目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPC...目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPCI+MIP)、联合组(PPCI+尼可地尔+MIP)。比较4组患者心肌血流灌注恢复、心肌损伤、心功能和预后的差异。结果与对照组比较,尼可地尔组、MIP组及联合组术后即刻TIMI血流帧数、术后24 h肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)、术后72 h cTnI降低,尼可地尔组及联合组术后无复流发生率降低,联合组术后12个月N末端B型脑钠肽前体、术后7天心律失常严重程度评分、12个月内心衰和心绞痛再住院率降低,尼可地尔组及联合组术后2 h ST段回落率升高(P<0.05)。联合组术后24 h CK-MB显著低于尼可地尔组(P<0.05)。结论尼可地尔联合MIP在心肌血流灌注恢复、降低心肌损伤及改善患者预后方面的效果值得肯定。展开更多
This paper embraces the key points of unpolluted internally combusted engine emissions.Core objective is focused on the recent effort to improve compression ignition(CI)and spark ignition(SI)engine to have fuel⁃effici...This paper embraces the key points of unpolluted internally combusted engine emissions.Core objective is focused on the recent effort to improve compression ignition(CI)and spark ignition(SI)engine to have fuel⁃efficient and minimized pollutant emissions.There are many advanced internal combustion engines to overcome the challenges of conventional compression ignition engines of the high level of particulate matter(PM)and oxides of nitrogen emission.One of the latest options on which many researchers work recently is low⁃temperature combustion which studies the engine advancement and emission at the same time.This review focuses on the released emissions,incinerations and performances features of partially premixed charge ignition with different fuel blends like n⁃butanol⁃gasoline,gasoline⁃diesel,alcohol⁃diesel,and NG⁃diesel effect on partially premixed charge ignition(PPCI)engine combustion.Therefore,PPCI is a single or a dual fuel strategy in that a pre⁃mixed low or high reactive fuel(L/HRF)is directly injected into the engine.It is one of the best low⁃temperature combustion(LTC)strategies by which emissions are minimized while thermal efficiency is acceptable.The recent PPCI of various fuels and their effect are compared.Accordingly,the initial pilot injection can extend the operating load that is a problem in diesel engine;gasoline fuel displayed fewer soot releases when compared with diesel oil in all working situations.The additional inspiring outcome for this combustion approach can be directly controlled by using the start of injection timing(SOI),which is impossible with most other LTC concepts.The diesel PPCI can overcome the NOx⁃PM tradeoff but needs more EGR rates.Another problem of diesel engine PPCI is associated with its comparatively higher boiling point and relatively lower volatility,which made use of advanced injection with a great number of fuel challenges.Thus,diesel fuel is not the best candidate with the LRF to the PPCI engine setup.展开更多
文摘目的观察尼可地尔联合缺血后适应(MIP)对急性ST段抬高心肌梗死(STEMI)患者急诊直接经皮冠脉介入术(PPCI)心肌血流灌注及预后的影响。方法选取急诊行PPCI的STEMI患者200例,随机均分为对照组(PPCI)、尼可地尔组(PPCI+尼可地尔)、MIP组(PPCI+MIP)、联合组(PPCI+尼可地尔+MIP)。比较4组患者心肌血流灌注恢复、心肌损伤、心功能和预后的差异。结果与对照组比较,尼可地尔组、MIP组及联合组术后即刻TIMI血流帧数、术后24 h肌钙蛋白I(cTnI)和肌酸激酶同工酶(CK-MB)、术后72 h cTnI降低,尼可地尔组及联合组术后无复流发生率降低,联合组术后12个月N末端B型脑钠肽前体、术后7天心律失常严重程度评分、12个月内心衰和心绞痛再住院率降低,尼可地尔组及联合组术后2 h ST段回落率升高(P<0.05)。联合组术后24 h CK-MB显著低于尼可地尔组(P<0.05)。结论尼可地尔联合MIP在心肌血流灌注恢复、降低心肌损伤及改善患者预后方面的效果值得肯定。
文摘This paper embraces the key points of unpolluted internally combusted engine emissions.Core objective is focused on the recent effort to improve compression ignition(CI)and spark ignition(SI)engine to have fuel⁃efficient and minimized pollutant emissions.There are many advanced internal combustion engines to overcome the challenges of conventional compression ignition engines of the high level of particulate matter(PM)and oxides of nitrogen emission.One of the latest options on which many researchers work recently is low⁃temperature combustion which studies the engine advancement and emission at the same time.This review focuses on the released emissions,incinerations and performances features of partially premixed charge ignition with different fuel blends like n⁃butanol⁃gasoline,gasoline⁃diesel,alcohol⁃diesel,and NG⁃diesel effect on partially premixed charge ignition(PPCI)engine combustion.Therefore,PPCI is a single or a dual fuel strategy in that a pre⁃mixed low or high reactive fuel(L/HRF)is directly injected into the engine.It is one of the best low⁃temperature combustion(LTC)strategies by which emissions are minimized while thermal efficiency is acceptable.The recent PPCI of various fuels and their effect are compared.Accordingly,the initial pilot injection can extend the operating load that is a problem in diesel engine;gasoline fuel displayed fewer soot releases when compared with diesel oil in all working situations.The additional inspiring outcome for this combustion approach can be directly controlled by using the start of injection timing(SOI),which is impossible with most other LTC concepts.The diesel PPCI can overcome the NOx⁃PM tradeoff but needs more EGR rates.Another problem of diesel engine PPCI is associated with its comparatively higher boiling point and relatively lower volatility,which made use of advanced injection with a great number of fuel challenges.Thus,diesel fuel is not the best candidate with the LRF to the PPCI engine setup.
