早期血乳酸水平检测在重症肺炎患者中的临床意义

目的：探讨早期血乳酸水平检测在重症肺炎患者中的临床意义。方法选取本院2011年5月~2014年5月收治的100例重症肺炎患者作为研究对象,根据存活或死亡分为观察组(生存患者)和对照组(死亡患者)。比较两组入院时、入院后6h、入院后24h的血乳酸水平及入院6h的乳酸清除率,记录不同乳酸清除率水平患者的死亡率。结果观察组入院时、入院6 h和入院24 h的血乳酸水平显著低于同期对照组,差异有统计学意义(P<0.05)。观察组入院6 h的乳酸清除率显著高于对照组,差异有统计学意义(P<0.05)。高乳酸清除率患者的死亡率显著低于低乳酸清除率患者,差异有统计学意义(P<0.05)。结论检测重症肺炎患者的血乳酸水平有助于了解患者的预后,血乳酸清除率低的患者死亡率高。     

Experimental Study on Optimization of Phosphogypsum Suspension Decomposition Conditions under Double Catalysis

Phosphogypsum (PG) is not only a solid waste discharged from the phosphate fertilizer industry, but also a valuable resource. After high-temperature heat treatment, it can be decomposed into SO₂ and CaO; the former can be used to produce sulfuric acid, and the latter can be used as building materials. In this paper, the catalytic thermal decomposition conditions of phosphogypsum were optimized, and the effects of the reaction temperature, reaction atmosphere, reaction time and carbon powder content on the decomposition of phosphogypsum were studied. The research shows that the synergistic effect of carbon powder and CO reducing atmosphere can effectively reduce the decomposition temperature of phosphogypsum. According to the results of the orthogonal test under simulated suspended laboratory conditions, the factors affecting the decomposition rate of phosphogypsum are temperature, time, atmosphere and carbon powder content in turn, and the factors affecting the desulfurization rate are time, temperature, atmosphere and carbon powder content in turn. Under laboratory conditions, the highest decomposition rate and desulfurization rate of phosphogypsum are 97.73% and 97.2%, and the corresponding reaction conditions are as follows: calcination temperature is 1180 °C, calcination time is 15 min, carbon powder content is 4%, and CO concentration is 6%. The results of thermal analysis of phosphogypsum at different temperature rising rates show that the higher the temperature rising rate, the higher the initial temperature of decomposition reaction and the temperature of maximum thermal decomposition rate, but the increase in the temperature rising rate will not reduce the decomposition rate of phosphogypsum.     

The blood pressure and heart rate during sauna bath correspond to cardiac responses during submaximal dynamic exercise

ObjectivesIn the present study, the reaction of blood pressure and heart rate are examined during and after a single acute sauna application.DesignIn 19 healthy adult volunteers (7 women, aged 46.4±10.2 years, BMI 24.4±2 kg /m²), blood pressure (BP) and heart rate (HR) were measured during a 25-minute sauna session (93°C, 13 % humidity) and during a subsequent 30-minute rest period. The parameters obtained were compared with the BP and HR responses during submaximal dynamic exercise testing.ResultsThe heat exposure resulted in a significant (p<0.01) and progressive increase in systolic and diastolic BP. After the sauna bath, BP decreased and showed significantly (p<0.001) lower values compared to baseline. HR also increased continuously during heat application (p<0.001), resulting in a significant increase (p<0.001) in systolic BP x HR as a measure of myocardial oxygen consumption. After the end of the sauna session, both the BP and the HR decreased steadily (p<0.001).When comparing BP and HR during the sauna session with the reaction during a dynamic exercise test, sauna bathing was equivalent to an exercise load of about 60-100 watts.ConclusionsContrary to popular belief, acute sauna use does not lead to a reduction, but to an increase in BP and HR with a consequent increase in myocardial oxygen consumption. The cardiac load during the sauna use corresponds to a moderate physical load of 60-100 watts.     

Do Ratings of Swallowing Function Differ by Videofluoroscopic Rate? An Exploratory Analysis in Patients After Acute Stroke

ObjectiveTo determine differences between continuous videofluoroscopic swallow studies (VFSS) with a pulse rate and frame rate of 30 and the same swallows reduced to 15 frames per second (fps) on measures of swallowing function in patients after acute ischemic stroke.DesignBlinded comparison.SettingAcute hospital.ParticipantsPatients after ischemic stroke (N=20).InterventionsNot applicable.Main Outcome MeasuresSingle and sequential sips of thin liquids, single sips of nectar liquids, pudding, and cookie boluses were rated on measures of timing of swallowing events, Modified Barium Swallowing Impairment Profile component scores, and Penetration-Aspiration Scale scores. The ratings for videos at 15 fps and 30 fps were compared by Wilcoxon signed rank tests.ResultsPharyngeal transit time was longer and bolus entry into the hypopharynx was later for 30 fps than for 15 fps. Components of Oral Residue and Pharyngoesophageal Segment Opening ratings were more severe for 15 fps than 30 fps, whereas Bolus Transport and Initiation of Pharyngeal Swallow were rated as more severe for 30 fps than for 15 fps. There was no difference between 30 fps and 15 fps on the remaining measures, including Penetration-Aspiration Scale scores.ConclusionContinuous VFSS recorded at 30 fps and their down-sampled 15 fps duplicates yielded contrasting results on certain durational and functional measures of swallowing, though not on others. VFSS should be administered continuously or at 30 pulses per second for valid assessment of swallowing while using other methods to reduce radiation exposure.