Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

BACKGROUND Cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum TBIL levels are decreased andγ-GGT levels are increased in T2DM+ACS patients,and the two indices are significantly negatively correlated.TBIL andγ-GGT are independent influencing factors for MACEs in such patients.

A Survey on Type-3 Fuzzy Logic Systems and Their Control Applications

In this paper,we offer a review of type-3 fuzzy logic systems and their applications in control.The main objective of this work is to observe and analyze in detail the applications in the control area using type-3 fuzzy logic systems.In this case,we review their most important applications in control and other related topics with type-3 fuzzy systems.Intelligent algorithms have been receiving increasing attention in control and for this reason a review in this area is important.This paper reviews the main applications that make use of Intelligent Computing methods.Specifically,type-3 fuzzy logic systems.The aim of this research is to be able to appreciate,in detail,the applications in control systems and to point out the scientific trends in the use of Intelligent Computing techniques.This is done with the construction and visualization of bibliometric networks,developed with VosViewer Software,which it is a free Java-based program,mainly intended to be used for analyzing and visualizing bibliometric networks.With this tool,we can create maps of publications,authors,or journals based on a co-citation network or construct maps of keywords,countries based on a co-occurrence networks,research groups,etc.

Heterogeneously elevated branched-chain/aromatic amino acids among new-onset type-2 diabetes mellitus patients are potentially skewed diabetes predictors

BACKGROUND The lack of specific predictors for type-2 diabetes mellitus(T2DM)severely impacts early intervention/prevention efforts.Elevated branched-chain amino acids(BCAAs:Isoleucine,leucine,valine)and aromatic amino acids(AAAs:Tyrosine,tryptophan,phenylalanine)show high sensitivity and specificity in predicting diabetes in animals and predict T2DM 10-19 years before T2DM onset in clinical studies.However,improvement is needed to support its clinical utility.AIM To evaluate the effects of body mass index(BMI)and sex on BCAAs/AAAs in new-onset T2DM individuals with varying body weight.METHODS Ninety-seven new-onset T2DM patients(<12 mo)differing in BMI[normal weight(NW),n=33,BMI=22.23±1.60;overweight,n=42,BMI=25.9±1.07;obesity(OB),n=22,BMI=31.23±2.31]from the First People’s Hospital of Yunnan Province,Kunming,China,were studied.One-way and 2-way ANOVAs were conducted to determine the effects of BMI and sex on BCAAs/AAAs.RESULTS Fasting serum AAAs,BCAAs,glutamate,and alanine were greater and high-density lipoprotein(HDL)was lower(P<0.05,each)in OB-T2DM patients than in NW-T2DM patients,especially in male OB-T2DM patients.Arginine,histidine,leucine,methionine,and lysine were greater in male patients than in female patients.Moreover,histidine,alanine,glutamate,lysine,valine,methionine,leucine,isoleucine,tyrosine,phenylalanine,and tryptophan were significantly correlated with abdominal adiposity,body weight and BMI,whereas isoleucine,leucine and phenylalanine were negatively correlated with HDL.CONCLUSION Heterogeneously elevated amino acids,especially BCAAs/AAAs,across new-onset T2DM patients in differing BMI categories revealed a potentially skewed prediction of T2DM development.The higher BCAA/AAA levels in obese T2DM patients would support T2DM prediction in obese individuals,whereas the lower levels of BCAAs/AAAs in NW-T2DM individuals may underestimate T2DM risk in NW individuals.This potentially skewed T2DM prediction should be considered when BCAAs/AAAs are to be used as the T2DM predictor.

Interplay of serum biomarkers bilirubin andγ-glutamyltranspeptidase in predicting cardiovascular complications in type-2 diabetes mellitus

This editorial synthesizes insights from a series of studies examining the interplay between metabolic and oxidative stress biomarkers in cardiovascular disease(CVD),focusing particularly on type-2 diabetes mellitus(T2DM)and acute coronary syndrome(ACS).The central piece of this synthesis is a study that investigates the balance between oxidative stress and antioxidant systems in the body through the analysis of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)levels in T2DM patients with ACS.This study highlights serum bilirubin as a protective antioxidant factor,while elevatedγ-GGT levels indicate increased oxidative stress and correlate with major adverse cardiovascular events.Complementary to this,other research contributions revealγ-GGT’s role as a risk factor in ACS,its association with cardiovascular mortality in broader populations,and its link to metabolic syndrome,further elucidating the metabolic dysregulation in CVDs.The collective findings from these studies underscore the critical roles ofγ-GGT and serum bilirubin in cardiovascular health,especially in the context of T2DM and ACS.By providing a balanced view of the body’s oxidative and antioxidative mechanisms,these insights suggest potential pathways for targeted interventions and improved prognostic assessments in patients with T2DM and ACS.This synthesis not only corroborates the pivotal role ofγ-GGT in cardiovascular pathology but also introduces the protective potential of antioxidants like bilirubin,illuminating the complex interplay between T2DM and heart disease.These studies collectively underscore the critical roles of serum bilirubin andγ-GGT as biomarkers in cardiovascular health,particularly in T2DM and ACS contexts,offering insights into the body’s oxidative and antioxidative mechanisms.This synthesis of research supports the potential of these biomarkers in guiding therapeutic strategies and improving prognostic assessments for patients with T2DM and some CVD.

A Non-Singleton Type-3 Fuzzy Modeling: Optimized by Square-Root Cubature Kalman Filter

In many problems,to analyze the process/metabolism behavior,a mod-el of the system is identified.The main gap is the weakness of current methods vs.noisy environments.The primary objective of this study is to present a more robust method against uncertainties.This paper proposes a new deep learning scheme for modeling and identification applications.The suggested approach is based on non-singleton type-3 fuzzy logic systems(NT3-FLSs)that can support measurement errors and high-level uncertainties.Besides the rule optimization,the antecedent parameters and the level of secondary memberships are also adjusted by the suggested square root cubature Kalmanfilter(SCKF).In the learn-ing algorithm,the presented NT3-FLSs are deeply learned,and their nonlinear structure is preserved.The designed scheme is applied for modeling carbon cap-ture and sequestration problem using real-world data sets.Through various ana-lyses and comparisons,the better efficiency of the proposed fuzzy modeling scheme is verified.The main advantages of the suggested approach include better resistance against uncertainties,deep learning,and good convergence.

基于病因和国际骨微循环研究协会分期的股骨头坏死患者骨代谢水平研究

背景:目前缺乏大样本研究对不同病因、分期的股骨头坏死患者的骨代谢水平进行分析,这不利于制定更优的促坏死修复策略。目的:研究不同病因、国际骨微循环研究协会(ARCO)分期股骨头坏死患者的骨代谢水平。方法:回顾性纳入股骨头坏死的患者401例作为试验组,81例健康体检者作为对照组。试验组按照病因不同分为激素性股骨头坏死、酒精性股骨头坏死和创伤性股骨头坏死3组,并按ARCO分期的不同分为Ⅱ期/Ⅲ期/Ⅳ期。收集所有受试者的7项骨代谢相关指标,包括骨代谢调控激素25-羟基维生素D,骨转换标志物Ⅰ型前胶原N末端前肽、β-胶原降解产物、骨钙素N端中分子片段,骨代谢一般生化标记血清Ca、P、碱性磷酸酶。比较各组受试者的骨代谢水平,并应用二元Logistic回归分析与股骨头坏死发病相关的独立因素。结果与结论:①与对照组比较,试验组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段、血清P、碱性磷酸酶水平均显著升高(均P<0.05);②以是否发病为结局,应用二元Logistic回归分析得出β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段是与股骨头坏死发病相关的独立因素;③不同病因3组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽水平均高于正常参考值;酒精性股骨头坏死组患者的25-羟基维生素D、血清Ca水平均高于其他2组(P<0.05);激素性股骨头坏死、创伤性股骨头坏死组患者的25-羟基维生素D水平均低于正常值;④ARCOⅡ、Ⅲ、Ⅳ期股骨头坏死患者的7项骨代谢指标水平比较差异均无显著性意义(均P>0.05),但3组患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽均高于正常参考值;ARCOⅡ期、Ⅳ期患者的25-羟基维生素D低于正常参考值;⑤结论:股骨头坏死患者的骨代谢水平异常,不同病因、ARCO分期的股骨头坏死患者的β-胶原降解产物、Ⅰ型前胶原N末端前肽均高于正常参考值,处于高骨转换状态;β-胶原降解产物、Ⅰ型前胶原N末端前肽、骨钙素N端中分子片段可能是股骨头坏死发病的危险因素。

25-Hydroxyvitamin D Is Associated with Islet Homeostasis in Type-2 Diabetic Patients with Abdominal Obesity

Objective Isletαcells input is essential for insulin secretion fromβcells.The present study aims to investigate the association between 25-hydroxyvitamin D[25(OH)D]and islet function homeostasis in type-2 diabetes(T2D)patients.Methods A total of 4670 T2D patients from seven communities in Shanghai,China were enrolled.The anthropometric indices,biochemical parameters,serum 25(OH)D,and islet function[including C-peptide(C-p)and glucagon]were measured.Results The fasting plasma glucose(FPG),glycated hemoglobin(HbA1c),glucagon,and C-p levels exhibited a significantly decreasing trend in T2D patients as the 25(OH)D levels increased.Next,the population was divided into two groups:abdominal obesity and non-abdominal obesity groups.After adjustment,the 25(OH)D level was found to be associated with HbA1c,glucagon,and homeostasis model assessment ofβ(HOMA-β)in the non-abdominal obesity group.There was a significant relationship between 25(OH)D and HbA1c,glucagon,HOMA-IR,baseline insulin or C-p in the abdominal obesity group.In the abdominal obesity group,the ordinary least squares(OLS)regression and quantile regression revealed that 25(OH)D was obviously associated with glucagon and fasting C-p levels.In the abdominal obesity group,the moderate analysis revealed a significant interaction effect of 25(OH)D and glucagon on C-p(P=0.0124).Furthermore,the conditional indirect effect of 25(OH)D on the glucagon/C-p ratio was significantly lower at 1 standard deviation(SD)below the mean(P=0.0002),and lower at the mean of the course of diabetes(P=0.0007).Conclusion 25(OH)D was found to be negatively correlated to glucagon and C-p in T2D patients with abdominal obesity.The 25(OH)D influenced C-p in part by influencing glucagon.The effect of 25(OH)D on the glucagon/C-p ratio in T2D patients with abdominal obesity,in terms of islet homeostasis,is influenced by the course of diabetes.

Type-2 Neutrosophic Set and Their Applications in Medical Databases Deadlock Resolution

Electronic patient data gives many advantages,but also new difficulties.Deadlocks may delay procedures like acquiring patient information.Distributed deadlock resolution solutions introduce uncertainty due to inaccurate transaction properties.Soft computing-based solutions have been developed to solve this challenge.In a single framework,ambiguous,vague,incomplete,and inconsistent transaction attribute information has received minimal attention.The work presented in this paper employed type-2 neutrosophic logic,an extension of type-1 neutrosophic logic,to handle uncertainty in real-time deadlock-resolving systems.The proposed method is structured to reflect multiple types of knowledge and relations among transactions’features that include validation factor degree,slackness degree,degree of deadline-missed transaction based on the degree of membership of truthiness,degree ofmembership of indeterminacy,and degree ofmembership of falsity.Here,the footprint of uncertainty(FOU)for truth,indeterminacy,and falsity represents the level of uncertainty that exists in the value of a grade of membership.We employed a distributed real-time transaction processing simulator(DRTTPS)to conduct the simulations and conducted experiments using the benchmark Pima Indians diabetes dataset(PIDD).As the results showed,there is an increase in detection rate and a large drop in rollback rate when this new strategy is used.The performance of Type-2 neutrosophicbased resolution is better than the Type-1 neutrosophic-based approach on the execution ratio scale.The improvement rate has reached 10%to 20%,depending on the number of arrived transactions.

细聚丙烯纤维混凝土介观离散力学模型及其Ⅰ型断裂强度负效应机理

细聚丙烯(PP,直径小于100μm)纤维混凝土Ⅰ型断裂强度随纤维含量增加呈现先增后减的变化规律,其机理尚不明晰。而且由于纤维数量过多,现有数值方法无法精细刻画细纤维混凝土力学行为。对此通过考虑细PP纤维亲水性提升基体局部水灰比的强度正效应和纤维桥接力强度贡献低于砂浆的强度负效应,并引入纤维直径等效系数(rf),实现介观尺度细聚丙烯纤维混凝土(PFRC)力学行为模拟。研究表明:纤维直径等效系数(rf)建议小于10;当纤维微量添加时,细PP纤维提升基体局部水灰比,使基体强度上升,此时正效应高于负效应;随着纤维含量增加,由于纤维桥接力贡献无法补偿相应面积基体强度,负效应持续增长,PFRC宏观Ⅰ型断裂强度下降。

铁死亡诱导剂RAS合成致死分子3抑制病理性瘢痕成纤维细胞的纤维化

背景:病理性瘢痕主要表现为异常的细胞外基质积累和过度的成纤维细胞增殖,成纤维细胞过度增殖就会产生大量以胶原纤维为主的细胞外基质。因此深入探讨成纤维细胞纤维化在病理性瘢痕形成中的作用,将为揭示病理性瘢痕的机制和生物学治疗提供新思路。目的:探讨铁死亡诱导剂RAS合成致死分子3(RAS-selective lethal small molecule 3,RSL3)对人病理性瘢痕成纤维细胞纤维化的影响。方法:收集10例宁夏医科大学总医院烧伤整形美容科提供的病理性瘢痕组织和同一个体正常皮肤组织,提取人病理性瘢痕成纤维细胞和人正常皮肤成纤维细胞用于后续实验;苏木精-伊红染色观察病理性瘢痕组织和正常皮肤组织的形态;倒置显微镜观察病理性瘢痕成纤维细胞和正常皮肤成纤维细胞的外观形态;免疫荧光实验验证所提取的细胞是否为成纤维细胞;用不同浓度的RSL3(1,3,5,7,9,11,13μmol/L)干预细胞,CCK-8法检测RSL3作用于成纤维细胞的半数抑制浓度(IC_(50));设置对照组(不做处理)和RSL3干预组(用7μmol/L的RSL3干预细胞24 h),qRT-PCR和Western blot检测谷胱甘肽过氧化物酶4、Ⅰ型胶原蛋白、Ⅲ型胶原蛋白和α-平滑肌肌动蛋白的mRNA和蛋白的表达;检测细胞丙二醛浓度;划痕试验检测细胞划痕后24 h剩余划痕面积,并计算剩余划痕面积百分比。结果与结论:①与正常皮肤组相比,病理性瘢痕组的谷胱甘肽过氧化物酶4高表达(mRNA:t=3.252,P<0.01;蛋白:t=5.075,P<0.01);②与正常皮肤成纤维细胞组相比,病理性瘢痕成纤维细胞组的谷胱甘肽过氧化物酶4高表达(mRNA:t=10.32,P<0.01;蛋白:t=26.22,P<0.01);③与对照组相比,RSL3干预组谷胱甘肽过氧化物酶4表达减少(mRNA:t=2.798,P<0.05;蛋白:t=4.643,P<0.01),丙二醛浓度上升(t=2.917,P<0.05),Ⅰ型胶原蛋白(mRNA:t=15.84,P<0.01;蛋白:t=4.610,P<0.01)、Ⅲ型胶原蛋白(mRNA:t=28.86,P<0.01;蛋白:t=7.713,P<0.01)和α-平滑肌肌动蛋白(mRNA:t=2.671,P<0.05;蛋白:t=7.417,P<0.01)的表达减少,迁移能力减弱(t=14.06,P<0.01);④提示RSL3通过抑制谷胱甘肽过氧化物酶4的表达,进而抑制病理性瘢痕成纤维细胞的纤维化和迁移能力。

海温异常对长江流域夏季典型旱涝的影响研究

为研究长江流域夏季旱涝特征及其与海温异常之间的关联性,基于中国326个气象站降水量、NCEP/NCAR再分析资料等,采用合成分析、EOF分解等方法,分析了长江流域夏季典型旱涝年的降水分布、同期大气环流及前期海温特征,并以2018年为例,初步揭示了2018年前期海温异常对大气环流的可能影响。结果表明:①长江流域夏季典型旱年,仅嘉陵江和岷沱江会表现出局部偏涝,全国为典型的Ⅰ类雨型,多雨区位于黄河流域及以北地区。前期冬季赤道太平洋表现出类拉尼娜的东冷西暖分布,同时黑潮区海温偏低,西风漂流区海温偏暖。受多海域协同作用,同期欧亚环流场上自西北向东南呈现出“+-+”三极型分布,东亚地区为自北向南“-+-”的EAP负位相。长江流域典型涝年,全国多为典型的Ⅱ类和Ⅲ类雨型,环流及海温呈现出相反特征。②2018年为典型的长江中下游偏旱年,仅在岷沱江降水偏多近3成,为历史第4多,与长江流域夏季降水的主模态正位相类似,解释方差达24%。③2018年前冬出现弱拉尼娜、春末夏初西风漂流区异常偏暖、NAT异常正位相,三者共同作用,使得东亚副热带西风急流偏北,东亚沿岸出现EAP负位相,大陆热低压明显偏强,东亚夏季风为1961年以来最强,同时副高脊线最北,造成夏季降水主雨带北推至华北、西北地区,岷沱江、嘉陵江异常多,而长江中下游异常少,为典型的Ⅰ类雨型。研究成果可为长江流域旱涝预测、水资源调度提供参考。

Interval Type-2 Fuzzy Model for Intelligent Fire Intensity Detection Algorithm with Decision Making in Low-Power Devices

Local markets in East Africa have been destroyed by raging fires,leading to the loss of life and property in the nearby communities.Electrical circuits,arson,and neglected charcoal stoves are the major causes of these fires.Previous methods,i.e.,satellites,are expensive to maintain and cause unnecessary delays.Also,unit-smoke detectors are highly prone to false alerts.In this paper,an Interval Type-2 TSK fuzzy model for an intelligent lightweight fire intensity detection algorithm with decision-making in low-power devices is proposed using a sparse inference rules approach.A free open–source MATLAB/Simulink fuzzy toolbox integrated into MATLAB 2018a is used to investigate the performance of the Interval Type-2 fuzzy model.Two crisp input parameters,namely:FIT and FIG��are used.Results show that the Interval Type-2 model achieved an accuracy value of FIO�=98.2%,MAE=1.3010,MSE=1.6938 and RMSE=1.3015 using regression analysis.The study shall assist the firefighting personnel in fully understanding and mitigating the current level of fire danger.As a result,the proposed solution can be fully implemented in low-cost,low-power fire detection systems to monitor the state of fire with improved accuracy and reduced false alerts.Through informed decision-making in low-cost fire detection devices,early warning notifications can be provided to aid in the rapid evacuation of people,thereby improving fire safety surveillance,management,and protection for the market community.

Ⅰ型倍增层对异质SAM结构InSb-APD红外探测器性能的影响

红外探测器的光电特性会受到内部结构倍增层参数的影响,为了能够改善器件的雪崩效应,借助仿真软件Silvaco-TCAD,详细探讨了Ⅰ型倍增层的残余掺杂浓度和厚度对异质SAM结构InSb-APD红外探测器性能的影响。研究结果表明,随着Ⅰ型倍增层掺杂浓度的增加,其倍增层内的电场强度峰值增加,同时光响应度略微增加;随着Ⅰ型倍增层厚度的增加,其倍增层的光响应度与暗电流密度升高,同时电场强度峰值减少。进一步研究表明,当Ⅰ型倍增层残余掺杂浓度和厚度分别为1×10^(15)cm^(−3)和3μm时,有利于雪崩过程。

广义定时截尾下Lomax分布的统计推断及剩余寿命预测

在定时截尾试验方案的基础上提出了一种新的截尾试验方案,即广义定时截尾。在广义定时截尾样本下,研究了两参数Lomax分布形状参数和可靠度的极大似然估计。把形状参数的先验分布取为Gamma分布,在三类损失函数下求出了形状参数及可靠度的Bayes估计。分别用经典方法和Bayes方法对元件的剩余使用寿命进行预测,包括点预测和区间预测。对Lomax型元件组成的串联和并联系统的可靠度函数进行估计。通过蒙特卡洛模拟对经典方法和Bayes方法的估计精度进行比较,从均方误差来看,Bayes估计要优于极大似然估计。最后对一个数值例子进行了分析,得出了相关结果。

双定时混合截尾下Lomax部件的可靠性分析

在双定时混合截尾数据下,利用极大似然法得到Lomax分布的未知参数、可靠度函数和危险函数的极大似然估计.基于连续型和离散型的混合先验分布在三类损失函数下得到了模型参数、可靠度及危险函数的Bayes估计.分别利用经典方法和Bayes方法得到了被截尾样品未来失效时刻的预测值和预测区间.利用极大似然法对先验分布中的超参数进行了估计,并证明了估计值的唯一性.为了考察估计量的性质,用蒙特卡洛模拟计算出了均方误差,结果表明Bayes估计优于极大似然估计.通过对一个数值例子进行分析,得出了未知参数及可靠性指标的估计.

双边定时截尾下Pareto分布的参数的极大似然估计的EM算法

给出了当寿命分布为Pareto分布时,双边定时截尾寿命试验下形状参数的极大似然估计。由于似然方程形式较复杂,无法得到参数的显式表达式。但可证明此极大似然估计是唯一存在的,并利用EM算法求出了此参数的一种估计。

骨质疏松症患者PINP、25-(OH)VitD_(3)、BMP-2与中医辨证分型的相关性研究

目的:分析骨质疏松症患者血清总I型胶原氨基末端前肽(PINP)、25-羟维生素D3[25-(OH)VitD_(3)]及骨形态发生蛋白2(BMP-2)与其中医辨证分型的相关性。方法:收集我院2020年8月~2023年8月医院收治的157例骨质疏松症患者的一般资料及中医四诊资料进行回顾性分析,并统计骨质疏松症患者中医辨证分型结果,对不同症型患者基本资料、PINP、25-(OH)VitD_(3)、BMP-2水平进行比较。结果:157例骨质疏松症患者中医辨证分型属肾阳虚证34例,脾肾阳虚证43例,肝肾阴虚证49例,血瘀气滞证31例。不同中医辨证分型的骨质疏松患者血清PINP、25-(OH)VitD_(3)及BMP-2水平整体相比,差异有统计学意义(P<0.05);其中,血瘀气滞组PINP水平显著高于肾阳虚组、脾肾阳虚组及肝肾阴虚组患者(P<0.05),而其余3组两两间相比,差异无统计学意义(P>0.05);脾肾阳虚证患者25-(OH)VitD_(3)水平明显低于肾阳虚组、肝肾阴虚组及血瘀气滞组(P<0.05),且肾阳虚组低于肝肾阴虚组及血瘀气滞组(P<0.05),而其余两组相比差异无统计学意义(P>0.05);血瘀气滞组BMP-2水平显著低于肾阳虚组、脾肾阳虚组及肝肾阴虚组患者(P<0.05),而其余3组两两间相比,差异无统计学意义(P>0.05);二分类logistics回归分析结果显示,血瘀气滞与PINP呈正相关(P<0.05),与BMP-2呈负相关(P<0.05);脾肾阳虚与25-(OH)VitD_(3)呈负相关(P<0.05)。结论:骨质疏松症患者的血清PINP、25-(OH)VitD_(3)、BMP-2水平与其中医辨证分型具有一定相关性,可作为评估患者中医辨证分型的参考指标。

内蒙古锡林浩特小乌兰沟地区晚石炭世二长花岗岩年代学、地球化学特征及其地质意义

笔者以锡林浩特小乌兰沟地区发育的晚石炭世二长花岗岩为研究对象,开展了岩石学、锆石U-Pb同位素年代学、岩石地球化学等研究,讨论其构造环境,为进一步研究古亚洲洋闭合时限提供新的依据。LA-ICP-MS锆石同位素U-Pb测年结果显示,该花岗岩的侵位年龄为(319.5±1.2)Ma,相当于晚石炭世。岩石地球化学研究表明,该岩石具有高Si、富K、贫Mg、贫Ca、低P和Ti的特征,属于高钾钙碱性、过铝质系列岩石;岩石富含大离子亲石元素Rb和高场强元素Th、Ta、Hf,亏损Sr、Ba、Nb;稀土元素以略富集轻稀土、Eu亏损为特征。地球化学特征反映其为I型花岗岩,来源于下地壳的部分熔融。构造环境判别图解显示该岩体形成于活动大陆边缘环境,表明研究区在晚石炭世期间仍存在洋壳的俯冲作用,暗示古亚洲洋此时尚未闭合。

基于短期观测记录的重现期风速预测

在偏僻地区或山区建设重要建筑物、构筑物或桥梁时,通常在附近安装风速观测仪器,获得至少1年的短期风速记录。提出了根据短期风速记录预测指定重现期风速极值及风压方法,为结构抗风设计提供了科学依据。提出独立风暴法提取短期风速记录的最大值,建立极值I型概率分布模型,采用最好线性无偏估计方法确定概率分布参数。依据短期风速最大值概率与年风速最大值概率的变换关系,建立年发生最大值的概率分布及重现期风速、风压的表达式。算例结果表明,重现期风速预测值的离散性与风速阈值有关,在预测值离散系数较小的情况下可确定重现期风速及其置信区间。

临床药师干预对Ⅰ类切口围术期预防用抗生素使用情况的影响分析

目的:分析临床药师干预对Ⅰ类切口围术期预防用抗生素使用情况的影响。方法:利用霍邱县第二人民医院医院信息系统(HIS)检索2020年1月—2021年12月行Ⅰ类切口手术治疗的2570例住院患者为研究对象,以临床药师对围术期预防用抗生素使用情况进行干预的时间节点(2021年1月1日)为界限将其分为对照组(1212例)与干预组(1358例),比较两组患者预防用抗生素使用率及合理率。结果:对照组预防性抗生素使用率为60.81%,高于干预组的预防性抗生素使用率29.38%,差异有统计学意义(P<0.05);对照组围术期预防性抗生素使用合理率为60.89%,低于干预组的围术期预防性抗生素使用合理率98.74%,差异有统计学意义(P<0.05)。结论:临床药师通过专项点评、医嘱审核、抗生素培训等措施能显著降低Ⅰ类切口围术期预防用抗生素使用率,并提高其使用合理率。