目的分析格拉斯哥昏迷评分(Glasgow coma scale,GCS)对急性脑卒中患者住院期间预后预测的价值,以及影响意识障碍程度的相关因素和转归。方法数据来自中国卒中医疗质量评估研究数据库,对6336例急性脑卒中患者进行分析。按照GCS评分分为...目的分析格拉斯哥昏迷评分(Glasgow coma scale,GCS)对急性脑卒中患者住院期间预后预测的价值,以及影响意识障碍程度的相关因素和转归。方法数据来自中国卒中医疗质量评估研究数据库,对6336例急性脑卒中患者进行分析。按照GCS评分分为无意识障碍组5745例(GCS>8分)和意识障碍组591例(GCS≤8分)。使用ROC曲线下面积分析GCS预测价值。多因素回归分析人口与社会学因素,以及院前急救特点、脑卒中危险因素、脑卒中亚型与意识障碍程度的关系。结果意识障碍组低教育程度(60.9%vs 46.7%,P=0.000)、利用救护车到院(62.1%vs 18.5%,P=0.000)、心房颤动(10.0%vs 4.8%,P=0.000)、出血性脑卒中(60.9%vs 20.8%,P=0.000)比例明显高于无意识障碍组,有规律饮酒(19.3%vs 27.7%,P=0.000)、缺血性脑卒中(36.9%vs78.3%,P=0.000)比例明显低于无意识障碍组。GCS预测患者1年内死亡和住院死亡的ROC曲线下面积分别为0.831(95%CI:0.804~0.858,P<0.01)和0.768(95%CI:0.748~0.787,P<0.01)。与无意识障碍组有关的因素有高水平教育、院前延误>6h、有规律饮酒、出血性脑卒中、到院交通方式(救护车)、心房颤动(P<0.01)。结论GCS可以提供急性脑卒中预后预测的信息。展开更多
The ^(25)Mg(p,γ)^(26)Al reaction plays an important role in the study of cosmic 1.809 MeV γ-ray as a signature of ongoing nucleosynthesis in the Galaxy.At astrophysical temperature around 0.1 GK,the ^(25)Mg(p,γ)^(2...The ^(25)Mg(p,γ)^(26)Al reaction plays an important role in the study of cosmic 1.809 MeV γ-ray as a signature of ongoing nucleosynthesis in the Galaxy.At astrophysical temperature around 0.1 GK,the ^(25)Mg(p,γ)^(26)Al reaction rates are dominated by the 92 keV resonance capture process.We report a precise measurement of the 92 keV ^(25)Mg(p,γ)^(26)Al resonance in the day-one experiment at Jinping Underground Nuclear Astrophysics experiment(JUNA)facility in the China Jinping Underground Laboratory(CJPL).The resonance strength and ground state feeding factor are determined to be 3.8±0.3×10^(-10) eV and 0:660:04,respectively.The results are in agreement with those reported in the previous direct underground measurement within uncertainty,but with significantly reduced uncertainties.Consequently,we recommend new ^(25)Mg(p,γ)^(26)Al reaction rates which are by a factor of 2.4 larger than those adopted in REACLIB database at the temperature around 0.1 GK.The new results indicate higher production rates of ^(26g)Al and the cosmic 1.809 MeV γ-ray.The implication of the new rates for the understanding of other astrophysical situations is also discussed.展开更多
目的探讨体质量指数(BMI)与腔隙性脑梗死患者预后的关系。方法纳入中国脑卒中管理质量评估登记研究(China Quality Evaluation of Stroke Care and Treatment)数据库中TOAST分型为腔隙性脑梗死的患者3410例,其中低体质量组(BMI<18.5k...目的探讨体质量指数(BMI)与腔隙性脑梗死患者预后的关系。方法纳入中国脑卒中管理质量评估登记研究(China Quality Evaluation of Stroke Care and Treatment)数据库中TOAST分型为腔隙性脑梗死的患者3410例,其中低体质量组(BMI<18.5kg/m^2)182例、正常体质量组(BMI 18.5~23.9kg/m^2)1639例、超重组(BMI24.0~27.9kg/m^2)1212例和肥胖组(BMI≥28.0kg/m^2)377例。终点事件包括12个月时全因死亡、死亡或严重残疾、感染并发症和脑卒中复发。结果与正常体质量组比较,低体质量组12个月时累计全因死亡率升高(19.1%vs 6.7%,P<0.01),超重组和肥胖组变化无显著差异(6.0%和3.8%vs 6.7%,P>0.05)。多因素分析显示,以正常体质量组为参照,低体质量组12个月累计全因死亡(HR=1.91,95%CI:1.22~2.98,P=0.004)、12个月时死亡或严重残疾(OR=1.50,95%CI:1.05~2.14,P=0.026)及感染并发症(OR=1.92,95%CI:1.21~3.06,P=0.006)的风险更高,脑卒中复发风险无显著差异;超重组和肥胖组患者发生上述终点事件的风险无显著差异。结论腔隙性脑梗死患者中,低体质量伴随脑卒中预后不良风险升高,但脑卒中复发的风险无显著改变。展开更多
基金supported by the National Natural Science Foundation of China(1149056312125509U18672111196114100311775133and 12175152)the Continuous Basic Scientific Research Project No.WDJC-2019-13+1 种基金the Equipment Research and Development Project of Chinese Academy of Sciences(28Y531040)research fund of CNNC。
文摘The ^(25)Mg(p,γ)^(26)Al reaction plays an important role in the study of cosmic 1.809 MeV γ-ray as a signature of ongoing nucleosynthesis in the Galaxy.At astrophysical temperature around 0.1 GK,the ^(25)Mg(p,γ)^(26)Al reaction rates are dominated by the 92 keV resonance capture process.We report a precise measurement of the 92 keV ^(25)Mg(p,γ)^(26)Al resonance in the day-one experiment at Jinping Underground Nuclear Astrophysics experiment(JUNA)facility in the China Jinping Underground Laboratory(CJPL).The resonance strength and ground state feeding factor are determined to be 3.8±0.3×10^(-10) eV and 0:660:04,respectively.The results are in agreement with those reported in the previous direct underground measurement within uncertainty,but with significantly reduced uncertainties.Consequently,we recommend new ^(25)Mg(p,γ)^(26)Al reaction rates which are by a factor of 2.4 larger than those adopted in REACLIB database at the temperature around 0.1 GK.The new results indicate higher production rates of ^(26g)Al and the cosmic 1.809 MeV γ-ray.The implication of the new rates for the understanding of other astrophysical situations is also discussed.
文摘目的探讨体质量指数(BMI)与腔隙性脑梗死患者预后的关系。方法纳入中国脑卒中管理质量评估登记研究(China Quality Evaluation of Stroke Care and Treatment)数据库中TOAST分型为腔隙性脑梗死的患者3410例,其中低体质量组(BMI<18.5kg/m^2)182例、正常体质量组(BMI 18.5~23.9kg/m^2)1639例、超重组(BMI24.0~27.9kg/m^2)1212例和肥胖组(BMI≥28.0kg/m^2)377例。终点事件包括12个月时全因死亡、死亡或严重残疾、感染并发症和脑卒中复发。结果与正常体质量组比较,低体质量组12个月时累计全因死亡率升高(19.1%vs 6.7%,P<0.01),超重组和肥胖组变化无显著差异(6.0%和3.8%vs 6.7%,P>0.05)。多因素分析显示,以正常体质量组为参照,低体质量组12个月累计全因死亡(HR=1.91,95%CI:1.22~2.98,P=0.004)、12个月时死亡或严重残疾(OR=1.50,95%CI:1.05~2.14,P=0.026)及感染并发症(OR=1.92,95%CI:1.21~3.06,P=0.006)的风险更高,脑卒中复发风险无显著差异;超重组和肥胖组患者发生上述终点事件的风险无显著差异。结论腔隙性脑梗死患者中,低体质量伴随脑卒中预后不良风险升高,但脑卒中复发的风险无显著改变。
