简介：骨盆的破裂是严重损害。在24个小时以内的死亡最经常是尖锐的血损失的结果。这些病人的紧急情况管理挑战性、争论。在它的管理的关键问题正在识别出血的地点然后控制流血。有骨盆的骨折的血液动力学地不稳定的病人的管理要求一个多学科的队。在这个管理算法处理的问题是诊断评估，损坏控制复活，为noninvasive的指示骨盆的稳定，preperitoneal有关外科的选择和angiography的骨盆的收拾行李和批评决定。这篇评论文章在那些决心上集中于知识的最近的身体。

简介：为随机的系统的噪音顺序的加权的和的顺序被在概率使用限制理论估计。然后，鞅差别顺序的噪音驾驶的不稳定的ARsystem的状态的分叉率被建立。

简介：Anondivergentbarotropicmodel(Model1)andabarotropicprimitiveequationvortexmodel(Model2)arelinearizedrespectivelyinthispaper.Thentheirperturbationwavespectrumsarecomputedwithanormalmodeapproachtostudytheinstabilityproblemonanappointedtropicalcyclone(TC)-likevortex,thereby,thedynamicinstabilitypropertiesofspiralcloudbandsofTCsarediscussed.Theresultsshowthattheunstablemodeofbothmodelsexhibitsaspiralband-likestructurethatpropagatesawayfromthevortexoutsidetheradiusofmaximumwinds.ThediscretemodalinstabilityofthepurevortexRossbywavecanaccountforthegenerationoftheeyewallandtheinnerspiralband.TheunstablemodeinModel2hasthreeparts,i.e.,eyewall,innerandouterspiralbands.ThismodecanbeinterpretedasamixedvortexRossby-inertiagravitationalwave.TheunbalancedpropertyofthewaveoutsidethestagnationradiusofthevortexRossbywaveisoneoftheimportantreasonsfortheformationoftheouterspiralbandinTCs.Accordingly,theouterspiralbandcanbeidentifiedtopossesspropertiesofaninertial-gravitationalwave.Whentheformationofunstableinnerandouterspiralbandsisstudied,abarotropicvortexmodelshallbeused.Inthismodel,themostunstableperturbationbearstheattributesofeitherthevortexRossbywaveortheinertial-gravitationalwave,dependingonthevortexradius.Sosuchperturbationsshallbeviewedasanunbalancedandunstablemixedwaveofthesetwokindsofwaves.

简介：一个简单方法被建议为一个系列串联控制系统设计P/PI控制器为不稳定首先订正时间延期(FOPTD)系统。在这份报纸，为与稳定/不稳定的FOPTD系统在系列串联的不稳定的FOPTD系统的控制器设计被考虑。建议方法基于等同s和s的相应力量的系数2为一个伺服问题在靠近环的转移的分母的到乘那些的1和2的分子工作。开的环系统由与一个稳定/不稳定的FOPTD系统在系列串联的一个不稳定的FOPTD系统组成。仅仅二调节参数(1和2)为控制器的设计被要求。靠近环的表演为伺服和规章的问题被评估，表演被发现比很好确定的合成方法的好。为在模型参数的无常的坚韧性被学习并且由合成方法与控制器的相比设计了。

简介：Withasimpletropicalcoupledocean-atmospheremodel,thispaperpresentsananalysisaimingtounderstandtherelativeroleofthemeridionalandzonalwindstressesinthetropicalunstableair-seainteraction.Therolesofthezonalwindstress,themeridionalwindstressandthebothareconsideredrespectivelyintothecoupledsystem.Itisdemonstratedthatthemeridionalcomponentofthewindstressdoesnotleadtoanyinstabilityunderthelocalthermalbalanceassumption,butitdoesleadtoaweakinstabilityundertheseasurfacetemperatureadvectionassumption.Unstableair-seainteractionisdominatedbythezonalcomponentofthewindstress,suggestingthatignoringthemeridionalwindstressisapproximatelyfeasibleinstudyingthetropicalunstableair-seainteraction.

简介：AbstractPurpose:Hemodynamically unstable patients with pelvic fractures still represent a challenge to trauma surgeons and have a very high mortality. This study was designed to explore the effect of the interventions of direct preperitoneal pelvic packing for the hemodynamically unstable pelvic fractures.Methods:This retrospective study enrolled 67 cases of severe pelvic fractures with unstable hemodynamics from October 2011 to December 2019. All patients presented in our emergency center and received preperitoneal pelvic packing were included in this study. The indication was persistent systolic blood pressure ≤90 mmHg during initial resuscitation and after transfusion of two units of red blood cells. Patients with hemodynamic stability who need no preperitoneal pelvic packing to control bleeding were excluded. Their demographic characteristics, clinical features, laboratory results, therapeutic interventions, adverse events, and prognostic outcomes were collected from digital information system of electronic medical records. Statistics were described as mean ± standard deviation or medium and analyzed using pair sample t-test or Mann-Whitney U-test.Results:The patients’ average age was 41.6 years, ranging from 10 to 88 years. Among them, 45 cases were male (67.2%) and 22 cases were female (32.8%). Significant difference was found regarding the systolic blood pressure (mmHg) in the emergency department (78.4 ± 13.9) and after preperitoneal pelvic packing in the surgery intensive care unit (100.1 ± 17.6) (p < 0.05). Simultaneously, the arterial base deficit (mmol/L) were significantly lower in the surgery intensive care unit (median -6, interquartile range -8 to -2) than in the emergency department (median -10, interquartile range -14 to -8) (p < 0.05). After preperitoneal pelvic packing, 15 patients (22.4%) underwent pelvic angiography for persistent hypotension or suspected ongoing haemorrhage. The overall mortality rate was 29.5% (20 of 67).Conclusions:Preperitoneal pelvic packing, as a useful surgical technique, is less invasive and can be very efficient in early intra-pelvic bleed control.

简介：Atimeseriesx（t）,t≥1,issaidtobeanunstableARMAprocessifx（t）satisfiesanunstableARMAmodelsuchasx（t）=a1x（t-1）+a2x（t-2）+…+a8x（t-s）+w（t）wherew（t）isastationaryARMAprocess;andthecharacteristicpolynomialA（z）=1-a1z-a2z2-…-a3z3hasallrootsontheunitcircle.Asymptoticbehaviorofsumform1ton（x2（t））willbestudiedbyshowingsomeratesofdivergenceofsumform1ton（x2（t））.ThiskindofpropertiesWillbeusedforgettingtheratesofconvergenceofleastsquaresestimatesofparametersa1,a2,…,a?

简介：ObjectivesTocomparetheshortandmid-termoutcomesincasesofpercutaneoustransluminalcoronaryangioplasty(PTCA)inpatientswithunstablevstableangina.MethodsPatientsselectedforPTCA/stentingweredividedintotwogroups,onewithstableanginapectoris(SAgroup,n=92)andonewithunstableanginapectoris(UAgroup,n=112).Theoutcomesofcoronaryangiographies(CAG),initial(30-d)successoftheprocedure,andfollow-upstatusinthetwogroupswerecompared.ResultsBaselinecharacteristicsweresimilar,althoughthepatientswithunstablesymptomsmorefemales(P<0.05),andhadahigheraverageCCSclass(P<0.05)andahigherincidenceofpostinfarctionangina(P<0.01).Thefrequencyof’complexstenosisinpatientswithunstableanginawashigherthanthatofpatientswithstableangina,33%v20%(P<0.01).Atotalof309vesselsacceptedtheprocedure;including210stentsweresuecessfullydeliveredto156patients.143and67stentswereimplantedinthe

简介：这份报纸与一个不稳定的边界条件，观察在服从于任意的确定的时间延期集中于一个一个维的波浪方程的边界稳定。observability不平等显示开环的系统是看得见的，基于哪个观察员和预言者被设计：系统的状态与可得到的观察被估计然后没有观察，预言了。在那以后，相等地，作者由backstepping方法转变原来的系统到提出得好、指数地稳定的系统。和观察员和预言者的设计的相等的系统给估计的产量反馈。靠近环的系统是指数地稳定的，这被显示出。数字模拟被介绍说明稳定的控制器的效果。

简介：Ｅｍｉｓｓｉｏｎ　Ｔｅｍｐｅｒａｔｕｒｅｓ　ｆｒｏｍ　Ｐｏｐｕｌａｔｉｏｎｓ　ｏｆ　Ｐａｒｔｉｃｌｅ　Ｕｎｓｔａｂｌｅ　Ｓｔａｔｅｓ　ａｓ　ａ　Ｆｕｎｃｔｉｏｎ　ｏｆ　Ｉｍｐａｃｔ　ＰａｒａｍｅｔｅｒＥｍｉｓｓｉｏｎＴｅｍｐｅｒａｔｕｒｅｓｆｒｏｍＰ...

简介：BackgroundAcutecoronarysyndrome(ACS)isaleadingcauseofmortalityandmorbidityworldwide,whichcomprisesunstableangina(UA)andacutemyocardialinfarction(AMI),andtheinvestigationofbiologicalmarkerstoassessthosemostatriskofrecurrentcardiovasculareventsisnecessary.MethodsSixty-sixhealthycontrolpeopleand67casesofUApatientswereenrolledinGuangdonggeneralhospital.Enzymelinkedimmunosorbentassay(ELISA)wasusedtodetectthelevelofplasmaACTG2.Thereceiveroperatingcharacteristiccurve(ROC)wasusedtoanalyzethepredictionvalueofACTG2forUA.AccordingtotheaveragelevelofplasmaACTG2inUApatients,UApatientsweredividedintothelowACTG2group(

简介：Ａｚｉｍｕｔｈａｌｌｙ　Ａｎｉｓｏｔｒｏｐｉｃ　Ｅｍｉｓｓｉｏｎ　ｏｆ　Ｕｎｓｔａｂｌｅ　Ｌｉｇｈｔ　Ｎｕｃｌｅｉ　ｉｎ　Ｈｅａｖｙ　Ｉｏｎ　Ｃｏｌｌｉｓｉｏｎｓ　ａｔ　Ｉｎｔｅｒｍｅｄｉａｔｅ　ＥｎｅｒｇｙＡｚｉｍｕｔｈａｌｌｙＡｎｉｓｏｔｒｏｐｉ...

简介：Inthispaper,theanalysisoftheoccurrenceandthedevelopmentoftyphoonandtropicalcycloneismadewiththeunstabletheoryofwave.Theresultindicatesthattheprimarywaveistheunstableinertia-gravitywaveintheprocessoftheoccurrenceandthedeveJopmantoftyphoonandtropicalcyclone:Theexistenceofthedeepmoistlayerandtheheatingbymoisturecondensationcanimpelandintensifytheunstabilityofthewaveandisfavourableforthereductionofthewaveenergydispersion,therefore,itisgoodfortheformationandthedevelopmentoftyphoonandtropicalcyclone,andalsocanslowdownthewavespeed.Besides,theconditionthatthechangeofthespecificvolumeofthebasicstatewithpressureislessthanthatofadiabaticstatemayalsoleadtothewaveunstability,thusmayhavecertaineffectontheoccurrenceandthedevelopmentoftyphoonandtropicalcyclone.

简介：Thispapertreatstheflowinstabilitiesinamixedflowpumpwithavaneddiffuser.Testpumphasapositiveslopeofahead-flowperformancecurveat65%flowrateofBEP(BestEfficiencyPoint)becauseofarotatingstall.DynamicParticleImageVelocimetry(PIV)andpressurefluctuationmeasurementsareusedforinvestigatingthepropagationmechanismofarotatingstall.Itwasfoundthatunstableperformancewascausedbyperiodicallargescaleabruptbackflowgeneratedfromthevaneddiffusertotheoutletofimpeller.Further,therelationbetweenthestaticpressureattheinletofdiffuservaneandtheinternalflowconditionwasclarified.Fromtheseexperimentalresults,inordertoimprovethepositiveslopeofahead-flowperformancecurve,tosuppressthegrowthofstrongvortextowardtheinletofdiffuservanewasprovedtobeakeypoint.

简介：ObjectivesToanalyzethechangesofvasoactivesubstancesoriginatedfromendotheliuminpatientswithunstableanginapectoristreatedbymodifiedthrombolytictherapyandexplorethemechanismsofthedrugtotreatunstableanginapectoris.Methods120patientswithunstableanginapectoriswhowerenotwellresponsedtocommonmedicationwerestudied.TheirECGstresstestswereabnormalandtherewereischemicchangesinHolter.Urokinase300,000Uwasaddedin100mlnormalsalineandinjectedwithin30minonceadayfor3days.300mgaspirinwasadministratedadaybeforeandduringurokinaseapplications.Beforeandafterurokinasetreatments,endothelin-1,plasmatissueplasminogenactivatoranditsinhibitor-1weredetermined.ResultsComparedwithpretreatments,aftertreatments,theactivitiesoftissueplasminogenactivatorincreased,endothelin-1andtheinhibitor-1decreased.Thechangesweresignificant.ConclusionsModifiedthrombolytictherapycanregulatethevasoactivesubstancesoriginatedendotheliuminpatientswithunstableanginapectoris.Themajorsubstancesincludeendothelin-1,plasmatissueplasminogenactivatorandinhibitor-1.Thismechanismmaysuggestthaturokinasecantreatcoronaryheartdiseaseeffectively.

简介：Background:Athleteshavebeenshowntoexhibitbetterbalancecomparedtonon-athletes(NON).However,fewstudieshaveinvestigatedhowthesurfaceonwhichathletestrainaffectsthestrategiesadoptedtomaintainbalance.Twodistinctathletegroupswhoexperiencedifferenttypesofsport-specificbalancetrainingarestablesurfaceathletes(SSA)suchasbasketballplayersandthosewhotrainonunstablesurfaces(USA)suchassurfers.ThepurposeofthisstudywastoinvestigatetheeffectsoftrainingsurfaceondynamicbalanceinathletescomparedtoNON.Methods:EightNON,eightSSA,andeightUSAperformedfive20-strialsineachoffiveexperimentalconditionsincludingastaticconditionandfourdynamicconditionsinwhichthesupportsurfacetranslatedintheanteroposterior(AP)ormediolateral(ML)planesusingpositiveornegativefeedbackparadigms.Approximateentropy(ApEn)androotmeansquaredistance(RMS)ofthecenterofpressure(CoP)werecalculatedfortheAPandMLdirections.Four3×5(group×condition)repeatedmeasuresANOVAswereusedtodeterminesignificanteffectsofgroupandconditiononvariablesofinterest.Results:USAexhibitedsmallerApEnvaluesthanSSAintheAPsignalswhilenosignificantdifferenceswereobservedintheMLCoPsignals.Generally,thenegativefeedbackconditionswereassociatedwithsignificantlygreaterRMSvaluesthanthepositivefeedbackconditions.Conclusion:USAexhibituniqueposturalstrategiescomparedtoSSA.Theseuniquestrategiesseeminglyexhibitadirection-specificattributeandmaybeassociatedwithdivergentmotorcontrolstrategies.

简介：BackgroundPatientswithunstableanginapectorisanddiabetesmellitusareverycommon.Whentheyreceiveinterventionaltherapy,contrastagentscancauserenalinjuryandplateletactivation.Alprostadilhasbeenshowntodecreaseinflammationandmicrovascularresistance.Thereisnoanyreportontheprotectioneffectsofalprostadilonrenalinjuryandtheplateletactivationduringcardiacinterventionaltherapy.MethodsAtotalof57patientsweredividedintotwogroups,alprostadilgroup(n=35)andnormalgroupn=22).BUN(bloodureanitrogen)andSCr(serumcreatine)weremeasuredastherenalfunctionparameters.GFR(glomerularfiltrationrate)wascalculatedbytheMDRDformula.Plateletparameters:PLT(plateletcount,109),PDW(plateletdistributionwidth,fL),MPV(meanplateletvolume,fL),PLCR(largeplateletscaleratio,%)weremeasuredastheplateletactivationindex.TtestandChi-squaretestwereusedasstatisticalmethods,andP<0.05wasconsideredstatisticallysignificant.ResultsInthealprostadilgroup,SCrwas71.1±13.8μmol/Land65.9±12.6μmol/L,beforeandafterinterventionaltherapy(P<0.05).BUNwas5.68±1.79mmol/Land3.86±1.19mmol/L(P<0.001),beforeandafterinterventionaltherapy.Intheplatelettests,MPVwasseemedtobetheonlyusefulplateletparameter,beforeandafterinterventionaltherapy(11.8±1.8fLand11.1±1.2fL,P<0.05),whilethePLT(109/L),PDW(fl),PLCR(%)didn'tshowanysignificantdifference.Inthenormalgroup,allthesetests'resultsdidn'tsignificantlychangeafterinterventionaltherapy.ConclusionsThepatientswiththeunstableanginapectorisanddiabetesmellitushaveontheriskofrenalfunctiondamageandplateletactivationwhenundertakingcardiacinterventionaltherapy.Alprostadilprotectsrenalfunctionandalleviatesplateletactivation.

简介：Ｉｎ－ｐｌａｎｅａｎｄＯｕｔ－ｏｆ－ｐｌａｎｅＥｍｉｓｓｉｏｎｏｆＵｎｓｔａｂｌｅＮｕｃｌｅｉｆｒｏｍ４０Ａｒ＋１９７ＡｕＲｅａｃｔｉｏｎＳｙｓｔｅｍ￥ＨｅＺｈｉｙｏｎｇ；ＤｕａｎＬｉｍｉｎ；ＬｉＺｕｙｕ；ＪｉｎＧｅｎｍｉ...

简介：AbstractPurpose:Combined anterior and posterior ring (APR) fixation is classically performed in Tile B2 and C1 injuries to achieve superior biomechanical stability. However, the posterior ring (PR) is the main weight bearing portion that is responsible for weight transmission from the upper parts of the body to the lower limbs through the sacrum and the linea terminalis. It is hypothesized that isolated PR fixation can achieve comparable radiological and clinical outcomes to APR fixation. Therefore, we conducted this study to compare the two fixation principles in managing Tile B2 and C1 injuries.Methods:Our study included 20 patients with Tile B2 injuries and 20 patients with Tile C1 injuries. This study was a randomized control single-blinded study via computerized random numbers with a 1:1 allocation by using random block method. The study was performed at a level one trauma center. A total of 40 patients with Tile B2 and C1 injuries underwent combined APR or isolated PR fixation (Group A and B, respectively). Matta & Tornetta radiological principles and Majeed pelvic scoring system were used for the assessment of primary outcomes and postoperative complications. Secondary outcomes included operative time, amount of blood loss, intraoperative assessment of reduction, need of another operation, length of hospital stay, ability to weight bear postoperatively and pain control metrics. We used student t-test to compare the difference in means between two groups, and Chi-square test to compare proportions between two qualitative parameters. We set the confidence interval to 95% and the margin of error accepted to 5%. So, p ≤ 0.05 was considered statistically significant.Results:The mean follow-up duration was 18 months. The operative time (mean difference 0.575 h) and the intraoperative blood loss (mean difference 97.5 mL) were lower in Group B. Also, despite the higher frequency of rami displacement before union in the same group, there were no significant differences in terms of radiological outcome (excellent outcome with OR = 2.357), clinical outcome (excellent outcome with OR = 2.852) and postoperative complications assessment (OR = 1.556) at last follow-up.Conclusion:The authors concluded that isolated PR fixation could favorably manage Tile B2 and C1 pelvic ring injuries with Nakatani zone II pubic rami fractures and intact inguinal ligament. Its final radiological and clinical outcomes and postoperative complications were comparable to combined APR fixation, but with less morbidity (shorter operation time, lower amount of blood, and no records of postoperative wound infection).