目的:对国内外危重症患者静脉血栓形成的危险因素进行系统荟萃分析。方法:从中国知网(CNKI)、维普期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、Cochrane Library和MEDLINE数据库筛选...目的:对国内外危重症患者静脉血栓形成的危险因素进行系统荟萃分析。方法:从中国知网(CNKI)、维普期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Embase、Web of Science、Cochrane Library和MEDLINE数据库筛选危重症患者静脉血栓形成危险因素的相关文献。采用纽卡斯卡一渥太华量表(Newcastle-Ottawa scale,NOS)对文献进行质量评价,应用Review Manager 5.4软件进行Meta分析。结果:最终纳入15篇文献进入统计分析,包括5351例住院患者。Meta分析显示人口学资料中,制动[OR=5.4,95%CI:3.58~8.14),P<0.001]、癌症(OR=1.64,95%CI:1.09~2.47,P=0.02),中心静脉置管(OR=2.12,95%CI:1.39~3.22,P=0.0005),透析(OR=2.38,95%CI:1.39~4.09,P=0.002),手术(OR=2.62,95%CI:1.14~6.02,P=0.02),机械通气(OR=2.13,95%CI:1.36~3.35,P=0.001),心力衰竭(OR=1.99,95%CI:1.41~2.82,P<0.0001)是危重症患者静脉血栓形成的高危因素。抗凝治疗(OR=0.16,95%CI:0.03~0.93,P<0.04),物理预防(OR=0.16,95%CI:0.14~0.18,P=0.001)是危重症患者静脉血栓形成的保护因素。结论:制动、癌症、中心静脉置管、透析、手术、机械通气及心力衰竭是危重症患者发生静脉血栓形成的危险因素。抗凝治疗,物理预防是危重症患者静脉血栓形成的保护因素。展开更多
The efficient hydrogenolysis of esters to alkanes is the key protocol for producing advanced biofuels from renewable plant oils or fats.Due to the low reactivity of the carbonyl group in esters,a high reaction tempera...The efficient hydrogenolysis of esters to alkanes is the key protocol for producing advanced biofuels from renewable plant oils or fats.Due to the low reactivity of the carbonyl group in esters,a high reaction temperature(>250℃)is the prerequisite to ensure high conversion of esters.Here,we report a highly dispersed MoO_(x)-Ru/C bimetallic catalyst for the efficient hydrogenolysis of esters to alkanes under 150°C.The optimal catalyst exhibits>99%conversion of methyl stearate and 99%selectivity to diesel-range alkanes,reaching a high rate of up to 2.0 mmol gcat^(–1)h^(–1),5 times higher than that of Ru/C catalyst(MoO_(x)/C is inert).Integrated experimental and theoretical investigations attribute the high performance to the abundant MoO_(x)-Ru interfacial sites on the catalyst surface,which offers high activity for the C–O cleavage of esters.Furthermore,the dispersed MoO_(x)species significantly weaken the hydrocracking activity of the metallic Ru for C–C bonds,thus yielding alkane products without carbon loss.This study provides a facile and novel strategy for the design of high-performance heterogeneous catalysts for the hydrodeoxygenation of biomass-derived esters to alkane products.展开更多
背景髋部骨折是老年患者致残、致死的主要原因之一。骨折后若发生下肢深静脉血栓可明显增加老年髋部骨折患者的住院时间和死亡率。目的探讨70岁以上老年髋部骨折患者术前发生下肢深静脉血栓的危险因素及麻醉特点。方法回顾性分析解放军...背景髋部骨折是老年患者致残、致死的主要原因之一。骨折后若发生下肢深静脉血栓可明显增加老年髋部骨折患者的住院时间和死亡率。目的探讨70岁以上老年髋部骨折患者术前发生下肢深静脉血栓的危险因素及麻醉特点。方法回顾性分析解放军总医院海南医院麻醉科2012年1月-2018年12月收治的258例70岁以上髋部骨折患者的临床资料。根据术前下肢静脉超声是否发生深静脉血栓分为深静脉血栓组和非深静脉血栓组。多因素分析术前发生深静脉血栓的危险因素,以及该类患者并存疾病和麻醉特点。结果本组15例(5.8%)患者术前发生深静脉血栓,其中3例放置下腔静脉滤器。152例(58.9%)患者术前ASA评级为Ⅲ~Ⅳ级;135例(52.3%)患者采取神经阻滞麻醉,48例(18.6%)患者采取全身麻醉;17例(6.6%)患者骨折后48 h内手术。深静脉血栓组与非深静脉血栓组术前贫血[12例(80.0%)vs 116例(48.5%)]、骨折到手术时间[14.0(7.3,31.8)d vs 9.0(6.0,11.0)d]差异均有统计学意义(P均<0.05);多因素logistic分析示术前贫血(OR:0.296;95%CI:0.075-1.170;P=0.083)和骨折到手术时间(OR:1.020;95%CI:0.997-1.044;P=0.094)不是术前发生深静脉血栓的独立危险因素。结论本研究尚未发现术前贫血和骨折到手术时间是高龄髋部骨折患者术前发生下肢深静脉血栓的独立危险因素。这类患者术前ASA评级高,基础疾病多,神经阻滞麻醉为其主要麻醉方式。展开更多
文摘The efficient hydrogenolysis of esters to alkanes is the key protocol for producing advanced biofuels from renewable plant oils or fats.Due to the low reactivity of the carbonyl group in esters,a high reaction temperature(>250℃)is the prerequisite to ensure high conversion of esters.Here,we report a highly dispersed MoO_(x)-Ru/C bimetallic catalyst for the efficient hydrogenolysis of esters to alkanes under 150°C.The optimal catalyst exhibits>99%conversion of methyl stearate and 99%selectivity to diesel-range alkanes,reaching a high rate of up to 2.0 mmol gcat^(–1)h^(–1),5 times higher than that of Ru/C catalyst(MoO_(x)/C is inert).Integrated experimental and theoretical investigations attribute the high performance to the abundant MoO_(x)-Ru interfacial sites on the catalyst surface,which offers high activity for the C–O cleavage of esters.Furthermore,the dispersed MoO_(x)species significantly weaken the hydrocracking activity of the metallic Ru for C–C bonds,thus yielding alkane products without carbon loss.This study provides a facile and novel strategy for the design of high-performance heterogeneous catalysts for the hydrodeoxygenation of biomass-derived esters to alkane products.
文摘背景髋部骨折是老年患者致残、致死的主要原因之一。骨折后若发生下肢深静脉血栓可明显增加老年髋部骨折患者的住院时间和死亡率。目的探讨70岁以上老年髋部骨折患者术前发生下肢深静脉血栓的危险因素及麻醉特点。方法回顾性分析解放军总医院海南医院麻醉科2012年1月-2018年12月收治的258例70岁以上髋部骨折患者的临床资料。根据术前下肢静脉超声是否发生深静脉血栓分为深静脉血栓组和非深静脉血栓组。多因素分析术前发生深静脉血栓的危险因素,以及该类患者并存疾病和麻醉特点。结果本组15例(5.8%)患者术前发生深静脉血栓,其中3例放置下腔静脉滤器。152例(58.9%)患者术前ASA评级为Ⅲ~Ⅳ级;135例(52.3%)患者采取神经阻滞麻醉,48例(18.6%)患者采取全身麻醉;17例(6.6%)患者骨折后48 h内手术。深静脉血栓组与非深静脉血栓组术前贫血[12例(80.0%)vs 116例(48.5%)]、骨折到手术时间[14.0(7.3,31.8)d vs 9.0(6.0,11.0)d]差异均有统计学意义(P均<0.05);多因素logistic分析示术前贫血(OR:0.296;95%CI:0.075-1.170;P=0.083)和骨折到手术时间(OR:1.020;95%CI:0.997-1.044;P=0.094)不是术前发生深静脉血栓的独立危险因素。结论本研究尚未发现术前贫血和骨折到手术时间是高龄髋部骨折患者术前发生下肢深静脉血栓的独立危险因素。这类患者术前ASA评级高,基础疾病多,神经阻滞麻醉为其主要麻醉方式。
