目的：探讨血清Kerbs von Lungren 6（KL-6）水平在创伤性急性呼吸窘迫综合征（ARDS）中的变化及其诊断价值。方法：共选取本院从2013年1月至2014年12月54例创伤性ARDS住院患者,所有病例均符合2011年＂ARDS柏林诊断标准＂。对照人群来...目的：探讨血清Kerbs von Lungren 6（KL-6）水平在创伤性急性呼吸窘迫综合征（ARDS）中的变化及其诊断价值。方法：共选取本院从2013年1月至2014年12月54例创伤性ARDS住院患者,所有病例均符合2011年＂ARDS柏林诊断标准＂。对照人群来自于到本院就诊而未发生ARDS的创伤患者53例。另选择到本院体检者50例,作为基础对照。采用ELISA检测了各人群血清KL-6水平,并进行肺损伤预测评分（LIPS）、肺损伤评分（LIS）,检测PaO2/FiO2。比较KL-6在不同人群中的表达情况,及其与LIPS、LIS、PaO2/FiO2的相关性。采用受试者工作特征（ROC）曲线评价血清KL-6在创伤性ARDS中的诊断价值。结果：血清KL-6水平在创伤性ARDS患者中明显上升,并且合并多器官功能障碍（MODS）的患者血清KL-6水平均明显增高于无并发多器官功能障碍患者。血清KL-6水平与LIPS、LIS评分呈正相关,与PaO2/FiO2呈负相关。ROC曲线分析显示,血清KL-6评分在预测创伤性ARDS方面有显著意义。其曲线下面积（AUC）为0.891,95%可信区间（confidence interval）为0.831-0.952（P〈0.01）。当血清KL-6水平大于426.4 units·ml^-1时,预测创伤性ARDS的敏感度为62.9%,特异性为91.2%。结论：KL-6是创伤性ARDS的良好生物标志物,可以用于该疾病的早期诊断。展开更多
目的探讨支气管肺发育不良(Bronchopulmonary dysplasia,BPD)儿童支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中Ⅱ型肺泡细胞表面抗原(Kerbs von Lungren 6 antigen,KL-6)、粒细胞集落刺激因子(Granulocyte-colony stimulatin...目的探讨支气管肺发育不良(Bronchopulmonary dysplasia,BPD)儿童支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中Ⅱ型肺泡细胞表面抗原(Kerbs von Lungren 6 antigen,KL-6)、粒细胞集落刺激因子(Granulocyte-colony stimulating factor,G-CSF)及胰岛素样生长因子(Insulin-like growth factor-1,IGF-1)表达意义,为临床诊疗提供参考。方法选取2020年2月-2023年10月河北梅奥心血管病医院收治的192例BPD患儿,根据吸入氧浓度(Inhalation of oxygen concentration,FiO_(2))分为轻度BPD组(n=103,未用氧)、中度BPD组(n=60,21%<FiO_(2)<30%),重度BPD组(n=29,FiO_(2)≥30%或机械通气)。比较不同吸氧程度BPD患儿出生后不同时间BALF中KL-6、G-CSF、IGF-1表达水平及FeNO、潮气呼吸肺功能。分析BALF中KL-6、G-CSF、IGF-1与吸氧程度、呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)及潮气呼吸肺功能[达峰容积比(Volume to peak expiratory flow as a proportion of exhaled volume,VPEF/VE)、达峰时间比(Time to peak tidal expiratory flow as a proportion of expiratory time,TPTEF/TE)]的相关性。结果轻度BPD组KL-6表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组G-CSF表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组IGF-1表达水平高于中度BPD组、重度BPD组,且中度BPD组高于重度BPD组(P<0.05);轻度BPD组FeNO小于中度BPD组、重度BPD组,VPEF/VE、TPTEF/TE大于中度BPD组、重度BPD组,且中度BPD组FeNO小于重度BPD组,VPEF/VE、TPTEF/TE大于重度BPD组(P<0.05);BPD患儿出生后1 d、7 d、14 d、28 d BALF中KL-6、G-CSF与吸氧程度呈正相关,IGF-1与吸氧程度呈负相关(P<0.05);BPD患儿出生后1 d BALF中KL-6、G-CSF与矫正胎龄40周时FeNO呈正相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈负相关(P<0.05);BPD患儿出生后1 d BALF中IGF-1与矫正胎龄40周时FeNO呈负相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈正相关(P<0.05)。结论BPD患儿BALF中KL-6、G-CSF、IGF-1与吸氧程度有关,且与远期FeNO及潮气呼吸肺功能有关,对临床干预有一定指导价值。展开更多
Road side barriers are constructed to protect passengers and contain vehicles when a vehicle crashes into a barrier. In general, full-scale crash testing needs to be carried out if a geometrically and structurally equ...Road side barriers are constructed to protect passengers and contain vehicles when a vehicle crashes into a barrier. In general, full-scale crash testing needs to be carried out if a geometrically and structurally equivalent barrier has not previously been proven to meet the requirements of containing the vehicle and dissipating sufficient impact energy for passenger protection. As full-scale crash testing is very expensive, the number of data that can be measured in a test is usually limited, and it may not always be possible to obtain good quality measurements in such a test, a reliable and efficient numerical simulation of crash testing is therefore very useful. This paper presents finite element simulations of a 3-rail steel road traffic barrier under vehicle impact. The performance levels defined in Australian Standards AS5100 Clause 10.5 for these barriers are checked. The numerical simulations show that the barrier is able to meet low performance levels. However, the maximum deceleration is higher than the acceptable limit for passenger protection. If present, a kerb launches the vehicles into the barrier, allowing for the possibility of overriding the barrier under certain circumstances, but it redirects the vehicle and reduces the incident angle, which reduces impact force on the barrier. Further investigation into all common kerb profiles on roads should be carried out, as only one kerb profile is investigated in this study.展开更多
文摘目的探讨支气管肺发育不良(Bronchopulmonary dysplasia,BPD)儿童支气管肺泡灌洗液(Bronchoalveolar lavage fluid,BALF)中Ⅱ型肺泡细胞表面抗原(Kerbs von Lungren 6 antigen,KL-6)、粒细胞集落刺激因子(Granulocyte-colony stimulating factor,G-CSF)及胰岛素样生长因子(Insulin-like growth factor-1,IGF-1)表达意义,为临床诊疗提供参考。方法选取2020年2月-2023年10月河北梅奥心血管病医院收治的192例BPD患儿,根据吸入氧浓度(Inhalation of oxygen concentration,FiO_(2))分为轻度BPD组(n=103,未用氧)、中度BPD组(n=60,21%<FiO_(2)<30%),重度BPD组(n=29,FiO_(2)≥30%或机械通气)。比较不同吸氧程度BPD患儿出生后不同时间BALF中KL-6、G-CSF、IGF-1表达水平及FeNO、潮气呼吸肺功能。分析BALF中KL-6、G-CSF、IGF-1与吸氧程度、呼出气一氧化氮(Fractional exhaled nitric oxide,FeNO)及潮气呼吸肺功能[达峰容积比(Volume to peak expiratory flow as a proportion of exhaled volume,VPEF/VE)、达峰时间比(Time to peak tidal expiratory flow as a proportion of expiratory time,TPTEF/TE)]的相关性。结果轻度BPD组KL-6表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组G-CSF表达水平低于中度BPD组、重度BPD组,且中度BPD组低于重度BPD组(P<0.05);轻度BPD组IGF-1表达水平高于中度BPD组、重度BPD组,且中度BPD组高于重度BPD组(P<0.05);轻度BPD组FeNO小于中度BPD组、重度BPD组,VPEF/VE、TPTEF/TE大于中度BPD组、重度BPD组,且中度BPD组FeNO小于重度BPD组,VPEF/VE、TPTEF/TE大于重度BPD组(P<0.05);BPD患儿出生后1 d、7 d、14 d、28 d BALF中KL-6、G-CSF与吸氧程度呈正相关,IGF-1与吸氧程度呈负相关(P<0.05);BPD患儿出生后1 d BALF中KL-6、G-CSF与矫正胎龄40周时FeNO呈正相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈负相关(P<0.05);BPD患儿出生后1 d BALF中IGF-1与矫正胎龄40周时FeNO呈负相关,与矫正胎龄40周时VPEF/VE、TPTEF/TE呈正相关(P<0.05)。结论BPD患儿BALF中KL-6、G-CSF、IGF-1与吸氧程度有关,且与远期FeNO及潮气呼吸肺功能有关,对临床干预有一定指导价值。
文摘目的观察老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)稳定期患者血清白细胞介素-6(interleukin-6,IL-6)、Ⅱ型肺泡细胞表面抗原(Kerbs von Lungren 6antigen,KL-6)水平变化,探讨其对老年COPD稳定期患者发生中重度气流受限的预测价值。方法 135例老年COPD稳定期患者,根据气流受限程度分为轻度组59例和中重度组76例。比较2组年龄、性别、病程、肺功能分级等临床资料;记录2组入院时用力肺活量(forced vital capacity,FVC)、第1秒用力呼气容积(forced expiratory volume in one second,FEV_(1))占预计值百分比(FEV_(1)%pred)、FEV_(1)/FVC及血清IL-6、KL-6水平;多因素logistic回归分析老年COPD稳定期患者发生中重度气流受限的影响因素;绘制ROC曲线,评估血清IL-6、KL-6预测老年COPD稳定期患者发生中重度气流受限的价值。结果中重度组血清IL-6[(29.85±5.07)ng/L]、KL-6[(452.39±57.61)ku/L]水平及肺功能分级Ⅳ级比率(47.37%)均高于轻度组[(24.02±4.31)ng/L、(391.64±43.51)ku/L、20.34%](P<0.05),FVC[(2.04±0.58)L]、FEV_(1)%pred[(44.82±4.57)%]、FEV_(1)/FVC[(66.67±0.48)%]均低于轻度组[(2.38±0.53)L、(48.36±4.29)%、(68.65±0.37)%](P<0.05),年龄、性别比例、病程、1年内急性发作次数与轻度组比较差异均无统计学意义(P>0.05)。血清IL-6(OR=1.314,95%CI:1.163~1.483,P<0.001)、KL-6(OR=1.027,95%CI:1.014~1.040,P<0.001)是老年COPD稳定期患者发生中重度气流受限的影响因素。血清IL-6、KL-6分别以26.70ng/L、412.55ku/L为最佳截断值,单独及联合预测老年COPD稳定期患者发生中重度气流受限的AUC分别为0.815(95%CI:0.744~0.887,P<0.001)、0.802(95%CI:0.729~0.875,P<0.001)、0.830(95%CI:0.761~0.898,P<0.001),灵敏度分别为72.9%、71.2%、83.1%,特异度分别为75.0%、71.1%、67.1%。结论中重度气流受限的老年COPD稳定期患者血清IL-6、KL-6水平升高,血清IL-6、KL-6是老年COPD稳定期患者发生中重度气流受限的影响因素,二者联合预测老年COPD稳定期患者发生中重度气流受限有较高价值。
文摘Road side barriers are constructed to protect passengers and contain vehicles when a vehicle crashes into a barrier. In general, full-scale crash testing needs to be carried out if a geometrically and structurally equivalent barrier has not previously been proven to meet the requirements of containing the vehicle and dissipating sufficient impact energy for passenger protection. As full-scale crash testing is very expensive, the number of data that can be measured in a test is usually limited, and it may not always be possible to obtain good quality measurements in such a test, a reliable and efficient numerical simulation of crash testing is therefore very useful. This paper presents finite element simulations of a 3-rail steel road traffic barrier under vehicle impact. The performance levels defined in Australian Standards AS5100 Clause 10.5 for these barriers are checked. The numerical simulations show that the barrier is able to meet low performance levels. However, the maximum deceleration is higher than the acceptable limit for passenger protection. If present, a kerb launches the vehicles into the barrier, allowing for the possibility of overriding the barrier under certain circumstances, but it redirects the vehicle and reduces the incident angle, which reduces impact force on the barrier. Further investigation into all common kerb profiles on roads should be carried out, as only one kerb profile is investigated in this study.
