Effect of combined spinal and epidural anesthesia on the level of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section

Objective: To discuss the effect of combined spinal and epidural anesthesia on the levels of pain media, stress indicators and inflammatory factors in patients undergoing high altitude cesarean section. Methods: Eighty patients who underwent cesarean section in our hospital from January 2017 to April 2019 were enrolled in the hospital. They were divided into two groups according to the patient's anesthesia. Fourty patients receiving epidural anesthesia were included in the control group, and another 40 patients received lumbar stiffness. The combined anesthesia patient was included in the observation group. Changes in pain mediators [Serum neuropeptide Y (NPY), endorphin (β-EP), substance P (SP)], stress indicators [Serum cortisol (Cor), C-peptide (C-P), advanced oxidative protein product (AOPP)], inflammatory factor levels [Hypersensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α)], and immunoglobulin levels [Serum IgA, IgG, IgM] were compared between the two groups. Results: Before anesthesia, there were no significant difference in pain media, stress index, inflammatory factor level and immunoglobulin level between the two groups (P>0.05). At 12 h after operation, the two groups of patients were NPY, β-EP, SP, Cor. The levels of C-P, AOPP, hs-CRP and TNF-α were higher than those before operation (P<0.05). The levels of IgA, IgG and IgM were lower than those before operation (P<0.05). Among them, observation group NPY, β-EP, SP, Cor, C-P, AOPP, hs-CRP and TNF-α were significantly lower than those of the control group (P<0.05). The serum levels of IgA, IgG and IgM were significantly higher than those of the control group (P<0.05). Conclusion: Combined spinal and epidural anesthesia can more effectively alleviate maternal pain in high altitude cesarean section, more effectively reduce the inflammatory stress response of patients, promote the humoral immune function of patients, and is beneficial to the early recovery of maternal postoperative, and has high clinical value.

COOPERATIVE DIRECTIONAL INTER-CELL HANDOVER SCHEME IN HIGH ALTITUDE PLATFORM COMMUNICATIONS SYSTEMS

A novel Cooperative Directional inter-cell Handover Scheme(CDHS) for High Altitude Platform(HAP) communications systems is proposed,in which the handover target cell and the two cells adjacent to this handover target cell work cooperatively to exploit the traffic fluctuation to improve handover performance.Users in the overlap area of the overloaded handover target cell will be forced to handover directionally before their optimal handover boundary in order to free up resources for the handover calls which would otherwise be dropped due to the shortage of resources and queue time out.Simulation results show that the handover call dropping probability is greatly reduced(at least 60%) compared with the general queue handover scheme,with little performance reduction to the call blocking probability,and the Not in the Best Cell(NBC) average time is only increased moderately.Moreover,an optimal cell radius can be achieved for a specific platform speed by minimizing the unified system performance,which is the linear combination of the handover call dropping probability and the NBC average time.

Effective administration of cranial drilling therapy in the treatment of fourth degree temporal,facial and upper limb burns at high altitude:A case report

BACKGROUND Fourth degree burns damage the full thickness of the skin and affect underlying tissues.Skin grafting after debridement is often used to cover the wounds of salvageable severe burns.A granulation wound can be formed by drilling the skull to the barrier layer to solve the problem of skull exposure.Low oxygen levels present at high altitudes aggravate ischemia and hypoxia which can negatively impact wound healing.The impaired healing in such cases can be ameliorated by hyperbaric oxygen therapy.CASE SUMMARY We describe a patient who presented with fourth degree burns to the left temporal and facial regions upon admission in December 2018.The periosteum of the skull and the deep fascia of the face were exposed.After the first stage of debridement and skin grafting,the temporal skin did not survive well.Granulation was induced by cranial drilling,and then a local flap was transferred to cover the wound.The left temporal and facial wounds were completely covered and the patient recovered well.CONCLUSION Skin grafting and flap transfer after early debridement to cover the wound and control infection were of great significance.In the later stages of the patient's treatment,survival of the skin graft and skin flap was observed.The second stage repair was performed to achieve successful skin grafting by cranial granulation.Granulation was formed by drilling the skull,and then the wound was closed,which is suitable for cases with skull exposure and wounds with poor blood supply.We consider that hyperbaric oxygen treatment and improving tissue oxygen supply were beneficial in this patient.

Plasma endothelin-1 and nitric oxide correlate with ligustrazine alleviation of pulmonary artery hypertension in patients of chronic cor pulmonale from high altitude plateau during acute exacerbation

Objective To explore the mechanisms involved in the ligustrazine alleviation of the pulmonary artery hypertension(PAH) in patients of chronic obstructive pulmonary disease(COPD) associated with chronic cor pulmonale(CCP) during exacerbation.Methods Seventy patients of COPD and CCP with acute exacerbation were randomly and equally divided into control group and treatment group.The control group received standard treatment with antibiotics,antiasthmatic and expectorant medications,and oxygenation;and the ligustrazine treatment group received ligustrazine treatment(80 mg/d;i.v.;for 2 weeks) in addition to the standard treatment.Before and at the end of 2 week treatment,the clinic responses of the two regimens were evaluated,plasma levels of endothelin-1(ET-1) and nitric oxide(NO) were determined;arterial oxygen partial pressure(PaO_2),mean pulmonary arterial pressure(mPAP),outflow tract of right ventricle(RVOT),and internal diameter of right ventricle(RV) were measured.Results Good clinic benefits were achieved in both the standard and ligustrazine regimens,plasma level of ET-1,values of mPAP,RV and RVOT decreased significantly,plasma level of NO and PaO_2 values decreased(all P<0.01 vs pretreatment to all parameters).Compared with the control group,ligustrazine greatly enhanced the clinic efficacy from 77.1%to 97.1%(P<0.05),and also resulted in more significant changes of all these parameters(P<0.01 vs control group for all parameters).For both groups,the levels of plasma ET-1 were positively correlated with values of mPAP,RVOT,and RV(r = 0.710,0.853,and 0.766,respectively,all P = 0.000),and negatively correlated with plasma NO and PaO_2(r =- 0.823,and- 0.752,respectively,all P = 0.000).Conclusion Ligustrazine is effective in treating pulmonary artery hypertension during acute exacerbation of COPD and CCP in patients from the plateau area.The observed changes in the plasma levels of NO and ET-1 in response to ligustrazine treatment suggest that ligustrazine may act through the selective effect on pulmonary blood vessels to enhance the synthesis and release of NO and suppress those of ET-1 from lung vascular endothelial cells,thus reducing pulmonary artery pressure and decreasing pulmonary arterial hypertension.

Technologies of oxygen supply for life support during the development of mineral resources in high altitude areas

In order to fulfill the needs of life-support oxygen supply during the development of plateau mineral resources,four oxygen supply patterns suitable for the plateau mine in specific environment were developed:tunnel face diffusive oxygen supply,tunnel oxygen-bar car,carried oxygen cylinder and portable oxygen generator. Through the study of safety oxygen supply experiments in low- pressure plateau areas,the mathematical relationship between maximum integration of secure oxygen volume and altitude has been achieved. Oxygen supply safety control should follow this relationship in plateau mines during the time of executing tunnel face or in room air diffusive oxygen supply. The application results of life-support oxygen supplement technologies in the development of mineral resources in high altitude areas show that the oxygen supply for tunneling miners in plateau mines can not only effectively enhance the oxygen saturation,reduce the pulse rate and the breath rate per minute,but also improve various symptoms caused by altitude hypoxia and high-intensity physical labor.

Industrial Poverty Alleviation Model in Southwestern High-altitude Mountainous Areas of China——A Case Study of Industrial Poverty Alleviation of Xueshan Township in Luquan County of Yunnan Province through Planting Codonopsis pilosula

Due to the severe restrictions of natural conditions and ecological environment,high-altitude mountainous areas usually become the " hard bones" in the battle against poverty. Xueshan Township,Luquan Yi and Miao Autonomous County of Yunnan Province,located in the alpine valley of Jinsha River,is a major township with wide and deep poverty,and the incidence of poverty is up to 45. 00%. In recent years,Xueshan Township has insisted on the battle against poverty,made effort to develop the Codonopsis pilosula industry,and successfully developed a road to poverty alleviation through C. pilosula industry,and formed a unique industrial poverty alleviation model by the end of 2018,the incidence of poverty dropped to 0. 74%. Based on field survey and interview,this paper analyzes and summarizes the specific practices,main results,practical experience and promotion and application measures of the poverty alleviation model of C. pilosula planting industry in Xueshan Township,in the hope of providing certain reference for the targeted poverty alleviation in similar areas in Yunnan Province and other provinces of China.

Study on Selection of Dust Collectors for Large Capacity Thermal Power Units in High Altitude Areas

A dust collector is an important equipment in a thermal power plant,and reasonable selection of a dust collector is important for environmental protection in the power plant. Huaneng Xining Power Plant is located at an elevation of 2 360 m. Based on the characteristics of the high altitude area and their special requirements for dust collectors,the selection of dust collectors for the thermal power unit in the high altitude area was studied,and then two types of dust collectors( a rotary electrode electrostatic precipitator and electric-bag composite precipitator) for the thermal power unit were compared from the aspects of technological and economical feasibility. Finally,a proposal to select a suitable dust collector for the thermal power plant was put forward.

Research progress of age-related macular degeneration related gene polymorphism at high altitude

Age-related macular degeneration(AMD)is a kind of progressive eye disease that seriously damages vision,and it is one of the important causes of blindness.In recent years,a large number of studies have found that there is a significant correlation between genetic factors and the occurrence and development of AMD.The study of gene polymorphism provides new ideas and directions for clinical diagnosis and treatment.In this paper,we will make a brief review of the research progress related to complement factor H(CFH),serine protease(HtrA1),age-related macular degeneration susceptibility factor 2(ARMS2)and vascular endothelial growth factor(VEGF)gene single nucleotide polymorphisms(SNP).

Systemic treatment for severe concentrated sulfuric acid burns in an adult male at high altitude:A case report

BACKGROUND The aim of this study was to report a case of a patient who suffered from severe concentrated sulfuric acid burns while working at high altitude.This patient recovered after systemic treatment.We also provide a literature review for a better understanding of the disease.CASE SUMMARY A 30-year-old male,who was working in a local chemical plant in Xining at an altitude of 2261 m,suffered from 85%burns(Ⅲ°70%,deep Ⅱ°15%)after a tank containing 80%concentration of sulfuric acid exploded.The patient immediately received a series of first aid treatments,as well as rigorous wound managements after admission,which included protection for the whole body and organs,prevention and treatment of eye burns,and the appropriate oxygen therapy.After 65 d of treatment,the burn wounds had completely healed,and the patient was transferred to another specialized hospital for further eye treatment.The first aid before admission and the emergency treatment of wounds following admission were appropriate.No severe complications of sepsis,severe renal insufficiency,septic costal chondritis,corneal perforation or other burns occurred during the treatment.CONCLUSION The main causes of concentrated sulfuric acid burns consisted of accidental burns at work,accidents in the outside,factitious injuries and improper laboratory operations.The clinical manifestations were mostly deep Ⅱ°and Ⅲ°burns,with a formation of brown-black,leather-like eschar on the wound surface and locally embolized dendrite-like vessels.The clear cause of the injury and typical clinical manifestations in this case made it easy to diagnosis.However,adult cases with severe concentrated sulfuric acid burns in high altitude areas are rare,so the successful treatment of this case is of great significance.

生草对贵州高海拔区苹果园土壤呼吸及水热环境的影响

【目的】探明西南冷凉高地苹果产区果园不同草种覆盖条件土壤呼吸特征及其与土壤水热的关系,为筛选苹果园适宜生草类型提供参考依据。【方法】设置鼠茅草(Vulpia myuros)、鸭茅(Dactylis glomerata)、黑麦草(Lolium perenne)、白三叶(Trifolium repens)、光叶紫花苕(Vicia villosa)、鼠茅草+鸭茅+白三叶混播、黑麦草+白三叶+鸭茅混播、鼠茅草+黑麦草+白三叶混播8个苹果园生草处理,以清耕作对照(CK),利用LI-6400XT便携式光合测定系统配套使用土壤呼吸气室(6400-09)测定果园土壤呼吸速率,采用非线性回归和指数模型,分析不同生草处理对土壤呼吸与土壤水热环境的影响。【结果】生草显著提高果园土壤呼吸速率,较清耕提高0.07%~256.39%,其中,黑麦草+白三叶+鸭茅混播处理提高幅度最高。生草覆盖显著提高土壤水分保持能力,对0~20 cm土层的影响最明显,相同月份不同生草处理间土壤水分差异明显,生草混播处理提高土壤水分能力优于生草单播处理。生草覆盖后显著降低夏季(5—7月)表层土壤(0~5 cm)温度。不同生草覆盖处理土壤水分含量与土壤呼吸以二次函数拟合效果最佳,决定系数R 2在0.242~0.989,拟合度较高。各生草处理土壤温度与土壤呼吸速率呈指数函数关系,0~5 cm和5~10 cm土层拟合模型决定系数R 2平均值高于10~15 cm和15~20 cm土层。土壤温度、水分及二者的交互作用对土壤呼吸的协同影响高于土壤单因子的影响。【结论】苹果园生草处理可显著提高土壤呼吸速率,显著增加0~20 cm土层土壤的水分保持能力,降低果园夏季表层土壤(0~5 cm)温度,有效改善苹果根系生长环境,有利于树体发育。不同生草模式中以黑麦草+白三叶+鸭茅混播处理效果最优。

高原地区卒中后癫痫的临床及预后特征

目的探讨高原地区居民卒中后癫痫(post-stroke epilepsy,PSE)的临床、治疗和预后特征,并分析影响PSE预后的风险因素,为制定高原地区PSE临床诊疗策略提供一定依据。方法回顾性连续纳入2019年1月—2023年6月在西藏自治区人民医院住院治疗的高原地区PSE患者。根据PSE类型分为早发性(卒中后≤7 d)PSE组和迟发性(卒中后>7 d)PSE组,于2023年9月通过电话和门诊相结合的方式进行随访,获取患者的功能预后(mRS评分)情况。比较两组患者的性别、年龄、卒中类型分布、卒中严重程度(发病时mRS评分)、实验室检查等基线资料,以及随访功能预后的差异,分析预后不良(随访mRS评分≥3分)的影响因素。结果共纳入符合入组标准的PSE患者89例,占同期住院高原卒中患者的4.2%,患者发病年龄中位数为55(44~69)岁,男性59例(66.3%),藏族87例(97.8%),发病时mRS评分为3(1~4)分。入组患者中早发性PSE组49例(55.1%),迟发性PSE组40例(44.9%)。卒中亚型分布中脑出血所占比例最高,为39.3%(35例)。最常见的癫痫发作类型为全面起源性发作,共69例(77.5%)。36例(40.4%)PSE患者合并癫痫持续状态。影像学检查显示卒中病灶中最常见的为皮质病灶,共48例(53.9%)。治疗方面85例(95.5%)PSE患者接受了抗癫痫药物治疗,其中79例(88.8%)患者接受单药治疗,最常应用的抗癫痫药物是奥卡西平/卡马西平(36例,40.4%)。PSE患者的院内死亡率为10.1%(9例)。随访时间中位数为27(15~40)个月,预后不良患者占56.7%(38/67),死亡率为35.8%(24/67)。与早发性PSE组相比,迟发性PSE组男性比例更高(78.6%vs.56.6%,P=0.043)且有癫痫家族史比例更高(10.0%vs.0,P=0.037)。两组间的卒中类型分布(P=0.040)和应用抗癫痫药物类型分布(P=0.047)差异有统计学意义。多因素回归分析显示,卒中症状严重(发病时mRS评分高)是PSE预后不良的独立危险因素(OR 1.691,95%CI 1.245~2.297,P<0.001)。结论PSE在高原地区住院卒中患者中的发生率为4.2%。高原地区PSE患者发病时临床症状重,40.4%的患者合并癫痫持续状态。高原地区PSE患者预后不良,致残率和死亡率高。

高海拔潮气量双环PID控制系统研究

为解决高海拔地区气压降低导致急救呼吸机潮气量控制精度下降的问题,提出了双环PID潮气量控制系统。该系统采用气压补偿型PID控制器调整风机转速,并辅以积分分离式PID控制器,以实现对气流速度的精确控制。在实际海拔4370 m、大气压59 kPa的环境中,系统性能测试表明,相较于单环PID控制,双环控制系统在高海拔条件下表现出快速响应和无超调的卓越性能。平均气流速度输出误差为3.19%,最大误差为4.1%,优于现有临床设备的准确性。这一技术突破不仅提供了高海拔急救呼吸机潮气量控制的有效解决方案,也为特殊环境下的通气控制技术发展贡献了重要参考。

急性缺氧暴露对人体生理反应及认知能力的影响研究

在低压环境舱开展高海拔环境中人体急性缺氧暴露实验,研究环境压力和温度对人体生理参数和认知能力的影响规律。实验结果表明,随大气压力的降低,人体平均皮肤温度、口腔温度、舒张压、心率和心率变异性均呈增加,而血氧饱和度和收缩压呈降低趋势。其中,平均皮肤温度、心率和血氧饱和度具有显著性差异(p<0.05)。随温度的增加,只有血氧饱和度降低,其他生理参数均升高。其中,平均皮肤温度、心率具有显著性差异(p<0.05)。感知能力、记忆能力和反应能力随大气压力的降低而降低,思辨能力反而提高。其中,记忆能力受压力影响具有显著性(p<0.05)。感知能力和记忆能力随温度的增加有所提高,思辨能力在不同压力下随温度的变化规律不同,反应能力随温度的降低而提高。其中反应能力受温度影响具有显著性(p<0.05)。该研究为保障平原地区人员急进高海拔地区生命健康安全提供有力支撑。

岐黄针疗法治疗高海拔地区盘源性腰痛临床观察

目的探讨岐黄针疗法对患者临床疗效、腰椎功能及疼痛程度的影响。方法回顾性选取该院收治的200例高海拔地区盘源性腰痛患者,按照治疗方法分为对照组(n=100)和观察组(n=100)。对照组患者予以口服七叶皂苷钠片、塞来昔布胶囊治疗,观察组在对照组用药基础上联合岐黄针疗法治疗。比较两组患者疗效、腰椎功能、疼痛程度、炎性因子水平、中医证候积分以及不良反应发生情况。结果两组疗效相比,观察组明显优于对照组(P<0.05);治疗后,两组患者腰椎功能均明显提高,疼痛显著缓解,两组相比,观察组优于对照组(P<0.05);治疗后,两组患者中医证候积分均明显降低,两组相比,观察组低于对照组(P<0.05);治疗后,两组患者炎性因子水平均降低,两组相比,观察组低于对照组(P<0.05);两组不良反应发生率相比差异无统计学意义(P>0.05)。结论岐黄针疗法治疗高海拔地区盘源性腰痛可提高患者疗效,缓解患者临床症状,改善腰椎功能及疼痛程度,并降低炎症反应。

An investigation of the influence of ground surface properties and shading on outdoor thermal comfort in a high-altitude residential area

Landscape elements in residential areas can effectively improve the outdoor thermal environment,with different outcomes depending on the climate conditions.This study explores how the ground surface and shading properties affect the outdoor thermal environment in a high-altitude plateau climate where few studies have been conducted.The measurements were conducted during summer and winter in a residential area in Lhasa,Tibet.Without natural shading such as trees,there is a positive correlation between Sky-view factor(SVF)and Physiological equivalent temperature(PET)during winter and a negative correlation during summer.When SVF exceeds 0.65 in summer,it may cause human discomfort.Compared to artificial shading such as a tensioned membrane,deciduous trees are superior at improving human comfort,as they can increase PET by 10.56℃ in winter and decrease it by 9.73℃ in summer.During summer,high-reflection water-permeable bricks can reduce the PET by 1.08℃,and lawns can reduce the mean rachation temperature(Tmrt)by 1.650C;however,the lawns may produce a microclimate with a high air temperature.The results from this paper can be used as a reference for landscape planning and design in residential areas in high-altitude cold-climate regions.

壁面热辐射对车内温度场影响的分析

高原地区空气稀薄,空气导热和对流换热降低,而辐射换热增强.文中通过数值模拟的方法研究了中国高原地区夏季条件下汽车壁面热辐射对整车温度场的影响.应用整体求解法从瞬态和稳态两种角度讨论了车内热辐射对温度场的影响并与平原情况作对比.结果表明在高原地区,考虑壁面辐射的车内空气整体平均温度比不考虑壁面辐射的低8.93 K,稳态时车身的总传热量中的辐射传热占比为41.16%,前玻璃的辐射传热的占比为23.59%,后玻璃的占比为35.94%,发动机罩的为29.91%,椅子为61.96%.因此,在高原地区,固体壁面的辐射换热是一种重要换热形式,不可被忽略.

高寒岩溶土壤微生物群落组成及其多样性

高寒岩溶是四川黄龙风景区独特的地质特征。为分析高寒岩溶区土壤微生物群落组成特征与土壤理化性质间的相关性,以黄龙风景区土壤为研究对象,对土壤细菌的16SrRNA基因序列和真菌ITS序列进行高通量测序。结果表明:不同岩溶区的土壤细菌多样性和丰富度具有显著差异,但土壤真菌差异不显著,且土壤细菌群落占主导地位;细菌群落以变形菌门(Proteobacteria)、酸杆菌门(Acidobacteria)为主;真菌群落以子囊菌门(Ascomycota)、担子菌门(Basidiomycota)为主,真菌在门和属水平的差异较大。冗余分析发现总磷和温度是黄龙风景区土壤微生物群落结构变化的重要环境因子,pH是第二重要的环境因子。

康北高原慢性阻塞性肺疾病急性加重患者发生静脉血栓栓塞症风险预测模型的构建及预测效能

目的筛选康北高原慢性阻塞性肺疾病急性加重患者发生静脉血栓栓塞症风险的预测因素,建立AECOPD发生VTE风险的联合预测模型并分析其预测效能。方法选择2018年1月-2022年9月因慢性阻塞性肺疾病急性加重在甘孜县人民医院住院治疗的患者71例,根据是否发生VTE分为血栓组35例,对照组36例。收集患者的基本资料和检查、检验资料等相关参数数据,选出两组之间具有显著差异的指标。将上述单因素分析中有显著差异的指标纳入多因素分析,筛选出AECOPD发生VTE风险的独立影响因素,并构建预测模型。利用受试者工作特征(receiver operating characteristic,ROC)曲线评价各独立因素及预测模型的应用价值,计算曲线下面积及其敏感度与特异度,分析其预测效能,霍斯默-莱梅肖检验评价拟合度。结果单因素分析显示血栓组PPS评分、乳酸脱氢酶(LDH)、D-二聚体、降钙素原(PCT)均高于对照组(均P<0.05)。Logistic回归分析显示PPS评分、乳酸脱氢酶(LDH)、D-二聚体为AECOPD发生VTE的独立预测因素。三者联合构建的预测模型曲线下面积(area under curve,AUC)为0.944(95%CI:0.893~0.996),灵敏度、特异度均明显优于各单一指标(灵敏度为94.3%、特异度为83.3%),霍斯默-莱梅肖检验拟合度好(χ^(2)=11.915,P=0.155)。结论PPS评分、乳酸脱氢酶(LDH)、D-二聚体可能是预测康北高原AECOPD发生VTE的因素,且三者联合构建的预测模型对VTE风险预测具有很好效能,可为预测AECOPD发生VTE的风险提供参考。

高海拔地区慢性阻塞性肺疾病急性加重期中医证素关联分析

目的探讨高海拔环境下慢性阻塞性肺疾病急性加重期(AECOPD)中医实证证素与人口学特征和临床医学资料之间的相关性。方法选取2020年10月至2021年9月青海省中医院肺病科住院患者634例,收集患者资料进行中医辨证,从证型提取证素,采用多因素Logistic回归分析各证素与人口学特征和临床医学资料之间的相关性。结果证素痰与血红蛋白(Hb)[OR=0.984,95%CI(0.977~0.992),P<0.001]呈负相关;证素饮与年龄[OR=1.041,95%CI(1.004~1.081),P=0.031]、AE次数[OR=1.288,95%CI(1.032~1.608),P=0.025]、AE时间[OR=1.036,95%CI(1.009~1.064),P=0.010]、肌钙蛋白[OR=1.015,95%CI(1.003~1.028),P=0.014]、IgM[OR=2.655,95%CI(1.317~5.352),P=0.006]呈正相关;证素浊与AE时间[OR=0.918,95%CI(0.857~0.984),P=0.016]、Hb[OR=0.967,95%CI(0.947~0.987),P=0.038]呈负相关,与血氧饱和度(SaO_(2))[OR=1.088,95%CI(1.005~1.179),P=0.002]、C3[OR=21.177,95%CI(2.12~211.517),P=0.009]呈正相关;证素瘀与mMRC(4)[OR=0.127,95%CI(0.019~0.835),P=0.032]、PLT[OR=0.995,95%CI(0.991~0.998),P=0.005]呈负相关,与PaCO_(2)[OR=1.048,95%CI(1.002~1.096),P=0.039]、Hb[OR=1.018,95%CI(1.008~1.027),P<0.001]呈正相关;证素湿与Hb[OR=1.022,95%CI(1.006~1.039),P=0.007]、降钙素原(PCT)[OR=1.802,95%CI(1.056~3.076),P=0.031]呈正相关。结论AECOPD实证证素为:痰>瘀>热>饮>浊>湿,证素以“痰”“瘀”为主。年龄越大、AE次数越多、AE时间越长、肌钙蛋白增高、IgM升高,证素饮出现的可能性较大;SaO_(2)及补体C3升高,证素浊出现的可能性较大,补体C3与证素浊有显著的相关性;PaCO_(2)及Hb升高,证素瘀出现的可能性较大;Hb与PCT同时升高,证素湿出现的可能性较大。

某超高海拔多金属矿复杂通风系统优化技术研究

高海拔矿井通风普遍存在系统复杂、设备效率低和效果差等问题。通过理论分析、现场实测和三维仿真模拟解算等技术方法,对某超高海拔多金属矿复杂通风系统进行了优化研究,根据采掘作业计划核算了矿井需风量和风量分配。针对现场实测中发现的总风量不足、主通风机效率偏低、各中段风量分配不合理和井下作业环境差等问题,提出了优化主通风机运行工况,增加深部回风工程和加强密闭等措施,并用Ventsim软件建立了三维仿真模型,进行仿真模拟验证。结果显示,主通风机双机35 Hz频率运行时,通风系统装机功率845 kW,实耗功率345.2 kW,风机平均效率70.8%,总风量137.3 m^(3)/s,风量分配合理,采区通风效果得到明显改善。