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脓毒症时凝血抑制物和弥散性血管内凝血
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作者 w.l.lee G.P.Downey 汤屹 《德国医学》 CAS 2001年第4期199-200,共2页
脓毒症是一种以感染和系统性炎症反应为特征的综合征,表现为发热和白细胞增加,病死率≥35%.最近的研究表明,机体反应所致细胞因子介导凝血系统的激活和纤溶系统的抑制,最终可使脓毒症发展为DIC,反过来促使器官衰竭并造成不良预后.由于... 脓毒症是一种以感染和系统性炎症反应为特征的综合征,表现为发热和白细胞增加,病死率≥35%.最近的研究表明,机体反应所致细胞因子介导凝血系统的激活和纤溶系统的抑制,最终可使脓毒症发展为DIC,反过来促使器官衰竭并造成不良预后.由于对脓毒症和感染性休克的有效治疗手段不多,因此调整患者的炎症反应备受关注. 展开更多
关键词 脓毒症 凝血 抑制物 DIC 抗凝血酶Ⅲ ATⅢ 临床试验 TFPI
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急性呼吸窘迫综合征的肺保护性机械通气治疗策略
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作者 w.l.lee A.S.Detsky +1 位作者 T.E.Stewart 赵建平 《德国医学》 CAS 2001年第5期247-248,共2页
急性呼吸窘迫综合征(ARDS)是以低氧血症、X线上双肺浸润和不伴左房压升高为特征的综合征.它与许多肺和肺外危险因素有关,往往伴有很高的死亡率.预后不良的因素包括支气管肺泡灌注和血浆细胞因子水平增加、脓毒血症及多器官功能的衰竭.... 急性呼吸窘迫综合征(ARDS)是以低氧血症、X线上双肺浸润和不伴左房压升高为特征的综合征.它与许多肺和肺外危险因素有关,往往伴有很高的死亡率.预后不良的因素包括支气管肺泡灌注和血浆细胞因子水平增加、脓毒血症及多器官功能的衰竭.治疗措施多为支持疗法,机械通气是主要的治疗手段. 给予病人理想的潮气量和呼气末正压通气(PEEP)水平可以通过测量病人的压力-容积曲线获得.ARDS时压力-容积曲线常呈乙状形态,伴有两个折点,一个在低肺容量,另一个在高肺容量(分别代表高、低两个折点).低折点(也称Pflex)代表塌陷的肺泡重新复张时的压力,而上折点反映了肺过度膨胀及顺应性降低.换言之,通过调节潮气量使气道压力低于上折点,同时使PEEP水平设在低折点之上,可减轻机械通气对肺的损害.然而这只是一种逻辑上的假设,只有通过人体试验才能证实它的合理性. 展开更多
关键词 急性 呼吸窘迫综合征 机械通气
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Probabilistic assessment of overcooling risk for a novel extra-low temperature dedicated outdoor air system for Hong Kong office buildings
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作者 Yani Bao w.l.lee Jie Jia 《Building Simulation》 SCIE EI CSCD 2021年第3期633-648,共16页
Overcooling causes thermal discomfort and wastes energy.Effectiveness of a novel dedicated outdoor air system(DOAS)consisting of a multi-stage direct expansion coil to generate extra-low temperature(XT)outdoor air to ... Overcooling causes thermal discomfort and wastes energy.Effectiveness of a novel dedicated outdoor air system(DOAS)consisting of a multi-stage direct expansion coil to generate extra-low temperature(XT)outdoor air to handle the entire space cooling demand for better energy and humidity control has been confirmed in previous studies.In these studies,the terminal system was assumed using variable air volume(VAV)without reheating.The conventional VAV system without reheating has overcooling problem.This is associated with uncertain fluctuations of operating characteristics.However,virtually no study has been done to investigate its overcooling risk,and how it is compared with XT-DOAS.In this study,a rigorous probabilistic approach is proposed to account for the uncertain fluctuations of operating characteristics to assess their overcooling risks.Monte Carlo simulations with 10,000 interactions was used for risk analysis.A morphing method was employed to develop 10,000 weather files that could give an accurate prediction of future variations in yearly weather conditions.Reliable datasets were used to develop the probability distribution functions to account for the daily variations in use patterns.The most probable operating characteristics were input to EnergyPlus for hour-by-hour simulations.The annual cooling load profile formulated by the probabilistic approach was successfully validated by in-situ measurements.The probabilistic assessment results show that XT-DOAS has far less overcooling hours and lower long-term percentage of dissatisfied than the conventional VAV system.The results also indicate that the proposed probabilistic approach is useful for a robust system performance evaluation. 展开更多
关键词 overcooling risk Monte Carlo simulation uncertainty analysis extra-low temperature system VAV system
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