BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the effic...BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.展开更多
Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic...Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic subgroup of index bounded above by c(n),a constant depending only on n,and we will survey partial results(up to date)on the c(n)-cyclic conjecture.展开更多
Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined...Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.展开更多
In this paper, we use the conductivity-temperature-depth (CTD) observation data and a three-dimensional ocean model in a seasonally-varying forcing field to study the barrier layer (BL) in the PN section in the East C...In this paper, we use the conductivity-temperature-depth (CTD) observation data and a three-dimensional ocean model in a seasonally-varying forcing field to study the barrier layer (BL) in the PN section in the East China Sea (ECS). The BL can be found along the PN section with obviously seasonal variability. In winter, spring and autumn, the BL occurs around the slope where the cold shelf water meets with the warm Kuroshio water. In summer, the BL can also be found in the shelf area near salinity front of the Changjiang (Yangtze) River Dilution Water (YRDW). Seasonal variations of BL in the PN section are caused by local hydrological characteristics and seasonal variations of atmospheric forcing. Strong vertical convection caused by sea surface cooling thickens the BL in winter and spring in the slope area. Due to the large discharge of Changjiang River in summer, the BL occurs extensively in the shelf region where the fresh YRDW and the salty bottom water meet and form a strong halocline above the seasonal thermocline. The formation mechanism of BL in the PN section can be explained by the vertical shear of different water masses, which is called the advection mechanism. The interannual variation of BL in summer is greatly affected by the YRDW. In the larger YRDW year (such as 1998), a shallow but much thicker BL existed on the shelf area.展开更多
Differential equation of restrained torsion for rectangular-section box bar with honeycomb core was established and solved by using the method of undetermined function.Non-dimension normal stress, shear stress acting...Differential equation of restrained torsion for rectangular-section box bar with honeycomb core was established and solved by using the method of undetermined function.Non-dimension normal stress, shear stress acting in the faceplate and shear stress acting in the honeycomb-core and warping displacement were deduced. Numerical analysis shows the normal stress attenuates quickly along x-axis. Normal stress acting on the cross section at a distance of 20 h from the fixed end is only one per cent of that acting on the fixed end.展开更多
Regular physical activity (PA) has numerous advantages in improving the physical and mental health of children and adolescents^([1]).However,the PA status quo for children and adolescents with intellectual disabilitie...Regular physical activity (PA) has numerous advantages in improving the physical and mental health of children and adolescents^([1]).However,the PA status quo for children and adolescents with intellectual disabilities (ID) is dismal.Children and adolescents with ID frequently exhibit sedentary behaviors because their physical,sensory,and/or cognitive impairments make it difficult to participate in sports and games with their peers^([2]).They have higher rates of mental illness,obesity,type 2diabetes,and other health problems than peers with typical development (TD).展开更多
Cross sections for K-shell ionization have been measured at electron energies of 0.1-0.40 MeV for Cu and Sn, and of 0.30MeV for Ag. The present results have been compared with theoretical calculations and previously r...Cross sections for K-shell ionization have been measured at electron energies of 0.1-0.40 MeV for Cu and Sn, and of 0.30MeV for Ag. The present results have been compared with theoretical calculations and previously reported experimental values.展开更多
In this work, the elastic cross section is calculated at energies above the Coulomb barrier for 3He + 58Ni using a Woods-Saxon potential. The solutions of the radial Schrödinger equations are calculated numer...In this work, the elastic cross section is calculated at energies above the Coulomb barrier for 3He + 58Ni using a Woods-Saxon potential. The solutions of the radial Schrödinger equations are calculated numerically and they are introduced in the S matrix, after which the cross section is obtained. The parameters in the potential are adjusted to satisfy known experimental data.展开更多
To overcome the limitations of low efficiency and reliance on manual processes in the measurement of geometric parameters for bridge prefabricated components,a method based on deep learning and computer vision is deve...To overcome the limitations of low efficiency and reliance on manual processes in the measurement of geometric parameters for bridge prefabricated components,a method based on deep learning and computer vision is developed to identify the geometric parameters.The study utilizes a common precast element for highway bridges as the research subject.First,edge feature points of the bridge component section are extracted from images of the precast component cross-sections by combining the Canny operator with mathematical morphology.Subsequently,a deep learning model is developed to identify the geometric parameters of the precast components using the extracted edge coordinates from the images as input and the predefined control parameters of the bridge section as output.A dataset is generated by varying the control parameters and noise levels for model training.Finally,field measurements are conducted to validate the accuracy of the developed method.The results indicate that the developed method effectively identifies the geometric parameters of bridge precast components,with an error rate maintained within 5%.展开更多
Introduction: Study compare spinal anesthesia using hyperbaric bupivacine (0.5% - 0.75%) between fixed dose and height adjusted dose during elective cesarean section. Methods: Hundred parturients who had given their c...Introduction: Study compare spinal anesthesia using hyperbaric bupivacine (0.5% - 0.75%) between fixed dose and height adjusted dose during elective cesarean section. Methods: Hundred parturients who had given their consent and were scheduled for elective cesarean section under spinal anesthesia, were divided into four groups—first group received 0.5% hyperbaric bupivacine fixed dose, the second group received 0.5% hyperbaric bupivacine in a dose adjusted to the height, the third received 0.75% hyperbaric bupivacine fixed dose, the fourth group received 0.75% hyperbaric bupivacine in a dose adjusted to height. The anesthesia onset time, haemodynamic changes, side effects and fetal outcome observed. Results: Spinal block provide excellent surgical anesthesia in all patients. Anesthesia onset time is longer in adjusted than fixed groups, in 0.5% (5 ± 0.816 vs. 3.84 ± 0.746) (P Conclusion: Adjusting dose of hyperbaric bupivacine (0.5% - 0.75%) to patient’s height, decreases the dose of bupivacine in use, it also provide adequate anesthesia for elective cesarean section with decrease the use of vasopressors, the incidence and severity of maternal hypotention also markedly reduced.展开更多
Population dynamics parameters and stock status of Squaliobarbus curriculus (Richardson, 1846) were analyzed from May to September 2021 in the Lanxi section of Qiantang River. FiSAT II software program was used. The g...Population dynamics parameters and stock status of Squaliobarbus curriculus (Richardson, 1846) were analyzed from May to September 2021 in the Lanxi section of Qiantang River. FiSAT II software program was used. The growth coefficient K = 0.21 year<sup>–1</sup>, asymptomatic length L<sub>∞</sub> = 39.48 cm, and age at theoretical zero-length t<sub>0</sub> = –0.74 years were estimated. The von Bertalanffy growth function was calculated as L<sub>t</sub> = 39.48[1 – e<sup>–</sup><sup>0.21(t + 0.74)</sup>]. The growth curve for weight had an inflection at 5.86 years, corresponding to 29.61 cm in standard length and 372.29 g in weight. The natural mortality rate (M), the fishing mortality rate (F), and the total mortality rate (Z) were calculated as 0.51, 0.61, and 1.12 year<sup>–1</sup>, respectively. The exploitation ratio (E) was 0.54, which is greater than the value of 0.5 suggested by Gull (1971), indicating a probable state of overdevelopment. The annual average stock number and biomass of S. curriculus in the Lanxi section of Qiantang River were 31.86 × 10<sup>6</sup> individuals and 3656.82 t, respectively.展开更多
Radar cross section(RCS)plays a critical role in modeling target scattering characteristics and enhancing the precision of target detection and localization in integrated sensing and communication(ISAC)systems.This pa...Radar cross section(RCS)plays a critical role in modeling target scattering characteristics and enhancing the precision of target detection and localization in integrated sensing and communication(ISAC)systems.This paper investigates the human body RCS at 26 GHz via multiangle channel measurements under different clothing conditions.Based on calibrated electromagnetic(EM)parameters,the RCS characteristics of the human body in far-field conditions are analyzed using ray-tracing(RT)simulations.Some suggestions for the design of ISAC systems are also discussed.The results provide a solid theoretical foundation and practical reference for the modeling of target scattering characteristics for ISAC channels.展开更多
Purpose: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study w...Purpose: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study was to investigate the clinical efficacy of levobupivacaine compared with hyperbaric bupivacaine for spinal anesthesia for cesarean section. Methods: 60 pregnant women in ASA I - II group scheduled to have elective cesarean operation were allocated into the study. Patients were randomly divided into two groups. The combinations 10 mg levobupivacaine (0.5%) + fentanyl (15 μcg) for Group LF (n = 30) patients, 10 mg hyperbaric bupivacaine (0.5%) + fentanyl (15 μcg) for BF (n = 30) patients were intrathecally administrated a total of 2.3 cc. Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale;observed hemodynamic changes and side effects were recorded. Results: The time to reach maximum dermatome for the sensory block, time to regression by two dermatomes and time to regress to T12 dermatome was found to be significantly long in Group BF. It was observed that in Group BF, the evolution of the motor block was faster and lasted longer. Whereas hypotension, bradycardia and nausea were less in Group LF, the need for ephedrine was higher in Group BF (p < 0.05). Conclusion: Since motor block time is shorter, and side effects like hypotension, bradycardia and nausea are less, the combination of levobupivacaine + fentanyl can be a good alternative in cesarean sections.展开更多
Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi...Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi-experimental design was carried out on the mothers scheduled for CS.Eighty participants were selected by a purposive sampling technique,which were divided(40 participants in each group)into an experimental group and a control group.Nurse-led informational video(NLIV)was shown to the experimental group,and routine care was provided for the control group.Modified hospital anxiety scale(HADS),scale for measuring maternal satisfaction in cesarean birth,and obstetric quality of recovery following cesarean delivery were used to assess anxiety,satisfaction,and recovery.Results:Both the experimental and control groups showed significant reductions in anxiety by the first postintervention day(P<0.001),with the experimental group experiencing a greater mean reduction(mean difference[MD]=4.37)than the control group(MD=3.35)but the intergroup difference was not statistically significant(P>0.05).The experimental group reported significantly higher satisfaction scores(175.55±9.42)on the 3rd postoperative day compared to the control group(151.93±14.89;P<0.001).Similarly,the experimental group’s recovery scores(79.90±6.24)were considerably higher than those of the control group(62.45±15.18;P<0.001).On the 3rd postintervention day,satisfaction was significantly associated with age(P<0.001),and recovery with gravidity(P<0.05).Conclusions:NLIV can be used in the preoperative period to reduce anxiety related to CS and to improve satisfaction and recovery after the CS.展开更多
Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who requ...Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.展开更多
Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiologic...Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiological and pathological conditions.Deciphering the spatial interaction of leptin receptor-expressing(LepR^(+))stromal cells with other compartments in the bone marrow is crucial for a deeper understanding of the stem cell niche and the skeletal tissue.In this study,we introduce an optimized protocol for the 3D analysis of skeletal tissues,enabling the visualization of hematopoietic and stromal cells,especially LepR+stromal cells,within optically cleared bone hemisections.Our method preserves the 3D tissue architecture and is extendable to other hematopoietic sites such as calvaria and vertebrae.The protocol entails tissue fixation,decalcification,and cryosectioning to reveal the marrow cavity.Completed within approximately 12 days,this process yields highly transparent tissues that maintain genetically encoded or antibody-stained fluorescent signals.The bone hemisections are compatible with diverse antibody labeling strategies.Confocal microscopy of these transparent samples allows for qualitative and quantitative image analysis using Aivia or Bitplane Imaris software,assessing a spectrum of parameters.With proper storage,the fluorescent signal in the stained and cleared bone hemisections remains intact for at least 2–3 months.This protocol is robust,straightforward to implement,and highly reproducible,offering a valuable tool for tissue architecture and cellular interaction studies.展开更多
Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,bu...Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,but severe obesity combined with refractory hypertension is very rare in clinical practice.The optimal anesthetic management strategy for obese pregnant women with a difficult airway and poorly controlled hypertension remains debatable.This report presents a 32-year-old woman with severe obesity and refractory hypertension at 36 weeks and 6 days of pregnancy.Owing to fetal heart rate abnormalities,she was scheduled for emergency cesarean section.Given the urgency of the fetal condition and the challenges posed by the patient's obesity for epidural puncture,the anesthesiologist opted for rapid sequence induction and tracheal intubation instead of intervertebral anesthesia.Short-acting antihypertensive medications were adminstrated preoperatively to control elevated blood pressure,and vasopressor agents were continuously infused during surgery to prevent severe hypotension induced by anesthetic drugs.The entire anesthesia and surgical procedure proceeded uneventfully,with no major adverse events observed.Both the patient and fetus achieved favorable outcomes.This case indicates that early anesthetic risk assessment and meticulous pre-delivery planning are paramount,necessitating personalized management of airway and hemodynamics to optimize outcomes in obese parturients.展开更多
OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar d...OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.展开更多
The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and...The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and development of the interchange system,as well as the design forms of the compound interchange interweaving section,were analyzed.Subsequently,based on the case method,the design of the compound interchange interweaving section of the ShiWu and ShiBai expressways in Shiyan,Hubei Province,was discussed,and a design scheme and scheme comparison were proposed.It is hoped that this article can provide technical reference and ideas for China’s road and bridge engineering teams,ensuring that the design results can not only guarantee the normal passage of traffic on the North Intersection Expressway but also ensure the straight-line traffic capacity of the main highway under the background of dislocation intersection,achieving smooth and safe transitions between different expressways.展开更多
Foamed concrete is widely employed in highway transition sections,due to its lightweight,high-strength,and effective settlement control.It is crucial to investigate its dynamic response linked to the traffic-loading i...Foamed concrete is widely employed in highway transition sections,due to its lightweight,high-strength,and effective settlement control.It is crucial to investigate its dynamic response linked to the traffic-loading influence zone of embankment and transition section smoothness.In this study,in-situ truck tests were conducted in the road-culvert-bridge transition section to obtain the spatio-temporal response patterns.Based on the vertical response,the influence zone was ascertained.Depending on the longitudinal response,the smoothness was evaluated by equivalent dynamic stiffness(EDS)and acceleration variation rate(AVR).Furthermore,the response discrepancies of embankments with different fillings were compared.Findings reveal exponential attenuation of dynamic stress and acceleration with increasing depth.The acceleration and dynamic displacement exhibit U-shaped patterns in the culvert subsection and abrupt changes in the bridgehead subsection.The influence zone determined by the acceleration attenuation coefficient method,dynamic stress attenuation method,and stress diffusion angle method was 1.55 m,2.05 m,and 2.89 m,respectively.The maximum disparity in EDS occurs at the culvert subsection and bridge abutment,and the AVR ranges from 0 to 0.52 s^(-2).Moreover,94.1%attenuation of the dynamic stress occurred within the 1.5-meter foamed concrete embankment under the setting of 100 kN-60 km/h.展开更多
文摘BACKGROUND Intrathecal bupivacaine is the traditional anesthetic drug used in spinal anesthesia for caesarean sections(CSs),but ropivacaine has emerged as a potential alter-native.This meta-analysis compares the efficacy and safety of intrathecal hyper-baric bupivacaine vs hyperbaric ropivacaine for cesarean sections.AIM To systematically evaluate and compare the efficacy and safety of intrathecal hyperbaric bupivacaine and hyperbaric ropivacaine for spinal anesthesia in CSs.METHODS A thorough search of electronic databases was carried out to find pertinent randomized controlled trials(RCTs)comparing intrathecal hyperbaric ropi-vacaine and hyperbaric bupivacaine during CSs.PubMed,Cochrane database,Google Scholar,and Scopus were searched,and papers from January 2000 to January 2024 were deemed eligible and filtered using predetermined inclusion and exclusion criteria.Studies were assessed for methodological quality,and data were extracted for time to adequate anesthesia(sensory and motor blockade),duration of sensory and motor block,hemodynamic changes and side effect profile.The standardized mean difference with 95%CI was used for continuous data.Dichotomous variables were assessed using the Mantel-Haenszel test and the random effect model to compute the odds ratio.RESULTS Total 8 RCTs were selected from a pool of 119 search results for meta-analysis.The meta-analysis evaluated pooled effect sizes and assessed heterogeneity among the studies.The primary objective was to compare key outcomes to identify any significant variances in efficacy and safety profiles between two local anesthetics.The analysis revealed that the difference in the onset of sensory blockade between the two local anesthetics was statistically insignificant(P=0.1586).However,the onset of motor blockade appeared to be faster with bupivacaine(P=0.03589).Additionally,the regression of sensory and motor blockade occurred earlier in the ropivacaine group.Furthermore,the duration of the first analgesic effect was shorter with a significance level of P<0.05.Regarding side effects profile,including hypotension,nausea,and shivering,the study did not observe any significant differences between the two groups.CONCLUSION This meta-analysis offers insights into the effectiveness and safety of hyperbaric bupivacaine vs ropivacaine for cesarean sections.Hyperbaric ropivacaine had a comparable safety profile and faster regression of sensory and motor blockade than hyperbaric bupivacaine,perhaps aiding early mobilization of parturient and facilitating mother-child bonding.Choosing ropivacaine may offer benefits beyond efficacy for cesarean section patients and short surgical procedures.
文摘Let M be a compact n-manifold of positive sectional curvature.We will review classical results on the fundamental group of M,a motivation on the c(n)-cyclic conjecture that the fundamental group of M contains a cyclic subgroup of index bounded above by c(n),a constant depending only on n,and we will survey partial results(up to date)on the c(n)-cyclic conjecture.
文摘Background： Spinal hyperbaric ropivacaine may produce more predictable and reliable anesthesia than plain ropivacaine for cesarean section. The dose-response relation for spinal hyperbaric ropivacaine is undetermined. This double-blind, randomized, dose-response study determined the ED50 （50% effective dose） and ED95 （95% effective dose） of spinal hyperbaric ropivacaine for cesarean section anesthesia. Methods： Sixty parturients undergoing elective cesarean section delivery with use of combined spinal-epidural anesthesia were enrolled in this study. An epidural catheter was placed at the L1-L2 vertebral interspace then lumbar puncture was performed at the L3-L4 vertebral interspace, and parturients were randomized to receive spinal hyperbaric ropivacaine in doses of 10.5 mg, 12 mg, 13.5 mg, or 15 mg in equal volumes of 3 ml. Sensory levels （pinprick） were assessed every 2.5 min until a T7 level was achieved and motor changes were assessed by modified Bromage Score. A dose was considered effective if an upper sensory level to pin prick of T7 or above was achieved and no intraoperative epidural supplement was required. ED50 and ED95 were determined with use of a logistic regression model. Results： ED50 （95% confidence interval） of spinal hyperbaric ropivacaine was determined to be 10.37 （5.23-11.59） mg and ED95 （95% confidence interval） to be 15.39 （13.81-23.59） mg. The maximum sensory block levels and the duration of motor block and the rate of hypotension, but not onset of anesthesia, were significantly related to the ropivacaine dose. Conclusion： The ED50 and ED95 of spinal hyperbaric ropivacaine for cesarean delivery under the conditions of this study were 10.37 mg and 15.39 mg, respectively. Ropivacaine is suitable for spinal anesthesia in cesarean delivery.
基金Supported by National Basic Research Program of China (973 Program, No. 2005CB422303 and 2007CB411804)the Key Project of the International Science and Technology Cooperation Program of China (No. 2006DFB21250)+1 种基金the "111 Project" of the Ministry of Education (No. B07036)the Program for New Century Excellent Talents in University, China (No. NECT-07-0781)
文摘In this paper, we use the conductivity-temperature-depth (CTD) observation data and a three-dimensional ocean model in a seasonally-varying forcing field to study the barrier layer (BL) in the PN section in the East China Sea (ECS). The BL can be found along the PN section with obviously seasonal variability. In winter, spring and autumn, the BL occurs around the slope where the cold shelf water meets with the warm Kuroshio water. In summer, the BL can also be found in the shelf area near salinity front of the Changjiang (Yangtze) River Dilution Water (YRDW). Seasonal variations of BL in the PN section are caused by local hydrological characteristics and seasonal variations of atmospheric forcing. Strong vertical convection caused by sea surface cooling thickens the BL in winter and spring in the slope area. Due to the large discharge of Changjiang River in summer, the BL occurs extensively in the shelf region where the fresh YRDW and the salty bottom water meet and form a strong halocline above the seasonal thermocline. The formation mechanism of BL in the PN section can be explained by the vertical shear of different water masses, which is called the advection mechanism. The interannual variation of BL in summer is greatly affected by the YRDW. In the larger YRDW year (such as 1998), a shallow but much thicker BL existed on the shelf area.
文摘Differential equation of restrained torsion for rectangular-section box bar with honeycomb core was established and solved by using the method of undetermined function.Non-dimension normal stress, shear stress acting in the faceplate and shear stress acting in the honeycomb-core and warping displacement were deduced. Numerical analysis shows the normal stress attenuates quickly along x-axis. Normal stress acting on the cross section at a distance of 20 h from the fixed end is only one per cent of that acting on the fixed end.
基金supported by the Beijing Social Science Foundation [No. 16YTC038]。
文摘Regular physical activity (PA) has numerous advantages in improving the physical and mental health of children and adolescents^([1]).However,the PA status quo for children and adolescents with intellectual disabilities (ID) is dismal.Children and adolescents with ID frequently exhibit sedentary behaviors because their physical,sensory,and/or cognitive impairments make it difficult to participate in sports and games with their peers^([2]).They have higher rates of mental illness,obesity,type 2diabetes,and other health problems than peers with typical development (TD).
文摘Cross sections for K-shell ionization have been measured at electron energies of 0.1-0.40 MeV for Cu and Sn, and of 0.30MeV for Ag. The present results have been compared with theoretical calculations and previously reported experimental values.
文摘In this work, the elastic cross section is calculated at energies above the Coulomb barrier for 3He + 58Ni using a Woods-Saxon potential. The solutions of the radial Schrödinger equations are calculated numerically and they are introduced in the S matrix, after which the cross section is obtained. The parameters in the potential are adjusted to satisfy known experimental data.
基金The National Natural Science Foundation of China(No.52338011,52378291)Young Elite Scientists Sponsorship Program by CAST(No.2022-2024QNRC0101).
文摘To overcome the limitations of low efficiency and reliance on manual processes in the measurement of geometric parameters for bridge prefabricated components,a method based on deep learning and computer vision is developed to identify the geometric parameters.The study utilizes a common precast element for highway bridges as the research subject.First,edge feature points of the bridge component section are extracted from images of the precast component cross-sections by combining the Canny operator with mathematical morphology.Subsequently,a deep learning model is developed to identify the geometric parameters of the precast components using the extracted edge coordinates from the images as input and the predefined control parameters of the bridge section as output.A dataset is generated by varying the control parameters and noise levels for model training.Finally,field measurements are conducted to validate the accuracy of the developed method.The results indicate that the developed method effectively identifies the geometric parameters of bridge precast components,with an error rate maintained within 5%.
文摘Introduction: Study compare spinal anesthesia using hyperbaric bupivacine (0.5% - 0.75%) between fixed dose and height adjusted dose during elective cesarean section. Methods: Hundred parturients who had given their consent and were scheduled for elective cesarean section under spinal anesthesia, were divided into four groups—first group received 0.5% hyperbaric bupivacine fixed dose, the second group received 0.5% hyperbaric bupivacine in a dose adjusted to the height, the third received 0.75% hyperbaric bupivacine fixed dose, the fourth group received 0.75% hyperbaric bupivacine in a dose adjusted to height. The anesthesia onset time, haemodynamic changes, side effects and fetal outcome observed. Results: Spinal block provide excellent surgical anesthesia in all patients. Anesthesia onset time is longer in adjusted than fixed groups, in 0.5% (5 ± 0.816 vs. 3.84 ± 0.746) (P Conclusion: Adjusting dose of hyperbaric bupivacine (0.5% - 0.75%) to patient’s height, decreases the dose of bupivacine in use, it also provide adequate anesthesia for elective cesarean section with decrease the use of vasopressors, the incidence and severity of maternal hypotention also markedly reduced.
文摘Population dynamics parameters and stock status of Squaliobarbus curriculus (Richardson, 1846) were analyzed from May to September 2021 in the Lanxi section of Qiantang River. FiSAT II software program was used. The growth coefficient K = 0.21 year<sup>–1</sup>, asymptomatic length L<sub>∞</sub> = 39.48 cm, and age at theoretical zero-length t<sub>0</sub> = –0.74 years were estimated. The von Bertalanffy growth function was calculated as L<sub>t</sub> = 39.48[1 – e<sup>–</sup><sup>0.21(t + 0.74)</sup>]. The growth curve for weight had an inflection at 5.86 years, corresponding to 29.61 cm in standard length and 372.29 g in weight. The natural mortality rate (M), the fishing mortality rate (F), and the total mortality rate (Z) were calculated as 0.51, 0.61, and 1.12 year<sup>–1</sup>, respectively. The exploitation ratio (E) was 0.54, which is greater than the value of 0.5 suggested by Gull (1971), indicating a probable state of overdevelopment. The annual average stock number and biomass of S. curriculus in the Lanxi section of Qiantang River were 31.86 × 10<sup>6</sup> individuals and 3656.82 t, respectively.
基金supported by the National Natural Science Foundation of China under Grant No.62271043Ministry of Education of China under Grant No.8091B032123Beijing Natural Science Foundation under Grant No.L212029。
文摘Radar cross section(RCS)plays a critical role in modeling target scattering characteristics and enhancing the precision of target detection and localization in integrated sensing and communication(ISAC)systems.This paper investigates the human body RCS at 26 GHz via multiangle channel measurements under different clothing conditions.Based on calibrated electromagnetic(EM)parameters,the RCS characteristics of the human body in far-field conditions are analyzed using ray-tracing(RT)simulations.Some suggestions for the design of ISAC systems are also discussed.The results provide a solid theoretical foundation and practical reference for the modeling of target scattering characteristics for ISAC channels.
文摘Purpose: Levobupivacaine showed a lower risk of cardiovascular and central nervous system (CNS) toxicity than bupivacaine which is the most popular local anesthetic agent in obstetric practice. The aim of this study was to investigate the clinical efficacy of levobupivacaine compared with hyperbaric bupivacaine for spinal anesthesia for cesarean section. Methods: 60 pregnant women in ASA I - II group scheduled to have elective cesarean operation were allocated into the study. Patients were randomly divided into two groups. The combinations 10 mg levobupivacaine (0.5%) + fentanyl (15 μcg) for Group LF (n = 30) patients, 10 mg hyperbaric bupivacaine (0.5%) + fentanyl (15 μcg) for BF (n = 30) patients were intrathecally administrated a total of 2.3 cc. Sensory and motor block characteristics of the groups were assessed with pinprick and Bromage scale;observed hemodynamic changes and side effects were recorded. Results: The time to reach maximum dermatome for the sensory block, time to regression by two dermatomes and time to regress to T12 dermatome was found to be significantly long in Group BF. It was observed that in Group BF, the evolution of the motor block was faster and lasted longer. Whereas hypotension, bradycardia and nausea were less in Group LF, the need for ephedrine was higher in Group BF (p < 0.05). Conclusion: Since motor block time is shorter, and side effects like hypotension, bradycardia and nausea are less, the combination of levobupivacaine + fentanyl can be a good alternative in cesarean sections.
文摘Objective:The objective of this study is to determine the effect of nurse-led instructional video(NLIV)on anxiety,satisfaction,and recovery among mothers admitted for cesarean section(CS).Materials and Methods:A quasi-experimental design was carried out on the mothers scheduled for CS.Eighty participants were selected by a purposive sampling technique,which were divided(40 participants in each group)into an experimental group and a control group.Nurse-led informational video(NLIV)was shown to the experimental group,and routine care was provided for the control group.Modified hospital anxiety scale(HADS),scale for measuring maternal satisfaction in cesarean birth,and obstetric quality of recovery following cesarean delivery were used to assess anxiety,satisfaction,and recovery.Results:Both the experimental and control groups showed significant reductions in anxiety by the first postintervention day(P<0.001),with the experimental group experiencing a greater mean reduction(mean difference[MD]=4.37)than the control group(MD=3.35)but the intergroup difference was not statistically significant(P>0.05).The experimental group reported significantly higher satisfaction scores(175.55±9.42)on the 3rd postoperative day compared to the control group(151.93±14.89;P<0.001).Similarly,the experimental group’s recovery scores(79.90±6.24)were considerably higher than those of the control group(62.45±15.18;P<0.001).On the 3rd postintervention day,satisfaction was significantly associated with age(P<0.001),and recovery with gravidity(P<0.05).Conclusions:NLIV can be used in the preoperative period to reduce anxiety related to CS and to improve satisfaction and recovery after the CS.
文摘Acute pulmonary edema is a leading cause of death in patients with preeclampsia.The authors reported a case of a pregnant woman at 25 weeks of gestation with severe preeclampsia complicated by pulmonary edema,who required an emergency cesarean section,posing a significant challenge to the anesthesiologist.The patient had developed Type 1 respiratory failure and needed supplemental oxygen with high-flow nasal oxygen.Due to contraindications for neuraxial anesthesia,the cesarean section was performed under general anesthesia.After induction of anesthesia,the patient’s hypoxemia worsened.Eventually,after treatment with fluid restriction,diuretics,and albumin,oxygenation improved gradually,and the procedure was performed successfully.Both the patient and the newborn had a good prognosis.
基金National Natural Science Foundation of China(grant number 82272563 to B.S.)National Science and Technology Major Project of the Ministry of Science and Technology of China(grant number 2023ZD0501202 to B.S.)+4 种基金institutional grants allocated to the National Institute of Biological Sciences,Beijing(NIBS)from the Chinese Ministry of Science and Technology,Beijing Municipal Commission of Science and Technology,and Tsinghua Universitythe support from China Pharmaceutical University(grant number 3150140001 to S.F.)National Natural Science Foundation of China(grant numbers 82203653 to S.F.,82371957 to L.W.,and 82371956 to X.C.)Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(grant number JYY2023-8 to X.C.)Research Grants Council of University Grants Committee Hong Kong(grant numbers 14113723,14108720,14121721,14202920,N_CUHK472/22,C7030-18G,T13-402/17-N,and AoE/M-402/20)。
文摘Tissue clearing combined with high-resolution confocal imaging is a cutting-edge approach for dissecting the three-dimensional(3D)architecture of tissues and deciphering cellular spatial interactions under physiological and pathological conditions.Deciphering the spatial interaction of leptin receptor-expressing(LepR^(+))stromal cells with other compartments in the bone marrow is crucial for a deeper understanding of the stem cell niche and the skeletal tissue.In this study,we introduce an optimized protocol for the 3D analysis of skeletal tissues,enabling the visualization of hematopoietic and stromal cells,especially LepR+stromal cells,within optically cleared bone hemisections.Our method preserves the 3D tissue architecture and is extendable to other hematopoietic sites such as calvaria and vertebrae.The protocol entails tissue fixation,decalcification,and cryosectioning to reveal the marrow cavity.Completed within approximately 12 days,this process yields highly transparent tissues that maintain genetically encoded or antibody-stained fluorescent signals.The bone hemisections are compatible with diverse antibody labeling strategies.Confocal microscopy of these transparent samples allows for qualitative and quantitative image analysis using Aivia or Bitplane Imaris software,assessing a spectrum of parameters.With proper storage,the fluorescent signal in the stained and cleared bone hemisections remains intact for at least 2–3 months.This protocol is robust,straightforward to implement,and highly reproducible,offering a valuable tool for tissue architecture and cellular interaction studies.
文摘Emergency cesarean section has always been a challenge for patients,surgeons,and anesthesiologists,as it endangers the safety of both parturients and fetuses.Obesity and hypertension are common among pregnant women,but severe obesity combined with refractory hypertension is very rare in clinical practice.The optimal anesthetic management strategy for obese pregnant women with a difficult airway and poorly controlled hypertension remains debatable.This report presents a 32-year-old woman with severe obesity and refractory hypertension at 36 weeks and 6 days of pregnancy.Owing to fetal heart rate abnormalities,she was scheduled for emergency cesarean section.Given the urgency of the fetal condition and the challenges posed by the patient's obesity for epidural puncture,the anesthesiologist opted for rapid sequence induction and tracheal intubation instead of intervertebral anesthesia.Short-acting antihypertensive medications were adminstrated preoperatively to control elevated blood pressure,and vasopressor agents were continuously infused during surgery to prevent severe hypotension induced by anesthetic drugs.The entire anesthesia and surgical procedure proceeded uneventfully,with no major adverse events observed.Both the patient and fetus achieved favorable outcomes.This case indicates that early anesthetic risk assessment and meticulous pre-delivery planning are paramount,necessitating personalized management of airway and hemodynamics to optimize outcomes in obese parturients.
文摘OBJECTIVE:To evaluate the clinical outcome of Traditional Chinese Medicine(TCM)syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section[previous cesarean scar defect(PCSD)]after cesarean section.METHODS:This is a single-center retrospective study.A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods,the TCM group(n=60)and the control group(n=60).The control group was treated with hysteroscopy,and the TCM group combined TCM syndrome differentiation with hysteroscopy.Clinical outcome included menstrual scores,menstrual days,TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.RESULTS:The total response rate of the TCM group was significantly higher than that of the control group(P<0.05);after treatment,the menstrual scores,menstrual days and TCM symptoms of the two groups were decreased,and the menstrual scores,menstrual days and TCM symptoms of the TCM group were all lower than that of the control group(P<0.05);the recurrence rate of the TCM group was significantly lower than that of the control group(P<0.05).Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group(P<0.05).The duration of menstruation before and after treatment,and the TCM group was better than the control group(P<0.05).CONCLUSION:TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD,which could significantly improve the recovery of menstruation,relief the symptoms of TCM,reduce the recurrence rate and accelerate wound healing.
文摘The purpose of this article is to explore the design of compound interchange interweaving sections on expressways.During the research phase,based on the support of the literature research method,the classification and development of the interchange system,as well as the design forms of the compound interchange interweaving section,were analyzed.Subsequently,based on the case method,the design of the compound interchange interweaving section of the ShiWu and ShiBai expressways in Shiyan,Hubei Province,was discussed,and a design scheme and scheme comparison were proposed.It is hoped that this article can provide technical reference and ideas for China’s road and bridge engineering teams,ensuring that the design results can not only guarantee the normal passage of traffic on the North Intersection Expressway but also ensure the straight-line traffic capacity of the main highway under the background of dislocation intersection,achieving smooth and safe transitions between different expressways.
基金National Natural Science Foundation of China under Grant Nos.52078205 and 42172322Joint Fund for High-Speed Railway Basic Research under Grant No.U2268213the Postgraduate Scientific Research Innovation Project of Hunan Province under Grant Nos.QL20230104 and CX20240431。
文摘Foamed concrete is widely employed in highway transition sections,due to its lightweight,high-strength,and effective settlement control.It is crucial to investigate its dynamic response linked to the traffic-loading influence zone of embankment and transition section smoothness.In this study,in-situ truck tests were conducted in the road-culvert-bridge transition section to obtain the spatio-temporal response patterns.Based on the vertical response,the influence zone was ascertained.Depending on the longitudinal response,the smoothness was evaluated by equivalent dynamic stiffness(EDS)and acceleration variation rate(AVR).Furthermore,the response discrepancies of embankments with different fillings were compared.Findings reveal exponential attenuation of dynamic stress and acceleration with increasing depth.The acceleration and dynamic displacement exhibit U-shaped patterns in the culvert subsection and abrupt changes in the bridgehead subsection.The influence zone determined by the acceleration attenuation coefficient method,dynamic stress attenuation method,and stress diffusion angle method was 1.55 m,2.05 m,and 2.89 m,respectively.The maximum disparity in EDS occurs at the culvert subsection and bridge abutment,and the AVR ranges from 0 to 0.52 s^(-2).Moreover,94.1%attenuation of the dynamic stress occurred within the 1.5-meter foamed concrete embankment under the setting of 100 kN-60 km/h.
