The diameters of the optic nerves in 54 patients with high intracranial pressure(ICP)were checked and measured with B type ultrasonic tomography and the relationship between thewidth of optic nerve and the optic papiliedema was studied. The results showed that the average diameter (6. 324-0.53)mm of the optic nerves in patients with high ICP was wider than that(3.61 ~:0.29 )mm in health subjects (P(0.01). The rate of increasing width of optic nerve (87.00%)was higher than that (67.00~)of papilledema (P(0.05). In addition,in 19 patients with ICP between 1.97 and 2.50 kPa, the rate of increasing width of optic nerve (79. 00~)was higher than that (42.00%)of papilledema (P (0. 05). These results indicated that measuring the diameter of optic nerve might be more practical than observing tile presence of papilledema in diagnosing high ICP,especially in early stage. （Chin J Ocul Fundus Dis,1996,12: 86-87）
OBJECTIVE: To investigate the clinical effect of skin flaps repairing severe thermopressure injury of hand. METHODS: From January 1989 to December 1998, 112 patients with severe thermopressure injury of hand were repaired by various skin flaps transfer, the size of skin flaps was 6 cm x 8 cm to 12 cm x 18 cm. Postoperative patients were treated by combined rehabilitation in early stage. RESULTS: All the flaps were survived with satisfactory effect. Sixty-six patients were followed up 6 to 12 months, skin flaps all showed better colour and texture, and function of the hand was satisfactory. CONCLUSION: Different skin flaps are adopted to repair severe thermopressure injury of the hand according to different skin defects of the hand, combined early rehabilitation treatment, to achieve good recovery of function and appearance of the hand to the greatest extent.
OBJECTIVE: To purify and study Schwann cells cytoplasmic neurotrophic protein. METHODS: The dissociated SC taken from 300 newborn rats sciatic nerves were cultured, collected, ultrasonicated and ultraspeed centrifuged. The supernates were ultrafiltrated and concentrated by using ultrafiltration units with PM10, PM30, PM50 ultrafiltration membranes. The ultrafiltrated-concentrated solution with the protein molecular weight 10-30 ku, 30-50 ku and gt; 50 ku were collected respectively. The dissociated spinal cord motoneurons of 14 days embryonic rats were cultured with serum-free conditional medium and the additional SC cytoplasmic proteins were added into the medium. The results showed that the 10-30 ku and gt; 50 ku SC cytoplasmic proteins were able to maintain the survival of motoneurons for 24 hours. Then the 26 ku and 58 ku proteins were further extracted and purified from SC cytoplasm by high pressure liquid chromatography, and their neurobiological activities were studied. RESULTS: The 26 ku and 58 ku Schwann cell’s cytoplasmic proteins were able to maintain the survival of motoneurons cultured in the serum-free medium for 48 hours. The highest biological activity concentration is 20 ng per well. CONCLUSION: Schwann cells cytoplasm contains motoneuron neurotrophic proteins with molecular weight 26 ku and 58 ku.
Objective To explore impact of climate change on aortic dissection and to put forward a new way about prediction and prevention of aortic dissection. Methods We retrospectively analyzed the characteristics of acute aortic dissection patients came from Hebei province in Fuwai Hospital between 2010 and 2016 year. Meanwhile, we collected monthly maximum temperature, minimum temperature, average temperature, average pressure, amount of rainfall, sunshine, humidity and other meteorological data. Generalized model was implied to explore climate change and the incidence of aortic dissection. Results A total of 1 121 acute aortic dissection patients from Hebei province were admitted in Fuwai Hospital during the period of 6 years. There were 774 patients were type A aortic dissection, and 347 patients were type B aortic dissection. The average age was 51.4±12.0 years. There were 873 males and 248 females. There were 889 (79.3%) patients with hypertension, 99 (8.83%) with Marfan syndrome. It was found that temperature, humidity and air pressure were all statistically significant for indication aortic dissection through single variable analysis (P<0.01). The temperature was only variable by one-way analysis of variance (P<0.01). The lowest temperature has the best predictive effect on the occurrence of aortic dissection. The relative risk was 1.02 with 95% confidence interval 1.02 to 1.03. Conclusion The change of climatic conditions can affect the occurrence of aortic dissection, and the lowest temperature is an important trigger factor for aortic dissection onset.
The Department of Thoracic Surgery of Shanghai Chest Hospital has performed esophageal function testing for over 30 years, being the only department of its kind in China with this capability. The pressure testing and 24-hour pH/impedance monitoring of the esophagus is of great help to assist in the diagnosis and treatment of benign and malignant esophageal diseases related to it. Thanks to the esophageal function test, in addition to the routine various endoscopic anti-reflux procedures, our hospital has taken the lead in China in recent years to carry out a series of clinical and research work for benign esophageal diseases, such as the development of magnetic ring, double nedoscopic combination and new anti-reflux endoscopic techniques. In recent years, we have carried out high-resolution esophageal manometry and 24-hour pH/impedance monitoring for patients with interstitial pneumonia and pulmonary fibrosis suspected to be caused by gastroesophageal acid reflux. We can better assess the correlation between gastroesophageal reflux and pulmonary fibrosis, and to provide the different clinical treatments and even surgical interventions. The Bravo capsule is used more often in the United States, and it has obvious advantages over traditional approach for acid measurement. We strongly call for the collaboration between industry and academic institutions in this field, and the development of our own related products with independent intellectual property rights.
The present paper is to study the center line of the plantar pressure of normal young people, and to find the relation between center line of the plantar pressure and gait stability and balance. The paper gives the testing principle and calculating methods for geometric center of plantar pressure distribution and the center of pressure due to the techniques of footprint frame. The calculating formulas in both x direction and y direction are also deduced in the paper. In the experiments carried out in our laboratory, the gait parameters of 131 young subjects walking as usual speed were acquired, and 14 young subjects of the total were specially analyzed. We then provided reference data for the walking gait database of young people, including time parameters, space parameters and plantar pressure parameters. We also obtained the line of geometry center and pressure center under the foot. We found that the differences existed in normal people's geometric center line and the pressure center line. The center of pressure trajectory revealed foot movement stability. The length and lateral changes of the center line of the plantar pressure could be applied to analysis of the plantar pressure of all kinds of people. The results in this paper are useful in clinical foot disease diagnosis and evaluation of surgical effect.
ObjectiveTo evaluate the effect of positive end-expiratory pressure (PEEP) on respiratory function and hemodynamics in acute lung injury (ALI) with intra-abdominal hypertension (IAH). MethodsSix pigs were anesthetized and received mechanical ventilation (MV). Volume controlled ventilation was set with tidal volumn(VT) of 8 mL/kg,respiratory rate(RR) of 16 bpm,inspired oxygen concentration (FiO2) of 0.40,and PEEP of 5 cm H2O. ALI was induced by repeated lung lavage with diluted hydrochloric acid (pH<2.5) until PaO2/FiO2 declined to 150 mm Hg or less to established ALI model. Intra-abdominal hypertension was induced by an nitrogen inflator to reach intra-abdominal pressure of 20 mm Hg. Respiratory parameters and hemodynamics were continuously recorded at different PEEP levels(5,10,15,and 20 cm H2O). Every level was maintained for one hour. ResultsPaO2/FiO2 in PEEP5,10,15 and 20 were 90±11,102±10,172±23 and 200±34 mm Hg respectively. PaO2/FiO2 in PEEP15 and 20 were significantly higher than those in PEEP5 and 10 (P<0.05). Chest wall compliance (Ccw) in PEEP5,15 and 20 were 26±3,76±15 and 85±14 mL/cm H2O respectively. Ccw in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in lung compliance (CL) in different PEEP levels (P>0.05). Plateau pressure(Pplat) in PEEP5,10,15 and 20 were 30±3,31±2,36±2 and 38±4 cm H2O respectively. Pplat in PEEP15 and 20 were significantly higher than those in PEEP5 and 10 (P<0.05). There was no significant difference in Pplat between PEEP15 and 20 (P>0.05). Heart rate (HR) in PEEP5,15 and 20 were 113±17,147±30,and 160±30 beat/min respectively. HR in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in HR between PEEP15 and 20 (P>0.05).Cardiac index (CI) in PEEP5 and 20 were 4.5±0.6 and 3.5±0.6 L·min-1·m-2 respectively. CI in PEEP20 was significantly lower than that in PEEP5 (P<0.05). There was no significant difference in CI in PEEP5,10 or 15(P>0.05). Central venous pressure(CVP) in PEEP5,15 and 20 were 12±2,17±2,and 18±3 mm Hg respectively. CVP in PEEP15 and 20 were significantly higher than those in PEEP5 (P<0.05). There was no significant difference in CVP between PEEP15 and 20 (P>0.05). There were no significant differences in MAP,SVRI,ITBVI,GEDI,PVPI,or EVLWI between different PEEP levels. ConclusionConcomitant ALI and IAH can induce great impairments in respiratory physiology. When PEEP is gradually increased,oxygenation and the respiratory function are improved without significant secondary hemodynamic disturbances.
Objective To propose a lightweight end-to-end neural network model for automated Korotkoff sound phase recognition and subsequent blood pressure (BP) measurement, aiming to improve measurement accuracy and population adaptability. Methods We developed a streamlined architecture integrating depthwise separable convolution (DSConv), multi-head attention (MHA), and bidirectional gated recurrent unit (BiGRU). The model directly processes Korotkoff sound time-series signals to identify auscultatory phases. Systolic BP (SBP) and diastolic BP (DBP) were determined using Phase Ⅰ and PhaseⅤdetections, respectively. Given the clinical relevance of phase Ⅳ for specific populations (e.g., children and pregnant women, denoted as DBPIV), BP values from this phase were also recorded. Results The study enrolled 106 volunteers with 70 males, 36 females at mean age of (40.0±12.0) years. The model achieved 94.25% phase recognition accuracy. Measurement errors were (0.1±2.5) mm Hg (SBP), (0.9±3.4) mm Hg (DBPIV), and (0.8±2.6) mm Hg (DBP). Conclusion Our method enables precise phase recognition and BP measurement, demonstrating potential for developing population-adaptive blood pressure monitoring systems.
Objective To investigate the antihypertensive effects of continuous airway positive pressure( CPAP) plus antihypertensive drugs on patients with obstructive sleep apnea hypopnea syndrome ( OSAHS) and hypertension.Methods 82 OSAHS patients with hypertension were enrolled in this study. They were randomly divided into a CPAP treatment group( 44 patients, treated with antihypertensive drugs and CPAP) , and a control group( 38 patients, treated with antihypertensive drugs only) . All the patients were performed polysomnography and 24-hour blood pressure monitoring before and 12 weeks after the treatment. Results After 12 weeks treatment, except the systolic pressure in night time( nSBP) , all the parameters of 24-hour blood monitoring improved better in the CPAP group than in the control group( all P lt; 0. 05) . The blood pressure dropped to normal in 75. 0% ( 33/44) CPAP patients and in 52. 6% ( 20 /38) control patients. In the CPAP group, 8( 18. 2% ) cases were withdrawn from antihypertensive drugs, 13( 29. 5% )cases required single agents, and 9( 20. 5% ) cases required three agents to achieve blood pressure control.But in the control group, all the patients needed two or more antihypertensive agents, in which 23( 60. 6% )patients needed three agents to achieve blood pressure control. After the treatment, the patients with dipping pattern blood pressure increased from10 to 29( 22. 7% -65. 9% , P lt;0. 05) in the CPAP group, and from10to 14( 26. 3% -36. 8%, P gt;0. 05) in the control group. Conclusions Combination therapy with CPAP and antihypertensive drugs controls blood pressure better than antihypertensive medication only for OSAHS patients with hypertension with fewer types of antihypertensive agents or even withdrawal from antihypertensive medication in some patients.
Objective To observe the short-term intraocular pressure after 25G+ pars plana vitrectomy (PPV) and analyze the possible influencing factors in rhegmatogenous retinal detachment (RRD) and proliferative diabetic retinopathy (PDR) eyes. Methods This is a retrospective case-control study. A total of 160 patients (163 eyes) of RRD and PDR who underwent 25G+ PPV were enrolled in this study. There were 88 males (89 eyes) and 72 females (74 eyes), with the mean age of (50.37±13.24) years. There were 90 patients (92 eyes) with RRD (the RRD group) and 70 patients (74 eyes) with PDR (the PDR group). Best corrected visual acuity (BCVA) and intraocular pressure (IOP) were performed on all the patients. The BCVA was ranged from hand motion to 0.6. The average IOP was (12.61±4.91) mmHg (1 mmHg=0.133 kPa). There were significant differences in crystalline state (χ2=9.285, P=0.009), IOP (χ2=58.45, P=0.000), history of PPV (χ2=4.915, P=0.027) and hypertension (χ2=24.018, P=0.000), but no significant difference in sex (χ2=0.314, P=0.635) and age (χ2=5.682, P=0.056) between the two groups. A non-contact tonometer has been used to measure IOP on postoperative day 1 and 3. The postoperative IOP distribution has been divided into five groups: severe ocular hypotension (≤5 mmHg), mild ocular hypotension (6 - 9 mmHg), normal (10 - 21 mmHg), mild ocular hypertension (22 - 29 mmHg), severe ocular hypertension (≥30 mmHg). Logistic regression analysis has been used to analyze the risk and protective factors. Results On the first day after surgery, there were 21 eyes (12.9%) in mild ocular hypotension, 96 eyes (58.9%) in normal, 22 eyes (13.4%) in mild ocular hypertension and 24 eyes (14.7%) in severe ocular hypertension. On the first day after surgery, there were 18 eyes (11.0%) in mild ocular hypotension, 117 eyes (71.7%) in normal, 23 eyes (14.1%) in mild ocular hypertension and 5 eyes (3.1%) in severe ocular hypertension. There was no significant difference of IOP distribution between the two groups (Z=−1.235, −1.642; P=0.217, 0.101). The results of logistic regression analysis showed that silicone tamponade was a risk factor for ocular hypertension in PDR eyes on the first day after surgery [odds ratio (OR)=15.400, 95% confidence interval (CI) 3.670 - 64.590; P＜0.001], while intraocular lens was the risk factor for ocular hypotension in PDR eyes on third day after surgery (OR=19.000, 95%CI 1.450 - 248.2; P=0.025). As for RRD eyes, the ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=3.755, 95%CI 1.088 - 12.955; P=0.036). For all eyes, silicone tamponade (OR=0.236, 95%CI 0.070 - 0.797), air tamponade (OR=0.214, 95%CI 0.050 - 0.911) and inert gas tamponade (OR=0.092, 95%CI 0.010 - 0.877) were protective factors for ocular hypotension on the first day after surgery (P=0.020, 0.037, 0.038); silicone tamponade was protective factor for ocular hypotension on the third day after surgery (OR=0.249, 95% CI 0.066 - 0.94, P=0.040); while aphakic eyes was the risk factor for ocular hypotension on third day after surgery (OR=7.765, 95% CI 1.377 - 43.794, P=0.020). The ocular hypotension before surgery was a risk factor for ocular hypertension on the third day after surgery (OR=4.034, 95% CI 1.475 - 11.033, P=0.007). Conclusions The abnormal IOP is common after 25G+ PPV with a rate from 28.3% to 31.1%. Silicone tamponade, air tamponade and inert gases tamponade are protective factors for postoperative ocular hypotension, aphakic eye is risk factor for postoperative ocular hypotension. Ocular hypotension before surgery and silicone oil tamponade are risk factors for postoperative ocular hypertension.