Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney tra...Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.展开更多
Multiple quadrotors target encirclement is widely used in the intelligent field,as it can effectively monitor and control target behavior.However,it faces the danger of collision,as well as difficulties in localizatio...Multiple quadrotors target encirclement is widely used in the intelligent field,as it can effectively monitor and control target behavior.However,it faces the danger of collision,as well as difficulties in localization and tracking.Therefore,we propose a complete target encirclement method.Firstly,based on Hooke's law,a collision avoidance controller is designed to maintain a safe flying distance among quadrotors.Then,based on the consensus theory,a formation tracking controller is designed to meet the requirements of formation transformation and encirclement tasks,and a stability proof based on Lyapunov was provided.Besides,the target detection is designed based on YOLOv5s,and the target location model is constructed based on the principle of pinhole projection and triangle similarity.Finally,we conducted experiments on the built platform,with 3 reconnaissance quadrotors detecting and localization 3 target vehicles and 7 hunter quadrotors tracking them.The results show that the minimum average error for localization targets with reconnaissance quadrotors can reach 0.1354 m,while the minimum average error for tracking with hunter quadrotors is only 0.2960 m.No quadrotors collision occurred in the whole formation transformation and tracking experiment.In addition,compared with the advanced methods,the proposed method has better performance.展开更多
Most of the existing studies on tunnel blast wave are based on spherical or grouped charges, however,conventional weapons are mostly cylindrical rather than spherical. In order to analyze the impact of cylindrical cha...Most of the existing studies on tunnel blast wave are based on spherical or grouped charges, however,conventional weapons are mostly cylindrical rather than spherical. In order to analyze the impact of cylindrical charges on the tunnel blast wave loads and to develop a quantitative calculation method, this study carried out experimental and numerical research. Initially, external explosion experiments were conducted using both 35 kg spherical charges and cylindrical charges with aspect ratio of 4.8 at two different distances from the tunnel entrance. Comparative analysis of the blast wave parameters in the tunnel revealed that the explosive equivalent of the cylindrical charges was significantly higher than that of the spherical charges. To address this, an equivalent coefficient κ based on the spherical charges was proposed for the cylindrical charges. Subsequently, numerical simulations were conducted for the experimental conditions, and the numerical simulation results match the experiments well. Through numerical calculations, the reliability of the equivalent coefficient κ under the experimental conditions was verified, and comparison analysis indicated that the explosion energy of cylindrical charges spreads more radially, resulting in more explosion energy entering the tunnel, which is the fundamental reason for the increase in tunnel blast wave loads. Additionally, analyzing the explosion energy ratio entering the tunnel is an effective method for calculating the equivalent coefficient κ. Finally, through more than one hundred sets of numerical calculation results, the impact of the proportional distance λ and the ratio of charge mass to the tunnel cross-section dimension φ on the equivalence coefficients κ was investigated. An empirical formula for the equivalence coefficient κ was derived through fitting, and the accuracy of the formula was validated through literature experimental results. The research findings of this paper will provide valuable guidance for the calculation of blast wave loads in tunnel.展开更多
Reusable and flexible capturing of space debris is highly required in future aerospace technologies.A tendon-actuated flexible robotic arm is therefore proposed for capturing floating targets in this paper.Firstly,an ...Reusable and flexible capturing of space debris is highly required in future aerospace technologies.A tendon-actuated flexible robotic arm is therefore proposed for capturing floating targets in this paper.Firstly,an accurate dynamic model of the flexible robotic arm is established by using the absolute nodal coordinate formulation(ANCF)in the framework of the arbitrary Lagrangian-Eulerian(ALE)description and the natural coordinate formulation(NCF).The contact and self-contact dynamics of the flexible robotic arm when bending and grasping an object are considered via a fast contact detection approach.Then,the dynamic simulations of the flexible robotic arm for capturing floating targets are carried out to study the influence of the position,size,and mass of the target object on the grasping performance.Finally,a principle prototype of the tendon-actuated flexible robotic arm is manufactured to validate the dynamic model.The corresponding grasping experiments for objects of various shapes are also conducted to illustrate the excellent performance of the flexible robotic arm.展开更多
Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or o...Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.展开更多
Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardio...Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardiography in 125 patients with one vessel disease before and 48 hours after selective coronary angioplasty. The following parameters of left ventricular diastolic function were evaluated: peak early (VE, m/s) and peak late diastolic (VA, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (DT, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular function. Results All of the patients were initially successful treated with coronary angioplasty (residual stenosis <40% ). In 98 patients( 78.4% ) stents were used to improve an inadequate result after coronary angioplasty. Both patient groups (27 patients with coronary angioplasty and 98 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after revascularisation. Surprisingly there was no significant short term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.Conclusions We suppose that stent implantation might normalize coronary blood flow faster than that of coronary balloon angioplasty.展开更多
Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(...Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.展开更多
Objective To evaluate short time effects of primary percutaneous coronary intervention (pPCI) and rtPA thrombolysis+PCI (rtPA+PCI) on myocardial viability and ventricular systolic synchrony in AMI patients.Methods Eig...Objective To evaluate short time effects of primary percutaneous coronary intervention (pPCI) and rtPA thrombolysis+PCI (rtPA+PCI) on myocardial viability and ventricular systolic synchrony in AMI patients.Methods Eighty seven patients with first AMI were divided into two groups: group A ( n =42), pPCI group, the patients underwent PCI within 6h after onset of AMI; group B ( n =45), rtPA+PCI group, the patients underwent PCI after thrombolysis within 6h after onset of AMI; Myocardial viability was measured by 99m Tc MIBI SPECT. While, the parameters of cardiac function LVEF and ventricular systolic synchrony LVPS were measured by 99m Tc gated cardiac blood pool image on the first and the fourth weekend. Results (1) The peak CK MB was significantly lower in group A than that in group B( P <0.01 ). (2) Myocardial infarction area (MIA) was decreased and radioactivity counts in MIA was significantly increased in group A and B on the 4th weekend compared with that on the first weekend ( P <0.01 ), but there were no significant difference between group A and group B. (3) LVEF, LVPS were no significant difference between group A and group B.Conclusions (1)pPCI in acute myocardial infartion can limit infarct area, maintain ventricular systolic synchrony and improve ventricular function; (2) but, in those hospitals that there were no any condition for PCI, they should transfer the patients to central hospital for PCI after thrombolysis at the first time. It is beneficial to improve myocardial viability and ventricular systolic synchrony of AMI patients in short time.展开更多
Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one pa...Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one patients with AML(aged 55-71 years) were randomly divided into two groups(Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival(RFS). Results · A total of 29 patients(70.7%) achieved complete remission(CR). The estimated 2-year overall survival(OS) was 66.8% in Group HCAG and 75.4% in Group IA(P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA(P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.展开更多
Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive u...Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.展开更多
Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operativ...Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operative comorbidity and mortality.However,little is known regarding the proportion of Chinese patients who denied to receive intervention and the reasons leading to the denial.This study is designed to analyze factors associated with decision-making and prognosis in elderly patients with severe,symptomatic AS.展开更多
Objective To investigate the old patients with aortic stenosis after transcatheter aortic valve implantation (TAVI) heating conditions,including the incidence of fever, heating time, risk factors, and the recent clini...Objective To investigate the old patients with aortic stenosis after transcatheter aortic valve implantation (TAVI) heating conditions,including the incidence of fever, heating time, risk factors, and the recent clinical outcomes, as TAVI postoperative fever prevention measures,provide clinical basis for the establishment of nursing standard.展开更多
Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecut...Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecutively enrolled a total of 1307 treated hypertensive patients from Fuwai Hospital during May 2014 to September 2017.展开更多
Objective Vasopressin has showed a beneficial use in pediatric patients with vasodilatory shock after cardiac surgery. However, the optimal timing of vasopressin initiation has not been investigated.Our aim was to eva...Objective Vasopressin has showed a beneficial use in pediatric patients with vasodilatory shock after cardiac surgery. However, the optimal timing of vasopressin initiation has not been investigated.Our aim was to evaluate the effect of early vasopressin initiation for these patients.展开更多
Controlled laboratory experiments are proved to be a valuable tool for investigating changes in underground physical properties and the related response of surface geophysical signals.The self-potential(SP)method is w...Controlled laboratory experiments are proved to be a valuable tool for investigating changes in underground physical properties and the related response of surface geophysical signals.The self-potential(SP)method is widely used in mineral resource exploration due to its direct correlation with underground electrochemical gradients.This paper presented the design and construction of an experimental platform based on a multi-channel SP monitoring system.The proposed platform was used to monitor the anodizing corrosion process of different metal blocks from a laboratory perspective,record the real-time SP signal generated by the redox reaction,as well as investigate the geobattery mechanism associated with the natural polarization process of metal mineral resources.The experimental results demonstrate that the constructed SP monitoring platform effectively captures time-series SP signals and provides direct laboratory evidence for the geobattery model.The measured SP data were quantitatively interpreted using the simulated annealing algorithm,and the inversion results closely match the real model.This finding highlights the potential of the SP method as a promising tool for determining the location and spatial distribution of underground polarizers.The study holds reference value for the exploration and exploitation of mineral resources in both terrestrial and marine environments.展开更多
Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvu...Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvular atrial fibrillation(NVAF).Methods Elderly patients(≥80 years)with NVAF admitted to our hospital from January 2009 to December 2015 were retrospectively studied and were followed up until April 2017.展开更多
Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Th...Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Therefore,timely diagnosis and proactive treatment are crucial.Definition of anaphylaxis,epidemiology of anaphylaxis and common allergens,specific anaphylaxis,diagnosis and management of peri-operative anaphylaxis in cardiac surgery patients were discussed in this review.展开更多
Objective To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in high-risk hypertensive patients with a high–normal level of total cholesterol...Objective To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in high-risk hypertensive patients with a high–normal level of total cholesterol(TC).Methods In a randomized,open-label,blinded-endpoint trial,hypertensive patients at high risk for cardiovascular events from 180 clinical centers in China were assigned to receive treatment with amlodipine plus amiloride/hydrochlorothiazide(n=6,776)or telmisartan(n=6,766).展开更多
Objective Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with AMI, but the safety of intracoronory infusion of autologous peripheral blood stem-cell(PBSCs) in patients wit...Objective Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with AMI, but the safety of intracoronory infusion of autologous peripheral blood stem-cell(PBSCs) in patients with AMI is unknown. For this reason, we observe the feasibility and safety of PBSCs transplantation by intracoronory infusion in such patients.Method Fourty one patients with AMI were allocated to receive Granulocyte Colony-Stimulating Factor (G-CSF:Filgrastim,300 μg) with the dose of 300 μg-600 μg/day to mobilize the stem cell, and the duration of applying G-CSF was 5 days . On the sixth day, PBSCs were separated by Baxter CS 3000 blood cell separator into suspend liquid 57 ml. Then the suspend liquid was infused into the infarct related artery (IRA)by occluding the over the wire balloon and infusing artery through balloon center lumen. In the process of the intracoronary infusion of PBSCs, the complications should be observed, which were arrhythmias including of bradycardia, sinus arrest or atrial ventricular block, premature ventricular beats ,ventricular tachycardia, ventricular fibrillation; and hypotention, etc. Results There were total 10 cases with complications during the intracoronary infusion of PBSCs. The incidence of complications was 24.4%(10/41), including bradycardia is 2.4 %(1/41), sinus arrest or atrial ventricular block is 4.9%(2/41), ventricular fibrillation is 2.4 %( 1/41), hypotention is14.6 % (6 /41).Conclusions In patients with AMI, intracoronary infusion of PBSCs is feasible and safe.展开更多
Since the latest revision of the TNM system reclassified T3N0 tumours into the ⅡB stage, N2 lesions became the major determinant of the ⅢA stage. Concerning the minority of patients with T3N1 tumours in this stage,
基金This work was supported by the Natural Science Foundation of Hunan Province,China (2024JJ9201)。
文摘Objective:Compared with long-term renal replacement therapy,kidney transplantation is the ideal treatment for end-stage renal disease(ESRD),significantly extending patient life and improving quality of life.Kidney transplant patients need to adhere to lifelong immunosuppressive medication regimens,but their medication adherence is generally poor compared with other organ transplant recipients.Medication adherence is closely related to medication literacy and psychological status,yet related studies are limited.This study aims to investigate the current status of medication adherence,inner strength,and medication literacy in kidney transplant patients,analyze the relationships among these 3 factors,and explore the mediating role of inner strength in the relationship between medication literacy and medication adherence.Methods:A cross-sectional survey was conducted from March to October 2023 involving 421 patients aged≥18 years who visited kidney transplantation outpatient clinics at 4 tertiary hospitals in Hunan Province.The inner strength,medication literacy,and medication adherence of kidney transplant patients were investigated using the Inner Strength Scale(ISS),the Chinese version of the Medication Literacy Assessment in Spanish and English(MedLitRxSE),and the Chinese version of the Morisky Medication Adherence Scale-8(C-MMAS-8),respectively.Univariate analysis was performed to examine the effects of demographic and clinical data on medication adherence.Correlation analysis was conducted to explore the relationships among medication literacy,medication adherence,and inner strength.Significant variables from univariate and correlation analyses were further analyzed using multiple linear regression,and the mediating effect of inner strength was explored.Results:Among the 421 questionnaires collected,408 were valid,with an effective rate of 96.91%.The scores of C-MMAS-8,MedLitRxSE,and ISS were 6.64±1.16,100.63±14.67,and 8.47±4.03,respectively.Among the 408 patients,only 86(21.08%)patients had a high level of medication adherence,whereas 230(56.37%)patients had a medium level of medication adherence,and 92(22.55%)patients had poor medication adherence.Univariate analysis indicated that the kidney transplant patients’age,marital status,education levels,years since their kidney transplant operation,number of hospitalizations after the kidney transplant,and adverse drug reactions showed significant differences in medication adherence(all P<0.05).Correlation analysis showed that inner strength positively correlated with both medication literacy(r=0.183,P<0.001)and medication adherence(r=0.201,P<0.001).Additionally,there was a positive correlation between medication adherence and medication literacy(r=0.236,P<0.001).Inner strength accounted for 13.22%of the total effect in the mediating role between medication literacy and medication adherence.Conclusion:The level of medication adherence among kidney transplant patients needs improvement,and targeted intervention measures are essential.Inner strength mediates the relationship between medication literacy and medication adherence in these patients.Healthcare professionals should focus on enhancing medication literacy and supporting patients’inner strength to improve medication adherence.
基金the National Natural Science Foundation of China(Grant Nos.62303348 and 62173242)the Aeronautical Science Foundation of China(Grant No.2024M071048002)the National Science Fund for Distinguished Young Scholars(Grant No.62225308)to provide fund for conducting experiments.
文摘Multiple quadrotors target encirclement is widely used in the intelligent field,as it can effectively monitor and control target behavior.However,it faces the danger of collision,as well as difficulties in localization and tracking.Therefore,we propose a complete target encirclement method.Firstly,based on Hooke's law,a collision avoidance controller is designed to maintain a safe flying distance among quadrotors.Then,based on the consensus theory,a formation tracking controller is designed to meet the requirements of formation transformation and encirclement tasks,and a stability proof based on Lyapunov was provided.Besides,the target detection is designed based on YOLOv5s,and the target location model is constructed based on the principle of pinhole projection and triangle similarity.Finally,we conducted experiments on the built platform,with 3 reconnaissance quadrotors detecting and localization 3 target vehicles and 7 hunter quadrotors tracking them.The results show that the minimum average error for localization targets with reconnaissance quadrotors can reach 0.1354 m,while the minimum average error for tracking with hunter quadrotors is only 0.2960 m.No quadrotors collision occurred in the whole formation transformation and tracking experiment.In addition,compared with the advanced methods,the proposed method has better performance.
文摘Most of the existing studies on tunnel blast wave are based on spherical or grouped charges, however,conventional weapons are mostly cylindrical rather than spherical. In order to analyze the impact of cylindrical charges on the tunnel blast wave loads and to develop a quantitative calculation method, this study carried out experimental and numerical research. Initially, external explosion experiments were conducted using both 35 kg spherical charges and cylindrical charges with aspect ratio of 4.8 at two different distances from the tunnel entrance. Comparative analysis of the blast wave parameters in the tunnel revealed that the explosive equivalent of the cylindrical charges was significantly higher than that of the spherical charges. To address this, an equivalent coefficient κ based on the spherical charges was proposed for the cylindrical charges. Subsequently, numerical simulations were conducted for the experimental conditions, and the numerical simulation results match the experiments well. Through numerical calculations, the reliability of the equivalent coefficient κ under the experimental conditions was verified, and comparison analysis indicated that the explosion energy of cylindrical charges spreads more radially, resulting in more explosion energy entering the tunnel, which is the fundamental reason for the increase in tunnel blast wave loads. Additionally, analyzing the explosion energy ratio entering the tunnel is an effective method for calculating the equivalent coefficient κ. Finally, through more than one hundred sets of numerical calculation results, the impact of the proportional distance λ and the ratio of charge mass to the tunnel cross-section dimension φ on the equivalence coefficients κ was investigated. An empirical formula for the equivalence coefficient κ was derived through fitting, and the accuracy of the formula was validated through literature experimental results. The research findings of this paper will provide valuable guidance for the calculation of blast wave loads in tunnel.
基金funded by the"14th Five-Year Plan"Civil Aerospace Pre-research Project of China(Grant No.D010301).
文摘Reusable and flexible capturing of space debris is highly required in future aerospace technologies.A tendon-actuated flexible robotic arm is therefore proposed for capturing floating targets in this paper.Firstly,an accurate dynamic model of the flexible robotic arm is established by using the absolute nodal coordinate formulation(ANCF)in the framework of the arbitrary Lagrangian-Eulerian(ALE)description and the natural coordinate formulation(NCF).The contact and self-contact dynamics of the flexible robotic arm when bending and grasping an object are considered via a fast contact detection approach.Then,the dynamic simulations of the flexible robotic arm for capturing floating targets are carried out to study the influence of the position,size,and mass of the target object on the grasping performance.Finally,a principle prototype of the tendon-actuated flexible robotic arm is manufactured to validate the dynamic model.The corresponding grasping experiments for objects of various shapes are also conducted to illustrate the excellent performance of the flexible robotic arm.
文摘Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.
文摘Objective The aim of this study was to determine the effect of successful coronary revascularisation on left ventricular diastolic function.Methods We consecutively studied the diastolic function by Doppler echocardiography in 125 patients with one vessel disease before and 48 hours after selective coronary angioplasty. The following parameters of left ventricular diastolic function were evaluated: peak early (VE, m/s) and peak late diastolic (VA, m/s) flow velocity, E/A ratio, acceleration time (AT, ms), deceleration time (DT, ms) and isovolumetric relaxation time (IVRT, ms). Ejection fraction (EF; %) was determined and used to characterise systolic left ventricular function. Results All of the patients were initially successful treated with coronary angioplasty (residual stenosis <40% ). In 98 patients( 78.4% ) stents were used to improve an inadequate result after coronary angioplasty. Both patient groups (27 patients with coronary angioplasty and 98 patients with combined coronary angioplasty and stent implantation) showed no relevant differences concerning sex, age, atherosclerotic risk factors, exercise capacity and results of exercise electrocardiography. All patients who underwent stent implantation showed an early improvement of left ventricular diastolic function 48 hours after revascularisation. Surprisingly there was no significant short term improvement (48 hours) of diastolic function in patients with initially successful angioplasty.Conclusions We suppose that stent implantation might normalize coronary blood flow faster than that of coronary balloon angioplasty.
文摘Objective Comparative study on the feasibility,safety and outcome of transradial artery and transfemoral artery access for primary percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI).Methods Two hundred and eight patients with AMI episoded within 12 hours, male 159, female 49, age 58.9 ±11.9 (34～88)years, were randomly divided into transradial artery access for primary PCI (TRA pPCI) group of 106 cases and transfemoral artery access for PCI (TFA pPCI) group of 102 cases during Sept, 2000 to Aug, 2002. The protocols of the manipulation duration and the effect for TRA pPCI and TFA pPCI procedures were respectively compared, including the time of transradial artery puncture and the rate of puncture success at first time ; the time of guiding catheter engaging into target coronary ostium; the rate of patence in infarct related artery (IRA); total duration of manipulation and the successful rate.The incidence of complications such as bleeding, vessel injury,thrombi and embolism as well as the average stay of hospitalization between two groups was compared. The status and the incidance of vessel spasm were observed and the effect of medicine administration to prevent from and relieve the vascular spasm was evaluated. The time of Allen’s test before and after TRA pPCI , the inner diameter and the peak of blood velocity of the right and left radial artery were investigated with color Doppler vessel echography as well as the complications of radial artery were followed up 1 month after TRA pPCI procedure. Results Two cases in every TRA pPCI and TFA pPCI groups were crossed over each other because procedure of the transradial or transfemoral access was failure. One handred and six vessels (48 vessels in LAD,22 vessels in LCX and 36 vessels in RCA) associated with 28 vessels of total occlusion in TRA pPCI group and 102 vessels (51 vessels in LAD,18 veesles in LCX and 33 vessels in RCA) with 24 vessels in total occlusion in TFA pPCI group were angioplasticized . The successful rates of the first time puncture in access artery, the re patence IRA and pPCI were similar in TRA pPCI and TFA pPCI groups ( 93.4% vs 96.1% ;100% vs 100%; 96.2% vs 97.1% , P >0.05 ). There were no significant diffierence in the average time of puncture time of access artery ,engaging in target vessels of guiding catheters and the total procedure of PCI between the two groups ( 1.3 ±0.3s vs 1.2 ±0.3s ; 6.0 ±1.6min vs 5.8 ±0.9min ; 49.2 ±24.1min vs 46.5 ± 26.4min , P >0.05 ). The access artery complications such as bleeding ,hematoma and embolism as well the veneous thrombosis in TFA pPCI group were much more than those in TRA pPCI group(p< 0.01 ). Although slight artery spasm of 4.7% cases in TRA pPCI group was happened during the procedure of PCI , the procedure had being continued after administration of medicine to release the spasm. The time of Allen’s test ,diameter and the systolic velocity of blood in daul radial arteries were no significant change before and after pPCI.Conclusions The duration and effect by TRA pPCI for AMI with stable hemodynamics was similar to TFA pPCI. The complications such as of bleeding,vessel injury, thrombi and embolism by TRA pPCI were few, and it was unnecessary to discontinue the anticoagulation medicine. TRA pPCI might be selected as a access vessel for pPCI in AMI patients with stable hemodynamics.
文摘Objective To evaluate short time effects of primary percutaneous coronary intervention (pPCI) and rtPA thrombolysis+PCI (rtPA+PCI) on myocardial viability and ventricular systolic synchrony in AMI patients.Methods Eighty seven patients with first AMI were divided into two groups: group A ( n =42), pPCI group, the patients underwent PCI within 6h after onset of AMI; group B ( n =45), rtPA+PCI group, the patients underwent PCI after thrombolysis within 6h after onset of AMI; Myocardial viability was measured by 99m Tc MIBI SPECT. While, the parameters of cardiac function LVEF and ventricular systolic synchrony LVPS were measured by 99m Tc gated cardiac blood pool image on the first and the fourth weekend. Results (1) The peak CK MB was significantly lower in group A than that in group B( P <0.01 ). (2) Myocardial infarction area (MIA) was decreased and radioactivity counts in MIA was significantly increased in group A and B on the 4th weekend compared with that on the first weekend ( P <0.01 ), but there were no significant difference between group A and group B. (3) LVEF, LVPS were no significant difference between group A and group B.Conclusions (1)pPCI in acute myocardial infartion can limit infarct area, maintain ventricular systolic synchrony and improve ventricular function; (2) but, in those hospitals that there were no any condition for PCI, they should transfer the patients to central hospital for PCI after thrombolysis at the first time. It is beneficial to improve myocardial viability and ventricular systolic synchrony of AMI patients in short time.
基金National Natural Science Foundation of China(81270621,81300451)National Public Health Grand Research Foundation(201202003)+1 种基金Shanghai Health System Advanced and Appropriate Technology Promotion Projects(2013SY001)Multiple Clinical Research Center Program of Shanghai Jiao Tong University School of Medicine(DLY201513)
文摘Objective · To compare the efficacy and prognostic factors of HCAG regimen with traditional IA regimen in the treatment of newly diagnosed elderly acute myeloid leukemia(AML) patients. Methods · Forty-one patients with AML(aged 55-71 years) were randomly divided into two groups(Group HCAG and Group IA) between 2014 and 2016 for induction and consolidation therapy. Multivariate analysis was applied to identify prognostic factors for relapse-free survival(RFS). Results · A total of 29 patients(70.7%) achieved complete remission(CR). The estimated 2-year overall survival(OS) was 66.8% in Group HCAG and 75.4% in Group IA(P=0.913). The estimated 2-year RFS was 61.8% in Group HCAG and 49.1% in Group IA(P=0.411). Age remained as the unfavorable prognostic factor, leading to significant differences in OS and RFS. In addition, RFS was influenced by cytogenetic/molecular risk stratification. Conclusion · Although HCAG seemed not to particularly benefit the group, the dose reduction of anthracyclines may be applied in elderly patients with comparable short-time outcome. Furthermore, the introduction of homoharringtonine resulted in an improvement of treatment response for more than 20% compared with CAG regimen.
文摘Objective The trial was designed to evaluate the safety and performance of the ev3 Protégé TM stent in the treatment of de novo or re-stenotic common and/or internal carotid artery stenoses with adjunctive use of a CE-marked filter embolic protection device.Methods This study was a prospective multi-center, single-arm trial. Between June and October 2003, 77 patients were enrolled in 8 investigational centers throughout Europe. The primary endpoint was the incidence of Major Neurological Events (MANE) through one month. Other endpoints were the ability to properly place the stent, and primary patency and MANE after six months. Eligible for the study were patients with a de novo or restenotic target lesion located in the common and/or internal carotid artery (>70% stenosis for asymptomatic and >50% stenosis for symptomatic patients). The ev3 Spider (Embolic Protection Filter was used in 75 of 77 cases. Results In 76 out of the 77 patients (99%), the stent could be successfully implanted with a residual stenosis ≤30% as criterion. Of the 74 patients that had a carotid ultrasound at one month follow-up, none had a re-stenosis of the target lesion. There were three MANEs during or immediately after the procedure (3.9%), two were major and one was a minor stroke. There were eight severe complications (9.1%); six of these happened during or immediately after the procedure and were related to the procedure, none was related to the device. They are resolved without sequelae. No deaths have occurred.Conclusions The Protégé stent is safe and performs well in the treatment of carotid artery stenosis. The technical success rate for placement of the Protégé stent as assessed by the residual stenosis post implant was very high and all stents were successfully deployed. The incidence of MANE was comparable with that in other recent carotid stent studies and still lower than standard CEA.
文摘Objective There is a consensus that intervention should be advised in patients with severe,symptomatic aortic stenosis(AS).Decision to operate raises specific problems in the elderly because of the increasing operative comorbidity and mortality.However,little is known regarding the proportion of Chinese patients who denied to receive intervention and the reasons leading to the denial.This study is designed to analyze factors associated with decision-making and prognosis in elderly patients with severe,symptomatic AS.
文摘Objective To investigate the old patients with aortic stenosis after transcatheter aortic valve implantation (TAVI) heating conditions,including the incidence of fever, heating time, risk factors, and the recent clinical outcomes, as TAVI postoperative fever prevention measures,provide clinical basis for the establishment of nursing standard.
文摘Objective To explore the current status of morning blood pressure control and associated risk factors among treated hypertensives,and toprovide useful information for morning blood pressure control.Methods We consecutively enrolled a total of 1307 treated hypertensive patients from Fuwai Hospital during May 2014 to September 2017.
文摘Objective Vasopressin has showed a beneficial use in pediatric patients with vasodilatory shock after cardiac surgery. However, the optimal timing of vasopressin initiation has not been investigated.Our aim was to evaluate the effect of early vasopressin initiation for these patients.
基金Project(42174170)supported by the National Natural Science Foundation of China。
文摘Controlled laboratory experiments are proved to be a valuable tool for investigating changes in underground physical properties and the related response of surface geophysical signals.The self-potential(SP)method is widely used in mineral resource exploration due to its direct correlation with underground electrochemical gradients.This paper presented the design and construction of an experimental platform based on a multi-channel SP monitoring system.The proposed platform was used to monitor the anodizing corrosion process of different metal blocks from a laboratory perspective,record the real-time SP signal generated by the redox reaction,as well as investigate the geobattery mechanism associated with the natural polarization process of metal mineral resources.The experimental results demonstrate that the constructed SP monitoring platform effectively captures time-series SP signals and provides direct laboratory evidence for the geobattery model.The measured SP data were quantitatively interpreted using the simulated annealing algorithm,and the inversion results closely match the real model.This finding highlights the potential of the SP method as a promising tool for determining the location and spatial distribution of underground polarizers.The study holds reference value for the exploration and exploitation of mineral resources in both terrestrial and marine environments.
文摘Objective Elevated serum uric acid predicts poor outcomes in patients with cardiovascular disease.We aimed to examine associations between hyperuricemia and clinical outcomes among very elderly patients with non-valvular atrial fibrillation(NVAF).Methods Elderly patients(≥80 years)with NVAF admitted to our hospital from January 2009 to December 2015 were retrospectively studied and were followed up until April 2017.
文摘Objective Patients undergoing cardiac surgery are exposed to a large range of drugs and foreign substances,which might result in anaphylaxis.Severe anaphylaxis in cardiac surgical patients could be life-threatening.Therefore,timely diagnosis and proactive treatment are crucial.Definition of anaphylaxis,epidemiology of anaphylaxis and common allergens,specific anaphylaxis,diagnosis and management of peri-operative anaphylaxis in cardiac surgery patients were discussed in this review.
文摘Objective To investigate the effects of simvastatin compared with standard treatment on cardiovascular outcomes and all-cause mortality in high-risk hypertensive patients with a high–normal level of total cholesterol(TC).Methods In a randomized,open-label,blinded-endpoint trial,hypertensive patients at high risk for cardiovascular events from 180 clinical centers in China were assigned to receive treatment with amlodipine plus amiloride/hydrochlorothiazide(n=6,776)or telmisartan(n=6,766).
文摘Objective Bone-marrow stem-cell transplantation has been shown to improve cardiac function in patients with AMI, but the safety of intracoronory infusion of autologous peripheral blood stem-cell(PBSCs) in patients with AMI is unknown. For this reason, we observe the feasibility and safety of PBSCs transplantation by intracoronory infusion in such patients.Method Fourty one patients with AMI were allocated to receive Granulocyte Colony-Stimulating Factor (G-CSF:Filgrastim,300 μg) with the dose of 300 μg-600 μg/day to mobilize the stem cell, and the duration of applying G-CSF was 5 days . On the sixth day, PBSCs were separated by Baxter CS 3000 blood cell separator into suspend liquid 57 ml. Then the suspend liquid was infused into the infarct related artery (IRA)by occluding the over the wire balloon and infusing artery through balloon center lumen. In the process of the intracoronary infusion of PBSCs, the complications should be observed, which were arrhythmias including of bradycardia, sinus arrest or atrial ventricular block, premature ventricular beats ,ventricular tachycardia, ventricular fibrillation; and hypotention, etc. Results There were total 10 cases with complications during the intracoronary infusion of PBSCs. The incidence of complications was 24.4%(10/41), including bradycardia is 2.4 %(1/41), sinus arrest or atrial ventricular block is 4.9%(2/41), ventricular fibrillation is 2.4 %( 1/41), hypotention is14.6 % (6 /41).Conclusions In patients with AMI, intracoronary infusion of PBSCs is feasible and safe.
文摘Since the latest revision of the TNM system reclassified T3N0 tumours into the ⅡB stage, N2 lesions became the major determinant of the ⅢA stage. Concerning the minority of patients with T3N1 tumours in this stage,
