目的:探索炎性疾病患者的乳酸林格氏液(Ringer's lactate,RL)液体动力学特征以及炎性生物标记物是否可以作为协变量影响RL分布和排泄。方法:本研究为前瞻性队列研究。选择40例美国麻醉医师分级(ASA)I-II级,腹腔镜下择期胆囊切除术(胆囊炎组,n=20)或者腹腔镜下急诊阑尾切除术(阑尾炎组,n=20)。所有患者麻醉诱导前开始输注RL,按15 mL/kg,35 min内输毕。采用酶联免疫(enzyme-linked immunosorbent assay,ELISA)方法测定血浆炎症(TNF-α,IL-10和CRP)或者内皮损伤生物标记物(syndecan-1,SDC-1);利用血红蛋白(Hb)稀释-时间曲线和尿量,使用Phoenix软件,采用非线性混合效应模型分析计算RL液体动力学参数和协变量的影响。结果:与胆囊炎组相比,阑尾炎组RL从组织间隙到血浆的转运速率常数(k21)显著降低(14×10-3min-1 versus 35×10-3min-1;P=0.012)。阑尾炎组C反应蛋白(CRP)升高[中位数38.1(1.8-143.6) μg/mL versus 1.3(0.1-159.0) μg/mL;P<0.001];与清醒状态相比,麻醉期间(输液开始后30~45 min),液体从中央室中到外周室的转运速率常数(k12)显著增加(57×10-3min-1 versus 32×10-3min-1;P<0.01)。清除速率常数(k10)降低90%(0.6×10-3min-1 versus 5.3×10-3min-1;P<0.001)。无论在清醒状态还是麻醉状态下低血压均能降低液体清除;炎症或者内膜损伤的生物标记物不能作为显著影响RL液体动力学参数的协变量。结论:阑尾炎或者胆囊炎患者术前输入液体后“炎症反应的生物标记物”不是RL的液体动力学的协变量,但是两组患者中,全身麻醉期间输入液体的清除率下降。 相似文献
Over the past decade, numerous studies have attempted to enhance the effectiveness of radiotherapy (external beam radiotherapy and internal radioisotope therapy) for cancer treatment. However, the low radiation absorption coefficient and radiation resistance of tumors remain major critical challenges for radiotherapy in the clinic. With the development of nanomedicine, nanomaterials in combination with radiotherapy offer the possibility to improve the efficiency of radiotherapy in tumors. Nanomaterials act not only as radiosensitizers to enhance radiation energy, but also as nanocarriers to deliver therapeutic units in combating radiation resistance. In this review, we discuss opportunities for a synergistic cancer therapy by combining radiotherapy based on nanomaterials designed for chemotherapy, photodynamic therapy, photothermal therapy, gas therapy, genetic therapy, and immunotherapy. We highlight how nanomaterials can be utilized to amplify antitumor radiation responses and describe cooperative enhancement interactions among these synergistic therapies. Moreover, the potential challenges and future prospects of radio-based nanomedicine to maximize their synergistic efficiency for cancer treatment are identified.
Effective thermal management of electronic integrated devices with high powder density has become a serious issue, which requires materials with high thermal conductivity (TC). In order to solve the problem of weak bonding between graphite and Cu, a novel Cu/graphite film/Cu sandwich composite (Cu/GF/Cu composite) with ultrahigh TC was fabricated by electro-deposition. The micro-riveting structure was introduced to enhance the bonding strength between graphite film and deposited Cu layers by preparing a rectangular array of micro-holes on the graphite film before electro-deposition. TC and mechanical properties of the composites with different graphite volume fractions and current densities were investigated. The results showed that the TC enhancement generated by the micro-riveting structure for Cu/GF/Cu composites at low graphite content was more effective than that at high graphite content, and the strong texture orientation of deposited Cu resulted in high TC. Under the optimizing preparing condition, the highest in-plane TC reached 824.3 W·m−1·K−1, while the ultimate tensile strength of this composite was about four times higher than that of the graphite film. 相似文献