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Relationship between neonatal respiratory distress syndrome pulmonary ultrasonography and respiratory distress score,oxygenation index,and chest radiography grading
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作者 Hai Yang Li-Jun Gao +5 位作者 Jing Lei Qiang Li Liu Cui Xiao-Hua Li Wu-Xuan Yin Sen-Hua Tian 《World Journal of Clinical Cases》 SCIE 2024年第20期4154-4165,共12页
BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a ... BACKGROUND Accurate condition assessment is critical for improving the prognosis of neonatal respiratory distress syndrome(RDS),but current assessment methods for RDS pose a cumulative risk of harm to neonates.Thus,a less harmful method for assessing the health of neonates with RDS is needed.AIM To analyze the relationships between pulmonary ultrasonography and respiratory distress scores,oxygenation index,and chest X-ray grade of neonatal RDS to identify predictors of neonatal RDS severity.METHODS This retrospective study analyzed the medical information of 73 neonates with RDS admitted to the neonatal intensive care unit of Liupanshui Maternal and Child Care Service Center between April and December 2022.The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest Xray grade of each newborn before and after treatment were collected.Spearman correlation analysis was performed to determine the relationships among these values and neonatal RDS severity.RESULTS The pulmonary ultrasonography score,respiratory distress score,oxygenation index,and chest X-ray RDS grade of the neonates were significantly lower after treatment than before treatment(P<0.05).Spearman correlation analysis showed that before and after treatment,the pulmonary ultrasonography score of neonates with RDS was positively correlated with the respiratory distress score,oxygenation index,and chest X-ray grade(ρ=0.429–0.859,P<0.05).Receiver operating characteristic curve analysis indicated that pulmonary ultrasonography screening effectively predicted the severity of neonatal RDS(area under the curve=0.805–1.000,P<0.05).CONCLUSION The pulmonary ultrasonography score was significantly associated with the neonatal RDS score,oxygenation index,and chest X-ray grade.The pulmonary ultrasonography score was an effective predictor of neonatal RDS severity. 展开更多
关键词 Neonatal respiratory distress syndrome Pulmonary ultrasonography Ultrasonography score Respiratory distress score oxygenation index Chest X-ray grading
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Oxygen Radical Generation as an Index of Neurotoxic Damage 被引量:2
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作者 STEPHEN C.BONDY CARL P.LEBEL 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 1991年第1期217-223,共7页
Biochemical, anatomical, and physiological characteristics of the brain make it especially vulnerable to insult. Specifically, some of these characteristics such as myelin and a high energy requirement provide for the... Biochemical, anatomical, and physiological characteristics of the brain make it especially vulnerable to insult. Specifically, some of these characteristics such as myelin and a high energy requirement provide for the introduction of free radical-induced insult. Recently, the biochemistry of free radicals has received considerable attention. It also has become increasingly suggestive that many drug and chemical-induced toxicities may be evoked via free radicals and oxidative stress. Major points addressed in this work are the regulation of neural-free radical generation by antioxidants and protective enzymes, xenobiotic-induced disruption of cerebral redox status, and specific examples of neurotoxic agent-induced alterations in free radicals as measured by the fluorescent probe dichlorofluorescein. This article considers that free radical mechanisms may contribute significantly to the properties of several diverse neurotoxic agents and proposes that free radicals may be common phenomena of neurotoxicity. 展开更多
关键词 oxygen Radical Generation as an index of Neurotoxic Damage
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Lymphocytopenia and Neutrophilia Deteriorate at the Lowest Oxygenation Index Timepoint in COVID-19 Patient
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作者 Yiwen Xu Weijun Hong +8 位作者 Gang Wu Weiling Li Chunqiang Xu Xiaofei Hu Meixian Zhang Huihui Xu En Wang Shaofa Ke Xiaoping Jin 《International Journal of Clinical Medicine》 2020年第12期810-822,共13页
<strong>Objective:</strong> Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respirato... <strong>Objective:</strong> Coronavirus disease 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death. However, the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression into account. <strong>Methods:</strong> A single-centered, retrospective study was carried out, which included moderate (n = 76) and severe COVID-19 cases (n = 22). The difference of laboratory findings from blood routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression was indicated by oxygenation index. <strong>Results: </strong>Age is a risk factor for disease progression from moderate to severe. Lymphocytopenia, neutrophilia, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients. <strong>Conclusions:</strong> Lymphocytopenia and neutrophilia, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia in severe COVID-19. Oxygenation index presented potentiality as predictor on the progression of COVID-19. 展开更多
关键词 COVID-19 oxygenation index LYMPHOCYTOPENIA NEUTROPHILIA GLUCOCORTICOIDS
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Lung recruitment maneuver effects on respiratory mechanics and extravascular lung water index in patients with acute respiratory distress syndrome 被引量:7
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作者 Jian-guo Zhan Xiao-juan Chen +2 位作者 Fen Liu Zhen-guo Zeng Ke-jian Qian 《World Journal of Emergency Medicine》 SCIE CAS 2011年第3期201-205,共5页
BACKGROUND:Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the e... BACKGROUND:Animal experiments showed that recruitment maneuver (RM) and protective ventilation strategy of the lung could improve oxygenation and reduce extravascular lung water. This study was to investigate the effects of RM on respiratory mechanics and extravascular lung water index (EVLWI) in patients with acute respiratory distress syndrome (ARDS). METHODS:Thirty patients with ARDS were randomized into a RM group and a non-RM group. In the RM group, after basic mechanical ventilation stabilized for 30 minutes, RM was performed and repeated once every 12 hours for 3 days. In the non-RM group, lung protective strategy was conducted without RM. Oxygenation index (PaO2/FiO2), peak inspiratory pressure (PIP), Plateau pressure (Pplat), static pulmonary compliance (Cst) and EVLWI of patients before treatment and at 12, 24, 48, 72 hours after the treatment were measured and compared between the groups. Hemodynamic changes were observed before and after RM. One-way ANOVA, Student's t test and Fisher's exact test were used to process the data. RESULTS:The levels of PaO2/FiO2 and Cst increased after treatment in the two groups, but they were higher in the RM group than in the non-RM group (P〈0.05). The PIP and Pplat decreased after treatment in the two groups, but they were lower in the RM group than in the non-RM group (P〈0.05). The EVLWI in the two groups showed downward trend after treatment (P〈0.05), and the differences were signifcant at all time points (P〈0.01); the EVLWI in the RM group was lower than that in the non-RM group at 12, 24, 48 and 72 hours (P〈0.05 or P〈0.01). Compared with pre-RM, hemodynamics changes during RM were significantly different (P〈0.01); compared with pre-RM, the changes were not significantly different at 120 seconds after the end of RM (P〉0.05). CONCLUSIONS: RM could reduce EVLWI, increase oxygenation and lung compliance. The effect of RM on hemodynamics was transient. 展开更多
关键词 Lung recruitment maneuver Acute respiratory distress syndrome Respiratory mechanics Extravascular lung water index HEMODYNAMICS Lung protective ventilation oxygenation index
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Effects of high-volume hemofiltration on alveolar- arterial oxygen exchange in patients with refractory septic shock 被引量:5
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作者 Hong-sheng Ren Shi-xue Gao +6 位作者 Chun-ting Wang Yu-fcng Chu Jin-jiao Jiang Ji-chcng Zhang Mci Mcng Guo-qian Qi Min Ding 《World Journal of Emergency Medicine》 SCIE CAS 2011年第2期127-131,共5页
BACKGROUND:High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to becom... BACKGROUND:High-volume hemofiltration (HVHF) is technically possible in severe acute pancreatitis (SAP) patients complicated with multiple organ dysfunction syndrome (MODS). Continuous HVHF is expected to become a beneficial adjunct therapy for SAP complicated with MODS. In this study, we aimed to explore the effects of fluid resuscitation and HVHF on alveolar- arterial oxygen exchange, the Acute Physiology and Chronic Health Evaluation II (APACHE II) score in patients with refractory septic shock. METHODS:A total of 89 refractory septic shock patients, who were admitted to ICU, the Provincial Hospital affiliated to Shandong University from August 2006 to December 2009, were enrolled in this retrospective study. The patients were randomly divided into two groups: fluid resuscitation (group A, n=41), and fluid resuscitation plus high-volume hemofiltration (group B, n=48), The levels of O2 content of central venous blood (CcvO2), arterial oxygen content (CaO2), alveolar-arterial oxygen pressure difference P(A-a)DO2, ratio of arterial oxygen pressure/alveolar oxygen pressure (PaO2/ PAO2), respiratory index (RI) and oxygenation index (OI) were determined. The oxygen exchange levels of the two groups were examined based on the arterial blood gas analysis at different times (0, 24, 72 hours and 7 days of treatment) in the two groups. The APACHE II score was calculated before and after 7-day treatment in the two groups. The levels of CcvO2, CaO2 on day 7 in group A were significantly lower than those in group B (CcvO2:0.60±0.24 vs, 0.72±0.28, P〈0.05; CaO2:0.84±0.43 vs. 0.94±0.46, P〈0.05). The level of oxygen extraction rate (O2ER) in group A on the 7th day was significantly higher than that in group B ( 28.7±2.4 vs. 21.7±3.4, P〈0.01). The levels of P(A-a)DO2 and RI in group B on the 7th day were significantly lower than those in group A. The levels of PaO2/PAO2 and OI in group B on 7th day were significantly higher than those in group A (P〈0.05 or P〈0.01). The APACHE II score in the two groups reduced gradually after 7-day treatment, and the APACHE II score on the 7th day in group B was significantly lower than that in group A (8.2±3.8 vs. 17.2±6.8, P〈0.01). HVHF combined with fluid resuscitation can improve alveolar- arterial-oxygen exchange, decrease the APACHE II score in patients with refractory septic shock, and thus it increases the survival rate of patients. 展开更多
关键词 Fluid resuscitation High-volume hemofiltration Septic shock oxygen extractionrate Alveolar-arterial oxygen exchange PaO2/PAO2 ratio Respiratory index oxygenation index AcutePhysiology and Chronic Health Evaluation II (APACHE II)
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Effect of electrochemical reactions droplet metal in direct current on oxygen contamination of submerged arc welding
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作者 李晓泉 初雅杰 +1 位作者 杨宗辉 贺显聪 《China Welding》 EI CAS 2013年第4期53-57,共5页
Agglomerated fluxes with different basicity index designed in laboratory were used to study electrochemical reactions between slag and metal in submerged arc welding under both power polarities. The droplet metal oxyg... Agglomerated fluxes with different basicity index designed in laboratory were used to study electrochemical reactions between slag and metal in submerged arc welding under both power polarities. The droplet metal oxygen and nitrogen contents were measured using oxygen-nitrogen instrument in order to analyze indirectly metallurgy electrochemical reactions taking place in cathode and anode of welding arc. The results show that just in the period of droplet growth at the tip of consumable electrode the electrochemical oxygen contamination is produced in the case of direct current electrode positive polarity whereas electrochemical oxygen lost in electrode negative polarity. Furthermore, the results indicate that the basicity index of molten slag has great influence upon electrochemical reaction. With basicity index increasing, the effect of oxygen transferring resulted from electrochemistry becomes more evident for reacting dynamics depended on ion characteristics of molten slag. The effect of basicity index on metal-slag electrochemical reaction is contrary to traditional thermo-chemical reaction and therefore it is necessary to be considered as a metallurgy factor. 展开更多
关键词 basicity index oxygen content electrochemical reaction submerged arc welding
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改良俯卧位通气对急性呼吸窘迫综合征患者呼吸功能及预后的影响 被引量:2
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作者 白奎 郭凤杰 秦国泉 《河南医学研究》 CAS 2024年第3期451-455,共5页
目的 探究改良俯卧位通气对急性呼吸窘迫综合征(ARDS)患者血流动力学、呼吸动力学及预后的影响。方法 前瞻性选取河南大学第一附属医院2020年3月至2022年6月收治的98例ARDS患者作为研究对象,通过随机数字表法分为A、B组。通过随机及前... 目的 探究改良俯卧位通气对急性呼吸窘迫综合征(ARDS)患者血流动力学、呼吸动力学及预后的影响。方法 前瞻性选取河南大学第一附属医院2020年3月至2022年6月收治的98例ARDS患者作为研究对象,通过随机数字表法分为A、B组。通过随机及前瞻性平行对照临床研究,评价不同通气方式在ARDS患者中的作用,其中A组52例接受改良式俯卧位通气,B组46例接受传统俯卧位通气。对比两组患者干预前、干预后(俯卧位通气4 h后)血流动力学[心率(HR)、平均动脉压、中心静脉压]、呼吸动力学指标[气道阻力、静态肺顺应性(Cst)]、氧合指数及腹腔压力的变化。比较两组患者不良事件发生情况,对所有患者进行3个月随访,比较两组患者病死率情况。结果 (1)A组机械通气时间低于B组,撤机成功率高于B组(P<0.05);(2)干预后,两组患者HR均较干预前上升,干预前后差值具有统计学意义(P<0.05);(3)干预后,两组Cst水平均较干预前上升且A组高于B组,干预前后差值具有统计学意义(P<0.05);(4)干预后,两组腹腔压力均较治疗前上升且A组低于B组,干预前后差值具有统计学意义(P<0.05);(5)A组不良事件总发生率[7.69%(4/52)]低于B组[23.91%(11/46)](P<0.05);(6)随访3个月结果显示,A组病死率[23.08%(12/52)]低于B组[43.48%(20/46)](P<0.05)。结论 改良俯卧位通气对ARDS血流动力学、呼吸动力学及相关指标均有显著的改善效果,不良事件的发生率较低且预后状况良好,值得临床参考借鉴。 展开更多
关键词 改良俯卧位通气 急性呼吸窘迫综合征 静态肺顺应性 氧合指数 腹腔压力 预后
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快速序贯器官功能衰竭评估评分联合氧合指数与急诊危重症患者危重程度的关系研究 被引量:1
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作者 赵向辉 陈乐乐 +2 位作者 甄运钰 吴亚光 刘静 《临床和实验医学杂志》 2024年第2期153-157,共5页
目的探讨快速序贯器官功能衰竭评估(qSOFA)评分联合氧合指数(OI)对急诊危重症患者危重程度的预测价值。方法回顾性选取2020年1月至2021年10月河北省第七人民医院收治的176例急诊危重症患者作为研究对象,包括脓毒症患者92例,社区获得性... 目的探讨快速序贯器官功能衰竭评估(qSOFA)评分联合氧合指数(OI)对急诊危重症患者危重程度的预测价值。方法回顾性选取2020年1月至2021年10月河北省第七人民医院收治的176例急诊危重症患者作为研究对象,包括脓毒症患者92例,社区获得性肺炎患者84例。根据入院24 h内的急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分结果,将所选患者分为轻度组(15分≤APACHEⅡ评分<20分,n=58)、中度组(20分≤APACHEⅡ评分<30分,n=70)和重度组(APACHEⅡ评分≥30分,n=48)。比较3组患者的血气指标[二氧化碳分压(PaCO_(2))、动脉氧分压(PaO_(2))、OI]、qSOFA评分;采用Pearson相关分析血气指标与qSOFA评分的相关性;采用多分类有序Logistic回归分析急诊危重症患者危重程度的影响因素;并采用受试者工作特征(ROC)曲线分析qSOFA评分联合OI预测急诊危重症患者危重程度的价值。结果重度组的PaCO_(2)和qSOFA评分均高于中度组和轻度组,且中度组的PaCO_(2)和qSOFA评分显著高于轻度组,差异均有统计学意义(P<0.05);3组的PaO_(2)和OI呈现下降趋势,重度组低于中度组和轻度组,中度组低于轻度组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,PaCO_(2)与qSOFA评分呈正相关(r=0.238,P<0.05);PaO_(2)、OI与qSOFA评分呈负相关(r=-0.197、-0.328,P<0.05)。多分类有序Logistic回归分析结果显示,PaCO_(2)和qSOFA评分越高,急诊危重症患者危重程度越严重;但PaO_(2)和OI越低急诊危重症患者危重程度越严重。ROC曲线分析结果示,qSOFA评分联合OI预测急诊危重症患者危重程度的曲线下面积(AUC)最大为0.895,大于各单独指标预测和其他联合指标的预测(P<0.05)。结论qSOFA评分、OI与急诊危重症患者危重程度有关,二者联合预测急诊危重症患者危重程度的价值更高,可作为临床诊断和评估急诊危重症的辅助指标。 展开更多
关键词 急诊 危重症 危重程度 快速序贯器官功能衰竭评估评分 氧合指数
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PICU机械通气治疗患儿谵妄发生情况及其影响因素分析
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作者 许莉莉 马朱圣颖 +4 位作者 钱雯 许雅雅 朱月钮 朱晓东 戈晓华 《临床儿科杂志》 CAS CSCD 北大核心 2024年第5期445-449,共5页
目的探讨儿科重症监护室(PICU)内接受机械通气(MV)治疗的患儿发生谵妄(PD)概率及其相关影响因素。方法回顾性分析2022年7月至2023年3月在医院PICU内接受MV治疗患儿的临床资料。结果149例患儿接受MV,中位年龄2.0(1.0~6.0)岁,男74例、女7... 目的探讨儿科重症监护室(PICU)内接受机械通气(MV)治疗的患儿发生谵妄(PD)概率及其相关影响因素。方法回顾性分析2022年7月至2023年3月在医院PICU内接受MV治疗患儿的临床资料。结果149例患儿接受MV,中位年龄2.0(1.0~6.0)岁,男74例、女75例。其中年龄≤2岁患儿86例(57.7%),治疗期间反复气管插管患儿34例(22.8%)。149例患儿中有81例(54.4%)发生谵妄,与非谵妄组相比,谵妄组年龄较小,俯卧位通气比例较低,年龄≤2岁比例较高,PICU住院时间延长,PICU住院时间>14天比例较高,差异有统计学意义(P<0.05)。与非谵妄组相比,谵妄组MV首日氧合指数≤150 mmHg比例较高,MV总时间较长,MV总时间≤168 h比例较低,差异有统计学意义(P<0.05)。多因素logistic回归分析显示患儿PICU住院时间>14 d、MV首日氧合指数≤150 mmHg是MV患儿发生谵妄的独立危险因素(P<0.05),而MV总时间≤168 h是MV患儿发生谵妄的保护因素(P<0.05)。结论PICU内接受MV治疗的患儿谵妄发生率较高,与低氧性损伤密切相关。长时间的MV和PICU住院治疗也是导致谵妄发生的重要影响因素。 展开更多
关键词 儿科重症监护室 机械通气 谵妄 氧合指数
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Evaluation of Partial Pressure of Arterial Oxygen in Obese Patients in Supine Position during General Anesthesia
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作者 Kenichi Satoh Mami Chikuda +3 位作者 Ayako Ohashi Miho Kumagai Akiyoshi Kuji Shigeharu Joh 《Open Journal of Anesthesiology》 2015年第5期85-92,共8页
Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard P... Background: Anesthetists should measure the concentration of supplemental oxygen to determine whether patients’ partial pressure of arterial oxygen (PaO2) is correct during general anesthesia. However, the standard PaO2 value in obese patients in the supine position is unknown. We evaluated the PaO2 with respect to the Broca-Katsura obesity index. Materials and Methods: From January 2001 to December 2013, we evaluated 472 patients aged ≥16 years old that underwent general anesthesia in the supine position. The anesthetic charts of 472 patients with an American Society of Anesthesiologists physical status of I or II were retrospectively reviewed to investigate the PaO2. Results: In patients aged 16 to 2 was 165.7 ± 25.6 mmHg at a Broca-Katsura index of 2 was 152.1 ± 23.8 mmHg at a Broca-Katsura index of 2 tended to decrease with age from 16 to 2 tended to decrease with age from 16 to <65 years at a Broca-Katsura index of 20% to <40%. 展开更多
关键词 ARTERIAL Partial Pressure of oxygen Broca-Katsura index General ANESTHESIA OBESITY SUPINE Position
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Multi-index analysis of the melting process of laterite metallized pellet 被引量:1
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作者 Yun Wang Rong Zhu +3 位作者 Kai-lu Tu Guang-sheng Wei Shao-yan Hu Hong Li 《International Journal of Minerals,Metallurgy and Materials》 SCIE EI CAS CSCD 2018年第12期1423-1430,共8页
Herein, a multi-index analysis of the nickel content of an alloy, output rate of the alloy, nickel recovery rate, and iron recovery rate during the melting of laterite metallized pellets was performed. The thermodynam... Herein, a multi-index analysis of the nickel content of an alloy, output rate of the alloy, nickel recovery rate, and iron recovery rate during the melting of laterite metallized pellets was performed. The thermodynamic reduction behavior of oxides such as NiO, FeO, Fe_3 O_4, and Cr_2 O_3 was studied using the FactSage software, which revealed that SiO_2 is not conducive to the reduction of iron oxides, whereas the addition of basic oxides such as CaO and MgO is beneficial for the reduction of iron oxides. On the basis of a comprehensive analysis to achieve greater nickel recovery and lower iron recovery rates, the optimum experimental parameters in the orthogonal experiment were A3 B1 C3(t = 30 min, C/O = 0.4, R = 1.2); the indicators wNi, φalloy, ηNi, and ηFe had values of 15.0 wt%, 12.1%, 44.9%, and 96.4%, respectively. In single-factor experiments, increasing basicity(R) substantially improved the separation effect in the low-basicity range 0.5 ≤ R ≤ 0.8 but not in the high-basicity range 0.8 ≤ R ≤ 1.2. Similar results were obtained for the effect of the C/O ratio. Moreover, the recovery rate of nickel increased with increasing recovery rate of iron. 展开更多
关键词 MELTING and separation LATERITE metallized PELLET multi-index ANALYSIS BASICITY carbon-to-oxygen ratio
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大鼠脓毒症肺损伤与中性粒细胞载脂蛋白的相关性研究
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作者 郑军 祝木建 +3 位作者 李江东 余涵聪 施明栋 李林 《中国感染控制杂志》 CAS CSCD 北大核心 2024年第11期1344-1349,共6页
目的探究大鼠脓毒症肺损伤与中性粒细胞载脂蛋白(HNL)的相关性。方法45只大鼠按照随机方法分为对照组、sham组及模型组,模型组建立脓毒症肺损伤大鼠模型,sham组开腹后仅游离盲肠后关腹,不进行结扎和穿刺,对照组为健康大鼠。使用试剂盒... 目的探究大鼠脓毒症肺损伤与中性粒细胞载脂蛋白(HNL)的相关性。方法45只大鼠按照随机方法分为对照组、sham组及模型组,模型组建立脓毒症肺损伤大鼠模型,sham组开腹后仅游离盲肠后关腹,不进行结扎和穿刺,对照组为健康大鼠。使用试剂盒检测各组大鼠血清白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)及HNL;血气分析仪检测氧合指数;计算肺组织湿/干比;HE染色观察肺组织病理形态,计算肺损伤评分。结果对照组及sham组12、24、36 h的IL-6、IL-1β、TNF-α、HNL水平、氧合指数、肺组织湿/干比、肺损伤评分比较,差异均无统计学意义(均P>0.05);与sham组相比,模型组12、24、36 h的IL-6、IL-1β、TNF-α、HNL水平、氧合指数、肺组织湿/干比、肺损伤评分均升高,差异均有统计学意义(均P<0.05)。对照组大鼠12、24、36 h肺组织结构正常,且未见水肿,sham组大鼠12、24、36 h肺组织仅有少量炎症细胞,模型组大鼠12、24、36 h肺组织结构严重破坏,肺泡萎陷,炎症细胞严重浸润,但随着时间延长病理改善。脓毒症肺损伤大鼠中,HNL与IL-6、IL-1β、TNF-α、肺部湿/干比、肺损伤评分呈现正相关性(均P<0.05),与氧合指数呈现负相关性(P<0.05)。结论脓毒症肺损伤大鼠中HNL显著升高,炎症反应严重,肺组织湿/干比、肺损伤加重,氧合指数降低,且HNL水平与IL-6、IL-1β、TNF-α水平、肺组织湿/干比、肺损伤呈正相关性,与氧合指数呈负相关性。 展开更多
关键词 脓毒症 肺损伤 中性粒细胞载脂蛋白 炎症因子 氧合指数 病理形态 动物试验 大鼠
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宣白承气汤治疗肺热腑实型重症肺炎合并胃肠功能障碍的临床研究
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作者 朱桂松 尹小芳 +3 位作者 诸虹 贾蓉 邹子萌 许飚 《南京中医药大学学报》 CAS CSCD 北大核心 2024年第8期831-837,共7页
目的探讨宣白承气汤对肺热腑实型重症肺炎合并胃肠功能障碍患者呼吸、氧合功能及血清水通道蛋白(AQP)1和AQP5表达水平的影响。方法60例肺热腑实型重症肺炎合并胃肠功能障碍患者随机分为对照组和试验组各30例。对照组采用西医常规治疗,... 目的探讨宣白承气汤对肺热腑实型重症肺炎合并胃肠功能障碍患者呼吸、氧合功能及血清水通道蛋白(AQP)1和AQP5表达水平的影响。方法60例肺热腑实型重症肺炎合并胃肠功能障碍患者随机分为对照组和试验组各30例。对照组采用西医常规治疗,试验组在对照组治疗基础上加服宣白承气汤,2组疗程均为7 d。比较治疗前后2组患者呼吸频率和氧合指数、机械通气使用率、临床疗效评分(CURB-65、CPIS量表)、中医证候积分、胃肠功能指标[腹内压、血清促胃液素(GAS)和血管活性肠肽(VIP)]、血清AQP1和AQP5水平,记录并比较2组患者治疗期间机械通气天数及ICU住院天数。结果治疗后,与对照组比较,试验组患者呼吸频率、中医证候积分、腹内压均显著下降(P<0.05,P<0.01),血清GAS、AQP1和AQP5水平及氧合指数显著提高(P<0.05,P<0.01)。结论宣白承气汤能显著改善患者的呼吸和氧合功能等临床症状,其机制可能与调控AQP1和AQP5有关。 展开更多
关键词 宣白承气汤 重症肺炎 胃肠功能障碍 肺热腑实型 氧合指数 水通道蛋白1 水通道蛋白5
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NT-proBNP对有创机械通气小儿急性呼吸衰竭28 d内死亡的预测价值研究
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作者 陈秀萍 李斯婕 +3 位作者 梁秀安 赵云柳 伍冬梅 林源 《广西医科大学学报》 CAS 2024年第4期579-584,共6页
目的:研究氧合指数(OI)和N末端B型钠尿肽前体(NT-proBNP)在儿童重症监护病房(PICU)需要有创机械通气的急性呼吸衰竭(ARF)患儿28 d内死亡的预测价值。方法:选取2017—2019年入住本院PICU的需要有创机械通气的111例ARF患儿,收集并分析患... 目的:研究氧合指数(OI)和N末端B型钠尿肽前体(NT-proBNP)在儿童重症监护病房(PICU)需要有创机械通气的急性呼吸衰竭(ARF)患儿28 d内死亡的预测价值。方法:选取2017—2019年入住本院PICU的需要有创机械通气的111例ARF患儿,收集并分析患儿临床资料,包括儿童机械通气死亡风险评分Ⅲ(PRISMⅢ)、OI、NT-proBNP、机械通气后28 d内生存情况等。采用单因素和多因素logistic回归分析评估ARF患儿28 d内死亡的危险因素。采用受试者工作特征(ROC)曲线评估NT-proBNP、OI和年龄预测28 d生存情况的效果。结果:患儿中位年龄12个月(4.5~66个月),28 d内79例存活(71.17%),32例死亡(28.83%)。与存活组相比,死亡组OI显著升高,NT-proBNP水平显著降低(均P<0.05),两组24 h内PRISMⅢ评分无显著差异(P>0.05)。多因素logistic回归分析结果显示,年龄、OI、NT-proBNP均为ARF患儿28 d内死亡的独立危险因素(P<0.05)。年龄、OI、NT-proBNP及三者联合的ROC曲线下面积(AUC)分别为0.625 0、0.603 6、0.602 8和0.657 2,年龄+OI+NT-proBNP联合具有更好的预测效果。结论:在ARF需机械通气患儿中,最初24 h的年龄、OI和NT-proBNP水平与28 d死亡风险相关;年龄、OI和NT-proBNP三者联合有助于早期识别ARF插管患儿死亡风险。 展开更多
关键词 氧合指数 N末端B型钠尿肽前体 死亡风险 儿童重症监护病房 呼吸衰竭
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不同角度俯卧位通气在急性呼吸窘迫综合征患者中的应用效果
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作者 梁艳东 何伟枫 +2 位作者 刘秋江 黎燕红 庾佳燕 《国际医药卫生导报》 2024年第12期2063-2067,共5页
目的评估不同角度俯卧位通气在急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法本研究为一项前瞻性、随机、对照临床试验,纳入2021年7月至2023年6月广东省第二中医院重症医学科(ICU)收治的ARDS患者共96例,随机分为A组(0°俯卧位通... 目的评估不同角度俯卧位通气在急性呼吸窘迫综合征(ARDS)患者中的应用效果。方法本研究为一项前瞻性、随机、对照临床试验,纳入2021年7月至2023年6月广东省第二中医院重症医学科(ICU)收治的ARDS患者共96例,随机分为A组(0°俯卧位通气)、B组(30°俯卧位通气)、C组(45°俯卧位通气),每组32例。A组男19例,女13例;年龄(50.25±11.31)岁;体重指数(BMI)(23.42±3.16)kg/m^(2)。B组男17例,女15例;年龄(51.93±12.48)岁;BMI(22.72±4.15)kg/m^(2)。C组男20例,女12例;年龄(52.39±12.82)岁;BMI(24.76±4.31)kg/m^(2)。观察时间为5 d。A组患者每天持续0°俯卧位通气16 h,每2 h将其托起一次防止压力性损伤。B组:维持0°俯卧位2 h后,使用30°翻身垫将患者身体向左倾斜30°,维持2 h;然后向右倾斜30°,同样维持2 h;最后恢复至0°俯卧位,如此循环,直至完成16 h俯卧位通气。C组:维持0°俯卧位2 h后,使用45°翻身垫将患者身体向左倾斜45°,维持2 h;然后向右倾斜45°,同样维持2 h;最后恢复至0°俯卧位,如此循环,直至完成16 h俯卧位通气。比较3组氧合指标[氧合指数(PaO_(2)/FiO_(2))、动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血流动力学指标[心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)]、Murray肺损伤评分(MLIS)、急性生理学及慢性健康状况评价Ⅱ(APACHEⅡ)评分、多器官功能障碍综合征(MODS)评分的变化,观察压力性损伤发生率。采用单因素方差分析、LSD法、配对t检验、χ^(2)检验。结果俯卧位通气5 d后,3组PaO_(2)/FiO_(2)、SaO_(2)、PaO_(2)、PaCO_(2)均较通气前改善,且A组、B组改善幅度均优于C组(均P<0.05);俯卧位通气前和通气5 d后,3组HR、MAP、CVP差异均无统计学意义(均P>0.05);俯卧位通气5 d后,3组MLIS、APACHEⅡ、MODS评分均较通气前降低,且A组、B组均低于C组[(1.72±0.37)分比(1.54±0.16)分比(1.89±0.26)分、(11.02±2.69)分比(11.01±2.01)分比(12.87±2.06)分、(5.64±0.37)分比(5.34±0.67)分比(6.19±0.43)分](均P<0.05);B组和C组压力性损伤发生率低于A组[15.63%(5/32)比18.75%(6/32)比40.63%(13/32)](P<0.05)。结论不同角度俯卧位通气均可以改善ARDS患者氧合和减轻病情,其中30°俯卧位通气改善最明显,并且可以降低压力性损伤发生率。 展开更多
关键词 急性呼吸窘迫综合征 俯卧位通气 不同角度 氧合指数 血流动力学 压力性损伤
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氧疗联合俯卧位呼吸治疗急性呼吸衰竭的临床效果
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作者 刘天荣 夏青 崔红 《医药前沿》 2024年第29期25-27,共3页
目的:分析急性呼吸衰竭(ARF)应用氧疗联合俯卧位呼吸治疗的效果。方法:选取2022年7月—2023年12月新疆医科大学第六附属医院收治的21例清醒急性呼吸衰竭患者为研究对象。比较分析不同时间患者的心电监测指标和动脉血气指标。结果:初始... 目的:分析急性呼吸衰竭(ARF)应用氧疗联合俯卧位呼吸治疗的效果。方法:选取2022年7月—2023年12月新疆医科大学第六附属医院收治的21例清醒急性呼吸衰竭患者为研究对象。比较分析不同时间患者的心电监测指标和动脉血气指标。结果:初始位、俯卧位0.5h、俯卧位1h患者的心率(HR)、呼吸频率(RR)、平均动脉压(MAP)、氧灌注指数(PI)水平比较,差异均无统计学意义(P>0.05);俯卧位0.5h时患者的血氧饱和度(SpO_(2))与初始位比较,差异无统计学意义(P>0.05);俯卧位1h患者的SpO_(2)与初始位比较,差异有统计学意义(Ρ<0.05);初始位与俯卧位1h时患者的pH值、二氧化碳分压(PaCO_(2))水平比较,差异无统计学意义(P>0.05);但动脉血氧分压(PaO_(2))、氧合指数水平比较,差异有统计学意义(Ρ<0.05)。21例患者中无患者发生血液动力学异常情况。结论:氧疗联合俯卧位呼吸治疗ARF患者疗效显著,可以改善患者氧合状况,可作为基层医疗机构和急诊进行急救的一种方法。 展开更多
关键词 急性呼吸衰竭 俯卧位呼吸 氧疗 血氧饱和度 灌注指数 氧合指数
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BLUE-plus方案的肺超声评分在急性呼吸衰竭患者胸部物理治疗中的应用
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作者 陈春艳 张艳阳 王柱 《湖北理工学院学报》 2024年第5期63-68,共6页
为了探究BLUE-plus方案的肺超声评分引导胸部物理治疗(CPT)在急性呼吸衰竭患者氧合能力、感染指标和肺通气功能方面的效果,根据样本量估算招募急性呼吸衰竭患者102例,随机分为试验组和对照组。试验组根据BLUE-plus肺超声征象、肺超声评... 为了探究BLUE-plus方案的肺超声评分引导胸部物理治疗(CPT)在急性呼吸衰竭患者氧合能力、感染指标和肺通气功能方面的效果,根据样本量估算招募急性呼吸衰竭患者102例,随机分为试验组和对照组。试验组根据BLUE-plus肺超声征象、肺超声评分实施精准CPT,对照组采用常规CPT。比较两组患者入ICU第1~5天的氧合指数和第1、5天的血感染指标(降钙素原(PCT)、白介素-6(IL-6))及肺部超声评分、机械通气时长和ICU住院时长,发现BLUE-plus方案的肺超声评分指导的CPT可以改善急性呼吸衰竭患者的氧合指数、感染指标(IL-6)、肺部情况,缩短机械通气的时间。相较于对照组,试验组在第3~5天的氧合指数具有统计学差异(P<0.05),第5天IL-6、肺部超声评分、机械通气时长差异具有统计学意义(P<0.05),PCT、ICU住院时长无统计学差异(P>0.05)。 展开更多
关键词 BLUE-plus肺超声引导 急性呼吸衰竭 胸部物理治疗 氧合指数 肺超声评分
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基于量化评估策略的护理模式结合袋鼠式护理在支气管肺发育不良早产儿中的应用价值
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作者 蒲庆 邢虹 +1 位作者 张国成 《临床医学研究与实践》 2024年第7期166-169,共4页
目的分析基于量化评估策略的护理模式结合袋鼠式护理在支气管肺发育不良(BPD)早产儿中的应用价值。方法选取2020年1月至2021年12月收治的120例BPD早产儿为研究对象,以随机数字表法将其分为对照组与观察组,各60例。两组均采用常规护理干... 目的分析基于量化评估策略的护理模式结合袋鼠式护理在支气管肺发育不良(BPD)早产儿中的应用价值。方法选取2020年1月至2021年12月收治的120例BPD早产儿为研究对象,以随机数字表法将其分为对照组与观察组,各60例。两组均采用常规护理干预,对照组采用袋鼠式护理,观察组在对照组基础上加施基于量化评估策略的护理模式。比较两组的干预效果。结果观察组的进奶量、每日体重增加量大于对照组,住院时间短于对照组(P<0.05)。干预后,观察组的动脉血氧饱和度(SaO_(2))、动脉血氧分压(PaO_(2))高于对照组,动脉血二氧化碳分压(PaCO_(2))低于对照组(P<0.05)。干预后,观察组的头围、身长、体质量大于对照组(P<0.05)。结论基于量化评估策略的护理模式结合袋鼠式护理不仅能够有效缩短BPD早产儿的治疗周期,改善血氧指标,还能促进其生长发育,值得推广。 展开更多
关键词 基于量化评估策略的护理模式 袋鼠式护理 支气管肺发育不良 血氧指标
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血乳酸/肌酐与脓毒症休克患者近期预后的关系
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作者 王李娟 郑潘 +1 位作者 曹鹏建 毛亚飞 《河南医学研究》 CAS 2024年第15期2808-2811,共4页
目的探析血乳酸(Lac)/肌酐(Scr)与脓毒症休克患者近期预后的关系。方法前瞻性选取新乡市第一人民医院2022年1月至2023年3月收治的140例脓毒症休克患者为研究对象,于入院时详细记录患者一般资料,并进行实验室检查,检测血Lac、Scr,计算二... 目的探析血乳酸(Lac)/肌酐(Scr)与脓毒症休克患者近期预后的关系。方法前瞻性选取新乡市第一人民医院2022年1月至2023年3月收治的140例脓毒症休克患者为研究对象,于入院时详细记录患者一般资料,并进行实验室检查,检测血Lac、Scr,计算二者比值。依据28 d生存情况将患者分为病死组与存活组,比较两组一般资料及实验室检查资料,采用点二列相关性分析Lac/Scr与脓毒症休克患者近期预后的关系,并绘制受试者工作特征(ROC)曲线,分析Lac/Scr对脓毒症休克患者短期病死的预测价值。结果140例脓毒症休克患者中3例患者家属放弃治疗,最终纳入137例脓毒症休克患者,共有31例患者28 d内病死,占比22.63%。病死组年龄、急性生理与慢性健康(APACHEⅡ)评分、Lac、Lac/Scr均高于存活组(P<0.05)。病死组氧合指数低于存活组(P<0.05)。点二列相关性分析显示,Lac、Lac/Scr与脓毒症休克患者近期预后病死呈正相关(r>0,P<0.05)。ROC曲线显示Lac、Lac/Scr预测脓毒症休克患者短期病死的曲线下面积(AUC)>0.7,且Lac/Scr的AUC值更高。结论血Lac/Scr可影响脓毒症休克患者近期预后,Lac/Scr水平越高患者短期内病死风险越大,且血Lac/Scr可作为预测脓毒症休克患者近期预后的敏感指标。 展开更多
关键词 脓毒症休克 血乳酸 肌酐 近期预后 氧和指数
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rSO2-BIS监测在儿童肱骨髁上骨折手术中的应用研究
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作者 罗春芳 冯应辉 +3 位作者 章征兵 许凯 李明 欧阳卫东 《中国现代医生》 2024年第27期22-25,共4页
目的 探讨局部脑氧饱和度(regional cerebral oxygen saturation,rSO2)-脑电双频指数(bispectral index,BIS)监测麻醉方式在儿童肱骨髁上骨折手术中的应用。方法 选取江西省儿童医院骨科2020年1月至2022年12月收治的60例肱骨髁上骨折手... 目的 探讨局部脑氧饱和度(regional cerebral oxygen saturation,rSO2)-脑电双频指数(bispectral index,BIS)监测麻醉方式在儿童肱骨髁上骨折手术中的应用。方法 选取江西省儿童医院骨科2020年1月至2022年12月收治的60例肱骨髁上骨折手术患儿,按随机数字表法分为对照组和观察组,每组30例。观察组患儿麻醉后给予rSO2-BIS监测,对照组患儿给予常规麻醉管理。结果 观察组患儿的丙泊酚中/长链脂肪乳和瑞芬太尼注射液用量明显少于对照组(P<0.05);患儿苏醒时各时间点的心率、血氧饱和度及平均动脉压比较,差异无统计学意义(P>0.05);术后镇痛药补救率低于对照组,拔管时间短于对照组(P<0.05);术后不良反应发生率及不良行为率低于对照组(P<0.001)。多因素分析结果发现丙泊酚中/长链脂肪乳和瑞芬太尼注射液的用量是诱发患儿术后出现不良反应和不良行为的独立危险因素,rSO2-BIS监测是减少患儿术后出现不良行为和不良反应的关键因素(P<0.05)。结论 儿童肱骨髁上骨折术中采用rSO2-BIS监测可降低手术患儿术后不良行为和不良反应的发生率,进而改善术后疗效。 展开更多
关键词 肱骨髁上骨折 局部脑氧饱和度 脑电双频指数 多模式麻醉管理 术后不良反应 术后不良行为
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