Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemo...Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemostatic agent with hemostasis by conventional technique (HCT) in thyroid surgery. Methods: The thyroid resection was performed from November 2009 to February 2010. Exclusion criteria were applied. There were 30 patients in the HCT group and 30 patients in the PerClot® group. The outcome parameters were postoperative bleeding, the drainage volume 24 hours postoperatively and adverse events according to PerClot®. Results: There was no post-operative hemorrhage in both groups. We found no significant difference between the control andPerClot® group with regard to total drainage volume after 24 h (51 ml ± 36.9 control group/53 ml ± 39.5 PerClot® group (p = 0.79)). There were no adverse events in the PerClot® group. Conclusions: Routine use of PerClot® hemostatic agent has no advantage over conventional hemostasis technique (HCT) in thyroid surgery. In addition, PerClot®?is safe and well tolerated.展开更多
In 1987,a catastrophic fire burned over 1330000 ha in the densely forested area of the Da Hinggan Mountains in the northeastern China.After the fire,intensive management including burned trunk harvesting and coniferou...In 1987,a catastrophic fire burned over 1330000 ha in the densely forested area of the Da Hinggan Mountains in the northeastern China.After the fire,intensive management including burned trunk harvesting and coniferous tree planting had been conducted to accelerate forest restoration.To study the long term effect of these activities on forest recovery,we used a simulation modeling approach to study long-term(300 years) forest dynamics under current planting and natural regeneration scenarios.Results indicate that under tree planting scenario in the severely burned area,the dominant species Dahurian larch(Larix gmelinii) can reach pre-fire level(60% of the area) within 20 years and the maximum abundance can reach nearly 90% within 100 years.While under natural regeneration scenario,it needs about 250 years to reach its pre-fire level.From the perspective of timber production,tree planting can bring twice as much timber volume as that under natural regeneration within 300 years,which is the average longevity of L.gmelinii.It needs about 70 years to reach the timber volume of pre-fire level under the planting scenario,whereas it requires at least 250 years to reach the timber volume of pre-fire level under natural regeneration scenario.Another dominant species Asian White birch(Betula platyphylla) responded negatively to the planting of coniferous species.In general,tree planting of coniferous species after fire can greatly accelerate forest restoration in terms of species abundance and target timber volume,with desirable ecological and economic returns.展开更多
目的探讨呼气末二氧化碳分压（PETCO2）联合被动抬腿试验（PLR）对心脏术后休克患者容量反应性的评估价值。方法采用前瞻性观察性自身前后配对研究设计方法，选择2014年6月至2015年10月浙江大学医学院附属第一医院重症医学科收治的完全...目的探讨呼气末二氧化碳分压（PETCO2）联合被动抬腿试验（PLR）对心脏术后休克患者容量反应性的评估价值。方法采用前瞻性观察性自身前后配对研究设计方法，选择2014年6月至2015年10月浙江大学医学院附属第一医院重症医学科收治的完全机械控制通气的心脏术后休克患者。分别在PLR及容量负荷试验（VE）前后监测PETCO2，用脉搏指示连续心排血量（PiCCO）监测技术监测每搏量变异度（SVV）、心排血指数（CI）、平均动脉压（MAP）等血流动力学指标。根据扩容后CI增加值（△CI）分为有反应组（△CI≥15％）和无反应组（△CI〈15％）。以受试者工作特征曲线（ROC）分析PLR后PETCO2增加幅度（APETCO2PLR）对容量反应性的评估价值。结果41例患者中有容量反应性21例（有反应组），无容量反应性20例（无反应组）。有反应组患者PLR后CI和PETCO2增加值均明显高于无反应组[△CI：（13．5±4．6）％比（3．6±3．5）％，△PETCO2：（7.4±3．4）％比（2．8±2．5）％，均P〈0．05]。△PET CO2 PLR和SVV基线与△CIPLR均呈正相关（r1=0．50、r2=0．38，均P〈0．05）；APETCO2VE、SVV基线、ACIPLR与△CIVE也均呈正相关（r1=0．58、r2=0．56、r3=0．84，均P〈0．01）。△PETCO2PLR评估容量反应性的ROC曲线下面积（AUC）为0．875±0．054[95％可信区间（95％CI）=0．769。0．981，P〈0．05]，以5．8％为临界值时敏感度为76．2％、特异度为90．0％；△CIPLR评估容量反应性的AUC为0．933±0．036（95％CI=0．862～1．000，P〈0．05），以10．4％为临界值时敏感度为81．0％、特异度为90．0％；SVV甚鳢评估容量反应性的AUC为0．831±0．066（95％CI=0．702～0．960，P〈0．05），以12．5％为临界值时敏感度为85．7％、特异度为75．0％。结论PLR后PETCO2的变化值可以作为预测心脏术后机械通气休克患者容量反应性简便、可靠的无�展开更多
文摘Background: Postoperative hemorrhage remains an uncommon but potentially life-threatening complication of thyroid surgery. The aim of this case-controlled study was to compare the effectiveness of PerClot® hemostatic agent with hemostasis by conventional technique (HCT) in thyroid surgery. Methods: The thyroid resection was performed from November 2009 to February 2010. Exclusion criteria were applied. There were 30 patients in the HCT group and 30 patients in the PerClot® group. The outcome parameters were postoperative bleeding, the drainage volume 24 hours postoperatively and adverse events according to PerClot®. Results: There was no post-operative hemorrhage in both groups. We found no significant difference between the control andPerClot® group with regard to total drainage volume after 24 h (51 ml ± 36.9 control group/53 ml ± 39.5 PerClot® group (p = 0.79)). There were no adverse events in the PerClot® group. Conclusions: Routine use of PerClot® hemostatic agent has no advantage over conventional hemostasis technique (HCT) in thyroid surgery. In addition, PerClot®?is safe and well tolerated.
基金Under the auspices of National Natural Science Foundation of China (No 30270225, 40871245, 40331008, 40671013)
文摘In 1987,a catastrophic fire burned over 1330000 ha in the densely forested area of the Da Hinggan Mountains in the northeastern China.After the fire,intensive management including burned trunk harvesting and coniferous tree planting had been conducted to accelerate forest restoration.To study the long term effect of these activities on forest recovery,we used a simulation modeling approach to study long-term(300 years) forest dynamics under current planting and natural regeneration scenarios.Results indicate that under tree planting scenario in the severely burned area,the dominant species Dahurian larch(Larix gmelinii) can reach pre-fire level(60% of the area) within 20 years and the maximum abundance can reach nearly 90% within 100 years.While under natural regeneration scenario,it needs about 250 years to reach its pre-fire level.From the perspective of timber production,tree planting can bring twice as much timber volume as that under natural regeneration within 300 years,which is the average longevity of L.gmelinii.It needs about 70 years to reach the timber volume of pre-fire level under the planting scenario,whereas it requires at least 250 years to reach the timber volume of pre-fire level under natural regeneration scenario.Another dominant species Asian White birch(Betula platyphylla) responded negatively to the planting of coniferous species.In general,tree planting of coniferous species after fire can greatly accelerate forest restoration in terms of species abundance and target timber volume,with desirable ecological and economic returns.
文摘目的探讨呼气末二氧化碳分压（PETCO2）联合被动抬腿试验（PLR）对心脏术后休克患者容量反应性的评估价值。方法采用前瞻性观察性自身前后配对研究设计方法，选择2014年6月至2015年10月浙江大学医学院附属第一医院重症医学科收治的完全机械控制通气的心脏术后休克患者。分别在PLR及容量负荷试验（VE）前后监测PETCO2，用脉搏指示连续心排血量（PiCCO）监测技术监测每搏量变异度（SVV）、心排血指数（CI）、平均动脉压（MAP）等血流动力学指标。根据扩容后CI增加值（△CI）分为有反应组（△CI≥15％）和无反应组（△CI〈15％）。以受试者工作特征曲线（ROC）分析PLR后PETCO2增加幅度（APETCO2PLR）对容量反应性的评估价值。结果41例患者中有容量反应性21例（有反应组），无容量反应性20例（无反应组）。有反应组患者PLR后CI和PETCO2增加值均明显高于无反应组[△CI：（13．5±4．6）％比（3．6±3．5）％，△PETCO2：（7.4±3．4）％比（2．8±2．5）％，均P〈0．05]。△PET CO2 PLR和SVV基线与△CIPLR均呈正相关（r1=0．50、r2=0．38，均P〈0．05）；APETCO2VE、SVV基线、ACIPLR与△CIVE也均呈正相关（r1=0．58、r2=0．56、r3=0．84，均P〈0．01）。△PETCO2PLR评估容量反应性的ROC曲线下面积（AUC）为0．875±0．054[95％可信区间（95％CI）=0．769。0．981，P〈0．05]，以5．8％为临界值时敏感度为76．2％、特异度为90．0％；△CIPLR评估容量反应性的AUC为0．933±0．036（95％CI=0．862～1．000，P〈0．05），以10．4％为临界值时敏感度为81．0％、特异度为90．0％；SVV甚鳢评估容量反应性的AUC为0．831±0．066（95％CI=0．702～0．960，P〈0．05），以12．5％为临界值时敏感度为85．7％、特异度为75．0％。结论PLR后PETCO2的变化值可以作为预测心脏术后机械通气休克患者容量反应性简便、可靠的无�
