目的探讨压疮愈合计分量表(pressure ulcer scale for healing,PUSH)在老年住院患者2期及以上压力性损伤治疗效果评价中的应用。方法便利抽样选取2016年11月至2017年11月期间在我科住院的带入压力性损伤老年患者130例共143处2期及以上...目的探讨压疮愈合计分量表(pressure ulcer scale for healing,PUSH)在老年住院患者2期及以上压力性损伤治疗效果评价中的应用。方法便利抽样选取2016年11月至2017年11月期间在我科住院的带入压力性损伤老年患者130例共143处2期及以上压力性损伤,由压力性损伤专科护士根据压力性损伤创面情况来指导制定治疗方案,采用PUSH评价压力性损伤的动态变化并记录。结果本组患者压力性损伤总体好转率为41.96%,入院评估PUSH评分为(12.5±2.63)分,出院评估PUSH评分为(10.76±3.29)分,差异有统计学意义(P<0.01)。结论压力性损伤护理总体有效;PUSH评分工具能较为客观和动态地评价压力性损伤愈合过程,体现压力性损伤管理效果。展开更多
Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have...Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have been considered： the push by mantle plumes from the sub-continental mantle which is called the active force for breakup, and the dragging force from oceanic subduction retreat which is called the passive force for breakup. However, the relative importance of these two forces is unclear. Here we model the supercontinent breakup coupled with global mantle convection in order to address this question. Our global model features a spherical harmonic degree-2 structure, which includes a major subduction girdle and two large upwelling（superplume） systems. Based on this global mantle structure,we examine the distribution of extensional stress applied to the supercontinent by both subsupercontinent mantle upwellings and subduction retreat at the supercontinent peripheral. Our results show that：（1） at the center half of the supercontinent, plume push stress is ～3 times larger than the stress induced by subduction retreat;（2） an average hot anomaly of no higher than 50 K beneath the supercontinent can produce a push force strong enough to cause the initialization of supercontinent breakup;（3） the extensional stress induced by subduction retreat concentrates on a ～600 km wide zone on the boundary of the supercontinent, but has far less impact to the interior of the supercontinent. We therefore conclude that although circum-supercontinent subduction retreat assists supercontinent breakup, sub-supercontinent mantle upwelling is the essential force.展开更多
The development of technologies such as big data and cyber-physical systems （CPSs） has increased the demand for product design. Product digital design involves completing the product design process using advanced di...The development of technologies such as big data and cyber-physical systems （CPSs） has increased the demand for product design. Product digital design involves completing the product design process using advanced digital technologies such as geometry modeling, kinematic and dynamic simulation, multi- disciplinary coupling, virtual assembly, virtual reality （VR）, multi-objective optimization （MOO）, and human-computer interaction. The key technologies of intelligent design for customized products include： a description and analysis of customer requirements （CRs）, product family design （PFD） for the customer base, configuration and modular design for customized products, variant design for customized products, and a knowledge push for product intelligent design. The development trends in intelligent design for customized products include big-data-driven intelligent design technology for customized products and customized design tools and applications. The proposed method is verified by the design of precision computer numerical control （CNC） machine tools.展开更多
Background In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push ente...Background In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push enteroscopy and capsule endoscopy are currently considered to be the most effective diagnostic procedures. The aim of this study was to compare the detection rates between capsule endoscopy and push enteroscopy. Methods From May 2002 through January 2003, we prospectively examined by capsule endoscopy 39 patients with suspected small bowel diseases, in particular GI bleeding of unknown origin in Renji Hospital. Among them, 32 complained of obscure recurrent GI bleeding. Between January 1993 and October 1996, we used push enteroscopy on 36 patients who suffered from unexplained GI bleeding. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy and/or angiography. Results M2A capsule endoscopy disclosed abnormal small bowel findings in 26 (82%) out of 32 patients. Twenty-one of them had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66% (21 of 32 patients). Definite bleeding sites diagnosed by capsule endoscopy in 21 patients included angiodysplasia (8), inflammatory small-bowel (5), small-bowel polyps (4), gastrointestinal stromal tumour (2), carcinoid tumour and lipoma (1), and hemorrhagic gastritis (1). Push enteroscopy detected the definite sources of bleeding in 9 (25%) of the 36 patients. Patients with definite bleeding sources included angiodysplasias (2), leiomyosarcoma (2), leiomyoma (1), lymphoma (1), Crohn’s disease (1), small-bowel polyps (1) and adenocarcinoma of ampulla (1). Suspected bleeding sources were shown by push enteroscopy in two additional patients (6%), and in other five patients (16%) by capsule endoscopy. Conclusions The present study of patients with obscure GI bleeding showed that capsule endoscopy significantly superior to push enteroscopy in detecting展开更多
文摘目的探讨压疮愈合计分量表(pressure ulcer scale for healing,PUSH)在老年住院患者2期及以上压力性损伤治疗效果评价中的应用。方法便利抽样选取2016年11月至2017年11月期间在我科住院的带入压力性损伤老年患者130例共143处2期及以上压力性损伤,由压力性损伤专科护士根据压力性损伤创面情况来指导制定治疗方案,采用PUSH评价压力性损伤的动态变化并记录。结果本组患者压力性损伤总体好转率为41.96%,入院评估PUSH评分为(12.5±2.63)分,出院评估PUSH评分为(10.76±3.29)分,差异有统计学意义(P<0.01)。结论压力性损伤护理总体有效;PUSH评分工具能较为客观和动态地评价压力性损伤愈合过程,体现压力性损伤管理效果。
基金supported by Australian Research Council Australian Laureate Fellowship grant to ZXL (FL150100133)by China’s Thousand Talents Plan (2015)+2 种基金NSFC41674098 to NZsupported by resources provided by the High-performance Computing Platform of Peking Universitythe Pawsey Supercomputing Centre with funding from the Australian Government and the Government of Western Australia
文摘Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have been considered： the push by mantle plumes from the sub-continental mantle which is called the active force for breakup, and the dragging force from oceanic subduction retreat which is called the passive force for breakup. However, the relative importance of these two forces is unclear. Here we model the supercontinent breakup coupled with global mantle convection in order to address this question. Our global model features a spherical harmonic degree-2 structure, which includes a major subduction girdle and two large upwelling（superplume） systems. Based on this global mantle structure,we examine the distribution of extensional stress applied to the supercontinent by both subsupercontinent mantle upwellings and subduction retreat at the supercontinent peripheral. Our results show that：（1） at the center half of the supercontinent, plume push stress is ～3 times larger than the stress induced by subduction retreat;（2） an average hot anomaly of no higher than 50 K beneath the supercontinent can produce a push force strong enough to cause the initialization of supercontinent breakup;（3） the extensional stress induced by subduction retreat concentrates on a ～600 km wide zone on the boundary of the supercontinent, but has far less impact to the interior of the supercontinent. We therefore conclude that although circum-supercontinent subduction retreat assists supercontinent breakup, sub-supercontinent mantle upwelling is the essential force.
基金The work presented in this article is funded by the National Natural Science Foundation of China （51375012 and 51675478）, the Science and Technology Plan Project of Zhejiang Province （2017C31002）, and the Fundamental Research Funds for the Central Universities （2017FZA4003）.
文摘The development of technologies such as big data and cyber-physical systems （CPSs） has increased the demand for product design. Product digital design involves completing the product design process using advanced digital technologies such as geometry modeling, kinematic and dynamic simulation, multi- disciplinary coupling, virtual assembly, virtual reality （VR）, multi-objective optimization （MOO）, and human-computer interaction. The key technologies of intelligent design for customized products include： a description and analysis of customer requirements （CRs）, product family design （PFD） for the customer base, configuration and modular design for customized products, variant design for customized products, and a knowledge push for product intelligent design. The development trends in intelligent design for customized products include big-data-driven intelligent design technology for customized products and customized design tools and applications. The proposed method is verified by the design of precision computer numerical control （CNC） machine tools.
文摘Background In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push enteroscopy and capsule endoscopy are currently considered to be the most effective diagnostic procedures. The aim of this study was to compare the detection rates between capsule endoscopy and push enteroscopy. Methods From May 2002 through January 2003, we prospectively examined by capsule endoscopy 39 patients with suspected small bowel diseases, in particular GI bleeding of unknown origin in Renji Hospital. Among them, 32 complained of obscure recurrent GI bleeding. Between January 1993 and October 1996, we used push enteroscopy on 36 patients who suffered from unexplained GI bleeding. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy and/or angiography. Results M2A capsule endoscopy disclosed abnormal small bowel findings in 26 (82%) out of 32 patients. Twenty-one of them had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66% (21 of 32 patients). Definite bleeding sites diagnosed by capsule endoscopy in 21 patients included angiodysplasia (8), inflammatory small-bowel (5), small-bowel polyps (4), gastrointestinal stromal tumour (2), carcinoid tumour and lipoma (1), and hemorrhagic gastritis (1). Push enteroscopy detected the definite sources of bleeding in 9 (25%) of the 36 patients. Patients with definite bleeding sources included angiodysplasias (2), leiomyosarcoma (2), leiomyoma (1), lymphoma (1), Crohn’s disease (1), small-bowel polyps (1) and adenocarcinoma of ampulla (1). Suspected bleeding sources were shown by push enteroscopy in two additional patients (6%), and in other five patients (16%) by capsule endoscopy. Conclusions The present study of patients with obscure GI bleeding showed that capsule endoscopy significantly superior to push enteroscopy in detecting
