Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conduct...Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conducted a prospective nested case-control study in children(age<18 years)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)at the Fuwai Hospital between April 01,2022 and July 30,2022.Cases were individuals who developed AKI within the first postoperative 7 days(AKI group)and controls were those without AKI(Non-AKI group)according to KDIGO criteria.AKI and Non-AKI groups unmatched and 1:1 matched by age,sex,and baseline serum creatinine were separately analyzed.Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI.Results:688 consecutively approached patients were included in the final analysis.On multivariate analysis,intra-CPB(adjusted odds ratio[OR]0.802;95%confidence interval[CI],0.706 to 0.912;p=0.001)and post-CPB(adjusted OR 0.830;95%CI,0.744 to 0.925;p=0.001)blood glucose levels were associated with postoperative AKI.There were no significant differences in pre-CPB blood glucose(adjusted OR 0.926;95%CI,0.759 to 1.129;p=0.446)or intraoperative glycemic fluctuations(adjusted OR 0.905;95%CI,0.723 to 1.132;p=0.382)between AKI and Non-AKI groups.Results based on matched cases and controls were consistent with those from the unmatched analyses.Conclusion:Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.展开更多
Relative roles of climate change and human activities in desertification are the hotspot of research on desertification dynamic and its driving mechanism.To overcome the shortcomings of existing studies,this paper sel...Relative roles of climate change and human activities in desertification are the hotspot of research on desertification dynamic and its driving mechanism.To overcome the shortcomings of existing studies,this paper selected net primary productivity(NPP) as an indicator to analyze desertification dynamic and its impact factors.In addition,the change trends of actual NPP,potential NPP and HNPP(human appropriation of NPP,the difference between potential NPP and actual NPP) were used to analyze the desertification dynamic and calculate the relative roles of climate change,human activities and a combination of the two factors in desertification.In this study,the Moderate Resolution Imaging Spectroradiometer(MODIS)-Normalised Difference Vegetation Index(NDVI) and meteorological data were utilized to drive the Carnegie-Ames-Stanford Approach(CASA) model to calculate the actual NPP from 2001 to 2010 in the Heihe River Basin.Potential NPP was estimated using the Thornthwaite Memorial model.Results showed that 61% of the whole basin area underwent land degradation,of which 90.5% was caused by human activities,8.6% by climate change,and 0.9% by a combination of the two factors.On the contrary,1.5% of desertification reversion area was caused by human activities and 90.7% by climate change,the rest 7.8% by a combination of the two factors.Moreover,it was demonstrated that 95.9% of the total actual NPP decrease was induced by human activities,while 69.3% of the total actual NPP increase was caused by climate change.The results revealed that climate change dominated desertification reversion,while human activities dominated desertification expansion.Moreover,the relative roles of both climate change and human activities in desertification possessed great spatial heterogeneity.Additionally,ecological protection policies should be enhanced in the Heihe River Basin to prevent desertification expansion under the condition of climate change.展开更多
基金the CAMS Innovation Fund for Medical Sciences(CIFMS)(2021-I2M-C&T-B-036).
文摘Purpose:This study sought to explore the effect of intraoperative mean blood glucose levels and variability on postoperative acute kidney injury(AKI)in children undergoing congenital cardiac surgery.Methods:We conducted a prospective nested case-control study in children(age<18 years)undergoing congenital heart surgery with cardiopulmonary bypass(CPB)at the Fuwai Hospital between April 01,2022 and July 30,2022.Cases were individuals who developed AKI within the first postoperative 7 days(AKI group)and controls were those without AKI(Non-AKI group)according to KDIGO criteria.AKI and Non-AKI groups unmatched and 1:1 matched by age,sex,and baseline serum creatinine were separately analyzed.Multivariate logistic and conditional logistic regressions were used to assess the associations between blood glucose variables and AKI.Results:688 consecutively approached patients were included in the final analysis.On multivariate analysis,intra-CPB(adjusted odds ratio[OR]0.802;95%confidence interval[CI],0.706 to 0.912;p=0.001)and post-CPB(adjusted OR 0.830;95%CI,0.744 to 0.925;p=0.001)blood glucose levels were associated with postoperative AKI.There were no significant differences in pre-CPB blood glucose(adjusted OR 0.926;95%CI,0.759 to 1.129;p=0.446)or intraoperative glycemic fluctuations(adjusted OR 0.905;95%CI,0.723 to 1.132;p=0.382)between AKI and Non-AKI groups.Results based on matched cases and controls were consistent with those from the unmatched analyses.Conclusion:Higher intraoperative blood glucose levels during and after CPB were protective factors against postoperative AKI in pediatric patients after congenital heart surgery.
基金supported by the National Basic Research Program of China(2010CB950702)the National High Technology Research and Development Program of China(2007AA10Z231)+2 种基金the National Natural Science Foundation of China(40871012,J1103512,J1210026)the Asia-Pacific Network(ARCP-2012-SP25-Li)the Australian Agency for International Development(64828)
文摘Relative roles of climate change and human activities in desertification are the hotspot of research on desertification dynamic and its driving mechanism.To overcome the shortcomings of existing studies,this paper selected net primary productivity(NPP) as an indicator to analyze desertification dynamic and its impact factors.In addition,the change trends of actual NPP,potential NPP and HNPP(human appropriation of NPP,the difference between potential NPP and actual NPP) were used to analyze the desertification dynamic and calculate the relative roles of climate change,human activities and a combination of the two factors in desertification.In this study,the Moderate Resolution Imaging Spectroradiometer(MODIS)-Normalised Difference Vegetation Index(NDVI) and meteorological data were utilized to drive the Carnegie-Ames-Stanford Approach(CASA) model to calculate the actual NPP from 2001 to 2010 in the Heihe River Basin.Potential NPP was estimated using the Thornthwaite Memorial model.Results showed that 61% of the whole basin area underwent land degradation,of which 90.5% was caused by human activities,8.6% by climate change,and 0.9% by a combination of the two factors.On the contrary,1.5% of desertification reversion area was caused by human activities and 90.7% by climate change,the rest 7.8% by a combination of the two factors.Moreover,it was demonstrated that 95.9% of the total actual NPP decrease was induced by human activities,while 69.3% of the total actual NPP increase was caused by climate change.The results revealed that climate change dominated desertification reversion,while human activities dominated desertification expansion.Moreover,the relative roles of both climate change and human activities in desertification possessed great spatial heterogeneity.Additionally,ecological protection policies should be enhanced in the Heihe River Basin to prevent desertification expansion under the condition of climate change.
