序贯机械通气联合尼可刹米治疗AECOPD合并Ⅱ型呼吸衰竭的临床观察

目的：观察序贯机械通气联合尼可刹米在慢性阻塞性肺疾病急性加重期（AECOPD）合并Ⅱ型呼吸衰竭中的的临床疗效及安全性。方法：按照随机原则将64例AECOPD合并Ⅱ型呼吸衰竭分成两组,对照组32例给予常规有创机械通气,治疗组患者给予序贯机械通气联合尼可刹米治疗,对两组治疗前、后24 h和48h的pH值、PaO2、PaCO2以及VAP、总机械通气时间、ICU时间,总住院时间,再插管率以及死亡率进行评价。结果：治疗组与对照组相比,pH值改善明显、PaO2明显增长、PaCO2下降显著,有统计学差异（P〈0.05）;治疗组ICU时间,总住院时间,再插管率以及死亡率与对照组相比,下降明显,有统计学差异（P〈0.05）。结论：序贯机械通气联合尼可刹米治疗AECOPD合并Ⅱ型呼吸衰竭的临床疗效确切,值得临床推广。     

多潘立酮对慢性阻塞性肺疾病机械通气患者胃肠功能障碍的临床效果观察

目的:探讨多潘立酮对慢性阻塞性肺疾病(COPD)机械通气患者胃肠功能障碍的临床效果.方法:采用前瞻性随机对照研究方法,选择2010年11月～2012年11月我院重症医学科收治的需要机械通气且存在胃肠功能障碍的COPD患者48例,按抽签法随机分为两组,对照组(n=24)为常规治疗组,治疗组(n_24)在常规治疗基础上给予鼻饲多潘立酮片10 mg,3次/天.观察周期为1周,通过观察患者胃肠功能障碍症状的恢复情况、胃排空情况及实验室检查指标评价多潘立酮的疗效.结果:治疗组和对照组胃肠功能障碍临床症状改善的有效率分别为87.5％和62.5％,治疗组显著高于对照组(P＜0.05);治疗组和对照组胃排空功能的有效率分别为83.33％和58.33％,治疗组显著高于对照组(P＜0.05);对照组治疗前后血红蛋白、离子、白蛋白、肌酐、尿素氮水平比较无显著差异(P＞0.05),治疗组治疗前后各指标亦无统计学差异(P＞0.05).治疗后两组血红蛋白,白蛋白有所升高,但各指标比较无统计学差异(P＞0.05).结论:多潘立酮辅助治疗可以有效改善COPD机械通气患者的胃肠功能障碍,促进胃排空,提高肠内营养的耐受性.     

The Utility of the Swine Model to Assess Biological Rhythms and Their Characteristics during Different Stages of Residence in a Simulated Intensive Care Unit: A Pilot Study

The purpose of this pilot study was to explore the utility of the mammalian swine model under simulated intensive care unit (sICU) conditions and mechanical ventilation (MV) for assessment of the trajectory of circadian rhythms of sedation requirement, core body temperature (CBT), pulmonary mechanics (PM) and gas exchange (GE). Data were collected prospectively with an observational time-series design to describe and compare circadian rhythms of selected study variables in four swine mechanically ventilated for up to seven consecutive days. We derived the circadian (total variance explained by rhythms of τ between 20 and 28?h)/ultradian (total variance explained by rhythms of τ between 1 and <20?h) bandpower ratio to assess the robustness of circadian rhythms, and compare findings between the early (first 3 days) and late (subsequent days) sICU stay. All pigs exhibited statistically significant circadian rhythms (τ between 20 and 28?h) in CBT, respiratory rate and peripheral oxygen saturation, but circadian rhythms were detected less frequently for sedation requirement, spontaneous minute volume, arterial oxygen tension, arterial carbon dioxide tension and arterial pH. Sedation did not appear to mask the circadian rhythms of CBT, PM and GE. Individual subject observations were more informative than group data, and provided preliminary evidence that (a) circadian rhythms of multiple variables are lost or desynchronized in mechanically ventilated subjects, (b) robustness of circadian rhythm varies with subject morbidity and (c) healthier pigs develop more robust circadian rhythm profiles over time in the sICU. Comparison of biological rhythm profiles among sICU subjects with similar severity of illness is needed to determine if the results of this pilot study are reproducible. Identification of consistent patterns may provide insight into subject morbidity and timing of such therapeutic interventions as weaning from MV.     

控制通气在全麻患儿支气管异物取出术中的应用研究

目的:探讨静脉全麻下小儿支气管异物取出术中控制通气的应用效果。方法:选择2014年1月～2018年7月本院收治的支气管异物患儿138例为研究对象,所有患儿均在静脉全麻下行支气管异物取出术,采用随机数字表法将其分为对照组(采用自主呼吸通气,69例)和观察组(采用控制通气,69例),比较两组手术时间、麻醉时间、苏醒时间、置镜首次成功率、置镜时间、置镜难易程度、心率、平均动脉压(MAP)、血氧饱和度(SpO_2)及不良反应发生率。结果:观察组手术时间、麻醉时间、苏醒时间均短于对照组(P0.05);观察组置镜首次成功率高于对照组,置镜难度低于对照组,置镜时间短于对照组(P0.05);观察组麻醉后心率、MAP水平低于对照组,SpO_2水平高于对照组(P0.05);观察组不良反应发生率均低于对照组(P0.05)。结论:静脉全麻患儿支气管异物取出术中,采用控制通气的方式效果较好,其具有较强的可控性,且安全性高,是一种较理想的手术麻醉方案。     

无创辅助通气早产儿呼吸道感染病原菌分布 及影响因素分析

目的分析无创辅助通气早产儿呼吸道感染的病原菌及相关影响因素。方法选择2016年3月至2018年10月我院新生儿监护室收治的100例行无创辅助通气呼吸的早产儿为观察组。选择同期100例正常早产儿作为对照组。对两组患儿痰样本进行细菌鉴定,记录患儿基本情况并检测血中CD3~+、CD3~+/CD8~+、CD3~+/CD19~+和CD19~+/CD23~+水平。结果观察组患儿呼吸困难、发热、咳嗽、肺部喘鸣音及湿罗音发生率均高于对照组,差异有统计学意义(均P0.05)。观察组患儿血液中CD3~+、CD3~+/CD8~+水平明显低于对照组,CD3~+/CD19~+及CD19~+/CD23~+水平明显高于对照组,差异有统计学意义(均P0.05)。观察组患儿革兰阳性菌的感染率为17.00%,革兰阴性菌感染率为27.00%,其中金黄色葡萄球菌、大肠埃希菌和肺炎克雷伯菌的感染率占比相对较高。季节、通气时间、胎龄及出生体重是影响患儿呼吸道感染发生的独立性影响因素(P0.05)。结论无创辅助通气早产儿呼吸道感染病原菌以金黄色葡萄球菌、大肠埃希菌和肺炎克雷伯菌为主,季节、通气时间、胎龄及出生体重均是导致感染发生及发展的独立性影响因素。     

拉萨世居藏族青年的最大氧摄取和氧转运功能

对拉萨市(海拔3658m)16名世居藏族和20名已习服的移居汉族健康青年男性的最大氧摄取、最大运动负荷及其影响因素进行了对此研究。结果发现在最大努力作功时,藏族的最大氧摄取量、最大运动负荷量、潮气量、肺通气量以及氧脉搏等均大于移居汉族。说明西藏高原世居藏族具有更佳的氧转运功能,对高原低氧已获得了良好的生理适应。     

Evaluation of several strategies to increase the residence time of Episyrphus balteatus (Diptera, Syrphidae) releases in sweet pepper greenhouses

We have investigated several factors affecting the augmentation of the aphidophagous syrphid Episyrphus balteatus in Mediterranean sweet pepper greenhouses. First, the effectiveness of releases has been assessed by recording the larva and pupa number. The abundance of E. balteatus varied between greenhouses, which was not observed to be a release effect. Second, two experiments were performed to assess the effect of three biological control management strategies on the release residence time. In the first experiment, the greenhouse ventilation was shown to have a significant influence on the adult population residence time, which was higher when the side walls were closed rather than open. The introduction of additional floral resources (sweet alyssum and coriander) did not have a significant effect on the release residence time. In the second experiment, the age of the released adults was assessed, and 2-day-old adults stayed longer in the greenhouse than 7-day-old adults, but the 7-day-old adults had more time to lay eggs. Although syrphids are effective aphid natural enemies, the release methodology of introducing pupae appears not to be effective in Mediterranean greenhouses. In this paper, we propose changing the methodology of releasing E. balteatus .     

A comparison of ventilation rates and haemoglobin concentrations between two species of loach,Noemacheilus barbatulus (L.) and Cobitis taenia (L.)

The mean haemoglobin concentration of Noemacheilus barbatulus was found to be significantly higher than that of Cobitis taenia. Under conditions of reduced oxygen saturation, both species achieved maximum rates of ventilation at 10% 0₂. An alteration in opercular beat pattern accounted for the increased ventilation rates between 20% and 30%. A slightly higher tolerance for lowered oxygen concentrations was demonstrated by Cobitis taenia with disorientation and aerial respiration occurring at lower oxygen tensions than in Noemacheilus barbatulus.     

Just keep swimming? Observations of resting behavior in gray reef sharks Carcharhinus amblyrhynchos (Bleeker, 1856)

Understanding the respiratory modes of sharks has important implications for studying the metabolism, energetics, and behavioral strategies of different species. Here we provide the first reported observations of resting behavior in the gray reef shark Carcharhinus amblyrhynchos, a species typically considered an obligate ram ventilator. Observations were made at several locations in the Republic of Seychelles, where sharks were found resting under reef ledges and were unresponsive to the presence of divers. These findings update our understanding of the respiratory mode of this species and have implications for future research.     

The Effect of Ventilation on in vitro Response of Seedlings of the Cultivated Tomato and its Wild Salt-tolerant Relative Lycopersicon pennellii to Salt Stress

Organs or plants grown in vitro do not always exhibit the same responses to salinity as the whole plant of same species grown ex vitro. The response to salinity (100 mM NaCl) of seedlings of the wild tomato species Lycopersicon pennellii acc. Atico (Lpa) and of the cultivated tomato L. esculentum cv. M82 (Lem), the former is known as salt tolerant and the second as relatively salt sensitive under ex vitro conditions, was compared under in vitro conditions with three different ventilation regimes. It was found that under salinity shoots of the wild species accumulated the same or even more dry biomass than the control (roots somewhat less) under all ventilation levels. Growth of shoots and roots of the cultivated species was inhibited under the same conditions especially under the high ventilation. Ventilation reduced some abnormalities of leaf development related to hyperhydricity and consequently ventilated leaves exhibited a more compounded structure, increased area, increased resistance to water loss and stomata functioning. Ventilation increased K⁺, Na⁺ and Cl⁻ accumulation in shoots of both tomato species. This was more pronounced under salinity and in Lpa. This work indicates that differences that characterize whole plants of these species in response to salinity under ex vitro conditions are exhibited also in whole plants grown in vitro under high ventilation. It is suggested that ventilation is needed to evaluate well the response of whole plants to salt stress applied in vitro.