Body composition measures from underwater weighing and dual energy X-ray absorptiometry in black and white girls: A comparative study

The purpose of this study was to compare estimates of body composition in two ethnic groups, 31 black and 38 white girls 10 through 16 years of age, to establish accurate and precise laboratory standards for field measures of body composition in the NHLBI Growth and Health Study HC 55025. The dual energy X-ray absorptiometry (DXA) measures of fat free mass (FFM) and % body fat (%BF) were made using Hologic QDR-1000/W. Corresponding values of FFM and %BF from underwater weighing (UWW) were determined using the two-component model of Siri, and these were corrected using the model of Lohman for white girls only. In the comparison of the different models and methods, the two-component model overestimated FFM compared to estimates from DXA for black girls, as did the corrected Lohman model for white girls. The two-component model significantly overestimated %BF in both white and black girls compared to corresponding estimates from DXA. The ratio of bone mineral content (BMC)/FFM affected the degree of %BF differences in black girls but not in white girls. Also, as the density of FFM increased or approached adult status in black girls (BMC/FFM increased), differences between the two-component model and estimates from DXA decreased. In both groups of girls, the relationship of %BF from UWW and DXA are a function of the level of body fatness. DXA values of %BF are greater than those from UWW under about 24% body fat, but the converse occurs above 25% body fat. The inability of UWW using the two-component model to account for the body composition in these girls can be corrected in part by measuring the variables for a multicomponent model or more easily by using DXA estimates of body composition. © 1994 Wiley-Liss, Inc.     

多发伤的骨折内固定

目的：认识多发伤中骨折的主要特点,探讨内固定在救治中的意义。方法：回顾1994－08～1999－08间手术救治多发伤66例,对其161处骨折中的98处进行了“仿AO技术”有关方法内固定。结果：骨折均满意愈合;涉及骨折关节51个,功能恢复满意率为96．08％。结论：在多发伤中,骨折、合并伤与并发症远较“一般骨折”复杂、严重;有效固定骨折是一种重要的救命措施;内固定手术应争取在伤后24h进行,但如受条件制约,伤后1－3wk内手术也可获得满意效果;仿AO技术中的某些方法,如拉力螺钉、张力带钢丝及自动加压钢板等,用于内固定可使骨折获得卓有成效的稳定性。     

高血压病以昼夜血压模式指导治疗初探

目的：探讨高血压以昼夜血压模式指导药物治疗的疗效。方法：124例高血压患者被随机分为两组：观察组80例,采用以昼夜血压模式为依据,指导选用药物进行治疗,着重加强异常升高血压部份的降压治疗,同时加强血压监测;对照组仍按照常规方法治疗,6周为1疗程,治疗前和治疗后都检测血压和24小时动态血压。结果：观察组降压的总有效率和昼夜血压模式转为正常杓形态明显高于对照组,结论：高血压病患者以昼夜血压模式为依据指导用药降压治疗有较好的医疗效果。     

Relationship between the Mutation of IRS-1 Gene and β_3-adrenergic Receptor Gene

Ｏｂｅｓｉｔｙｉｓａｓｓｏｃｉａｔｅｄｗｉｔｈｉｎｓｕｌｉｎｒｅｓｉｓ ｔａｎｃｅ (ＩＲ) ,ｗｈｉｃｈｐｌａｙｓａｃｒｉｔｉｃａｌｒｏｌｅｉｎｔｈｅｄｅｖｅｌｏｐｍｅｎｔｏｆｔｙｐｅ 2ｄｉａｂｅｔｅｓｍｅｌｌｉｔｕｓ.ＴｈｅｍｅｃｈａｎｉｓｍｏｆＩＲｉｓｒｅｌａｔｅｄｔｏｔｈｅａｂｎｏｒｍａｌｉｔｉｅｓｏｆｉｎｓｕｌｉｎｒｅｃｅｐｔｏｒ,ｐｒｅ ｒｅｃｅｐｔｏｒ,ｐｏｓｔ ｒｅｃｅｐ ｔｏｒ ,ｒｅｓｕｌｔｉｎｇｉｎｄｅｆｅｃｔｉｖｅｍｅｔａｂｏｌｉｃｐａｔｈｗａｙｏｆｇｌｕｃｏｓｅ,ｌｉｐｉｄａｎｄ ｐｒ…     

以呕吐原因待查住院的疾病分析

目的 分析哎吐的发病情况,以期充分提高对其临床表现的认识,并提出合理的检查步骤。方法 采用回顾性方法分析了315例哎吐原因待查病例。结果 消化系统疾病与非消化系统疾病的比例分别为77．14％和20．23％,无论是消化系统疾病还是消化系统疾病,女性发病的比例均高于男性。结论 哎吐原因待查住院的病人病史较长病情复杂,可根据疾病的发病规律和临床特点,先将其分为消化系统疾病和非消化系统疾病两类,然后再根据各自的特点逐一分析,结合相应的检查最终明确诊断。     

对基地班学生实施导师制的体会

本总结了2届基地班学生参加生理学科导师组活动的情况,提出几点经验与体会。根据基地班学生的特点和实施导师的制的初衷,运用问题先导法,培养学生的创新意识,加强师生交流,使之成为合格的基础医学人才。     

开胸术后呼吸衰竭2 6例临床分析

目的:探讨开胸术后呼吸衰竭的发病原因、临床特点及有效的预防、治疗方法.方法:对本院1993年1月～1999年4月开胸术后并发呼吸衰竭的发病情况及其治疗结果进行统计分析.结果:术前心肺功能异常、麻醉、手术创伤、感染、术后出血等为术后呼吸衰竭的主要原因,其发生率为3.56%(26/730),死亡率为23.1%(6/26).结论:加强围手术期呼吸道管理,减轻手术创伤,预防和正确处理术后并发症是防止呼吸衰竭的关键,及时有效的机械通气是抢救成功的最有效手段.     

一氧化氮对犬下食管括约肌压力的作用

目的 :应用苄基二甲基十四烷氯化铵 (benzyldim ethyltetradecyl amm onium chloride,BAC)建立犬下食管括约肌(L ES)无神经动物模型 ,研究一氧化氮 (NO)对 L ES压力的作用。方法 :将 BAC环周注入犬 L ES,对照组注入等量生理盐水 ,均于注射前及注射后 6周测定 L ES压力 ;并观察 L -精氨酸、D -精氨酸、硝普钠及一氧化氮合酶 (NOS)抑制剂 N-硝基 - L -精氨酸 (L - NNA)对 L ES压力的影响 ;此外还测定了两组犬 L ES中 NO含量和 NOS活性。结果 :BAC处理组 L ES压力 [(4 2 .43±4.19) m m Hg,1m m Hg=0 .133 k Pa]显著高于对照组 [(2 2 .71± 5 .19) mm Hg]。 L -精氨酸可使对照组 L ES压力降低 ;L - NNA使其增高 ,但对 BAC处理组 L ES压力均无影响。硝普钠可降低两组犬 L ES压力。对照组 L ES中 NO为 (6 .0 5 8± 2 .0 6 7)μm ol/g,NOS为 (1.45 8± 0 .146 ) U /mg;而 BAC处理组 NO为 (1.797± 0 .873)μmol/g,NOS为 (0 .46 3± 0 .0 39) U /m g,均较对照组显著降低 (P<0 .0 1)。 结论 :BAC可使犬 L ES压力增高 ,其机制可能与 L ES局部 NO减少有关。     

Outcomes and factors associated with early mortality in pediatric postcardiotomy veno‐arterial extracorporeal membrane oxygenation

Mortality and morbidity of children received veno‐arterial extracorporeal membrane oxygenation (VA‐ECMO) support after cardiac surgery remain high despite remarkable advances in medical management and devices. The purpose of this study was to describe outcomes and risk factors of applying VA‐ECMO in the surgical pediatric population. We retrospectively analyzed 85 consecutive pediatric patients (aged <18 years) who received postcardiotomy VA‐ECMO from January 2010 to December 2018. Median (IQR) age at ECMO implantation in this cohort was 12.7 (6.4, 43.2) months, median weight was 8.5 (6.0, 12.8) kg, mean ECMO duration was 143.2 ± 81.6 hours and mean hospital length of stay was 48.4 ± 32.4 days. Seventy‐five patients (88.2%) were indicated for postcardiotomy cardiogenic shock. The successful ECMO weaning rate was 70.6% and in‐hospital mortality was 52.9%. The most common diagnosis was transposition of great arteries (n = 18, 21.2%), while acute kidney injury occurred most often (n = 64, 75.3%). Multivariate logistic regression analysis showed that thrombocytopenia, hemolysis, and nosocomial infection were positively correlated with in‐hospital mortality. Multivariate Cox proportional hazard regression analysis presented that thrombocytopenia significantly increased the 180‐day mortality in patients with successful weaning. Therefore, multiple factors had adverse effects on prognosis. Patient selection and procedures from ECMO implantation to weaning need to be closely monitored and performed in a timely manner to improve outcome.