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Overexpression of HSP27 and HSP70 is associated with decreased survival among patients with esophageal adenocarcinoma 预览
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作者 Henna K Soerstrom Juha T Kauppi +4 位作者 Niku Oksala Timo Paavonen Leena Krogerus Jari Rasanen Tuomo Rantanen 《世界临床病例杂志》 2019年第3期260-269,共10页
BACKGROUND Overexpression of heat shock proteins(HSPs)is associated with several malignancies and contributes to the development,progression,and metastasis of cancer,in addition to the inhibition of cellular death.In ... BACKGROUND Overexpression of heat shock proteins(HSPs)is associated with several malignancies and contributes to the development,progression,and metastasis of cancer,in addition to the inhibition of cellular death.In recent years,there has been active research into using HSP inhibitors in several malignancies.Due to the poor prognosis of esophageal adenocarcinoma(EAC),it would be valuable to find new biomarkers for the development of cancer treatments.AIM To evaluate the expressions of HSP27 and HSP70 and their effect on survival in EAC.METHODS Immunohistochemical analyses and evaluations of HSP27 and HSP70 expression were performed on all available samples from 93 patients diagnosed with EAC between 1990 and 2007 at two university hospitals.Fifteen cases with Barrett’s metaplasia and 5 control cases from the same patient population were included in the analysis.HSP expression was quantitatively assessed and classified as high or low.Kaplan-Meier analyses and Cox regression models adjusting for age and sex as well as tumor site,stage,and grade were used to evaluate the effect on survival.RESULTS Tumor stage and surgical treatment were the main prognostic factors.High HSP27 expression in cancer cases was a strong negative predictive factor,with a mean survival of 23 mo compared to the 49 mo in cases with a low expression(P=0.018).The results were similar for HSP70,with a poorer survival of 17 mo in cases with high HSP70 expression,in contrast to 40 mo(P=0.006)in cases with a low expression.A Cox regression survival analysis was performed,adjusting for possible confounding factors,and higher HSP27 and HSP70 expressions remained an independent negative prognostic factor.The HSPs’correlation with survival was not affected by cancer treatments.When the analysis was adjusted for all factors,the odds ratios for HSP27 and HSP70 were 3.3(CI:1.6–6.6,P=0.001)and 2.2(CI:1.2–3.9,P=0.02),respectively.CONCLUSION HSP27 and HSP70 overexpression is associated with poor survival in EAC,which is,to the best of our knowledge, 展开更多
关键词 Esophageal adenocarcinoma HEAT shock proteins HEAT shock PROTEIN 27 HEAT shock PROTEIN 70 OVEREXPRESSION SURVIVAL
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严重失血性休克与脓毒性休克大鼠大循环与微循环变化的一致性 预览
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作者 胡乔华 郑胜才 +3 位作者 凌钦 伍靓靓 杨正飞 方向韶 《实用医学杂志》 CAS 北大核心 2019年第3期384-387,共4页
目的探讨严重失血性休克与脓毒性休克大鼠的大循环以及微循环的动态改变和协调一致性。方法20只雄性SD大鼠(450~550g)随机分为2组(n=10):失血性休克组(H-Shock)和脓毒性休克组(S-Shock)。H-Shock组于1h内抽出全身血容量的40%;S-Shock组... 目的探讨严重失血性休克与脓毒性休克大鼠的大循环以及微循环的动态改变和协调一致性。方法20只雄性SD大鼠(450~550g)随机分为2组(n=10):失血性休克组(H-Shock)和脓毒性休克组(S-Shock)。H-Shock组于1h内抽出全身血容量的40%;S-Shock组行盲肠结扎穿孔后关腹。两组均连续记录平均动脉压(MAP)、呼气末二氧化碳分压(ETCO2),于基线状态(BL)后1、2、3h以此类推行心脏超声、舌下微循环检查,共观察12h或大鼠死亡(End)。于BL、MAP≤65mmHg(Shock)、End时测量动脉血气。结果H-Shock组中反映大循环和微循环的各指标在不同时间点监测值较BL均下降(P<0.05);S-Shock组中反映大循环的MAP、ETCO2、心输出量等指标在3h内无明显变化(P>0.05),而微循环指标各时间点监测值与BL相比均下降(P<0.05);随着休克进展,两组动物的酸碱度均进行性降低,乳酸则进行性升高(P<0.05)。结论严重失血性休克大循环与微循环变化基本一致;脓毒性休克大循环与微循环不协调,大循环早期明显滞后于微循环的变化。 展开更多
关键词 休克 失血性休克 脓毒性休克 血流动力学 大循环 微循环
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增长与收缩——珠三角城市经济韧性的测度与影响因素(英文)
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作者 杜志威 张虹鸥 +2 位作者 叶玉瑶 金利霞 徐茜 《地理学报:英文版》 SCIE CSCD 2019年第8期1331-1345,共15页
In the aftermath of the global financial crisis of 2008, China witnessed gradual shrinkage of cities in the Pearl River Delta(PRD). In this study, we introduce the concept of economic resilience to analyse urban growt... In the aftermath of the global financial crisis of 2008, China witnessed gradual shrinkage of cities in the Pearl River Delta(PRD). In this study, we introduce the concept of economic resilience to analyse urban growth and shrinkage in the context of a rapidly-urbanising region. Multiple regression analysis is performed to explore the determinants of economic resilience in the PRD. By measuring resistance in the shrinking phase and recoverability in the growing phase in a group of cities in the PRD, this study distinguishes four scenarios and investigates their characteristics from a spatial perspective. The results demonstrate that the financial crisis had a severe and asymmetric influence on this area, indicating more than 15% of cities are faced with shrinking. The spatial distribution of economic resilience indicates a centre-periphery pattern, that is, high economic resilience in the inner ring and low economic resilience in the outer ring of the PRD. The service economy is found to play a significant role in promoting urban economic resilience. Results imply that sound economic policies for enhancing resilience: both poor local financial status and a high degree of export concentration adversely impact resistance, while upgrading the manufacturing economy and stimulating of industrial innovation are conducive to improve recoverability. 展开更多
关键词 economic RESILIENCE urban SHRINKAGE global FINANCIAL CRISIS shock resistance shock RECOVERABILITY PEARL River Delta
Th1/Th2细胞因子对粒细胞缺乏和非粒细胞缺乏脓毒症患儿预后评估的意义
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作者 奚悦玲 宁铂涛 +6 位作者 王莹 李璧如 钱娟 任宏 张建 张芳 项龙 《中华急诊医学杂志》 CAS CSCD 北大核心 2019年第6期691-696,共6页
目的探讨粒细胞缺乏(粒缺)和非粒细胞缺乏(非粒缺)的脓毒症患儿细胞因子特点及与预后的关系。方法138例诊断为脓毒症的患儿,根据外周血中性粒细胞绝对计数,分为粒缺组、非粒缺组,根据有无脓毒性休克,分为休克组、非休克组,分别分析各组... 目的探讨粒细胞缺乏(粒缺)和非粒细胞缺乏(非粒缺)的脓毒症患儿细胞因子特点及与预后的关系。方法138例诊断为脓毒症的患儿,根据外周血中性粒细胞绝对计数,分为粒缺组、非粒缺组,根据有无脓毒性休克,分为休克组、非休克组,分别分析各组炎性指标(CRP、PCT)、Th1/Th2细胞因子(IL-2、IL-4、IL-6、IL-10、TNF-α、INF-γ)、PRISM-Ⅲ评分及治疗转归。结果1)138例脓毒症患儿,64例为粒缺,74例为非粒缺,粒缺组PRISM-Ⅲ评分显著高于非粒缺组(P=0.048),两组患儿的病死率差异无统计学意义(P=0.4),粒缺组住院时间显著延长(P=0.02)。粒缺组CRP、IL-6、IL-10显著高于非粒缺组(P=0.001;P=0.001;P=0.032),粒缺组TNF-α显著低于非粒缺组(P=0.032)。2)在64例粒缺脓毒症患儿中有23例为脓毒性休克,41例非脓毒性休克,休克组PRISM-Ⅲ显著高于非休克组(P=0.001),休克组病死率(10/23,43.5%)显著高于非休克组(1/41,2.4%)(P=0.001)。休克组的CRP、PCT、IL-6、IL-10、TNF-α显著高于非休克组(P=0.001;P=0.001;P=0.001;P=0.005;P=0.019),ROC曲线分析,IL-6曲线下面积为0.80,Cut-off值为315.38 pg/mL,IL-10曲线下面积为0.80,Cut-off值为45.18 pg/mL,TNF-α曲线下面积为0.85,Cut-off值为1.95 pg/mL。3)在74例非粒缺脓毒症患儿中,19例为脓毒性休克,55例非脓毒性休克,休克组PRISM-Ⅲ显著高于非休克组(P=0.022),两组病死率比较差异无统计学意义(P=0.3)。休克组IL-10显著高于非休克组(P=0.015)。4)对42例脓毒性休克的患儿分析,23例为粒缺组,19例为非粒缺组,粒缺组PRISM-Ⅲ评分显著高于非粒缺组(P=0.005),粒缺组病死率(47.8%)和非粒缺(31.6%)差异无统计学意义(P=0.29)。粒缺组CRP、PCT、IL-6、IL-10因子显著高于非粒缺组(P=0.001;P=0.001;P=0.001;P=0.035),两组TNF-α差异无统计学意义(P=0.57)。5)分析96例非脓毒性休克的患儿,41例为粒缺组,55例为非粒缺组,两组PRISM-Ⅲ评分差异无统计学意义(P=0.6),非粒缺组� 展开更多
关键词 脓毒症 休克 脓毒性休克 粒细胞缺乏 非粒细胞缺乏 细胞因子 儿童 预后
Resuscitation incoherence and dynamic circulation-perfusion coupling in circulatory shock
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作者 Huai-Wu He Yun Long +1 位作者 Da-Wei Liu Can Ince 《中华医学杂志:英文版》 SCIE CAS CSCD 2019年第10期1218-1227,共10页
Objective: Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circul... Objective: Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock. Data sources: We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations, including resuscitation, circulatory shock, septic shock, tissue perfusion, hemodynamic coherence, and microcirculation (Micro). Study selection: The data from peer-reviewed journals printed in English on the relationships of tissue perfusion, shock, and resuscitation were included. Results: A binary (coherence/incoherence, coupled/uncoupled, or associated/disassociated) mode is used to describe resuscitation coherence. The phenomenon of resuscitation incoherence (RI) has gained great attention. However, the RI concept requires a more practical, systematic, and comprehensive framework for use in clinical practice. Moreover, we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro, Micro, and cell. The RI is divided into four types (Type 1: Macro-Micro incoherence + impaired cell;Type 2: Macro-Micro incoherence + normal cell;Type 3: Micro-Cell incoherence + normal Micro;and Type 4: both Macro-Micro and Micro-cell incoherence). Furthermore, we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock. Conclusions: The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock. Moreover, these concepts require further studies in clinical practice. 展开更多
关键词 Circulatory shock Shock Tissue PERFUSION MICROCIRCULATION HEMODYNAMIC COHERENCE RESUSCITATION INCOHERENCE
Interplanetary shock-associated aurora 预览
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作者 LIU Jianjun HU Hongqiao +1 位作者 HAN Desheng YANG Huigen 《极地科学进展:英文版》 CSCD 2019年第1期11-23,共13页
Interplanetary shocks or solar wind pressure pulses have prompted impacts on Earth’s magnetospheric and ionospheric environment, especially in causing dynamic changes to the bright aurora in the polar ionosphere. The... Interplanetary shocks or solar wind pressure pulses have prompted impacts on Earth’s magnetospheric and ionospheric environment, especially in causing dynamic changes to the bright aurora in the polar ionosphere. The auroral phenomenon associated with shock impingements, referred to as shock aurora, exhibits distinct signatures differing from other geophysical features on the dayside polar ionosphere. Shock aurora provides a direct manifestation of the solar wind–magnetosphere–ionosphere interaction. Imagers onboard satellites can obtain the associated large-scale auroral characteristics during shock impingement on the magnetopause. Therefore, auroral data from satellites are very useful for surveying the comprehensive features of shock aurora and their general evolution. Nonetheless, the ground-based high temporal-spatial resolution all-sky imagers installed at scientific stations play an essential role in revealing medium-and small-scale characteristics of shock aurora. Here, we focus on shock aurora imaging signatures measured by imagers onboard satellites and ground-based all-sky imagers. 展开更多
关键词 INTERPLANETARY shock SUDDEN IMPULSE shock AURORA wave-particle interaction field-aligned current
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Dorsomorphin induces cancer cell apoptosis and sensitizes cancer cells to HSP90 and proteasome inhibitors by reducing nuclear heat shock factor 1 levels 预览
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作者 Na Li Ting Wang +12 位作者 Zongmeng Li Xiaoli Ye Bo Deng Shu Zhuo Pengle Yao Mengmei Yang Hong Mei Xiaofang Chen Tengfei Zhu Shiting Chen Hui Wang Jiming Wang Yingying Le 《癌症生物学与医学:英文版》 CAS CSCD 2019年第2期220-233,共14页
Objective: Heat shock factor 1(HSF1), a transcriptional regulator of heat shock proteins(HSPs), is an attractive therapeutic target for cancer. However, only a few HSF1 inhibitors have been identified so far.Methods: ... Objective: Heat shock factor 1(HSF1), a transcriptional regulator of heat shock proteins(HSPs), is an attractive therapeutic target for cancer. However, only a few HSF1 inhibitors have been identified so far.Methods: The mRNA and protein levels of HSF1, HSPs, cleaved PARP, and phosphorylated HSF1 were examined by real-time PCR and Western blot. Forced expression, RNA interference, and immunofluorescence assay were used for mechanistic studies.Cell viability and apoptosis were measured by WST-8 assay and flow cytometry, respectively. Xenograft studies were performed in nude mice to evaluate the effect of dorsomorphin and an HSP90 inhibitor on tumor growth.Results: Dorsomorphin suppressed multiple stimuli-induced and constitutive HSPs expression in cancer cells. Mechanistic studies revealed that dorsomorphin reduced heat-induced HSP expression independent of adenosine monophosphate activated protein kinase. Dorsomorphin reduced heat-stimulated HSF1 Ser320 phosphorylation and nuclear translocation, as well as resting nuclear HSF1 levels in cancer cells. Dorsomorphin induced cancer cell apoptosis by inhibiting HSF1 expression. A structure-activity study revealed that the 4-pyridyl at the 3-site of the pyrazolo [1, 5-a]pyrimidine ring is critical for the anti-HSF1 activities of dorsomorphin. Dorsomorphin sensitized cancer cells to HSP90 and proteasome inhibitors and inhibited HSP70 expression induced by these inhibitors in vitro. In tumor-bearing nude mice, dorsomorphin enhanced HSP90 inhibitor-induced cancer cell apoptosis, tumor growth inhibition, and HSP70 expression.Conclusions: Dorsomorphin is an HSF1 inhibitor. It induces cancer cell apoptosis, sensitizes cancer cells to both HSP90 and proteasome inhibitors, and suppresses HSP upregulation by these drugs, which may prevent the development of drug resistance.Hence, dorsomorphin and its derivates may serve as potential precursors for developing drugs against cancer. 展开更多
关键词 Dorsomorphin HEAT shock factor 1 HEAT shock protein APOPTOSIS cancer
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Tuberculosis septic shock, an elusive pathophysiology and hurdles in management: A case report and review of literature 预览
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作者 Rashmi Mishra Harish K Patel +1 位作者 Rakesh Singasani Trupti Vakde 《世界重症医学杂志》 2019年第5期72-81,共10页
BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the ma... BACKGROUND Tuberculosis (TB) is a rare etiology of the septic shock. Timely administration of the anti-microbial agents has shown mortality benefit. Prompt diagnosis and a high index of suspicion are crucial to the management. We present three cases of TBSS with poor outcome in the majority despite timely and susceptible antibiotic administration. CASE SUMMARY Sixty-seven-year-old woman with latent TB presented with fever, cough, and shortness of breath. She was promptly diagnosed with active TB and started on the appropriate anti-microbial regimen;she had a worsening clinical course with septic shock and multi-organ failure after initiation of antibiotics. Thirty-threeyear- old man immunocompromised with acquired immune deficiency syndrome presented with fever, anorexia and weight loss. He had no respiratory symptoms, and first chest X-ray was normal. He had enlarged liver, spleen and lymph nodes suspicious for lymphoma. Despite broad-spectrum antibiotics, he succumbed to refractory septic shock and multi-organ failure. It was shortly before his death that anti-TB antimicrobials were initiated based on pathology reports of bone marrow and lymph node biopsies. Forty-nine-year-old woman with asthma and latent TB admitted with cough and shortness of breath. Although Initial sputum analysis was negative, a subsequent broncho-alveolar lavage turned out to be positive for acid fast bacilli followed by initiation of susceptible ant-TB regimen. She had a downward spiral clinical course with shock, multi-organ failure and finally death. CONCLUSION Worse outcome despite timely initiation of appropriate antibiotics raises suspicion of TB immune reconstitution as a possible pathogenesis for TB septic shock. 展开更多
关键词 TUBERCULOSIS SEPTIC shock TUBERCULOSIS and immune RECONSTITUTION TUBERCULOSIS in intensive care unit CASE FATALITY for TUBERCULOSIS SEPTIC shock CASE report
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Investigation of convergent Richtmyer–Meshkov instability at tin/xenon interface with pulsed magnetic driven imploding
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作者 张绍龙 刘伟 +6 位作者 王贵林 章征伟 孙奇志 张朝辉 李军 池原 张南川 《中国物理B:英文版》 SCIE EI CAS CSCD 2019年第4期247-253,共7页
The Richtmyer–Meshkov instability at the interface of solid state tin material and xenon gases under cylinder geometry is studied in this paper. The experiments were conducted at FP-1 facility in Institute of Fluid P... The Richtmyer–Meshkov instability at the interface of solid state tin material and xenon gases under cylinder geometry is studied in this paper. The experiments were conducted at FP-1 facility in Institute of Fluid Physics, China Academy of Engineering Physics(CAEP). The FP-1 facility is a pulsed power driver which could generate high amplitude magnetic field to drive metal liner imploding. Convergent shock wave was generated by impacting a magnetic-driven aluminium liner onto a inner mounted tin liner. The convergent evolution of the disturbance pre-machined onto the tin liner’s inner surface was diagnosed by x-radiography. The spike amplitudes were derived from x-ray frames and were compared with linear theory.An analytical model containing material strength effect was derived and matched well to the experimental results. This sensibility of the disturbance evolution to material strength property shines light to the application of Richtmyer–Meshkov instability to infer material strength. 展开更多
关键词 Richtmyer–Meshkov INSTABILITY PULSED power DRIVER CONVERGENT shock wave
注射用复方甘草酸苷致过敏性休克
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作者 王鑫璐 李月阳 +1 位作者 闫荟羽 王相峰 《药物不良反应杂志》 CSCD 2019年第4期297-298,共2页
1例43岁女性患者因肝损伤给予注射用还原型谷胱甘肽(1.2 g入5%葡萄糖注射液100 ml)、多烯磷脂酰胆碱(697.5 mg入5%葡萄糖注射液250 ml)、注射用复方甘草酸苷(120 mg入5%葡萄糖注射液250 ml)静脉滴注,1次/d。首次静脉滴注注射用复方甘草... 1例43岁女性患者因肝损伤给予注射用还原型谷胱甘肽(1.2 g入5%葡萄糖注射液100 ml)、多烯磷脂酰胆碱(697.5 mg入5%葡萄糖注射液250 ml)、注射用复方甘草酸苷(120 mg入5%葡萄糖注射液250 ml)静脉滴注,1次/d。首次静脉滴注注射用复方甘草酸苷约20 min(注射液入量约50 ml)时,患者突发皮疹、心悸、呼吸困难、全身大汗、腹痛、烦躁不安,心率126次/min,血压85/45 mmHg(1 mmHg=0.133 kPa)。考虑为注射用复方甘草酸苷引起的过敏性休克,立即停用注射用该药并静脉给予地塞米松、盐酸异丙嗪、葡萄糖酸钙、肾上腺素后,患者症状缓解。次日停用注射用复方甘草酸苷和注射用还原型谷胱甘肽,继续原剂量应用多烯磷脂酰胆碱,并给予乙酰半胱氨酸8 g入10%葡萄糖注射液250 ml静脉滴注、1次/d,双环醇片50 mg口服、3次/d,患者未再出现过敏反应。7 d后,患者肝功能明显改善。 展开更多
关键词 过敏反应 休克 复方甘草酸苷
盐酸多柔比星脂质体注射液致过敏性休克并脑死亡
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作者 毛丽超 张越 +1 位作者 闫荟羽 李月阳 《药物不良反应杂志》 CSCD 2019年第4期301-302,共2页
1例32岁女性患者因滤泡性淋巴瘤给予注射用盐酸多柔比星脂质体注射液20 mg入5%葡萄糖注射液250 ml静脉滴注。静脉滴注开始约1 min患者出现面部潮红,诉咽喉发痒。2 min后突发抽搐,并且意识丧失、双眼凝视、牙关紧闭、伴有小便失禁。诊断... 1例32岁女性患者因滤泡性淋巴瘤给予注射用盐酸多柔比星脂质体注射液20 mg入5%葡萄糖注射液250 ml静脉滴注。静脉滴注开始约1 min患者出现面部潮红,诉咽喉发痒。2 min后突发抽搐,并且意识丧失、双眼凝视、牙关紧闭、伴有小便失禁。诊断:过敏性休克。立即停药,先后给予静脉注射盐酸肾上腺素注射液、地塞米松磷酸钠注射液和注射用甲泼尼龙琥珀酸钠,氧气吸入,静脉注射尼可刹米注射液、盐酸洛贝林注射液和重酒石酸去甲肾上腺素注射液以及心肺复苏术,但患者一直处于深昏迷状态,无自主呼吸,血压、排尿均需药物维持。住院第112天,脑血管彩超提示符合脑死亡频谱改变。第253天,经患者家属要求办理出院。 展开更多
关键词 多柔比星 脂质体 过敏反应 休克 脑死亡
急性重症胰腺炎七例误诊原因分析 预览
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作者 李静 徐宁 《临床误诊误治》 2019年第7期1-4,共4页
目的分析急性重症胰腺炎的误诊原因,提高临床诊治水平。方法回顾性分析2016年2月—2017年10月我院7例急性重症胰腺炎误诊病例资料。结果本组因畏寒腹痛、发热腹痛、呕吐腹泻入院各1例,腹痛入院4例,7例误诊时间14h~3d,误诊为感染性休克... 目的分析急性重症胰腺炎的误诊原因,提高临床诊治水平。方法回顾性分析2016年2月—2017年10月我院7例急性重症胰腺炎误诊病例资料。结果本组因畏寒腹痛、发热腹痛、呕吐腹泻入院各1例,腹痛入院4例,7例误诊时间14h~3d,误诊为感染性休克合并结石性胆囊炎、急性胃肠炎合并低血容量性休克各2例,泌尿系统结石、胆道蛔虫症、消化道穿孔各1例。所有患者按误诊疾病给予治疗效果不佳,后经血尿淀粉酶检查及影像学检查均确诊为急性重症胰腺炎。确诊后均予禁食、抑制胰液分泌、抗感染、手术等治疗后好转出院。结论临床医生应加强对急性重症胰腺炎的认识,详细问诊,仔细查体,对疑似患者及时行血尿淀粉酶检查排查本病,或可减少或避免误诊的发生。 展开更多
关键词 胰腺炎 误诊 胆囊炎 休克
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榍石的冲击高压行为与辐照损伤效应对比研究 预览
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作者 刘孙利 白彬 +5 位作者 贺红亮 褚健 孙亚平 王绪 王洪龙 张铭 《高压物理学报》 CAS CSCD 北大核心 2019年第1期34-41,共8页
高压和辐照这两种极端条件会造成晶体材料的晶体结构发生改变或损伤。以榍石(CaTiSiO5)为研究对象,利用冲击高压和样品回收技术,探索冲击高压作用后结构的变化规律,并与辐照造成的损伤榍石作对比研究,认识冲击高压与辐照造成榍石结构损... 高压和辐照这两种极端条件会造成晶体材料的晶体结构发生改变或损伤。以榍石(CaTiSiO5)为研究对象,利用冲击高压和样品回收技术,探索冲击高压作用后结构的变化规律,并与辐照造成的损伤榍石作对比研究,认识冲击高压与辐照造成榍石结构损伤的异同。研究表明:冲击高压作用下,晶态的榍石出现结构损伤和非晶化,出现类似于榍石的辐照损伤现象,但具体过程和受损的晶体结构有明显不同。具体表现为:X射线衍射、红外和拉曼光谱的特征峰强度减弱,谱线变宽,细节丢失;冲击高压导致晶态榍石拉曼光谱的Ti–O伸缩振动主峰出现红移,与辐照损伤蜕晶化过程出现的蓝移相反。此外,晶胞参数a、b、c和晶胞体积V减小,与辐照损伤过程相反。 展开更多
关键词 榍石 冲击 高压 辐照损伤 非晶化
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循证护理干预在重症肺炎患者治疗中的应用观察 预览
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作者 郭静 《中国继续医学教育》 2019年第17期178-180,共3页
目的分析循证护理干预在重症肺炎患者治疗中的应用效果。方法选择2018年1-10月医院重症医学科收治的重症肺炎患者60例作为研究对象。按照入院顺序分组,对照组、观察组各入组30例,分别采用常规护理以及循证护理干预。结果观察组全肠内营... 目的分析循证护理干预在重症肺炎患者治疗中的应用效果。方法选择2018年1-10月医院重症医学科收治的重症肺炎患者60例作为研究对象。按照入院顺序分组,对照组、观察组各入组30例,分别采用常规护理以及循证护理干预。结果观察组全肠内营养支持时间、机械通气时间、重症医学科停留时间、住院时间低于对照组,差异均具有统计学意义(P<0.05)。观察组喂养不耐受、并发症合计发生率低于对照组,观察组护理满意率高于对照组,差异均具有统计学意义(P<0.05)。结论在重症肺炎患者治疗中的应用循证护理干预,可以降低并发症发生风险,提升护理满意率。 展开更多
关键词 重症肺炎 循证护理干预 护理质量 休克 机械通气
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休克患者的血流动力学监测现状与展望
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作者 马渝 《实用休克杂志(中英文)》 2019年第3期137-141,共5页
过去十年血流动力学监测不断向更小程度的侵入性和可实时测量不同指标参数方向发展。对休克患者而言,心脏超声检查仍是目前的一线评估方式,同时对于最初治疗无反应或非常复杂的休克病人则推荐监测心输出量以及运用高级的血流动力学监测... 过去十年血流动力学监测不断向更小程度的侵入性和可实时测量不同指标参数方向发展。对休克患者而言,心脏超声检查仍是目前的一线评估方式,同时对于最初治疗无反应或非常复杂的休克病人则推荐监测心输出量以及运用高级的血流动力学监测技术。未来集成大循环、微循环和代谢指标的最低程度侵入性、多模式监测方法将为重症休克患者提供更加个体化的监测和治疗。 展开更多
关键词 血流动力学监测 休克
自动化集装箱码头全自动堆垛机轨道系统研究 预览
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作者 张连钢 修方强 +1 位作者 周兆君 邹子青 《水运工程》 北大核心 2019年第7期17-22,共6页
全自动堆垛机轨道系统的主要功能在于引导全自动堆垛机高速运行,为大车机构提供连续、平顺和阻力较小的良好运行条件,保证设备平稳运行、精准定位。为了解决轨道基础不均匀沉降以及轨道受到外力产生变形所带来的一系列问题,结合青岛港... 全自动堆垛机轨道系统的主要功能在于引导全自动堆垛机高速运行,为大车机构提供连续、平顺和阻力较小的良好运行条件,保证设备平稳运行、精准定位。为了解决轨道基础不均匀沉降以及轨道受到外力产生变形所带来的一系列问题,结合青岛港自动化码头工程实际情况,从轨道基础、轨道类型、轨道扣件、轨道基座等4个方面对全自动堆垛机轨道系统进行了研究。结果表明:为了确保全自动堆垛机可靠运行、高效装卸,要求轨道基础基本无沉降、轨道和轨道扣件具有较强的承载能力、轨道扣件和基座具有很好的减震缓冲性能。研究结论对自动化集装箱码头全自动堆垛机轨道系统的设计具有参考意义。 展开更多
关键词 全自动堆垛机 高速 重载 冲击 轨道系统
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乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响 预览
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作者 薛骅 鲁丽利 +1 位作者 向辉 钱振华 《中国临床药理学与治疗学》 CAS CSCD 2019年第3期313-317,共5页
目的:探讨乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响。方法:选择2015年12月至2017年12月我院接诊的87例重症脓毒症继发休克患者作为研究对象,通过随机数表法分为对照组43例,试验组44例。对照组给予常规治疗... 目的:探讨乌司他丁联合氢化可的松治疗重症脓毒血症休克的疗效及对血清因子的影响。方法:选择2015年12月至2017年12月我院接诊的87例重症脓毒症继发休克患者作为研究对象,通过随机数表法分为对照组43例,试验组44例。对照组给予常规治疗,试验组在对照组基础上,联合乌司他丁20万U加入5%葡萄糖溶液250 mL中静脉滴注+200 mg氢化可的松加入5%葡萄糖溶液250 mL中静脉滴注,1次/d,均连续治疗2周。比较2组临床疗效、实验室指标、血清降钙素原(PCT)、IL-6、IL-10、机械通气时间、住院时间、药物不良反应及28 d死亡率。结果:治疗后,试验组和对照组临床疗效总有效率分别为86.36%(38/44)、67.44%(29/43),差异具有统计学意义(P<0.05);治疗后,试验组和对照组收缩压(SBP)分别为(85.82±6.25)、(78.80±9.26) mmHg,C反应蛋白(CRP)分别为(34.78±4.79)、(46.76±5.93) mg/L,白细胞计数(WBC)分别为(7.85±2.02)、(12.49±2.14)×10~9/L,PCT分别为(1.50±0.22)、(2.70±0.46) ng/mL,IL-6分别为(59.13±12.73)、(82.32±18.40) pg/mL,IL-10分别为(10.04±1.25)、(14.41±1.88) pg/mL,急性生理和慢性健康评分(APACHEⅡ)分别为(10.30±1.41)、(14.51±1.68)分,差异具有统计学意义(P<0.05);试验组机械通气时间和住院时间分别为(10.02±1.65)、(16.00±1.36) d,对照组分别为(17.58±2.54)、(24.00±1.69) d,差异具有统计学意义(P<0.05);治疗期间,2组均未出现严重不良反应,试验组出现1例注射部位皮疹,2组不良反应发生率差异无统计学意义(P>0.05);试验组和对照组28 d死亡率为4.55%(2/44)、20.93%(9/43),差异具有统计学意义(P<0.05)。结论:乌司他丁联合氢化可的松用于重症脓毒症继发休克患者中效果显著,可有效缓解病情、降低死亡率,且药物不良反应少,安全性高。 展开更多
关键词 重症脓毒血症 休克 乌司他丁 糖皮质激素 氢化可的松
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Application of pulse index continuous cardiac output system in elderly patients with acute myocardial infarction complicated by cardiogenic shock: A prospective randomized study 预览
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作者 Yuan-Bo Zhang Zhi-Zhong Zhang +6 位作者 Jun-Xia Li Yu-Hong Wang Wei-Lin Zhang Xin-Li Tian Yun-Feng Han Meng Yang Yu Liu 《世界临床病例杂志》 2019年第11期1291-1301,共11页
BACKGROUND Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompa... BACKGROUND Cardiogenic shock (CS) secondary to acute myocardial infarction (AMI) complicates management of the condition, and often leads to poor prognosis. Prompt and accurate monitoring of cardiovascular and accompanying hemodynamic changes is crucial in achieving adequate management of the condition. Advances in technology has availed procedures such as pulse index continuous cardiac output (PiCCO), which can offer precise monitoring of cardiovascular functions and hemodynamic parameters. In this study, PiCCO is evaluated for its potential utility in improving management and clinical outcomes among elderly patients with AMI complicated by CS. AIM To assess whether use of the PiCCO system can improve clinical outcomes in elderly patients with AMI complicated by CS.METHODS Patients from emergency intensive care units (EICU) or coronary care units (CCU) were randomized to receive PiCCO monitoring or not. The APACHE II score, SOFA score, hs-TnI, NT-proBNP, PaO2/FiO2 ratio and lactate levels on day 1, 3 and 7 after treatment were compared. The infusion and urine volume at 0-24 h, 24-48 h and 48-72 h were recorded, as were the cardiac index (CI), extravascular lung water index (EVLWI), intrathoracic blood volume index (ITBVI) and global end diastolic volume index (GEDVI) at similar time intervals. RESULTS Sixty patients with AMI complicated by CS were included in the study. The PiCCO group had a significantly lower APACHE II score, SOFA score, hs-TnI and NT-proBNP levels on day 1, 3 and 7 after treatment. The infusion and urine volume during 0-24 h in the PiCCO group were significantly greater, and this group also showed significantly higher ADL scores. Furthermore, the PiCCO group spent lesser days on vasoactive agents, mechanical ventilation, and had a reduced length of stay in EICU/CCU. Additionally, the CI was significantly higher at 48 h and 72 h in the PiCCO group compared with that at 24 h, and the EVLWI, ITBVI and GEDVI were significantly decreased at 48 h and 72 h. CONCLUSION Applying the PiCCO system could 展开更多
关键词 PULSE INDEX CONTINUOUS cardiac output Elderly patients CARDIOGENIC shock Acute myocardial INFARCTION
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参芪扶正注射液联合血必净治疗感染性休克临床疗效分析 预览
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作者 刘玉明 张丽华 +3 位作者 张亚丽 李颖华 李桓 樊宏丹 《西部中医药》 2019年第2期5-8,共4页
目的:分析参芪扶正注射液联合血必净治疗感染性休克的临床疗效,并评价其安全性。方法:选取就诊的120例感染性休克患者随机分为对照组和观察组,每组60例。对照组给予常规抗感染及对症治疗,观察组在对照组治疗方案基础上加用参芪扶正注射... 目的:分析参芪扶正注射液联合血必净治疗感染性休克的临床疗效,并评价其安全性。方法:选取就诊的120例感染性休克患者随机分为对照组和观察组,每组60例。对照组给予常规抗感染及对症治疗,观察组在对照组治疗方案基础上加用参芪扶正注射液和血必净注射液,2组疗程均为5天。观察并比较2组患者临床疗效,危重疾病严重程度评分(APACHEⅡ)及序贯器官衰竭评分(SOFA),复苏液体用量、缩血管药物用量、肢体水肿发生率,机械通气时间、住ICU时间、28天病死率,血流动力学指标,血清炎症细胞因子水平。结果:总有效率观察组高于对照组,差异有统计学意义(P<0.05);APACHEⅡ评分、SOFA评分治疗后2组均降低,差异有统计学意义(P<0.05),且观察组较对照组降低更明显,差异有统计学意义(P<0.05);复苏液体用量、缩血管药物用量和肢体水肿发生率观察组均低于对照组,差异均有统计学意义(P<0.05),机械通气时间和住ICU时间观察组均短于对照组,差异有统计学意义(P<0.05),28天病死率2组比较差异无统计学意义(P>0.05);治疗后血流动力学指标2组均明显改善,其中观察组心排血量指数、体循环血管阻力指数较对照组显著升高、心率(HR)显著降低(P<0.05),差异均有统计学意义(P<0.05),平均动脉压、肺血管楔压、混合静脉血氧饱和度2组比较,差异无统计学意义(P>0.05);治疗后C反应蛋白、血清降钙素原及肿瘤坏死因子α水平2组均显著降低,差异有统计学意义(P<0.05),且观察组降低较对照组明显(P<0.05);2组治疗期间均未见明显不良反应。结论:参芪扶正注射液联合血必净治疗感染性休克临床疗效显著,安全可靠。 展开更多
关键词 休克 感染性 参芪扶正注射液 血必净注射液
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An increase in heart rate variability can be an index for end point of resuscitation in trauma patients
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作者 Ali Foroutan Shahram Paydar +2 位作者 Seyyed Taghi Heydari Leila Mohammadi Farnaz Rahbar 《中华创伤杂志:英文版》 CAS CSCD 2019年第3期134-137,共4页
Purpose: The measurement of heart rate variability (HRV) is a non-invasive method to analyze the balance of the autonomic nervous system. The aim of this study was to compare the changes of HRV and base deficit (BD) d... Purpose: The measurement of heart rate variability (HRV) is a non-invasive method to analyze the balance of the autonomic nervous system. The aim of this study was to compare the changes of HRV and base deficit (BD) during the treatment of trauma patients. Methods: Forty-three trauma patients with a low injury severity scores (ISS < 24) and negative base excess on admission were included in this study. Based on the BD changes, patients were divided into three groups:‘end pointed’ group (n =13), patients' BDs instantly cleared after primary hydration;‘needs further resuscitation’ group (n=21), patients' BDs did not reach the end point and thus required further hydration or packed red blood cells transfusion;and ‘hydration minimal change’ group (n=9), patients' BDs lower than 2.5 mmol/L at the onset of admission and thereafter had minimal change (near normal range). The changes in HRV during fluid resuscitation were detected and compared to BD changes in their arterial blood gases. All data were analysed using the SPSS software Version 15.0. Repeated measures ANOVA was used to determine the changes in HRV, heart rate, blood pressure, and BD among groups. Results: A significant reverse correlation was found between the BD ratio and the HRV ratio (r=0.562;p= 0.01). The HRV of patients with aggravated BDs after fluid resuscitation was decreased. There was an increase in HRV at the time of BD clearance. A decrease in HRV after primary crystalloid hydration bore a significant connection with the need for an ICU (p = 0.021) and transfusion of packed red blood cells (p < 0.001). Conclusion: Increase in HRV may be a new non-invasive index for the end point of resuscitation in trauma patients. 展开更多
关键词 HEART rate VARIABILITY TRAUMA End point of RESUSCITATION Shock
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