目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和...目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和临床资料变化,多因素Logistic回归分析脑卒中合并上肢上臂肌痉挛发生的危险因素并建立风险预测模型,该模型的区分度用受试者工作特征曲线(ROC)评估,拟合度采用Hosmer-Lemeshow test。结果痉挛组上肢肱二头肌的伸展iEMG、协同收缩率和肱三头肌协同收缩率均高于非痉挛组(P<0.001),肱二头肌屈曲iEMG和肱三头肌的屈曲iEMG、伸展i EMG均低于非痉挛组(P<0.001),男性、年龄<60岁、卒中病程≥3个月、颅内手术史、疼痛、大面积病变和美国国立卫生院卒中量表(NIHSS)评分≥13分患者占比均高于非痉挛组(P<0.05)。男性、年龄<60岁、卒中病程≥3个月、疼痛和NIHSS评分≥13分是脑卒中患者上肢上臂肌痉挛的独立危险因素,低、中、高风险脑卒中患者上肢上臂肌痉挛发生率分别为5.38%、38.24%、85.71%,差异有统计意义(χ^(2)=79.023,P<0.001),建立的脑卒中患者上肢上臂肌痉挛风险预测ROC曲线下面积(AUC)为0.901(95%CI:0.835~0.967,P<0.001),Hosmer-Lemeshow test P=0.168。结论脑卒中合并上肢屈肌痉挛患者早期上臂功能下降,性别、年龄、卒中病程、疼痛以及NIHSS评分是其独立危险因素,建立的风险预测模型的预测效能高。展开更多
Significant differential hydrocarbon enrichment occurs in depressions in a petroliferous basin.There are multiple depressions in the Bohai Bay Basin, and each depression as a relatively independent unit of hydrocarbon...Significant differential hydrocarbon enrichment occurs in depressions in a petroliferous basin.There are multiple depressions in the Bohai Bay Basin, and each depression as a relatively independent unit of hydrocarbon generation, migration and accumulation, contains significantly different hydrocarbon generation conditions and enrichment degree. On the basis of previous documents and a large number of statistical data, this work comparatively analyzed the differential hydrocarbon enrichment and its major controlling factors in depressions of the Bohai Bay Basin. The results show that depressions in the Bohai Bay Basin have various hydrocarbon enrichment degrees, and can be categorized into four types, namely enormously oil-rich, oil-rich, oily and oil-poor depressions. In general, the enormously oil-rich and oil-rich depressions are distributed in the eastern part of the basin along the Tan-Lu and Lan-Liao faults, whereas depressions in the western part of the basin are poor in hydrocarbons. Moreover, the vertical distribution of hydrocarbons is also highly heterogeneous, with Pre-Paleogene strata rich in hydrocarbons in the northern and western depressions, Paleogene strata rich in hydrocarbons in the entire basin, and Neogene strata rich in hydrocarbons in the off-shore areas of the Bohai Bay Basin. From early depressions in onshore areas to the late depressions in offshore areas of the Bohai Bay Basin, the source rocks and source-reservoir-cap rock assemblages gradually become younger and shallower, and the hydrocarbon resource abundance gradually increases. Hydrocarbon supplying condition is the key factor constraining the hydrocarbon enrichment for different depressions,while the main source-reservoir-cap rock assemblage, sufficient hydrocarbons and the transportation capacity of faults control the vertical distribution of hydrocarbons. The main factors controlling hydrocarbon enrichment are different for different layers. The hydrocarbon supplying condition of source rocks is the key controlling factor, whereas the source-reservoir configuration, the main sourcereservoir-cap rock assemblages, and the fault transportation are the main factors of hydrocarbon enrichment in the Paleogene, Paleogene and Neogene, respectively.展开更多
文摘目的探讨脑卒中早期上肢肌动图信号与上肢上臂肌痉挛发生的关系及其风险预测模型。方法选取2019-06—2021-06北京康复医院收治脑卒中患者196例,根据患者是否发生上肢屈肌痉挛分为痉挛组和非痉挛组,比较2组患者早期上肢肌动图信号变化和临床资料变化,多因素Logistic回归分析脑卒中合并上肢上臂肌痉挛发生的危险因素并建立风险预测模型,该模型的区分度用受试者工作特征曲线(ROC)评估,拟合度采用Hosmer-Lemeshow test。结果痉挛组上肢肱二头肌的伸展iEMG、协同收缩率和肱三头肌协同收缩率均高于非痉挛组(P<0.001),肱二头肌屈曲iEMG和肱三头肌的屈曲iEMG、伸展i EMG均低于非痉挛组(P<0.001),男性、年龄<60岁、卒中病程≥3个月、颅内手术史、疼痛、大面积病变和美国国立卫生院卒中量表(NIHSS)评分≥13分患者占比均高于非痉挛组(P<0.05)。男性、年龄<60岁、卒中病程≥3个月、疼痛和NIHSS评分≥13分是脑卒中患者上肢上臂肌痉挛的独立危险因素,低、中、高风险脑卒中患者上肢上臂肌痉挛发生率分别为5.38%、38.24%、85.71%,差异有统计意义(χ^(2)=79.023,P<0.001),建立的脑卒中患者上肢上臂肌痉挛风险预测ROC曲线下面积(AUC)为0.901(95%CI:0.835~0.967,P<0.001),Hosmer-Lemeshow test P=0.168。结论脑卒中合并上肢屈肌痉挛患者早期上臂功能下降,性别、年龄、卒中病程、疼痛以及NIHSS评分是其独立危险因素,建立的风险预测模型的预测效能高。
基金granted by the Important National Science&Technology Specific Projects(grants No.2011ZX05006-003 and 2016ZX05006-003)the National Natural Science Foundation(grant No.41372132)
文摘Significant differential hydrocarbon enrichment occurs in depressions in a petroliferous basin.There are multiple depressions in the Bohai Bay Basin, and each depression as a relatively independent unit of hydrocarbon generation, migration and accumulation, contains significantly different hydrocarbon generation conditions and enrichment degree. On the basis of previous documents and a large number of statistical data, this work comparatively analyzed the differential hydrocarbon enrichment and its major controlling factors in depressions of the Bohai Bay Basin. The results show that depressions in the Bohai Bay Basin have various hydrocarbon enrichment degrees, and can be categorized into four types, namely enormously oil-rich, oil-rich, oily and oil-poor depressions. In general, the enormously oil-rich and oil-rich depressions are distributed in the eastern part of the basin along the Tan-Lu and Lan-Liao faults, whereas depressions in the western part of the basin are poor in hydrocarbons. Moreover, the vertical distribution of hydrocarbons is also highly heterogeneous, with Pre-Paleogene strata rich in hydrocarbons in the northern and western depressions, Paleogene strata rich in hydrocarbons in the entire basin, and Neogene strata rich in hydrocarbons in the off-shore areas of the Bohai Bay Basin. From early depressions in onshore areas to the late depressions in offshore areas of the Bohai Bay Basin, the source rocks and source-reservoir-cap rock assemblages gradually become younger and shallower, and the hydrocarbon resource abundance gradually increases. Hydrocarbon supplying condition is the key factor constraining the hydrocarbon enrichment for different depressions,while the main source-reservoir-cap rock assemblage, sufficient hydrocarbons and the transportation capacity of faults control the vertical distribution of hydrocarbons. The main factors controlling hydrocarbon enrichment are different for different layers. The hydrocarbon supplying condition of source rocks is the key controlling factor, whereas the source-reservoir configuration, the main sourcereservoir-cap rock assemblages, and the fault transportation are the main factors of hydrocarbon enrichment in the Paleogene, Paleogene and Neogene, respectively.
