Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship...Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.展开更多
Objective To explore the correlation of blood glucose variability with the outcome in patients with severe acute stroke.Methods This retrospective clinical study was performed on patients with severe acute stroke.Base...Objective To explore the correlation of blood glucose variability with the outcome in patients with severe acute stroke.Methods This retrospective clinical study was performed on patients with severe acute stroke.Based on the three months mRS score after discharge,they were divided into good outcome groups and poor outcome groups.The blood glucose on admission,mean blood glucose,blood glucose standard deviation,coefficient variation of blood glucose and other clinical data were compared between both groups.Multivariate logistic regression analysis was used to determine the independent predictors of poor outcome in patients with severe acute stroke.Results A total of 420 patients with severe acute stroke were included,207(49.3%)with good outcome groups,213(50.7%)with poor outcome groups.Multivariate logistic regression analysis showed that age,NIHSS score,GCS score,APACHEⅡscore,blood glucose standard deviation,coefficient of variation of blood glucose were independent predictors of poor outcome in patients with severe acute stroke on 3 months after discharge.Conclusion Blood glucose variability are the independent predictors of poor outcome of the three months after discharge in patients with severe acute stroke,the great range of glycemic excursion indicates poor outcome.展开更多
Collisions between a moving mass and an anti-collision device increase structural responses and threaten structural safety.An active mass damper(AMD)with stroke limitations is often used to avoid collisions.However,a ...Collisions between a moving mass and an anti-collision device increase structural responses and threaten structural safety.An active mass damper(AMD)with stroke limitations is often used to avoid collisions.However,a strokelimited AMD control system with a fixed limited area shortens the available AMD stroke and leads to significant control power.To solve this problem,the design approach with variable gain and limited area(VGLA)is proposed in this study.First,the boundary of variable-limited areas is calculated based on the real-time status of the moving mass.The variable gain(VG)expression at the variable limited area is deduced by considering the saturation of AMD stroke.Then,numerical simulations of a stroke-limited AMD control system with VGLA are conducted on a high-rise building structure.These numerical simulations show that the proposed approach has superior strokelimitation performance compared with a stroke-limited AMD control system with a fixed limited area.Finally,the proposed approach is validated through experiments on a four-story steel frame.展开更多
目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,...目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。展开更多
Septic shock is a common critical condition, for which effective early fluid resuscitation is the therapeutic focus. According to the 2008 international guidelines for management of severe sepsis and septic shock, res...Septic shock is a common critical condition, for which effective early fluid resuscitation is the therapeutic focus. According to the 2008 international guidelines for management of severe sepsis and septic shock, resuscitation should achieve a central venous pressure （CVP） of 8-12 mmHg within the first 6 h. However, it is still uncertain about the sensitivity and specificity of CVP in reflecting the cardiac preload. Ultrasonography is a simple, rapid, non-invasive, and repeatable method for the measurement of sensitivity and specificity of CVP and has thus gradually attracted the increasing attention of physicians. It was reported that ultrasonography can show the inferior vena cava diameter, respiratory variability index, and blood volume in patients with sepsis or heart failure.展开更多
基金The study was supported by grants from the National Natural Science Foundation of China(No.81760221 and No.81660209)National Science&Technology Foundational Resource Investigation Program of China(No.2018FY100900)the Major Program of the Natural Science Foundation of Jiangxi Province(No.2016ACB20015).
文摘Visit-to-visit variability in systolic blood pressure(SBP)may have an important additional role in increasing the risk of vascular complications,including stroke.We conducted a meta-analysis to assess the relationship between visit-to-visit SBP variability(SBPV)and stroke risk.PubMed,EMBASE,and the Cochrane library databases were searched for cohort studies with data on visit-to-visit SBPV and stroke risk.Studies that reported adjusted relative risks(RRs)with 95%Cis of stroke associated with SBPV were included.Fourteen cohort studies met the inclusion criteria and were included in our meta-analysis.After adjustment for age,sex,and existing vascular risk factors,the analysis showed that the risk of stroke in patients with SBPV was significantly increased compared with patients with a small baseline SBPV[SD(RR=1.20,95%CI=(1.07-1.35),P=0.0005),CV(RR=1.12,95%CI=(1.00-1.26),P=0.008)].In addition,follow-up variations of more than 5 years were associated with a higher risk of stroke than those of less than 5 years[RR=1.08,95%CI=(1.04-1.11)].Visit-to-visit SBPV was associated with an increased risk of stroke,especially in terms of the time of variation.Taken together,SBPV data may be useful as a preventative diagnostic method in the management of stroke.
文摘Objective To explore the correlation of blood glucose variability with the outcome in patients with severe acute stroke.Methods This retrospective clinical study was performed on patients with severe acute stroke.Based on the three months mRS score after discharge,they were divided into good outcome groups and poor outcome groups.The blood glucose on admission,mean blood glucose,blood glucose standard deviation,coefficient variation of blood glucose and other clinical data were compared between both groups.Multivariate logistic regression analysis was used to determine the independent predictors of poor outcome in patients with severe acute stroke.Results A total of 420 patients with severe acute stroke were included,207(49.3%)with good outcome groups,213(50.7%)with poor outcome groups.Multivariate logistic regression analysis showed that age,NIHSS score,GCS score,APACHEⅡscore,blood glucose standard deviation,coefficient of variation of blood glucose were independent predictors of poor outcome in patients with severe acute stroke on 3 months after discharge.Conclusion Blood glucose variability are the independent predictors of poor outcome of the three months after discharge in patients with severe acute stroke,the great range of glycemic excursion indicates poor outcome.
基金This research was founded by the Funds for Creative Research Groups of National Natural Science Foundation of China(Grant No.51921006)the National Natural Science Foundations of China(Grant No.51978224)+2 种基金the National Major Scientific Research Instrument Development Program of China(Grant No.51827811)the National Natural Science Foundation of China,(Grant No.52008141)the Shenzhen Technology Innovation Program(Grant Nos.JCYJ20170811160003571,JCYJ20180508152238111 and JCYJ20200109112803851).
文摘Collisions between a moving mass and an anti-collision device increase structural responses and threaten structural safety.An active mass damper(AMD)with stroke limitations is often used to avoid collisions.However,a strokelimited AMD control system with a fixed limited area shortens the available AMD stroke and leads to significant control power.To solve this problem,the design approach with variable gain and limited area(VGLA)is proposed in this study.First,the boundary of variable-limited areas is calculated based on the real-time status of the moving mass.The variable gain(VG)expression at the variable limited area is deduced by considering the saturation of AMD stroke.Then,numerical simulations of a stroke-limited AMD control system with VGLA are conducted on a high-rise building structure.These numerical simulations show that the proposed approach has superior strokelimitation performance compared with a stroke-limited AMD control system with a fixed limited area.Finally,the proposed approach is validated through experiments on a four-story steel frame.
文摘目的观察针药并用治疗卒中恢复期自主神经功能障碍的临床疗效,并观察对24 h心率变异性(heart rate variability,HRV)指标的影响。方法将60例卒中恢复期自主神经功能障碍患者随机分为治疗组和对照组,每组30例。对照组采用对症药物治疗,治疗组在对照组治疗基础上采用针刺治疗。观察两组治疗前后临床特征量表(clinical feature scale,CFS)评分、24 h HRV指标[窦性R-R间期标准差(standard deviation of normal-to-normal intervals,SDNN)、窦性R-R间期平均值标准差(standard deviation of the average of normal-to-normal intervals,SDANN)、连续差值的均方根(root mean square of successive differences,RMSSD)、相邻两个窦性R-R间期差值>50 ms的个数所占的百分率(percentage of normal-to-normal intervals differing by more than 50 milliseconds,PNN50)、低频(low frequency,LF)功率、高频(high frequency,HF)功率及LF/HF]的变化,并比较两组临床疗效。结果治疗组总有效率为93.3%,高于对照组的73.3%(P<0.05)。治疗后,两组CFS评分均降低,且治疗组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组SDNN、RMSSD、日间及夜间LF、HF水平较治疗前升高,且治疗组高于对照组,差异有统计学意义(P<0.05);两组SDANN、日间及夜间LF/HF、PNN50水平与治疗前比较差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05)。结论针药并用能够调节卒中恢复期自主神经功能障碍患者的自主神经平衡,有利于患者自主神经功能的恢复。
文摘Septic shock is a common critical condition, for which effective early fluid resuscitation is the therapeutic focus. According to the 2008 international guidelines for management of severe sepsis and septic shock, resuscitation should achieve a central venous pressure （CVP） of 8-12 mmHg within the first 6 h. However, it is still uncertain about the sensitivity and specificity of CVP in reflecting the cardiac preload. Ultrasonography is a simple, rapid, non-invasive, and repeatable method for the measurement of sensitivity and specificity of CVP and has thus gradually attracted the increasing attention of physicians. It was reported that ultrasonography can show the inferior vena cava diameter, respiratory variability index, and blood volume in patients with sepsis or heart failure.
