园区综合能源系统(park-level integrated energy system,PIES)的工程建设往往分为多期,但目前PIES的规划未考虑系统建设时序,并假设在整个规划周期内负荷水平保持不变,造成了规划前期冗余配置、超前投资,后期设备容量短缺、供能质量下...园区综合能源系统(park-level integrated energy system,PIES)的工程建设往往分为多期,但目前PIES的规划未考虑系统建设时序,并假设在整个规划周期内负荷水平保持不变,造成了规划前期冗余配置、超前投资,后期设备容量短缺、供能质量下降等诸多问题,严重影响了PIES的经济效益。因此,提出一种考虑建设时序的PIES多阶段规划方法。将规划周期分成若干个阶段,随着园区负荷水平的不断提升,在每个规划阶段期初增加设备投入,以满足长时间尺度下负荷增长的需求。首先,建立各能量生产、转换、储存单元数学模型;在此基础上,以计及投资、运行和维护费用的全寿命周期成本最低为目标,以每个规划阶段的设备运行和功率平衡为约束,建立PIES的多阶段规划模型,并采用混合整数线性规划算法进行求解,得到各规划阶段的最优配置方案。最后,通过算例验证了多阶段规划方法在提升园区供能经济性、促进光伏消纳等方面的有效性。展开更多
This paper reports a comprehensive study on the observed and projected spatiotemporal changes in mean and extreme climate over the arid region of northwestern China, based on gridded observation data and CMIP5 simulat...This paper reports a comprehensive study on the observed and projected spatiotemporal changes in mean and extreme climate over the arid region of northwestern China, based on gridded observation data and CMIP5 simulations under the RCP4.5 and RCP8.5 scenarios. The observational results reveal an increase in annual mean temperature since 1961, largely attributable to the increase in minimum temperature. The annual mean precipitation also exhibits a significant increasing tendency. The precipitation amount in the most recent decade was greater than in any preceding decade since 1961. Seasonally, the greatest increase in temperature and precipitation appears in winter and in summer, respectively. Widespread significant changes in temperature-related extremes are consistent with warming, with decreases in cold extremes and increases in warm extremes. The warming of the coldest night is greater than that of the warmest day, and changes in cold and warm nights are more evident than for cold and warm days. Extreme precipitation and wet days exhibit an increasing trend, and the maximum number of consecutive dry days shows a tendency toward shorter duration. Multi-model ensemble mean projections indicate an overall continual increase in temperature and precipitation during the 21 st century. Decreases in cold extremes, increases in warm extremes, intensification of extreme precipitation, increases in wet days, and decreases in consecutive dry days, are expected under both emissions scenarios, with larger changes corresponding to stronger radiative forcing.展开更多
BACKGROUND： Severe acute pancreatitis（SAP） remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis（IPN）, a life-threatening evolution seconda...BACKGROUND： Severe acute pancreatitis（SAP） remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis（IPN）, a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS： The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP. A receiver operating characteristic（ROC） curve was created for each of the qualified independent risk factors. RESULTS： Of the 115 eligible patients, 39（33.9%） progressed to IPN, and the overall in-hospital mortality was 11.3%（13/115）.The early enteral nutrition（EEN）（P=0.0092, OR=0.264）, maximum intra-abdominal pressure（IAP）（P=0.0398, OR=1.131）and maximum D-dimer level（P=0.0001, OR=1.006） in the first three consecutive days were independent risk factors associated with IPN secondary to SAP. The area under ROC curve（AUC） was 0.774 for the maximum D-dimer level in the first three consecutive days and the sensitivity was 90% and the specificity was 58% at a cut-off value of 933.5 μg/L; the AUC was 0.831 for the maximum IAP in the first three consecutive days and the sensitivity was 95% and specificity was 58%at a cut-off value of 13.5 mm Hg. CONCLUSIONS： The present study suggested that the maximum D-dimer level and/or maximum IAP in the first three consecutive days after admission were risk factors of IPN secondary to SAP; an EEN might be helpful to prevent the progression of IPN secondary to SAP.展开更多
INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HU...INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.展开更多
BACKGROUND Type I Helicobacter pylori(H.pylori)infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis.However,its infection status in stepwise gastric disease progression ...BACKGROUND Type I Helicobacter pylori(H.pylori)infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis.However,its infection status in stepwise gastric disease progression in this gastric cancer prevalent area has not been evaluated;it is also not known its impact on commonly used epidemiological gastric cancer risk markers such as gastrin-17(G-17)and pepsinogens(PGs)during clinical practice.AIM To explore the prevalence of type I and type II H.pylori infection status and their impact on G-17 and PG levels in clinical practice.METHODS Thirty-five hundred and seventy-two hospital admitted patients with upper gastrointestinal symptoms were examined,and 523 patients were enrolled in this study.H.pylori infection was confirmed by both 13C-urea breath test and serological assay.Patients were divided into non-atrophic gastritis(NAG),nonatrophic gastritis with erosion(NAGE),chronic atrophic gastritis(CAG),peptic ulcers(PU)and gastric cancer(GC)groups.Their serological G-17,PG I and PG II values and PG I/PG II ratio were also measured.RESULTS A total H.pylori infection rate of 3572 examined patients was 75.9%,the infection rate of 523 enrolled patients was 76.9%,among which type I H.pylori infection accounted for 72.4%(291/402)and type II was 27.6%;88.4%of GC patients were H.pylori positive,and 84.2%of them were type I infection,only 11.6%of GC patients were H.pylori negative.Infection rates of type I H.pylori in NAG,NAGE,CAG,PU and GC groups were 67.9%,62.7%,79.7%,77.6%and 84.2%,respectively.H.pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio.Both types of H.pylori induced higher G-17 level,but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG,NAGE and CAG groups over uninfected controls.Overall PG I levels showed no difference among all disease groups and in the presence or absence of H.pylori;in stratified analysis,its level was increased in GC and PU patients in H.pylori a展开更多
There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessar...There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.展开更多
文摘园区综合能源系统(park-level integrated energy system,PIES)的工程建设往往分为多期,但目前PIES的规划未考虑系统建设时序,并假设在整个规划周期内负荷水平保持不变,造成了规划前期冗余配置、超前投资,后期设备容量短缺、供能质量下降等诸多问题,严重影响了PIES的经济效益。因此,提出一种考虑建设时序的PIES多阶段规划方法。将规划周期分成若干个阶段,随着园区负荷水平的不断提升,在每个规划阶段期初增加设备投入,以满足长时间尺度下负荷增长的需求。首先,建立各能量生产、转换、储存单元数学模型;在此基础上,以计及投资、运行和维护费用的全寿命周期成本最低为目标,以每个规划阶段的设备运行和功率平衡为约束,建立PIES的多阶段规划模型,并采用混合整数线性规划算法进行求解,得到各规划阶段的最优配置方案。最后,通过算例验证了多阶段规划方法在提升园区供能经济性、促进光伏消纳等方面的有效性。
基金jointly supported by the National Basic Research Program of China(Grant No.2012CB955900)the National Key Research and Development Program of China(Grant No.2016YFA0600701)the National Natural Science Foundation of China(Grant No.41675069)
文摘This paper reports a comprehensive study on the observed and projected spatiotemporal changes in mean and extreme climate over the arid region of northwestern China, based on gridded observation data and CMIP5 simulations under the RCP4.5 and RCP8.5 scenarios. The observational results reveal an increase in annual mean temperature since 1961, largely attributable to the increase in minimum temperature. The annual mean precipitation also exhibits a significant increasing tendency. The precipitation amount in the most recent decade was greater than in any preceding decade since 1961. Seasonally, the greatest increase in temperature and precipitation appears in winter and in summer, respectively. Widespread significant changes in temperature-related extremes are consistent with warming, with decreases in cold extremes and increases in warm extremes. The warming of the coldest night is greater than that of the warmest day, and changes in cold and warm nights are more evident than for cold and warm days. Extreme precipitation and wet days exhibit an increasing trend, and the maximum number of consecutive dry days shows a tendency toward shorter duration. Multi-model ensemble mean projections indicate an overall continual increase in temperature and precipitation during the 21 st century. Decreases in cold extremes, increases in warm extremes, intensification of extreme precipitation, increases in wet days, and decreases in consecutive dry days, are expected under both emissions scenarios, with larger changes corresponding to stronger radiative forcing.
基金supported by grants from the National Natural Science Foundation of China(81372613 and 81170431)Doctoral Fund of Ministry of Education of China(21022307110012)Special Fund of Ministry of Public Health of China(210202007)
文摘BACKGROUND： Severe acute pancreatitis（SAP） remains a clinical challenge with considerable morbidity and mortality.An early identification of infected pancreatic necrosis（IPN）, a life-threatening evolution secondary to SAP, is obliged for a more preferable prognosis. Thus, the present study was conducted to identify the risk factors of IPN secondary to SAP. METHODS： The clinical data of patients with SAP were retrospectively analyzed. Univariate and multivariate logistic regression analyses were sequentially performed to assess the associations between the variables and the development of IPN secondary to SAP. A receiver operating characteristic（ROC） curve was created for each of the qualified independent risk factors. RESULTS： Of the 115 eligible patients, 39（33.9%） progressed to IPN, and the overall in-hospital mortality was 11.3%（13/115）.The early enteral nutrition（EEN）（P=0.0092, OR=0.264）, maximum intra-abdominal pressure（IAP）（P=0.0398, OR=1.131）and maximum D-dimer level（P=0.0001, OR=1.006） in the first three consecutive days were independent risk factors associated with IPN secondary to SAP. The area under ROC curve（AUC） was 0.774 for the maximum D-dimer level in the first three consecutive days and the sensitivity was 90% and the specificity was 58% at a cut-off value of 933.5 μg/L; the AUC was 0.831 for the maximum IAP in the first three consecutive days and the sensitivity was 95% and specificity was 58%at a cut-off value of 13.5 mm Hg. CONCLUSIONS： The present study suggested that the maximum D-dimer level and/or maximum IAP in the first three consecutive days after admission were risk factors of IPN secondary to SAP; an EEN might be helpful to prevent the progression of IPN secondary to SAP.
文摘INTRODUCTIONThe prevalence of hyperuricenlia （HUA） has increased in China in the recent years in relation to socioeconomic developments and changing lifestyles and diets, with a trend toward onset at younger age. HUA has become the second most common metabolic disease after diabetes mellitus. Like gout, HUA is also associated with the occurrence and progression of disorders of the urinary, endocrine, metabolic, cardio-cerebrovascular, and other systems.
基金Supported by National Natural Science Foundation of China,No.U1604174Henan Provincial Government-Health and Family Planning Commission,No.20170123+1 种基金Henan Provincial Government-Health and Family Planning Commission Research Innovative Talents Project,No.51282Henan Provincial Government-Science and Technology Bureau,No.142300410050.
文摘BACKGROUND Type I Helicobacter pylori(H.pylori)infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis.However,its infection status in stepwise gastric disease progression in this gastric cancer prevalent area has not been evaluated;it is also not known its impact on commonly used epidemiological gastric cancer risk markers such as gastrin-17(G-17)and pepsinogens(PGs)during clinical practice.AIM To explore the prevalence of type I and type II H.pylori infection status and their impact on G-17 and PG levels in clinical practice.METHODS Thirty-five hundred and seventy-two hospital admitted patients with upper gastrointestinal symptoms were examined,and 523 patients were enrolled in this study.H.pylori infection was confirmed by both 13C-urea breath test and serological assay.Patients were divided into non-atrophic gastritis(NAG),nonatrophic gastritis with erosion(NAGE),chronic atrophic gastritis(CAG),peptic ulcers(PU)and gastric cancer(GC)groups.Their serological G-17,PG I and PG II values and PG I/PG II ratio were also measured.RESULTS A total H.pylori infection rate of 3572 examined patients was 75.9%,the infection rate of 523 enrolled patients was 76.9%,among which type I H.pylori infection accounted for 72.4%(291/402)and type II was 27.6%;88.4%of GC patients were H.pylori positive,and 84.2%of them were type I infection,only 11.6%of GC patients were H.pylori negative.Infection rates of type I H.pylori in NAG,NAGE,CAG,PU and GC groups were 67.9%,62.7%,79.7%,77.6%and 84.2%,respectively.H.pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio.Both types of H.pylori induced higher G-17 level,but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG,NAGE and CAG groups over uninfected controls.Overall PG I levels showed no difference among all disease groups and in the presence or absence of H.pylori;in stratified analysis,its level was increased in GC and PU patients in H.pylori a
基金The study was supported by National Key Research and Development Program(2018YFA0704100,2018YFA0704104)National Natural Science Foundation of China(81827805,82130060)Jiangsu Provincial Special Program of Medical Science(BE2019750).The funding sources had no role in the writing of the report,or decision to submit the paper for publication.
文摘There is considerable potential for integrating transarterial chemoembolization(TACE),programmed death-(ligand)1(PD-[L]1)inhibitors,and molecular targeted treatments(MTT)in hepatocellular carcinoma(HCC).It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations.In this nationwide,retrospective,cohort study,826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT(combination group,n=376)or TACE monotherapy(monotherapy group,n=450)were included from January 2018 to May 2021.The primary endpoint was progression-free survival(PFS)according to modified RECIST.The secondary outcomes included overall survival(OS),objective response rate(ORR),and safety.We performed propensity score matching approaches to reduce bias between two groups.After matching,228 pairs were included with a predominantly advanced disease population.Median PFS in combination group was 9.5 months(95%confidence interval[CI],8.4-11.0)versus 8.0 months(95%CI,6.6-9.5)(adjusted hazard ratio[HR],0.70,P=0.002).OS and ORR were also significantly higher in combination group(median OS,19.2[16.1-27.3]vs.15.7 months[13.0-20.2];adjusted HR,0.63,P=0.001;ORR,60.1%vs.32.0%;P<0.001).Grade 3/4 adverse events were observed at a rate of 15.8%and 7.5%in combination and monotherapy groups,respectively.Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS,OS,and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice,with an acceptable safety profile.
