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Objective To evaluate the influencing factors for severe absolute lymphatic count (ALC) reduction during concurrent chemoradiotherapy (CCRT) in patients with esophageal squamous cell carcinoma (ESCC), to develop a predictive model for severe ALC reduction during CCRT in patients with ESCC, and to validate its efficacy. Methods Clinical baseline data, radiotherapy regimen, and radiotherapy dosimetry parameters were collected from 286 ESCC patients who underwent CCRT. Trends in ALC during CCRT were analyzed based on pre-treatment ALC and weekly ALC during treatment. Patients were divided into the severe ALC reduction group and non-severe ALC reduction group according to whether severe ALC reduction occurred during CCRT. We compared the above information between the two groups, and screened the independent risk factors for severe ALC reduction during CCRT in ESCC patients by multifactorial Logistic regression analysis, constructed the risk prediction model based on risk factors, and plotted a nomogram (nomogram model). Receiver operating characteristics (ROC) curve, consistency index (C-index), calibration curve, and decision analysis (DCA) curve were used to assess the discrimination, consistency, calibration, and clinical applicability of the nomogram model. Results ESCC patients showed a gradual decrease in ALC during CCRT (P＜0. 05). Statistically significant differences were found in BMI, pre-treatment ALC, mean vertebral dose (MVD), and estimated dose of circulating immune cells (EDIC) between the two groups (all P＜0. 05). BMI (OR=0. 829, 95%CI:0. 760-0. 900), pretreatment ALC (OR=0. 412, 95% CI:0. 253-0. 648), MVD (OR=1. 079, 95% CI:1. 011-1. 155) and EDIC (OR=1. 711, 95%CI:1. 422-2. 292) were independent influencing factors for severe ALC reduction during CCRT in ESCC patients (all P＜0. 05). A nomogram model was constructed based on the above risk factors. The area under the ROC of the nomogram model in predicting the occurrence of severe ALC reduction during CCRT was 0. 799 (95% CI:0. 748-0. 850), the C-index was 0. 789, and the predicted risk of ALC reduction was consistent with the risk of the actual occurrence;the prediction of severe ALC reduction had good clinical applicability in the probability range of 0. 25 to 0. 90. Conclusions The independent influencing factors for severe ALC reduction during CCRT in ESCC patients are BMI, pretreatment ALC, MVD, and EDIC, and the nomogram model for predicting severe ALC reduction during CCRT in ESCC patients based on the above mentioned influencing factors has good differentiation, consistency, calibration, and clinical applicability. [ABSTRACT FROM AUTHOR]

Objective To investigate the application value of transumbilical single-site laparoscopic surgery combined with early postoperative enteral nutrition (EEN) in rapid recovery of congenital duodenal obstruction. Methods Clinical data of 87 children with duodenal obstruction were analyzed. The children who received three-hole laparoscopic treatment were classified as the three-hole group (n=39), and children who received transumbilical single-site laparoscopic treatment were divided into the single-hole group (conventional feeding, n=26) and the single-hole EEN group (EEN, n=22) according to different postoperative feeding methods. The differences of operation time, postoperative intestinal function recovery time, hospital stay and cost, laboratory indicators and complications were compared between the three groups. Results There was no significant difference in operation time between the three groups (P＞0.05). There were no significant differences in the time of initial enteral nutrition, the time to total enteral nutrition, the time of first defecation, the time of postoperative hospitalization, the cost of hospitalization and levels of albumin (ALB), hemoglobin (Hb) and C-reactive protein (CRP) one week after surgery between the single-hole group and the three-hole group (P＞0.05). The time of initial enteral nutrition, the time of total enteral nutrition, the time of first defecation, the time of postoperative hospitalization were significantly shortened in the single-hole EEN group than those of the single-hole group (P＜0.05), and the Hb level was higher one week after surgery (P＜0.05). There were no significant differences in hospital expenses, ALB and CRP levels one week after surgery between the two groups (P＞0.05). During follow-up after discharge, there was one case of recurrent intestinal torsion in the single-hole group and the three-hole group, which were cured after re-operation. Conclusion In the treatment of neonatal duodenal obstruction, transumbilical single-site laparoscopic surgery combined with early enteral nutrition is safe, feasible and effective, which can promote early postoperative recovery. The abdominal incision is hidden, which has good clinical application value. [ABSTRACT FROM AUTHOR]

When the meta-heuristic algorithm solves the joint resource allocation problem of multi-beam satellites, the computational complexity increases and the algorithm is difficult to converge due to the time delay constraint and capacity constraint. This paper introduced a penalty mechanism in the objective function, and added a penalty value to the objective function of the invalid solution, so that the optimized solution adaptively satisfied these two constraints. Based on this, this paper proposed a joint resource allocation algorithm based on quantum-behaved particle swarm optimization. Simulation results show that the introduction of the penalty strategy solves the problem of difficulty in handling the delay constraint and capacity constraint when applying the meta-heuristic algorithm. The quantum-behaved particle swarm optimization algorithm with penalty mechanism outperforms the existing joint allocation algorithm in terms of allocation fairness index and total system capacity. [ABSTRACT FROM AUTHOR]

: Net carbon sink from land-use change has been one of the most important factors on the process of cultivated land use. The comprehensive zoning optimization of cultivated land use can be an effective way to realize the green and sustainable development of agriculture and improve the net carbon sink level of cultivated land use in China. A theoretical basis can also be provided for the protection of cultivated land at the national level, and the optimal allocation of cultivated land resources. In this study, the trend of net carbon sink of cultivated land use was estimated in 31 Provinces (cities and districts) in China from 2005 to 2020, particularly from the perspective of carbon source and carbon sink of cultivated land use. The dynamic evolution and interval difference were analyzed using Kernel density estimation. The decoupling effect was also established between the net carbon emission of cultivated land and agricultural economy. After that, the comprehensive zoning of cultivated land use was optimized to combine with the decoupling and characteristics in the main grain producing areas. A Grey Model (GM) was utilized to predict the change trend and decoupling status of net carbon sink in each comprehensive zoning from 2021 to 2035. The results showed that: 1) There was a fluctuating upward trend for the net carbon sink of cultivated land use, with an average annual growth rate of 3.740% in the study period. The spatial difference of carbon sink capacity was much better in the main grain producing areas, compared with the rest. 2) Kernel density estimation shows that the regional gap of net carbon sink of cultivated land use was gradually narrowing. However, there was still a regional imbalance. The main grain producing areas, the balance of production and marketing areas, and the main sales areas all showed a trend of diffusion to the high-value carbon sink areas. 3) There was the mainly strong decoupling between the net carbon emissions from the cultivated land use and agricultural economy in the study period. A comprehensive zone was achieved for the coordination of economic and ecological benefits in the most provinces (cities and districts), except for Beijing, Shanghai, Guangdong and Hainan in 2020. 4) The GM predicted that the carbon sink capacity of cultivated land use would maintain a steady growth from 2021 to 2035, and there was the strong decoupling status of each comprehensive zone. Consequently, it is very feasible for the unification of economic and ecological benefits in the future cultivated land use. The finding can also provide a strong reference and guidance for the “double carbon” goal in the field of cultivated land. Finally, the targeted optimization strategies and directions can be greatly contribute to the coordinated development of economic and ecological benefits of cultivated land use in the whole country and various comprehensive divisions, in order to achieve low-carbon, green, and high-quality development of cultivated land use. [ABSTRACT FROM AUTHOR]

Objective: To investigate the clinical efficacy and safety of high-flow nasal cannula (HFNC) and non-invasive positive pressure ventilation (NPPV) in the treatment of type 1 respiratory failure. Methods: 60 patients with acute type 1 respiratory failure admitted to our hospital from September 2016 to December 2017 were randomly divided into the HFNC group and the NPPV group according to the order of admission, 23 patients in each group were treated with HFNC and NPPV treatment respectively. The arterial blood gas pH value, PaCO2, PaO2, oxygenation index, respiratory rate, heart rate were compared before and at 2 h, 24 h and 48 h after treatment. Results: There was no significant difference in the pH value of arterial blood gas before treatment and at 2 h, 24 h and 48 h after treatment (P>0.05). The PaO2 and arterial blood oxygenation index were significantly higher in the two groups at 2 h, 24 h and 48 h after treatment, and gradually increased with time (P<0.05), and at 48 h after treatment, it was significantly higher in the NPPV group than that of the HFNC group (P<0.05). The PaCO2 values at 2 h, 24 h and 48 h after treatment showed no significant difference from those before treatment (P>0.05), while the PaCO2 values in the NPPV group at 48 h after treatment were significantly lower than those in the HFNC group (P<0.05). The respiratory rate at 2 h, 24 h and 48 h after treatment was significantly lower than that before treatment, and gradually decreased with time (P<0.05), and the respiratory rate of NPPV group was significantly higher than those of the HFNC group at 2 h, 24 h and 48 h after treatment (P<0.05). The heart rate at 2 h, 24 h and 48 h after treatment were significantly lower than that before treatment, and gradually decreased with time (P<0.05). [ABSTRACT FROM AUTHOR]

Since 1980s, as the advantage of modular construction technology in avoiding the labor shortage, high human cost and strict environmental requirements of the construction place, some large construction companies of petroleum and natural gas engineering in developed countries have adopted it in quantities of engineer constructions, and their design and construction level both developed rapidly. At present, the modular design technology of large petrochemical industry and natural gas treatment device has not been mastered by domestic design companies. The modular design technology and skids were adopted only in the fields such as oil field ground engineering, medium and small natural gas treatment devices and so on. The scientific and systematic technical system has not been developed. Based on the analysis presented above, the project group of "modular design and construction technology research" of CNPC, based on a project of 300×108 m3/a natural gas treatment plant, has deeply studied the modular design technology, and clearly defined the concepts in the modular design process of petroleum and natural gas devices, including the skid, module, module/skid specification, modularization, module splice, pipe splice, ship loose and so on. The above concepts are rich in content, clear in extension and practical. It can meet the requirements of modular construction process. By analyzing above key concepts, it can help the engineering technicians to understand the basic concepts and principles of modular design, so as to guide them to the correct direction of modular design. [ABSTRACT FROM AUTHOR]

The technology of multilevel encoding modulation is widely used in the new generation ultrahigh speed optical communication systems, its hardware is integrated circuit so it is complex. To satisfy the experiment teaching and make the students understand urology fronts and skilled technology. A digital voice transmission experiment system based on multilevel encoding is designed. The system can realize sending and receiving of digital voice signal which comes from two channels accurately, the idea of modularization design makes the students know the functions of each module visually though observing the time domain waveform, and the modules can be alternative designed. With the aid of the experiment system, undergraduate research innovation experiments are developed. It shows a practical environment which is easy to innovate outcomes and integrate knowledge, and it can improve students' comprehensive utilization and innovation ability. [ABSTRACT FROM AUTHOR]

Objective: To investigate and analyze the distribution and drug resistance of carbapenem-resistant Klebsiella pneumoniae in patients with renal insufficiency in intensive care unit(ICU). Methods: From February 2015 to December 2017, 46 specimens of patients with renal insufficiency in ICU were collected. The source of specimen and the clinical data of patients were investigated, the pathogens were isolated and identified. Results: A total of 165 strains of Carbapenem resistant Klebsiella pneumoniae were isolated from 46 cases of patients. The specimens were derived from 6 cases of urine, 20 cases of sputum, 4 cases of blood, 10 cases of lavage fluid, 3 cases of secretion, 3 cases of bile. The resistance rates of 165 strains of carbapenem-resistant Klebsiella pneumoniae to meropenem, imipenem and ertapenem, retinoic acid and ciprofloxacin, cefalotin, cefotaxime, ampicillin, amoxicillin/carat were over80%, and the resistance rates to piperacillin/tazobactam and gentamicin were about 75%, and for the tetracycline and tega were below40%. Among the 46 patients, there were 16 cases were cured, 17 cases were improved, 13 cases were ineffective, and the total effective rates were 71.74%; the average hospital stay in ICU were(11.48±2.11)d; the total hospital stay were(45.29±1.48)d, and the hospital died were 11 case that the rates 23.91%. Multivariate logistic regression analysis showed deep venous catheterization(OR=1.893), age≥65 years(OR=2.154), use of carbapenem antibiotics(OR=2.041) for ICU patients with renal insufficiency Patients had independent risk factors for carcinol-resistant Klebsiella pneumoniae infection(P <0.05). Conclusion: The patients with renal insufficiency in ICU are resistant to carcinol-resistant Klebsiella pneumoniae, which are mostly derived from sputum specimens and have low resistance to minocycline, tetracycline and tigecycline. These drugs can be selected clinically. Reasonably grasp the time and dosage of medication,and enhance the efficiency of anti-infection. At the same time, deep venous catheter placement, age ≥65 years, the use of carbapenem antibiotics as the main risk factors in the treatment process, in the treatment of ICU patients with renal insufficiency, should be considered, improve treatment efficiency. [ABSTRACT FROM AUTHOR]