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Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019

《医学前沿（英文）》 doi: 10.1007/s11684-023-1014-x

摘要： This cohort study was performed to explore the influence of intensive care unit (ICU) quality on in-hospital mortality of veno-venous (V-V) extracorporeal membrane oxygenation (ECMO)-supported patients in China. The study involved all V-V ECMO-supported patients in 318 of 1700 tertiary hospitals from 2017 to 2019, using data from the National Clinical Improvement System and China National Critical Care Quality Control Center. ICU quality was assessed by quality control indicators and capacity parameters. Among the 2563 V-V ECMO-supported patients in 318 hospitals, a significant correlation was found between ECMO-related complications and prognosis. The reintubation rate within 48 hours after extubation and the total ICU mortality rate were independent risk factors for higher in-hospital mortality of V-V ECMO-supported patients (cutoff: 1.5% and 7.0%; 95% confidence interval: 1.05–1.48 and 1.04–1.45; odds ratios: 1.25 and 1.23; P = 0.012 and P = 0.015, respectively). Meanwhile, the V-V ECMO center volume was a protective factor (cutoff of ≥ 50 cases within the 3-year study period; 95% confidence interval: 0.57–0.83, odds ratio: 0.69, P = 0.0001). The subgroup analysis of 864 patients in 11 high-volume centers further strengthened these findings. Thus, ICU quality may play an important role in improving the prognosis of V-V ECMO-supported patients.

关键词： veno-venous extracorporeal membrane oxygenation     in-hospital mortality     high-volume centers     quality control     intensive care unit capacity parameters    

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Sclerosing cholangitis in critically ill patients: an important and easily ignored problem based on a German experience

null

《医学前沿（英文）》 2014年 第8卷 第1期   页码 118-126 doi: 10.1007/s11684-014-0306-6

摘要：

Intensive care unit (ICU) is important in the rehabilitation of critically ill patients. In the past decades, many patients who received aggressive treatment in ICU developed sclerosing cholangitis in multiple centers. Sclerosing cholangitis in critically ill patients (SC-CIP) is a relatively new issue. To investigate the causes, clinical manifestation, treatment, and prognosis of SC-CIP, we searched for published cases in the databases of PubMed, Highwire, and Elsevier from 2001 to 2012. Data were extracted using a standard form and retrospectively analyzed. Twelve eligible studies covering 88 patients, with 64 men and 24 women, were enrolled in this analysis. The mean age was 49.8 years. All of the patients recovered from critical illnesses, such as trauma, infection, burn, and major surgeries. High pressure positive end-expiratory pressure (PEEP, peak level at 12.8 cm H2O) was utilized for all patients, with the average duration of 36.3 d. In addition, vasopressor agents were administered in approximately 60% of SC-CIP. A rapid increase in cholestasis and irregular strictures in the intrahepatic bile ducts was observed in the following months. With an average follow-up period of 17.9 months, poor outcomes were observed in 54 patients, including 34 deaths. In conclusion, ischemic injury of the biliary tree, which may be affected by PEEP and/or vasopressor administration, affects cholangiopathic procedure. As a newly discovered type of secondary sclerosing cholangitis, SC-CIP is a severe progressive complication of patients in ICU and should be carefully monitored by clinicians.

关键词： intensive care unit     sclerosing cholangitis     ischemic injury     prognosis     systemic review    

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High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

ZHU Wenyu, TAN Liping, CHEN Xiangfeng, HUANG Qiang, LAN Qing

《医学前沿（英文）》 2007年 第1卷 第3期   页码 299-303 doi: 10.1007/s11684-007-0057-8

摘要： By analyzing the high risk factors for pulmonary fungous infection in intensive care units of neurosurgery, the strategy of early diagnosis and treatment was explored. According to the domestic diagnostic standard on pulmonary fungous infection, clinical data on 58 patients with the infection in our department were analyzed. One hundred and seventeen strains of fungi were separated from the 58 cases. Candidiasis was the most frequent type, accounting for 92.3% of the cases. Conditions such as the severity of primary diseases, long-time coma, long-term use of broad-spectrum antibiotic, abuse of glucocorticoid, the open airway, and some invasive intubations, may be regarded as high risk factors for pulmonary fungous infection. Fluconazole showed good clinical effects on the treatment of fungous infection. To eliminate these high risk factors, early diagnosis and the use of prophylactic antifungal agents can help reduce the incidence of pulmonary fungous infection.

关键词： seventeen     incidence     glucocorticoid     broad-spectrum antibiotic     Candidiasis    

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Characterising populations living close to intensive farming and composting facilities in England

《环境科学与工程前沿（英文）》 2021年 第15卷 第3期 doi: 10.1007/s11783-020-1332-z

摘要：

• Bioaerosol emitted from farming and composting facilities may pose health risks.

关键词： Composting     Intensive farming     Bioaerosol     Population characteristics     Public health    

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Socialized care services for the aged population: System construction and support measures

《工程管理前沿（英文）》 2023年 第10卷 第2期   页码 339-353 doi: 10.1007/s42524-022-0208-2

摘要： Given the aging society, an increase in social demand, information- and communication technology-driven culture, and government policy support emerges to enable the development of the socialized care services system for the aged (SCSSA). The development of the SCSSA would be a significant step toward addressing China’s aging population. However, the construction of the SCSSA challenges the theories and methods of traditional elderly care service system construction. Specifically, the implementation path for such elderly care service policies is unclear, the necessary technological support is insufficient, and the mechanism for integrating intelligent information technology remains underexplored. Thus, this paper focuses on the needs of the elderly, grounded in the context of the changing elderly care service policies in China, and proposes a research paradigm that integrates system construction and support measure embedding. We then construct the original SCSSA, which includes “material + spirit + medical treatment + healthcare” and propose a method of optimization and iteration. Finally, we build the research framework of systematic support measures from the perspectives of policy reconstruction, institutional embeddedness, and technical support. Our work provides theoretical support and practical guidance for the construction and dynamic optimization of the SCSSA, thus making a significant contribution that will help China effectively cope with its aging society.

关键词： socialized     care service for the elderly     system construction     support measure    

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Optimization of process parameters for preparation of powdered activated coke to achieve maximum SO

Binxuan ZHOU, Tao WANG, Tianming XU, Cheng LI, Yuan ZHAO, Jiapeng FU, Zhen ZHANG, Zhanlong SONG, Chunyuan MA

《能源前沿（英文）》 2021年 第15卷 第1期   页码 159-169 doi: 10.1007/s11708-020-0719-7

摘要： Powdered activated coke (PAC) is a good adsorbent of SO , but its adsorption capacity is affected by many factors in the preparation process. To prepare the PAC with a high SO adsorption capacity using JJ-coal under flue gas atmosphere, six parameters (oxygen-coal equivalent ratio, reaction temperature, reaction time, O concentration, CO concentration, and H O concentration) were screened and optimized using the response surface methodology (RSM). The results of factor screening experiment show that reaction temperature, O concentration, and H O (g) concentration are the significant factors. Then, a quadratic polynomial regression model between the significant factors and SO adsorption capacity was established using the central composite design (CCD). The model optimization results indicate that when reaction temperature is 904.74°C, O concentration is 4.67%, H O concentration is 27.98%, the PAC (PAC-OP) prepared had a higher SO adsorption capacity of 68.15 mg/g while its SO adsorption capacity from a validation experiment is 68.82 mg/g, and the error with the optimal value is 0.98%. Compared to two typical commercial activated cokes (ACs), PAC-OP has relatively more developed pore structures, and its and are 349 m /g and 0.1475 cm /g, significantly higher than the 186 m /g and 0.1041 cm /g of AC1, and the 132 m /g and 0.0768 cm /g of AC2. Besides, it also has abundant oxygen-containing functional groups, its surface O content being 12.09%, higher than the 10.42% of AC1 and 10.49% of AC2. Inevitably, the SO adsorption capacity of PAC-OP is also significantly higher than that of both AC1 and AC2, which is 68.82 mg/g versus 32.53 mg/g and 24.79 mg/g, respectively.

关键词： powdered activated coke (PAC)     SO2 adsorption capacity     parameters optimization     response surface methodology    

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Advancing pediatric care before birth

《医学前沿（英文）》 2023年 第17卷 第2期   页码 352-354 doi: 10.1007/s11684-022-0974-6

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Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai

《医学前沿（英文）》 2022年 第16卷 第1期   页码 126-138 doi: 10.1007/s11684-021-0897-7

摘要： This cross-sectional study aimed to investigate the quality of care of diabetes in Shanghai, China. A total of 173 235 patients with type 2 diabetes in 2017 were included in the analysis. Profiles of risk factors and intermediate outcomes were determined. The patients had a mean age of 66.43±8.12 (standard deviation (SD)) years and a mean diabetes duration of 7.95±5.53 (SD) years. The percentage of patients who achieved the target level for HbA1c (<7.0%) was 48.6%. Patients who achieved the target levels for blood pressure (BP)<130/80 mmHg and low-density lipoprotein-cholesterol (LDL-c)<2.6 mmol/L reached 17.5% and 34.0%, respectively. A total of 3.8% achieved all three target levels, and the value increased to 6.8% with an adaptation of the BP target level (<140/90 mmHg) for those over 65 years. Multivariable analysis identified the factors associated with a great likelihood of achieving all three target levels: male, young age, short diabetes duration, low body mass index, macrovascular complications, no microvascular complications, prescribed with lipid-lowering medication, and no prescription of antihypertensive medication. In conclusion, nearly 50% and one-third of the patients with diabetes met the target levels for HbA1c and LDL-c, respectively, with a low percentage achieving the BP target level. The percentage of patients who achieved all three target levels needs significant improvement.

关键词： type 2 diabetes     quality of care     macrovascular complication     microvascular complication     treatment pattern     epidemiology    

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黏聚裂纹阻抗的弯曲梁承载力

王利民,徐世,任传波

《中国工程科学》 2007年 第9卷 第2期   页码 30-35

摘要：

在混凝土类软化材料断裂研究中，裂纹端部损伤区被简化为具有黏聚应力分布的非线性裂纹，该黏 聚力对裂纹扩展有阻抗作用。裂纹体的应力强度因子是断裂力学标志载荷作用与几何构型因素的量化表达指标； 黏聚力形成的阻抗强度因子数值，与黏聚裂纹长度和材料极值拉伸应力存在数量关系。通过双K断裂判据，以 带切口的三点弯曲梁为断裂力学模型，分析了裂纹黏聚阻力对断裂过程的影响规律，计算该弯曲梁结构断裂试 样的最大承担载荷；其结果比较符合实验数据。

关键词： 黏聚裂纹     三点弯曲梁     混凝土     双K断裂参数     结构承载力    

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三峡工程巨型水轮发电机组设计与实践

邵建雄,刘景旺,袁达夫

《中国工程科学》 2011年 第13卷 第7期   页码 104-110

摘要：

分析了三峡水轮发电机组设计中必须考虑的主要问题；总结了所进行的关键技术研究；通过关键技术问题研究，使得三峡水轮发电机组参数达到最优化。机组运行结果表明三峡水轮发电机组性能良好，能够长期安全、稳定、高效运行，从而有效地验证了对三峡巨型水轮发电机组的总体技术设计是科学合理的。

关键词： 三峡工程     700 MW级水电机组     单机容量     设计研究     运行稳定性     实践    

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Model for the Coordinated Development of a Circular Economy in China and Its Application to Energy-intensive

Ji-liang Zheng,Chen Zheng,Pan Chen,Ching Yuan Luk

《工程管理前沿（英文）》 2014年 第1卷 第4期   页码 364-371 doi: 10.15302/J-FEM-2014053

摘要： Energy-intensive industries (EIIs) are fundamental to the industrial development of China and are also the key industries of a circular economic infrastructure. It is worth paying attention to the coordinated development of a circular economy using EIIs due to the present interrelationship among EIIs. It is related to the optimization and comprehensive performance improvement of a circular economy. Based on the perspective of order parameter, this study uses economic and environmental subsystems to establish an evaluation model that examines the coordinated development of a circular economy within six main EIIs and an EII cluster from 2006 to 2011 in China. The result shows that the level of coordinated development in a circular economy among six EIIs differs and the level of coordinated development of circular economy among the EII cluster lags behind that of each EII examined. It also shows that the outside coordinated degree of EIIs is lower than the inside coordinated degree of each EII.

关键词： order parameter     coordinated degree evaluation     energy-intensive industry     circular economy    

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REGIONAL ASSESSMENT OF SOIL NITROGEN MINERALIZATION IN DIVERSE CROPLAND OF A REPRESENTATIVE INTENSIVE

《农业科学与工程前沿（英文）》 2023年 第10卷 第4期   页码 530-540 doi: 10.15302/J-FASE-2023515

摘要：

Soil nitrogen mineralization (Nmin) is a key process that converts organic N into mineral N that controls soil N availability to plants. However, regional assessments of soil Nmin in cropland and its affecting factors are lacking, especially in relation to variation in elevation. In this study, a 4-week incubation experiment was implemented to measure net soil Nmin rate, gross nitrification (Nit) rate and corresponding soil abiotic properties in five field soils (A–C, maize; D, flue-cured tobacco; and E, vegetables; with elevation decreasing from A to E) from different altitudes in a typical intensive agricultural area in Dali City, Yunnan Province, China. The results showed that soil Nmin rate ranged from 0.10 to 0.17 mg·kg−1·d−1 N, with the highest value observed in field E, followed by fields D, C, B, and A, which indicated that soil Nmin and Nit rates varied between fields, decreasing with elevation. The soil Nit rate ranged from 434.2 to 827.1 µg·kg−1·h−1 N, with the highest value determined in field D, followed by those in fields E, C, B, and A. The rates of soil Nmin and Nit were positively correlated with several key soil parameters, including total soil N, dissolved organic carbon and dissolved inorganic N across all fields, which indicated that soil variables regulated soil Nmin and Nit in cropland fields. In addition, a strong positive relationship was observed between soil Nmin and Nit. These findings provide a greater understanding of the response of soil Nmin among cropland fields related to spatial variation. It is suggested that the soil Nmin from cropland should be considered in the evaluation of the N transformations at the regional scale.

关键词： cropland     gross nitrification rate     regulatory factors     soil nitrogen mineralization     spatial variation    

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Determination and occurrence of endocrine disrupting compounds, pharmaceuticals and personal care products

Yong YU,Laosheng WU

《环境科学与工程前沿（英文）》 2015年 第9卷 第3期   页码 475-481 doi: 10.1007/s11783-014-0640-6

摘要： Endocrine disrupting compounds (EDCs), pharmaceuticals and personal care products (PPCPs) have attracted much attention due to widespread contamination in aquatic environment. In this study, we determined 13 EDCs and PPCPs in fish blood, bile and muscle by using gas chromatography-mass spectrometry (GC-MS). The limits of quantitation (LOQ) were in the ranges of 0.23–2.54, 0.22–2.36 ng·mL , and 0.24–2.57 ng·g dry weight (dw) for fish blood, bile and muscle, respectively. Recoveries of target compounds spiked into sample matrices and passed through the entire analytical procedure ranged from 65% to 95%, from 60% to 92% and from 62% to 91% for blood, bile and muscle, respectively. The methods were applied to the analysis of fish from a lake in California. Target compounds were relatively low in bile, and only bisphenol A (BPA) and diclofenac were measurable near the LOQ. Seven of 13 compounds were detected in blood, with total concentrations up to 39 ng·mL . Only BPA was frequently found in muscle, with mean concentration of 7.26 ng·g dw. The estimated daily intake of BPA through fish consumption for U.S. resident was significantly lower than the tolerable daily intake recommended by the European Food Safety Authority. This study showed that the exposure to the bisphenol A from fish diet is unlikely to pose a health risk.

关键词： endocrine disrupting compounds (EDCs)     pharmaceuticals and personal care products (PPCPs)     fish     bisphenol A (BPA)     risk assessment    

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Primary health care for all by 2020: The systematic reform of the medical and health system in China

《医学前沿（英文）》 2010年 第4卷 第1期   页码 3-7 doi: 10.1007/s11684-010-0024-7

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Arthrogryposis multiplex congenita: classification, diagnosis, perioperative care, and anesthesia

null

《医学前沿（英文）》 2017年 第11卷 第1期   页码 48-52 doi: 10.1007/s11684-017-0500-4

摘要：

Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients. Most patients require surgery to release contracture and reconstruct joints. However, perioperative care is challenging, and difficult airway is the first concern of anesthesiologists. Postoperative pulmonary complications are common and regional anesthesia is recommended for postoperative analgesia. This review on AMC is intended for anesthesiologists. Thus, we discuss the treatment and perioperative management of patients undergoing surgery, as well as the diagnosis and classification of AMC.

关键词： arthrogryposis     amyoplasia     distal arthrogryposis     anesthesia    

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标题 作者 时间 类型 操作

Association between ICU quality and in-hospital mortality of V-V ECMO-supported patients—the ECMO quality improvement action (EQIA) study: a national cohort study in China from 2017 to 2019

期刊论文

Sclerosing cholangitis in critically ill patients: an important and easily ignored problem based on a German experience

null

期刊论文

High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

ZHU Wenyu, TAN Liping, CHEN Xiangfeng, HUANG Qiang, LAN Qing

期刊论文

Characterising populations living close to intensive farming and composting facilities in England

期刊论文

Socialized care services for the aged population: System construction and support measures

期刊论文

Optimization of process parameters for preparation of powdered activated coke to achieve maximum SO

Binxuan ZHOU, Tao WANG, Tianming XU, Cheng LI, Yuan ZHAO, Jiapeng FU, Zhen ZHANG, Zhanlong SONG, Chunyuan MA

期刊论文

Advancing pediatric care before birth

期刊论文

Effectiveness of quality of care for patients with type 2 diabetes in China: findings from the Shanghai

期刊论文

黏聚裂纹阻抗的弯曲梁承载力

王利民,徐世,任传波

期刊论文

三峡工程巨型水轮发电机组设计与实践

邵建雄,刘景旺,袁达夫

期刊论文

Model for the Coordinated Development of a Circular Economy in China and Its Application to Energy-intensive

Ji-liang Zheng,Chen Zheng,Pan Chen,Ching Yuan Luk

期刊论文

REGIONAL ASSESSMENT OF SOIL NITROGEN MINERALIZATION IN DIVERSE CROPLAND OF A REPRESENTATIVE INTENSIVE

期刊论文

Determination and occurrence of endocrine disrupting compounds, pharmaceuticals and personal care products

Yong YU,Laosheng WU

期刊论文

Primary health care for all by 2020: The systematic reform of the medical and health system in China

期刊论文

Arthrogryposis multiplex congenita: classification, diagnosis, perioperative care, and anesthesia

null

期刊论文