目的:分析近两年中国医学科学院阜外医院确诊为原发性醛固酮增多症(PA)的高血压患者的临床特征。方法:回顾性收集2016-01至2017-12期间中国医学科学院阜外医院高血压病房收治的4 782例高血压患者资料,将其中的PA患者与原发性高血压(PH)...目的:分析近两年中国医学科学院阜外医院确诊为原发性醛固酮增多症(PA)的高血压患者的临床特征。方法:回顾性收集2016-01至2017-12期间中国医学科学院阜外医院高血压病房收治的4 782例高血压患者资料,将其中的PA患者与原发性高血压(PH)患者根据年龄、性别1:2匹配后比较其临床特征,并比较血钾正常和低钾血症(<3.5 mmol/L)PA患者的临床特征。结果:247例(5.2%)患者确诊为PA,其中位年龄48.8(16.6)岁,男性148例(59.9%),143例(57.9%)有低钾血症。与PH患者相比,PA患者收缩压较高[150(24)mm Hg vs 145(27)mm Hg,1 mm Hg=0.133 k Pa],左心室质量指数(LVMI)较高[83.4(36.6)g/m^2 vs 75.7(26.2)g/m^2],尿微量白蛋白/肌酐较高[24.1(41.1)mg/g vs 10.5(22.1)mg/g],合并冠心病(12.6%vs 7.7%)和外周动脉疾病(11.7%vs 4.7%)者比例较高,但低密度脂蛋白胆固醇[2.6(1.0)mmol/L vs 2.9(1.1)mmol/L]、总胆固醇[4.4(1.2)mmol/L vs 4.6(1.3)mmol/L]和糖化血红蛋白水平[5.4(0.6)%vs 5.6(0.6)%]较低,差异均有统计学意义(P均<0.05)。与血钾正常的PA患者相比,低钾血症PA患者年龄较小[45.9(16.8)岁vs51.3(14.3)岁],但舒张压[95(26)mm Hg vs 90(20)mm Hg]、尿微量白蛋白/肌酐[28.5(40.6)mg/g vs 20.5(32.8)mg/g]和LVMI [86.5(34.8)g/m2 vs 77.9(31.8)g/m^2]较高,差异均有统计学意义(P均<0.05)。结论:与PH患者相比,PA患者靶器官损害重,合并心血管病比例高。有低钾血症的PA患者年龄较小,但舒张压较高且靶器官损害较重。展开更多
For the tunnel crossing active fault,the damage induced by fault movement is always serious.To solve such a problem,a detailed anti-faulting tunnel design process for Urumqi subway line 2 was introduced,and seven thre...For the tunnel crossing active fault,the damage induced by fault movement is always serious.To solve such a problem,a detailed anti-faulting tunnel design process for Urumqi subway line 2 was introduced,and seven three-dimensional elastic-plastic finite element models were established.The anti-faulting design process included three steps.First,the damage of tunnel lining from different locations of fault rupture surfaces was analyzed.Then,the analysis of the effect on tunnel buried depth was given.Finally,the effect of the disaster mitigation method on the flexible joint was verified and the location of the flexible joint was discussed.The results show that when the properties of surrounding rock at the tunnel bottom grows soft,the tunnel deformation curve is smoother and tunnel damage induced by fault movement is less serious.The vertical displacement change ratio of secondary linings along the tunnel axis may be the main factor to cause shear damage to the tunnel.The interface between the hanging wall and fracture zone is defined as the most adverse fault rupture surface.The tunnel damage was reduced with the decrease in the tunnel buried depth as more energy was dissipated by overburden soil and the differential uplift zone of soil became more diffuse.The method of the flexible joint can reduce the tunnel damage significantly and the disaster mitigation effect of different locations on the flexible joint is different.The tunnel damage is reduced by the greatest degree when the flexible joint is located on the fault rupture surface.展开更多
In order to obtain the seismic responses of the soil-rectangular tunnel structure,based on the PL-Finn constitutive model,four different conditions,namely,the liquefied soil around the rectangular tunnel,the liquefied...In order to obtain the seismic responses of the soil-rectangular tunnel structure,based on the PL-Finn constitutive model,four different conditions,namely,the liquefied soil around the rectangular tunnel,the liquefied soil below the rectangular tunnel,the liquefied soil on either side of the tunnel and the structure on non-liquefied soil,are compared.In accordance to the time at which a large deformation occurs,the possibility of destruction from hard to easy follows a descending order:the liquefied soil all around the structure,the liquefied soil on the bottom of the structure,and the liquefied soil on the two sides of the structure.The area of large deformation is mostly beneath the two arch angles of the tunnel floor.The soil on the two sides,especially close to the structure,is the hardest to liquefy and deform.The large deformation of soil caused by the liquefaction appears after the peak seismic value occurs.The higher the input seismic value is,the easier a large deformation can take place.With the same input of peak ground motion,the total displacement vector of the structure and differential displacement of the side-wall are in accordance with an order from large to small in the three situations:when the saturated sand is on two sides,all around the structure,and on the bottom of the structure.展开更多
文摘目的:分析近两年中国医学科学院阜外医院确诊为原发性醛固酮增多症(PA)的高血压患者的临床特征。方法:回顾性收集2016-01至2017-12期间中国医学科学院阜外医院高血压病房收治的4 782例高血压患者资料,将其中的PA患者与原发性高血压(PH)患者根据年龄、性别1:2匹配后比较其临床特征,并比较血钾正常和低钾血症(<3.5 mmol/L)PA患者的临床特征。结果:247例(5.2%)患者确诊为PA,其中位年龄48.8(16.6)岁,男性148例(59.9%),143例(57.9%)有低钾血症。与PH患者相比,PA患者收缩压较高[150(24)mm Hg vs 145(27)mm Hg,1 mm Hg=0.133 k Pa],左心室质量指数(LVMI)较高[83.4(36.6)g/m^2 vs 75.7(26.2)g/m^2],尿微量白蛋白/肌酐较高[24.1(41.1)mg/g vs 10.5(22.1)mg/g],合并冠心病(12.6%vs 7.7%)和外周动脉疾病(11.7%vs 4.7%)者比例较高,但低密度脂蛋白胆固醇[2.6(1.0)mmol/L vs 2.9(1.1)mmol/L]、总胆固醇[4.4(1.2)mmol/L vs 4.6(1.3)mmol/L]和糖化血红蛋白水平[5.4(0.6)%vs 5.6(0.6)%]较低,差异均有统计学意义(P均<0.05)。与血钾正常的PA患者相比,低钾血症PA患者年龄较小[45.9(16.8)岁vs51.3(14.3)岁],但舒张压[95(26)mm Hg vs 90(20)mm Hg]、尿微量白蛋白/肌酐[28.5(40.6)mg/g vs 20.5(32.8)mg/g]和LVMI [86.5(34.8)g/m2 vs 77.9(31.8)g/m^2]较高,差异均有统计学意义(P均<0.05)。结论:与PH患者相比,PA患者靶器官损害重,合并心血管病比例高。有低钾血症的PA患者年龄较小,但舒张压较高且靶器官损害较重。
基金The National Natural Science Foundation of China(No.41572276)the National Key Research and Development Program of China(No.2017YFC0805400).
文摘For the tunnel crossing active fault,the damage induced by fault movement is always serious.To solve such a problem,a detailed anti-faulting tunnel design process for Urumqi subway line 2 was introduced,and seven three-dimensional elastic-plastic finite element models were established.The anti-faulting design process included three steps.First,the damage of tunnel lining from different locations of fault rupture surfaces was analyzed.Then,the analysis of the effect on tunnel buried depth was given.Finally,the effect of the disaster mitigation method on the flexible joint was verified and the location of the flexible joint was discussed.The results show that when the properties of surrounding rock at the tunnel bottom grows soft,the tunnel deformation curve is smoother and tunnel damage induced by fault movement is less serious.The vertical displacement change ratio of secondary linings along the tunnel axis may be the main factor to cause shear damage to the tunnel.The interface between the hanging wall and fracture zone is defined as the most adverse fault rupture surface.The tunnel damage was reduced with the decrease in the tunnel buried depth as more energy was dissipated by overburden soil and the differential uplift zone of soil became more diffuse.The method of the flexible joint can reduce the tunnel damage significantly and the disaster mitigation effect of different locations on the flexible joint is different.The tunnel damage is reduced by the greatest degree when the flexible joint is located on the fault rupture surface.
基金The National Natural Science Foundation of China(No.41572276)the National Key Research and Development Program of China(No.2017YFC0805400)
文摘In order to obtain the seismic responses of the soil-rectangular tunnel structure,based on the PL-Finn constitutive model,four different conditions,namely,the liquefied soil around the rectangular tunnel,the liquefied soil below the rectangular tunnel,the liquefied soil on either side of the tunnel and the structure on non-liquefied soil,are compared.In accordance to the time at which a large deformation occurs,the possibility of destruction from hard to easy follows a descending order:the liquefied soil all around the structure,the liquefied soil on the bottom of the structure,and the liquefied soil on the two sides of the structure.The area of large deformation is mostly beneath the two arch angles of the tunnel floor.The soil on the two sides,especially close to the structure,is the hardest to liquefy and deform.The large deformation of soil caused by the liquefaction appears after the peak seismic value occurs.The higher the input seismic value is,the easier a large deformation can take place.With the same input of peak ground motion,the total displacement vector of the structure and differential displacement of the side-wall are in accordance with an order from large to small in the three situations:when the saturated sand is on two sides,all around the structure,and on the bottom of the structure.
