简介：Itisveryimportanttomaintainthelevelofmeanarterialpressure(MAP).TheMAPcontrolisappliedinmanyclinicalsituations,includinglimitingbleedingduringcardiacsurgeryandpromotinghealingforpatient'spost-surgery.Thispaperpresentsafuzzycontroller-basedmultiple-modeladaptivecontrolsystemforpostoperativebloodpressuremanagement.Multiple-modeladaptivecontrol(MMAC)algorithmisusedtoidentifythepatientmodel,anditisafeasiblesystemidentificationmethodeveninthepresenceoflargenoise.Fuzzycontrol(FC)methodisusedtodesigncontrollerbank.Eachfuzzycontrollerinthecontrollerbankisinfactanonlinearproportional-integral(PI)controller,whoseproportionalgainandintegralgainareadjustedcontinuouslyaccordingtoerrorandrateofchangeoferroroftheplantoutput,resultinginbetterdynamicandstablecontrolperformancethantheregularPIcontroller,especiallywhenanonlinearprocessisinvolved.Fordemonstration,anonlinear,pulsatile-flowpatientmodelisusedforsimulation,andtheresultsshowthattheadaptivecontrolsystemcaneffectivelyhandlethechangesinpatient'sdynamicsandprovidesatisfactoryperformanceinregulationofbloodpressureofhypertensionpatients.

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简介：Treated58patients(32malesand26females)withpostoperativeuroschesisbyacupuncture.Therapeuticresultswereexcellentin33cases,goodin22cases,andineffectivein3cases.

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简介：INTRODUCTIONSincetheirintroductioninmid-1980s,polyamidoamide(PAMAM)dendrimershaveattractedconsiderableattentionbecauseoftheiruniquestructuresandproperties.Accordingtopreliminarystudiesinanimals,PAMAMdendrimersarenon-immunogenic,verylowinvivotoxicityandcanbeexcretedbyurineandfeces.

简介：目的：观察推拿治疗手术后尿潴留的临床疗效。方法：对37例手术后尿潴留患者施行穴位推拿治疗，穴位选用气海、关元、中极，双侧三阴交。结果：治疗1～3次后，治愈36例，1例因退出治疗而未统计疗效。结论：穴位推拿是治疗手术后尿潴留的一种有效方法。

简介：BackgroundPostoperativewoundinfectionwasfrequentlyreportedinpatientsundergoingheartvalvereplacementandcoronaryarterybypasssurgery(CABG)duetomajortrauma,long-termbedrest,malnutritionandcompromisedimmunesystem.Infectedpatientswereusuallyhousedinthesameairborneinfectionisolationrooms.Aseriesofairmonitoringandcontrolstrategiesshouldbestrictlyenforcedtoaimatavoidingairbornefungalcontaminationandachievinghighercurerateininfectedpatients.TheefficacyofAirinspaceplasmairsysteminreducingairbornefungalcontaminationincardiacpostoperativeinfectionwardshasnotbeenclearlydetermined.MethodsAsurveyofaircontaminationwasconductedinthecardiacpostoperativeinfectionwardusingAirinspaceplasmairsystem.Laserparticlecounterwasusedtodeterminetheairborneparticlesof0.3μm?and0.5μm?insize.Airsampleswereincubatedandexaminedforfungaldevelopment.AirborneparticlecountsandfungalloadsofairsamplescollectedbeforeandaftertreatmentwithAirinspaceplasmairsystemwerecompared.ResultsTheparticlecountsin0.3μmrangecollectedbefore(52206<2345)andafter(9408<4317)treatedwithAirinspaceplasmairsystemdifferedsignificantly(P<0.01).Theparticlecountsin0.5μmrangebefore(12995<422)andafter(2016<915)treatmentwithAirinspaceplasmairsystemalsodifferedsignificantly(P<0.01).ThefungalloadsbeforeandafterusingAirinspaceplasmairsystemshowedsignificantdifference[(1975.3<356.1)cfu/m3vs.(193.83<29.5)cfu/m3,P<0.01].ConclusionAirinspaceplasmairsystemusedincardiacpostoperativeinfectionwardshasshownremarkableefficacyinreducingairborneparticlesandfungalcontaminationandhelpespreventcrossinfection.

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简介：AbstractInfectious diseases are an increasing threat to global biosafety. Vaccination is the most effective and cost-efficient method for preventing and controlling infectious diseases. The development of new vaccines is inextricably linked to the advancement of materials that serve as essential components of vaccines, such as antigens, adjuvants, and their carriers. The physicochemical and biological properties of vaccines—such as the kinetics of antigen retention and presentation—are determined by the material compositions of vaccines and carriers, affecting the overall efficacy. The sustained release of antigens prolongs their retention time in germinal centers and improves humoral immune responses. Pulsatile release that imitates clinical dosing regimens can improve patient adherence to vaccination, affording increased vaccine coverage. Herein, we review progress of materials innovation on altering vaccine release kinetics, which affects the overall vaccine efficacy, safety, and compliance.

简介：Colorectalcancer（CRC）isthethirdmostcommoncancerdiagnosedworldwideinhumanbeings.Surgery,chemotherapy,radiotherapyandtargetedtherapiesaretheconventionalfourapproacheswhicharecurrentlyusedforthetreatmentofCRC.Thesitespecificdeliveryofchemotherapeuticstotheirsiteofactionwouldincreaseeffectivenesswithreducingsideeffects.Targetedoraldrugdeliverysystemsbasedonpolysaccharidesarebeinginvestigatedtotargetanddeliverchemotherapeuticandchemopreventiveagentsdirectlytocolonandrectum.Site-specificdrugdeliverytocolonincreasesitsconcentrationatthetargetsite,andthusrequiresalowerdoseandhenceabridgedsideeffects.Somenoveltherapiesarealsobrieflydiscussedinarticlesuchasreceptor（epidermalgrowthfactorreceptor,folatereceptor,wheatgermagglutinin,VEGFreceptor,hyaluronicacidreceptor）basedtargetingtherapy;colontargetedproapoptoticanticancerdrugdeliverysystem,genetherapy.EventhoughgoodtreatmentoptionsareavailableforCRC,theultimatetherapeuticapproachistoaverttheincidenceofCRC.ItwasalsofoundthatCRCscouldbepreventedbydietandnutritionsuchascalcium,vitaminD,curcumin,quercetinandfishoilsupplements.ImmunotherapyandvaccinationareusednowadayswhichareshowingbetterresultsagainstCRC.

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简介：Timelyandcost-efficientmulti-hopdatadeliveryamongvehiclesisessentialforvehicularad-hocnetworks(VANETs),andvariousroutingprotocolsareenvisionedforinfrastructure-lessvehicle-to-vehicle(V2V)communications.Generally,whenapacket(oraduplicate)isdeliveredoutoftheroutingpath,itwillbedropped.However,weobservethatthesepackets(orduplicates)mayalsobedeliveredmuchfasterthanthepacketsdeliveredalongtheoriginalroutingpath.Inthispaper,weproposeanoveltreebasedroutingscheme(TBRS)forultilizingthedroppedpacketsinVANETs.InTBRS,thepacketisdeliveredalongaroutingtreewiththedestinationasitsroot.Andwhenthepacketisdeliveredoutitsroutingtree,itwon'tbedroptimmediatelyandwillbedeliveredforawhileifitcanarriveatanotherbranchofthetree.WeconducttheextensivesimulationstoevaluatetheperformanceofTBRSbasedontheroadmapofarealcitycollectedfromGoogleEarth.ThesimulationresultsshowthatTBRScanoutperformtheexistingprotocols,especiallywhenthenetworkresourcesarelimited.

简介：Thephenomenonofparticleinteractioninvolvedinpulmonarydrugdeliverybelongstoawidevarietyofdisciplinesofparticletechnology,inparticular,fluidization.Thispaperreviewsthebasicconceptsofpulmonarydrugdeliverywithreferencestofluidizationresearch,inparticular,studiesonGeldartgroupCpowders.Drypowderinhalerdevice-formulationcombinationhasbeenshowntobeaneffectivemethodfordeliveringdrugstothelungfortreatmentofasthma,chronicobstructivepulmonarydiseaseandcysticfibrosis.Evenwithadvanceddesigns,however,deliveryefficiencyisstillpoormainlyduetopowderdispersionproblemswhichcausepoorlungdepositionandhighdosevariability.Drugparticlesusedincurrentinhalersmustbe1-5mindiameterforeffectivedepositioninsmall-diameterairwaysandalveoli.Thesepowdersareverycohesive,havepoorflowability,andaredifficulttodisperseintoaerosolduetocohesionarisingfromvanderWaalsattraction.Theseproblemsarewellknowninfluidizationresearch,muchofwhichishighlyrelevanttopulmonarydrugdelivery.

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简介：Thearticleisaboutsolvingthelastmiledeliveryprobleminruraltownorvillage.Wewanttotestthedrone’spotentialinparceldelivery.Theobjectivesare1)tointroducetheclusterandtruck-droneintandemdeliverymethod,2)tocomparethenewmethodwiththetraditionalTSPmethodinaspectoftruckrunningdistance,energyusingandtimeoccupation.Theparceldeliverydemandissparse,soitisnotdenseenoughforatrucktocarryondelivery.Wetrytoidentifythebestrouteforthedronetodeliverthegoods.Weusek-meanmethodtocarryonclustering,thenweuseenumerationmethodtofulfillthecentroidsdelivery,whichcomesfromthedepot.Wedesignamodelandcalculatetheenergy,timeanddistancesavingbetweendroneusingmethod(DTSP)andtraditionalTSPmethod.Thedroneattendeddeliverysavestruckdeliverydistance,energyconsumptionandtime.ThetruckrunningdistanceofDTSPmethodsaves91.87%,thetruckrunningdistanceisshortenedfrom189.69kmto15.4252km.TheDTSPmethodsaves90.45%ofenergy.TheDTSPmethodbringsa29.75%cutoffintimeaspectwhentherearetwodroneinrunning.TheresearchintroducestheclusterandTSPcombinationmethod,whichisagoodwaytocarryonlastmiledelivery.Theresultshowsabrightfuturefordronetoattendparceldelivery.Thee-commercecorporationcanapplythismethodinpractice.

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简介：AbstractEnhanced recovery after cesarean (ERAC) delivery is an evidence-based, multi-disciplinary approach throughout pre-, intra-, post-operative period. The ultimate goal of ERAC is to enhance recovery and improve the maternal and neonatal outcomes. This review highlights the role of anesthesiologist in ERAC protocols. This review provided a general introduction of ERAC including the purposes and the essential elements of ERAC protocols. The tool used for evaluating the quality of ERAC (ObsQoR-11) was discussed. The role of anesthesiologist in ERAC should cover the areas including management of peri-operative hypotension, prevention and treatment of intra- and post-operative nausea and vomiting, prevention of hypothermia and multi-modal peri-operative pain management, and active pre-operative management of unplanned conversion of labor analgesia to cesarean delivery anesthesia. Although some concerns still remain, ERAC implementation should not be delayed. Regular assessment and process improvement should be imbedded into the protocol. Further high-quality studies are warranted to demonstrate the effectiveness and efficacy of the ERAC protocol.

简介：Inordertoinvestigatetheimmtmogenicityofthecontrolled-releasemicroencapsulatedhepatitisBvaccineinmice,polyethyleneglycol-poly-dl-lactide(PELA)microsphereswithentrappedHSsAgwerepreparedbydoubleemulsionW/O/Wbasedonsolventextractionmethods.BALB/cmicewereimmunizedwiththeencapsulatedvaccinebyoralfeedingorinjection.Bloodsampleswerecollectedat8^th,10^th,14^thand24^thweeks,respectively,andthelevelsofantibodyresponseweredetectedbyEI.ISA.Itwasfoundthatthescanningelectronmicroscopyshowedthepreparedmicrosphereshadsmoothandsphericalsurface,suitableforvaccinedelivery.Twogroupsofmiceorallyfedwiththeencapsulatedorconventionalrecombinantvaccines,respectively,theresereshowednoobviousdifferenceintheIgGlevels.At14^thweek,thegroupinjectedwithasingledoseofencapsulatedvaccinehadasimilarlevelofIgGresponsetothegroupinjectedwithtwodosesoftherecombinationvaccine.At24^thweek,theIgGlevelsofthegroupinjectedwithtwodosesofencapsulatedvaccinewerehigherthanthoseofthegroupinjectedwithtwodosesoftherecombinationvaccine.ItconcludesthatControlled-releasemicroencapsulatedhepatitisBvaccinepossessesthefeatureofslowlyreleasinginv/voandlongtimesimmtmogenicity.

简介：AbstractBackground:Postoperative pneumonia (POP) is one of the most common infections following heart valve surgery (HVS) and is associated with a significant increase in morbidity, mortality, and health care costs. This study aimed to identify the major risk factors associated with the occurrence of POP following HVS and to derive and validate a clinical risk score.Methods:Adults undergoing open HVS between January 2016 and December 2019 at a single institution were enrolled in this study. Patients were randomly assigned to the derivation and validation sets at 1:1 ratio. A prediction model was developed with multivariable logistic regression analysis in the derivation set. Points were assigned to independent risk factors based on their regression coefficients.Results:POP occurred in 316 of the 3853 patients (8.2%). Multivariable analysis identified ten significant predictors for POP in the derivation set, including older age, smoking history, chronic obstructive pulmonary disease, diabetes mellitus, renal insufficiency, poor cardiac function, heart surgery history, longer cardiopulmonary bypass, blood transfusion, and concomitant coronary and/or aortic surgery. A 22-point risk score based on the multivariable model was then generated, demonstrating good discrimination (C-statistic: 0.81), and calibration (Hosmer-Lemeshow χ2 = 8.234, P = 0.312). The prediction rule also showed adequate discriminative power (C-statistic: 0.83) and calibration (Hosmer-Lemeshow χ2 = 5.606, P = 0.691) in the validation set. Three risk intervals were defined as low-, medium-, and high-risk groups.Conclusion:We derived and validated a 22-point risk score for POP following HVS, which may be useful in preventive interventions and risk management.Trial Registration:Chictr.org, ChiCTR1900028127; http://www.chictr.org.cn/showproj.aspx?proj=46932