Au is considered as one of the most promising catalysts for nitrogen reduction reaction(NRR),however maximizing the activity utilization rate of Au and understanding the synergistic effects between Au and carriers pos...Au is considered as one of the most promising catalysts for nitrogen reduction reaction(NRR),however maximizing the activity utilization rate of Au and understanding the synergistic effects between Au and carriers pose ongoing challenges.Herein,we systematically explore the synergistic catalytic effect of incorporating Au with boron clusters for accelerating NRR kinetics.An in-situ abinitio strategy is employed to construct B-doped Au nanoparticles(2-6 nm in diameter)loaded on BO_(x) substrates(AuBO_(x)),in which B not only modulates the surface electronic structure of Au but also forms strong coupling interactions to stabilize the nanoparticles.The electrochemical results show that Au-BO_(x) possesses excellent NRR activity(NH_(3) yield of 48.52μg h^(-1)mg_(cat)^(-1),Faraday efficiency of 56.18%),and exhibits high stability and reproducibility throughout the electrocatalytic NRR process.Theoretical calculations reveal that the introduction of B induces the formation of both Au dangling bond and Au-B coupling bond.which considerably facilitates the hydrogenation of~*N_(2)^(-)~*NH_(3).The present work provides a new avenue for the preparation of metal-boron materials achieved by one-step reduction and doping process,utilizing boron clusters as reducing and stabilizing agents.展开更多
目的探讨股动脉穿刺介入术后穿刺部位出血的危险因素。方法检索从建库至2022年12月31日中国知网、万方、维普、中国生物医学文献服务系统数据库(CBM)、PubMed、Medline、The Cochrane Library、EMbase、Web of Science数据库中关于经股...目的探讨股动脉穿刺介入术后穿刺部位出血的危险因素。方法检索从建库至2022年12月31日中国知网、万方、维普、中国生物医学文献服务系统数据库(CBM)、PubMed、Medline、The Cochrane Library、EMbase、Web of Science数据库中关于经股动脉穿刺介入术后穿刺部位出血危险因素的观察性研究,包括横断面研究、病例对照和队列研究文献。采用Newcastle-Ottawa量表(NOS)评分对纳入研究的文献质量进行评价,应用RevMan 5.3软件对文献数据进行Meta分析。结果最终纳入文献8篇(总样本量35250例),术后出血组患者1410例,非出血组33840例。Meta分析结果显示,高龄(OR=2.71,95%CI=2.17~3.38)、女性(OR=4.26,95%CI=1.08~16.89)、高血压(OR=2.48,95%CI=1.69~3.63)、肥胖(OR=2.33,95%CI=1.59~3.42)、使用溶栓剂/抗凝剂/血小板拮抗剂(OR=2.95,95%CI=2.24~3.89)、人工按压(OR=6.78,95%CI=1.34~34.43)是股动脉穿刺介入术后穿刺部位出血的危险因素。结论高龄、女性、高血压、肥胖、使用溶栓剂/抗凝剂/血小板拮抗剂、人工按压是股动脉穿刺介入术后穿刺部位出血的危险因素。展开更多
目的构建科学、实用的出血中心护士核心素养培训体系,为出血中心护士的培养和课程设置提供参考。方法检索PubMed、Web of Science、中国生物医学文献服务系统(CBM)、中国知网(CNKI)、万方等数据库中的文献,并结合患者、家属及医护人员...目的构建科学、实用的出血中心护士核心素养培训体系,为出血中心护士的培养和课程设置提供参考。方法检索PubMed、Web of Science、中国生物医学文献服务系统(CBM)、中国知网(CNKI)、万方等数据库中的文献,并结合患者、家属及医护人员访谈结果,小组讨论后初步拟定出血中心护士培训体系,最后应用德尔菲法对12个省21名专家进行2轮函询,确定了三级指标体系。结果第1轮函询问问卷有效回收21/21份,第2轮专家函询问卷有效回收19/21份。出血中心护士核心素养培训体系专家咨询判断系数0.99,权威系数0.89,Miller金字塔理论专家咨询判断系数0.72,权威系数0.85,熟悉程度0.80。最终确立出血中心护士培训体系涵盖理论、应用、技能及实际表现能力4个层面,培训内容、培训管理及考核评价等3个部分。其中,培训内容一级指标22个、二级指标96个、三级指标78个;培训管理一级指标4个,二级指标8个,三级指标12个;考核评价一级指标5个,二级指标16个。结论基于Miller金字塔理论构建的出血中心护士核心素养培训体系专家意见集中,可信度高,能为出血中心护士开展培训提供参考。展开更多
目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified ...目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified Rankin scale,mRS)评估和计算患者的生存状况。采用单因素分析和二元logistic回归分析筛选与高血压脑出血预后相关的独立危险因素。采用R软件(4.2.2)建立基于独立危险因素的列线图预测模型,并评价其性能。结果基于463例高血压脑出血患者资料建立的二元logistic回归分析结果显示,年龄、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、卒中史、手术时机、非手术时使用呼吸机时间、血肿体积、脑室铸型、血肌酐为独立危险因素,为此建立列线图。Hosmer-Lemeshow拟合优度检验P=0.537,证明模型中自变量的预测能力较好。Bootstrap验证(迭代次数:200次),计算得到的C-index为0.862(95%CI:0.860~0.864)。曲线下面积(area under the curve,AUC)为0.859(95%CI:0.824~0.895),表明该预测模型具有较高的预测价值。结论以高血压脑出血患者年龄、GCS、卒中史、手术时机、非手术时呼吸机使用时间、血肿量、脑室铸形、血肌酐为指标制作列线图预测模型,可以直观地预测高血压脑出血不良预后的概率,为临床决策提供参考。展开更多
目的Meta分析评价延续护理对经皮经肝穿刺胆管引流术(PTBD)后出院患者并发症发生率的影响。方法检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献服务系统(CBM)、PubMed、Cochrane Library、EMbase、Web of Science等数据库中关...目的Meta分析评价延续护理对经皮经肝穿刺胆管引流术(PTBD)后出院患者并发症发生率的影响。方法检索中国知网(CNKI)、万方、维普(VIP)、中国生物医学文献服务系统(CBM)、PubMed、Cochrane Library、EMbase、Web of Science等数据库中关于PTBD后出院延续护理的随机对照研究文献。采用澳大利亚Joanna Briggs研究所(JBI)文献质量评价工具评价纳入文献的质量,RevMan 5.4软件对纳入文献作Meta分析。结果最终纳入9篇有效文献,总样本量854例(对照组425例,干预组429例)。Meta分析显示,延续护理有效降低了PTBD后出院患者胆道感染(RR=0.42,95%CI=0.30~0.57)、穿刺处伤口感染(RR=0.19,95%CI=0.06~0.65)、导管脱出或移位(RR=0.31,95%CI=0.18~0.54)、导管堵塞(RR=0.23,95%CI=0.13~0.42)、引流管周围皮肤感染(RR=0.30,95%CI=0.12~0.77)、导管相关原因再入院(RR=0.34,95%CI=0.18~0.65)发生率,均P<0.05。结论与常规出院护理相比,延续护理可有效降低PTBD后出院患者胆道感染、穿刺处伤口感染、导管脱出或移位、导管堵塞、引流管周围皮肤感染、导管相关原因再入院等并发症发生。展开更多
This paper presents a digital rights management model, which considers the integrated factors including legality, communication security, integrity of the content, and trading fairness. The architecture of the model, ...This paper presents a digital rights management model, which considers the integrated factors including legality, communication security, integrity of the content, and trading fairness. The architecture of the model, the necessary protocol for the copyright control and content distribution, the authentication mechanism which offer consumption registration for content fair distribution, of the model are all provided. The scheme also provides distribution and evidence for using the copyright of digital content fairly and effectively. Finally, analysis shows the proposed model has both high security and good performance.展开更多
基金supported by the National Natural Science Foundation of China(22075133,62288102,22375091,21971114,and 21701086)the Jiangsu Provincial Funds(BX2022013)。
文摘Au is considered as one of the most promising catalysts for nitrogen reduction reaction(NRR),however maximizing the activity utilization rate of Au and understanding the synergistic effects between Au and carriers pose ongoing challenges.Herein,we systematically explore the synergistic catalytic effect of incorporating Au with boron clusters for accelerating NRR kinetics.An in-situ abinitio strategy is employed to construct B-doped Au nanoparticles(2-6 nm in diameter)loaded on BO_(x) substrates(AuBO_(x)),in which B not only modulates the surface electronic structure of Au but also forms strong coupling interactions to stabilize the nanoparticles.The electrochemical results show that Au-BO_(x) possesses excellent NRR activity(NH_(3) yield of 48.52μg h^(-1)mg_(cat)^(-1),Faraday efficiency of 56.18%),and exhibits high stability and reproducibility throughout the electrocatalytic NRR process.Theoretical calculations reveal that the introduction of B induces the formation of both Au dangling bond and Au-B coupling bond.which considerably facilitates the hydrogenation of~*N_(2)^(-)~*NH_(3).The present work provides a new avenue for the preparation of metal-boron materials achieved by one-step reduction and doping process,utilizing boron clusters as reducing and stabilizing agents.
文摘目的构建科学、实用的出血中心护士核心素养培训体系,为出血中心护士的培养和课程设置提供参考。方法检索PubMed、Web of Science、中国生物医学文献服务系统(CBM)、中国知网(CNKI)、万方等数据库中的文献,并结合患者、家属及医护人员访谈结果,小组讨论后初步拟定出血中心护士培训体系,最后应用德尔菲法对12个省21名专家进行2轮函询,确定了三级指标体系。结果第1轮函询问问卷有效回收21/21份,第2轮专家函询问卷有效回收19/21份。出血中心护士核心素养培训体系专家咨询判断系数0.99,权威系数0.89,Miller金字塔理论专家咨询判断系数0.72,权威系数0.85,熟悉程度0.80。最终确立出血中心护士培训体系涵盖理论、应用、技能及实际表现能力4个层面,培训内容、培训管理及考核评价等3个部分。其中,培训内容一级指标22个、二级指标96个、三级指标78个;培训管理一级指标4个,二级指标8个,三级指标12个;考核评价一级指标5个,二级指标16个。结论基于Miller金字塔理论构建的出血中心护士核心素养培训体系专家意见集中,可信度高,能为出血中心护士开展培训提供参考。
文摘目的探讨高血压脑出血预后相关危险因素,建立高血压脑出血远期预后的列线图预测模型。方法回顾性分析2018年1月至2021年12月广东医科大学附属医院463例高血压性脑出血患者的临床资料。发病6个月后进行随访,采用改良Rankin量表(modified Rankin scale,mRS)评估和计算患者的生存状况。采用单因素分析和二元logistic回归分析筛选与高血压脑出血预后相关的独立危险因素。采用R软件(4.2.2)建立基于独立危险因素的列线图预测模型,并评价其性能。结果基于463例高血压脑出血患者资料建立的二元logistic回归分析结果显示,年龄、格拉斯哥昏迷评分(Glasgow coma scale,GCS)、卒中史、手术时机、非手术时使用呼吸机时间、血肿体积、脑室铸型、血肌酐为独立危险因素,为此建立列线图。Hosmer-Lemeshow拟合优度检验P=0.537,证明模型中自变量的预测能力较好。Bootstrap验证(迭代次数:200次),计算得到的C-index为0.862(95%CI:0.860~0.864)。曲线下面积(area under the curve,AUC)为0.859(95%CI:0.824~0.895),表明该预测模型具有较高的预测价值。结论以高血压脑出血患者年龄、GCS、卒中史、手术时机、非手术时呼吸机使用时间、血肿量、脑室铸形、血肌酐为指标制作列线图预测模型,可以直观地预测高血压脑出血不良预后的概率,为临床决策提供参考。
基金Supported by Scientific Research Common Programof Beijing Municipal Commission of Education( KM200610772008)the Graduate Innovation Fund of Xidian University(05001)
文摘This paper presents a digital rights management model, which considers the integrated factors including legality, communication security, integrity of the content, and trading fairness. The architecture of the model, the necessary protocol for the copyright control and content distribution, the authentication mechanism which offer consumption registration for content fair distribution, of the model are all provided. The scheme also provides distribution and evidence for using the copyright of digital content fairly and effectively. Finally, analysis shows the proposed model has both high security and good performance.
