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氢吗啡酮联合帕瑞昔布钠对合并冠心病行非心脏胸部手术患者镇痛效果的影响

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中国医药导报 2024年第4期21卷 119-124页

作者：许浬渊何胤琰曲丕盛浙江中医药大学附属杭州市中医院麻醉科浙江杭州310000

目的探讨氢吗啡酮联合帕瑞昔布钠对合并冠心病行非心脏胸部手术患者镇痛效果的影响。方法选取2020年9月至2022年9月浙江中医药大学附属杭州市中医院138例合并冠心病行非心脏手术患者,按照随机数字表法将其分为A组、B组、C组,各46例。... 详细信息

目的探讨氢吗啡酮联合帕瑞昔布钠对合并冠心病行非心脏胸部手术患者镇痛效果的影响。方法选取2020年9月至2022年9月浙江中医药大学附属杭州市中医院138例合并冠心病行非心脏手术患者,按照随机数字表法将其分为A组、B组、C组,各46例。三组均在全麻下进行手术,A组给予氢吗啡酮+帕瑞昔布钠,B组给予帕瑞昔布钠,C组给予氢吗啡酮。比较三组拔管前5 min(T_(0))、拔管即刻(T_(1))、拔管后5 min(T_(2))、拔管后10 min(T_(3))平均动脉压(MAP)、心率(HR)、呼吸频率(RR);比较三组术后4、12、24、72 h咳嗽时、静息时视觉模拟评分法(VAS)评分;比较三组术后24 h患者自控静脉镇痛(PCIA)有效按压次数;比较三组术前、术后12 h、术后72 h前列腺素E_(2)(PGE_(2))、神经肽Y(NPY)、肾上腺皮质激素(ACTH)、醛固酮(ALD)、C-肽(C-P);记录不良反应发生情况。结果整体比较:三组MAP、HR、RR组间、时间、交互作用比较,差异有统计学意义(P0.05);A组与C组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论氢吗啡酮联合帕瑞昔布钠可缓解合并冠心病行非心脏手术患者术后疼痛感,调节内分泌、循环功能,且安全性高。

关键词：冠心病胸部手术氢吗啡酮帕瑞昔布钠循环功能疼痛介质

儿童冠状动脉异常主动脉起源伴大动脉间走行的临床特点和超声漏误诊分析

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中国超声医学杂志 2024年第3期40卷 283-287页

作者：薛丽杨娇孙妍李静雅刘国文徐丽媛马宁国家儿童医学中心·首都医科大学附属北京儿童医院心脏超声科

目的总结分析冠状动脉异常主动脉起源(AAOCA)伴大动脉间走行患儿的临床特点并探讨超声心动图对该病的诊断价值，分析可能漏诊、误诊原因。方法回顾性分析37例AAOCA患儿的临床资料，汇总临床症状、心肌酶、心电图等结果，对比经胸超声... 详细信息

目的总结分析冠状动脉异常主动脉起源(AAOCA)伴大动脉间走行患儿的临床特点并探讨超声心动图对该病的诊断价值，分析可能漏诊、误诊原因。方法回顾性分析37例AAOCA患儿的临床资料，汇总临床症状、心肌酶、心电图等结果，对比经胸超声心动图与冠脉CT血管造影(CTA)检查结果，观察超声心动图图像特点，分析可能漏诊、误诊原因。结果本组患儿共包含左冠状动脉异常起源(ALCA)5例、右冠状动脉异常起源(ARCA)32例，中位年龄7岁。4例(80%)ALCA患儿主诉运动中晕厥或抽搐，伴心电图ST段压低、心肌酶明显增高；10例(31%)ARCA患儿主诉胸痛、胸闷，余因其他原因就诊时偶然发现。21例(66%)ARCA患儿伴心律失常。超声漏诊ALCA患儿2例(40%)、ARCA患儿11例(34%)。超声漏诊、误诊率较高，分析原因可能与超声伪像、超声立体分辨力低及医师对该病认识不足等相关。结论通过结合患儿临床表现、联合彩色及二维超声、加强冠脉开口的探查、加强超声开口伪像的鉴别有助于减少超声对该病的漏误诊。

关键词：冠状动脉异常主动脉起源超声心动图儿童诊断

超声心动图在诊断不合并先天性心脏病儿童感染性心内膜炎中的临床应用价值

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中国超声医学杂志 2024年第4期40卷 427-430页

作者：徐丽媛张红菊孙妍李静雅杨娇刘国文马宁国家儿童医学中心首都医科大学附属北京儿童医院心脏超声科

目的探讨超声心动图诊断不合并先天性心脏病(CHD)儿童感染性心内膜炎(IE)的临床应用价值。方法回顾性分析住院确诊的不合并CHD儿童IE的临床及超声心动图特征。结果共42例患儿纳入研究，其中男性24例，女性18例，平均年龄(7.09±4.27... 详细信息

目的探讨超声心动图诊断不合并先天性心脏病(CHD)儿童感染性心内膜炎(IE)的临床应用价值。方法回顾性分析住院确诊的不合并CHD儿童IE的临床及超声心动图特征。结果共42例患儿纳入研究，其中男性24例，女性18例，平均年龄(7.09±4.27)岁。临床表现发热最常见。血培养阳性32例(76.2%),其中金黄色葡萄球菌22例。39例(92.9%)超声心动图提示赘生物，其中位于左心31例，右心7例，累及双心系统1例。赘生物多位于瓣膜，21例累及二尖瓣。37例患儿出现瓣膜反流，1例患儿出现瓣膜轻度狭窄。内科治疗后超声发现赘生物减小或消失16例。结论超声心动图能够为不合并CHD儿童IE的早期诊断、临床治疗的效果监测提供重要的科学依据。

关键词：感染性心内膜炎儿童超声心动图

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基于超声心动图观察儿童单纯二叶式主动脉瓣

中国医学影像技术 2024年第7期40卷 978-981页

作者：杨娇马宁徐丽媛薛丽孙妍张红菊刘国文苏瑞娟国家儿童医学中心首都医科大学附属北京儿童医院心脏中心心脏超声科北京100045

目的基于超声心动图观察儿童单纯二叶式主动脉瓣(i-BAV)表现。方法回顾性分析79例i-BAV患儿超声心动图,观察其i-BAV分型;根据有无瓣膜和/或主动脉受累分为并发症组(n=50)与无并发症组(n=29),比较组间超声心动图参数。结果经体表面积(BSA... 详细信息

目的基于超声心动图观察儿童单纯二叶式主动脉瓣(i-BAV)表现。方法回顾性分析79例i-BAV患儿超声心动图,观察其i-BAV分型;根据有无瓣膜和/或主动脉受累分为并发症组(n=50)与无并发症组(n=29),比较组间超声心动图参数。结果经体表面积(BSA)校正后,并发症组左心室收缩末期内径/BSA低于、而左心室心肌质量指数高于无并发症组(P均<0.05)。79例中,Type 0型22例、以lat亚型最多见(18/22,81.82%),TypeⅠ型57例、以L-R亚型最多见(39/57,68.42%)。并发症组以TypeⅠL-R亚型最多见(31/50,62.00%);瓣膜受累发生率为90.00%(45/50),以轻度主动脉瓣狭窄和/或关闭不全为主(37/45,82.22%);主动脉受累发生率为24.00%(12/50),均表现为Ⅰ、Ⅱ型主动脉增宽。结论儿童i-BAV最常见分型为TypeⅠL-R亚型,以轻度瓣膜损害为主要并发症,可存在左心室心肌重构。

关键词：主动脉瓣儿童超声心动描记术

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Design of distributed dynamic absorbers for vibration suppression of panel structures

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Acta Mechanica Sinica 2024年第7期40卷 164-180页

作者： liyuan Li Bin Li Zehua xu School of Aeronautics Northwestern Polytechnical UniversityXi'an 710072China China Aero-Polytechnology Establishment Beijing 100028China

Distributed dynamic absorbers have many advantages such as wide frequency bandwidth for vibration suppression,strong detuning adaptability,and high system stability,making them very suitable for the vibration and noise control of continuous ***,they have broad application prospects in various fields such as transportation,aviation,and ***,there are still many challenges in the engineering applications of distributed dynamic absorbers for vibration suppression,including the engineering realization of the optimal damping of traditional optimal coherence dynamic absorbers,and the engineering applicability of the finite periodic array dynamic *** on the damping material properties obtained by the dynamic mechanical analyzer tests,this paper establishes the finite element model of the cantilever-beam-type dynamic absorber with constrained damping layers,aiming to realize the accurate determination of the optimal *** are conducted by attaching the traditional dynamic absorbers with the optimal damping to a thin-walled panel with four clamped *** show that the vibration of the panel is well suppressed,with the reduction of the frequency response peak larger than 14 dB and the reduction ratio of RMS larger than 58%within 500 ***,the periodically arrayed dynamic absorbers are designed according to the bandgap regulation *** tuning behavior of the arrayed dynamic absorbers by changing designing parameters is *** vibration reduction effect of arrayed dynamic absorbers is compared with that of the traditional dynamic absorbers under the same mass ratio through *** indicate that the arrayed dynamic absorbers are easier to design,and have a similar reduction effect on the modal vibration of the thin panel as the traditional dynamic absorbers within a narrow frequency range near the natural frequency,while they perform unsatisfactory in a broad ***,if t

关键词： Distributed dynamic absorbers Engineering realization of the optimal damping Vibration suppression Low-frequency and broadband

Dpaper:An Authoring Tool for Extractable Digital Papers

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Journal of Data and Information Science 2016年第1期1卷 86-97页

作者： Xiaoqiu Le Chenyu Mao Yuanbiao He Changlei Fu liyuan xu National Science Library the Chinese Academy of SciencesBeijing 100190China University of the Chinese Academy of Sciences Beijing 100049China

Purpose： To develop a structured, rich media digital paper authoring tool with an object- based model that enables interactive, playable, and convertible functions. Design/methodology/approach： We propose Dpaper to organize the content （text, data, rich media, etc.） of dissertation papers as XML and HTML5 files by means of digital objects and digital templates. Findings： Dpaper provides a structured-paper editorial platform for the authors of PhDs to organize research materials and to generate various digital paper objects that are playable and reusable. The PhD papers are represented as Web pages and structured XML files, which are marked with semantic tags. Research limitations： The proposed tool only provides access to a limited number of digital objects. For instance, the tool cannot create equations and graphs, and typesetting is not yet flexible compared to MS Word. Practical implications： The Dpaper tool is designed to break through the patterns of unstructured content organization of traditional papers, and makes the paper accessible for not only reading but for exploitation as data, where the document can be extractable and reusable. As a result, Dpaper can make the digital publishing of dissertation texts more flexible and efficient, and their data more assessable. Originality/value： The Dpaper tool solves the challenge of making a paper structured and object-based in the stage of authoring, and has practical values for semantic publishing.

关键词： Dpaper Extractable paper Digital object Authoring tool

儿童感染性心内膜炎合并瓣膜损害超声心动图表现

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中国医学影像技术 2024年第7期40卷 968-972页

作者：徐丽媛张红菊李静雅孙妍杨娇薛丽刘国文胡翼飞马宁国家儿童医学中心首都医科大学附属北京儿童医院心脏中心心脏超声科北京100045 首都医科大学公共卫生学院北京100069

目的观察儿童感染性心内膜炎(IE)合并瓣膜损害超声心动图表现。方法回顾性分析104例IE患儿,根据是否合并瓣膜损害及损害程度将其分为无损害组(n=34)、轻度损害组(n=39)及功能障碍组(n=31);比较3组一般资料及超声心动图资料,分析合并瓣... 详细信息

目的观察儿童感染性心内膜炎(IE)合并瓣膜损害超声心动图表现。方法回顾性分析104例IE患儿,根据是否合并瓣膜损害及损害程度将其分为无损害组(n=34)、轻度损害组(n=39)及功能障碍组(n=31);比较3组一般资料及超声心动图资料,分析合并瓣膜损害IE患儿超声心动图特点。结果3组合并其他先天性心脏病(即排除主动脉瓣二叶畸形)占比、住院期间栓塞事件发生率及左心系统心内膜炎发生率差异均有统计学意义(P均0.05)。结论儿童IE合并瓣膜损害多累及左心系统,栓塞事件风险高于无瓣膜损害者;超声心动图可作为评估瓣膜受累部位及损害程度的重要手段。

关键词：心内膜炎,细菌性心脏瓣膜儿童超声心动描记术

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疼痛科护士对糖尿病周围神经病变延续护理知信行的现况调查

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中国护理管理 2024年第2期24卷 272-276页

作者：许丽媛杨心雨沈意娜魏梦娅杜倩蒋杏齐腾歌李哲王钰颖樊碧发中日友好医院疼痛科北京市100029 北京中医药大学护理学院

目的:调查疼痛科护士对糖尿病周围神经病变患者延续护理的知识、态度、行为现状并分析相关因素,为制订患者延续护理计划,提升延续护理服务质量提供依据。方法:采用便利抽样的方法,于2023年7月选取全国各级医院疼痛科护士561名,采用自制... 详细信息

目的:调查疼痛科护士对糖尿病周围神经病变患者延续护理的知识、态度、行为现状并分析相关因素,为制订患者延续护理计划,提升延续护理服务质量提供依据。方法:采用便利抽样的方法,于2023年7月选取全国各级医院疼痛科护士561名,采用自制的糖尿病周围神经病变患者延续护理知信行问卷进行调查。结果:疼痛科护士对糖尿病周围神经病变延续护理知识、态度、行为的得分分别为(42.17±4.17)分、(34.95±4.12)分、(33.68±5.21)分,护士是否接受延续护理培训、科室是否提供延续护理规范、护士提供延续护理频率和跨学科沟通频率对知信行得分有影响(P<0.05)。结论:疼痛科护士对糖尿病周围神经病变延续护理态度积极,但知识和行为水平有待加强,建议制订延续护理规范,加强护士相关培训,以提升临床延续护理质量。

关键词：糖尿病周围神经病变疼痛科延续护理知信行

Comparative analysis of thermodynamic and mechanical responses between underground hydrogen storage and compressed air energy storage in lined rock caverns

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International Journal of Mining Science and Technology 2024年第4期34卷 531-543页

作者： Bowen Hu liyuan Yu Xianzhen Mi Fei xu Shuchen Li Wei Li Chao Wei Tao Zhang State Key Laboratory of Intelligent Construction and Healthy Operation and Maintenance of Deep Underground Engineering China University of Mining and TechnologyXuzhou 221116China Key Laboratory of Large Structure Health Monitoring and Control Shijiazhuang Tiedao UniversityShijiazhuang 050043China School of Mechanics and Civil Engineering China University of Mining and TechnologyXuzhou 221116China

Underground hydrogen storage(UHS)and compressed air energy storage(CAES)are two viable largescale energy storage technologies for mitigating the intermittency of wind and solar ***,it is meaningful to compare the properties of hydrogen and air with typical thermodynamic storage *** study employs a multi-physical coupling model to compare the operations of CAES and UHS,integrating gas thermodynamics within caverns,thermal conduction,and mechanical deformation around rock *** thermodynamic responses are validated using additional simulations and the field test *** and pressure variations of air and hydrogen within rock caverns exhibit similarities under both adiabatic and diabatic simulation *** reaches higher temperature and pressure following gas charging stage compared to air,and the ideal gas assumption may lead to overestimation of gas temperature and *** steel lining of CAES,the sealing layer(fibre-reinforced plastic FRP)in UHS is prone to deformation but can effectively mitigates stress in the sealing *** CAES,the first principal stress on the surface of the sealing layer and concrete lining is tensile stress,whereas UHS exhibits compressive stress in the same *** present research can provide references for the selection of energy storage methods.

关键词： Underground hydrogen storage Compressed air energy storage Mechanical response Thermodynamic response Lined rock caverns