反复下体负压暴露对心脏泵血功能的影响

目的　探讨反复下体负压暴露对心脏泵血功能的影响及其与下体负压耐力的关系 .方法　 2 7名男性健康被试者随机分成 3组 ,分别进行 - 5 .33 k Pa 8min(A组 )、- 6 .6 7k Pa4min(B组 )、- 6 .6 7k Pa8m in(C组 )的下体负压锻炼 ,1次· d- 1 ,连续 8d,记录心率及血压 .锻炼前、后测量平卧位心脏泵血功能 .结果　 A组锻炼前后心脏功能各项指标无显著变化 (P>0 .0 5 ) ,B组锻炼后左室射血期 (L VET)、每搏输出量 (SV)、心输出量 (CO)、心指数 (CI)、血管顺应性 (C)分别为 :(2 97± 14) ms,(113± 37) m L,(7.3± 2 .3) L· min- 1 ,(4.2± 1.4) L·min- 1·m- 2 ,(2 .7± 1.0 ) m L·Pa- 1 ,较锻炼前显著增加 (P<0 .0 5 ) .而总外周阻力 (TPR)为 (7.6± 2 .9)L· Pa- 1·cm- 5,较锻炼前显著降低 (P<0 .0 5 ) .C组锻炼后较锻炼前上述指标变化趋势与 B组相同 ,但未达显著水平 .结论　 - 6 .6 7k Pa反复下体负压暴露可改善心脏泵血功能 ,其可能通过相对提高心水平动脉血压而提高下体负压耐力     

先天性心脏病肺动脉高压心内直视手术患者吸入NO对再灌注肺功能的影响

目的　评价先天性心脏病合并肺动脉高压患者吸入一氧化氮 (NO)对再灌注肺功能的影响 .方法　先天性心脏病合并中重度肺动脉患者 4 4例 ,分为对照组 (2 2例 )和吸入NO组 (2 2例 ) .吸入 NO组在升主动脉开放即刻连续吸入NO2 0 m L· L- 1 2 4 h,监测和计算平均动脉压 (m Bp)、平均肺动脉压 (m PA)、肺血管阻力 (PVR)、心排出量 (CO) ;氧分压(Po2 )、二氧化碳分压 (Pco2 )、肺泡动脉氧分压差 (A- a Do2 )、肺内动静脉分流 (Qs/ Qt) .结果　吸入 NO组 m PA肺再灌注后3,6 ,12 ,2 4 h分别为 (5 .8± 1.9) ,(5 .6± 1.6 ) ,(5 .1± 1.3)和 (4.4± 1.1) k Pa,对照组为 (7.8± 1.6 ) ,(7.3± 1.7) ,(6 .8± 1.5 )和 (6 .9± 1.5 ) k Pa,吸入 NO组下降显著 (P<0 .0 5 ) ;吸入 NO组 m PVR肺再灌注后 3,6 ,12 ,2 4 h分别为(87± 17) ,(79± 12 ) ,(6 7± 9)和 (6 0± 9) k Pa· s· L- 1 ,对照组为 (14 5± 2 2 ) ,(135± 16 ) ,(130± 14 )和 (114± 11) k Pa· s- 1·L- 1 ,吸入 NO组下降明显 (P<0 .0 5 ) ;吸入 NO组肺再灌注后 6 ,12 ,2 4 h分别为 (4.2± 1.2 ) ,(4.5± 0 .9)和 (4.4± 1.2 )L· min- 1 ,对照组为 (3.3± 0 .8) ,(3.4± 0 .8)和 (3.5± 0 .9)L· min- 1 ,吸入 NO组明显升高 (P<0 .0 5 ) .与对照     

Mapleson D装置在小儿全麻中的应用

目的 :评价 Mapleson D装置在小儿全麻中的可行性。方法 :选择 30例腭裂手术患儿。以同组病例前后比较紧闭循环通气与 Mapleson D回路通气的各呼吸动力学指标。以呼吸频率 (RR) 2 0次 /分 ,I∶ E=1∶ 1.5 ,术中潮气量(VT) 10 m L/ kg,每分钟通气量 (MV) =VT× RR,观察密闭通气时与 Mapleson D装置分别为 1.5 MV、2 .0 MV及 2 .5MV时 ,动脉血二氧化碳分压 (Pa CO2 ) ,CO2 重复吸入 (Fi) ,血氧饱和度 (Sa O2 ) ,正性终末呼吸压 (PEEP) ,气道峰压(Ppeak)及心率 (HR)变化。结果紧闭循环气与 Mapleson D装置通气时 Sa O2 ,PEEP、PPeak,及 HR无显著差异 (P>0 .0 5 ) ,而 Fi及 Pa CO2 ,在 2 .0 MV、2 .5 MV时与紧闭循环通气时降低明显 P<0 .0 5。结论 :Mapleson D装置当每分钟通气量达2 .0 MV及 2 .5 MV时用于小儿通气是可行的 ,CO2 重复吸入少     

电视胸腔镜手术的麻醉处理

目的　探讨对电视胸腔镜手术 (VATS)的病人采用双腔管气管插管行单肺通气时对 Sp O2 和 PETCO2 的影响及麻醉管理。方法　 30例进行 VATS病人行双腔管气管插管全麻 ,单肺通气 (OL V) ,VT8～ 10 m l/ kg,RR14～ 16次 /分 ,术中监测 Sp O2 、 PETCO2 、 MAP、 HR等。结果　 Sp O2 在 OL V 15 min时比 TL V时显著下降 (从 99.99± 0 .0 1降至 97.77± 3.18,P <0 .0 1) ,以后逐渐回升。 3例病人 Sp O2 <90 % ,经处理后 Sp O2 回升。 PETCO2 在 OL V 15 min时比 TL V时显著升高 [从(4.16± 0 .15 ) k Pa升至 (4.95± 0 .46 ) k Pa,P <0 .0 1],但在正常范围。结论　施行双腔管插管行 OL V麻醉的 VATS由于病人肺内分流 (Qs/ Qt)增加 ,使 Pa O2 降低 ,麻醉中要注意 Sp O2 的监测 ,必要时采取增加通气量 ,非通气肺行 HFV等措施提高 Pa O2 。     

呼气末二氧化碳分压监测在小儿机械通气中的应用

目的　探讨小儿不同心肺疾病条件下机械通气的特点及呼气末二氧化碳分压 (PetCO2 )与动脉血二氧化碳分压 (PaCO2 )的相关性及其影响因素。方法　选择 10 2例小儿根据心肺疾病不同分三组 ,无心肺疾患组 18例 ,月龄11.2± 7.5。严重肺部疾病组 10例 ,月龄 14 .3± 6.5 ,严重的先天性心脏病术后用呼吸机支持的患儿 74例 ,月龄 2 0 .3±9.3。监测方法 :呼吸机应用 1小时后患儿安静状态下采取动脉血气标本 ,并记录即刻PetCO2 ,计算出PaCO2 与PetCO2 差(a—ETCO2 )。结果　三组患儿的PaCO2 与PetCO2 均有显著相关性 (r1=0 .5 83 ,r2 =0 .786,r3 =0 .790 ,P均 >0 .0 5 )。而三组间a—ETCO2 有组间差异 ,其中第 3组与第 1组差异显著。结论　PetCO2 可用于判断小儿机械通气状态下PaCO2的变化 ,PetCO2 是一种有用的无创性指标。     

不同呼吸频率对动脉血二氧化碳分压和血清钾的影响

目的　在全麻过程中观察不同机械通气频率对动脉二氧化碳分压 (Pa CO2 )和血清钾的影响并寻求一个理想的机械通气频率。方法　 4 2例行全麻手术的患者 ,术前动脉血 Pa CO2 和血清钾在正常范围内。随机分成两组 ,麻醉诱导插管后进行机械通气 ,两组患者潮气量 (VT) 10 m l/ kg,氧流量 1.5 L/ min。 组呼吸频率为 12次 /min, 组呼吸频率为 8次 / m in,通气 30 m in后根据血气中 Pa CO2 调节呼吸频率。结果　两组各时点 Pa CO2(m m Hg)与 K+ (mm ol/ L )之间存在相关性。 组诱导插管通气后与术前及调整呼吸频率后比较 Pa CO2 、K+ 值明显下降 (P<0 .0 5 ) ,术前与调整呼吸频率后比较 Pa CO2 值、K+ 值无明显变化 (P>0 .0 5 )。通气 30 min后的血清钾、Pa-CO2 异常发生率高于调整呼吸频率后。调整后呼吸频率 (次 / m in)为 8.85± 0 .73。 组各时点 Pa CO2 值、K+值无明显变化 (P>0 .0 5 )。结论　本研究结果提示 ,目前教科书提供的机械通气参数有可能造成麻醉中过度通气 ,Pa CO2下降 ,血清钾下降低于正常值范围。     

开胸术后复张性肺水肿的治疗

目的 :探讨机械通气在复张性肺水肿治疗中的作用。方法 :全组共 6例 ,年龄 ( 2 3± 5 )岁。单侧自发性气胸 ,肺萎陷超过 90 % ,持续 4周以上者 3例 ,3周以上者 2例 ;外伤性血气胸 ,一侧肺全部萎陷持续 4周以上者 1例。病人均行开胸手术 ,肺大疱缝扎术 5例 ,开胸止血术 1例。复张性肺水肿发生时间从萎陷肺复张后 15～ 3 0 m in不等 ,血气分析 Pa O2 ( 7.18± 1.73 )k Pa。结果 :术后均行机械通气辅助呼吸 ,通气时间 6～ 78h,平均 ( 4 8± 16) h,呼气末正压通气 ( PEEP) ( 0 .5 8± 0 .12 ) k Pa。机械通气期间保持病人每天适当出超 ,有效强心利尿。停用呼吸机前血气分析 Pa O2 ( 13 .0 3± 0 .93 ) k Pa,Fi O2 为 0 .4 0 ,病人均顺利脱机。结论 :在复张性肺水肿的治疗中维持病人充足的氧合和稳定的血流动力学状态至关重要 ,带 PEEP的机械通气非常有效。     

旁气流型PETCO2监测用于婴儿麻醉呼吸管理的可行性

[摘要] 目的 探讨成人的旁气流型呼气末二氧化碳分压(PETCO2)监测用于婴儿紧闭循环法麻醉的可行性。方法 选择28例唇裂或腭裂手术的婴儿,按体重分为两组：A组,体重≤5 kg(1.7±0.5 )kg;B组体重>5 kg(7±3) kg。全麻气管插管后,由Datex ULT气体检测仪进行连续、无创性的通气监测,左侧桡动脉穿刺置管,进行动脉血血气分析。结果 在维持相同的血流动力学,呼气末二氧化碳分压的前提下,A组,PETCO2与PaCO2无相关性（P＞0.05）,体重与PaCO2- PETCO2值无相关性（P＞0.05）;B组,PETCO2与PaCO2间呈正相关（r=0.81,P＜0.01）,体重与PaCO2- PETCO2值呈负相关（r=-0.89,P＜0.01）。结论 成人的旁气流型PETCO2监测用于婴儿紧闭循环法麻醉,对于体重≤5 kg婴儿,PETCO2 不能正确监测PaCO2值;对于体重>5 kg婴儿,PETCO2 可以正确监测PaCO2值,正确评价足够的通气。     

高胆固醇对兔胆囊和胆道口括约肌的动力及超微结构影响

目的　研究高胆固醇 (Ch)对兔胆囊成石前胆囊和胆道口括约肌 (SO)的功能及其超微结构影响及 SO动力异常和胆囊动力异常之间关系 .方法　高 Ch饲养兔 2 wk(实验 组 )、4wk(实验 组 )制作实验性高 Ch血症模型 ,实验组与正常组进行 B超测定胆囊排空功能、SO压力测定及超微结构病理对照 .结果　实验 组、 组与对照组比较 ,胆囊空腹体积和残存体积增大 (P<0 .0 5 ) ,最大排空率减少 [(5 1.1±7.6 ) % ,(39.8± 5 .9) % vs(72 .7± 4.0 ) % ,P<0 .0 5 ];胆总管插入引流管后实验 组胆囊最大排空率无明显减少 (P>0 .0 5 ) ,实验 组胆囊最大排空率减少 [(5 2 .9± 5 .7) % vs(72 .7± 4.0 ) % ,P<0 .0 5 ].实验 组和 组与对照组比较 ,SO近侧段基础压升高 [(3.98± 0 .80 ) k Pa,(5 .73± 1.13)k Pa vs(2 .15± 0 .33) k Pa,P<0 .0 5 ]和高压带 (HPZ)压力升高 [(8.18± 1.0 1) k Pa,(10 .5 8± 2 .81) k Pa vs (4 .89± 0 .75 )k Pa,P<0 .0 5 ],SO收缩幅度降低 (P<0 .0 5 ) .电镜显示实验 组胆囊平滑肌和实验 , 组 SO肌丝疏松 ,线粒体肿胀 .结论　高 Ch作用下 SO功能异常发生于胆囊收缩功能降低之前 ,导致胆囊淤胆 ,为胆囊结石形成奠定基础 .     

龙牙葱木皂苷对大鼠血流动力学的影响

目的 :观察龙牙葱木皂苷 (Aralosides,As)对大鼠血流动力学的影响。方法 :静脉注射 As(5、10、2 0 mg/ kg) ,各组均以给药前各项指标为对照 ,用四导生理记录仪同步记录 L VSP、± dp/ dtmax、LVEDP、SAP和 DAP等心功能指标 ,计算机监视记录结果及分析 ,用彩色绘图仪绘制曲线。结果 :静脉注射 As(5、10、2 0 mg/ kg)后 ,LVSP、±dp/ dtmax绝对值明显增加 ,而 L VEDP下降 ,+ dp/ dtmax分别从给药前的 (318± 5 7)、(311± 5 0 )、(32 5± 6 0 ) k Pa/ s上升到给药后的 (381± 79)、(441± 5 8)、(46 4±6 1) k Pa/ s,- dp/ dtmax分别从给药前的 (- 2 5 1± 6 1)、(- 2 6 1± 4 2 )、(- 2 5 5± 4 7) k Pa/ s下降到给药后的(- 317± 5 5 )、(- 333± 4 2 )、(- 330± 4 6 ) k Pa/ s。结论 :As对大鼠正常在体心肌具有正性肌力作用 ,并且呈一定的剂量依赖关系。     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Analysis of CK-19,PDX-1,Nestin,Ngn3 in different donor islet purity in rats

Objective: To investigate if there are the CK-19, PDX-1, Nestin, Ngn3 positive cells in the donor islets of different purity in rats. Methods: Thirty male adult SD rats were randomly divided into 3 groups. Islets were isolated using digestion by ductal injection of collagenase. Group Ⅰ (n=10): Separating cell preparations were not purified, Group Ⅱ(n=10): Islet sediment was purified with 25% Ficoll400 ,Group Ⅲ (n=10): Islet sediment was purified with 25% and 11% Ficoll-400. The levels of protein of CK-19, PDX-1, Nestin and Ngn3 were detected by immunohistochemistry and the mRNA of CK-19, PDX-1, Nestin, Ngn3 was amplified by RT-PCR. Results: After two different purification methods applied, three islet preparations of different purities were obtained. The difference of islet purity was significant among various groups (P＜0.05). Compared with group Ⅱ and group Ⅲ,the protein and mRNA of CK-19, PDX-1, Nestin,Ngn3 were both higher in group Ⅰ; group Ⅲ was poorly expressed. Conclusions: The three different islet purity donor islet have different CK-19, PDX-1, Nestin, Ngn3 positive cells within them, indicating that there are some islet stem cells in the purified donor islet.     

A preliminary screening study on the associated proteins in human psoriasis vulgaris by serum proteomics technologies

Objective：To investigate the optimum screening conditions of associated proteins in human psoriasis vulgaris by serum proteomics technique, and to screen the different expression proteins related with psoriasis vulgaris. Methods：Serum samples of peripheral blood were collected from newly diagnosed psoriasis vulgaris patients in the clinic, and 20 matched healthy persons. Serum albumin IgG was removed by filtering with ProteoExtract Albumin/IgG. After comparative proteomics analysis the different protein spots were identified using 2-DE and MS. Results ：Electrophoresis figures with high resolution and reproducibility were obtained. Three different expression proteins were found only in the serum from psoriasis vulgaris patients, while nine other different proteins expressing from healthy volunteers. Conclusion：The protein expression was different in the serum between the psoriasis vulgaris patients and healthy volunteers. It was hoped that we could find the biomarkers related to psoriasis vulgaris by using proteomics.     

A CASE OF HUGE GASTRIC DISOPYROBEZOAR

PYTOBEZOARS are common bezoars in gastrontestinal tract, commonly seen in stomach and mall intestine,1but huge disopyrobezoars are     

Acupuncture Treatment of Chest Bi Syndrome

CASE HISTORY A male,a retired officer of 61 years old,paid his first visit on May 12,2006.The patient stated that 2 weeks before he suddenly got paroxysmal precordial choking pain,with irregular attacks.Each attack would last several seconds to several minutes.The attack was accompanied with heavy oppressed sensation in the precordial region,palpitation,lassitude,and in severe cases,sweating,which was once diagnosed by a hospital as'coronary heart disease'.Recalling the case history,the patient said that several days before he got angry with others because of some affairs in work,and he was not so used to the life pattern since he had just retired from his busy working post.At usual times,he was quick tempered and peevish.In recent days,he had poor appetite,and loose stool.     

Instructions to Contributors

The English edition of Chinese Journal of Integrative Medicine is edited and published by the Chinese Journal of Integrated Traditional and Western Medicine Press.Original scientific papers of advanced clinical and experimental medicine in the field of complementary/alternative medicine or integrative medicine are expected.     

Development Is A High Level Inheritance for China Time-honored Brand Products

<正>As culture is the soul of a nation,the three books,"History of Chinese Philosophy,""History of Chinese Culture"and"History of Chinese Science and Technology"have demonstrated the superiority of our great Chinese culture,and its significant impact in the field of international culture.Both core value and practical value of the Chinese culture are very clear,reflected in the views of universe,nature,life,health,disease,and therapy and related considerations,concepts,and technical methods.