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Objective To investigate the effect of care bundles based on the concept of enhanced recovery after surgery in perioperative nursing of patients undergoing laparoscopic cholecystectomy. Methods A total of 260 cases of laparoscopic cholecystectomy were randomly divided into observation group (n=130, received routine nursing care) and control group (n=130, received care bundles based on the concept of enhanced recovery). Postoperative recovery condition, incidence of complications and postoperative pain were compared between the two groups. Results At 2, 6 and 24 h after surgery, the Visual Analogue Scale of pain in the observation group were lower than those in the control group, with a significant difference(P＜0. 05). The time to first postoperative exhaustion, time to off-bed activities and hospital stays in the observation group were shorter than those in the control group (P＜0. 05). The incidence of vomiting, incision infection, and bile leakage in the control group was significantly higher than that in the observation group, with a significant difference (P＜0. 05). Conclusion The application of care bundles based on the concept of enhanced recovery after surgery are conducive to the postoperative recovery of patients undergoing laparoscopic cholecystectomy, as well as the improvement of postoperative quality of life. (目的 探讨基于加速康复外科理念的集束化干预措施在腹腔镜胆囊切除患者围术期护理中的应用效果。方法 选取2021年1月—2023年1月某三甲肝胆专科医院收治的260例行腹腔镜胆囊切除术的患者为研究对象, 随机分为两组: 对照组(n=130)围手术期间给予常规护理; 观察组(n=130)实施基于加速康复外科理念的集束化干预措施。比较两组术后恢复情况、并发症发生率以及术后疼痛情况。结果 术后2 h、6 h、24 h观察组患者疼痛视觉模拟(VAS)评分低于对照组, 差异有统计学意义(P＜0. 05)。与对照组相比, 观察组患者术后排气时间、下床时间和住院天数均缩短, 差异有统计学意义(P＜0. 05)。对照组呕吐、切口感染与胆漏发生率高于观察组, 差异有统计学意义(P＜0. 05)。结论 基于加速康复外科理念的集束化干预措更有利于患者术后康复, 提高术后生活质量 。)

Chickpeas (Cicer arietinum L.) are an important legume crop known for their rich nutrient content, including proteins, carbohydrates, and minerals. Thus, they are enjoyed by people worldwide. In recent years, the production scale of chickpeas has been growing gradually. The planting area of chickpeas represents roughly 35–36% of the total planting area, and the output of the beans is roughly 47–48%. However, the growth and development process of chickpeas is limited by a number of factors, including high temperature, drought, salt stress, and so forth. In particular, high temperatures can reduce the germination rate, photosynthesis, seed setting rate, and filling rate of chickpeas, restricting seed germination, plant growth, and reproductive growth. These changes lead to a decrease in the yield and quality of the crop. Heat shock proteins (HSPs) are small proteins that play an important role in plant defense against abiotic stress. Therefore, in the present study, HSP20 gene family members were identified based on the whole-genome data of chickpeas, and their chromosomal positions, evolutionary relationships, promoter cis-acting elements, and tissue-specific expression patterns were predicted. Subsequently, qRT-PCR was used to detect and analyze the expression characteristics of HSP20 genes under different temperature stress conditions. Ultimately, we identified twenty-one HSP20 genes distributed on seven chromosomes, and their gene family members were found to be relatively conserved, belonging to ten subfamilies. We also found that CaHSP20 promoter regions have many cis-acting elements related to growth and development, hormones, and stress responses. In addition, under high-temperature stress, the relative expression of CaHSP20-17, CaHSP20-20, CaHSP20-7, CaHSP20-3, and CaHSP20-12 increased hundreds or even thousands of times as the temperature increased from 25 °C to 42 °C. Among them, excluding CaHSP20-5, the other five genes all contain 1-2 ABA cis-regulatory elements. This finding indicates that CaHSP20s are involved in the growth and development of chickpeas under heat stress, and the mechanisms of their responses to high-temperature stress may be related to hormone regulation. The results of the present study lay the foundation for exploring HSP20 gene family resources and the molecular mechanisms of heat resistance in chickpeas. Our results can also provide a theoretical basis for breeding high-temperature-resistant chickpea varieties and provide valuable information for the sustainable development of the global chickpea industry. [ABSTRACT FROM AUTHOR]

Currently, collaborative distribution models have not reached the optimal state of carbon emissions. The cost of additional low-carbon expenditures and the problem of carbon data verification have led to the lack of motivation for reducing emissions among collaborative distribution enterprises. Therefore, how to incentivize them to adopt the low-carbon model is crucial for achieving low-carbon goal. By relying on a government-led digital platform, this paper designs a dual low-carbon incentive strategy to encourage enterprise-alliance to adopt a low-carbon distribution model. In this paper, we first construct an evolutionary game model of the government, enterprise-alliance and end-users; then we explore the conditions of the three-party equilibrium evolution strategy by solving the model and analyzing the stability; and finally, we conduct simulation validation and results analysis with the help of MATLAB. In summary, we found that government punishment is more effective at regulating enterprise-alliance than reward. End-users' behavior is affected by the costs they need to bear, and they no longer support enterprise-alliance to carry out collaborative low-carbon distribution above a certain threshold. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to obtain a constitutive model of cement-based material in the rheological stage, which owns the different water-cement ratio (w/c) and temperature and have a significant impact on the workability of concrete materials. Design/methodology/approach: It is introduced a modified Arrhenius equation into the Herschel–Bulkley model, which is widely applied in rheological analysis and constructed an ordinary differential equation (ODE) of w/c from the Navier–Stokes equation. By solving the ODE, an approximate constitutive relation of cement-based materials included w/c and temperature is derived. Compared with the experimental results, the present model is validated. Findings: The shear stress and shear rate curves with different w/c and temperature are simulated by the present method, and the present model can be applied to analyze the changes of apparent viscosity in cement-based material slurry as the w/c and temperature varying. Originality/value: This work gives a mathematical model, which can effectively approximate the shear stress–shear rate relation with different w/c and temperature in the rheological stage of cement-based material. [ABSTRACT FROM AUTHOR]