正常人和气道障碍患者的通气熵变的比较

使用ＳＦ６作为示踪气体，对１９名受试者（１２名正常人和７名气道障碍病人）进行了多呼吸洗出试验，计算了通气的熵变（ＥＣＶ）和其他７项常规洗出指标。为了计算ＥＣＶ和肺清洗滞后（ＰＣＤ），建立了自动分析呼出ＳＦ６浓度曲线为多组分的方法，ＥＣＶ同其他７项指标有显著的相关。这些指标中，ＥＣＶ能最好地区分正常和病人，并且它比其他的指标能更好地区分正常人之间的差别以及病人之间的差别，因此，它不仅可用于诊断肺部疾     

慢性阻塞性肺疾病病人机械通气时内源性呼气末正压测定

目的：测定慢性阻塞性肺疾病（ＣＯＰＤ）患者机械通气时的内源性呼气末正压（ＰＥＥＰｉ）。方法：应用呼气末阻断法测定了３６例ＣＯＰＤ患者机械通气时的ＰＥＥＰｉ。结果：１５例中度ＣＯＰＤ病人中的７例和２１例重度ＣＯＰＤ病人中的１８例存在ＰＥＥＰｉ。两组间Ｐ＜０．０１。结论：ＣＯＰＤ病人机械通气时应常规测量ＰＥＥＰｉ，加强气道管理，调整通气模式和参数，可提高通气治疗疗效。     

低氧性肺动脉高压大鼠肺内血管内皮生长因子分布和水平的变化

为了观察低氧性肺动脉高压大鼠肺内ＶＥＧＦ内皮生长因子（ＶＥＧＦ）分布和水平的变化，将雄性大鼠２０只（体重２００ｇ～２２０ｇ）随机分为对照组（７只）和低氧组（１３只），低氧组采用常压低氧３周，对照组在同一实验室不进行处理，用ＲＭ—６０００型多道生理仪测...     

心肌收缩成分缩短加速度的测定及在运动性心脏研究中的应用

采用经颈动脉插入导管的方法，在麻醉不开胸条件下，测试了３组（正常对照组，游泳训练组和力竭游泳组）共６１只ＳＤ大鼠心肌收缩成分缩短加速度（ａ_（ＣＥ））。结果表明：（１）ａ_（ＣＥ）类指标对正性变力和负性变力因素干预敏感性高，并与心率和舒张期室内最低压无相关性，证明了ａ_（ＣＥ）是评价心肌收缩性能敏感可靠参数之一；（２）经７周游泳训练后，大鼠心肌ａ_（ＣＥ）类指标值明显提高。力竭游泳后，ａ_（ＣＥ）指标值明显降低。展现出ａ_（ＣＥ）在运动性心脏心肌收缩性的研究中有良好的应用前景。     

气管内吹气对支气管痉挛家兔血气及呼吸力学的作用

为探讨气管内吹气（ＴＧＩ）对支气管痉挛家兔动脉血气及呼吸力学的影响。用自行设计的ＴＧＩ装置对实施常规机械通气（ＣＭＶ）和容许性高碳酸血症（ＰＨＣ）机械通气的支气管痉挛家兔行ＴＧＩ,观察乙酰甲胆碱诱发支气管痉挛前后ＰａＣＯ２水平,,气道峰压,平台压等生理指标的变化。结果：ＰＨＣ机械通气时并用ＴＧＩ可明显降低ＰａＣＯ２水平,促进体内ＣＯ２清除,并能在潮气量（ＶＴ）降低３３％的情况下维持ＰａＣＯ２在正常     

内毒素致肺血管内皮细胞粘附中性粒细胞增加的机理研究

目的：为观察内毒素性急性肺损伤肺血管内皮细胞（ＶＥＣ）内皮细胞白细胞粘附分子－１（ＥＬＡＭ－１）和细胞间粘附分子－１（ＩＣＡＭ－１）转录水平的表达规律。方法：应用地高辛标记的ｃＲＮＡ探针原位杂交技术，检测内毒素急性肺损伤大鼠肺组织。结果：内毒素致伤后，肺小静脉、微静脉及毛细血管ＶＥＣ首先出现ＥＬＡＭ－１ｍＲＮＡ的表达，高峰在给毒后３～６小时之间，其后逐渐减弱，２４小时内基本消失，而肺ＶＥＣ在轻微背景表达基础上呈现ＩＣＡＭ－１ｍＲＮＡ的表达增加是继ＥＬＡＭ－１ｍＲＮＡ的表达之后，增强高峰在１２～２４小时之间，其表达维持时间较长，２４小时仍无减弱倾向。结论：肺血管床ＶＥＣ这种ＥＬＡＭ－１和ＩＣＡＭ－１ｍＲＮＡ的相继表达提示了内毒素性急性肺损伤肺血管床扣压大量中性粒细胞（ＰＭＮ）并进而导致肺组织损伤过程的重要分子基础。     

精氨酸加压素对内皮细胞脂质过氧化的影响

以培养的大鼠血管内皮细胞为模型，观察了精氨酸加压素对其脂质过氧化的影响及相关血管活性肽的调节作用，旨在探讨ＡＶＰ等血管活性肽对ＶＥＣ脂质过氧化的影响及与高血压病发病的关系。结果表明：（１）１０－７Ｍ的ＡＶＰ作用后，ＶＥＣ的丙二醛含量明显高于对照组（Ｐ＜０．０１）；（２）１０－７Ｍ的降钙素基因相关肽（ＣＧＲＰ）、Ｐ物质分别与１０－７Ｍ的ＡＶＰ共同作用后，ＶＥＣ的ＭＤＡ含量均减少，与ＡＶＰ对照组比较差异非常显著（Ｐ＜０．０１）。此表明，ＡＶＰ可能通过增强ＶＥＣ脂质过氧化作用引起ＶＥＣ损伤，与高血压病发病有一定关系。ＣＧＲＰ、ＳＰ对ＡＶＰ有拮抗作用     

飞行员通气过度训练方法的建立

旨在建立体验通气过度症状的训练方法，并与缺氧训练相结合，使飞行员区分该两类症状和掌握正确的处理方法。受训者为３０名歼机飞行员。采用以肺阻抗通气图为主的呼吸强度宣控制技术，使呼吸频率和潮气量分别控制在４０次／ｍｉｎ和１．２Ｌ／次，实验６００ｓ通气过度训练，并记录脑电图、脑血流图、心电图、血压、呼气末ＣＯ２分压、ｆ、ＴＶ。     

不同水平呼气末正压对ARDS患者中心静脉压的影响

呼气末正压（ＰＥＥＰ）已被广泛用于急性呼吸窘迫综合征（ＡＲＤＳ）的机械通气治疗,而中心静脉压（ＣＶＰ）监测则在ＡＲＤＳ治疗过程中也起着重要作用。ＣＶＰ可受多种因素的影响。本文拟探讨不同水平ＰＥＥＰ对ＣＶＰ的影响及其意义。１　临床资料患者,女,４８岁,因严重双肺肺炎、感染性休克而并发ＡＲＤＳ,即给予呼吸机辅助呼吸（机型为纽邦－２００）,同时给予ＰＥＥＰ１５ｃｍＨ２Ｏ。用美国ＡＲＲＯＷ深静脉导管从右锁骨下静脉置入测定ＣＶＰ,导管尖端经Ｘ线证实达右心房。先测定在有ＰＥＥＰ时ＣＶＰ数值,然后撤除ＰＥＥＰ…     

高频喷射通气对兔海水淹溺肺水肿时肺CYTO与血PaO_2和SO_2的影响

目的　探讨高频喷射通气（ＨＦＪＶ）对海水淹溺肺水肿（ＰＥ－ＳＷＤ）兔肺毛细血管内皮细胞的细胞色素氧化酶（ＣＹＴＯ）、动脉血氧分压（ＰａＯ２ ）和血氧饱和度（ＳＯ２ ）的影响及其机制。方法　复制兔ＰＥ－ＳＷＤ模型,用细胞化学和图像定量分析法测定兔肺ＣＹＴＯ 活性,血气分析仪测定ＰａＯ２ 和ＳＯ２。结果　通气组ＣＹＴＯ 活性、ＰａＯ２ 和ＳＯ２ 比未通气组有明显升高（Ｐ＜ ０．０１ 或Ｐ＜ ０．０５）,但未恢复到海水淹溺前水平。结论　ＨＦＪＶ 改善肺泡通气功能,提高ＰａＯ２ 和ＳＯ２ ,改善低氧血症,恢复ＣＹＴＯ活性,减轻细胞水肿,减轻或延缓肺不张,改善肺换气功能。同时,ＣＹＴＯ活性的恢复,又有利于肺换气功能和通气功能的改善。     

Knee injury and Osteoarthritis Outcome Score (KOOS) - validation of a Swedish version

The Knee injury and Osteoarthritis Outcome Score (KOOS) is a self-administered instrument measuring outcome after knee injury at impairment, disability, and handicap level in five subscales. Reliability, validity, and responsiveness of a Swedish version was assessed in 142 patients who underwent arthroscopy because of injury to the menisci, anterior cruciate ligament, or cartilage of the knee. The clinimetric properties were found to be good and comparable to the American version of the KOOS. Comparison to the Short Form-36 and the Lysholm knee scoring scale revealed expected correlations and construct validity. Item by item, symptoms and functional limitations were compared between diagnostic groups. High responsiveness was found three months after arthroscopic partial meniscectomy for all subscales but Activities of Daily Living.     

Endovascular management of carotid-cavernous fistulas

Objective To investigate endovascular treatment of traumatic direct carotid-cavernous fistulas （CCF） and their complications such as pseudoaneurysms. Methods： Over a five-year period, 22 patients with traumatic direct CCFs were treated endovascularly in our institution. Thirteen patients were treated once with the result of CCF occluded, 8 twice and 1 three times. Treatment modalities included balloon occlusion of the CCF, sacrifice of the ipsilateral internal carotid artery with detachable balloon, coll embolization of the cavernous sinus and secondary pseudoaneurysms, and covered-stem management of the pseudoaneurysms. Results All the direct CCFs were successfully managed endovascularly. Four patients developed a pseudoaneurysm after the occlusion of the CCF with an incidence of pseudoaneurysm formation of 18.2% （4/22）. A total number of 8 patients experienced permanent occlusion of the ICA with a rate of ICA occlusion reaching 36.4% （8/22）. Followed up through telephone consultation from 6 months to 5 years, all did well with no recurrence of CCF symptoms and signs. Conclusion Traumatic direct CCFs can be successfully managed with endovascular means. The pseudoaneurysms secondary to the occlusion of the CCFs can be occluded with stent-assisted coiling and implantation of covered stents.     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

The acutely limping child

Acute limping may be the result of multiple pathologies in children. The differential diagnosis varies based on the age of the child. Irrespective of age, the initial imaging work-up includes AP and frog leg radiographs of the pelvis and ultrasound; MRI may sometimes be helpful. In children less than 3 years, infections and trauma are most frequent. MRI is the imaging modality of choice when osteomyelitis is clinically suspected. Between the ages of 3 and 10 years, transient synovitis of the hip and Legg-Calvé-Perthes disease are main considerations but infection, inflammation and focal bony lesions are also considered. In children over 10 years, slipped capital femoral epiphysis also is considered.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.