Interaction of an idealized cavopulmonary circulation with mechanical circulatory assist using an intravascular rotary blood pump

This study evaluated the performance of an intravascular, percutaneously-inserted, axial flow blood pump in an idealized total cavopulmonary connection (TCPC) model of a Fontan physiology. This blood pump, intended for placement in the inferior vena cava (IVC), is designed to augment pressure and blood flow from the IVC to the pulmonary circulation. Three different computational models were examined: (i) an idealized TCPC without a pump; (ii) an idealized TCPC with an impeller pump; and (iii) an idealized TCPC with an impeller and diffuser pump. Computational fluid dynamics analyses of these models were performed to assess the hydraulic performance of each model under varying physiologic conditions. Pressure-flow characteristics, fluid streamlines, energy augmentation calculations, and blood damage analyses were evaluated. Numerical predictions indicate that the pump with an impeller and diffuser blade set produces pressure generations of 1 to 16 mm Hg for rotational speeds of 2000 to 6000 rpm and flow rates of 1 to 4 L/min. In contrast, for the same flow range, the model with the impeller only in the IVC demonstrated pressure generations of 1 to 9 mm Hg at rotational speeds of 10,000 to 12,000 rpm. Influence of blood viscosity was found to be insignificant at low rotational speeds with minimal performance deviation at higher rotational speeds. Results from the blood damage index analyses indicate a low probability for damage with maximum damage index levels less than 1% and maximum fluid residence times below 0.6 s. The numerical predictions further indicated successful energy augmentation of the TCPC with a pump in the IVC. These results support the continued design and development of this cavopulmonary assist device.     

A home‐based progressive resistance exercise programme for patients with venous leg ulcers: a feasibility study

This study aimed to assess the feasibility of a home‐based exercise programme and examine the effects on the healing rates of venous leg ulcers. A 12‐week randomised controlled trial was conducted investigating the effects of an exercise intervention compared to a usual care group. Participants in both groups (n = 13) had active venous ulceration and were treated in a metropolitan hospital outpatients clinic in Australia. Data were collected on recruitment from medical records, clinical assessment and questionnaires. Follow‐up data on progress in healing and treatments were collected fortnightly for 12 weeks. Calf muscle pump function data were collected at baseline and 12 weeks from recruitment. Range of ankle motion data were collected at baseline, 6 and 12 weeks from recruitment. This pilot study indicated that the intervention was feasible. Clinical significance was observed in the intervention group with a 32% greater decrease in ulcer size (P = 0·34) than the usual care group, and a 10% (P = 0·74) improvement in the number of participants healed in the intervention group compared to the usual care group. Significant differences between groups over time were observed in calf muscle pump function parameters [ejection fraction (P = 0·05), residual volume fraction (P = 0·04)] and range of ankle motion (P = 0·01). This pilot study is one of the first to examine and measure clinical healing rates for participants involved in a home‐based progressive resistance exercise programme. Further research is warranted with a larger multi‐site study.     

Is Venous Foot Pump Effective In Prevention of Thromboembolic Disease After Joint Arthroplasty: A Meta-Analysis

The goal of this meta-analysis was to evaluate the efficacy of venous foot pumps in prevention of venous thromboembolism following joint arthroplasty. Using different databases, we found 13 prospective clinical trials published meeting our inclusion criteria. In total, 1514 patients were included in the final analysis. Venous foot pump devices are effective in prevention of venous thromboembolic disease after total hip and knee arthroplasty compared to chemoprophylaxis. This was especially significant in prevention of major deep vein thrombosis and pulmonary emboli rate. The use of mechanical devices like venous calf or foot pump, either alone or in combination with less potent chemical prophylaxis, on the other hand can reduce the rate of venous thromboembolism and complications of potent chemoprophylaxis like wound hematoma.     

CYP2C19基因多态性对质子泵抑制剂治疗胃食管反流病疗效影响的Meta分析

目的：系统评价药物代谢酶CYP2C19基因多态性与质子泵抑制剂治疗胃食管反流病疗效的关系,以期为临床治疗提供循证参考。方法检索PubMed、Embase、CBM、CNKI、WanFang data、CQVIP等数据库,收集CYP2C19基因多态性与质子泵抑制剂治疗胃食管反流病的临床文献。根据纳入和排除标准筛选文献、评价和提取数据后,采用RevMan 5.3软件进行Meta分析。结果共纳入4篇文献,包含347例对象。 Meta分析结果显示：CYP2C19强代谢型（EM）、中间代谢型（IM）与弱代谢型（PM）的胃食管反流病治愈率不存在统计学差异。结论 CYP2C19基因多态性不影响质子泵抑制剂对胃食管反流病的治愈率。     

输注设备准确性自动测试系统的设计与研究

根据国家标准GB9706.27-2005中的规定,使用天平对注射泵和输液泵工作数据的准确性进行测试。采用称重法测量输注设备的准确性,通过对数据的获取与处理,生成喇叭曲线,计算百分比误差A和B。目前,国内外尚没有自动化程度较高的产品,本研究拟利用一台PC电脑和多串口卡,使用Python编程开发工具,可同时对多台天平进行实时的数据获取、存储、显示、处理及结果判定,最后一键打印原始记录,实现闭环式检测过程。     

埃索美拉唑与奥美拉唑治疗十二指肠溃疡疗效比较

目的：评估埃索美拉唑治疗十二指肠溃疡（duodenal ulcer,DU）的临床疗效和安全性。方法70例DU患者,分别用埃索美拉唑片剂40 mg,qd和奥美拉唑胶囊40 mg,qd进行治疗,胃镜观察溃疡愈合程度。结果4周后埃索美拉唑组和奥美拉唑组溃疡愈合率分别为91.4%和88.6%,总有效率分别为97.1%和94.2%。但埃索美拉唑比奥美拉唑缓解DU疼痛更为快速,埃索美拉唑组1 d内的疼痛消失率为42.9%,而奥美拉唑组为14.3%。结论埃索美拉唑治疗DU具有较好的疗效,且无明显不良反应,值得临床推广。     

微量注射泵常见故障及对应解决方案

目的:通过分析史密斯微量注射泵的典型故障,探讨对应解决方案。方法:统计广东省妇幼保健院450台史密斯注射泵故障情况,分析其中3个典型故障,探讨快速维修方法。结果:史密斯注射泵常见故障主要集中在药液不注故障、断电故障和药液残留故障,发生率约占报警故障总量78%。结论:掌握微量注射泵的典型故障可快速修复婴儿辐射保暖台,减少维修费用的支出,更能保障患者得到安全、有效的治疗。     

三七总皂甙改善高血压病左室舒张功能的临床与实验研究

目的；研究三七总皂甙对高血压病左室舒张功能的影响及其可能机理。方法：测定３０例Ｉ期ＥＨ患者联合运用ＴＳＰＮＳ和开搏通治疗前后的左室舒张功能（Ｅ峰、Ａ峰、Ｅ／Ａ、Ｅ面积分数、Ａ面积分数）、左室心肌重量指数（ＬＶＭＩ）、红细胞内Ｃａ＾２＋及其膜上Ｃａ泵活性；并以单用开搏通治疗为自身对照。同时通过对ＴＳＰＮＳ及生理盐水治疗ＳＨＲ大鼠的疗效的对比研究，以月龄相仿的ＷＫＹ大鼠为正常对照。同时通过对ＴＳＰＮＳ     

自制益智方渗透泵片的体外释放度考察

目的:考察激光打孔的孔径与释放条件对自制益智方渗透泵片体外释放的影响。方法:处方量主药与辅料混合均匀,70%乙醇制粒、压片、包衣,衣膜增重7%,熟化,激光打孔器双面打孔,制备孔径为0.2、0.4、0.6、0.8、1.0mm激光打孔片剂。考察不同测定方法(转篮法、桨法)、不同孔径、不同转速、不同渗透压条件下释放度,并比较4种有效成分(人参皂苷Rg1、人参皂苷Rb1、人参皂苷R1、桅子苷)释放度,探索其释放规律。结果:转篮法测定该渗透泵片,释放度重复性较好;激光打孔孔径为0.2-0.6mm时,近恒速释放;在50r/min转速条件下,0.4mm孔径片中4种成分12h累积释放度均达到了85%以上;释药度随着释放介质渗透压的升高而减少;4种检测成分间释放度相似因子均大于50;0.4mm孔径,转篮法50r/min条件下,10h释放较符合零级释放方程y=9.1034t+4.5482(r=0.9915)。结论:转篮法适于测定益智渗透泵片的释放度,激光打孔孔径对释放度有一定影响,衣膜内外渗透压是片剂释放动力,4种有效成分释放度相似,该制剂的释放符合零级释放方程。     

Role of disturbance of ependymal ciliary movement in development of hydrocephalus in rats

We have developed a new in vitro method of quantitatively analyzing ciliary movement in the ependymal wall of the aqueduct in rats. An axial slice of the midbrain containing ependymal wall was placed in a culture dish filled with a culture medium containing latex beads 1 m in diameter at a concentration of 10⁷ beads/ml. The movement of the beads caused by flow of culture medium generated by the to-and-fro ciliary movement was recorded by a high speed video system attached to an inverted phase-contrast microscope. Ciliary movement was expressed by the speed of the latex beads (m/s). Aqueductal ciliary movement in congenitally hydrocephalic HTX rats, congenitally hydrocephalic WIC-Hyd rats, and other normal rats was evaluated. The results suggest that in congenitally hydrocephalic WIC-Hyd rats the degree of hydrocephalus related strongly to the degree of ciliary dyskinesia, but in congenitally hydrocephalic HTX rats it did not. Considering this discrepancy, we attempted to see whether or not hydrocephalus was caused by artificial disturbance of ependymal ciliary movement in vivo. We found that continuous infusion of metavana date, an inhibitor of ciliary movement, into the III ventricle of normal Sprague-Dawley rats for 7 days induced dilatation of the ventricular system. Although the question whether or not disturbance of aqueductal ependymal ciliary movement is related to the development of human congenital hydrocephalus is debatable, the results of the present in vitro and in vivo experimental investigations appear to suggest that the disturbance of ciliary movement in the aqueduct could at least be one of the factors contributing to the inducement of hydrocephalus in experimental conditions.