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医院感染监测系统精准手卫生干预对多药耐药菌感染的防控效果

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中华医院感染学杂志 2024年第17期34卷 2693-2697页

作者：沈小玥苏欣董维鹏戚瑾黄慧敏李亚楠尹诺方红梅东部战区总医院疾病预防控制科南京鼓楼医院呼吸与危重症医学科

目的采用医院感染实时监控软件对重症监护病房(ICU)多药耐药菌(MDROs)动态监测，精准干预手卫生，观察对MDROs防控的效果。方法自2023年1月-12月在某综合性三甲医院普外科采用医院感染软件“杏林医院感染实时监控系统”对ICU患者从入... 详细信息

目的采用医院感染实时监控软件对重症监护病房(ICU)多药耐药菌(MDROs)动态监测，精准干预手卫生，观察对MDROs防控的效果。方法自2023年1月-12月在某综合性三甲医院普外科采用医院感染软件“杏林医院感染实时监控系统”对ICU患者从入院到出院的全程在线动态监测，一旦患者检测出MDROs感染或定值立即对相关医护人员、护工、保洁人员、患者及患者家属的手卫生进行精准干预。结果手卫生进行精准干预后，护工、患者、患者家属和医务人员手卫生依从性及手卫生合格率均明显升高(P<0.05);医院感染发病率(9.19%vs. 4.47%),尤其是MDROs感染率(5.29%vs. 1.26%)明显下降(P<0.05);耐甲氧西林金黄色葡萄球菌(MRSA)、耐碳青霉烯铜绿假单胞菌(CRPA)、耐碳青霉烯鲍氏不动杆菌(CRAB)和耐碳青霉烯肠杆菌(CRE)检出率下降(P<0.05),其中MRSA检出率明显下降(63.64%vs. 5.56%)。结论采用医院感染实时监控软件对ICU MDROs动态监测，精准干预手卫生，可以明显提高相关医护人员、患者和患者家属、护工、保洁人员的手卫生依从性，从而使MDROs医院感染发病率降低，提升MDROs防控效果。

关键词：医院感染监测手卫生干预多药耐药菌预防与控制

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Endoscopic characteristics in predicting prognosis of biopsy-diagnosed gastric low-grade intraepithelial neoplasia

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Chinese Medical Journal 2022年第1期135卷 26-35页

作者： Long Zou Qingwei Jiang Tao guo Xi Wu Qiang Wang Yunlu Feng Shengyu Zhang Weigang fang Weixun Zhou Aiming Yang Department of Gastroenterology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Internal Medicine Shanghai Jiahui International HospitalShanghai 200233China Department of Pathology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China

Background: Endoscopic biopsy can underestimate gastric malignancies as low-grade intraepithelial neoplasia (LGIN). Definitively diagnosed LGIN would progress. This study aimed to evaluate predictive factors to identify malignancies misdiagnosed as LGIN by biopsy and LGIN at high risk of ***: The clinical records of patients diagnosed with gastric LGIN by endoscopic biopsy who underwent at least two endoscopies during the first year of follow-up between 2007 and 2017 were retrospectively collected. Three endoscopists reviewed photographs of the initial endoscopy, described lesion characteristics, and made endoscopic diagnoses. Logistic regression was used to analyze predictors to identify malignancies underestimated as LGIN. A receiver operating characteristic curve was used to evaluate the diagnostic accuracy of these predictors. Patient clinical outcomes of follow-up >1 year were collected. Kaplan-Meier estimates with log-rank tests and Cox proportional hazards regression were used to analyze predictors of ***: Overall, 48 of 182 (26.4%) patients were proven to have malignancies. A single lesion, a large lesion size, and marked intestinal metaplasia (IM) were independent predictors of initially misdiagnosed malignancies. The area under the curve of these predictors was 0.871, with a sensitivity of 68.7% and specificity of 92.5%. Twelve of 98 patients (12.2%) progressed during the 33-month median follow-up period. A whitish appearance, irregular margins, marked IM, and histological diagnosis of LGIN more than twice within the first year were predictors for ***: Lesions diagnosed as LGIN by biopsy with marked IM and other predictors above should be prudently treated for high potential to be malignancies or progress. Endoscopic follow-up with repeated biopsies within the first year is recommended.

关键词： Diagnostic errors Disease progression Endoscopy Metaplasia Stomach neoplasms

Geochemical insights into contribution of petroleum hydrocarbons to the formation of hydrates in the Taixinan Basin, the South China Sea

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Geoscience Frontiers 2021年第6期12卷 394-403页

作者： Yan Li Yun-Xin fang Qian-Zhi Zhou Xiang-Po Xu Jin-Zhong Liu guo-Yi Zhou Jiang-Hai Wang Guangdong Provincial Key Laboratory of Marine Resources and Coastal Engineering School of Marine SciencesSun Yat-Sen UniversityGuangzhou510006China Guangzhou Marine Geological Survey Guangzhou510760China State Key Laboratory of Organic Geochemistry Guangzhou Institute of GeochemistryChinese Academy of SciencesGuangzhou510640China Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai) Zhuhai519000China

Methane hydrate in the South China Sea (SCS) has extensively been considered to be biogenic on the basis of its δ13C andδD *** previous efforts have greatly been made,the contribution of thermogenic oil/gas has still been *** this study,biomarkers and porewater geochemical parameters in hydrate-free and hydrate-bearing sediments in the Taixinan Basin,the SCS have been measured for evaluating the contribution of petroleum hydrocarbons to the formation of hydrate deposits via a comparative study of their source inputs of organic matters,environmental conditions,and microbial *** results reveal the occurrence of C_(14)–C_(16) branched saturated fatty acids (bSFAs) with relatively high concentrations from sulfate-reducing bacteria(SRBs) in hydrate-bearing sediments in comparison with hydrate-free sediments,which is in accord with the positive δ^(13)C values of dissolved inorganic carbon (DIC),increasing methane concentrations,decreasing alkalinity,and concentration fluctuation of ions (Cl^(-),Br^(-),SO_(4)^(2-),Ca^(2+),and Mg^(2+)).These data indicate the relatively active microbial activities in hydrate-bearing sediments and coincident variations of environmental *** isotope compositions of b SFAs (-34.0‰to -21.2‰),n-alkanes (-34.5‰to-29.3‰),and methane(-70.7‰to -69.9‰) jointly demonstrate that SRBs might thrive on a different type of organic carbon rather than *** with numerous gas/oil reservoirs and hydrocarbon migration channels in the SCS,the occurrence of unresolved complex mixtures (UCMs),odd-even predominance (OEP) values (about 1.0),and biomarker patterns suggest that petroleum hydrocarbons from deep oil/gas reservoirs are the most probable carbon *** new results provide significant evidence that the deep oil/gas reservoirs may make a contribution to the formation of methane hydrate deposits in the SCS.

关键词： Petroleum hydrocarbons Sulfate-reducing bacteria(SRBs) Biomarkers Porewater geochemistry Gas hydrates The South China Sea(SCS)

抗谷氨酸脱羧酶65抗体综合征的临床特征分析

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中国临床神经科学 2024年第3期32卷 284-291页

作者：黄丽芳邵志海周颖董继宏费国强汪昕复旦大学附属中山医院(厦门)神经内科厦门361006 复旦大学附属中山医院神经内科上海200032

目的分析探讨抗谷氨酸脱羧酶65(GAD65)抗体综合征相关的各种神经系统损害的临床特点,提高对抗GAD65抗体综合征的认识。方法回顾性收集2018年1月至2022年12月复旦大学附属中山医院及厦门分院收治的6例抗GAD65抗体阳性患者的临床、影像学... 详细信息

目的分析探讨抗谷氨酸脱羧酶65(GAD65)抗体综合征相关的各种神经系统损害的临床特点,提高对抗GAD65抗体综合征的认识。方法回顾性收集2018年1月至2022年12月复旦大学附属中山医院及厦门分院收治的6例抗GAD65抗体阳性患者的临床、影像学、电生理和实验室检查资料,分析并总结抗GAD65抗体综合征的特征。结果6例抗GAD65抗体阳性患者,均为女性,平均年龄(55±12.7)岁,平均病程(23.6±15.3)个月。6例患者的神经系统损害包括:经典型僵人综合征2例,僵人综合征合并小脑性共济失调1例,颞叶癫癎1例,自身免疫性脑炎伴症状性癫间1例,小脑性共济失调伴重症肌无力1例。神经系统外损害:合并成人迟发型自身免疫性糖尿病3例,合并自身免疫性甲状腺炎2例,合并干燥综合征1例,合并恶性贫血2例,合并甲状腺癌1例。患者的血清抗GAD65抗体滴度均高于脑脊液,但临床症状严重程度、病程与抗GAD65抗体滴度高低无相关性。头颅影像学检查:1例自身免疫性脑炎患者提示右侧海马肿胀,1例小脑性共济失调患者提示双侧小脑半球显著萎缩。2例癫间患者脑电图提示一侧或双侧颞区高波幅尖波、尖慢复合波散在发放,3例僵人综合征患者的针电极肌电图提示腰椎椎旁肌、腹直肌同步的持续运动单位发放。4例患者进行了免疫抑制治疗,其临床症状明显改善。结论抗GAD65抗体综合征以女性多见,临床表现形式多样,常合并多种其他系统自身免疫性疾病,部分可能合并肿瘤;头颅MRI及神经电生理检查在本病的临床分型诊断中有特殊定位价值;血清抗GAD65抗体滴度高于脑脊液,但抗GAD65抗体滴度高低并不影响临床症状的严重程度;免疫调节治疗是最主要的治疗方法。

关键词：抗谷氨酸脱羧酶65抗体抗谷氨酸脱羧酶65抗体综合征自身免疫性疾病神经电生理

基于TM-Net网络估计的三维人体姿态运动监测算法

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南通职业大学学报 2024年第1期38卷 81-86页

作者：郭意凡陈钲方张路王健汪洋继鸿大连民族大学机电工程学院辽宁大连116650

针对三维人体姿态估计的便捷性与准确性提升需求,提出一种基于TM-Net网络估计算法。该算法以MediaPipe为中心,融合帧率计算、动作检测、动作计数和真实坐标解析等多功能模块,实现对人体运动的精准检测与计数。针对公共数据集LSP(Leeds S... 详细信息

针对三维人体姿态估计的便捷性与准确性提升需求,提出一种基于TM-Net网络估计算法。该算法以MediaPipe为中心,融合帧率计算、动作检测、动作计数和真实坐标解析等多功能模块,实现对人体运动的精准检测与计数。针对公共数据集LSP(Leeds Sports Pose)和自建校园健身房运动数据集使用关键点的正确性概率(Probability of Correct Keypoint,PCK)、关节位置误差平均值(Mean Per Joint Position Error,MPJPE)和普罗克鲁斯对齐后的平均关节位置误差(Procrustes-Aligned Mean Per Joint Position Error,PA-MPJPE)等指标对该算法进行评估,并与目前先进的TP-3D网络估计算法进行对比。结果表明,TM-Net具有更高的准确率。此外,以开合跳为例进行消融实验,结果表明,TM-Net具有更强的泛化能力,能适应不同个体及拍摄角度的变化,满足了运动监测的实际需求。

关键词：三维人体姿态估计 TM-Net网络 MediaPipe LSP数据集运动监测

Planar bi-metallic lattice with tailorable coefficient of thermal expansion

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Acta Mechanica Sinica 2022年第7期38卷 192-200,I0005页

作者： Mengchuan Xu Zeang Zhao Panding Wang Yijin Zhang Xiaogang guo Hongshuai Lei Daining fang Beijing Key Laboratory of Lightweight Multi-Functional Composite Materials and Structures Beijing Institute of TechnologyBeijing100081China

A mechanical metamaterial that has a tailorable coefficient of thermal expansion(CTE)is promising for guaranteeing the reliability of electrical and optical instruments under thermal *** growing research on the design and manufacturing of metamaterials with extraordinary CTEs,it remains challenging to achieve a nearly isotropic tailorable CTE while ensuring a sufficient load bearing capacity for applications,such as mechanical supporting *** this research,we propose a type of bi-metallic lattice whose CTE is artificially programmed from positive(75 ppm/K)to negative(−45 ppm/K),and whose equivalent modulus can be as high as 80 *** bi-metallic lattice with a tailorable CTE in two orthogonal directions can be readily assembled without special modifications to construct large-scale planar structures with desired isotropic CTEs.A theoretical model that considers the actual configuration of the bi-metallic joint is developed;the model precisely captures the thermal deformations of lattice structures with varied geometries and material *** by our theoretical design method,planar metallic structures that were manufactured using Al,Ti,and Invar alloy were experimentally characterized;the structures exhibited outstanding performance when compared with typical engineering materials.

关键词： Mechanical metamaterial Metallic lattice Coefficient of thermal expansion Load bearing capacity

Incidence of Pleural Effusion in Patients with Pulmonary Embolism

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Chinese Medical Journal 2015年第8期128卷 1032-1036页

作者： min Liu Ai Cui Zhen-guo Zhai Xiao-Juan guo Man Li Lei-Lei Teng Li-Li Xu Xiao-Juan Wang Zhen Wang Huan-Zhong Shi Department of Radiology Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China Department of Respiratory and Critical Care Medicine Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital Capital Medical University Beijing 100020 China

Background： No data on the incidence ofpleural effusion （PE） in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism. Methods： This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography （CTPA） performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed. Results： From January 2008 until December 2013, PE was identified in 423 of 3141 patients （13.5%） with clinically suspected pulmonary embolism who underwent CTPA, The incidence of PE in patients with pulmonary embolism （19.9%） was significantly higher than in those without embolism （9.4%）（P 〈 0.001 ）. Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE, Conclusions： PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.

关键词： Computed Tomography Pulmonary Angiography Pleural Effusion Pulmonary Embolism

2,2-双(4-羟基苯基)六氟丙烷制备研究进展

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浙江化工 2024年第7期55卷 1-6页

作者：方忠元郭天佐罗霞于万金刘武灿浙江省化工研究院有限公司含氟温室气体替代及控制处理国家重点实验室浙江杭州310023 中化蓝天集团有限公司浙江杭州310051

2,2-双(4-羟基苯基)六氟丙烷(BPAF)作为交联剂在氟橡胶领域具有重要的应用,是功能性聚合物及医药、农药行业的重要中间体。本文介绍了不同酸为催化剂时2,2-双(4-羟基苯基)六氟丙烷的制备方法。

关键词： 2,2-双(4-羟基苯基)六氟丙烷苯酚六氟丙酮傅-克烷基化

Rapid development methodology of agricultural robot navigation system working in GNSS-denied environment

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Advances in Manufacturing 2023年第4期11卷 601-617页

作者： Run-Mao Zhao Zheng Zhu Jian-Neng Chen Tao-Jie Yu Jun-Jie Ma guo-Shuai Fan min Wu Pei-Chen Huang School of Mechanical Engineering Zhejiang Sci-Tech UniversityHangzhou310018People’s Republic of China Key Laboratory of Transplanting Equipment and Technology of Zhejiang ProvinceHangzhou310018People’s Republic of China School of Transportation Zhejiang Industry Polytechnic CollegeShaoxing312000ZhejiangPeople’s Republic of China College of Automation Zhongkai University of Agriculture and EngineeringGuangzhou510225People’s Republic of China

Robotic autonomous operating systems in global n40avigation satellite system(GNSS)-denied agricultural environments(green houses,feeding farms,and under canopy)have recently become a research hotspot.3D light detection and ranging(LiDAR)locates the robot depending on environment and has become a popular perception sensor to navigate agricultural robots.A rapid development methodology of a 3D LiDAR-based navigation system for agricultural robots is proposed in this study,which includes:(i)individual plant clustering and its location estimation method(improved Euclidean clustering algorithm);(ii)robot path planning and tracking control method(Lyapunov direct method);(iii)construction of a robot-LiDAR-plant unified virtual simulation environment(combination use of Gazebo and SolidWorks);and(vi)evaluating the accuracy of the navigation system(triple evaluation:virtual simulation test,physical simulation test,and field test).Applying the proposed methodology,a navigation system for a grape field operation robot has been *** virtual simulation test,physical simulation test with GNSS as ground truth,and field test with path tracer showed that the robot could travel along the planned path quickly and *** maximum and mean absolute errors of path tracking are 2.72 cm,1.02 cm;3.12 cm,1.31 cm,respectively,which meet the accuracy requirements of field operations,establishing the effectiveness of the proposed *** proposed methodology has good scalability and can be implemented in a wide variety of field robot,which is promising to shorten the development cycle of agricultural robot navigation system working in GNSS-denied environment.

关键词： Agricultural robot Global navigation satellite system(GNSS)-denied environment Navigation system 3D light detection and ranging(LiDAR) Rapid developing Methodology