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经支气管冷冻肺活检后按需手术肺活检对比即刻手术肺活检诊断间质性肺疾病(COLD研究):一项随机对照临床试验

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中华结核和呼吸杂志 2024年第9期47卷 826-826页

作者： kalverda ka Ninaber MK Wijmans L 阳胜朱娅琳肖奎不详中南大学湘雅二医院呼吸与危重症医学科中南大学呼吸疾病研究所湖南省呼吸与危重症疾病临床医学研究中心中南大学呼吸疾病诊疗中心长沙410000

背景:间质性肺疾病(ILD)的充分诊断对于临床决策和预后非常重要。大多数ILD患者可通过对临床和放射学数据的评估做出准确诊断,但还有相当一部分患者仍需进行肺活检。手术肺活检(SLB)是获取组织的最常用方法,但其发病率甚至死亡率都很高... 详细信息

背景:间质性肺疾病(ILD)的充分诊断对于临床决策和预后非常重要。大多数ILD患者可通过对临床和放射学数据的评估做出准确诊断,但还有相当一部分患者仍需进行肺活检。手术肺活检(SLB)是获取组织的最常用方法,但其发病率甚至死亡率都很高。最近,临床引入了经支气管冷冻肺活检,其不良反应较SLB少,但诊断率低于SLB。本研究旨在比较两种诊断策略:阶梯策略(经支气管冷冻肺活检,如果冷冻活检获得的信息不够,再进行SLB)与即刻SLB策略。方法:COLD研究是一项在荷兰6家医院开展的多中心、随机对照临床试验。该研究纳入了经多学科团队讨论评估有肺活检指征的ILD患者。以1∶1的比例将患者随机分配到阶梯策略或即刻SLB策略中,并从首次手术开始随访12周。本研究的治疗对患者、临床医生和病理学家均未设盲。主要研究终点是非预期的胸管引流,定义为经支气管冷冻肺活检后需要胸管引流,或SLB后胸管引流时间延长(>24 h)。次要研究终点是诊断率、住院时间、术后疼痛评分和严重不良事件,其中,严重不良事件包括研究期间患者出现死亡、危及患者生命、患者需再次入院或患者住院时长增加[经支气管镜检查超过2 d(1个夜晚),SLB超过4 d(3个夜晚)]。研究进行了改良的意向治疗分析。研究已在荷兰试验注册中心(NL7634)注册,现已结束。结果:在2019年4月8日至2021年10月24日期间,122例ILD患者接受了研究评估;55例患者被随机分配至阶梯组(n=28)或即刻SLB组(n=27);即刻SLB组有3例患者被排除。阶梯组的28例患者中有3例发生意外胸管引流(11%,95%CI:4%~27%),而即刻SLB组24例患者中有11例(46%,95%CI:2%~65%)在24 h内无法拔除胸管,绝对风险降低35%(11%~56%,P=0.0058)。在阶梯策略中,仅经支气管冷冻肺活检后的多学科团队诊断率为82%(64%~92%),在经支气管冷冻肺活检不确定后进行后续SLB时,诊断率增至89%(73%~96%)。在即刻SLB策略中,多学科团队的诊断率为88%(69%~97%)。阶梯组的总住院时间为1 d(IQR 1~1),而即刻SLB组为5 d(IQR 4~6)。阶梯组发生了1起(4%)严重不良事件,而即刻SLB组发生了12起(50%)严重不良事件。结论:在ILD诊断中,如果需要对肺组织进行评估,那么诊断策略应从经支气管冷冻肺活检开始,然后在经支气管冷冻肺活检不能得出诊断结论时进行SLB,这样似乎可显著减轻患者负担,缩短住院时间,且诊断率与即刻SLB相似。

关键词：间质性肺疾病支气管镜检查多学科团队患者负担病理学家肺活检临床决策诊断策略

Coupled quantum molecular cavity optomechanics with surf.ce plasmon enhancement

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Photonics Research 2017年第5期5卷 450-456页

作者： JIAN LIU ka-DI ZHU Key Laboratory of.Artif.cial Structures and Quantum Control (Ministry of.Education) School of.Physics and Astronomy Shanghai Jiao Tong University

Cavity optomechanics is applied to study the coupling behavior of.interacting molecules in surf.ce plasmon systems driven by two-color laser beams. Dif.erent f.om the traditional f.rce–distance measurement, due to a resonant f.equency shif. or a peak splitting on the probe spectrum, we have proposed a convenient method to measure the van der Waals f.rce strength and interaction energy via nonlinear spectroscopy. The minimum f.rce value can reach approximately 10^(-15) N, which is 3 to 4 orders of.magnitude smaller than the widely applied atomic f.rce microscope(Af.). It is also shown that two adjacent molecules with similar chemical structures and nearly equal vibrational f.equencies can be easily distinguished by the splitting of.the transparency peak. Based on this coupled optomechanical system, we also conceptually design a tunable optical switch by van der Waals interaction. Our results will provide new approaches f.r understanding the complex and dynamic interactions inmolecule–plasmon systems.

关键词： Coupled quantum molecular cavity optomechanics with surf.ce plasmon enhancement THz

A Registry-Based Observational Study on the Maternal and f.tal Outcomes of.COVID-19 Patients in Hong Kong,China

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Maternal-f.tal Medicine 2024年第3期6卷 156-163页

作者： Hillary HY Leung Teresa WL Ma f.orrie NY Yu Meliza CW Kong Tsz Kin Lo Pauline PL So Wing-Cheong Leung Wendy Shu ka Wang Cheung Sakita Moungmaithong Chi Chiu Wang Liona C.Poon Department of.Obstetrics and Gynaecology The Chinese University of HongKongHong Kong 999077China Department of.Obstetrics and Gynaecology Queen Elizabeth HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology United Christian HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology Princess Margaret HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology Tuen Mun HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology Kwong Wah HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology Pamela Youde Nethersole Eastern HospitalHong Kong 999077China Department of.Obstetrics and Gynaecology Queen Mary HospitalHong Kong 999077China

Objective:To report the clinical maternal and f.tal outcomes of.pregnant women with coronavirus disease 2019(COVID-19),along with any associated pregnancy complications,in Hong Kong,China,and to assess the impact of.COVID-19 vaccination on these ***:This prospective registry-based observational study included pregnant women who were recruited through convenient sampling and had a laboratory-conf.rmed severe acute respiratory syndrome coronavirus 2 inf.ction with a cycle threshold(Ct)value result available on admission to eight local hospitals in Hong Kong,*** on clinical symptoms,laboratory results,medical treatments,delivery timing and mode,and pregnancy complications were extracted f.om the Hospital Authority’s electronic medical record ***,f.tal,and pregnancy outcomes were compared between unvaccinated pregnant women with COVID-19 and those who had received at least one dose of.COVID-19 vaccine bef.re *** continuous variables and categorical variables were analyzed using the Mann-Whitney U test and the Pearson’s chi-squared test respectively.A P value less than 0.05 was considered statistically ***:A total of.164 pregnant women were included,of.whom 78(47.56%)were ***-19 was diagnosed bef.re 28 weeks’gestation in 30(18.29%),while 134(81.71%)were diagnosed at or af.er 28 weeks’***-two(37.80%)women received at least one dose of.COVID-19 *** were no signif.cant dif.erences between vaccinated and unvaccinated groups in the time interval between COVID-19 diagnosis and delivery,the Ct value,and the gestational age at inf.ction onset or delivery(P>0.05).The majority of.women were symptomatic at diagnosis regardless of.vaccination status 55(88.71%)in vaccinated group vs.78(76.47%)in unvaccinated group(P=0.052).Symptoms did not signif.cantly dif.er between groups except f.r cough(62.90%vs.47.06%,P=0.049).The overall rate of.severe COVID-19 in pregnant women was *** t

关键词： COVID-19 Maternal outcomes f.tal outcomes Pregnancy complications Severe COVID-19

Building an e-Portf.lio with a learning plan centric approach

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Journal of.Zhejiang University-Science C(Computers and Electronics) 2012年第1期13卷 37-47页

作者： Lam-f.r KWOK ka-shing CHAN Department of.Computer Science City University of Hong Kong

A portf.lio records achievements in the personal growth process. A personal development e-Portf.lio assists an individual in planning his/her development path and ref.ecting upon his/her own learning. In this article, we propose an approach to constructing a personal development portf.lio. An abstract inf.rmation model is presented to support such a portf.lio. The inf.rmation model is proposed based upon and according to IMS standards. The use of.this approach is illustrated by way of.a prototype e-Portf.lio system. The usage scenario and limitations of.such a portf.lio are also discussed.

关键词： E-Portf.lio Educational technology system Lif.long learning

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清水混凝土在桥梁施工中的应用研究

工程建设与设计 2024年第6期 185-187页

作者：张卡叶腾飞中交一航局第二工程有限公司山东青岛266071

以具体工程为例,介绍了清水混凝土的特点,阐述了脚手架的搭设要点,对清水混凝土模板安装工艺进行了分析,并就清水混凝土浇筑、振捣、养生等施工技术措施展开了详细的研究,以提高桥梁工程中清水混凝土施工效率,确保桥梁工程整体施工质量... 详细信息

以具体工程为例,介绍了清水混凝土的特点,阐述了脚手架的搭设要点,对清水混凝土模板安装工艺进行了分析,并就清水混凝土浇筑、振捣、养生等施工技术措施展开了详细的研究,以提高桥梁工程中清水混凝土施工效率,确保桥梁工程整体施工质量,从而推进我国桥梁建筑工程可持续发展。

关键词：桥梁工程清水混凝土应用

Microstructure and Property Relationships in Resistance Spot Weld between 7114 Interstitial f.ee Steel and 304 Austenitic Stainless Steel

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Journal of.Materials Science & Technology 2006年第3期22卷 375-381页

作者： Ahmet Hasanba■o■lu Ramazan kaar Department of.Metal Education karabük Technical Education f.culty Karabük 78100 Turkey

Due to the dif.erences in physical, chemical and mechanical properties of.the base metals, the resistance spot welding of.dissimilar materials is generally more challenging than that of.similar materials. The inf.uence of.the primary welding parameters af.ecting the heat input such as peak current on the morphology, microhardness, and tensile shear load bearing capacity of.dissimilar welds between 304 grades austenitic and 7114 grade interstitial f.ee steel has been investigated in this study. The optimum welding parameters producing maximum joint strength were established at a peak current of.9 ka, where the electrode f.rce is kept 6×10^-5 Pa and weld time is kept constant 17 cycles, respectively. The primary cause of.weakening the weldment is identif.ed as the excessive grain growing region of.heat af.ected zone （HAZ） in case of.7114 grade interstitial f.ee steel.

关键词： Resistance spot weld Interstitial f.ee steel Austenitic stainless steel

护理风险管理策略在鼻胃管并发症管理中应用的研究进展

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护理研究 2024年第16期38卷 2868-2872页

作者：廖曦杨婕蒋理立刘雨薇李卡四川大学华西医院结直肠肿瘤中心四川610041 四川大学华西医院普通外科四川大学华西护理学院四川大学华西医院

总结鼻胃管并发症现状,提出护理风险管理策略应用于鼻胃管技术的管理建议,进行风险识别、风险衡量、风险处理及实施效果评价,不仅可以发现可能出现的护理问题及潜在的风险隐患,还能促使护理工作者主动预防鼻胃管相关风险,维护鼻胃管病... 详细信息

总结鼻胃管并发症现状,提出护理风险管理策略应用于鼻胃管技术的管理建议,进行风险识别、风险衡量、风险处理及实施效果评价,不仅可以发现可能出现的护理问题及潜在的风险隐患,还能促使护理工作者主动预防鼻胃管相关风险,维护鼻胃管病人住院安全,保障临床鼻胃管技术的安全性、科学性和舒适性。

关键词：鼻胃管护理风险管理策略并发症不良事件影响因素综述

Economic analysis in product design——A case study of.a TCM dietary supplement

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Chinese Journal of.Chemical Engineering 2016年第1期24卷 202-214页

作者： Yuen Shan Cheng ka Yip f.ng ka Ming Ng Christianto Wibowo Department of.Chemical and Biomolecular Engineering The Hong Kong University of Science and Technology ClearWaterBay Technology Inc.

An approach f.r the economic analysis of.chemical product design is proposed. It takes into account of.customers' pref.rence on product quality and economic considerations such as pricing, prof.t, market share, capital investment, and operating cost. The activities needed to support business decision making – identif.ing product quality, estimating product cost, calculating f.nancial metrics, and perf.rming make–buy analysis – are *** design of.a Ganoderma lucidum dietary supplement, a traditional Chinese medicinal(TCM) product, is used to illustrate all the activities in this approach.

关键词： Product design Product conceptualization TCM dietary supplement Economic analysis Make–buy analysis

Exacerbated VEGf.up-regulation accompanies diabetes-aggravated hemorrhage in mice af.er experimental cerebral ischemia and delayed reperf.sion

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Neural Regeneration Research 2022年第7期17卷 1566-1575页

作者： Angela ka Wai Lai Tsz Chung Ng Victor ka Lok Hung ka Cheung Tam Chi Wai Cheung Sookja Kim Chung Amy Cheuk Yin Lo Department of.Ophthalmology Li Ka Shing Faculty of MedicineThe University of Hong KongHong Kong Special Administration RegionChina Department of.Anesthesiology Laboratory and Clinical Research Institute for PainThe University of Hong KongHong Kong Special Administration RegionChina Macao University of.Science and Technology TaipaMacao Special Administration RegionChinaSchool of Biomedical SciencesThe State Key Laboratory of Pharmaceutical BiotechnologyThe University of Hong KongHong Kong Special Administration RegionChina

Reperf.sion therapy is the pref.rred treatment f.r ischemic stroke,but is hindered by its short treatment window,especially in patients with diabetes whose reperf.sion af.er prolonged ischemia is of.en accompanied by exacerbated *** mechanisms underlying exacerbated hemorrhage are not f.lly *** study aimed to identif. this mechanism by inducing prolonged 2-hour transient intraluminal middle cerebral artery occlusion in diabetic Ins2Akita/+mice to mimic patients with diabetes undergoing delayed mechanical *** results showed that at as early as 2 hours af.er reperf.sion,Ins2Akita/+mice exhibited rapid development of.neurological def.cits,increased inf.rct and hemorrhagic transf.rmation,together with exacerbated down-regulation of.tight-junction protein ZO-1 and upregulation of.blood-brain barrier-disrupting matrix metallopeptidase 2 and matrix metallopeptidase 9 when compared with normoglycemic Ins2+/+*** indicated that diabetes led to the rapid compromise of.vessel integrity immediately af.er reperf.sion,and consequently earlier death and f.rther aggravation of.hemorrhagic transf.rmation 22 hours af.er *** observation was associated with earlier and stronger up-regulation of.pro-angiogenic vascular endothelial growth f.ctor(VEGf.and its downstream phospho-Erk1/2 at 2 hours af.er reperf.sion,which was suggestive of.premature angiogenesis induced by early VEGf.up-regulation,resulting in rapid vessel disintegration in diabetic *** reticulum stress-related pro-apoptotic C/EBP homologous protein was overexpressed in challenged Ins2Akita/+mice,which suggests that the exacerbated VEGf.up-regulation may be caused by overwhelming endoplasmic reticulum stress under diabetic *** conclusion,the results mimicked complications in patients with diabetes undergoing delayed mechanical thrombectomy,and diabetes-induced accelerated VEGf.up-regulation is likely to underlie exacerbated hemorrhagic transf.rmat

关键词： blood-brain barrier brain injury diabetes mellitus hemorrhagic transf.rmation inf.rct ischemia/reperf.sion injury middle cerebral artery occlusion mouse model stroke vascular endothelial growth f.ctor