目的分析老年维持性血液透析(maintenance hemodialysis,MHD)患者透析中进食误吸危险因素并构建预测模型。方法选取无锡市第二人民医院血液透析中心行MHD老年(年龄≥60岁)患者220例。通过最小绝对值选择与收缩算子(least absolute selec...目的分析老年维持性血液透析(maintenance hemodialysis,MHD)患者透析中进食误吸危险因素并构建预测模型。方法选取无锡市第二人民医院血液透析中心行MHD老年(年龄≥60岁)患者220例。通过最小绝对值选择与收缩算子(least absolute selection and shrinkage operator,LASSO)方法筛选预测因子,采用多因素Logistic回归分析建立预测模型,并用列线图展示;接受者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估模型预测效果,校准曲线评价模型的校准度。结果卒中史(OR=9.460,95%CI:3.218~27.813,P<0.001)、合并肺炎(OR=6.499,95%CI:1.912~22.096,P=0.003)、镇静催眠药(OR=5.978,95%CI:1.323~27.005,P=0.020)、慢性肾脏病矿物质与骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)类药(OR=3.069,95%CI:1.074~8.773,P=0.036)、血氧饱和度(<95%)(OR=11.545,95%CI:3.932~33.901,P<0.001)及进食非固体食物(OR=0.253,95%CI:0.078~0.826,P=0.023)为影响老年MHD患者发生误吸的独立危险因素。ROC曲线下面积(area under curve,AUC)为0.917(95%CI:0.879~0.955),P<0.001。校准曲线、决策曲线评价其一致性及获益性良好。结论本研究构建模型预测效果较好,为临床医务人员识别老年MHD患者透析中进食发生误吸及采取相应护理措施提供参考。展开更多
Meltability is one of the most important properties of Mozzarella cheese, as it is generally used in pizza and other foods. Mozzarella was prepared by no salted and immature production technology, and the effect of di...Meltability is one of the most important properties of Mozzarella cheese, as it is generally used in pizza and other foods. Mozzarella was prepared by no salted and immature production technology, and the effect of different addition amounts of salt on the meltability of mozzarella cheese was measured by Schreiber method and small amplitude oscillatory shear analysis（SAOSA） method. The results showed that different adding amounts of NaCl had significant influence on the meltability of Mozzarella cheese, and 2% NaCl addition was the best condition. The results measured by the methods of Schreiber and SAOSA were basically same： adding different amounts of NaCl had significant influence on the hardness and elasticity of mozzarella cheese, but no significant influence on the sticky. It was a good microscopic structure arrangement of Mozzarella cheese with 2% NaCl addition. Scanning electron micrographs showed that a space grid structure formed by casein had changed, and formed many uniform molecular holes. The results indicated that different addition amounts of salt had influence on meltability of no salted immature Mozzarella cheese, and this technology could be drastically shorten the processing time.展开更多
文摘目的分析老年维持性血液透析(maintenance hemodialysis,MHD)患者透析中进食误吸危险因素并构建预测模型。方法选取无锡市第二人民医院血液透析中心行MHD老年(年龄≥60岁)患者220例。通过最小绝对值选择与收缩算子(least absolute selection and shrinkage operator,LASSO)方法筛选预测因子,采用多因素Logistic回归分析建立预测模型,并用列线图展示;接受者操作特征曲线(receiver operating characteristic curve,ROC曲线)评估模型预测效果,校准曲线评价模型的校准度。结果卒中史(OR=9.460,95%CI:3.218~27.813,P<0.001)、合并肺炎(OR=6.499,95%CI:1.912~22.096,P=0.003)、镇静催眠药(OR=5.978,95%CI:1.323~27.005,P=0.020)、慢性肾脏病矿物质与骨异常(chronic kidney disease-mineral and bone disorder,CKD-MBD)类药(OR=3.069,95%CI:1.074~8.773,P=0.036)、血氧饱和度(<95%)(OR=11.545,95%CI:3.932~33.901,P<0.001)及进食非固体食物(OR=0.253,95%CI:0.078~0.826,P=0.023)为影响老年MHD患者发生误吸的独立危险因素。ROC曲线下面积(area under curve,AUC)为0.917(95%CI:0.879~0.955),P<0.001。校准曲线、决策曲线评价其一致性及获益性良好。结论本研究构建模型预测效果较好,为临床医务人员识别老年MHD患者透析中进食发生误吸及采取相应护理措施提供参考。
基金Supported by 12th Five-year Plan of National Ministry of Science and Technology(2011BAD09B02)National Ministry of Science and Technology(2009GJB20010)
文摘Meltability is one of the most important properties of Mozzarella cheese, as it is generally used in pizza and other foods. Mozzarella was prepared by no salted and immature production technology, and the effect of different addition amounts of salt on the meltability of mozzarella cheese was measured by Schreiber method and small amplitude oscillatory shear analysis（SAOSA） method. The results showed that different adding amounts of NaCl had significant influence on the meltability of Mozzarella cheese, and 2% NaCl addition was the best condition. The results measured by the methods of Schreiber and SAOSA were basically same： adding different amounts of NaCl had significant influence on the hardness and elasticity of mozzarella cheese, but no significant influence on the sticky. It was a good microscopic structure arrangement of Mozzarella cheese with 2% NaCl addition. Scanning electron micrographs showed that a space grid structure formed by casein had changed, and formed many uniform molecular holes. The results indicated that different addition amounts of salt had influence on meltability of no salted immature Mozzarella cheese, and this technology could be drastically shorten the processing time.
