Search

In response to the problems of long debugging cycle, high debugging cost, high safety risk, and difficult quality evaluation in the current automatic forming and cutting control of roadways, a digital twin driven virtual debugging method for roadway automatic forming and cutting is proposed. Firstly, by using real-time appearance mapping (RTAP-MAP) technology to reconstruct the three-dimensional environment of the roadway, a control system model of the roadheader is constructed to form a virtual debugging environment. The virtual sensor technology is used to achieve precise mapping from physical space to virtual environment state. A performance evaluation method for roadway automatic forming cutting has been established to address the problem of difficulty in quantitatively evaluating the quality of section forming. Based on the recording of the section forming cutting control process in the data transmission center, the evaluation indicators of section forming precision, cutting efficiency and the number of oil cylinder switches, hard rock cutting adjustment, and over excavation and under excavation are mainly calculated. This provides precise feedback signals for the iterative optimization of deep learning algorithms. An automatic cutting control strategy that integrates reinforcement learning is proposed to improve the adaptability and precision of automated operations. To verify the effectiveness and accuracy of the virtual debugging method, an automatic control experimental platform for roadheader is built. The virtual debugging system is applied to the automatic control program for forming cutting of excavation roadway. The virtual simulation results show the following points. ① The maximum positioning errors of the X, Y, and Z axes of the debugged software at the control key points are 74.8, 72.93, 123.67 mm, respectively. It indicates that the positioning precision of the virtual debugging method meets the performance requirements. ② The trajectory of the virtual prototype is basically consistent with that of the physical prototype, indicating that this debugging method has achieved mapping to the physical space. The application result shows the following points. ① The reinforcement learning controller adapts to complex environments in virtual excavation testing, effectively converts virtual sensor inputs into precise control instructions, and verifies the feasibility of simulation reality transfer training. By processing real-time feedback on excavation precision and avoiding over excavation and under excavation, the controller learns and optimizes the strategy. ② The improved section forming cutting control performance has been improved. According to the control quantity timestamp records in the database, it takes 126 seconds, which is 8 seconds less than before the improvement. ③ After improvement, the maximum error in tracking the end trajectory of the cutting section is 6.0 mm, which is 0.3 mm lower than before. This avoids the under excavation caused by the shaking of the cutting trajectory and makes the trajectory and section smoother.

The location and size of tumors, treatment methods and prognosis of patients with head and neck cancer can seriously affect their oral function and neck activity, thereby affecting daily activities such as eating, speech and upper limb movement. Early rehabilitation after head and neck cancer surgery can accelerate functional recovery, alleviate discomfort symptoms, improve quality of life, and reduce unnecessary rehabilitation or treatment measures. Developing a clinical rehabilitation nursing pathway for head and neck cancer, forming personalized rehabilitation plans, and conducting early and effective nursing interventions are currently one of the key points of clinical work for patients with head and neck cancer. At present, domestic and foreign guidelines or consensus pays less attention to the impairments of speech function, chewing and swallowing function, neck and shoulder function etc., and lacks a systematic and comprehensive rehabilitation nursing guide or consensus to provide practical guidance for the care of patients with head and neck cancer. Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine organized relevant experts from Beijing, Shanghai, Sichuan, Shaanxi, Zhejiang and Anhui to draft Expert consensus on postoperative rehabilitation nursing of patients with head and neck cancer basing on previous literature and clinical nursing skills and experiences, of which the aim is to provide guidance for those patients in the aspects of oral care, nutritional support, flap donor area care, care after tracheotomy, chewing and swallowing rehabilitation, speech function rehabilitation, neck and shoulder function rehabilitation, restricted mouth opening rehabilitation, risk identification and prevention and follow-up.

In recent years, immunotherapy has become a new method for solid tumor treatment, and a large number of immune preparations have been developed and applied in clinical practice. Among them, immune checkpoint inhibitors (ICIs) are widely used, ushering in a new era for tumor treatment. In particular, cytotoxic T-lymphocyte-associated protein 4(CTLA-4), as a representative drug, enriches tumor immunotherapy methods and opens up a new treatment mode of dual immunotherapy. This article reviews the clinical application progress of CTLA-4 in the treatment of advanced solid tumors, with the hope of providing reference for immunotherapy of tumors.

Here we presented a case of a 19-month-old boy who developed severe aplastic anemia postacute hepatitis. He was treated successfully with the umbilical cord-derived mesenchymal stromal cells (UC-MSCs) infusion and cyclosporine A (CsA). The boy achieved both hematopoietic recovery and normal lymphocyte proportion. So far, his condition still remains stable. To our knowledge, there is a rare previous report on the utility of MSCs infusion for the treatment of hepatitis-associated aplastic anemia (HAAA). Considering the efficacy, safety, and strong operability, particularly for pediatric patient, the infusion of UC-MSCs combined with CsA could be an effective alternative for the treatment of HAAA.