期刊文献+
共找到30,179篇文章
< 1 2 250 >
每页显示 20 50 100
Overexpression of HSP27 and HSP70 is associated with decreased survival among patients with esophageal adenocarcinoma 预览
1
作者 Henna K Soerstrom Juha T Kauppi +4 位作者 Niku Oksala Timo Paavonen Leena Krogerus Jari Rasanen Tuomo Rantanen 《世界临床病例杂志》 2019年第3期260-269,共10页
BACKGROUND Overexpression of heat shock proteins(HSPs)is associated with several malignancies and contributes to the development,progression,and metastasis of cancer,in addition to the inhibition of cellular death.In ... BACKGROUND Overexpression of heat shock proteins(HSPs)is associated with several malignancies and contributes to the development,progression,and metastasis of cancer,in addition to the inhibition of cellular death.In recent years,there has been active research into using HSP inhibitors in several malignancies.Due to the poor prognosis of esophageal adenocarcinoma(EAC),it would be valuable to find new biomarkers for the development of cancer treatments.AIM To evaluate the expressions of HSP27 and HSP70 and their effect on survival in EAC.METHODS Immunohistochemical analyses and evaluations of HSP27 and HSP70 expression were performed on all available samples from 93 patients diagnosed with EAC between 1990 and 2007 at two university hospitals.Fifteen cases with Barrett’s metaplasia and 5 control cases from the same patient population were included in the analysis.HSP expression was quantitatively assessed and classified as high or low.Kaplan-Meier analyses and Cox regression models adjusting for age and sex as well as tumor site,stage,and grade were used to evaluate the effect on survival.RESULTS Tumor stage and surgical treatment were the main prognostic factors.High HSP27 expression in cancer cases was a strong negative predictive factor,with a mean survival of 23 mo compared to the 49 mo in cases with a low expression(P=0.018).The results were similar for HSP70,with a poorer survival of 17 mo in cases with high HSP70 expression,in contrast to 40 mo(P=0.006)in cases with a low expression.A Cox regression survival analysis was performed,adjusting for possible confounding factors,and higher HSP27 and HSP70 expressions remained an independent negative prognostic factor.The HSPs’correlation with survival was not affected by cancer treatments.When the analysis was adjusted for all factors,the odds ratios for HSP27 and HSP70 were 3.3(CI:1.6–6.6,P=0.001)and 2.2(CI:1.2–3.9,P=0.02),respectively.CONCLUSION HSP27 and HSP70 overexpression is associated with poor survival in EAC,which is,to the best of our knowledge, 展开更多
关键词 Esophageal adenocarcinoma HEAT shock proteins HEAT shock PROTEIN 27 HEAT shock PROTEIN 70 OVEREXPRESSION SURVIVAL
在线阅读 免费下载
严重失血性休克与脓毒性休克大鼠大循环与微循环变化的一致性 预览
2
作者 胡乔华 郑胜才 +3 位作者 凌钦 伍靓靓 杨正飞 方向韶 《实用医学杂志》 CAS 北大核心 2019年第3期384-387,共4页
目的探讨严重失血性休克与脓毒性休克大鼠的大循环以及微循环的动态改变和协调一致性。方法20只雄性SD大鼠(450~550g)随机分为2组(n=10):失血性休克组(H-Shock)和脓毒性休克组(S-Shock)。H-Shock组于1h内抽出全身血容量的40%;S-Shock组... 目的探讨严重失血性休克与脓毒性休克大鼠的大循环以及微循环的动态改变和协调一致性。方法20只雄性SD大鼠(450~550g)随机分为2组(n=10):失血性休克组(H-Shock)和脓毒性休克组(S-Shock)。H-Shock组于1h内抽出全身血容量的40%;S-Shock组行盲肠结扎穿孔后关腹。两组均连续记录平均动脉压(MAP)、呼气末二氧化碳分压(ETCO2),于基线状态(BL)后1、2、3h以此类推行心脏超声、舌下微循环检查,共观察12h或大鼠死亡(End)。于BL、MAP≤65mmHg(Shock)、End时测量动脉血气。结果H-Shock组中反映大循环和微循环的各指标在不同时间点监测值较BL均下降(P<0.05);S-Shock组中反映大循环的MAP、ETCO2、心输出量等指标在3h内无明显变化(P>0.05),而微循环指标各时间点监测值与BL相比均下降(P<0.05);随着休克进展,两组动物的酸碱度均进行性降低,乳酸则进行性升高(P<0.05)。结论严重失血性休克大循环与微循环变化基本一致;脓毒性休克大循环与微循环不协调,大循环早期明显滞后于微循环的变化。 展开更多
关键词 休克 失血性休克 脓毒性休克 血流动力学 大循环 微循环
在线阅读 免费下载
增长与收缩——珠三角城市经济韧性的测度与影响因素(英文)
3
作者 杜志威 张虹鸥 +2 位作者 叶玉瑶 金利霞 徐茜 《地理学报:英文版》 SCIE CSCD 2019年第8期1331-1345,共15页
In the aftermath of the global financial crisis of 2008, China witnessed gradual shrinkage of cities in the Pearl River Delta(PRD). In this study, we introduce the concept of economic resilience to analyse urban growt... In the aftermath of the global financial crisis of 2008, China witnessed gradual shrinkage of cities in the Pearl River Delta(PRD). In this study, we introduce the concept of economic resilience to analyse urban growth and shrinkage in the context of a rapidly-urbanising region. Multiple regression analysis is performed to explore the determinants of economic resilience in the PRD. By measuring resistance in the shrinking phase and recoverability in the growing phase in a group of cities in the PRD, this study distinguishes four scenarios and investigates their characteristics from a spatial perspective. The results demonstrate that the financial crisis had a severe and asymmetric influence on this area, indicating more than 15% of cities are faced with shrinking. The spatial distribution of economic resilience indicates a centre-periphery pattern, that is, high economic resilience in the inner ring and low economic resilience in the outer ring of the PRD. The service economy is found to play a significant role in promoting urban economic resilience. Results imply that sound economic policies for enhancing resilience: both poor local financial status and a high degree of export concentration adversely impact resistance, while upgrading the manufacturing economy and stimulating of industrial innovation are conducive to improve recoverability. 展开更多
关键词 economic RESILIENCE urban SHRINKAGE global FINANCIAL CRISIS shock resistance shock RECOVERABILITY PEARL River Delta
Th1/Th2细胞因子对粒细胞缺乏和非粒细胞缺乏脓毒症患儿预后评估的意义
4
作者 奚悦玲 宁铂涛 +6 位作者 王莹 李璧如 钱娟 任宏 张建 张芳 项龙 《中华急诊医学杂志》 CAS CSCD 北大核心 2019年第6期691-696,共6页
目的探讨粒细胞缺乏(粒缺)和非粒细胞缺乏(非粒缺)的脓毒症患儿细胞因子特点及与预后的关系。方法138例诊断为脓毒症的患儿,根据外周血中性粒细胞绝对计数,分为粒缺组、非粒缺组,根据有无脓毒性休克,分为休克组、非休克组,分别分析各组... 目的探讨粒细胞缺乏(粒缺)和非粒细胞缺乏(非粒缺)的脓毒症患儿细胞因子特点及与预后的关系。方法138例诊断为脓毒症的患儿,根据外周血中性粒细胞绝对计数,分为粒缺组、非粒缺组,根据有无脓毒性休克,分为休克组、非休克组,分别分析各组炎性指标(CRP、PCT)、Th1/Th2细胞因子(IL-2、IL-4、IL-6、IL-10、TNF-α、INF-γ)、PRISM-Ⅲ评分及治疗转归。结果1)138例脓毒症患儿,64例为粒缺,74例为非粒缺,粒缺组PRISM-Ⅲ评分显著高于非粒缺组(P=0.048),两组患儿的病死率差异无统计学意义(P=0.4),粒缺组住院时间显著延长(P=0.02)。粒缺组CRP、IL-6、IL-10显著高于非粒缺组(P=0.001;P=0.001;P=0.032),粒缺组TNF-α显著低于非粒缺组(P=0.032)。2)在64例粒缺脓毒症患儿中有23例为脓毒性休克,41例非脓毒性休克,休克组PRISM-Ⅲ显著高于非休克组(P=0.001),休克组病死率(10/23,43.5%)显著高于非休克组(1/41,2.4%)(P=0.001)。休克组的CRP、PCT、IL-6、IL-10、TNF-α显著高于非休克组(P=0.001;P=0.001;P=0.001;P=0.005;P=0.019),ROC曲线分析,IL-6曲线下面积为0.80,Cut-off值为315.38 pg/mL,IL-10曲线下面积为0.80,Cut-off值为45.18 pg/mL,TNF-α曲线下面积为0.85,Cut-off值为1.95 pg/mL。3)在74例非粒缺脓毒症患儿中,19例为脓毒性休克,55例非脓毒性休克,休克组PRISM-Ⅲ显著高于非休克组(P=0.022),两组病死率比较差异无统计学意义(P=0.3)。休克组IL-10显著高于非休克组(P=0.015)。4)对42例脓毒性休克的患儿分析,23例为粒缺组,19例为非粒缺组,粒缺组PRISM-Ⅲ评分显著高于非粒缺组(P=0.005),粒缺组病死率(47.8%)和非粒缺(31.6%)差异无统计学意义(P=0.29)。粒缺组CRP、PCT、IL-6、IL-10因子显著高于非粒缺组(P=0.001;P=0.001;P=0.001;P=0.035),两组TNF-α差异无统计学意义(P=0.57)。5)分析96例非脓毒性休克的患儿,41例为粒缺组,55例为非粒缺组,两组PRISM-Ⅲ评分差异无统计学意义(P=0.6),非粒缺组� 展开更多
关键词 脓毒症 休克 脓毒性休克 粒细胞缺乏 非粒细胞缺乏 细胞因子 儿童 预后
Interplanetary shock-associated aurora 预览
5
作者 LIU Jianjun HU Hongqiao +1 位作者 HAN Desheng YANG Huigen 《极地科学进展:英文版》 CSCD 2019年第1期11-23,共13页
Interplanetary shocks or solar wind pressure pulses have prompted impacts on Earth’s magnetospheric and ionospheric environment, especially in causing dynamic changes to the bright aurora in the polar ionosphere. The... Interplanetary shocks or solar wind pressure pulses have prompted impacts on Earth’s magnetospheric and ionospheric environment, especially in causing dynamic changes to the bright aurora in the polar ionosphere. The auroral phenomenon associated with shock impingements, referred to as shock aurora, exhibits distinct signatures differing from other geophysical features on the dayside polar ionosphere. Shock aurora provides a direct manifestation of the solar wind–magnetosphere–ionosphere interaction. Imagers onboard satellites can obtain the associated large-scale auroral characteristics during shock impingement on the magnetopause. Therefore, auroral data from satellites are very useful for surveying the comprehensive features of shock aurora and their general evolution. Nonetheless, the ground-based high temporal-spatial resolution all-sky imagers installed at scientific stations play an essential role in revealing medium-and small-scale characteristics of shock aurora. Here, we focus on shock aurora imaging signatures measured by imagers onboard satellites and ground-based all-sky imagers. 展开更多
关键词 INTERPLANETARY shock SUDDEN IMPULSE shock AURORA wave-particle interaction field-aligned current
在线阅读 下载PDF
Resuscitation incoherence and dynamic circulation-perfusion coupling in circulatory shock
6
作者 Huai-Wu He Yun Long +1 位作者 Da-Wei Liu Can Ince 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第10期1218-1227,共10页
Objective: Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circul... Objective: Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock. Data sources: We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations, including resuscitation, circulatory shock, septic shock, tissue perfusion, hemodynamic coherence, and microcirculation (Micro). Study selection: The data from peer-reviewed journals printed in English on the relationships of tissue perfusion, shock, and resuscitation were included. Results: A binary (coherence/incoherence, coupled/uncoupled, or associated/disassociated) mode is used to describe resuscitation coherence. The phenomenon of resuscitation incoherence (RI) has gained great attention. However, the RI concept requires a more practical, systematic, and comprehensive framework for use in clinical practice. Moreover, we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro, Micro, and cell. The RI is divided into four types (Type 1: Macro-Micro incoherence + impaired cell;Type 2: Macro-Micro incoherence + normal cell;Type 3: Micro-Cell incoherence + normal Micro;and Type 4: both Macro-Micro and Micro-cell incoherence). Furthermore, we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock. Conclusions: The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock. Moreover, these concepts require further studies in clinical practice. 展开更多
关键词 Circulatory shock Shock Tissue PERFUSION MICROCIRCULATION HEMODYNAMIC COHERENCE RESUSCITATION INCOHERENCE
Dorsomorphin induces cancer cell apoptosis and sensitizes cancer cells to HSP90 and proteasome inhibitors by reducing nuclear heat shock factor 1 levels 预览
7
作者 Na Li Ting Wang +12 位作者 Zongmeng Li Xiaoli Ye Bo Deng Shu Zhuo Pengle Yao Mengmei Yang Hong Mei Xiaofang Chen Tengfei Zhu Shiting Chen Hui Wang Jiming Wang Yingying Le 《癌症生物学与医学:英文版》 CAS CSCD 2019年第2期220-233,共14页
Objective: Heat shock factor 1(HSF1), a transcriptional regulator of heat shock proteins(HSPs), is an attractive therapeutic target for cancer. However, only a few HSF1 inhibitors have been identified so far.Methods: ... Objective: Heat shock factor 1(HSF1), a transcriptional regulator of heat shock proteins(HSPs), is an attractive therapeutic target for cancer. However, only a few HSF1 inhibitors have been identified so far.Methods: The mRNA and protein levels of HSF1, HSPs, cleaved PARP, and phosphorylated HSF1 were examined by real-time PCR and Western blot. Forced expression, RNA interference, and immunofluorescence assay were used for mechanistic studies.Cell viability and apoptosis were measured by WST-8 assay and flow cytometry, respectively. Xenograft studies were performed in nude mice to evaluate the effect of dorsomorphin and an HSP90 inhibitor on tumor growth.Results: Dorsomorphin suppressed multiple stimuli-induced and constitutive HSPs expression in cancer cells. Mechanistic studies revealed that dorsomorphin reduced heat-induced HSP expression independent of adenosine monophosphate activated protein kinase. Dorsomorphin reduced heat-stimulated HSF1 Ser320 phosphorylation and nuclear translocation, as well as resting nuclear HSF1 levels in cancer cells. Dorsomorphin induced cancer cell apoptosis by inhibiting HSF1 expression. A structure-activity study revealed that the 4-pyridyl at the 3-site of the pyrazolo [1, 5-a]pyrimidine ring is critical for the anti-HSF1 activities of dorsomorphin. Dorsomorphin sensitized cancer cells to HSP90 and proteasome inhibitors and inhibited HSP70 expression induced by these inhibitors in vitro. In tumor-bearing nude mice, dorsomorphin enhanced HSP90 inhibitor-induced cancer cell apoptosis, tumor growth inhibition, and HSP70 expression.Conclusions: Dorsomorphin is an HSF1 inhibitor. It induces cancer cell apoptosis, sensitizes cancer cells to both HSP90 and proteasome inhibitors, and suppresses HSP upregulation by these drugs, which may prevent the development of drug resistance.Hence, dorsomorphin and its derivates may serve as potential precursors for developing drugs against cancer. 展开更多
关键词 Dorsomorphin HEAT shock factor 1 HEAT shock protein APOPTOSIS cancer
在线阅读 下载PDF
Investigation of convergent Richtmyer–Meshkov instability at tin/xenon interface with pulsed magnetic driven imploding
8
作者 张绍龙 刘伟 +6 位作者 王贵林 章征伟 孙奇志 张朝辉 李军 池原 张南川 《中国物理B:英文版》 SCIE EI CAS CSCD 2019年第4期247-253,共7页
The Richtmyer–Meshkov instability at the interface of solid state tin material and xenon gases under cylinder geometry is studied in this paper. The experiments were conducted at FP-1 facility in Institute of Fluid P... The Richtmyer–Meshkov instability at the interface of solid state tin material and xenon gases under cylinder geometry is studied in this paper. The experiments were conducted at FP-1 facility in Institute of Fluid Physics, China Academy of Engineering Physics(CAEP). The FP-1 facility is a pulsed power driver which could generate high amplitude magnetic field to drive metal liner imploding. Convergent shock wave was generated by impacting a magnetic-driven aluminium liner onto a inner mounted tin liner. The convergent evolution of the disturbance pre-machined onto the tin liner’s inner surface was diagnosed by x-radiography. The spike amplitudes were derived from x-ray frames and were compared with linear theory.An analytical model containing material strength effect was derived and matched well to the experimental results. This sensibility of the disturbance evolution to material strength property shines light to the application of Richtmyer–Meshkov instability to infer material strength. 展开更多
关键词 Richtmyer–Meshkov INSTABILITY PULSED power DRIVER CONVERGENT shock wave
急性重症胰腺炎七例误诊原因分析 预览
9
作者 李静 徐宁 《临床误诊误治》 2019年第7期1-4,共4页
目的分析急性重症胰腺炎的误诊原因,提高临床诊治水平。方法回顾性分析2016年2月—2017年10月我院7例急性重症胰腺炎误诊病例资料。结果本组因畏寒腹痛、发热腹痛、呕吐腹泻入院各1例,腹痛入院4例,7例误诊时间14h~3d,误诊为感染性休克... 目的分析急性重症胰腺炎的误诊原因,提高临床诊治水平。方法回顾性分析2016年2月—2017年10月我院7例急性重症胰腺炎误诊病例资料。结果本组因畏寒腹痛、发热腹痛、呕吐腹泻入院各1例,腹痛入院4例,7例误诊时间14h~3d,误诊为感染性休克合并结石性胆囊炎、急性胃肠炎合并低血容量性休克各2例,泌尿系统结石、胆道蛔虫症、消化道穿孔各1例。所有患者按误诊疾病给予治疗效果不佳,后经血尿淀粉酶检查及影像学检查均确诊为急性重症胰腺炎。确诊后均予禁食、抑制胰液分泌、抗感染、手术等治疗后好转出院。结论临床医生应加强对急性重症胰腺炎的认识,详细问诊,仔细查体,对疑似患者及时行血尿淀粉酶检查排查本病,或可减少或避免误诊的发生。 展开更多
关键词 胰腺炎 误诊 胆囊炎 休克
在线阅读 免费下载
榍石的冲击高压行为与辐照损伤效应对比研究 预览
10
作者 刘孙利 白彬 +5 位作者 贺红亮 褚健 孙亚平 王绪 王洪龙 张铭 《高压物理学报》 CAS CSCD 北大核心 2019年第1期34-41,共8页
高压和辐照这两种极端条件会造成晶体材料的晶体结构发生改变或损伤。以榍石(CaTiSiO5)为研究对象,利用冲击高压和样品回收技术,探索冲击高压作用后结构的变化规律,并与辐照造成的损伤榍石作对比研究,认识冲击高压与辐照造成榍石结构损... 高压和辐照这两种极端条件会造成晶体材料的晶体结构发生改变或损伤。以榍石(CaTiSiO5)为研究对象,利用冲击高压和样品回收技术,探索冲击高压作用后结构的变化规律,并与辐照造成的损伤榍石作对比研究,认识冲击高压与辐照造成榍石结构损伤的异同。研究表明:冲击高压作用下,晶态的榍石出现结构损伤和非晶化,出现类似于榍石的辐照损伤现象,但具体过程和受损的晶体结构有明显不同。具体表现为:X射线衍射、红外和拉曼光谱的特征峰强度减弱,谱线变宽,细节丢失;冲击高压导致晶态榍石拉曼光谱的Ti–O伸缩振动主峰出现红移,与辐照损伤蜕晶化过程出现的蓝移相反。此外,晶胞参数a、b、c和晶胞体积V减小,与辐照损伤过程相反。 展开更多
关键词 榍石 冲击 高压 辐照损伤 非晶化
在线阅读 免费下载
循证护理干预在重症肺炎患者治疗中的应用观察 预览
11
作者 郭静 《中国继续医学教育》 2019年第17期178-180,共3页
目的分析循证护理干预在重症肺炎患者治疗中的应用效果。方法选择2018年1-10月医院重症医学科收治的重症肺炎患者60例作为研究对象。按照入院顺序分组,对照组、观察组各入组30例,分别采用常规护理以及循证护理干预。结果观察组全肠内营... 目的分析循证护理干预在重症肺炎患者治疗中的应用效果。方法选择2018年1-10月医院重症医学科收治的重症肺炎患者60例作为研究对象。按照入院顺序分组,对照组、观察组各入组30例,分别采用常规护理以及循证护理干预。结果观察组全肠内营养支持时间、机械通气时间、重症医学科停留时间、住院时间低于对照组,差异均具有统计学意义(P<0.05)。观察组喂养不耐受、并发症合计发生率低于对照组,观察组护理满意率高于对照组,差异均具有统计学意义(P<0.05)。结论在重症肺炎患者治疗中的应用循证护理干预,可以降低并发症发生风险,提升护理满意率。 展开更多
关键词 重症肺炎 循证护理干预 护理质量 休克 机械通气
在线阅读 免费下载
休克患者的血流动力学监测现状与展望
12
作者 马渝 《实用休克杂志(中英文)》 2019年第3期137-141,共5页
过去十年血流动力学监测不断向更小程度的侵入性和可实时测量不同指标参数方向发展。对休克患者而言,心脏超声检查仍是目前的一线评估方式,同时对于最初治疗无反应或非常复杂的休克病人则推荐监测心输出量以及运用高级的血流动力学监测... 过去十年血流动力学监测不断向更小程度的侵入性和可实时测量不同指标参数方向发展。对休克患者而言,心脏超声检查仍是目前的一线评估方式,同时对于最初治疗无反应或非常复杂的休克病人则推荐监测心输出量以及运用高级的血流动力学监测技术。未来集成大循环、微循环和代谢指标的最低程度侵入性、多模式监测方法将为重症休克患者提供更加个体化的监测和治疗。 展开更多
关键词 血流动力学监测 休克
自动化集装箱码头全自动堆垛机轨道系统研究 预览
13
作者 张连钢 修方强 +1 位作者 周兆君 邹子青 《水运工程》 北大核心 2019年第7期17-22,共6页
全自动堆垛机轨道系统的主要功能在于引导全自动堆垛机高速运行,为大车机构提供连续、平顺和阻力较小的良好运行条件,保证设备平稳运行、精准定位。为了解决轨道基础不均匀沉降以及轨道受到外力产生变形所带来的一系列问题,结合青岛港... 全自动堆垛机轨道系统的主要功能在于引导全自动堆垛机高速运行,为大车机构提供连续、平顺和阻力较小的良好运行条件,保证设备平稳运行、精准定位。为了解决轨道基础不均匀沉降以及轨道受到外力产生变形所带来的一系列问题,结合青岛港自动化码头工程实际情况,从轨道基础、轨道类型、轨道扣件、轨道基座等4个方面对全自动堆垛机轨道系统进行了研究。结果表明:为了确保全自动堆垛机可靠运行、高效装卸,要求轨道基础基本无沉降、轨道和轨道扣件具有较强的承载能力、轨道扣件和基座具有很好的减震缓冲性能。研究结论对自动化集装箱码头全自动堆垛机轨道系统的设计具有参考意义。 展开更多
关键词 全自动堆垛机 高速 重载 冲击 轨道系统
在线阅读 下载PDF
乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响 预览
14
作者 薛骅 鲁丽利 +1 位作者 向辉 钱振华 《中国临床药理学与治疗学》 CAS CSCD 2019年第3期313-317,共5页
目的:探讨乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响。方法:选择2015年12月至2017年12月我院接诊的87例重症脓毒症继发休克患者作为研究对象,通过随机数表法分为对照组43例,试验组44例。对照组给予常规治疗... 目的:探讨乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响。方法:选择2015年12月至2017年12月我院接诊的87例重症脓毒症继发休克患者作为研究对象,通过随机数表法分为对照组43例,试验组44例。对照组给予常规治疗,试验组在对照组基础上,联合乌司他丁20万U加入5%葡萄糖溶液250 mL中静脉滴注+200 mg氢化可的松加入5%葡萄糖溶液250 mL中静脉滴注,1次/d,均连续治疗2周。比较2组临床疗效、实验室指标、血清降钙素原(PCT)、IL-6、IL-10、机械通气时间、住院时间、药物不良反应及28 d死亡率。结果:治疗后,试验组和对照组临床疗效总有效率分别为86.36%(38/44)、67.44%(29/43),差异具有统计学意义(P<0.05);治疗后,试验组和对照组收缩压(SBP)分别为(85.82±6.25)、(78.80±9.26) mmHg,C反应蛋白(CRP)分别为(34.78±4.79)、(46.76±5.93) mg/L,白细胞计数(WBC)分别为(7.85±2.02)、(12.49±2.14)×10~9/L,PCT分别为(1.50±0.22)、(2.70±0.46) ng/mL,IL-6分别为(59.13±12.73)、(82.32±18.40) pg/mL,IL-10分别为(10.04±1.25)、(14.41±1.88) pg/mL,急性生理和慢性健康评分(APACHEⅡ)分别为(10.30±1.41)、(14.51±1.68)分,差异具有统计学意义(P<0.05);试验组机械通气时间和住院时间分别为(10.02±1.65)、(16.00±1.36) d,对照组分别为(17.58±2.54)、(24.00±1.69) d,差异具有统计学意义(P<0.05);治疗期间,2组均未出现严重不良反应,试验组出现1例注射部位皮疹,2组不良反应发生率差异无统计学意义(P>0.05);试验组和对照组28 d死亡率为4.55%(2/44)、20.93%(9/43),差异具有统计学意义(P<0.05)。结论:乌司他丁联合氢化可的松用于重症脓毒症继发休克患者中效果显著,可有效缓解病情、降低死亡率,且药物不良反应少,安全性高。 展开更多
关键词 重症脓毒血症 休克 乌司他丁 糖皮质激素 氢化可的松
在线阅读 免费下载
Viscous Shock Wave to an Inflow Problem for Compressible Viscous Gas with Large Density Oscillations
15
作者 Dong-fen BIAN Li-li FAN +1 位作者 Lin HE Hui-jiang ZHAO 《应用数学学报:英文版》 SCIE CSCD 2019年第1期129-157,共29页
This paper is concerned with the inflow problem for one-dimensional compressible Navier-Stokes equations. For such a problem, Huang, Matsumura, and Shi showed in [4] that there exists viscous shock wave solution to th... This paper is concerned with the inflow problem for one-dimensional compressible Navier-Stokes equations. For such a problem, Huang, Matsumura, and Shi showed in [4] that there exists viscous shock wave solution to the inflow problem and both the boundary layer solution, the viscous shock wave, and their superposition are time-asymptotically nonlinear stable provided that both the initial perturbation and the boundary velocity are assumed to be sufficiently small. The main purpose of this paper is to show that similar stability results still hold for a class of large initial perturbation which can allow the initial density to have large oscillations. The proofs are given by an elementary energy method and our main idea is to use the smallness of the strength of the viscous shock wave and the boundary velocity to control the possible growth of the solutions induced by the nonlinearity of the compressible Navier-Stokes equations and the inflow boundary condition.The key point in our analysis is to deduce the desired uniform positive lower and upper bounds on the density. 展开更多
关键词 COMPRESSIBLE Navier-Stokes equations INFLOW PROBLEM VISCOUS shock wave large DENSITY OSCILLATIONS
Influence of Microstructures on Thermal Shock and Sintering Behavior of YSZ-based Thermal Barrier Coatings 预览
16
作者 Kirsten Bobzin Lidong Zhao +1 位作者 Mehmet Ote Tim Konigstein 《表面技术》 EI CAS CSCD 北大核心 2019年第4期28-33,共6页
In this study, two thermal barrier coatings based on YSZ were produced by using a commercially available agglomerated and sintered powder and a special spray powder prepared by high energy ball milling. Both thermal b... In this study, two thermal barrier coatings based on YSZ were produced by using a commercially available agglomerated and sintered powder and a special spray powder prepared by high energy ball milling. Both thermal barrier coatings exhibited similar overall porosities, but significantly different microstructures. Application of the special spray powder prepared by high energy ball milling led to a microstructure with numerous inclusions of semi-molten agglomerates, which introduced a plethora of clusters of fine pores into the coating and several more microstructural defects. This microstructure resulted in a significantly better thermal shock behavior compared to the conventional thermal barrier coating. The heat treatment of both thermal barrier coatings atθ=1150℃for t=100 h led to a sintering of both coatings. The results were reduced overall porosity and significantly increased fracture toughness. A correlation between the fracture toughness of both coatings after the heat treatment and the thermal shock life time could not be identified. 展开更多
关键词 THERMAL barrier coating ZrO2-7%Y2O3 high energy ball MILLING THERMAL shock
在线阅读 免费下载
Experimental investigation on aero-heating of rudder shaft within laminar/turbulent hypersonic boundary layers
17
作者 Qiang LI Liang NIE +3 位作者 Kouli ZHANG Yu LI Suyu CHEN Guangsheng ZHU 《中国航空学报:英文版》 SCIE EI CAS CSCD 2019年第5期1215-1221,共7页
The aero-heating of the rudder shaft region of a hypersonic vehicle is very harsh, as the peak heat flux in this region can be even higher than that at the stagnation point. Therefore, studying the aero-heating of the... The aero-heating of the rudder shaft region of a hypersonic vehicle is very harsh, as the peak heat flux in this region can be even higher than that at the stagnation point. Therefore, studying the aero-heating of the rudder shaft is of great significance for designing the thermal protection system of the hypersonic vehicle. In the wind tunnel test of the aero-heating effect, we find that with the increase of the angle of attack of the lifting body model, the increasement of the heat flux of the rudder shaft is larger under laminar flow conditions than that under turbulent flow conditions. To understand this, we design a wind tunnel experiment to study the effect of laminar/turbulent hypersonic boundary layers on the heat flux of the rudder shaft under the same wind tunnel freestream conditions. The experiment is carried out in the ?2 m shock tunnel(FD-14 A) affiliated to the China Aerodynamics Research and Development Center(CARDC). The laminar boundary layer on the model is triggered to a turbulent one by using vortex generators, which are 2 mm-high diamonds. The aero-heating of the rudder shaft(with the rudder) and the protuberance(without the rudder) are studied in both hypersonic laminar and turbulent boundary layers under the same freestream condition. The nominal Mach numbers are 10 and 12, and the unit Reynolds numbers are2.4 × 106 m-1 and 2.1 × 106 m-1. The angle of attack of the model is 20°, and the deflection angle of the rudder and the protuberance is 10°. The heat flux on the model surface is measured by thin film heat flux sensors, and the heat flux distribution along the center line of the lifting body model suggests that forced transition is achieved in the upstream of the rudder. The test results of the rudder shaft and the protuberance show that the heat flux of the rudder shaft is lower in the turbulent flow than that in the laminar flow, but the heat flux of the protuberance is the other way around,i.e., lower in the laminar flow than in the turbulent flow. The wind tunnel test results is 展开更多
关键词 Heat flux HYPERSONIC boundary layer RUDDER Shock tunnel Transition Vortex generator
中国烧伤休克液体复苏70年进展 预览
18
作者 孙业祥 《中国烧伤创疡杂志》 2019年第4期229-235,共7页
建国70年以来,中国烧伤休克液体复苏从最初的引用美国补液公式逐步发展到创立国内通用烧伤液体复苏公式、现代烧伤液体复苏公式与烧伤延迟复苏补液公式等液体复苏公式,并经历了“机械遵循补液公式”“个性化补液”与“目标复苏”三个阶... 建国70年以来,中国烧伤休克液体复苏从最初的引用美国补液公式逐步发展到创立国内通用烧伤液体复苏公式、现代烧伤液体复苏公式与烧伤延迟复苏补液公式等液体复苏公式,并经历了“机械遵循补液公式”“个性化补液”与“目标复苏”三个阶段,显著提高了烧伤休克液体复苏的成功率。然而,随着研究的不断深入,部分研究学者发现了烧伤休克液体复苏的发展规律不明确、复苏监测指标不完善等新的问题,遂笔者于本研究中对建国70年来国内烧伤休克液体复苏公式与治疗方案的发展、晶胶体液与水分的应用以及烧伤休克复苏监测指标的变迁等进行了综述,旨在为烧伤休克液体复苏新问题、新方法与新指标的进一步深入研究提供思路与帮助,从而有效提高烧伤休克的防治效果。 展开更多
关键词 烧伤 休克 液体复苏 血流动力学监测 终级复苏指标 综述
在线阅读 免费下载
儿童多发创伤的液体复苏
19
作者 叶盛 许丹 《中国小儿急救医学》 CAS 2019年第5期368-371,共4页
在儿童多发创伤患者中,低血容量是休克最常见的原因,在创伤复苏过程中,早期发现和治疗低血容量是十分重要的。已大量失血时会出现代偿性休克,血压会通过心动过速和血管收缩而得以维持。低压性休克表现为低血压及心动过速。多发创伤的液... 在儿童多发创伤患者中,低血容量是休克最常见的原因,在创伤复苏过程中,早期发现和治疗低血容量是十分重要的。已大量失血时会出现代偿性休克,血压会通过心动过速和血管收缩而得以维持。低压性休克表现为低血压及心动过速。多发创伤的液体复苏分出血已控制时、出血未控制时两种情况。此外,大量输血方案也与多发创伤密切相关。 展开更多
关键词 休克 液体复苏 大量输血 多发创伤
When joggers meet robots:the past,present,and future of research on humanoid robots 预览
20
作者 George H.Z.Liu Michael Z.Q.Chen Yonghua Chen 《生物设计与制造(英文)》 CSCD 2019年第2期108-118,共11页
Spawned by fast-paced progress in new materials and integrate circuit technology,the past two decades have witnessed tremendous development of humanoid robots for both scientific and commercial purposes,e.g.emergency ... Spawned by fast-paced progress in new materials and integrate circuit technology,the past two decades have witnessed tremendous development of humanoid robots for both scientific and commercial purposes,e.g.emergency response and daily life assistant.At the root of this trend are the increasing research interests and cooperation opportunities across different laboratories and countries.The application-driven requirements of high effectiveness and reliability of humanoid robots led intensive research and development in humanoid locomotion and control theories.In spite of the progress in the area,challenges such as unnatural locomotion control,inefficient multi-motion planning,and relatively slow disturbances recovery set further requirements for the next generation of humanoid robots.Therefore,the purpose of this work is to review the current development of highly representative bipedal humanoid robots and discuss the potential to move the ideas and models forward from laboratory settings into the real world.To this end,we also review the current clinical understanding of the walking and running dynamics to make the robot more human-like. 展开更多
关键词 HUMANOID ROBOT Walking dynamics Dynamic control BIO-INSPIRED GAIT ROBOT efficiency Shock absorption
在线阅读 免费下载
上一页 1 2 250 下一页 到第
使用帮助 返回顶部 意见反馈