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A numerical model of the rod laser medium pumped by laser-diode array (LDA) end is set up. Considering the influence of temperature correlation of the thermodynamic parameters of the material and heat transfer coefficient between air and medium, using the thermal conduction equations and the thermal-elastic equations, the transient distributions of temperature and thermal stress and strain in the composite rod medium and un-composite rod medium are calculated by the finite element analysis method. The effects of pump power and heat transfer coefficient and time on transient distributions of temperature and thermal stress and strain in the medium are analyzed. The results indicate that the positions of maximal temperature maximal tensile stress and maximal axial strain of the composite rod are different from those of the un-composite rod. And the maximal temperature, maximal tensile stress and maximal axial strain of the composite rod are respectively 73 per cent, 60 per cemt, and 33 per cent of the corresponding values of the un-composite rod. It is obvious that the thermal effect of the composite rod is greatly reduced. The theoretical results provide theoretical reference for the design of solid laser pumped by LDA and experimental study.

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The General Secretary Xi Jinping underlined at the 18 th CPC Central Committee at its fifth plenary session: "Sustainable development of agricultural is very important due to the soil fertility overdraft". As the CPC Central Committee's Proposal for Formulating the 13 th Five-Year Plan for National Economic and Social Development adopted since 29 th October of 2015 clearly point out: "A system of rotation and fallow of cultivated land should be implemented", and as notice on the issuance of an action plan for the prevention and control of soil pollution from State Council since 28 th May of 2016 clearly point out: "government should clearly

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BACKGROUND:The drug instruction for dabigatran recommends the does adjustment 110 mg twice-a-day for the patient with bleeding risk, and at least 1 time of renal function test per year for moderate renal impairment. However, dabigatran still can be abnormal accumulation due to the chronic insidiously progressive renal insufficiency, which requiring idarucizumab to reverse the anticoagulation on account of acute erosive gastritis with extensive gastric mucosal bleeding.CASE SUMMARY: A 76-year-old female, with a history of Atrial Fibrillation (AF), took dabigatran 110 mg twice-a-day as recommended does adjustment to reduce the risk of stroke, and admitted to the hospital for the main complaints of hematemesis and melena. The laboratory findings showed severe life-threatening blood-loss anemia with hemoglobin (Hb) 41.0g/L, and significant coagulation abnormalities with thrombin time (TT) > 180s, most likely caused by dabigatran metabolic disorder. Aggressive acid suppressive, hemostatic and blood transfusion therapy brought out a short-time bleed-controlled misconception, which situation was exactly confirmed by re-bleeding. Idarucizumab was given timely to reverse the anticoagulation effect of dabigatran. 12 hours later, TT was tested as 17.4s which belonged to the normal range. Finally, she had no active bleeding signs, with labs showing Hb 104g/L and TT 17.7s.CONCLUSION:It is recommended to monitor renal function regularly, even coagulation function and dabigatran concentration, for the elder. There is at present no general agreement on the use of Proton Pump Inhibitor (PPI)–dabigatran coadministration to prevent upper gastrointestinal bleeding.

Objective: To investigate the clinical efficacy of cognitive behavioral therapy combined with pinaverium bromide tablets in admitted patients with irritable bowel syndrome (IBS). Methods: This is a retrospective study. A total of 60 patients with IBS admitted to Beijing Hospital of Integrated Traditional Chinese and Western Medicine between June 2021 and June 2022 were selected and randomly divided into two groups. Patients in the control group were treated with pinaverium bromide tablets, and those in the observation group were treated with cognitive behavior therapy combined with pinaverium bromide tablets. The improvement of clinical symptoms and quality of life before and after treatment was compared for the two groups, IBS-SSS scale and IBS-QOL scale were used to compare the improvement of clinical symptoms and quality of life between the two groups of patients before and after treatment. SAS score and SDS score were used to evaluate the psychology of the two groups. Adverse reactions occurring during the treatment were recorded, such as nausea and vomiting, dizziness and headache, etc. Results: The efficacy of the observation group was higher than that of the control group and the difference was significant (P<0.05). After treatment, the IBS-SSS score in the observation group and the control group decreased and the IBS-QOL score increased. The SDS score and SAS score in the observation group were better than those in the control group (P< 0.05). After treatment, there was no significant difference in adverse reactions between the observation group and the control group (P > 0.05). Conclusion: Cognitive behavioral therapy combined with pinaverium bromide tablets is significantly effective in the treatment of patients with IBS, which can effectively relieve symptoms such as diarrhea and abdominal pain, and reduce irritable bowel reactions. doi: https://doi.org/10.12669/pjms.39.4.6994 How to cite this: Liu Q, Zhu Y, Wang W, Dong Y. Clinical efficacy of cognitive behavioral therapy combined with pinaverium bromide tablets on irritable bowel syndrome. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.6994 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The blind holes processing experiment is conducted on the silicon under the radiation of a 355 nm nanosecond UV repetitive pulse laser. With the increase of the laser pulse number, the variations of the silicon morphology,the depth and aperture of the blind holes are observed, and the thermodynamic process of UV laser irradiating silicon is analyzed. The results show that the formation of the blind silicon hole in the laser ablation process is due to the interaction between thermal effect and force effect. Thermal effect results in fusion, vaporization and even producing laser plasma by ionization in silicon, which is essential to the removal of the material. The molten material is compressed by the plasma shock wave and the expansion of the high-temperature gaseous material,and then ejection outward, which will benefit the further ablation; the force propagates along the laser transmission direction,perpendicular to the silicon surface, so the removal parts are distributed mainly along the depth direction of the hole, reaching a high aperture ratio, which is up to 8:1 in our experiments. In addition, the laser-induced plasma also prevents the effect of laser on the target surface, and with the increase of hole depth, laser defocusing occurs. The two aspects finally restrict the ablation depth. The results shows that in the process of laser irradiation on the material, the ablation efficiency is much higher when the former 100 pulses arrived than the sequent laser pulses.