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1.
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
2.
Conducting poly(aniline‐co‐o‐anisidine) (PAS) films with different ratios of aniline units in the polymer chain were prepared by oxidative polymerization of different molar ratios of aniline and o‐anisidine in 1 M HCl using cyclic voltammetry. Due to the much higher reactivity of o‐anisidine, the structure and properties of PASs were found to be dominated by the o‐anisidine units. The polymerization of poly‐o‐anisidine and PASs followed zero‐order kinetics with respect to formation of the polymer (film thickness) and the autocatalytic polymerization of aniline was completely inhibited. In contrast to polyaniline, a decrease in the polymerization temperature was found to increase the amount of copolymer formed and its redox charge. The presence of aniline units in PASs led to a pronounced increase in the molecular weight and conductivity, and a decrease in the solubility in organic solvents. Repetitive charging/discharging cycles showed that PASs resist degradation more than polyaniline. Copyright © 2003 Society of Chemical Industry 相似文献
3.
在分析了双极型晶体管和场效应晶体管各自的特点和不足后,介绍了一种既具有双极型晶体管较大电流容量和功率输出,又具有场效应晶体管高输入阻抗的电子器件——双极MOS场效应晶体管(BJMOSFET),同时指出体硅BJMOSFET的阳极扩散区与衬底之间存在较大的漏电流,可产生较大的寄生效应。提出了一种新型固体电子器件——基于SOI的BJMOSFET,分析了其工作原理j与体硅BJMOSFET比较,由于SOI技术完整的介质隔离避免了体硅器件中存在的大部分寄生效应,使基于SOI的BJMOSFET在体效应、热载流子效应、寄生电容、短沟道效应和闩锁效应等方面具有更优良的特性。 相似文献
4.
High division of the brachial artery was observed in two cadavers, during routine dissection of upper extremities. In the first case, the brachial artery of the right upper extremity was divided into its two terminal branches immediately after passing between the lateral and medial roots of the median nerve and just below the origin of the profunda brachii artery. The lateral branch was the radial artery, located in the space normally occupied by the brachial artery and the medial one was the ulnar artery. In the second case, the brachial artery was divided into its two terminal branches just below the origin of the profunda brachii artery. Accurate knowledge of the relationships and course of these major arterial conduits and particularly of their variational patterns, is of considerable practical importance in the conduct of reperative surgery in the arm, forearm and hand. 相似文献
5.
6.
用Tow-Thomas电路设计含有限非零传输零点有源滤波器的方法 总被引:4,自引:1,他引:3
Tow-Thomas电路是一种实现全极点滤波器的典型电路。本文给出了用Tow-Thoms电路设计含有限非零传输零点有源滤波器的方法,从而使Tow-Thomas电路可用于单片集成滤波器电路。而文中给出的公式可用于计算外接元件。设计实例表明了文中给出的计算公式的正确性。 相似文献
7.
FS Nielsen P Rossing MA Gall P Sk?tt UM Smidt HH Parving 《Canadian Metallurgical Quarterly》1997,46(7):1182-1188
The aim of our study was to evaluate whether inhibition of ACE (lisinopril 10-20 mg/day) can reduce the rate of decline in kidney function more than reducing blood pressure with conventional antihypertensive treatment (atenolol 50-100 mg/day), usually in combination with a diuretic. We performed a prospective, randomized, parallel study for 42 months, double blind for the first 12 months and single blind thereafter. Forty-three (21 lisinopril and 22 atenolol) hypertensive NIDDM patients with diabetic nephropathy were enrolled. Data from 36 patients (17 lisinopril and 19 atenolol, 60 +/- 7 years of age, 27 men) who completed at least 12 months of the study period are presented. At baseline, the two groups were comparable: glomerular filtration rate (51Cr-EDTA plasma clearance) was 75 +/- 6 and 74 +/- 8 ml x min(-1) x 1.73 m(-2), mean 24-h ambulatory blood pressure (A&D TM2420) was 110 +/- 3 and 114 +/- 2 mmHg, and 24-h urinary albumin excretion rate was 961 (range 331-5,727) and 1,578 (476-5,806) mg/24 h in the lisinopril and atenolol groups, respectively. The mean follow-up time was similar, 37 and 35 months in the lisinopril and atenolol groups, respectively. Mean ambulatory blood pressure was equally reduced in the two groups, 12 +/- 2 and 10 +/- 2 mmHg in the lisinopril and atenolol groups, respectively. Glomerular filtration rate declined in a biphasic manner with a faster initial (0 to 6 months) change of 1.25 +/- 0.49 and 0.81 +/- 0.29 ml x min(-1) x month(-1) followed by a slower sustained decline (6 to 42 months) of 0.59 +/- 0.10 and 0.54 +/- 0.13 ml x min(-1) x month(-1) in the lisinopril and atenolol groups, respectively. No significant differences were observed in either initial or sustained decline in glomerular filtration rate between the two groups. Urinary albumin excretion was reduced (% reduction of baseline) more in the lisinopril than in the atenolol group, at 55 (95% CI 29-72) and 15% (-13 to 34), respectively (P = 0.01). In conclusion, the relentless decline in kidney function characteristically found in hypertensive NIDDM patients with diabetic nephropathy can be reduced equally effectively by two antihypertensive treatments, the beta-blocker atenolol and the ACE inhibitor lisinopril. 相似文献
8.
The heat-stable enterotoxin of Escherichia coli binds to an intestinal receptor, guanylyl cyclase-C, and produces cGMP to induce diarrhea. Guanylin is an endogenous ligand of this receptor. In the present in vivo study, the intestinal water and ion secretion induced by mucosal application of 2 nmol/ml guanylin or 5 or 10 units/ml heat-stable enterotoxin into closed loops was compared in the rat. The characteristics of secretion induced by cAMP following intravenous perfusion of 1.2 nmol/100 g per h vasoactive intestinal peptide were compared to those induced by cGMP. Unidirectional Na+ and Cl- fluxes were estimated by addition of 22Na into the loop and i.v. injection of 36Cl. Guanylin induced less water and ion secretion than that produced by heat-stable enterotoxin in the colon, confirming the results of in vitro studies, and also in duodenum and ileum. The cAMP- or cGMP-mediated response had a similar pattern, i.e., an inhibition of Na+ absorption and an increase in anion secretion. 相似文献
9.
HH Grenn 《Canadian Metallurgical Quarterly》1997,38(6):357-362
RATIONALE AND OBJECTIVES: Simplifying data collection and analysis should promote utilization management in review of examinations of the small bowel in the general practice. METHODS: A case control format with the generation of an odds ratio to answer sets of binary questions derived from annual examination data is shown. The positive examination results applied were compared with the literature as a cross-checking mechanism. The examination identified as most likely to be positive was recommended prospectively in a protocol for the following year. Two of 5 years are illustrated to emphasize the development of the methodology. RESULTS: Application of this model in testing its validity, since 1990 at Madigan Army Medical Center, allows for the generation of a new protocol each year to prospectively improve clinical definition. CONCLUSIONS: A 5-year analysis of small bowel examination protocols, subdivisions, and odds ratios, will be forthcoming. The 2 years illustrated show how strongly our practice was influenced in using enteroclysis or in using the small bowel follow through as the examination of choice in the various clinical categories of small bowel disease: (1) practice was influenced by protocol and (2) outcome was steered toward positive examinations. 相似文献
10.