Pediatric intracranial pressure monitoring in hypoxic and nonhypoxic brain injury

We reviewed the results of all pediatric patients undergoing intracranial pressure (ICP) monitoring in a 2-year period at our institution. The outcome of patients suffering hypoxia or ischemic injuries (HII) is compared to those suffering non-hypoxic or non-ischemic injuries (NHII). Thirty-four patients had ICP monitors placed during the study period. Inconplete patient information led to the exclusion of 5 patients. An additional 5 patients were excluded because no measures to control ICP were taken after the monitor was placed. Twenty-four patients required treatment for raised ICP (hyperventilation, 24; mannitol, 19; barbiturate coma, 6). Admission Glasgow Coma Score in patients suffering HII (median score 5) and NHII (median score 6) were not significantly different (Mann-Whitney U Test). Only 2 of 8 patients with HII were near-drowning vietims. The remaining 6 had HII from other causes (5 survivors of various forms of asphyxia and 1 of cardiac arrest). All 8 patients had poor outcomes (1 severely disabled; 7 died). The 16 patients with NHII had a variety of diagnoses (6 trauma, 5 encephalitis, 4 bacterial meningitis, 1 diabetic ketoacidosis). Among these, 6 had good outcomes and 10 poor outcomes (2 severely disabled, 2 vegetative, and 6 died). The difference in outcome between patients with NHII and HII is significant at P=0.059 (Fischer Exact test). Patients with NHII may benefit from ICP monitoring. Patients with HII from near-drowning and other causes did not appear to benefit from ICP monitoring and interventions directed at controlling ICP.     

无创伤性测定门静脉压力与肝血流二法联合应用研究肝硬化的价值

目的　为临床研究肝硬化提供有价值的手段。方法　采用99mTc -RBC测定 93例肝硬化患者肝血流 ,选择峰时 (Tmax) ,半廓清时 (T1/2 )、廓清率 (K值 )、肝血流 (LBF)等作为观察指标 ,与正常对照组比较 ;同时用99mTc-MIBI经直肠给药测定其中 5 4例患者门静脉压力 (PVP) ,以心 /肝 (H/L)比值作为分流指数。结果　肝硬化组Tmax、T1/2 、K及LBF分别为 1.2 6± 0 .99(93)min、5 .75± 3.38(93)min、0 .15 4± 0 .116 (93)及 0 .6 10± 0 .2 89(93)L/min ,除Tmax外 ,与对照组均有非常显著性差异 ;Child -A、B、C级各组之间 (除Tmax外 )也均有非常显著性差异或显著性差异 ;Child -A、B、C级各组H/L分别为 0 .49± 0 .18(2 1)、0 .6 9± 0 .16 (15 )、0 .91± 0 .2 1(18) ;PVP分别为 2 .2 2± 0 .5 7(2 1)kPa、2 .85± 0 .38(15 )kPa及 3.5 4± 0 .6 5 (18)kPa。而对照组的H/L及PVP分别为 0 .30± 0 .12 (16 )及 1.6 1± 0 .38(16 )kPa。Child -A、B、C级各组分别与对照组及各组之间比较 ,除Child -B与C级组PVP无显著性差异 (P >0 .0 5 )外 ,其余均有非常显著性差异 (P <0 .0 1)及显著性差异 (P <0 .0 5 )。结论　本法测定肝血流及门脉压力方便 ,无创伤 ,对分析病情 ,判断疗效 ,指导制订治疗方案 ,估计预后等均有较     

老年危重病人人工气道气囊压力监测及护理

[目的 ]探讨人工气道气囊压力监测在老年危重病人气管导管护理中的应用价值。 [方法 ]将 60例建立人工气道的老年危重病人随机分成两组 ,实验组应用PORTEX专用气囊压力监测表注气测压 ,对照组采用传统的手指捏感法注气 ;用呼吸机检查漏气情况 ,并比较两组病人的气囊注气容积、气囊压力及并发症发生率。 [结果 ]实验组气囊压力为 2 .45 2kPa±0 .490kPa时 ,气囊容积为 10 .0mL± 4.7mL ,呼吸机检查不漏气 ;对照组气囊压力为 3 .92 3kPa± 0 .73 6kPa时 ,气囊容积为 15 .0mL± 5 .1mL ,呼吸机检查不漏气。两组病人气管黏膜损伤、气囊破裂发生率比较有统计学意义 (P <0 .0 5 ) ;两组病人误吸、食管气管瘘发生率比较无统计学意义 (P >0 .0 5 )。 [结论 ]建立人工气道的老年危重病人气囊压力维持在1.961kPa～ 2 .942kPa ,能有效避免误吸的发生和气管黏膜的损伤。     

Depressed levels of circulating menaquinones in patients with osteoporotic fractures of the spine and femoral neck

Vitamin K₁ functions in the conversion of glutamate residues, present in certain bone peptides, into the putatively active γ-carboxyglutamate form. We have shown previously that the circulating levels of vitamin K₁ are depressed in osteoporotic patients. However, it is known that menaquinones (vitamin K₂:MK) may be more effective than vitamin K₁ in this conversion of the inactive to active form of glutamate residues. A procedure for measuring such menaquinones has now demonstrated a marked deficiency of MK-7 and MK-8 in patients with osteoporotic fractures. It is suggested that estimates of circulating levels of K₁, MK-7, and MK-8 might provide a biochemical risk marker of osteoporotic fractures.     

大鼠脑组织单胺类递质及其代谢产物的检测方法研究

目的 :研究大鼠脑组织中单胺类递质及其代谢产物的高效液相反相离子对色谱测定法。方法 :采用LiChrosorbC18,10 μm色谱柱 ,流动相为甲醇 :水 (4 0 :60 ) ,含 0 .0 2 8g LEDTANa2 ,0 .15g LSDS ,0 .2ml LH2 SO4(pH 2 .5～ 3 ) ,荧光检测波长 :λEX=2 85 ,λEM=3 3 3。结果 :对 87只大鼠脑组织中 4种单胺类递质及其代谢产物的含量进行了同时测定 ,高香草酸 (HVA) 2 .5 0～ 40 .0 μg ml、去甲肾上腺素 (NE) 0 .0 1～ 0 .5 0 μg ml、多巴胺 (DA)0 .0 5～ 1.0 0 μg ml、5 羟色胺 (5 HT) 0 .0 2 5～ 0 .5 0 μg ml,峰面积与其含量呈良好的线性关系。 结论 :该法操作简便、快速、准确 ,为组织中单胺类递质及其代谢产物检测的一种理想方法 ,并适用于临床相关研究。     

建立筋膜间室综合征模型的新方法

目的：建立一种更符合临床的筋膜间室综合征动物模型，以便于基础及临床研究。方法：用宽度和犬小腿肌腹长度相当的袖带包绕小腿，然后充气使实验肢体全长受压、缺血。12只犬随机分为两组，I组：袖带充气至40kPa，压迫8h；Ⅱ组：袖带充气至80kPa，压迫8h。结果：动态监测组织压并对神经、肌肉行组织学检查，发现实验动物肢体胫前筋膜间室内组织压远远超过4.0kPa，神经、肌肉发生不可逆变性、坏死。结论：用充气袖带压迫法建立的动物模型是成功的，各项指标均达到筋膜间室综合征的诊断标准。     

两种石油加工残油对制备可纺丝中间相沥青的影响

用常压液相炭化法制备中间相沥青，并用熔融法检验中间相沥青的可纺性，研究了汽油裂解残油和催化裂化重柴油参混比的不同对中间相沥青的制备速率，产率，中间相含量，显微结构以及可纺性的影响，指出最佳配比。     

推拿治疗老年高血压及对动态血压负荷的影响

目的研究推拿治疗老年高血压及对动态血压负荷的影响。方法选择60例轻、中度高血压患者，随机分为推拿治疗组30例，药物对照组组30例。结果推拿治疗组总有效率为83．3％。药物对照组为86．7％；治疗组主要症状疗效前后对比有显著性差异（p〈0．05），治疗组治疗后动态血压负荷值明显降低，较治疗前差异有显著性（p〈0．01，p〈0．05）。结论推拿治疗老年高血压疗效显著，推拿可降低动态血压负荷。     

Monitoring pressure ulcer healing in persons with disabilities.

Pressure ulcers are a high-risk, high-volume, and high-cost problem for persons with disabilities. This article describes four tools published in the literature and reports the validity, reliability, strengths, and limitations of each. These tools include the Pressure Ulcer Scale for Healing (PUSH), the Pressure Sore Status Tool (PSST), the Sussman Wound Healing Tool (SWHT), and the Sessing Scale. Rehabilitation nurses should use a consistent framework with accurate quantification to assess, document, and monitor changes in pressure ulcers over time. Such a measurement tool must prove valid for the disabled population in which the tool is used. This will enable healthcare providers to communicate more effectively and evaluate the therapeutic plan of care.     

芳香族聚酯的相转移催化合成及其介晶态行为的研究——Ⅰ.聚酯的合成及介晶态行为

本文用相转移催化方法合成了四种新颖的芳香族聚酯。对所得聚合物进行了红外光谱、热重分析、偏光显微镜、示差扫描量热仪和解偏振光强等测试,以研究它们的结构和性能。它们的热分解温度都在330℃以上。其中的聚对,对′-1,4,7-三氧杂庚撐基二苯甲酸对苯二酚酯和聚对苯二甲酸对,对′-1,8-二氧杂辛撐基二苯酚酯,呈现向列型相转变,它们的清晰点分别为237℃和327℃。其它两种含双酚A或酚酞基团的聚酯则不存在液晶行为。对实验结果进行了讨论。