Continuous recording of urethral activity in healthy female volunteers

The pressure variations at the maximal urethral closure pressure (MUCP) were continuously recorded in healthy female volunteers by means of a two-point microtip transducer catheter for one hour. Before the investigation a normal voiding was assured objectively and bladder instability was excluded. All women showed pressure variations both at the MUCP and more distally. The pressure variations, from 3 to 66 cm H₂O, showed rhythmicity and three frequency ranges could be identified. Slow pressure waves with a frequency of one in eight to 19 minutes were observed. Relatively fast-pressure waves were observed (one every one to four minutes) and relatively fast-frequency pressure waves were observed (rate: one to eight per minute). The pressure variations of the urethra seem to be an aspect of normal urethral physiology possibly contributing to continence and urinary tract infection prevention.     

兔孤束核区微量注射γ-氨基丁酸的降压效应

在53只乌拉坦麻醉家兔身上,观察到延髓孤束核(NTS)区注射γ-氨基丁酸(GABA)使血压显著下降,安定(DZ)有相似的降压效应,荷包牡丹碱(BIC)和印防己毒素(PIC)则使血压升高;促甲状腺素释放激素(TRH)和甲硫脑啡肽(MTP)对血压无明显影响;延髓的另一些区域应用GABA等药物后血压变化不明显;提示GABA能神经递质系统参与心血管活动的抑制性中枢调节,NTS区是其作用部位之一。     

Significance of beaten copper appearance on skull radiographs in children with isolated sagittal synostosis

Aims and Objectives The significance of beaten copper appearance (BCA) on skull radiographs in children following surgery for isolated sagittal craniosynostosis has not been studied. This study was designed to look for any correlation between BCA and symptoms suggestive of intracranial hypertension in this group of patients. Materials and Methods Forty-eight consecutive children, who were operated for isolated sagittal synostosis from1987 to 2000 and had postoperative skull radiographs, were included. Patients were divided into: (a) BCA group (n = 20), consisting of children who had beaten copper appearance on skull radiographs at last follow up, and (b) Non-BCA group (n = 28), consisting of children who did not have this finding. Records were reviewed to look for symptoms suggestive of intracranial hypertension, such as headache, head banging, and irritability. Results Median age at surgery was 4.8 months for BCA group and 4 months for the non-BCA group. Follow up ranged from 4 to 156 months with a mean of 36.2 months. Total of 28.6% (n = 6) of the children with follow up radiographs done at ≤18 months of age had BCA. The incidence of BCA increased to 83.3% in children with skull radiographs performed after 48 months of age. In 18 (90%) children, the BCA was ‘diffuse’ with 5 (25%) children having the maximum possible score of 8. In the BCA group, 45% (n = 9) had symptoms compared to 10.7% (n = 3) in the control group (p = 0.0068). Conclusions This study suggests a significant number of children with BCA on radiographs develop symptoms suggestive of raised ICP following surgical treatment in infancy and prolonged follow up may be warranted in this group of patients.     

非控制性出血休克大鼠早期低压液体复苏的理想复苏压力研究

目的利用大鼠非控制性出血休克模型,探讨早期低压复苏的理想复苏压力。方法W istar大鼠64只,基础平均动脉血压(MAP)为(129.9±14.3)mmHg,断脾法复制非控制性出血休克模型,将血压(MAP)降至40或50mmHg,分为3个处理时段,第1时段模拟院前救治时段,用2∶1乳酸林格氏液和6%的右旋糖酐输注分别将MAP维持在40、50、60、70、80、100mmHg,维持1小时;第2时段模拟医院确定性处理情况,结扎脾动脉止血,输血输液将MAP恢复至100mmHg,维持2小时;第3时段,观察第1时段不同压力复苏对大鼠休克复苏效果的影响。观察指标包括动物存活情况、血压、液体输注量、血细胞比容及动脉血气等。结果院前急救采用高压复苏(80、100mmHg),动物存活时间短,在第1时段末就有50%的动物死亡,需要的液体输注量大,血液稀释严重,代谢性酸中毒明显,血气指标差;而以<70mmHg(50、60、70mmHg)的血压复苏,动物存活时间延长,液体输注量小,血液稀释轻,血气指标正常或接近正常;以50、60mmHg血压输注效果最好,但太低的输注压力(40mmHg)也不利于休克复苏,在第三时段末动物死亡率为75%。结论对非控制性出血休克及活动性出血,止血前采用高压复苏会增加血液丢失及血液稀释,明显影响休克复苏效果,适当低压复苏有利于动物的后期恢复,输注压力以50、60mmHg最好,但太低的输注压力(40mmHg)也不利于休克复苏。     

常用生理参数的测量原理

随着医学事业的发展,监护仪得到广泛的运用,就医用监护仪常用生理参数的工作原理简述如下。     

脑梗死急性期降压治疗对预后的影响

目的 研究脑梗死急性期降压及在不同时间进行降压治疗对患者近期预后的影响.方法 据发病后是否降压及进行降压的时间,将198例急性脑梗死患者分为6组,观察各组患者神经功能缺损程度及心脑血管事件的再发生率和病死率.结果 在发病后进行降压治疗的患者中其心脑血管事件再发率和病死率明显低于未降压组（P＜0.01） 3d后降压组患者神经功能恢复的程度明显好于未降压组（P＜0.01）.结论 降压治疗可以降低患者心脑血管事件的发生率和病死率3d后进行降压治疗的患者神经功能恢复明显要好.     

抑郁患者血清皮质醇与血压在应激前后的变化

目的研究抑郁患者血清皮质醇浓度、血压在应激前后的变化以及它们之间的关系。方法分别在安静状态、心理应激状态和心理应激后 (恢复状态 )测量抑郁组和对照组的血清皮质醇浓度、血压 ,比较两组上述指标的差异 ,以及心理应激前后的变化。心理应激以规定时间内的计算试验模拟 ,血清皮质醇以酶联免疫试验检测 ,血压为常规检测。结果 1.皮质醇 :抑郁组在安静状态、应激状态、恢复状态的皮质醇浓度显著高于对照组 (P <0 .0 5 ) ,抑郁组应激前后皮质醇浓度的波动显著小于对照组 (P <0 .0 5 )。2 .收缩压 :安静状态和恢复状态时抑郁组的收缩压显著高于对照组 (P <0 .0 5 ) ,应激状态时两组无统计学差异 ;应激前后收缩压的波动两组无统计学差异。 3 .舒张压 :抑郁组在安静状态时舒张压显著高于对照组(P <0 .0 5 ) ,在应激状态和恢复状态时两组无统计学差异 ;应激前后舒张压的波动两组无统计学差异。结论抑郁患者存在基础血压升高 ,此现象可能与抑郁患者血清皮质醇浓度升高有关。     

Measurement of nonlinear property of artery wall using remote cyclic actuation

Purpose For tissue characterization of the arterial wall, we developed a “phased tracking” method to measure the strain (change in wall thickness) and elasticity of the arterial wall. To improve the accuracy of tissue characterization, we are now attempting to measure other mechanical properties in addition to elasticity. Methods In this study, the change in elasticity during the cardiac diastole was measured with ultrasound by generating a change in internal pressure using remote cyclic actuation. Results From the measured change in elasticity during cardiac diastole, the nonlinear property in the stress–strain relationship of the artery wall was estimated. In basic experiments using a silicone rubber tube and in vivo experiments in human carotid arteries. Conclusion The proposal method enables the noninvasive measurement of the nonlinear mechanical property in addition to the elasticity of the arterial wall.     

输尿管镜气压弹道碎石治疗输尿管结石(附108例报告)

目的探讨输尿管镜气压道弹碎石术治疗输尿管结石的临床疗效.方法在输尿管镜窥视下采用气压弹道碎石机对108例输尿管结石进行治疗.结果 103例原位碎石成功,总成功率95.3%,其中输尿管上段结石成功率为83.3%,中段结石为96.3%,下段结石为98.4%.平均碎石时间(4.5±2.2)min,术后1～3个月结石排净率100%.结论输尿管镜气压弹道碎石术治疗输尿管结石具有安全、有效、容易操作等特点,是治疗输尿管结石的首选方法.