Current apparent treatment‐resistant hypertension in patients undergoing peritoneal dialysis: A multi‐center cross‐sectional study

Apparent treatment‐resistant hypertension (aTRH) is the most commonly used term to report resistant hypertension (RH) and is considered as a common problem in dialysis population. However, few reports have focused on peritoneal dialysis (PD) hypertensive patients. The authors conducted a multi‐center cross‐sectional study involving 1789 PD patients from nine centers in Guangdong, China. The prevalence of aTRH was estimated by home blood pressure (BP) monitoring. Evaluating drug adherence through Eight‐item Morisky Medication Adherence Scale (MMAS‐8) and pill counting was performed to assess RH in one PD center. Related factors of aTRH were analyzed using logistic regression analysis. The prevalence of aTRH in PD patients was estimated at 42.2% (755 out of 1789 hypertensive patients) based on home BP. Of those, 91.4% patients were classified as uncontrolled RH, 2.0% as controlled RH, and 6.6% as refractory hypertension. The prevalence of RH was 40.6% and 41.9% among those with medium/high adherence based on the MMAS‐8 scores and the pill counting rate, respectively. PD patients who were younger, with higher body mass index, with lower serum albumin and poorer dialysis adequacy were significantly associated with higher aTRH incident. In conclusion, the present study demonstrates a high prevalence of aTRH in PD population, which occurs in about two in five treated hypertensive patients. Nutritional status and dialysis adequacy might tightly associate with aTRH.     

Identification of Multiple Mechanical Properties of Laminates from a Single Compressive Test

In-plane elastic and interlaminar properties of composite laminates are commonly obtained through separate experiments. In this paper, a simultaneous identification method for both properties using a single experiment is proposed. The mechanical properties of laminates were treated as uncertainties and Bayesian inference was employed with measured strain-load curves in compression tests of laminates with embedded delamination. The strain–load curves were separated into two stages: the pre-delamination stage and the post-delamination stage. Sensitivity analysis was carried out to determine the critical properties at different stages, in order to alleviate the ill-posed problem in inference. Results showed that the in-plane Young’s modulus and shear modulus in elastic properties are dominant in the pre-delamination stage, and the interlaminar strength and type I fracture toughness in interlaminar properties are dominant in the post-delamination stage. Five times of property identification were carried out; the maximum coefficient of variation of identified properties was less than 1.11%, and the maximum error between the mean values of the identified properties and the ones from standard experiments was less than 5.44%. The proposed method can reduce time and cost in obtaining multiple mechanical properties of laminates.     

脑胶质瘤显微手术治疗78例临床分析

目的 分析显微外科手术治疗脑胶质瘤的临床疗效.方法 回顾性分析78例脑胶质瘤显微手术治疗的临床资料.结果 72例病人术前诊断与术后病理诊断符合率92.3%.经手术治疗显效38例(48.7%),有效35例(44.9%),无效5例(6.4%),治疗总有效率93.6%.结论 显微手术以其损伤小、适应证宽、全切除率高等优点,临床效果好.     

有机锡中毒性脑病225例临床分析

目的 :探讨有机锡中毒性脑病的发病机制及抢救治疗方法。方法 :对 2 2 5例有机锡中毒性脑病临床救治资料进行回顾性分析。结果 :中毒性脑病的病情轻重与脑电图改变及低血钾程度呈正相关 ;经脱水降颅压、激素、超常规补钾等治疗 ,全部治愈。结论 :有机锡引起神经细胞代谢障碍 ,脑水肿、低钾血症是产生中毒性脑病的病理基础 ;诊断一经确立 ,即应采取综合措施 ,积极脱水降颅压 ,大剂量激素使用 ,纠正低血钾是抢救成功的关键     

Evaporation behavior of 233Pa in FLiBeZr molten salt

In thorium molten salt reactors (TMSR), ²³³Pa is an important intermediate nuclide in the conversion chain of ²³²Th to ²³³U, its timely separation from the fuel salt is critically important for both the thorium–uranium (Th–U) fuel cycle and the neutron economy of the reactor. In this study, the evaporation behavior of ²³³Pa in the FLiBeZr molten salt was investigated during a vacuum distillation process. The separation characteristics between ²³³Pa and the major components of the fuel (salt and fission products) were evaluated in a calculation of the separation factors between these components. It was found that ²³³Pa⁵⁺ evaporated more readily than ²³³Pa⁴⁺ and the other components of the fuel, the relatively low temperature and medium pressure were much more beneficial to the separation of ²³³Pa⁵⁺ from FLiBeZr salt in the evaporation process, with the maximum value of the separation factor achieving more than 10². Results of distillation experiments also show that increasing the temperature and decreasing the ambient pressure enhances the separation between ²³³Pa⁵⁺ and most of the fission product nuclides due to the ²³³Pa⁵⁺ volatility more strongly depending on the process conditions. These results will be utilized to design a concept for a process for ²³³Pa separation from the fuel of a molten salt reactor.

The evaporation behavior of ²³³Pa in the FLiBeZr molten salt was investigated during a vacuum distillation process.     

使用悬浮床治疗重度烧伤病人的护理

流体悬浮治疗床是利用气体滚动悬浮原理设计的具有治疗作用的病床,是美国在20世纪60年代末发明并应用于临床,其以悬浮、温控抽湿为基本功能,具有避免创面受压、加快创面干燥、减少感染、减轻疼痛、促进血液循环及降低护理工作量等优,     

基于CT扫描及CAD技术建立下腰椎三维有限元模型

背景：近年来,计算机技术和有限元理论的飞速发展为构建腰椎模型提供了技术支持,有限元模型的精确性和可靠性显著提高,为研究椎间盘、椎板切除、腰椎融合、脊柱内固定材料等临床相关的生物力学问题提供了更好的平台。目的：应用三维有限元法建立L3～5腰椎活动节段力学模型。方法：通过CT扫描、Unigraphics V18.0软件进行影像边界记录、定标等方法,按照点、线、面、体的顺序重建三维结构,采用CAD数据处理技术,输入相关的材料特性,验证重建模型的有效性。结果与结论：建立下腰椎的三维有限元模型（L3～5）,分析结果证明其在仿真分析中是可行的,可以模拟生物力学实验。建立的模型共有6482个节点,31326个单元,生成网格时利用网格生成器的扫掠和优化功能,尽量依据模型的几何外形,使网格生成的最少,兼顾了对建模准确性和计算可行性,同时又能充分满足对腰椎的生物力学研究。     

Effect of Electromagnetic Field on Wear Resistance of Fe901/Al2O3 Metal Matrix Composite Coating Prepared by Laser Cladding

Fe901/Al₂O₃ metal matrix composite (MMC) coatings were deposited on the surface of 45 steel via electromagnetic field (EF)-assisted laser cladding technology. The influences of EF on the microstructure, phase composition, microhardness, and wear resistance of the Fe901/Al₂O₃ MMC coating were investigated. The generated Lorentz force (F_L) and Joule heating due to the application of EF had a positive effect on wear resistance. The results showed that F_L broke up the columnar dendrites. Joule heating produced more nuclei, resulting in the formation of fine columnar dendrites, equiaxed dendrites, and cells. The EF affected the content of hard phase in the coatings while it did not change the phase composition of the coating, because the coatings with and without EF assistance contained (Fe, Cr), (Fe, Cr)₇C₃, Fe₃Al, and (Al, Fe)₄Cr phases. The microhardness under 20 mT increased by 84.5 HV_0.2 compared to the coating without EF due to the refinement of grains and the increased content of hard phase. Additionally, the main wear mechanism switched from adhesive wear to abrasive wear.     

Prognostic Significance of Tumor Growth Rate (TGR) in Patients with Huge Hepatocellular Carcinoma Undergoing Transcatheter Arterial Chemoembolization

The prognostic value of the tumor growth rate (TGR) in huge hepatocellular carcinoma (HHCC) patients treated with transcatheter arterial chemoembolization (TACE) as an initial treatment remains unclear. This two-center retrospective study was conducted in 97 patients suffering from HHCC. Demographic characteristics, oncology characteristics, and some serological markers were collected for analysis. The TGR was significantly linear and associated with the risk of death when applied to restricted cubic splines. The optimal cut-off value of TGR was −8.6%/month, and patients were divided into two groups according to TGR. Kaplan–Meier analysis showed that the high-TGR group had a poorer prognosis. TGR (hazard ratio (HR), 2.06; 95% confidence interval (CI), 1.23–3.43; p = 0.006), presence of portal vein tumor thrombus (PVTT) (HR, 1.93; 95% CI, 1.13–3.27; p = 0.016), and subsequent combination therapy (HR, 0.59; 95% CI, 0.35–0.99; p = 0.047) were independent predictors of OS in the multivariate analysis. The model with TGR was superior to the model without TGR in the DCA analysis. Patients who underwent subsequent combination therapy showed a longer survival in the high-TGR group. This study demonstrated that higher TGR was associated with a worse prognosis in patients with HHCC. These findings will distinguish patients who demand more personalized combination therapy and rigorous surveillance.