鼻塞法吸入一氧化氮治疗新生儿低氧型呼吸衰竭及其随访的研究

为探讨吸入一氧化氮 ( NO)对低氧型呼吸衰竭 ( 型呼衰 )新生儿的病程和生长发育的影响 ,将 型呼衰的新生儿随机分为治疗组和对照组 ,每组 2 1例。前者以鼻塞法持续气道正压 ( CPAP)吸入 10～ 2 0 ppm的 NO,后者除NO外 ,CPAP等治疗与前者相同。监测动脉血氧分压 ( Pa O2 )、经皮氧饱和度 ( Tc SO2 )等 ;两组患儿均每隔 6个月随访 1次 ,至其 2岁半 ,测量其体重和身长 ,并应用贝利婴幼儿发展量表测定其智力发展指数 ( MDI)和精神运动发展指数( PDI)。结果 :治疗组患儿 Tc SO2 达 93 %及 Pa O2 达 9.3 3 k Pa( 70 mm Hg)的时间为 3 4 .5± 4 8.4 h和 3 9.8± 4 4 .5 h,均显著短于对照组的 87.8± 5 4 .3 h和 10 2 .9± 2 2 .0 h( P <0 .0 5 )。治疗组患儿 CPAP、头罩吸氧和住院的时间分别为 74 .2±2 3 .1h、91.8± 72 .3 h和 19.1± 13 .5 d,均显著短于对照组的 12 5 .1± 10 .5 h、14 0 .7± 72 .9h和 2 5 .9± 6.9d( P<0 .0 5 )。治疗组 /对照组患儿 6、12、18、2 4、3 0个月时分别有 14 / 16、13 / 13、12 / 11、10 / 9、8/ 6例随访 ,两组各次随访的体重、身长、MDI和 PDI测定结果也无显著差异。鼻塞法 CPAP吸入 NO缩短了纠正 型呼衰的时间和氧疗及住院的时间。吸入 NO对患儿近期的体格生长和智力及?     

节氧供氧面罩的研制与应用

介绍了节氧供氧面罩的结构、原理和应用效果，其主要特点是通过两侧带有吸气活门的氧气储存器，使吸气时先吸高浓度氧气，后吸氧空气混合气，呼气时，面罩的吸气活门关闭，氧气储存器中的氧气不能排出，从而达到节氧目的，低压舱模拟缺氧条件，并进行不同方法供氧的实验表明，该面罩有明显的节氧效果。     

同步鼻塞式CPAP呼吸机在肺透明膜病早产儿中的临床应用

目的:探讨在肺透明膜病(HMD)早产儿中应用同步鼻塞式持续正压通气(CPAP)呼吸机(NCPAP)的临床疗效。方法:选取2011年8月～2012年8月入住该院NICU确诊的HMD早产儿42例,按随机数字表分为观察组和对照组,每组21例,观察组给予肺表面活性物质(PS)+NCPAP治疗,对照组给予PS+有创机械通气(CMV)治疗,比较两组患儿治疗后效果。结果:两组患儿治疗前血气分析差异无统计学意义(P均>0.05)。治疗后1 h、12 h血气分析发现观察组优于对照组,观察组较对照组氧疗时间短(0.3±0.3)天,呼吸机相关性肺炎(VAP)发生率降低33.33%(7/21),呼吸机所致肺损伤(VI-LI)发生率降低33.33%(7/21),成功率高28.57%(6/21),经统计分析,差异均有统计学意义(P<0.05)。结论:NCPAP治疗HMD早产儿具有模仿生理呼吸同步性,氧耗减少,用氧时间缩短,治疗成功率明显提高,值得推广应用。     

一种新型雾化吸入面罩的研制

目的:设计一种新型雾化吸入面罩,以确保需要雾化吸入治疗的患者处在不同体位时吸入效果不受影响.方法:该新型雾化吸入面罩由雾化组件、送气组件和转向组件3个部分组成.雾化组件由进气管和药液杯组成,进气管与药液杯底部的进气口相连接,药液杯内设有射流喷嘴,顶端设有挡板.送气组件由送气管和罩杯组成,送气管两端分别与药液杯和罩杯相连...     

Development of a scaled-down aerobic fermentation model for scale-up in recombinant protein vaccine manufacturing

A simple approach to the development of an aerobic scaled-down fermentation model is presented to obtain more consistent process performance during the scale-up of recombinant protein manufacture. Using a constant volumetric oxygen mass transfer coefficient (k(L)a) for the criterion of a scale-down process, the scaled-down model can be "tuned" to match the k(L)a of any larger-scale target by varying the impeller rotational speed. This approach is demonstrated for a protein vaccine candidate expressed in recombinant Escherichia coli, where process performance is shown to be consistent among 2-L, 20-L, and 200-L scales. An empirical correlation for k(L)a has also been employed to extrapolate to larger manufacturing scales.     

肺表面活性物质及鼻塞式CPAP早产儿肺透明膜病的治疗探讨

目的:评价鼻塞式CPAP加肺表面活性物质(Curosurf)对早产儿肺透明膜病的治疗作用,并与常规的机械通气做比较。方法:27例患肺透明膜病的早产儿经气管内滴入Curosurf(100mg/kg),然后拔管予鼻塞式CPAP呼吸支持治疗,与25例常规的机械通气病例比较两组患儿的临床症状、体征及血气变化、并发症、住院时间以及住院费用。结果:治疗后1h,患儿症状、体征明显好转,6h、12h及24h,两组患儿的血气较治疗前显著改善,两组比较,无明显差异。而CPAP组肺部感染及慢性肺疾病的发生率明显低于机械通气组,氧疗及住院时间明显少于机械通气组,而且住院费用也较低。结论:鼻塞式CPAP及肺表面活性物质能有效地治疗早产儿肺透明膜病,与常规机械通气比较,具有治疗效果好,并发症及住院时间少,住院费用少等特点。     

激光治疗机废气收集装置的研讨

目的;在使用激光治疗机进行手术时,经常产生大量的由人体组织气化后的废气。这些废气全部散发在手术间内,不但影响工作,而且影响工作人员及患者的人身健康。为解决该问题进行技术改进,将手术产生的废气进行收集,并进行排放。方法;由激光输出管外包套废气收集管组成,安装在现使用的激光治疗机激光输出口前,废气收集管的另一端连接吸引装置,将手术过程中产生的废气及时吸走。结果;激光治疗机废气收集装置获实用新型专利。结论;该装置结构简单、制作成本低、使用方便。     

INSURE技术防治新生儿呼吸窘迫综合征的临床研究

目的通过与传统气管插管机械通气(mechanical ventilation,MV)比较,分析气管插管-肺表面活性物质-拔管使用持续气道正压通气(INtubate-SURfactant-Extubate to CPAP,INSURE)技术防治新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)的作用。方法回顾性分析2011年1月-2012年12月采用INSURE技术(INSURE组)或机械通气(MV组)治疗的127例NRDS患儿,比较两组患儿早期结局(二次使用PS、肺出血、气漏综合症、PPHN、PDA)、晚期结局(BPD、ROP、IVH、PVL);与感染相关并发症(败血症、NEC);预后。结果 1)两组患儿一般情况具有可比性(P0.05);2)早期结局:INSURE组二次使用PS、肺出血、气漏综合症、PPHN均低于MV组(P0.05);3)感染相关并发症:败血症发生率更低(P值均0.05);4)晚期结局:INSURE组BPD、ROP、IVH(III级以上)及PVL与MV组比较差异无统计学意义(P0.05);5)预后:两组死亡率及治愈率差异无统计学意义(P0.05)。结论 INSURE技术能更好改善NRDS患儿早期结局,减少二次PS使用,降低肺出血、气漏综合症、PPHN发生;降低败血症的发生;缩短用氧时间;未增加BPD、ROP、IVH、PVL的发生率及死亡率。     

一种新型无创通气口鼻面罩的设计

针对传统无创通气口鼻面罩耐受性差和治疗效果差不好．设计了一种高舒适性、高安全性和低漏气量的新型口鼻面罩,莘效地提高了无创通气的成功率。     

Development of a cryogenic system and tools for surgery and therapy

The design principles of the Elamed KRIO-01 multipurpose cryogenic apparatus for surgery and therapy are described. Original engineering solutions involved in the apparatus design provide local cryogenic effects of different types: contact and penetration cryodestruction, cryoablution, cooling and freezing with a dry low-temperature jet of cryogenic gas.     

Development of a medical nutrition therapy protocol for female collegiate athletes

Nutrition intervention can improve athletic performance and reduce the risk of nutrition related problems in women athletes. The current healthcare environment demands that dietitians document the outcomes of the medical nutrition therapy (MNT) they provide. This requires the development and validation of MNT protocols so that outcomes can be documented and compared in similar populations across multiple settings. The purpose of this project was to develop a sports nutrition management MNT protocol for collegiate women athletes. A registered dietitian currently working with collegiate women athletes collaborated with four dietitians from the community to develop an MNT protocol. Further testing and validation using this MNT protocol will help dietitians document the outcomes of their interventions in this population.     

Development of a method for rating cognitive responses to a diagnosis of cancer

The development of a method for rating cognitive responses to the diagnosis of early breast cancer, lymphoma and Hodgkin's disease is described in the context both of recent coping theory and a previous study by this Unit relating outcome to response to diagnosis. The ratings are defined in a manual using simple language and avoiding assumptions about the functions of responses; examples are given.     

Development of a decision aid for women choosing a method of birth control

The choice of a contraceptive method is complex and difficult. This study identifies issues for concern for women in selecting a birth control method, examines the accuracy of a self-administered questionnaire based upon these outcomes in predicting actual use, and in a preliminary fashion evaluates the usefulness of such an instrument as a decision aid. A questionnaire was designed to assess women's perceptions of the likelihood of each issue of concern for four birth control methods--oral contraceptives, intrauterine device (IUD), diaphragm, and foam or condoms--as well as the relative value of each issue. It was then tested among a convenience sample of 106 women. A weighted score was constructed by combining likelihood and value estimates for each contraceptive method. The method with the highest score was compared with actual contraceptive use and the intention to use such methods in the future. Positive predictive values were highest for pill use (83 percent) and lowest for IUD use (40 percent). While 65 percent of the sample were satisfied with their current method, 60 percent also found the questionnaire helpful. This attitude was most prevalent among younger, unmarried women. A decision aid for contraceptive decision making appears to be reasonably predictive of actual contraceptive use and helpful in thinking about the choice of a birth control method.