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CPR方法与高分辨率二阶格式的混合算法

空气动力学学报 2022年第5期40卷 122-132页

作者：郭嘉朱华君石国权燕振国宋松和唐玲艳中国空气动力研究与发展中心空气动力学国家重点实验室绵阳621000 国防科技大学理学院数学系长沙410073

重构修正方法(correction procedure via reconstruction,CPR)具有紧致高效的优点,但对较强激波的捕捉能力还相对较弱,而加权紧致非线性格式(weighted compact nonlinear scheme,WCNS)具有很强的激波捕捉能力。将基于高阶WCNS插值的二... 详细信息

重构修正方法(correction procedure via reconstruction,CPR)具有紧致高效的优点,但对较强激波的捕捉能力还相对较弱,而加权紧致非线性格式(weighted compact nonlinear scheme,WCNS)具有很强的激波捕捉能力。将基于高阶WCNS插值的二阶格式引入到高阶CPR方法中,构造了一种高效高分辨率的混合激波捕捉格式。首先,基于非线性权偏离线性权的程度的激波侦测器侦测出问题单元,并在问题单元附近引入缓冲单元,其余单元则标记为光滑单元。然后,针对问题单元和缓冲单元采用二阶格式计算,光滑单元采用CPR方法计算,构造混合格式。通过对等熵涡问题、含激波的问题以及激波旋涡干扰问题的数值模拟,测试了混合格式的精度、激波捕捉能力和计算效率。数值模拟结果充分说明了该混合格式具有很强的激波捕捉能力,同时在光滑区具有高分辨特性,可以应用于高超声速流动问题的高效数值模拟中。相比于基于高阶WCNS插值的二阶格式,此格式具有更高的计算效率和更高的分辨率。

关键词： CPR 二阶格式混合算法激波捕捉高超声速流动

急诊ECPR应设置独立的ECMO-CPR室

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中华急诊医学杂志 2022年第12期31卷 1575-1577页

作者：马娜季学丽张劲松南京医科大学第一附属医院(江苏省人民医院)急诊医学中心南京210029

近年来,我国ECMO技术迅猛发展,尤其是体外生命支持心肺复苏(extracroporeal cardiopulmonary resuscitation,ECPR)方面技术发展已然成熟。考虑到本院在省内的定位和急诊患者的特点与需求,本科室将“ECMO-CPR”确立为重点发展方向[1]。虽... 详细信息

近年来,我国ECMO技术迅猛发展,尤其是体外生命支持心肺复苏(extracroporeal cardiopulmonary resuscitation,ECPR)方面技术发展已然成熟。考虑到本院在省内的定位和急诊患者的特点与需求,本科室将“ECMO-CPR”确立为重点发展方向[1]。虽然ECMO-CPR在急诊红区应用越来越为广泛,但仍缺乏统一的标准和规范,为ECMO-CPR的快速实施带来了难度。故在ECMO-CPR实施三年的基础上,于2020年1月开始设置ECMO-CPR Room,现已运行实践两年,笔者认为如同急诊创伤复苏室的建设和设置一样,有必要在ECPR开展中实施配置规范化的ECMO-CPR Room,本文就此述评,供同行借鉴。

关键词： ECMO 急诊创伤心肺复苏复苏室 CPR 体外生命支持急诊患者重点发展方向

基于高级调度在线生命支持系统实施电话指导心肺复苏的新策略

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中华急诊医学杂志 2023年第1期32卷 6-9页

作者：高丁李斗张进军北京急救中心北京100031

院外心脏骤停(out-of-hospital cardiac arrest,OHCA)是全球公认威胁人类健康最为严重的疾病之一,欧洲每年发生约28万例、美国约38万例、我国约55万例[1-3]。心肺复苏(cardiopulmonary resuscitation,CPR)是全球公认救治心脏骤停的最有... 详细信息

院外心脏骤停(out-of-hospital cardiac arrest,OHCA)是全球公认威胁人类健康最为严重的疾病之一,欧洲每年发生约28万例、美国约38万例、我国约55万例[1-3]。心肺复苏(cardiopulmonary resuscitation,CPR)是全球公认救治心脏骤停的最有效措施,且越早启动CPR预后越好,早期高质量CPR对于恢复自主循环、降低病死率和致残率,并提高患者生存质量至关重要[4-6]。但由于受CPR等急救知识普及率和法律保障不健全等因素的制约,我国旁观者实施CPR的比例较低,报警人第一时间不能正确识别是否心脏骤停,或是不会、不敢、也不愿意尽快实施CPR,是导致我国OHCA的病死率居高不下重要因素之一。

关键词：心肺复苏生命支持系统心脏骤停自主循环 CPR 新策略

Pre-recorded instructional audio vs. dispatchers' conversational assistance in telephone cardiopulmonary resuscitation: A randomized controlled simulation study

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World Journal of Emergency Medicine 2018年第3期9卷 165-171页

作者： Alexei Birkun Maksim Glotov Herman Franklin Ndjamen Esther Alaiyex Esther Alaiye Temidara Adeleke Sergey Samarin Department of Anaesthesiology Resuscitation and Emergency MedicineMedical Academy named after S.I.Georgievsky of V.I.Vernadsky Crimean Federal University

BACKGROUND:To assess the effectiveness of the telephone chest-compression-only cardiopulmonary resuscitation(CPR)guided by a pre-recorded instructional audio when compared with dispatcher-assisted resuscitation.METHODS:It was a prospective,blind,randomised controlled study involving 109 medical students without previous CPR training.In a standardized mannequin scenario,after the step of dispatcher-assisted cardiac arrest recognition,the participants performed compression-only resuscitation guided over the telephone by either:(1)the pre-recorded instructional audio(n=57);or(2)verbal dispatcher assistance(n=52).The simulation video records were reviewed to assess the CPR performance using a 13-item checklist.The interval from call reception to the first compression,total number and rate of compressions,total number and duration of pauses after the first compression were also recorded.RESULTS:There were no significant differences between the recording-assisted and dispatcher-assisted groups based on the overall performance score(5.6±2.2 vs.5.1±1.9,P>0.05)or individual criteria of the CPR performance checklist.The recording-assisted group demonstrated provided(170.2±48.0 vs.156.2±60.7).CONCLUSION:When provided by untrained persons in the simulated settings,the compression-only resuscitation guided by the pre-recorded instructional audio is no less efficient than dispatcher-assisted CPR.Future studies are warranted to further assess feasibility of using instructional audio aid as a potential alternative to dispatcher assistance.

关键词： Cardiopulmonary resuscitation Cardiac arrest Dispatcher Telephone CPR Audio instructions Instructional aid

CVPS联合CPR在评价重度子痫前期胎儿心功能中的研究

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CVPS联合CPR在评价重度子痫前期胎儿心功能中的研究

作者：吴雪娇甘肃中医药大学

学位级别：硕士

目的:本研究旨在应用心血管整体评分（Cardiovascular profile scores,CVPS）联合脑-胎盘比（cerebroplacental ratio,CPR）评价重度子痫前期胎儿心功能,通过半定量及定量指标评价重度子痫前期对胎儿心功能的影响,从而探讨其可能的作用... 详细信息

目的:本研究旨在应用心血管整体评分（Cardiovascular profile scores,CVPS）联合脑-胎盘比（cerebroplacental ratio,CPR）评价重度子痫前期胎儿心功能,通过半定量及定量指标评价重度子痫前期对胎儿心功能的影响,从而探讨其可能的作用机制;同时进一步了解重度子痫前期对胎儿心脏结构以及功能等方面是否存在不同程度的影响;最后初步探索该评估体系用于早期妊娠结局预测的可能性。以期及时发现并进行临床干预,为保证围产期母婴安全提供有力证据。方法:按照纳入、排除标准选取2020年12月到2021年8月在甘肃省妇幼保健院诊断为重度子痫前期的孕妇50例,选择同一时期来院检查的正常孕妇50例作为健康对照组。分别通过二维超声,彩色血流指标多普勒及胎儿超声心动图对其指标进行测量,包括CVPS,胎儿大脑中动脉,脐动脉及胎儿心功能各项指标。血流频谱参数包括:收缩期峰值速度（peak systolic velocity,PSV）、舒张末期速度（end-systolic volume,EDV）、血流搏动指数（pulsatility Index,PI）及血流阻力指数（resistance index,RI）及S/D值,通过公式计算胎儿出CPR,胎儿心功能指标:二、三尖瓣环位移（TAD）。比较重度子痫前期组和健康组之间各参数差别,探讨其对母儿预后的影响,并将CVPS评分与CPR及胎儿心功能指标进行相关性分析。结果:1.组间心血管整体评分指标比较,观察组在胎儿水肿情况、脐静脉和静脉导管血流频谱情况、脐动脉血流频谱、心胸比值、心脏瓣膜功能等方面的评分,心血管整体总分低于对照组（P＜0.05）,差异具有显著性。2.组间大脑中动脉、脐血流参数比较重度子痫前期MCA各指标S/D（3.84±1.23）、PI（1.29±0.31）、RI（0.68±0.08）,对照组各指标分别为S/D（4.16±1.5）、PI（1.45±0.36）、RI（0.73±0.09）,结果均低于对照组,P＜0.05,差异具有统计学意义,相关性分析可发现其与对照组呈负相关,脐血流各指标S/D（2.70±0.54）、PI、RI均高于对照组,与对照组呈正相关。3.组间脑-胎盘比值比较通过MCA和UA的PI比计算得出脑-胎盘比病例组CPR（1.48±0.72）,对照组CPR（1.72±0.51）,病例组模型低于对照组,P＜0.05,差异具有统计学意义,且分析ROC曲线下面积可得出CPR敏感性相较于单一的MCA和UA更高。4.组间二尖瓣位移比较病例组MAPSE（5.98±2.44）,对照组MAPSE（6.01±0.45）,病例组二尖瓣位移明显小于对照组,P＜0.05,差异具有统计学意义。5.组间三尖瓣位移比较病例组TAPSE（9.27±1.16）,对照组TAPSE（9.97±0.96）,病例组三尖瓣位移明显小于对照组,P＜0.05,差异具有统计学意义。6.组内二尖瓣、三尖瓣的位移分析病例组的TAPSE明显高于病例组MAPSE,对照组的TAPSE明显高于病例组MAPSE。结论:1.本研究对重度子痫前期胎儿的CVPS各指标进行监测,研究结果显示重度子痫前期可以引起胎儿心功能减低甚至发生心力衰竭,临床可以通过监测CVPS来及时防治重度子痫前期的母婴安全。2.CPR是近年来发现的具有高敏感度和灵敏度的指标,对于胎儿宫内缺氧等异常情况可以较早的发现,相对于单一的MAC和UA对于胎儿生长发育情况的提示更为灵敏,并能早期诊断出严重程度不同的心功能异常,为产科提供更多有效治疗方案;同时CPR也能够在一定程度上反映围生期母亲及新生儿健康状况,有助于提高母儿健康水平,降低孕产妇病死率和新生儿死亡率。3.二、三尖瓣的位移是评估胎儿心脏较为灵敏性的指标,当胎儿心功能出现异常时二、三尖瓣的位移可出现不同程度的下降,本研究结果显示二、三尖瓣位移有望成为重度子痫前期胎儿心功能的产前诊断标准。4.CVPS联合CPR可以更准确的评估胎儿心功能,为临床对重度子痫孕产妇的分级诊疗处理措施以及合适终止妊娠提供数据支持,避免更严重的并发症出现,更好的保证孕产妇及胎儿在围生期的生命安全。

关键词： CVPS CPR 重度子痫前期胎儿心功能瓣环位移

Characteristics and outcomes of out-of-hospital cardiac arrest in Zhejiang Province

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World Journal of Emergency Medicine 2018年第2期9卷 141-143页

作者： Min Fei Wen-wei Cai Sheng-ang Zhou Department of Emergency Medicine Zhejiang Provincial People's Hospital

China has undergone tremendous economic growth,but there still remains much room for improvement inemergency medical service （EMS） system.[1] The EMSin China comprises of three parts： the pre-hospitalemergency service, the emergency department, andthe intensive care unit. Not much is known about theexact numbers of out-of-hospital cardiac arrest （OHCA）across the whole of China, though there are reports fromspecifi c provinces.

关键词： EMS CPR

Expert consensus on prevention and cardiopulmonary resuscitation for cardiac arrest in COVID-19

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Asian Pacific Journal of Tropical Medicine 2021年第6期14卷 241-253页

作者： Wei Song Jie Wei Xiangdong Jian Deren Wang Yanhong Ouyang Yuanshui Liu Xianjin Du Ying Chen Yingqi Zhang Heping Xu Shuming Xianyu Qiong Ning Xiang Li Xiaotong Han Feng Zhan Tao Yu Wenteng Chen Jun Zhang Wenwei Cai Sheng’ang Zhou Shengyang Yi Yu Cao Xiaobei Chen Shunjiang Xu Zong’an Liang Duohu Wu Fen Ai Zhong Wang Qingyi Meng Yuhong Mi Sisen Zhang Rongjia Yang Shouchun Yan Wenbin Han Yong Lin Chuanyun Qian Wenwu Zhang Yan Xiong Jun Lv Baochi Liu Yan Cao Xiaojun He Xuelian Sun Yufang Cao Tian’en Zhou Department of Emergency Medicine Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 570311China Emergency Department&Intensive Care Unit Renmin Hospital of Wuhan UniversityWuhan 430060China Department of Poisoning and Occupational Diseases EmergencyQilu HospitalCheeloo College of MedicineShandong UniversityJinan 250012China Center of Cerebrovascular Diseases Department of NeurologyWest China Hospital of Sichuan UniversityChengdu 610041China Department of Emergency People's Hospital of Wuhan UniversityWuhan 430060China Department of Emergency Medicine the First Hospital of Hebei Medical UniversityShijiazhuang 050030China Hospital Infection Control Office Hainan General HospitalHaikou 570311China Department of Occupational Diseases Jinan HospitalJinan 250013China Department of Emergency Medicine Hunan Provincial People's HospitalChangsha 410005China Department of Emergency Medicine Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhou 510120China Department of Emergency Medicine Zhejiang Provincial People's HospitalHangzhou 310014China Department of Emergency Department West China Hospital of Sichuan UniversityChengdu 610041China Department of Infectious Diseases People's Hospital of Wuhan UniversityWuhan 430060China Department of Teaching Affairs The First Hospital of Hebei Medical UniversityShijiazhuang 050031China Department of Pulmonary and Critical Care Medicine West China Hospital of Sichuan UniversityChengdu 610041China Medical Service Department Hainan General HospitalHainan Affiliated Hospital of Hainan Medical UniversityHaikou 570311China Department of Emergency Medicine the Central Hospital of WuhanWuhan 430015China Tsinghua Changgung Hospital School of Clinical MedicineTsinghua UniversityBeijing 102218China Department of Emergency Medicine the First Medical CenterChinese PLA General HospitalBeijing 100853China Emergency&Critical Care Center Beijing Anzhen HospitalCapital Medical University.Beijing 100029China Peopl

Background:Cardiopulmonary resuscitation(CPR)strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest.During CPR,both healthcare and non-healthcare workers who provide resuscitation are at risk of infection.The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients.Main recommendations:1)A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs.2)Psychological counseling and treatment are highly recommended,since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest.3)Healthcare workers should wear personal protective equipment(PPE).4)Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19.5)Hands-only chest compression and mechanical chest compression are recommended.6)Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early.7)CPR should be provided for 20-30 min.8)Various factors should be taken into consideration such as the interests of patients and family members,ethics,transmission risks,and laws and regulations governing infectious disease control.Changes in management:The following changes or modifications to CPR strategy in COVID-19 patients are proposed:1)Healthcare workers should wear PPE.2)Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols.3)Both the benefits to patients and the risk of infection should be considered.4)Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

关键词： SARS-CoV-2 COVID-19 Cardiac arrest CPR Nosocomial infection Personal protective equipment

Hsp90 Is Involved in the Regulation of Cytosolic =recursor Protein Abundance in Tomato

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Molecular Plant 2015年第2期8卷 228-241页

作者： Bodo Tillmann Sascha Roeth Daniela Bublak Manuel Sommer Ernst H.K. Stelzer Klaus-Dieter Scharf Enrico Schleiff Department of Molecular Cell Biology of Plants Goethe-University Max-von-Laue Street 9 60438 Frankfurt am Main Germany Cluster of Excellence 'Macromolecular Complexes' Goethe-University 60438 Frankfurt am Main Germany Center of Membrane Proteomics Goethe University Max-von-Laue Street 9 60438 Frankfurt am Main Germany Buchman Institute for Molecular Life Sciences Goethe University Max-von-Laue Street 15 60438 Frankfurt am Main Germany Institute of Cell Biology Goethe-Universitat Max-von-Laue StraBe 9 60438 Frankfurt am Main Germany

Cytosolic chaperones are involved in the regulation of cellular protein homeostasis in general. Members of the families of heat stress proteins 70 （Hsp70） and 90 （Hsp90） assist the transport of preproteins to organelles such as chloroplasts or mitochondria. In addition, Hsp70 was described to be involved in the degradation of chloroplast preproteins that accumulate in the cytosol. Because a similar function has not been established for Hsp90, we analyzed the influences of Hsp90 and Hsp70 on the protein abundance in the cellular context using an in vivo system based on mesophyll protoplasts. We observed a differential behavior of preproteins with respect to the cytosolic chaperone-dependent regulation. Some preproteins such as pOE33 show a high dependence on Hsp90, whereas the abundance of preproteins such as pSSU is more strongly dependent on Hsp70. The E3 ligase, C-terminus of Hsp70-interacting protein （Chip）, appears to have a more general role in the control of cytosolic protein abundance. We discuss why the different reaction modes are comparable with the cytosolic unfolded protein response.

关键词： Hsp70 Hsp90 chip cytosolic unfolded protein response CPR preprotein degradation

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光伏电站系统标准能效比的修正方法研究

电力科技与环保 2023年第3期39卷 194-200页

作者：陆江王文彬袁廷璧段震清柳殿彬崔亚辉国家能源集团新能源技术研究院有限公司北京102200 华北电力大学(保定) 河北保定071000

为减小光伏系统标准能效比(Corrective Performance Ratio,CPR)的计算误差,降低运维成本,提高电站管理水平,基于光伏组件工程简化模型计算考虑组件温度、辐照度变化的电能变化量,并利用该变化量计算CPR。将该方法运用于实际电站,对比行... 详细信息

为减小光伏系统标准能效比(Corrective Performance Ratio,CPR)的计算误差,降低运维成本,提高电站管理水平,基于光伏组件工程简化模型计算考虑组件温度、辐照度变化的电能变化量,并利用该变化量计算CPR。将该方法运用于实际电站,对比行业标准NB/T 10394-2020的计算方法并分析其差异,结果表明,该方法的计算结果与行业标准的计算结果在日总辐照量大于6(kW·h)/m^(2)时差值小于2%,且在日总辐照量小于6(kW·h)/m^(2)时,可减少因组件自身特性造成的误差,相比于行业标准NB/T 10394-2020的计算方法更具优势。

关键词：能效光伏电站功率温度系数辐照度 CPR