Morphological and Sulfur-Isotopic Characteristics of Pyrites in the Deep Sediments from Xisha Trough,South China Sea

Pyrite is one of the common authigenic minerals in marine sediments.Previous studies have shown that the morphological and isotopic characteristics of pyrite are closely related to the geochemical environment where it is formed.To better understand the for-mation mechanism of authigenic pyrite,we analyzed the isotopic composition,morphology,and distribution of pyrite in the sediment at 500m below the seafloor from Xisha Trough,South China Sea.Mineral morphologies were observed by scanning electron micros-copy and Raman spectrography.X-Ray computed tomography was applied to measure the particle size of pyrite.The size of pyrite crystals in the matrix sediment mainly ranged between 25 and 65µm(av.ca.40µm),although crystals were larger(av.ca.50μm)in the veins.The pyrites had a fine-grained truncated octahedral shape with occasionally well-developed growth steps,which implies the low growth rate and weak anaerobic oxidation of methane-sulfate reduction when pyrite was formed.Theδ^(34)S values of pyrites ranged from+20.8‰Vienna-defined Canyon Diablo Troilite(V-CDT)to+33.2‰V-CDT and from+44.8‰V-CDT to+48.9‰,which suggest two growth stages.In the first stage,with the continuous low methane flux,the pyrite possibly formed in an environment with good access to seawater.In the second stage,the pyrites mainly developed in sediment fractures and appeared in veins,probably due to the limited availability of sulfate.The less exposure of pyrite to the environment in the second stage was probably caused by sediment accumulation or perturbation.In this study,an episodic pyritization process was identified,and the paleoenvironment was reconstructed for the sediment investigated.

Persistent Variations in the East Asian Trough from March to April and the Possible Mechanism

The East Asian trough(EAT)profoundly influences the East Asian spring climate.In this study,the relationship of the EATs among the three spring months is investigated.Correlation analysis shows that the variation in March EAT is closely related to that of April EAT.Extended empirical orthogonal function(EEOF)analysis also confirms the co-variation of the March and April EATs.The positive/negative EEOF1 features the persistent strengthened/weakened EAT from March to April.Further investigation indicates that the variations in EEOF1 are related to a dipole sea surface temperature(SST)pattern over the North Atlantic and the SST anomaly over the tropical Indian Ocean.The dipole SST pattern over the North Atlantic,with one center east of Newfoundland Island and another east of Bermuda,could trigger a Rossby wave train to influence the EAT in March−April.The SST anomaly over the tropical Indian Ocean can change the Walker circulation and influence the atmospheric circulation over the tropical western Pacific,subsequently impacting the southern part of the EAT in March−April.Besides the SST factors,the Northeast Asian snow cover could change the regional thermal conditions and lead to persistent EAT anomalies from March to April.These three impact factors are generally independent of each other,jointly explaining large variations in the EAT EEOF1.Moreover,the signals of the three factors could be traced back to February,consequently providing a potential prediction source for the EAT variation in March and April.

Heat Transfer Enhancement of the Absorber Tube in a Parabolic Trough Solar Collector through the Insertion of Novel Cylindrical Turbulators

This study includes an experimental and numerical analysis of the performances of a parabolic trough collector(PTC)with and without cylindrical turbulators.The PTC is designed with dimensions of 2.00 m in length and 1.00 m in width.The related reflector is made of lined sheets of aluminum,and the tubes are made of stainless steel used for the absorption of heat.They have an outer diameter of 0.051 m and a wall thickness of 0.002 m.Water,used as a heat transfer fluid(HTF),flows through the absorber tube at a mass flow rate of 0.7 kg/s.The dimensions of cylindrical turbulators are 0.04 m in length and 0.047 m in diameter.Simulations are performed using the ANSYS Fluent 2020 R2 software.The PTC performance is evaluated by comparing the experimental and numerical outcomes,namely,the outlet temperature,useful heat,and thermal efficiency for a modified tube(MT)(tube with novel cylindrical turbulators)and a plain tube(PT)(tube without novel cylindrical turbulators).According to the results,the experimental outlet temperatures recorded 63.2°C and 50.5°C for the MT and PT,respectively.The heat gain reaches 1137.5 Win the MT and 685.8 Win the PT.Compared to the PT collector,the PTC exhibited a(1.64 times)higher efficiency.

Elemental Compositions of Clinopyroxenes from Southern Okinawa Trough Basalt:Implications for Magmatism and Structural Environment in an Initial Back-Arc Basin

The major and trace elemental compositions of clinopyroxene from basalt were used to characterize the nature of the primitive magma and structural environment beneath the southern Okinawa Trough(SOT),which is an initial back-arc basin at a continental margin.The clinopyroxenes in the basalt were augite with variable Mg^(#)contents(73.37-78.22).The regular variations in major oxide contents(i.e.,CaO,FeO,TiO_(2),and Cr)with decreasing Mg#implied that the clinopyroxenes evolved from being enriched in Mg,Ca,and Cr to being enriched in Fe and Ti.The clinopyroxenes had relatively low rare earth element concentrations(7.51×10^(-6) to 12.68×10^(-6))and negative Eu anomalies(δEu=0.67-0.95).The Kd_(cpx) values of clinopyroxenes(0.2-0.26),which were used to examine whether the clinopyroxene was equilibrated with its host basalt,demonstrate that these clinopyroxene phenocrysts were not captured crystals but were instead produced by crystallization differentiation of the magma.The calculated clinopyroxene crystallization temperatures showed a narrow range of 990-1061℃,and their crystallization pressures ranged from 2.0 to 3.2 kbar.The geochemistry features of these clinopyroxenes indicated that the parent magma belonged to the subalkaline tholeiitic magma series and suggested that the magma experienced crystallization differentiation of olivine,plagioclase,and clinopyroxene,where the crystallization of plagioclase occurred earlier than that of clinopyroxene.Combined with geophysical data,this research on primitive magma and its crystallization differentiation from clinopyroxene indicates that the SOT is in the stage of‘seafloor spreading’and that basaltic rocks produced from tholeiitic magma represent the generation of oceanic crust.

Design and Development of a Parabolic Trough Solar Air Heater for a Greenhouse Dryer

Design and Development of a Parabolic Trough Solar Air Heater (PTSAH) for a Greenhouse Dryer (GD) was done to improve the dryer’s performance. The materials used for the fabrication of the PTSAH included galvanized sheets covered with aluminium foil, an absorber tube made of GI pipe painted matt black to increase heat absorbance at the focal line, mild steel square tubes, shutter plywood, and an axial fan to push air through the absorber tube. Key geometrical parameters used for the design of the PTSAH were a rim angle of 98 degrees, focal length of 0.2608 m, height of 0.3451 m, length of 2 m, and an aperture width of 1.2 m. The PTSAH’s total aperture surface area was 2.4 m2, while its absorber tube surface area was 0.1587 m2. The PTSAH was experimentally tested to establish its thermal performance. It was found that the ambient air recorded an average value of 31.1˚C and that the air heater could increase the air temperature by 45.6˚C above ambient with a thermal efficiency of 5.3%. It can, therefore, be concluded that the PTSAH can significantly improve the performance of a GD by supplying the GD with air at a higher temperature than ambient.

Improving Heat Transfer in Parabolic Trough Solar Collectors by Magnetic Nanofluids

A parabolic trough solar collector(PTSC)converts solar radiation into thermal energy.However,low thermal efficiency of PTSC poses a hindrance to the deployment of solar thermal power plants.Thermal performance of PTSC is enhanced in this study by incorporating magnetic nanoparticles into the working fluid.The circular receiver pipe,with dimensions of 66 mm diameter,2 mm thickness,and 24 m length,is exposed to uniform temperature and velocity conditions.The working fluid,Therminol-66,is supplemented with Fe3O4 magnetic nanoparticles at concentrations ranging from 1%to 4%.The findings demonstrate that the inclusion of nanoparticles increases the convective heat transfer coefficient(HTC)of the PTSC,with higher nanoparticle volume fractions leading to greater heat transfer but increased pressure drop.The thermal enhancement factor(TEF)of the PTSC is positively affected by the volume fraction of nanoparticles,both with and without a magnetic field.Notably,the scenario with a 4%nanoparticle volume fraction and a magnetic field strength of 250 G exhibits the highest TEF,indicating superior thermal performance.These findings offer potential avenues for improving the efficiency of PTSCs in solar thermal plants by introducing magnetic nanoparticles into the working fluid.

Discovery of Yanting-Tongnan Trough of Late Permian in Sichuan Basin and Its Significance

ABSTRACT： Reef-bank of Sichuan （四川） basin have been explored along the platform margin belt on both sides of the Kaijiang （开江）-Liangping （梁平） trough for a long time. Correspondingly, a series of major breakthroughs have been obtained and a number of large oil and gas fields have been found. After the breakthroughs of Kaijiang-Liangping trough, how reef-bank exploration will proceed？ Is there another ＂Kaijiang-Liangping trough＂ in Sichuan basin？ Previous research shows that Sichuan basin underwent intracratonic rift and basement fault activities in Late Permian, developing a paleogeography framework of ＂three uplifts and three depressions＂ under the background of the regional large ramp, including Exi （鄂西）-Chengkou （城口） trough, Kaijiang-Liangping trough and Yanting （盐亭）-Tongnan （潼南） trough. Based on sedimentology and tectonics dynamics analysis, data of drillings, outcrops and seismic, Yanting-Tongnan trough has been discovered in central Sichuan basin in our study which distributes from Mianzhu （绵竹）, Jiangyou （江油） in western Sichuan basin through Nan-chong （南充） to Guang＇an （广安）, as long as about 210 km, extending in NW-SE nearly paralleling to Kaijiang-Liangping trough, opening to the sea north-westward, and gradually pinchout to the east platform. Similar to Kaijiang-Liangping trough, another platform margin reef belt distributes along a U-shape belt around Yanting-Tongnan trough, which is expected to become another natural gas accumulation zone after the platform margin around Kaijiang-Liangping trough. The discovery of Yanting-Tongnan trough expands favorable reef exploration area from original 2x 10^4 km2 on both sides of Kaijiang-Liangping trough to more than 6x10^4 km2 in Yanting-lbngnan trough platform margin belt and Kaijiang-Liangping platform margin belt, greatly enlarging the reef exploration field. But com-pared to Kaijiang-Liangping trough, YantingTongnan trough is relatively shallower and smaller, and the scale and quality of reef-bank reservoirs in its margin belt is a little poor relatively. Therefore, much research should be done timely such as comparative study of two troughs, detailed research of formation and evolution of the trough, regularity of reef migration, meticulous depiction of reef-bank reservoir size andDiscovery of Yanting-Tongnan Trough of Late Permian in Sichuan Basin and Its Significancedistribution in order to obtain major breakthroughs around the Yanting-Tongnan trough.

Clinical Evaluation of a Vancomycin Dosage Strategy Based on a Serum Trough Concentration Model in Elderly Patients with Severe Pneumonia

Objective This study aimed to evaluate the clinical benefits of a vancomycin dosage strategy based on a serum trough concentration model in elderly patients.Methods This prospective single-center, open-label, randomized controlled trial categorized 66 elderly patients with severe pneumonia into study and control groups. The control group received vancomycin using a regimen decided by the attending physician. Meanwhile, the study group received individualized vancomycin therapy with a dosing strategy based on a serum trough concentration model. The primary endpoint was the proportion of patients with serum trough concentrations reaching the target values.The secondary endpoints were clinical response, vancomycin treatment duration, and vancomycinassociated acute kidney injury(VA-AKI) occurrence.Results All patients were at least 60 years old(median age = 81 years). The proportion of patients with target trough concentration achievement(≥ 15 mg/L) with the initial vancomycin regimen was significantly higher in the study group compared to the control group(75.8% vs. 42.4%, P = 0.006).Forty-five patients(68.2%) achieved clinical success, the median duration of vancomycin therapy was10.0 days, and VA-AKI occurred in eight patients(12.1%). However, there were no significant differences in these parameters between the two groups. The model for predicting vancomycin trough concentrations was upgraded to: serum trough concentration(mg/L) = 17.194-0.104 × creatinine clearance rate(mL/min) + 0.313 × vancomycin daily dose [mg/(kg·d)].Conclusion A vancomycin dosage strategy based on a serum trough concentration model can improve the proportion of patients achieving target trough concentrations in elderly patients with severe pneumonia.

Geological characteristics of the southern segment of the Late Sinian–Early Cambrian Deyang-Anyue rift trough in Sichuan Basin, SW China

Based on the latest drilling, seismic and field outcrop data, the geological characteristics(e.g. strata, development and sedimentary evolution) of the southern segment of the Late Sinian–Early Cambrian Deyang–Anyue rift trough in the Sichuan Basin are analyzed. First, the strata in the southern segment are complete. The first to second members of Dengying Formation(Deng 1 + Deng 2) are found with relatively stable thickness(400–550 m), and the third to fourth members(Deng 3+ Deng 4) show great thickness difference between the marginal trough and the inner trough, which is up to 250 m. The Cambrian Maidiping Formation and Qiongzhusi Formation in southern Sichuan Basin are relatively thin, with the thickness changing greatly and frequently. Second, the Deyang–Anyue rift trough extended southward during the Deng 4 period, affecting southern Sichuan Basin. Compared to the middle and northern segments of the rift trough, the southern segment is generally wide, gentle and shallow, with multiple steps, and alternating uplifts and sags, which are distributed in finger shape. Third, the Deng 1 + Deng 2 in southern Sichuan Basin records the dominance of carbonate platform and unobvious sedimentary differentiation, and the Deng 4 exhibits obvious sedimentary differentiation, namely, basin–slope–secondary slope–slope–secondary slope–platform margin–restricted platform, from the inner trough to the marginal trough. Fourth, the rift trough in southern Sichuan Basin has evolved in four stages: stabilization of Deng 1–Deng 2, initialization of Deng 3–Deng 4, filling of Maidiping–Qiongzhusi, and extinction of Canglangpu Formation.

Effect of Different Silica Fumes on Properties of Al_(2)O_(3)-SiC-C Castables for Iron Trough

In order to improve the performance of Al_(2)O_(3)-SiC-C castables for iron trough,samples were prepared using brown corundum,dense corundum,activated alumina micropowder,ball pitch,and silicon as main raw materials,calcium aluminate cement as the binder.Several kinds of silica fumes(93SiO_(2),96SiO_(2),and 99SiO_(2))with different particle size distributions and chemical composition were added to research the effects on the properties of castables.The results show that the sample with 99SiO_(2) fume has high water requirement for molding,but the bulk density is the lowest,the apparent porosity is the highest,the oxidation resistance is the worst,and the permanent linear change on heating is low after firing at 1 450 ℃ for 3 h.The bulk density and the apparent porosity of the sample with 93SiO_(2) fume or 96SiO_(2) fume are equivalent,the hot modulus of rupture of the sample with 93SiO_(2) fume is the lowest,and the slag resistance of the sample with 96SiO_(2) fume is the best.The comprehensive performance of the sample with 96SiO_(2) fume is the best.

The Mamfe Basin in the southern Benue trough extension between Cameroon and Nigeria:Gem origin and problem of lithostratigraphic nomenclature and marine transgression

The Mamfe Basin has been the subject of many studies,but some debates persist,especially concerning the stratigraphic nomenclature,corundum origin,and marine transgression.The aims of this work are(1)to propose a new lithostratigraphic nomenclature of the Mamfe Basin formation based on new field observations,(2)to determine the source rock distribution and the origin of gem deposits and(3)to correlate the Cameroon section of the Mamfe Basin with the Nigerian deposits.The main results show that the name Manyu River Group is more appropriate as the Manyu River crosses all the facies in the Mamfe sedimentary Basin belonging to the Manyu Division.According to the facies analysis,the age of deposition,the mineralogic and geochemical data such as the V vs.Al2O3andΣREE vs.Al_(2)O_(3),TiO_(2)MgO,Na_(2)O,P_(2)O_(5),and CaO diagrams,this Group is composed of at least five Formations,including four Cretaceous Formations,from bottom to top:the Etoko Formation(alluvial and fluvial channel to fluvio-lacustrine deposits),the Nfaitok Formation(lagoonal deposits),the Bachuo Ntai Formation(fluvial braided channels or fluvio-deltaic environment)and the Eyumojock/NsanaragatiFormation(fluvio-lacustrine deposits)and the new Cenozoic Formation named Bakebe Formation(fluvio-lacustrine deposits).The gem minerals such as corundum,rutile,or tourmaline in the Cretaceous deposits of the Mamfe Basin are mainly detrital as indicated by the presence of worn shapes and fragments of these minerals.The presence of sapphire in the AlboCenomanian deposits indicates a Precambrian age of the felsic source rock,likely the plutonic rocks such as granite or pegmatite as indicated by the abundance of tourmaline and high LREE/HREE ratios(14.81–34.29)and slightly negative and positive Eu anomalies(0.85–1.15).This marine incursion in the Mamfe Basin was probably from West Nigeria,according to the geographic location of the Mamfe Basin and the general palaeogeographic evolution of the Benue Trough.

Evaluating Vancomycin Clinical Outcomes Using Area under the Curve versus Trough Based Dosing Strategies

Background: The 2020 consensus guidelines recommend AUC guided dosing as the preferred monitoring method for vancomycin. AUC based dosing has shown to reduce incidence of acute kidney injury (AKI), utilize lower daily doses in obese patients, and maintain efficacy. Several institutions have adjusted their protocols to utilize AUC guided dosing. However, there are limited studies comparing the clinical outcomes of AUC versus trough monitoring. Methods: This was a retrospective, observational, single centered study. The primary outcome was to evaluate the clinical success of AUC dosing versus trough based dosing of vancomycin for MRSA infections using a composite outcome of afebrile post treatment ( Results: Forty-seven patients were included in this study, 17 in the AUC group and 30 in the trough group. The primary composite outcome showed a significant benefit of AUC dosing (p = 0.04). The composite component culture clearance showed the largest improvement for the AUC group when compared with the trough group (p = 0.03). More patients achieved therapeutic target attainment and reached the target sooner (3 days versus 4 days, p = 0.2) in the AUC group. Over the study course, 94.1% of patients in the AUC group were considered therapeutic compared to 63.8% in the trough group (p = 0.03). Vancomycin levels were collected less frequently in the AUC group (3 versus 4, p = 0.2). Conclusion: The outcomes of this study may suggest AUC guided dosing as a beneficial alternative to trough based dosing. AUC based dosing may improve clinical success which can be further explored in larger prospective clinical trials.

Investigation and simulation of parabolic trough collector with the presence of hybrid nanofluid in the finned receiver tube

The present study discusses the thermal performance of the receiver tube,which contains a wall with various fin shapes in the parabolic trough collector.Inserted fins and bulge surfaces of the inner wall of the receiver tube increase the turbulent fluid flow.In pursuance of uniform distribution of heat transfer,various fin shapes such as square-shape,circle-shape,triangle-shape,and combined square-circle shapes were inserted,examined,and compared.A study of the temperature differences and fluid flow is meaningful for this project therefore finite volume method was used to investigate heat transfer.Also,hybrid Nano-Fluid AL_(2)O_(3-)CuO,TiO_(2-)Cu,and AgMgO were applied to increase thermal diffusivity.When the combined square-circle-shaped fin was inserted,the thermal peak of fluid flow in the receiver tube was lower than the other studied fin shapes by almost 1%.Besides,the hybrid nano-fluid Ag-MgO Syltherm-oil-800 has lower thermal waste in comparison to others by more than 3%.

Modified Circumpolar Deep Water inflow to the Dotson-Getz Trough in the summers of 2020 and 2022

The melting of the West Antarctic Ice Shelf has increased since the 1990s,driven by the relatively warm Circumpolar Deep Water(CDW)that penetrates into the West Antarctic Ice Shelf cavities through submarine glacial troughs across the continental shelf.In this study,temperature,salinity,and current velocity data obtained by the Chinese National Antarctic Research Expedition in the Dotson-Getz Trough(DGT)shows clear differences in distribution of modified Circumpolar Deep Water(mCDW)in the summers of 2020 and 2022.Combined with contemporaneous wind data and additional temperature and salinity data from instrumented seals,the processes and mechanisms responsible for this variation are discussed.Compared with 2020,there is a significant increase in mCDW thickness in 2022,with a doubling of total heat content as the mCDW inflow path across the DGT shifts towards the eastern bank.We propose that a southward shift in the westerly winds in the summer of 2022 moved the upper oceanic divergence zone southward towards the continental slope,promoting the upwelling of mCDW above 500 m.Concurrently,stronger westerly winds over the continental slope strengthened the eastward undercurrent,increasing the transport of this mCDW and its associated heat content to the DGT through Ekman dynamics.These observations show there is strong interannual variability in the strength,path and extent of mCDW inflows to the DGT and that care must be taken when planning observation programs for long-term monitoring of the oceanic heat input to the ice shelves of this globally significant region.

计及AA-CAES与PTC集成的综合能源系统运行优化与性能分析

为进一步发挥综合能源系统的多能互补优势,提出一种计及先进绝热压缩空气储能(AA-CAES)与槽式太阳能集热器(PTC)集成的综合能源系统(IES-PTC-CAES)优化运行策略。首先,对AA-CAES、PTC以及系统中其他设备进行分析并建立相应模型;进而以经济性、环保性和能效性为优化目标,以设备运行的关键参数为优化变量,基于分时电价建立了协同优化策略,并通过K-means算法将模拟出的典型年负荷聚类为典型日负荷;最终,使用并行式的遗传算法对系统进行寻优,得到不同目标下IES-PTC-CAES的最优运行策略。结果表明:与参考系统相比,IES-PTC-CAES系统经济目标下总成本降低了14.61万元,环保目标下二氧化碳排放量减少了6194.38 kg。

连续电磁剖面法在塔里木盆地麦盖提斜坡裂陷槽深部构造研究中的应用

随着对塔里木盆地深层油气勘探认识不断深入,认为震旦—南华系裂陷槽对烃源岩的发育保存有着重要的控制作用,因此对该区域的裂陷槽探测是油气勘探的重要探索方向。前人研究认为对塔西南地区麦盖提斜坡处存在震旦—南华系裂陷槽,但受限于该区域地震资料品质,对该区域深层结构尤其是对基底和裂陷槽分布形态和范围认知不清。因此,通过一条跨过麦盖提斜坡与叶城凹陷的连续电磁剖面法剖面,结合研究区地质情况与井资料,构建了区域电阻率的物性分层结构,完成了对实际数据的二维反演,获取了该区域的深部电性结构与CEMP剖面的综合地质解释结果。为该区域新元古代裂陷槽发育情况的判断提供了新的电磁证据,也进一步刻画了基底、裂陷槽的电性特征与结构。探测结果认为裂陷主要由正断层控制,呈现裂陷群特点,裂陷多呈半地堑、不对称地堑及堑—垒相间的构造样式,在麦盖提斜坡、叶城凹陷处中部、南部的区域发育两个裂陷群,有利于区域内的烃源岩沉积,其中裂陷内震旦—南华系地层沉积较厚的区域具有较好的深层油气勘探潜力。

比较浓度-时间曲线下面积与谷浓度指导万古霉素治疗重症患者的临床随机对照研究

目的探讨浓度-时间曲线下面积和谷浓度指导万古霉素治疗重症患者的临床安全性和疗效差异。方法入选2021年1月至2023年12月收住兰州大学第二医院重症医学科因革兰阳性菌感染且经医师确认需使用万古霉素治疗的患者,经纳排标准筛选后,采用随机数字表法将入选患者分为两组进行前瞻性、随机、单盲对照研究,对照组以万古霉素谷浓度10~20 mg/L为目标靶值,观察组以万古霉素浓度-时间曲线下面积400~600 mg·h/L为目标靶值。经过监测,最终对照组77例、观察组79例符合目标靶值范围并进行相关统计学分析与比较。结果观察组万古霉素相关急性肾损伤(AKI)发生率明显低于对照组(P=0.002),两组临床疗效及总治疗时间差异无统计学意义。根据多因素Logistic回归分析显示,谷浓度(OR=1.021,95%CI 1.019~1.577,P=0.033)及急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分(OR=1.189,95%CI 1.055~1.339,P=0.004)是万古霉素相关AKI独立危险因素,采样总数量(OR=0.476,95%CI 0.247~0.917,P=0.000)是临床转归独立危险因素。对谷浓度与万古霉素相关AKI进行受试者工作特征(ROC)曲线分析,谷浓度预测万古霉素相关AKI临界值为15.65 mg/L,敏感度为0.786,特异度为0.697,ROC曲线下面积为0.727。结论基于浓度-时间曲线下面积为目标靶值的药物监测方法,可以减少万古霉素相关AKI发生,但临床疗效无差别。

万古霉素在重症感染中的治疗药物监测现状及前景

万古霉素被誉为治疗革兰阳性菌感染的最后一道防线,也是推荐的一线用药。因其治疗窗窄,重症患者需监测药物浓度以指导临床安全用药。传统上基于万古霉素谷浓度的治疗药物监测已被临床广泛接受。2009年美国传染病学会(IDSA)指南建议,对于重症患者目标谷浓度为15~20 mg/L。近十余年国内外学者对于该治疗浓度的安全性及有效性评价不一。2020年更新指南提出,肾损伤风险最小、最准确且最佳的给药方法是通过曲线下面积(AUC)指导给药剂量和监测,提倡个体化目标AUC/最低抑菌浓度(MIC)比值为400~600 mg/(h·L)。由此可见目前就万古霉素临床监测指标存在争议。因此,本文就万古霉素治疗重症感染过程中进行治疗浓度监测的手段及策略进行综述,对指导临床合理用药具有重要意义,有助于临床医师制定个体化给药方案,最大程度减少或避免药物毒性。

牛马不同槽——嘉峪关魏晋墓两幅壁画的现实表达与文化意涵

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