有创血压测量技术的研究进展

本文阐述了有创血压测量的实现过程、优点和测量的影响因素,综述了有创血压测量技术及其装置(包括有创血压监护仪和传感器)的研究进展,并对植入式测压装置和降压装置的临床试验前景进行了展望。     

床边监护仪无创血压传感器改造代换两例

长期使用发现，床边监护仪无创血压传感器平均约5年需要更换。厂家的标准处理方法是更换无创血压板，这样用户经济压力过大，且存在某些型号配件无法购买的困难。针对临床需要，我们尝试了血压测量模块压力传感器的代换工作，取得了成功。现将具体方法介绍如下，供同行参考。     

改进型压力传感器在急性心肌梗死术后患者有创血压监测中的应用

目的 分析急性心肌梗死（AMI）术后患者使用改进型压力传感器进行有创血压监测的效果。方法 选取2022年2月至2023年3月医院收治的120例AMI患者为研究对象，随机分为对照组（使用常规压力传感器）和观察组（使用改进型压力传感器），各60例。比较护理人员使用不同装置的满意度、并发症控制情况满意度及并发症发生情况。结果 观察组护理人员严格执行无菌操作、使用过程牢固固定的满意度高于对照组，观察组护理人员对预防管道脱落、预防动脉出血的满意度高于对照组，差异均有统计学意义（P<0.05）。观察组患者动脉出血、发生血肿发生率低于对照组，差异有统计学意义（P<0.05）。结论 护理人员对经皮冠状动脉介入手术治疗的AMI患者进行有创血压监测时，使用改进型压力传感器有助于完成有创血压监测过程，且并发症控制效果较好。     

Datex监护仪无创血压压力传感器的更换及校准

无创血压是监护仪的一个重要参数。本文着重介绍了Datex -Ohmeda监护仪无创血压压力传感器的更换及校准方法。     

导管顶端血压传感器检测及标准的探讨

随着我国冠脉支架集采新政的实施,导管顶端血压传感器作为冠脉病变诊断、治疗必不可少的医疗器械之一,将迎来新的行业发展契机,将有一批医疗器械企业积极投入导管顶端血压传感器的研发与注册中;作为有创血压传感器,导管顶端血压传感器应满足现行有效行业标准YY 0781-2010,但是由于其与普通的血管穿刺血压传感器在产品结构、工作方式的不同,导致在按照YY 0781-2010对其进行检测时存在诸多问题。该研究通过对导管顶端血压传感器在执行YY 0781-2010的过程中存在的“使用说明书”“电气性能”“安全要求”等问题进行详细的探讨和分析,希望给更多的导管顶端血压传感器的研发制造企业以及医疗器械检测机构的检验人员提供一些启发,也希望能够为我国导管顶端血压传感器行业的高质量发展贡献一份力量。     

基于振动法和柯氏音法的无创血压测量值差异性研究

对无创血压测量仪测量值误差异性展开分析。用与各种血压测量技术进行比较的方法，着重分析了振动法无创血压测量和柯氏音听诊法。使用振动法无创伤血压测量监护仪和柯氏音听诊法对样本人群进行了血压测量，分析所得数据，结果表明，基于振动法和柯氏音法无创血压测量仪测量值差异小，准确性也比较好。同时，也展望了无创血压装置未来的发展方向。     

生物传感器在体外循环心脏手术中的应用

心脏直视手术围术期动脉血压测量是循环监测的重要指标。其中，压力传感器为有创动脉压监测，既提供了准确、可靠、连续的动脉压力值，又能通过波形分析初步判断血容量及心脏病理生理情况；掌握其组成、原理、技术要求是临床实践中灵活运用生物传感器的必要条件。     

载人离心机无创连续血压监测系统设计与实现

目的：设计载人离心机无创连续血压监测系统,以监测飞行员在高载荷环境下的连续血压变化。方法：该系统由无创连续血压监测设备主机、前端传感器单元和上位机生理参数监测软件3个部分组成。其中,无创连续血压监测设备主机选用FMS公司的FMS-8C无创连续血压测量仪,并采取整体与局部加固相结合的方法进行改造;前端传感器单元选用FMS公司的NanoCore传感器模块,主要由指套、袖带和高度校正单元组成;上位机生理参数监测软件基于Windows系统、使用Visual Studio 2015软件开发。结果：该系统可以在15g加速度作用下对人体的连续动态血压进行监测,并能在上位机生理参数监测软件界面中实时显示。结论：该系统可以实时获取飞行员离心机训练中伴随抗荷动作的连续血压变化,为正加速度（+Gz）引起的意识丧失预警研究奠定了基础。     

无创血压测量技术与进展

介绍了无创血压测量技术的发展简史，重点分析了当今无创血压测量领域里具有代表性的柯氏音听诊法、示波法、恒定容积法的原理和特点，综述了国内外血压测量的现状．对血压无创测量技术的发展趋势提出了展望。     

简易的有创动脉内直接测压

血流动力学检测是临床麻醉和ICU的重要内容之一，是大手术和抢救危重患者不可缺少的手段。血压是重要的生命体征，是判断麻醉对患者心血管系统影响的最基本手段。根据血压可决定患者的治疗，因此如何得到可靠及时的血压数据就显得非常重要。血压的监测可通过无创的方法用袖带测得，也可通过动脉穿刺这种有创方法获得。无创监测具有操作简单、无创伤、并发症少等优点，但对于血压波动较大、无创血压监测不准确等情况需应用有创血压监测以获得及时准确的血压数据。     

Cholera in Haiti and other Caribbean regions, 19th century

Medical journals and other sources do not show evidence that cholera occurred in Haiti before 2010, despite the devastating effect of this disease in the Caribbean region in the 19th century. Cholera occurred in Cuba in 1833-1834; in Jamaica, Cuba, Puerto Rico, St. Thomas, St. Lucia, St. Kitts, Nevis, Trinidad, the Bahamas, St. Vincent, Granada, Anguilla, St. John, Tortola, the Turks and Caicos, the Grenadines (Carriacou and Petite Martinique), and possibly Antigua in 1850-1856; and in Guadeloupe, Cuba, St. Thomas, the Dominican Republic, Dominica, Martinique, and Marie Galante in 1865-1872. Conditions associated with slavery and colonial military control were absent in independent Haiti. Clustered populations, regular influx of new persons, and close quarters of barracks living contributed to spread of cholera in other Caribbean locations. We provide historical accounts of the presence and spread of cholera epidemics in Caribbean islands.     

Clinical Update on Nursing Home Medicine: 2013

This is the seventh article in the series of Clinical Updates on Nursing Home Care. The topics covered are antiresorptive drugs, hip fracture, hypertension, orthostatic hypotension, depression, undernutrition, anorexia, cachexia, sarcopenia, exercise, pain, and behavioral and psychological symptoms of dementia.     

Heavy Metals in Aquatic Macrophytes from Two Small Rivers Polluted by Urban,Agricultural and Textile Industry Sewages SW Poland

This article presents the results from a study of the comparison of 2 lowland rivers: the Olobok and the Pilawa in southwest Poland polluted by urban, agricultural, and textile industry sewages. pH and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Ni, Pb, Zn, nitrate, nitrite, ammonia, phosphate, and sulfate were measured in water samples and concentrations of Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, N, Na, Ni, P, Pb, S, and Zn were measured in stream bottom sediments and in the aquatic macrophytes Elodea canadensis, Callitriche verna, Potamogeton crispus, Potamogeton natans, and Ceratophyllum demersum from the river Olobok and Elodea canadensis, Polygonum amphibium, Potamogeton crispus, and Veronica beccabunga from the river Pilawa. The matrix of concentrations of 16 elements in 27 plant samples of 7 species from 15 sampling sites of 2 rivers and concentrations of 15 elements and pH in water samples and 16 elements and pH in bottom sediment samples of these sites was submitted to numerical classification, which revealed that sampling sites from the rivers were differentiated by the value of factor 1 of principal component analysis (PCA), which was related to the pH of water, Ca, Cu, Mg, Mn, and Ni in water and Cd, Cr, Cu, Fe, K, Mg, Na, Ni, P, and S in bottom sediments. More polluted parts of both rivers were differentiated from less polluted parts by the value of factor 2 of PCA, which was related to Pb, Zn, and sulfates in water and Ca and Zn in bottom sediments. Macrophytes from the Olobok and Pilawa rivers were differentiated by the value of factor 1, which was related to Ca, Co, Cr, Cu, Fe, Mg, Ni, N, Na, Pb, and S. Groups of macrophytes of more and less polluted parts of both rivers differed by the value of factor 2, which was related to P, K, and Mn. Downstream of the sewage outputs in both rivers, a significantly increased level of pollution occurs with elements correlated with factor 1: Among others were Cu and Cr, typical for the textile industry along the river Pilawa, and among others were Mn and Ni, typical for the urban and agricultural activities in the river Olobok.     

Evidence-Based Recommendations for an Optimal Prenatal Supplement for Women in the U.S., Part Two: Minerals

The levels of many essential minerals decrease during pregnancy if un-supplemented, including calcium, iron, magnesium, selenium, zinc, and possibly chromium and iodine. Sub-optimal intake of minerals from preconception through pregnancy increases the risk of many pregnancy complications and infant health problems. In the U.S., dietary intake of minerals is often below the Recommended Dietary Allowance (RDA), especially for iodine and magnesium, and 28% of women develop iron deficiency anemia during their third trimester. The goal of this paper is to propose evidence-based recommendations for the optimal level of prenatal supplementation for each mineral for most women in the United States. Overall, the evidence suggests that optimal mineral supplementation can significantly reduce a wide range of pregnancy complications (including anemia, gestational hypertension, gestational diabetes, hyperthyroidism, miscarriage, and pre-eclampsia) and infant health problems (including anemia, asthma/wheeze, autism, cerebral palsy, hypothyroidism, intellectual disability, low birth weight, neural tube defects, preterm birth, rickets, and wheeze). An evaluation of 180 commercial prenatal supplements found that they varied widely in mineral content, often contained only a subset of essential minerals, and the levels were often below our recommendations. Therefore, there is a need to establish recommendations on the optimal level of mineral supplementation during pregnancy.     

Interdisciplinary health professional education: a historical review

A historical review was conducted to examine the advances made, nationally and internationally, in interdisciplinary health professional education since the mid-1960s. One hundred and nineteen articles were reviewed and divided by decade into the following subheadings: models, courses, communication/group process issues, and international perspectives. Twenty-seven articles, categorized as models, defined the conceptual field, described curriculum and program development, or provided a framework for evaluation.Thirty-two articles dealt with interdisciplinary courses, focusing on objectives, content areas, or innovative methods. Nine articles contributed contenton interdisciplinary communication and group process issues, from which guidelines were abstracted. Fifty-one articles contributed an international perspective, leading to the recognition that interdisciplinary health professional education, practice, and research is a global movement.This revised version was published online in October 2005 with corrections to the Cover Date.     

Workshop report: Nucleic acid delivery devices for HIV vaccines: Workshop proceedings,National Institute of Allergy and Infectious Diseases,Bethesda, Maryland,USA, May 21, 2015

On May 21st, 2015, the U.S. National Institute of Allergy and Infectious Diseases (NIAID) convened a workshop on delivery devices for nucleic acid (NA) as vaccines in order to review the landscape of past and future technologies for administering NA (e.g., DNA, RNA, etc.) as antigen into target tissues of animal models and humans. Its focus was on current and future applications for preventing and treating human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) disease, among other infectious-disease priorities. Meeting participants presented the results and experience of representative clinical trials of NA vaccines using a variety of alternative delivery devices, as well as a broader group of methods studied in animal models and at bench top, to improve upon the performance and/or avoid the drawbacks of conventional needle-syringe (N–S) delivery. The subjects described and discussed included (1) delivery targeted into oral, cutaneous/intradermal, nasal, upper and lower respiratory, and intramuscular tissues; (2) devices and techniques for jet injection, solid, hollow, and dissolving microneedles, patches for topical passive diffusion or iontophoresis, electroporation, thermal microporation, nasal sprayers, aerosol upper-respiratory and pulmonary inhalation, stratum-corneum ablation by ultrasound, chemicals, and mechanical abrasion, and kinetic/ballistic delivery; (3) antigens, adjuvants, and carriers such as DNA, messenger RNA, synthesized plasmids, chemokines, wet and dry aerosols, and pollen-grain and microparticle vectors; and (4) the clinical experience and humoral, cellular, and cytokine immune responses observed for many of these target tissues, technologies, constructs, and carriers. This report summarizes the presentations and discussions from the workshop (https://web.archive.org/web/20160228112310/https://www.blsmeetings.net/NucleicAcidDeliveryDevices/), which was webcast live in its entirety and archived online (http://videocast.nih.gov/summary.asp?live=16059).     

Special Considerations for Prophylaxis for and Treatment of Anthrax in Pregnant and Postpartum Women

In August 2012, the Centers for Disease Control and Prevention, in partnership with the Association of Maternal and Child Health Programs, convened a meeting of national subject matter experts to review key clinical elements of anthrax prevention and treatment for pregnant, postpartum, and lactating (P/PP/L) women. National experts in infectious disease, obstetrics, maternal fetal medicine, neonatology, pediatrics, and pharmacy attended the meeting, as did representatives from professional organizations and national, federal, state, and local agencies. The meeting addressed general principles of prevention and treatment for P/PP/L women, vaccines, antimicrobial prophylaxis and treatment, clinical considerations and critical care issues, antitoxin, delivery concerns, infection control measures, and communication. The purpose of this meeting summary is to provide updated clinical information to health care providers and public health professionals caring for P/PP/L women in the setting of a bioterrorist event involving anthrax.     

Dynamics of cholera outbreaks in Great Lakes region of Africa, 1978-2008

Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Nino warm events (abnormally warm El Ninos) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.     

妊娠期糖尿病与妊娠期高血压疾病病理机制的相关性

妊娠期糖尿病(GDM)为妊娠期特有疾病,易造成孕产妇难产、产褥期感染、酮症酸中毒,胎儿窘迫、胎儿畸形甚至胎死宫内等不良妊娠结局。妊娠期高血压疾病(HDP)包括妊娠期高血压、子痫前期(preeclampsia)、子痫,以及慢性高血压并发子痫前期和妊娠合并慢性高血压,临床表现为高血压、蛋白尿及水肿,严重影响孕妇体内各脏器功能,是孕产妇及围生儿死亡的主要原因。HDP中子痫前期,尤其是重度子痫前期,是造成新生儿不良妊娠结局的重要原因,通常需要及时剖宫产终止妊娠。近年国内外许多研究已经证实GDM和HDP在内皮功能紊乱、血脂异常、炎症因子、肾素-血管紧张素-醛固酮系统(RAAS)等多方面有相关性。现就两种疾病在上述相关性方面进行综述。     

Major and trace element compositions of the UICC standard asbestos samples

Major and trace element compositions for chrysotile (2 samples), amosite, crocidolite, and anthophyllite UICC standard asbestos samples have been determined using UV-visible spectrophotometry, atomic absorption spectometry, flame photometry, volumetric analysis, and gravimetric analysis for major elements and x-ray and optical spectrometry for trace elements. The trace element data are for Li, S, Cl, Sc, V, Cr, Co, Ni, Cu, Zn, Ga, Rb, Sr, Zr, Nb, Ba, La, Ce, Pb, and Th and distribution in the various mineral phases is discussed. Am. J. Ind. Med. 32:592–594, 1997. © 1997 Wiley-Liss, Inc.