简介:Thepatient,achildsurnamedXie,male,was2yearsoldwithHartnationality,hisadmissionNo.is2001426.At10:00am,June,8th,2000,afteraccidentallytakingonemouthfuloflong-actingphosphorus(about5ml),hebecamecomatosewithfoamatthemouth.Afterfindingthissituation,hisparentssenthimtotheclinicoftheirtmit.Emeticeliminationoftoxicantwasgivenbutfailedthere.Thenat11:00thesameday,hewassenttoourhospitalforemergencytreatment.Physicalexaminationon
简介:Shuigou(GV26)isalsocalledRenzhong,locatinginthephiltrum,thejunctionofthesuperior1/3andthemiddle1/3.Itisoftenappliedtotreattheacutediseasesandsymptoms.Withregardtoacutelumbarsprainandacuterigidneck,Shuigou(GV26)functionstorelaxthemusclesandtendonsandbenefitthespinalcolumn.ItissaidinOdeoftheEssentialsofUnerstanding(TongXuanZhiYaoFu):'Shuigou(GV26)relievesthestiffnessandpainofthespinalcolumnanderectormuscleofspine.'ItissaidinSongsoftheJadeDragon(YuLongFu):'Forstiffnessandpainofspineandback,
简介:Withthedevelopmentofmetropolitanregionsandtheappearanceofurbanagglomerations,citieshavebeenmorecloselyrelated.Fortherestrictedemergencyrescueresourceinasinglecity,ithasbecomemoreandmoreimminentforthedemandoftheintercitycollaborativeresistancetomajoraccident,soastoimprovetheprotectioncapacityofurbansecurity.Inordertofindaneffectiveintercityemergencyrescuecollaborativesystem,thispaperintroducestheconceptandanalysismethodofecosystemtheoryintointercityemergencyrescue.Basedontheanalysisoftheformation-processofemergencyrescueindividual,populationandcommunity,athree-levelintercityemergencyrescuecollaborativesystemisconstructedaccordingtothecharacteristicsofdynamicsandstructureofintercityemergencyrescueecosystem,thenthecollaborationmechanismofinformation,resourceandprocessintheintercityemergencyrescueecosystemisalsostudiedinthispaper,soastoofferavailablestrategyandmethodfortheecosystemtheoryappliedtointercityemergencyrescue.Throughthestudiesofintercityemergencyrescueeco-system,itilluminatesthattheproposedemergencysystemcannotonlycopewiththemajoraccidentmoretimelyandeffectively,butalsointegratetheintercityinformationresourcesandemergencyrescueresourceandprocessoptimization.
简介:Inordertoformanemergencycontrolpolicytablequickly,thispaperproposesafastalgorithmofemergencycontrolnamed'micro-stepdiscretemethod',whichisbasedonthephysicalmeaningofthegradientandthediscretecharacteristicsofemergencycontrol.Thenitisimprovedthroughthestabilitycriterion,integralstep,andmicro-stepfactor.Thispapertakesgenerator-sheddingastheemergencycontrolmeasures.Astheoptimalgenerator-sheddingcontrolisessentiallyanoptimalcontrolproblemandthegenerator-sheddingvariablesarealwaysconstant,itisconvenienttousethecontrolparameteralgorithmtosolvetheproblem,whichcancalculatethegradientofthetransientstabilityfunctiontocontrolvariables.
简介:Basedonthesystemdynamics(SD)model,thispaperputsforwardaquantitativemethodtoevaluatetheearthquakeemergencyplaninChina.Firstly,weanalyzethedisastersystemstructureandthecontentofplan.Usingtheanalysisresults,weestablishasystemdynamics(SD)modelandthencarryoutitssimulation.Accordingtothesimulationresults,therescueeffectusingtheplanof2012isbetterthanthatof2006.Fromthepolicylevel,inordertoreduceloss,governmentshouldmaintaincommunicationsmoothly,improvetheabilityofselfandmutualhelp,strengthenthemanagementofpublicopinion,andpaymoreattentiontosecondarydisasters.
简介:ObjectiveTofurtherimprovetherateofreperfusionofinfarctionrelatedarteryinAMI,removethestricture,rescueischemicmyocardium,protectcardiacfunctionandamelioratethelong-termprognosis.MethodAmong73patientswithA-MI,50underwentdirectPICA,15immediatePICA,8rescuePTCAand20braceswereimplanted.ResultTheproportionofrecanalizationis94.5%(69/73).Thegradeofbloodflow(TIMI)improvedtograde3in20patientswithbraceimplantation,while44tograde3and5tograde2among49patientswithsimplePTCA.Residualstenosisinvesselwas1.8±5.9(-10-10)%inpatientswithbraceimplantationversus15.4±11.(0-30)%withsimplePTCA.Theincidenceofreperfusivecardiacarrythmiawas18.1%(10/62).Therewasmainlyfrequentventricularprematurebeatandshortparoxysmalventriculartachycardia,ifleftanteriordecendingbranchwasreopened,whilebradycardiaandatrialventricularblockusuallyoccurredafterrightcoronaryreperfused.ConclusionEmergencyP
简介:Whenanemergencyhappens,theschedulingofreliefresourcestomultipleemergencylocationsisarealisticandintricateproblem,especiallywhentheavailableresourcesarelimited.Anon-cooperativegamesmodelandanalgorithmforschedulingofreliefresourcesarepresented.Inthemodel,theplayerscorrespondtothemultipleemergencylocations,strategiescorrespondtoallresourcesschedulingandthepayoffofeachemergencylocationcorrespondstothereciprocalofitsschedulingcost.Thus,the...
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简介:AbstractInterleukins (ILs) and associated cytokines serve as the means of communication for immune cells and non-immune cells. The use of ILs in harnessing the immune system to cancer treatment has been a promising approach. ILs not only nurture an environment enabling cancer growth but also simultaneously trigger a productive tumor-directed immune response. These properties of ILs are increasingly being explored as a strategy to improve the outcomes of cancer. Here, we describe recently innovative technological approaches that have been developed to improve the pharmacokinetics, safety, and efficacies of IL-2, 15, 10, and 18 in the treatment of melanoma. Furthermore, the combination of ILs and immune checkpoint inhibition may synergize to reshape the tumor environment, thus yielding better clinical benefits in the future.
简介:AbstractBlunt traumatic tracheobronchial injury is rare, but can be potentially life-threatening. It accounts for only 0.5%-2% of all trauma cases. Patients may present with non-specific signs and symptoms, requiring a high index of suspicion with accurate diagnosis and prompt treatment. A 26-year-old female was brought into the emergency department after sustained a blunt trauma to the chest from a high impact motor vehicle accident. She presented with signs of respiratory distress and extensive subcutaneous emphysema from the chest up to the neck. Her airway was secured and chest drain was inserted for right sided pneumothorax. CT of the neck and thorax revealed a collapsed right middle lung lobe with a massive pneumothorax, raising the suspicion of a right middle lobe bronchus injury. Diagnosis was confirmed by bronchoscopy. In view of the difficulty in maintaining her ventilation and persistent pneumothorax with a massive air leak, immediate right thoracotomy via posterolateral approach was performed. The right middle lobar bronchus tear was repaired. There were no intra- or post-operative complications. She made an uneventful recovery. She was asymptomatic at her first month follow-up. A repeated chest X-ray showed expanded lungs. Details of the case including clinical presentation, imaging and management were discussed with an emphasis on the early uses of bronchoscopy in case of suspected blunt traumatic tracheobronchial injury. A review of the current literature of tracheobronchial injury management was presented.
简介:AbstractBackground:Existing clinical prediction models for in vitro fertilization are based on the fresh oocyte cycle, and there is no prediction model to evaluate the probability of successful thawing of cryopreserved mature oocytes. This research aims to identify and study the characteristics of pre-oocyte-retrieval patients that can affect the pregnancy outcomes of emergency oocyte freeze-thaw cycles.Methods:Data were collected from the Reproductive Center, Peking University Third Hospital of China. Multivariable logistic regression model was used to derive the nomogram. Nomogram model performance was assessed by examining the discrimination and calibration in the development and validation cohorts. Discriminatory ability was assessed using the area under the receiver operating characteristic curve (AUC), and calibration was assessed using the Hosmer-Lemeshow goodness-of-fit test and calibration plots.Results:The predictors in the model of "no transferable embryo cycles" are female age (odds ratio [OR] = 1.099, 95% confidence interval [CI] = 1.003-1.205, P = 0.0440), duration of infertility (OR = 1.140, 95% CI = 1.018-1.276, P = 0.0240), basal follicle-stimulating hormone (FSH) level (OR = 1.205, 95% CI = 1.051-1.382, P = 0.0084), basal estradiol (E2) level (OR = 1.006, 95% CI = 1.001-1.010, P = 0.0120), and sperm from microdissection testicular sperm extraction (MESA) (OR = 7.741, 95% CI = 2.905-20.632, P < 0.0010). Upon assessing predictive ability, the AUC for the "no transferable embryo cycles" model was 0.799 (95% CI: 0.722-0.875, P < 0.0010). The Hosmer-Lemeshow test (P = 0.7210) and calibration curve showed good calibration for the prediction of no transferable embryo cycles. The predictors in the cumulative live birth were the number of follicles on the day of human chorionic gonadotropin (hCG) administration (OR = 1.088, 95% CI = 1.030-1.149, P = 0.0020) and endometriosis (OR = 0.172, 95% CI = 0.035-0.853, P = 0.0310). The AUC for the "cumulative live birth" model was 0.724 (95% CI: 0.647-0.801, P < 0.0010). The Hosmer-Lemeshow test (P = 0.5620) and calibration curve showed good calibration for the prediction of cumulative live birth.Conclusions:The predictors in the final multivariate logistic regression models found to be significantly associated with poor pregnancy outcomes were increasing female age, duration of infertility, high basal FSH and E2 level, endometriosis, sperm from MESA, and low number of follicles with a diameter >10 mm on the day of hCG administration.