BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid tre...BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.展开更多
Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascul...Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.展开更多
BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation...BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation failure is poor bone quality.On the other hand,some evidence suggests that surgical tactics can influence long-term instrumentation stability.AIM To assess factors that influence the stability of spinal instrumentation in patients with thoracolumbar injuries.METHODS This study is a non-randomized single center ambispective evaluation of 204 consecutive patients(117 men;87 women)with unstable thoracolumbar injuries.All patients underwent either stand-alone or combined with anterior column reconstruction instrumentation.In cases with spinal cord and nerve root injuries,either posterior or anterior decompression were performed.Patients with pedicle screw loosening were identified via computed tomography imaging.Out of those,cases with clinically significant instrumentation failure were registered.RESULTS The rate of pedicle screw loosening detected by computed tomography was inversely correlated with bone radiodensity figures and an increased association with the number of instrumented levels,residual kyphotic deformity,laminectomy,and lumbosacral fixation.Intermediate screws and anterior reconstruction were associated with a clinically relevant decreased risk of pedicle screw loosening development.Either complete or partial posterior fusion within instrumented levels was capable of decreasing instrumentation failure risk,while extensive decompression with laminectomy and at least one-level total facetectomy were associated with an increased risk of instrumentation failure.Anterior decompression does not have a negative impact on instrumentation stability.CONCLUSION Intermediate screws,anterior reconstruction and posterior tension band preservation are associated with decreased rates of instrumentation instability development.Posterior fusion is beneficial in terms of instrumentation failure prevention.展开更多
[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with p...[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with phlegm-stasis syndrome were randomly divided into a treatment group and a control group(30 each).The control group received standardized Western medicine treatment,while the treatment group also took Qinjin Tablet.After a 4-week treatment,comparisons were made on improvement of angina symptoms,TCM syndrome scores,blood stasis scores,reduction/cessation of short-acting anti-angina drugs,Seattle Angina Questionnaire(SAQ)scores,blood lipid levels,and matrix metalloproteinase-9(MMP-9)concentrations between the two groups.[Results]No statistical differences existed in baseline data like age,gender,and disease duration between the two groups(P>0.05).The treatment group showed significantly better efficacy than the control group in improving angina symptoms,TCM syndrome scores,blood stasis scores,and reduction or discontinuation of short-acting anti-anginal drugs(P<0.05).The SAQ score increase was more significant in the treatment group(P<0.05).The control group significantly reduced low-density lipoprotein cholesterol(LDL-C)(P<0.05),while the treatment group markedly increased high-density lipoprotein cholesterol(HDL-C)(P<0.05).Post-treatment,the treatment group had a marked reduction in serum MMP-9(P<0.05),with no significant change in the control group.[Conclusions]Qinjin Tablet can significantly alleviate clinical symptoms and improve quality of life in UA patients by modulating the HDL-C/MMP-9 signaling pathway.展开更多
In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and l...In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and lower constraints and the sensor in the feedback loop is subjected to network-induced unknown time-varying delay and noise.With this nonlinear control method,we first employ right coprime factorization based on isomorphism and operator theory to factorize the plant,so that bounded input bounded output(BIBO)stability can be guaranteed.Next,continuous-time generalized predictive control(CGPC)is utilized for the unstable operator of the right coprime factorized plant to guarantee inner stability and enables the closed-loop dynamics of the system with predictive characteristics.Meanwhile,a second-Do F(degrees of freedom)switched controller that satisfies a perturbed Bezout identity and a robustness condition is designed.By using the CGPC controller that possesses predictive behavior and the second-Do F switched stabilizer,the overall stability of the plant subjected to actuator limitations is guaranteed.To address sensor limitations that exist in networked plants in the form of delay and noise which often cause system performance degradation,we implement an identity operator definition in the feedback loop to compensate for these adverse effects.Further,a pre-operator is designed to ensure that the plant output tracks the reference input.Finally,the effectiveness of the proposed design scheme is demonstrated by simulations.展开更多
Convectively unstable processes caused by dense water subsidence are common occurrences in high-latitude oceanic regions,and significantly modulate mass and heat transport and mixing processes in the ocean.An idealize...Convectively unstable processes caused by dense water subsidence are common occurrences in high-latitude oceanic regions,and significantly modulate mass and heat transport and mixing processes in the ocean.An idealized numerical experiment using the large eddy simulation method was conducted to analyze the three-dimensional flow field structure and the mechanism for dense water subsidence.Specifically,a negative salt flux is set at the sea surface,in which salt flux enters the sea surface to simulate the icing and salting-out phenomena that occur at high latitudes.Results show that the mean-state 3D flow field of dense water subsidence exhibits a hollow conical distribution.The horizontal flow field is characterized by a cyclonic vortex that driven primarily by the pressure gradient and influenced by the Coriolis effect.Moreover,the inverse vertical pressure gradient generated by this vortex inhibits the sinking of the plume,leading to its off-axis deflection and the development of an anticyclonic precession.In addition,the impact of rotation on the structure of a sinking plume within a stratified environment is discussed.Both horizontal vortex intensity and cone angle of the hollow cone flow field are increased with increasing rotation rate,resulting in a decrease in the plume’s maximum sinking depth.Variances in rotation direction cause the horizontal vortex and sinking plumes of dense water in the northern and southern hemispheres to rotate in opposite directions.展开更多
Interactions among ecosystem services(ESs)are spatially heterogeneous,shaped by both stable(unidirectional)and unstable(context-dependent)influences of socio-economic development and climate change.These complexities ...Interactions among ecosystem services(ESs)are spatially heterogeneous,shaped by both stable(unidirectional)and unstable(context-dependent)influences of socio-economic development and climate change.These complexities pose significant challenges for spatially adaptive ecosystem management.Ecosystem service bundles(ESBs),as recurring combinations of ESs,offer a valuable framework to capture such interactions.Here,we proposed an integrated analytical framework that combines K-means clustering,the geographical detector(GD)model,and geographically and temporally weighted regression(GTWR)models to evaluate how socio-economic and climatic drivers influence ESBs across space and time.Using Hanshui River Basin(HRB)in central China as a case study,we quantified ES dynamics from 2000 to 2020,identified ESBs and stable and unstable effects of multiple drivers.The results showed that carbon sequestration(CS),water yield(WY),and aesthetic landscape(AL)increased by 32.80%,9.00%,and 7.34%,respectively,while soil retention(SR)and food supply(FS)declined by 8.38%and 5.36%.Five distinct ESBs were identified,namely ecologically fragile bundle(EFB),agricultural production bundle(APB),water supply bundle(WSB),forest ecological bundle(FEB),and ecological conservation bundle(ECB).Among these,FEB expanded to more than 35.75%of the HRB,and APB exhibited the sharpest decline(-28.64%).Land use intensity(LUI)was the primary driver of the spatial heterogeneity of ESBs,while synergistic and nonlinear interactions among multiple factors increasingly amplified their effects over time.Notably,annual precipitation(AP)emerged as the only stable basin-scale driver,consistently enhancing ES performance,while gross domestic product(GDP)and normalized difference vegetation index(NDVI)had stable yet spatially differentiated effects across bundles.Our findings highlight the significance of distinguishing stable/unstable driver effects on ES dynamics to inform regionally adaptive ecosystem governance.The proposed framework provides valuable insights into ES interactions,identify spatial priorities,and support policy interventions that balance ecological conservation with socio-economic development.展开更多
Objective:To evaluate and analyze the actual efficacy of percutaneous vertebroplasty in the treatment of old unstable osteoporotic spinal fractures.Methods:From March 2023 to March 2024,46 patients with old unstable o...Objective:To evaluate and analyze the actual efficacy of percutaneous vertebroplasty in the treatment of old unstable osteoporotic spinal fractures.Methods:From March 2023 to March 2024,46 patients with old unstable osteoporotic spinal fractures in our hospital were included in this study.They were divided into the conventional group and the observation group based on treatment differences,with 23 patients in each group.The conventional group received conservative drug therapy,while the observation group underwent percutaneous vertebroplasty.The following indicators were compared and analyzed between the two groups:clinical treatment effect and improvement in physical function indicators.Results:The treatment efficiency of the observation group was 95.65%(22/23),while that of the conventional group was 69.57%(16/23).There was a significant difference between the groups,and the treatment effect of the observation group was significantly better(P<0.05).After treatment,the scores of physical status,daily living ability,functional independence,and life obstacles in the observation group were(89.33±4.08),(88.72±4.08),(90.41±2.89),(72.35±3.22),respectively,while those in the conventional group were(68.54±4.21),(67.42±4.11),(73.48±2.75),(72.35±3.22).There was a significant difference between the groups,and the improvement in physical function indicators in the observation group was more pronounced(P<0.05).Conclusion:For patients with old unstable osteoporotic spinal fractures,the basic value of percutaneous vertebroplasty is significant.It can not only improve clinical efficacy and safety but also promote the gradual recovery of patients'physical function indicators.It is recommended for clinical reference and practical application.展开更多
Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and ...Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and Conclusion The criteria for singular points, closed orbits and hyperbolic equilibrium points of a second order autonomous Birkhoff system are given. Moreover the stability of equilibria, stable manifolds and unstable manifolds are obtained.展开更多
The present paper studies the unstable nonlinear Schr¨odinger equations, describing the time evolution of disturbances in marginally stable or unstable media. More precisely, the unstable nonlinear Schr¨odin...The present paper studies the unstable nonlinear Schr¨odinger equations, describing the time evolution of disturbances in marginally stable or unstable media. More precisely, the unstable nonlinear Schr¨odinger equation and its modified form are analytically solved using two efficient distinct techniques, known as the modified Kudraysov method and the sine-Gordon expansion approach. As a result, a wide range of new exact traveling wave solutions for the unstable nonlinear Schr¨odinger equation and its modified form are formally obtained.展开更多
A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Takin...A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Taking Ti-6.5Al-3.5Mo-1.5Zr-0.3Si alloy as the testing material, the thermomechnical parameter windows of the unstable deformation zones for the Ti-alloy are integrated into a commercial finite element simulation software platform. The distribution and variation of the unstable deformation zones of the alloy in hot compression process are simulated and predicted using the tailor-made finite element codes in the finite element platform. The simulation results tally with the physical experiments and the proposed method for simulation and prediction of the unstable deformation is thus verified and its efficiency is validated.展开更多
Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few s...Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few scholars have explored the unstable evolution of railway slopes under the joint action of rainfall-vibration.Based on the model test of sandy soil slope,the unstable evolution process of slope under locomotive vibration,rainfall,and rainfall-vibration joint action conditions was simulated in this paper.By comparing and analyzing the variation trends of soil pressure and water content of slope under these conditions,the change laws of pore pressure under the influence of vibration and rainfall were explored.The main control factors affecting the stability of slope structure under the joint action conditions were further defined.Combined with the slope failure phenomena under these three conditions,the causes of slope instability resulting from each leading factor were clarified.Finally,according to the above conclusions,the unstable evolution of the slope under the rainfall-vibration joint action was determined.The test results show that the unstable evolution process of sandy soil slope,under the rainfall-vibration joint action,can be divided into:rainfall erosion cracking,vibration promotion penetrating,and slope instability sliding three stages.In the process of slope unstable evolution,rainfall and vibration play the roles of inducing and promoting slide respectively.In addition,the deep cracks,which are the premise for the formation of the sliding surface,and the violent irregular fluctuation of soil pressure,which reflects the near penetration of the sliding surface,constitute the instability characteristics of the railway slope together.This paper reveals the unstable evolution of sandy soil slopes under the joint action of rainfall-vibration,hoping to provide the theoretical basis for the early warning and prevention technology of railway slopes.展开更多
This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtai...This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtained.展开更多
OBJECTIVE:To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection(DCI)in the treatment of unstable angina pectoris(UAP).METHODS:Randomized controlled trials(RCTs)regarding DCI used for tre...OBJECTIVE:To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection(DCI)in the treatment of unstable angina pectoris(UAP).METHODS:Randomized controlled trials(RCTs)regarding DCI used for treating UAP were searched in English and Chinese electronic databases from inception to January 2014.Two reviewers independently retrieved RCTs and extracted relevant information.The Cochrane risk of bias method was used to assess the quality of included studies,and a Meta-analysis was conducted with Review Manager5.2 software.RESULTS:Eleven RCTs involving 1034 participants were included.The methodological quality was relatively passable.The Meta-analysis indicated that the combined use of DCI and conventional treatment with Western Medicine(WM)was more efficacious in the outcomes of total effective rate[Relative Risk(RR)=1.27,95%CI(confidence interval;1.18,1.35),P<0.000 01],the total effective rate of ECG[RR=1.40,95%CI(1.18,1.66),P<0.000 01],total cholesterol[Mean difference(MD)=-0.58,95%CI(-0.83,-0.33),P<0.000 01],total triglycerides[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001],and the number of ST-segment depression[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001].There were two adverse drug reactions reported in one study.CONCLUSION:Based on the systematic review,DCI combined with WM appeared to be efficacious in the treatment UAP.However,the evidence of DCI for treating UAP requires large-scale and double-blind RCTs to substantiate these findings.展开更多
The research on the rock burst prediction was made on the basis of seismology,rock mechanics and the data from Dongguashan Copper Mine(DCM) ,the deepest metal mine in China.The seismic responses to mining in DCM were ...The research on the rock burst prediction was made on the basis of seismology,rock mechanics and the data from Dongguashan Copper Mine(DCM) ,the deepest metal mine in China.The seismic responses to mining in DCM were investigated through the analyses of the spatio-temporal distribution of hypocenters,apparent stress and displacement of seismic events,and the process of the generation of hazardous seismicity in DCM was studied in the framework of the theory of asperity in the seismic source mechanism.A method of locating areas with hazardous seismicity and a conceptual model of hazardous seismic nucleation in DCM were proposed.A criterion of rockburst prediction was analyzed theoretically in the framework of unstable failure theories,and consequently,the rate of change in the ratio of the seismic stiffness of rock in a seismic nucleation area to that in surrounding area,dS/dt,is defined as an index of the rockburst prediction.The possibility of a rockburst will increase if dS/dt>0,and the possibility of rock burst will decrease if dS/dt<0.The correctness of these methods is demonstrated by analyses of rock failure cases in DCM.展开更多
OBJECTIVE: To undertake a systematic review and network meta-analysis(NMA) to compare the effectiveness among the different regimens of Salvia miltiorrhiza injection classes(SMICs) for unstable angina pectoris(UAP) tr...OBJECTIVE: To undertake a systematic review and network meta-analysis(NMA) to compare the effectiveness among the different regimens of Salvia miltiorrhiza injection classes(SMICs) for unstable angina pectoris(UAP) treatment.METHODS: A systematic retrieval was conducted in several literature databases to identify randomized controlled trials focusing on the different regimens of SMICs for UAP treatment until January2016. The quality assessment was accomplished according to the Cochrane risk of bias tool. Pair-wise meta-analyses were carried out by Rev Man 5.3. A random-effects model of NMA was used to compare the different regimens of SMICs with regard to efficacy by STATA 13.0.RESULTS: A total of 111 studies involving 10 500patients were included in the NMA. The methodological quality of included studies was not high.Current evidence shows that salvianolate(SI) is the optimal treatment for UAP in improving the total efficacy against UAP. Guanxingning(GXN) is the optimal treatment for UAP for improving the total effectiveness of electrocardiography.CONCLUSION: SMICs have advantages in preventing cardiovascular events. GXN, SI, and Danhong had the greatest probability of being the best treatment in the total efficacy against UAP and for improving the total effectiveness of electrocardiography.展开更多
Millimeter wave(mmWave) communications of unmanned aerial vehicles(UAVs) have drawn dramatic attentions for its flexibility on a variety of applications.Recently,channel tracking base on the spatial features has been ...Millimeter wave(mmWave) communications of unmanned aerial vehicles(UAVs) have drawn dramatic attentions for its flexibility on a variety of applications.Recently,channel tracking base on the spatial features has been proposed to solve the problem of beam misalignments due to the UAV navigation.However,unstable beam pointing caused by the non-ideal beam tracking environment may impact the performance of mmWave systems significantly.In this paper,an improved beamforming method is presented to overcome this shortcoming.Firstly,the effect of the beam deviation is analyzed through the establishment of the equivalent data rate.Then,combining the quantification of spatial angle and the improved orthogonal matching pursuit(OMP) algorithm,an optimized beam corresponding to the beam deviation is obtained.Simulation results show that the optimized beam of the proposed approach can effectively improve the spectral efficiency without improving the complexity when the beam pointing is unstable.展开更多
Unstable angina（UA） is the most dangerous type of Coronary Heart Disease（CHD） to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metabolomics is...Unstable angina（UA） is the most dangerous type of Coronary Heart Disease（CHD） to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metabolomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performanees for the three methods. Alternatively, we combined inde- pendent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.展开更多
BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can c...BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.展开更多
Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in pa...Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.展开更多
文摘BACKGROUND Unstable intertrochanteric fractures in elderly patients require effective surgical management,with both cementless bipolar hemiarthroplasty(CBHA)and proximal femoral nail anti-rotation(PFNA)being valid treatment options to reduce morbidity and mortality.AIM To evaluate and compare the outcomes of CBHA and PFNA in treatment of unstable intertrochanteric fractures.METHODS A comprehensive search was conducted to identify relevant studies discussing the outcomes of using both CBH and PFNA in treatment of unstable intertrochanteric fractures.Studies published up to January 1,2025 were searched across multiple databases,including PubMed,EMBASE,Scopus,Web of Science,Cochrane Library,and Google Scholar.Full texts of the selected articles were retrieved,reviewed,and independently assessed by the investigators.Discrepancies were resolved by consensus,with any remaining disagreements being arbitrated by a third author.RESULTS This meta-analysis included three studies,all of which were retrospective,involving a total of 240 patients.The follow-up period for participants was at least 12 months.CBHA was associated with significantly higher blood loss compared to PFNA[mean differences(MD):129.14,95%CI(52.51,205.77),P=0.001],though heterogeneity was high(I²=97%).Operative time showed no significant difference initially[MD:6.10,95%CI(-13.34,25.54),P=0.54],but after excluding one study,BHA had longer operative times[MD:21.51,95%CI(18.60,24.41),P<0.00001].Hospital stay and Harris scores showed no significant differences between groups.CBHA facilitated faster progression to weight-bearing[MD:-11.92,95%CI(-22.46,-1.39),P=0.03]and a lower incidence of prosthetic loosening[risk ratio:0.21,95%CI(0.05,0.92),P=0.04].Refracture and thrombus formation rates were comparable between the two groups.CONCLUSION CBHA offers shorter weight-bearing duration and reduced prosthetic loosening but incurs greater blood loss and longer operative times compared to PFNA.Both techniques show comparable functional recovery,hospital stay,refracture,and thrombus risks.Clinical choice should prioritize early mobilization or surgical minimalism,guided by patient needs.Further prospective studies are warranted.
基金supported by the National Natural Science Foundation of China(No.82030016,No 82230011 and No.82200533).
文摘Background and Objective Inflammation plays a pivotal role in the progression of coronary artery disease(CAD).High-sensitivity C-reactive protein(hsCRP)serves as a well-established biomarker for assessing cardiovascular inflammation risk.However,the specific intestinal microbiota alteration contributing to increased inflammation remains unclear.Therefore,the present study investigated the correlation between the intestinal microbiota and inflammation in patients with unstable angina(UA).Methods A cohort of 92 patients with UA was recruited for this study.The plasma hsCRP level was measured via a CardioPhase hsCRP assay,fecal samples were collected after admission,and 16S rRNA sequencing was conducted to identify the fecal microbial profile.The participants were classified into two groups according to the median hsCRP level(1.11 mg/L).The composition of the fecal microbiota was compared between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Additionally,the correlations between the fecal microbiota and clinical characteristics were analyzed.Results A notable reduction in the relative abundance of Akkermansia was observed in patients with hsCRP≥1.11 mg/L,whereas the diversity of the fecal microbiota was not significantly different between patients with hsCRP≥1.11 mg/L and those with hsCRP<1.11 mg/L.Furthermore,the abundance of Akkermansia was negatively correlated with hsCRP levels.Conclusion This study suggested a significant association between decreased levels of Akkermansia and inflammatory risk in patients with UA.These findings underscore the potential role of the intestinal microbiota in contributing to inflammation in UA patients.Further work is needed on the mechanism by which the microbiota contributes to inflammatory risk.
基金Supported by AI For Spinal Surgery Planning and Results Assessment Project under the“Priority 2030”Academic Leadership Initiative,No.6.18-01/240724-15.
文摘BACKGROUND Pedicle screw fixation is frequently used to treat unstable thoracolumbar injuries;however,the rate of instrumentation failure remains considerable.The primary contributing factor leading to instrumentation failure is poor bone quality.On the other hand,some evidence suggests that surgical tactics can influence long-term instrumentation stability.AIM To assess factors that influence the stability of spinal instrumentation in patients with thoracolumbar injuries.METHODS This study is a non-randomized single center ambispective evaluation of 204 consecutive patients(117 men;87 women)with unstable thoracolumbar injuries.All patients underwent either stand-alone or combined with anterior column reconstruction instrumentation.In cases with spinal cord and nerve root injuries,either posterior or anterior decompression were performed.Patients with pedicle screw loosening were identified via computed tomography imaging.Out of those,cases with clinically significant instrumentation failure were registered.RESULTS The rate of pedicle screw loosening detected by computed tomography was inversely correlated with bone radiodensity figures and an increased association with the number of instrumented levels,residual kyphotic deformity,laminectomy,and lumbosacral fixation.Intermediate screws and anterior reconstruction were associated with a clinically relevant decreased risk of pedicle screw loosening development.Either complete or partial posterior fusion within instrumented levels was capable of decreasing instrumentation failure risk,while extensive decompression with laminectomy and at least one-level total facetectomy were associated with an increased risk of instrumentation failure.Anterior decompression does not have a negative impact on instrumentation stability.CONCLUSION Intermediate screws,anterior reconstruction and posterior tension band preservation are associated with decreased rates of instrumentation instability development.Posterior fusion is beneficial in terms of instrumentation failure prevention.
基金Supported by Jiangsu Provincial Traditional Chinese Medicine Leading Talent Training Project[Su TCM Science-Education(2023)17]National Administration of Traditional Chinese Medicine Fifth Batch of National Excellent Clinical Talent Training Project[TCM Personnel-Education(2022)1].
文摘[Objectives]To explore the clinical efficacy of Qinjin Tablet in treating unstable angina with phlegm-stasis syndrome and preliminarily explore its intervention mechanism.[Methods]Sixty unstable angina patients with phlegm-stasis syndrome were randomly divided into a treatment group and a control group(30 each).The control group received standardized Western medicine treatment,while the treatment group also took Qinjin Tablet.After a 4-week treatment,comparisons were made on improvement of angina symptoms,TCM syndrome scores,blood stasis scores,reduction/cessation of short-acting anti-angina drugs,Seattle Angina Questionnaire(SAQ)scores,blood lipid levels,and matrix metalloproteinase-9(MMP-9)concentrations between the two groups.[Results]No statistical differences existed in baseline data like age,gender,and disease duration between the two groups(P>0.05).The treatment group showed significantly better efficacy than the control group in improving angina symptoms,TCM syndrome scores,blood stasis scores,and reduction or discontinuation of short-acting anti-anginal drugs(P<0.05).The SAQ score increase was more significant in the treatment group(P<0.05).The control group significantly reduced low-density lipoprotein cholesterol(LDL-C)(P<0.05),while the treatment group markedly increased high-density lipoprotein cholesterol(HDL-C)(P<0.05).Post-treatment,the treatment group had a marked reduction in serum MMP-9(P<0.05),with no significant change in the control group.[Conclusions]Qinjin Tablet can significantly alleviate clinical symptoms and improve quality of life in UA patients by modulating the HDL-C/MMP-9 signaling pathway.
文摘In this paper,a nonlinear control approach for an unstable networked plant in the presence of actuator and sensor limitations using robust right coprime factorization is proposed.The actuator is limited by upper and lower constraints and the sensor in the feedback loop is subjected to network-induced unknown time-varying delay and noise.With this nonlinear control method,we first employ right coprime factorization based on isomorphism and operator theory to factorize the plant,so that bounded input bounded output(BIBO)stability can be guaranteed.Next,continuous-time generalized predictive control(CGPC)is utilized for the unstable operator of the right coprime factorized plant to guarantee inner stability and enables the closed-loop dynamics of the system with predictive characteristics.Meanwhile,a second-Do F(degrees of freedom)switched controller that satisfies a perturbed Bezout identity and a robustness condition is designed.By using the CGPC controller that possesses predictive behavior and the second-Do F switched stabilizer,the overall stability of the plant subjected to actuator limitations is guaranteed.To address sensor limitations that exist in networked plants in the form of delay and noise which often cause system performance degradation,we implement an identity operator definition in the feedback loop to compensate for these adverse effects.Further,a pre-operator is designed to ensure that the plant output tracks the reference input.Finally,the effectiveness of the proposed design scheme is demonstrated by simulations.
基金Supported by the National Natural Science Foundation of China(Nos.42250710152,42192562)the Southern Laboratory of Ocean Science and Engineering(Guangdong Zhuhai)(No.SML 2020 SP 007)。
文摘Convectively unstable processes caused by dense water subsidence are common occurrences in high-latitude oceanic regions,and significantly modulate mass and heat transport and mixing processes in the ocean.An idealized numerical experiment using the large eddy simulation method was conducted to analyze the three-dimensional flow field structure and the mechanism for dense water subsidence.Specifically,a negative salt flux is set at the sea surface,in which salt flux enters the sea surface to simulate the icing and salting-out phenomena that occur at high latitudes.Results show that the mean-state 3D flow field of dense water subsidence exhibits a hollow conical distribution.The horizontal flow field is characterized by a cyclonic vortex that driven primarily by the pressure gradient and influenced by the Coriolis effect.Moreover,the inverse vertical pressure gradient generated by this vortex inhibits the sinking of the plume,leading to its off-axis deflection and the development of an anticyclonic precession.In addition,the impact of rotation on the structure of a sinking plume within a stratified environment is discussed.Both horizontal vortex intensity and cone angle of the hollow cone flow field are increased with increasing rotation rate,resulting in a decrease in the plume’s maximum sinking depth.Variances in rotation direction cause the horizontal vortex and sinking plumes of dense water in the northern and southern hemispheres to rotate in opposite directions.
基金Under the auspices of National Natural Science Foundation of China(No.42171414)。
文摘Interactions among ecosystem services(ESs)are spatially heterogeneous,shaped by both stable(unidirectional)and unstable(context-dependent)influences of socio-economic development and climate change.These complexities pose significant challenges for spatially adaptive ecosystem management.Ecosystem service bundles(ESBs),as recurring combinations of ESs,offer a valuable framework to capture such interactions.Here,we proposed an integrated analytical framework that combines K-means clustering,the geographical detector(GD)model,and geographically and temporally weighted regression(GTWR)models to evaluate how socio-economic and climatic drivers influence ESBs across space and time.Using Hanshui River Basin(HRB)in central China as a case study,we quantified ES dynamics from 2000 to 2020,identified ESBs and stable and unstable effects of multiple drivers.The results showed that carbon sequestration(CS),water yield(WY),and aesthetic landscape(AL)increased by 32.80%,9.00%,and 7.34%,respectively,while soil retention(SR)and food supply(FS)declined by 8.38%and 5.36%.Five distinct ESBs were identified,namely ecologically fragile bundle(EFB),agricultural production bundle(APB),water supply bundle(WSB),forest ecological bundle(FEB),and ecological conservation bundle(ECB).Among these,FEB expanded to more than 35.75%of the HRB,and APB exhibited the sharpest decline(-28.64%).Land use intensity(LUI)was the primary driver of the spatial heterogeneity of ESBs,while synergistic and nonlinear interactions among multiple factors increasingly amplified their effects over time.Notably,annual precipitation(AP)emerged as the only stable basin-scale driver,consistently enhancing ES performance,while gross domestic product(GDP)and normalized difference vegetation index(NDVI)had stable yet spatially differentiated effects across bundles.Our findings highlight the significance of distinguishing stable/unstable driver effects on ES dynamics to inform regionally adaptive ecosystem governance.The proposed framework provides valuable insights into ES interactions,identify spatial priorities,and support policy interventions that balance ecological conservation with socio-economic development.
文摘Objective:To evaluate and analyze the actual efficacy of percutaneous vertebroplasty in the treatment of old unstable osteoporotic spinal fractures.Methods:From March 2023 to March 2024,46 patients with old unstable osteoporotic spinal fractures in our hospital were included in this study.They were divided into the conventional group and the observation group based on treatment differences,with 23 patients in each group.The conventional group received conservative drug therapy,while the observation group underwent percutaneous vertebroplasty.The following indicators were compared and analyzed between the two groups:clinical treatment effect and improvement in physical function indicators.Results:The treatment efficiency of the observation group was 95.65%(22/23),while that of the conventional group was 69.57%(16/23).There was a significant difference between the groups,and the treatment effect of the observation group was significantly better(P<0.05).After treatment,the scores of physical status,daily living ability,functional independence,and life obstacles in the observation group were(89.33±4.08),(88.72±4.08),(90.41±2.89),(72.35±3.22),respectively,while those in the conventional group were(68.54±4.21),(67.42±4.11),(73.48±2.75),(72.35±3.22).There was a significant difference between the groups,and the improvement in physical function indicators in the observation group was more pronounced(P<0.05).Conclusion:For patients with old unstable osteoporotic spinal fractures,the basic value of percutaneous vertebroplasty is significant.It can not only improve clinical efficacy and safety but also promote the gradual recovery of patients'physical function indicators.It is recommended for clinical reference and practical application.
文摘Aim To study singular points, closed orbits, stable manifolds and unstable manifolds of a second order autonomous Birkhoff system. Methods Qualitative methods of ordinary differential equation were used. Results and Conclusion The criteria for singular points, closed orbits and hyperbolic equilibrium points of a second order autonomous Birkhoff system are given. Moreover the stability of equilibria, stable manifolds and unstable manifolds are obtained.
文摘The present paper studies the unstable nonlinear Schr¨odinger equations, describing the time evolution of disturbances in marginally stable or unstable media. More precisely, the unstable nonlinear Schr¨odinger equation and its modified form are analytically solved using two efficient distinct techniques, known as the modified Kudraysov method and the sine-Gordon expansion approach. As a result, a wide range of new exact traveling wave solutions for the unstable nonlinear Schr¨odinger equation and its modified form are formally obtained.
基金Project (51005112) supported by the National Natural Science Foundation of ChinaProject (GF200901008) supported by the Open Fund of National Defense Key Disciplines Laboratory of Light Alloy Processing Science and Technology,China
文摘A method is proposed for prediction of the unstable deformation in hot forging process using both the determined thermomechnical parameter windows of the unstable deformation zones and finite element simulation. Taking Ti-6.5Al-3.5Mo-1.5Zr-0.3Si alloy as the testing material, the thermomechnical parameter windows of the unstable deformation zones for the Ti-alloy are integrated into a commercial finite element simulation software platform. The distribution and variation of the unstable deformation zones of the alloy in hot compression process are simulated and predicted using the tailor-made finite element codes in the finite element platform. The simulation results tally with the physical experiments and the proposed method for simulation and prediction of the unstable deformation is thus verified and its efficiency is validated.
基金supported by the Major Research Plan of the National Natural Science Foundation of China(Grant No.42027806)the Key Programme of the Natural Science Foundation of China(Grant No.41630639)National Natural Science Foundation of China General Program(Grant No.42372324).
文摘Understanding the unstable evolution of railway slopes is the premise for preventing slope failure and ensuring the safe operation of trains.However,as two major factors affecting the stability of railway slopes,few scholars have explored the unstable evolution of railway slopes under the joint action of rainfall-vibration.Based on the model test of sandy soil slope,the unstable evolution process of slope under locomotive vibration,rainfall,and rainfall-vibration joint action conditions was simulated in this paper.By comparing and analyzing the variation trends of soil pressure and water content of slope under these conditions,the change laws of pore pressure under the influence of vibration and rainfall were explored.The main control factors affecting the stability of slope structure under the joint action conditions were further defined.Combined with the slope failure phenomena under these three conditions,the causes of slope instability resulting from each leading factor were clarified.Finally,according to the above conclusions,the unstable evolution of the slope under the rainfall-vibration joint action was determined.The test results show that the unstable evolution process of sandy soil slope,under the rainfall-vibration joint action,can be divided into:rainfall erosion cracking,vibration promotion penetrating,and slope instability sliding three stages.In the process of slope unstable evolution,rainfall and vibration play the roles of inducing and promoting slide respectively.In addition,the deep cracks,which are the premise for the formation of the sliding surface,and the violent irregular fluctuation of soil pressure,which reflects the near penetration of the sliding surface,constitute the instability characteristics of the railway slope together.This paper reveals the unstable evolution of sandy soil slopes under the joint action of rainfall-vibration,hoping to provide the theoretical basis for the early warning and prevention technology of railway slopes.
文摘This paper discusses a class of unstable second order neutral differential equations with positive and negative coeffcients. Sufficient conditions for all bounded solutions of the equations to be oscillatory are obtained.
基金Supported by National Natural Science Foundation of China(Study on the Key Factors of Allergic Reaction that Caused by Chinese Herbal Injection Based on the Three-Dimensional Database and Multi-Dimensional Data-Mining,No.81473547)Scientific Research Innovation Team Project of Beijing University of Chinese Medicine(the Basic Theory of Traditional Chinese Medicine,No.2011-CXTD-14)
文摘OBJECTIVE:To evaluate systematically the efficacy and safety of Danshenchuanxiongqin Injection(DCI)in the treatment of unstable angina pectoris(UAP).METHODS:Randomized controlled trials(RCTs)regarding DCI used for treating UAP were searched in English and Chinese electronic databases from inception to January 2014.Two reviewers independently retrieved RCTs and extracted relevant information.The Cochrane risk of bias method was used to assess the quality of included studies,and a Meta-analysis was conducted with Review Manager5.2 software.RESULTS:Eleven RCTs involving 1034 participants were included.The methodological quality was relatively passable.The Meta-analysis indicated that the combined use of DCI and conventional treatment with Western Medicine(WM)was more efficacious in the outcomes of total effective rate[Relative Risk(RR)=1.27,95%CI(confidence interval;1.18,1.35),P<0.000 01],the total effective rate of ECG[RR=1.40,95%CI(1.18,1.66),P<0.000 01],total cholesterol[Mean difference(MD)=-0.58,95%CI(-0.83,-0.33),P<0.000 01],total triglycerides[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001],and the number of ST-segment depression[MD=-0.36,95%CI(-0.54,-0.17),P=0.0001].There were two adverse drug reactions reported in one study.CONCLUSION:Based on the systematic review,DCI combined with WM appeared to be efficacious in the treatment UAP.However,the evidence of DCI for treating UAP requires large-scale and double-blind RCTs to substantiate these findings.
基金Project(2010CB732004) supported by the National Basic Research Program of ChinaProject(50490274) supported by the National Natural Science Foundation of China
文摘The research on the rock burst prediction was made on the basis of seismology,rock mechanics and the data from Dongguashan Copper Mine(DCM) ,the deepest metal mine in China.The seismic responses to mining in DCM were investigated through the analyses of the spatio-temporal distribution of hypocenters,apparent stress and displacement of seismic events,and the process of the generation of hazardous seismicity in DCM was studied in the framework of the theory of asperity in the seismic source mechanism.A method of locating areas with hazardous seismicity and a conceptual model of hazardous seismic nucleation in DCM were proposed.A criterion of rockburst prediction was analyzed theoretically in the framework of unstable failure theories,and consequently,the rate of change in the ratio of the seismic stiffness of rock in a seismic nucleation area to that in surrounding area,dS/dt,is defined as an index of the rockburst prediction.The possibility of a rockburst will increase if dS/dt>0,and the possibility of rock burst will decrease if dS/dt<0.The correctness of these methods is demonstrated by analyses of rock failure cases in DCM.
基金Supported by National Natural Science Foundation of China:Study on the Key Influencing Factors of Anaphylaxis in Traditional Chinese Medicine Injection(No.81473547)Multi-dimensional Clinical Evaluation Model of Salvia Injection for the Treatment of Unstable Angina Pectoris(No.81673829)
文摘OBJECTIVE: To undertake a systematic review and network meta-analysis(NMA) to compare the effectiveness among the different regimens of Salvia miltiorrhiza injection classes(SMICs) for unstable angina pectoris(UAP) treatment.METHODS: A systematic retrieval was conducted in several literature databases to identify randomized controlled trials focusing on the different regimens of SMICs for UAP treatment until January2016. The quality assessment was accomplished according to the Cochrane risk of bias tool. Pair-wise meta-analyses were carried out by Rev Man 5.3. A random-effects model of NMA was used to compare the different regimens of SMICs with regard to efficacy by STATA 13.0.RESULTS: A total of 111 studies involving 10 500patients were included in the NMA. The methodological quality of included studies was not high.Current evidence shows that salvianolate(SI) is the optimal treatment for UAP in improving the total efficacy against UAP. Guanxingning(GXN) is the optimal treatment for UAP for improving the total effectiveness of electrocardiography.CONCLUSION: SMICs have advantages in preventing cardiovascular events. GXN, SI, and Danhong had the greatest probability of being the best treatment in the total efficacy against UAP and for improving the total effectiveness of electrocardiography.
基金supported by Aeronautical Science Foundation of China(2017ZC52021)the Fundamental Research Funds for the Central Universities(NS2017066)+1 种基金the Foundation of Graduate Innovation Center in NUAA(kfjj20171501)China Postdoctoral Science Foundation Funded Project(2015M581791)
文摘Millimeter wave(mmWave) communications of unmanned aerial vehicles(UAVs) have drawn dramatic attentions for its flexibility on a variety of applications.Recently,channel tracking base on the spatial features has been proposed to solve the problem of beam misalignments due to the UAV navigation.However,unstable beam pointing caused by the non-ideal beam tracking environment may impact the performance of mmWave systems significantly.In this paper,an improved beamforming method is presented to overcome this shortcoming.Firstly,the effect of the beam deviation is analyzed through the establishment of the equivalent data rate.Then,combining the quantification of spatial angle and the improved orthogonal matching pursuit(OMP) algorithm,an optimized beam corresponding to the beam deviation is obtained.Simulation results show that the optimized beam of the proposed approach can effectively improve the spectral efficiency without improving the complexity when the beam pointing is unstable.
基金Supported by the National Basic Research Program of China(No2011CB505106)the National Natural Science Foundation of China(No30902020)+2 种基金the Foundation of National Department of Public Benefit Research of China(No200807007)the Creation Fund for Significant New Drugs of China(No2009ZX09502-018)the Foundation of International Science and Technology Cooperation of China(No2008DFA30610)
文摘Unstable angina（UA） is the most dangerous type of Coronary Heart Disease（CHD） to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metabolomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performanees for the three methods. Alternatively, we combined inde- pendent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.
文摘BACKGROUND Older people are more likely to experience pelvic fractures than younger people.Multi-slice spiral computed tomography(CT)uses three-dimensional(3D)reconstruction technology to generate 3D images that can clearly demonstrate the 3D space of fractures and detect fractures at a higher rate.AIM To investigate the clinical value of multi-slice spiral CT 3D reconstruction in the diagnosis of unstable pelvic fractures in the elderly as well as the effect of less invasive stabilization.METHODS A total of 86 patients with unstable pelvic fractures treated between March 2016 and March 2019 underwent femoral supracondylar bone traction before surgery.Pelvic radiography and multi-row spiral CT were performed successively once the patient’s vital signs and hemodynamic indices were stable.Secondary processing of the original data was performed to obtain 3D reconstruction images and determine the vertical displacement of the pelvis.After basic or complete reduction,minimally invasive internal fixation using hollow lag screws was performed.The detection rates of fracture location and classification by X-ray and CT reconstruction were compared.Patients were divided into two groups according to the presence or absence of preoperative 3D reconstruction to compare postoperative reduction,wound healing time,fracture healing time,hospitalization time,visual analog scale(VAS)score,poor internal fixation,and functional recovery.RESULTS The diagnostic coincidence rates of X-rays for pubic symphysis,ilium wing,sacroiliac periarticular,and sacral fractures were lower than those of CT reconstruction.The coincidence rate of CT reconstruction in the clinical classification of pelvic fractures was 100%,whereas 11 cases were misdiagnosed by X-ray;the total coincidence rate was 87.21%.The total excellent and good rates of postoperative reduction were significantly higher in the study group than in the control group(P<0.05).The wound healing,fracture healing,and hospitalization times were significantly shorter in the study group than in the control group(P<0.05).The VAS scores decreased in both groups postoperatively and were lower in the study group than in the control group(P<0.05).The total incidence of poor postoperative internal fixation was significantly lower in the study group than in the control group(P<0.05).The overall rate of postoperative functional recovery was significantly higher in the study group than in the control group(P<0.05).CONCLUSION Multi-slice spiral CT has high guiding significance for the diagnosis,classification,and treatment of unstable pelvic fractures in the elderly.Preoperative 3D reconstruction can effectively shorten the operation time and promote fracture healing,while minimally invasive internal fixation can effectively reduce pain and promote functional recovery of fracture sites,making it worthy of clinical application.
文摘Background The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index （LAAI） has predictive value for prognosis in patients with unstable angina pectoris （UAP）. This study was aimed to assess the association between LAAI and outcomes in UAP patients. Methods We enrolled a total of 391 in-hospital patients diag- nosed as UAP. Clinical and echocardiographic data at baseline were collected. The patients were followed for the development of ad- verse cardiovascular （CV） events, including hospital readmission for angina pectoris, acute myocardial infarction （AMI）, congestive heart failure （CHF）, stroke and all-cause mortality. Results During a mean follow-up time of 26.3±8.6 months, 98 adverse CV events occurred （84 hospital readmission for angina pectoris, four AMI, four CHF, one stroke and five all-cause mortality）. In a multivariate Cox model, LAAI [OR： 1.140, 95% CI： 1.01±1.279, P = 0.026], diastolic blood pressure （OR： 0.976, 95% CI： 0.956-0.996, P = 0.020） and pulse pressure （OR 1.020, 95% CI： 1.007-1.034, P = 0.004） were independent predictors for adverse CV events in UAP patients. Conclusions LAAI is a predictor of adverse CV events independent of clinical and other echocardiographic parameters in UAP patients.
