64 research outputs found

    Efficacy and safety comparison of esketamine-propofol with nalbuphine-propofol for upper gastrointestinal endoscopy in children: a multi-center randomized controlled trial

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    Background and AimsAnesthetics such as propofol, esketamine and nalbuphine are used during the upper gastrointestinal endoscopy to achieve and maintain the desired sedation level. The aim of the study was to evaluate the effectiveness and safety of propofol-nalbuphine and propofol-esketamine in children.MethodsA multi-centered study was performed at three tertiary class-A hospitals. Children between 3 and 12 years old undergoing diagnostic painless upper gastrointestinal endoscopy were included and randomly divided into esketamine or nalbuphine group to estimate the primary outcome of successful endoscope insertion. The patients were given esketamine 0.5 mg/kg and propofol 2 mg/kg intravenously in esketamine group, with nalbuphine 0.2 mg/kg and propofol 2 mg/kg in the nalbuphine group. The primary outcome was success rate for the first attempt of endoscope insertion in each group. Secondary outcomes included the safety of both anesthesia regimens and gastroenterologist's satisfaction. We used the Face, Leg, Activity, Cry and Consolability (FLACC) scale to evaluate the level of pain before and during the procedure and the Pediatric Anesthesia Emergence Delirium (PAED) scale to assess the level of agitation and delirium after awakening from anesthesia.ResultsAmong 246 patients, 200 were randomly included in the final intention-to-treat analysis, with 100 patients in each group. The success rate for the first attempt of endoscope insertion in the esketamine group was higher than the nalbuphine group (97% vs. 66%; P < 0.01). The heart rate and mean arterial pressure after intraoperative administration in the esketamine group were higher than those in the nalbuphine group, while the delirium incidence during awakening was higher in esketamine group (all P < 0.05).ConclusionThe success rate for the first attempt of endoscope insertion of children undergoing upper gastrointestinal endoscopy in the esketamine group was higher than the nalbuphine group, propofol-related hemodynamic changes were reduced accordingly, while the incidence of esketamine-related adverse effects could be high.Clinical Trial RegistrationChinese Clinical Trial Registry: ChiCTR2000040500

    Fast SINS Initial Alignment Method Based on Iterative Algorithms in Inertial Frame

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    Iterative algorithms based on saved data have been researched for strapdown inertial navigation system to make the best use of sensor data, and different alignment algorithms can be carried out during the iterative process to fulfil initial alignment. This paper firstly analysed two interactive processes. The forward-backward process needs to change the normal system model in the backward process and have additional error factors. While the forward-forward process is easy to be carried out without changing the system model, the transition error will also decrease the accuracy. In addition, traditional iterative methods always need to save a large amount of data and do redundant computation, which is not highly effective, especially in view of the real-time property. To address these effects, a forward-forward solution in the inertial frame based on Kalman filter is analysed. This method calculates the attitude transfer matrix in the inertial frame to deal with angular disturbances and avoids saving all the original measurement data during the process, which makes the method more stable and faster to fulfil in the real-time system. Simulation and turntable test validates the performance of the proposed method

    Open circuit fault diagnosis strategy of PMSM drive system based on grey prediction theory for industrial robot

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    Permanent magnet synchronous motor (PMSM) is widely used in industrial robot joints and machine tools due to its high torque density, good controllability, and compact structure. Automatic fault diagnosis and early warning of PMSM drive system of industrial robot is the key and difficult point for the smooth development of automatic production process. In view of the problems that the traditional open circuit fault diagnosis method is not fast enough, not intelligent enough, and prone to misdiagnosis in the case of load change, an open circuit fault diagnosis and location strategy for windings and power switches of PMSM drive system based on grey prediction theory is proposed. The grey prediction method only needs to collect a small amount of motor current data and uses the grey model to estimate and predict the rule of the system. It can still diagnose and locate faults accurately in the case of load change, and compared with the traditional current detection method, the diagnosis speed is fast, and the accuracy is high. Through the theoretical analysis, simulation, and experimental results, it is verified that proposed strategy can diagnose the power switch and winding open circuit faults accurately in real time, which improves the reliability of the electric drive system in the application of industrial robot

    Development of SFM of probing sensor look-alike

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    This paper mainly introduces the development of a cantilever driving scanner. Based on this scanner a up-scanning mode of SFM has been developed which was originally aiming at mounting on the top of NMM as a probing sensor. SFM was connected to electronic control unit of CSPM a nano-instrument of CBeing to do experiment and test. As a result, it successfully scanned and imaged the sample within 23μm×23μm×5μm scanning range. Tests, analysis and calculations shows that its lateral and vertical resolutions are 0.25nm and 0.1nn respectively on all axes for all scan sizes, and lateral accuracy is 5% on lateral axes for all scan sizes without any software and hardware correction and compensation

    Clinical reasoning: A 14-year-old girl with headache, seizures, and confusion.

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    Comparison of the sisters clinical characters. Primers used for mutation screening in CBS gene. Sequence results of CBS and MTHFR mutations. Mutations identified in this family with homocystinuria.The information of controls. Ethics Approval

    Novel SINS Initial Alignment Method under Large Misalignment Angles and Uncertain Noise Based on Nonlinear Filter

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    For the SINS initial alignment problem under large misalignment angles and uncertain noise, two novel nonlinear filters, referred to as transformed unscented quadrature Kalman filter (TUQKF) and robust transformed unscented quadrature Kalman filter (RTUQKF), are proposed in this paper, respectively. The TUQKF sets new deterministic sigma points to address the nonlocal sampling problem and improve the numerical accuracy. The RTUQKF is the combination of H∞ technique and TUQKF. It improves the accuracy and robustness of state estimation. Simulation results indicate that TUQKF performs better than traditional filters when misalignment angles are large. Turntable and vehicle experiments results indicate that, under the condition of uncertain noise, the performances of RTUQKF are better than other filters and more robust. These two methods can effectively further increase precision and convergence speed of SINS initial alignment

    Data from: Clinical reasoning: a 14-year-old girl with headache, seizures, and confusion

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    In this report, we characterized describe a 14-year-old girl who developed progressive cerebral venous sinus thrombosis (CVST) and, with multiple organs and systems disfunction in 7 days which are similar to Marfan Syndrome in partial clinical characteristics. Through clinical phenotype and gene detection information, During our workup we uncovered we found two novel compound heterozygous mutations of cystathionine beta-synthase (CBS) gene, c.551 T>C and c.949 A>G, leading to hyperhomocysteinemia (HHcy). This, which suggested an irreplaceable correlation in likely led to her CVST and was a well answer for the multiple organs and systems failure in the case multiorgan dysfunction. This case highlights that (1) HHcy is of great clinical significance in CVST young patients; and (2) for patients with HHcy, excluding all exogenous factors of HHcy such as dietary deficiency of vitamins, genetic factors. neurologists should recognize the potential genetic component to this disorder, especially when there is a strong family history and multisystem failure, should be paid much more attention, especially accompanied with multiple organs and systems disfunction and/or patient family history
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