RESUMO
The impact of infrastructure investment on social-economic system or ecological system has been widely discussed, yet, the overall impact of infrastructure investment on social-ecological system (SES) is still unknown. This study summarized the impact mechanism of infrastructure investment on social ecosystem vulnerability. We first sorted out the impact mechanism of infrastructure investment on SES vulnerability, and then empirically analyzed the effect of provincial infrastructure investment on SES vulnerability by using spatial autocorrelation and spatial econometric models on the basis of accounting provincial per capita infrastructure capital stock and comprehensive evaluation of SES vulnerability. The results showed that the infrastructure capital stock per capita at provincial level increased significantly during 2004-2017, with a spatial pattern that the north was higher than the south and the east/west was higher than the middle in China. The provincial SES vulnerability was improved, with spatial distribution characteristics of gradually getting worse from east to west in China. There was positive spatial correlation between provincial infrastructure investment and SES vulnerability, with aggregation distribution characteristics. There was inverted U-shaped relationship between infrastructure investment and SES vulnerability in China, that was, the appropriate investment of infrastructure at early could decrease SES vulnerability, while over-investment would increase it. Our results revealed the overall impact mechanism and dynamic characteristics of infrastructure investment on SES vulnerability, and could provide theoretical and policy-making support for the coordination of infrastructure construction and SES vulnerability governance at the macro level for China.
Assuntos
Ecossistema , China , Análise EspacialRESUMO
BACKGROUND: Total parenteral nutrition (TPN) has been recognized as the mainstay of nutritional support in patients with severe hepatopancreatobiliary (HPB) diseases for decades. However, recent studies advocate the utilization of endoscopic nasojejunal feeding tube placement (ENFTP), rather than the conventional approach. This study was designed to compare the clinical value of ENFTP and TPN in patients with severe HPB diseases. METHODS: Two groups of patients with severe HPB diseases were analyzed retrospectively. One group of 88 patients received ENFTP, and the other 96 received TPN. Routine blood levels, serum glucose and prealbumin, hepatic and renal function, serum lipid, and calcium were measured at baseline and after 1, 2, and 4 weeks of nutritional support. Also, complication rate, mortality, nutritional support time, mechanical ventilation time, mean length of time in intensive care unit, and duration of hospital stay were analyzed. RESULTS: After 4 weeks of nutritional support, the degree of recovery of red blood cells, prealbumin, and blood glucose was greater in the ENFTP than in the TPN group (P<0.05). Furthermore, the ENFTP group showed a lower incidence of septicemia, multiple organ dysfunction syndrome, peri-pancreatic infection, biliary infection, and nosocomial infection, in addition to shorter nutritional support time and hospital stay (P<0.05). CONCLUSIONS: ENFTP is much more effective than TPN in assisting patients with severe HPB diseases to recover from anemia, low prealbumin level, and high serum glucose, as well as in decreasing the rates of various infections (pulmonary infection excluded), multiple organ dysfunction syndrome rate, nutrition support time, and length of hospital stay. Therefore, ENFTP is safer and more economical for clinical application.
