Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the ＇Shacklette＇ data set,was generated by a U.S. Geologica...Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the ＇Shacklette＇ data set,was generated by a U.S. Geological Survey（USGS） project conducted from 1961 to 1975.This project used soil collected from a depth of about 20 cm as the sampling medium at 1323 sites throughout the conterminous U.S.The National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance（NUREHSSR） Program of the U.S.Department of Energy was conducted from 1975 to 1984 and collected either stream sediments,lake sediments,or soils at more than 378,000 sites in both the conterminous U.S.and Alaska.The sampled area represented about 65%of the nation.The Natural Resources Conservation Service（NRCS）,from 1978 to 1982,collected samples from multiple soil horizons at sites within the major crop-growing regions of the conterminous U.S.This data set contains analyses of more than 3000 samples.The National Geochemical Survey,a USGS project conducted from 1997 to 2009,used a subset of the NURE-HSSR archival samples as its starting point and then collected primarily stream sediments, with occasional soils,in the parts of the U.S.not covered by the NURE-HSSR Program.This data set contains chemical analyses for more than 70,000 samples.The USGS,in collaboration with the Mexican Geological Survey and the Geological Survey of Canada,initiated soil sampling for the North American Soil Geochemical Landscapes Project in 2007.Sampling of three horizons or depths at more than 4800 sites in the U.S.was completed in 2010,and chemical analyses are currently ongoing.The NRCS initiated a project in the 1990s to analyze the various soil horizons from selected pedons throughout the U.S.This data set currently contains data from more than 1400 sites.This paper（1） discusses each data set in terms of its purpose,sample collection protocols,and analytical methods;and（2） evaluates each data set in terms of its appropriateness as a national-scale geochemical database and its usefulness for nationalscale geochemical mapping.展开更多
目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未...目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未合并肺部感染患者作为对照组(n=104),合并肺部感染患者作为观察组(n=110)。对患者性别、年龄、发病至入院时间、合并基础疾病、鼻饲饮食、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、气管插管、呼吸机辅助通气等临床资料进行调查,分析缺血性脑卒中患者合并肺部感染的危险因素。结果观察组男56例,女54例,年龄(73.59±8.21)岁;对照组男45例,女59例,年龄(65.32±5.62)岁。单因素分析结果显示,观察组患者年龄、鼻饲饮食、NIHSS评分、GCS评分、是否气管插管、是否呼吸机辅助通气与对照组比较差异有统计学意义(t=8.511、χ^(2)=11.622、t=5.721、t=4.282、χ^(2)=6.868、χ^(2)=6.145,P均<0.05)。多因素Logistic回归分析结果显示,鼻饲饮食(OR=5.447,95%CI:2.477~11.976)、NIHSS评分(OR=8.339,95%CI:2.598~26.768)、GCS评分(OR=7.660,95%CI:3.369~17.413)、气管插管(OR=6.184,95%CI:2.447~15.628)、呼吸机辅助通气(OR=4.302,95%CI:1.830~10.110)是缺血性脑卒中患者合并肺部感染的独立危险因素。结论鼻饲饮食、病情严重程度、意识障碍、气管插管及呼吸机辅助通气是导致缺血性脑卒中患者发生肺部感染的独立危险因素,因此在患者入院时应及时评估,有针对性地实施预防措施。展开更多
文摘Six national-scale,or near national-scale,geochemical data sets for soils or stream sediments exist for the United States.The earliest of these,here termed the ＇Shacklette＇ data set,was generated by a U.S. Geological Survey（USGS） project conducted from 1961 to 1975.This project used soil collected from a depth of about 20 cm as the sampling medium at 1323 sites throughout the conterminous U.S.The National Uranium Resource Evaluation Hydrogeochemical and Stream Sediment Reconnaissance（NUREHSSR） Program of the U.S.Department of Energy was conducted from 1975 to 1984 and collected either stream sediments,lake sediments,or soils at more than 378,000 sites in both the conterminous U.S.and Alaska.The sampled area represented about 65%of the nation.The Natural Resources Conservation Service（NRCS）,from 1978 to 1982,collected samples from multiple soil horizons at sites within the major crop-growing regions of the conterminous U.S.This data set contains analyses of more than 3000 samples.The National Geochemical Survey,a USGS project conducted from 1997 to 2009,used a subset of the NURE-HSSR archival samples as its starting point and then collected primarily stream sediments, with occasional soils,in the parts of the U.S.not covered by the NURE-HSSR Program.This data set contains chemical analyses for more than 70,000 samples.The USGS,in collaboration with the Mexican Geological Survey and the Geological Survey of Canada,initiated soil sampling for the North American Soil Geochemical Landscapes Project in 2007.Sampling of three horizons or depths at more than 4800 sites in the U.S.was completed in 2010,and chemical analyses are currently ongoing.The NRCS initiated a project in the 1990s to analyze the various soil horizons from selected pedons throughout the U.S.This data set currently contains data from more than 1400 sites.This paper（1） discusses each data set in terms of its purpose,sample collection protocols,and analytical methods;and（2） evaluates each data set in terms of its appropriateness as a national-scale geochemical database and its usefulness for nationalscale geochemical mapping.
文摘目的分析缺血性脑卒中患者院内合并肺部感染的影响因素。方法回顾性分析2020年3月至2022年2月期间在南通市第三人民医院治疗的214例缺血性脑卒中患者病历资料。根据《中国成人医院获得性肺炎与呼吸机相关性肺炎诊断和治疗指南》分组,未合并肺部感染患者作为对照组(n=104),合并肺部感染患者作为观察组(n=110)。对患者性别、年龄、发病至入院时间、合并基础疾病、鼻饲饮食、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分、气管插管、呼吸机辅助通气等临床资料进行调查,分析缺血性脑卒中患者合并肺部感染的危险因素。结果观察组男56例,女54例,年龄(73.59±8.21)岁;对照组男45例,女59例,年龄(65.32±5.62)岁。单因素分析结果显示,观察组患者年龄、鼻饲饮食、NIHSS评分、GCS评分、是否气管插管、是否呼吸机辅助通气与对照组比较差异有统计学意义(t=8.511、χ^(2)=11.622、t=5.721、t=4.282、χ^(2)=6.868、χ^(2)=6.145,P均<0.05)。多因素Logistic回归分析结果显示,鼻饲饮食(OR=5.447,95%CI:2.477~11.976)、NIHSS评分(OR=8.339,95%CI:2.598~26.768)、GCS评分(OR=7.660,95%CI:3.369~17.413)、气管插管(OR=6.184,95%CI:2.447~15.628)、呼吸机辅助通气(OR=4.302,95%CI:1.830~10.110)是缺血性脑卒中患者合并肺部感染的独立危险因素。结论鼻饲饮食、病情严重程度、意识障碍、气管插管及呼吸机辅助通气是导致缺血性脑卒中患者发生肺部感染的独立危险因素,因此在患者入院时应及时评估,有针对性地实施预防措施。
文摘目的 探究标准剂量rt-PA静脉溶栓联合动脉取栓治疗急性脑梗死的效果。方法 随机选取海阳市人民医院于2021年7月—2023年7月收治的80例急性脑梗死患者为研究对象,通过随机数表法分成溶栓组与桥接组,各40例。溶栓组运用标准量静脉溶栓治疗,桥接组在经过30 min静脉溶栓治疗之后,对治疗效果不理想的患者,进行机械取栓。比较两组的国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分以及不良反应发生情况。结果 治疗后24 h、7 d、30 d,桥接组的NIHSS评分均低于溶栓组,差异有统计学意义(P均<0.05)。桥接组的不良反应总发生率为7.50%,溶栓组为2.50%,两组对比,差异无统计学意义(χ^(2)=0.263,P>0.05)。结论 标准剂量rt-PA静脉溶栓联合动脉取栓治疗有效地促进了患者神经功能的恢复,不良反应与溶栓治疗相当,对急性脑梗死的治疗提供了有力的支持。
