青藏高原东缘麝类资源保护及生态型发展战略的探讨

青藏高原东缘在我国自然地理的第一、二阶梯的交汇区,是麝类重要的分布区,为麝香Moschus的重要产区。随着传统中医药对麝香的需求不断增长,麝类资源保护与利用的矛盾愈加突出。因此,立足于生态环境保护与传统中医药发展,围绕青藏高原东缘自然地理条件在生态型发展上的优势和劣势,从野生麝类资源的保护、麝类生态型构建及区域经济发展的战略视角,探讨青藏高原东缘区域乡村振兴、社会经济发展的新思路,服务于青藏高原东缘生态安全屏障建设、经济发展新途径及中医药麝香原料的可持续保障,希望对麝类生态型发展战略的布局有所裨益。     

桃红四物汤辅助治疗胫骨平台骨折术后的疗效及对骨代谢指标的影响

目的 探讨桃红四物汤辅助治疗胫骨平台骨折术后的疗效及对骨代谢指标的影响.方法 选取2017年12月—2019年12月期间在广州中医药大学附属深圳市宝安中医院骨伤科行胫骨平台骨折手术的92例患者作为研究对象,随机分为对照组和治疗组,各46例.两组患者均进行锁定钢板内固定治疗,对照组在术后给予常规治疗.治疗组在对照组基础上...     

CLINICAL ANALYSIS ON INTEGRATED TREATMENT OF 2240 CASES OF PERIPHERAL FACIAL PARALYSIS BY STAGES IN PLATEAU REGION

Facial paralysis including central facial paralysisand peripheral facial paralysis,is a commonly encoun-teredillnessin practice.Peripheral facial paralysis(orfacial palsy)is marked by sudden onset,retroauricu-lar pain,facial numbness,epiphora,parageusia,de-creased tearing,and hyperacusis in the early stage;peripheral facial paresis,hypoesthesia or dysesthesiaof cranial nerves V and IX,motor paresis of cranialnerves IX and X,and papillitis of the tongue.InQinghai-Tibetan Plateau,cold and win…     

The effect of driving pressures in COVID-19 ARDS: Lower may still be better as in classic ARDS

BackgroundThe respiratory dynamics of coronavirus disease 2019 (COVID-19) patients under invasive ventilation are still not well known. In this prospective cohort, we aimed to assess the characteristics of the respiratory system in COVID-19 patients under invasive mechanical ventilation and evaluate their relationship with mortality.MethodsFifty-eight COVID-19 patients who underwent invasive mechanical ventilation between March 11, 2020 and September 1, 2020 were enrolled for the present study. Demographics and laboratory values at baseline were recorded. Respiratory variables such as tidal volume, plateau pressure, positive end expiratory pressure, static compliance, and driving pressure were recorded daily under passive conditions. Further, the median values were analyzed.ResultsMedian age of the patients was 64 years (58–72). Mortality was 60% on day 28. Plateau pressure, driving pressure, and static compliance significantly differ between the survivors and non-survivors. When patients were categorized into two groups based on the median driving pressure (Pdrive) of ≤15 cmH₂O or >15 cmH₂O during their invasive mechanical ventilation period, there was significantly better survival on day 28 in patients having a Pdrive ≤ 15 cmH₂O [28 days (95% CI = 19–28) vs 16 days (95% CI = 6–25), (log-rank p = 0.026).ConclusionCOVID-19 related acute respiratory distress syndrome (ARDS) seemed to have similar characteristics as other forms of ARDS. Lung protective ventilation with low plateau and driving pressures might be related to lower mortality.     

全面性围术期护理在高原地区口腔种植体植入术患者中的应用效果

目的 探讨全面性围术期护理在高原地区口腔种植术患者中的应用效果。 方法 选择青海省人民 医院2021年2月-2022年2月收治的100例高原地区口腔种植体植入术患者作为研究对象，随机分为对照组 和研究组，各50例。对照组给予常规围术期护理，研究组给予全面性围术期护理，比较两组手术成功率、 心理状态改善情况、不良事件发生情况及患者满意度。 结果 研究组干预后HAMD与HAMA评分低于对照 组，差异有统计学意义（P＜0.05）；研究组手术成功率为96.00%，高于对照组的72.00%，差异有统计学意 义（P＜0.05）；研究组不良事件发生率为2.00%，低于对照组的14.00%，差异有统计学意义（P＜0.05）； 研究组患者满意度为96.00%，高于对照组的78.00%，差异有统计学意义（P＜0.05）。 结论 全面性围术期 护理可有效改善口腔种植体植入术患者的心理状态，提高手术成功率及患者满意度，减少不良事件发生 率，在高原地区口腔种植体植入术患者中具有较高的应用价值。     

高原藏族COPD600例患者合并症的临床分析

【摘要】 目的 探讨高原藏族慢性阻塞性肺疾病（COPD）患者合并症的临床分布特点，为高原藏族COPD合并症的预防提供参考。方法 以2012年3月~2016年4月临床确诊的565例伴有合并症的高原藏族COPD患者作为研究对象，回顾性分析高原藏族COPD合并症的患病率、危险因素及发病机制。结果 高原藏族COPD患者的合并症类型主要包括CVD（心血管疾病）、代谢综合征、支气管扩张、感染、焦虑抑郁及支气管哮喘，以合并高血压比例最高为（333%），其次为CVD（包括肺心病及冠状动脉粥样硬化性心脏病、心律失常所致）为165%，糖尿病118%及代谢紊乱合并症97%，支气管扩张症63%。随着增龄，在不同性别中的发病比例无明显差异（P＞005）, 3个不同年龄段相比，高原藏族COPD合并高血压、CVD在60~80岁年龄段的患病比例最高（P＜005），而代谢综合征、支气管扩张和感染的患病比例在＞80岁年龄段的患病比例最高，差异有统计学意义（P＜005）。结论 在高原缺氧环境下,COPD可与多种疾病伴发，而在COPD低氧、炎症和氧化应激等作用下，进一步促进了CVD、尤其高血压的发生，也可能导致和加重代谢紊乱和糖尿病。因而，重视和研究这些疾病的相关机制对预防高原COPD合并症的发生、进展有重要的临床意义。     

Effects of orientation and distance of goats on blast lung injury characteristics on a plateau above 4500-meter

PurposeHigh explosives are used to produce blast waves to study their biological effects. The lungs are considered as the critical target organ in blast-effect studies. The degree of lung hemorrhaging is related to both the explosive power and the increased lung weight. We studied the characteristics of the biological effects from an air explosion of a thermobaric bomb in a high-altitude environment and the lethality and lung injury severity of goats in different orientations and distances.MethodsGoats were placed at 2.5, 3, 4, and 5 m from the explosion center and exposed them to an air blast at an altitude of 4700-meter. A group of them standing oriented to the right side and the other group seated facing the explosion center vertically. The lung injuries were quantified according to the percentage of surface area contused, and using the pathologic severity scale of lung blast injury (PSSLBI) to score the 4 injury categories (slight, moderate, serious and severe) as 1, 2, 3, and 4, respectively. The lung coefficient (lung weight [g]/body weight [kg]) was the indicator of pulmonary edema and was related to lung injury severity. Blast overpressure data were collected using blast test devices placed at matching locations to represent loadings to goats. All statistical analyses were performed using SPSS, version 26.0, statistical software (SPSS, Inc., Chicago, IL, USA).ResultsIn total, 127 goats were involved in this study. Right-side-standing goats had a significantly higher mortality rate than those seated vertical-facing (p < 0.05). At the 2.5 m distance, the goat mortality was nearly 100%, whereas at 5 m, all the goats survived. Lung injuries of the right-side-standing goats were 1 – 2 grades more serious than those of seated goats at the same distances, the scores of PSSLBI were significantly higher than the seated vertical-facing goats (p < 0.05). The lung coefficient of the right-side-standing goats were significantly higher than those of seated vertical-facing (p < 0.05). Mortality, PSSLBI, and the lung coefficient results indicated that the right-side-standing goats experienced severer injuries than the seated vertical-facing goats, and the injuries were lessened as the distance increased. The blast overpressure was consistent with these results.ConclusionThe main killing factors of the thermobaric bomb in the high-altitude environment were blast overpressure, blast wind propulsions and burn. The orientation and distances of the goats significantly affected the blast injury severity. These results may provide a research basis for diagnosing, treating and protecting against injuries from thermobaric explosions.     

助听器干预对西藏高原地区听障患者的疗效分析

目的 探讨助听器干预对久居(超过40年)西藏高原地区听障患者的疗效情况。方法 选取49例(63耳)助听器佩戴者进行分析，包括听力情况、听阈、助听器后言语及助听器效果国际问卷主观感受相关分析等，并对助听器补偿效果进行了综合评价。结果 63耳中，中度听力损失34耳，重度听力损失25耳，极重度听力损失4耳。其中单耳35例，问卷平均得分(20.34±4.39)分；双耳14例，问卷平均得分(27.07±4.16)分；双耳得分高于单耳分数。助听言语分辨率与问卷主观评估呈正相关(r=0.528,P<0.01)。助听阈值显示大多数患耳未得到最佳的听力补偿，但助听器干预前后听力比较具有统计学意义(P<0.05),高频听力补偿更为明显。助听后言语测听显示，助听后言语最大分辨率较助听前高(P<0.05)。结论 高原地区听障者对助听器的使用客观听力参数与主观评价相对一致，助听效果较为显著而且双耳验配较单耳验配更具优势，总体助听效果持肯定态度。