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Adhesive small bowel obstruction (ASBO) causes a major burden in emergency medicine. Owing to in situ decompression, nasointestinal tube (NIT) placement has been increasingly used in clinical practice compared with traditional conservation (TC); however, the indications remain controversial. This study was designed to explore the indications for each treatment in ASBOs and then suggest the optimal strategy.After propensity score matching, 128 pairs were included (the NIT and TC groups). The occurrence of severe adverse events (SAEs), peri-treatment clinical parameters, and radiological features were compared between the successful and failed treatment groups.According to different stages of the entire treatment, the independent risk factors for adverse effects for ASBO were analysed in phase I and phase II. In phase I, normal red blood cells (RBC) levels (p = 0.011) and a balanced sodium ion level (p = 0.016) positively affected the outcomes of TC treatment. In phase II, for the TC group, the successful treatment rate reached 79.5% for patients with ASBOs whose normal RBC levels (p = 0.006) or decreasing white blood cells (WBC) levels (p = 0.014) after treatment. For the NIT group, the treatment success rate was 68.1% for patients whose electrolyte imbalance could be reversed or whose neutrophil count/lymphocyte ratio (NLR) levels was lower than 4.3 (p = 0.018).TC treatment is highly recommended for patients with normal RBC counts and sodium levels pretreatment. After dynamic monitoring of the treatment process, for both the TC and NIT groups, once ASBOs had elevated inflammatory biomarkers or irreversible electrolyte disturbances, surgical interference was preferred.

Abstract Palaeodrainage basin, as an important component of the source-to-sink system, contains critical information on provenance and palaeoenvironment. Previous studies indicate that the scaling relationships of source-to-sink system components generally follow power laws, and channel-belt thickness represents a reliable first-order proxy for the drainage area. In this study, a database of borehole cores and geophysical well logs of the Jurassic coal measures from Saishiteng area in the northern Qaidam Basin was used to reconstruct the palaeogeography, and to identify single-story channel-belts. Three palaeochannels, namely, River A, River B and River C, were identified which were persistent throughout the Dameigou and Shimengou Formations during the Middle Jurassic. The mean channel-belt thicknesses of River A, River B and River C in the Dameigou Formation were 9.8 m, 8.9 m and 7.9 m, respectively, and those in the Shimengou Formation were 7.4 m, 6.2 m and 5.4 m, respectively. We estimate the drainage area of three major rivers by using scaling relationships between drainage area and channel-belt thickness. The drainage areas of River A, River B and River C in the Dameigou Formation were 63.0 × 103 km2, 50.1 × 103 km2 and 37.7 × 103 km2, respectively, and those in the Shimengou Formation were 32.3 × 103 km2, 21.2 × 103 km2 and 15.3 × 103 km2, respectively. The drainage basin lengths of River A, River B and River C in the Dameigou Formation were 300.4 km, 239 km and 180.2 km, respectively, and those in the Shimengou Formation were 154.3 km, 101.3 km and 73.1 km, respectively. For both the Dameigou and Shimengou Formations, River A showed the largest scale, followed by River B and River C succeedingly, which was mainly determined by the stretch direction of provenance in the southern Qilian Mountains. The variations of channel-belt thickness, drainage area and drainage basin length between Dameigou and Shimengou Formations are the response of source-to-sink system to the transformation from extension to compression depression during the Middle Jurassic in the northern Qaidam Basin.