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标准号: DB34/T 3919-2021

关键词： diabetes mellitus   non-insulin-dependent   basal insulin   glycemic control   prandial insulin   blood glucose meters (medical device)   continuous glucose monitoring   glycosylated hemoglobin a   hemoglobin a   primary health care   glucose  

摘要： IMPORTANCE Continuous glucose monitoring (CGM) has been shown to be beneficial for adults with type 2 diabetes using intensive insulin therapy, but its use in type 2 diabetes treated with basal insulin without prandial insulin has not been well studied. OBJECTIVE To determine the effectiveness of CGM in adults with type 2 diabetes treated with basal insulin without prandial insulin in primary care practices. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trialwas conducted at 15 centers in the US (enrollment from July 30, 2018, to October 30, 2019;follow-up completed July 7, 2020) and included adults with type 2 diabetes receiving their diabetes care from a primary care clinician and treated with 1 or 2 daily injections of long- or intermediate-acting basal insulin without prandial insulin, with or without noninsulin glucose-lowering medications. INTERVENTIONS Random assignment 2:1 to CGM (n = 116) or traditional blood glucose meter (BGM) monitoring (n = 59). MAIN OUTCOMES AND MEASURES The primary outcome was hemoglobin A1c (HbA1c) level at 8 months. Key secondary outcomes were CGM-measured time in target glucose range of 70 to 180mg/dL, time with glucose level at greater than 250mg/dL, and mean glucose level at 8 months. RESULTS Among 175 randomized participants (mean [SD] age, 57 [9] years;88 women [50%];92 racial/ethnic minority individuals [53%];mean [SD] baseline HbA1c level, 9.1% [0.9%]), 165 (94%) completed the trial. Mean HbA1c level decreased from 9.1% at baseline to 8.0% at 8 months in the CGM group and from 9.0% to 8.4% in the BGM group (adjusted difference, -0.4%[95% CI, -0.8% to -0.1%];P =.02). In the CGM group, compared with the BGM group, the mean percentage of CGM-measured time in the target glucose range of 70 to 180mg/dL was 59% vs 43%(adjusted difference, 15%[95% CI, 8% to 23%];P <.001), the mean percentage of time at greater than 250mg/dL was 11% vs 27%(adjusted difference, -16%[95% CI, -21% to -11%];P <.001), and the means of the mea

关键词： Molecules   Ions   Metal organic frameworks   Encapsulation   Cations  

摘要： Encapsulating a certain guest molecule in an assigned molecular compartment and then endowing the corresponding potential remains a huge challenge for metal-organic frameworks. To this end, we demonstrate a good example, for the first time, based on an actinide-based MOF. The used MOF (namely, ECUT-300) shows a unique uranyl-TPE anionic skeleton with three distinct cages, viz., mesopore A (2.8 nm), mesopore B (2.0 nm), and micropore C (0.9 nm). Through solid-liquid reaction, a RhB+ molecule can be encapsulated into ECUT-300 with the exact location in mesopore B, whereas the encapsulation of a metal-organic cation of [Fe(tpy)(2)](3+) was observed with the location in micropore C, suggesting unprecedented classified encapsulation. Impressively, the potential of the resulting guest@MOF composites is also highly dependent on the type of encapsulated guest molecules, for example, white-light emission for RhB+ and selective adsorption of C2H2 over CO2 for [Fe(tpy)(2)](3+).

关键词： 双层动车组   楼梯结构设计   TSI   有限元分析  

摘要： 根据TSI要求,为双层动车组车辆设计一种楼梯结构。该楼梯结构包含脚踏、扶手等结构,以中间层过渡,分别连接车辆的上层和下层。在设计过程中,对TSI进行符合性分析,结合车辆的总体布局,构建了楼梯结构设计细节;通过有限元分析,对楼梯结构的强度和位移进行验证,为实际应用提供理论依据。结果表明:楼梯设计方案满足实际需求,采用有限元分析提高了产品的开发效率。