目的探讨长时间用无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)(简称重叠综合征)的临床疗效。方法回顾性分析2016年6月至2018年6月在哈尔滨医科大学附属第一医院呼吸内科治疗的66例重叠综合征患者的临床...目的探讨长时间用无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)(简称重叠综合征)的临床疗效。方法回顾性分析2016年6月至2018年6月在哈尔滨医科大学附属第一医院呼吸内科治疗的66例重叠综合征患者的临床资料,依据NIPPV使用时间不同分为对照组(33例)和试验组(33例)。患者均接受NIPPV和噻托溴铵粉吸入剂治疗。对照组NIPPV使用时间为4 h/d,试验组NIPPV使用时间为8 h/d,两组均治疗6个月。比较两组患者的临床疗效,治疗前后血气分析指标、呼吸频率、心率、第一秒用力呼气量占预计值的百分比(FEV_(1)%)、COPD评估测试(CAT)评分、COPD急性加重(AECOPD)发作次数、改良英国医学研究学会呼吸困难指数(mMRC)分级的变化。结果治疗6个月后,试验组的总有效率高于对照组[93.94%(31/33)比84.85%(28/33)](P<0.05)。治疗6个月后,两组患者的pH值、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))较治疗前升高(P<0.05),动脉血二氧化碳分压(PaCO_(2))、呼吸频率、心率较治疗前降低(P<0.05);治疗6个月后,试验组PaO_(2)和SaO_(2)高于对照组,PaCO_(2)、呼吸频率、心率低于对照组(P<0.05)。FEV_(1)%、AECOPD发作次数的组间和时点间无交互作用(P>0.05),CAT评分的组间和时点间存在交互作用(P<0.05),治疗6个月后,两组CAT评分降低,试验组低于对照组(P<0.05)。治疗后试验组mMRC分级整体低于对照组(P<0.05)。结论每日8 h NIPPV治疗重叠综合征的疗效更好,可改善患者临床症状和肺功能,提高患者生活质量。展开更多
Among the plethora of IoT(Internet of Things)applications,the smart home is one of the fastest-growing.However,the rapid development of the smart home has also made smart home systems a target for attackers.Recently,r...Among the plethora of IoT(Internet of Things)applications,the smart home is one of the fastest-growing.However,the rapid development of the smart home has also made smart home systems a target for attackers.Recently,researchers have made many efforts to investigate and enhance the security of smart home systems.Toward a more secure smart home ecosystem,we present a detailed literature review on the security of smart home systems.Specifically,we categorize smart home systems’security issues into the platform,device,and communication issues.After exploring the research and specific issues in each of these security areas,we summarize the root causes of the security flaws in today's smart home systems,which include the heterogeneity of internal components of the systems,vendors'customization,the lack of clear responsibility boundaries and the absence of standard security standards.Finally,to better understand the security of smart home systems and potentially provide better protection for smart home systems,we propose research directions,including automated vulnerability mining,vigorous security checking,and data-driven security analysis.展开更多
文摘目的探讨长时间用无创正压通气(NIPPV)治疗慢性阻塞性肺疾病(COPD)合并阻塞性睡眠呼吸暂停(OSA)(简称重叠综合征)的临床疗效。方法回顾性分析2016年6月至2018年6月在哈尔滨医科大学附属第一医院呼吸内科治疗的66例重叠综合征患者的临床资料,依据NIPPV使用时间不同分为对照组(33例)和试验组(33例)。患者均接受NIPPV和噻托溴铵粉吸入剂治疗。对照组NIPPV使用时间为4 h/d,试验组NIPPV使用时间为8 h/d,两组均治疗6个月。比较两组患者的临床疗效,治疗前后血气分析指标、呼吸频率、心率、第一秒用力呼气量占预计值的百分比(FEV_(1)%)、COPD评估测试(CAT)评分、COPD急性加重(AECOPD)发作次数、改良英国医学研究学会呼吸困难指数(mMRC)分级的变化。结果治疗6个月后,试验组的总有效率高于对照组[93.94%(31/33)比84.85%(28/33)](P<0.05)。治疗6个月后,两组患者的pH值、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2))较治疗前升高(P<0.05),动脉血二氧化碳分压(PaCO_(2))、呼吸频率、心率较治疗前降低(P<0.05);治疗6个月后,试验组PaO_(2)和SaO_(2)高于对照组,PaCO_(2)、呼吸频率、心率低于对照组(P<0.05)。FEV_(1)%、AECOPD发作次数的组间和时点间无交互作用(P>0.05),CAT评分的组间和时点间存在交互作用(P<0.05),治疗6个月后,两组CAT评分降低,试验组低于对照组(P<0.05)。治疗后试验组mMRC分级整体低于对照组(P<0.05)。结论每日8 h NIPPV治疗重叠综合征的疗效更好,可改善患者临床症状和肺功能,提高患者生活质量。
基金supported by the Hubei Provincial Key Research and Development Technology Special Innovation Project under Grant No.2021BAA032the Wuhan Applied Foundational Frontier Project under Grant No.2020010601012188the Guangdong Provincial Key Research and Development Plan Project of China under Grant No.2019B010139001.
文摘Among the plethora of IoT(Internet of Things)applications,the smart home is one of the fastest-growing.However,the rapid development of the smart home has also made smart home systems a target for attackers.Recently,researchers have made many efforts to investigate and enhance the security of smart home systems.Toward a more secure smart home ecosystem,we present a detailed literature review on the security of smart home systems.Specifically,we categorize smart home systems’security issues into the platform,device,and communication issues.After exploring the research and specific issues in each of these security areas,we summarize the root causes of the security flaws in today's smart home systems,which include the heterogeneity of internal components of the systems,vendors'customization,the lack of clear responsibility boundaries and the absence of standard security standards.Finally,to better understand the security of smart home systems and potentially provide better protection for smart home systems,we propose research directions,including automated vulnerability mining,vigorous security checking,and data-driven security analysis.
