负压封闭引流术治疗犬胸壁全层缺损的实验研究

目的:探讨不同负压大小下的封闭负压引流术(vacuum sealing drainage,VSD)在治疗犬胸壁全层缺损创面愈合的效果。方法:25只健康成年犬的右胸壁制作3cm×4cm大小的全层缺损,随机分为5组,所有胸壁缺损处安装一次性封闭式负压吸引器,手动抽吸负压排出胸膜腔气体产生负压,致伤24小时后复查CT观察气胸情况;然后按照压力表显示调节负压至60kpa,40kpa,20kpa,10kpa,0kpa吸引胸壁,比较五组1d,3d,5d的伤口液体引流量,胸膜闭合时间;5d时伤口取材做HE染色及CD34免疫组化染色观察伤口愈合情况。结果:在60kpa和40kpa负压吸引下,1天引流液体量最多,分别为77.6±6.62 ml,77.8±4.97 ml;胸膜闭合最快,分别为3.2±1.30天,3.6±0.55天,但是60kpa组有一只犬血气分析显示为Ⅰ型呼吸衰竭;HE染色和CD34免疫组化染色显示各组均有肉芽组织增生及血管新生,且40kpa和60kpa负压组肉芽组织和血管密度明显多于其他组,二者之间无明显差异。结论:封闭负压吸引器对胸壁全层缺损创面有明显治疗作用,并且在40kpa负压下治疗效果最好而且安全。     

胸腔闭式引流联合尿激酶注入对包裹性胸腔积液的临床研究

目的:探讨胸腔闭式引流联合尿激酶注入对包裹性胸腔积液的临床疗效。方法:对我院2007年2月-2011年4月收治的包裹性胸腔积液患者87例,随机分为实验组以及对照组,实验组采用胸腔闭式引流联合尿激酶注入进行治疗,对照组采用常规治疗。结果:实验组患者临床疗效明显优于对照组(P<0.05);实验组患者治疗后其积液中蛋白量以及白细胞含量明显低于对照组(P<0.05);实验组患者治疗时间、胸膜壁厚度等比较明显优于对照组(P<0.05)。结论:对包裹性胸腔积液患者采用胸腔闭式引流联合尿激酶注入进行治疗,可有效改善患者预后,提高患者临床治疗效果。     

PKP 在治疗多节段胸腰椎骨质疏松压缩性骨折方面的应用

目的:探讨经皮椎体后凸成形术(PKP)治疗多节段骨质疏松性椎体压缩性骨折(OVCF)的疗效和安全性。方法:应用PKP治疗37例共112节胸腰椎多节段骨质疏松性椎体压缩骨折,分析患者术前、术中、术后的临床及影像学资料,采用模拟视觉评分(VAS)及Oswesty功能障碍指数(ODI)评价术前、术后疼痛缓解及日常活动功能恢复情况。结果:13例一次手术完成1节椎体,12例一次手术完成2～3节段椎体,12例两次手术完成3～4个节段椎体。1例术中出现一过性血压降低和呛咳。VAS评分术前为(8.55±1.22)分,术后1周为(2.12±1.09)分,术后3个月为(2.01±1.07)分;ODI值术前为83.02±11.14,术后1周为25.23±7.17,术后3个月为27.45±9.67,疼痛缓解及日常活动功能恢复明显。结论:初步的临床结果显示PKP是多节段骨质疏松性椎体压缩性骨折的有效治疗方法,单椎体信号改变者治疗效果好于多椎体信号改变者。多椎体信号改变者只选择第一责任椎的单节段PKP可能获得更好的效果;多节段患者同时选择第一和第二责任椎一次完成PKP术效果可能好于分次完成。一次治疗多椎体病变更为经济、适用。     

急诊PCI 治疗中应用血栓抽吸术及主动脉内球囊反搏术 与血浆脑钠肽水平、心功能参数的关系

目的:观察血栓抽吸术与主动脉内球囊反搏术(IABP)联用在急诊冠状动脉介入治疗(PCI)的疗效。方法:ST段抬高型急性心肌梗塞(AMI)行急诊冠状动脉造影提示大量血栓征象、并行血栓抽吸术患者98例,随机分为实验组和对照组,实验组术前行IABP后联合血栓抽吸;对照组仅进行血栓抽吸。观察两组患者的BNP及心功能参数。结果:术后24小时两组BNP有普遍升高趋势,对照组升高更明显(P<0.01),术后2周普遍回降,实验组下降更明显(P<0.01);2周后实验组的心脏指数(CI)、每搏指数(SI)、混合静脉血氧饱和度(SvO2)均高于对照组(P<0.01)。结论:对于行急诊冠状动脉介入治疗的患者联合使用主动脉内球囊反搏术和血栓抽吸术,可以明显改善患者的心肌缺血情况,增加冠脉灌注,有利于患者心功能的恢复。     

Toward using δ13C of ecosystem respiration to monitor canopy physiology in complex terrain

In 2005 and 2006, air samples were collected at the base of a Douglas-fir watershed to monitor seasonal changes in the delta13CO2 of ecosystem respiration (delta13C(ER)). The goals of this study were to determine whether variations in delta13C(ER) correlated with environmental variables and could be used to predict expected variations in canopy-average stomatal conductance (Gs). Changes in delta13C(ER) correlated weakly with changes in vapor pressure deficit (VPD) measured 0 and 3-7 days earlier and significantly with soil matric potential (psi(m)) (P value <0.02) measured on the same day. Midday G (s) was estimated using sapflow measurements (heat-dissipation method) at four plots located at different elevations within the watershed. Values of midday Gs from 0 and 3-7 days earlier were correlated with delta13C(ER), with the 5-day lag being significant (P value <0.05). To examine direct relationships between delta13C(ER) and recent Gs, we used models relating isotope discrimination to stomatal conductance and photosynthetic capacity at the leaf level to estimate values of stomatal conductance ("Gs-I") that would be expected if respired CO2 were derived entirely from recent photosynthate. We compared these values with estimates of Gs using direct measurement of transpiration at multiple locations in the watershed. Considering that the approach based on isotopes considers only the effect of photosynthetic discrimination on delta13C(ER), the magnitude and range in the two values were surprisingly similar. We conclude that: (1) delta13C(ER) is sensitive to variations in weather, and (2) delta13C(ER) potentially could be used to directly monitor average, basin-wide variations in Gs in complex terrain if further research improves understanding of how delta13C(ER) is influenced by post-assimilation fractionation processes.     

Percutaneous Exposure to VX: Clinical Signs, Effects on Brain Acetylcholine Levels and EEG

The nerve agent VX has a variable and delayed absorption through the skin, which may have implications for treatment regimens. In the present study, central and peripheral effects of percutaneous VX intoxication were investigated in hairless guinea pigs. Although onset times of clinical signs varied considerably, the relative onset times of signs of poisoning were shown to have a predictive value for survival time. All animals showed elevation of brain choline (Ch) levels. Only two of six animals demonstrated seizure activity on EEG, which was accompanied by acetylcholine (ACh) accumulation. The non-seizing animals displayed only marginal increases of ACh levels, but significant changes in all EEG bands. Acetylcholinesterase activity was highly inhibited in brain and diaphragm. The increases in Ch levels and EEG effects observed in non-seizing animals probably reflected those of ischemia induced by peripheral effects leading to cardiorespiratory compromise. In conclusion, clinical signs will mainly serve as indicators for the onset and maintenance of treatment in subsequent studies. Special issue article in honor of Dr. Frode Fonnum.     

Soil CN ratio as a scalar parameter to predict nitrous oxide emissions

Forested histosols have been found in some cases to be major, and in other cases minor, sources of the greenhouse gas nitrous oxide (N₂O). In order to estimate the total national or global emissions of N₂O from histosols, scaling or mapping parameters that can separate low‐ and high‐emitting sites are needed, and should be included in soil databases. Based on interannual measurements of N₂O emissions from drained forested histosols in Sweden, we found a strong negative relationship between N₂O emissions and soil CN ratios (r²_adj=0.96, mean annual N₂O emission=ae^{(?b CN ratio)}). The same equation could be used to estimate the N₂O emissions from Finnish and German sites based on CN ratios in published data. We envisage that the correlation between N₂O emissions and CN ratios could be used to scale N₂O emissions from histosols determined at sampled sites to national levels. However, at low CN ratios (i.e. below 15–20) other parameters such as climate, pH and groundwater tables increase in importance as regulating factors affecting N₂O emissions.     

黑河流域生态经济带分异协调规律与耦合发展模式

在西北干旱地区建设黑河流域生态经济带,是从根本上高效配置流域水资源,彻底化解流域上,下游利益冲突,实现利益共享,保护流域生态环境,推进流域可持续发展,全面实施国务院黑河流域分水方案的重要途径,通过对黑河流域生态经济带上－中－下游投入产出效益的比较分析和流域上、中、下游生态－生产、生活系统发展分异及互动协调关系的分析,提出了黑河流域生态经济带上－中－下游多维互动的协调耦合发展模式,进而提出了黑河流域生态经济带建设与发展的主要途径,包括推进黑河流域经济发展一体化和集成管理公司化,大力推行全流域水资源的差异化有偿使用制度,实施流动上、中、下游的水权转让贸易,实行规范的流域财政转移支付制度,建立流域资源与生态环境和经济的整合帐户体系,实行跨行政区域河流边界水量水质达标交接制度,等等。