Implication of the systolic hump in systemic arterial pressure waves

The systolic hump in the aortic blood pressure wave is defined as the aorticresistance component proportional to the aortic blood flow superimposed on the windkessel component. An electrical analogue comprising a series resistance (aortic resistance) plus a resistance (peripheral resistance) and capacitance (aortic compliance) in parallel (i.e. windkessel component) is used for analysis. Curve fitting using the leastsquares method is performed on calculated and measured blood pressure waves from dogs under haemodynamical conditions induced by infusion of three drugs (noradrenaline, isoproterenol and acetylcholine). The curve fitting RMS (root mean square) errors are <3% for blood pressure waves and <30% for blood flow waves, with good agreement between measured and calculated blood flow waveforms. Infusion of noradrenaline and acetylcholine is found to induce a significant decrease and increase in the aortic resistance, respectively. Although only a small fraction of the blood pressure wave, the systolic hump has a marked effect on the systolic pressure waveform.     

Fluctuating PEEP (F–PEEP) versus conventional PEEP in dogs with asymmetrical lung injury

Fluctuating PEEP (F-PEEP) is a newly developed PEEP in which end-expiratory pressure (EEP) is periodically changed within a certain range. In a dog model with unilateral lung injury induced by the introduction of hydrochloric acid, F-PEEP in which the EEP was periodically changed from 0.5 to 1.5 kPa at periods of 6 min, and conventional PEEP (C-PEEP) with an optimized EEP of 1.0 kPa, were each applied for 30 min. F-PEEP produced a significantly greater improvement of PaO2 and intrapulmonary shunt (QS/QT) than C-PEEP, and at the low EEP phase, the greatest improvement accompanied by an increased dynamic compliance and a large cardiac output was obtained. These results suggest that F-PEEP provides a useful mode of artificial ventilation for the treatment of unilateral lung injury.     

综合疗法治疗儿童弱视的疗效分析

目的 :评价综合疗法治疗儿童弱视的远期疗效。方法 :追踪观察治疗 3年以上的弱视患者 2 30例、36 5眼 ,在治疗过程中根据患者弱视程度、年龄及注视性质采用传统遮盖疗法 ,光学及药物压抑疗法 ,后像疗法及脉冲红光闪烁疗法等综合治疗。结果 :总治愈率为 71.78% ,其中轻度弱视治愈率为 93.85 %、中度为 82 .6 7%、重度为 34.6 9%。屈光不正性弱视 81.95 %、屈光参差性弱视 6 4.13%、斜视性弱视 4 9.4 7%。中心注视与旁中心注视之间差异有显著性 (P <0 .0 5 )。表明弱视程度越轻 ,治疗效果越好。各种类型弱视中 ,以屈光不正性弱视疗效最好。中心注视者疗效明显好于旁中心注视者。结论 :采用综合疗法治疗弱视 ,疗效显著 ,能明显缩短疗程 ,是目前治疗弱视最有效的方法。     

经内镜鼻胰管引流在重症急性胰腺炎治疗中的应用

目的 :初步总结经内镜鼻胰管引流在重症急性胰腺炎治疗中应用的疗效。　方法 :自 1998年 3月以来 ,在重症急性胰腺炎患者入院后常规非手术监测治疗的同时 ,随机床旁行经内镜置放鼻胰管引流 14例。其中明确合并胆结石 8例。观察每天胰管引流量和入院后第 5天在体温、心率、白细胞计数、血糖、血钙、动脉氧分压和血、尿淀粉酶的变化 ,并与第 1天比较 ,记录治疗结果和住院时间。　结果 :经鼻胰管引流时间为 (7.3± 4 .0 )天 ,前 5天的胰液引流量分别为每天 (2 36 .4± 176 .6 )、(2 87.1± 16 4 .7)、(2 84 .6± 2 16 .4 )、(435 .0± 35 7.8)ml和 (377.8± 2 2 3.8)ml。入院后第 1天和第 5天的体温为 (38.2± 0 .6 )和 (37.2± 0 .8)℃ (P <0 .0 1)、心率为 (10 2 .3± 17.0 )和 (82 .9± 14 .5 )次 /min(P <0 .0 1) ,白细胞计数为 (14 .6± 4 .2 )和 (10 .1± 5 .4 )× 10 9/L(P <0 .0 5 ) ,血糖为 (10 .0± 4 .9)和 (8.6± 3.3)mmol/L(P >0 .0 5 ) ,血钙为 (2 .1± 0 .2 )和 (2 .2± 0 .2 )mmol/L(P >0 .0 5 )　动脉氧分压为 (78.0± 16 .3)和 (113.0± 4 1.6 )mmHg(P <0 .0 1) ,血淀粉酶为 (6 95 .7± 4 4 5 .2 )和 (82 .6± 4 7.1)U/L(P <0 .0 1) ,尿淀粉酶为 (3174 .1± 2 5 4 2 .5 )和(2 86 .8± 2     

Periodontal conditions among the middle-aged and the elderly in Hong Kong

Abstract The aim of this study was to describe the periodontal conditions in 372 35–44-yr-old and 537 noninstitutionalized 65–74-yr-old Hong Kong Chinese who were examined clinically for loss of attachment, recession, probing depth, calculus, and bleeding after probing. Community Periodontal Index (CPI) data and treatment need indications were compiled from index teeth or their substitutes. The prevalence of loss of attachment varied considerably in both cohorts according to the definition of the threshold (≥6, ≥9, and ≥12 mm, respectively). The mean numbers of teeth with loss of attachment at the ≥6-mm threshold and at higher thresholds were small. In both age cohorts, about one-fifth of subjects had probing depths ≥6-mm, while al the ≥9-mm threshold only 2–3% were so affected. Although recession was an important component of loss of attachment in the younger cohort, in the older cohort the prevalence and extent of recession were greater than for probing depths at thresholds ≥4 mm. All subjects had one or more teeth with calculus, bleeding, or both, most teeth being so affected. Eighty-four of the 537 65–74-yr-old subjects were excluded either because of edentulousness or because extractions indicated for the remaining teeth would have rendered the subjects edentulous. The distribution of subjects according to their highest CPI score was remarkably similar for the two cohorts. No subjects in either age group were assessed as “healthy” (CPI code 0) or had “bleeding only” (code 1) as their highest score. While most subjects scored CPI code 2 or 3 us their highest score, only 17% of the younger and 15% of the older cohort scored Community Periodontal Index of Treatment Needs (CPITN) code 4. Differences in the mean number of sextants affected by CPI codes between the two cohorts were mainly due to a greater number of excluded sextants in the older cohort. CPI findings for 35–44-yr-olds differed little from those reported in 1984.     

Pilon骨折的治疗

作者自1988年1月至1993年12月收治Pilon骨折31例，根据Riled的分类祛：Ⅰ型5例，Ⅱ型10例，Ⅲ型16例．手术治疗22例，保守治疗9例．随访l－4年，疗效按Bourne的标准评定，Ⅰ型骨折手术或保守治疗优良率100％，Ⅱ、Ⅲ型骨折手术治疗优良率85％，保守治疗优良率33．3％．作者认为Pilon骨折Ⅱ、Ⅲ型应手术治疗．保守治疗仅用于Ⅰ型骨折．手术控AO的四步重建法进行．但严重的粉碎骨折或开放骨折伴软组织缺损，内固定确定难干实施者，则改用踝部超关节外固定支架固定．     

重组人红细胞生成素治疗肾性贫血的临床分析

目的　观察重组人红细胞生成素 (RhEPO)对肾性贫血的治疗作用。方法　根据使用EPO剂量的不同将 39例慢性肾衰竭并血液透析病人分成 4组 ,观察治疗后 2、4、12个月时与治疗前 (0月 )相比红细胞数 (RBC)、红细胞比积 (Hct)及血红蛋白含量 (Hb)的变化。结果　 2 4例使用EPO10 0 - 15 0IU/ (kg·w) (6 0 0 0IU/w - 90 0 0IU/w) ,治疗后RBC、Hct、Hb较治疗前有显著升高 (P≤ 0 .0 0 1) ;5例使用EPO5 0IU/ (kg·w) (30 0 0IU/w) +间断输血患者 ,其RBC、Hct、Hb升高不显著 ;10例不用EPO而单纯输血患者 ,其RBC、Hct、Hb无明显变化 (P >0 .0 5 )。结论　EPO能较好地纠正肾性贫血 ;单纯输血不能治疗肾性贫血     

沐舒坦治疗重型颅脑损伤后肺部感染的临床分析

目的:探讨沐舒坦对重型颅脑损伤后肺部感染的治疗作用.方法:选择GCS3～8分重型颅脑损伤后肺部感染的患者90例,随机选45例(实验组)加用沐舒坦治疗,另45例(对照组)未予沐舒坦治疗。所有患者其他治疗措施均基本相同。结果:实验组有42例感染控制,感染控制时间平均(7.8±2.6)d:对照组有35例感染控制,感染控制时间平均(14.1±3.2)d。实验组肺部感染控制率显著高于对照组(P<0.05),而控制感染平均时间显著短于对照组(P<0.05)。结论:沐舒坦治疗重型颅脑损伤后肺部感染有较好的临床疗效,值得临床推广应用。     

射频与中药联合治疗肥厚性咽炎的临床观察

目的 :探讨应用射频与中药联合治疗肥厚性咽炎的疗效。方法 :随机将 16 8例肥厚性咽炎患者分为射频与中药联合治疗组和对照组 ,进行临床观察。结果 :治疗组显效率 76 .3% ,总有效率 10 0 % ,对照组显效率 14 % ,总有效率 82 % ,两组差异有高度显著性 (P<0 .0 1)。 结论 :射频配合中药联合治疗肥厚性咽炎效果显著。     

肝内胆管癌的诊断与治疗(附12例报告)

目的探讨肝内胆管癌发病的诊治方法。方法对我院1990年1月至2003年3月经手术和病理证实的12例肝内胆管癌病例资料进行回顾性分析。结果早期症状无特异性，AFP检查均为阴性，血CEA检查升高显著3例，4例术前诊断为肝内胆管癌，8例误诊，本组行根治性切除5例(41．6％)，姑息性手术7例。结论肝内胆管癌误诊率高，根治性手术率低，熟悉本病的临床特征，B超检查仍是首选方法。术中病理学检查是避免误诊漏诊的重要方法，根治性手术切除是本病最有效的治疗方法。