小型电热灭菌器常见故障检修一例

故障现象：进行消毒操作时,内室压力已经达到0.14MPa,但温度计的指示只有70～80℃.反复加压、排汽、开门,故障依旧,但在加压状态下,轻轻敲击外围管路,温度计的指示有时会上升一点.     

一次性多功能上肢加压止血器的研制

目的：设计一种一次性上肢加压止血器,应用于上肢外伤后止血及前臂动静脉穿刺后加压止血。方法：由固定带与空气球连接而成,固定带中间为透明可视的充气气囊;气囊下方为压力指示卡,指示卡标注为黄、绿、红三色带,分别代表不同的压力区问。结果：该止血器具有体积小、易携带、压力恒定、成本低、操作简单的特点,止血效果明显且并发症少.结论：适用于战伤、院前急救、前臂动静脉采血等方面,值得广泛推广。     

自制加压腹带用于结肠镜检查的研究

目的探讨加压腹带用于结肠镜检查,提高结肠镜检查效率的效果.方法选择220例在我院接受结肠镜检查的病人随机分成两组.传统方法组在进镜20cm时增加一名医务人员用手按压病人左下腹乙状结肠部,直至肠镜到达回盲部.加压腹带组用我们自己研制的加压腹带捆在病人下腹部,充气加压垫置于乙状结肠部,在肠镜检查时向充气加压垫中充气加压固定乙状结肠.结果加压腹带组在病人痛苦程度及进镜时间上显著优于传统方法组.结论加压腹带稳妥牢固,压力持续均匀,极大节省了人力资源、减轻病人痛苦.     

桡动脉采血后不同按压时间及按压压强的止血效果探讨

目的：为一次性多功能上肢加压止血器压力指示卡的设计探索最佳的按压时间及按压压强。方法：抽取需桡动脉穿刺采血的住院患者350例,按入院时间随机分成7组,每组50例,在桡动脉采血后,使用一次性多功能上肢加压止血器加压止血,设定止血压强20-40 mm Hg（1 mm Hg=133.322 Pa）,止血时间5-15 min,分别观察其出血、皮下瘀血及患者主诉。结果：止血效果最佳的是20 mm Hg按压15 min,30 mm Hg按压10-15 min。结论：为一次性多功能上肢加压止血器的压力指示卡设置20-30 mm Hg的压强区间,按压时间15 min,可达到较好的止血效果,减少并发症的发生,减轻患者痛苦。     

战地简易局部气压式止血带的制作和应用

目的：探讨战地简易局部气囊气压式止血带在未来战争中，伤员四肢损伤出血现场急救应用的可行性。方法：利用一次性输液袋包扎在三角巾底部替代止血带气囊和固定带，接上血压计打气球和压力表以及肝素帽，打气加压并且控制在上肢24kPa（180mmHg）、下肢26．67kPa（200mmHg）的压力。结果：该可控简易气囊加压止血带操作简便，压力调节灵活，体积小携带方便，价格低廉，止血效果艮好，并发症发生率低，安全可靠。结论：该止血带简单易用，可以提高伤员自救和互救，降低休克发生率。     

腹股沟斜疝患者腹内压力的临床研究

目的 通过对斜疝患者及非斜疝患者不同角度下的静息、加压时的腹腔内压力变化及其特点,探讨在其临床中的意义.方法 对2013年1月-10月期间的30例斜疝患者（实验组）和行留置导尿的非斜疝患者（对照组）30例,均男性.通过测量不同角度（0°、15°、30°、45°、60°、75.及直立）下的膀胱内压力,测量两组患者在静息及腹内加压时腹腔压力.并通过统计学方法进行比较分析.结果 两组患者在两种不同状态下,随着角度的增大均有增加,每个角度的平均值均有明显的统计学差异（P＜0.05）;实验组中加压前后的腹腔内压力差平均值比对照组升高得更明显.结论 斜疝患者的腹腔内压力随着仰卧角度的增大而增加,且比非斜疝患者增加得更明显.     

中医脉象仪加压检测方法的研究初探

目的：探讨压力式脉象传感器正向加压法和反向加压法两种脉象检测方法对于测试结果的影响。方法：利用ZM-Ⅲc型脉象仪对于同一组受试者分别进行反向加压与正向加压两种方法进行操作测试,通过对两种不同方法下所加压力漂移值大小的对比,以及最佳取脉压力下各脉图参数的对比,比较两种方法的优劣。结果：正向加压法和反向加压法所产生的压力漂移值差异有统计学意义（P〈0.05）;两种方法最佳取脉压力下,各幅值参数除去h1外,其余P值均大于0.05,差异无统计学意义;脉象主峰波h1测量结果有影响（P〈0.05）;两种测量方法下脉搏波时间参数的变化情况差异无统计学意义（P〉0.05）。结论：反向加压测试方法更稳定,有利于脉象测量结果的正确性。     

高压舱快速加减压系统设计

目的：为了模拟水下数百米或海拔数万米的气压状态,设计能够快速进行加减压、安全、可靠的高压舱系统。方法：通过压力传感器获取调压舱的实际压力,通过输入装置输入调压舱的目标压力及对应的时间,进而由控制器根据调压舱的目标压力和实际压力调节加压阀或减压阀的开启度,从而使调压舱的实际压力在对应的时间内达到目标压力。结果：该高压舱快速加减压系统加减压过程平稳,无震荡、超调现象,可以实现高速、准确、简便和安全的加减压控制。结论：该系统可以有效地保证压力控制,安装实现简便,适用于多种高压舱。     

水银柱式血压计的原理及维护

血压计是测量血流压力的器械.以加压空气压迫在局部动脉上,然后观察施加了多大的压力,才能够制止局部动脉的波动.因此所加的空气压力也就代表了血流动的压力.血压测量在临床上具有十分重要的意义.     

介绍一种自制加压输液的装置

在急救和一些特殊治疗时,常常需要加压输液或快速补液,通常是向输液瓶内注气以大针筒直接加压推注,但压力不能恒定和持续,重复操作又很麻烦,不能适应临床治疗的需要。我们研制的这套装置,利用氧气筒的高压氧对输液进行加压,圆满地解决了上述问题。经临床使用,该装置非常简单、实用,操作又很方便,现介绍如下：1结构组成该装置由以下几部分组成（示意图见图1）：（1）橡皮管。此管分别长约90cm和10cm,质地要可供高压消毒,重复使用。管壁厚度要在2mm以上,否则不能耐受较大的压力,也影响安全孔的开闭性能。（2）安全孔。用做皮试…     

澳门地区高血压调查分析

目的掌握澳门地区高血压现状和人群血压水平。方法于１９９６年１０～１２月间,按照《全国１９９１年高血压抽样调查工作手册》的要求,对澳门地区≥１５岁的常住居民５１７７名,采用标准化调查方法,在严格质控下进行调查和血压测定。结果高血压患病粗率为２９４６％,标化患病率为２０４５％。按国内患病率标准划分属高血压高发区。收缩压及舒张压均值：男性１７１８ｋＰａ（１２８８２ｍｍＨｇ）、１０８６ｋＰａ（８１４７ｍｍＨｇ）,女性１６３２ｋＰａ（１２２３８ｍｍＨｇ）、１０１５ｋＰａ（７６１５ｍｍＨｇ）,高于国内广东省和北京市。高血压患病率男性高于女性。患病率增幅３５岁以后较快,与国内相似。同年龄组的新移民较原居民患病率低。结论本地区高血压流行状况相当严峻,是不容忽视的社会公共卫生问题。必须加强健康教育和健康促进活动,切实做好高血压的一、二级预防     

儿童期心血管病危险因素现状研究

为了解城市儿童心血管病危险因素现状，作者在北京８～１１岁儿童中，进行了血压、血脂谱、肥胖、膳食状况及心血管病家族史等主要心血管病危险因素目前水平的小样本调查。主要结果为：以收缩压＞１６．０ｋＰａ（１２０ｍｍＨｇ）和／或舒张压＞１０．７ｋＰａ（８０ｍｍＨｇ）为诊断标准，血压偏高检出率为７．２％；２１．９％的儿童血脂水平超过膳食干预推荐值；单纯性肥胖患病率为１１．７％。膳食状况中最突出的问题是摄入高胆固醇，平均日胆固醇摄入量为４８３．４ｍｇ，有７２％的儿童超过３００ｍｇ。与以往资料相比，这一儿童人群有较高的心血管病危险因素暴露水平。本结果提示，加强儿童期心血管病危险因素的监测与干预是十分必要的。     

Physiological effects of pressure demand masks during heavy exercise

Inward leakage in a respiratory protective device may constitute a health hazard. The pressure demand system causes a slightly positive pressure in the facepiece throughout the breathing cycle, so that any insufficient seal in such a system will result in an outward leakage. One question is whether this positive pressure will influence work capacity. Five subjects worked until exhaustion on a bicycle ergometer with four different breathing equipments: two masks with positive pressure (0.5 kPa and 0.8 kPa) and two mouthpieces without positive pressure, one control and one with high resistance. No difference in endurance time was found. Heart rate, oxygen consumption, rated perceived exertion and blood lactate at breaking point did not show any significant changes. The high resistance mouthpiece, -1.1 kPa to +1.3 kPa, at breaking point, did reduce minute ventilation by 21% and end tidal PCO2 was increased by 16% without any influence on work performance.     

CO2 retention with minimal symptoms but severe dysfunction during wet simulated dives to 6.8 atm abs

During wet dives in a hyperbaric chamber to 6.8 atm abs (690 kPa), air breathing subjects were experimentally exposed to external breathing resistance. Two of them were, unbeknownst to themselves, severely incapacitated. In the first incident the subject had been exercising for 25 min (end-tidal PCO2 60-65 mmHg, 7.3-8.0 kPa) when the breathing resistance was rapidly increased from low to very high (requiring pressure swings of 80 cmH2O, 8 kPa, peak to peak). He functioned normally (end-tidal PCO2 72 mmHg, 9.6 kPa) for about 100 s but 20 s later he was confused and irrational. After being extracted from the water (end-tidal PCO2 above 90 mmHg, 12 kPa), he lost consciousness for about 60 s. In the second incident the subject was exercising and breathing against a high resistance (pressure swings of 50-55 cmH2O, 5.0-5.6 kPa). His end-tidal PCO2 was high (65-68 mmHg, 8.7-9.3 kPa) throughout the exercise period, and after 24 min he reported mild dyspnea. A few seconds later he became confused. In other experiments both subjects voluntarily terminated experiments when the breathing resistance became overwhelming. These 2 subjects generally had high end-tidal PCO2 levels, but 1 other subject with end-tidal PCO2 levels in the same range never experienced any problems. These incidents indicate that severe hypercapnia does not necessarily correlate with dyspnea and that severe disturbances in mental function due to hypercapnia can develop suddenly when high breathing resistance is encountered in diving.     

戊巴比妥在顽固性颅内高压中的应用及对脑组织氧分压的影响

目的 研究戊巴比妥在外伤后顽固性颅内高压患者中应用,监测其对脑组织氧分压（PbtO2）的影响.方法 顽固性颅内高压患者60例,分为对照组和治疗组,对照组采用常规治疗,治疗组除常规治疗外,于24 h内加用戊巴比妥.两组均持续监测PbtO2和颅内压（ICP）,并对不同时段的PbtO2及ICP进行统计分析.于伤后3个月对患者行GOS评分并对两组患者预后进行比较.结果 应用巴比妥治疗后24、48 h和72 h治疗组PbtO2[72 h：（26.7±6.7）mmHg]均高于对照组[72h：（21.1±7.2）mmHg]（P〈0.05）,而给药第3天、第5天治疗组ICP[5 d：（2.48±1.11）kPa]均低于对照组[5 d：（3.12±1.09）kPa];治疗组预后优于对照组（P〈0.05）.结论 戊巴比妥可以有效降低顽固性颅内高压患者的颅内压、提高脑组织氧分压、改善预后.PbtO2监测是一种较为理想的病情监测手段,并可以在一定程度上判断预后.     

儿童门静脉高压症研究进展

儿童门静脉高压症是指在多种病因作用下,门静脉系统的血流受阻和（或）血流量增加、血管舒缩功能障碍,引起门静脉及其属支的压力持续增高,门静脉压力＞5 mmHg（1 mmHg=0.133 kPa）,或门静脉、肝静脉压力梯度＞10 mmHg,最终导致脾大、门腔侧支循环形成和开放、腹水等临床表现,是一种血流动力学异常综合征。儿童门静脉高压症根据病因不同分为肝硬化性门静脉高压症和非肝硬化性门静脉高压症;根据压力来源的解剖部位,可将门静脉高压症分为肝前性、肝内性（窦前性、窦性、窦后性）及肝后性。治疗方法有药物治疗、曲张静脉套扎或硬化、手术治疗等。虽然儿童门静脉高压症发病率较低,但可以引起胃食管静脉曲张破裂出血、肝性脑病等严重并发症。为加强对本病的认识,减少并发症,提高治愈率,现将其病因分类、发病机制、诊断和治疗方面的研究进展作一综述。     

A leak quantification method using sulfur hexafluoride as tracer gas

Filter holders and continuous air monitors are used extensively in the nuclear industry. It is important to minimize leakage in these devices, and, in recognition of this consideration, a limit on leakage for sampling systems is specified in; however, the protocol given in the standard is really germane to measurement of significant leakage, e.g., several percent of the sampling flow rate. In the present study, we developed a technique for quantifying leakage and used that approach to measure the sealing integrity of a continuous air monitor and two kinds of filter holders. The methodology involves use of sulfur hexafluoride as a tracer gas with the device being tested operated under dynamic flow conditions. The leak rates in these devices were determined in the pressure range from 2.49 kPa (10 inches H2O) vacuum to 2.49 kPa (10 inches H2O) pressure at a flow rate of 56.6 L min-1 (2 cfm). For the two filter holders, the leak rates were less than 0.007% of the nominal flow rate. The leak rate in the continuous air monitors was less than 0.2% of the nominal flow rate. These values are well within the limit prescribed in the ANSI standard, which is 5% of the nominal flow rate. We suggest that the limit listed in the ANSI standard should be reconsidered as lower values can be achieved, and the methodology presented herein can be used to quantify lower leakage values in sample collectors and analyzers.     

小梁切开联合小梁切除术治疗开角型青光眼

目的：观察小梁切开联合小梁切除治疗开角型青光眼的临床疗效。方法：对10例（16眼）开角型青光眼患者施行外路小梁切开联合小梁切除术。术后观察视力、前房反应、眼压及滤过泡情况。随诊时间1～36个月,平均13.4个月。结果：术后视力3眼无变化,其余均超过术前水平;术后1周眼压为0.93～2.67kPa,平均（1.92±0.67）kPa,末次回访眼压为1.33～2.67kPa,平均（2.05±0.53）kPa。与术前用药后眼压（4.67～4.93kPa,平均5.88kPa）相比下降3.69kPa。结论：小梁切开联合小梁切除治疗开角型青光眼的降眼压效果安全可靠,适用于小梁组织病变或发育异常的宽房角青光眼。     

多功能心脏麻痹液灌注器的研制

为在心脏手术时更好地保护心肌，我们研制了心脏麻痹液灌注器。该灌注器具有如下优点：（1）能与任何心肺机和不同的管道系统相配套。（2）能实现晶体液和胶体液同时灌注和分别灌注。（3）能准确地监测灌注压和温度。（4）可随意调整灌注液成分。（5）结构简单，制作方便，造价低廉，效果确切。     

Oxidative stress during oxygen tolerance test

Reactive oxygen species, including oxygen free radicals are normally generated in human cells during aerobic metabolism. Their production may increase during breathing of hyperoxic mixtures. The 'oxidative stress' has been postulated to be an important contributor to CNS oxygen toxicity. One of the highest partial pressure of oxygen used in healthy humans is 280 kPa(a) during 30 min of 'oxygen tolerance tests' (OTT). This test is conducted in order to detect some individuals with an increased sensitivity to high partial pressures of oxygen leading them to develop CNS oxygen toxicity earlier than others. The purpose of this study was to investigate whether the OTT (30 min of breathing pure oxygen at 280 kPa(a)) would significantly induce oxidative stress in healthy population. The first group consisted of 52 subjects, in whom total antioxidant status (TAS) was measured. The second group consisted of 44 subjects, in whom protein carbonyls (PC), total thiol (t-SH) and heat shock proteins (HSP70) were measured. All measurements were done just before and immediately after the OTT. There was no statistically significant change of TAS. We observed a small, however statistically significant increase of PC and decrease of t-SH. A significant decrease of HSP70 was detected, however false positives of initial measurements are suspected. In summary, in young healthy subjects 30 min of breathing oxygen under pressure of 280 kPa(a) induces oxidative stress which can be detected by increase of protein carbonyls and by decrease of total thiol. In our study this stress was not reflected in measurement of total oxidative status and heat shock proteins.