BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for ...BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.展开更多
Prepulse combined hydraulic fracturing facilitates the development of fracture networks by integrating prepulse hydraulic loading with conventional hydraulic fracturing.The formation mechanisms of fracture networks be...Prepulse combined hydraulic fracturing facilitates the development of fracture networks by integrating prepulse hydraulic loading with conventional hydraulic fracturing.The formation mechanisms of fracture networks between hydraulic and pre-existing fractures under different prepulse loading parameters remain unclear.This research investigates the impact of prepulse loading parameters,including the prepulse loading number ratio(C),prepulse loading stress ratio(S),and prepulse loading frequency(f),on the formation of fracture networks between hydraulic and pre-existing fractures,using both experimental and numerical methods.The results suggest that low prepulse loading stress ratios and high prepulse loading number ratios are advantageous loading modes.Multiple hydraulic fractures are generated in the specimen under the advantageous loading modes,facilitating the development of a complex fracture network.Fatigue damage occurs in the specimen at the prepulse loading stage.The high water pressure at the secondary conventional hydraulic fracturing promotes the growth of hydraulic fractures along the damage zones.This allows the hydraulic fractures to propagate deeply and interact with pre-existing fractures.Under advantageous loading conditions,multiple hydraulic fractures can extend to pre-existing fractures,and these hydraulic fractures penetrate or propagate along pre-existing fractures.Especially when the approach angle is large,the damage range in the specimen during the prepulse loading stage increases,resulting in the formation of more hydraulic fractures.展开更多
With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.I...With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.展开更多
Following the COVID-19 outbreak,a vast array of chlorine disinfectants was used to eliminate the virus,leading to inevitable discharge into aquatic ecosystems.These environments also contain various anthropogenic micr...Following the COVID-19 outbreak,a vast array of chlorine disinfectants was used to eliminate the virus,leading to inevitable discharge into aquatic ecosystems.These environments also contain various anthropogenic micropollutants,such as pharmaceuticals,which pose threats to the survival and activities of biological communities.Consequently,the presence of discharged chlorine disinfectants and pharmaceuticals can simultaneously impact the structure and function of aquatic ecosystems.To investigate the combined effects of chlorine disinfectants and pharmaceuticals on the periphyton and zoobenthos(Limnodrilus hoffmeisteri)community composition and function,we conducted a 12-flume reactor experiment using sodium hypochlorite and representative pharmaceuticals(abundant in the Yangtze River)as influents.Results demonstrated that the discharge of chlorine disinfectants further altered the composition of river prokaryotic communities.Eukaryotic organisms within the periphyton exhibited greater resilience to chlorine exposure compared to prokaryotic communities.Metagenomic analysis revealed that prokaryotic communities with different compositions can execute similar functions,while RNA sequencing indicated that co-exposure promoted biological processes such as focal adhesion and ribosome synthesis,but inhibited activities related to nitrogen metabolism and resistance to folate antimicrobials.Additionally,co-exposure induced oxidative stress in L.hoffmeisteri,leading to stronger environmental adaptation.展开更多
Nanoplastics are emerging contaminants that may co-exist with organochlorine pesticides and adversely affect invertebrates in the environment.However,the impact of environmental aging on the combined toxicity of nanop...Nanoplastics are emerging contaminants that may co-exist with organochlorine pesticides and adversely affect invertebrates in the environment.However,the impact of environmental aging on the combined toxicity of nanoplastics and organochlorine pesticides remains unclear.This study investigated the effects of aging on the combined toxicity of polystyrene nanoplastics(PS NPs)and chlordane against Caenorhabditis elegans.The results showed that photo-aging altered the physicochemical properties of PS NPs and promoted the combined toxicity of PS NPs and chlordane to nematodes by reducing survival rate,body length and enhancing germline apoptosis.Additionally,combined exposure of nematodes to aged PS NPs and chlordane significantly increased reactive oxygen species production and intestinal permeability,suggesting that aging enhances combined toxicity through oxidative stress and intestinal damage.Moreover,aging increased chlordane contents in nematodes without promoting PS NPs accumulation,potentially leading to increased combined toxicity of PS NPs and chlordane.Notably,aging significantly increased the accumulation of PS NPs in the posterior intestine of the nematode during co-exposure,which may be responsible for the most sensitive and highest degree of change in germline apoptosis.These observations emphasize the significance of accounting for environmental aging as well as the accumulation and distribution of nanoplastics in organisms when assessing the combined effects of nanoplastics and coexisting pollutants.展开更多
China boasts abundant heavy oil resources,which is vital for its energy security.However,its heavy oil typically exhibits high viscosity,which severely hinders its flow and extraction.Enhancing heavy oil flowability i...China boasts abundant heavy oil resources,which is vital for its energy security.However,its heavy oil typically exhibits high viscosity,which severely hinders its flow and extraction.Enhancing heavy oil flowability is vital for its effective exploitation.This study independently developed a visualization experimental system and explored the mechanisms through which combined thermal flooding(a combination of heat,chemical agents and gas)enhances heavy oil flowability.Results indicate that combined thermal flooding,that is,synergistically integrating heat,chemical agents,and gas,can effectively enhance the recovery of heavy oil by improving its flowability.Its working mechanisms were explored from the aspects of thermal effects,emulsification,precursor film,profile control capacity,and CO_(2) solution and extraction effects.The emulsification was observed using a confocal laser scanning fluorescence microscope(CLSFM).Findings reveal that steam flooding can boost crude oil flowability by augmenting temperature,while a chemical system tends to produce low-viscosity oil-in-water emul-sions,thus further aiding the flow of crude oil.During CO_(2) flooding,the solvent initially reduced crude oil viscosity and formed foamy oil,followed by the pronounced component separation of the produced fluids in the later stage.This demonstrates the effectiveness of CO_(2) in viscosity reduction and component extraction.Additionally,the results of interfacial tension experiments indicate that surfactants can reduce the heavy oil's interfacial tension,fostering the formation of nano-scale precursor films.They can also thicken these films and diminish their spreading resistance,thus accelerating residual oil removal and promoting heavy oil production.This study further elaborated the mechanisms behind the combined thermal flooding's efficiency in enhancing heavy oil recovery,offering a theoretical foundation for its broader application.展开更多
Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendici...Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendicitis from February 2022 to February 2025 were selected as samples and randomly divided into two groups.The study group received combined spinal-epidural anesthesia,while the control group received epidural anesthesia.Anesthesia indicators,vital signs,and complication indicators were compared between the two groups.Results:The onset time of anesthesia in the study group was shorter than that in the control group,the visual analog scale(VAS)score was lower than that in the control group,and the highest plane of anesthesia block was lower than that in the control group(P<0.05).At 15 minutes after anesthesia induction and at the end of surgery,the heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SPO2)in the study group were significantly different from those in the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).Conclusion:Combined spinal-epidural anesthesia for appendicitis surgery can reduce the impact of anesthesia on vital signs,shorten the onset time of anesthesia,and is highly effective and feasible.展开更多
Unstable operating conditions such as surge could cause damage to both aerodynamic performance and structural integrity of a compression system.This paper addresses the critical issue of aerodynamic instability in com...Unstable operating conditions such as surge could cause damage to both aerodynamic performance and structural integrity of a compression system.This paper addresses the critical issue of aerodynamic instability in compressor design,particularly focusing on an axial-centrifugal combined compressor,a widely used yet underexplored configuration.An experimental investigation was conducted on a three-stage axial and one-stage centrifugal compressor(3A1C),using two pipe systems and employing fast-responding transducers to capture the dynamic instability process from choke condition to deep surge.Results reveal that at the design speed,3A1C enters deep surge directly,whereas at off-design speeds,it experiences rotating stall and mild surge across a wide mass flow range.Some special instability features in the combined compressor can be found in the steady state map and dynamic process.The characteristic curve of the first axial stage keeps a positive slope during the whole mass flow range at an off-design speed.The first stage could work stably on the stall characteristic curve because the centrifugal stage has stronger pressurization and plays a dominant role in global aerodynamic instability.Besides,rotating instability occurs at the first rotor tip and disappears as the back pressure increases,which is also rarely seen in a single-axial compressor.This is also related to the strong pressurization of the centrifugal stage.The findings of this paper will contribute to the understanding of aerodynamic instabilities in combined compressors.展开更多
BACKGROUND Alveolar and cystic echinococcoses are lethal zoonotic diseases caused by Echinococcus multilocularis and Echinococcus granulosus infections,leading to alveolar echinococcosis(AE)or cystic echinococcosis(CE...BACKGROUND Alveolar and cystic echinococcoses are lethal zoonotic diseases caused by Echinococcus multilocularis and Echinococcus granulosus infections,leading to alveolar echinococcosis(AE)or cystic echinococcosis(CE),respectively.No study has hitherto reported effective treatment approaches for AE or CE with concurrent hepatorenal involvement.AIM To investigate the feasibility and efficacy of simultaneous combined surgery(SCS)as a comprehensive treatment approach for patients with hepatorenal echinococcosis.METHODS Clinical datasets of hepatorenal AE(n=10)and CE(n=11)patients were retrospectively collected and systematically analyzed.The SCS approach was introduced,and surgical outcomes,complications,and prognoses were documented in detail.RESULTS The SCS approach incorporated hybridized techniques,including partial hepatectomy,partial or total nephrectomy,ex vivo liver resection and autotransplantation,and total or subtotal cystectomy with endocystectomy.Radical SCS was achieved in 100%of AE patients and 63.6%of CE patients.All surgeries were completed without intraoperative complications.The short-term complication rate was 28.6%(Clavien-Dindo classification:AE-1 IIIb,3 IIIa;CE-2 II),while the long-term complication rate was 4.8%(Clavien-Dindo classification:AE-1 IIIb).Patients were followed up for a median of 37 months(AE:6-81 months;CE:34-123 months),with no reported deaths or disease relapses.CONCLUSION CS appears to be a feasible and effective treatment method for patients with hepatorenal involvement of AE or CE.It fulfills the management criteria for advanced AE or CE cases,aiming to maximize patient benefits.展开更多
Research on the effects of drug therapy combined with psychological intervention in adolescent patients with depression represents a critical focus in contemporary psychiatric medicine.This study aims to explore the s...Research on the effects of drug therapy combined with psychological intervention in adolescent patients with depression represents a critical focus in contemporary psychiatric medicine.This study aims to explore the synergistic therapeutic approach of integrating pharmacological treatment with psychological interventions,focusing on its positive impacts on symptom alleviation,quality-of-life enhancement,and clinical recovery in adolescent depression.A cohort of 62 adolescents was selected as research participants,with randomized allocation into either monotherapy(drug-only)or combination therapy(drugs+psychological intervention)groups.Key evaluation metrics included anxiety levels,clinical efficacy,and incidence of adverse reactions.展开更多
Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnorm...Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnormalities were selected for this experiment,and they were intervened with form and body training and form and body training+visceral body acupressure techniques,and the anxiety and depression scores,spinal Cobb angle,vertebral body rotation of the parietal vertebrae,and the treatment efficiency were compared between the groups after the clinical interventions.Results:The anxiety and depression scores of patients in the form group were significantly higher than those of the combined group,P<0.05;the improvement of the Cobb angle and vertebral rotation of the parietal vertebrae of patients in the combined group was better than that of the form group,P<0.05;and the total effective rate of the treatment of patients in the form group was significantly lower than that of the combined group,P<0.05.Conclusion:After intervening in adolescents’abnormalities of form,patients were treated with a combination of the internal organs and body acupressure techniques and form training methods,and the results were compared between groups.After the joint intervention of the visceral massage technique and physical training,the patients’scoliosis and other physical problems were positively improved,and the psychological status of the patients was relatively adjusted to ensure their physical and mental health.展开更多
Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a rare hetero-geneous primary malignant liver tumor containing both hepatocellular and cholangiocarcinoma features.The complex presentation of cHCC-CCA tends to b...Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a rare hetero-geneous primary malignant liver tumor containing both hepatocellular and cholangiocarcinoma features.The complex presentation of cHCC-CCA tends to be poorly investigated,and the information derived from traditional diagnostic techniques(histopathology and radiological imaging)is often not optimal.Since cHCC-CCA is usually difficult to diagnose due to complex histopathological features(edge learning)as excessive photos,hence,achieves treatment delays and poor prognosis,the incorporation of advanced artificial intelligence like edge learning is able to improve the patient’s outcome.Using artificial intelligence,particularly deep learning,has recently opened new doorways for the impro-vement of diagnostic accuracy.If artificial intelligence models are deployed on local devices,edge learning exercises this type of learning,which provides real time processing,improved data privacy and reduced bandwidth usage.This narrative review investigates the conceptual formulation of edge learning together with its opportunities for clinical applications in the prediction and classification of cHCC-CCA,the technical solution strategies,the clinical benefits it offers,and associated challenges and future directions.展开更多
Severe combined immunodeficiency disease(SCID),characterized by profound immune system dysfunction,can lead to life-threatening infections and death.Animal models play a pivotal role in elucidating biological processe...Severe combined immunodeficiency disease(SCID),characterized by profound immune system dysfunction,can lead to life-threatening infections and death.Animal models play a pivotal role in elucidating biological processes and advancing therapeutic strategies.Recent advances in gene-editing technologies,including zincfinger nucleases(ZFNs),transcription activator-like effector nucleases(TALENs),CRISPR/Cas9,and base editing,have significantly enhanced the generation of SCID models.These models have not only deepened our understanding of disease pathophysiology but have also driven progress in cancer therapy,stem cell transplantation,organ transplantation,and infectious diseasemanagement.Thisreviewprovidesa comprehensive overview of current SCID models generated using novel gene-editing approaches,highlighting their potential applications in translational medicine and their role in advancing biomedical research.展开更多
The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and cli...The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and clinically significant prostate cancer(csPCa).Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center(Shanghai,China)between January 2019 and December 2023 were analyzed.Propensity score matching(PSM)was used to balance baseline characteristics,and detection rates were compared before and after PSM.Subgroup analyses based on prostate-specific antigen(PSA)levels and Prostate Imaging-Reporting and Data System(PI-RADS)scores were performed.Primary and secondary outcomes were the detection rates of PCa and csPCa,respectively.Of 2572 men,1778 were included in the PSM analysis.Before PSM,CB had higher detection rates for both PCa(62.9%vs 52.4%,odds ratio[OR]:1.54,P<0.001)and csPCa(54.9%vs 43.3%,OR:1.60,P<0.001)compared to SB.After PSM,CB remained superior in detecting PCa(63.1%vs 47.9%,OR:1.86,P<0.001)and csPCa(55.0%vs 38.2%,OR:1.98,P<0.001).In patients with PSA 4–12 ng ml−1(>4 ng ml-1 and≤12 ng ml-1,which is also applicable to the following text),CB detected more PCa(59.8%vs 40.7%,OR:2.17,P<0.001)and csPCa(48.1%vs 27.7%,OR:2.42,P<0.001).CB also showed superior csPCa detection in those with PI-RADS 3 lesions(32.1%vs 18.0%,OR:2.15,P=0.038).Overall,CB significantly improves PCa and csPCa detection,especially in patients with PSA 4–12 ng ml−1 or PI-RADS 3 lesions.展开更多
Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Method...Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Methods:90 patients with lumbar disc herniation who underwent radiofrequency ablation(RFA)combined with ozone interventional therapy in the Orthopedics and Traumatology Department of our hospital from January to December 2019 were included as research samples.They were randomly divided into two groups using a random number table method:the control group(45 cases)received routine perioperative nursing and health education;the experimental group(45 cases)received a comprehensive psychological intervention program consisting of MBSR combined with relaxation training in addition to the control group’s treatment.Changes in pain perception(VAS),sleep quality(PSQI),psychological state(SAS/SDS),and life satisfaction(SWLS)were compared between the two groups before and after the intervention.Results:After the intervention,both groups showed a significant decrease in SAS and SDS scores(P<0.05),with a greater decrease in the experimental group(P<0.05);the experimental group had lower PSQI total scores and scores in each dimension compared to the control group(P<0.05);the experimental group had a significantly lower VAS score(3.56±0.88)compared to the control group(5.94±0.62)(P<0.05);the experimental group had a higher SWLS score(28.59±5.61)compared to the control group(22.46±4.15)(P<0.05).Conclusion:MBSR combined with relaxation training can significantly optimize the perioperative psychological state of patients undergoing RFA combined with ozone interventional therapy,reduce pain sensitivity and stress responses,and simultaneously improve sleep quality and treatment satisfaction.展开更多
A holistic and precise assessment of retaining wall deformations is critical for on-site risk management of large combined deep excavation projects,where the risk-related points are highly dispersed,evolving,and inter...A holistic and precise assessment of retaining wall deformations is critical for on-site risk management of large combined deep excavation projects,where the risk-related points are highly dispersed,evolving,and interacting.Despite extensive exploration of this topic in previous studies,the omission of intricate spatiotemporal characteristics of wall deformations has resulted in diminished prediction accuracy and stability.To mitigate this deficiency,a spatiotemporal characteristics matrix for all data points and time series was first generated for a deep excavation scenario and used as input for a new hybrid model that combines convolutional neural network(CNN)and long short-term memory(LSTM)with incorporated attention mechanism(CNN-LSTM-Att),which enables the cross-learning mechanism and improves interpretability.In addition,by leveraging the attention weight,a new risk assessment index for retaining wall deformations across various scenarios was formulated.Then the proposed method was applied in a large combined deep excavation in Shanghai,China.The results show that:(1)The incorporation of fedin characteristic data and the attention mechanism enables the proposed method to produce satisfactory prediction results for the holistic spatiotemporal distribution of a large combined excavation;(2)Compared with other published models,the proposed model shows much better prediction accuracy,interpretability,and stability,especially in medium-and long-term predictions;and(3)The new risk assessment index serves as a reliable decision-making tool for assessing the risk evolution of retaining wall deformations and provides valuable guidance for effective risk management in multi-scenario excavation projects.展开更多
To address problems in surface integrity and machining allowance distribution during combined electric arc-mechanical milling,this paper takes TC4 as the research object,examines the influence of electric arc milling(...To address problems in surface integrity and machining allowance distribution during combined electric arc-mechanical milling,this paper takes TC4 as the research object,examines the influence of electric arc milling(EAM)depth on recast layer thickness and surface roughness,alongside an analysis of the recast layer’s organization characteristics and sur-face morphology.A comparative evaluation of cutting forces,surface roughness,and surface hardening is conducted between combined milling and conventional mechanical milling.Key findings reveal that electric arc machining produces a recast layer with a hardness of 313.21 HV.As the EAM depth increases,the localized recast layer thickness and peak-to-valley(PV)differ-ences also rise.To ensure effective surface defect removal,the machining allowance for subsequent mechanical milling must exceed the combined thickness of the recast layer and the PV difference.Under identical parameters,combined milling yields higher surface roughness(0.584μm)and greater surface hardening(10.4%)compared to mechanical milling alone,alongside an 18.716 N increase in cutting force.Response surface methodology(RSM)analysis identifies feed per tooth as the most significant factor affecting surface roughness,followed by spindle speed,with milling depth having the least influence.展开更多
BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High...BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High levels of anti-ganglionic nicotinic acetylcholine receptor(gAChR)serum antibodies are detected in approximately 50%of AAG cases,confirming the diagnosis.CASE SUMMARY We present the case of a 68-year-old man who developed autonomic failure gradually over a 2-year period.Recently,the patient was unable to stand upright for more than a few seconds before fainting.Additionally,he presented with decreased sweating,dry mouth,urinary retention,early satiety,weight loss,bloating,constipation,and erectile dysfunction.Neurological examination revealed dilated pupils that were unresponsive to light.Deep tendon reflexes were absent or diminished.Serologic evaluation revealed the presence of gAChR autoantibodies.An orthostatic hypotension test yielded a positive result.The patient did not respond to symptomatic therapy,including midodrine,fludrocortisone and atomoxetine.Second-line therapy with immunoadsorption produced a noticeable clinical improvement;however,orthostatic hypotension persisted.Sequential rituximab infusion therapy successfully led to a significant improvement in symptoms.CONCLUSION Our case report supports the benefit of combined immunomodulatory therapy for refractory AAG cases that are unresponsive to single-agent treatment.展开更多
Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial...Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial pneumonia as the observation group and 50 patients with non-bacterial pneumonia as the control group,recruited from May 2022 to October 2023.Fasting venous blood samples were collected in the morning from all 100 participants.CRP levels were measured using a fully automated biochemical analyzer,while PCT levels were detected using the immunoturbidimetric luminescence method.Results:CRP and PCT levels were significantly higher in bacterial pneumonia patients[(98.25±11.59)mg/L and(3.57±1.35)μg/L,respectively]compared to the control group[(5.55±2.78)mg/L and(0.25±0.12)μg/L,respectively],with significant intergroup differences(P<0.05).Patients with severe bacterial pneumonia exhibited higher serum CRP and PCT levels compared to those with moderate or mild disease(P<0.05).The combined testing of CRP and PCT showed higher sensitivity and specificity than individual tests.In the observation group,CRP and PCT levels significantly decreased after treatment compared to pre-treatment levels.Conclusion:The combination of CRP and PCT testing provides high diagnostic accuracy for bacterial pneumonia in elderly patients.It effectively differentiates bacterial from non-bacterial infections,offering valuable data to guide clinical treatment.展开更多
In the 3D inversion modeling of gravity and magnetic potential field data,the model weighting function is often applied to overcome the skin eff ect of inversion results.However,divergence occurs at the the deep area,...In the 3D inversion modeling of gravity and magnetic potential field data,the model weighting function is often applied to overcome the skin eff ect of inversion results.However,divergence occurs at the the deep area,and artificial weak negative anomalies form around the positive anomalies in the horizontal direction,resulting in a reduction in the overall resolution.To fully utilize the model weighting function,this study constructs a combined model weighting function.First,a new depth weighting function is constructed by adding a regulator into the conventional depth weighting function to overcome the skin eff ect and inhibit the divergence at the deep area of the inversion results.A horizontal weighting function is then constructed by extracting information from the observation data;this function can suppress the formation of artificial weak anomalies and improve the horizontal resolution of the inversion results.Finally,these two functions are coupled to obtain the combined model weighting function,which can replace the conventional depth weighting function in 3D inversion.It improves the vertical and horizontal resolution of the inversion results without increasing the algorithm complexity and calculation amount,is easy to operate,and adapts to any 3D inversion method.Two model experiments are designed to verify the effectiveness,practicability,and anti-noise of the combined model weighting function.Then the function is applied to the 3D inversion of the measured aeromagnetic data in the Jinchuan area in China.The obtained inversion results are in good agreement with the known geological data.展开更多
文摘BACKGROUND Currently,very few studies have examined the analgesic effectiveness and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.AIM To investigate the analgesic effect and safety of dexmedetomidine-assisted intravenous-inhalation combined general anesthesia in laparoscopic minimally invasive surgery for inguinal hernia.METHODS In this retrospective study,94 patients scheduled for laparoscopic minimally invasive surgery for inguinal hernia,admitted to Yiwu Central Hospital between May 2022 and May 2023,were divided into a control group(inhalation combined general anesthesia)and a treatment group(dexmedetomidine-assisted intrave-nous-inhalation combined general anesthesia).Perioperative indicators,analgesic effect,preoperative and postoperative 24-hours blood pressure(BP)and heart rate(HR),stress indicators,immune function levels,and adverse reactions were com-pared between the two groups.RESULTS Baseline data,including age,hernia location,place of residence,weight,monthly income,education level,and underlying diseases,were not significantly different between the two groups,indicating comparability(P>0.05).No significant difference was found in operation time and anesthesia time between the two groups(P>0.05).However,the treatment group exhibited a shorter postoperative urinary catheter removal time and hospital stay than the control group(P<0.05).Preoperatively,no significant differences were found in the visual analog scale(VAS)scores between the two groups(P>0.05).However,at 12,18,and 24 hours postoper-atively,the treatment group had significantly lower VAS scores than the control group(P<0.05).Although no significant differences in preoperative hemodynamic indicators were found between the two groups(P>0.05),both groups experienced some extent of changes in postoperative HR,diastolic BP(DBP),and systolic BP(SBP).Nevertheless,the treatment group showed smaller changes in HR,DBP,and SBP than the control group(P<0.05).Preoperative immune function indicators showed no significant differences between the two groups(P>0.05).However,postoperatively,the treatment group demonstrated higher levels of CD3+,CD4+,and CD4+/CD8+and lower levels of CD8+than the control group(P<0.05).The rates of adverse reactions were 6.38%and 23.40%in the treatment and control groups,respectively,revealing a significant difference(χ2=5.371,P=0.020).CONCLUSION Dexmedetomidine-assisted intravenous-inhalation combined general anesthesia can promote early recovery of patients undergoing laparoscopic minimally invasive surgery for inguinal hernia.It ensures stable blood flow,improves postoperative analgesic effects,reduces postoperative pain intensity,alleviates stress response,improves immune function,facilitates anesthesia recovery,and enhances safety.
基金financially supported by,the Fundamental Research Funds for the Central Universities(Grant No.2023QN1064)the China Postdoctoral Science Foundation(Grant No.2023M733772)Jiangsu Funding Program for Excellent Postdoctoral Talent(Grant No.2023ZB847)。
文摘Prepulse combined hydraulic fracturing facilitates the development of fracture networks by integrating prepulse hydraulic loading with conventional hydraulic fracturing.The formation mechanisms of fracture networks between hydraulic and pre-existing fractures under different prepulse loading parameters remain unclear.This research investigates the impact of prepulse loading parameters,including the prepulse loading number ratio(C),prepulse loading stress ratio(S),and prepulse loading frequency(f),on the formation of fracture networks between hydraulic and pre-existing fractures,using both experimental and numerical methods.The results suggest that low prepulse loading stress ratios and high prepulse loading number ratios are advantageous loading modes.Multiple hydraulic fractures are generated in the specimen under the advantageous loading modes,facilitating the development of a complex fracture network.Fatigue damage occurs in the specimen at the prepulse loading stage.The high water pressure at the secondary conventional hydraulic fracturing promotes the growth of hydraulic fractures along the damage zones.This allows the hydraulic fractures to propagate deeply and interact with pre-existing fractures.Under advantageous loading conditions,multiple hydraulic fractures can extend to pre-existing fractures,and these hydraulic fractures penetrate or propagate along pre-existing fractures.Especially when the approach angle is large,the damage range in the specimen during the prepulse loading stage increases,resulting in the formation of more hydraulic fractures.
基金the National Natural Science Foundation of China(No.52075264)。
文摘With the continuous escalation of modern war,soldiers need to transport more combat materials to the combat area.The limited load-bearing capacity of soldiers seriously restricts their carrying capacity and mobility.It is urgent to develop a power-assisted exoskeleton robot suitable for individual combat.In the past,most power-assisted exoskeleton robots were driven by motors.This driving method has an excellent power-assisted effect,but the endurance is often insufficient.In view of this shortcoming,this study designed an ankle exoskeleton robot based on an active-passive combined drive through simulation analysis of human motion.It used OpenSim software to simulate and verify that the addition of spring could achieve a good effect.At the same time,according to the gait characteristics of the human body,the gait planning of an exoskeleton robot was carried out.Afterwards,theoretical analysis explained that the cooperation among spring,motor and wearer could be realized in this gait.Finally,the assisting ability and driving coordination of the active-passive combination driven ankle exoskeleton robot were verified through experiments.
基金supported by the National Natural Science Foundation of China(Nos.52293442,52300249,and 52388101)the Scientific Research Project of China Three Gorges Corporation(No.201903139).
文摘Following the COVID-19 outbreak,a vast array of chlorine disinfectants was used to eliminate the virus,leading to inevitable discharge into aquatic ecosystems.These environments also contain various anthropogenic micropollutants,such as pharmaceuticals,which pose threats to the survival and activities of biological communities.Consequently,the presence of discharged chlorine disinfectants and pharmaceuticals can simultaneously impact the structure and function of aquatic ecosystems.To investigate the combined effects of chlorine disinfectants and pharmaceuticals on the periphyton and zoobenthos(Limnodrilus hoffmeisteri)community composition and function,we conducted a 12-flume reactor experiment using sodium hypochlorite and representative pharmaceuticals(abundant in the Yangtze River)as influents.Results demonstrated that the discharge of chlorine disinfectants further altered the composition of river prokaryotic communities.Eukaryotic organisms within the periphyton exhibited greater resilience to chlorine exposure compared to prokaryotic communities.Metagenomic analysis revealed that prokaryotic communities with different compositions can execute similar functions,while RNA sequencing indicated that co-exposure promoted biological processes such as focal adhesion and ribosome synthesis,but inhibited activities related to nitrogen metabolism and resistance to folate antimicrobials.Additionally,co-exposure induced oxidative stress in L.hoffmeisteri,leading to stronger environmental adaptation.
基金supported by the National Key Research and Development Program of China(No.2020YFC1808204)the National Natural Science Foundation of China(Nos.22206001 and U22A20406)the Scientific Research Foundation of Education Department of Anhui Province of China(No.KJ2021A0074).
文摘Nanoplastics are emerging contaminants that may co-exist with organochlorine pesticides and adversely affect invertebrates in the environment.However,the impact of environmental aging on the combined toxicity of nanoplastics and organochlorine pesticides remains unclear.This study investigated the effects of aging on the combined toxicity of polystyrene nanoplastics(PS NPs)and chlordane against Caenorhabditis elegans.The results showed that photo-aging altered the physicochemical properties of PS NPs and promoted the combined toxicity of PS NPs and chlordane to nematodes by reducing survival rate,body length and enhancing germline apoptosis.Additionally,combined exposure of nematodes to aged PS NPs and chlordane significantly increased reactive oxygen species production and intestinal permeability,suggesting that aging enhances combined toxicity through oxidative stress and intestinal damage.Moreover,aging increased chlordane contents in nematodes without promoting PS NPs accumulation,potentially leading to increased combined toxicity of PS NPs and chlordane.Notably,aging significantly increased the accumulation of PS NPs in the posterior intestine of the nematode during co-exposure,which may be responsible for the most sensitive and highest degree of change in germline apoptosis.These observations emphasize the significance of accounting for environmental aging as well as the accumulation and distribution of nanoplastics in organisms when assessing the combined effects of nanoplastics and coexisting pollutants.
基金The authors thank the National Natural Science Foundation of China(Grant No.U20B6003)for their financial support to carry out this research.
文摘China boasts abundant heavy oil resources,which is vital for its energy security.However,its heavy oil typically exhibits high viscosity,which severely hinders its flow and extraction.Enhancing heavy oil flowability is vital for its effective exploitation.This study independently developed a visualization experimental system and explored the mechanisms through which combined thermal flooding(a combination of heat,chemical agents and gas)enhances heavy oil flowability.Results indicate that combined thermal flooding,that is,synergistically integrating heat,chemical agents,and gas,can effectively enhance the recovery of heavy oil by improving its flowability.Its working mechanisms were explored from the aspects of thermal effects,emulsification,precursor film,profile control capacity,and CO_(2) solution and extraction effects.The emulsification was observed using a confocal laser scanning fluorescence microscope(CLSFM).Findings reveal that steam flooding can boost crude oil flowability by augmenting temperature,while a chemical system tends to produce low-viscosity oil-in-water emul-sions,thus further aiding the flow of crude oil.During CO_(2) flooding,the solvent initially reduced crude oil viscosity and formed foamy oil,followed by the pronounced component separation of the produced fluids in the later stage.This demonstrates the effectiveness of CO_(2) in viscosity reduction and component extraction.Additionally,the results of interfacial tension experiments indicate that surfactants can reduce the heavy oil's interfacial tension,fostering the formation of nano-scale precursor films.They can also thicken these films and diminish their spreading resistance,thus accelerating residual oil removal and promoting heavy oil production.This study further elaborated the mechanisms behind the combined thermal flooding's efficiency in enhancing heavy oil recovery,offering a theoretical foundation for its broader application.
文摘Objective:To analyze the effects of combined spinal-epidural anesthesia and epidural anesthesia in patients undergoing appendicitis surgery.Methods:Seventy-eight patients who underwent surgical treatment for appendicitis from February 2022 to February 2025 were selected as samples and randomly divided into two groups.The study group received combined spinal-epidural anesthesia,while the control group received epidural anesthesia.Anesthesia indicators,vital signs,and complication indicators were compared between the two groups.Results:The onset time of anesthesia in the study group was shorter than that in the control group,the visual analog scale(VAS)score was lower than that in the control group,and the highest plane of anesthesia block was lower than that in the control group(P<0.05).At 15 minutes after anesthesia induction and at the end of surgery,the heart rate(HR),mean arterial pressure(MAP),and blood oxygen saturation(SPO2)in the study group were significantly different from those in the control group(P<0.05).The complication rate in the study group was lower than that in the control group(P<0.05).Conclusion:Combined spinal-epidural anesthesia for appendicitis surgery can reduce the impact of anesthesia on vital signs,shorten the onset time of anesthesia,and is highly effective and feasible.
基金supported by the National Science and Technology Major Project of China(Nos.2017-II-0004-0016 and J2019-I-0011-0011).
文摘Unstable operating conditions such as surge could cause damage to both aerodynamic performance and structural integrity of a compression system.This paper addresses the critical issue of aerodynamic instability in compressor design,particularly focusing on an axial-centrifugal combined compressor,a widely used yet underexplored configuration.An experimental investigation was conducted on a three-stage axial and one-stage centrifugal compressor(3A1C),using two pipe systems and employing fast-responding transducers to capture the dynamic instability process from choke condition to deep surge.Results reveal that at the design speed,3A1C enters deep surge directly,whereas at off-design speeds,it experiences rotating stall and mild surge across a wide mass flow range.Some special instability features in the combined compressor can be found in the steady state map and dynamic process.The characteristic curve of the first axial stage keeps a positive slope during the whole mass flow range at an off-design speed.The first stage could work stably on the stall characteristic curve because the centrifugal stage has stronger pressurization and plays a dominant role in global aerodynamic instability.Besides,rotating instability occurs at the first rotor tip and disappears as the back pressure increases,which is also rarely seen in a single-axial compressor.This is also related to the strong pressurization of the centrifugal stage.The findings of this paper will contribute to the understanding of aerodynamic instabilities in combined compressors.
基金Supported by the National Natural Science Foundation of China,No.82360111Xinjiang Science and Technology Department-Leading Talents in Technological Innovation-High-Level Leading Talents,No.2022TSYCLJ0034+1 种基金State Key Laboratory for The Cause and Control of High Incidence in Central Asia Jointly Constructed by The Ministry and The Province,No.SKL-HIDCA-2023-2 and No.SKLHIDCA-2024-22Xinjiang Uygur Autonomous Region Graduate Innovation Program,No.XJ2024G153.
文摘BACKGROUND Alveolar and cystic echinococcoses are lethal zoonotic diseases caused by Echinococcus multilocularis and Echinococcus granulosus infections,leading to alveolar echinococcosis(AE)or cystic echinococcosis(CE),respectively.No study has hitherto reported effective treatment approaches for AE or CE with concurrent hepatorenal involvement.AIM To investigate the feasibility and efficacy of simultaneous combined surgery(SCS)as a comprehensive treatment approach for patients with hepatorenal echinococcosis.METHODS Clinical datasets of hepatorenal AE(n=10)and CE(n=11)patients were retrospectively collected and systematically analyzed.The SCS approach was introduced,and surgical outcomes,complications,and prognoses were documented in detail.RESULTS The SCS approach incorporated hybridized techniques,including partial hepatectomy,partial or total nephrectomy,ex vivo liver resection and autotransplantation,and total or subtotal cystectomy with endocystectomy.Radical SCS was achieved in 100%of AE patients and 63.6%of CE patients.All surgeries were completed without intraoperative complications.The short-term complication rate was 28.6%(Clavien-Dindo classification:AE-1 IIIb,3 IIIa;CE-2 II),while the long-term complication rate was 4.8%(Clavien-Dindo classification:AE-1 IIIb).Patients were followed up for a median of 37 months(AE:6-81 months;CE:34-123 months),with no reported deaths or disease relapses.CONCLUSION CS appears to be a feasible and effective treatment method for patients with hepatorenal involvement of AE or CE.It fulfills the management criteria for advanced AE or CE cases,aiming to maximize patient benefits.
文摘Research on the effects of drug therapy combined with psychological intervention in adolescent patients with depression represents a critical focus in contemporary psychiatric medicine.This study aims to explore the synergistic therapeutic approach of integrating pharmacological treatment with psychological interventions,focusing on its positive impacts on symptom alleviation,quality-of-life enhancement,and clinical recovery in adolescent depression.A cohort of 62 adolescents was selected as research participants,with randomized allocation into either monotherapy(drug-only)or combination therapy(drugs+psychological intervention)groups.Key evaluation metrics included anxiety levels,clinical efficacy,and incidence of adverse reactions.
文摘Purpose:To investigate the clinical effects of improving adolescents’form anxiety after the intervention of visceral massage technique and form training.Methods:A total of 80 adolescent patients with scoliosis abnormalities were selected for this experiment,and they were intervened with form and body training and form and body training+visceral body acupressure techniques,and the anxiety and depression scores,spinal Cobb angle,vertebral body rotation of the parietal vertebrae,and the treatment efficiency were compared between the groups after the clinical interventions.Results:The anxiety and depression scores of patients in the form group were significantly higher than those of the combined group,P<0.05;the improvement of the Cobb angle and vertebral rotation of the parietal vertebrae of patients in the combined group was better than that of the form group,P<0.05;and the total effective rate of the treatment of patients in the form group was significantly lower than that of the combined group,P<0.05.Conclusion:After intervening in adolescents’abnormalities of form,patients were treated with a combination of the internal organs and body acupressure techniques and form training methods,and the results were compared between groups.After the joint intervention of the visceral massage technique and physical training,the patients’scoliosis and other physical problems were positively improved,and the psychological status of the patients was relatively adjusted to ensure their physical and mental health.
文摘Combined hepatocellular-cholangiocarcinoma(cHCC-CCA)is a rare hetero-geneous primary malignant liver tumor containing both hepatocellular and cholangiocarcinoma features.The complex presentation of cHCC-CCA tends to be poorly investigated,and the information derived from traditional diagnostic techniques(histopathology and radiological imaging)is often not optimal.Since cHCC-CCA is usually difficult to diagnose due to complex histopathological features(edge learning)as excessive photos,hence,achieves treatment delays and poor prognosis,the incorporation of advanced artificial intelligence like edge learning is able to improve the patient’s outcome.Using artificial intelligence,particularly deep learning,has recently opened new doorways for the impro-vement of diagnostic accuracy.If artificial intelligence models are deployed on local devices,edge learning exercises this type of learning,which provides real time processing,improved data privacy and reduced bandwidth usage.This narrative review investigates the conceptual formulation of edge learning together with its opportunities for clinical applications in the prediction and classification of cHCC-CCA,the technical solution strategies,the clinical benefits it offers,and associated challenges and future directions.
基金supported by the Postdoctoral Fellowship Program of CPSF (GZC20231064)China Postdoctoral Science Foundation (2024M761345)+3 种基金Guangzhou Basic and Applied Basic Research Foundation (2024A04J6615)Scientific Research Project of Southern Medical University Stomatological Hospital (PY2023004)National Key Research and Development Program of China (2021YFA0805300)National Natural Science Foundation of China (82171244,32470564)。
文摘Severe combined immunodeficiency disease(SCID),characterized by profound immune system dysfunction,can lead to life-threatening infections and death.Animal models play a pivotal role in elucidating biological processes and advancing therapeutic strategies.Recent advances in gene-editing technologies,including zincfinger nucleases(ZFNs),transcription activator-like effector nucleases(TALENs),CRISPR/Cas9,and base editing,have significantly enhanced the generation of SCID models.These models have not only deepened our understanding of disease pathophysiology but have also driven progress in cancer therapy,stem cell transplantation,organ transplantation,and infectious diseasemanagement.Thisreviewprovidesa comprehensive overview of current SCID models generated using novel gene-editing approaches,highlighting their potential applications in translational medicine and their role in advancing biomedical research.
基金supported financially by the National Nature Science Foundation of China(No.82373355,No.82172703,No.82303856,and No.82473505)the Discipline Leader Project of Shanghai Municipal Health Commission(No.2022XD013)the AoXiang Project of Shanghai Anti-Cancer Association(No.SACA-AX202302).
文摘The choice of biopsy method is critical in diagnosing prostate cancer(PCa).This retrospective cohort study compared systematic biopsy(SB)or cognitive fusion-targeted biopsy combined with SB(CB)in detecting PCa and clinically significant prostate cancer(csPCa).Data from 2572 men who underwent either SB or CB in Fudan University Shanghai Cancer Center(Shanghai,China)between January 2019 and December 2023 were analyzed.Propensity score matching(PSM)was used to balance baseline characteristics,and detection rates were compared before and after PSM.Subgroup analyses based on prostate-specific antigen(PSA)levels and Prostate Imaging-Reporting and Data System(PI-RADS)scores were performed.Primary and secondary outcomes were the detection rates of PCa and csPCa,respectively.Of 2572 men,1778 were included in the PSM analysis.Before PSM,CB had higher detection rates for both PCa(62.9%vs 52.4%,odds ratio[OR]:1.54,P<0.001)and csPCa(54.9%vs 43.3%,OR:1.60,P<0.001)compared to SB.After PSM,CB remained superior in detecting PCa(63.1%vs 47.9%,OR:1.86,P<0.001)and csPCa(55.0%vs 38.2%,OR:1.98,P<0.001).In patients with PSA 4–12 ng ml−1(>4 ng ml-1 and≤12 ng ml-1,which is also applicable to the following text),CB detected more PCa(59.8%vs 40.7%,OR:2.17,P<0.001)and csPCa(48.1%vs 27.7%,OR:2.42,P<0.001).CB also showed superior csPCa detection in those with PI-RADS 3 lesions(32.1%vs 18.0%,OR:2.15,P=0.038).Overall,CB significantly improves PCa and csPCa detection,especially in patients with PSA 4–12 ng ml−1 or PI-RADS 3 lesions.
基金General Project,Scientific Research Project Plan for Traditional Chinese Medicine in Hebei Province(Project No.:T2025117)。
文摘Objective:To explore the application effect of MBSR combined with relaxation training in the perioperative period of radiofrequency ablation combined with ozone interventional therapy for lumbar disc herniation.Methods:90 patients with lumbar disc herniation who underwent radiofrequency ablation(RFA)combined with ozone interventional therapy in the Orthopedics and Traumatology Department of our hospital from January to December 2019 were included as research samples.They were randomly divided into two groups using a random number table method:the control group(45 cases)received routine perioperative nursing and health education;the experimental group(45 cases)received a comprehensive psychological intervention program consisting of MBSR combined with relaxation training in addition to the control group’s treatment.Changes in pain perception(VAS),sleep quality(PSQI),psychological state(SAS/SDS),and life satisfaction(SWLS)were compared between the two groups before and after the intervention.Results:After the intervention,both groups showed a significant decrease in SAS and SDS scores(P<0.05),with a greater decrease in the experimental group(P<0.05);the experimental group had lower PSQI total scores and scores in each dimension compared to the control group(P<0.05);the experimental group had a significantly lower VAS score(3.56±0.88)compared to the control group(5.94±0.62)(P<0.05);the experimental group had a higher SWLS score(28.59±5.61)compared to the control group(22.46±4.15)(P<0.05).Conclusion:MBSR combined with relaxation training can significantly optimize the perioperative psychological state of patients undergoing RFA combined with ozone interventional therapy,reduce pain sensitivity and stress responses,and simultaneously improve sleep quality and treatment satisfaction.
基金supported by the National Natural Science Foundation of China(Grant No.52090082).
文摘A holistic and precise assessment of retaining wall deformations is critical for on-site risk management of large combined deep excavation projects,where the risk-related points are highly dispersed,evolving,and interacting.Despite extensive exploration of this topic in previous studies,the omission of intricate spatiotemporal characteristics of wall deformations has resulted in diminished prediction accuracy and stability.To mitigate this deficiency,a spatiotemporal characteristics matrix for all data points and time series was first generated for a deep excavation scenario and used as input for a new hybrid model that combines convolutional neural network(CNN)and long short-term memory(LSTM)with incorporated attention mechanism(CNN-LSTM-Att),which enables the cross-learning mechanism and improves interpretability.In addition,by leveraging the attention weight,a new risk assessment index for retaining wall deformations across various scenarios was formulated.Then the proposed method was applied in a large combined deep excavation in Shanghai,China.The results show that:(1)The incorporation of fedin characteristic data and the attention mechanism enables the proposed method to produce satisfactory prediction results for the holistic spatiotemporal distribution of a large combined excavation;(2)Compared with other published models,the proposed model shows much better prediction accuracy,interpretability,and stability,especially in medium-and long-term predictions;and(3)The new risk assessment index serves as a reliable decision-making tool for assessing the risk evolution of retaining wall deformations and provides valuable guidance for effective risk management in multi-scenario excavation projects.
基金supported by the National Natural Science Foundation of China“Study on the evolution law of discharge channel and deformation suppression method for low-pressure micro-arc milling machining of aerospace thin-walled parts”(52265061)The Tianshan Innovation Team“Robotics and intelligent equipment technology science and technology innovation team”(2022D14002).
文摘To address problems in surface integrity and machining allowance distribution during combined electric arc-mechanical milling,this paper takes TC4 as the research object,examines the influence of electric arc milling(EAM)depth on recast layer thickness and surface roughness,alongside an analysis of the recast layer’s organization characteristics and sur-face morphology.A comparative evaluation of cutting forces,surface roughness,and surface hardening is conducted between combined milling and conventional mechanical milling.Key findings reveal that electric arc machining produces a recast layer with a hardness of 313.21 HV.As the EAM depth increases,the localized recast layer thickness and peak-to-valley(PV)differ-ences also rise.To ensure effective surface defect removal,the machining allowance for subsequent mechanical milling must exceed the combined thickness of the recast layer and the PV difference.Under identical parameters,combined milling yields higher surface roughness(0.584μm)and greater surface hardening(10.4%)compared to mechanical milling alone,alongside an 18.716 N increase in cutting force.Response surface methodology(RSM)analysis identifies feed per tooth as the most significant factor affecting surface roughness,followed by spindle speed,with milling depth having the least influence.
文摘BACKGROUND Autoimmune autonomic ganglionopathy(AAG),formerly known as acute pandysautonomia,is a rare,acquired,antibody-mediated,potentially curable autonomic disorder that presents with diffuse autonomic failure.High levels of anti-ganglionic nicotinic acetylcholine receptor(gAChR)serum antibodies are detected in approximately 50%of AAG cases,confirming the diagnosis.CASE SUMMARY We present the case of a 68-year-old man who developed autonomic failure gradually over a 2-year period.Recently,the patient was unable to stand upright for more than a few seconds before fainting.Additionally,he presented with decreased sweating,dry mouth,urinary retention,early satiety,weight loss,bloating,constipation,and erectile dysfunction.Neurological examination revealed dilated pupils that were unresponsive to light.Deep tendon reflexes were absent or diminished.Serologic evaluation revealed the presence of gAChR autoantibodies.An orthostatic hypotension test yielded a positive result.The patient did not respond to symptomatic therapy,including midodrine,fludrocortisone and atomoxetine.Second-line therapy with immunoadsorption produced a noticeable clinical improvement;however,orthostatic hypotension persisted.Sequential rituximab infusion therapy successfully led to a significant improvement in symptoms.CONCLUSION Our case report supports the benefit of combined immunomodulatory therapy for refractory AAG cases that are unresponsive to single-agent treatment.
文摘Objective:To analyze the diagnostic value of combined testing of C-reactive protein(CRP)and procalcitonin(PCT)in elderly patients with bacterial pneumonia.Methods:This study included 50 elderly patients with bacterial pneumonia as the observation group and 50 patients with non-bacterial pneumonia as the control group,recruited from May 2022 to October 2023.Fasting venous blood samples were collected in the morning from all 100 participants.CRP levels were measured using a fully automated biochemical analyzer,while PCT levels were detected using the immunoturbidimetric luminescence method.Results:CRP and PCT levels were significantly higher in bacterial pneumonia patients[(98.25±11.59)mg/L and(3.57±1.35)μg/L,respectively]compared to the control group[(5.55±2.78)mg/L and(0.25±0.12)μg/L,respectively],with significant intergroup differences(P<0.05).Patients with severe bacterial pneumonia exhibited higher serum CRP and PCT levels compared to those with moderate or mild disease(P<0.05).The combined testing of CRP and PCT showed higher sensitivity and specificity than individual tests.In the observation group,CRP and PCT levels significantly decreased after treatment compared to pre-treatment levels.Conclusion:The combination of CRP and PCT testing provides high diagnostic accuracy for bacterial pneumonia in elderly patients.It effectively differentiates bacterial from non-bacterial infections,offering valuable data to guide clinical treatment.
基金jointly funded by the National Natural Science Foundation of China(No.U2244220,No.42004125)the China Geological Survey Projects(No.DD20240119,No.DD20243245,No.DD20230114,No.DD20243244)the China Postdoctoral Science Foundation(No.2020M670601)。
文摘In the 3D inversion modeling of gravity and magnetic potential field data,the model weighting function is often applied to overcome the skin eff ect of inversion results.However,divergence occurs at the the deep area,and artificial weak negative anomalies form around the positive anomalies in the horizontal direction,resulting in a reduction in the overall resolution.To fully utilize the model weighting function,this study constructs a combined model weighting function.First,a new depth weighting function is constructed by adding a regulator into the conventional depth weighting function to overcome the skin eff ect and inhibit the divergence at the deep area of the inversion results.A horizontal weighting function is then constructed by extracting information from the observation data;this function can suppress the formation of artificial weak anomalies and improve the horizontal resolution of the inversion results.Finally,these two functions are coupled to obtain the combined model weighting function,which can replace the conventional depth weighting function in 3D inversion.It improves the vertical and horizontal resolution of the inversion results without increasing the algorithm complexity and calculation amount,is easy to operate,and adapts to any 3D inversion method.Two model experiments are designed to verify the effectiveness,practicability,and anti-noise of the combined model weighting function.Then the function is applied to the 3D inversion of the measured aeromagnetic data in the Jinchuan area in China.The obtained inversion results are in good agreement with the known geological data.
