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医院中子照射器 6

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IHNI-1反应堆；热工水力；子通道；安全分析 1

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SinoSCORE: a logistically derived additive prediction model for post-coronary artery bypass grafting in-hospitalmortality in a Chinese population

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《医学前沿（英文）》 2013年第7卷第4期页码 477-485 doi: 10.1007/s11684-013-0284-0

摘要：

This study aims to construct a logistically derived additive score for predicting in-hospital mortality risk in Chinese patients undergoing coronary artery bypass surgery (CABG). Data from 9839 consecutive CABG patients in 43 Chinese centers were collected between 2007 and 2008 from the Chinese Coronary Artery Bypass Grafting Registry. This database was randomly divided into developmental and validation subsets (9:1). The data in the developmental dataset were used to develop the model using logistic regression. Calibration and discrimination characteristics were assessed using the validation dataset. Thresholds were defined for each model to distinguish different risk groups. After excluding 275 patients with incomplete information, the overall mortality rate of the remaining 9564 patients was 2.5%. The SinoSCORE model was constructed based on 11 variables: age, preoperative NYHA stage III or IV, chronic renal failure, extracardiac arteriopathy, chronic obstructive pulmonary disease, preoperative atrial fibrillation or flutter (within 2βweeks), left ventricular ejection fraction, other elective surgery, combined valve procedures, preoperative critical state, and BMI. In the developmental dataset, calibration using a Hosmer-Lemeshow (HL) test was at =β0.44 and discrimination based on the area under the receiver operating characteristic curve (ROC) was 0.80. In the validation dataset, the HL test was at =β0.34 and the area under the ROC (AUC) was 0.78. A logistically derived additive model for predicting in-hospital mortality among Chinese patients undergoing CABG was developed based on the most up-to-date multi-center data from China.

关键词： coronary artery bypass grafting risk stratification in-hospital mortality

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Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality

《医学前沿（英文）》 doi: 10.1007/s11684-023-1014-x

摘要： This cohort study was performed to explore the influence of intensive care unit (ICU) quality on in-hospital mortality of veno-venous (V-V) extracorporeal membrane oxygenation (ECMO)-supported patients in China. The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019, using data from the National Clinical Improvement System and China National Critical Care Quality Control Center. ICU quality was assessed by quality control indicators and capacity parameters. Among the 2563 V-V ECMO-supported patients in 318 hospitals, a significant correlation was found between ECMO-related complications and prognosis. The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients (cutoff: 1.5% and 7.0%; 95% confidence interval: 1.05–1.48 and 1.04–1.45; odds ratios: 1.25 and 1.23; P = 0.012 and P = 0.015, respectively). Meanwhile, the V-V ECMO center volume was a protective factor (cutoff of ≥ 50 cases within the 3-year study period; 95% confidence interval: 0.57–0.83, odds ratio: 0.69, P = 0.0001). The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings. Thus, ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation in-hospital mortality high-volume centers quality control intensive care unit capacity parameters

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医院中子照射器建造

李义国,夏普,彭旦,邹淑芸,吴小波, 张金花,张永保,张紫竹,刘彤,周永茂

《中国工程科学》 2012年第14卷第8期页码 17-19

摘要：

医院中子照射器装置于2007年开始建造，2008年12月完成了反应堆厂房建造，2009年3月完成了相关系统的安装和调试。2009年12月7日首次达到临界，2010年1月22日达到满功率运行。物理调试结果表明，医院中子照射器反应堆最终后备反应性为4.2 mk，满功率最大可连续运行时间为12 h，功率波动小于0.3 %；4.2 mk反应性释放实验表明，反应堆在229 s时达到85.7 kW的最大峰值功率，随后，由于燃料元件多普勒效应和慢化剂的负温度效应会非能动地把功率限制在允许的安全水平之下，反应堆具有良好的固有安全特性。

关键词：医院中子照射器调试物理启动

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医院中子照射器试运行

李义国,彭旦,邹淑芸,吴小波,张金花,张紫竹,夏普,左晓艳,刘彤,周永茂

《中国工程科学》 2012年第14卷第8期页码 23-27

摘要：

医院中子照射器及其辅助系统于2010年年初完成热调试试验，随后投入试运行至今，共开堆99次（天），累积释放能量1 832.42 kW·h (折合积分中子注量为2.198 9×10¹⁷ cm^-2)。试运行期间实验数据显示，医院中子照射器及其辅助系统满足规定的运行限值和条件，未发生任何事故，具有很好的安全性与可靠性，达到了设计要求。

关键词：医院中子照射器试运行限值和条件

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医院中子照射器性能与特性

李义国,夏普,彭旦,邹淑芸,吴小波,张金花, 张紫竹,高集金,王理玉,付金树,刘彤,周永茂

《中国工程科学》 2012年第14卷第8期页码 20-22

摘要：

介绍了医院中子照射器及其相关系统的设计情况，描述了医院中子照射器的性能和特性。为验证医院中子照射器的固有安全特性，进行了4.2 mk反应性释放实验。实验结果表明，反应堆功率快速上升，在229 s时，功率达到85.7 kW峰值，随后，由于燃料元件多普勒效应和慢化剂的负温度效应会非能动地把功率限制在允许的安全水平之下。满功率运行时，各个工艺房间γ剂量率小于1 μSv/h，且中子剂量率为本底水平，具有低辐射特点。

关键词：医院中子照射器硼中子俘获治疗固有安全特性

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事故工况下医院中子照射器I型堆瞬态特性研究

朱磊,陈立新,江新标,赵柱民,周永茂

《中国工程科学》 2012年第14卷第8期页码 60-63

摘要：

采用RELAP5/SCDAP/MOD3.4程序对医院中子照射器I型堆（IHNI-1）在事故工况下的瞬态特性进行研究，对意外大反应性引入和池水丧失事故工况进行了计算和分析，计算结果表明：IHNI-1堆具有良好的固有安全性，在发生大反应性引入和池水丧失事故时，最终能够稳定在较低功率，确保反应堆安全。

关键词：医院中子照射器I型堆事故工况瞬态特性 RELAP5

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Qualitative analysis of direction of public hospital reforms in China

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《医学前沿（英文）》 2018年第12卷第2期页码 218-223 doi: 10.1007/s11684-017-0534-7

摘要：

Reforms in public hospitals are among the most important improvements in China’s health care system over the last two decades. However, the reforms that should be implemented in public hospitals are unclear. Thus, a feasible direction of reforms in Chinese public hospitals is suggested and reliable policy suggestions are provided for the government to reform public hospitals. The data used in this study were mainly derived from a qualitative study. Focus group discussions and in-depth interviews were conducted in Shanghai, Guangdong, and Gansu between May and December 2014. Government funding accounted for approximately eight percent of the total annual revenue of public hospitals in China, and the insufficient government subsidy considerably affects the operation mechanism of public hospitals. However, solely increasing this subsidy cannot address the inappropriate incentives of public hospitals in China. The most crucial step in setting the direction of reforms in public hospitals in China is transforming inappropriate incentives by implementing a new evaluation index system for directors and physicians in public hospitals.

关键词： public hospital government hospital public funding operation mechanism

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医院中子照射器I型堆超热中子束流孔道的优化设计

江新标,朱养妮,赵柱民,陈立新,周永茂

《中国工程科学》 2012年第14卷第8期页码 33-37

摘要：

采用蒙特卡罗程序(Monte Carlo neutron and photo transport code, MCNP)对医院中子照射器I型堆（IHNI-1）超热中子束流孔道的慢化层、反射层进行了优化设计。首先对FLUENTAL、Al等材料组成的6种慢化体方案进行了分析比较，给出了孔道出口处超热中子通量密度较大的两种设计方案；基于此两种慢化体设计方案，在保持束流孔道外框尺寸不变情况下，对慢化体周围的反射层进行了分析比较，给出了反射层的推荐方案；基于慢化体和反射层优化方案，最后给出了超热中子束流孔道出口处束流参数的空间分布。

关键词：医院中子照射器I型堆超热中子束流中子通量密度

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Projections of heat-related excess mortality in China due to climate change, population and aging

《环境科学与工程前沿（英文）》 2023年第17卷第11期 doi: 10.1007/s11783-023-1732-y

摘要：

● Four scenarios were used to project heat-related excess mortality in China.

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低浓化医院中子照射器（IHNI-1）堆芯的物理方案设计

江新标,张文首,高集金,李义国,周永茂

《中国工程科学》 2009年第11卷第11期页码 17-21

摘要：

采用蒙特卡罗程序MCNP/4B模拟计算了功率为30 kW的低浓化医院中子照射器的堆芯物理参数，设计了合理的堆芯布置方案、²³⁵U富集度、控制棒价值、后备反应性和停堆深度，得到固有安全性较高、寿期达10年且无需换料、采用低浓化UO₂燃料的医院中子照射器的堆芯物理设计方案，为后续反应堆工程设计以及硼中子俘获治疗肿瘤用中子束的设计提供理论依据。

关键词：医院中子照射器硼中子俘获治疗反应性

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Association of cardiac disease with the risk of post-lung transplantation mortality in Chinese recipients

《医学前沿（英文）》 2023年第17卷第1期页码 58-67 doi: 10.1007/s11684-022-0937-y

摘要： The current organ allocation rules prioritize elderly and urgent patients on the lung transplantation (LT) waiting list. A steady increase in the threshold at which age is taken into consideration for LT has been observed. This retrospective cohort study recruited 166 lung transplant recipients aged ≥ 65 years between January 2016 and October 2020 in the largest LT center in China. In the cohort, subgroups of patients aged 65–70 years (111 recipients, group 65–70) and ≥ 70 years (55 recipients, group ≥ 70) were included. Group D restrictive lung disease was the main indication of a lung transplant in recipients over 65 years. A significantly higher percentage of coronary artery stenosis was observed in the group ≥ 70 (30.9% vs. 14.4% in group 65–70, P = 0.014). ECMO bridging to LT was performed in 5.4% (group 65–70) and 7.3% (group ≥ 70) of patients. Kaplan–Meier estimates showed that recipients with cardiac abnormalities had a significantly increased risk of mortality. After adjusting for potential confounders, cardiac abnormality was shown to be independently associated with the increased risk of post-LT mortality (HR 6.37, P = 0.0060). Our result showed that LT can be performed in candidates with an advanced age and can provide life-extending benefits.

关键词： cardiac disease mortality aged population lung transplantation

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The main and added effects of heat on mortality in 33 Chinese cities from 2007 to 2013

《环境科学与工程前沿（英文）》 2023年第17卷第7期 doi: 10.1007/s11783-023-1681-5

摘要：

● The main and added effect from heat co-existed in China.

关键词： Heat Main effect Added effect Mortality Vulnerable population

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Temporal trend of mortality from major cancers in Xuanwei, China

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《医学前沿（英文）》 2015年第9卷第4期页码 487-495 doi: 10.1007/s11684-015-0413-z

摘要：

Although a number of studies have examined the etiology of lung cancer in Xuanwei County, China, other types of cancer in this county have not been reported systematically. This study aimed to investigate the temporal trend of eight major cancers in Xuanwei County using data from three mortality surveys (1973–1975, 1990–1992, and 2004–2005). The Chinese population in 1990 was used as a standard population to calculate age-standardized mortality rates. Cancers of lung, liver, breast, brain, esophagus, leukemia, rectum, and stomach were identified as the leading cancers in this county in terms of mortality rate. During the three time periods, lung cancer remained as the most common type of cancer. The mortality rates for all other types of cancer were lower than those of the national average, but an increasing trend was observed for all the cancers, particularly from 1990–1992 to 2004–2005. The temporal trend could be partly explained by changes in risk factors, but it also may be due to the improvement in cancer diagnosis and screening. Further epidemiological studies are warranted to systematically examine the underlying reasons for the temporal trend of the major cancers in Xuanwei County.

关键词： cancer mortality Xuanwei temporal trend

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医院中子照射器I型堆堆芯热工水力分析

陈立新,赵柱民,江新标,朱磊,周永茂

《中国工程科学》 2012年第14卷第8期页码 51-55

摘要：

针对医院中子照射器I型堆（IHNI-1）的堆芯特点和运行工况，建立了适用于IHNI-1反应堆堆芯的热工分析模型，并对模型进行了验证。利用所建模型，计算了IHNI-1反应堆堆芯热工参数。最后分析了IHNI-1反应堆堆芯入口流量对堆芯出口温度的影响，同时给出了堆芯发生过冷沸腾时的功率计算结果。

关键词： IHNI-1反应堆；热工水力；子通道；安全分析

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Membrane bioreactors for hospital wastewater treatment: recent advancements in membranes and processes

《化学科学与工程前沿（英文）》 2022年第16卷第5期页码 634-660 doi: 10.1007/s11705-021-2107-1

摘要： Discharged hospital wastewater contains various pathogenic microorganisms, antibiotic groups, toxic organic compounds, radioactive elements, and ionic pollutants. These contaminants harm the environment and human health causing the spread of disease. Thus, effective treatment of hospital wastewater is an urgent task for sustainable development. Membranes, with controllable porous and nonporous structures, have been rapidly developed for molecular separations. In particular, membrane bioreactor (MBR) technology demonstrated high removal efficiency toward organic compounds and low waste sludge production. To further enhance the separation efficiency and achieve material recovery from hospital waste streams, novel concepts of MBRs and their applications are rapidly evolved through hybridizing novel membranes (non hydrophilic ultrafiltration/microfiltration) into the MBR units (hybrid MBRs) or the MBR as a pretreatment step and integrating other membrane processes as subsequent secondary purification step (integrated MBR-membrane systems). However, there is a lack of reviews on the latest advancement in MBR technologies for hospital wastewater treatment, and analysis on its major challenges and future trends. This review started with an overview of main pollutants in common hospital wastewater, followed by an understanding on the key performance indicators/criteria in MBR membranes (i.e., solute selectivity) and processes (e.g., fouling). Then, an in-depth analysis was provided into the recent development of hybrid MBR and integrated MBR-membrane system concepts, and applications correlated with wastewater sources, with a particular focus on hospital wastewaters. It is anticipated that this review will shed light on the knowledge gaps in the field, highlighting the potential contribution of hybrid MBRs and integrated MBR-membrane systems toward global epidemic prevention.

关键词： membrane technology membrane bioreactor hospital wastewater hybrid MBR integrated MBR-membrane system