利用SCR文件在AutoCAD中绘制复杂曲线

介绍运用VC++6.0语言编程,经exe文件生成AutoCAD的SCR命令文件,并在AutoCAD中一次性地绘制出复杂公式曲线的一种方法。该方法不但扩充了AutoCAD的绘图功能,绘制出精确的曲线,而且还提高了绘图效率。

基于MATLAB生成的SCR文件实现AutoCAD中复杂曲线/曲面的绘制

精确地绘制各种复杂公式曲线和曲面是MATLAB的优势。该文主要介绍利用MATLAB生成AutoCAD的SCR脚本命令文件,来实现AutoCAD中复杂曲线/曲面的绘制方法,有助于弥补AutoCAD作为通用软件在绘制复杂曲线/曲面中的不足。

Study on the accuracy of glomerular filtration rate formulas by double plasma method as "gold standard"

Objective: To evaluate the accuracy of glomerular filtration rate formula by comparising the CKD-EPI 2009 formula and the modified Modified MDRD formula with the 99mTc-DTPA double-phase plasma method as "gold standard" respectively. Methods: Totally 166 patients diognosed as chronic kidney disease (CKD) were enrolled. The 99mTc-DTPA double-plasma method (rGFR) was used as the "gold standard". The CKD-EPI 2009 formula and the modified MDRD formula were used to calculate eGFR. Statistical software was used to analyze the correlation between the calculated values of the two formulas and the gold standard value and the bias. Then we evaluated the accuracy of the two GFR formulas. Results: Among the CKD stage 1 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (13.9911.45;20.1815.90);both formulas were weakly correlated with the gold standard (correlation coefficients were 0.216, 0.229, P<0.01, respectively);The probability that the bias of the calculated value of the CKD-EPI 2009 formula less than 15%, 30%, and 50% of the gold standard value is smaller. Among the CKD stage 2 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (12.748.45;15.6811.01);both formulas were moderately correlated with the gold standard (correlation coefficients were 0.568, 0.581, P<0.01, respectively);The probability that the bias of the calculated value of the CKD-EPI 2009 formula less than 15%, 30%, and 50% of the gold standard value is smaller. Among the CKD stage 3 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (12.6410.27;12.8810.97), and both formulas were strongly correlated with the gold standard (correlation coefficients were 0.664, 0.670, P<0.01, respectively);The probability that the bias of the calculated value of the Modified MDRD formula less than 15%, 30%, and 50% of the gold standard value is smaller. Among the CKD stage 4 to 5 patients, the bias of the CKD-EPI 2009 formula was smaller than that of the Modified MDRD formula (5.585.36;5.945.20);The CKD-EPI 2009 formula and the Modified MDRD formula were strongly correlated with the gold standard (correlation coefficient r was 0.808. 0.802, P<0.01, respectively);The probability of the bias of the calculated value of the CKD-EPI 2009 formula less than 15%, 30%, and 50% of the gold standard value is smaller. In patients with decreased renal function with GFR <60 ml/min, the sensitivity and positive predictive value of the CKD-EPI 2009 formula for the diagnosis of "decreased renal function"were higher, and the specificity was comparable. Conclusion: 1. When the renal function is only slightly decreased, the accuracy of the two formulas is not good. In this condition, the CKD-EPI 2009 formula is more accurate and recommended. 2. It is necessary to further improve the current formulas especialy when it comes to value the slightly declined renal function;3. When we try to identify the stage of CKD patients, only based on eGFR may cause misclassification, it is recommended to combine the cause-GFR-albuminuria staging to assess the stage of CKD;4. The current formulas have limitations.in the case that requires a highly accurate assessment of GFR, the 99mTc-DTPA dual plasma method is recommended.

健脾补肾温阳方治疗老年糖尿病肾病综合征的疗效及对中医证候评分、血肌酐、尿素氮指标的影响

目的探析健脾补肾温阳方在老年糖尿病肾病综合征患者中的治疗效果,分析该方对中医证候评分、血肌酐(SCr)、尿素氮(BUN)指标的影响。方法选取该院2019年2月—2020年2月收治的82例老年糖尿病肾病综合征患者,根据不同疗法将其分为A组与B组,每组41例,A组予以前列地尔治疗,B组予以前列地尔联合健脾补肾温阳方治疗,对比两组患者的中医证候评分、临床疗效、肾功能指标(SCr、BUN)、血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白数)以及不良反应发生情况(恶心、头晕、腹泻、皮疹、发热)。结果 B组治疗后的中医证候评分(12.32±2.18)分,低于A组(15.74±2.71)分,P<0.05;B组的总有效率(90.24%,37/41)高于A组(75.61%,31/41),P<0.05;B组治疗后的SCr、BUN水平(141.16±25.01)μmol/L、(8.03±3.99)mmol/L均低于A组(175.33±26.82)μmol/L、(10.15±4.31)mmol/L,P<0.05;B组治疗后的空腹血糖、餐后2h血糖、糖化血红蛋白水平(7.15±1.85)mmol/L、(8.03±1.74)mmol/L、(6.38±1.16)%均低于A组(8.22±2.03)mmol/L、(10.67±2.16)mmol/L、(7.52±1.23)%,P<0.05;B组的不良反应发生率(12.20%,5/41)与A组(9.76%,4/41)相近,P>0.05。结论健脾补肾温阳方在老年糖尿病肾病综合征患者中的治疗效果显著,可快速缓解患者的临床症状,改善肾功能指标,降低血糖水平,且与单纯西药治疗相比未新增不良反应,值得临床推行。

4种常用公式对常驻高原慢性肾脏病官兵肾小球滤过率的准确性评估

目的:评估常驻高原罹患慢性肾脏病官兵使用肾脏疾病膳食改良研究工作组(The modification of diet in renal disease,MDRD)公式、2009年慢性肾脏病合作组织(Chronic kidney disease epidemiology collaboration,CKD-EPI)3种CKD-EPI公式基于血清肌酐(serum creatinine,Scr)及胱抑素C(serum cystatin C,Scys C)的eGFR估算公式估算肾小球滤过率的准确性。方法:分析2019-01-01~2020-12-31在我院住院治疗的慢性肾脏病官兵(甘肃青海地区常驻海拔>2400 m)的临床资料,以99m Tc-DTPA直接测定为金标准,评估中国改良MDRD公式、CKD-EPI Scr、CKD-EPI Scys C及CKD-EPI Scr-Scys C与99m Tc-DTPA实测GFR的准确性。结果:共收集官兵107例,士官69例(64.5%),军官38例(35.5%)。士官组较军官组年龄小(P<0.05),病程短(P<0.05),但肾功能较差(P<0.05)。在常驻高原官兵中具有最低的偏倚和最高的准确度eGFR公式依次是CKD-EPI Scr-Scys C、CKD-EPI Scys C、CKD-EPI Scr和MDRD公式。CKD-EPI Scr-Scys C和CKD-EPI Scys C公式的准确性高于CKD-EPI Scr和MDRD公式(P<0.05)。CKD-EPI公式与mGFR线性比较总体优于MDRD公式,CKD-EPI Scr-Scys C相关性最好,判定系数R 2为0.796。结论:常驻高原官兵CKD-EPI公式较MDRD公式具有更好的评估准确性。3种CKD-EPI公式中,CKD-EPI Scr-Sys C和CKD-EPI Sys C在评估中准确性最高。