Prognostic Role of Preoperative Tricuspid Annular Plane Systolic Excursion (TAPSE) in Mitral Valve Replacement (MVR) for Rheumatic Mitral Stenosis Patients

Tricuspid annular plane systolic excursion has been proposed as a simple and reproducible parameter for quantitative assessment of the right ventricular ejection fraction. The prognostic importance of preoperative TAPSE in patients with mitral valve replacement for rheumatic mitral stenosis patients is still under focused. Therefore, the objective of the study was to predict the outcome after MVR in rheumatic mitral stenosis patients in relation to preoperative TAPSE. This comparative cross-sectional study was conducted at the Department of Cardiac Surgery, National Heart Foundation Hospital and Research Institute. A total of 72 patients of rheumatic mitral stenosis patients who underwent mitral valve replacement were included in the study. They were divided into two groups: Group A and B. Group A included 36 patients with TAPSE 0.05) except for the preoperative TAPSE. Mean TAPSE of Group A was 13.17 (±1.40) and Group B was 18.61 (±1.57), the difference was statistically significant (p 0.05). Among the postoperative complications, including postoperative atrial fibrillation was higher in Group A (30.56%) than Group B (11.11%), mean ventilation time was higher in Group A (27.78%) than Group B (5.56%), length of intensive care was higher in Group A (33.33%) than Group B (11.12%), and hospital stay was higher in Group A (25.0%) than Group B (5.56%), (p < 0.05). Higher preoperative TASPE could be used as a prognostic tool for MVR in rheumatic mitral stenosis patients in our settings.

Effects of glucagon-like peptide-1 receptor agonists on glucose excursion and inflammation in overweight or obese type 2 diabetic patients

BACKGROUND Currently,the lack of comparative studies between weekly and daily formulations of glucagon-like peptide-1 receptor agonists(GLP-1RAs)for glucose excursion is worth investigation.AIM To investigate the effects of weekly and daily formulations of GLP-1RA on glucose excursion and inflammation in overweight and obese patients with type 2 diabetes.METHODS Seventy patients with type 2 diabetes mellitus who were treated at our hospital between January 2019 and January 2022 were enrolled in this retrospective analysis.All patients were treated with metformin.We evaluated changes in blood glucose levels and a series of important indicators in patients before and after treatment with either a weekly or daily preparation of GLP-1RA(group A;n=33 and group B;n=37).RESULTS The degree of decrease in the levels of fasting blood glucose,mean blood glucose,mean amplitude of glycemic excursions,total cholesterol,triglycerides,tumor necrosis factor-α,interleukin-6,and high-sensitivity C-reactive protein after treatment in group A was higher than that in group B(P<0.05),whereas the 2-h postprandial blood glucose levels decreased more so in group B than in group A(P<0.001).However,there were no statistically significant differences in the levels of glycated hemoglobin,standard deviation of blood glucose,coefficient of variation,absolute mean of daily differences,percentage of time with 3.9 mmol/L<glucose<10 mmol/L,and high-and low-density lipoproteins between the two groups(P>0.05).The incidence of adverse reactions was significantly lower in group A than in group B(P<0.05).CONCLUSION The effect of the weekly preparation of GLP-1RA in controlling blood glucose levels in the patients,suppressing inflammation,and reducing adverse reactions was significantly higher than that of the daily preparations,which is worthy of clinical promotion.

The Relationship between Glucose Excursion and Cognitive Function in Aged Type 2 Diabetes Patients

Objective Evidence suggests that type 2 diabetes （T2DM） is associated with an increased risk of dementia and that glucose variability is an independent risk factor for diabetic complications. This study investigated the relationship between glucose excursion and cognitive function in aged T2DM patients. Methods A total of 248 aged T2DM patients wore a continuous glucose monitoring system （CGMS） for 3 days in order to evaluate glucose excursion, including mean amplitude of glycemic excursions （MAGE） and mean of daily difference （MODD）. All subjects were evaluated with a number of accepted cognitive function tests, including the mini-mental status examination （MMSE）. The relationship between MAGE and MODD and performance on these cognitive tests was assessed. Results The MAGE and MMSE score were negatively correlated, likewise with the correlation between MODD and MMSE. Liner multivariate regression analysis showed that MAGE and MODD were also negatively related to MMSE independent of age, sex, glycemic control, hypertension, smoking, or coronary heart disease history. Conclusion Glucose excursion is related to cognitive function in aged T2DM patients. Elevated glucose excursion decreased the MMSE score, which reflects general cognitive function. Thus, therapy aimed at controlling glucose excursion may be beneficial for maintaining cognitive function in aged T2DM patients.

Correlation between the Amplitude of Glucose Excursion and the Oxidative/Antioxidative System in Subjects with Different Types of Glucose Regulation

Objective To investigate effects of glucose excursion on the oxidative/antioxidative system in subjects with different types of glucose regulation. Methods A total of 30 individuals with normal glucose regulation (NGR), 27 subjects with impaired glucose regulation (IGR) and 27 subjects with newly diagnosed type 2 diabetes mellitus (T2DM) were selected and recruited for 3 days’ continuous glucose monitor system (CGMS) assessment. The data from CGMS was used to calculate the mean amplitude of glycemic excursion (MAGE), mean blood glucose (MBG) and its standard deviation (SDBG), area under the ROC curve when the blood glucose 5.6 mmol/L within 24 h (AUC 5.6), mean of daily differences (MODD), and mean postprandial glucose excursion (MPPGE). In all groups, the content or activity of malondialdehyde (MDA), total antioxidation capacity (TAOC) and glutathione peroxidase (GSH‐Px) were detected. Results Glucose excursion parameters of subjects with T2DM or IGR were higher than those of NGR subjects (P0.05 or 0.01). Moreover, Glucose excursion parameters of T2DM subjects were higher than those of IGR subjects (P0.05 or 0.01). Subjects with T2DM or IGR had significant higher MDA levels and lower GSH‐Px/MDA and TAOC/MDA levels compared to NGR subjects (P0.01). T2DM subjects had even higher MDA levels and lower GSH‐Px/MDA levels than IGR (P0.05 or 0.01). According to the median of normal population for MAGE, T2DM and IGR subjects were divided into MAGE2.6mmol/L Group and MAGE≤2.6mmol/L Group. MAGE2.6mmol/L Group had higher levels of MDA and lower levels of GSH‐Px/MDA than MAGE≤2.6mmol/L Group (P0.05). There was no significant difference between the two groups (P0.05) in terms of the levels of TAOC/MDA. Pearson correlation analysis showed that MDA was positively correlated with FPG, 2hPG, MAGE, and SBP. GSH‐Px/MDA was negatively correlated with MAGE and TC. TAOC/MDA was negatively correlated with FPG. Partial correlation analysis showed that the relationship between MDA and MAGE, GSH‐Px/MDA, and MAGE remained significant after adjustments for the other differences among groups. Conclusion Glucose excursion contributed significantly to promoting lipid peroxidation and decreasing antioxidation capacity than chronic sustained hyperglycemia did in the subjects with different types of glucose regulation.

Shuram-Wonoka carbon isotope excursion:Ediacaran revolution in the world ocean's meridional overturning circulation

The late Ediacaran Shuram-Wonoka excursion, with δ^(13)C_(carb) values as low as-12‰(PDB) in marineshelf deposits and spanning up to 10 Myr, is the deepest and most protracted δ^(13)C_(carb) negative anomaly recognised in Earth history. The excursion formed on at least four continents in low(≤32°) palaeolatitudes, and in China is associated with a major phosphogenic event. Global and intrabasinal correlation, magnetostratigraphy, isotope conglomerate tests and further geochemical data are consistent with a primary or syn-depositional origin for the excursion. Continental-margin phosphorites are generated by oceanic upwelling driven by surface winds, and δ^(13)C_(carb) negative anomalies are explicable by oceanic upwelling of 13 C-depleted deep oceanic waters, arguing that a feature common to these exceptional Ediacaran events was unprecedented perturbation of the world ocean. These events occurred during the transition from an alien Proterozoic world marked by low-palaeolatitude glaciation near sea level and strong seasonality to the familiar Phanerozoic Earth with circum-polar glaciation and temperate climate, suggesting that the Shuram-Wonoka excursion is related to this profound change in Earth's climate system. Of various hypotheses for Proterozoic low-palaeolatitude glaciation, only the high obliquity(>54°) hypothesis, which posits secular decrease in obliquity to near the present-day value(23.5°) during the Ediacaran, predicts an unparalleled revolution in the Ediacaran world ocean. The obliquity controls the sense of the world ocean's meridional overturning circulation, which today is driven by the sinking of cold, dense water at the poles and upwelling driven by zonal surface winds.When the decreasing obliquity passed the critical value of 54° during the Ediacaran the meridional temperature gradient reversed, with the equator becoming warmer than the poles and Hadley lowlatitude(<30°-35°) atmospheric zonal circulation reversing. This reversal of the temperature gradient is unique to the Ediacaran Period and caused reversal of the oceanic meridional overturning circulation,with upwelling of anoxic, 13 C-depleted deep oceanic waters producing a deeply negative and protractedδ^(13)C_(carb) signature on late Ediacaran marine-shelf deposits.

Effects of Fuscoporia obliqua on Postprandial Glucose Excursion and Endothelial Dysfunction in Type 2 Diabetic Patients

Postprandial hyperglycemia has been reported to elicit endothelial dysfunction and provoke future cardiovascular complications. A reduction of postprandial blood glucose levels by the glucosidase inhibitor Fuscoporia obliqua was associated with a risk reduction of cardiovascular complications, but the effects of Fuscoporia obliqua on endothelial function have never been elucidated. This study is aimed to assess the efficacy of Fuscoporia obliqua on postprandial metabolic parameters and endothelial function in type 2 diabetic patients. Postprandial peak glucose (14.47±1.27 vs. 8.50±0.53 mmol/liter), plasma glucose excursion (PPGE), and change in the area under the curve (AUC) glucose after a single loading of test meal (total 450 kcal; protein 15.3%; fat 32.3%; carbohydrate 51.4%) were significantly higher in the diet-treated type 2 diabetic patients (n=14) than the age-and sex-matched controls (n=12). The peak forearm blood flow response and total reactive hyperemic flow (flow debt repayment) during reactive hyperemia, indices of resistance artery endothelial function on strain-gauge plethysmography, were unchanged before and after meal loading in the controls. But those of the diabetics were significantly decreased 120 and 240 min after the test meal. A prior administration of Fuscoporia obliqua decreased postprandial peak glucose, PPGE, and AUC glucose. The peak forearm blood flow and flow debt repayment were inversely well correlated with peak glucose, PPGE, and AUC glucose, but not with AUC insulin or the other lipid parameters. Even a single loading of the test meal was shown to impair the endothelial function in type 2 diabetic patients, and the postprandial endothelial dysfunction was improved by a prior use of Fuscoporia obliqua. Fuscoporia obliqua might reduce macrovascular complication by avoiding endothelial injury in postprandial hyperglycemic status.

Probing the Troodos Ophiolite:IGCP-649 Workshop and Field Excursion Held in Agros-Cyprus

The second IGCP-649 Workshop, held in Agros-Cyprus during 14-20 May 2016, brought together nearly fifty international scientists from around the world, and included a 5-day field excursion on the classic Troodos ophiolite. Organized by the IGCP-649 Project Leadership and the Geological Survey Department of Cyprus, the workshop provided a forum for discussions on the latest views and interpretations on the petrogenesis of crustal and upper mantle peridotites in ophiolites, and introduced many young researchers and students to the intemal structure of the classical Troodos ophiolite. This was particularly the case for a large group of Chinese scholars and students, who visited Cyprus and the Troodos ophiolite for the first time. A 4-day profile across the complete ophiolite sequence gave these scientists a first- hand opportunity to examine the lithological and compositional variations within the Cretaceous oceanic crust and to study the igneous and tectonic contacts between them. Lively discussions by the experts and students in front of some of the best 3-dimensional outcrops were most fruitful and allowed all participants to compare the Troodos tectonics with some of ophiolites elsewhere. structure, geochemistry and the other well-documented

Paleomagnetic Excursions Recorded in the Yanchi Playa in Middle Hexi Corridor, NW China Since the Last Interglacial

Paleomagnetic determinations on lithological profiles of two paralleled[( )-275(long )]drilling cores covering the past 130 kyr B.P., GT40 and GT60, from the Yanchi Playa in the arid Northwestern China, indicate that a series of pronounced paleomagnetic excursions have been documented. By correlating our results with published regional and worldwide reports, 4 excursion events out of 10 apparent reversal signals (labeled from GT-1 to GT-10) were identified as excursion events coeval with the Mono Lake Event ([(28.4)( )]kyr~[(25.8)( )]kyr), Laschamp Event ([(43.3)( )]kyr^40.5 kyr), Gaotai Event (82.8 kyr~[(72.4)25( )]kyr) and the Blake Event (127.4 kyr^113.3 kyr), respectively. GT-9 correlates with the above-mentioned Gaotai Event, GT-7 and GT-6 correspond to two stages of the Laschamp Event and GT-5 to the Mono Lake Event. It is noteworthy that the so-called Gaotai Event has not been reported as a pronounced paleomagnetic excursion in the Northwestern China. Every magnetic excursion event corresponds to paleointensity minima, anteceding those established abrupt paleoclimatic change events, such as the Younger Drays and the Heinrich Events (H1-H6)[(. )-250( )]Here,[( )-250( )]we tentatively[( )-250( )]propose that these geomagnetic excursions/reversals can be viewed as precursors to climate abruptness. During the transitional stages when the earths magnetic field shifted between a temporal normal and a negative period, the earths magnetic paleointensity fell correspondingly to a pair of minima. Although more precise chronology and more convincing rock magnetic parameter determinations are essentially required for further interpretation of their intricate coupling mechanism, these results may have revealed, to some extent, that the earths incessantly changing magnetic field exerts an strong influence on the onset of saw-tooth shaped abrupt climate oscillations through certain feedback chains in arid Central Asia or even North Hemispheric high latitude regions.

On the Possibility of Obtaining a High Resolution Relative Paleointensity Record of the Pringle Falls Excursion at the Type Locality of Pringle Falls, Oregon, USA

In order to further understand the full vector excursional details of the geomagnetic field, a paleomagnetic and rock magnetic study of four sites has been conducted at the type locality of Pringle Falls, Oregon where 827 samples were drilled and spaced along a distance of 5 km, for their detailed directional and relative paleointensity studies. The profiles have registered a high-reso- lution (>10 cm/kyr) paleomagnetic record of the excursion (ca. 211+/13 ka) as recorded by diatomaceous lacustrine sediments. Remanence as well as induced magnetization experiments to investigate the reproducibility of the signal throughout the profiles have been conducted. In addition, low-field susceptibility vs. temperature analysis was performed indicating that the main magnetic carrier is pure magnetite (Curie point 575 ℃). The magnetic grain size also has indicated Single Domain-Multi-Domain (SD-MD) magnetite. The demagnetization was done by alternating field (a.f.) experiments, and the mean directions were determined by principal component analyses. In addition, induced magnetic tests were done, such as magnetic susceptibility (x) analyses, saturation IRM, anhysteretic remanent magnetization (ARM70) as well as the normalization of J17.5 mT/ARM70 to attempt to obtain relative paleointensity records of these sediments in question. The results of the induced rock magnetic tests such as the normalization studies indicate a direct correlation between the decrease of the relative paleointensity variations (i.e. lows) with respect to the directional changes. The detailed behavior of the paleosignal is highly consistent, since they are rapidly deposited sediments providing a detailed representation of the paleofield. The dissected VGP paths in 3 different phases are highly internally consistent and are defined by clockwise and anticlockwise loops traveling from the high northern latitudes over eastern North America and the North Atlantic to South America and then to high southern latitudes. They then return to the high northern latitudes through the Pacific and over to Kamchatka. This VGP behavior defines the geomagnetic signature of the Pringle Falls excursion as recorded at the type locality.

Carbon Isotope Excursions and Paleo-Oceanography of the Ordovician–Silurian Boundary Carbonate Rocks from the Xainza Area, Tibet

Objective The Ordovician–Silurian transitional period is a special time when the global paleo-environment changed greatly.It witnessed the first mass extinction as of Phanerozoic period and glaciations that occurred frequently at a large scale in a very short time,which has thus attracted much attention among geoscientists at home and abroad.

Experimental study on the 350 msw simulated heliox saturation-370 msw excursion diving

-The chief purpose of the research was to understand the physiological function change regularity, performance and adaptability of the human body living and working under high pressure for prolonged time.In January 1989, 4 naval divers entered the habital of NMRI's 500 msw saturation diving system after a series of adaptive diving training. The breathing mixture was helium-oxygen. After 55 h compression (including intermediate stages) the 350 msw depth was reached, where the divers lived and worked for 72 h 10 min. No sign of discomfort or significant HPNS was found in the 4 divers.The second and third day of the saturation exposure, the divers carried out 370 msw dry and wet chamber excursion diving 2 man-time each, the divers effectively carried out operational work under water, the total excursion time was 1 h each excursion dive.Saturation decompression started after 3-day storage exposure, the divers were gradually brought toward the surface 25 msw a day on the average by employing the linear steady rate of decompression. During decompression, no case of DCS occurred. Immediate post-dive medical check-ups shows that they were physically normal.More than 120 biomedical indices were monitored and measured on the divers at different period of the experiment. The organisms showed a good adaptability and certain operating capability, and both the compression and decompression profiles were proved to be satisfactory.The detailed experimental data obtained provided sound scientific basis for the practical application of future great depth open sea saturation diving.

The Joint Distribution of the Maximum Excursion and the Minimum Excursion for Brownian Motion with Drift

In this paper, we discuss the problem of extreme value for Brownian motion with positive drift. We obtain the joint distribution of the maximum excursion and the minimum excursion.

On the Possibility of Obtaining Geomagnetic Volcanic Records of the Short-Term Behavior of the Laschamp and Pringle Falls Excursions from the Long Sequence of Kahuku and Ninole Hills, Big Island of Hawaii, USA

The Mauna Loa volcano of the Big Island of Hawaii offers the “ad-hoc” lava flows that have recorded the geomagnetic short-term behavior (i.e. excursions) at two key localities such as the younger Kahuku volcanic series (ca. ~41 ka) where 29 flows are exposed for detailed paleomagnetic sampling making up 102 meters of section where the uppermost flow sampled lies directly under the Pahala ash. The second sampling site is the Ninole volcanic series where 25 flows spanning 56 meters of section were also sampled from the northeast and southwest sides of the Kilohana Ridge. The most recent age estimate indicates that the Kahuku flows can correlate well with the transitional/excursional directional results obtained from both volcanic and deep-sea sediments of the global record of the Laschamp (ca. ~41 ka calendar years B.P) excursion and the Ninole flows which are associated to the also global Pringle Fall excursion (ca. 211 ± 13 ka) recorded at the type section.

Analysis on blood glucose excursions in well-controlled patients with type 2 diabetes mellitus

Objective:To probe glycemic excursions in type 2 diabetic patients whose hemoglobin A1c(HbA1c) was kept ≤6.0%.Methods:Totally 36 cases with type 2 diabetes(T2DM) with HbA1c≤6.0% and 30 cases with normal glucose tolerance(NGT) from December 2005 to December 2007 in our department were subjected prospectively.Continuous glucose monitoring system(CGMS) was employed to record their continuous blood glucose level for 3 d.The blood glucose profiles including the mean blood glucose(MBG),standard differentiation(SD),mean amplitude of glycemic excursions(MAGE) and absolute means of daily differences(MODD) were analyzed.Results:T2DM group had obviously postprandial hyperglycemia,in about 2 h after meal,especially after breakfast.Fifty-two hypoglycemic episodes occurred during the monitoring period in T2DM groups,of which 73.1%(38 episodes) were absence of symptomatic hypoglycemia with the lowest value of blood glucose only 2.0 mmol/L.And 20 episodes took place during the day hours,while 32 episodes observed during the night hours.Compared with NGT groups,SD,MAGE and MODD were all significantly higher in T2DM groups.MBG was significantly correlated with HbA1c in T2DM groups,but SD,MAGE,NGE and MODD were all independent of HbA1c.MAGE was independent of MODD.Conclusion:The amplitude of glycemic excursions is higher in normol-controlled T2DM groups than the NGT groups.Thus ideally glycemic control is not only to make HbA1c reach standard,but also to lessen glycemic excursions and reduce hypoglycemia episodes.

Excursions to 60 and 80 MSW with Heliox from Saturation at 25 MSW

Vertical excursions allow divers in seafloor habitats to work at depths deeper than thehabitat.Descending excursions from saturation in nitrox have almost all used air as the breathing gas;depth is effectively restricted to less than 60 msw by narcosis and oxygenexposure.The objective is to investigate use of helium mixtures for excursions, taking

A COMPUTATIONAL METHOD FOR FIRST-EXCURSION RELIABILITY

An efficient computational method is suggested for the first-excursion reliability assessment of nonstationary process. In the proposed method, the nonlinear performance function is Linearized at the Hasofer-Lind point obtained by an iterative algorithm. The problem of the nonstationary processes is solved by the discrete-time method, in which the precision can be controlled by choosing the steps of discretization. The derived formulae can be conveniently degraded to calculate both the first-excursion reliability with linear performance function of stationary processes and the time-independent reliability. The suggested method is useful for the analysis of components and systems with nonstationary responses in structural design where some uncertainties are represented by a vector of nonstationary processes. Examples are given to demonstrate the fast convergency and effectiveness of the presented method.

飞机雷雨情景着陆冲偏出跑道的贝叶斯网络风险分析

为解决飞机雷雨情景下着陆冲偏出跑道风险因素之间关系不清且量化程度不足的问题,提出一种融合文本挖掘与贝叶斯网络的飞机雷雨情景着陆冲偏出跑道风险量化分析模型。首先,通过136起事故报告建立语料库,构建潜在狄利克雷分配(Latent Dirichlet Allocation,LDA)模型并对文本进行挖掘以提取关键词,进而形成包含3个一级指标和26个二级指标的风险分析指标体系;其次,采用因果效应公式确定节点优先次序,并运用K2算法和期望最大(Expectation Maximization Algorithm,EM)算法分别学习贝叶斯网络的结构和参数;最后,使用贝叶斯网络模型对飞机冲偏出跑道事故数据进行算例分析,计算风险因素的发生概率并分析事故与风险因素间的灵敏度。研究结果显示:飞机在雷雨情景下着陆时更倾向于由跑道末端冲出跑道;导致飞机冲出跑道的主要风险因素为道面积水、飞机空中平飘过长以及进场过高;导致飞机偏出跑道的主要原因为跑道过窄及滑跑方向偏离。研究表明了贝叶斯网络(Bayesian Network,BN)模型用于飞行事故风险因素分析的可行性,为飞机在雷雨天气下的运行管理、风险处置策略提供了重要参考。

利拉鲁肽、双歧杆菌三联活菌胶囊用于胰岛素+口服药疗效不佳的肥胖2型糖尿病患者的疗效观察

目的:基于血糖漂移、脂肪细胞炎症反应、磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(Akt)通路,探讨利拉鲁肽+双歧杆菌三联活菌胶囊用于胰岛素+口服药疗效不佳的肥胖2型糖尿病(T2DM)患者的效果与机制。方法:前瞻性选取2022年6月至2023年6月该院收治的胰岛素+口服药疗效不佳的肥胖T2DM患者980例,采用单盲法,以随机数字表法分为利拉鲁肽组、联合组,各490例。两组患者均给予胰岛素+口服药;在此基础上,利拉鲁肽组患者给予利拉鲁肽,联合组患者给予利拉鲁肽+双歧杆菌三联活菌胶囊。比较两组患者的空腹血糖、餐后2 h血糖(2 hBG)、糖化血红蛋白(HbA1c)、体重指数(BMI)、胰岛素抵抗指数(HOMA-IR)、C肽、血糖漂移、平均血糖波动幅度(MAGE)、血糖曲线下面积(AUCPG)、脂肪细胞炎症反应指标[分泌型卷曲相关蛋白5(sfrp5)、内脂素(Visfatin)、趋化素(Chemerin)、肿瘤坏死因子α(TNF-α)和白细胞介素6(IL-6)]、PI3K/Akt通路[磷酸化PI3K(P-PI3K)、磷酸化Akt(P-Akt)和核因子κB(NF-κB)]及安全性。结果:治疗4、12周后,联合组患者空腹血糖、2 hBG和HbA1c水平低于利拉鲁肽组,BMI、HOMA-IR低于利拉鲁肽组,C肽水平高于利拉鲁肽组,血糖漂移系数、血糖漂移最大幅度、MAGE和AUCPG>7.8 mmol/L低于利拉鲁肽组,sfrp5水平高于利拉鲁肽组,Visfatin、Chemerin、TNF-α和IL-6水平低于利拉鲁肽组,P-PI3K、P-Akt水平高于利拉鲁肽组,NF-κB水平低于利拉鲁肽组,上述差异均有统计学意义(P<0.05)。利拉鲁肽组患者的不良反应发生率为1.22%(6/490),与联合组的0.61%(3/490)相比,差异无统计学意义(P>0.05)。结论:利拉鲁肽+双歧杆菌三联活菌胶囊用于胰岛素+口服药疗效不佳的肥胖T2DM患者,能发挥降糖和减重双重作用,改善患者血糖漂移、胰岛素抵抗和胰岛β细胞功能,抑制脂肪细胞炎症反应,调控PI3K/Akt通路,安全可靠,或可作为胰岛素+口服药疗效不佳的肥胖T2DM患者的一个治疗选择。

冲偏出跑道事件风险影响指标分析

目前对冲偏出跑道风险的研究多基于事故统计数据,较少从飞行数据及飞行操作特征的角度进行分析。基于飞行数据,对冲偏出跑道事件开展风险分析,将飞行数据分为飞行状态、操作指令、信息3类,以此研究飞机在起飞滑跑、着陆、着陆滑跑3个阶段的状况及风险影响指标;通过数据所反映的操作特征,结合标准操作程序,推导出飞机偏离正常数据、与标准操作不相符的操作,得到影响正常飞行的风险因素;基于行为安全2-4模型,建立冲偏出跑道风险评价指标体系,对实际案例的事故致因机理进行研究,着重分析操作特征及人为因素,并提出冲偏出跑道风险防控措施。结果表明:从操作类、数据类以及环境类3个维度建立风险影响指标体系,可以降低指标因素对冲偏出跑道事件的影响;从人、机、环、管方面提出改进措施,可有效降低冲偏出跑道事件发生的概率。

右心室收缩功能对急性前壁ST段抬高型心肌梗死的预后价值

目的:本研究探讨右心室收缩功能障碍(right ventricular systolic dysfunction,RVSD)对接受PCI治疗急性前壁ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者预后的影响。方法:本研究纳入了356例经PCI治疗的急性前壁STEMI患者。根据出院前超声心动图检查结果,将三尖瓣环平面收缩期位移(tricuspid annular plane systolic displacement,TAPSE)<17mm或三尖瓣环收缩期峰值速度(tricuspid annular peak systolic velocity,TAPSV)<9.5cm/s定义为RVSD,并将患者分为RVSD组和非RVSD组。比较两组2年随访期间临床事件发生情况,并采用Cox回归模型分析影响患者预后的因素。结果:两组患者在临床特征以及冠状动脉造影和介入治疗特征方面组间对比,差异无统计学意义(P均>0.05)。偏相关分析可知,LVEF与TAPSE呈显著正相关(r=0.132,P=0.012),与TAPSV呈显著正相关(r=0.121,P=0.023)。在2年临床随访期间,预期心力衰竭发生率(Log-rank P=0.015)和全因死亡率(Log-rank P=0.015),差异存在统计学意义。RVSD组和非RVSD组,术后2年预期无主要不良心脏事件(major adverse cardiac events,MACE)累积生存率分别为79.2%和84.1%(Log-rank P=0.041)。多因素Cox回归分析显示,TAPSE(HR=0.456;95%CI:0.223~0.931;P=0.031)为预测2年MACE发生的独立因素。结论:在经PCI治疗的急性前壁STEMI患者中,伴有RVSD的患者MACE发生率明显升高,2年预期无MACE事件累积生存率明显低于不伴RVSD的患者。