This review focuses on the pathophysiology of gastroesophageal reflux disease (GERD) and its implications for treatment. The role of the natural anti-reflux mechanism (lower esophageal sphincter, esophageal peristalsi...This review focuses on the pathophysiology of gastroesophageal reflux disease (GERD) and its implications for treatment. The role of the natural anti-reflux mechanism (lower esophageal sphincter, esophageal peristalsis, diaphragm, and trans-diaphragmatic pressure gradient), mucosal damage, type of refluxate, presence and size of hiatal hernia, Helicobacter pylori infection, and Barrett’s esophagus are reviewed. The conclusions drawn from this review are: (1) the pathophysiology of GERD is multifactorial; (2) because of the pathophysiology of the disease, surgical therapy for GERD is the most appropriate treatment; and (3) the genesis of esophageal adenocarcinoma is associated with GERD.展开更多
As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was...As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was around 25%in the 1990s,has been increasing year by year in recent years and has exceeded 35%in the past few years(1).The spectrum of disease includes nonalcoholic fatty liver(NAFL),characterized by macrovesicular hepatic steatosis that may be accompanied by mild inflammation,and nonalcoholic steatohepatitis(NASH),which is additionally characterized by the presence of inflammation and cellular injury(2).展开更多
In this paper, the performance of a waste rock transportation process in an open pit mine was assessed by using cycle time data. A computerized truck-excavator dispatch system was used to record the cycle times. The p...In this paper, the performance of a waste rock transportation process in an open pit mine was assessed by using cycle time data. A computerized truck-excavator dispatch system was used to record the cycle times. The process was broken into seven steps (or components of the total cycle), durations of which were recorded for a period of 1 month, leading to N = 60,690 data points or dispatches. The open pit mine studied consisted of 12 waste types loaded by 14 excavators and hauled by 49 trucks (at a trucks-to-excavator ratio of 3.5:1) in 75 changing locations. The string-type data was coded using integers to allow a FORTRAN code to extract process performance parameters using statistical analysis. The study established a wide range of parameters including: the waste material generation rate (about 1.73 million t/month, 81% comprising waste rock), truck fill factor, f, total cycle time (Tct), production capacity, theoretical cycle time, non-productive cycle time Tnp, and cycle time performance ratio (CTPR), denoted as Tpr. The factors affecting the process performance include: truck model, excavator model, location (haul distance and road conditions) and material type. For a fixed material type and tonnage, the PDFs of the cycle time components were logarithmic in nature, capable of differentiating performance variations under different factors. It was concluded that the performance of the waste material transportation system in this mine was determined to be acceptable due to mean value of Tpr = 2.432 being closer to unity. Reduction measures were suggested to minimize the cycle time for the process bottlenecks determined from Pareto analysis (that is, full haul, empty haul and loading processes).展开更多
AIM:To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH(MII-pH)is linked to gastroparesis(GP).METHODS:A case control study was c...AIM:To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH(MII-pH)is linked to gastroparesis(GP).METHODS:A case control study was conducted in which 42 patients undergoing clinical evaluation for continued symptoms of gastroesophageal reflux disease(both typical and atypical symptoms)despite acid suppression therapy.MII-pH technology was used over 24 h to detect reflux episodes and record patients’symptoms.Parameters evaluated in patients with documented GP and controls without GP by scintigraphy included total,upright,and supine number of acid and non-acid reflux episodes(pH<4 and pH>4,respectively),the duration of acid and non-acid reflux in a 24-h period,and the number of reflux episodes lasting longer than 5 min.RESULTS:No statistical difference was seen between the patients with GP and controls with respect to the total number or duration of acid reflux events,total number and duration of non-acid reflux events or the duration of longest reflux episodes.The number of nonacid reflux episodes with a pH>7 was higher in subjects with GP than in controls.In addition,acid reflux episodes were more prolonged(lasting longer than 5min)in the GP patients than in controls;however,these values did not reach statistical significance.Thirty-five patients had recorded symptoms during the 24 h study and of the 35 subjects,only 9%(n=3)had a positive symptom association probability(SAP)for acid/non-acid reflux and 91%had a negative SAP.CONCLUSION:The evaluation of patients with a documented history of GP did not show an association between GP and more frequent episodes of non-acid reflux based on MII-pH testing.展开更多
This study presents the effect of excavator model, loading operation location, shift availability and truck-shovel combination on loading cycle time and productivity of an open-pit mine. The loading cycle time was use...This study presents the effect of excavator model, loading operation location, shift availability and truck-shovel combination on loading cycle time and productivity of an open-pit mine. The loading cycle time was used to assess the material loading system performance which is one of the key components of the total cycle time for material transportation in an open-pit mine. Loading is among the components of cycle time during which material is being handled. The data analyzed?was?collected from a computerized dispatch system at GGM from which 62,000 loading dispatches per month involving several shifts, 14 excavators and 49 trucks were loaded. About 4465 dispatches per excavator and 1276 dispatches per truck were assessed using loading cycle time data for each dispatch for a period of four months (between August and December). Under fixed tonnage loaded and waste type (33 t of non-acid forming waste rock),?it was observed that loading cycle time depends on excavator model, location and truck being loaded. Average cycle times, PDFS?and CDFS of loading cycle time series were used to identify differences in performance under different situations. It was concluded that shift availability for excavators, loading location, excavator model and truck-shovel combinations strongly affect the productivity during loading process in an open-pit mine.展开更多
目的分析不同亚型难治性胃食管反流病(rGERD)患者的心理状态。方法选择2017年1月至2019年10月在安徽医科大学附属省立医院消化内科门诊就诊的182例rGERD患者,均行24 h pH-阻抗监测,根据临床表现与病理学检查结果分为反流性食管炎组(RE组...目的分析不同亚型难治性胃食管反流病(rGERD)患者的心理状态。方法选择2017年1月至2019年10月在安徽医科大学附属省立医院消化内科门诊就诊的182例rGERD患者,均行24 h pH-阻抗监测,根据临床表现与病理学检查结果分为反流性食管炎组(RE组,n=54)、非糜烂性反流病组(NERD组,n=108)和Barrett食管组(BE组,n=20),利用汉密尔顿焦虑量表(HAMA)与汉密尔顿抑郁量表(HAMD)评估患者的心理状态,应用GERD专用生活质量(GERD-HRQL)量表对3组患者的生活质量进行评价。结果 3组患者HAMA、HAMD评分的差异有统计学意义(P<0.05),且NERD组患者HAMA和HAMD评分高于RE组,差异有统计学意义(P<0.05)。NERD组患者弱酸反流发生率高于RE组、BE组,差异均有统计学意义(P<0.0167)。结论 NERD患者比RE、BE患者更易发生弱酸反流,更易出现焦虑、抑郁症状,可能是rGERD的发病机制之一。展开更多
[目的]分析不同反流类型的难治性胃食管反流病(rGERD)患者情绪障碍特点。[方法]入选rGERD患者182例,所有患者行食管高分辨率测压以及24 h pH-阻抗监测检查,将其分为酸反流(AR)组106例、弱酸反流(WAR)组61例和非酸反流(NAR)组15例。并对...[目的]分析不同反流类型的难治性胃食管反流病(rGERD)患者情绪障碍特点。[方法]入选rGERD患者182例,所有患者行食管高分辨率测压以及24 h pH-阻抗监测检查,将其分为酸反流(AR)组106例、弱酸反流(WAR)组61例和非酸反流(NAR)组15例。并对各组患者进行HAMA、HAMD和GERD-HRQL量表评分。[结果](1)各组患者的性别、年龄、体质指数及GERD-HQRL比较均差异无统计学意义(P>0.05),但3组间病程比较差异有统计学意义(H=7.002,P=0.03),WAR组患者病程较短;(2)WAR组患者焦虑发生率与AR组和NAR组比较,均差异有统计学意义(χ^(2)=11.913,P=0.001;χ^(2)=12.270,P=0.005);(3)AR组与NAR组患者焦虑发生率比较差异无统计学意义(χ^(2)=0.272,P=0.602),而2组抑郁发生率比较差异有统计学意义(χ^(2)=6.121,P=0.013)。[结论]弱酸反流患者发生焦虑的可能性更大,病程相对较短;弱酸/非酸反流都可能是rGERD的发病机制,且易合并焦虑、抑郁。展开更多
云南某低品位黏土型锂矿石含锂0.147%,为探究低能耗、环保的开发利用工艺,采用新型焙烧助剂ASH开展了低温焙烧—无酸浸出的提锂工艺研究,并结合XRD、SEM-EDS等分析手段阐述了反应机理。试验结果表明,在试样与ASH质量比为1∶0.3、焙烧温...云南某低品位黏土型锂矿石含锂0.147%,为探究低能耗、环保的开发利用工艺,采用新型焙烧助剂ASH开展了低温焙烧—无酸浸出的提锂工艺研究,并结合XRD、SEM-EDS等分析手段阐述了反应机理。试验结果表明,在试样与ASH质量比为1∶0.3、焙烧温度为400℃、焙烧时间为1.0 h,去离子水浸出时间为2 h、浸出温度为70℃、液固比为5 m L/g条件下,锂浸出率为83.81%。机理分析显示,焙烧—浸出前后,样品中主要矿物相未发生变化,但衍射峰强度降低;经焙烧—浸出后,浸渣表面均匀分布着裂纹和空隙,Al、Si、Fe、Ti含量均有所降低。说明ASH与矿物发生反应,破坏了矿物的表面结构,生成了可溶性盐Li-ASH。与传统焙烧—浸出工艺相比,本研究所采用的提锂工艺焙烧温度低、浸出时无酸,降低了生产能耗、简化了工艺流程,对同类型低品位黏土型锂矿的绿色高效开发利用具有重要借鉴意义。展开更多
文摘This review focuses on the pathophysiology of gastroesophageal reflux disease (GERD) and its implications for treatment. The role of the natural anti-reflux mechanism (lower esophageal sphincter, esophageal peristalsis, diaphragm, and trans-diaphragmatic pressure gradient), mucosal damage, type of refluxate, presence and size of hiatal hernia, Helicobacter pylori infection, and Barrett’s esophagus are reviewed. The conclusions drawn from this review are: (1) the pathophysiology of GERD is multifactorial; (2) because of the pathophysiology of the disease, surgical therapy for GERD is the most appropriate treatment; and (3) the genesis of esophageal adenocarcinoma is associated with GERD.
文摘As obesity continues to escalate worldwide,nonalcoholic fatty liver disease(NAFLD)has emerged as the most prevalent form of liver disease,with a reported global prevalence of 30.1%(1).The prevalence of NAFLD,which was around 25%in the 1990s,has been increasing year by year in recent years and has exceeded 35%in the past few years(1).The spectrum of disease includes nonalcoholic fatty liver(NAFL),characterized by macrovesicular hepatic steatosis that may be accompanied by mild inflammation,and nonalcoholic steatohepatitis(NASH),which is additionally characterized by the presence of inflammation and cellular injury(2).
文摘In this paper, the performance of a waste rock transportation process in an open pit mine was assessed by using cycle time data. A computerized truck-excavator dispatch system was used to record the cycle times. The process was broken into seven steps (or components of the total cycle), durations of which were recorded for a period of 1 month, leading to N = 60,690 data points or dispatches. The open pit mine studied consisted of 12 waste types loaded by 14 excavators and hauled by 49 trucks (at a trucks-to-excavator ratio of 3.5:1) in 75 changing locations. The string-type data was coded using integers to allow a FORTRAN code to extract process performance parameters using statistical analysis. The study established a wide range of parameters including: the waste material generation rate (about 1.73 million t/month, 81% comprising waste rock), truck fill factor, f, total cycle time (Tct), production capacity, theoretical cycle time, non-productive cycle time Tnp, and cycle time performance ratio (CTPR), denoted as Tpr. The factors affecting the process performance include: truck model, excavator model, location (haul distance and road conditions) and material type. For a fixed material type and tonnage, the PDFs of the cycle time components were logarithmic in nature, capable of differentiating performance variations under different factors. It was concluded that the performance of the waste material transportation system in this mine was determined to be acceptable due to mean value of Tpr = 2.432 being closer to unity. Reduction measures were suggested to minimize the cycle time for the process bottlenecks determined from Pareto analysis (that is, full haul, empty haul and loading processes).
文摘AIM:To determine whether an increased number and duration of non-acid reflux events as measured using the multichannel intraluminal impedance pH(MII-pH)is linked to gastroparesis(GP).METHODS:A case control study was conducted in which 42 patients undergoing clinical evaluation for continued symptoms of gastroesophageal reflux disease(both typical and atypical symptoms)despite acid suppression therapy.MII-pH technology was used over 24 h to detect reflux episodes and record patients’symptoms.Parameters evaluated in patients with documented GP and controls without GP by scintigraphy included total,upright,and supine number of acid and non-acid reflux episodes(pH<4 and pH>4,respectively),the duration of acid and non-acid reflux in a 24-h period,and the number of reflux episodes lasting longer than 5 min.RESULTS:No statistical difference was seen between the patients with GP and controls with respect to the total number or duration of acid reflux events,total number and duration of non-acid reflux events or the duration of longest reflux episodes.The number of nonacid reflux episodes with a pH>7 was higher in subjects with GP than in controls.In addition,acid reflux episodes were more prolonged(lasting longer than 5min)in the GP patients than in controls;however,these values did not reach statistical significance.Thirty-five patients had recorded symptoms during the 24 h study and of the 35 subjects,only 9%(n=3)had a positive symptom association probability(SAP)for acid/non-acid reflux and 91%had a negative SAP.CONCLUSION:The evaluation of patients with a documented history of GP did not show an association between GP and more frequent episodes of non-acid reflux based on MII-pH testing.
文摘This study presents the effect of excavator model, loading operation location, shift availability and truck-shovel combination on loading cycle time and productivity of an open-pit mine. The loading cycle time was used to assess the material loading system performance which is one of the key components of the total cycle time for material transportation in an open-pit mine. Loading is among the components of cycle time during which material is being handled. The data analyzed?was?collected from a computerized dispatch system at GGM from which 62,000 loading dispatches per month involving several shifts, 14 excavators and 49 trucks were loaded. About 4465 dispatches per excavator and 1276 dispatches per truck were assessed using loading cycle time data for each dispatch for a period of four months (between August and December). Under fixed tonnage loaded and waste type (33 t of non-acid forming waste rock),?it was observed that loading cycle time depends on excavator model, location and truck being loaded. Average cycle times, PDFS?and CDFS of loading cycle time series were used to identify differences in performance under different situations. It was concluded that shift availability for excavators, loading location, excavator model and truck-shovel combinations strongly affect the productivity during loading process in an open-pit mine.
文摘目的分析不同亚型难治性胃食管反流病(rGERD)患者的心理状态。方法选择2017年1月至2019年10月在安徽医科大学附属省立医院消化内科门诊就诊的182例rGERD患者,均行24 h pH-阻抗监测,根据临床表现与病理学检查结果分为反流性食管炎组(RE组,n=54)、非糜烂性反流病组(NERD组,n=108)和Barrett食管组(BE组,n=20),利用汉密尔顿焦虑量表(HAMA)与汉密尔顿抑郁量表(HAMD)评估患者的心理状态,应用GERD专用生活质量(GERD-HRQL)量表对3组患者的生活质量进行评价。结果 3组患者HAMA、HAMD评分的差异有统计学意义(P<0.05),且NERD组患者HAMA和HAMD评分高于RE组,差异有统计学意义(P<0.05)。NERD组患者弱酸反流发生率高于RE组、BE组,差异均有统计学意义(P<0.0167)。结论 NERD患者比RE、BE患者更易发生弱酸反流,更易出现焦虑、抑郁症状,可能是rGERD的发病机制之一。
文摘[目的]分析不同反流类型的难治性胃食管反流病(rGERD)患者情绪障碍特点。[方法]入选rGERD患者182例,所有患者行食管高分辨率测压以及24 h pH-阻抗监测检查,将其分为酸反流(AR)组106例、弱酸反流(WAR)组61例和非酸反流(NAR)组15例。并对各组患者进行HAMA、HAMD和GERD-HRQL量表评分。[结果](1)各组患者的性别、年龄、体质指数及GERD-HQRL比较均差异无统计学意义(P>0.05),但3组间病程比较差异有统计学意义(H=7.002,P=0.03),WAR组患者病程较短;(2)WAR组患者焦虑发生率与AR组和NAR组比较,均差异有统计学意义(χ^(2)=11.913,P=0.001;χ^(2)=12.270,P=0.005);(3)AR组与NAR组患者焦虑发生率比较差异无统计学意义(χ^(2)=0.272,P=0.602),而2组抑郁发生率比较差异有统计学意义(χ^(2)=6.121,P=0.013)。[结论]弱酸反流患者发生焦虑的可能性更大,病程相对较短;弱酸/非酸反流都可能是rGERD的发病机制,且易合并焦虑、抑郁。
文摘云南某低品位黏土型锂矿石含锂0.147%,为探究低能耗、环保的开发利用工艺,采用新型焙烧助剂ASH开展了低温焙烧—无酸浸出的提锂工艺研究,并结合XRD、SEM-EDS等分析手段阐述了反应机理。试验结果表明,在试样与ASH质量比为1∶0.3、焙烧温度为400℃、焙烧时间为1.0 h,去离子水浸出时间为2 h、浸出温度为70℃、液固比为5 m L/g条件下,锂浸出率为83.81%。机理分析显示,焙烧—浸出前后,样品中主要矿物相未发生变化,但衍射峰强度降低;经焙烧—浸出后,浸渣表面均匀分布着裂纹和空隙,Al、Si、Fe、Ti含量均有所降低。说明ASH与矿物发生反应,破坏了矿物的表面结构,生成了可溶性盐Li-ASH。与传统焙烧—浸出工艺相比,本研究所采用的提锂工艺焙烧温度低、浸出时无酸,降低了生产能耗、简化了工艺流程,对同类型低品位黏土型锂矿的绿色高效开发利用具有重要借鉴意义。
