Search

There has been a raising concern about frailty in elderly patients with esophageal cancer, and effective management of frailty may improve clinical outcomes of patients. This paper reviewed the studies about screening, assessment, and management strategies for frailty in elderly patients with esophageal cancer, as well as early identification of frailty using appropriate tools, in order to facilitate the development of screening and assessment tools and individualized management plans for esophageal cancer patients in China. (老年食管癌患者衰弱状况堪忧, 及时有效的衰弱管理能有效改善患者的临床结局。本文综述食管癌患者衰弱的筛查、评估及管理策略, 以及使用合适的工具尽早识别衰弱, 以期为构建适合我国食管癌患者衰弱筛查评估工具及个体化管理方案提供参考。)

Objective To investigate the effect of endotracheal suctioning method using suctioning sputum with suctioning salivary tube in patients with craniocerebral injury undergoing tracheotomy. Methods A randomized controlled trial was conducted in 106 patients with traumatic brain injury after tracheotomy who met the inclusion criteria. According to the random number table method, they were divided into two groups, with 53 cases in each group. The experimental group was treated with endotracheal suctioning method using sputum suction tube combined with sputum suction tube, while the control group was treated with routine sputum suction method using sputum suction tube . The secretion severity grade under electronic laryngoscope swallowing function assessment (FEES) before and after sputum aspiration was compared between the two groups. The number of sputum aspiration, blood oxygen saturation and heart rate changes at 1 minute before and after sputum aspiration were observed in the two groups at 1, 3 and 7 days after admission. The mucosal damage under electronic hose bronchoscopy was observed in the two groups at 1, 3 and 7 days after admission. Results The severity of FEES was significantly lower in the experimental group than in the control group (P

Climate change has significant influences on irrigation water demand (IWD) and available irrigation water supply (IWS), which poses grave challenges to farmers and administrators of agriculture and water resources. Due to the complexity and uncertainties from climate, agriculture and water systems, only a few studies have combined these systems together, especially at irrigation district scale. Furthermore, most climate change scenarios (CCS) are continuous time series with uncertainties, meanwhile the corresponding CCS of the typical hydrological years are deficient. Thus it is difficult for the administrators from water sectors and agriculture to make positive responses to climate change. The object of the study was to provide an approach to estimate and assess the influences of climate change on IWS and IWD systems in irrigation district. The study area was a typical northern irrigation district of China, the Baojixia Irrigation District. The model considering IWD, IWS and CCS was developed using system dynamics software i.e. structure thinking experimental learning laboratory with animation (STELLA). There were four function modules: IWDM, IWSM, CCSM and WSDBI. CCSM included the reference crop evapotranspiration (ET0) and the climate factors of future typical hydrological years. Climate factors (i.e. precipitation, air temperature, wind speed, relative humidity and sunshine duration) were predicted using historical data and hydrological frequency calculation principle of inconsistent series. ET0 was calculated by Penman-Monteith equation from the Food and Agriculture Organization of the United Nations (FAO) based on the predicted climate factors. IWDM calculated the irrigation water demands of main crops (wheat, maize, cotton, cole and apple). Crop water requirement was calculated by a simple soil water balance model including effective precipitation, crop coefficient (Kc) and ET0. Net irrigation water demand (NIWD) was the sum of crop water requirements multiplied by their planting areas. IWD was NIWD divided by coefficient of irrigation water effective utilization. IWS was the available irrigation water supply which consisted of ground water and surface water (runoff of Weihe River and reservoirs). The runoff was estimated by historical data and hydrological frequency calculation principle of inconsistent series. The outputs were IWD, IWS and a water supply-demand balance index (WSDBI, i.e. the ratio of IWD and IWS), which were used to evaluate the effects of climate change. The model was verified by historical hydro-meteorological and agriculture data from 2000 to 2010. After validation the predicted CCS and IWS were used as inputs for the simulation of the future irrigation water balance conditions. The conclusions of this research are: 1) The water supply and demand model based on STELLA has a good performance and can be a steady approach for agriculture and water resource simulation. The mean relative errors for IWD and WSDBI are both 3.13%. The mean absolute errors for IWD and WSDBI are 3.9×10-7 m3 and 0.06, respectively. 2) The runoff of Weihe River at Linjiacun station had a significant downward trend at the 0.05 level from 1954 to 2010. It was a jump type of change with its jump range of about -1.43×10-9 m3 occurred in 1989. Compared with the runoff values of different typical hydrological years from 1954 to 2010, the predicted values from 1989 to 2030 were declined by 40%-55% which caused a large reduction of agricultural water supply. The mean temperature and maximum temperature significantly increased meanwhile relative humidity and wind speed significantly decreased at the 0.05 level during 1981-2010. 3) Compared with 2010, the simulation values of IWD in 2030 for wet year (P=25%), normal year (P=50%) and dry year (P=75%) increased by 1.08×10-8, 1.29×10-8 and 1. 21×10-8 m3 respectively, meanwhile the corresponding values of WSDBI increased by 14.46%, 11.70% and 9.06% respectively. The simulation indicated that the IWD and WSDBI increased dramatically under the synthetic action of meteorological factors in future. The supply could not meet the demands except wet years and the situation could be worse over the time, so effective measures should be taken in water resource and agriculture planning and management. This research can provide the reference for assessing the effect of climate change on agricultural water supply and demand in the irrigation district. [ABSTRACT FROM AUTHOR]

Healthy groundwater cycle can ensure that water resources are used more efficiently and securely in northern irrigation district. In recent years, groundwater cycle condition in the irrigation district affected by climate change and human activities has changed greatly. Environmental problems such as the attenuation of groundwater storage capacity, hanging pump wells and the groundwater deterioration occur with the unhealthy groundwater cycle in some northern areas, which directly affect the safety and efficiency of water resource utilization in the irrigation district. Therefore, studies on response of groundwater cycle to environmental changes in the irrigation district are urgent and important. This study took Jinghui Canal Irrigation District in Shaanxi province as a research area, analyzed variations of characteristics of external environment factors for groundwater system and groundwater cycle elements over the years by trend analysis and spearman rank correlation test. A forecasting model of groundwater depth affected by external environment was established based on multivariate time series CAR model (Controlled Auto-regressive). Groundwater depth under different environmental scenarios were predicted using validated models. The prediction problem of complex nonlinear time series can be effectively solved by using CAR model. In order to evaluate the prediction effects of CAR model， its results were compared with those from other models including support vector machine (SVM) prediction model and radial basis function (RBF) network model. The results showed that the prediction effect of CAR model was much better than SVM model and RBF network model. The specific research results of this paper showed that the main external environment factors affecting groundwater cycle were precipitation, evaporation, irrigation intake water from canal head, and irrigation water ratio of channel and well. Precipitation was in a significantly decreasing trend while evaporation was in a unnotable increasing trend from 1955 to 2010. The Hurst index of precipitation and evaporation were 0.69 and 0.56 respectively. The irrigation intake water from canal head, the surface irrigation water use and the groundwater exploitation showed a decreasing trend from 1977 to 2010, and was reduced by 62.5%, 44.7%, and 34.5% respectively. With the decrease in the irrigation water ratio of channel and well, the groundwater depth tended to increase gradually. The decreased precipitation, the increased evaporation, also the reduced amounts of groundwater recharge and the increased amounts of excretion all led to groundwater level dropping gradually, which dropped from 395.4 m in 1977 to 383.6 m in 2010 and the cumulative decline was 11.8 m in nearly 34 years. The simulation results of groundwater depth under different environmental scenarios showed that in scenarioⅠwith the average precipitation of 512.5 mm, the suitable irrigation water ratio of channel and well for keeping groundwater cycle healthy was 1.53. When the irrigation intake water from canal head was 2.15×108 m3, and the groundwater exploitation was 1.39×108 m3, so that the groundwater level could be stabilized with an average level and the balance of groundwater recharge and discharge could be maintained. In scenarioⅡ with precipitation reduced to 486.9 mm, the suitable irrigation water ratio of channel and well was 1.61. Groundwater recharge and discharge balance could be reached when the irrigation intake water from canal head was 2.19×108 m3 and the groundwater exploitation was 1.36×108 m3. [ABSTRACT FROM AUTHOR]

Objective: To investigate the pathological characteristic of gastrocnemius (GM) and quantitatively assess GM tissue stiffness in spinal cord injury (SCI) rat models; to explore the novel method in evaluation of GM stiffness., Methods: A total of 54 SD male rats (weight 260-280 g) were allocated into normal control group (0 w) and model groups (2, 4, 8 and 12 w) in this study. Complete SCI (T10 level) was applied in model groups. At the above different time points, Modified Ashworth Scale (MAS) was used to assess the GM spasticity; Basso, Beattie, and Bresnahan Locomotor Rating Scale (BBB) was used to assess the movement ability of lower limb. GM stiffness was assessed with shear wave sonoelastography technology in these groups. All GM at right side of rats was further checked by pathological examinations (muscle weight, ATP staining, myosin heavy chain (MyHC) electrophoretic analysis) after sonoelastography imaging examinations., Results: After removing the overweight and underweight rat models which were alive, six rats were included in each group. There were some pathologic changes in GM in SCI rat models. Compared with normal control group, data from model groups showed ankle dorsiflexors MAS (1.5±0.8-0.8±0.7 score) was increased (P≤0.05), BBB scores of lower limb (3.2±1.0-7.2±1.3score) were decreased (P≤0.05). The GM elastic modulus was increased at dorsiflexion location in model group (25.1±2.4-37.4±5.5 kPa, P≤0.05); GM weights were decreased, ratio of type Ⅰ fibers was decreased and ratio of type Ⅱ fibers was increased in GM. Compared with normal control group, MyHC-Ⅰ was decreased, while MyHC-Ⅱ was increased according electrophoretic analysis., Conclusions: Both pathological characteristic and muscle stiffness of GM change after SCI. Shear-wave sonoelastography technology can be used to assess the GM stiffness in SCI rat models.

Objective: To explore the relationship between electrocardiographic (ECG) and genetic mutations of patients with hypertrophic cardiomyopathy (HCM), and early ECG changes in HCM patients., Methods: Clinical, 12-lead ECG and echocardiographic examination as well as genetic examinations were made in a three-generation Chinses HCM pedigree with 8 family members (4 males). The clinical characterization and ECG parameters were analyzed and their relationship with genotypes in the family was explored., Results: Four missense mutations (MYH7-H1717Q, MYLK2-K324E, KCNQ1-R190W, TMEM70-I147T) were detected in this pedigree. The proband carried all 4 mutations and 5 members carried 2 mutations. Corrected QTc interval of KCNQ1-H1717Q carriers was significantly prolonged and was consistent with the ECG characterization of long QT syndrome. MYLK2-K324E and KCNQ1-R190W carriers presented with Q wave and(or) depressed ST segment, as well as flatted or reversed T waves in leads from anterolateral and inferior ventricular walls. ECG results showed ST segment depression, flat and inverted T wave in the gene mutation carriers with normal echocardiographic examination results. ECG and echocardiographic results were normal in TMEM70-I147T mutation carrier., Conclusions: The combined mutations of the genes associated with cardiac ion channels and HCM are linked with the ECG phenotype changes in this HCM pedigree. The variations in ECG parameters due to the genetic mutation appear earlier than the echocardiography and clinical manifestations. Variation in ECG may become one of the indexes for early diagnostic screening and disease progression of the HCM gene mutation carriers.