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关键词： Calculi   Lithotripsy   Pancreatitis, chronic   Treatment outcome  

摘要： Objective To investigate the effect and safety of pancreatic extracorporeal shock wave lithotripsy (P-ESWL) in treating the chronic pancreatitis (CP) patients with main pancreatic duct (MPD) stones and to analyze the influencing factors of success of lithotripsy. Methods Clinical data of 132 patients with CP complicated with MPD stones treated with P-ESWL in the Department of Gastroenterology, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2022 to December 2023 were retrospectively analyzed, including 103 males and 29 females, aged (50.3±16.9) years. The times of P-ESWL, the success rate of stone fragmentation, the necessity of combining endoscopic retrograde cholangiopancreatograhy (ERCP), clearance rate of MPD stones, and incidence of post-P-ESWL complications (acute pancreatitis, abdominal hematoma, infection, steinstrasse, perforation, etc.) were evaluated. The factors influencing the success rate of lithotripsy were analyzed using univariate and multivariate logistic regression. Results All patients underwent P-ESWL treatment, with (2.23±0.82) times of P-ESWL per person. The success rate of stone fragmentation was 87.1%(115/132). Of 107 CP patients (81.1%, 107/132) were treated with their first P-ESWL. Of 12 patients (9.1%, 12/132) underwent single P-ESWL, and 120 (90.9%, 120/132) underwent P-ESWL combined with ERCP. There were 95 cases (72.0%, 95/132) with effective removal of stones, and 62 (47.0%, 62/132) with complete removal of stones. Post-P-ESWL complications included eight cases (6.1%, 8/132) of acute pancreatitis, two (7.6%, 2/132) of steinstrasse complicated with acute pancreatitis and one (0.8%, 1/132) of abdominal hematoma. No infection or perforation occurred. Multivariate logistic regression analysis showed that the higher CT value of stones (OR=1.239, 95%CI: 1.040-1.477, P=0.017) was associated with the lower success rate of stone fragmentation. Conclusion P-ESWL is safe and effective in treating patie

关键词： Decision tree   Dental implantation   Esthetics, dental   Soft tissue augmentation   Vertical bone augmentation  

摘要： Vertical bone augmentation (VBA) in the anterior maxilla is a technically and biologically challenging technique with high complication rates and unpredictable outcomes. Selecting appropriate soft tissue management strategies is crucial to avoid short-term and long-term complications. This article aims to assist clinicians in making treatment decisions based on different soft tissue conditions during VBA. It is divided into two parts. Incision and flap design based on the quality and quantity of different soft tissues during VBA. For mucosa of good quality and quantity, a trapezoidal flap incision design is adopted, and the periosteum extension technique is applied for tension reduction. For a shallow vestibular sulcus, a larger trapezoidal flap is used, and the tension reduction method of mucosa-oralis muscle separation is applied, along with papilla transposition suture to ensure primary wound closure. For thin mucosa or with perforating defects, a pedicled periosteal flap is used for repair. Selection of appropriate soft tissue augmentation techniques during the second-stage surgery based on the soft tissue status to improve esthetic outcomes. For horizontal soft tissue defects, free connective tissue graft (CTG) or palatal pedicled flap can be used for treatment; for vertical soft tissue defects, techniques such as the iceberg technique or customized CTG with bowtie-like shape can be used for vertical augmentation; for combined horizontal and vertical defects, the connective tissue platform technique can be used for three-dimensional soft tissue reconstruction.

关键词： 糖尿病   2型   心血管疾病   脑血管障碍   药物素养   用药信念   服药依从性   心脑血管并发症   风险预测模型  

摘要： 目的了解2型糖尿病（T2DM）患者发生心脑血管并发症的影响因素，构建列线图风险预测模型。方法研究设计为前瞻性临床观察研究，研究对象选自黄山市人民医院2022年5月—2023年4月收治的T2DM住院患者。应用医院电子病历系统收集患者性别、年龄、体重指数、饮酒、吸烟情况、家族性疾病史、胰岛素使用情况、T2DM病程、血压及实验室检查结果。出院时进行T2DM患者特异性用药信念量表（总分10~50分）、药物素养评估量表（总分0~7分）、Morisky服药依从性量表（总分0~8分）测评；出院后电话随访6个月。以是否发生心脑血管并发症将患者分为2组。应用SPSS 26.0软件进行logistic回归分析，筛选T2DM患者出现心脑血管并发症的影响因素；应用R 4.1.0软件构建列线图预测模型，以Bootstrap法对列线图模型进行内部验证。结果共294例T2DM患者纳入分析，用药信念评分为（32.6±5.6）分，药物素养评分为（4.2±0.5）分，服药依从性评分为（6.1±0.8）分。随访6个月，共有43例（14.6%）发生心脑血管并发症，包括冠心病（23例）、心力衰竭（12例）、脑卒中（8例）。与无心脑血管并发症组相比，心脑血管并发症组患者体重指数、糖化血红蛋白（HbA1c）、D-二聚体、血尿酸较高，用药信念评分、药物素养评分、服药依从性评分较低（均P<0.05）。二元logistic回归分析结果显示，HbA1c、D-二聚体、血尿酸、用药信念、药物素养、服药依从性是T2DM患者发生心脑血管并发症的影响因素。依此建立列线图预测模型，内部验证结果显示，一致性指数为0.958，受试者工作特征曲线下面积为0.824，校准曲线趋近于理想曲线。结论T2DM患者用药信念、药物素养和服药依从性现状并不理想。HbA1c、D-二聚体和血尿酸水平高，用药信念、药物素养和服药依从性差是T2DM患者发生心脑血管并发症的危险因素，综合多种因素建立列线图模型，对预测该类风险具有较高价值。

关键词： 功能性胃肠病   横断面调查   海军官兵   影响因素  

摘要： 目的调查海军官兵功能性胃肠病（FGIDs）的患病情况并分析其相关影响因素。方法2022年9月至2023年6月，采用简单随机抽样方法，以建制为单位在东部战区、北部战区、南部战区、海岛岸防驻地开展FGIDs相关调研。根据自制专用调查问卷，采用现场发放并回收问卷形式开展调查。调查问卷内容包括受访对象的人口学信息、临床既往史、近3个月的消化道症状、饮食情况、睡眠情况等。依托电子数据库系统，形成FGIDs相关的临床资料研究队列。采用Logistic回归模型分析FGIDs发生的相关影响因素。结果共发放7 500份调查问卷，回收有效问卷6 297份，有效回收率为83.96%。7种最常见的FGIDs亚类为肠易激综合征、功能性消化不良、功能性便秘、功能性腹泻、反流高敏感、功能性胸痛、恶心呕吐症，总体发生率为34.62%。55.44%的调查对象饮食十分规律，42.42%饮食偶尔不规律，2.14%饮食较为不规律；84.98%的调查对象采用分餐制用餐方式；烹饪餐占比99.65%。海军官兵总体睡眠时间（6.91±1.01）h/d，自述十分满意42.18%、比较满意45.50%；白天困倦明显群体（n=705）中，睡眠时间（6.37±1.01）h/d，自述十分满意10.92%、比较满意43.83%。多因素分析发现11个与FGIDs发生相关的潜在因素，包括持续吸烟（OR=1.154）、频繁使用消化系统药物（OR=3.237）、饮食不规律（OR=1.433）、不吃/极少摄入主食（OR=1.531）、不吃/极少摄入水产品（OR=1.248）、不吃/极少摄入牛奶（OR=1.201）、不吃/极少摄入酸奶（OR=1.189）、睡眠质量较差（OR=1.766）、每日睡眠时间（OR=0.930）、工作压力感受度（P<0.001）和工作场所（P<0.001）。结论海军官兵中FGIDs发生率较高，对相关影响因素进行有针对性的干预预防可能有较好的临床价值。

摘要： 《控制与决策》创刊于1986年,由教育部主管、东北大学主办,月刊,A4开本,国内外发行.本刊面向国家战略与经济社会发展需求,聚焦基础前沿和高新科技领域中的控制与决策相关理论与技术问题,报道具有高度学术价值和现实意义的研究成果与进展,致力服务和促进学科发展,推动面向未来的科技创新,为实现我国高水平科技自立自强,建设世界科技强国贡献力量.选题方向涵盖:控制理论与控制技术;先进控制与预测控制;运行优化与决策;生产计划、调度与控制一体化;先进传感与智能感知;系统运行性能评价与自优化;异常工况检测与自愈控制;故障诊断、预测与维护;工业数字孪生与智慧工厂;工业大数据与工业人工智能;信息物理系统的安全与智能化;机器人与无人系统的智能感知、协同决策与安全;智能决策系统与应用;物流优化与运作管理;复杂网络与系统的控制、优化与安全等研究方向.

摘要： "来了来了,那个人来了—— 他的脸上没有泪,他一夜没睡像条可怜的黑狗." 谁在说话?鸟在说话,什么鸟在说话?林中的鸟在说话,它们可是世间任何一只鸟,他们在说人话,鸟在一首诗里说人话,鸟在周瑟瑟的一首诗里在说人话,鸟替那个失去父亲的儿子,替那个叫周瑟瑟的诗人在说话,鸟把诗人内心的悲伤平抑住,不让它奔泻出来,不让不可名状的伤心的火烧透纸背,他借助林中的鸟说出这一切,寥寥几行,已抵达忧思的谷底.