目的:探讨老年血液透析患者红细胞体积分布宽度(red cell distribution width,RDW)水平及其临床意义。方法:前瞻性入选2017年7月至12月在上海市健康医学院附属嘉定区中心医院血液净化中心维持性透析老年患者128例。其中男性48例,女性80...目的:探讨老年血液透析患者红细胞体积分布宽度(red cell distribution width,RDW)水平及其临床意义。方法:前瞻性入选2017年7月至12月在上海市健康医学院附属嘉定区中心医院血液净化中心维持性透析老年患者128例。其中男性48例,女性80例,年龄(69.2±4.5)岁,透析龄(64.3±42.5)个月。所有患者均收集临床病史,并于周中透析前检测血红蛋白、红细胞体积分布宽度、电解质、高敏C反应蛋白、血清白蛋白、铁蛋白、甲状旁腺素等临床指标。应用Pearson相关分析和多元线性逐步回归模型分析各临床指标与RDW的关系。应用曲线拟合模型分析可能与RDW呈非线性相关的临床指标。所有患者临床随访12个月,主要终点为死亡,次要终点为各类型心脑血管事件。应用Kaplan-Meier法分析RDW高值组和低值组患者上述终点事件的差异。应用Cox比例风险模型分析与预后相关的独立预测因子。结果:整组患者RDW为[(16.24±2.22)%,(14.0~20.4)%],中位数15.1%,105(82.1%)例患者RDW水平超过参考值上限。男性患者RDW水平低于女性患者组。Pearson相关分析提示RDW与透析龄、每周促进细胞生成素(EPO)剂量、高敏C反应蛋白、透析间期体质量增加比例显著正相关。RDW与血清白蛋白显著负相关。多元线性逐步回归模型结果提示RDW与血清白蛋白显著负相关(P<0.01),与每周EPO剂量显著正相关(P<0.01)。RDW与血红蛋白呈曲线相关,以二次方程拟合优度最佳(P<0.001)。全部患者均随访12个月,共死亡6例,其中RDW高值组4例,RDW低值组2例,差异无统计学意义。随访期间发生各类心脑血管事件36例,其中RDW高值组26例,RDW低值组10例。Kaplan-Meier分析提示RDW高值组和RDW低值组患者在12个月随访期内心脑血管事件发生率差异有统计学意义(log-rank=16.224,P<0.001)。单因素Cox回归显示RDW水平与12个月内心脑血管事件正相关,血红蛋白、血清白蛋白和12个月内心脑血管事件负相关。多因素Cox回归结果显示RDW(HR=1.231,P=0.015)、血清白蛋白水平(HR=0.964,P<0.001)是老年维持性血液透析患者12个月内心脑血管事件的独立预测因素。结论:老年血液透析患者中RDW水平普遍增高,且与贫血、透析龄、营养水平、炎症状态、心脏功能、EPO剂量及反应等多项临床指标有关;RDW水平增高与老年维持性血液透析患者短期临床心脑血管事件转归相关。展开更多
The Lidang circular structure in the center of the Guangxi Province is about 8 km in diameter. This structure appears as an abnormal shallow depression that has disturbed the rather harmonic regional joint systems. It...The Lidang circular structure in the center of the Guangxi Province is about 8 km in diameter. This structure appears as an abnormal shallow depression that has disturbed the rather harmonic regional joint systems. Its unique occurrence in the whole region, the circular morphology, negative topography, and the spatial distribution of interior and exterior strata are all consistent with those of impact craters that are formed by asteroidal or cometary collision. To test the impact hypothesis, we carried out both field investigation and remote sensing study of this structure. Regional geological history suggests that if the impact hypothesis were correct, the impact event should have occurred at or after the Early Permian. Field investigation found that the strata inside and outside the crater are dominated by parallel stacks of Lower and Upper Permian limestone that have various thicknesses and different mud contents. The layers of limestone within and outside the circular structure have identical attitudes;no structural disturbances were visible in the outcrops. Field investigations provide conclusive evidence against the impact cratering hypothesis. A high-resolution digital elevation model shows that the spatial distribution of rounded mountains within the structure is controlled by faint but continual extension of joints, suggesting that the crater interior has gone through a much higher degree of erosion. Therefore, regional joints that had once existed within the crater are preserved less well than exterior terrains, forming the abruptly disrupted circular depression. Differential erosion, as the possible formation mechanism of the Lidang structure, is consistent with the different mud contents found between the interior and exterior limestone. The circular outline of this structure may correspond to the shape of the original deposition basin. In conclusion, the Lidang circular structure is a polje formed by karstification, not an astrobleme.展开更多
The Baisha Structure,with a rim-to-rim diameter of^3.7 km,in the center of the Hainan Province,southern China has been considered to be an impact crater.Field investigation and petrological study are presented in this...The Baisha Structure,with a rim-to-rim diameter of^3.7 km,in the center of the Hainan Province,southern China has been considered to be an impact crater.Field investigation and petrological study are presented in this paper to investigate the impact hypothesis for this structure.The^600-m-thick Lower Cretaceous feldspathic quartz sandstones from the Lumuwan Formation are the major outcrops both within and outside of the structure.The amphitheater-shaped rim of the structure is composed of granite porphyries that are intruded in the Lumuwan Formation.Previously interpreted impact breccia and impact melt rocks are actually granite porphyries different cooling rates and weathering status.Rocks from locations that most likely have recorded shock metamorphic signatures are sampled,but petrographic analyses reveal no indications of shock metamorphism.While subtle structural deformation occurs at the contact boundary between the granite porphyries and the feldspathic quartz sandstones,the feldspathic quartz sandstones exhibit uniformed dipping strata across the crater floor and walls.All the evidence suggests that the Baisha Structure was not formed by impact cratering.It most likely has been shaped by a combination of magmatic intrusion and long-term differential erosion.展开更多
文摘目的:探讨老年血液透析患者红细胞体积分布宽度(red cell distribution width,RDW)水平及其临床意义。方法:前瞻性入选2017年7月至12月在上海市健康医学院附属嘉定区中心医院血液净化中心维持性透析老年患者128例。其中男性48例,女性80例,年龄(69.2±4.5)岁,透析龄(64.3±42.5)个月。所有患者均收集临床病史,并于周中透析前检测血红蛋白、红细胞体积分布宽度、电解质、高敏C反应蛋白、血清白蛋白、铁蛋白、甲状旁腺素等临床指标。应用Pearson相关分析和多元线性逐步回归模型分析各临床指标与RDW的关系。应用曲线拟合模型分析可能与RDW呈非线性相关的临床指标。所有患者临床随访12个月,主要终点为死亡,次要终点为各类型心脑血管事件。应用Kaplan-Meier法分析RDW高值组和低值组患者上述终点事件的差异。应用Cox比例风险模型分析与预后相关的独立预测因子。结果:整组患者RDW为[(16.24±2.22)%,(14.0~20.4)%],中位数15.1%,105(82.1%)例患者RDW水平超过参考值上限。男性患者RDW水平低于女性患者组。Pearson相关分析提示RDW与透析龄、每周促进细胞生成素(EPO)剂量、高敏C反应蛋白、透析间期体质量增加比例显著正相关。RDW与血清白蛋白显著负相关。多元线性逐步回归模型结果提示RDW与血清白蛋白显著负相关(P<0.01),与每周EPO剂量显著正相关(P<0.01)。RDW与血红蛋白呈曲线相关,以二次方程拟合优度最佳(P<0.001)。全部患者均随访12个月,共死亡6例,其中RDW高值组4例,RDW低值组2例,差异无统计学意义。随访期间发生各类心脑血管事件36例,其中RDW高值组26例,RDW低值组10例。Kaplan-Meier分析提示RDW高值组和RDW低值组患者在12个月随访期内心脑血管事件发生率差异有统计学意义(log-rank=16.224,P<0.001)。单因素Cox回归显示RDW水平与12个月内心脑血管事件正相关,血红蛋白、血清白蛋白和12个月内心脑血管事件负相关。多因素Cox回归结果显示RDW(HR=1.231,P=0.015)、血清白蛋白水平(HR=0.964,P<0.001)是老年维持性血液透析患者12个月内心脑血管事件的独立预测因素。结论:老年血液透析患者中RDW水平普遍增高,且与贫血、透析龄、营养水平、炎症状态、心脏功能、EPO剂量及反应等多项临床指标有关;RDW水平增高与老年维持性血液透析患者短期临床心脑血管事件转归相关。
基金supported by National Natural Science Foundation of China (Nos. 41773063 and 41830214)the Science and Technology Development Fund (FDCT) of Macao (0042/2018/A2)the Fundamental Research Funds for the Central Universities, China University of Geosciences (Wuhan) (Nos. CUG180601)
文摘The Lidang circular structure in the center of the Guangxi Province is about 8 km in diameter. This structure appears as an abnormal shallow depression that has disturbed the rather harmonic regional joint systems. Its unique occurrence in the whole region, the circular morphology, negative topography, and the spatial distribution of interior and exterior strata are all consistent with those of impact craters that are formed by asteroidal or cometary collision. To test the impact hypothesis, we carried out both field investigation and remote sensing study of this structure. Regional geological history suggests that if the impact hypothesis were correct, the impact event should have occurred at or after the Early Permian. Field investigation found that the strata inside and outside the crater are dominated by parallel stacks of Lower and Upper Permian limestone that have various thicknesses and different mud contents. The layers of limestone within and outside the circular structure have identical attitudes;no structural disturbances were visible in the outcrops. Field investigations provide conclusive evidence against the impact cratering hypothesis. A high-resolution digital elevation model shows that the spatial distribution of rounded mountains within the structure is controlled by faint but continual extension of joints, suggesting that the crater interior has gone through a much higher degree of erosion. Therefore, regional joints that had once existed within the crater are preserved less well than exterior terrains, forming the abruptly disrupted circular depression. Differential erosion, as the possible formation mechanism of the Lidang structure, is consistent with the different mud contents found between the interior and exterior limestone. The circular outline of this structure may correspond to the shape of the original deposition basin. In conclusion, the Lidang circular structure is a polje formed by karstification, not an astrobleme.
基金The Hainan Geological Survey kindly provided support during the field tripThis study was supported by the National Natural Science Foundation of China(Nos.41773063 and 41403053)to Zhiyong Xiao and Jiang Pu+2 种基金the Fundamental Research Funds for the Central Universities,China University of Geosciences(Wuhan)(Nos.CUG180601 and CUG2018JM10)the National Natural Science Foundation of China(No.41772050)to Long Xiaothe Natural Science Foundation of Jiangxi Province(No.20171BAB213027)to Cheng Huang.
文摘The Baisha Structure,with a rim-to-rim diameter of^3.7 km,in the center of the Hainan Province,southern China has been considered to be an impact crater.Field investigation and petrological study are presented in this paper to investigate the impact hypothesis for this structure.The^600-m-thick Lower Cretaceous feldspathic quartz sandstones from the Lumuwan Formation are the major outcrops both within and outside of the structure.The amphitheater-shaped rim of the structure is composed of granite porphyries that are intruded in the Lumuwan Formation.Previously interpreted impact breccia and impact melt rocks are actually granite porphyries different cooling rates and weathering status.Rocks from locations that most likely have recorded shock metamorphic signatures are sampled,but petrographic analyses reveal no indications of shock metamorphism.While subtle structural deformation occurs at the contact boundary between the granite porphyries and the feldspathic quartz sandstones,the feldspathic quartz sandstones exhibit uniformed dipping strata across the crater floor and walls.All the evidence suggests that the Baisha Structure was not formed by impact cratering.It most likely has been shaped by a combination of magmatic intrusion and long-term differential erosion.
