The muzzle blast overpressure induces disturbances in the flow field inside the crew compartment(FFICC)of a truck-mounted howitzer during the artillery firing.This overpressure is the primary factor preventing personn...The muzzle blast overpressure induces disturbances in the flow field inside the crew compartment(FFICC)of a truck-mounted howitzer during the artillery firing.This overpressure is the primary factor preventing personnel from firing artillery within the cab.To investigate the overpressure characteristics of the FFICC,a foreign trade equipment model was used as the research object,and a numerical model was established to analyze the propagation of muzzle blast from the muzzle to the interior of the crew compartment under extreme firing condition.For comparative verification,the muzzle blast experiment included overpressure data from both the flow field outside the crew compartment(FFOCC)and the FFICC,as well as the acceleration data of the crew compartment structure(Str-CC).The research findings demonstrate that the overpressure-time curves of the FFICC exhibit multi-peak characteristics,while the pressure wave shows no significant discontinuity.The enclosed nature of the cab hinders the dissipation of pressure wave energy within the FFICC,leading to sustained high-amplitude overpressure.The frameskin structure helps attenuate the impact of muzzle blast on the FFICC.Conversely,local high overpressure caused by the convex or concave features of the cab's exterior significantly amplifies the overpressure amplitude within the FFICC.展开更多
Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone...Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone fractures,crush injuries,and burns.[1,2]While rare,ACoS can also occur in atraumatic settings following periods of prolonged limb compression,such as intoxication.[3]Atraumatic ACoS is easily overlooked,resulting in diagnostic delay and poor patient outcomes.Prompt recognition and surgical management is essential to prevent critical sequelae.展开更多
BACKGROUND Hypoganglionosis is a rare gastrointestinal acquired motility disorder that res-embles Hirschsprung’s disease and can manifest in the adult life.Abdominal compartment syndrome,a condition characterized by ...BACKGROUND Hypoganglionosis is a rare gastrointestinal acquired motility disorder that res-embles Hirschsprung’s disease and can manifest in the adult life.Abdominal compartment syndrome,a condition characterized by an increase in intra-abdo-minal pressure with physiological disturbance can be caused by severe massive fecal impaction.CASE SUMMARY A 33-year-old female presented to the emergency room with massive abdominal distension that rapidly progressed to abdominal compartment syndrome.The pa-tient was diagnosed with hypoganglionosis.Life-saving emergent proctoco-lectomy was performed to save the patient.CONCLUSION Abdominal compartment syndrome can develop secondary to excessive colonic distension.This extreme but rare situation must be addressed immediately.Hypo-ganglionosis is a potential cause of severe constipation that may present in adu-lthood.展开更多
This study investigates the wet towing characteristics of an integrated wellhead platform supported by a bucket foundation.These characteristics are crucial for optimizing offshore construction efficiency and enabling...This study investigates the wet towing characteristics of an integrated wellhead platform supported by a bucket foundation.These characteristics are crucial for optimizing offshore construction efficiency and enabling the development of small marginal oil fields.The wet towing behavior of the integrated wellhead platform was explored through a combination of physical experiments and numerical simulations.Physical experiments were conducted to validate the accuracy of the numerical simulations.Subsequently,numerical simulations were employed to determine the impacts of towing speed and wave direction on the towing process of the integrated wellhead platform.Finally,the impact of compartment failure due to bulkhead damage on towage stability was analyzed.Findings indicate that the wave and towing directions influence the motion of the platform at various degrees of freedom.The platform demonstrates optimal stability when towing against waves,particularly when the towing direction aligns at a specific angle relative to the wave direction.In addition,a controlled increase in towing speed within a specific range effectively mitigates roll and pitch motions,which enhances the overall tow stability of the platform.Notably,compartment failure has an adverse effect on the towing stability,particularly in aft compartments.Therefore,it requires careful consideration and attention in practical engineering scenarios.展开更多
Deterministic compartment models(CMs)and stochastic models,including stochastic CMs and agent-based models,are widely utilized in epidemic modeling.However,the relationship between CMs and their corresponding stochast...Deterministic compartment models(CMs)and stochastic models,including stochastic CMs and agent-based models,are widely utilized in epidemic modeling.However,the relationship between CMs and their corresponding stochastic models is not well understood.The present study aimed to address this gap by conducting a comparative study using the susceptible,exposed,infectious,and recovered(SEIR)model and its extended CMs from the coronavirus disease 2019 modeling literature.We demonstrated the equivalence of the numerical solution of CMs using the Euler scheme and their stochastic counterparts through theoretical analysis and simulations.Based on this equivalence,we proposed an efficient model calibration method that could replicate the exact solution of CMs in the corresponding stochastic models through parameter adjustment.The advancement in calibration techniques enhanced the accuracy of stochastic modeling in capturing the dynamics of epidemics.However,it should be noted that discrete-time stochastic models cannot perfectly reproduce the exact solution of continuous-time CMs.Additionally,we proposed a new stochastic compartment and agent mixed model as an alternative to agent-based models for large-scale population simulations with a limited number of agents.This model offered a balance between computational efficiency and accuracy.The results of this research contributed to the comparison and unification of deterministic CMs and stochastic models in epidemic modeling.Furthermore,the results had implications for the development of hybrid models that integrated the strengths of both frameworks.Overall,the present study has provided valuable epidemic modeling techniques and their practical applications for understanding and controlling the spread of infectious diseases.展开更多
BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to pat...BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.展开更多
We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 mmHg.Indeed,in this setting...We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 mmHg.Indeed,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly restored.We report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.展开更多
Background Goose, descendants of migratory ancestors, have undergone extensive selective breeding, resulting in their remarkable ability to accumulate fat in the liver and exhibit a high tolerance for significant ener...Background Goose, descendants of migratory ancestors, have undergone extensive selective breeding, resulting in their remarkable ability to accumulate fat in the liver and exhibit a high tolerance for significant energy intake. As a result, goose offers an excellent model for studying obesity, metabolic disorders, and liver diseases in mammals. Although the impact of the three-dimensional arrangement of chromatin within the cell nucleus on gene expression and transcriptional regulation is widely acknowledged, the precise functions of chromatin architecture reorganization during fat deposition in goose liver tissues still need to be fully comprehended.Results In this study, geese exhibited more pronounced changes in the liver index and triglyceride(TG) content following the consumption of the high-fat diet(HFD) than mice without significant signs of inflammation. Additionally, we performed comprehensive analyses on 10 goose liver tissues(5 HFD, 5 normal), including generating highresolution maps of chromatin architecture, conducting whole-genome gene expression profiling, and identifying H3K27ac peaks in the livers of geese and mice subjected to the HFD. Our results unveiled a multiscale restructuring of chromatin architecture, encompassing Compartment A/B, topologically associated domains, and interactions between promoters and enhancers. The dynamism of the three-dimensional genome architecture, prompted by the HFD, assumed a pivotal role in the transcriptional regulation of crucial genes. Furthermore, we identified genes that regulate chromatin conformation changes, contributing to the metabolic adaptation process of lipid deposition and hepatic fat changes in geese in response to excessive energy intake. Moreover, we conducted a cross-species analysis comparing geese and mice exposed to the HFD, revealing unique characteristics specific to the goose liver compared to a mouse. These chromatin conformation changes help elucidate the observed characteristics of fat deposition and hepatic fat regulation in geese under conditions of excessive energy intake.Conclusions We examined the dynamic modifications in three-dimensional chromatin architecture and gene expression induced by an HFD in goose liver tissues. We conducted a cross-species analysis comparing that of mice. Our results contribute significant insights into the chromatin architecture of goose liver tissues, offering a novel perspective for investigating mammal liver diseases.展开更多
BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidate...BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidates for surgical release.However,risks with surgery include damage to the superficial radial nerve and an incomplete release due to inadequate dissection.Currently,there is a paucity of literature demonstrating the exact anatomic location of the first dorsal extensor compartment in reference to surface anatomy.Thus,this cadaveric study was performed to determine the exact location of the first extensor compartment and to devise a reliable surgical incision to prevent complications.AIM To describe the location of the first dorsal compartment in relation to bony surface landmarks to create replicable surgical incisions.METHODS Six cadaveric forearms,including four left and two right forearm specimens were dissected.Dissections were performed by a single fellowship trained upper extremity orthopaedic surgeon.Distance of the first dorsal compartment from landmarks such as Lister’s tubercle,the wrist crease,and the radial styloid were calculated.Other variables studied included the presence of the superficial radial nerve overlying the first dorsal compartment,additional compartment subsheaths,number of abductor pollicis longus(APL)tendon slips,and the presence of a pseudo-retinaculum.RESULTS Distance from the radial most aspect of the wrist crease to the extensor retinaculum was 5.14 mm±0.80 mm.The distance from Lister’s tubercle to the distal aspect of the extensor retinaculum was 13.37 mm±2.94 mm.Lister’s tubercle to the start of the first dorsal compartment was 18.43 mm±2.01 mm.The radial styloid to the initial aspect of the extensor retinaculum measured 2.98 mm±0.99 mm.The retinaculum length longitudinally on average was 26.82 mm±3.34 mm.Four cadaveric forearms had separate extensor pollicis brevis compartments.The average number of APL tendon slips was three.A pseudo-retinaculum was present in four cadavers.Two cadavers had a superficial radial nerve that crossed over the first dorsal compartment and retinaculum proximally(7.03 mm and 13.36 mm).CONCLUSION An incision that measures 3 mm proximal from the radial styloid,2 cm radial from Lister’s tubercle,and 5 mm proximal from the radial wrist crease will safely place surgeons at the first dorsal compartment.展开更多
The residence-time distribution （RTD） and the compartment model were applied to characterizing the flow regions in red mud separation thickener’s feedwells. Combined with the experimental work, validated mathematic...The residence-time distribution （RTD） and the compartment model were applied to characterizing the flow regions in red mud separation thickener’s feedwells. Combined with the experimental work, validated mathematical model as well as three-dimensional computational fluid dynamics （CFD） model was established to analyze the flow regions of feedwells on an industrial scale. The concept of RTD, although a well-known method for the characterization of mixing behavior in conventional mixers and reactors, is still a novel measure for the characterization of mixing in feedwells. Numerical simulation results show that the inlet feed rate and the aspect ratio of feedwells are the most critical parameters which affect the RTD of feedwell. Further simulation experiments were then carried out. Under the optimal operation conditions, the volume fraction of dead zone can reduce by10.8% and an increasement of mixing flow volume fraction by 6.5% is also observed. There is an optimum feed inlet rate depending on the feedwell design. The CFD model in conjunction with the RTD analysis then can be used as an effective tool in the design, evaluation and optimization of thickener feedwell in the red mud separation.展开更多
The gene encoded for tryptophan decarboxylase (TDC), which is the key enzyme in terpenoil indole alkaloids pathway, was targeted to different subcellular compartments and stably expressed in transgenic tobacco (Nicoti...The gene encoded for tryptophan decarboxylase (TDC), which is the key enzyme in terpenoil indole alkaloids pathway, was targeted to different subcellular compartments and stably expressed in transgenic tobacco (Nicotiana tabacum L.) plants at the levels detected by Western blot and tryptamine accumulation analysis. It was shown that the TDC was located in subcellular compartments, the chloroplasts and cytosol. The recombinant TDC targeted to chloroplasts and cytosol in tobacco plants was effectively expressed as soluble protein by Western blot analysis and enzymatic assay. The level of tryptamine accumulation in chloroplast was higher than that in cytosol and very low in vacuole and endoplasmic reticulum (ER) to be hardly detected by Western blot analysis. It was indicated that the highest amount of tryptamine was in chloroplasts, lower in endoplasmic reticula and the lowest in vacuoles as compared to those in wild type plants. The TDC targeted to different subcellular compartments of tobacco plants and its expression level were studied by different nucleotide sequences coding signal peptides at 5'-end of tdc gene in order to know the effects of the TDC in compartmentation on its functionality.展开更多
The two compartment model with variable extracellular volume is presented and solved by using both perturbation and analytical method. The computation for both creatinine and urea show that the perturbation solution ...The two compartment model with variable extracellular volume is presented and solved by using both perturbation and analytical method. The computation for both creatinine and urea show that the perturbation solution is not only simple but also accurate enough and is a good substitute for the more exact analytical solution.展开更多
This article makes a comparison between American English and British En glish in the use of words from two aspects. The purpose is to point out some differences between them in colloquial English,and make the language...This article makes a comparison between American English and British En glish in the use of words from two aspects. The purpose is to point out some differences between them in colloquial English,and make the language learners practice the language better.展开更多
Strictosidine synthase (STR) is a key enzyme involved in the biosynthesis of terpenoid indole alkaloids (TIA) by condensing tryptamine and secologanin into strictosidine. The transgenic tobacco plants targeting STR to...Strictosidine synthase (STR) is a key enzyme involved in the biosynthesis of terpenoid indole alkaloids (TIA) by condensing tryptamine and secologanin into strictosidine. The transgenic tobacco plants targeting STR to subcellular compartments were established to express STR in chloroplast, vacuole and endoplasmic reticulum (ER) by the tobacco stable transformation. It was shown that STR was effectively expressed in the above subcellular compartments by Western blot analysis and STR enzymatic assay. In vitro , STR enzymatic assay was measured indirectly by fluorimetrically detecting depletion of tryptamine feeding on secologanin in the reaction mixture. The tryptamine were completely depleted by STR in the crude extract of leaves of transgenic tobacco plants targeting and expressing STR in the chloroplast, vacuole and ER, which ascertained the STR functionally targeted to the three subcellular compartments. To confirm STR correct targeting and expressing in chloroplast, the chloroplasts were isolated and the fractions of purified chloroplasts were analyzed by Western blot. The hypothesis of STR correct targeting to the chloroplast was tested. The results have implications on our understanding of the complex intracellular trafficking in metabolic intermediates of TIA biosynthesis.展开更多
AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on phys...AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period ofthe first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is a frequent finding in patients admitted to the ICU because of AP. Patients with IAP at approximately 10-12 mmHg and early signs of changes in physiologic variables should be seriously considered for urgent decompression to improve survival.展开更多
AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment s...AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.展开更多
The nitrogen （N） distribution and cycling of atmosphere-plant-soil system in the typical meadow Calamagrostis angustifolia wetland （TMCW） and marsh meadow Calamagrostis angustifolia wetland （MMCW） in the Sanjian...The nitrogen （N） distribution and cycling of atmosphere-plant-soil system in the typical meadow Calamagrostis angustifolia wetland （TMCW） and marsh meadow Calamagrostis angustifolia wetland （MMCW） in the Sanjiang plain were studied by a compartment model. The results showed that the N wet deposition amount was 0.757 gN/（m^2·a）, and total inorganic N （TIN） was the main body （0.640 gN/（m^2·a））. The ammonia volatilization amounts of TMCW and MMCW soils in growing season were 0.635 and 0.687 gN/m^2, and the denitrification gaseous lost amounts were 0.617 and 0.405 gN/m^2, respectively. In plant subsystem, the N was mainly stored in root and litter. Soil organic N was the main N storage of the two plant-soil systems and the proportions of it were 93.98% and 92.16%, respectively. The calculation results of N turnovers among compartments of TMCW and MMCW showed that the uptake amounts of root were 23.02 and 28.18 gN/（m^2·a） and the values of aboveground were 11.31 and 6.08 gN/（m^2·a）, the re-translocation amounts from aboveground to root were 5.96 and 2.70 gN/（m^2·a）, the translocation amounts from aboveground living body to litter were 5.35 and 3.38 gN/（m^2·a）, the translocation amounts from litter to soil were larger than 1.55 and 3.01 gN/（m^2·a）, the translocation amounts from root to soil were 14.90 and 13.17 gN/（m^2·a）, and the soil （0-15 cm） N net mineralization amounts were 1.94 and 0.55 gN/（m^2·a）, respectively. The study of N balance indicated that the two plant-soil systems might be situated in the status of lacking N, and the status might induce the degradation of C. angustifolia wetland.展开更多
AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on...AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference. CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.展开更多
This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension （IAH）/abdominal compartment syndrome （ACS） among intensive care physicians in tertiary Chinese ...This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension （IAH）/abdominal compartment syndrome （ACS） among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units （ICUs）. A total of 108 （76.6%） questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission, ICU length of stay, acute physiology and chronic health evaluation （APACHE）II score, and mortality were 18.2 beds, 764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure （IAP）. Although the vast majority of the ICUs adopted the exclusively transvesicular method, the over- whelming majority （88.0%） only measured lAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for lAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended ab- domen （92%）, worsening oliguria （80%）, and increased ventilatory support requirement （68%）. Common causes for IAH/ACS were ＂third-spacing from massive volume resuscitation in different settings＂ （88%）, ＂intra-abdominal bleeding＂, and ＂liver failure with ascites＂ （52% for both）. Though 60% respondents would recommend surgical decompression when the lAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of re- spondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physicians in China to help to establish clear diagnostic criteria and appropriate management for these common, but life-threatening, diseases.展开更多
基金supported by the National Natural Science Foundation of China(Grant No.U2341269)。
文摘The muzzle blast overpressure induces disturbances in the flow field inside the crew compartment(FFICC)of a truck-mounted howitzer during the artillery firing.This overpressure is the primary factor preventing personnel from firing artillery within the cab.To investigate the overpressure characteristics of the FFICC,a foreign trade equipment model was used as the research object,and a numerical model was established to analyze the propagation of muzzle blast from the muzzle to the interior of the crew compartment under extreme firing condition.For comparative verification,the muzzle blast experiment included overpressure data from both the flow field outside the crew compartment(FFOCC)and the FFICC,as well as the acceleration data of the crew compartment structure(Str-CC).The research findings demonstrate that the overpressure-time curves of the FFICC exhibit multi-peak characteristics,while the pressure wave shows no significant discontinuity.The enclosed nature of the cab hinders the dissipation of pressure wave energy within the FFICC,leading to sustained high-amplitude overpressure.The frameskin structure helps attenuate the impact of muzzle blast on the FFICC.Conversely,local high overpressure caused by the convex or concave features of the cab's exterior significantly amplifies the overpressure amplitude within the FFICC.
文摘Acute compartment syndrome(ACoS)involves a complex pathological process in which rising pressures within an enclosed muscle space ultimately result in anoxia and cell death.The most common etiologies include long bone fractures,crush injuries,and burns.[1,2]While rare,ACoS can also occur in atraumatic settings following periods of prolonged limb compression,such as intoxication.[3]Atraumatic ACoS is easily overlooked,resulting in diagnostic delay and poor patient outcomes.Prompt recognition and surgical management is essential to prevent critical sequelae.
文摘BACKGROUND Hypoganglionosis is a rare gastrointestinal acquired motility disorder that res-embles Hirschsprung’s disease and can manifest in the adult life.Abdominal compartment syndrome,a condition characterized by an increase in intra-abdo-minal pressure with physiological disturbance can be caused by severe massive fecal impaction.CASE SUMMARY A 33-year-old female presented to the emergency room with massive abdominal distension that rapidly progressed to abdominal compartment syndrome.The pa-tient was diagnosed with hypoganglionosis.Life-saving emergent proctoco-lectomy was performed to save the patient.CONCLUSION Abdominal compartment syndrome can develop secondary to excessive colonic distension.This extreme but rare situation must be addressed immediately.Hypo-ganglionosis is a potential cause of severe constipation that may present in adu-lthood.
基金the National Natural Science Foundation of China(No.52271287).
文摘This study investigates the wet towing characteristics of an integrated wellhead platform supported by a bucket foundation.These characteristics are crucial for optimizing offshore construction efficiency and enabling the development of small marginal oil fields.The wet towing behavior of the integrated wellhead platform was explored through a combination of physical experiments and numerical simulations.Physical experiments were conducted to validate the accuracy of the numerical simulations.Subsequently,numerical simulations were employed to determine the impacts of towing speed and wave direction on the towing process of the integrated wellhead platform.Finally,the impact of compartment failure due to bulkhead damage on towage stability was analyzed.Findings indicate that the wave and towing directions influence the motion of the platform at various degrees of freedom.The platform demonstrates optimal stability when towing against waves,particularly when the towing direction aligns at a specific angle relative to the wave direction.In addition,a controlled increase in towing speed within a specific range effectively mitigates roll and pitch motions,which enhances the overall tow stability of the platform.Notably,compartment failure has an adverse effect on the towing stability,particularly in aft compartments.Therefore,it requires careful consideration and attention in practical engineering scenarios.
基金supported by the National Natural Science Foundation of China(Grant Nos.82173620 to Yang Zhao and 82041024 to Feng Chen)partially supported by the Bill&Melinda Gates Foundation(Grant No.INV-006371 to Feng Chen)Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘Deterministic compartment models(CMs)and stochastic models,including stochastic CMs and agent-based models,are widely utilized in epidemic modeling.However,the relationship between CMs and their corresponding stochastic models is not well understood.The present study aimed to address this gap by conducting a comparative study using the susceptible,exposed,infectious,and recovered(SEIR)model and its extended CMs from the coronavirus disease 2019 modeling literature.We demonstrated the equivalence of the numerical solution of CMs using the Euler scheme and their stochastic counterparts through theoretical analysis and simulations.Based on this equivalence,we proposed an efficient model calibration method that could replicate the exact solution of CMs in the corresponding stochastic models through parameter adjustment.The advancement in calibration techniques enhanced the accuracy of stochastic modeling in capturing the dynamics of epidemics.However,it should be noted that discrete-time stochastic models cannot perfectly reproduce the exact solution of continuous-time CMs.Additionally,we proposed a new stochastic compartment and agent mixed model as an alternative to agent-based models for large-scale population simulations with a limited number of agents.This model offered a balance between computational efficiency and accuracy.The results of this research contributed to the comparison and unification of deterministic CMs and stochastic models in epidemic modeling.Furthermore,the results had implications for the development of hybrid models that integrated the strengths of both frameworks.Overall,the present study has provided valuable epidemic modeling techniques and their practical applications for understanding and controlling the spread of infectious diseases.
文摘BACKGROUND Unicompartmental knee arthroplasty(UKA)and high tibial osteotomy(HTO)are well-established operative interventions in the treatment of knee osteoarthritis.However,which intervention is more beneficial to patients with knee osteoarthritis remains unknown and a topic of much debate.Simultaneously,there is a paucity of research assessing the relationship between radiographic parameters of knee joint alignment and patient-reported clinical outcomes,preoperatively and following HTO or UKA.AIM To compare UKAs and HTOs as interventions for medial-compartment knee osteoarthritis:Examining differences in clinical outcome and investigating the relationship of joint alignment with respect to this.METHODS This longitudinal observational study assessed a total of 42 patients that had undergone UKA(n=23)and HTO(n=19)to treat medial compartment knee osteoarthritis.Patient-reported outcome measures(PROMs)were collected to evaluate clinical outcome.These included two disease-specific(Knee Injury and Osteoarthritis Outcome Score,Oxford Knee Score)and two generic(EQ-5D-5L,Short Form-12)PROMs.The radiographic parameters of knee alignment assessed were the:Hip-knee-ankle angle,mechanical axis deviation and angle of Mikulicz line.RESULTS Statistical analyses demonstrated significant(P<0.001),preoperative to postoperative,improvements in the PROM scores of both groups.There were,however,no significant inter-group differences in the postoperative PROM scores of the UKA and HTO group.Several significant correlations associated a more distolaterally angled Mikulicz line with worse knee function and overall health preoperatively(P<0.05).Postoperatively,two clusters of significant correlations were observed between the disease-specific PROM scores and knee joint alignment parameters(hip-knee-ankle angle,mechanical axis deviation)within the HTO group;yet no such associations were observed within the UKA group.CONCLUSION UKAs and HTOs are both efficacious operations that provide a comparable degree of clinical benefit to patients with medial compartment knee osteoarthritis.Clinical outcome has a limited association with radiographic parameters of knee joint alignment postoperatively;however,a more distolaterally angled Mikulicz line appears associated with worse knee function/health-related quality of life preoperatively.
文摘We suggest that during severe acute pancreatitis(SAP)with intra-abdominal hypertension,practitioners should consider decompressive laparotomy,even with intra-abdominal pressure(IAP)below 25 mmHg.Indeed,in this setting,non-occlusive mesenteric ischemia(NOMI)may occur even with IAP below this cutoff and lead to transmural necrosis if abdominal perfusion pressure is not promptly restored.We report our experience of 18 critically ill patients with SAP having undergone decompressive laparotomy of which one third had NOMI while IAP was mostly below 25 mmHg.
基金supported by the National Key R&D Program of China (2022YFF1000100 to Long Jin and 2023YFD1300012 to Long Jin)the Sichuan Science and Technology Program (2022JDJQ0054 to Long Jin and 2021YFYZ0009 to Mingzhou Li)the National Natural Science Foundation of China (32225046 to Mingzhou Li)。
文摘Background Goose, descendants of migratory ancestors, have undergone extensive selective breeding, resulting in their remarkable ability to accumulate fat in the liver and exhibit a high tolerance for significant energy intake. As a result, goose offers an excellent model for studying obesity, metabolic disorders, and liver diseases in mammals. Although the impact of the three-dimensional arrangement of chromatin within the cell nucleus on gene expression and transcriptional regulation is widely acknowledged, the precise functions of chromatin architecture reorganization during fat deposition in goose liver tissues still need to be fully comprehended.Results In this study, geese exhibited more pronounced changes in the liver index and triglyceride(TG) content following the consumption of the high-fat diet(HFD) than mice without significant signs of inflammation. Additionally, we performed comprehensive analyses on 10 goose liver tissues(5 HFD, 5 normal), including generating highresolution maps of chromatin architecture, conducting whole-genome gene expression profiling, and identifying H3K27ac peaks in the livers of geese and mice subjected to the HFD. Our results unveiled a multiscale restructuring of chromatin architecture, encompassing Compartment A/B, topologically associated domains, and interactions between promoters and enhancers. The dynamism of the three-dimensional genome architecture, prompted by the HFD, assumed a pivotal role in the transcriptional regulation of crucial genes. Furthermore, we identified genes that regulate chromatin conformation changes, contributing to the metabolic adaptation process of lipid deposition and hepatic fat changes in geese in response to excessive energy intake. Moreover, we conducted a cross-species analysis comparing geese and mice exposed to the HFD, revealing unique characteristics specific to the goose liver compared to a mouse. These chromatin conformation changes help elucidate the observed characteristics of fat deposition and hepatic fat regulation in geese under conditions of excessive energy intake.Conclusions We examined the dynamic modifications in three-dimensional chromatin architecture and gene expression induced by an HFD in goose liver tissues. We conducted a cross-species analysis comparing that of mice. Our results contribute significant insights into the chromatin architecture of goose liver tissues, offering a novel perspective for investigating mammal liver diseases.
文摘BACKGROUND De-Quervain’s tenosynovitis is a disorder arising from the compression and irritation of the first dorsal extensor compartment of the wrist.Patients who fail conservative treatment modalities are candidates for surgical release.However,risks with surgery include damage to the superficial radial nerve and an incomplete release due to inadequate dissection.Currently,there is a paucity of literature demonstrating the exact anatomic location of the first dorsal extensor compartment in reference to surface anatomy.Thus,this cadaveric study was performed to determine the exact location of the first extensor compartment and to devise a reliable surgical incision to prevent complications.AIM To describe the location of the first dorsal compartment in relation to bony surface landmarks to create replicable surgical incisions.METHODS Six cadaveric forearms,including four left and two right forearm specimens were dissected.Dissections were performed by a single fellowship trained upper extremity orthopaedic surgeon.Distance of the first dorsal compartment from landmarks such as Lister’s tubercle,the wrist crease,and the radial styloid were calculated.Other variables studied included the presence of the superficial radial nerve overlying the first dorsal compartment,additional compartment subsheaths,number of abductor pollicis longus(APL)tendon slips,and the presence of a pseudo-retinaculum.RESULTS Distance from the radial most aspect of the wrist crease to the extensor retinaculum was 5.14 mm±0.80 mm.The distance from Lister’s tubercle to the distal aspect of the extensor retinaculum was 13.37 mm±2.94 mm.Lister’s tubercle to the start of the first dorsal compartment was 18.43 mm±2.01 mm.The radial styloid to the initial aspect of the extensor retinaculum measured 2.98 mm±0.99 mm.The retinaculum length longitudinally on average was 26.82 mm±3.34 mm.Four cadaveric forearms had separate extensor pollicis brevis compartments.The average number of APL tendon slips was three.A pseudo-retinaculum was present in four cadavers.Two cadavers had a superficial radial nerve that crossed over the first dorsal compartment and retinaculum proximally(7.03 mm and 13.36 mm).CONCLUSION An incision that measures 3 mm proximal from the radial styloid,2 cm radial from Lister’s tubercle,and 5 mm proximal from the radial wrist crease will safely place surgeons at the first dorsal compartment.
基金Project (50876116) supported by the National Natural Science Foundation of China
文摘The residence-time distribution （RTD） and the compartment model were applied to characterizing the flow regions in red mud separation thickener’s feedwells. Combined with the experimental work, validated mathematical model as well as three-dimensional computational fluid dynamics （CFD） model was established to analyze the flow regions of feedwells on an industrial scale. The concept of RTD, although a well-known method for the characterization of mixing behavior in conventional mixers and reactors, is still a novel measure for the characterization of mixing in feedwells. Numerical simulation results show that the inlet feed rate and the aspect ratio of feedwells are the most critical parameters which affect the RTD of feedwell. Further simulation experiments were then carried out. Under the optimal operation conditions, the volume fraction of dead zone can reduce by10.8% and an increasement of mixing flow volume fraction by 6.5% is also observed. There is an optimum feed inlet rate depending on the feedwell design. The CFD model in conjunction with the RTD analysis then can be used as an effective tool in the design, evaluation and optimization of thickener feedwell in the red mud separation.
文摘The gene encoded for tryptophan decarboxylase (TDC), which is the key enzyme in terpenoil indole alkaloids pathway, was targeted to different subcellular compartments and stably expressed in transgenic tobacco (Nicotiana tabacum L.) plants at the levels detected by Western blot and tryptamine accumulation analysis. It was shown that the TDC was located in subcellular compartments, the chloroplasts and cytosol. The recombinant TDC targeted to chloroplasts and cytosol in tobacco plants was effectively expressed as soluble protein by Western blot analysis and enzymatic assay. The level of tryptamine accumulation in chloroplast was higher than that in cytosol and very low in vacuole and endoplasmic reticulum (ER) to be hardly detected by Western blot analysis. It was indicated that the highest amount of tryptamine was in chloroplasts, lower in endoplasmic reticula and the lowest in vacuoles as compared to those in wild type plants. The TDC targeted to different subcellular compartments of tobacco plants and its expression level were studied by different nucleotide sequences coding signal peptides at 5'-end of tdc gene in order to know the effects of the TDC in compartmentation on its functionality.
文摘The two compartment model with variable extracellular volume is presented and solved by using both perturbation and analytical method. The computation for both creatinine and urea show that the perturbation solution is not only simple but also accurate enough and is a good substitute for the more exact analytical solution.
文摘This article makes a comparison between American English and British En glish in the use of words from two aspects. The purpose is to point out some differences between them in colloquial English,and make the language learners practice the language better.
文摘Strictosidine synthase (STR) is a key enzyme involved in the biosynthesis of terpenoid indole alkaloids (TIA) by condensing tryptamine and secologanin into strictosidine. The transgenic tobacco plants targeting STR to subcellular compartments were established to express STR in chloroplast, vacuole and endoplasmic reticulum (ER) by the tobacco stable transformation. It was shown that STR was effectively expressed in the above subcellular compartments by Western blot analysis and STR enzymatic assay. In vitro , STR enzymatic assay was measured indirectly by fluorimetrically detecting depletion of tryptamine feeding on secologanin in the reaction mixture. The tryptamine were completely depleted by STR in the crude extract of leaves of transgenic tobacco plants targeting and expressing STR in the chloroplast, vacuole and ER, which ascertained the STR functionally targeted to the three subcellular compartments. To confirm STR correct targeting and expressing in chloroplast, the chloroplasts were isolated and the fractions of purified chloroplasts were analyzed by Western blot. The hypothesis of STR correct targeting to the chloroplast was tested. The results have implications on our understanding of the complex intracellular trafficking in metabolic intermediates of TIA biosynthesis.
文摘AIM: To study retrospectively the influence of intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) in patients with early acute pancreatitis (AP) (during the first week after admission) on physiological functions, and the association of the presence of IAH/ACS and outcome. METHODS: Patients (n = 74) with AP recruited in this study were divided into two groups according to intra-abdominal pressure (IAP) determined by indirect measurement using the transvesical route via Foley bladder catheter during the first week after admission. Patients (n = 44) with IAP ≥ 12 mmHg were assigned in IAH group, and the remaining patients (n = 30) with IAP < 12 mmHg in normal IAP group. For analysis of the influence of IAH/ACS on organ function and outcome, the physiological parameters and the occurrence of organ dysfunction during intensive care unit (ICU) stay were recorded, as were the incidences of pancreatic infection and in-hospital mortality. RESULTS: IAH within the first week after admission was found in 44 patients (59.46%). Although the APACHE Ⅱ scores on admission and the Ranson scores within 48 h after hospitalization were elevated in IAH patients in early stage, they did not show the statistically significant differences from patients with normal IAP within a week after admission (16.18 ± 3.90 vs 15.70 ± 4.25, P = 0.616; 3.70 ± 0.93 vs 3.47 ± 0.94, P = 0.285, respectively). ACS in early AP was recorded in 20 patients (27.03%). During any 24-h period ofthe first week after admission, the recorded mean IAP correlated significantly with the Marshall score calculated at the same time interval in IAH group (r = 0.635, P < 0.001). Although ACS patients had obvious amelioration in physiological variables within 24 h after decompression, the incidences of pancreatitic infection, septic shock, multiple organ dysfunction syndrome (MODS) and death in the patients with ACS were significantly higher than that in other patients without ACS (pancreatitic infection: 60.0% vs 7.4%, P < 0.001; septic shock: 70.0% vs 11.1%, P < 0.001; MODS: 90.0% vs 31.5%, P < 0.001; mortality: 75.0% vs 3.7%, P < 0.001). CONCLUSION: IAH/ACS is a frequent finding in patients admitted to the ICU because of AP. Patients with IAP at approximately 10-12 mmHg and early signs of changes in physiologic variables should be seriously considered for urgent decompression to improve survival.
文摘AIM： To assess the value of widely used clinical scores in the early identification of acute pancreatitis （AP） patients who are likely to suffer from intra-abdominal hypertension （IAH） and abdominal compartment syndrome （ACS）.METHODS： Patients （η = 44） with AP recruited in this study were divided into two groups （ACS and non-ACS） according to intra-abdominal pressure （IAP） determined by indirect measurement using the transvesical route via Foley bladder catheter. On admission and at regular intervals, the severity of the AP and presence of organ dysfunction were assessed utilizing different multifactorial prognostic systems： Glasgow-Imrie score, Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE-Ⅱ） score, and Multiorgan Dysfunction Score （MODS）. The diagnostic performance of scores predicting ACS development, cut-off values and specificity and sensitivity were established using receiver operating characteristic （ROC） curve analysis.RESULTS： The incidence of ACS in our study population was 19.35%. IAP at admission in the ACS group was 22.0 （18.5-25.0） mmHg and 9.25 （3.0-12.4） mmHg in the non-ACS group （P 〈 0.01）. Univariate statistical analysis revealed that patients in the ACS group had significantly higher multifactorial clinical scores （APACHE Ⅱ, Glasgow-Imrie and MODS） on admission and higher maximal scores during hospitalization （P 〈 0.01）. ROC curve analysis revealed that APACHE Ⅱ, Glasgow-Imrie, and MODS are valuable tools for early prediction of ACS with high sensitivity and specificity, and that cut-off values are similar to those used for stratification of patients with severe acute pancreatitis （SAP）.CONCLUSION： IAH and ACS are rare findings in patients with mild AR Based on the results of our study we recommend measuring the IAP in cases when patients present with SAP （APACHE Ⅱ 〉 7; MODS 〉 2 or Glasgow-Imrie score 〉 3）.
基金Project supported by the Knowledge Innovation Foundation of Chinese Academy of Sciences(KZCX2-YW-309,KZCX3-SW-332)the National Natural Science Foundation of China(No.920211003).
文摘The nitrogen （N） distribution and cycling of atmosphere-plant-soil system in the typical meadow Calamagrostis angustifolia wetland （TMCW） and marsh meadow Calamagrostis angustifolia wetland （MMCW） in the Sanjiang plain were studied by a compartment model. The results showed that the N wet deposition amount was 0.757 gN/（m^2·a）, and total inorganic N （TIN） was the main body （0.640 gN/（m^2·a））. The ammonia volatilization amounts of TMCW and MMCW soils in growing season were 0.635 and 0.687 gN/m^2, and the denitrification gaseous lost amounts were 0.617 and 0.405 gN/m^2, respectively. In plant subsystem, the N was mainly stored in root and litter. Soil organic N was the main N storage of the two plant-soil systems and the proportions of it were 93.98% and 92.16%, respectively. The calculation results of N turnovers among compartments of TMCW and MMCW showed that the uptake amounts of root were 23.02 and 28.18 gN/（m^2·a） and the values of aboveground were 11.31 and 6.08 gN/（m^2·a）, the re-translocation amounts from aboveground to root were 5.96 and 2.70 gN/（m^2·a）, the translocation amounts from aboveground living body to litter were 5.35 and 3.38 gN/（m^2·a）, the translocation amounts from litter to soil were larger than 1.55 and 3.01 gN/（m^2·a）, the translocation amounts from root to soil were 14.90 and 13.17 gN/（m^2·a）, and the soil （0-15 cm） N net mineralization amounts were 1.94 and 0.55 gN/（m^2·a）, respectively. The study of N balance indicated that the two plant-soil systems might be situated in the status of lacking N, and the status might induce the degradation of C. angustifolia wetland.
文摘AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference. CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.
基金supported by the Medical Scientific Research Foundation of Zhejiang Province, China (No. 2010KYA109)the Administration of Traditional Chinese Medicine of Zhejiang Province, China (No. 2010ZB080)
文摘This survey was designed to clarify the current understanding and clinical management of intra-abdominal hypertension （IAH）/abdominal compartment syndrome （ACS） among intensive care physicians in tertiary Chinese hospitals. A postal twenty-question questionnaire was sent to 141 physicians in different intensive care units （ICUs）. A total of 108 （76.6%） questionnaires were returned. Among these, three quarters worked in combined medical-surgical ICUs and nearly 80% had primary training in internal or emergency medicine. Average ICU beds, annual admission, ICU length of stay, acute physiology and chronic health evaluation （APACHE）II score, and mortality were 18.2 beds, 764.5 cases, 8.3 d, 19.4, and 21.1%, respectively. Of the respondents, 30.6% never measured intra-abdominal pressure （IAP）. Although the vast majority of the ICUs adopted the exclusively transvesicular method, the over- whelming majority （88.0%） only measured lAP when there was a clinical suspicion of IAH/ACS and only 29.3% measured either often or routinely. Moreover, 84.0% used the wrong priming saline volume while 88.0% zeroed at reference points which were not in consistence with the standard method for lAP monitoring recommended by the World Society of Abdominal Compartment Syndrome. ACS was suspected mainly when there was a distended ab- domen （92%）, worsening oliguria （80%）, and increased ventilatory support requirement （68%）. Common causes for IAH/ACS were ＂third-spacing from massive volume resuscitation in different settings＂ （88%）, ＂intra-abdominal bleeding＂, and ＂liver failure with ascites＂ （52% for both）. Though 60% respondents would recommend surgical decompression when the lAP exceeded 25 mmHg, accompanied by signs of organ dysfunction, nearly three quarters of re- spondents preferred diuresis and dialysis. A total of 68% of respondents would recommend paracentesis in the treatment for ACS. In conclusion, urgent systematic education is absolutely necessary for most intensive care physicians in China to help to establish clear diagnostic criteria and appropriate management for these common, but life-threatening, diseases.
