目的:总结重症监护病房(ICU)病人全程血糖管理最佳证据,为ICU医护人员提供血糖管理循证依据。方法:系统检索Up To Date、BMJ Best Practice、the Cochrane Library、乔安娜布里格斯研究所图书馆、美国国立指南库、国际网络指南网、英国...目的:总结重症监护病房(ICU)病人全程血糖管理最佳证据,为ICU医护人员提供血糖管理循证依据。方法:系统检索Up To Date、BMJ Best Practice、the Cochrane Library、乔安娜布里格斯研究所图书馆、美国国立指南库、国际网络指南网、英国国家临床医学研究所指南库、苏格兰学院间指南网、加拿大安大略注册护士协会网站、加拿大医学会临床实践指南、PubMed、EMbase、Springer、ScienceDirect、英国NEWT网站、CINAHL、中国生物医学文献数据库、中国知网、万方数据库、医脉通等数据库、系统评价库中与ICU病人血糖管理有关的文献,包括临床决策、临床实践指南、证据总结、专家共识、随机对照研究。检索时限为自建库至2022年4月30日。由2名研究者独立对文献质量进行评价并提取资料。结果:共纳入文献11篇,包括指南4篇、专家共识5篇、证据总结1篇、随机对照研究1篇。总结的最佳证据包括ICU病人血糖监测方式、末梢血糖监测方法、末梢血糖结果影响因素、血糖控制目标、血糖控制方案、围术期血糖管理、质量控制、效果评价7个方面,共33条。结论:ICU病人全程血糖管理最佳证据总结可为ICU医护人员血糖管理提供循证依据。证据应用人员在进行证据转化时应考虑具体情境,合理选择证据,以便制订符合个体情况的ICU病人血糖管理方案。展开更多
This study explores the characteristics of high temperature anomalies over eastern China and associated influencing factors using observations and model outputs.Results show that more long-duration（over 8 days） high...This study explores the characteristics of high temperature anomalies over eastern China and associated influencing factors using observations and model outputs.Results show that more long-duration（over 8 days） high temperature events occur over the middle and lower reaches of the Yangtze River Valley（YRV） than over the surrounding regions,and control most of the interannual variation of summer mean temperature in situ.The synergistic effect of summer precipitation over the South China Sea（SCS） region（18°–27°N,115°–124°E） and the northwestern India and Arabian Sea（IAS） region（18°–27°N,60°–80°E） contributes more significantly to the variation of summer YRV temperature,relative to the respective SCS or IAS precipitation anomaly.More precipitation（enhanced condensational heating） over the SCS region strengthens the western Pacific subtropical high（WPSH） and simultaneously weakens the westerly trough over the east coast of Asia,and accordingly results in associated high temperature anomalies over the YRV region through stimulating an East Asia–Pacific（EAP） pattern.More precipitation over the IAS region further adjusts the variations of the WPSH and westerly trough,and eventually reinforces high temperature anomalies over the YRV region.Furthermore,the condensational heating related to more IAS precipitation can adjust upper-tropospheric easterly anomalies over the YRV region by exciting a circumglobal teleconnection,inducing cold horizontal temperature advection and related anomalous descent,which is also conducive to the YRV high temperature anomalies.The reproduction of the above association in the model results indicates that the above results can be explained both statistically and dynamically.展开更多
文摘目的:总结重症监护病房(ICU)病人全程血糖管理最佳证据,为ICU医护人员提供血糖管理循证依据。方法:系统检索Up To Date、BMJ Best Practice、the Cochrane Library、乔安娜布里格斯研究所图书馆、美国国立指南库、国际网络指南网、英国国家临床医学研究所指南库、苏格兰学院间指南网、加拿大安大略注册护士协会网站、加拿大医学会临床实践指南、PubMed、EMbase、Springer、ScienceDirect、英国NEWT网站、CINAHL、中国生物医学文献数据库、中国知网、万方数据库、医脉通等数据库、系统评价库中与ICU病人血糖管理有关的文献,包括临床决策、临床实践指南、证据总结、专家共识、随机对照研究。检索时限为自建库至2022年4月30日。由2名研究者独立对文献质量进行评价并提取资料。结果:共纳入文献11篇,包括指南4篇、专家共识5篇、证据总结1篇、随机对照研究1篇。总结的最佳证据包括ICU病人血糖监测方式、末梢血糖监测方法、末梢血糖结果影响因素、血糖控制目标、血糖控制方案、围术期血糖管理、质量控制、效果评价7个方面,共33条。结论:ICU病人全程血糖管理最佳证据总结可为ICU医护人员血糖管理提供循证依据。证据应用人员在进行证据转化时应考虑具体情境,合理选择证据,以便制订符合个体情况的ICU病人血糖管理方案。
基金the support of the National Natural Science Foundation of China(Grant Nos.41375090 and 41375091)the Basic Research Fund of the Chinese Academy of Meteorological Sciences(Grant Nos.2013Z002 and 2015Z001)the support of a Direct Grant of the Chinese University of Hong Kong(Grant No.4052057)
文摘This study explores the characteristics of high temperature anomalies over eastern China and associated influencing factors using observations and model outputs.Results show that more long-duration（over 8 days） high temperature events occur over the middle and lower reaches of the Yangtze River Valley（YRV） than over the surrounding regions,and control most of the interannual variation of summer mean temperature in situ.The synergistic effect of summer precipitation over the South China Sea（SCS） region（18°–27°N,115°–124°E） and the northwestern India and Arabian Sea（IAS） region（18°–27°N,60°–80°E） contributes more significantly to the variation of summer YRV temperature,relative to the respective SCS or IAS precipitation anomaly.More precipitation（enhanced condensational heating） over the SCS region strengthens the western Pacific subtropical high（WPSH） and simultaneously weakens the westerly trough over the east coast of Asia,and accordingly results in associated high temperature anomalies over the YRV region through stimulating an East Asia–Pacific（EAP） pattern.More precipitation over the IAS region further adjusts the variations of the WPSH and westerly trough,and eventually reinforces high temperature anomalies over the YRV region.Furthermore,the condensational heating related to more IAS precipitation can adjust upper-tropospheric easterly anomalies over the YRV region by exciting a circumglobal teleconnection,inducing cold horizontal temperature advection and related anomalous descent,which is also conducive to the YRV high temperature anomalies.The reproduction of the above association in the model results indicates that the above results can be explained both statistically and dynamically.
