目的 探讨慢性阻塞性肺疾病急性加重期(AECOPD)合并重症肺炎患者应用经鼻高流量湿化氧疗(HFNC)治疗的疗效及安全性.方法 选择2020年6月至2021年7月上海交通大学医学院附属第九人民医院黄浦分院急诊科接诊的60例AECOPD合并重症肺炎患者进行研究,按随机数表法分为观察组和对照组各30例.两组患者均给予常规治疗,对照组同时给予无创正压通气(NIPPV)治疗,观察组则同时给予HFNC治疗,两组患者均连续治疗1周.比较两组患者治疗前和治疗1周后的炎症因子[白介素-6(IL-6)、降钙素原(PCT)、C反应蛋白(CRP)]、肺功能指标[第一秒最大呼气容积(FEV1)、FEV1与用力肺活量比值(FEV1/FVC)％、最大呼气流量(PEF)]、动脉血气指标[动脉氧分压(PaO2)、动脉二氧化碳(PaCO2)、血氧饱和度(SpO2)]的变化,并记录治疗后两组患者的并发症发生情况.结果 治疗1周后,观察组患者的血清IL-6、PCT、CRP水平分别为(15.35±3.23)pg/mL、(1.09±0.16)ng/mL、(24.19±3.06)mg/L,明显低于对照组的(26.18±5.30)pg/mL、(2.74±0.30)ng/mL、(40.42±5.50)mg/L,差异均有统计学意义(P<0.05);治疗1周后,观察组患者的FEV1、FEV1/FVC、PEF、PaO2、SpO2水平分别为(1.85±0.36)L、(73.64±6.73)％、(3.98±1.34)L/s、(88.46±6.73)mmHg、(86.25±12.31)％,明显高于对照组的(1.53±0.38)L、(61.48±6.24)％、(3.16±1.38)L/s、(82.33±7.94)mmHg、(78.37±13.62)％,PaCO2水平为(34.30±8.51)mmHg,明显低于对照组的(40.62±6.44)mmHg,差异均有统计学意义(P<0.05);观察组患者的心肺功能障碍、低血压的发生率分别是40.00％、14.00％,明显低于对照组的66.67％、76.67％,差异均有统计学意义(P<0.05);而两组患者的贫血发生率比较差异无统计学意义(P>0.05).结论 应用HFNC治疗AECOPD合并重症肺炎能降低患者的炎症反应,促进肺功能恢复,改善血气指标,且并发症少,具有临床应用价值.

目的 比较培美曲塞联合顺铂与吉西他滨联合顺铂治疗ⅢB、Ⅳ期非小细胞肺癌(NSCLC)的临床疗效.方法 根据治疗方法的不同将68例NSCLC患者分为观察组和对照组,每组34例.对照组患者采用吉西他滨联合顺铂治疗,观察组患者采用培美曲塞联合顺铂治疗,均治疗6周.比较两组患者的近期疗效、肿瘤标志物[癌胚抗原(CEA)、细胞角质蛋白19片段抗原21-1(CYFRA21-1)]水平、肿瘤血管生成指标[基质金属蛋白酶2(MMP2)和基质金属蛋白酶9(MMP9)]、免疫功能指标(CD3+、CD4+、CD8+水平及CD4+/CD8+)及治疗期间的不良反应发生情况.结果 治疗后,观察组患者的客观缓解率(ORR)高于对照组,差异有统计学意义(P﹤0.05).治疗后,观察组患者的CEA、CYFRA21-1、MMP2和MMP9水平均低于对照组,CD3+、CD4+水平及CD4+/CD8+均高于对照组,CD8+水平低于对照组,差异均有统计学意义(P﹤0.05).治疗期间,观察组患者白细胞减少及血小板减少的发生率均低于对照组,差异均有统计学意义(P﹤0.05).结论 与吉西他滨联合顺铂相比,培美曲塞联合顺铂治疗ⅢB、Ⅳ期NSCLC患者的近期疗效较佳,可有效降低肿瘤标志物水平,抑制肿瘤血管生成,调节免疫应答且血液学毒性较小.

目的:基于超声数据建立能够预测机械通气患者呼吸机撤机成功率的列线图.方法:选择我院ICU收治的需要有创机械通气的患者82例,所有患者均接受自主呼吸试验(SBT).在拔管前测定患者血清脑钠肽(BNP)水平,记录心、肺以及膈肌超声数据.撤机拨管后维持自主呼吸48 h以上的患者纳入撤机成功组,其余患者纳入撤机失败组.比较两组临床资料以及心、肺、膈肌超声数据.采用多因素Logistic回归筛选能够预测撤机结局的指标,并建立列线图根据预测指标判断撤机成功率.结果:撤机成功组52例(63.4％),撤机失败组30例(36.6％).多因素分析显示,BNP(P=0.048)、左心房压力(LAP) (P=0.021)、肺部超声B线评分(LUBS) (P=-0.039)和膈肌功能(P=0.020)是影响撤机结局的独立影响因子.基于上述数据建立用于预测机械通气患者撤机成功的列线图具有良好的辨别力(AUG=0.850)和校准度(x2=6.438,P=-0.598,Hosmer-Lemeshow检验).结论:基于心、肺、膈肌超声数据联合BNP建立的列线图可以用于预测机械通气患者撤机成功率.

In this study, we assess the effects of weld metal strength and transformation temperature on the residual stress in 2·25Cr–1·6W steel welded joints. We find that the stress levels in the weld and the peak residual stress position in the base metal can be controlled by the appropriate selection of filler metal. Low transformation temperature weld metals are capable of inducing compressive residual stresses in the weld bead. Meanwhile, for stresses and bending moment equilibrium, the high strength weld metal pushes the peak tensile stress outward to reside at the base metal, keeping off the weak region. A reasonable agreement is obtained between the numerical modelling considering phase transformation and the accurate local stresses measurement associated to weld microstructure regions.

The leaving high-skilled operators and the unqualified new operators, make the assembly line de-crease in production capacity, or even shut down. In this paper, the rebalancing problem concerns how to reassign assembly operators under the constraints of human resources and space, to make sure the assembly line operates normally. The objectives are to maximize the production of the assembly line and minimize the staff costs. A multi-objective heuristic algorithm is proposed to solve this problem. Eventually, the effec-tiveness of the proposed method is verified by an engineering project.

<正>一、病例摘要病例1患者,男性,52岁,因"咳嗽、气促1天"于2011年5月22日收治我院呼吸内科,患者病程中有发热,体温最高39℃,右侧胸痛,有咯血,色鲜红,量约100 ml左右。胸片示右肺炎(图1a)。患者既往体健。入院查体:体温38.2℃,脉搏108次/分,呼吸频率32次/分,血压75/44 mmHg,神志清,气促明显,对答困难,口唇轻度紫绀,双肺呼吸音粗,可及明显

Large-scale component assembly, such as the installation of aircraft wings and ship section etc., is usually high cost, long cycle. Virtual assembly simulation gives the possibility of direct and visual perceive of assembly before the actual assembly using digital prototype. A new virtual assembly model, called VAFM (Virtual Assembly Fat Model), is presented. It integrates not only geometry data, but non-geometry information is embedded. All information of model will evolve, mature and derived gradually, from thin to fat, during the whole assembly process. The paper gives the definition of a VAFM, its framework and the evolution rules of the fat model. Meanwhile the paper design the modeling language based XML. Finally, the visualization of VAFM is also presented..

To improve the maintainability, scalability, and reusability of models in complicated Missile Weapon System simulation, the system of a hardware-in-the-loop (HIL) simulation system based on high Level Architecture (HLA) and Modelica is designed, which can satisfy the need of interoperability among federates, and the simulation model library of missile based on Modelica is developed. Simulation application of missile trajectory and scene simulation is devised and is introduced into the federation to achieve the interaction between them and other federates. New simulation application incorporated with latest simulation technology can easily be introduced into the existing simulation system if they are in accordance with the HLA standards. The scene simulation application provides developers with a visual method to assess the performance of the system, which works as a federation in the HLA-based system. The results of missile trajectory simulation and scene simulation are given. The reusability of Modelica-based missile model provides designers with great flexibility and reusability in developing new missile models.

Agent-oriented scene simulation developing technology based on XML is proposed.Behaviors of simulation entities are described in an Agent-oriented approach,which are stored in an XML file.In this way,the description and control of simulation entities are separated from the simulation software.By applying this method to the deep submergence rescue and life-saving scene simulation,the efficiency of developing a scene simulation system is improved.

In the production process, some goods or materials stored in carts distributed in a job shop need to be transported to some destination locations by vehicles as soon as possible for storing or processing, which gives rise to a problem called the multiple vehicle transporting goods problem (MVTGP). In the MVTGP, distances of vehicles transporting carts with goods or materials from start locations to end locations are changed dynamically according to schedules. A genetic particle swarm optimization (PSO), a hybrid genetic PSO and an improved hybrid genetic PSO algorithm are employed for solving the problem. The computational results show that the performances of the improved hybrid genetic PSO algorithm are the best. Copyright © 2010 Binary Information Press.

Submarine rescue is a necessary and complicate project with many uncertainties. To evaluate and validate rescue scheme, a simulation system of deep submarine rescue was developed based on virtual reality. In the system, an initial schedule was obtained by applying discrete scheduling approach, physical behaviors of entities were reflected by human factors analysis, dynamics and hydrodynamics calculation, the initial rescue scheme was validated and improved by human-computer interaction. Data inputting, scene modeling and scene driving were established, and key technologies of the system were described detailedly. The simulation system supplies necessary theory basis and direct visual expression for submarine rescue.

In order to determine sequences and vehicles of containers to their goal locations, multiple vehicle dragging goods problem was put forward. Influence of space constraint on vehicle scheduling process should be considered in this problem. Aiming at this problem, an integer programming model for the problem was established, and it was proved to be NP complete hard. To solve this problem, four kinds of coding methods were proposed. Hybrid particle swarm alogirthm was used to solve this problem by integrating simulated annealing algorithm with particle swarm algorithm. And the performance of the hybrid particle swarm algorithm was compared to the simulated annealing algorithm and the particle swarm algorithm. The computational results showed that the two chromosome representation using the first-come-first-served rule was more effective than other three representations in resolving the problem.

Welding distortion control of ship structure is a vital component of precision shipbuilding.It is significant to improve ship quality and to shorten building period.Process of research and application on prediction and control welding distortion of ship structure is reported.Various numerical simulation methods and features about prediction welding distortion have been discussed.The anticipation of thermo-elastic-plasticity finite element method and inherent strain method in shipbuilding has been represented detailed.Measures of control welding distortion have also given.Thus,precision shipbuilding technology could be promoted in shipyards.

To simulate the lunar rover traveling on lunar environment,virtual reality technology was used to create a lunar rover simulation environment,and in the environment a six-wheeled lunar rover's physical model was set up,a numerical method was given to solve the physical model.Thus,the rover's movement performance analysis was achieved by running the virtual six-wheeled lunar rover on the virtual(moon's) surface environments.By comparing the real lunar rover prototype test results and simulation test results,the effectiveness of the virtual simulation was verified.The high fidelity simulation of lunar rover brings an effective auxiliary tool for its design.

The reheat-stop-valve mechanism is a vital component which controls high temperature and high pressure steam in a steam turbine. But there is a great probability of catastrophic failures such as mechanical jamming or insufficiency in the mechanisms when closing the valve in working condition. This paper analyzes the leading influencing factors causing variant dynamic response, even failures in the mechanisms based on failure analysis. Then a method of performance analysis of the mechanism with clearance joints is represented involving all the leading factors. These factors are the dimensional errors, assembly deformation caused by interference coupling, misalignment and eccentricity in bearings and thermal deformation of high temperature steam. Our results demonstrate that the mechanism performance is exceedingly sensitive to the uncertain factors: dimensional errors, assembly deformation and misalignment in working condition. An infinitesimal variation range of 0.025mm may lead to great uncertainty of dynamic performance or even failures when closing the valve. However, eccentricity at equivalent level contributes little effect. Recommendations based on this study have been adopted in engineering, which are proved to be effective.

Lunar rover development involves a large amount of validation works in realistic operational conditions, including its mechanical subsystem and on-board software. The traditional simulation step is to construct model, input parameters, execute a simulation, and visualize the results. However, a more insight and higher productivity can be achieved if these activities are guided by human simultaneously. In this paper, a human-guided simulation method for China lunar rover simulation environment (CLRSE) that affords real time capabilities with high fidelity has been presented. It studied the input of kinematics simulation, analyzed a quick steering method of complex dynamic interactions between wheel and soft moon ground, and presented a way of path choosing by human guided. And the application which runs on PC Cluster and Silicon Graphics is also developed in this environment.

This paper presents a hybrid vision-based navigation method under virtual environment. It combines monocular vision and binocular stereo vision together to complement each other. Monocular vision completes the recognition and location as a macro-scene path plan,while binocular vision is for close-scence path plan and to avoid ovstacles in close distance. Meanwhile,a new path plan method which considers the rover's kinematics and dynamica factors is presented. The autonomous navigation module which would avoid the obstacles as well as shorten the distance for the rover to move has been integrated in the prototype system.

In a populated environment,boundaries of obstacles are complex,and Generalized Voronoi Diagrams(GVDs) are employed to represent the spatial environment.In the motion planning for multiple robots,it must be considered for coordinating these robots according to passage width in the constructed GVDs.Thus an algorithm for computing the passage width in the constructed GVDs according to the populated environment is proposed.A algorithm is employed for planning paths for multiple robots in the constructed GVDs,and a distributed method is used for coordinating motions of multiple robots.An instance for coordinating two robots is given and simulated.The simulation results show that the multiple robot motion planning can be completed based on the GVDs with passage width.

The development of virtual simulation technology provides more and more support for research and test of lunar rover.Autonomous navigation is a key technology in lunar rover system,but rarely involved in virtual simulation system.This paper researched an autonomous navigation simulation module integrated in lunar rover virtual simulation system.An approach of using XML language to express the digitalized properties of lunar terrain is presented.Stereo navigation technology is investigated and the approach of realizing autonomous navigation in virtual simulation system is developed.These technologies have been applied to one prototype system for lunar rover simulation.The simulation results indicate that the system can provide efficient support for research on the autonomous navigation of lunar rover.

In order to improve design safety and reliability on ship-borne device,dynamic character of a ship-borne device was simulated based on sea state excitation.Wave excitation under 5 and 8 level of sea state were loaded on the condition of limit marine working environment.Kinetic property of ship-borne device was simulated through ADAMS,dynamic behaviors of key parts were also analyzed.Mechanism optimal strategy was proposed and verified by increasing horizontal roller layout and extending gap between horizontal roller and track,providing with an analysis tool for the optimization design of ship-borne device.