Validation of esophageal pressure occlusion test after paralysis

Measurements of respiratory mechanics are frequently made in ventilated infants and children. Esophageal pressure measurements (P_es using a balloon on a catheter have been used to partition the respiratory mechanics into lung and chest wall components. Appropriate positioning of this balloon is crucial to obtain accurate estimates of pleural pressure. Traditionally, in spontaneously breathing subjects the balloon position is assessed with an occlusion test. In ventilated subjects, it is not always possible to perform an occlusion test prior to paralysis, and even if such a test is performed it may not be relevant under conditions of positive pressure ventilation. We have assessed a positive pressure occlusion test that is suitable for paralyzed subjects. By occluding the airway opening and applying gentle pressure to the abdomen or rib cage, positive swings in pressure can be measured by both P_es and airway opening pressure (P_ao). We compared traditional occlusion tests measured in 16 spontaneously breathing puppies to the positive pressure occlusion test performed after paralysis. In 2 pups we were unable to obtain a reasonable traditional occlusion test (>15% difference between P_es and P_ao) but we obtained 10 traditional occlusion tests in each of the remaining 14 pups (2.1–14 kg). In 11 of these animals Ape, was within 10% of P_ao. This compared well to positive pressure occlusion test using abdominal pressure performed after paralysis, where Apes was within 10% of ΔP_ao in 10 animals. In 9 of these pups occlusion tests were also performed by applying pressure on the rib cage, where ΔP_es was within 10% of ΔP_ao in 6 animals. These results suggest that it is possible to perform accurate occlusion tests in paralyzed subjects by abdominal or rib cage compression with the airway occluded. Pediatr Pulmonol. 1994; 17:56–62. © 1994 Wiley-Liss, Inc.     

联合断流术治疗食管静脉曲张出血的临床研究及远期疗效观察

自1981年1月以来,行联合断流术治疗门脉高压症食管静脉曲张出血102例,手术死亡率为6.9%。随访1～8年的生存率为85.7%,食管静脉曲张减轻或消失者为90%,未发现肝性脑病症状。远期死亡9例(14.3%),再出血4例(6.3%)。资料表明,这种手术既阻断了胃外又阻断了胃壁内的门-奇静脉交通血流,止血效果肯定而持久。由于未降低门静脉压力,故有利于维持肝脏的血流灌注。肝功能状况是决定治疗效果的主要因素。文章提出了选择手术适应证的条件。     

食管癌切除术并发胸导管损伤的早期诊断及治疗

我院1990年至1993年共施行食管癌切除术160例，术中胸导管损伤5例，发生率为2．1％，5例中3例于术中发现并及时处理，未发生乳糜胸，另2例于术后并发乳糜胸才诊断，经早期剖胸手术治愈,本文介绍了食管癌切除术并发胸导管损伤的早期诊治体会。     

Lähmung des N. hypoglossus nach operativem Eingriff – Behandlung mit Akupunktur

Acupuncture is able to accelerate the process of healing significantly when employed in cases of nerve paresis as shown in the following analysis. The patient's constant condition of speech and swallowing impediment before treatment changed relatively fast after starting acupuncture treatment. It is self evident that we took into account the primary disease (AIDS) and its problems. The simplicity of a complementary treatment with acupuncture according to the possible results should make us consider the use of acupuncture as an important way to treat paresis in the early subacute phase and if possible during clinical stay.     

食管癌3p24等位基因LOH及其扩增产物克隆的研究

目的；研究3p24EAβMD位点与食管癌的关系。为寻找该位点附近可能存在的抑癌基因奠定基础。方法：采用PCR—RFLP法检测45例食管癌患者3p24位点杂合缺失情况。并对该片段进行克隆。结果：在22例食管癌信息个体中共检出9例杂合缺失。并通过序列分析可知变化为点突变。结论：3p24EAβMD较高的杂合缺失率显示该位点附近可能存在潜在的抑癌基因。     

交链孢酚单甲醚在大鼠小鼠体内的分布

对食管癌高发区粮食中分离的互隔交链孢霉的毒素交链孢酚单甲醚(AME)在大鼠、小鼠体内的分布进行研究。给动物腹腔内注射氚标记的交链孢酚单甲醚(~3H-AME),然后在不同时间测各脏器的放射性。结果表明:在所测9个脏器中,2h肝脏含量最高,食管下段在大小鼠分别居第四和第三。但大小鼠分别在72、24h则以食管下段最高,说明AME及其代谢物在此清除较慢,即对其有较高的亲和力。     

新疆食管癌的分布

我们回顾调查了1974～1976年新疆恶性肿瘤死亡情况,发现新疆居民食管癌死亡病例最小年龄出现在15岁年龄组,男女性比值为1.2。食管癌的民族分布特点是,哈萨克族居民最高,调整死亡率达68.88/10万,其他民族依次为蒙古、维吾尔、汉、柯尔克孜和塔吉克族。塔吉克族的食管癌调整死亡率仅为5.13/10万,食管癌地区分布特点是北疆高于南疆,最高的是北疆托里县,其食管癌调整死亡率达90.75/10万,最低的是南疆于田县,仅2.07/10万。     

Fibrovascular polyp of the esophagus requiring esophagectomy

Fibrovascular polyps of the esophagus are rare, with only 110 cases reported in the world literature to date. Dysphagia is the most common symptom. The diagnosis is usually made by barium swallow or upper endoscopy, but almost a third of cases can be missed with these studies. Treatment is surgical. Only four cases in the literature underwent esophagectomy for removal. We present a female patient with a fibrovascular polyp of the esophagus who required a transhiatal esophagectomy to safely remove this mass.     

自发性食管破裂的护理

目的 总结自发性食管破裂患者的护理措施，提高护理水平。方法 在保守及手术治疗的同时，严密观察病情变化，做好心理护理，加强呼吸道、消化道及各种管道的护理。结果 7例患者治愈出院。结论 精心的专业化护理在治疗自发性食管破裂中起重要作用。