目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机...目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机分配到针刺组、假针刺组和等待治疗组,并记录了4周治疗期及4周随访期内应急使用抗组胺药的情况。本研究主要评估指标为应急使用抗组胺药的平均天数,通过单因素方差分析(ANOVA)及Tukey HSD多重比较探讨不同时期组间应急使用抗组胺药的平均天数差异。对于组内比较,采用Welch的t检验评估不同时期的差异。非参数Mann-Whitney-U检验进一步验证了组间差异的稳健性。卡方检验和Fisher精确检验用于分析治疗组间用药人数的统计学差异。结果:共分析了296名患者的数据。与针刺组相比,等待治疗组在治疗期(0.30,95%CI0.08 to 0.53,P=0.005)和随访期(0.31,95%CI0.12 to 0.50,P<0.001)应急使用抗组胺药的频率增加。组内分析表明,尽管3组应急使用抗组胺药的平均天数有所下降,但这些变化无统计学意义(P>0.05)。此外,与等待治疗组相比,治疗和随访期间接受针刺治疗的患者中应急用药的人数较少(P<0.05)。结论:针刺治疗显示了减轻CSU患者依赖应急用药的潜力,为减少药物负担提供了一个有效的非药物治疗选择。展开更多
Understanding of how combinations of agronomic options can be used to improve the grain yield and nitrogen use efficiency（NUE） of winter wheat is limited. A three-year experiment involving four integrated management...Understanding of how combinations of agronomic options can be used to improve the grain yield and nitrogen use efficiency（NUE） of winter wheat is limited. A three-year experiment involving four integrated management strategies was conducted from 2013 to 2015 in Tai＇an, Shandong Province, China, to evaluate changes in grain yield and NUE. The integrated management treatments were as follows： current practice（T1）; improvement of current practice（T2）; high-yield management（T3）, which aimed to maximize grain yield regardless of the cost of resource inputs; and integrated soil and crop system management（T4） with a higher seeding rate, delayed sowing date, and optimized nutrient management. Seeding rates increased by 75 seeds m^-2 with each treatment from T1（225 seeds m^-2） to T4（450 seeds m^-2）. The sowing dates were delayed from T1（5 th Oct.） to T2 and T3（8 th Oct.）, and to T4 treatment（12 th Oct.）. T1, T2, T3, and T4 received 315, 210, 315, and 240 kg N ha^-1, 120, 90, 210 and 120 kg P2O5 ha^-1, 30, 75, 90, and 45 kg K2O ha^-1, respectively. The ratio of basal application to topdressing for T1, T2, T3, and T4 was 6：4, 5：5, 4：6, and 4：6, respectively, with the N topdressing applied at regreening for T1 and at jointing stage for T2, T3, and T4. The P fertilizers in all treatments were applied as basal fertilizer. The K fertilizer for T1 and T2 was applied as basal fertilizer while the ratio of basal application to topdressing（at jointing stage） of K fertilizer for both T3 and T4 was 6：4. T1, T2, T3, and T4 were irrigated five, four, four and three times, respectively. Treatment T3 produced the highest grain yield among all treatments over three years and the average yield was 9 277.96 kg ha^-1. Grain yield averaged across three years with the T4 treatment（8 892.93 kg ha^-1） was 95.85% of that with T3 and was 21.72 and 6.10% higher than that with T1（7 305.95 kg ha^-1） and T2（8 381.41 kg ha^-1）, respectively. Treatment T2 produced the highest NUE of a展开更多
目的本研究拟评价体外循环中华西综合血液管理(HIBM)策略对患者异体血需要量的影响。方法回顾性分析四川大学华西医院于2019年1月1日至2020年12月31日在体外循环下行成人心血管手术患者。HIBM包括减少预充量、逆预充技术、机血管理等9...目的本研究拟评价体外循环中华西综合血液管理(HIBM)策略对患者异体血需要量的影响。方法回顾性分析四川大学华西医院于2019年1月1日至2020年12月31日在体外循环下行成人心血管手术患者。HIBM包括减少预充量、逆预充技术、机血管理等9项策略。根据策略实施的时间,将患者分为实施前、推行期、全面实施。主要预后指标为围术期血制品使用量和使用率。结果3292例患者纳入分析,其中实施前为2265例、推行期318例,全面实施709例。与实施前比较,HIBM实施后全主动脉弓置换等大血管手术比例更高(14.7%vs.22.7%,P<0.001)而瓣膜置换手术比例较少(76.1%vs.67.0%,P<0.001);HIBM实施前后比较,血制品输注量红细胞(RBC)、新鲜冰冻血浆(FFP)、血小板(PLT)分别为:2.43 U vs.0.42 U;0.78 U vs.0.15 U;0.53 U vs.0.13 U、输注率(RBC、FFP、PLT分别为:47.0%vs.10.0%,23.0%vs.5.5%,35.0%vs.9.2%)均显著降低(所有P<0.001)。逻辑回归分析显示,HIBM能显著降低患者异体血暴露风险(RBC:OR=0.13,95%CI:0.10~0.16;FFP:OR=0.18,95%CI:0.13~0.26;PLT:OR=0.19,95%CI:0.14~0.25)。不同手术类型亚组分析也得出相似结果。结论HIBM能显著减少体外循环下心血管手术患者的输血量和异体血暴露风险,值得推广。展开更多
文摘目的:本研究通过对前期多中心随机对照试验数据进行二次分析,评估针刺作为非药物疗法在减少慢性自发性荨麻疹(Chronic Spontaneous Urticaria,CSU)患者对应急使用抗组胺药依赖方面的潜力,为CSU的多元化管理提供新的证据。方法:患者随机分配到针刺组、假针刺组和等待治疗组,并记录了4周治疗期及4周随访期内应急使用抗组胺药的情况。本研究主要评估指标为应急使用抗组胺药的平均天数,通过单因素方差分析(ANOVA)及Tukey HSD多重比较探讨不同时期组间应急使用抗组胺药的平均天数差异。对于组内比较,采用Welch的t检验评估不同时期的差异。非参数Mann-Whitney-U检验进一步验证了组间差异的稳健性。卡方检验和Fisher精确检验用于分析治疗组间用药人数的统计学差异。结果:共分析了296名患者的数据。与针刺组相比,等待治疗组在治疗期(0.30,95%CI0.08 to 0.53,P=0.005)和随访期(0.31,95%CI0.12 to 0.50,P<0.001)应急使用抗组胺药的频率增加。组内分析表明,尽管3组应急使用抗组胺药的平均天数有所下降,但这些变化无统计学意义(P>0.05)。此外,与等待治疗组相比,治疗和随访期间接受针刺治疗的患者中应急用药的人数较少(P<0.05)。结论:针刺治疗显示了减轻CSU患者依赖应急用药的潜力,为减少药物负担提供了一个有效的非药物治疗选择。
基金supported by the National Basic Research Program of China (2015CB150404)the Special Fund for Agro-scientific Research in the Public Interest, China (201203096)the Project of Shandong Province Higher Educational Science and Technology Program, China (J15LF07)
文摘Understanding of how combinations of agronomic options can be used to improve the grain yield and nitrogen use efficiency（NUE） of winter wheat is limited. A three-year experiment involving four integrated management strategies was conducted from 2013 to 2015 in Tai＇an, Shandong Province, China, to evaluate changes in grain yield and NUE. The integrated management treatments were as follows： current practice（T1）; improvement of current practice（T2）; high-yield management（T3）, which aimed to maximize grain yield regardless of the cost of resource inputs; and integrated soil and crop system management（T4） with a higher seeding rate, delayed sowing date, and optimized nutrient management. Seeding rates increased by 75 seeds m^-2 with each treatment from T1（225 seeds m^-2） to T4（450 seeds m^-2）. The sowing dates were delayed from T1（5 th Oct.） to T2 and T3（8 th Oct.）, and to T4 treatment（12 th Oct.）. T1, T2, T3, and T4 received 315, 210, 315, and 240 kg N ha^-1, 120, 90, 210 and 120 kg P2O5 ha^-1, 30, 75, 90, and 45 kg K2O ha^-1, respectively. The ratio of basal application to topdressing for T1, T2, T3, and T4 was 6：4, 5：5, 4：6, and 4：6, respectively, with the N topdressing applied at regreening for T1 and at jointing stage for T2, T3, and T4. The P fertilizers in all treatments were applied as basal fertilizer. The K fertilizer for T1 and T2 was applied as basal fertilizer while the ratio of basal application to topdressing（at jointing stage） of K fertilizer for both T3 and T4 was 6：4. T1, T2, T3, and T4 were irrigated five, four, four and three times, respectively. Treatment T3 produced the highest grain yield among all treatments over three years and the average yield was 9 277.96 kg ha^-1. Grain yield averaged across three years with the T4 treatment（8 892.93 kg ha^-1） was 95.85% of that with T3 and was 21.72 and 6.10% higher than that with T1（7 305.95 kg ha^-1） and T2（8 381.41 kg ha^-1）, respectively. Treatment T2 produced the highest NUE of a
文摘目的本研究拟评价体外循环中华西综合血液管理(HIBM)策略对患者异体血需要量的影响。方法回顾性分析四川大学华西医院于2019年1月1日至2020年12月31日在体外循环下行成人心血管手术患者。HIBM包括减少预充量、逆预充技术、机血管理等9项策略。根据策略实施的时间,将患者分为实施前、推行期、全面实施。主要预后指标为围术期血制品使用量和使用率。结果3292例患者纳入分析,其中实施前为2265例、推行期318例,全面实施709例。与实施前比较,HIBM实施后全主动脉弓置换等大血管手术比例更高(14.7%vs.22.7%,P<0.001)而瓣膜置换手术比例较少(76.1%vs.67.0%,P<0.001);HIBM实施前后比较,血制品输注量红细胞(RBC)、新鲜冰冻血浆(FFP)、血小板(PLT)分别为:2.43 U vs.0.42 U;0.78 U vs.0.15 U;0.53 U vs.0.13 U、输注率(RBC、FFP、PLT分别为:47.0%vs.10.0%,23.0%vs.5.5%,35.0%vs.9.2%)均显著降低(所有P<0.001)。逻辑回归分析显示,HIBM能显著降低患者异体血暴露风险(RBC:OR=0.13,95%CI:0.10~0.16;FFP:OR=0.18,95%CI:0.13~0.26;PLT:OR=0.19,95%CI:0.14~0.25)。不同手术类型亚组分析也得出相似结果。结论HIBM能显著减少体外循环下心血管手术患者的输血量和异体血暴露风险,值得推广。
