目的观察多模式镇痛方法在小儿扁桃体腺样体切除术后的应用效果。方法选取在医院择期行扁桃体腺样体切除手术的90例患儿,术后均接受静脉自控镇痛(PCIA),依据随机数字表法分为3组,每组30例。给予S组舒芬太尼联合右美托咪定;给予T组酮咯...目的观察多模式镇痛方法在小儿扁桃体腺样体切除术后的应用效果。方法选取在医院择期行扁桃体腺样体切除手术的90例患儿,术后均接受静脉自控镇痛(PCIA),依据随机数字表法分为3组,每组30例。给予S组舒芬太尼联合右美托咪定;给予T组酮咯酸氨丁三醇联合右美托咪定;给予ST组舒芬太尼、酮咯酸氨丁三醇联合右美托咪定。记录3组手术时间、麻醉时间;记录3组术后4、8、12、24、48 h儿童疼痛行为评估量表(FLACC)评分、Ramsay镇静评分以及48 h内PCIA的总按压次数、有效按压次数、补救镇痛及不良反应的发生情况。结果与T组比较,术后4、8、12、24 h S组和ST组FLACC评分降低(P<0.05)。与S组比较,术后4、8、12、24、48 h T组和ST组Ramsay镇静评分降低(P<0.05);与ST组比较,术后4、8 h T组Ramsay镇静评分降低(P<0.05)。术后48 h内T组镇痛泵总按压次数和有效按压次数多于S组和ST组(P<0.05)。术后48 h内S组恶心呕吐、嗜睡、皮肤瘙痒的发生率高于T组和ST组(P<0.05),T组的补救镇痛率高于S组和ST组(P<0.05)。结论舒芬太尼复合酮咯酸氨丁三醇及右美托咪定的多模式镇痛方法用于扁桃体腺样体切除术后PCIA的效果较好,不良反应发生率低。展开更多
Conventional soil maps generally contain one or more soil types within a single soil polygon.But their geographic locations within the polygon are not specified.This restricts current applications of the maps in site-...Conventional soil maps generally contain one or more soil types within a single soil polygon.But their geographic locations within the polygon are not specified.This restricts current applications of the maps in site-specific agricultural management and environmental modelling.We examined the utility of legacy pedon data for disaggregating soil polygons and the effectiveness of similarity-based prediction for making use of the under-or over-sampled legacy pedon data for the disaggregation.The method consisted of three steps.First,environmental similarities between the pedon sites and each location were computed based on soil formative environmental factors.Second,according to soil types of the pedon sites,the similarities were aggregated to derive similarity distribution for each soil type.Third,a hardening process was performed on the maps to allocate candidate soil types within the polygons.The study was conducted at the soil subgroup level in a semi-arid area situated in Manitoba,Canada.Based on 186 independent pedon sites,the evaluation of the disaggregated map of soil subgroups showed an overall accuracy of 67% and a Kappa statistic of 0.62.The map represented a better spatial pattern of soil subgroups in both detail and accuracy compared to a dominant soil subgroup map,which was commonly used in practice.Incorrect predictions mainly occurred in the agricultural plain area and the soil subgroups that are very similar in taxonomy,indicating that new environmental covariates need to be developed.We concluded that the combination of legacy pedon data with similarity-based prediction is an effective solution for soil polygon disaggregation.展开更多
The American Science journal,on the occasion of its 125 publication anniversary,in 2016,released 125 of the most challenging scientific issues(Kennedy et al.,2005)to the world.According to the basics,breadth and the i...The American Science journal,on the occasion of its 125 publication anniversary,in 2016,released 125 of the most challenging scientific issues(Kennedy et al.,2005)to the world.According to the basics,breadth and the influence,25 of the issues which considered to be the most important were screened,including"How many people can the Earth carry?"(Stokstad,2005;Dailyg et al.,1992;Cohen,1995)and"How high will the greenhouse effect make the earth temperature?展开更多
目的采用网状Meta分析的方法比较不同药物降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的效果。方法计算机检索Cochrane Library、Pubmed、Web of Science、EMBASE、知网、万方和中国生物医学文献数据库等,搜索通过干预措施降低小儿...目的采用网状Meta分析的方法比较不同药物降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的效果。方法计算机检索Cochrane Library、Pubmed、Web of Science、EMBASE、知网、万方和中国生物医学文献数据库等,搜索通过干预措施降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的随机对照试验(RCT),检索时限均从建库至2023年7月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用STATA 17.0软件依据频率学框架进行网状Meta分析。结果共纳入20篇RCT,患者1687例。与安慰剂比较,10种干预措施能降低小儿扁桃体腺样体切除术后苏醒期躁动发生率,概率排序依次为:右美托咪定[OR值及其95%CI为0.13(0.09~0.20)]、氯胺酮[OR值及其95%CI为0.15(0.08~0.26)]、可乐定[OR值及其95%CI为0.15(0.05~0.50)]、曲马多[OR值及其95%CI为0.16(0.04~0.61)]、瑞马唑仑[OR值及其95%CI为0.17(0.06~0.47)]、阿芬太尼[OR值及其95%CI为0.22(0.08~0.62)]、瑞芬太尼[OR值及其95%CI为0.24(0.12~0.48)]、地佐辛[OR值及其95%CI为0.29(0.12~0.69)]、芬太尼[OR值及其95%CI为0.31(0.19~0.52)]及丙泊酚[OR值及其95%CI为0.46(0.24~0.86)];4种干预措施可降低术后补救用药的使用率,概率排序依次为:右美托咪定[OR值及其95%CI为0.19(0.11~0.32)]、曲马多[OR值及其95%CI为0.20(0.10~0.42)]、氯胺酮[OR值及其95%CI为0.49(0.28~0.86)]及芬太尼[OR值及其95%CI为0.49(0.32~0.77)];1种干预措施可降低术后恶心呕吐发生率:右美托咪定[OR值及其95%CI为0.54(0.31~0.94)]。结论右美托咪定降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的效果最好。展开更多
文摘目的观察多模式镇痛方法在小儿扁桃体腺样体切除术后的应用效果。方法选取在医院择期行扁桃体腺样体切除手术的90例患儿,术后均接受静脉自控镇痛(PCIA),依据随机数字表法分为3组,每组30例。给予S组舒芬太尼联合右美托咪定;给予T组酮咯酸氨丁三醇联合右美托咪定;给予ST组舒芬太尼、酮咯酸氨丁三醇联合右美托咪定。记录3组手术时间、麻醉时间;记录3组术后4、8、12、24、48 h儿童疼痛行为评估量表(FLACC)评分、Ramsay镇静评分以及48 h内PCIA的总按压次数、有效按压次数、补救镇痛及不良反应的发生情况。结果与T组比较,术后4、8、12、24 h S组和ST组FLACC评分降低(P<0.05)。与S组比较,术后4、8、12、24、48 h T组和ST组Ramsay镇静评分降低(P<0.05);与ST组比较,术后4、8 h T组Ramsay镇静评分降低(P<0.05)。术后48 h内T组镇痛泵总按压次数和有效按压次数多于S组和ST组(P<0.05)。术后48 h内S组恶心呕吐、嗜睡、皮肤瘙痒的发生率高于T组和ST组(P<0.05),T组的补救镇痛率高于S组和ST组(P<0.05)。结论舒芬太尼复合酮咯酸氨丁三醇及右美托咪定的多模式镇痛方法用于扁桃体腺样体切除术后PCIA的效果较好,不良反应发生率低。
基金supported by the National Natural Science Foundation of China (41130530,91325301,41431177,41571212,41401237)the Project of "One-Three-Five" Strategic Planning & Frontier Sciences of the Institute of Soil Science,Chinese Academy of Sciences (ISSASIP1622)+1 种基金the Government Interest Related Program between Canadian Space Agency and Agriculture and Agri-Food,Canada (13MOA01002)the Natural Science Research Program of Jiangsu Province (14KJA170001)
文摘Conventional soil maps generally contain one or more soil types within a single soil polygon.But their geographic locations within the polygon are not specified.This restricts current applications of the maps in site-specific agricultural management and environmental modelling.We examined the utility of legacy pedon data for disaggregating soil polygons and the effectiveness of similarity-based prediction for making use of the under-or over-sampled legacy pedon data for the disaggregation.The method consisted of three steps.First,environmental similarities between the pedon sites and each location were computed based on soil formative environmental factors.Second,according to soil types of the pedon sites,the similarities were aggregated to derive similarity distribution for each soil type.Third,a hardening process was performed on the maps to allocate candidate soil types within the polygons.The study was conducted at the soil subgroup level in a semi-arid area situated in Manitoba,Canada.Based on 186 independent pedon sites,the evaluation of the disaggregated map of soil subgroups showed an overall accuracy of 67% and a Kappa statistic of 0.62.The map represented a better spatial pattern of soil subgroups in both detail and accuracy compared to a dominant soil subgroup map,which was commonly used in practice.Incorrect predictions mainly occurred in the agricultural plain area and the soil subgroups that are very similar in taxonomy,indicating that new environmental covariates need to be developed.We concluded that the combination of legacy pedon data with similarity-based prediction is an effective solution for soil polygon disaggregation.
基金granted by the United Nations Educational,Scientific and Cultural Organization program(IGCP665)the China basic geological Investigation Program(Grant No.DD20160316).
文摘The American Science journal,on the occasion of its 125 publication anniversary,in 2016,released 125 of the most challenging scientific issues(Kennedy et al.,2005)to the world.According to the basics,breadth and the influence,25 of the issues which considered to be the most important were screened,including"How many people can the Earth carry?"(Stokstad,2005;Dailyg et al.,1992;Cohen,1995)and"How high will the greenhouse effect make the earth temperature?
文摘目的采用网状Meta分析的方法比较不同药物降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的效果。方法计算机检索Cochrane Library、Pubmed、Web of Science、EMBASE、知网、万方和中国生物医学文献数据库等,搜索通过干预措施降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的随机对照试验(RCT),检索时限均从建库至2023年7月。由2位研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用STATA 17.0软件依据频率学框架进行网状Meta分析。结果共纳入20篇RCT,患者1687例。与安慰剂比较,10种干预措施能降低小儿扁桃体腺样体切除术后苏醒期躁动发生率,概率排序依次为:右美托咪定[OR值及其95%CI为0.13(0.09~0.20)]、氯胺酮[OR值及其95%CI为0.15(0.08~0.26)]、可乐定[OR值及其95%CI为0.15(0.05~0.50)]、曲马多[OR值及其95%CI为0.16(0.04~0.61)]、瑞马唑仑[OR值及其95%CI为0.17(0.06~0.47)]、阿芬太尼[OR值及其95%CI为0.22(0.08~0.62)]、瑞芬太尼[OR值及其95%CI为0.24(0.12~0.48)]、地佐辛[OR值及其95%CI为0.29(0.12~0.69)]、芬太尼[OR值及其95%CI为0.31(0.19~0.52)]及丙泊酚[OR值及其95%CI为0.46(0.24~0.86)];4种干预措施可降低术后补救用药的使用率,概率排序依次为:右美托咪定[OR值及其95%CI为0.19(0.11~0.32)]、曲马多[OR值及其95%CI为0.20(0.10~0.42)]、氯胺酮[OR值及其95%CI为0.49(0.28~0.86)]及芬太尼[OR值及其95%CI为0.49(0.32~0.77)];1种干预措施可降低术后恶心呕吐发生率:右美托咪定[OR值及其95%CI为0.54(0.31~0.94)]。结论右美托咪定降低小儿扁桃体腺样体切除术后苏醒期躁动发生率的效果最好。
