Establishment and validation of a predictive model for peripherally inserted central catheter-related thrombosis in patients with liver cancer

BACKGROUND Peripherally inserted central catheters(PICCs)are commonly used in hospitalized patients with liver cancer for the administration of chemotherapy,nutrition,and other medications.However,PICC-related thrombosis is a serious complication that can lead to morbidity and mortality in this patient population.Several risk factors have been identified for the development of PICC-related thrombosis,including cancer type,stage,comorbidities,and catheter characteristics.Understanding these risk factors and developing a predictive model can help healthcare providers identify high-risk patients and implement preventive measures to reduce the incidence of thrombosis.AIM To analyze the influencing factors of PICC-related thrombosis in hospitalized patients with liver cancer,construct a predictive model,and validate it.METHODS Clinical data of hospitalized patients with liver cancer admitted from January 2020 to December 2023 were collected.Thirty-five cases of PICC-related thrombosis in hospitalized patients with liver cancer were collected,and 220 patients who underwent PICC placement during the same period but did not develop PICC-related thrombosis were randomly selected as controls.A total of 255 samples were collected and used as the training set,and 77 cases were collected as the validation set in a 7:3 ratio.General patient information,case data,catheterization data,coagulation indicators,and Autar Thrombosis Risk Assessment Scale scores were analyzed.Univariate and multivariate unconditional logistic regression analyses were performed on relevant factors,and the value of combined indicators in predicting PICC-related thrombosis in hospitalized patients with liver cancer was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Univariate analysis showed statistically significant differences(P<0.05)in age,sex,Karnofsky performance status score(KPS),bedridden time,activities of daily living impairment,parenteral nutrition,catheter duration,distant metastasis,and bone marrow suppression between the thrombosis group and the non-thrombosis group.Other aspects had no statistically significant differences(P>0.05).Multivariate regression analysis showed that age≥60 years,KPS score≤50 points,parenteral nutrition,stage III to IV,distant metastasis,bone marrow suppression,and activities of daily living impairment were independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer(P<0.05).Catheter duration of 1-6 months and catheter duration>6 months were protective factors for PICC-related thrombosis(P<0.05).The predictive model for PICC-related thrombosis was obtained as follows:P predictive probability=[exp(Logit P)]/[1+exp(Logit P)],where Logit P=age×1.907+KPS score×2.045+parenteral nutrition×9.467+catheter duration×0.506+tumor-node-metastasis(TNM)staging×2.844+distant metastasis×2.065+bone marrow suppression×2.082+activities of daily living impairment×13.926.ROC curve analysis showed an area under the curve(AUC)of 0.827(95%CI:0.724-0.929,P<0.001),with a corresponding optimal cut-off value of 0.612,sensitivity of 0.755,and specificity of 0.857.Calibration curve analysis showed good consistency between the predicted occurrence of PICC-related thrombosis and actual occurrence(P>0.05).ROC analysis showed AUCs of 0.888 and 0.729 for the training and validation sets,respectively.CONCLUSION Age,KPS score,parenteral nutrition,TNM staging,distant metastasis,bone marrow suppression,and activities of daily living impairment are independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer,while catheter duration is a protective factor for the disease.The predictive model has an AUC of 0.827,indicating high predictive accuracy and clinical value.

Physics package based on intracavity laser cooling ^(87)Rb atoms for space cold atom microwave clock

This article proposes a new physics package to enhance the frequency stability of the space cold atom clock with the advantages of a microgravity environment. Clock working processes, including atom cooling, atomic state preparation,microwave interrogation, and transition probability detection, are integrated into the cylindrical microwave cavity to achieve a high-performance and compact physics package for the space cold atom clock. We present the detailed design and ground-test results of the cold atom clock physics package in this article, which demonstrates a frequency stability of 1.2×10^(-12) τ^(-1/2) with a Ramsey linewidth of 12.5 Hz, and a better performance is predicted with a 1 Hz or a narrower Ramsey linewidth in microgravity environment. The miniaturized cold atom clock based on intracavity cooling has great potential for achieving space high-precision time-frequency reference in the future.

Prediction model establishment and validation for enteral nutrition aspiration during hospitalization in patients with acute pancreatitis

BACKGROUND Acute pancreatitis(AP)is a disease caused by abnormal activation of pancreatic enzymes and can lead to self-digestion of pancreatic tissues and dysfunction of other organs.Enteral nutrition plays a vital role in the treatment of AP because it can meet the nutritional needs of patients,promote the recovery of intestinal function,and maintain the barrier and immune functions of the intestine.However,the risk of aspiration during enteral nutrition is high;once aspiration occurs,it may cause serious complications,such as aspiration pneumonia,and suffocation,posing a threat to the patient’s life.This study aims to establish and validate a prediction model for enteral nutrition aspiration during hospitalization in patients with AP.AIM To establish and validate a predictive model for enteral nutrition aspiration during hospitalization in patients with AP.METHODS A retrospective review was conducted on 200 patients with AP admitted to Chengdu Shangjin Nanfu Hospital,West China Hospital of Sichuan University from January 2020 to February 2024.Clinical data were collected from the electronic medical record system.Patients were randomly divided into a validation group(n=40)and a modeling group(n=160)in a 1:4 ratio,matched with 200 patients from the same time period.The modeling group was further categorized into an aspiration group(n=25)and a non-aspiration group(n=175)based on the occurrence of enteral nutrition aspiration during hospitalization.Univariate and multivariate logistic regression analyses were performed to identify factors influencing enteral nutrition aspiration in patients with AP during hospitalization.A prediction model for enteral nutrition aspiration during hospitalization was constructed,and calibration curves were used for validation.Receiver operating characteristic curve analysis was conducted to evaluate the predictive value of the model.RESULTS There was no statistically significant difference in general data between the validation and modeling groups(P>0.05).The comparison of age,gender,body mass index,smoking history,hypertension history,and diabetes history showed no statistically significant difference between the two groups(P>0.05).However,patient position,consciousness status,nutritional risk,Acute Physiology and Chronic Health Evaluation(APACHE-II)score,and length of nasogastric tube placement showed statistically significant differences(P<0.05)between the two groups.Multivariate logistic regression analysis showed that patient position,consciousness status,nutritional risk,APACHE-II score,and length of nasogastric tube placement were independent factors influencing enteral nutrition aspiration in patients with AP during hospitalization(P<0.05).These factors were incorporated into the prediction model,which showed good consistency between the predicted and actual risks,as indicated by calibration curves with slopes close to 1 in the training and validation sets.Receiver operating characteristic analysis revealed an area under the curve(AUC)of 0.926(95%CI:0.8889-0.9675)in the training set.The optimal cutoff value is 0.73,with a sensitivity of 88.4 and specificity of 85.2.In the validation set,the AUC of the model for predicting enteral nutrition aspiration in patients with AP patients during hospitalization was 0.902,with a standard error of 0.040(95%CI:0.8284-0.9858),and the best cutoff value was 0.73,with a sensitivity of 91.9 and specificity of 81.8.CONCLUSION A prediction model for enteral nutrition aspiration during hospitalization in patients with AP was established and demonstrated high predictive value.Further clinical application of the model is warranted.

Establishment of predictive models and determinants of preoperative gastric retention in endoscopic retrograde cholangiopancreatography

BACKGROUND Study on influencing factors of gastric retention before endoscopic retrograde cholangiopancreatography(ERCP)background:With the wide application of ERCP,the risk of preoperative gastric retention affects the smooth progress of the operation.The study found that female,biliary and pancreatic malignant tumor,digestive tract obstruction and other factors are closely related to gastric retention,so the establishment of predictive model is very important to reduce the risk of operation.METHODS A retrospective analysis was conducted on 190 patients admitted to our hospital for ERCP preparation between January 2020 and February 2024.Patient baseline clinical data were collected using an electronic medical record system.Patients were randomly matched in a 1:4 ratio with data from 190 patients during the same period to establish a validation group(n=38)and a modeling group(n=152).Patients in the modeling group were divided into the gastric retention group(n=52)and non-gastric retention group(n=100)based on whether gastric retention occurred preoperatively.General data of patients in the validation group and identify factors influencing preoperative gastric retention in ERCP patients.A predictive model for preoperative gastric retention in ERCP patients was constructed,and calibration curves were used for validation.The receiver operating characteristic(ROC)curve was analyzed to evaluate the predictive value of the model.RESULTS We found no statistically significant difference in general data between the validation group and modeling group(P>0.05).The comparison of age,body mass index,hypertension,and diabetes between the two groups showed no statistically significant difference(P>0.05).However,we noted statistically significant differences in gender,primary disease,jaundice,opioid use,and gastrointestinal obstruction between the two groups(P<0.05).Mul-tivariate logistic regression analysis showed that gender,primary disease,jaundice,opioid use,and gastrointestinal obstruction were independent factors influencing preoperative gastric retention in ERCP patients(P<0.05).The results of logistic regression analysis revealed that gender,primary disease,jaundice,opioid use,and gastroin-testinal obstruction were included in the predictive model for preoperative gastric retention in ERCP patients.The calibration curves in the training set and validation set showed a slope close to 1,indicating good consistency between the predicted risk and actual risk.The ROC analysis results showed that the area under the curve(AUC)of the predictive model for preoperative gastric retention in ERCP patients in the training set was 0.901 with a standard error of 0.023(95%CI:0.8264-0.9567),and the optimal cutoff value was 0.71,with a sensitivity of 87.5 and specificity of 84.2.In the validation set,the AUC of the predictive model was 0.842 with a standard error of 0.013(95%CI:0.8061-0.9216),and the optimal cutoff value was 0.56,with a sensitivity of 56.2 and specificity of 100.0.CONCLUSION Gender,primary disease,jaundice,opioid use,and gastrointestinal obstruction are factors influencing preoperative gastric retention in ERCP patients.A predictive model established based on these factors has high predictive value.

育苗容器对紫叶紫薇容器苗生长、开花及生理的影响

【目的】探讨育苗容器类型和规格对紫叶紫薇容器苗生长、开花及生理的影响,筛选出培育紫叶紫薇容器苗的适宜育苗容器,为高效培育紫薇容器苗提供理论依据。【方法】以紫叶紫薇优良新品种‘丹红紫叶’2年生苗木为研究材料,选用黑色塑料营养杯(C1)、白色无纺布美植袋(C2)、黑色控根容器(C3)3个类型以及16×16(D1)、21×21(D2)、25×25(D3)3种规格(直径×高,cm),组成9种容器组合处理,测定不同处理容器苗生长、开花及生理指标。【结果】(1)不同育苗容器处理对紫叶紫薇容器苗的生长、开花及生理指标均影响显著,同一容器类型苗木的生长、根系、生物量、花期、花径、花序、可溶性蛋白含量、可溶性糖含量、相对叶绿素含量、净光合速率、气孔导度、蒸腾速率等指标均随着育苗容器规格的增大而显著增加。(2)地径生长量、总根长、总根表面积、总根体积、根尖数、地上部干质量、地下部干质量、总干质量、花期均以C3D3处理最大,比最小的C1D1处理分别显著提高817.12%、108.12%、94.60%、75.66%、144.14%、135.67%、228.45%、164.65%、34.48%;苗高生长量、冠幅生长量、叶面积、花序长和宽均以C1D3处理最高,比最低的C1D1处理分别显著提高116.05%、81.39%、114.95%、70.44%和65.79%;相对叶绿素含量、水分利用效率均以C3D3处理最大,可溶性蛋白和可溶性糖含量、净光合速率、气孔导度均以C1D3处理最高;胞间CO_(2)浓度、水分利用效率在各处理之间无显著差异。(3)各处理隶属函数法综合评价得分排序为:C3D3>C1D3>C2D3>C3D2>C2D2>C1D2>C2D1>C3D1>C1D1。【结论】黑色控根容器在地径生长量、根系生长指标、生物量、花期和花径、叶绿素相对含量及净光合速率方面表现最佳;紫叶紫薇2年生苗的最适宜育苗容器是直径25 cm、高25 cm的黑色控根容器。

健康管理护理基本技术质量控制与评价指标体系的构建

目的:构建健康管理护理基本技术质量控制与评价指标体系,为健康管理护理基本技术规范化、同质化管理提供参考依据。方法:在三维质量结构理论基础上,采用文献检索法、研究小组讨论和德尔菲专家函询法,筛选指标并量化质量控制与评价的维度、条目及各级评价指标。结果:最终形成健康管理护理基本技术质量控制与评价指标体系,包括一级指标3项,二级指标10项,三级指标51项。2轮专家函询问卷有效应答率均为94.4%,函询专家的权威系数为0.879,第1、第2轮咨询的肯德尔和谐系数分别为0.210、0.199,均P<0.001。结论:本研究构建的健康管理护理基本技术质量控制与评价指标体系科学、有效、客观、可操作,对规范健康管理护理服务实践、培训和考核具有参考意义,也可为健康管理机构开展健康管理护理基本技术质量控制提供可借鉴的指标。

热液脉型萤石矿床隐伏矿体定位预测综合技术方法

萤石是国家战略性新兴产业发展中不可或缺的关键支撑原材料,被国际社会普遍列为“关键矿产”,随着萤石露头矿的发现殆尽,急需开展隐伏矿体的深部定位预测研究。文章简要论述了断裂构造控制的热液脉型萤石矿床地质特征、分带模式和成矿规律,评述了萤石找矿中常用的勘查技术方法。结合找矿标志和控矿要素分析,总结了隐伏-半隐伏萤石矿体定位预测的找矿模型,提出了“分带型”和“掩埋型”两种类型隐伏萤石矿体及相应的找矿技术方法组合。笔者建立了隐伏萤石矿体定位预测的地质-物探-化探-遥感综合找矿模型及其四步勘查技术流程,这对指导隐伏萤石矿床(体)的找矿勘查具有重要的理论和实践意义。

干旱胁迫对紫叶紫薇容器苗生长及生理的影响

为探究干旱胁迫对紫叶紫薇容器苗的生长及生理影响,以紫叶紫薇优良新品种‘丹红紫叶’2年生容器苗为研究对象,设计了5个干旱胁迫强度处理,测定不同干旱胁迫处理对容器苗生长及生理相关指标的影响。结果表明:干旱胁迫对紫叶紫薇容器苗的生长及生理的影响显著。随着干旱胁迫强度增加,紫叶紫薇容器苗叶片相对含水量、过氧化物酶活性、超氧化物歧化酶活性、可溶性蛋白含量、净光合速率、气孔导度、蒸腾速率总体上呈现降低趋势,重度干旱时这些指标分别比正常供水显著下降了21.45%、40.45%、31.92%、3.30%、81.25%、89.29%、87.17%,极重度干旱时达到最低值。可溶性糖含量、脯氨酸含量、丙二醛含量随着干旱胁迫程度增强而一直上升,重度干旱时分别比正常供水显著增加了122.92%、74.98%、288.34%,极重度干旱时达到最大值。随着干旱胁迫强度加重,过氧化氢酶活性、叶绿素相对含量、水分利用效率呈现先升高后降低的趋势,中度干旱时过氧化氢酶活性最大,叶绿素相对含量和水分利用效率则是轻度干旱最高,极重度干旱时最低。胞间CO_(2)浓度随着干旱胁迫加强而先降后升,正常供水的胞间CO_(2)浓度最高,中度干旱最低。紫叶紫薇容器苗具有抵御中度干旱的能力,当土壤相对含水量下降至30%~35%时应及时给苗木浇水灌溉。

梨火疫病抗性评价体系的建立及其种质资源抗性鉴定

【目的】利用梨幼果建立梨火疫病(Erwinia amylovora)抗性资源评价体系,筛选出对梨火疫病具有抗性的材料,为抗病育种提供技术支撑。【方法】以36个梨品种和41个库尔勒香梨杂交后代为材料,利用人工接种的方式对幼果期、膨大期和成熟期的果实进行接种试验,并根据接种后致病力的强弱,制定梨品种(种质)的抗性分级指标,综合评价77份种质资源的抗病水平。【结果】与梨果实膨大期和成熟期相比,接种幼果期果实更能准确评估梨品种(种质)的抗性水平;在接种24 h后,梨幼果开始显症;77个品种(种质)对梨火疫病的抗性水平差异显著,高感品种(种质)13个,感病品种(种质)11个,中感品种(种质)27个,抗病品种(种质)26个;供试品种(种质)对梨火疫病的抗性不高,其中只有33.77%的品种(种质)表现抗病性,66.23%的品种(种质)不同程度感病。【结论】本研究建立以梨果实的幼果期为接种时期,在接种24 h时开始观察发病情况的梨火疫病抗性资源评价体系;从供试品种(种质)筛选出的26份材料达到抗性水平,为培育新的抗性品种提供参考。

22种抗生素对梨火疫病菌的室内毒力测定及对花器安全性评价

【目的】筛选出抑制梨火疫病的药剂,为梨火疫病的绿色安全防控提供技术支持。【方法】采用抑菌圈法筛选22种抗生素,评价其在库尔勒香梨花器上的安全性。【结果】13种抗生素对梨火疫病菌有抑制作用,其中在抑菌圈直径达到9 mm时,氯霉素①、注射用头孢噻肟钠、注射用头孢曲松钠和诺氟沙星的药剂有效浓度由低至高是5.30、7.60、9.88、11.64 mg/L,使用同等剂量下4种药剂的抑制作用强于其它药剂;氯霉素①、注射用头孢噻肟钠、注射用头孢曲松钠、罗红霉素分散片、诺氟沙星对库尔勒香梨花器的危害较轻。【结论】氯霉素①、诺氟沙星、注射用头孢曲松钠和注射用头孢噻肟钠可在田间防治梨火疫病上应用。

医学生童年期创伤与心理健康:心理弹性的中介作用

目的探讨医学生童年期创伤与心理弹性、心理健康的关系。方法采用儿童期创伤问卷、心理弹性量表、症状自评量表对3888名医学生进行问卷调查。结果医学生童年期创伤发生率为30.8%,不同性别、是否独生子女、不同生源地、有无留守经历和心理治疗(咨询)求助史的医学生童年期创伤、心理弹性和SCL-90得分差异有统计学意义(t=2.33~6.96,P<0.05);童年期创伤与心理弹性得分呈负相关(r=-0.31,P<0.05),与SCL-90得分呈正相关(r=0.38,P<0.05),心理弹性在童年期创伤与心理健康之间有中介作用(β=0.10,P<0.05)。结论童年期创伤经历越多的医学生,心理弹性越弱,心理健康状况越差。医学生童年期创伤对心理健康有直接预测作用,且受心理弹性的中介效应调节,须重点关注农村地区、非独生子女、有留守和心理治疗(咨询)求助经历的医学生,提升其心理弹性水平,促进其心理健康。

淹水胁迫对紫薇苗生长及生理特性的影响

以紫薇优良新品种‘丹红紫叶’二年生苗为试材,采用套盆淹水方法,设计了5个淹水持续时间处理,研究不同淹水胁迫处理对紫薇苗生长及生理指标的影响,以期为紫薇苗培育及园林应用的水分管理提供参考依据。结果表明:紫薇能承受14 d的淹水,淹水21 d是紫薇忍受淹水胁迫持续时间的极限。随着淹水胁迫时间增长,紫薇苗的叶片相对含水量、过氧化物酶活性、超氧化物歧化酶活性、可溶性蛋白质含量、净光合作用速率(Pn)、气孔导度(Gs)、蒸腾速率(Tr)、胞间CO_(2)浓度(Ci)均总体呈下降趋势,淹水21 d时分别比对照处理显著下降了24.29%、79.88%、18.66%、3.16%、80.45%、92.51%、93.10%、25.43%,淹水28 d时达到最低值;脯氨酸、丙二醛含量呈上升趋势,淹水21 d时分别比对照显著增加67.34%、360.54%,淹水28 d最大;过氧化氢酶活性呈先升后降的趋势,淹水21 d最大,比对照显著增加252.65%;可溶性糖含量呈先降后升再降的趋势,淹水21 d最大,比对照显著增加19.38%;淹水胁迫期间紫薇苗的叶绿素相对含量变化不明显;水分利用效率(WUE)呈起伏波动走势,对照最低,淹水21 d较高,比对照显著高184.00%。紫薇苗具有一定的耐涝性,淹水胁迫持续时间不宜超过14 d。

不同基质对‘丹红紫叶’紫薇容器苗开花和光合特性的影响

[目的]为探究不同育苗基质对‘丹红紫叶’紫薇容器苗开花及光合特性的影响,筛选出紫薇容器苗培育的适宜育苗基质,为紫薇容器苗高效培育提供理论指导。[方法]以‘丹红紫叶’紫薇2年生容器苗为研究对象,用圃地土、泥炭、珍珠岩、蛭石不同比例配制16种育苗基质处理,以圃地土为对照(CK)基质,测定不同处理对容器苗开花及光合特性的影响。[结果]不同育苗基质对‘丹红紫叶’紫薇容器苗的开花及光合特性影响显著,T11处理的开花指标和光合特性指标综合表现最好,花期、花径、花序长和宽分别比CK增加了23d、22.63%、26.40%和30.20%,叶绿素相对含量、净光合速率、蒸腾速率、气孔导度、水分利用效率分别比CK显著提高了8.88%、413.58%、115.20%、100.00%、138.46%,T11处理的胞间CO 2浓度最低,比CK显著降低29.27%。开花指标与光合特性指标的相关性分析表明,花序与净光合速率、水分利用效率显著正相关,与胞间CO_(2)浓度显著负相关。主成分分析的综合得分最高为T11处理,最低为CK,T11处理基质配方有利于促进‘丹红紫叶’紫薇容器苗开花,提高光合效率。[结论]圃地土30%+泥炭50%+蛭石10%+珍珠岩10%的基质是‘丹红紫叶’紫薇2年生容器苗培育的最适宜基质。

基于“痰浊内阻”与“脂代谢紊乱”的联系论治结肠腺瘤复发与恶变

结直肠腺瘤作为结直肠癌的重要癌前病变,内镜下切除虽作为首要治疗手段,但腺瘤复发率较高,如何预防腺瘤的发生,阻断腺瘤癌序列的进展是我们的研究方向。中医理论中“痰浊内阻”是结肠腺瘤发生与复发的主要原因,并且“痰浊”与“脂代谢”二者联系密切,因此本文将就“痰浊内阻”与“脂代谢紊乱”在结肠腺瘤中的联系进行讨论,探讨结肠腺瘤“痰浊内阻”的现代生物学内涵。通过探讨二者之间的联系可为临床治疗结肠腺瘤提供思路,同时还可将其运用到其他有关痰浊内阻、脂代谢紊乱的疾病中,以扩展临床诊治思维。

基于大数据的高校学生心理危机智能预警模型构建

目的本研究基于大学生心理健康测评数据,综合学生基本信息及日常行为数据,利用大数据、人工智能技术,探索建立大学生心理危机智能预警模型。方法采用整群抽样法,选取某高校部分在校大学生作为测试样本;采取大数据技术,分析提取影响大学生心理健康问题的特征量;采取神经网络技术,构建大学生心理危机预警模型。结果1)成功提取大学生心理健康问题的有效特征量,其中心理健康症状特征因子4个,分别是强迫、人际关系敏感、抑郁等3个单症状因子,1个多症状因子;学生基本信息特征量4个,分别是母亲教养方式、父亲教养方式、家庭经济条件、有无心理治疗(咨询)史;学生日常行为特征量2个,分别是学生学业情况和出勤情况。2)实现特征量归一化处理,通过数据对比分析及特征量的影响大小,分别对3个方面的10个特征量赋予权重并进行归一化处理。3)完成大学生心理危机预警模型构建。结论本研究提取了影响大学生心理健康问题的主要特征,建立了大学生心理危机预警指标体系,并结合心理危机预警等级,利用神经网络技术,搭建了大学生心理危机预警模型,为及时有效干预大学生心理危机提供了新的解决方案。

70kVp联合深度学习图像重建算法对胸主动脉血管内修复术后双低CTA图像质量的影响

目的探讨70 kVp联合深度学习图像重建(DLIR)算法在低辐射剂量低对比剂用量的情况下对胸主动脉血管内修复术(TEVAR)后主动脉CT血管成像(CTA)图像质量的影响。方法前瞻性纳入65例TEVAR术后需接受主动脉CTA扫描的患者,随机分为两组。常规剂量组(A组)接受100 kVp管电压和60 mL对比剂扫描,低剂量组(B组)接受“双低”方案:管电压70 kVp,对比剂用量为0.5 mL·kg^(-1)。A组图像采用50%多模型迭代重建算法(ASIR-V)重建,B组图像分别采用滤波反投影(FBP)算法(B1亚组)、50%ASIR-V(B2亚组)、90%ASIR-V(B3亚组)及DLIR-H算法(B4亚组)重建。测量并比较各组主动脉CT值、图像噪声、对比噪声比(CNR)及品质因数(FOM)。采用5分制对图像噪声、血管锐利度和整体图像质量进行评估。结果B4亚组噪声最低,较A组降低约23.49%(P<0.001)。A组、B4亚组主动脉各感兴趣区(ROI)CT值、CNR值及图像主观评分差异无统计学意义(P>0.05);B4亚组FOM值大于A组(P<0.001)。与A组比较,B组辐射剂量降低约52.38%(P<0.001),对比剂用量和注射流率分别降低约39%和33.6%(P<0.001)。结论采用70 kVp结合DLIR算法在TEVAR术后主动脉CTA扫描中可获得与常规剂量相当的图像质量,且辐射剂量和对比剂用量大幅度降低。

10 kV配网耐张型复合绝缘横担研究综述

复合绝缘横担具有轻质高强、绝缘可靠性高且防雷效果优异等特点,正逐步在10 kV配电线路中得到推广应用。围绕配网耐张型复合绝缘横担结构设计、耐久性研究及性能测试三个问题,首先综述10 kV配网耐张型复合绝缘横担的发展现状,指出研究必要性,进而针对其设计依据、现有设计型式、以疲劳振动老化为代表的耐久性研究进展及关键性能测试与评估展开论述,同时分析目前存在的问题及有待解决的困难,最后结合应用情况进行总结与展望,以期为配网耐张型复合绝缘横担的结构优化、性能提升以及后续大规模应用提供参考。

穴位贴敷联合四磨汤加减在老年功能性便秘患者中的应用

目的:研究穴位贴敷联合四磨汤加减在老年功能性便秘患者中的应用。方法:选取2016年10月—2022年10月广西壮族自治区民族医院门诊及住院收治的128例老年功能性便秘患者。根据随机数表法将其分为对照组和研究组,各64例。对照组给予比沙可啶肠溶片,研究组在对照组基础上给予穴位贴敷联合四磨汤加减。比较两组治疗前后中医症候积分、粪便性状、排便间隔时间、腹部肌群肌电图指标,临床疗效,不良反应及复发情况。结果:治疗后,两组中医症候积分、Bristol评分、排便间隔时间均降低,研究组中医症候积分、Bristol评分均低于对照组,排便间隔时间短于对照组,差异有统计学意义(P<0.05)。治疗后,两组3 s收缩幅度(FSC)、10 s收缩幅度(10SC)、净压力(net)均升高,10 s松弛压力(10SR)降低,研究组FSC、10SC、net均高于对照组,10SR低于对照组,差异有统计学意义(P<0.05)。研究组总有效率为95.31%(61/64),高于对照组的82.81%(53/64),差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05);随访6个月,研究组复发率显著低于对照组,差异有统计学意义(P<0.05)。结论:穴位贴敷联合四磨汤加减可有效改善老年功能性便秘患者的症状,促进肠排空,提高临床疗效,安全性好,且复发率低。

经口气管插管患者口腔黏膜压力性损伤风险预测模型的构建及验证

目的构建并验证经口气管插管患者发生口腔黏膜压力性损伤的风险预测模型。方法纳入2022年12月至2023年7月浙江省某三级甲等医院ICU的400例经口气管插管患者为模型训练集,2023年8-10月的152例为模型外部验证集。采用logistic回归筛选口腔黏膜压力性损伤的预测变量。绘制受试者工作特征曲线下面积、校准曲线和临床决策曲线来评估预测模型的预测性能。采用Bootstrap法对模型进行内部验证。结果logistic回归结果显示,年龄、躁动-镇静程度量表评分、急性生理与慢性健康评分Ⅱ、血清白蛋白水平、气管插管操作者、气管导管固定方式和人工气道留置时间是口腔黏膜压力性损伤的影响因素(P<0.05)。训练集和验证集的受试者工作特征曲线下面积分别为0.913(95%CI:0.873~0.954)和0.956(95%CI:0.922~0.981);Hosmer-Lemeshow检验结果表明,模型预测值与实际值吻合较好,模型校准度较好(χ^(2)=1.702,P=0.427)。Bootstrap法重抽样结果显示,受试者工作特征曲线下面积为0.908(95%CI:0.852~1.105),灵敏度为94.9%,特异度为60.8%,准确率为83.7%。结论本研究构建的风险预测模型具有较好的区分度、校准度和临床应用价值,可为精准识别经口气管插管患者口腔黏膜压力性损伤高风险人群提供参考依据。

社会养老保险对农村包容性增长的影响——基于收入流动性的视角

使用CFPS 2010—2018年5期数据,考察农户参与新农保后收入增长的差异及其作用机制。研究发现:农户在期初参与新农保会显著提高其收入增长率,这主要是由于缴纳保险费用后农户预期养老风险的降低,会提高家庭的农业生产投入,促进经营性收入增长。并且,对不同收入水平农户的异质性分析表明,新农保对较低收入家庭收入增长促进效果更大,有利于农村包容性增长。因此,应当不断提高农村家庭应对养老风险的能力,将健全社会养老保险体系作为巩固和拓展脱贫攻坚成果、促进包容性增长、实现共同富裕的重要抓手。