目的探讨烧伤合并吸入性损伤患者行机械通气第24小时的氧合指数(OI)对患者预后的影响。方法142例烧伤合并吸入性损伤行机械通气患者,根据第24小时的OI值分为A组[OI≤200 mm Hg(1 mm Hg=0.133 kPa),36例]、B组(200 mm Hg<OI≤300 mm H...目的探讨烧伤合并吸入性损伤患者行机械通气第24小时的氧合指数(OI)对患者预后的影响。方法142例烧伤合并吸入性损伤行机械通气患者,根据第24小时的OI值分为A组[OI≤200 mm Hg(1 mm Hg=0.133 kPa),36例]、B组(200 mm Hg<OI≤300 mm Hg,46例)、C组(OI>300 mm Hg,60例)。比较三组一般资料及预后情况;依据预后情况将患者分为预后不良组(86例)与预后良好组(56例)。采用单因素和多因素Logistic回归分析烧伤合并吸入性损伤机械通气患者预后不良的危险因素。结果三组年龄、烧伤总面积(TBSA)、机械通气前氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))及预后情况比较,差异具有统计学意义(P<0.05)。C组年龄(40.07±21.20)岁小于A组的(54.64±17.83)岁和B组的(51.72±17.99)岁(P<0.05);B组TBSA(60.43±29.04)%和C组TBSA(62.89±24.85)%小于A组的(74.14±21.90)%,预后不良率54.3%、48.3%低于A组的88.9%(P<0.05)。机械通气前,A组和B组PaO_(2)水平显著低于C组,PaCO_(2)高于C组(P<0.05);B和C组SaO_(2)高于A组(P<0.05)。三组机械通气开始时间、三度烧伤面积及入院延迟复苏情况比较差异无统计学意义(P>0.05)。预后不良组与预后良好组患者的年龄、TBSA、机械通气后第24小时OI比较差异具有统计学意义(P<0.05);预后不良组与预后良好组患者的机械通气开始时间、机械通气时间及机械通气前PaO_(2)、PaCO_(2)、SaO_(2)比较差异无统计学意义(P>0.05)。将筛选出P<0.05的因素纳入多元Logistic回归分析,排除混杂因素后,结果显示:机械通气后第24小时OI≤200 mm Hg、TBSA大、老年是烧伤合并吸入性损伤行机械通气患者预后不良的独立危险因素(OR=5.551、1.046、10.187,P<0.05)。结论机械通气第24小时OI≤200 mm Hg的烧伤合并吸入性损伤患者预后不良,TBSA越大,机械通气前PaO_(2)及SaO_(2)越低,通气后第24小时的OI可能越低。展开更多
Designing the specific crystal phase with better intrinsic activity and more active sites is a very promising strategy for earth-abundant electrocatalysts for oxygen evolution reaction(OER).Herein,a facile two-step me...Designing the specific crystal phase with better intrinsic activity and more active sites is a very promising strategy for earth-abundant electrocatalysts for oxygen evolution reaction(OER).Herein,a facile two-step method including the high-pressure microwave and the hydrothermal sulfurization is adopted to prepare the WS_(x)/Ni_(9)S_(8) hetero-catalyst on nickel foam(WS_(x)/Ni_(9)S_(8)/NF).Firstly,WO3 polyhedrons homogeneously cover the surface of NF through the high-pressure microwave hydrothermal process.Secondly,WS_(x)/Ni_(9)S_(8) nanoparticles on the surface of NF can be synthesized after a hydrothermal sulfurization,which has been confirmed by scanning electron microscopy(SEM) elemental mapping and high-resolution transmission electron microscopy(HRTEM).The amorphous WSx and Ni9 S8 phase may provide the dual active sites for OER.The electrochemical measurements show that WS_(x)/Ni_(9)S_(8)/NF has superior OER activity with a low overpotential of 320 mV at the current density of 100 mA·cm^(-2),better than those of other samples.The enhanced OER performance may be due to the synergistic catalysis from Ni9 S8 phase and high valence of W.Owing to the stable structure of Ni9 S8,the long-term stability of WS_(x)/Ni_(9)S_(8)/NF for at least 10 h can be obtained.This work may provide a new approach for the doped nickel sulfides crystal phase through high-pressure microwave hydrothermal assistance for OER.展开更多
文摘目的探讨烧伤合并吸入性损伤患者行机械通气第24小时的氧合指数(OI)对患者预后的影响。方法142例烧伤合并吸入性损伤行机械通气患者,根据第24小时的OI值分为A组[OI≤200 mm Hg(1 mm Hg=0.133 kPa),36例]、B组(200 mm Hg<OI≤300 mm Hg,46例)、C组(OI>300 mm Hg,60例)。比较三组一般资料及预后情况;依据预后情况将患者分为预后不良组(86例)与预后良好组(56例)。采用单因素和多因素Logistic回归分析烧伤合并吸入性损伤机械通气患者预后不良的危险因素。结果三组年龄、烧伤总面积(TBSA)、机械通气前氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、血氧饱和度(SaO_(2))及预后情况比较,差异具有统计学意义(P<0.05)。C组年龄(40.07±21.20)岁小于A组的(54.64±17.83)岁和B组的(51.72±17.99)岁(P<0.05);B组TBSA(60.43±29.04)%和C组TBSA(62.89±24.85)%小于A组的(74.14±21.90)%,预后不良率54.3%、48.3%低于A组的88.9%(P<0.05)。机械通气前,A组和B组PaO_(2)水平显著低于C组,PaCO_(2)高于C组(P<0.05);B和C组SaO_(2)高于A组(P<0.05)。三组机械通气开始时间、三度烧伤面积及入院延迟复苏情况比较差异无统计学意义(P>0.05)。预后不良组与预后良好组患者的年龄、TBSA、机械通气后第24小时OI比较差异具有统计学意义(P<0.05);预后不良组与预后良好组患者的机械通气开始时间、机械通气时间及机械通气前PaO_(2)、PaCO_(2)、SaO_(2)比较差异无统计学意义(P>0.05)。将筛选出P<0.05的因素纳入多元Logistic回归分析,排除混杂因素后,结果显示:机械通气后第24小时OI≤200 mm Hg、TBSA大、老年是烧伤合并吸入性损伤行机械通气患者预后不良的独立危险因素(OR=5.551、1.046、10.187,P<0.05)。结论机械通气第24小时OI≤200 mm Hg的烧伤合并吸入性损伤患者预后不良,TBSA越大,机械通气前PaO_(2)及SaO_(2)越低,通气后第24小时的OI可能越低。
基金financially supported by Qingdao Science and Technology Benefiting People Special Project (No. 20-3-4-8-nsh)the Fundamental Research Funds for the Central Universities (No.20CX02212A)the Development Fund of State Key Laboratory of Heavy Oil Processing and China University of Petroleum Training Program of Innovation and Entrepreneurship for Undergraduates (No.201910425018)。
文摘Designing the specific crystal phase with better intrinsic activity and more active sites is a very promising strategy for earth-abundant electrocatalysts for oxygen evolution reaction(OER).Herein,a facile two-step method including the high-pressure microwave and the hydrothermal sulfurization is adopted to prepare the WS_(x)/Ni_(9)S_(8) hetero-catalyst on nickel foam(WS_(x)/Ni_(9)S_(8)/NF).Firstly,WO3 polyhedrons homogeneously cover the surface of NF through the high-pressure microwave hydrothermal process.Secondly,WS_(x)/Ni_(9)S_(8) nanoparticles on the surface of NF can be synthesized after a hydrothermal sulfurization,which has been confirmed by scanning electron microscopy(SEM) elemental mapping and high-resolution transmission electron microscopy(HRTEM).The amorphous WSx and Ni9 S8 phase may provide the dual active sites for OER.The electrochemical measurements show that WS_(x)/Ni_(9)S_(8)/NF has superior OER activity with a low overpotential of 320 mV at the current density of 100 mA·cm^(-2),better than those of other samples.The enhanced OER performance may be due to the synergistic catalysis from Ni9 S8 phase and high valence of W.Owing to the stable structure of Ni9 S8,the long-term stability of WS_(x)/Ni_(9)S_(8)/NF for at least 10 h can be obtained.This work may provide a new approach for the doped nickel sulfides crystal phase through high-pressure microwave hydrothermal assistance for OER.
