简介：AbstractPurpose:Trauma is a major health concern. Length of hospital stay (LOS) has been targeted as an important metric to assess trauma care. This study aims to evaluate the risk factors that affect LOS among trauma patients in a trauma center in Southwestern Iran.Methods:This cross-sectional study was conducted on patients admitted to Rajaee Trauma Center, Shiraz, Iran between January 1, 2018 and December 30, 2018. The inclusion criteria were age above 15 years and having traffic accident injuries, including car, motorcycle and pedestrian injury mechanisms. The exclusion criteria were existing diseases including cardiovascular, cerebral, renal, and pulmonary diseases prior to this study, dead upon arrival or within 48 h after admission, and stay at the hospital for less than 6 h. The risk variables analyzed for prolonged LOS were age, gender, mechanism of traffic accident injury, infection during hospital stay, type of injury, injury severity score, surgery during hospitalization, and survival. Poisson regression was performed to evaluate the partial effects of each co- variate on trauma hospitalization (≥3 days as longer stay).Results:This study was conducted on 14,054 patients with traffic accident injury and the mean age was (33.89 ± 15.78) years. Additionally, 74.35% of the patients were male, with male to female ratio of 2.90. The result of Poisson regression indicated that male patients, higher age, combination of thoracic injuries, onset of infected sites, and surgery patients were more susceptible to have a longer LOS. Considering the site of injury, patients with face injuries followed by those with thorax injuries had the highest means of LOS (3.74 days and 3.36 days, respectively). Simultaneous existence of surgical inter- vention and infection in a patient had the greatest impact on prolonged LOS.Conclusion:This study identified that age, gender, mechanism of injury, infection, type of injury, survival, and ISS could lead to prolongation of LOS, but the affect can be reduced by eliminating modifiable risk factors.

简介：AbstractPurpose:Lengthy hospitalization places a burden on patients and healthcare resources. However, the factors affecting the length of hospital stay (LHoS) and length of emergency room stay (LERS) in non-fatal bicycle accidents are currently unclear. We investigated these factors to inform efforts to minimize hospitalization.Methods:We performed a retrospective analysis of data from non-fatal injured bicyclists admitted to the Emergency and Critical Care Center at Kyoto Medical Center between January 2012 and December 2016. We measured LHoS, LERS, mechanism of injury, head injury prevalence, polytrauma, operations performed, injury severity score (ISS), abbreviated injury scale (AIS) score, maximum AIS score, and trauma and injury severity score probability of survival. We conducted multiple regression analysis to determine predictors of LHoS and LERS.Results:Within the study period, 82 victims met the inclusion and exclusion criteria and were included. Mean age was (46.0 ± 24.7) years. Overall mean LHoS was (16.8 ± 25.2) days, mean LERS was (10.6 ± 14.7) days, median ISS was 9 (interquartile range (IQR): 3-16), median maximum AIS was 3 (IQR: 1-4), and median trauma and injury severity score probability of survival was 98.0% (IQR: 95.5%-99.6%). Age, maximum AIS, ISS, and prevalence of surgery were significantly greater in long LHoS and LERS group compared with short LHoS and LERS group (p < 0.05). Performance of surgery independently explained LHoS (p = 0.0003) and ISS independently explained LERS (p = 0.0009).Conclusion:Surgery was associated with long hospital stays and ISS was associated with long emergency room stays. To improve the quality life of the bicyclists, preventive measures for reducing injury severity or avoiding injuries needing operation are required.

简介：Inthispaper,itwasinvestigatedthattheeffectofparameterssuchastheionicstrength,pH,counter-iontypeofreleasemedium,particlesize,andcrosslinkageofcationexchangeresinonthereleaseofmodeldrugpseudoephedrinehydrochloride(PE)fromuncoateddrug-resincomplex.Thedrug-resincomplexwaspreparedbythereactionofPEwithstronglyacidiccationexchangeresin(001×4,001×7,001×14).TheresultshowedthattheloadingofPEincreasedwiththeincreaseoftemperatures.ThereleaseofPEfromdrug-resincomplexat37℃wasmonitoredinvitro.Fromtheexperiments,itwasfoundthatthereleaserateofPEdependsonthepH,compositionofthereleasingmedia,increasedatlowerpHmediaorwithincreaseofionicstrengthofmedia.Moreover,thereleaserateofPEwasinverselyproportionaltothecross-linkageandparticlesizeofthecationexchangeresin.

简介：客观尽管翻斗车上的许多临床的研究在非小的房间肺癌症的淋巴的转移被报导了，为淋巴的转移仍然是的翻斗车的风险因素争吵并且可争辩。这研究调查了，由multivariate逻辑回归分析，到在非小的房间肺癌症(NSCLC)的mediastinal淋巴节点(N2)的翻斗车转移的临床的特征病人。我们收集了在福建医药大学联合医院里加全身的淋巴节点解剖经历了叶切除术的256个pN2-NSCLC病人的clinicopathological数据的方法。在现在的学习的案例被划分成二个组：翻斗车转移(N2skip+)并且非--翻斗车转移(N2翻斗车)。二个组的临床的病理学的特征的回顾的分析被执行。决定一个独立因素，multivariate逻辑回归分析被用来识别可能的风险因素。256个pN2-NSCLC病人全部的结果A被招募。分析结果证明那性，病理学的类型，手术，肋膜的参与，吸烟历史，年龄，肿瘤阶段，和区别不是在pN2-NSCLC影响翻斗车转移的统计重要因素(P>0.05)，而肿瘤尺寸是为翻斗车转移(P=0.02)的一个独立因素。结论淋巴的转移在pN2-NSCLC病人增加的翻斗车的率，在里面与一种增加的肿瘤尺寸伴随。

简介：[摘要]目的：分析心内科护理风险因素及处理对策。方法：选取我院2018年11月~2020年8月期间心内科收治患者152例作为本文研究对象，将152例患者分为实验组和对照组，对照组采取常规护理干预，实验组实施风险因素针对性护理，对比两组患者护理效果、护理满意度以及不良事件发生率。结果：实验组患者护理有效率高于对照组，实施针对性护理能够提高心内科护理效果，两组对比具有差异表示统计学有意义。实验组患者采取对症护理后，护理满意度明显提升，对比对照组更高，对比两组患者护理满意度的对比具有差异表示统计学有意义（P〈0.05）。实验组患者护理后，出现1例用药错误，1例跌倒；对照组护理后，出现3例用药错误，3例坠床和4例跌倒，对比两组护理后的不良事件发生率对比就有差异，因此实施针对性护理能够提高护理质量，保证护理安全，两组对比具有统计学意义。结论：由于心内科患者的病情比较复杂，为患者实施的护理管理也存在很多的风险因素，分析心内科常见的护理风险制定针对性护理干预，能够提高护理质量，保证护理效果，改善患者对护理服务的满意度，降低不良事件发生率，改善患者预后。

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简介：Thestudypresentedhereininvestigatedthemaincharacteristicsofcarbonmonoxideintraseasonalvariabilityandevaluateditspossibleimpactfactorsusingtheuppertroposphereandlowerstratosphere(UT/LS)AuraMicrowaveLimbSounder(MLS)observationsoverTibetanPlateauanditsadjacentareasinsummer(JunetoAugust)of2005and2006.ObservationsshowapersistentconstituentextremeextendingupintotheUT/LSthroughoutsummer,aswellasatemporallyreversedphasevariationbetweenthecarbonmonoxideandozoneinUT/LS.Theintraseasonaloscillations(ISOs)ofcarbonmonoxideduringsummerareinvestigatedbyusingmethodsofwaveletandbandpassfilteranalysis.ItisfoundthatISOsovertheTibetanPlateauhaveperiodsof10to20daysand30to60days.Theformermainlyappearedinuppertropospherewhilethelatterinlowerstratosphere.FurtheranalysisshowsthatthesetwoperiodsofISOsinUT/LSaremainlyinphasetotheactivitiesofconvectionoverthesouthoftheplateauandthevariationofSouthAsiaHigh,respectively.TheabovetwofactorsandtheirdynamicalcouplingmayberesponsibleforthetracerISOsatdifferentlevels.

简介：Aim:Toinvestigatetheeffectofhome-basedcardiacrehabilitationonfunctionalcapacity,healthbehavior,andriskfactorsinpatientswithacutecoronarysyndromeinChina.Methods:Eightypatientswithacutecoronarysyndromewereenrolledinthisprospectiverandomizedcontrolledstudy.Patientsinthecardiacrehabilitationgroup(n=52)receivedhome-basedcardiacrehabilitationwithaheartmanualandahomeexercisevideofor3monthsandpatientsinthecontrolgroup(n=28)receivedonlyroutinesecondaryprevention.The6-minwalkdistance,laboratorytestresults,healthybehavior(questionnaire),qualityoflife(12-itemShortFormHealthSurvey),anxiety(7-itemGeneralizedAnxietyDisorderQuestionnaire),anddepression(9-itemPatientHealthQuestionnaire)wereevaluatedatthebeginningandaftertreatmentfor3months.Results:Comparedwithbaselinedata,52patientswhoparticipatedincardiacrehabilitationhadlonger6-minwalkdistance(515.26±113.74mvs0.445.30±97.92m,P<0.0002),higherproportionsof“alwaysexercise”(78.26%vs.28%,P<0.05),“alwayslimitfoodwithsugar”(65.22%vs12%,P<0.05),“alwayseatfruits200–400geveryday”(82.61%vs.4%,P<0.05).and“alwayseatvegetables300–500geveryday”(21.74%vs.12%,P<0.06)aftertreatmentfor3months.Thelow-densitylipoproteincholesterolcontrolrate(52.17%vs.28%,P<0.05)andthesystolicbloodpressurecontrolrate(100%vs.68%,P<0.05)werealsosignificantlyincreasedaftertreatmentfor3monthsinthecardiacrehabilitationgroup.Nosignificantincreasewasfoundinthecontrolgroupaftertreatmentfor3months.Nocardiac-eventrelatedtohomeexercisewasreportedinbothgroups.Conclusion:Home-basedcardiacrehabilitationisafeasibleandavailablecardiacrehabilitationmodeinChina.

简介：AbstractBackground:Globally, colorectal cancer (CRC) imposes a substantial burden on healthcare systems and confers considerable medical expenditures. We aimed to evaluate the global and regional burden in epidemiological trends and factors associated with the incidence and mortality of CRC.Methods:We used data from the GLOBOCAN database to estimate CRC incidence and mortality worldwide in 2020 and their association with the human development index (HDI). Trends of age-standardized rates of incidence and mortality in 60 countries (2000-2019) were evaluated by Joinpoint regression analysis using data of Global Burden of Disease 2019. The association between exposure to country-level lifestyle, metabolic and socioeconomic factors obtained from the World Health Organization Global Health Observatory and World Bank DataBank data and CRC incidence and mortality was determined by multivariable linear regression.Results:CRC incidence and mortality varied greatly in the 60 selected countries, and much higher incidence and mortality were observed in countries with higher HDIs, and vice versa. From 2000 to 2019, significant increases of incidence and mortality were observed for 33 countries (average annual percent changes [AAPCs], 0.24-3.82) and 18 countries (AAPCs, 0.41-2.22), respectively. A stronger increase in incidence was observed among males (AAPCs, 0.36-4.54) and individuals <50 years (AAPCs, 0.56-3.86). Notably, 15 countries showed significant decreases in both incidence (AAPCs, -0.24 to -2.19) and mortality (AAPCs, -0.84 to -2.74). A significant increase of incidence among individuals <50 years was observed in 30 countries (AAPCs, 0.28-3.62). Countries with higher incidence were more likely to have a higher prevalence of alcohol drinking, higher level of cholesterol level, higher level of unemployment, and a poorer healthcare system.Conclusions:Some high-HDI countries showed decreasing trends in CRC incidence and mortality, whereas developing countries that previously had low disease burden showed significantly increased incidence and mortality trends, especially in males and populations ≥50 years, which require targeted preventive health programs.

简介：AbstractImportance:Dexmedetomidine inhibits the inflammatory response associated with cardiopulmonary bypass (CPB) and protects neural function. However, the mechanism of dexmedetomidine’s anti-inflammatory pathway is unclear.Objective:To investigate the effect of dexmedetomidine on the cognitive level and expression of inflammatory factors in children with congenital heart disease undergoing intraoperative CPB.Methods:Ninety children with congenital heart disease were recruited and randomly divided into 3 groups of 30 children in each. In Group 1, a 1.0 µg·kg-1·h-1 intravenous bolus of dexmedetomidine was administered 10 minutes after induction of anesthesia, followed by a 0.2 µg·kg-1·h-1 infusion until the surgical incision. In Group 2, a 0.5 µg/kg intravenous bolus of dexmedetomidine was administered 10 minutes after induction of anesthesia, followed by a 0.1 µg·kg-1·h-1 infusion until the surgical incision. The control group was given physiological saline using the same method as in Groups 1 and 2. The serum levels of nuclear factor-kappa B (NF-κB), S-100β protein, neuron-specific enolase (NSE), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) were measured before the surgery (T1), at the end of CPB (T2), 2 hours after CPB (T3), 6 hours after CPB (T4), and 24 hours after CPB (T5). The Wechsler Intelligence Scale for children (WISC) was measured before the operation and at 3, 6, and 12 months after the operation to evaluate the neurodevelopmental state of the children.Results:The levels of the NF-κB, S-100β protein, NSE, TNF-α, IL-6 were significantly higher at T2, T3, or T4 than before the surgery (T1) in the control group or the dexmedetomidine groups. However, the increases of NF-κB, TNF-α, IL-6, S-100β and NSE levels were significantly smaller in the dexmedetomidine groups than those in the control group (P < 0.017). The WISC scores were similar among the three groups before or after the operation.Interpretation:The increases in NF-κB, TNF-α, and IL-6 levels indicated aggravation of the inflammatory reaction and the increase S-100β protein and NSE levels indicated that the nervous system was damaged. Administration of dexmedetomidine to children with congenital heart disease undergoing intraoperative CPB can inhibit the inflammatory response and may ameliorate the neurodevelopmental damage caused by CPB.

简介：Objective:Toinvestigatetheuptakerateofprostatespecificantigen(PSA)testingamongHongKongChinesemalesaged50orabove,andidentifyfactorsassociatedwiththelikelihoodofundergoingaPSAtest.Methods:Apopulation-basedtelephonesurveywasconductedinHongKongin2007.Thesurveycovereddemographicinformation,perceivedhealthstatus,useofcomplementarytherapy,cancerscreeningbehavior,perceivedsusceptibilitytocancerandfamilyhistoryofcancer.Descriptivestatistics,percentagesandlogisticregressionanalysiswereusedfordataanalysis.Results:Atotalof1,002menaged50orabovetookpartinthestudy(responserate=67%),andtheuptakerateofPSAtestingwasfoundtobe10%.Employmentstatus,useofcomplementarytherapy,perceivingregularvisitstoadoctorasgoodforhealthandtherecommendationsofhealthprofessionalsweresignificantfactorsassociatedwithPSAtesting.Conclusion:TheuptakerateofPSAtestinginthestudypopulationwasverylow.Amongallthefactorsidentified,recommendationsfromhealthprofessionalshadthestrongestassociationwiththeuptakeofPSAtesting,andtheyshouldthereforetakeanactiveroleineducatingthispopulationaboutcancerpreventionanddetection.

简介：Effectsofspacevelocity,reactiontemperatureandsupportacidityonproductdistributionandinductionperiodin1-buteneisomerizationandmetathesisoverMo/mordenite-aluminawereinvestigated.Asrevealedbythecatalyticperformanceresults,inductionperiodandobjectiveproductwerecloselyrelatedtothereactionconditions.Lowerspacevelocityledtolongerinductionperiodandhigherpropeneyield.Theoptimalreactiontemperatureforpropeneproductionisaround150Canditshiftedto100Cforetheneproduction.1-Buteneauto-metathesispredominatedinthereactionnetworkifthesupportwithlowerdegreeofsodiumexchanged.Andpropenegraduallybecamethedominantproductuponincreasingthesupportsodiumexchangedegree.6Mo/H100Na0M-30Alcatalystwithasupportoffullsodiumexchangedegreeexhibitedthehighestpropeneyield.

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简介：Background:Couplingbiomassmodelswithnutrientconcentrationscanprovidesoundestimationsofcarbonandnutrientcontents,enablingtheimprovementofcarbonandnutrientbalanceinforestecosystems.Althoughnutrientconcentrationsareoftenassumedtobeconstantforsomespeciesandspecifictreecomponents,atleastinmaturestands,theconcentrationsusuallyvarywithage,siteindexandevenwithtreedensity.Themainobjectiveofthisstudywastoevaluatethesourcesofvariationinnutrientconcentrationsinbiomasscompartmentsusuallyremovedduringharvestingoperations,coveringarangeofspeciesandmanagementconditions:semi-naturalforest,conventionalforestplantationsandshortrotationforestry(SRF).Fivespecies(Betulapubescens,Quercusrobur,Eucalyptusglobulus,EucalyptusnitensandPopulusspp.)and14genotypeswereconsidered.Atotalof430treesweresampledin61plotstoobtain6biomasscomponents:leaves,twigs,thinbranches,thickbranches,barkandwood.AbovegroundleaflessbiomassWaspooledtogetherforpoplar.TheconcentrationsofC,N,K,P,Ca,Mg,S,Fe,Mn,Cu,ZnandBweremeasuredandtheto:[albiomassofeachsampledtreeandplotweredetermined.Thedatawereanalysedusingboostedregressiontreesandconventionaltechniques.Results:Themainsourcesofvariationinnutrientconcentrationswerebiomasscomponent>>genotype(species)≈age>treediameter.TheconcentrationsofCa,MgandKweremoststronglyaffectedbygenotypeandage.TheconcentrationsofP,K,Ca,Mg,SandCuinthewoodcomponentdecreasedwithage,whereasCconcentrationsincreased,withatrendtoreach50%intheoldertrees.IntheSRF,interamericanpoplarandP.trichocarpogenotypeswerecomparativelymoreefficientintermsofCaandKnutrientassimilationindex(NAI)(+65-85%)thaneucalypts,,mainlybecauseleaflessbiomasscanberemoved.Intheconventionaleucalyptplantations(rotation15years),debarkingthewoodatlogging(savingsof225%ofCaand254%ofMgforE.globulus)ortheuseofselectedgenotype

简介：[摘要 ] 目的：探讨心血管护理中的危险因素和应对方法。方法：在我院收治的心血管疾病患者中选取 90例，起止时间是 2017年 3月～ 2019年 12月。按照入院编号分成 2个小组：对照组 45例，给予常规护理；试验组 45例，分析护理危险因素并针对性护理干预。比较 2组的护理指标数据。结果：相比于对照组，试验组护理风险事件发生率更低（ 2.2%vs15.6%），患者的护理总满意率更高（ 95.6%vs80.0%），差异显著（ P＜ 0.05）。结论：心血管护理中，明确危险因素并制定应对方法，能减少护理不良事件，提高患者的满意度。

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简介：北方中国平原(NCP)是地下水弄空的全球热点之一，地下水是为在这个区域的农业、工业、喝的水的水的几乎唯一的来源。在深地下水的long-terms在利用上以后，在那里出现了几个深地下水消沉锥例如Cangzhou锥，Dezhou锥，Hengshui锥，天津锥，等等，Cangzhou锥在是为它的特殊地理的典型的锥之一和hydrogeology条件。在这研究，作者打算在Cangzhou区域分析深地下水消沉锥的进化特征和影响因素，特别没有。III含水土层消沉锥，它是在这个区域的主要利用地区。地下水消沉锥的进化的分析没有。在Cangzhou区域的III含水土层组证明也就是，这个过程能被划分成四个阶段开发，稳定的发展，快速的扩大，和渐渐的恢复。在不同阶段的消沉锥的形状和进化特征被分析地下水桌子的30，40，和50个轮廓的进化描述，例如，50m的水桌子轮廓的关上的区域从95km被扩大了在1985～6528.5km的2在2005的2。在不同阶段影响进化特征的主导的因素被建议。结果证明有更少的降水，地质的专辑和hydrogeological条件的相对长的干燥时期，和为工业、农业的开发的严厉地增加的水消费是引起深地下水消沉锥的形成的主要因素。同时，对地下水利用的环境回答被介绍，并且合理答案被建议避免水危机。

简介：Threeessentialfactorsofforestfire(firesource,environment,andlitter)weretakenasthepointofview,andhasapproachedtheforecastmethodofforestfireintropicalareaofsouthwestChinainamacroscopicscale.Thisstudysupportedbymathematicalmethodwasfromanewangle.Forexample,intheaspectofforestfireforecast,ithasbeenthoughtoverthatmostforestfireisartificialfire,whichhaslotsofrandomness.SoitcouldbestudiedinakindofMarkovrandomprocesses.Inthe...

简介：Background:Biomassregressionequationsareclaimedtoyieldthemostaccuratebiomassestimatesthanbiomassexpansionfactors(BEFs).Yet,nationalandregionalbiomassestimatesaregenerallycalculatedbasedonBEFs,especiallywhenusingnationalforestinventorydata.ComparisonofregressionequationsbasedandBEF-basedbiomassestimatesarescarce.Thus,thisstudywasintendedtocomparethesetwocommonlyusedmethodsforestimatingtreeandforestbiomasswithregardtoerrorsandbiases.Methods:Thedatawerecollectedin2012and2014.In2012,atwo-phasesamplingdesignwasusedtofittreecomponentbiomassregressionmodelsanddeterminetreeBEFs.In2014,additionaltreeswerefelledoutsidesamplingplotstoestimatethebiasesassociatedwithregressionequationbasedandBEF-basedbiomassestimates;thoseestimateswerethencomparedintermsofthefollowingsourcesoferror:plotselectionandvariability,biomassmodel,modelparameterestimates,andresidualvariabilityaroundmodelprediaion.Results:Theregressionequationbasedbelow-,abovegroundandwholetreebiomassstockswere,approximately,7.7,8.5and8.3%largerthantheBEF-basedones.Forthewholetreebiomassstock,thepercentageofthetotalerrorattributedtofirstphase(randomplotselectionandvariability)was90and88%forregression-andBEF-basedestimates,respeaively,beingtheremainingattributedtobiomassmodels(regressionandBEFmodels,respeaively).ThepercentbiasofregressionequationbasedandBEF-basedbiomassestimatesforthewholetreebiomassstockwere-2.7and5.4%,respeaively.Theerrorsduetomodelparameterestimates,thoseduetoresidualvariabilityaroundmodelprediaion,andthepercentageofthetotalerrorattributedtobiomassmodelwerelargerforBEFmodels(thanforregressionmodels),exceptforstemandstemwoodcomponents.Conclusions:Theregressionequationbasedbiomassstockswerefoundtobeslightlylarger,associatedwithrelativelysmallererrorsandleastbiasedthantheBEF-basedones.Forstemandst

简介：瞄准：为了在煽动性的肠疾病(IBD)评估肝炎B(HBV)感染的流行，在我们的医院和尝试里列在后面在上面到的病人识别涉及这感染传播的可能的风险因素。方法：这是176个病人为医药会见根据他们的到达为被选择的代表性的研究。所有这些病人已经有IBD诊断。病人被会见，一张问询表被填写。结果：在我们检查了的176个病人的组，我们发现(30)17%是anti-HBc积极。从有积极anti-HBc的30个病人，(4)2.3%有积极HBsAg和否定HBV-DNA。在里面识别可能的HBV感染传播的一次尝试在IBD病人冒因素的风险，117个病人被提交了到某种外科的过程，而是仅仅24个病人，这被观察有的积极anti-HBc(P=0.085)。对待IBD复杂并发症的外科不是为HBV感染传播的一个风险因素，这也被观察，自从我们没得到静态地重要的P价值。然而，被提交了到外科对待IBD复杂并发症的IBD病人然后收到了更多的输血提交到另外的外科的干预的病人(P=0.015)。结论：在IBD病人有积极anti-HBc(17%)和积极HBsAg(2.3%)的高发生什么时候与全面人口(7.9%)相比。