Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-05-04 Cooperative journals: 《中国全科医学》
Abstract： Background Early reperfusion therapy for acute myocardial infarction（AMI） is an effective approach to reduce mortality in AMI patients. Percutaneous coronary intervention（PCI） is one of the reperfusion therapy modalities，and contrast-induced acute kidney injury（CI-AKI） after PCI has become one of the common causes of AKI. Objective To investigate the risk factors for the development of CI-AKI in AMI patients after PCI，establish a risk prediction model for CI-AKI based on risk factors and evaluate its validity. Methods The clinical data of 1 274 patients who attended the Affiliated Hospital of Xuzhou Medical University diagnosed of AMI and treated with PCI were collected consecutively from 2019 to 2021. According to the chronological order of admission，the included patients were divided into the training group （January 2019 to March 2021，900 cases） and validation group（April 2021 to December 2021，374 cases） in a ratio of approximately 7：3；and divided into the CI-AKI and non-CI-AKI groups according to the diagnostic criteria of CI-AKI. Independent risk factors were screened using univariable Logistic regression analysis，Lasso regression，cross-validation，multivariable Logistic regression analysis，and a nomogram for predicting the risk of CI-AKI was plotted. Their discriminatory power，calibration ability，and clinical application value were evaluated by calculating concordance statistic（C-statistic），plotting calibration curve and decision curve. Results Among the 900 patients in the training group，109 patients（12.1%） developed CI-AKI after PCI；among the 374 patients in the validation group，27 patients（7.2%） developed CI-AKI. Multivariable Logistic regression analysis showed that LVEF〔OR=0.903，95%CI（0.873，0.934）〕，platelet distribution width〔OR=1.158，95%CI（1.053，1.274）〕，MPVLR〔OR=1.047，95%CI（1.016，1.079）〕，NHR〔OR=1.072，95%CI（1.021，1.124）〕，Scr〔OR=1.006，95%CI（1.002，1.011）〕，and diuretics〔OR=2.321，95%CI（1.452，3.709）〕 were independent influencing factors for CI-AKI after PCI in AMI patients（P<0.05）. A prediction model containing 6 risk factors of LVEF，platelet distribution width，MPVLR，NHR，Scr and diuretics was constructed and a nomogram for predicting the risk of CI-AKI was plotted. The C-statistic was 0.794〔95%CI（0.766，0.820）〕 for the training group and 0.799〔95%CI（0.774，0.855）〕 for the validation group，and the calibration plots showed good consistency between the predicted and actual results；the decision curve and clinical impact curve showed clinical application value of nomogram. Conclusion The CI-AKI risk prediction model including LVEF，platelet distribution width，MPVLR，NHR，Scr，and diuretics has good discrimination and accuracy，which can intuitively and independently screen high-risk population and has high predictive value for the development of CI-AKI after PCI in AMI patients.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2023-04-18 Cooperative journals: 《中国全科医学》
CAI Gaojun
SHI, Ganwei
LI, Feng
LI, Wenhua
XUE, Sheliang
XIAO, Jianqiang
GU, Jun
SONG, Yanbin
ZHANG, Liuyan
LU, Wei
GONG, Chun
Abstract： Percutaneous coronary diagnosis and intervention via distal transradial artery approach has become one of the hot research topics in the field of coronary angiography and intervention. Compared with transradial approach，the distal transradial artery approach has the advantages of higher patient comfort and fewer related complications；however，due to the tortuosity of radial artery and relatively small size of distal radial artery，there is a significant learning curve for distal transradial artery approach puncture. This paper analyzes and summarizes the common causes（mainly including patient factors and operational factors）and treatment strategies of distal transradial artery approach puncture failure based on the experience of more than 2000 cases，in order to provide a reference for improving the success rate of puncture and promoting the application of distal transradial artery approach.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2022-12-23 Cooperative journals: 《中国全科医学》
Abstract：
Coronary interventional diagnosis and treatment via the distal radial artery approach has become a research hotspot in the field of interventional approaches. Compared with the conventional radial artery approach, it has the advantages of higher patient comfort and fewer complications related to vascular access; however, due to the tortuous and relatively small radial artery, there is a significant learning curve for puncture. Based on the experience of our center, we introduce the common causes and treatment strategies of distal radial artery puncture failure, in order to help the interventionalists shorten the puncture time, improve the puncture success rate, and promote the further clinical application of the distal radial artery approach.
Subjects: Dynamic and Electric Engineering >> Electrical Engineering submitted time 2019-03-05 Cooperative journals: 《电气工程学报》
Abstract：铁路继电器工作中的可靠性与安全性是确保各种铁路设备正常工作的必须 要求，在列车控制方面发挥着重要的作用。本文根据加速试验原理与试验条件制定了 在振动应力下铁路继电器的加速寿命试验方案，并通过加速寿命试验获得了铁路继电 器触点接触压降的数据。选择接触压降作为继电器性能退化特征参数，利用小波阈值 法对得到的接触压降数据进行去噪处理，并建立了 EEMD-RBF 预测模型对继电器寿命 进行预测。对 EEMD-RBF 与 RBF 的误差进行对比分析，结果表明 EEMD-RBF 模型预 测精度更高。最后，根据预测出来的寿命，运用逆幂律方程预测出正常振动应力水平 下铁路继电器的寿命。
Subjects: Dynamic and Electric Engineering >> Electrical Engineering submitted time 2019-03-05 Cooperative journals: 《电气工程学报》
Abstract：航天继电器在国防、航天工业等重要领域使用范围十分广泛，因此，为了 提高航天继电器的可靠性，研究其贮存寿命具有十分重要的意义。目前，基于性能退 化数据的大多文献局限于研究单个特征参数的情况，然而许多产品具有多个性能退化 特征量。针对航天继电器具有多个性能参数的特点，本文提出了退化距离分析法，并 在此基础上引入主元分析法（PCA），融合了多个特征参数，给出了参数权重因子求解 方法。文中选择了航天继电器的接触电阻 Rj、吸合时间 Tx 和释放电压 Us 这三个参数， 通过该方法实现了贮存寿命预测，并选取实测数据对该方法进行了验证。
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