A novel uni-traveling-carrier photodiode (UTC-PD) array's structure for power combining above 110GHz was designed and fabricated to extend a single PD's power limit in the THz regime. Four identical monolithically integrated UTC-PDs' power was combined with T-junctions connecting every 6.5 mu m-diameter anode of these InGaAs-InP PDs. All PDs and combiner were fabricated on a 12 mu m-thick InP substrate, and the fulfilled chip was then measured after flip-chip bonding on a 50 mu m-thick AlN-based coplanar waveguide circuit. A continuous wave output power 0.19mW was measured at an operating frequency of 112GHz with a bias voltage of -3V.

A novel high-power charge-compensated modified uni-traveling carrier (CC-MUTC) PD on a semi-insulating InP substrate was designed and fabricated. To extend its 3-dB bandwidth, its absorption layer adopted a p-type Gaussian doping structure, and thickness of the InP substrate is reduced to 12 mu m. The back-illuminated device was flip-chipped mounted on a 100 mu m-thick diamond-based coplanar waveguide circuit to facilitate heat dissipation. Typical responsivity of the fabricated PDs is 0.7A/W at 1.55 mu m wavelength for a bias voltage of -6V. The output power of 20.4dBm was measured at 8GHz, 21.7dBm at 10GHz and 19.4dBm at 12GHz. The newly designed UTC-PD has sufficiently good potential for application in need of the high output power and also for next-generation digital and analog optical fiber transmission systems.

This randomized controlled study aimed to prospectively evaluate the application effects of other venous access in patients undergoing cardiopulmonary resuscitation. A total of 212 patients who underwent respiratory and cardiac arrest were randomly divided into peripheral intravenous (IV) access group (IV group, n = 69), femoral vein catheterization group (FVC group, n = 72), and internal jugular vein catheterization group (IJVC group, n = 71). The puncture time, first administration time, pressure interruption time caused by the establishment of fluid pathway, endotracheal intubation time, complications, ROSC time, and ETCO2 were recorded. The time of establishing venous access was: IVIJVC>IV, P = 0.04). There was no significant difference in EtCO2 between the FVC, IV group, and IJVC group (PVC>IJVC>IV, P = 0.17). Due to catheterization, the time of suspending chest compression in the FVC group was significantly lower than in the IJVC group (5s vs. 12s). The time of establishing an artificial airway in the IV (38s) and FVC (35s) group were significantly longer than that in IJVC (52s) group. Central venous catheterization is more effective than peripheral venous catheterization in cardiopulmonary resuscitation. Moreover, femoral vein access was more effective than internal jugular vein access.

Objective: To investigate the efficacy and safety of tranexamic acid (TXA) in preventing upper gastrointestinal (GI) bleeding in patients with gastric cancer.Methods: The clinical data of patients with gastric cancer complicated with acute non-operative GI bleeding treated in the Fourth Hospital of Hebei Medical University from 2020 to 2022 were collected and retrospectively analyzed.The survival status of the patients was followed up by telephone.The dataset of 168 patients was divided into a control group (n=85) and a TXA group (n=83), at a 1:1 ratio.The patients in the control group were treated with esomeprazole, and the patients in the TXA group received additional TXA.The hemostatic effect, rebleeding rate, and mortality of patients were compared between the two groups.The Cox proportional hazard model was used to evaluate the overall survival of patients as well as the related risk factors.Results: The success rate of hemostasis and the normal blood coagulation rate in the TXA group were significantly higher than those in the control group (P=0.003 and P=0.016).The secondary bleeding rate, thrombus formation rate and digestive tract perforation rate in the TXA group were significantly lower than those in the control group (P=0.002,P=0.003 and P=0.035).The improvement of all indicators in the TXA group was better than that in the control group (all P<0.05).For patients with gastric cancer complicated with acute GI bleeding treated with TXA, the Cox proportional hazard model identified III~IV stage, time of TXA treatment, surgical treatment after hemorrhage, and an increase of D-dimer as independent risk factors for upper GI bleeding (all P<0.05).Conclusion: TXA can be an effective treatment for patients with gastric cancer complicated by GI bleeding.

To assess the initial success rate and its correlated factors on cardiopulmonary resuscitation (CPR) in emergency prehospital cardiac arrest patients. The clinical information of 429 patients with cardiac arrest who underwent prehospital CPR in the fourth hospital of Hebei Medical University from Jan 2020 to Apr 2022 were evaluated. The patients were divided into the successful group (ROSC, n = 25) and the unsuccessful group (non-ROSC, n = 404) according to whether the autonomous circulation (ROSC) was resumed. The univariate analysis was performed to evaluate the differences in age, the start time of CPR, the application of electric defibrillation, and other related data between the two groups. The multivariate analysis evaluated protective factors affecting CPR's success in prehospital cardiac arrest patients. Patients with cardiogenic causes had the highest success rate of cardiopulmonary resuscitation. The causes of traffic accidents and drowning account for a low proportion. Furthermore, the median CPR length was 25.0 min, alternating from 1.5 to 64 mi. The univariate analysis revealed that age, the start time of CPR, application of electric defibrillation, and adrenaline dosage were correlated with CPR attempts (p < 0.05). Multivariate logistic regression analysis showed that the age of patients with prehospital CA, the location of prehospital CA, etiology, bystander CPR, CPR start time, defibrillation start time, tracheal intubation time, type of rhythm before resuscitation, adrenaline dosage <5 mg, and adrenaline administration time were all the influencing factors of prehospital CPR success (p < 0.01). The factors affecting CPR's success rate in prehospital CA patients are complicated. Establishing a few procedures to diminish the incidence of these risk factors is crucial.

Context:With the rapidly aging population globally, osteoporosis (OP) has become a major public health problem, and fracture is a common complication of OP. Older adults, especially postmenopausal women, have a higher incidence of OP.Objective:The study intended to analyze the clinical information, epidemiological characteristics, treatments, and follow-up results of patients with osteoporotic fractures (OPFs) in adults over 65 years old, to provide data support for the prevention, treatment, and use of OPF focus groups in clinical practice.Design:The research team performed a retrospective analysis using electronic medical records and related imaging data of patients.Setting:The study took place at Hebei General Hospital in Hebei, China.Participants:Participants were 387 patients over 65 years old with osteoporotic fractures who had been admitted to the hospital between July 2012 and July 2018.Outcome Measures:The research team recorded participants' ages, genders, fracture causes, and fracture sites. The team performed a follow-up analysis on refractures, treatment with anti-osteoporotic drugs, exercise, and survival status within the 3 years after surgery.Results:The study's male-to-female ratio was 1:3.1, and the rate of osteoporotic fracture for females was significantly higher than that of males. The mean age of participants with fractures was 75.6 ± 8.5 years, and most fractures occurred in participants 78 to 85 years old. Of the 387 participants, 169 participants had hip fractures (43.67%); 98 had vertebral compression fractures (25.32%); 51 had distal radius and ulna fractures (13.18%); 42 had proximal humerus fractures (10.85%); and 27 had other fractures (6.98%). The number of women with fractures at each site was greater than the number of men, but the differences weren't statistically significant (P > .05). The main causes of injury were falls (71.58%), and the main place of the occurrence of injury was at home (65.6%). Of the 387 participants, 346 had surgical treatment (89.41%), and the effective rate of surgical treatment was 99.42%. Three years after surgery, the research team followed up with 235 participants, for a follow-up rate of 60.72%. Within the 3 years of the follow-up period, 61 participants had refractures (25.63%), 29 received treatment with regular anti-osteoporotic drugs (12.34%), 36 exercised twice or more a week (15.32%), and 32 had died for various reasons (13.62%).Conclusions:The study preliminarily described the epidemiological characteristics of 387 osteoporotic fractures in adults over 65 years old. More women had fractures than men; the hip was the most common fracture site, and falls were the main cause of injury. Most of the fractures occurred in the place of residence, and the refracture rate was 25.96% at three years after surgery.

BACKGROUND The goal was to investigate the inhibitory effect of formononetin, an active component in Astragalus membranaceus, on the pathogenesis and development of esophageal cancer and the mechanism of action. METHODS The expression of COX-2 in cancer tissue and paracancerous tissue of patients with esophageal cancer detected early. C57BL/6 mice were used to construct a 4-nitroquinoline 1-oxide (4-NQO)-induced esophageal cancer model to verify the inhibitory effect of formononetin on the pathogenesis of esophageal cancer. Additionally, human esophageal cancer cells were treated with formononetin, and the effects on the proliferation and cell cycle of esophageal cancer cells were assessed by the CCK-8 assay and flow cytometry. Changes in the expression levels of cyclin D1 and COX-2 mRNA in cells were detected by RT-qPCR and western blot (WB) analysis. RESULTS The expression level of COX-2 mRNA in esophageal cancer tissue was significantly higher than that in paracancerous tissue. In the mouse cancer model, the incidence of esophageal cancer in mice in the formononetin treatment group was significantly reduced at week 18 (0/15 vs. 2/15) and at week 24 (6/15 vs. 13/15) (all p < 0.05). Formononetin significantly inhibited the proliferation ability of KYSE170 and KYSE150 cells and inhibited the protein expression of COX-2 and cyclin D1 (both p < 0.05). CONCLUSIONS Formononetin, an active component of Astragalus membranaceus, can prevent the pathogenesis and progression of esophageal cancer by reducing the expression of the inflammatory proteins COX-2 and cyclin D1.

InP-based uni photodiode(UTC-PD) array consisting of four photodiodes, power combiner and a monolithically integrated bias circuit using a 1/4-wavelength microstrip is presented. To increase the upper limit of power output, four identical UTC-PDs were monolithically integrated along with T-junctions to combine the power from the four PDs. Each single photodiode exhibits at least -6dBm at 110GHz, and the array was designed to produce at least 1mW in the terahertz frequency band with photocurrent of around 25mA per PD and bias voltage of -3V. The circuit has been fabricated on a 12µm-thick InP substrate, and is flipped on a 50μm-thick AlN-based coplanar waveguide circuit for test.

Objective:To investigate the effect of high-flow nasal cannula (HFNC) and Oxygen Nebuliser mask (ONM) on patients recovering from inhalation anesthesia.Methods:A retrospective analysis was performed on 128 patients after inhalation of general anesthesia in the recovery room of the Anesthesiology Department of The Fourth Hospital of Hebei Medical University from September 2019 to September 2021. All patients received the same anesthesia induction and analgesia methods, inhalation anesthesia or intravenous-inhalation anesthesia maintenance, recovered spontaneous breathing and removed endotracheal intubation after surgery, then were divided into HFNC group and ONM group for oxygen therapy. HFNC setting mode: flow rate: 20-60 L/minutes, humidification temperature: 37°C, the oxygen concentration was adjusted to maintain finger pulse oxygen saturation SPO2>90%; ONM group, the oxygen flow rate was adjusted to maintain finger pulse oxygen saturation SPO2>90%. All patients in the two groups were compared immediately after they entered the recovery room for 0 minutes,, 10 minutes, and 20 minutes,, including tidal volume, blood gas, Richmond Agitation-Sedation Scale (RASS) score and time from sedation to awakening.Results:The changes in tidal volume, oxygenation index and RASS score over time in the HFNC group were higher than those in the ONM group (p<0.05), and the awakening time in the HFNC group was faster than that in the ONM group (p<0.01), with significant statistical differences.Conclusions:Compared with ONM, HFNC can shorten postoperative recovery time, reduce the incidence of agitation and improve lung function and oxygenation state during recovery from anesthesia.

文中介绍了一种E面波导枝节加载型移相器的设计和制造.该移相器为F波段45.固定移相器,主通道采用三阶E面短路波导枝节加载结构.为了方便测试和未来应用,研制了F波段E面波导90.相移电桥功分器,一路为参考通道,另一路加载45.移相器的移相主通道.对功分器的两通路进行了对比测试,测试结果表明两通道在100～110 GHz频段内,相位差45°±2°,差损值低于0.4 dB.

针对太赫兹GaAs肖特基二极管倍频器芯片散热能力差导致输出功率低的问题,开展了GaAs/AlN异构集成太赫兹倍频器芯片研究.通过稳态热仿真发现,将肖特基二极管芯片衬底由GaAs替换为热导率更高的AlN可以降低结温.对芯片衬底替换工艺开展了研究,获得了GaAs/AlN异构集成太赫兹二极管.分别对基于GaAs衬底二极管和基于GaAs/AlN异构集成二极管的162 GHz倍频器开展功率性能测试对比.测试结果表明:装配GaAs衬底二极管的倍频器输入功率为200 mW时,输出功率最高为43.6 mW;而装配GaAs/AlN异构集成二极管的倍频器输入功率提高到316 mW,输出功率为72.4 mW.肖特基二极管由GaAs衬底替换为AlN衬底后耐受功率(输入功率)提高了约58％,倍频效率由21.8％提升至22.9％,输出功率也相应提升,验证了相比GaAs衬底肖特基二极管,GaAs/AlN异构集成太赫兹二极管的散热性能及耐受功率具有明显的优越性.

BACKGROUND:Stereotactic radiotherapy (SBRT) is widely used in the treatment of thoracic cancer. OBJECTIVE:To evaluate the efficacy of a non-rebreather mask (NRBM) and high-flow nasal cannula (HFNC) in patients with radiation pneumonia complicated with respiratory failure. METHODS:This was a single-center randomized controlled study. Patients admitted to the EICU of the Fourth Hospital of Hebei Medical University were selected and divided into NRBM and HFNC group. Arterial blood gas analysis, tidal volume, respiratory rates and the cases of patients receiving invasive assisted ventilation were collected at 0, 4, 8, 12, 24, 48, and 72 h after admission. RESULTS:(1) The PaO2/FiO2, respiratory rates, and tidal volume between the two groups at 0, 4, 8, 12, 24, 48, and 72 h were different, with F values of 258.177, 294.121, and 134.372, all P< 0.01. These indicators were different under two modes of oxygenation, with F values of 40.671, 168.742, and 55.353, all P< 0.01, also varied with time, with an F value of 7.480, 9.115, and 12.165, all P< 0.01. (2) The incidence of trachea intubation within 72 h between HFNC and NRBM groups (23 [37.1%] vs. 34 [54.0%], P< 0.05). The transition time to mechanical ventilation in the HFNC and NRBM groups (55.3 ± 3.2 h vs. 45.9 ± 3.6 h, P< 0.05). (3) The risk of intubation in patients with an APACHE-II score > 23 was 2.557 times than score ⩽ 23, and the risk of intubation in the NRBM group was 1.948 times more than the HFNC group (P< 0.05). CONCLUSION:Compared with the NRBM, HFNC can improve the oxygenation state of patients with radiation pneumonia complicated with respiratory failure in a short time, and reduce the incidence of trachea intubation within 72 h.

基于在30 μm厚的GaAs衬底上开发的平面肖特基二极管,设计了 220 GHz GaAs单片集成分谐波混频器.考虑了二极管外形结构对电磁波传输的影响,采用场路结合联合仿真的经典方法建立二极管模型来仿真其电性能,并利用这一模型在非线性电路仿真软件中对混频器的性能进行仿真和优化.制作的220 GHz分谐波混频器模块在本振频率为110 GHz、输入功率为6 dBm的条件下进行测试.结果表明,在射频频率210～220 GHz内,混频器模块的单边带变频损耗小于11dB,在220 GHz处具有最小变频损耗,为7.2dB.

Objectives Medial patellofemoral ligament (MPFL) reconstruction is an important surgical therapy for recurrent patellar dislocation. However, few studies have focused on exercise therapy after MPFL reconstruction. Therefore, the first purpose was to compare the active and traditional postoperative exercise therapies on the recovery of knee joint function and reduction of muscle atrophy after MPFL reconstruction, and the second purpose was to compare the active and traditional postoperative exercise therapies on the patellar stability after MPFL reconstruction. Methods The cases of 31 patients with recurrent patellar dislocation treated with patella double semi-tunnel anatomical MPFL reconstruction from February 2016 and February 2019 were retrospectively reviewed. The clinical outcomes, including the patellar tilt angle (PTA), lateral patellofemoral angle (LPFA), thigh circumference reduction, Kujala score, and Lysholm score, were compared between two groups (i.e., active exercise and traditional exercise groups) preoperatively, 3 months postoperatively, 6 months postoperatively, 12 months postoperatively, and 24 months postoperatively. Results The Kujala score was significantly higher in the active exercise group than traditional exercise group 3 months postoperatively (80.06 vs. 74.80, P < 0.01), 6 months postoperatively (89.19 vs. 82.07, P < 0.01), 12 months postoperatively (91.43 vs. 86.60, P < 0.01), and 24 months postoperatively (92.50 vs. 90.27, P = 0.02). Similarly, there was a higher Lysholm score in the active exercise group compared with traditional exercise group 3 months postoperatively (81.25 vs. 76.53, P < 0.01), 6 months postoperatively (89.81 vs. 84.80, P < 0.01), 12 months postoperatively (93.25 vs. 88.40, P < 0.01), and 24 months postoperatively (93.69 vs. 90.67, P < 0.01). Significantly lower thigh circumference reduction was reported in the active exercise group compared with that in the traditional exercise group 3 months postoperatively (1.90 ± 0.57 vs. 2.45 ± 0.45, P < 0.01) and 6 months postoperatively (1.50 ± 0.31 vs. 1.83 ± 0.32, P < 0.01). No statistical difference was observed between the two groups in terms of PTA (P > 0.05) or LPFA postoperatively (P > 0.05). Conclusions Our results suggested that active exercise therapy might benefit the early recovery of knee joint function and reduction of muscle atrophy in patients with recurrent patellar dislocation after MPFL reconstruction.

The paper entitled "Analysis of risk factors and countermeasures of sepsis-associated encephalopathy" by YU et al., which was published online on October 15, 2021, has been withdrawn by the Publisher upon request by the authors. Their recent studies found that some data used in this paper could not be replicated in their latest studies and, as a result, they now have doubts about the accuracy of the published results.

Background The aim of the present study was to evaluate the therapeutic effect of high-flow nasal cannula (HFNC) oxygen therapy on patients with aspiration pneumonia accompanied by respiratory failure in the post-stroke sequelae stage, with the goal of providing more effective oxygen therapy and improving patient prognosis. Methods Retrospective analysis was conducted on 103 elderly patients with post-stroke aspiration pneumonia and moderate respiratory failure (oxygenation index: 100–200 mmHg) that had been admitted. The patients were divided into two groups according to the mode of oxygen therapy that was used: the Venturi mask group and the HFNC treatment group. The two groups were analyzed and compared in terms of the changes in the blood gas indices measured at different points in time (4, 8, 12, 24, 48, and 72 h), the proportion of patients that required transition to invasive auxiliary ventilation, and the 28-day mortality rate. Results A total of 103 patients were retrospectively analyzed; 16 cases were excluded, and 87 patients were included in the final patient group (42 in the HFNC group and 45 in the Venturi group). There was a statistically significant difference in the oxygenation indices of the HFNC group and the Venturi group (F = 546.811, P < 0.05). There was a statistically significant interaction between the monitored oxygenation indices and the mode of oxygen therapy (F = 70.961, P < 0.05), and there was a statistically significant difference in the oxygenation indices for the two modes of oxygen therapy (F = 256.977, P < 0.05). HFNC therapy contributed to the improvement of the oxygenation indices at a rate of 75.1%. The Venturi and HFNC groups also differed significantly in terms of the proportion of patients that required transition to invasive auxiliary ventilation within 72 h ( P < 0.05). The HFNC group’s risk for invasive ventilation was 0.406 times that of the Venturi group ( P < 0.05). There was no statistical difference in the 28-day mortality rate of the two groups ( P > 0.05). Conclusion HFNC could significantly improve the oxygenation state of patients with post-stroke aspiration pneumonia and respiratory failure, and it may reduce the incidence of invasive ventilation.

OBJECTIVEChlamydia psittaci (Cps) feeds on gram-negative aerobic cells. Respiratory inhalation of Cps or close contact with infected animals can cause psittacosis in humans. Given its challengeable early diagnosis and rapid progression, misdiagnosis or improper antibacterial drugs may lead to multi-organ dysfunction with a high mortality.CASE REPORTA pregnant woman at 29+1 weeks of gestational age had a fever. CT images of the chest showed lamellar consolidations in the inferior lobe of the right lung, light inflammation in the middle lobe of the right lung. Negative results were obtained from multiple times of blood and sputum culture. Next generation sequencing (NGS) results identified that Cps caused severe pneumonia, which was alleviated by specific antibiotic treatment.CONCLUSIONCps can cause severe pneumonia in the pregnant woman and be cured through precise antibiotic treatment. NGS is efficient in the rapid identification of pathogens and accurate diagnosis when bacteriological culture fails.

Based on the nearly-ballistic optimization method, a high performance uni-traveling-carrier photodiode (UTC-PD) design scheme is proposed in this paper. The UTC-PD prepared by this scheme has high response speed, high responsivity, and large saturation output, and can alleviate the load voltage swing effect. The designed novel photodiode uses a partially depleted absorption layer with gradient doping. A thin p-type doped charge layer is inserted at the bottom of the collection layer. The internal electric field of the device is optimized to make the photogenerated electrons drift at the overshoot speed, reduce the electron transit time, make the device have high bias voltage operation ability, and therefore increase the 3 dB bandwidth and improve the saturation performance. Simulation results show that under the condition of high reverse bias voltage of 8 V, the device with an active area of 16 mu m(2) can obtain a 3 dB bandwidth exceeding 86 GHz with a responsivity of 0.17 A/W.

InP-based back-illuminated modified uni-traveling-carrier photodiodes (MUTC-PDs) with high-speed and high-responsivity are demonstrated using flip-chip technology in this letter. The partially depleted absorption layer with gradual doping and cliff layer are utilized to realize large 3-dB bandwidth. A high responsivity of 0.54 A/W with over 40 GHz large 3-dB bandwidth from a 7-mu m-diameter back-illuminated MUTC-PD is achieved. The results demonstrate that the modified design can effectively enhance the internal electric field and concentration gradient, so as to optimize the response speed of the device.

Schottky diode-based frequency sources are the crucial elements for the room temperature terahertz heterodyne receiver in terahertz imaging and radio astronomy applications. Here, a near 1 THz biasless frequency tripler based on the membrane technology was presented. Linear/Nonlinear co-simulation shows its practicability of full integration up to 1 THz. The power measurement gives 56 uW output power at 930 GHz.