经食管超声心动图在心血管手术麻醉与监测中的应用

目的　评价经食管超声心动图 (TEE)在心血管手术麻醉中的价值。方法　本组共完成 1 2 2例TEE监测。主要观察指标 :(1 )对 4 1例瓣膜置换患者的瓣膜作返流和狭窄分级及评价机械或生物瓣的功能 ;(2 ) 4 8例不停跳冠状动脉搭桥 (CABG)患者手术前后心功能变化〔①面积减少分数(FAC) ;②E波与A波峰值流速比率 (E/A)和各自的流速时间积分比率 (VTIE/VTIA) ;③E波减速时间 (DT) ;④心脏指数 (CI)〕 ;(3)手术前后对 2 0例不停跳CABG患者左室室壁 (前壁、后壁、侧壁和室间隔 )运动分级 ;(4 )监测先心病矫正前后心脏结构变化。结果　TEE检测瓣膜病变与经胸超声结果一致 ,手术后瓣膜活动正常。术后FAC、CI和VTIE/VTIA分别为 (0 5 2± 0 0 8)、(2 6 4± 0 6 9)L·min 1 ·m 2 和 1 2 9± 0 1 8,与术前比较 (0 4 2± 0 0 9)、(2 0 5± 0 4 8)L·min 1 ·m 2 和 1 1 4± 0 1 6有显著性差异 (P <0 0 5 ) ;术后E/A 0 86± 0 2 1与术前 0 77± 0 1 8比较P <0 0 1。DT无显著性变化。术前节段性室壁运动异常大于 2级的占 1 0 % ,术后为 5 %。结论　在心血管手术中 ,TEE是一种新的有用的监测技术     

主动脉弓粥样硬化和缺血性脑卒中的关系

主动脉弓粥样斑块与缺血性脑卒中密切相关,主动脉粥样硬化是缺血性脑血管病的重要栓塞源。,经食道超声技术是检测活体胸主动脉脉粥样硬化病变的重要方法。     

Potential health risks to adults and children in the UK from exposure to dietary lead in gamebirds shot with lead ammunition

We estimate potential risks to human health in the UK from dietary exposure to lead from wild gamebirds killed by shooting. The main source of exposure to lead in Europe is now dietary. We used data on lead concentrations in UK gamebirds, from which gunshot had been removed following cooking to simulate human exposure to lead. We used UK food consumption and lead concentration data to evaluate the number of gamebird meals consumed weekly that would be expected, based upon published studies, to result in changes, over and above those resulting from exposure to lead in the base diet, in intelligence quotient (IQ), Systolic Blood Pressure and chronic kidney disease (CKD) considered in a recent opinion of the European Food Safety Authority (EFSA) to be significant at a population level and also in SAT test scores and in rates of spontaneous abortion. We found the consumption of <1 meal of game a week may be associated with a one point reduction in IQ in children and 1.2–6.5 gamebird meals per week may be associated with the other effects. These results should help to inform the development of appropriate responses to the risks from ingesting lead from ammunition in game in the UK and European Union (EU).