Search

The article discusses the similarities and differences between T-cell large granular lymphocytic leukaemia (T-LGLL) subtypes, specifically γδ and αβ T-LGLL. It compares the clinical features, treatment responses, and outcomes of 56 γδ T-LGLL patients with 306 αβ T-LGLL patients, finding similar characteristics between the two groups. The study suggests that similar therapeutic strategies can be employed for both γδ and αβ T-LGLL cases in future clinical practice. [Extracted from the article]

In pursuit–evasion scenarios, the pursuer typically possesses a lethal zone. If the evader effectively utilizes perceptual information, they can narrowly escape the lethal zone while minimizing energy consumption, thereby avoiding excessive and unnecessary maneuvers. Based on optimal control theory, we propose a guidance law for achieving critical safe miss distance evasion under bounded control. First, we establish the zero-effort miss (ZEM) state equation for the evader, while approximating disturbances from the pursuer. Next, we formulate an optimal control problem with energy consumption as the objective function and the ZEM at the terminal time as the terminal constraint. Subsequently, we design an iterative algorithm that combines the homotopy method and Newton's iteration to solve the optimal control problem, applying Pontryagin's Maximum Principle. The simulation results indicate that the designed iterative method converges effectively; through online updates, the proposed guidance law can successfully achieve critical safe miss distance evasion. Compared to programmatic maneuvering and norm differential game guidance law, this approach not only stabilizes the evader's evasion capabilities but also significantly reduces energy consumption. [ABSTRACT FROM AUTHOR]

Objective To compare the analgesic effect and postoperative recovery quality of ultrasound-guided superficial and deep injection to superior costal transverse ligament (SCTL) for local anesthetics in thoracic paravertebral block (TPVB) combined with patient-controlled intravenous analgesia (PCIA) for postoperative analgesia in patients undergoing thoracoscopic surgery. Methods A total of 106 patients undergoing elective thoracoscopic surgery in the thoracic surgery department of our hospital from May 2021 to September 2021 were eligible for inclusion. They were randomly divided into SCTL superficial block group (Group S) and SCTL deep block group (Group T). Routine anesthesia induction and maintenance were performed in the both groups. After extubation, TPVB was operated under the guidance of ultrasound, and corresponding analgesic agent was injected into the superficial or deep surface of SCTL for local anesthetics, with 20 mL of 0.375% ropivacaine hydrochloride for single-point TPVB on the affected side, and PCIA was given at the same time. The positioning time and puncture time of ultrasonic image were recorded, the distance from the tip of ultrasonic image needle to pleura was measured, and the pleural depression and puncture related complications of ultrasonic image were observed. Visual analogue score (VAS) in resting and exercise (cough) states was evaluated at 5, 10, 20 and 30 min, and 4, 12 and 24 h (T0~6) after block. The use of analgesic pump within 24 h after operation was observed in terms of sufentanil dosage, first compression time, effective compression times, and actual compression times. QOR-40 was employed to investigate the quality of recovery before and 24 h after operation. Results Group S had significantly shorter puncture time (P < 0.05) and longer distance from the tip of the needle to the pleura on ultrasound image when compared with Group T (P < 0.05). Pleural depression could be observed in ultrasound image of 15 cases in Group S and of 51 cases in Group T (P < 0.05). There was 1 case of epidural block in Group T. The VAS score at T6 in exercise (cough) state was obviously higher in Group S than Group T (P < 0.05). But, because the scores in both groups belonged to the range of mild pain score, no clinical difference was identified between the 2 groups. There were no statistical differences in the other VAS scores in resting and exercise (cough) states, time of image positioning under ultrasound guidance, and use of analgesic pump within 24 h after operation, and QOR-40 scores before and 24 h after operation between the 2 groups. Conclusion Both ultrasound-guided superficial and deep injection of analgesic drugs into SCTL for TPVB can provide effective postoperative analgesia and equivalent postoperative recovery quality for patients after thoracoscopic surgery. SCTL can be used as injection reference for ultrasound guidance. But the superficial injection of SCTL is safer, easier and simpler in operation.

Objective To analyze the effect of continuous intravenous injection of different doses on dexmedetomidine on the recovery period of general anesthesia in patients undergoing thyroid surgery. Methods A total of 120 patients with thyroidectomy admitted to the First Affiliated Hospital of Army Medical University from November 2017 to November 2019 were randomly divided into a control group (60 patients) with continuous intravenous injection of 0.8 μg/kg dexmedetomidine. The observation group (60 patients) were given 0.4 μg/kg dexmedetomidine. The SBP, DBP, HR, Ramsay, VAS score, arousal index and adverse reactions were compared between the two groups at different time periods. Results The scores of SBP, DBP, HR and VAS, the incidence of nausea, vomiting, laryngospasm and choking cough in the observation group were not different from those in the control group at different time periods. The Ramsay scores of the observation group at different time periods were significantly lower than those of the control group(P＜0.05). The time of eye opening, extubation and directional force recovery in the observation group were significantly shorter than those in the control group (P＜0.05). The incidence of bradycardia in the observation group was 1.67%, which was significantly lower than that in the control group(6.68%) (P＜0.05). Conclusions 0.4 and 0.8 μg/kg dexmedetomidine can maintain hemodynamic stability in the recovery period of general anesthesia in patients undergoing thyroid surgery, but 0.8 μg/kg has more sedative effect and higher incidence of bradycardia, so it is recommended to use 0.4 μg/kg dexmedetomidine.

Objective: This study aimed to investigate the expressions of glycemic parameters, lipid profile, and thyroid hormone in type 2 diabetes mellitus (T2DM) patients and their correlation. Methods: Eighty‐four patients with T2DM in our hospital were included as the observation group. The T2DM patients were divided into mild group, moderate group, and severe group according to the fasting plasma glucose (FPG) level. Another 84 healthy subjects in the same period of health examination in our hospital were included as the control group. The levels of glycemic parameters, (HbA1c and FPG), lipid profile (TC, TG, LDL‐C, and HDL‐C) and thyroid hormone (FT3, TSH, and FT4) were measured by automatic biochemical analyzer. The correlation between glycemic parameters, lipid profile, and thyroid hormone was analyzed by Pearson correlation analysis. Results: The FPG, TC, TG, LDL‐C, HbA1c, and TSH levels were significantly elevated, while the HDL‐C and FT3 levels were significantly declined in the observation group versus to control group (p <.05). The levels of HbA1c, FPG, TC, LDL‐C, and TSH were significantly increased, while the levels of HDL‐C and FT3 were decreased in moderate and severe groups, when compared to mild group (p <.05). The levels of HbA1c, FPG, TC, LDL‐C and TSH were higher, while the level of FT3 was lower in severe group than those in moderate group (p <.05). Pearson Correlation analysis showed that FT3 level in T2DM patients was positively correlated with FPG, HbAlc, TC, TG, and LDL‐C levels (p <.05), but negatively correlated with HDL‐C level (p <.05). TSH level was negatively correlated with FPG, HbAlc, TC, TG, and LDL‐C levels (p <.05), while positively correlated with HDL‐C level. Conclusion: The thyroid hormone levels were of clinical significance in evaluating glycolipid metabolism and severity of T2DM. Clinical detection of glycolipid metabolism and thyroid hormone levels in T2DM patients is of great significance for diagnosis, evaluation, and targeted treatment of the disease. [ABSTRACT FROM AUTHOR]

Objective To observe the changes of cardiopulmonary function in elderly patients undergoing unilateral knee arthroplasty, and to explore the effects of ischemic preconditioning and ulinastatin infusion on them. Methods A total of 45 elderly patients undergoing knee arthroplasty under epidural combined subarachnoid anesthesia in our hospital from November 2012 to May 2018 were prospectively recruited in this study. They were randomly divided into control group (Group C, n=15, routine anesthesia management), limb ischemic preconditioning group (Group IP, n=15, the tourniquet pressurized to 480 mmHg followed by being opened 5 min later, 3 cycles before surgery) and ulinastati infusion group [Group U, n=15, venous infusion of 200 kU ulinastatin within 20 min after anesthesia, then continuously pumping at 20 U/(kg·min) until the end of surgery]. Iliac (femoral) arterial blood samples were collected at 5 min before (T0) and 1 (T1), 6 (T2) and 24 h (T3) after tourniquets were relaxed. Myocardial enzymes detection (CK, CKMB, LDH), blood gas analysis [respiratory index (RI), lactic acid (cLac)], inflammatory cytokines (TNF-α, IL-1, IL-6), malondialdehyde (MDA) and xanthine oxidase (XOD) measurement were carried out respectively. Results In Group C, CK were significantly increased at T2 and T3 (P < 0.05), RI remarkably rose at T1 and T2 (P < 0.05), cLac and OXD also elevated notably at T2 (P < 0.05) when compared with the levels at T0. These markers were significantly reduced in Group IP at T2 (P < 0.05) and tended to decline in Group U at the above time points (P>0.05). There were no obvious differences in the levels of CKMB, LDH, TNF-α, IL-1, IL-6 and MDA in intra- or inter-groups (P>0.05). Conclusion For the elderly patients undergoing knee arthroplasty, no significant changes are seen in cardiac function, but their pulmonary function may be impaired at different degrees due to oxidative stress instead of systemic inflammatory reaction. Lower limb ischemic preconditioning can improve pulmonary function by inhibiting oxidative stress.

With Hexi Corridor as the study case, this study established an evaluation index system for the development of the industrial parks and industrial clusters, and used the coupling coordination model and exploratory spatial data analysis method (ESDA) to explore the evolution and spatial correlation of the coupling coordination between the industrial park and industrial clusters in Hexi Corridor from 2005 to 2017. It is found that from 2005 to 2017, the industrial parks and industrial clusters has shown closer correlations; despite the high level of coordination, the degree of coupling remains low; the Hexi Corridor has not yet developed a growth engine for the coordinated development of the industrial parks and the clusters, and there is no county-level industrial entities that have strong stimulating power. Given the requirements of the current industrial agglomeration model for regional innovation capabilities, this study proposes suggestions for coordinated development of industrial parks and industrial clusters in Hexi Corridor.

As Gansu accelerates the building of green eco-industrial system, improving the quality and efficiency of cultural tourism industry has become an important driving force for the transformation of economic quality. To effectively optimize economic structure with tourism resources, a measurement index system of cultural tourism and urban economic development is established, based on which the coordination development model on cultural tourism and urban economy of Gansu is established. The paper can provide theoretical basis for evaluating, tracking and comparing the coordination level between cultural tourism and urban economy of Gansu. It can provide city managers with decision-making basis on developing cultural tourism, protecting cultural heritage and enhancing the comprehensive urban development level.