conclusion The therapeutic effect of the needling method for regulating wei qi and strengthening brain on insomnia is superior to that of normal needling method.展开更多
AIM To prospectively investigate the efficacy and safety of clipflap assisted endoscopic submucosal dissection(ESD) for gastric tumors.METHODS From May 2015 to October 2016, we enrolled 104 patients with gastric cance...AIM To prospectively investigate the efficacy and safety of clipflap assisted endoscopic submucosal dissection(ESD) for gastric tumors.METHODS From May 2015 to October 2016, we enrolled 104 patients with gastric cancer or adenoma scheduled for ESD at Shiga University of Medical Science Hospital. We randomized patients into two subgroups using the minimization method based on location of the tumor(upper, middle or lower third of the stomach), tumor size(< 20 mm or > 20 mm) and ulcer status: ESD using an endoclip(the clip-flap group) and ESD without an endoclip(the conventional group). Therapeutic efficacy(procedure time) and safety(complication: Gastrointestinal bleeding and perforation) were assessed. RESULTS En bloc resection was performed in all patients. Four patients had delayed bleeding(3.8%) and two had perforation(1.9%). No significant differences in en bloc resection rate(conventional group: 100%, clip flap group: 100%), curative endoscopic resection rate(conventional group: 90.9%, clip flap group: 89.8%, P = 0.85), procedure time(conventional group: 70.8 ± 46.2 min, clip flap group: 74.7 ± 53.3 min, P = 0.69), area of resected specimen(conventional group: 884.6 ± 792.1 mm^2, clip flap group: 1006.4 ± 1004.8 mm^2, P = 0.49), delayed bleeding rate(conventional group: 5.5%, clip flap group: 2.0%, P = 0.49), or perforation rate(conventional group: 1.8%, clip flap group: 2.0%, P = 0.93) were found between the two groups. Lessexperienced endoscopists did not show any differences in procedure time between the two groups.CONCLUSION For patients with early-stage gastric tumors, the clipflap method has no advantage in efficacy or safety compared with the conventional method.展开更多
A trial equation method to nonlinear evolution equation with rank inhomogeneous is given. As appncations, the exact traveling wave solutions to some higher-order nonlinear equations such as generalized Boussinesq equa...A trial equation method to nonlinear evolution equation with rank inhomogeneous is given. As appncations, the exact traveling wave solutions to some higher-order nonlinear equations such as generalized Boussinesq equation, generalized Pochhammer-Chree equation, KdV-Burgers equation, and KS equation and so on, are obtained. Among these, some results are new. The proposed method is based on the idea of reduction of the order of ODE. Some mathematical details of the proposed method are discussed.展开更多
In this paper, the trial function method is extended to study the generalized nonlinear Schrodinger equation with time- dependent coefficients. On the basis of a generalized traveling wave transformation and a trial f...In this paper, the trial function method is extended to study the generalized nonlinear Schrodinger equation with time- dependent coefficients. On the basis of a generalized traveling wave transformation and a trial function, we investigate the exact envelope traveling wave solutions of the generalized nonlinear Schrodinger equation with time-dependent coefficients. Taking advantage of solutions to trial function, we successfully obtain exact solutions for the generalized nonlinear Schrodinger equation with time-dependent coefficients under constraint conditions.展开更多
Objective:To evaluate the clinical effect differences between conducting qi and regulating the spirit needling method and regular needling method.Methods:Sixty-nine patients of insomnia were randomly divided into an o...Objective:To evaluate the clinical effect differences between conducting qi and regulating the spirit needling method and regular needling method.Methods:Sixty-nine patients of insomnia were randomly divided into an observation group(35 cases)and a control group(34 cases).Bǎihuì(百会GV20),Sìshéncōng(四神聪EX-HN1),Hégǔ(合谷LI4),Tàichōng(太冲LR3),Zúsānlǐ(足三里ST36)and Sānyīnjiāo(三阴交SP6)were selected in the two groups.The patients in the observation group were treated with needling method for conducting qi and regulating the spirit.The patients in the control group were treated with the regular needling method.The treatment was given once every other day,both groups were treated for 12 times.Pittsburgh Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were observed before and after the treatment and the clinical effect was evaluated.Results:After treatment,the total score and the score of each item of PSQI as well as the result of ESS were all improved after the treatment in the two groups(all P<0.05).The improvements in the total score of PSQI and the result of ESS in the observation group were better than the control group(both P<0.05).The total effective rate was 88.57%(31/35)in the observation group,significantly superior to 76.47%(26/34)in the control group(P<0.05).Conclusion:The conducting qi and regulating the spirit needling method achieves a better effect on insomnia as compared with the regular needling method.This method achieves a remarkable improvement in sleep latency,sleep quality and daytime sleepiness.展开更多
As an improved version of trial equation method, a new trial equation method is proposed. Using this method, abundant new exact traveling wave solutions to a high-order KdV-type equation are obtained.
Trial equation method is a powerful tool for obtaining exact solutions of nonlinear differential equations. In this paper, the improved Boussinesq is reduced to an ordinary differential equation under the travelling w...Trial equation method is a powerful tool for obtaining exact solutions of nonlinear differential equations. In this paper, the improved Boussinesq is reduced to an ordinary differential equation under the travelling wave transformation. Trial equation method and the theory of complete discrimination system for polynomial are used to establish exact solutions of the improved Boussinesq equation.展开更多
N-of-1 trial designs have rarely been used in bodywork research.Using a recent trial as a methodological pilot,critical issues related to the applicability of N-of-1 trials to bodywork are discussed.These include the ...N-of-1 trial designs have rarely been used in bodywork research.Using a recent trial as a methodological pilot,critical issues related to the applicability of N-of-1 trials to bodywork are discussed.These include the issues of carry-over effects,bias-controlling approaches and statistical analysis.The discussion highlights the importance of mixed methods and draws some suggestions for a future research program.N-of-1 trials could be used to provide insights about some essential elements of bodywork modalities and their effectiveness.展开更多
Analysis of multi-environment trials （METs） of crops for the evaluation and recommendation of varieties is an important issue in plant breeding research. Evaluating on the both stability of performance and high yiel...Analysis of multi-environment trials （METs） of crops for the evaluation and recommendation of varieties is an important issue in plant breeding research. Evaluating on the both stability of performance and high yield is essential in MET analyses. The objective of the present investigation was to compare 11 nonparametric stability statistics and apply nonparametric tests for genotype-by-environment interaction （GEI） to 14 maize （Zea mays L.） genotypes grown at 25 locations in southwestern China during 2005. Results of nonparametric tests of GEl and a combined ANOVA across locations showed that both crossover and noncrossover GEI, and genotypes varied highly significantly for yield. The results of principal component analysis, correlation analysis of nonparametric statistics, and yield indicated the nonparametric statistics grouped as four distinct classes that corresponded to different agronomic and biological concepts of stability. Furthermore, high values of TOP and low values of rank-sum were associated with high mean yield, but the other nonparametric statistics were not positively correlated with mean yield. Therefore, only rank-sum and TOP methods would be useful for simultaneously selection for high yield and stability. These two statistics recommended JY686 and HX168 as desirable and ND108, CM12, CN36, and NK6661 as undesirable genotypes.展开更多
In the article, the nonlinear equation is reduced to an ordinary differential equation under the travelling wave transformation. Using trial equation method, the ODE is reduced to the elementary integral form. In the ...In the article, the nonlinear equation is reduced to an ordinary differential equation under the travelling wave transformation. Using trial equation method, the ODE is reduced to the elementary integral form. In the end, complete discrimination system for polynomial is used to solve the corresponding integrals and obtain the classification of all single travelling wave solutions to the equation.展开更多
Based on the homogenous balance method and the trial function method, several trial function methods composed of exponential functions are proposed and applied to nonlinear discrete systems. With the.help of symbolic ...Based on the homogenous balance method and the trial function method, several trial function methods composed of exponential functions are proposed and applied to nonlinear discrete systems. With the.help of symbolic computation system, the new exact solitary wave solutions to discrete nonlinear mKdV lattice equation, discrete nonlinear （2 ＋ 1） dimensional Toda lattice equation, Ablowitz-Ladik-lattice system are constructed.The method is of significance to seek exact solitary wave solutions to other nonlinear discrete systems.展开更多
In the pilot project of the substantive reform of court trials,“unexpected” judgments appeared constantly because the traditional documentary investigation mode has been replaced by an investigation mode under the p...In the pilot project of the substantive reform of court trials,“unexpected” judgments appeared constantly because the traditional documentary investigation mode has been replaced by an investigation mode under the principle of directness and verbalism. This change in the logic of factual judgments has caused a change in the methods of evidence examination. In traditional evidence examination, evidence obtained from investigations is supposed to be genuine and reliable. In the substantive reform of court trials, it is presumed that evidence obtained from investigations cannot be fully trusted and it is easier to ascertain the facts of the case by investigating using the principles of directness, verbalism and individualized judging methods for evidence examinations. In practice, there are three main factors affecting the genuineness of evidence: the cognitive rules of testifiers, the motivation of the subjects who provide evidence, and the methods used by investigators to obtain evidence. Based on any one of these three factors, it cannot be concluded that evidence obtained from investigations is superior to evidence presented in court. The substantive court investigation is more advantageous to establishing the facts of a case than the traditional court investigation. The essential characteristics of the substantive reform of court trials are pursuing reality in essence instead of in form, and using the files of the court trials instead of the files of the investigation to avoid the evidence obtained through investigations from playing a decisive role in the adjudication thus making criminal procedures trial-centered rather than investigation-centered.展开更多
In recent years,the perceivable difference in observed and computed deflections for arch dams suggests the necessity to consider the side-load action of the hydrostatic pressure on reservoir basin(HPRB).In this paper,...In recent years,the perceivable difference in observed and computed deflections for arch dams suggests the necessity to consider the side-load action of the hydrostatic pressure on reservoir basin(HPRB).In this paper,two additional Vogt coefficients with regard to the normal and angular deflections of arch dam foundation due to the action of HPRB are firstly elaborated,then an algorithm of the improved trial load method(ITLM)taking into account of conventional(six)and additional(two)Vogt coefficients is implemented.The elastic finite element method is employed as the bench mark in the verification of the improved method,which confirms that a better prediction of dam deflections and their gradient related stresses for arch dams may be provided by the ITLM taking into account of HPRB action.展开更多
With the increasing depletion of coal resources in China and the gradual increase of coal mining near corner coal and faults, there is an urgent need for more rational coal mining. For example, the "trial value m...With the increasing depletion of coal resources in China and the gradual increase of coal mining near corner coal and faults, there is an urgent need for more rational coal mining. For example, the "trial value method" is used to reserve fault coal pillars for coal mine faults, which can not only prevent the threat of coal mine water damage, but also reduce the stagnant coal resources. Therefore, the position of coal pillar line (the width of fault safety water barrier coal pillar) should be reasonably determined. It is imperative for aging or resource exhausted mines. At the same time, it also provides a powerful guarantee for prolonging the service life of the mine. The definition of fault coal pillar is that in order to reduce coal loss and avoid poor roadway stability caused by construction in fault zone, some necessary coal pillars of coal mine are arranged in fault (such as horizontal coal pillar and section coal pillar), which is called fault coal pillar. Water drainage coal pillar is to separate aquifer or goaf and other water bearing space from the workplace. This paper describes in detail the selection of the target layer of waterproof coal pillar, the basis and calculation method of waterproof coal (rock) pillar reservation, and the specific steps of calculating fault waterproof coal (rock) pillar by "trial value method", and describes in detail the quoted specific formula, corresponding parameters and the selection of the best point of "trial value method" by drawing method, which provides an effective reference basis for everyone.展开更多
OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicent...OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.展开更多
The arbitrary Lagrangian-Eulerian（ALE） adaptive remeshing technology and the HyperXtrude software of transient finite element simulations were used on analogue simulation of aluminium extrusion processing.The field ...The arbitrary Lagrangian-Eulerian（ALE） adaptive remeshing technology and the HyperXtrude software of transient finite element simulations were used on analogue simulation of aluminium extrusion processing.The field distributions of strain rate,stress,temperature and velocity of metal flow were obtained.The results are basically consistent with the experiment,which indicates that this method may successfully predict the defects in the actual extrusion process.展开更多
目的基于风险管理模式构建研究者发起的临床研究(IIT)全流程风险评估与分级管控体系,并验证。方法基于文献分析法检索中国知网(CNKI)、万方(WanFang)、Web of Science、PubMed数据库及互联网搜索工具等IIT相关文献、研究报告、现行管理...目的基于风险管理模式构建研究者发起的临床研究(IIT)全流程风险评估与分级管控体系,并验证。方法基于文献分析法检索中国知网(CNKI)、万方(WanFang)、Web of Science、PubMed数据库及互联网搜索工具等IIT相关文献、研究报告、现行管理政策等资料,检索时限为各数据库自建库起至2023年12月,建立IIT风险评估标准条目池初稿。采用德尔菲(Delphi)法对专家进行2轮咨询,确定最终的IIT全流程风险评估指标和分级管控体系,进行方法学评估,并结合真实世界研究和Spearman相关性分析验证指标体系的实用效能。结合地市级医院IIT项目管理现状,提出基于不同阶段、评估实施者、风险分级的分类、分级管控体系。结果组建了由17名专家构成的Delphi咨询小组,以女性(12名,70.59%)、工作年限>10年(13名,76.47%)、硕士研究生(8名,47.06%)、高级职称(9名,52.94%)、药物临床试验(GCP)主要研究者(9名,52.94%)居多。2轮Delphi咨询专家积极系数(问卷回收率)均为100%,专家权威系数分别为0.953和0.965,专家意见集中程度分别为4.495分和4.709分,变异系数分别为0.096和0.065。最终构建了涵盖立项、实施、结题全流程的IIT风险评估指标体系,包含8个一级指标、20个二级指标及36个三级指标,且三级指标风险分级为一级风险点8条、二级风险点21条和三级风险点7条。真实世界验证结果表明,构建的IIT风险评估指标体系与专家独立风险评分在全流程(ρ=0.894)、立项阶段(ρ=0.706)、实施阶段(ρ=0.761)、结题阶段(ρ=0.780)均呈极显著正相关(P<0.001)。针对地市级医疗机构提出了基于风险等级的“归口管理+分级联动”差异化管控措施。结论构建的IIT风险评估与管控体系具有较好的实用效能和评价一致性,可为地市级医疗机构开展IIT潜在风险点管理提供标准化工具支持,并为监管部门制订行业管理规范提供理论参考。展开更多
BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not sho...BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine（TCM） diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.METHODS/DESIGN： We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.DISCUSSION： The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.TRIAL REGISTRATION NUMBER： Clinical Trials.gov Identifier NCT02553005.展开更多
BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does...BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA. METHODS AND DESIGN： This is a 12-week, randomized, placebo-controlled, double-blind, multicenter trial on the treatment of RA. The participants will be randomly assigned to the experimental group and the control group at a ratio of 1：1. Participants in the experimental group will receive Xinfeng Capsule and a pharmaceutical placebo （imitation leflunomide）. The control group will receive leflunomide and an herbal placebo （imitation Xinfeng Capsule）. The American College of Rheumatology （ACR） Criteria for RA will be used to measure the efficacy of the Xinfeng Capsule. The primary outcome measure will be the percentage of study participants who achieve an ACR 20% response rate （ACR20）, which will be measured every 4 weeks after randomization. Secondary outcomes will include the ACR50 and ACR70 responses, the side effects of the medications, the Disease Activity Score 28, RA biomarkers, quality of life, and X-rays of the hands and wrists. The first four of the secondary outcomes will be measured every 4 weeks and the others will be measured at baseline and after 12 weeks of treatment. DISCUSSION： The result of this trial will help to evaluate whether Xinfeng Capsule is effective and safe in the treatment of RA. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is N CT01774877.展开更多
OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Trad...OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.展开更多
基金Supported by Project of State Administration of Traditional Chinese Medicine:2002 ZL 29
文摘Objective To observe the clinical efficacy of the needling method for regulating wei qi and strengthening brain on insomnia.Method Two hundred patients with insomnia were randomly divided into a group of regulating wei qi and strengthening brain（group A） and a group of normal acupuncture（group B）through random number table method,with 100 cases in each group.In group A,Baihui（百会 GV20）,Dazhui（大椎 GV 14）,Shenmai（申脉 BL62）,Zhaohai（照海 KI 6） and auricular points Yuanzhong（缘中 AT 2,3,4i）,and Shenmen（神门TF 4） were selected;and in group B,Sishencong（四神聪 EX-HN 1）,Shenmen（神门 HT 7）,and Sanyinjiao（三阴交 SP 6） were selected.Acupuncture was given on these points once daily for 15 days.Pittsburgh sleep quality index（PSQI） was used for scoring and curative effect was evaluated before and after treatment.Results The total effective rate was 89.0%（89/100） in group A and 65.0%（65/100） in group B with a very significant difference between the two groups（P〈0.01）;the difference of PSQI scores before and after treatment was（-9.15±5.68）in group A and（-5.64±5.73）in group B,with a very significant difference before and after treatment in the two groups（P〈0.01）.Conclusion The therapeutic effect of the needling method for regulating wei qi and strengthening brain on insomnia is superior to that of normal needling method.
文摘AIM To prospectively investigate the efficacy and safety of clipflap assisted endoscopic submucosal dissection(ESD) for gastric tumors.METHODS From May 2015 to October 2016, we enrolled 104 patients with gastric cancer or adenoma scheduled for ESD at Shiga University of Medical Science Hospital. We randomized patients into two subgroups using the minimization method based on location of the tumor(upper, middle or lower third of the stomach), tumor size(< 20 mm or > 20 mm) and ulcer status: ESD using an endoclip(the clip-flap group) and ESD without an endoclip(the conventional group). Therapeutic efficacy(procedure time) and safety(complication: Gastrointestinal bleeding and perforation) were assessed. RESULTS En bloc resection was performed in all patients. Four patients had delayed bleeding(3.8%) and two had perforation(1.9%). No significant differences in en bloc resection rate(conventional group: 100%, clip flap group: 100%), curative endoscopic resection rate(conventional group: 90.9%, clip flap group: 89.8%, P = 0.85), procedure time(conventional group: 70.8 ± 46.2 min, clip flap group: 74.7 ± 53.3 min, P = 0.69), area of resected specimen(conventional group: 884.6 ± 792.1 mm^2, clip flap group: 1006.4 ± 1004.8 mm^2, P = 0.49), delayed bleeding rate(conventional group: 5.5%, clip flap group: 2.0%, P = 0.49), or perforation rate(conventional group: 1.8%, clip flap group: 2.0%, P = 0.93) were found between the two groups. Lessexperienced endoscopists did not show any differences in procedure time between the two groups.CONCLUSION For patients with early-stage gastric tumors, the clipflap method has no advantage in efficacy or safety compared with the conventional method.
文摘A trial equation method to nonlinear evolution equation with rank inhomogeneous is given. As appncations, the exact traveling wave solutions to some higher-order nonlinear equations such as generalized Boussinesq equation, generalized Pochhammer-Chree equation, KdV-Burgers equation, and KS equation and so on, are obtained. Among these, some results are new. The proposed method is based on the idea of reduction of the order of ODE. Some mathematical details of the proposed method are discussed.
基金Project supported in part by the National Natural Science Foundation of China(Grant No.11071177)
文摘In this paper, the trial function method is extended to study the generalized nonlinear Schrodinger equation with time- dependent coefficients. On the basis of a generalized traveling wave transformation and a trial function, we investigate the exact envelope traveling wave solutions of the generalized nonlinear Schrodinger equation with time-dependent coefficients. Taking advantage of solutions to trial function, we successfully obtain exact solutions for the generalized nonlinear Schrodinger equation with time-dependent coefficients under constraint conditions.
基金Supported by Zhejiang Science Research Fund of Traditional Chinese Medicine:2017ZA027
文摘Objective:To evaluate the clinical effect differences between conducting qi and regulating the spirit needling method and regular needling method.Methods:Sixty-nine patients of insomnia were randomly divided into an observation group(35 cases)and a control group(34 cases).Bǎihuì(百会GV20),Sìshéncōng(四神聪EX-HN1),Hégǔ(合谷LI4),Tàichōng(太冲LR3),Zúsānlǐ(足三里ST36)and Sānyīnjiāo(三阴交SP6)were selected in the two groups.The patients in the observation group were treated with needling method for conducting qi and regulating the spirit.The patients in the control group were treated with the regular needling method.The treatment was given once every other day,both groups were treated for 12 times.Pittsburgh Sleep Quality Index(PSQI)and Epworth Sleepiness Scale(ESS)were observed before and after the treatment and the clinical effect was evaluated.Results:After treatment,the total score and the score of each item of PSQI as well as the result of ESS were all improved after the treatment in the two groups(all P<0.05).The improvements in the total score of PSQI and the result of ESS in the observation group were better than the control group(both P<0.05).The total effective rate was 88.57%(31/35)in the observation group,significantly superior to 76.47%(26/34)in the control group(P<0.05).Conclusion:The conducting qi and regulating the spirit needling method achieves a better effect on insomnia as compared with the regular needling method.This method achieves a remarkable improvement in sleep latency,sleep quality and daytime sleepiness.
文摘As an improved version of trial equation method, a new trial equation method is proposed. Using this method, abundant new exact traveling wave solutions to a high-order KdV-type equation are obtained.
文摘Trial equation method is a powerful tool for obtaining exact solutions of nonlinear differential equations. In this paper, the improved Boussinesq is reduced to an ordinary differential equation under the travelling wave transformation. Trial equation method and the theory of complete discrimination system for polynomial are used to establish exact solutions of the improved Boussinesq equation.
文摘N-of-1 trial designs have rarely been used in bodywork research.Using a recent trial as a methodological pilot,critical issues related to the applicability of N-of-1 trials to bodywork are discussed.These include the issues of carry-over effects,bias-controlling approaches and statistical analysis.The discussion highlights the importance of mixed methods and draws some suggestions for a future research program.N-of-1 trials could be used to provide insights about some essential elements of bodywork modalities and their effectiveness.
基金the Program for Changjiang Scholars and Innovative Research Team in University,China(IRT0453)the Youth Foundation of Sichuan Province Office of Education(2006B005) of China,for supporting this research
文摘Analysis of multi-environment trials （METs） of crops for the evaluation and recommendation of varieties is an important issue in plant breeding research. Evaluating on the both stability of performance and high yield is essential in MET analyses. The objective of the present investigation was to compare 11 nonparametric stability statistics and apply nonparametric tests for genotype-by-environment interaction （GEI） to 14 maize （Zea mays L.） genotypes grown at 25 locations in southwestern China during 2005. Results of nonparametric tests of GEl and a combined ANOVA across locations showed that both crossover and noncrossover GEI, and genotypes varied highly significantly for yield. The results of principal component analysis, correlation analysis of nonparametric statistics, and yield indicated the nonparametric statistics grouped as four distinct classes that corresponded to different agronomic and biological concepts of stability. Furthermore, high values of TOP and low values of rank-sum were associated with high mean yield, but the other nonparametric statistics were not positively correlated with mean yield. Therefore, only rank-sum and TOP methods would be useful for simultaneously selection for high yield and stability. These two statistics recommended JY686 and HX168 as desirable and ND108, CM12, CN36, and NK6661 as undesirable genotypes.
文摘In the article, the nonlinear equation is reduced to an ordinary differential equation under the travelling wave transformation. Using trial equation method, the ODE is reduced to the elementary integral form. In the end, complete discrimination system for polynomial is used to solve the corresponding integrals and obtain the classification of all single travelling wave solutions to the equation.
基金the National Natural Science Foundation of China (10461006)the Science Research Foundation of Institution of Higher Education of Inner Mongolia Autonomous Region (NJZZ07031)+1 种基金the Natural Science Foundation of Inner Mongolia Autonomous Region (200408020103)the Natural Science Research Program of Inner Mongolia Normal University (QN005023)
文摘Based on the homogenous balance method and the trial function method, several trial function methods composed of exponential functions are proposed and applied to nonlinear discrete systems. With the.help of symbolic computation system, the new exact solitary wave solutions to discrete nonlinear mKdV lattice equation, discrete nonlinear （2 ＋ 1） dimensional Toda lattice equation, Ablowitz-Ladik-lattice system are constructed.The method is of significance to seek exact solitary wave solutions to other nonlinear discrete systems.
文摘In the pilot project of the substantive reform of court trials,“unexpected” judgments appeared constantly because the traditional documentary investigation mode has been replaced by an investigation mode under the principle of directness and verbalism. This change in the logic of factual judgments has caused a change in the methods of evidence examination. In traditional evidence examination, evidence obtained from investigations is supposed to be genuine and reliable. In the substantive reform of court trials, it is presumed that evidence obtained from investigations cannot be fully trusted and it is easier to ascertain the facts of the case by investigating using the principles of directness, verbalism and individualized judging methods for evidence examinations. In practice, there are three main factors affecting the genuineness of evidence: the cognitive rules of testifiers, the motivation of the subjects who provide evidence, and the methods used by investigators to obtain evidence. Based on any one of these three factors, it cannot be concluded that evidence obtained from investigations is superior to evidence presented in court. The substantive court investigation is more advantageous to establishing the facts of a case than the traditional court investigation. The essential characteristics of the substantive reform of court trials are pursuing reality in essence instead of in form, and using the files of the court trials instead of the files of the investigation to avoid the evidence obtained through investigations from playing a decisive role in the adjudication thus making criminal procedures trial-centered rather than investigation-centered.
基金Supported by the Key Program of the National Natural Science Foundation of China(51939008)。
文摘In recent years,the perceivable difference in observed and computed deflections for arch dams suggests the necessity to consider the side-load action of the hydrostatic pressure on reservoir basin(HPRB).In this paper,two additional Vogt coefficients with regard to the normal and angular deflections of arch dam foundation due to the action of HPRB are firstly elaborated,then an algorithm of the improved trial load method(ITLM)taking into account of conventional(six)and additional(two)Vogt coefficients is implemented.The elastic finite element method is employed as the bench mark in the verification of the improved method,which confirms that a better prediction of dam deflections and their gradient related stresses for arch dams may be provided by the ITLM taking into account of HPRB action.
文摘With the increasing depletion of coal resources in China and the gradual increase of coal mining near corner coal and faults, there is an urgent need for more rational coal mining. For example, the "trial value method" is used to reserve fault coal pillars for coal mine faults, which can not only prevent the threat of coal mine water damage, but also reduce the stagnant coal resources. Therefore, the position of coal pillar line (the width of fault safety water barrier coal pillar) should be reasonably determined. It is imperative for aging or resource exhausted mines. At the same time, it also provides a powerful guarantee for prolonging the service life of the mine. The definition of fault coal pillar is that in order to reduce coal loss and avoid poor roadway stability caused by construction in fault zone, some necessary coal pillars of coal mine are arranged in fault (such as horizontal coal pillar and section coal pillar), which is called fault coal pillar. Water drainage coal pillar is to separate aquifer or goaf and other water bearing space from the workplace. This paper describes in detail the selection of the target layer of waterproof coal pillar, the basis and calculation method of waterproof coal (rock) pillar reservation, and the specific steps of calculating fault waterproof coal (rock) pillar by "trial value method", and describes in detail the quoted specific formula, corresponding parameters and the selection of the best point of "trial value method" by drawing method, which provides an effective reference basis for everyone.
基金supported by the National Key Research and Development Program of China(No.2022YFC3602500)Beijing High-level Public Health Technical Talents Construction Project(Discipline Leader-03-24)Beijing Hospitals Authority’s Ascent Plan(DFL20240601).
文摘OBJECTIVE To evaluate the safety and effectiveness of robot-assisted percutaneous coronary intervention(R-PCI)compared to traditional manual percutaneous coronary intervention(M-PCI).METHODS This prospective,multicenter,randomized controlled,non-inferior clinical trial enrolled patients with coronary heart disease who met the inclusion criteria and had indications for elective percutaneous coronary intervention.Participants were randomly assigned to either the R-PCI group or the M-PCI group.Primary endpoints were clinical and technical success rates.Clinical success was defined as visually estimated residual post-percutaneous coronary intervention stenosis<30% with no 30-day major adverse cardiac events.Technical success in the R-PCI group was defined as successful completion of percutaneous coronary intervention using the ETcath200 robot-assisted system,without conversion to M-PCI in the event of a guidewire or balloon/stent catheter that was unable to cross the vessel or was poorly supported by the catheter.Secondary endpoints included total procedure time,percutaneous coronary intervention procedure time,fluoroscopy time,contrast volume,operator radiation exposure,air kerma,and dose-area product.RESULTS The trial enrolled 152 patients(R-PCI:73 patients,M-PCI:79 patients).Lesions were predominantly B2/C type(73.6%).Both groups achieved 100% clinical success rate.No major adverse cardiac events occurred during the 30-day follow-up.The R-PCI group had a technical success rate of 100%.The R-PCI group had longer total procedure and fluoroscopy times,but lower operator radiation exposure.The percutaneous coronary intervention procedure time,contrast volume,air kerma,and dose-area product were similar between the two groups.CONCLUSIONS For certain complex lesions,performing percutaneous coronary intervention using the ETcath200 robot-assisted system is safe and effective and does not result in conversion to M-PCI.
基金Project (2009A080205003) supported by the Major Science and Technology Project of Guangdong Province,ChinaProject (30815009) supported by the Foundation of State Key Laboratory of Advanced Design and Manufacture for Vehicle Body,China
文摘The arbitrary Lagrangian-Eulerian（ALE） adaptive remeshing technology and the HyperXtrude software of transient finite element simulations were used on analogue simulation of aluminium extrusion processing.The field distributions of strain rate,stress,temperature and velocity of metal flow were obtained.The results are basically consistent with the experiment,which indicates that this method may successfully predict the defects in the actual extrusion process.
文摘目的基于风险管理模式构建研究者发起的临床研究(IIT)全流程风险评估与分级管控体系,并验证。方法基于文献分析法检索中国知网(CNKI)、万方(WanFang)、Web of Science、PubMed数据库及互联网搜索工具等IIT相关文献、研究报告、现行管理政策等资料,检索时限为各数据库自建库起至2023年12月,建立IIT风险评估标准条目池初稿。采用德尔菲(Delphi)法对专家进行2轮咨询,确定最终的IIT全流程风险评估指标和分级管控体系,进行方法学评估,并结合真实世界研究和Spearman相关性分析验证指标体系的实用效能。结合地市级医院IIT项目管理现状,提出基于不同阶段、评估实施者、风险分级的分类、分级管控体系。结果组建了由17名专家构成的Delphi咨询小组,以女性(12名,70.59%)、工作年限>10年(13名,76.47%)、硕士研究生(8名,47.06%)、高级职称(9名,52.94%)、药物临床试验(GCP)主要研究者(9名,52.94%)居多。2轮Delphi咨询专家积极系数(问卷回收率)均为100%,专家权威系数分别为0.953和0.965,专家意见集中程度分别为4.495分和4.709分,变异系数分别为0.096和0.065。最终构建了涵盖立项、实施、结题全流程的IIT风险评估指标体系,包含8个一级指标、20个二级指标及36个三级指标,且三级指标风险分级为一级风险点8条、二级风险点21条和三级风险点7条。真实世界验证结果表明,构建的IIT风险评估指标体系与专家独立风险评分在全流程(ρ=0.894)、立项阶段(ρ=0.706)、实施阶段(ρ=0.761)、结题阶段(ρ=0.780)均呈极显著正相关(P<0.001)。针对地市级医疗机构提出了基于风险等级的“归口管理+分级联动”差异化管控措施。结论构建的IIT风险评估与管控体系具有较好的实用效能和评价一致性,可为地市级医疗机构开展IIT潜在风险点管理提供标准化工具支持,并为监管部门制订行业管理规范提供理论参考。
文摘BACKGROUND： Rheumatoid arthritis（RA） is a systemic inflammatory disease characterized by functional disability and pain. Although acupuncture is widely used, until now Western acupuncture studies on RA have not shown conclusive positive results. Acupuncture is regarded as a reflex therapy that has effects on the human autonomic nervous system. By establishing a traditional Chinese medicine（TCM） diagnosis first, the practitioner is able to choose acupoints according to the state of each individual patient.METHODS/DESIGN： We are interested if acupuncture, using a classical diagnostic procedure to allocate acupoints to the patient according to the Shang Han Lun theory, can be effective in relieving pain, improving hand function and increasing health-related quality of life in RA.The authors intend to harmonize TCM diagnosis according to clinical and genetic profiles. Patients with the TCM diagnosis of a so-called Turning Point syndrome will be followed up in a randomized, prospective, double-blind, placebo-controlled, multicenter and three-armed parallel-group study with a standardized treatment in order to optimize potential therapeutic effects of acupuncture on pain, strength and muscle function of patients with RA as well as the influence on inflammation and quality of life.DISCUSSION： The findings of this study will provide important clinical information about the feasibility and efficacy of acupuncture treatment for RA patients. In addition, it will explore the feasibility of further acupuncture research.TRIAL REGISTRATION NUMBER： Clinical Trials.gov Identifier NCT02553005.
基金supported by the Twelfth Five-Year Support Project of the Ministry of Science and Technology for clinical studies investigating Xin'an medicine in the treatment of complicated ascites diseases(No.2012BAI26B02)
文摘BACKGROUND： Rheumatoid arthritis （RA）, as a common systemic inflammatory autoimmune disease, affects approximately 1 in 100 individuals. Effective treatment for RA is not yet available because current research does not have a clear understanding of the etiology and pathogenesis of RA. Xinfeng Capsule, a patent Chinese herbal medicine, has been used in the treatment of RA in recent years. Despite its reported clinical efficacy, there are no large-sample, multicenter, randomized trials that support the use of Xinfeng Capsule for RA. Therefore, we designed a randomized, double-blind, multicenter, placebo-controlled trial to assess the efficacy and safety of Xinfeng Capsule in the treatment of RA. METHODS AND DESIGN： This is a 12-week, randomized, placebo-controlled, double-blind, multicenter trial on the treatment of RA. The participants will be randomly assigned to the experimental group and the control group at a ratio of 1：1. Participants in the experimental group will receive Xinfeng Capsule and a pharmaceutical placebo （imitation leflunomide）. The control group will receive leflunomide and an herbal placebo （imitation Xinfeng Capsule）. The American College of Rheumatology （ACR） Criteria for RA will be used to measure the efficacy of the Xinfeng Capsule. The primary outcome measure will be the percentage of study participants who achieve an ACR 20% response rate （ACR20）, which will be measured every 4 weeks after randomization. Secondary outcomes will include the ACR50 and ACR70 responses, the side effects of the medications, the Disease Activity Score 28, RA biomarkers, quality of life, and X-rays of the hands and wrists. The first four of the secondary outcomes will be measured every 4 weeks and the others will be measured at baseline and after 12 weeks of treatment. DISCUSSION： The result of this trial will help to evaluate whether Xinfeng Capsule is effective and safe in the treatment of RA. TRIAL REGISTRATION： This trial has been registered in ClinicalTrials.gov. The identifier is N CT01774877.
文摘OBJECTIVE: To evaluate the therapeutic effectiveness and safety of Jinying capsule on pelvic inflammatory disease(PID) in patients with symptoms identified as the pattern of damp and heat accumulation in terms of Traditional Chinese Medicine(TCM).METHODS: We conducted a double-blinded, multicenter, randomized, placebo-controlled clinical trial which included 155 patients diagnosed with PID and identified as symptom pattern of damp and heat accumulation. They were randomly divided into experimental group(n = 78) and control group(n = 77) according to a random number table. The treatment lasted for a period of 28 d. The experimental group was given Jinying capsules and oral levofloxacin plus oral metronidazole for first 7 d.They continued with Jinying capsules and levofloxacin placebo and metronidazole placebo for another 7 d. For the remaining 14 d, they continued with Jinying capsules only. Whereas, the control group was treated with oral levofloxacin and metronidazole and Jinying capsule placebo for the first 14 d in the same way as the experimental group and then continued with Jinying capsule placebo only for the remaining 14 d. The clinical efficacy was assessed using McCormack scale, TCM symptom pattern scores, physicochemical indexes including white blood cell and erythrocyte sedimentation rate, C-reaction protein, smear of vaginal discharge,and pelvic ultrasound.RESULTS: Comparing McCormack scale between both groups after treatment, the difference in curative effect between both groups was significant (P = 0.0269). The cure rate of the experimental group and control group is 76.32% and 59.46% respectively at week 4. Comparing TCM symptom pattern scores between both groups before and after treatment, the differences in total effective rate were both significant(P < 0.05). The curative effect rate of experimental group is 2.63% and 13.70% of the control group at week 1(P = 0.0131), and73.33% of the experimental group and 56.94% of the control group at week 4(P = 0.0369). No significant differences were found between the two groups on the Physicochemical indexes(all P >0.05). No adverse events or reactions occurred in the experimental groups.CONCLUSION: Jinying capsule can reduce the dosage of antibiotics needed for PID treatment, and improve the symptoms in PID patients.
