目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期...目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期进行管理,以抢救生命、治疗疾病为重点,期间以控制管理基础疾病为基础,包括预防感染、血糖管理、症状护理、血浆置换护理、管道管理、心理护理等方面。结果:连续治疗10 d后患者生命体征暂时能够平稳,病情得到控制。结论:对患者生命治疗周期进行整体管控护理,针对基础慢性疾病合并疑难急症进行科学合理地护理,能迅速保障患者生命安全、提升治疗效率。Objective: To summarize the key points of nursing for a 64-year-old patient with type II diabetes mellitus complicated with thrombotic thrombocytopenic purpura during inpatient treatment for major nursing problems such as infection, endocrine and metabolic disorders, bleeding and gas exchange disorders during plasma exchange treatment, in order to provide reference for similar cases. Methods: The whole cycle of treatment was managed, focusing on life-saving and disease treatment, and the control and management of underlying diseases were the basis, including infection prevention, blood glucose management, symptom nursing, plasmapheresis nursing, pipeline management, and psychological nursing. Results: After 10 days of continuous treatment, the patient’s vital signs were temporarily stable and the condition was controlled. Conclusion: The overall control and nursing of the patient’s life cycle and the scientific and reasonable nursing for the underlying chronic diseases combined with intractable and urgent diseases can quickly ensure the life safety of patients and improve the treatment efficiency.展开更多
目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分...目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.展开更多
Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles o...Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles of human alveolar type II epithelial cells(A549 cells)exposed directly to silica were characterized using non-targeted metabolomic approaches.A total of 84 differential metabolites(DMs)were identified in silica-treated A549 cells undergoing EMT,which were mainly enriched in metabolisms of amino acids(e.g.,glutamate,alanine,aspartate),purine metabolism,glycolysis,etc.The number of DMs identified in the A549 cells obviously increased with the elevated exposure concentration of silica.Remarkably,glutamine catabolism was significantly promoted in the silica-treated A549 cells,and the levels of related metabolites(e.g.,succinate)and enzymes(e.g.,α-ketoglutarate(α-KG)dehydrogenase)were substantially up-regulated,with a preference toα-KG pathway.Supplementation of glutamine into the cell culture could substantially enhance the expression levels of both EMT-related markers and Snail(zinc finger transcription factor).Our results suggest that the EMT of human alveolar epithelial cells directly induced by silica can be essential to the development of silicosis.展开更多
The distribution networks sometimes suffer from excessive losses and voltage violations in densely populated areas. The aim of the present study is to improve the performance of a distribution network by successively ...The distribution networks sometimes suffer from excessive losses and voltage violations in densely populated areas. The aim of the present study is to improve the performance of a distribution network by successively applying mono-capacitor positioning, multiple positioning and reconfiguration processes using GA-based algorithms implemented in a Matlab environment. From the diagnostic study of this network, it was observed that a minimum voltage of 0.90 pu induces a voltage deviation of 5.26%, followed by active and reactive losses of 425.08 kW and 435.09 kVAR, respectively. Single placement with the NSGAII resulted in the placement of a 3000 kVAR capacitor at node 128, which proved to be the invariably neuralgic point. Multiple placements resulted in a 21.55% reduction in losses and a 0.74% regression in voltage profile performance. After topology optimization, the loss profile improved by 65.08% and the voltage profile improved by 1.05%. Genetic algorithms are efficient and effective tools for improving the performance of distribution networks, whose degradation is often dynamic due to the natural variability of loads.展开更多
常见的精神疾病包括抑郁、焦虑、双相情感障碍和精神分裂症等。伴随现代社会高速发展,社会压力与日俱增,精神疾病的发病率亦呈明显上升趋势。钙/钙调蛋白依赖性蛋白激酶II(calcium/calmodulin dependent protein kinase II,CaMKII)可通...常见的精神疾病包括抑郁、焦虑、双相情感障碍和精神分裂症等。伴随现代社会高速发展,社会压力与日俱增,精神疾病的发病率亦呈明显上升趋势。钙/钙调蛋白依赖性蛋白激酶II(calcium/calmodulin dependent protein kinase II,CaMKII)可通过作用于钙信号级联反应途径,参与调控体内生物学功能或疾病发生发展。目前,CaMKII相关研究越来越广泛且深入,其在神经精神疾病中的调控作用受到广泛关注。本文将对CaMKII在焦虑、抑郁等精神疾病中的研究进展及相关病理生理机制进行综述。展开更多
文摘目的:总结一例64岁II型糖尿病合并血栓性血小板减少性紫癜患者在院治疗调控血糖期间针对在血浆置换治疗过程中出现感染、内分泌代谢紊乱、出血、气体交换障碍等主要护理问题的护理要点,以期为相似案例提供借鉴。方法:就患者治疗全周期进行管理,以抢救生命、治疗疾病为重点,期间以控制管理基础疾病为基础,包括预防感染、血糖管理、症状护理、血浆置换护理、管道管理、心理护理等方面。结果:连续治疗10 d后患者生命体征暂时能够平稳,病情得到控制。结论:对患者生命治疗周期进行整体管控护理,针对基础慢性疾病合并疑难急症进行科学合理地护理,能迅速保障患者生命安全、提升治疗效率。Objective: To summarize the key points of nursing for a 64-year-old patient with type II diabetes mellitus complicated with thrombotic thrombocytopenic purpura during inpatient treatment for major nursing problems such as infection, endocrine and metabolic disorders, bleeding and gas exchange disorders during plasma exchange treatment, in order to provide reference for similar cases. Methods: The whole cycle of treatment was managed, focusing on life-saving and disease treatment, and the control and management of underlying diseases were the basis, including infection prevention, blood glucose management, symptom nursing, plasmapheresis nursing, pipeline management, and psychological nursing. Results: After 10 days of continuous treatment, the patient’s vital signs were temporarily stable and the condition was controlled. Conclusion: The overall control and nursing of the patient’s life cycle and the scientific and reasonable nursing for the underlying chronic diseases combined with intractable and urgent diseases can quickly ensure the life safety of patients and improve the treatment efficiency.
基金the National Key R&D Program of China(2022YFB3206000)the National Natural Science Foundation of China(U23A20487)+1 种基金Dr.Li Dak Sum&Yip Yio Chin Development Fund for Regenerative Medicine,Zhejiang Universitythe National Natural Science Foundation of China(61975172).
文摘近红外二区(the second near-infrared window,NIR-II,900~1880 nm)荧光成像具有信号背景比高、穿透深度大的优势,在生物医学领域具有广泛的应用前景。对NIR-II成像窗口的划分有利于优化成像过程,其中,NIRIIx(1400~1500 nm)成像窗口得益于其独特的水吸收,可以有效抑制散射背景,实现高对比度成像。文章通过仿真模拟和活体实验,系统评估了NIR-IIx窗口的成像潜力。为了更好地推进NIR-IIx荧光成像的临床转化,研究采用美国食品及药物管理局(FDA)批准的有机小分子染料吲哚菁绿(Indocyanine Green,ICG)作为荧光探针,利用其延伸至NIR-II的荧光发射拖尾,实现了高对比度和清晰度的小鼠血管和肠道的NIR-IIx成像。此外,研究还结合同样通过FDA认证的亚甲基蓝(Methylene Blue,MB),成功实现了高质量的NIR-II双通道成像,精准定位小鼠的血管和淋巴结。文章进一步挖掘了NIR-IIx在生物成像上的独特优势和临床应用的潜力,并为NIR-II荧光成像的临床转化提供了重要参考。
文摘目的:探讨外周血平均血小板体积/淋巴细胞计数(MPVLR)联合APACHE II评分对脓毒症患者预后的预测价值。方法:采用回顾性队列研究方法,选择该院2020年8月至2023年8月收治的符合脓毒症3.0诊断标准的患者。根据脓毒症患者的28 d预后情况分为生存组及死亡组。收集患者的临床资料及确诊脓毒症后24 h内血小板体积(MPV)、淋巴细胞(LYM)计数的最差值,并计算平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分及SOFA评分。随后使用多因素Logistic回归分析,确定脓毒症患者预后的影响因素,再构建受试者工作特征曲线,评估各项指标对脓毒症患者预后的预测价值。结果:共纳入患者127例,生存组患者76例,死亡组患者51例。死亡组患者更易合并慢性阻塞性肺疾病,且平均血小板体积(MPV)、平均血小板体积/淋巴细胞计数(MPVLR)、APACHE II评分、SOFA评分、及年龄均高于生存组,且差异具有统计学意义(P Objective: To investigate the prognostic value of the mean platelet volume (MPV)-to-lymphocyte ratio (MPVLR) combined with the APACHE II score in predicting the outcomes of patients with sepsis. Methods: This retrospective study screened patients with sepsis who were hospitalized in our hospital, from August 2020 to August 2023 were included and categorized into the survival group and the non-survival group based on 28-day outcomes of sepsis patients. Clinical date and the worst of mean platelet volume (MPV), lymphocyte (LYM) count values within 24 hours of sepsis diagnosis were collected, MPVLR and APACHE II scores were calculated. Multifactorial logistic regression analysis was used to identify risk factors affecting the prognosis of sepsis patients, and then a subject operating characteristic curve (ROC) was constructed to assess the predictive value of each indicator on the prognosis of sepsis patients. Results: A total of 127 patients were included, with 76 in the survival group and 51 in the non-survival group. Patients in the non-survival group were more likely to have chronic obstructive pulmonary disease, and had significantly higher MPV, MPVLR, APACHE II scores, SOFA scores and age compared to the survival group (P < 0.05). In contrast, peripheral blood lymphocyte counts in the survival group were significantly higher than that in the non-survival group (P < 0.05). Multivariate logistic regression analysis showed that MPVLR and APACHE II scores were independent risk factors for 28-day mortality in sepsis patients (P < 0.05). Receiver operating characteristic curve (ROC) curve analysis showed that the area under the curve (AUC) values for MPVLR, APACHE II scores, and their combination were 0.840, 0.800, and 0.885, respectively. Notably, the MPVLR combined with the APACHE II score showed the best predictive value, with an AUC of 0.824. It demonstrated excellent predictive performance, achieving a sensitivity of 94.6% and a specificity of 82.4%. Conclusion: APACHE II scores and MPVLR are independent risk factors for 28-day mortality in sepsis patients, and their combined use provides higher predictive value.
基金supported by the National Natural Science Foundation of China(Nos.22206207,22127810,and 22276224)the Natural Science Foundation of Guangdong Province(Nos.2021A1515011546 and 2023A1515010085)the Science and Technology Planning Project of Guangzhou(No.202102080005)。
文摘Epithelial-mesenchymal transition(EMT)plays an irreplaceable role in the development of silicosis.However,molecular mechanisms of EMT induced by silica exposure still remain to be addressed.Herein,metabolic profiles of human alveolar type II epithelial cells(A549 cells)exposed directly to silica were characterized using non-targeted metabolomic approaches.A total of 84 differential metabolites(DMs)were identified in silica-treated A549 cells undergoing EMT,which were mainly enriched in metabolisms of amino acids(e.g.,glutamate,alanine,aspartate),purine metabolism,glycolysis,etc.The number of DMs identified in the A549 cells obviously increased with the elevated exposure concentration of silica.Remarkably,glutamine catabolism was significantly promoted in the silica-treated A549 cells,and the levels of related metabolites(e.g.,succinate)and enzymes(e.g.,α-ketoglutarate(α-KG)dehydrogenase)were substantially up-regulated,with a preference toα-KG pathway.Supplementation of glutamine into the cell culture could substantially enhance the expression levels of both EMT-related markers and Snail(zinc finger transcription factor).Our results suggest that the EMT of human alveolar epithelial cells directly induced by silica can be essential to the development of silicosis.
文摘The distribution networks sometimes suffer from excessive losses and voltage violations in densely populated areas. The aim of the present study is to improve the performance of a distribution network by successively applying mono-capacitor positioning, multiple positioning and reconfiguration processes using GA-based algorithms implemented in a Matlab environment. From the diagnostic study of this network, it was observed that a minimum voltage of 0.90 pu induces a voltage deviation of 5.26%, followed by active and reactive losses of 425.08 kW and 435.09 kVAR, respectively. Single placement with the NSGAII resulted in the placement of a 3000 kVAR capacitor at node 128, which proved to be the invariably neuralgic point. Multiple placements resulted in a 21.55% reduction in losses and a 0.74% regression in voltage profile performance. After topology optimization, the loss profile improved by 65.08% and the voltage profile improved by 1.05%. Genetic algorithms are efficient and effective tools for improving the performance of distribution networks, whose degradation is often dynamic due to the natural variability of loads.
文摘常见的精神疾病包括抑郁、焦虑、双相情感障碍和精神分裂症等。伴随现代社会高速发展,社会压力与日俱增,精神疾病的发病率亦呈明显上升趋势。钙/钙调蛋白依赖性蛋白激酶II(calcium/calmodulin dependent protein kinase II,CaMKII)可通过作用于钙信号级联反应途径,参与调控体内生物学功能或疾病发生发展。目前,CaMKII相关研究越来越广泛且深入,其在神经精神疾病中的调控作用受到广泛关注。本文将对CaMKII在焦虑、抑郁等精神疾病中的研究进展及相关病理生理机制进行综述。
