1岁以下室间隔缺损合并肺动脉高压心内直视术的体外管理

婴儿的解剖、生理功能与成人差别甚大，婴儿的脏器发育尚不成熟，细胞膜稳定性差，易发生组织水肿，未成熟心肌在结构、代谢和功能上与成熟心肌有着较大差异，体外循环（CPB）对婴儿生理扰乱非常严重，尤其是室缺合并肺高压患儿，术后发生急性呼吸窘迫综合征、低心排等并发症的几率增高，死亡率亦较高，因此对CPB管理提出了更高的要求。我院自1999年6月至今共开展1岁以下室缺合并肺高压心脏直视术26例，取得了满意效果，现将CPB管理体会介绍如下。

室缺肺高压术后低心排血量综合征的护理

室缺肺高压术后低心排血量综合征的护理王兰（中国人民解放军第４６５医院心胸外科１３２０１３）低心排血量综合征（下称ＬＯＳ）是心脏病手术后严重并发症，也是危重心脏手术后常见并发症之一。一旦发生ＬＯＳ，除及时诊断和治疗外，良好的术后护理对降低死亡率十分重要...

配电变压器高压侧缺相过压分析

针对在配电变压器高压侧缺相时引发的过电压损害，分析了造成这类过电压的原因，并提出了针对性解决办法。

室缺并重度肺高压术后早期并发症的发生原因及处理的探讨

本文介绍１２５例室缺并重度肺高压术后早期４种并发症：暴发性非心源性肺水肿、呼吸窘迫综合征、肺高压危象、室上性心动过速，对其发生原因及处理进行探讨。

二氧化碳压缩机高压缸转子的窜轴原因及对策

详述了大型化肥厂二氧化碳压缩机高压缸转子窜轴的原因 ,并制定了相应的对策 。

一起配电变压器损坏故障分析

针对坑内变压器故障后同时存在一相高压跌落熔丝熔断、变压器散热片出现破口和台区两相供电电压偏低的故障,逐一分析故障原因,由于变压器长期过负荷运行,低压出线与变压器散热片距离太近,引起绝缘损坏,出现间歇性电弧放电,造成散热片出现破口,从低压线与散热片之间的空气间隙完全被击穿,演变成单相接地短路,变压器缺相运行,文章在工艺上和运行管控上提出建议。

Deformation defects and electron irradiation effect in nanostructured Al-Mg alloy processed by severe plastic deformation

In order to explore the exact nature of deformation defects previously observed in nanostructured Al-Mg alloys subjected to severe plastic deformation, a more thorough examination of the radiation effect on the formation of the planar defects in the high pressure torsion （HPT） alloys was conducted using high-resolution transmission electron microscopy （HRTEM）. The results show that high density defects in the HRTEM images disappear completely when these images are exposed under the electron beam for some duration of time. At the same time, lattice defects are never observed within no-defect areas even when the beam-exposure increases to the degree that holes appear in the areas. Therefore, it is confirmed that the planar defects observed in the HPT alloys mainly result from the significant plastic deformation and are not due to the radiation effect during HRTEM observation.

CMP300智能电力监控仪

介绍自主研发的一款融电参量、计算、分析、诊断、控制、保护、通过标准通讯接口实现远程监控功能的CMP300智能电力监控仪,有效地解决了市场同类电力监控仪在广播电视台站复杂系统环境下不能正确判断高压缺相问题。

电力监控在邵永高速公路的应用

由于湖南邵永高速公路有限公司营运管理模式是采用集中监控,大站带小站集中居住的管理模式,即小站时无水电工及维护人员值守如果要及时了解发电机的运行状况及参数就显得鞭长莫及。而电力监控可以很好地解决该类问题,本文浅谈了电力监控在邵永高速公路的应用。

INCREASED EXPRESSION OF PDGF AND C-MYC GENES IN LUNGS AND PULMONARY ARTERIES OF PULMONARY HYPERTENSIVE RATS INDUCED BY HYPOXIA

The role of growth factors and proto-oncogene in pulmonary vascular structural remodelling is not well known.The present study examined gene expression of platelet-derived growth factor(PDGF)-A and -B chain and proto-oncogene,c-myc,in lung tissue and pulmonary artery of rats exposed to hypoxia and compared to those levels of gene expression in normal rats.Normal lungs and pulmonary artery expressed PDGF-A chain transcript of 1.7 kb and PDGF-B chain transcript of 3.5 Kb.The c-myc transcript of 2.2 kb was expressed as well. After hypoxic exposure for 7 and 14 days mRNA levels of PDGF-B chain and cmyc were elevated significantly compared with those of control rats.PDGF-A chain mRNA increased after hypoxia for 7 days,and then declined.These results suggest that activation of autocrine and/or paracrine is important in proliferation mechanism of pulmonary artery smooth muscle cells in hypoxic pulmonary hypertensive rats.

Effects of hyperbaric oxygen and Pgg-glucan on ischemic colon anastomosis

AIM： In colorectal surgery, anastomotic failure is still a problem in ischemia. Here, we analyzed the effects of hyperbaric oxygen and beta-glucan on colon anastomoses in ischemic condition. METHODS： Colonic resection and anastomosis in rectosigmoid region were done in forty Wistar-Albino rats of four groups of equal number. Colon mesentery was ligated to induce ischemia. The first group was the control group. The subjects of second group were treated with hyperbaric oxygen; the third group with glucan and the forth group were treated with both. At the forth day, rats were sacrificed, anastomotic segment was resected and burst pressures and hydroxyproline levels of anastomotic line were measured. RESULTS： The burst pressure difference of second and third groups from the control group were meaningful （P〈0.01）; the forth group differed significantly from the control （P〈0.001）. There was no difference between the treated groups on burst pressure level （P〉0.05）. The hydroxyproline levels in all treated groups were different from the control group significantly （P〈0.001）. Hydroxyproline levels in the forth group were higher than those of the second and the third groups （P〈 0.001）. There were no significant differences between the second and the fourth groups in burst pressure and hydroxyproline levels （P〉 0.05）. CONCLUSION： Hyperbaric oxygen and glucan improve healing in ischemic colon anastomoses by anti-microbic,immune stimulating properties and seem to act synergistically when combined together.

Home-made fenestrated amplatzer occluder for atrial septal defect and pulmonary arterial hypertension

We report the management of a patient with secundum atrial septal defect （ASD） and severe pulmonary hypertension. A 65-year-old male with recently diagnosed atrial septal defect was referred to our centre for decompensated right heart failure with rest and exercise induced dispnea and severe pulmonary hypertension. Right heart catheterization confirmed a mean pulmonary pressure of about 55 mmHg and a Qp/Qs of 2.7. An occlusion test with a compliant large balloon demonstrated partial fall of pulmonary arterial pressure. The implantation of a home-made fenestrated Amplatzer ASD Occluder （ASO） was planned in order to decrease left-to-right shunt and promote further decrease of pulmonary arterial pressure in the long-term. Thus, by means of mechanical intracardiac echocardiography study with a 9F 9 MHz Ultralce catheter （Boston Scientific Corp.）, we selected a 34 mm ASO for implantation. Four millimeter fenestration was made inflating a 4 mm non-compliant coronary balloon throughout the waist of the ASO, which was successfully implanted under intmcardiac echocardiography. After six months, a decrease of pulmonary arterial pressure to 24 mmHg and full compensated right heart failure was observed on transthoracic echocardiography and clinical examination. This case suggests that Wanscatheter closure with home-made fenestrated ASD in elderly patients with severe pulmonary hypertension is feasible.

Relationship of serum vitamin D level on geriatric syndromes and physical performance impairment in elderly hypertensive patients

Objective To investigate the relationship among serum vitamin D levels, physical performance impairment, and geriatric syndromes in elders with hypertension. Methods According to the concentration of vitamin D levels, a total of 143 elderly patients with hypertension were classified into vitamin D deficient group （vitamin D 〈 20 ng/mL, n = 94） and vitamin D appropriate group （vitamin D 〉 20 ng/rnL, n = 49）. Geriatric syndromes and physical performance were assessed by using comprehensive geriatric assessment （CGA）. Correlation among vitamin D levels, geriatric syndromes and physical performance was analyzed. Results No statistical differences were found in various aspects of geriatric syndromes between the two groups （P 〉 0.05）. While correlation analysis indicated that vitamin D levels had a positive association with ADL score （r = 0.235, P 〈 0.01） and a negative association with Morse fall scale score （r = 0.238, P 〈 0.01）. Patients with deficient vitamin D level had longer time both in the Five Time Sit to Stand Test （5tSTS）, （15.765 ± 5.593） and the four-meter walk test [7.440 （5.620, 9.200）], a weaker hand-grip in the grip strength test （28.049 ± 9.522）, and a lower Tinetti performance-oriented mobility assessment （Tinetti POMA） [26 （22, 27）] and Balance subscale of the Tinetti performance-oriented mobility assessment （B-POMA） score [ 14 （12, 16）], compared with appropriate vitamin D level [（13.275 ± 3.692）; 5.810 （4.728, 7.325）]; （31.989 ± 10.217）; [26.5 （25, 28）]; [15 （14, 16）, respectively, all P 〈 0.05]. Furthermore, results of logistic regression indicated that vitamin D was significantly associated with 5tSTS （OR = 1.2, 95% CI = 1.050-1.331, P 〈 0.01）, Tinetti POMA （OR = 3.7, 95% CI：1.284-10.830, P 〈 0.05） and B-POMA （OR = 0.8, 95% CI：0.643-0.973, P 〈 0.05）. Conclusions In elderly hypertensive patients, serum vitamin D deficient level is associated with physical performance impairment. However, no statistical significance was found between vitamin D and geriatric syndromes. Further study is required to investigate possible mechanisms for the association between vitamin D and physical performance.

Characteristics and formation mechanisms of defect bands in vacuum-assisted high-pressure die casting AE44 alloy

The microstructure in vacuum-assisted high-pressure die casting(HPDC) Mg-4Al-4RE(AE44) alloy was studied. Special attention was paid to the characteristics of defect bands and their formation mechanisms. Since double defect bands are commonly observed, the cross section of die cast samples is divided into five parts with different grain morphologies and size distributions. The inner defect band is much wider than the outer one. Both the defect bands are solute segregation bands, resulting in a higher area fraction of Al;RE;phase than that in the adjacent regions. No obvious aggregation of porosities is observed in the defect bands of AE44 alloy. This may be due to a narrow solidification temperature range of AE44 alloy and a large amount of latent heat released during the precipitation of intermetallic phases. The formation of the defect bands is related to the shear stress acting upon the partially solidified alloy, which can lead to collapse of the grain network. However, the generation mechanisms of shear stress in the outer and inner defect bands are quite different.

A new measuring technique in detecting of high voltage three phase induction motor for single phasing

Open phase in three phase induction motors is a common fault that can occur as a result of a fuse blowing or a pro- tective device failing on one phase of the motor. This paper introduces a new method,which is based on the transient mea- surement and can distinguish the fault of one phase connecting ground. The method has been proved to be in correspondence with the simulation results by Matlab and LabVIEW in practice, The method has merits of simplicity, accuracy and ease of USe.

THE ROLES OF bcl-2 GENE FAMILY IN THE PULMONARY ARTERY REMODELING OF HYPOXIA PULMONARY HYPERTENSION IN RATS

Objective. To investigate the roles of apoptosis in the pulmonary artery remodeling of pulmonary hypertension secondary to hypoxia and illustrate the relative genes expression. Methods. Thirty rats were divided into hypoxia group（ 10％ O2, 8h/d） and normal control group. On the 15th day of hypoxia, pulmonary artery pressure and right ventricular hypertrophy index were measured and pulmonary artery vessels were studied by light microscope. Then terminal deoxynucleotidyl transferase- mediated dUTP nick- end labeling（ TUNEL） technique was used to detect nucleosomal DNA fragmentation of apoptotic cells. In situ hybridization and RT- PCR were used to detect the expression level of bcl- 2 and bax. Results. The pulmonary artery pressure and right ventricular hypertrophy index of hypoxia group were increased significantly, the pulmonary artery wall of hypoxic group become incrassate than control group. Apoptotic cells can be found in lung with hypoxia or without hypoxia. Compared with control group, apoptotic index of hypoxic group decreased significantly. Through the methods of in situ hybridization and RT- PCR, we found the expression of bcl- 2 increased whereas bax decreased significantly in the hypoxic group. Conclusion. The alternation in bcl- 2 and bax expression induced by hypoxia play an important role in the pulmonary artery remodeling which is the main pathologic change of pulmonary hypertension secondary to hypoxia.

Hypoxia-inducible factor 1 alpha upregulates the expression of inducible nitric oxide synthase gene in pulmonary arteries of hypoxic rat

Objective To investigate the expression of hypoxia inducible factor 1 alpha (HIF 1α) and inducible nitric oxide synthase (iNOS) genes in rats’ pulmonary arteries in different phases of hypoxia induced pulmonary hypertension development Methods Models of chronic hypoxic pulmonary hypertension rat were duplicated by intermittent hypoxia Mean pulmonary arterial pressure (mPAP) was measured by right heart catheterization HIF 1α and iNOS messenger ribonucleic acid (mRNA) were detected by in situ hybridization HIF 1α and iNOS protein were measured by immunohistochemical analysis Results Expression of HIF 1α protein was upregulated in pulmonary arterial tunica intimae of all hypoxic rats In pulmonary arterial tunica media, the level of HIF 1α protein was markedly upregulated at days 3 and 7 of hypoxia ( P 【0 01), then tended to restore at 14 days and 21 days HIF 1α mRNA levels in pulmonary arteries of rats began to increase significantly at day 14 of hypoxia ( P 【0 01) Expression of iNOS mRNA and protein in pulmonary arteries of rats were upregulated by hypoxia for 3 days ( P 【0 01), then reached its peak and maitained the same level while the extension of hypoxia Linear correlation analysis showed that iNOS protein was associated with both mean pulmonary arterial pressure ( r =0 74, P 【0 01) and hypoxic pulmonary vascular remodeling ( r =0 78, P 【0 01), whereas the inverse was associated with HIF 1α protein ( r =-0 52, P 【0 01) Conclusions HIF 1α and iNOS are both involved in the pathogenesis of hypoxia induced pulmonary hypertension in rat HIF 1α protein may upregulate the expression of iNOS gene by transcriptional activation; in addition, iNOS protein may inhibit the expression of HIF 1α protein

Observation on Therapeutic Effect in Treatment of Hypoxemic Infantile Encephalopathy by Acupuncture plus Hyperbaric Oxygen

Objective： To investigate the therapeutic effect of acupuncture plus hyperbaric oxygen in treating hypoxemic infantile encephalopathy （HIE）. Methods： Fifty-nine HIE children were divided into treatment （33 cases） and control （26 cases） groups. Both groups were treated by basic therapy of removing acidosis, controlling cerebral edema and convulsion, and intravenous drip of cerebrolysin or citicoline. The treatment group was treated by acupuncture plus hyperbaric oxygen and the control group was treated by hyperbaric oxygen only. Results： The total effective rate was 97.0% in the treatment group and 73.1% in the control group. Statistical analysis showed a highly significant difference （P〈0.01）. Conclusion： Acupuncture plus hyperbaric oxygen was better than simple hyperbaric oxygen in treating HIE. Its main manifestations were shortening the course of disease, increasing cure rate, decreasing death rate and reducing the occurrence of sequelae. HIE children should be treated as early as possible.

Simple flaps for reconstruction of pediatric scalp defects after electrical burn

Objective： To analyze the management of high-voltage electrical burn injury of the scalp in our hospital. Methods： This study involved 10 patients who suf- fered from high-voltage electrical bum injury of the scalp. Scalp reconstruction was done by different modalities ac- cording to the size and location of the defect. Results： Complete flap viability was achieved in all the cases. We had one case of gapped wound which was managed only by dressing. Widening of the scar was found in 2 cases. Conclusion： Rotation, advancement and transposi- tion scalp flaps are used for reconstructing scalp defects caused by electrical bum. The choice of ideal flaps for re- construction depends upon the size and site of scalp defect.