咽喉部及气管内高频喷射通气对狗通气效率影响的比较研究

近年来国内把叫喉部及鼻前庭高频喷射通气(HFJV)用于治疗急、慢性呼吸衷竭。但对这些部位HFJV的生理影响还没有见到系统研究的报道,为探索其通气效率,本研究比较了咽喉部HFJV(LP-HFJV)和给氧(Lp-O_2)及气管内HFJV(IT-HFJV)对狗的血气、气道内压和呼吸型式的影响。     

高频振荡通气在新生儿呼吸窘迫综合征治疗中的应用

目的探讨高频振荡通气（HFOV）治疗新生儿呼吸窘迫综合征（NRDS）的疗效及安全性。方法将62例NRDS患儿随机分为常频机械通气（CMV）组30例和高频振荡通气（HFOV）组32例,比较两组患儿治疗前后的血气分析,吸入氧浓度（FiO2）,氧合指数（OI）及并发症等指标。结果 HFOV组患儿吸入氧分数明显低于CMV组,PaCO2及氧合指数下降,pH及PO2明显上升;HFOV组发生肺气漏及慢性肺部疾病（CTD）等并发症低于CMV组（P〈0.05）。结论 HFOV治疗新生儿呼吸窘迫综合征的疗效肯定、安全性好。     

呼末二氧化碳监测在ERCP麻醉中预防麻醉期间低氧血症应用效果

摘要 目的：探讨呼末二氧化碳监测在内镜下经胰胆管造影（ERCP）麻醉中预防麻醉期间低氧血症应用效果。方法：选择2022年1月-2023年6月本院-行ERCP治疗的300例患者,用随机数表法分为试验组（n=150）和对照组（n=150）。对照组给予行常规心电图、血压和血氧饱和度监测,试验组在对照组基础上行呼末二氧化碳监测。比较两组一般资料、低氧血症、呼吸暂停、面罩加压给氧及改变头部姿势发生情况。结果：两组一般资料进行比较,无统计学差异（P>0.05）;试验组低氧血症、呼吸暂停、面罩加压给氧均显著低于对照组,改变头部姿势发生率显著高于对照组,两组比较有统计学意义（P<0.05）。结论：ERCP麻醉患者中使用呼末二氧化碳监测可实时指导对患者进行辅助呼吸处理,降低ERCP 麻醉期间低氧血症的发生率和面罩加压给氧率。     

90例原发性癫痫患者睡眠呼吸障碍及其相关事件分析

目的:探讨原发性癫痫患者夜间睡眠呼吸障碍及相关事件的特点.方法:对90例原发性癫痫患者进行夜间多导睡眠图(PSG)检查.分析夜间睡眠呼吸暂停低通气指数、睡眠各期SPO2值及相关腿动事件.结果:本组病人的PSG检测结果表现为SPO2监测显示有26.67%的患者合并有睡眠呼吸暂停低通气综合症(SAHS),合并SAHS组与不合并SAHS组在年龄、体重指数、是否合并高血压病方面进行比较P均<0.05,其差异有统计学意义.两组在病程、性别、发作形式、有无痫样放电、有无周期性腿动方面比较P值均>0.05,其差异无统计学意义.SPO2仪显示癫痫患者夜间存在不同程度低氧事件,其中SPO2最低值均发生在REM期.肌电显示孤立性腿动指数增加人数为27例(占30%),周期性腿动指数增加人数为15人(占16.67%),其中因激醒事件及呼吸事件因素而导致腿动指数增加分别占一定比例,且腿动事件主要集中在NREM期.结论:原发性癫痫患者常伴有睡眠呼吸障碍及夜间低氧事件.     

经鼻高流量湿化氧疗对肺癌放射性肺炎合并呼吸衰竭患者的临床疗效观察

摘要 目的：探究经鼻高流量湿化氧疗对肺癌放射性肺炎合并呼吸衰竭患者的临床疗效,以期为临床治疗提供参考。方法：选取2020年9月至2022年8月在我院呼吸内科住院的因肺癌放射治疗出现放射性肺炎合并呼吸衰竭患者86例为研究对象,根据氧疗方法的不同分为HFNC组和COT组,每组各43例, COT组患者在此基础上给予鼻导管供氧治疗。HFNC组患者给予HFNC氧疗方式。比较两组患者治疗前后血气分析指标、呼吸频率及舒适度、疲劳程度评分的差异及对比两组的预后情况。结果：治疗后12 h、24 h、48 h两组PaO₂//FiO₂/指标均较治疗前明显升高（P<0.05）,且治疗后各个时间点HFNC组对PaO₂/FiO₂/指标改善明显优于COT组,差异具有统计学意义（P<0.01）。治疗后12 h、24 h、48 h两组呼吸频率均较治疗前明显降低（P<0.05）,且治疗后各个时间点HFNC组对呼吸频率改善明显优于COT组,差异具有统计学意义（P<0.01）。治疗后两组患者舒适度评分均较治疗前明显升高、疲劳程度评分较治疗前明显降低（P<0.05）,HFNC组对舒适度、疲劳程度评分改善程度明显优于COT组（P<0.01）。HFNC组患者气管插管占比、非机械通气天数明显少于COT组（P<0.01）,死亡人数占比两组患者差异无统计学意义（P>0.05）。结论：经鼻高流量湿化氧疗可以改善肺癌放射性肺炎合并呼吸衰竭患者氧合指数,降低患者呼吸频率,改善患者舒适度和促进患者预后。     

咽喉部高频喷射通气调节各参数对狗肺通气效率的影响

用相关和回归处理方法,研究了8条正常狗咽喉部高频喷射通气时,调节驱动压、呼吸比和频率对喷气量、吸入气氧浓度、动脉血气及气道内压的作用。结果显示,驱动压和呼吸此对各观察指标几乎有同等重要的作用,频率的影响很小,喷气量与吸入气氧浓度、动脉血气、气道内压间存在显著的正相关关系。说明调节参数的意义主要在于改变了喷气量。     

异丙酚复合芬太尼静脉麻醉镇痛对门诊人工流产术的影响

目的:观察异丙酚复合芬太尼静脉麻醉对于人工流产术时及术后的影响。方法:选择2001年3月——2001年9月在本院计划生育门诊就诊、自愿要求无痛人工流产的妇女120例作为无痛人工流产组(简称:无痛组),同期按常规方法行人工流产的妇女120例作为对照组(简称:对照组),进行配对研究。无痛组用异丙酚1.5mg/kg复合芬太尼2μg/kg诱导,术中用异丙酚维持,人工流产术按常规方法施行。结果:无痛组术中异丙酚用量为2.7±0.7mg/kg,芬太尼2μg/kg,术中无知觉,120例妇女均无疼痛主诉。对照组轻度疼痛82例(68.3％),中度疼痛33例(27.5％),重度疼痛3例(4.2％)。无痛组在麻醉诱导及维持期间均出现呼吸频率下降,通过控制呼吸、面罩吸氧,SaO_2可以保持在99％以上,不需气管插管。两组妇女术前及术后宫腔深度无明显差异(P>0.05)。无痛组术中出血量为32.2±23.2ml,对照组为19.8±15.9ml,无痛组较对照组明显增多,有极显著统计学差异(P<0.01)。结论:异丙酚复合芬太尼静脉麻醉对人工流产术的主要影响是手术的出血量略增多,但不影响子宫收缩及术后恶露持续时间,该麻醉是一种有效镇痛方法,适用于门诊人工流产术。     

无创机械通气治疗急性心肌梗死低氧血症的护理体会

目的:探讨Bi PAP无创呼吸机辅助呼吸治疗急性心肌梗死低氧血症的临床疗效和护理措施。方法:选取我院2013年8月至2014年12月抢救中心急性心肌梗死伴低氧血症患者,在常规治疗及高流量吸氧后,末梢血氧饱和度(SPO2)90%者40例,采用无创呼吸机辅助治疗并加强护理,观察治疗后血气指标SPO2、Pa O2和Pa CO2的变化。结果:所有患者在无创通气30 min后SPO2均升至90%以上,而PO2升至正常低限,1 h后Pa O2恢复正常。结论:无创呼吸机辅助治疗是治疗急性心肌梗死低氧血症的有效方法。     

经鼻面罩BiPAP正压通气治疗重症支气管哮喘合并Ⅱ型呼吸衰竭的临床观察

目的观察经鼻面罩BiPAP无创正压通气治疗重症支气管哮喘合并Ⅱ型呼吸衰竭的临床效果。方法观察患者行呼吸机治疗前,治疗后4、12、24、48h的临床症状及血气分析。结果治疗后患者的临床症状、血气分析（pH、PaCO2、PaO2）均有显著改善,且无严重并发症发生。结论 BiPAP无创正压通气有助于呼吸改善,正确有效的护理措施对保证通气治疗的效果、减少并发症具有重要意义。     

西北地区无痛支气管镜的临床应用

目的:观察西北地区开展无痛支气管镜检查方法的优越性。方法:将600例患者随机分为A、B两组,A组为观察组,给予异丙酚复合瑞芬太尼静脉麻醉法,经喉罩人工辅助通气,B组为对照组,给予单纯利多卡因表面麻醉,方法为利多卡因氧气加压口鼻面罩雾化,鼻腔、气管内滴药,连续观察患者在支气管镜诊疗前、过程中血压、心率、血氧饱和度变化及术中、术后反应情况。结果:观察组气管镜操作前、中的血氧饱和度无明显改变,心率、血压有所升高,术后舒适度明显高于对照组。结论:无痛支气管镜诊疗时可以获得满意的麻醉效果,优于常规局麻法,值得临床推广应用。     

Recent advances in the study of Kaposi's sarcoma-associated herpesvirus replication and pathogenesis

It has now been over twenty years since a novel herpesviral genome was identified in Kaposi's sarcoma biopsies. Since then, the cumulative research effort by molecular biologists, virologists, clinicians, and epidemiologists alike has led to the extensive characterization of this tumor virus, Kaposi's sarcoma-associated herpesvirus(KSHV; also known as human herpesvirus 8(HHV-8)), and its associated diseases. Here we review the current knowledge of KSHV biology and pathogenesis, with a particular emphasis on new and exciting advances in the field of epigenetics. We also discuss the development and practicality of various cell culture and animal model systems to study KSHV replication and pathogenesis.     

The structure, reproduction and taxonomy of Vidalia and Osmundaria (Rhodophyta, Rhodomelaceae)

Comprises species occurring mostly in subtidal habitats in tropical, subtropical and warm-temperate areas of the world. An analysis of the type species, V. spiralis (Sonder) Lamouroux ex J. Agardh, a species from Australia, establishes basic characters for distinguishing species in the genus. These characters are (1) branching patterns of thalli, (2) flat blades that may be spiralled on their axis, (3) width of the blade, (4) primary or secondary derivation of sterile and fertile branchlets and (5) position of sterile and fertile branchlets on the thalli. Application of the latter two characters provides an important basic method for separation of species into three major groups. Osmundaria , a genus known only in southern Australia, was studied in relation to Vidalia , and its separation from the Vidalia assemblage is not accepted. Species of Vidalia therefore are transferred to the older genus name, Osmundaria. Two new species, Osmundaria papenfussii and Osmundaria oliveae are described from Natal. Confusion in the usage of the epithet, Vidalia fimbriala Brown ex Turner has been clarified, and Vidalia gregaria Falkenberg, described as an epiphyte on Osmundaria pro/ifera Lamouroux, is revealed to be young branches of the host, Osmundaria prolifera.     

New or rare chromosome counts in Artemisia L. (Asteraceae, Anthemideae) and related genera from Kazakhstan

Fifteen chromosome counts of six Artemisia taxa and one species of each of the genera Brachanthemum, Hippolytia, Kaschgaria, Lepidolopsis and Turaniphytum are reported from Kazakhstan. Three of them are new reports, two are not consistent with previous counts and the remainder are confirmations of very scarce (one to four) earlier records. All the populations studied have the same basic chromosome number, x = 9, with ploidy levels ranging from 2x to 6x. Some correlations between ploidy level, morphological characters and distribution are noted.     

肝癌中HBV和HCV基因和抗原的分布及意义

采用原位分子杂交方法检测HCV RNA及HBV X基因;采用免疫组织化学方法研究HCV核心抗原,非结构区C33c抗原及HBxAg在肝细胞肝癌中的定位及分布.结果表明(1)HCV RNA、HBV X基因在肝细胞肝癌组织检出率分别为40%(55/136)和82%(112/136).HCV RNA定位于癌细胞的胞浆内,阳性细胞呈散在、灶状及弥漫分布三种形式;HBV X基因在肝癌细胞中的分布呈胞浆型、核型及核浆型,阳性细胞也呈上述三种分布形式;(2)HCV C33c抗原、核心抗原在肝细胞肝癌中的阳性率为81%(133/164)及86%(141/164).C33c抗原定位于癌细胞及肝细胞的胞浆内;核心抗原既定位于癌细胞核中,又可定位于胞浆中.C33c抗原阳性细胞以灶状分布为主;而核心抗原阳性细     

Selection with two alleles and complete dominance

For a plant selection model with frequency-independent viabilities, fertilities and selfing rates, it is shown that apart from global fixation, for certain parameter combinations a protected polymorphism and facultative fixation (either allele may become fixed according to initial frequencies) may both occur. Facultative fixation requires different selling rates for the dominant and recessive type. Protection of the polymorphism requires resource allocation for male and female function. In this connection the problem of purely genetically caused population extinction is discussed.
For general frequency dependence and regular segregation, the chances for establishment of a completely recessive gene are compared to those of a completely dominant gene. It is proven that the process of establishment of the recessive gene, despite a fitness advantage, may be considerably endangered by drift effects if random mating prevails. The recessive gene may reach the same effectivity in establishment as a dominant gene, only if the recessive homozygote mates exclusively with its own type during the period of establishment.