Correlation of Inferior Vena Cava Respiratory Variability Index with Central Venous Pressure and Hemodynamic Parameters in Ventilated Pigs with Septic Shock

Septic shock is a common critical condition, for which effective early fluid resuscitation is the therapeutic focus. According to the 2008 international guidelines for management of severe sepsis and septic shock, resuscitation should achieve a central venous pressure （CVP） of 8-12 mmHg within the first 6 h. However, it is still uncertain about the sensitivity and specificity of CVP in reflecting the cardiac preload. Ultrasonography is a simple, rapid, non-invasive, and repeatable method for the measurement of sensitivity and specificity of CVP and has thus gradually attracted the increasing attention of physicians. It was reported that ultrasonography can show the inferior vena cava diameter, respiratory variability index, and blood volume in patients with sepsis or heart failure.

The Relationship between Siberian High Anomaly and SSTA

By using the monthly average dataset of NCEP/NCAR reanalysis and the monthly average ocean temperature data of NOAA satellite center,we analyzed and probed into the relationship between Siberian high anomaly and SSTA,and found that the sea area anomaly is a bigger area,which have greater effect on the variation of Siberian high.The results indicated that there was a wonderful contemporaneously correlation between the area and intensity index of Siberian high and ocean temperature.The correlation type of the synchronous correlative areas between the central intensity index of Siberian high and ocean temperature have structural similarities with the correlative field's structure of area index,but the positive correlative regions expanded,and the intensity of negative correlative regions weakened significantly.The correlation among the area index of Siberian high and the central intensity index,as well as the ocean temperature anomaly of the North Atlantic during spring,autumn and summer of the same year was remarkable.The area index and the central intensity index of Siberian high anomaly have obvious correlation with the ocean temperature anomaly of Southwest Atlantic Ocean during spring,summer and autumn,however,they have apparent seasonal differences with the prominent negative correlative areas of subtropical South Indian Ocean and tropical South Pacific Ocean as well as Southwest Atlantic Ocean.The correlative index of area anomaly is greater than those of intensity anomaly.Larger impact on the variability of Siberian high anomaly are the SSTA of subtropical South Indian Ocean,mid and high latitudes of North Pacific Ocean,North Atlantic,tropical South Pacific Ocean,Southwest Atlantic Ocean,etc.several areas.

基于集聚度和集中指数的广西区域卫生资源配置公平性分析

目的分析“十三五”期间广西区域卫生资源分布情况及配置公平性,为优化广西区域卫生资源配置提供参考。方法综合运用集聚度和集中指数,从人口、地理分布和经济状况评价广西区域卫生资源配置的公平性。结果“十三五”规划收官时,广西各地医疗卫生资源集聚度为0.41~2.47,50%的地区卫生资源集聚度大于1(达到公平区间),卫生资源集聚度与人口集聚度的比值为0.67~1.66,67.86%地区比值小于1(公平性不足),南宁、北海、柳州、桂林等经济发达地区的配置公平性优于百色、贺州、河池、来宾、崇左等经济欠发达地区。2020年末,卫生技术人员、执业(助理)医师、注册护士、实有床位4项指标的集中指数分别为0.134、0.150、0.144、0.082,全区各项指标的集中曲线较2015年均出现不同程度的回升,且都分布于45°标准线下方。“十三五”期间,广西各地卫生资源集聚度及其与人口集聚度的比值分布跨度较大,区域卫生资源配置公平性存在较大差异。从总体上看,卫生资源按地理配置的公平性优于按人口配置的公平性。结论2020年末,广西卫生技术人员、执业(助理)医师、注册护士、实有床位4项资源的集中指数均出现下降,说明4项资源配置的公平性有所提升。人力资源配置公平性仍然欠佳,卫生从业人员不足问题依然突出。广西卫生资源倾向分布于经济水平较好的地区。建议加大欠发达地区的医疗卫生建设支出,因地制宜优化地区卫生资源配置,多管齐下推动卫生人力资源公平发展,以促进广西区域卫生资源合理配置。