某三甲医院造口伤口失禁门诊诊疗现状调查

Objective: To investigate the present situation of wound ostomy continence(WOC) clinic as well as to provide objective basis and expand working thoughts for carrying out WOC clinic.Method:3251 patients who visited our WOC clinic between December 2010 and March 2015 were retrospectively analyzed.Results: The patients know WOC clinic mostly (94.72%) by medical staff in our hospital. Chronic wound patients have the highest demand (63.82%). 6.51% patients with poor health and economic condition can’t stick to outpatient dressing. Most ostomy patients receive well health guidance during their hospitalization.Conclusion: The patients show great demands for WOC clincic. Next we should strengthen the propaganda, develop continuous nursing and telemedicine network.目的  调查造口伤口失禁门诊的工作现状，为更好地开展造口伤口失禁门诊提供客观依据和方向，拓展工作思路。方法  对我院自2010年12月—2015年3月造口伤口失禁门诊的3251名患者的诊疗状况进行回顾性分析。结果  造口伤口失禁门诊患者主要是通过本院医护人员知晓造口伤口失禁门诊（94.72%），患者中慢性伤口患者的需求量最大（63.82%），部分患者身体及家庭经济条件较差，未能坚持在门诊换药治疗（6.51%），造口患者在住院期间大部分已获得良好的健康指导。结论  患者对造口伤口失禁门诊有极大的需求，下一步须加强门诊宣传力度，开展延续性护理及远程治疗平台

Thermodynamic and techno-economic analysis of a direct thermal oil vaporization solar power system

A unique direct thermal oil vaporization solar power system employing cascade organic-steam Rankine cycle is proposed. The oil is a mixture of biphenyl and diphenyl oxide, and it is used for heat transfer, storage and power cycle fluid in the novel system. Stable electricity output and prolonged storage capacity can be facilitated. In the rated mode, the oil is vaporized at 390 °C in the collectors and drives a top turbine. The exhaust heat is used for preheating and evaporating water of the bottom cycle. Meanwhile, the hot oil in a high-temperature tank (HTT) superheats and reheats the generated steam. When the irradiation is insufficient, the heat released by the oil from the HTT to a low-temperature tank drives the bottom cycle. Fundamentals, thermodynamic performance and techno-economic feasibility are elaborated. The results indicate that, compared with the mainstream dual-tank solar power systems, the proposed system has a higher thermal efficiency with a lower water evaporation temperature (42.90% at 260 °C vs. 38.06% at 310 °C) and a larger temperature drop between the two tanks (121 °C vs. 100 °C). The equivalent payback time with respect to the top oil cycle is less than 3 years

Early development of the Amur sleeper (Perccottus glenii, Dybowski, 1877): a remarkable invasive species in Eurasia

To investigate the ontogeny of Perccottus glenii, embryonic, larval and juvenile development of P. glenii were examined under captive condition. The fertilized eggs with numerous oil droplets were orange-pink in color, prolate spherical in shape and had average length of 3.32±0.14 mm and width of 1.24±0.04 mm. From fertilization to hatching, the ontogenesis of the fish spent more than 200 h, and the process of embryonic development was divided into 25 stages based on the morphological characteristics. The newly hatched larvae, with well-developed swim bladder and pectoral fins, measured 5.07±0.18mm in total length. Initial feeding occurred at day 2 after hatching (AH) and the complete absorption of yolk sphere was observed 3 days after hatching. At day 40 AH, scales and vertical pigment were found to be appear. Scales covered the entire body and all fins were well developed 70 days AH, at which time the juveniles reached the young stage with a total length (TL) of 24.74±4.28 mm. At day 140 AH, The fry with a TL of 29.57±4.65 mm, were morphologically similar to the adults except for size

Screening Key Indicators for Acute Kidney Injury Prediction Using Machine Learning

Acute kidney injury is a common critical disease with a high mortality. The large number of indicators in AKI patients makes it difficult for clinicians to quickly and accurately determine the patient’s condition. This study used machine learning methods to filter key indicators and use key indicator data to achieve advance prediction of AKI so that a small number of indicators could be measured to reliably predict AKI and provide auxiliary decision support for clinical staff. Sequential forward selection based on feature importance calculated by XGBoost was used to screen out 17 key indicators. Three machine learning algorithms were used to make predictions, namely, logistic regression (LR), decision tree, and XGBoost. To verify the validity of the method, data were extracted from the MIMIC III database and the eICU-CRD database for 1,009 and 1,327 AKI patients, respectively. The MIMIC III database was used for internal validation, and the eICU-CRD database was used for external validation. For all three machine learning algorithms, the prediction performance from using only the key indicator dataset was very close to that from using the full dataset. The XGBoost algorithm performed the best, and LR was the next best. The decision tree performed the worst. The key indicator screening method proposed in this study can achieve a good predictive performance while streamlining the number of indicators

Thermo-economic analysis of a novel partial cascade organic-steam Rankine cycle

Conventional heat batteries and concentrated solar power systems adopt subcritical steam Rankine cycles (SRCs) to avoid the technical challenges of supercritical cycles. The water evaporation temperature of 310–337 °C and live steam pressure of 10–14 MPa limit the cycle efficiency (around 42%). This paper proposes a novel partial cascade organic-steam Rankine cycle (ORC-SRC) system to increase the fluid evaporation temperature and thermal efficiency. The ORC-SRC uses a mixture of biphenyl and diphenyl oxide as the top cycle fluid. The mixture absorbs heat from the molten salts and evaporates at about 400 °C to drive a turbine, and then the exhaust vapor releases heat to the bottom SRC. The ORC contributes to saturated steam generation, and molten salts supply the rest heat to the SRC through the steam superheater and reheater. The fundamentals of the system are illustrated, and mathematical models are built. Thermo-economic performance of the system is investigated. The results show that the proposed system significantly increases the average temperature of the power fluid in the heating process, leading to a maximum cycle efficiency of 45.3%. Meanwhile, the moderate live steam pressure of 7.44 MPa in the SRC reduces the leakage loss of the high-pressure turbine and equipment costs. Despite a smaller temperature drop of molten salts during discharge, the equivalent payback period of the ORC-SRC is within 4 years

A novel approach to thermal storage of direct steam generation solar power systems through two-step heat discharge

© 2018 Elsevier Ltd Steam accumulators are the only commercial solution for heat storage of direct steam generation (DSG) solar thermal power plants. Current accumulators have low storage capacity as the turbine suffers from inefficient off-design operation during heat discharge, thereby restricting the development of DSG technology. This work presents a novel approach to solving this problem by using two-stage accumulators and steam-organic Rankine cycles (RC-ORC). The system involves unique two-step heat discharge. Heat is initially released via water vaporization in a high temperature accumulator (HTA) to drive the RC-ORC, leading to an HTA temperature drop of approximately 30 °C. Water at a reduced temperature then flows from the HTA to a low temperature accumulator through a heat exchanger and the heat is used only to drive the ORC. Water temperature further drops by 130–190 °C. The fundamentals of the system are illustrated. A comparison with the conventional DSG system is conducted at a nominal power of 10 MW with an accumulator volume of 2500 m3. Thermodynamic performance of the system is investigated. The equivalent payback period (EPP) regarding the use of the second step heat discharge is estimated. Results indicate that the second step heat discharge can increase the storage capacity by 460%, with an EPP of less than 5 years in most cases. Overall, the proposed solution improves the cost-effectiveness of the DSG system

The economic burden of chronic neurological disease

Figure S2. Forest plots of the 5 studies evaluating the association between EP and endometriosis according to the endometriosis stage (stage 4 versus stage 1, and stages 3–4 versus stages 1–2). (TIFF 2134 kb

Effect of regenerator on the direct steam generation solar power system characterized by prolonged thermal storage and stable power conversion

The direct steam generation (DSG) solar power system using two stage accumulators and cascade steam-organic Rankine cycle (RC-ORC) has remarkably enlarged storage capacity. It can facilitate stable power generation and address the challenges of conventional DSG systems. Regenerator is generally an issue worthy of discussion in organic Rankine cycle (ORC) systems. However, its influence on the newly proposed DSG system has not been investigated yet and is expected to be appreciable. Introducing a regenerator affects not only the ORC efficiency, RC-ORC efficiency, heat exchanger area, but also heat storage capacity, discharge duration, discharge efficiency, aperture area of collectors and the net profit (ΔP). Detailed performance comparison between the DSG systems without/with regenerator is carried out in this paper. The results indicate that at a given power output, aperture area is reduced by the regenerator especially for MM, R365mfc and pentane due to the increment in ORC, RC-ORC and discharge efficiencies, as well as the decrement in heat input. Discharge duration is shortened by 0.01–1.78 h depending on ORC fluids. R365mfc exhibits the maximum ΔP (4.19∼6.48 million USD), followed by MM and pentane. On the contrary, ΔP is negative for benzene (−5.61∼-4.31 million USD)

MicroRNA-186 suppresses cell proliferation and metastasis in bladder cancer

Purpose: Bladder cancer (BCa) is a common malignancy in the urinary system. This study aims to explore the role of miR-186 in BCa tumorigenesis. Methods: The expression of miR-186 and ADAMTS12 in clinical BCa tissues and cell lines was detected. BCa cell lines T24, 5637 and EJ were used to transfect miR-186 mimics or inhibitors. Luciferase reporter gene detection confirmed the correlation between miR-186 and ADAMTS12. MTT method and flow cytometry were used to detect cell viability and apoptosis. Cell migration and invasion ability was detected by transwell assay. The protein level of ADAMTS12, β-catenin, GSK-3β and p-GSK-3β was determined using western blot analysis. Results: MiR-186 was negatively correlated with the expression of ADAMTS12 in BCa tissues. Further research confirmed that ADAMTS12 is the direct target of miR-186. In addition, overexpression of miR-186 down-regulated the expression of ADAMTS12,inhibiting cell viability and apoptosis, while knockout of miR-186 led to the opposite result. miR-186 also inhibits the phosphorylation of GSK-3 β and β-catenin without changing the total GSK-3β level. Our study shows that miR-186 has a negative regulatory effecton the expression of ADAMTS12 in clinical specimens and in vitro. miR-186 can inhibit the proliferation and invasion of BCa cells. Conclusions: miR-186 has the potential to be used as a biomarker in the early detection of BCa. Keywords: Purpose: Bladder cancer (BCa) is a common malignancy in the urinary system. This study aims to explore the role of miR-186 in BCatumorigenesis.Methods: The expression of miR-186 and ADAMTS12 in clinical BCa tissues and cell lines was detected. BCa cell lines T24, 5637 andEJ were used to transfect miR-186 mimics or inhibitors. Luciferase reporter gene detection confirmed the correlation between miR-186 and ADAMTS12. MTT method and flow cytometry were used to detect cell viability and apoptosis. Cell migration and invasionability was detected by transwell assay. The protein level of ADAMTS12, β-catenin, GSK-3β and p-GSK-3β was determined usingwestern blot analysis.Results: MiR-186 was negatively correlated with the expression of ADAMTS12 in BCa tissues. Further research confirmed thatADAMTS12 is the direct target of miR-186. In addition, overexpression of miR-186 down-regulated the expression of ADAMTS12,inhibiting cell viability and apoptosis, while knockout of miR-186 led to the opposite result. miR-186 also inhibits the phosphorylationof GSK-3 β and β-catenin without changing the total GSK-3β level. Our study shows that miR-186 has a negative regulatory effecton the expression of ADAMTS12 in clinical specimens and in vitro. miR-186 can inhibit the proliferation and invasion of BCa cells.Conclusions: miR-186 has the potential to be used as a biomarker in the early detection of BCa.Keywords: miR-186; ADAMTS12; bladder cancer; proliferation; metastasis biomarker