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持续低剂量肝素和低分子肝素抗凝治疗对急性呼吸窘迫综合征患者预后的荟萃分析

中华危重病急救医学 2020年第12期32卷 1479-1486页

作者：郑兴昊沈锋李想杨贵霞程玉梅何天慧李书文秦进成李清李伟贵州医科大学附属医院重症医学科贵阳550004

目的通过系统分析方法评价持续低剂量肝素及低分子肝素抗凝治疗对急性呼吸窘迫综合征(ARDS)患者的疗效及安全性。方法检索万方数据库、维普数据库、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)、美国国立医学图书馆数据库(PubM... 详细信息

目的通过系统分析方法评价持续低剂量肝素及低分子肝素抗凝治疗对急性呼吸窘迫综合征(ARDS)患者的疗效及安全性。方法检索万方数据库、维普数据库、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)、美国国立医学图书馆数据库(PubMed)、荷兰医学文摘数据库(Embase)、Cochrane图书馆数据库等中英文数据库中1999年7月至2020年6月发表的有关肝素或低分子肝素治疗ARDS的临床随机对照试验(RCT)。对照组给予常规治疗,试验组在常规治疗基础上加用肝素5~10 U·kg^(-1)·h^(-1)或低分子肝素皮下注射2500~5000 U,每12 h 1次,疗程均为7 d;主要结局指标为28 d病死率、治疗7 d后动脉血氧饱和度(SaO2)及急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、重症监护病房(ICU)住院时间及机械通气时间;次要结局指标为治疗7 d后C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、肺损伤评分、呼吸频率、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)等指标。由2名研究者收集数据,依据Cochrane 5.1手册评价文献质量,采用RevMan 5.3软件进行Meta分析;Meta分析结果的稳定性用敏感性分析方法检验,同时通过漏斗图分析SaO2的发表偏倚。结果最终纳入14篇中文文献,共涉及894例患者,其中试验组454例,对照组440例。Meta分析结果显示,与对照组相比,试验组28 d病死率明显降低〔相对危险度(RR)=0.54,95%可信区间(95%CI)为0.38~0.76,P=0.0004〕,治疗7 d SaO2均显著升高〔肝素:均数差(MD)=48.27,95%CI为29.95~66.59,P<0.00001;低分子肝素:MD=56.67,95%CI为41.22~71.13,P<0.00001〕;与对照组相比,治疗7 d后试验组APACHEⅡ评分(MD=-4.28,95%CI为-5.15^-3.42,P<0.00001)、肺损伤评分(MD=-1.19,95%CI为-1.35^-1.03,P<0.00001)及呼吸频率(MD=-4.76,95%CI为-6.26^-3.26,P<0.00001)均明显降低,试验组患者ICU住院时间(MD=-4.85,95%CI为-6.94^-2.76,P<0.00001)、机械通气时间(MD=-2.93,95%CI为-3.34^-2.52,P<0.00001)亦均明显低于对照组;治疗7 d后试验组IL-6(MD=-38.50,95%CI为-59.01^-17.99,P<0.00001)、TNF-α(MD=-16.24,95%CI为-31.11^-1.38,P<0.00001)及CRP(MD=-5.5,95%CI为-6.47^-4.27,P<0.00001)亦显著降低。但两组治疗7 d后APTT(MD=-0.55,95%CI为-1.61~0.51,P=0.27)及治疗7 d PT(MD=-0.41,95%CI为-1.48~0.66,P=0.45)比较差异均无统计学意义。对异质性较高的指标通过排除任意一项研究再次进行Meta分析,其总体效应值未发生明显改变,提示结果比较稳健。对纳入文献数量超过10篇的指标进行漏斗图分析,结果显示文献存在发表偏倚,但偏倚较小。结论持续性低剂量肝素和低分子肝素抗凝治疗可改善ARDS患者预后,降低病死率。

关键词：急性肺损伤急性呼吸窘迫综合征抗凝治疗肝素低分子肝素预后

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A Neoarchean subduction recorded by the Eastern Hebei Precambrian basement, North China Craton: Geochemical fingerprints from metavolcanic rocks of the Saheqiao-Shangying-Qinglong supracrustal belt

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JOURNAL OF ASIAN EARTH SCIENCES 2017年 135卷 347-369页

作者： Guo, Rongrong Liu, shuwen Bai, xiang Wang, Wei Northeastern Univ Sch Resources & Civil Engn Dept Geol Key LabMinist Educ Safe Min Deep Met Mines Shenyang 110819 Peoples R China Peking Univ Sch Earth & Space Sci Key Lab Orogen Belts & Crustal Evolut Minist Educ Beijing 100871 Peoples R China China Earthquake Adm Inst Geol Beijing 100029 Peoples R China China Univ Geosci Sch Earth Sci & Resources State Key Lab Geol Proc & Mineral Resources Beijing 100083 Peoples R China

The Sahegiao-Shangying-Qinglong supracrustal belt (SSQB) in the northern Eastern Hebei Precambrian basement (EHPB) is located in the northern margin of the Eastern Block (EB) of the North China Craton (NCC). The Shangying terrane constitutes the middle segment of the SSQB and contains primarily metamorphic volcanics and plutonic tonalitic gneisses. The metamorphic volcanics mainly consist of pyroxene plagioclase amphibolites, garnet plagioclase amphibolites, biotite plagioclase amphibole gneisses, and amphibole plagioclase gneisses. Zircon U-Pb-Lu-Hf isotopic analyses reveal that the metavolcanic rocks from the Shangying terrane crystallized at 2506-2613 Ma with TOM (Hf) values of 2541-2944 Ma. These metamorphic volcanic rocks are subdivided into four groups based on their lithological and chemical features. Group I consists chiefly of tholeiites that are characterized by slightly light rare earth element (LREE) depleted patterns and flat multi-element spider diagrams, which are similar to back-arc basin basalt (BABB)-like rocks and were derived from the partial melting of the depleted mantle. The tholeiites in Group II have slightly fractionated rare earth element (REE) patterns without Nb anomalies, exhibit an affinity to Nb-enriched basalt (NEB)-like rocks, and were produced by the partial melting of HFSE-enriched mantle peridotites. Group III is composed of slightly LREE-enriched tholeiites with negative Nb-Ta anomalies that resemble island arc tholeiites. Group IV comprises calc-alkaline basalts and andesites with highly enriched LREEs and evident Nb, Ta and Ti depletions that are geochemically similar to the products of island arcs. The island arc tholeiites and calc-alkaline basalt-Andesites originated from the partial melting of sub-arc mantle peridotites that were previously metascimatized by slab-derived fluids melts with the fractional crystallization of ferromagnesian minerals. Collectively, the BABB-like rocks, the NEBs, arc tholeiites and calc-alkaline

关键词： Geochemistry of metamorphosed volcanic rocks Zircon U-Pb-Lu-Hf isotopes Neoarchean subduction Saheqiao-Shangying-Qinglong supracrustal belt North China Craton

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冷镦钢M6平头螺丝成型过程热-力耦合数值模拟研究

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材料导报 2020年第S02期34卷 399-406页

作者：樊卓志张书彦温树文向明林晏民张志明钟寿军王青松东莞材料基因高等理工研究院东莞523808 宝武集团广东韶关钢铁有限公司韶关512123 春雨(东莞)五金制品有限公司东莞523795

采用有限元方法建立SWRCH15A冷镦钢M6平头螺丝成型过程的热力耦合数值计算模型,并对SWRCH15A冷镦钢从拔制(第三道冷拔)到最终冷镦(三模三冲)成型过程中的应力、等效塑性应变、温度及工件形貌和尺寸进行了分析。结果表明:线材在拔制完成... 详细信息

采用有限元方法建立SWRCH15A冷镦钢M6平头螺丝成型过程的热力耦合数值计算模型,并对SWRCH15A冷镦钢从拔制(第三道冷拔)到最终冷镦(三模三冲)成型过程中的应力、等效塑性应变、温度及工件形貌和尺寸进行了分析。结果表明:线材在拔制完成后芯部等效应力最大,而最大等效塑性应变位于距表面0.5 mm处;在二冲和三冲成型过程中,螺丝头部侧边表层承受较大的环向拉应力,这是导致头部易产生轴向开裂的主要外因;从拔制到三模三冲,坯料中的最大等效塑性应变呈线性增加,在三冲过程中,材料内部最高温度可达269.4℃;三模三冲样件形貌及尺寸的模拟结果与实际形貌及尺寸十分接近,说明建立的M6平头螺丝成型热力耦合模型是准确可靠的。

关键词：冷镦钢螺丝成型有限元热力耦合冷镦开裂

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针对既有双曲线型冷却塔结构的安全性检测鉴定及处理

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工程质量 2019年第6期37卷 66-70页

作者：高海军卢淑雯黄翔中国建筑科学研究院有限公司

详细论述某双曲线型自然通风冷却塔的检测鉴定项目、内容及流程,同时依据现场检测数据进行有限元数值模拟,为其后续改造设计、施工提供可靠依据,并保证结构功能的实现和安全使用。其相关的检测、鉴定程序可为类似双曲线型冷却塔工程提... 详细信息

详细论述某双曲线型自然通风冷却塔的检测鉴定项目、内容及流程,同时依据现场检测数据进行有限元数值模拟,为其后续改造设计、施工提供可靠依据,并保证结构功能的实现和安全使用。其相关的检测、鉴定程序可为类似双曲线型冷却塔工程提供参考。

关键词：安全性鉴定双曲线型冷却塔数值模拟处理措施

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Power Flow for Grids with Unfixed Topologies by Using Deep Neural Network

Power Flow for Grids with Unfixed Topologies by Using Deep N...

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第37届中国控制会议

作者： Qianying Ye Yanjun Li shuwen Pan Ji xiang School of Information and Electrical Engineering Zhejiang University City College College of Electrical Engineering Zhejiang University

The power flow problem is critical in power systems, providing fundamental and vital information in system planning,operational management, and control strategy. The mathematical model of power flow problem is composed of several non-linear equations conventionally solved by the Newton-Raphson method. In this paper, the deep neural network which is called stacked auto-encoder（SAE）, has been used to solve the power flow problem. Compared to the traditional neural network, stacked autoencoder is a more effective method in terms of getting better local optimum and solving the problem of gradient diffusion. The resulted deep neural network can deal with the grids with various topologies corresponding to various line or bus faults. After a detailed description, the proposed method is evaluated by a comparison with a traditional neural network by Matlab simulation.

关键词： Power Flow Artificial Neural Network Stacked Auto-Encoder

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Power Flow for Grids with Unfixed Topologies by Using Deep Neural Network

Power Flow for Grids with Unfixed Topologies by Using Deep N...

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Chinese Control Conference (CCC)

作者： Qianying Ye Yanjun Li shuwen Pan Ji xiang School of Information and Electrical Engineering Zhejiang University City College Hangzhou P. R. China College of Electrical Engineering Zhejiang University Hangzhou P. R. China

The power flow problem is critical in power systems, providing fundamental and vital information in system planning, operational management, and control strategy. The mathematical model of power flow problem is composed of several non-linear equations conventionally solved by the Newton-Raphson method. In this paper, the deep neural network which is called stacked auto-encoder (SAE), has been used to solve the power flow problem. Compared to the traditional neural network, stacked auto-encoder is a more effective method in terms of getting better local optimum and solving the problem of gradient diffusion. The resulted deep neural network can deal with the grids with various topologies corresponding to various line or bus faults. After a detailed description, the proposed method is evaluated by a comparison with a traditional neural network by Matlab simulation.

关键词： Neurons Biological neural networks Power systems Training Machine learning Mathematical model

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不确定下广义博弈强Berge均衡的存在性

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应用数学学报 2015年第2期38卷 200-211页

作者：邓喜才向淑文贵州大学数学系贵阳550025 贵州师范学院数学系贵阳550018

本文基于不确定下的非合作博弈NS均衡给出了不确定下广义非合作博弈强Berge均衡与广义多目标弱Pareto强Berge均衡的定义,利用Fan-Glicksberg不动点定理证明了不确定下广义非合作博弈强Berge均衡与不确定下广义多目标弱Pareto强Berge均... 详细信息

本文基于不确定下的非合作博弈NS均衡给出了不确定下广义非合作博弈强Berge均衡与广义多目标弱Pareto强Berge均衡的定义,利用Fan-Glicksberg不动点定理证明了不确定下广义非合作博弈强Berge均衡与不确定下广义多目标弱Pareto强Berge均衡存在性定理.

关键词：非合作博弈强Berge均衡不动点不确定性

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小剂量低分子肝素可改善老年重症肺炎患者预后:一项1 173例患者的Meta分析

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中华危重病急救医学 2020年第1期32卷 26-32页

作者：杨惠邻钱红沈锋刘博吴彦其程玉梅杨贵霞李想郑兴昊秦进成李书文何天慧贵州医科大学贵阳550004 贵州医科大学附属医院重症医学科贵阳550004

目的通过系统评价方法探讨小剂量低分子肝素对老年重症肺炎患者疗效及预后的影响。方法检索万方数据、维普数据库(VIP)、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)和美国国立医学图书馆PubMed数据库、荷兰医学文摘Embase数据... 详细信息

目的通过系统评价方法探讨小剂量低分子肝素对老年重症肺炎患者疗效及预后的影响。方法检索万方数据、维普数据库(VIP)、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)和美国国立医学图书馆PubMed数据库、荷兰医学文摘Embase数据库、Cochrane图书馆数据库等中英文数据库,从建库至2019年8月发表的有关比较常规治疗与低分子肝素对老年重症肺炎患者疗效及预后影响的随机对照试验(RCT)。常规治疗组给予改善通气、抗感染、祛痰、平喘、纠正内环境等常规治疗;低分子肝素组在常规治疗基础上,加用低分子肝素4000 U皮下注射、每日1次、治疗7 d。主要结局指标为治疗7 d后氧合指数(PaO2/FiO2)、呼吸机支持时间、住院病死率;次要结局指标为治疗7 d后急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ)、凝血功能指标以及重症监护病房(ICU)住院时间和出血发生率。对纳入文献进行严格的质量评价与资料提取,应用RevMan 5.3软件对符合质量标准的RCT进行Meta分析。对纳入文献数不少于10篇的指标进行漏斗图分析,评价纳入文献的发表偏倚。结果最终纳入14项RCT、共1173例患者,均为老年重症肺炎患者;其中低分子肝素组590例,常规治疗组583例。纳入研究整体设计良好,质量较高。Meta分析结果显示,与常规治疗组相比,低分子肝素组患者治疗7 d后PaO2/FiO2明显升高〔均数差(MD)=19.25,95%可信区间(95%CI)为16.88~21.61,P<0.00001〕,呼吸机支持时间明显缩短(MD=-48.88,95%CI为-67.42^-30.33,P<0.00001),住院病死率明显降低〔优势比(OR)=0.40,95%CI为0.22~0.73,P=0.003〕,治疗7 d后APACHEⅡ评分显著降低(MD=-3.38,95%CI为-3.94^-2.83,P<0.00001),ICU住院时间明显缩短(MD=-4.51,95%CI为-5.75^-3.27,P<0.00001);而两组治疗7 d后凝血指标及治疗期间出血发生率比较差异均无统计学意义〔7 d凝血酶时间(TT):MD=0.57,95%CI为-0.15~1.28,P=0.12;7 d凝血酶原时间(PT):MD=0.32,95%CI为-0.35~0.98,P=0.35;7 d纤维蛋白原(FIB):MD=-0.17,95%CI为-0.45~0.10,P=0.22;出血发生率:OR=0.86,95%CI为0.36~2.07,P=0.74〕。对纳入文献数为10篇的APACHEⅡ评分进行漏斗图分析,结果显示文献存在发表偏倚。结论小剂量低分子肝素能够改善老年重症肺炎患者预后,且对凝血功能无明显影响。

关键词：老年重症肺炎低分子肝素预后凝血功能 Meta分析

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Alternative polyadenylation coordinates embryonic development, sexual dimorphism and longitudinal growth in Xenopus tropicalis

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CELLULAR AND MOLECULAR LIFE SCIENCES 2019年第11期76卷 2185-2198页

作者： Zhou, xiang Zhang, Yangzi Michal, Jennifer J. Qu, Lujiang Zhang, shuwen Wildung, Mark R. Du, Weiwei Pouchnik, Derek J. Zhao, Hui Xia, Yin Shi, Honghua Ji, Guoli Davis, Jon F. Smith, Gary D. Griswold, Michael D. Harland, Richard M. Jiang, Zhihua Washington State Univ Dept Anim Sci Pullman WA 99164 USA Washington State Univ Ctr Reprod Biol Pullman WA 99164 USA Washington State Univ Ctr Reprod Biol Lab Biotechnol & Bioanal Pullman WA 99164 USA Chinese Univ Hong Kong Fac Med Sch Biomed Sci Hong Kong Peoples R China East China Normal Univ State Key Lab Estuarine & Coastal Res Shanghai Peoples R China Xiamen Univ Dept Automat Xiamen Peoples R China Washington State Univ Dept Integrat Physiol & Neurosci Pullman WA 99164 USA Univ Michigan Dept OB GYN Ann Arbor MI 48109 USA Univ Michigan Dept Physiol Ann Arbor MI 48109 USA Univ Michigan Dept Urol Ann Arbor MI 48109 USA Univ Calif Berkeley Dept Mol & Cell Biol 229 Stanley Hall Berkeley CA 94720 USA Huazhong Agr Univ Coll Anim Sci & Vet Med Wuhan Hubei Peoples R China China Agr Univ Coll Anim Sci & Technol Beijing Peoples R China

RNA alternative polyadenylation contributes to the complexity of information transfer from genome to phenome, thus amplifying gene function. Here, we report the first X. tropicalis resource with 127,914 alternative polyadenylation (APA) sites derived from embryos and adults. Overall, APA networks play central roles in coordinating the maternal-zygotic transition (MZT) in embryos, sexual dimorphism in adults and longitudinal growth from embryos to adults. APA sites coordinate reprogramming in embryos before the MZT, but developmental events after the MZT due to zygotic genome activation. The APA transcriptomes of young adults are more variable than growing adults and male frog APA transcriptomes are more divergent than females. The APA profiles of young females were similar to embryos before the MZT. Enriched pathways in developing embryos were distinct across the MZT and noticeably segregated from adults. Briefly, our results suggest that the minimal functional units in genomes are alternative transcripts as opposed to genes.

关键词： Whole transcriptome termini site sequencing (WTTS-seq) Gene biotypes APA site types Genomic neighborhoods RNA origin

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Development and control of a robotic arm for percutaneous surgery

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ASSEMBLY AUTOMATION 2017年第3期37卷 314-321页

作者： Zhou, Chunlin Wu, Huifeng Xu, xiang Liu, Yong Zhu, Qi Pan, shuwen Zhejiang Univ Coll Control Sci & Engn Hangzhou Zhejiang Peoples R China Hangzhou Dianzi Univ Coll Comp Sci & Technol Hangzhou Zhejiang Peoples R China Zhejiang Univ City Coll Hangzhou Zhejiang Peoples R China

Purpose - The purpose of this paper is to propose a robotic system for percutaneous surgery. The key component in the system, a robotic arm that can manipulate a puncture needle is presented. The mechanical design, the motion control and the force control method of the robotic arm are discussed in the paper. Design/methodology/approach - The arm with an arc mechanism placed on a 3D Cartesian stage is developed as a puncture needle manipulator to locate the position of the needle tip, tune the needle's posture and actuate the puncture motion under the visual guidance of two orthogonal X-ray images of a patient by a surgeon. A focusing method by using two laser spots is proposed to automatically move the needle tip to a surgery entry point on the skin. A dynamics model is developed to control the position of the needle mechanism and an explicit force control strategy is utilized to perform the needle insertion. Findings - With the surgical system, a surgeon can easily perform puncture operation by taking two orthogonal real-time X-ray images as a visual feedback and accurately navigating the needle insertion. The laser-guided focusing method is efficient in placement of the needle tip. The explicit force control strategy is proved to be effective for holding constant and stable puncture force in experiments. Originality/value - The robotic arm has an advantage in easy redirection of the needle because the rotation and the translation are decoupled in the mechanism. By adopting simple laser pens and a well-developed kinematics model, the system can handle the entry point, locating task automatically. The focusing method and the force control method proposed in the paper are useful for the present system and could be intuitive for similar surgical robots.

关键词： Surgical robot Percutaneous surgery X-ray

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