有机磷中毒呼吸衰竭与无创通气的应用

目的探讨无创通气在急性有机磷农药中毒呼吸衰竭中的应用。方法将16例急性有机磷农药中毒并呼吸衰竭患者常规治疗加机械通气辅助呼吸,应用有创—无创序贯通气策略,观察对比无创通气前后血气及症状体征的变化。结果无创通气前后13例有效,3例患无效,有效率81.25%。结论有创—无创序贯通气对急性有机磷农药中毒呼吸衰竭病人有效,但应选择合适的病例。     

参麦注射液配合西医治疗慢性肺病并重度呼吸衰竭的影响

目的观察补气通气类中药配合西药治疗慢性阻塞性肺病并重度呼吸衰竭的疗效。方法:采用参麦注射液(红参、麦冬)配合西药(对症)治疗本病30例,并设对照组观察血氧饱和度、神志、呼吸、心率、呼吸困难等变化。结果:住院时间、通气时间两组比较差异均有显著性(P<0.05)。动脉血气分析治疗组明显优于对照组(P<0.05);结论:本方法对本病有补气通气,改善呼吸功能的功效。     

无创正压通气治疗50例COPD并II型呼吸衰竭的疗效观察

目的观察无创正压通气法在治疗COPD并II型呼吸衰竭的应用。方法对我科2007年1月至2009年6月住院的50例COPD伴Ⅱ型呼吸衰竭的患者在相关基础治疗的基础上,予无创正压通气(NIPPV)。观察治疗前后24h的动脉血气分析结果以及心率、呼吸频率和血压的变化。结果NIPPV治疗24h后,患者的心率显著降低,pH、PaCO2和PaO2明显改善,比较差异均有统计学意义(P<0.05),而且未见严重的不良反应发生。结论NIPPV治疗COPD伴Ⅱ型呼吸衰竭患者疗效肯定,缩短病程,能显著降低COPD伴Ⅱ型呼吸衰竭患者的死亡率。     

双水平无创正压通气治疗COPD并Ⅱ型呼吸衰竭20例疗效观察

目的 研究无创机械通气治疗慢性阻塞性肺疾病(COPD)并发Ⅱ型呼吸衰竭的疗效。方法 42例COPD并发Ⅱ型呼吸衰竭的住院患者随机分为2组,对照组22例给予常规治疗,实验组的20例患者在给予常规治疗的基础上予面罩无创正压通气。观察治疗前后患者的意识、呼吸、心率、血气等指标的变化。结果 治疗前后2组临床症状、血气分析指标均有显著变化,实验组各项指标的变化优于对照组。结论 无创机械通气是治疗COPD并Ⅱ型呼吸衰竭的一种有效方法。     

无创正压通气治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的临床效果

目的无创正压通气治疗慢性阻塞性肺疾病(COPD)急性加重合并呼吸衰竭的临床效果。方法选择2005年1月至2009年5月我院呼吸内64例COPD患者在常规综合治疗的同时,选用BiPAP呼吸机行无创正压通气。在机械通气前,机械通气后1h、机械通气后4h、机械通气后24h,和通气结束时作血气分析,并观察临床转归。结果与治疗前相比,无创正压通气后1、4、24h和治疗结束时,PH值改善(P0.05),PaO2上升、PaO2下降(P0.01)30例患者好转出院,2例患者因病情加重,改用有创通气后死亡,抢救成功率93.8%。结论 NPPV是治疗慢性阻塞性肺疾病急性加重合并呼吸衰竭的一种有效方法 ,早期应用可能阻止病情进一步发展,缩短病程。     

无创机械通气治疗急性左心衰的疗效效果

目的观察无创正压通气治疗急性左心衰的临床研究与疗效效果。方法选择急性左心衰患者35例,对照组予常规治疗,治疗组在常规治疗基础上,辅以口鼻面罩接双水平无创正压通气治疗急性左心衰。观察2组治疗后2h患者症状、心率、呼吸频率、肺部体征,疗效评价。结果治疗组症状、相关指标改善均明显优于对照组,有统计学意义(P<0.05)。结论合理应用无创正压机械通气是治疗急性左心衰的一种快速安全有效的方法 。     

序贯性通气治疗重症急性左心衰竭伴呼吸衰竭的临床观察

目的观察有创-无创序贯通气对重症急性左心衰伴呼吸衰竭的治疗效果。方法对24例常规治疗无效的重度急性左心衰伴呼吸衰竭患者加用序贯通气治疗,比较治疗前后的临床症状、生命体征及血气分析结果。结果 24例患者20例经序贯通气后低氧血症较前明显好转,生命体征及血气分析指标也有明显改善(P<0.05)。结论序贯通气能及时有效地缓解急性左心衰竭所致的低氧血症和高碳酸血症,是抢救重症急性左心衰发作的有效措施,值得临床推广。     

慢性阻塞性肺疾病伴Ⅱ型呼吸衰竭机械通气的护理

目的探讨无创正压机械通气在慢性阻塞性肺疾病(COPD)伴呼吸衰竭治疗中的疗效及护理要点。方法对我院60例COPD伴Ⅱ型呼衰患者采取无创正压机械通气和全面细致观察和护理,比较治疗前后动脉血气变化。结果本组患者经无创机械通气后,均有好转,各项指标较治疗前明显改变,差异有统计学意义(P<0.05)。结论全面细致观察和护理,及时进行血气分析,就可以减少并发症的发生,达到最佳治疗效果。     

无创正压通气治疗慢性阻塞性肺疾病合并Ⅱ型呼吸衰竭44例分析

目的探讨无创正压机械通气治疗慢性阻塞性肺疾病(COPD)合并Ⅱ型呼吸衰竭的疗效。方法选择我院近年来收治的COPD合并Ⅱ型呼吸衰竭患者44例,随机分为治疗组和对照组,2组均给予常规抗感染、解痉平喘、祛痰、能量支持等常规治疗,对照组予低浓度氧疗,治疗组采用面罩BIPAP呼吸机治疗。观察患者临床症状、生命体征、血气分析变化。结果治疗组与对照组相比,治疗2h后,患者心率、呼吸频率、动脉血二氧化碳开始下降,72h后,临床症状明显缓解。治疗后患者血气分析指标恢复正常。结论COPD合并呼吸衰竭患者早期使用BIPAP呼吸机治疗,对低氧和二氧化碳潴留改善明显,疗效显著。     

机械通气在慢性阻塞性肺疾病急性加重期患者治疗中的临床观察

目的探讨机械通气治疗慢性阻塞性肺疾病急性加重期患者的疗效。方法65例慢性阻塞性肺疾病急性加重期患者随机分为两组,治疗组33例采用常规治疗 机械通气;对照组32例;仅采用常规治疗;比较治疗前、治疗1h、24h后两组同期动脉血气、呼吸频率及并发症。结果两组动脉血气分析在短期内均有改善,但行机械通气治疗,可迅速改善通气,经通气1h后,各指标与治疗前比较差异有统计学意义(P<0.05),与对照组同期比较差异也有统计学意义(P<0.05);同时机械通气24h后呼吸频率逐渐减慢,而对照组呼吸频率治疗前后变化不明显(P>0.05)。结论在常规治疗基础上行机械通气是治疗慢性阻塞性肺疾病急性加重期患者的有效方法。     

PIMS-TS,the New Paediatric Systemic Inflammatory Disease Related to Previous Exposure to SARS-CoV-2 Infection—“Rheumatic Fever” of the 21st Century?

Paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (PIMS-TS) is a new systemic inflammatory disease that mainly affects children. Its course in many features resembles that of acute rheumatic fever (ARF). Therefore, it is interesting that the experiences with ARF can be used in the management of patients with PIMS-TS. The aim of the article is to analyse the current data on PIMS-TS in relation to ARF. PIMS-TS and ARF are associated with an abnormal immune response to specific pathogens (SARS-CoV-2 and group A streptococcus, respectively). The main symptoms of both diseases are fever and cardiac involvement. Current therapy for PIMS-TS is based on anti-inflammatory treatment: intravenous immunoglobulin (first-line), intravenous glucocorticoids (second-line), or biological therapy (third-line; including interleukin [IL]-1 antagonists, IL-6 receptor blockers, and anti-tumour necrosis factor agents). Vaccination might be good prophylaxis, but the efficacy and safety of the vaccines against SARS-CoV-2 have not yet been established in children. Interesting insights may be gained by considering PIMS-TS in light of what is known of ARF due to their similar courses, but there are still many unanswered questions surrounding this disease and its pathogenesis.     

Resistance training with soy vs whey protein supplements in hyperlipidemic males

Background  

The purpose of this study was to examine the acute effects of a weight loss supplement on resting oxygen uptake (VO₂), respiratory quotient (RQ), caloric expenditure (kcal), heart rate (HR), and blood pressure (BP) in healthy and physically active individuals.     

High‐resolution thermogravimetry/coupled mass spectrometry analysis of flame‐retardant rubber

A bromobutyl rubber composition containing a variety of conventional flame retardants, such as Saytex (decabromodiphenyl oxide), Sb₂O₃, chlorinated paraffin wax, and polychloroprene rubber, was prepared and used to coat nylon 6 fabric in a laboratory‐coating device. An attempt was made to evaluate the decomposition profile, the evolved gases, and the kinetics of the decomposition process at a dynamic heating rate with high‐resolution thermogravimetric analysis (HR‐TGA). HR‐TGA was used with mass spectrometry for evolved gas analysis (EGA). The HR‐TGA results were compared with results from conventional thermogravimetric analysis (TGA) at a constant heating rate; the former offered sharp transitions, an economic timescale, and an accurate activation energy. The resolution optimization for stability analysis and the effect of its variation on the kinetic parameters offered better results for HR‐TGA than conventional TGA. A lifetime and temperature relationship was evaluated in HR‐TGA with Toop's method, and it was observed that the shelf life decreased sharply with temperature. The effluents HBr, HCl, Br ·, and Cl ·, generated between 210 and 496°C during EGA, were correlated with the thermal stability and fire‐retardancy behavior of the material. © 2003 Wiley Periodicals, Inc. J Appl Polym Sci 89: 2051–2057, 2003     

西北沙区4种能源树种评价研究

运用开放式气体交换Li-6400便携式光合作用测定系统和热值测定仪对乌兰布和沙漠4种人工林能源树种进行了测试分析,研究了生物量、热能产出、净光合速率、蒸腾速率及水分利用效率特征.结果表明:4种植物均具有较高的生物量、平茬后再生能力强、热能产出高等特点.6年生植株生物量均在8 t/hm²以上,其中梭梭、沙棘、沙枣和沙拐枣分别为23、17、12和8.9t/hm²;单位面积热能产出:梭梭、沙棘、沙枣和沙拐枣分别为435、322、222和158 GJ/hm²;4种植物按单位面积生物量和热能产出指标综合排序:梭梭>沙棘>沙枣>沙拐枣;按水分利用效率排序:沙枣>梭梭>沙棘>沙拐枣.研究指出:选择沙生植物作为能源树种,除了考虑其生物量、热值指标外,还应注意植物在平茬后的再生能力及其水分生态生理特征.     

Thermogenic Effect from Nutritionally Enriched Coffee Consumption

Background  

The purpose of this study was to examine the effect of nutritionally enriched JavaFit™ (JF) coffee (450 mg of caffeine, 1200 mg of garcinia cambogia, 360 mg of citrus aurantium extract, and 225 mcg of chromium polynicotinate) on resting oxygen uptake (VO₂), respiratory exchange ratio (RER), heart rate (HR), and blood pressure (BP) in healthy and physically active individuals.     

Association of IgG1 Antibody Clearance with FcγRIIA Polymorphism and Platelet Count in Infliximab-Treated Patients

The FcγRIIA/CD32A is mainly expressed on platelets, myeloid and several endothelial cells. Its affinity is considered insufficient for allowing significant binding of monomeric IgG, while its H131R polymorphism (histidine > arginine at position 131) influences affinity for multimeric IgG2. Platelet FcγRIIA has been reported to contribute to IgG-containing immune-complexe clearance. Given our finding that platelet FcγRIIA actually binds monomeric IgG, we investigated the role of platelets and FcγRIIA in IgG antibody elimination. We used pharmacokinetics analysis of infliximab (IgG1) in individuals with controlled Crohn’s disease. The influence of platelet count and FcγRIIA polymorphism was quantified by multivariate linear modelling. The infliximab half-life increased with R allele number (13.2, 14.4 and 15.6 days for HH, HR and RR patients, respectively). It decreased with increasing platelet count in R carriers: from ≈20 days (RR) and ≈17 days (HR) at 150 × 10⁹/L, respectively, to ≈13 days (both HR and RR) at 350 × 10⁹/L. Moreover, a flow cytometry assay showed that infliximab and monomeric IgG1 bound efficiently to platelet FcγRIIA H and R allotypes, whereas panitumumab and IgG2 bound poorly to the latter. We propose that infliximab (and presumably any IgG1 antibody) elimination is partly due to an unappreciated mechanism dependent on binding to platelet FcγRIIA, which is probably tuned by its affinity for IgG2.     

Concomitant NH_4~+ Secretion During Astaxanthin Synthesis in Haematococcus pluvialis Under High Irradiance and Nitrogen Defi-cient Conditions

The present study is focused on protein degradation during astaxanthin synthesis in Haematococcus plu- vialis under high irradiance and nitrogen deficient conditions. It was found that with the onset of astaxanthin syn-thesis in the cultures of high light and nitrogen-free (HF), high light and nitrogen-repletion (HR), and low light and nitrogen-free (LF), (1) endopeptidase (EP) activities increased along with decrease in protein content, (2) aspar-agine in HF and HR rose significantly before the first 4 and 5 day, but fell after that time. While, it increased slowly and continuously in LF, (3) ammonium increased continuously in HF and HR, whereas in LF, it was detected on the sixth day, and increased slowly on the following days. By contrast, in low light and nitrogen-repletion culture, (LR), the contents of protein and asparagine as well as EP activity were maintained relatively constant, no astaxanthin and ammonium were detected. Furthermore, when HF was sealed and bubbled with CO2-free gas (O2 and N2), astaxan-thin content increased as the protein level decreased. These results strongly suggest that (1) the degraded protein served as a substitutive carbon source, to some extent, for the biosynthesis of astaxanthin, (2) endopeptidase was involved in the degradative process, (3) for detoxification, part of the ammonium generated by protein degradation was transiently stored in asparagine, whereas the rest of it was expelled into the culture broth.     

雨生红球藻合成虾青素过程中分泌铵离子

The present study is focused on protein degradation during astaxanthin synthesis in Haematococcus plu- vialis under high irradiance and nitrogen deficient conditions. It was found that with the onset of astaxanthin synthesis in the cultures of high light and nitrogen-free （HF）, high light and nitrogen-repletion （HR）, and low light and nitrogen-free （LF）, （1） endopeptidase （EP） activities increased along with decrease in protein content, （2） asparagine in HF and HR rose significantly before the first 4 and 5 day, but fell after that time. While, it increased slowly and continuously in LF, （3） ammonium increased continuously in HF and HR, whereas in LF, it was detected on the sixth day, and increased slowly on the following days. By contrast, in low light and nitrogen-repletion culture, （LR）, the contents of protein and asparagine as well as EP activity were maintained relatively constant, no astaxanthin and ammonium were detected. Furthermore, when HF was sealed and bubbled with CO2-free gas （02 and N2）, astaxan- thin content increased as the protein level decreased. These results strongly suggest that （1） the degraded protein served as a substitutive carbon source, to some extent, for the biosynthesis of astaxanthin, （2） endopeptidase was involved in the degradative process, （3） for detoxification, part of the ammonium generated by protein degradation was transiently stored in asparagine, whereas the rest of it was expelled into the culture broth.     

The Complete Loss of p53 Expression Uniquely Predicts Worse Prognosis in Colorectal Cancer

p53 immunohistochemistry is considered an accurate surrogate marker reflecting the underlying TP53 mutation status and has utility in tumor diagnostics. In the present study, 269 primary CRCs were immunohistochemically evaluated for p53 expression to assess its utility in diagnostic pathology and prognostication. p53 expression was wild-type in 59 cases (23%), overexpressed in 143 cases (55%), completely lost in 50 cases (19%), and cytoplasmic in 10 cases (4%). p53 immunoreactivity was associated with tumor size (p = 0.0056), mucus production (p = 0.0015), and mismatch repair (MMR) system status (p < 0.0001). Furthermore, among CRCs with wild-type p53 expression, a significantly higher number of cases had decreased CDX2 than those with p53 overexpression (p = 0.012) or complete p53 loss (p = 0.043). In contrast, among CRCs with p53 overexpression, there were significantly fewer ALCAM-positive cases than p53 wild-type cases (p = 0.0045). However, no significant association was detected between p53 immunoreactivity and the “stem-like” immunophenotype defined by CDX2 downregulation and ALCAM-positivity. Multivariate Cox hazards regression analysis identified tubular-forming histology (hazard ratio [HR] = 0.17, p < 0.0001), younger age (HR = 0.52, p = 0.021), and female sex (HR = 0.55, p = 0.046) as potential favorable factors. The analysis also revealed complete p53 loss (HR = 2.16, p = 0.0087), incomplete resection (HR = 2.65, p = 0.0068), and peritoneal metastasis (HR = 5.32, p < 0.0001) as potential independent risk factors for patients with CRC. The sub-cohort survival analyses classified according to chemotherapy after surgery revealed that CRC patients with wild-type p53 expression tended to have better survival than those with overexpression or complete loss after chemotherapy. Thus, immunohistochemistry for p53 could be used for the prognostication and chemotherapy target selection of patients with CRC.     

Micromechanics of Creep-Crack Growth in a Glass-Ceramic

The near-tip strain and opening behavior of creep cracks in a glass-ceramic were studied at temperatures for which grain-boundary sliding is the dominant deformation mechanism. Using the stereoimaging displacement measurement technique, near-tip creep strain and crack-opening displacement (COD) increments were obtained as functions of distance from the crack tip and time of creep. Both the time and radial dependence of the strain and COD were observed to be consistent with the Riedel and Rice (RR) field when the time of creep and crack extension were small. Increasing creep time and crack extension led to the formation of a localized shear zone located directly ahead of the crack tip. Further crack extension tended to follow this shear zone within which creep damage accumulated. Neither the rate of COD nor the strain-rate distribution within this shear zone could be described by the RR field or the Hui and Riedel (HR) field for growing cracks. Steady-state, stable crack growth exhibiting both Mode I and II components was observed in the glass-ceramic despite a creep exponent of ≅2. Varying the test temperature and applied stress intensity influenced both the development of the crack-tip shear zone and the crack growth process. These observations are discussed on the basis of the interrelationships between the near-tip field, creep damage accumulation, and grain-boundary sliding.