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Objective To investigate the effect of Tuina combined with auricular acupoint pressing therapy in the treatment of post-stroke constipation. Methods Totally 100 bedridden patients with post-stroke constipation were randomly divided in the observation group and control group, with 50 cases in each group. All patients received comprehensive treatment and routine nursing interventions, and those in the observation group were given Tuina combined with aricular acupoint pressing therapy. The intervention effect was evaluated and compared between two groups. Results The total effective rate was 94. 00%(47/50) in the observation, which was higher than 66. 00%(33/50) in the control group(P＜0. 05). Conclusion Tuina combined with aricular acupoint pressing therapy is effective to relive the symptoms of constipation in bedridden patients with post-stroke constipation. (目的 探讨便秘推拿联合耳穴压豆治疗中风后恢复期便秘的效果。方法 将100例卧床的中风后恢复期便秘患者随机分为观察组及对照组, 各50例。对照组实施常规护理干预, 观察组在对照组基础上增加便秘推拿联合耳穴压豆。评价两组干预效果。结果 观察组总有效率94. 00%(47/50), 高于对照组的66. 00%(33/50), 差异有统计学意义(P＜0. 05)。结论 对中风后恢复期患者采用便秘推拿配合耳穴压豆, 能进一步缓解便秘症状。)

Objective To evaluate the Health Education Accurately Linking System (HEALS) combined with case-based leaning (CBL)I n nursing teaching ward round in the encephalopathy clinic. Methods Totally 19 registered nurses were recruited. The routing management had been adopted in nursing teaching ward round between January and December. 2021. A modified model based on the HEALS combined with CBL was adopted in the in nursing teaching ward round between January and December. 2021. Practical skills of nurses and their evaluation on nursing teaching ward round were measured. Results Nurses had achieved a higher score of practical skills assessment after implementation of HEALS combined with CBL model (P＜0. 05). The evaluation of enhancing interest, problem solving skills and independent learning in nursing ward rounds based on HEALS combined with CBL was superior to that in routine nursing ward rounts (P＜0. 05). Conclusion The HEALS combined with CBL model has obvious advantages in nursing teaching ward rounds, which can better meet the needs of clinical nursing teaching, effectively cultivate clinical practice and thinking ability, and is conducive to teaching management. (目的 分析健康教育精准连接系统(HEALS)助手联合基于案例学习(CBL)模式在脑病科护理教学查房中的应用效果。方法 选择脑病科19名注册护士作为研究对象。2021年1月—12月实施常规护理查房; 2022年1月—12月护理查房中采用HEALS助手联合CBL模式。比较实施前和实施后护士技能操作成绩, 对比两种模式下护士对护理教学查房效果的评价。结果 实施HEALS助手联合CBL模式后, 护士各项技能操作成绩高于实施前, 差异有统计学意义(P＜0. 05)。在提升兴趣、问题解决能力、自主学习能力方面, 护士对HEALS助手联合CBL模式下护理教学查房的评价优于常规护理查房, 差异有统计学意义(P＜0. 05)。结论 在脑病科护理教学查房中, 应用基于HEALS助手联合CBL模式优势明显, 能更好地满足临床护理教学需求, 有效培养护士临床实践和思维能力, 利于教学管理。)

ObjectiveTo study the relationship and molecular characteristics of a non-toxic ogawa serotype Vibrio cholerae food isolate with food and clinical isolates at home and abroad.MethodsQuantitative polymerase chain reaction （qPCR） and high-throughput sequencing was applied to obtain virulent genes distribution and genome sequence. Bioinformatic methods were used to identify their multi-locus sequencing typing （MLST） types. One hundred and one isolates genomes were mapped to reference genome Vibrio cholerae N16961 to obtain the single nucletiode variant （SNV）. All alignment was applied to construct the evolutionary tree after removing recombination. Comparative genome analysis was applied to the genes presence and absence in food isolates and close strains.ResultsThe food isolate was a cholera toxin negative and toxin-coregulated pilus positive （CNTP） strain of Vibrio cholerae. The MLST type was ST1480 which belonged to the same clonal complex of the ST75 CNTP strain prevalent in Hangzhou. It was in the branch of L3b.1 in the phylogenic tree， and highly homologous to clinical isolates in 2011 （HZ11-1， HZ11-2）. After removing the recombination， there were only 26 different SNVs.ConclusionThe food isolate was highly close to the clones of the CNTP Vibrio cholerae L3b.1 branch in Hangzhou. The source of infection in the sporadic cases in Hangzhou may be related to the contamination of reptile so that the disinfection of its breeding sites and sales sites should be strengthen.

Objective To investigate the effect of mechanical vibration sputum expectoration in the adjuvant treatment of stroke-associated pneumonia. Methods Totally 60 patients with stroke-associated pneumonia were divided into control group (n=30)and study group(n=30) according to the arrival sequences of hospital admission. All patients received anti-infective therapy for stroke-associated pneumonia. The routine hand-assisted percussion on the back was adopted in the control group, while the mechanical vibration sputum expectoration was carried out in the study group. The clinical symptoms and clinical pulmonary infection scores of the two groups were observed at one week after intervention. Results The overall response rate of treatment was 96. 67%(29/30)in the study group, which was higher than 80. 00%(24/30)in the control group (P＜0. 05). Patients in the study group had a higher volume of sputum expectoration and shorter time to moist rale disappear compared with those in the control group (P＜0. 01). Patients in the study group achieved better outcomes of respiratory rate, SaO 2 and PaO 2 compared with those in the control group (P＜0. 01). Conclusion Application of mechanical vibration sputum expectoration is potentially effective to improve the condition of patients and enhance the treatment efficacy of stroke-associated pneumonia. (目的 探讨机械振动排痰辅助治疗卒中相关性肺炎的效果。方法 选取2019年 2 月—2020 年 8 月医院收治的脑卒中患者60例为研究对象, 均确诊卒中相关性肺炎。按患者入院时间顺序分为对照组和研究组, 各30例。2组患者均接受基础抗感染治疗, 对照组给予传统人工叩背手段排痰, 研究组给予机械振动排痰。1周后观察2组患者的临床症状和临床肺部感染评分。结果 研究组总有效率96. 67%(29/30), 高于对照组的80. 00%(24/30), 差异有统计学意义(P＜0. 05)。研究组排痰量多于对照组, 肺部湿啰音消失时间短于对照组, 差异有统计学意义(P＜0. 01)。研究组呼吸频率、血氧饱和度(SaO 2 )、动脉血氧分压(PaO 2 )改善幅度优于对照组, 差异有统计学意义(P＜0. 01)结论 运用机械振动排痰辅助治疗可以改善卒中相关性肺炎善患者肺部感染病情, 提高治疗效果。)

This study focuses on establishing a cost-benefit evaluation model of low NOx combustion technology and the environmental benefits and economic benefits evaluation of technology operation were carried out as well. Results showed that: (1) The operation cost per unit calorific supply of the low NOx combustor with larger capacity (14 MW) boilers was 1.5-2.1 yuan/GJ, which was 22.3% to 26.2% as much as that of boilers with smaller capacity (0.7 MW). Compared with scattered boilers with smaller capacity, it is more economical to use boilers with larger capacity for centralized heating. (2) The lower the NOx emission concentration was, the greater the NOx emission reduction was. Furthermore, the lower the NOx emission benefits of low NOx combustor per unit calorific supply was, the greater the economic benefit of NOx reduction per unit calorific supply was. Based on the environmental and economic benefits analysis, the lean premixed combustor is recommended for natural gas boilers with capacity of 7 MW and below, and flue gas recirculation combustor (FGR-30) could be selected for natural gas boilers with capacity above 7 MW to achieve the NOx retrofits requirements of 30 mg/m3 or 80 mg/m3.

Phase change material (PCM) can be used in building envelope for heat insulation and energy-saving. However, the energy-saving effect of the PCM wall system is limited in summer since the PCM storing heat in the daytime will become a secondary heat source and release heat into the room again at night. This paper proposed a novel pipe-encapsulated PCM wall system. It integrates phase change technology and nocturnal radiation cooling technology together to realize building insulation and active heat removal. A simulation platform is established for the thermal performance simulation of this wall system. It mainly includes the simplified pipe-encapsulated PCM wall model and nocturnal radiation model. The simplified wall model includes the 5R2C wall model, 4R2C PCM model and 2R1C pipe model. The model parameters are identified and the model is also validated with good accuracy. Based on this platform, the thermal performance of a light weight room with pipe-encapsulated PCM wall system in Wuhan is simulated. About 50%-60% of heat from the outdoor environment can be conserved by the pipe-encapsulated PCM wall, and 50% of that can be removed by the radiant cooler at night. Results show the pipe-encapsulated PCM wall system has good thermal performance for light weight building.

High-performance, fast-growing natural materials with sustainable and functional features currently arouse significant attention. Here, facile processing, involving delignification, in situ hydrothermal synthesis of TiO2 and pressure densification, is employed to transform natural bamboo into a high-performance structural material. The resulting TiO2-decorated densified bamboo exhibits high flexural strength and elastic stiffness, with both properties more than double that of natural bamboo. Real-time acoustic emission reveals the key role of the TiO2 nanoparticles in enhancing the flexural properties. The introduction of nanoscale TiO2 is found to markedly increase the degree of oxidation and the formation of hydrogen bonds in bamboo materials, leading to extensive interfacial failure between the microfibers, a micro-fibrillation process that results in substantial energy consumption and high fracture resistance. This work furthers the strategy of the synthetic reinforcement of fast-growing natural materials, which could lead to the expanded applications of sustainable materials for high-performance structural applications.