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基于家庭医生签约服务的慢性阻塞性肺疾病社区筛查方式的卫生经济学评价

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中华全科医师杂志 2024年第9期23卷 935-943页

作者：宦红梅刘帅张驰慕永红曹维金揭志军金鸣上海市闵行区古美社区卫生服务中心上海201100 上海市闵行区华漕社区卫生服务中心上海201107 上海理工大学中英国际学院上海200031 复旦大学附属上海市第五人民医院呼吸与危重症医学科上海200240

目的从卫生经济学角度探索基于家庭医生签约服务的慢性阻塞性肺疾病(简称慢阻肺)筛查的成本效果和成本效益。方法2023年1—10月,采用立意抽样、横断面调查的方法选取1040例在上海市闵行区华漕、古美社区卫生服务中心体检的、年龄60~75... 详细信息

目的从卫生经济学角度探索基于家庭医生签约服务的慢性阻塞性肺疾病(简称慢阻肺)筛查的成本效果和成本效益。方法2023年1—10月,采用立意抽样、横断面调查的方法选取1040例在上海市闵行区华漕、古美社区卫生服务中心体检的、年龄60~75岁的老年人为研究对象。研究对象分为对照组与观察组,对照组532名,采用常规社区宣教、体检中心为主导的方式开展慢阻肺筛查;观察组508名,采用紧密医联体支持下的家庭医生为主导的服务方式开展筛查,两组筛查内容均包括评估问卷初筛、复筛、肺功能检查、支气管舒张试验、CT检查等;比较两组的筛查依从率、阳性率及成本效果、成本效益,评价筛查成效。结果通过初筛及复筛,查见两组对象慢阻肺高危人群及患者合计251例,占24.13%,其中高危人群222例,占比21.35%,确诊患者29例,占比2.79%。观察组问卷初筛、复筛、肺功能检查、支气管舒张试验、确诊及后续CT检查的依从率均明显优于对照组(χ^(2)=33.563、41.425、24.842、17.363,均P<0.05)。两组对象筛查发现的高危人群及患者占比有明显差异,观察组高危人群及患者占比较高(χ^(2)=44.880,均P<0.05)。观察组问卷初筛、肺功能检查、支气管舒张试验、CT检查的阳性率均明显高于对照组(χ^(2)=29.191、11.313、12.370、4.429,均P<0.05)。对照组、观察组筛查的成本分别为3.61万元、5.39万元,两组总计9.00万元。对照组、观察组复筛项目中的肺功能检查费的成本分别为1.44万元、2.45万元,合计3.89万元,占比43.19%,在各项成本中占比最高。对照组、观察组及全体对象每发现并筛出1例慢阻肺高危人群及患者的人均成本分别为429.45元、322.75元、358.46元;两组初筛、复筛人均成本的比较显示,观察组人均成本明显低于对照组(χ^(2)=20.396,P<0.05)。两组对象合计的人均净效益为0.37万元,效益成本比为43.50。观察组、对照组的人均净效益分别为0.49万元、0.26万元,观察组的人均净效益较对照组高0.23万元;观察组、对照组的效益成本比分别为46.77、38.61,观察组的效益成本比较对照组高8.16。结论基于家庭医生签约服务的慢阻肺筛查效果显著,筛查依从性提升明显,具有较高的成本效益。

关键词：肺疾病,慢性阻塞性成本及成本分析多相筛查医师,家庭

Implementation of regional Acute Stroke Care Map increases thrombolysis rates for acute ischaemic stroke in Chinese urban area in only 3 months

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Stroke & Vascular Neurology 2021年第1期6卷 87-94页

作者： Yi Sui Jianfeng Luo Chunyao Dong Liqiang Zheng weijin Zhao Yao Zhang Ying Xian Huaguang Zheng Bernard Yan Mark Parsons Li Ren Ying Xiao Haoyue Zhu Lijie Ren Qi Fang Yi Yang Weidong Liu Bing xu Department of Neurology Shenyang Brain HospitalShenyang Medical CollegeShenyangChina Department of Biostatistics Fudan University School of Public HealthShanghaiChina Department of Clinical Epidemiology Shengjing Hospital of China Medical UniversityShenyangChina Department of Neurology Duke Clinical Research InstituteDurhamNorth CarolinaUSA Department of Neurology Beijing Tiantan HospitalBeijingChina Department of Neurology at Melbourne Brain Center The University of Melbourne Medicine at Royal Melbourne HospitalParkvilleVictoriaAustralia Department of Neurology Shenzhen University 1st Affiliated HospitalShenzhen Second People’s HospitalShenzhenChina Department of Neurology The First Affiliated Hospital of Soochow UniversitySuzhouChina Department of Neurology The First Affiliated Hospital of Jilin UniversityChangchunChina Department of Neurosurgery Liaocheng People’s HospitalLiaochengChina

Background The rate of intravenous thrombolysis for acute ischaemic stroke remains low in *** investigated whether the implementation of a citywide Acute Stroke Care Map(ASCaM)is associated with an improvement of acute stroke care quality in a Chinese urban *** The ASCaM comprises 10 improvement strategies and has been implemented through a network consisting of 20 tertiary *** identified 7827 patients with ischaemic stroke admitted from April to October 2017,and 506 patients underwent thrombolysis were finally included for *** Compared with‘pre-ASCaM period’,we observed an increased rate of administration of tissue plasminogen activator within 4.5 hours(65.4% vs 54.5%;adjusted OR,1.724;95% CI 1.21 to 2.45;p=0.003)during‘ASCaM period’.In multivariate analysis models,‘ASCaM period’was associated with a significant reduction in onset-to door time(114.1±55.7 vs 135.7±58.4 min,p=0.0002)and onset-to needle time(ONT)(169.2±58.1 vs 195.6±59.3 min,p<0.0001).Yet no change was found in door-to needle *** outcomes such as symptomatic intracranial haemorrhage,favourable functional outcome(modified Rankin Scale≤2)and in-hospital mortality remained *** The implementation of ASCaM was significantly associated with increased rates of intravenous thrombolysis and shorter *** ASCaM may,in proof-of principle,serve as a model to reduce treatment delay and increase thrombolysis rates in Chinese urban areas and possibly other highly populated Asian regions.

关键词： thrombolysis needle admitted

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海藻玉壶汤治疗甲状腺结节的疗效与争议概述

山东中医杂志 2024年第10期43卷 1164-1168页

作者：黄薇瑾曲笑啸何燕铭张丹杨宏杰上海中医药大学附属岳阳中西医结合医院内分泌科上海200437

甲状腺结节属中医学瘿病范畴,海藻玉壶汤是治疗瘿病的代表方之一。研究发现,海藻玉壶汤可以缩小甲状腺结节,改善患者临床症状。然而,由于碘盐普及后群众碘摄入量提高,甲状腺疾病谱发生了相应变化,临床对于是否能用以海藻玉壶汤为代表的... 详细信息

甲状腺结节属中医学瘿病范畴,海藻玉壶汤是治疗瘿病的代表方之一。研究发现,海藻玉壶汤可以缩小甲状腺结节,改善患者临床症状。然而,由于碘盐普及后群众碘摄入量提高,甲状腺疾病谱发生了相应变化,临床对于是否能用以海藻玉壶汤为代表的富碘复方治疗甲状腺结节颇有争议。本文对相关内容进行综述,为临床应用海藻玉壶汤治疗甲状腺结节提供参考。参考文献52篇。

关键词：甲状腺结节海藻玉壶汤碘自身免疫性甲状腺病甲状腺功能亢进

Dinitrogen fixation mediated by lanthanum hydride

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Journal of Energy Chemistry 2022年第9期31卷 1-7,I0001页

作者： Hanxue Yan Wenbo Gao Jirong Cui weijin Zhang Qijun Pei Qianru Wang Yeqin Guan Sheng Feng Han Wu Hujun Cao Jianping Guo Ping Chen Dalian Institute of Chemical Physics Chinese Academy of SciencesDalian 116023LiaoningChina University of Chinese Academy of Sciences Beijing 100049China

Dinitrogen fixation is one of the key reactions in chemistry, which is closely associated with food, environment, and energy. It has been recently recognized that the hydride materials containing negatively charged hydrogen(H~-) show promises for Nfixation and hydrogenation to ammonia. Herein, we report that rare earth metal hydrides such as lanthanum hydride can also fix Neither by heating to 200 °C or ball milling under ambient Npressure and temperature. The Nfixation by lanthanum hydride may proceed via an intermediate lanthanum hydride-nitride(La-H-N) structure to form the final lanthanum nitride product. The hydride ion functions as an electron donor, which provides electrons for Nactivation possibly mediated by the lanthanum atoms. It is observed that N–H bond is not formed during the Nfixation process, which is distinctly different from the alkali or alkaline earth metal hydrides. The hydrolysis of La-H-N to ammonia is feasible using water as the hydrogen source. These results provide new insights into the nitrogen fixation by hydride materials and more efforts are needed for the development of rare earth metal-based catalysts and/or nitrogen carriers for ammonia synthesis processes.

关键词： Hydride Lanthanum hydride Nitrogen fixation Lanthanum hydride-nitride Rare earth metal hydride

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海水循环泵三元流节能改造分析

能源与节能 2024年第5期 88-90页

作者：王玮惠斌斌孙伟晋王坤马媛媛王大志国能(福州)热电有限公司福建福州350309 烟台龙源电力技术股份有限公司山东烟台264000

针对沿海地区电厂海水循环泵复杂多变的运行环境,提出了优化海水循环泵运行特性的综合节能改造方案。采用新一代三元流高效节能转子技术设计制造的新型三元流高效节能斜流泵叶轮和导叶体代替原有斜流泵叶轮和导叶体,大幅度提升海水循环... 详细信息

针对沿海地区电厂海水循环泵复杂多变的运行环境,提出了优化海水循环泵运行特性的综合节能改造方案。采用新一代三元流高效节能转子技术设计制造的新型三元流高效节能斜流泵叶轮和导叶体代替原有斜流泵叶轮和导叶体,大幅度提升海水循环泵在大流量工况下的运行效率,同时优化运行模式,从而实现循环水泵系统的综合节能。该技术方案在国能(福州)热电有限公司2~#机组B循环水泵改造中实施。现场实测结果表明,该海水循环泵综合节能改造方案节能效果显著,对提高大型火电机组的经济性有重大意义。

关键词：海水循环泵节能改造三元流斜流泵

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关于高速棒材圆钢直线度的研究与实践

山西冶金 2024年第4期47卷 152-153,156页

作者：李罗扣詹卫金第五文博宫叶茂首钢长治钢铁有限公司轧钢厂山西长治046000

热轧圆钢产品对直线度要求高,直线度差会增加客户切损率。长钢轧钢厂针对连续发生的多起高棒圆钢因直线度差的质量异议,找出导致直线度差的原因,通过改造转毂、矫直冷床齿条以及降低精整工序钢材温度,有效提高了高棒圆钢产品质量。

关键词：圆钢直线度转毂改造冷床齿条剪切温度

NURBS reconstruction of digital terrain for hydropower engineering based on TIN model

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Progress in Natural Science:Materials International 2008年第11期18卷 1409-1415页

作者： Denghua Zhong Jie Liu Mingchao Li Caiwei Hao School of Civil Engineering,Tianjin University,92 weijin Road,Nankai District,Tianjin 300072,China School of Civil Engineering Tianjin University 92 Weijin Road Nankai District Tianjin 300072 China

Digital terrain model(DTM)has played an important role in 3D designing,visual analysis and 3D geological modeling in large-scale hydropower *** the pivotal base of 3D visualization and modeling,DTM should be characterized by high precision,less storage and well interactivity during graphic *** the diversity of data source and taking advantage of two data structures, triangulated irregular network(TIN)and non-uniform rational B-splines(NURBS),a novel methodology is presented for reconstructing engi- neering terrain ofhydropower *** integration of multi-source data,enhanced Delaunay algorithm is introduced to rebuild the TIN DTM,which is a terrain surface in TIN and a faithful depiction of complex topography but in low-memory *** on the TIN model, applying section scanning sampling and linear interpolation,the transformation from discrete,irregular and diverse data to continuous and regular sampling cross-sectional curve sequence,is *** appropriate compression of the sampling data is also imposed to be performed for guaranteeing the following reconstruction ***,employing the NURBS technique and skinning method,the NURBS DTM, which represents a NURBS surface and satisfies the requirement after precision assess with weighted errors,is reconstructed with the inter- mediate ***,there is another achievement that two databases of terrain data,one from initial data and the other from sampling data,are established for repeatable reconstruction with different *** the successful application of the presented method,a stable foundation is laid for 3D engineering geological modeling,visual designing and analysis of the hydropower projects.

关键词： Terrain reconstruction TIN NURBS Data compression Weighted error Hydropower engineering

Synthesis, crystal structure and thermal analysis of a new stilbazolium salt crystal

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Frontiers of Materials Science 2015年第2期9卷 147-150页

作者： Bing TENG weijin KONG Ke FENG Fei YOU Lifeng CAO Degao ZHONG Lun HAO Qing SUN Sander van SMAALEN Wenhui GONG College of Physics Qingdao University Qingdao 266071 China Key Laboratory of Photonics Materials and Technology in Universi~iesof Shand'ongl Qingdao 266071 China Laboratory of Crystallography Universityof Bayreuth D-95440 BayreuihGermany

A new organic crystal of 4-N, N-dimethylamino-4＇-N＇-methyl-stilbazolium benzene sulfonate （DASBS） was synthesized and characterized for the first time. It is a derivative of 4-N, N-dimethylamino-4＇-N＇-methyl-stilbazolium tosylate （DAST） with the benzene sulfonate replacing p-toluenesulfonate. Single crystal XRD demonstrated that the crystal structure of DASBS. H20 was triclinic. The thermal analysis of this new crystal was also conducted, and the melting point was obtained to be 232℃.

关键词： organic crystal crystal growth single crystal X-ray diffraction thermalanalysis

Optimization of Load Balancing Algorithm for Virtual Machine Dynamic Migration under Mobile Cloud Computing

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China Communications 2020年第6期17卷 237-245页

作者： weijin Jiang Fang Ye Shengjie Yang Wei Liu Xiaoliang Liu Sijian Lv School of Computer Science and Technology Hunan University of Technology and BusinessChangsha 410205China Key Laboratory of Hunan Province for New Retail Virtual Reality Technology Hunan University of Technology and BusinessChangsha 410205China School of Computer Science and Technology Wuhan University of TechnologyWuhan 430073China

As one of the key technologies of cloud computing,the virtualization technology can virtualize all kinds of resources and integrate them into the unified planning of the cloud computing management *** migration of virtual machines is one of the important technologies of virtual machine ***,there are still many deficiencies in the implementation of load balancing by virtual machine dynamic migration in cloud *** triggering strategy thresholds are mostly *** there is an instantaneous peak,it will cause migration,which will cause a waste of *** order to solve this problem,based on improving the dynamic migration framework,this paper proposes node selection optimization algorithm and node load balancing strategy and designs a prediction module,which uses a one-time smooth prediction to avoid the shortcoming of peak load *** simulation experiments and conclusions analysis results show that the fusion algorithm has performance advantages obvious.

关键词： cloud computing dynamic migration load balance node selection load value prediction