rt-PA静脉溶栓联合介入治疗对急性缺血性脑卒中患者MRS评分、Barthel指数、脑部血流动力学的影响

目的探究重组组织型纤溶酶原激活剂(rt-PA)静脉溶栓联合介入治疗对急性缺血性脑卒中(AIS)患者的影响。方法前瞻性选取2021年1月至2022年6月宜宾市第一人民医院收治的AIS患者106例作为研究对象,按随机数字表法将其分为对照组和观察组,各53例。对照组给予rt-PA进行静脉溶栓治疗,观察组在对照组的基础上进行介入治疗。比较两组的临床疗效;比较两组患者治疗前、治疗后24 h、治疗后3个月的美国国立卫生研究院卒中量表(NIHSS)评分,治疗前、治疗后3个月的改良Rankin’s量表(MRS)评分、Barthel指数、大脑中动脉(MCA)、大脑前动脉(ACA)、基底动脉(BA)的平均血流速度;并记录治疗后3个月内发生的不良反应以及病死率。结果观察组总有效率为88.68%,高于对照组(73.58%),差异有统计学意义(P<0.05)。治疗后24 h、治疗后3个月,两组患者的NIHSS评分均较治疗前均降低,且观察组分别为(6.37±1.24)、(2.67±1.11)分,均低于对照组[(7.25±1.36)、(3.63±1.54)分],差异均有统计学意义(P<0.05)。治疗后3个月,两组MRS评分较治疗前降低,Barthel指数分数较治疗前升高,且观察组MRS评分为(1.98±0.21)分,低于对照组[(2.56±0.34)分],Barthel指数分数为(87.12±6.81)分,高于对照组[(71.33±6.54)分],差异均有统计学意义(P<0.05)。治疗后3个月,两组MCA、ACA、BA的平均血流速度均高于治疗前,且观察组分别为(60.65±5.96)、(43.24±5.36)、(39.86±5.36)cm/s,均高于对照组[(52.33±6.14)、(38.41±5.84)、(34.68±5.72)cm/s],差异有统计学意义(P<0.05)。观察组不良反应率为9.43%,低于对照组(24.53%),差异有统计学意义(P<0.05);两组病死率比较,差异无统计学意义(P>0.05)。结论rt-PA静脉溶栓联合介入治疗有利于AIS患者神经功能恢复,有利于患者生活质量以及日常生活能力的提高,促进脑血流动力学的改善,并能减少不良反应的发生,值得临床推广应用。

SuperPATH入路初次单侧全髋关节置换术对骨质疏松导致的股骨颈骨折患者肌酸磷酸激酶、Harris评分及改良Barthel指数的影响

目的调研和分析SuperPATH入路初次单侧全髋关节置换术对骨质疏松导致的股骨颈骨折患者肌酸磷酸激酶、Harris评分及改良Barthel指数的影响。方法回顾性选取2019年3月至2022年3月唐山市第二医院收治的64例骨质疏松导致的股骨颈骨折患者纳入至本次研究,按照治疗方法的不同将其分为对照组(n=32)与观察组(n=32)。对照组给予外侧小切口入路全髋关节置换术,观察组则行SuperPATH入路初次单侧全髋关节置换术。观察两组患者术前、术后1 d、5 d、15 d、3个月、6个月疼痛疼痛视觉模拟评分法(VAS)评分,比较术前、术后1、5、15 d两组患者血清肌酸磷酸激酶水平变化情况,统计术前、术后1 d、5 d、15 d、3个月、6个月的髋关节功能恢复情况以及术前、术后1 d、5 d、3个月、6个月的日常生活活动能力情况。结果术后3、6个月,两组评分较术前降低,观察组患者术后5 d、15 d、3个月、6个月的VAS评分分别为(4.23±0.53)、(3.53±0.43)、(1.83±0.21)、(0.24±0.12)分,均低于对照组[(4.93±0.98)、(4.21±0.94)、(2.45±0.52)、(0.78±0.36)]分,差异均有统计学意义(P<0.05)。术后1、5、15 d,两组血清肌酸磷酸激酶水平较术前升高,且观察组患者的血清肌酸磷酸激酶水平分别为(478.39±234.12)、(216.28±131.27)、(138.23±63.12)U/L,显著低于对照组[(893.47±428.13)、(436.29±261.57)、(198.67±98.47)U/L],差异均有统计学意义(P<0.05)。术后1 d、5 d、15 d、3个月、6个月,两组Harris评分均较术前升高,且观察组患者的Harris评分分别为(52.36±5.23)、(61.24±6.15)、(72.46±5.26)、(86.28±6.31)、(91.21±3.15)分,均明显高于对照组[(41.78±6.29)、(56.39±6.78)、(63.49±6.34)、(70.47±6.21)、(81.47±5.23)分],差异均有统计学意义(P<0.05)。术后1 d、5 d、1个月、6个月,两组改良Barthel指数均较术前升高,且观察组患者的改良Barthel指数分别为(49.23±7.26)、(68.29±7.23)、(76.28±7.31)、(89.46±7.34)分,均高于对照组[(40.58±6.19)、(60.12±6.45)、(70.36±6.73)、(81.37±6.81)分],差异均有统计学意义(P<0.05)。结论在骨质疏松导致的股骨颈骨折患者接受治疗的过程中,采用SuperPATH入路初次单侧全髋关节置换术的临床治疗效果较好,可显著降低血清肌酸磷酸激酶水平,提升Harris评分、改良Barthel指数,可有效改善患者的髋关节功能,值得在临床治疗中推广。

用药数量和Barthel指数对住院老年人跌倒的影响

目的探讨住院老年人跌倒的发生情况以及影响因素。方法收集2019—2021年于南京市第一医院住院治疗的老年人,根据病例系统跌倒发生情况,共纳入跌倒老年人(≥60岁)183例,收集研究对象的一般资料、合并疾病、用药情况以及实验室检查指标,并收集Barthel评分、跌倒坠床评分,分析跌倒老年人的基本特征。根据性别、年龄匹配,选取同期住院治疗的未发生跌倒的174例老年人作为对照组,比较跌倒组与对照组临床特征的差异,并采用多因素Logistic回归分析影响老年人跌倒的影响因素。结果183例发生跌倒的老年人跌倒发生时间主要集中在6:00~9:00(19.8%)以及17:00~20:00(17.0%);发生地点主要是病房内(68.9%),其次是卫生间(18.0%)。单因素分析显示,跌倒组与对照组BMI、Na、Cl、Ca、Hb、白蛋白、总蛋白、血糖、用药数量、跌倒坠床评分、Barthel评分以及使用胰岛素、利尿剂、退烧药、助眠药、止疼药、喹诺酮类药物的比例差异均有统计学意义;多因素Logistic回归分析显示,BMI、Hb、血糖、Na、用药数量以及Barthel评分41~60分以及41分以下是住院老年人跌倒的独立影响因素,OR(95%CI)分别为0.922(0.857~0.992)、0.980(0.965~0.995)、1.345(1.186~1.527)、0.872(0.804~0.947)、2.957(1.687~5.181)、2.979(1.157~7.672)、4.419(1.480~13.193)。结论老年人用药数量以及生活自理能力下降是跌倒的危险因素,应对此采取措施,积极预防跌倒。

早期康复护理对股骨颈骨折术后患者Barthel指数及Harris髋关节评分的影响

目的探讨早期康复护理对股骨颈骨折术后患者Barthel指数及Harris评分的影响。方法选取2018年10月至2020年10月在我院接受手术治疗的80例股骨颈骨折患者作为研究对象,根据随机编号将其分为对照组和研究组,各40例。对照组采用常规护理,研究组采用早期康复护理。比较两组的并发症发生情况、Barthel指数、Harris髋关节评分及生活质量。结果研究组的并发症总发生率低于对照组(P<0.05)。护理1、2、4周后,两组的Barthel指数及Harris髋关节评分均升高,且研究组高于对照组(P<0.05)。研究组的心理功能、躯体功能、社会功能及物质生活评分均高于对照组(P<0.05)。结论早期康复护理应用于股骨颈骨折术后患者中能有效减少并发症,促进髋关节功能及活动能力的恢复,提高Barthel指数及Harris髋关节评分,改善生活质量。

Joint Detection of Serum Vitamin D,Body Mass Index,and Tumor Necrosis Factor Alpha for the Diagnosis of Crohn’s Disease

Objective Vitamin D(VD)deficiency was reported to contribute to the progression of Crohn’s disease(CD)and affect the prognosis of CD patients.This study investigated the role of serum VD,body mass index(BMI),and tumor necrosis factor alpha(TNF-α)in the diagnosis of Crohn’s disease.Methods CD patients(n=76)and healthy subjects(n=76)were enrolled between May 2019 and December 2020.The serum 25-hydroxyvitamin D[25(OH)D]levels,BMI,and TNF-αlevels,together with other biochemical parameters,were assessed before treatment.The diagnostic efficacy of the single and joint detection of serum 25(OH)D,BMI,and TNF-αwas determined using receiver operating characteristic(ROC)curves.Results The levels of 25(OH)D,BMI,and nutritional indicators,including hemoglobin,total protein,albumin,and high-density lipoprotein cholesterol,were much lower,and the TNF-αlevels were much higher in the CD patients than in the healthy subjects(P<0.05 for all).The areas under the ROC curve for the single detection of 25(OH)D,BMI,and TNF-αwere 0.887,0.896,and 0.838,respectively,with the optimal cutoff values being 20.64 ng/mL,19.77 kg/m^(2),and 6.85 fmol/mL,respectively.The diagnostic efficacy of the joint detection of 25(OH)D,BMI,and TNF-αwas the highest,with an area under the ROC curve of 0.988(95%CI:0.968–1.000).Conclusion The joint detection of 25(OH)D,TNF-α,and BMI showed high sensitivity,specificity,and accuracy in CD diagnosis;thus,it would be effective for the diagnosis of CD in clinical practice.

非医疗专业护工使用Barthel指数评估脑卒中患者日常生活活动能力的可行性分析

目的 探讨非医疗专业的护工使用Barthel指数(BI)评估脑卒中患者日常生活活动能力的可行性。方法 选取深圳3家医院的3个康复医学科共134例脑卒中患者。将6名康复治疗师,6名实习生及6护工平均分为6个评分小组,分析不同评估者及同一评估者第1天和第7天的BI评分的一致性及相关性。结果 不同评估者的BI得分在第1天和第7天比较,差异无统计学意义(P>0.05);三类评估者的BI总分的评估者间一致性较好。治疗师与护工第1天和第7天的平均差值分别为3.8、0.5,95%CI分别为(-17.3~24.8)、(-14.8~25.9);治疗师与实习生第1天和第7天的平均差值分别为-0.2、-1.1,95%CI分别为(-21.9~20.7)、(-15.6~13.3);实习生与护工第1天和第7天的平均差值为3.9、1.8,95%CI分别为(-18.8~26.6)、(10.7~14.2);三类评估者的BI评估总分的内部一致性较好;治疗师和护工除了第1天的“穿衣”和第7天的“修饰”外,其余条目均有良好或非常好的一致性。实习生和护工除了第1天的“床椅转移”外,其余条目均有很好的一致性;不同类别的评估者在第1天和第7天的BI总分均显著相关(P<0.05)。结论 医务人员和护工使用BI评估脑卒中患者具有较高的一致性,表明护工在培训后可有效使用BI评估脑卒中患者的日常生活活动能力。

Association between childhood obesity and gut microbiota:16S rRNA gene sequencing-based cohort study

BACKGROUND This study aimed to identify characteristic gut genera in obese and normal-weight children(8-12 years old)using 16S rDNA sequencing.The research aimed to provide insights for mechanistic studies and prevention strategies for childhood obesity.Thirty normal-weight and thirty age-and sex-matched obese children were included.Questionnaires and body measurements were collected,and fecal samples underwent 16S rDNA sequencing.Significant differences in body mass index(BMI)and body-fat percentage were observed between the groups.Analysis of gut microbiota diversity revealed lowerα-diversity in obese children.Differences in gut microbiota composition were found between the two groups.Prevotella and Firmicutes were more abundant in the obese group,while Bacteroides and Sanguibacteroides were more prevalent in the control group.AIM To identify the characteristic gut genera in obese and normal-weight children(8-12-year-old)using 16S rDNA sequencing,and provide a basis for subsequent mechanistic studies and prevention strategies for childhood obesity.METHODS Thirty each normal-weight,1:1 matched for age and sex,and obese children,with an obese status from 2020 to 2022,were included in the control and obese groups,respectively.Basic information was collected through questionnaires and body measurements were obtained from both obese and normal-weight children.Fecal samples were collected from both groups and subjected to 16S rDNA sequencing using an Illumina MiSeq sequencing platform for gut microbiota diversity analysis.RESULTS Significant differences in BMI and body-fat percentage were observed between the two groups.The Ace and Chao1 indices were significantly lower in the obese group than those in the control group,whereas differences were not significant in the Shannon and Simpson indices.Kruskal-Wallis tests indicated significant differences in unweighted and weighted UniFrac distances between the gut microbiota of normal-weight and obese children(P<0.01),suggesting substantial disparities in both the species and quantity of gut microbiota between the two groups.Prevotella,Firmicutes,Bacteroides,and Sanguibacteroides were more abundant in the obese and control groups,respectively.Heatmap results demonstrated significant differences in the gut microbiota composition between obese and normal-weight children.CONCLUSION Obese children exhibited lowerα-diversity in their gut microbiota than did the normal-weight children.Significant differences were observed in the composition of gut microbiota between obese and normal-weight children.

Did weekly economic index and volatility index impact US food sales during the first year of the pandemic?

We explore the impacts of economic and financial dislocations caused by COVID-19 pandemic shocks on food sales in the United States from January 2020 to January 2021.We use the US weekly economic index(WEI)to measure economic dislocations and the Chicago Board Options Exchange volatility index(VIX)to capture the broader stock market dislocations.We validate the NARDL model by testing a battery of models using the autoregressive distributed lags(ARDL)methodology(ARDL,NARDL,and QARDL specifications).Our study postulates that an increase in WEI has a significant negative long-term effect on food sales,whereas a decrease in WEI has no statistically significant(long-run)effect.Thus,policy responses that ignore asymmetric effects and hidden cointegration may fail to promote food security during pandemics.

The diagnostic value of liver stiffness measurement combined with S index in the degree of hepatitis B liver fibrosis

Objective:To investigate the value of liver stiffness measurement(LSM)combined with S index in predicting the degree of liver fibrosis in hepatitis B patients.Methods:A total of 187 chronic hepatitis B patients who were admitted to the Department of Infection,the First Affiliated Hospital of Hainan Medical College from January 2019 to December 2021 were selected.General data were collected,blood routine,liver function,liver fibrosis and liver stiffness measurement were tested,and S index,APRI and FIB-4 index were calculated,and liver biopsy was performed.Results:According to the pathological results of liver puncture,The patients were divided into no significant fibrosis group(n=86),significant fibrosis group(n=71)and cirrhosis group(n=30).There were significant differences in age,PLT,GGT,ALB,S index,HA,LN and LSM levels among the three groups(P<0.05).There was a good correlation between S index and the degree of hepatic fibrosis(rs=0.738,P<0.001).The AUC of S index and LSM for the diagnosis of significant fibrosis in hepatitis B were 0.873 and 0.792,respectively.And the AUC of S index and LSM for the diagnosis of liver cirrhosis were 0.966 and 0.879,respectively.The AUC for the combined diagnosis of significant fibrosis and cirrhosis were 0.908 and 0.988,respectively.The AUROC of combined detection in the diagnosis of cirrhosis was higher than that of LSM,APRI and FIB-4(P<0.05).Conclusion:LSM combined with S index has certain application value in the diagnosis of liver fibrosis/cirrhosis in hepatitis B patients.

基于BiLSTM-Attention的F_(10.7)指数预测模型与中国自主数据集的应用

F_(10.7)指数是太阳活动的重要指标,准确预测F_(10.7)指数有助于预防和缓解太阳活动对无线电通信、导航和卫星通信等领域的影响.基于F_(10.7)射电流量的特性,在双向长短时记忆网络(Bidirectional Long Short-Term Memory Network,BiLSTM)基础上融入注意力机制(Attention),提出了一种基于BiLSTM-Attention的F_(10.7)预报模型.在加拿大DRAO数据集上其平均绝对误差(MAE)为5.38,平均绝对百分比误差(MAPE)控制在5%以内,相关系数(R)高达0.987,与其他RNN模型相比拥有优越的预测性能.针对中国廊坊L&S望远镜观测的F_(10.7)数据集,提出了一种转换平均校准(Conversion Average Calibration,CAC)方法进行数据预处理,处理后的数据与DRAO数据集具有较高的相关性.基于该数据集对比分析了RNN系列模型的预报效果,实验结果表明,BiLSTM-Attention和BiLSTM两种模型在预测F_(10.7)指数方面具有较好的优势,表现出较好的预测性能和稳定性.

New indices to balanceα-diversity against tree size inequality

The number and composition of species in a community can be quantified withα-diversity indices,including species richness(R),Simpson’s index(D),and the Shannon-Wiener index(H΄).In forest communities,there are large variations in tree size among species and individu-als of the same species,which result in differences in eco-logical processes and ecosystem functions.However,tree size inequality(TSI)has been largely neglected in studies using the available diversity indices.The TSI in the diameter at breast height(DBH)data for each of 99920 m×20 m forest census quadrats was quantified using the Gini index(GI),a measure of the inequality of size distribution.The generalized performance equation was used to describe the rotated and right-shifted Lorenz curve of the cumulative proportion of DBH and the cumulative proportion of number of trees per quadrat.We also examined the relationships ofα-diversity indices with the GI using correlation tests.The generalized performance equation effectively described the rotated and right-shifted Lorenz curve of DBH distributions,with most root-mean-square errors(990 out of 999 quadrats)being<0.0030.There were significant positive correlations between each of threeα-diversity indices(i.e.,R,D,and H’)and the GI.Nevertheless,the total abundance of trees in each quadrat did not significantly influence the GI.This means that the TSI increased with increasing spe-cies diversity.Thus,two new indices are proposed that can balanceα-diversity against the extent of TSI in the com-munity:(1−GI)×D,and(1−GI)×H’.These new indices were significantly correlated with the original D and H΄,and did not increase the extent of variation within each group of indices.This study presents a useful tool for quantifying both species diversity and the variation in tree sizes in forest communities,especially in the face of cumulative species loss under global climate change.

基于CSLE的泛第三极地区土壤侵蚀强度空间分布特征

[目的]定量评估泛第三极地区的土壤侵蚀状况,明确土壤侵蚀的分布特征,以期为土壤侵蚀的科学防治提供依据。[方法]基于分层不等概系统抽样方法,共布设31 406个调查单元。利用中国土壤流失方程CSLE计算泛第三极地区土壤侵蚀速率,并利用莫兰指数(I)探讨其分布特征。[结果](1)泛第三极地区平均土壤侵蚀速率为162.73 t/(km^(2)·a),水土流失面积比例为7.75%,土壤侵蚀速率超过500 t/(km^(2)·a)的地区主要位于西亚、东亚和南亚;(2)土壤侵蚀存在明显的空间聚集性(I=0.920 9),以高高型和低低型聚集为主,高高型聚集主要分布在西亚北部、南亚北部和西南部以及中国的东北、黄土高原和西藏南部;(3)草地、灌丛和耕地是土壤侵蚀较严重的土地利用类型,其中>1 000 m的草地、>500 m的灌丛和耕地的土壤侵蚀更严重,超过25%的土地都发生了水土流失,平均土壤侵蚀速率变化于426.85~683.72 t/(km^(2)·a)。[结论]海拔介于1 000~6 000 m的草地、500~4 000 m的灌丛以及1 000~4 000 m的耕地是泛第三极地区土壤侵蚀发生的重点区域,需特别关注。

Elevation transition of aquatic insects closely matches a thermal feature in the Yungas of Northwestern Argentina

Temperature is a key factor that shapes the distribution of organisms.Having knowledge about how species respond to temperature is relevant to devise strategies for addressing the impacts of climate change.Aquatic insects are particularly vulnerable to climate change,yet there is still much to learn about their ecology and distribution.In the Yungas ecoregion of Northwestern Argentina,cold-and warm-adapted species of the orders Ephemeroptera,Plecoptera,and Trichoptera(EPT)are segregated by elevation.We modeled the ecological niche of South American EPT species in this region using available data and projected their potential distribution in geographic space.Species were grouped based on their ecogeographic similarity,and we analyzed their replacement pattern along elevation gradients,focusing on the ecotone where opposing thermal preferences converge.Along this interface,we identified critical points where the combined incidence of cold and warm assemblages maximizes,indicating a significant transition zone.We found that the Montane Cloud Forest holds the interface,with a particularly greater suitability at its lower boundary.The main axis of the interface runs in a N-S direction and falls between 14°C-16°C mean annual isotherms.The probability of a particular location within a basin being classified as part of the interface increases as Kira’s warmth index approaches a score around 150.Understanding the interface is critical for defining the thermal limits of species distribution and designing biomonitoring programs.Changes in the location of thermal constants related to mountainous ecotones may cause vertical displacement of aquatic insects and vegetation communities.We have recognized significant temperature thresholds that serve as indicators of suitability for the interface.As global warming is anticipated to shift these indicators,we suggest using them to monitor the imprints of climate change on mountain ecosystems.

Assessment of perianal fistulizing Crohn’s disease activity with endoanal ultrasound: A retrospective cohort study

BACKGROUND Perianal fistulas pose dual challenges to Crohn's disease(CD)patients.Low patient compliance due to the complexity of existing examination methods plagues the treatment and follow-up management of perianal CD.AIM To determine the accuracy of endoanal ultrasound(EUS)and shear wave elastography(SWE)for evaluating perianal fistulizing CD(PFCD)activity.METHODS This was a retrospective cohort study.A total of 67 patients from August 2022 to December 2023 diagnosed with CD were divided into three groups:Non-anal fistula group(n=23),low-activity perianal fistulas[n=19,perianal disease activity index(PDAI)≤4],high-activity perianal fistulas(n=25,PDAI>4)based on the PDAI.All patients underwent assessments including EUS+SWE,pelvic magnetic resonance[pelvic magnetic resonance imaging(MRI)],C-reactive protein,fecal calprotectin,CD activity index,PDAI.RESULTS The percentage of fistulas indicated by pelvic MRI and EUS was consistent at 82%,and there was good consistency in the classification of perianal fistulas(Kappa=0.752,P<0.001).Significant differences were observed in the blood flow Limberg score(χ^(2)=8.903,P<0.05)and shear wave velocity(t=2.467,P<0.05)between group 2 and 3.Shear wave velocity showed a strong negative correlation with magnetic resonance novel index for fistula imaging in CD(Magnifi-CD)score(r=-0.676,P<0.001),a weak negative correlation with the PDAI score(r=-0.386,P<0.05),and a weak correlation between the Limberg score and the PDAI score(r=0.368,P<0.05).CONCLUSION EUS combined with SWE offers a superior method for detecting and quantitating the activity of perianal fistulas in CD patients.It may be the ideal tool to assess PFCD activity objectively for management strategies.

BPS对金鲫鱼中肾抗氧化指标的影响

为研究作为双酚A替代物的双酚S(BPS)对金鲫鱼中肾抗氧化指标的影响,将提前驯养适应1周的金鲫鱼随机分为5组,每组10尾鱼。在安全浓度的基础上,设置1个对照组和以等对数浓度差设置1、10、100、1 000μg/L 4个BPS质量浓度组,进行为期15 d的急性暴露。试验结束后分别从每组取3尾鱼进行采样,测定金鲫鱼中肾中总超氧化物歧化酶(T-SOD)、丙二醛(MDA)及过氧化氢酶(CAT)含量,分析不同BPS浓度对于金鲫鱼中肾抗氧化指标的影响。经试验得出,在安全浓度的基础上,随着BPS浓度的升高,金鲫鱼中肾中的CAT活力与总SOD活力显著降低;MDA含量明显增加。

基于Barthel指数及运动功能的一体化护理在老年脑卒中患者中的应用

目的探讨基于Barthel指数及运动功能的一体化护理在老年脑卒中患者中的应用效果。方法将2021年3月至2023年3月我院收治的150例老年脑卒中患者按照入组顺序分为观察组与对照组。观察组采用基于Barthel指数及运动功能的一体化护理,对照组采用常规护理。比较两组的不良情绪、肢体功能、日常生活能力及生活质量。结果护理后,观察组SAS、SDS评分低于对照组(P<0.05)。护理后观察组FMA上肢、下肢评分、MBI评分、生活质量评分高于对照组(P<0.05)。结论基于Barthel指数及运动功能的一体化护理可缓解老年脑卒中患者的不良情绪,改善其肢体功能及日常生活能力,提升其生活质量。

Ⅰ期综合心脏康复对ST段抬高型心肌梗死急诊经皮冠状动脉介入术后患者的疗效

目的 探究Ⅰ期综合心脏康复对于急性ST段抬高型心肌梗死(ST elevation myocardial infarction, STEMI)患者急诊经皮冠状动脉介入治疗(percutaneous coronary intervention, PCI)后的康复疗效。方法 选取2021年6月至2022年6月国家电网公司北京电力医院心血管内科收治的72例急性ST段抬高型心肌梗死并行急诊PCI的患者作为研究对象,采用随机数字表法将其随机分为常规治疗组和康复组,每组各36例。常规治疗组采用常规护理与健康宣教,康复组在此基础上实施Ⅰ期综合心脏康复,包括初期评估(心血管综合评估)、运动训练(运动训练和呼吸训练)、日常活动指导与健康教育、出院评估(6分钟步行试验和Barthel指数评估)。比较两组患者出院时Barthel指数(BI)得分、出院时6分钟步行试验测试距离(6MWD)、住院期间及出院1个月内主要不良心血管事件(major adverse cardiovascular event,MACE)的发生率和住院时间等。结果 干预后,康复组6MWD和BI得分均优于常规治疗组,差异有统计学意义(P <0.05);住院期间及出院1个月内MACE发生率,康复组低于常规治疗组,差异有统计学意义(P <0.05);康复组患者的住院时间低于常规治疗组,但差异无统计学意义(P> 0.05)。结论 Ⅰ期综合心脏康复训练应用于STEMI并行急诊PCI术后患者,可提高患者的运动能力、提高其日常活动能力、降低发病早期MACE的发生率,有利于患者尽快回归家庭与社会,改善其生活质量,具有较高的临床应用价值。

阿富汗地震R/S分形特征及地震活动性分析

地震的发生具有非线性特征,分形理论能够刻画地震时空分布特征及其变化过程。本文基于R/S分析方法确定阿富汗主要地震带的分形特征,利用ARIMA模型对兴都—库什山地震带可能发生的年度最大震级进行预测。R/S分析表明,兴都—库什山地震带Hurst指数为0.9125,地震活动记忆周期为8年;苏莱曼山地震带Hurst指数为0.7281,地震活动记忆周期为9年。兴都—库什山和苏莱曼山地震带地震活动的变化趋势与历史变化一致,且兴都—库什山地震带的趋势延续性比苏莱曼山地震带更为显著。ARIMA模型预测结果显示,2022—2026年兴都—库什山地震带可能发生的年度最大震级分别为M_(b)6.2、M_(b)6.1、M_(b)5.8、M_(b)5.8和M_(b)6.1。

Existence of Monotone Positive Solution for a Fourth-Order Three-Point BVP with Sign-Changing Green’s Function

This paper is concerned with the following fourth-order three-point boundary value problem , where , we discuss the existence of positive solutions to the above problem by applying to the fixed point theory in cones and iterative technique.

基于D-S证据理论的危化品水路运输风险模糊综合评价

针对危险化学品水路运输风险因素的不确定性和模糊性,提出一种D-S证据理论与模糊综合评价法相结合的危化品水路安全运输风险评价方法。识别分析风险因素,建立危化品水路运输风险因素指标体系;引入距离函数,获取证据可信度后将可信度作为专家权重,结合D-S证据理论,融合专家信息,合理分配指标权重;构建危化品水路运输风险模糊综合评价模型,对危化品水路运输风险等级进行评价。结果表明,该案例的量化风险值为37.389,隶属于较低风险等级,人员、管理、货物因素为关键影响因素,二级指标中教育培训不足、违规操作、安全意识不足、货物敏感条件、通航环境复杂风险值相对较高,需要进行重点防控。