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本研究分析肺炎肺实变患儿支气管肺泡灌洗液病原谱构成,旨在为临床经验性抗感染治疗提供指导。收集2019年1月-2020年1月复旦大学附属儿科医院纤维支气管镜室诊治的住院肺炎病例临床资料,其中肺实变的诊断基于影像学证据,依托国家儿童医学中心病原学检测平台,并参考感染传染科医生解读,本研究对肺炎伴肺实变患儿支气管肺泡灌洗液标本的病原学检测结果进行回顾性分析。结果显示,286例肺炎患儿的286份支气管肺泡灌洗液标本被纳入研究,平均年龄5.5(5.8±3.1)岁,其中195例(68.2%)存在肺炎伴肺实变。总病原体检出率为76.6%(219/286),肺实变和无肺实变肺炎患儿病原体检出率分别为77.9%(152/195)和73.6%(67/91),差异无统计学意义;检出的前5种病原体均为肺炎支原体、腺病毒、鼻病毒、呼吸道合胞病毒和副流感病毒3型。5周岁及以上患儿肺炎支原体检出率达最高77.0%(127/165),肺实变病例和无肺实变病例肺炎支原体检出率分别为67.2%(131/195)和61.5%(56/91),差异无统计学意义。本研究结果提示,肺炎支原体、腺病毒、鼻病毒、呼吸道合胞病毒和副流感病毒3型是导致本研究目标人群患病的主要病原体;病原体检出率高低与是否肺实变无关。  相似文献   
85.
We introduce a generic, simple, and inexpensive method for performing microbiological, enzymatic, or inorganic catalysis with solids using standard histology and microbiology laboratory equipment. Histology cassettes were used to standardize hydrodynamic conditions and to protect the catalysts and their solid supports. Histology cassettes have the following advantages: they are readily available, inexpensive, solvent and acid resistant, automatable, and the slots in the cassette walls allow liquid to circulate freely. Standard Erlenmeyer flasks were used as reaction vessels. We developed a new camera to observe the movement and position of the histology cassettes as well as the liquid in the Erlenmeyer flasks. The camera produces a stable image of the rotating liquid in the Erlenmeyer flask. This visualization method revealed that in a 250?ml Erlenmeyer flask, stable operating conditions are achieved at a shaking frequency of 300?rpm and a fill volume of 30?ml. In vessels with vertical walls, such as beakers or laboratory bottles, the movement of the histology cassette is not reproducible. Mass transfer characterization using a biological model system and the chemical sulfite-oxidation method revealed that the histology cassette does not influence gas-liquid mass transfer.  相似文献   
86.
Sperm competition is a powerful and widespread evolutionary force that drives the divergence of behavioural, physiological and morphological traits. Elucidating the mechanisms governing differential fertilization success is a fundamental question of sperm competition. Both sperm and nonsperm ejaculate components can influence sperm competition outcomes. Here, we investigate the role of a nonsemen copulatory fluid in sperm competition. Male Japanese quail possess a gland that makes meringue‐like foam. Males produce and store foam independent of sperm and seminal fluid, yet transfer foam to females during copulation. We tested whether foam influenced the outcome of sperm competition by varying foam state and mating order in competitive matings. We found that the presence of foam from one male decreased the relative fertilization success of a rival, and that foam from a given male increased the probability he obtained any fertilizations. Mating order also affected competitive success. Males mated first fertilized proportionally more eggs in a clutch and had more matings with any fertilizations than subsequent males. We conclude that the function of foam in sperm competition is mediated through the positive interaction of foam with a male's sperm, and we speculate whether the benefit is achieved through improving sperm storage, fertilizing efficiency or retention. Our results suggest males can evolve complex strategies to gain fertilizations at the expense of rivals as foam, a copulatory fluid not required for fertilization, nevertheless, has important effects on reproductive performance under competition.  相似文献   
87.
Computational fluid dynamics (CFD) modelling based on a commercial package, FLUENT, has been used in the present study. The primary aim of this study is to develop a novel implant by employing CFD techniques. Firstly, CFD analyses on the best design commercially available, which is the Ahmed Glaucoma Valve (AGV®), are accomplished. In the light of the results, the new design focus is selected as the valve. The new design is analysed using GAMBIT and FLUENT software. CFD analyses of the new design and the AGV® are compared and the strengths of the new design are revealed. The results are also compared with the experimental studies AGV® in the literature. It is deduced that the proposed model shows a nonlinear pressure drop response, which is quite similar to that of AGV®. The optimum combination would be a flow rate of 2.5 μl/min and a pressure drop of 1054.58 Pa for the proposed model.  相似文献   
88.
A computational fluid dynamics (CFD) method is presented to investigate the flow of cerebro-spinal fluid (CSF) in the cerebral aqueduct. In addition to former approaches exhibiting a rigid geometry, we propose a model which includes a deformable membrane as the wall of this flow channel. An anatomical shape of the aqueduct was computed from magnetic resonance images (MRI) and the resulting meshing was immersed in a marker-and-cell (MAC) staggered grid for to take into account fluid–structure interactions. The time derivatives were digitized using the Crank–Nicolson scheme. The equation of continuity was modified by introducing an artificial compressibility and digitized by a finite difference scheme.

Calculations were validated with the simulation of laminar flow in a rigid tube. Then, comparisons were made between simulations of a rigid aqueduct and a deformable one. We found that the deformability of the walls has a strong influence on the pressure drop for a given flow.  相似文献   
89.
Despite the advancement of cardiac imaging technologies, these have traditionally been limited to global geometrical measurements. Computational fluid dynamics (CFD) has emerged as a reliable tool that provides flow ?eld information and other variables essential for the assessment of the cardiac function. Extensive studies have shown that vortex formation and propagation during the filling phase acts as a promising indicator for the diagnosis of the cardiac health condition. Proper setting of the boundary conditions is crucial in a CFD study as they are important determinants, that affect the simulation results. In this article, the effect of different transmitral velocity profiles (parabolic and uniform profile) on the vortex formation patterns during diastole was studied in a ventricle with dilated cardiomyopathy (DCM). The resulting vortex evolution pattern using the uniform inlet velocity profile agreed with that reported in the literature, which revealed an increase in thrombus risk in a ventricle with DCM. However the application of a parabolic velocity profile at the inlet yields a deviated vortical flow pattern and overestimates the propagation velocity of the vortex ring towards the apex of the ventricle. This study highlighted that uniform inlet velocity profile should be applied in the study of the filling dynamics in a left ventricle because it produces results closer to that observed experimentally.  相似文献   
90.
Measuring the blood flow is still limited by current imaging technologies and is generally overcome using computational fluid dynamics (CFD) which, because of the complex geometry of blood vessels, has widely relied on tetrahedral meshes. Hexahedral meshes offer more accurate results with lower-density meshes and faster computation as compared to tetrahedral meshes, but their use is limited by the far more complex mesh generation. We present a robust methodology for conformal and structured hexahedral mesh generation – applicable to complex arterial geometries as bifurcating vessels – starting from triangulated surfaces. Cutting planes are used to slice the lumen surface and to construct longitudinal Bezier splines. Afterwards, an isoparametric transformation is used to map a parametrically defined quadrilateral surface mesh into the vessel volume, resulting in stacks of sections which can then be used for sweeping. Being robust and open source based, this methodology may improve the current standard in patient-specific mesh generation and enhance the reliability of CFD to patient-specific haemodynamics.  相似文献   
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