Hypothermia for newborns with hypoxic ischemic encephalopathy

Hypoxic ischemic encephalopathy (HIE) remains a significant cause of mortality and long-term disability in late preterm and term infants. Mild therapeutic hypothermia to a rectal temperature of 34±0.5°C initiated as soon as possible within the first 6 h of life decreases mortality and severe long-term neurodevelopmental disabilities in infants with moderate HIE who are ≥36 weeks’ gestational age. There are minimal side effects, and the incidence of disability in survivors is not increased. Infants with severe encephalopathy are less likely to benefit from treatment. Cooling may be achieved by either total body or selective head cooling. As cooling is now considered a standard of care, infants ≥36 weeks’ gestational age who are depressed at birth should be assessed to determine whether they meet the criteria for cooling. There is currently no evidence that therapeutic hypothermia offers any benefit to infants <36 weeks’ gestational age.     

Comparison of cooling and EMLA to reduce the burning pain during capsaicin 8% patch application: A randomized,double-blind,placebo-controlled study

Topical capsaicin 8% was developed for the treatment of peripheral neuropathic pain. The pain reduction is associated with a reversible reduction of epidermal nerve fiber density (ENFD). During its application, topical capsaicin 8% provokes distinct pain. In a randomized, double-blind study analyzed with a block factorial analysis of variance, we tested whether cooling the skin would result in reliable prevention of the application pain without inhibiting reduction of ENFD. A capsaicin 8% patch was cut into 4 quarters and 2 each were applied for 1 hour on the anterior thighs of 12 healthy volunteers. A randomization scheme provided for 1 of the application sites of each thigh to be pretreated with EMLA and the other with placebo, whereas both application sites of 1 thigh, also randomly selected, were cooled by cool packs, resulting in a site temperature of 20°C during the entire treatment period. The maximum pain level given for the cooled sites (visual analogue scale [VAS] 1.3 ± 1.4) proved to be significantly lower than for the non-cooled sites (VAS 7.5 ± 1.9) (P < .0001). In contrast, there was no significant difference in application pain between the sites pretreated with EMLA or with placebo (VAS 4.1 ± 3.6 vs 4.8 ± 3.5, P = .1084). At all application sites, ENFD was significantly reduced by 8.0 ± 2.8 (ENF/mm ± SD, P < .0001), that is, 70%, with no significant differences between the sites with the different experimental conditions. In conclusion, cooling the skin to 20°C reliably prevents the pain from capsaicin 8% patch application, whereas EMLA does not. ENFD reduction is not inhibited by cooling.     

Effects of cooling and clothing on vertical trajectories of the upper arm and muscle functions during repetitive light work

The present study was designed to find out if cooling and/or clothing affect the vertical trajectories and muscle function of the upper arm during repetitive light work. Twelve female subjects performed a one-handed lifting task for 60 min while standing in front of a table with six target angles (30 degrees to 220 degrees ). The experiment was carried out in a climatic chamber in three different conditions: at 10 degrees C (C), at 25 degrees C (TN), and at 10 degrees C dressed in cold-protective clothing (C(p)). Skin and rectal temperatures were measured continuously. The vertical trajectories of the head, shoulder, elbow, and wrist on the right side of the body were recorded. Muscular strain (averaged EMG, a-EMG) and EMG gaps in eight muscles on the right upper arm were measured. The variation of the vertical trajectory amplitude of the upper arm measured from the elbow was significantly higher (at 200 degrees ) both at C and C(p) (50 and 25% respectively) and in shoulder (at 220 degrees angle) at C (33%) compared with TN (P < 0.05). Both C and C(p) increased a-EMG and reduced the number and duration of EMG gaps significantly in all muscles studied. In conclusion, in repetitive tasks the high mean vertical trajectory and changes in the amplitude of the trajectory of the upper arm at C and C(p) compared with TN were associated with increased muscular strain and reduced number of EMG gaps (more continuous activation of given muscle fibers). The changes in trajectories may serve as indicator of a risk for local muscle fatigue.     

Self-paced exercise performance in the heat with neck cooling,menthol application,and abdominal cooling

Objectives

To investigate whether the exercise performance benefits with neck cooling in the heat are attributable to neck-specific cooling, general body cooling, a cooler site-specific thermal perception or a combination of the above.

小儿高热惊厥的诊治分析

目的探讨小儿高热惊厥的诊治方法和临床效果。方法选取2007年6月至2008年11月收治的60例小儿高热惊厥患者的临床资料进行回顾性分析,该组患儿主要采用药物、物理降温的治疗方法。结果采用降温方法和药物治疗,小儿的高热体温在1h内能够缓解或降至正常,达到了控制体温的目的,无不良反应出现。结论对于小儿高热惊厥的早期诊断、及时防治、科学护理能够减少患儿后遗症的发生,提高生活质量。     

注射用丹参无菌粉末冷冻干燥工艺研究

目的:优化注射用丹参无菌粉末的冷冻干燥工艺,缩短冻干时间。方法:采用单因素试验,对降温方式、药液装量、浓度、预冻时间、压力、升华干燥温度、升华干燥时间、解析干燥温度等参数进行优化,确定最佳冷冻干燥工艺参数。结果:选择浓度为100mg.mL-1,装量为3.480mL,采用阶段性降温方式,预冻时间为120min,压力为5Pa,解析干燥温度为35℃,冷冻干燥总时间为36h。结论:最优参数下产品性状良好,冷冻干燥时间约缩短15h。     

Computer simulations on multiprobe freezing of irregularly shaped tumors

Cryosurgery is particularly suitable for the treatment of unresectable liver tumors. However, a major bottleneck is encountered during the treatment of large-sized irregularly shaped tumors. Large and complex liver tumors have varying degree of shape irregularity. Adopting a multiprobe freezing model, simulations for an irregularly shaped liver tumor were conducted. The model, validated with both in-vitro data from an experimental setup, showed good agreement of up to 5.8%. The chosen mathematical treatment and simulation technique permit the study of employing multiple cryoprobes to destroy cancer cells in irregularly shaped tumors. Results from our study indicated that multiple cryoprobes can be strategically positioned to form ice-fronts with various contours that adhere to the shape and size of the tumor. The amount of cell-deaths within the tumor after the −50 °C ice-front can be quantitatively calculated to determine the efficacy of different multiprobe arrangements in order to maximize cell destruction. The paper also underlines a piecewise approach of using several cryoprobes to quickly ‘sculpt’ the desired shape of the ice-front based on the physical morphology of an irregular-shaped tumor. This numerical study forms an essential framework in allowing surgeons to make informed decisions on the most effective surgical protocol based on the degree of irregularity in shape and size of tumor.     

凉血化瘀燥湿方配合针刺治疗急性湿疹61例临床观察

目的:观察凉血化瘀燥湿方配合针刺治疗急性湿疹的临床疗效。方法:将符合选择标准的急性湿疹患者随机分为治疗组和对照组各61例,治疗组给予凉血化瘀燥湿方龙蛇六一煎口服、外洗;针刺双侧曲池、血海,若腑行不畅,大便干结者,加刺双侧支沟、照海;对照组给予常规抗过敏治疗及局部皮炎平外涂。两组疗程均为7d。结果:治疗组能显著降低证候积分,缓解症状,对急性湿疹治疗的有效率为95.1%,均明显优于常规对照组(P0.05或P0.01)。结论:凉血化瘀燥湿方配合针刺治疗急性湿疹具有良好疗效,且简便易行,适宜在广大基层医院使用。     

Pathological changes in the lung and brain of mice during heat stress and cooling treatment

BACKGROUND:

Heatstroke often leads to multiple organ dysfunction syndrome (MODS) with a death rate of 40% or a neurological morbidity of 30%. These high rates in patients with heatstroke are largely due to the progression of heat stress to MODS, resulting in no specific treatment available. This study aimed to develop a mouse model of heat stress and determine the pathological changes in the lung and brain during heat stress and cooling treatment.

METHODS:

A mouse model of heat stress was established in a pre-warmed incubator set at 35.5 ± 0.5°C and with a relative humidity of 60% ± 5%. Rectal temperature was monitored, and at a temperature of 39 °C, 40 °C, 41 °C, or 42 °C, the mice were sacrificed. The remaining animals were removed from the incubator and cooled at an ambient temperature of 25 ± 0.5 °C and a humidity of 35% ± 5% for 12 or 24 hours at a temperature of 41 °C or for 6 hours at a temperature of 42 °C. The control mice were sham-heated at a temperature of 25 ± 0.5 °C and a humidity of 35% ± 5%. The lungs and brains of all animals were isolated. Hematoxylin and eosin staining and light microscopy were performed to detect pathological changes.

RESULTS:

All mice demonstrated a uniform response to heat stress. A low degree of heat stress induced marked pathological changes of the lungs. With the rise of the temperature to 42°C, progressively greater damage to the lungs with further congestion of the lung matrix, asystematic hemorrhage of alveolar space, abscission of alveolar epithelial cells, and disappearance of pulmonary alveolus tissue structure were detected. However, absorption of congestion and hemorrhage as well as recovery of pulmonary alveolus tissue structure was observed following cooling treatment at an ambient temperature. With a low degree of heat stress, the brain only showed moderate edema. Neuronal denaturation and necrosis were detected at a temperature of 42°C. Interestingly, the lesions in the brain were further aggravated at 42 °C regardless of cooling treatment, but recovery was observed after cooling treatment at 41 °C.

CONCLUSIONS:

The pathological changes of the lungs and brain of mice showed distinctive lesions following heat stress and cooling treatment, and they were correlated with the time and duration of cooling treatment. The results of this study are helpful for further study of the mechanisms linking heatstroke.     

牙种植术中钻孔提拉方式及冷却系统对术区温度的影响

目的: 研究牙种植术中不同钻孔提拉方式及不同冷却系统对术区牙槽骨温度的影响, 探讨牙种植术中温度场的变化。方法: 制作48个统一标准的模拟骨块, 根据不同钻孔提拉方式和不同冷却系统分为6组, 每组8个骨块, 进行温度场试验, 测定不同骨块中温度场的温度最高值。采用SPSS12.0软件包对数据进行单因素方差分析。结果: 在相同的钻孔提拉方式下, 内冷却系统温度控制方式术区温度低于外冷却系统的温度控制方式;在相同的冷却系统下, 2次钻孔提拉方式术区温度低于直接1次钻孔方式。其中, 采用内冷却系统进行温度控制时, 2次钻孔提拉方式的术区温度最低(P<0.05)。结论: 牙种植术中采用多次钻孔提拉方式及内冷却系统的温度控制方式, 可以有效降低术区温度, 减少手术产热, 提高牙种植术成功率。