目的本研究旨在探索血浆D-二聚体(D-dimer,D-D)对心源性栓塞(cardiogenic embolization,CE)型急性大血管闭塞性脑卒中(acute large vascular occlusion stroke,ALVOS)患者行机械取栓(mechanical thrombectomy,MT)术后预后不良的预测价...目的本研究旨在探索血浆D-二聚体(D-dimer,D-D)对心源性栓塞(cardiogenic embolization,CE)型急性大血管闭塞性脑卒中(acute large vascular occlusion stroke,ALVOS)患者行机械取栓(mechanical thrombectomy,MT)术后预后不良的预测价值分析。方法连续选取2020年1月—2023年3月南京医科大学附属常州第二人民医院接受MT的心源性栓塞(cardioembolism,CE)型ALVOS患者,共158例,回顾性分析其临床基础资料、手术信息及预后情况,比较预后良好组与预后不良组基线资料。采用Logistic回归分析MT术后90 d预后不良的独立危险因素,并应用ROC曲线评估MT术后24 h内的D-D水平对90 d转归不良的预测价值。结果CE型ALVOS患者预后不良组在基线美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、空腹血糖(fasting plasm glucose,FPG)、D-D水平均显著高于预后良好组,吸烟、饮酒史、症状性颅内出血(symptomatic intracerebral hemorrhage,sICH)及较差的改良脑梗死溶栓(modified thrombolysis in cerebral infarction,mTICI)分级与预后不良正相关。Logistic回归在校正NIHSS评分、吸烟、饮酒、FPG、sICH、mTICI后,发现D-D(OR=2.14,95%CI:2.02~2.27,P<0.05)是CE型ALVOS患者MT术后90 d转归不良的独立危险因素。D-D预测MT术后90 d转归不良的曲线下面积(area under the curve,AUC)为0.708,最佳截断值为0.404,此时敏感度和特异度分别为81.0%和58.5%。结论MT术后24 h内D-D水平升高对预测CE型ALVOS患者90 d预后不良有一定的价值。展开更多
To improve the living standards,economical efficiency and environmental protection of isolated islands,remote areas and other areas with weak electric power facilities construction,a multi-source independent microgrid...To improve the living standards,economical efficiency and environmental protection of isolated islands,remote areas and other areas with weak electric power facilities construction,a multi-source independent microgrid system is studied,including diesel generators,photovoltaic power generation system,wind power generation system and energy storage unit.Meanwhile,in order to realize the voltage and frequency stability control of AC bus of multisource microgrid,the virtual synchronous generator technology is introduced into the energy storage unit,and the charge and discharge control of the energy storage battery are simulated as the control behavior characteristics of synchronous motors,so as to provide damping and inertia support for the microgrid.The operation mode and control principle of each energy subsystem are expounded and analyzed.The algorithm principle of virtual synchronous generator and the control method of energy storage unit are given.Then,the working modes of the microgrid system under different environmental conditions are analyzed,and the multi-source microgrid system simulation model is built based on MATLAB/Simulink.The simulation results show that the microgrid system can run stably under different working modes and the energy storage unit using the virtual synchronous generator technology can provide good voltage and frequency support for the microgrid system.Finally,experiments verify the supporting function of energy storage unit on the voltage and frequency of the microgrid system.展开更多
文摘目的本研究旨在探索血浆D-二聚体(D-dimer,D-D)对心源性栓塞(cardiogenic embolization,CE)型急性大血管闭塞性脑卒中(acute large vascular occlusion stroke,ALVOS)患者行机械取栓(mechanical thrombectomy,MT)术后预后不良的预测价值分析。方法连续选取2020年1月—2023年3月南京医科大学附属常州第二人民医院接受MT的心源性栓塞(cardioembolism,CE)型ALVOS患者,共158例,回顾性分析其临床基础资料、手术信息及预后情况,比较预后良好组与预后不良组基线资料。采用Logistic回归分析MT术后90 d预后不良的独立危险因素,并应用ROC曲线评估MT术后24 h内的D-D水平对90 d转归不良的预测价值。结果CE型ALVOS患者预后不良组在基线美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、空腹血糖(fasting plasm glucose,FPG)、D-D水平均显著高于预后良好组,吸烟、饮酒史、症状性颅内出血(symptomatic intracerebral hemorrhage,sICH)及较差的改良脑梗死溶栓(modified thrombolysis in cerebral infarction,mTICI)分级与预后不良正相关。Logistic回归在校正NIHSS评分、吸烟、饮酒、FPG、sICH、mTICI后,发现D-D(OR=2.14,95%CI:2.02~2.27,P<0.05)是CE型ALVOS患者MT术后90 d转归不良的独立危险因素。D-D预测MT术后90 d转归不良的曲线下面积(area under the curve,AUC)为0.708,最佳截断值为0.404,此时敏感度和特异度分别为81.0%和58.5%。结论MT术后24 h内D-D水平升高对预测CE型ALVOS患者90 d预后不良有一定的价值。
基金supported by the Science and Technology Research&Development Project of China Construction Second Engineering Bureau Ltd.(No.91110000100024296D180009)。
文摘To improve the living standards,economical efficiency and environmental protection of isolated islands,remote areas and other areas with weak electric power facilities construction,a multi-source independent microgrid system is studied,including diesel generators,photovoltaic power generation system,wind power generation system and energy storage unit.Meanwhile,in order to realize the voltage and frequency stability control of AC bus of multisource microgrid,the virtual synchronous generator technology is introduced into the energy storage unit,and the charge and discharge control of the energy storage battery are simulated as the control behavior characteristics of synchronous motors,so as to provide damping and inertia support for the microgrid.The operation mode and control principle of each energy subsystem are expounded and analyzed.The algorithm principle of virtual synchronous generator and the control method of energy storage unit are given.Then,the working modes of the microgrid system under different environmental conditions are analyzed,and the multi-source microgrid system simulation model is built based on MATLAB/Simulink.The simulation results show that the microgrid system can run stably under different working modes and the energy storage unit using the virtual synchronous generator technology can provide good voltage and frequency support for the microgrid system.Finally,experiments verify the supporting function of energy storage unit on the voltage and frequency of the microgrid system.
