Objective The northern margin of the North China Craton (NCC),as an adjacent part between the northern NCC and the southeastern Central Asian Orogenic Belt (CAOB), has recorded multi-stage tectonic evolution information.
目的:探究血糖波动与危重患儿不良预后的关系,寻找代表血糖波动的最优指标。方法:前瞻性收集2020年1月1日至2020年8月31日重庆医科大学附属儿童医院重症医学科(pediatric intensive care unit,PICU)收治的280例危重患儿资料,以入PICU后2...目的:探究血糖波动与危重患儿不良预后的关系,寻找代表血糖波动的最优指标。方法:前瞻性收集2020年1月1日至2020年8月31日重庆医科大学附属儿童医院重症医学科(pediatric intensive care unit,PICU)收治的280例危重患儿资料,以入PICU后28 d转归情况分为生存组和死亡组,记录入住PICU后72 h内的生理参数及结局资料,运用受试者工作特征(receiver operating characteristic,ROC)曲线及logistic回归分析等统计学方法进行统计分析。结果:(1)不同血糖波动指标中,血糖标准差(standard deviation,SD)(AUC=0.759,95%CI=0.688~0.830,P<0.001)和血糖不稳定指数(glycemic lability index,GLI)(AUC=0.752,95%CI=0.680~0.825,P<0.001)对预后具有更好的评价效能。多因素logistic回归分析显示,调整了疾病严重程度、血管活性药物评分、心肺复苏等其他影响死亡率的混杂因素及平均血糖后,SD所代表的血糖波动(OR=3.356,95%CI=1.536~7.332,P=0.002),PIM(pediatric index of mortality)评分(OR=1.155,95%CI=1.023~1.303,P=0.020)及PICU住院时间(OR=0.895,95%CI=0.837~0.956,P=0.001)是PICU患儿28 d死亡率的独立危险因素。(2)进一步将平均血糖水平及血糖波动分层分析,高血糖波动组的死亡率均高于低血糖波动组,具有低平均血糖同时具有高血糖波动的患儿死亡率最高。结论:危重患儿血糖波动是独立于平均血糖的死亡危险因素,SD、GLI可能是代表血糖波动的优势指标。临床医生关注平均血糖水平的同时更要关注血糖波动。展开更多
Objective Many previous researches have documented the tectonic evolution of the northern margin of North China Craton. However, whether the age of original Silurian Badangshan Formation in the study area belongs to ...Objective Many previous researches have documented the tectonic evolution of the northern margin of North China Craton. However, whether the age of original Silurian Badangshan Formation in the study area belongs to the Archean, Silurian or Devonian remains controversial, and the ductile deformation time of this formation also lack of chronological study. This work focused on the composition of the rocks in the original Silurian Badangshan Formation of the Jiefangyingzi and Dachaoyanggou area of Chifeng, and the U-Pb dating of rhyolite and late intrusive rocks, and then discussed the age of ductile deformation in order to provide new basic information for the structural evolution of this area.展开更多
文摘目的:探讨先天性心脏病(congenital heart disease,CHD)患儿术后脑组织氧饱和度(cerebral tissue oxygen saturation,SctO2)与临床预后的相关性。方法:前瞻性队列研究。随机收集2016年12月至2017年10月于我院接受体外循环下CHD矫治术,并于术后转入重症监护室(intensive care unit,ICU)的患儿,共65例。采用美国CAS Medical System公司生产的Fore-sight近红外光谱仪(near-infrared spectroscopy,NIRS)对该65例患儿行术后24 h连续SctO2监测,分析监测期间最低SctO2(nadir of SctO2,n SctO2)、平均SctO2(mean of SctO2,mSctO2)与严重病情结局(adverse outcome,AO:包括低心排综合征、心肺复苏或死亡)、术后第三代24 h小儿死亡危险评分(pediatric risk of mortalityⅢ,Prism-Ⅲ)、术后24 h最大血管活性药物指数(maximum of vasoactive-inotropic score,VISmax)、机械通气时间及ICU留置时间的相关性。结果:AO组患儿26例(40.00%),非AO组患儿39例(60.00%);AO组nSctO2、mSctO2较非AO组均明显减低[44.00%(32.00%~47.25%)vs. 56.00%(50.00%~60.00%),P=0.000]、[61.94%(58.95%~65.15%)vs. 70.00%(66.67%~73.76%),P=0.000]。Spearman秩相关分析示nSctO2及mSctO2分别与Prism-Ⅲ评分负相关(rs=-0.653,P=0.000;rs=-0.593,P=0.000)、与VISmax负相关(rs=-0.346,P=0.005;rs=-0.422,P=0.000)、与呼吸机时间负相关(rs=-0.424,P=0.001;rs=-0.519,P=0.000)、与ICU留置时间负相关(rs=-0.407,P=0.000;rs=-0.528,P=0.001);ROC曲线示nSctO2临界值51.50%对预测AO具有中等准确性(AUROC=0.849,P=0.000),95%CI=0.756~0.942,灵敏度为92.30%,特异度为74.40%。结论:CHD术后24 h内SctO2降低与不良预后有关,SctO2越低,持续时间越长,预后可能更差。nSctO2低于51.50%可能是预后不良的一个危险因素。
基金the geological survey project of China Geological Survey (grant No. DD20160155 and DD20190021)
文摘Objective The northern margin of the North China Craton (NCC),as an adjacent part between the northern NCC and the southeastern Central Asian Orogenic Belt (CAOB), has recorded multi-stage tectonic evolution information.
文摘目的:探究血糖波动与危重患儿不良预后的关系,寻找代表血糖波动的最优指标。方法:前瞻性收集2020年1月1日至2020年8月31日重庆医科大学附属儿童医院重症医学科(pediatric intensive care unit,PICU)收治的280例危重患儿资料,以入PICU后28 d转归情况分为生存组和死亡组,记录入住PICU后72 h内的生理参数及结局资料,运用受试者工作特征(receiver operating characteristic,ROC)曲线及logistic回归分析等统计学方法进行统计分析。结果:(1)不同血糖波动指标中,血糖标准差(standard deviation,SD)(AUC=0.759,95%CI=0.688~0.830,P<0.001)和血糖不稳定指数(glycemic lability index,GLI)(AUC=0.752,95%CI=0.680~0.825,P<0.001)对预后具有更好的评价效能。多因素logistic回归分析显示,调整了疾病严重程度、血管活性药物评分、心肺复苏等其他影响死亡率的混杂因素及平均血糖后,SD所代表的血糖波动(OR=3.356,95%CI=1.536~7.332,P=0.002),PIM(pediatric index of mortality)评分(OR=1.155,95%CI=1.023~1.303,P=0.020)及PICU住院时间(OR=0.895,95%CI=0.837~0.956,P=0.001)是PICU患儿28 d死亡率的独立危险因素。(2)进一步将平均血糖水平及血糖波动分层分析,高血糖波动组的死亡率均高于低血糖波动组,具有低平均血糖同时具有高血糖波动的患儿死亡率最高。结论:危重患儿血糖波动是独立于平均血糖的死亡危险因素,SD、GLI可能是代表血糖波动的优势指标。临床医生关注平均血糖水平的同时更要关注血糖波动。
基金granted by the geological survey project of China Geological Survey (grant No.DD20160155)
文摘Objective Many previous researches have documented the tectonic evolution of the northern margin of North China Craton. However, whether the age of original Silurian Badangshan Formation in the study area belongs to the Archean, Silurian or Devonian remains controversial, and the ductile deformation time of this formation also lack of chronological study. This work focused on the composition of the rocks in the original Silurian Badangshan Formation of the Jiefangyingzi and Dachaoyanggou area of Chifeng, and the U-Pb dating of rhyolite and late intrusive rocks, and then discussed the age of ductile deformation in order to provide new basic information for the structural evolution of this area.
