2型糖尿病合并阻塞性睡眠呼吸暂停综合征病情严重程度与糖脂代谢、炎症因子及肾功能的相关性研究

目的探讨2型糖尿病合并阻塞性睡眠呼吸暂停综合征(OSAS)病情严重程度与糖脂代谢、炎症因子及肾功能的相关性。方法按照每小时睡眠呼吸暂停次数(AHI)将2016年3月-2018年6月右江民族医学院附属医院收治的123例2型糖尿病患者分为单纯糖尿病组(39例,AHI<5次/h)、OSAS轻度组(32例,AHI5~15次/h)、OSAS中度组(28例,AHI 16~30次/h)和OSAS重度组(24例,AHI>30次/h),同期随机选取40例健康体检者为对照组。比较各组睡眠呼吸指标:AHI、最低动脉血氧饱和度(LSaO2)、夜间动脉平均血氧饱和度(MSaO2),血糖指标:空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、糖化血红蛋白(HbA1c),血脂指标:总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、甘油三酯(TG),炎症因子指标:白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hs-CRP)、胞间黏附分子-1(ICAM-1),以及肾功能:血清肌酐(Scr)、肾小球滤过率(e GFR),并分析睡眠呼吸指标与糖脂代谢指标、炎症因子指标及肾功能指标的相关性。结果2型糖尿病患者体重指数(BMI)、FBG、HbA1c、TC、LDL、TG高于对照组,HDL低于对照组(P<0.05),OSAS轻、中、重度组患者FBG、HbA1c、TC、LDL、TG高于单纯糖尿病组,HDL低于单纯糖尿病组(P<0.05)。2型糖尿病患者血清IL-6、IL-8、TNF-α、hs-CRP、ICAM-1水平均高于对照组(P<0.05),OSAS轻、中、重度组患者上述指标高于单纯糖尿病组(P<0.05)。2型糖尿病患者e GFR水平低于对照组(P<0.05),OSAS轻、中、重度患者e GFR水平低于单纯糖尿病组(P<0.05)。糖尿病肾脏疾病(DKD)组患者AHI高于非DKD组,LSaO2、MSaO2低于非DKD组(P<0.05)。经Pearson相关分析,AHI与BMI、FBG、HbA1c、TC、LDL、TG、IL-6、IL-8、TNF-α、hs-CRP、ICAM-1呈正相关(P<0.05),LSaO2、MSaO2与上述指标呈负相关(P<0.05);AHI与HDL、e GFR呈负相关(P<0.05),LSaO2、MSaO2与HDL、eGFR呈正相关(P<0.05)。结论OSAS可致2型糖尿病患者糖脂代谢异常、炎症反应加剧及肾功能损伤,并且OSAS病情越严重,患者糖脂代谢异常越明显,炎症反应越重,肾功能损伤越严重。

Estimation of unloading relaxation depth of Baihetan Arch Dam foundation using long-short term memory network

The unloading relaxation caused by excavation for construction of high arch dams is an important factor influencing the foundation’s integrity and strength.To evaluate the degree of unloading relaxation,the long-short term memory(LSTM)network was used to estimate the depth of unloading relaxation zones on the left bank foundation of the Baihetan Arch Dam.Principal component analysis indicates that rock charac-teristics,the structural plane,the protection layer,lithology,and time are the main factors.The LSTM network results demonstrate the unloading relaxation characteristics of the left bank,and the relationships with the factors were also analyzed.The structural plane has the most significant influence on the distribution of unloading relaxation zones.Compared with massive basalt,the columnar jointed basalt experiences a more significant unloading relaxation phenomenon with a clear time effect,with the average unloading relaxation period being 50 d.The protection layer can effectively reduce the unloading relaxation depth by approximately 20%.

Seismic stability safety evaluation of gravity dam with shear strength reduction method

A new method of numerical seismic stability safety evaluation for a rock slope is proposed based on the analysis of a gravity dam foundation subjected to earthquake loading. The shear strengths of the weak discontinuities are divided by different shear strength reduction ratios （K） and numerical seismic analysis is carried out after the static analysis is completed. With different K values, the curves of the permanent horizontal displacement of key points of the dam foundation （K-displacement curves） are studied. According to the curve change, the distribution of plastic zones in the foundation, and the slow convergence of the finite element method （FEM）, the seismic stability safety factor is defined as Kwhen the gravity dam is in the limit equilibrium state subjected to earthquake loading. These concepts were applied to the evaluation of seismic stability safety of a gravity dam for a hydropower project. The analysis of the example shows that the proposed method is feasible and is an effective method of seismic stability safety evaluation.