目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)...目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)为金标准,将患者分成将2型糖尿病患者分成早期肾损伤组(n=78,20μg/min≤UAER≤200μg/min)、糖尿病肾病组(n=28,UAER>200μg/min)和正常组(n=215,UAER<20μg/min)。比较3组外周血CCN1表达,Pearson法测定UAER与外周血CCN1的相关性,使用ROC曲线评估外周血CCN1对2型糖尿病早期肾损伤和糖尿病肾病的预测价值。单因素分析基线资料,多因素Logistic回归分析确定早期肾损伤或糖尿病肾病的影响因素。结果糖尿病肾病组CCN1和UAER水平高于早期肾损伤组和正常组;早期肾损伤组的CCN1和UAER水平也高于正常组(P<0.05);外周血CCN1与UAER呈正相关(r=0.916,P<0.001)。以外周血CCN1为检验变量,以是否发生早期肾损伤为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为1.59μg/L,其对应的敏感度为85.85%,特异度为73.02%,AUC为0.871(95%CI:0.831~0.903)。以外周血CCN1为检验变量,以是否发生糖尿病肾病为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为3.41μg/L,其对应的敏感度为71.43%,特异度为73.72%,AUC为0.761(95%CI:0.707~0.813)。糖尿病肾病组、早期肾损伤组和正常组的病程、高血压、高血脂、收缩压、FPG、糖化血红蛋白(glycated hemoglobin,HbA1c)、尿酸(uric acid,UA)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)和低密度脂蛋白(low-density lipoprotein,LDL)等方面比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,病程(OR=1.740,95%CI:1.180~2.565)、收缩压(OR=1.943,95%CI:1.267~2.978)、高血脂(OR=1.654,95%CI:1.310~2.088)、FPG(OR=2.776,95%CI:1.260~6.116)、UA(OR=2.228,95%CI:1.174~4.229)和CCN1(OR=3.744,95%CI:1.709~8.200)是2型糖尿病早期肾损伤发生的影响因素(P<0.05)。Logistic回归分析结果显示,病程(OR=1.752,95%CI:1.177~2.609)、收缩压(OR=1.818,95%CI:1.034~3.198)、高血脂(OR=1.680,95%CI:1.320~2.138)、FPG(OR=2.389,95%CI:1.519~3.758)、UA(OR=1.260,95%CI:1.038~1.530)和CCN1(OR=3.815,95%CI:1.636~8.897)是糖尿病肾病发生的影响因素(P<0.05)。结论外周血CCN1与尿液微量白蛋白排泄率呈正相关,是早期肾损伤或糖尿病肾病的危险因素,并可应用于预测早期肾损伤或糖尿病肾病的发生,值得临床进一步研究并推广。展开更多
目的探讨检测胃腔内气体浓度对机械通气患者气管食管瘘的诊断价值。方法对机械辅助通气状态的患者,选用容量控制模式,给予100%氧,通气15~20 min后,抽出胃内气体10~50 m L,进行氧浓度检测,胃内气体氧浓度大于30%即为阳性结果。结果 2017...目的探讨检测胃腔内气体浓度对机械通气患者气管食管瘘的诊断价值。方法对机械辅助通气状态的患者,选用容量控制模式,给予100%氧,通气15~20 min后,抽出胃内气体10~50 m L,进行氧浓度检测,胃内气体氧浓度大于30%即为阳性结果。结果 2017年6月~2020年3月我院疑似气管食管瘘的14例患者进行胃内气体检测,胃内气体氧浓度最低32%,最高71%,均经食管镜或气管镜检查确诊。结论对机械通气状态的怀疑气管食管瘘的危重患者,胃内气体检测氧浓度法可作为一项安全、快捷、可靠的筛查方法。展开更多
With an increasing population and changing diet structure, summer maize is increasingly becoming an important energy crop in China. However, traditional farmer practices for maize production are inefficient and unsust...With an increasing population and changing diet structure, summer maize is increasingly becoming an important energy crop in China. However, traditional farmer practices for maize production are inefficient and unsustainable. To ensure food security and sustainable development of summer maize production in China, an improved, more sustainable farmer management system is needed. Establishing this system requires a comprehensive understanding of the limitations of current farming practice and the ways it could be improved. In our study, 235 plots from three villages in the North China Plain(NCP) were monitored. Maize production on farms was evaluated;our results showed that the maize yield and nitrogen partial factor productivity(PFPN) were variable on smallholder farms at 6.6–13.7 t ha^–1 and 15.4–88.7 kg kg^–1, respectively.Traditional farming practices also have a large environmental impact(nitrogen surplus:–64.2–323.78 kg ha^–1). Key yield components were identified by agronomic diagnosis. Grain yield depend heavily on grain numbers per hectare rather than on the 1 000-grain weight. A set of improved management practices(IP) for maize production was designed by employing a boundary line(BL) approach and tested on farms. Results showed that the IP could increase yield by 18.4% and PFPN by 31.1%, compared with traditional farmer practices(FP), and reduce the nitrogen(N) surplus by 57.9 kg ha^–1. However,in terms of IP effect, there was a large heterogeneity among different smallholder farmers’ fields, meaning that, precise technologies were needed in different sites especially for N fertilizer management. Our results are valuable for policymakers and smallholder farmers for meeting the objectives of green development in agricultural production.展开更多
In this paper the existence of solutions of the singularly perturbed boundary value problems on infinite interval for the second order nonlinear equation containing a small parameterε>0,εy'=f(x,y,y'),y...In this paper the existence of solutions of the singularly perturbed boundary value problems on infinite interval for the second order nonlinear equation containing a small parameterε>0,εy'=f(x,y,y'),y'(0)=a,y(∞)=βis examined,where are constants,and i=0,1.Moreover,asymptotic estimates of the solutions for the above problems are given.展开更多
In this paper existence,uniqueness and asymptotic estimations of solutions of the boundary value problems on infinite interval for the second order nonlinear equation depending singularly on a small parameter are exam...In this paper existence,uniqueness and asymptotic estimations of solutions of the boundary value problems on infinite interval for the second order nonlinear equation depending singularly on a small parameter are examined,where are constants,and i=0,1.展开更多
文摘目的探讨外周血富含半胱氨酸蛋白61(cysteine-rich protein 61,CCN1)与2型糖尿病患者早期肾损伤的相关性研究。方法回顾性研究河北省石家庄市第二医院2型糖尿病患者321例,以尿液微量白蛋白排泄率(urinary albumin excretion rate,UAER)为金标准,将患者分成将2型糖尿病患者分成早期肾损伤组(n=78,20μg/min≤UAER≤200μg/min)、糖尿病肾病组(n=28,UAER>200μg/min)和正常组(n=215,UAER<20μg/min)。比较3组外周血CCN1表达,Pearson法测定UAER与外周血CCN1的相关性,使用ROC曲线评估外周血CCN1对2型糖尿病早期肾损伤和糖尿病肾病的预测价值。单因素分析基线资料,多因素Logistic回归分析确定早期肾损伤或糖尿病肾病的影响因素。结果糖尿病肾病组CCN1和UAER水平高于早期肾损伤组和正常组;早期肾损伤组的CCN1和UAER水平也高于正常组(P<0.05);外周血CCN1与UAER呈正相关(r=0.916,P<0.001)。以外周血CCN1为检验变量,以是否发生早期肾损伤为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为1.59μg/L,其对应的敏感度为85.85%,特异度为73.02%,AUC为0.871(95%CI:0.831~0.903)。以外周血CCN1为检验变量,以是否发生糖尿病肾病为状态标量,以敏感度为Y轴,以“1-特异度”为X轴绘制ROC曲线。ROC结果显示,CCN1诊断的临界值为3.41μg/L,其对应的敏感度为71.43%,特异度为73.72%,AUC为0.761(95%CI:0.707~0.813)。糖尿病肾病组、早期肾损伤组和正常组的病程、高血压、高血脂、收缩压、FPG、糖化血红蛋白(glycated hemoglobin,HbA1c)、尿酸(uric acid,UA)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG)和低密度脂蛋白(low-density lipoprotein,LDL)等方面比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,病程(OR=1.740,95%CI:1.180~2.565)、收缩压(OR=1.943,95%CI:1.267~2.978)、高血脂(OR=1.654,95%CI:1.310~2.088)、FPG(OR=2.776,95%CI:1.260~6.116)、UA(OR=2.228,95%CI:1.174~4.229)和CCN1(OR=3.744,95%CI:1.709~8.200)是2型糖尿病早期肾损伤发生的影响因素(P<0.05)。Logistic回归分析结果显示,病程(OR=1.752,95%CI:1.177~2.609)、收缩压(OR=1.818,95%CI:1.034~3.198)、高血脂(OR=1.680,95%CI:1.320~2.138)、FPG(OR=2.389,95%CI:1.519~3.758)、UA(OR=1.260,95%CI:1.038~1.530)和CCN1(OR=3.815,95%CI:1.636~8.897)是糖尿病肾病发生的影响因素(P<0.05)。结论外周血CCN1与尿液微量白蛋白排泄率呈正相关,是早期肾损伤或糖尿病肾病的危险因素,并可应用于预测早期肾损伤或糖尿病肾病的发生,值得临床进一步研究并推广。
文摘目的探讨检测胃腔内气体浓度对机械通气患者气管食管瘘的诊断价值。方法对机械辅助通气状态的患者,选用容量控制模式,给予100%氧,通气15~20 min后,抽出胃内气体10~50 m L,进行氧浓度检测,胃内气体氧浓度大于30%即为阳性结果。结果 2017年6月~2020年3月我院疑似气管食管瘘的14例患者进行胃内气体检测,胃内气体氧浓度最低32%,最高71%,均经食管镜或气管镜检查确诊。结论对机械通气状态的怀疑气管食管瘘的危重患者,胃内气体检测氧浓度法可作为一项安全、快捷、可靠的筛查方法。
基金supported by the National Basic Research Program of China (2015CB150405)the National Key R&D Program of China (2016YFD0200401)
文摘With an increasing population and changing diet structure, summer maize is increasingly becoming an important energy crop in China. However, traditional farmer practices for maize production are inefficient and unsustainable. To ensure food security and sustainable development of summer maize production in China, an improved, more sustainable farmer management system is needed. Establishing this system requires a comprehensive understanding of the limitations of current farming practice and the ways it could be improved. In our study, 235 plots from three villages in the North China Plain(NCP) were monitored. Maize production on farms was evaluated;our results showed that the maize yield and nitrogen partial factor productivity(PFPN) were variable on smallholder farms at 6.6–13.7 t ha^–1 and 15.4–88.7 kg kg^–1, respectively.Traditional farming practices also have a large environmental impact(nitrogen surplus:–64.2–323.78 kg ha^–1). Key yield components were identified by agronomic diagnosis. Grain yield depend heavily on grain numbers per hectare rather than on the 1 000-grain weight. A set of improved management practices(IP) for maize production was designed by employing a boundary line(BL) approach and tested on farms. Results showed that the IP could increase yield by 18.4% and PFPN by 31.1%, compared with traditional farmer practices(FP), and reduce the nitrogen(N) surplus by 57.9 kg ha^–1. However,in terms of IP effect, there was a large heterogeneity among different smallholder farmers’ fields, meaning that, precise technologies were needed in different sites especially for N fertilizer management. Our results are valuable for policymakers and smallholder farmers for meeting the objectives of green development in agricultural production.
文摘In this paper the existence of solutions of the singularly perturbed boundary value problems on infinite interval for the second order nonlinear equation containing a small parameterε>0,εy'=f(x,y,y'),y'(0)=a,y(∞)=βis examined,where are constants,and i=0,1.Moreover,asymptotic estimates of the solutions for the above problems are given.
文摘In this paper existence,uniqueness and asymptotic estimations of solutions of the boundary value problems on infinite interval for the second order nonlinear equation depending singularly on a small parameter are examined,where are constants,and i=0,1.
