Background and Aim. Upper gastrointestinal bleeding is a threat to patients with gastric varices (GVs). Previous studies have concluded that both transjugular intrahepatic portosystemic shunt (TIPS) and balloon-occluded retrograde transvenous obliteration (BRTO) are effective treatments for patients with GV. We aimed to compare the efficiency and outcomes of these two procedures in GV patients through meta-analysis. Methods. The PubMed, Cochrane Library, EMBASE, and Web of Science databases were searched using the keywords: GV, bleeding, TIPS, and BRTO to identify relevant randomized controlled trials and cohort studies. The overall survival (OS) rate, imminent haemostasis rate, rebleeding rate, technical success rate, procedure complication rate (hepatic encephalopathy and aggravated ascites), and Child-Pugh score were evaluated. Randomized clinical trials and cohort studies comparing TIPS and BRTO for GV due to portal hypertension were included in our meta-analysis. Two independent reviewers performed data extraction and assessed the study quality. A meta-analysis was performed to calculate risk ratios (RRs), mean differences (MDs), and 95% CIs using random effects models. Results. A total of nine studies fulfilled the inclusion criteria. There was a significant difference between TIPS and BRTO in the OS rate (RR, 0.81 (95% CI, 0.66 to 0.98); P=0.03) and rebleeding rate (RR, 2.61 (95% CI, 1.75 to 3.90); P<0.00001). TIPS had a higher incidence rate of hepatic encephalopathy (RR, 16.11 (95% CI, 7.13 to 36.37); P<0.00001). There was no significant difference between TIPS and BRTO in the immediate haemostasis rate (RR, 0.99 (95% CI, 0.89 to 1.10); P=0.84), technical success rate (RR, 1.06 (95% CI, 0.98 to 1.16); P=0.16), aggravated ascites rate (RR, 0.60 (95% CI, 0.33 to 1.09); P=0.10), or Child-Pugh change (MD, 0.22 (95% CI, −0.21 to 0.65); P=0.31). Conclusions. In this meta-analysis, BRTO brought more benefits to patients, with a higher OS rate and lower rebleeding rate. BRTO is a feasible method for GVB.
In order to solve the key technical problem in maintenance and repairing of heavy CNC machine tools, the concept of precision reliability and its forecasting module are proposed. The method is especially used for researching of reliability of heavy machine tools of which the samples are not enough for statistical methods. Firstly, spatial error module is established for a type of super heavy mill &boring machine tool based on multy-body kinematics. Then, the effect of wearing amount of kinematic pair of machine tools on machining precision is researched. Therefore forecasting modules for maintenance period and premature wearing of heavy CNC machine tools are built up. The method proposed can be used in calculating for maintenance period of heavy machine tools, analyzing for source of machining errors, and optimal design for total life of CNC machine tools. It can also be used in research of reliability for similar product of single piece or small batch.
To improve the design process efficiency, this paper proposes the principle and methodology that design process gene controls the characteristics of design process under the framework of design process reuse and optimization based on design process gene. First, the concept of design process gene is proposed and analyzed, as well as its three categories i.e., the operator gene, the structural gene and the regulator gene. Second, the trigger mechanism that design objectives and constraints trigger the operator gene is constructed. Third, the expression principle of structural gene is analyzed with the example of design management gene. Last, the regulation mode that the regulator gene regulates the expression of the structural gene is established and it is illustrated by taking the design process management gene as an example.
Many researchers have indicated that standard genetic algorithm suffers from the dilemma---premature or non-convergence. Most researchers focused on finding better search strategies, and designing various new heuristic methods. It seemed effective. From another view, we can transform search space with a samestate-mapping. A special genetic algorithm applied to the new search space would achieve better performance. Thus, we present a new genetic algorithm based on optimal solution orientation. In this paper, a new genetic algorithm based on optimum solution orientation is presented. The algorithm is divided into "optimum solution orientation" phase and "highly accurately searching in local domain of global optimal solution" phase. Theoretical analysis and experiments indicate that OSOGA can find the "optimal" sub domain effectively. Cooperating with local search algorithm, OSOGA can achieve highly precision solution with limited computing resources.
This paper introduces the reactive power compensation technology in the development of power system. From the new technology of reactive power compensation, controller, capacitor connection mode and switching on-off switch to briefly describes the current situation of the development of reactive compensation technology.
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