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个体化单侧椎弓根外入路与双侧椎弓根入路椎体成形后骨水泥的弥散效果被引量:1
2025年
背景:目前已有的临床研究认为,椎弓根外入路与椎弓根入路行椎体成形治疗均可改善脊柱压缩骨折患者的疼痛并改善其生活质量,相较于椎弓根入路相比,椎弓根外入路的穿刺角度更加自由,可通过调整穿刺外倾角获得良好的骨水泥弥散效果。目的:通过量化骨水泥弥散效果,对比个体化单侧椎弓根外入路与双侧椎弓根入路行椎体成形治疗脊柱压缩性骨折的效果。方法:纳入80例胸腰椎压缩骨折患者,采用随机数字表法分为2组,双侧椎弓根组(n=40)接受双侧椎弓根入路椎体成形手术,单侧椎弓根外组(n=40)接受个体化单侧椎弓根外入路椎体成形手术。术后3 d内拍摄患椎正侧位X射线片,评估骨水泥弥散效果、弥散类型。术前及术后1 d、7 d、1个月,评估患者目测类比评分、骨折周围压痛阈值、Oswestry功能障碍指数。结果与结论:①单侧椎弓根外组患者骨水泥弥散效果优于双侧椎弓根组(P<0.001),骨水泥灌注量多于双侧椎弓根组(P<0.001);双侧椎弓根入路组骨水泥弥散类型主要集中在Ⅰ型和Ⅲ型,单侧椎弓根外组骨水泥弥散类型主要集中在Ⅰ型和Ⅱ型,两组骨水泥弥散类型比较差异有显著性意义(P<0.001);②两组患者术后的目测类比评分、Oswestry功能障碍指数均低于术前(P<0.001),术后骨折周围压痛阈值呈现先降低后升高的趋势;治疗后相同时间点,两组间目测类比评分、Oswestry功能障碍指数、骨折周围压痛阈值比较差异均无显著性意义(P>0.05);③结果表明,个体化单侧椎弓根外入路椎体成形手术可获得更好的骨水泥弥散效果,并且治疗效果与经典双侧椎弓根入路椎体成形手术一致。
张立创杨雯丁广江李培坤肖忠宇陈营方雪张腾
关键词:脊柱压缩性骨折经皮椎体成形术
Chyle leak following root of mesentery dissection in pancreaticoduodenectomy with inferior infracolic superior mesenteric artery first approach
2025年
BACKGROUND The root of mesentery dissection is one of the critical maneuvers,especially in borderline resectable pancreatic head cancer.Intra-abdominal chyle leak(CL)including chylous ascites may ensue in up to 10%of patients after pancreatic resections.Globally recognized superior mesenteric artery(SMA)first approaches are invariably performed.The mesenteric dissection through the inferior infracolic approach has been discussed in this study emphasizing its post-operative impact on CL which is the cornerstone of this study.AIM To assess incidence,risk factors,clinical impact of CL following root of mesentery dissection,and the different treatment modalities.METHODS This is a retrospective study incorporating the patients who underwent dissection of the root of mesentery with inferior infracolic SMA first approach pancreat-oduodenectomy for the ventral body and uncinate mass of pancreas in the Department of Gastrointestinal and General Surgery of Kathmandu Medical College and Teaching Hospital from January 1,2021 to February 28,2024.Intraop-erative findings and postoperative outcomes were analyzed.RESULTS In three years,ten patients underwent root of mesentery dissection with inferior infracolic SMA first approach pancreatoduodenectomy.The mean age was 67.6 years with a male-to-female ratio of 4:5.CL was seen in four patients.With virtue of CL,Clavien-Dindo grade Ⅱ or higher morbidity was observed in four patients.Two patients had a hospital stay of more than 20 days with the former having a delayed gastric emptying and the latter with long-term total parenteral nutrition requirement.The mean operative time was 330 minutes.Curative resection was achieved in 100%of the patients.The mean duration of the intensive care unit and hospital stay were 2.55±1.45 days and 15.7±5.32 days,respectively.CONCLUSION Root of mesentery dissection with lymphadenectomy and vascular resection correlated with occurrence of CL.After complete curative resection,these were managed with total parenteral nutrition without adversely imp
Prabir MaharjanSujan RegmeeSpandan D AdhikariRabin PahariRoshan GhimireDhiresh K MaharjanSuman K ShresthaPrabin B Thapa
碳排放权交易制度的权利逻辑与规范进路
2025年
当下我国碳排放权交易制度体系正在经历着由政策引领向法治构建的转变。目前碳排放权交易制度行政立法中简单将“权利”与“配额”等同的做法,既无法体现碳排放权所兼具的公法、私法双重特征,也难以有效回应碳排放权交易市场的发展需求以及完善碳排放权交易制度的规范构建。为此,需要构建以碳排放权交易市场为语境、以碳排放“权利”为逻辑主线的碳排放权交易制度,夯实其法治基础并明确其规范进路。从语境与语义出发,“碳排放权”的表述本身就意味着其私法的权利属性。在碳排放权交易制度的理论逻辑层面,双阶理论可以为碳排放权交易制度中“配额”到“权利”的过渡提供理论支撑;在其实践逻辑层面,碳排放权交易制度需要借助“权利”的确立为其交易市场的展开提供法治的基础。最后,考虑到碳排放权权利属性共识不足、碳排放权交易制度结构尚待稳定、权利基础呈现多元特征以及权利来源并非稳固不变等因素,策略上可以考虑暂时搁置碳排放权权属争议,以权益为抓手、以“权益表现—适用规范领域—法律保护方式”为主线,分步骤、分阶段推进碳排放权交易制度的规范构建。
柯坚曹辰
关键词:碳排放权权益配额
基于模糊层次综合分析的残损状态纯木结构安全评估方法
2025年
现存古建筑大多带伤服役,体内残损状态复杂多样,且对古建筑进行的加固维修与原有残损对结构本体的安全性能影响截然相反。为实现对古建筑的预防性保护,需要量化古建筑纯木结构中的残损状态及修缮措施对其安全状态的影响。基于山西万荣飞云楼各构件残损状态普查统计数据,结合现有规范及工程经验对构件残损状态等级详细划分,建立4级模糊层次分析模型,确定结构体中承重构件及构件残损类型的权重值及判断矩阵,通过模糊层次分析方法对飞云楼进行安全状态评估。结果表明,建立的模糊层次安全评价模型能反映残损状态及修缮措施对飞云楼安全状态的影响,有效将结构评价与构件评价联系起来,验证了修缮措施能有效增强古建筑结构本体的安全性及稳定性,该模型及方法可以应用到多层古建木结构的安全等级评价中。
杨庆山赵剑波刘纲王娟
关键词:修缮加固安全评估
An Enhanced Lung Cancer Detection Approach Using Dual-Model Deep Learning Technique
2025年
Lung cancer continues to be a leading cause of cancer-related deaths worldwide,emphasizing the critical need for improved diagnostic techniques.Early detection of lung tumors significantly increases the chances of successful treatment and survival.However,current diagnostic methods often fail to detect tumors at an early stage or to accurately pinpoint their location within the lung tissue.Single-model deep learning technologies for lung cancer detection,while beneficial,cannot capture the full range of features present in medical imaging data,leading to incomplete or inaccurate detection.Furthermore,it may not be robust enough to handle the wide variability in medical images due to different imaging conditions,patient anatomy,and tumor characteristics.To overcome these disadvantages,dual-model or multi-model approaches can be employed.This research focuses on enhancing the detection of lung cancer by utilizing a combination of two learning models:a Convolutional Neural Network(CNN)for categorization and the You Only Look Once(YOLOv8)architecture for real-time identification and pinpointing of tumors.CNNs automatically learn to extract hierarchical features from raw image data,capturing patterns such as edges,textures,and complex structures that are crucial for identifying lung cancer.YOLOv8 incorporates multiscale feature extraction,enabling the detection of tumors of varying sizes and scales within a single image.This is particularly beneficial for identifying small or irregularly shaped tumors that may be challenging to detect.Furthermore,through the utilization of cutting-edge data augmentation methods,such as Deep Convolutional Generative Adversarial Networks(DCGAN),the suggested approach can handle the issue of limited data and boost the models’ability to learn from diverse and comprehensive datasets.The combined method not only improved accuracy and localization but also ensured efficient real-time processing,which is crucial for practical clinical applications.The CNN achieved an accuracy of 97.67%in cl
Sumaia Mohamed ElhassanSaad Mohamed DarwishSaleh Mesbah Elkaffas
关键词:CNN
Unraveling the mechanism of action of Shangxia Liangji formula for treating insomnia:a metabolomics and network pharmacology approach
2025年
Background:Insomnia is a prevalent clinical condition and Shangxia Liangji formula(SXLJF)is a well-established method of treatment.Nevertheless,the specific mechanism of action of SXLJF remains unclear.Methods:The mouse model of insomnia was established by intraperitoneal injection of para-chlorophenylalanine.Forty-two mice were randomly divided into a negative control group,model group,SXLJF group(18.72 g/kg/day),and positive control group(diazepam,2 mg/kg)and treated with the corresponding drugs for 7 consecutive days.The open field test and pentobarbital-induced sleeping test were conducted.LC-MS-based untargeted metabolomics and network pharmacology were applied to explore the potential targets of SXLJF for treating insomnia.Finally,key targets were validated using RT-qPCR.Results:Behavioral tests demonstrated that SXLJF reduced the total distance,average velocity,central distance,and sleep latency,and prolonged sleep duration.Metabolomics and network pharmacology revealed potential targets,signaling pathways,metabolic pathways,and metabolites associated with the anti-insomnia effects of SXLJF.Specifically,tyrosine hydroxylase(TH)and tyrosine metabolism emerged as crucial metabolic pathways and targets,respectively.RT-qPCR results supported the role of TH in the mechanism of SXLJF in treating insomnia.Conclusion:In conclusion,TH and tyrosine metabolism may represent significant targets and pathways for SXLJF in treating insomnia.
Xia-Jie QuanHao LiangYong-Hong TangLi JiangXiong-Ying JiFeng-Ying ZhangPing ZhangBo Ouyang
关键词:INSOMNIA
“生活·实践”教育理念推动课堂教学改革深度发生的逻辑理路与实践进路
2025年
新课改中课堂教学模式等技术操作层面所发生的争议,与指导改革的教育理念不匹配有一定关系。相比之下周洪宇教授提出的“生活·实践”教育学说,其基本理念、具体主张和实践过程在课堂教学上展现出了良好的应用前景,对缓解当下教育与生活、教学与实践脱节的问题提供了理论指导。文章在理论层面论述了“生活·实践”教育理念推动课堂教学改革深层次发生的逻辑进程,在实践层面探讨了具体方式推动的实践路径。
程永洲汪亮周业琳胡薇薇余锦烨
关键词:课堂教学改革逻辑理路实践进路
Mechanism of action of Linggui Zhugan Decoction in treating non-alcoholic fatty liver disease using untargeted metabolomics approach
2025年
Background:Non-alcoholic fatty liver disease(NAFLD)is a liver disorder characterized by the accumulation and degeneration of fat in the liver cells,a condition that may further deteriorate and lead to cirrhosis and liver cancer.Numerous studies showed that metabolic dysfunction can promote NAFLD development.Linggui Zhugan Decoction(LGZGD)has therapeutic effects on NAFLD.The mechanism of LGZGD still remains unclear.This study was to examine the impact of LGZGD on the metabolic processes involved in the development of NAFLD.Methods:A mice model of NAFLD was treated with LGZGD.The therapeutic potential of LGZGD was evaluated by assessing the activity of transaminases,lipids levels of blood,and pathological changes in the liver of the mice model of NAFLD.Additionally,this study also evaluated the influence of LGZGD on liver inflammation and oxidative stress.Results:The results of untargeted metabolomics analysis showed that LGZGD reduced the disordered lipid metabolism in NAFLD mice.LGZGD improved the oxidative stress and also reduced the levels of pro-inflammatory cytokines in the liver.Untargeted metabolomics analysis of liver samples revealed that LGZGD treatment improved metabolic disorders,including alanine,aspartate,glutamate,glycerophospholipid metabolism,and citrate cycle.Further RT-qPCR and Western blot results showed that LGZGD could regulate the expression of key enzymes in the metabolic pathway of the citrate cycle,including ATP-citrate lyase(ACLY),alanine-glyoxylate aminotransferase-2(AGXT2),phosphatidylethanolamine N-methyltransferase(PEMT),and succinate dehydrogenase(SDH).Conclusion:We found that LGZGD can treat NAFLD by reducing inflammatory responses,inhibiting oxidative stress,regulating alanine,aspartate,glutamate,and glycerophospholipid metabolism,and citrate cycle pathways.
Huan PeiRen-Lin LiXin-Ran SongQian-Qian WanYu-Ming WangHan-Zhou LiWei-Quan XuJia-Bao LiaoWei-Bo WenJing MiaoHuan-Tian Cui
关键词:NAFLD
经“O”点穿刺与传统单侧入路治疗L_(5)椎体骨质疏松性压缩性骨折
2025年
背景:单侧穿刺入路经皮穿刺球囊扩张椎体后凸成形治疗骨质疏松性椎体压缩骨折优于双侧穿刺入路,由于L_(5)特殊解剖形态和位置特殊,传统单侧穿刺入路治疗L_(5)椎体骨质疏松性椎体压缩骨折适用性差,因此提出“O”点穿刺入路来解决该问题。目的:比较经横突基底部-椎弓根后上部-关节突外侧交点(“O”点)入路与传统单侧入路经皮穿刺球囊扩张椎体后凸成形治疗L_(5)椎体骨质疏松性压缩骨折的疗效差异。方法:回顾性分析西南医科大学附属医院2020年1月至2022年12月收治的54例L_(5)椎体骨质疏松性压缩骨折行经“O”点入路或传统经皮穿刺球囊扩张椎体后凸成形治疗的患者,根据手术方式分为2组,“O”点入路组(A组)29例,传统入路组(B组)25例。术前在X射线正位片测量A组“O”点与髂棘位置及穿刺角度;比较两组术前与术后第2天、末次随访的局部Cobb角、椎体前缘、中部高度及骨水泥分布情况;术前、术后第2天及末次随访采用疼痛目测类比评分、Oswestry功能障碍指数评估患者疼痛缓解情况与日常生活能力,记录手术相关并发症。结果与结论:①A组手术时间、术中透视次数均少于B组,差异有显著性意义(P<0.05);两组术中出血量及骨水泥注射量差异无显著性意义;②两组患者术后第2天及末次随访疼痛目测类比评分、Oswestry功能障碍指数较术前明显降低,且A组降低比B组更明显(P<0.05);③“O”点位于双侧髂棘最高点连线之下平均距离1.23 cm;“O”点到髂棘平均横向距离2.89 cm;④两组患者末次随访Cobb角较术前明显改善(P<0.05),但两组间比较差异无显著性意义(P>0.05);⑤术后骨水泥分布,A组分布良好占97%(28/29),B组分布良好占88%(22/25),A组明显优于B组(P<0.05);⑥提示经“O”点穿刺入路与传统入路经皮穿刺球囊扩张椎体后凸成形治疗L_(5)椎体骨质疏松性压缩骨折疗效满意,但“O”点
徐雨果黄家虎王清徐双王松
关键词:骨质疏松性压缩骨折骨水泥
Global Piecewise Analysis of HIV Model with Bi-Infectious Categories under Ordinary Derivative and Non-Singular Operator with Neural Network Approach
2025年
This study directs the discussion of HIV disease with a novel kind of complex dynamical generalized and piecewise operator in the sense of classical and Atangana Baleanu(AB)derivatives having arbitrary order.The HIV infection model has a susceptible class,a recovered class,along with a case of infection divided into three sub-different levels or categories and the recovered class.The total time interval is converted into two,which are further investigated for ordinary and fractional order operators of the AB derivative,respectively.The proposed model is tested separately for unique solutions and existence on bi intervals.The numerical solution of the proposed model is treated by the piece-wise numerical iterative scheme of Newtons Polynomial.The proposed method is established for piece-wise derivatives under natural order and non-singular Mittag-Leffler Law.The cross-over or bending characteristics in the dynamical system of HIV are easily examined by the aspect of this research having a memory effect for controlling the said disease.This study uses the neural network(NN)technique to obtain a better set of weights with low residual errors,and the epochs number is considered 1000.The obtained figures represent the approximate solution and absolute error which are tested with NN to train the data accurately.
Ghaliah AlhamziBadr Saad TAlkahtaniRavi Shanker DubeyMati ur Rahman

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作品数:6被引量:2H指数:1
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作品数:47被引量:53H指数:4
供职机构:河北科技大学理学院
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