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PEEP impedes thoracic duct drainage (LF). This can be counteracted by a thoracic duct fistula. Consequently, lung oedema (LOE) should develop during PEEP more slowly with LF at atmospheric pressure (LFAP) than with LF against jugular venous pressure (LFJVP). In 12 anaesthetized dogs LOE was produced by Ringer's solution i.v. (2.5 ml/min per kg) for 6 h during PEEP (10 mmHg) with either LFAP or LFJVP. Ringer's+PEEP greatly increased aortic, pulmonary artery and wedge pressures, JVP, and cardiac output. Colloid osmotic pressures in plasma and lymph were drastically reduced, pulmonary effective filtration pressure (EFP) rose by about 20 mmHg. LFJVP increased 7-fold, LFAP about 19-fold, the respective loss of plasma proteins was 1.83 and 1.06 g/kg during 6 h. Thermal-dye extravascular lung water showed an increment of 68 with LFJVP versus 43 l/h/g per mmHg with LFAP. Final lung water content was at any EFP (12.8–31.9 mmHg) lower with LFAP than with LFJVP amounting 512 with LFJVP versus 377 l/g/per mmHg with LFAP. LFAP decreased the development of LOE during PEEP by bypassing the PEEP-induced high JVP and thus facilitating the removal of interstitial fluid. It is hypothesized that a thoracic duct fistula might aid the treatment of patients with LOE due to ARDS and therefore requiring high levels of PEEP. 相似文献
13.
Anthony Xiang Wei Hou Sina Rashidian Richard N Rosenthal Kayley Abell-Hart Xia Zhao Fusheng Wang 《JMIR Public Health and Surveillance》2021,7(4)
BackgroundOpioid overdose-related deaths have increased dramatically in recent years. Combating the opioid epidemic requires better understanding of the epidemiology of opioid poisoning (OP) and opioid use disorder (OUD).ObjectiveWe aimed to discover geospatial patterns in nonmedical opioid use and its correlations with demographic features related to despair and economic hardship, most notably the US presidential voting patterns in 2016 at census tract level in New York State.MethodsThis cross-sectional analysis used data from New York Statewide Planning and Research Cooperative System claims data and the presidential voting results of 2016 in New York State from the Harvard Election Data Archive. We included 63,958 patients who had at least one OUD diagnosis between 2010 and 2016 and 36,004 patients with at least one OP diagnosis between 2012 and 2016. Geospatial mappings were created to compare areas of New York in OUD rates and presidential voting patterns. A multiple regression model examines the extent that certain factors explain OUD rate variation.ResultsSeveral areas shared similar patterns of OUD rates and Republican vote: census tracts in western New York, central New York, and Suffolk County. The correlation between OUD rates and the Republican vote was .38 (P<.001). The regression model with census tract level of demographic and socioeconomic factors explains 30% of the variance in OUD rates, with disability and Republican vote as the most significant predictors.ConclusionsAt the census tract level, OUD rates were positively correlated with Republican support in the 2016 presidential election, disability, unemployment, and unmarried status. Socioeconomic and demographic despair-related features explain a large portion of the association between the Republican vote and OUD. Together, these findings underscore the importance of socioeconomic interventions in combating the opioid epidemic. 相似文献
14.
适当的呼气末正压(PEEP)是保护性肺通气策略的重要组成部分,PEEP可以保持肺泡开放,减少肺萎陷伤。尽管个体化PEEP已被越来越多的临床医师认可,但最佳的PEEP滴定方法尚存争议。电阻抗断层成像(EIT)是一种无创、无辐射的成像技术,可在床边实时动态评估肺功能,将肺通气过程中的阻抗变化以动态图像呈现,能够反映PEEP调整前后肺内通气及气体分布变化,因此,EIT可用于滴定个体化PEEP。本文简要概括EIT的基本原理及监测指标,阐述临床应用EIT指导下的PEEP(PEEPEIT)滴定方法,旨在加强对EIT的优点和局限性的理解,为优化个体化PEEP的设置提供参考。 相似文献
15.
Valrie Kouskoff Jean-Luc Vonesch Christophe Benoist Diane Mathis 《European journal of immunology》1995,25(1):54-58
The expression of recombination activating gene (RAG) products, responsible for T cell receptor (TcR) gene rearrangement, is shut off during positive selection of thymocytes. The precise stage at which this down-regulation occurs remains somewhat controversial. We have analyzed RAG-1 expression in thymocytes of TcR transgenic mice carried on selecting versus non-selecting genetic backgrounds, both by in situ hybridization on thymus sections and by polymerase chain reaction amplification of RNA from sorted cells. The data from several transgenic lines indicate that RAG expression is already reduced in immature, cortical, CD4+CD8+ cells in the presence of positively selecting major histocompatibility complex molecules, although complete shut-off is not achieved until the mature, medullary, single-positive stage. This finding has practical and theoretical significance for studies on the mechanism of positive selection. 相似文献
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Shono M Shono H Ito Y Muro M Maeda Y Sugimori H 《Psychiatry and clinical neurosciences》2000,54(3):307-308
A new periodogram was proposed using one-way analysis of variance (ANOVA), termed ANOVA periodogram, in order to reveal a precise significant periodicity. Thirty 3-day complex computer-simulated time series with known periodicity (24 h) and three 2-h data-missing occurring periodically (23 h, 20 min) were used to compare the ANOVA periodogram with Enright's one. In results, the ANOVA periodogram was superior to Enright's periodogram in the accuracy of assessing the major periodicity. 相似文献
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目的 通过对梅毒检测结果的分析,掌握出入境人员的梅毒感染情况,有针对性的进行梅毒的防治。方法 对24503名经天津口岸出入境的各类人员进行梅毒血清学检测,并对检测结果进行统计分析。结果 24503名出入境人员中共检出梅毒阳性39例,阳性率为1.59%o,分析发现各年份检出梅毒阳性率呈逐年递增的趋势,不同职业人群中船员的梅毒阳性率为2.01‰,远远高于其他人群的0.88‰。结论 出入境船员作为一个特殊人群,是梅毒感染的高危人群,需加强卫生保健意识,减少感染梅毒的机会,进一步说明梅毒血清学检测在国境口岸传染病监测中的重要性。 相似文献
20.
Ravi A Mallika A Sama V Begum AS Khan RS Reddy BM 《Journal of ethnopharmacology》2011,137(3):1353-1359