纽邦WAVE E200呼吸机常见故障分析与检修二例

本文将对呼吸机以下两种常见故障进行简要分析:①呼吸机在抢救病人过程中出现自动切断电源②呼吸机气道口湿度报警。     

Insulin reduces the BOLD response but is without effect on the VEP during presentation of a visual task in humans.

Functional magnetic resonance imaging (fMRI) based on blood oxygen level-dependent (BOLD) contrast has become an invaluable tool in the assessment of in vivo neuronal activation. Quantification of the BOLD response is determined by the hemodynamic and metabolic changes that occur in response to brain stimulation. However, these changes may vary by changes in insulin, a hormone known to be vasoactive in some tissues. To determine if insulin has an effect on fMRI, we measured the BOLD response to a visual stimulus in five normal volunteers in which insulin was first suppressed and then brought to a high physiological concentration. In addition, we also examined the effect of insulin on activation of the visual cortex as measured by the visual-evoked potential (VEP). We found that the BOLD response measured in the presence of insulin (serum insulin=236+/-29 pmol/L) was significantly lower (P<0.001) than that measured in its absence (serum insulin=8+/-2 pmol/L). Insulin was without effect on P100 amplitude or latency acquired in the presence or absence of insulin in 28 subjects using the same stimulus as that used for the fMRI experiments. Our observations suggest that insulin may have effects on cerebral blood flow and/or metabolism that affect the BOLD signal that are independent of its effects on neuronal activation identified by event related potentials (ERP). These findings highlight the complexity that must be considered when interpreting differences in fMRI responses between groups of subjects that differ in insulin concentration and/or insulin sensitivity.     

Urinary 17α-hydroxyprogesterone in management of 21 -hydroxylase deficiency

Objectives: The study was designed to assess the reliability of measurement of 24-hour urinary 17α-hydroxyprogesterone (17-OHP) by radio-immunoassay (RIA) as an alternative biochemical assessment for monitoring the treatment of congenital adrenal hyperplasia (CAH) due to 21 -hydroxylase deficiency (21 -OHD) and to assess the need for sample purification by column chromatography to improve assay specificity.
Methodology: Morning serum 17-OHP was measured using RIA and 24-hour urinary pregnanetriol using gas chromatography. Twenty-four-hour urinary 17-OHP was measured in samples from 17 prepubertal patients with CAH due to 21 -OHD, and 20 normal prepubertal children as controls. In 24 urine samples, RIA of 17-OHP was performed with and without column chromatography.
Results: There was a good correlation between 24-hour urinary 17-OHP and 24-hour urinary pregnanetriol (r = 0.962, P <0.01) and between 24-hour urinary 17-OHP and morning serum 17-OHP ( r = 0.955, P <0.01). There was no significant difference in the RIA of the urine samples with and without purification by column chromatography.
Conclusions: The measurement of 24-hour urinary 17-OHP is a reliable alternative for the biochemical monitoring of 21-OHD, and RIA specificity is unaffected by omission of column chromatography.     

Effects of Intraventricular Injection of Calmodulin Antagonist （Trifluoperazine） on Pregnancy in Rats

Injection of TFP (a specific antagonist of CaM) into the lateral ventricles of the rat brain on the fourth day of pregnancy causes marked antifertility effect in 83% of the rats (0% in the control group). Examination with the pontamone blue reaction for the implantation elucidated that the antifertitity effect was due to the blockage of implantation of the follicle. Injection of TFP into the lateral ventricles of the brain markedly reduced the concentration of CaM in hypothalamus, ovary and uterus. Serum progesterone was also reduced. However, injection glven on day 7 was ineffective to terminate the pregnancy. Injection given on certain time of pregnancy was able to reduce the cellular CaM content and to cause antifertitity. This finding demonstrated that CaM played an important rote during the course of pregnancy.     

锌离子对大鼠海马突触体Ca^2＋—Mg^2＋ATP酶活性及蛋白合成的影响

行为实验己经证明，锌过多或缺锌均可影响脑功能。锌作为体内重要的微量元素，影响多种酶的活性及蛋白质和核酸的台成。本实验通过体外分离大鼠脑海马突触体，观察不同浓度锌离子对Ca2 －Mg2 ATP酶的活性和3H－Leu掺入突触蛋白合成的影响．结果表明：1．锌离子浓度在25μmol／L时增加该酶的活性（＜0．01），并促进3H－Leur掺入蛋白质的合成（＜0．05）。2．锌离子在50,100，200μmol／L的较高浓度时对Co2 －M2 ATP酶的活性有显著的抑制作用（分别为：P＜0.05．P＜0．01，P＜0.01），仅200μmol／L对3H—Leu掺入突触蛋白合成有抑制作用。本研究提示：适量的锌对突触体功能的维持是必要的，但剂量过高则起相反作用。     

Epinephrine-induced pulmonary oedema in rats is inhibited by corticotropin-releasing factor.

In various animal models of injury to skin, mucous membranes, muscle and brain, corticotropin-releasing factor (CRF) attenuated vascular leakage in the injured tissues. Here, the effects of CRF on a rat model of pulmonary oedema were examined. Male albino rats (220-290 g) received saline or CRF s.c., 30 min before pentobarbital anaesthesia, 60 mg/kg i.p., and 1 h before 1-epinephrine bitartrate (Epi), 30 micrograms/kg i.v. Within 30 min after Epi all (n = 27) saline-pretreated rats were dead from pulmonary oedema, but animals receiving human/rat CRF at doses of 7 to 57 micrograms/kg s.c. (n = 25) were all alive. Body wt, wet and dry wt of lungs were used to calculate an oedema index. This index increased from 3.6 +/- 0.1 to 9.6 +/- 0.3 after Epi but was inhibited by 87% after CRF 28 micrograms/kg s.c. The ED50 of CRF for reducing pulmonary oedema was 3.2 (1.3-7.4) micrograms/kg s.c. Mean arterial pressure increased from 119 +/- 4 to 167 +/- 2 mmHg after Epi 10 micrograms/kg i.v., but was not different (118 +/- 3 to 169 +/- 4 mmHg) after CRF pretreatment, 6 micrograms/kg s.c., a dose which reduced lung oedema. Pharmacokinetic estimates suggest that plasma levels of CRF sufficient to attenuate lung oedema in rats approximate those seen in pregnant women at delivery, raising the possibility that endogenous CRF may protect the maternal organism during parturition.     

胎儿耳廓弹性软骨及其组织的发生

用９周－３９周引产胎儿标本７２例，取右耳廓石蜡切片，ＨＥ和Ｗｅｉｔｅｒｔ弹性纤维染色，光镜观察其弹性软骨、弹性纤维、耳廓肌和结缔组织的发生。     

儿科急诊抢救中存在问题的分析及对策

"工欲善其事,必先利其器",具备抢救急重危患儿的能力,是每个儿科护士在护理危重患儿中的利器之一.因此,本文针对护理人员在急诊抢救护理过程中的问题进行分析,提出解决问题的相应对策,以提升护理专业素质.