58例低血容量性休克的护理体会

总结低血容量性休克(Hypovolemic Shock)的有效护理方法和观察要点,提高护理质量,降低死亡率。回顾性分析了低血容量性休克的抢救、观察和护理体会。通过加强对低血容量性休克观察和护理,迅速准确的抢救治疗和细致的临床护理,是抢救病人生命的关键。     

温氧合血诱导停搏及终末再灌注心肌保护的研究

目的：对比研究4℃冷晶体停搏液间断灌注和温氧合血诱导停搏及终末再灌注的心肌保护作用。方法：选择40例术前心功能Ⅲ-Ⅳ级（NYHA分级）需在体外循环下施行心内直视手术的风湿性心脏病患，随机分成主动脉根部4℃冷晶体停搏液间断灌注的冷晶体组（n=20），主动脉根部温氧合血顺灌诱导停搏及终末再灌注，4℃冷晶体停搏液间断灌注维持停搏的温血组（n=20）。两组病例在性别、年龄、体重、手术种类、术前心功能、机器预充液、体外转流时问、主动脉阻断时间、开放时温度等均无显差异。通过（1）临床观察心脏自动复跳率及复苏后心律紊乱情况；（2）测定停跳前、复跳后0、6、12、18、24小时的血浆心肌肌钙蛋白Ⅰ（cTnⅠ）。（3）停跳前及开放后10分钟取右心室流出道心肌活检，观察心肌超微结构改变及用FlaMeng线粒体半定量分析法对线粒体作量化计分。结果：（1）临床观察心脏自动复跳率，温血组（95％）明显高于冷晶体组（40％）（P＜0.01）（2）体外循环后温血组血浆cTnⅠ明显低于冷晶体组，温血组cTnⅠ高峰出现时间（复跳后12小时）较冷晶体组（复跳后18小时）早；（2）线粒体量化计分分数反映复跳后心脏超微结构，温血组心肌损伤较冷晶体组轻。结论心脏自动复跳率、血浆cTnⅠ、心肌超微结构改变及线粒体量化计分能反映心肌缺血及再灌注损伤。温氧合血诱导停搏及终末再灌注较冷晶体停搏液心肌保护效果为好，对心功能不全，心肌能贮低下的高危病例应采用温氧合血诱导停搏及终末再灌注。     

p53/p21通路对氧糖剥夺复氧诱导肝细胞死亡的保护作用

缺血再灌注损伤参与了各种病理生理过程.在肝脏中,由手术导致的缺血再灌注损伤可导致肝脏功能衰竭.以前的研究发现,周期蛋白依赖的抑制蛋白p21在缺血再灌注损伤中起保护器官的作用.为研究其作用机制,用肝细胞氧糖剥夺复氧(oxygen glucose deprivation and re-oxygenation, OGD/R)模型,对p53/p21通路在肝脏缺血再灌注损伤的机制作用进行探讨.结果表明,在OGD/R处理后,表达p53野生型的HepG2细胞的死亡率和活性氧(ROS)水平均显著低于p53缺失型的Hep3B细胞.在HepG2细胞中,RNAi沉默p53基因促进ROS水平和死亡率升高.抗氧化剂维生素E显著降低HepG2细胞的死亡率和ROS.进一步研究发现,p53通过上调其靶基因p21表达,抑制ROS产生,降低HepG2细胞死亡.因此,p53/p21通路在肝脏缺血再灌注损伤的保护作用可能与抑制ROS产生有关.     

老年人肺心病多器官衰竭84例分析

分析84例老年人肺心病呼吸衰竭患者并发多器官衰竭、累及器官数目与病死率是正相关关系，累及2—5个器官死亡率分别为34．3％、65．4％、86．7％、100％，其中并发肺性脑病最多，但病死率较低。而肾功能进行性加重预后不佳。揭示老年肺心病患者病程较长，各器官功能减退、免疫功能低下，是导致肺心病多器官衰竭的重要死亡原因。     

缺血再灌注损伤致远位器官功能障碍及其防治

关于组织器官缺血后再灌注会损伤原住器官的研究众多，而再灌注损伤远隔器官的研究较少。本文综述了缺血再灌注损伤的可能发生机制．其引起的远隔器官功能损伤及其防治策略。     

探讨损伤控制性手术治疗严重腹部创伤40例的效果

目的：对损伤控制性手术治疗40例严重腹部创伤的临床效果进行分析探讨。方法：对在我院进行损伤控制性手术的40例严重腹部创伤的患者的临床资料进行回顾性分析。结果：40例严重腹部创伤的经损伤控制性手术治疗后,32例治愈,占80%,其中2例患者再次手术后出现肝脓肿、1例出现胆漏、1例出现胰瘘,经有效治疗后均未出现肝脏、脾脏、胰腺等手术并发症。8例死亡,占20%,1例死亡与严重脑挫伤,4例死亡于术后多器官并发症,3例死亡与脑部创伤合并呼吸道综合征。结论：损伤控制性手术治疗严重腹部创伤临床效果肯定,安全性高,有一定的临床应用价值。     

高容量血液滤过治疗严重颅脑损伤后多器官功能障碍的研究

探讨高容量血液滤过治疗严重颅脑损伤后多器官功能障碍患者的预后及与肿瘤坏死因子(TNF-α)、白介素-1、白介素-10水平的变化。无肝素化血液滤过治疗重度颅脑损伤多脏器衰竭患者,监测病人14 d死亡率及监测病人、24 h、48 h TNF-α、IL-1、IL-10变化。结果血液滤过治疗24 h及48 h的TNF-α、IL-1、IL-10水平明显低于血滤治疗前。治疗14 d后治疗组死亡率明显低于对照组。高容量血液滤过治疗严重颅脑损伤后多器官功能障碍的患者,能够降低炎症介质改善其预后。     

连续性血液净化治疗ARF并MODS 66例

目的：总结应用连续性血液净化治疗66例急性肾功能衰竭并多器官功能障碍综合征患者患者的疗效。方法：全部用连续性静脉-静脉血液滤过(CVVH)方式治疗。结果：66例患者中治愈48例，治愈率72．7％，死亡18例，死亡率27．3％；结论：该疗法可明显提高ARF并MODS者的抢救成功率，降低死亡率，且床旁可实施。是值得推广的新疗法。     

脑室内复达欣灌注治疗颅内感染

目的 报告应用脑室内灌注复达欣治疗严重颅内感染21例。方法 床边锥颅侧脑室前角穿刺置管，复达欣灌注，结合腰穿脑脊液引流法。结果 本组2例因多脏器衰竭死亡，1例因复发病死亡，颅内感染均达治愈。结论 采用脑室内复达欣灌注治疗颅内感染是提高治愈率、降低死亡率的有效方法。     

重症颅脑外伤合并创伤性休克的抢救体会

目的总结抢救重症颅脑外伤合并创伤性休克患者的经验。方法对于重症颅脑外伤患者合并休克,及时补充血容量和保持气道通畅。结果经抢救的18例患者15例生存,3例死亡。结论对重症颅脑外伤合并刨伤性休克的患者实施综合措施进行抢救有利于提高抢救成功率、降低死亡率。     

Markedness and its Interpretation in Language Use

Language markedness is a common phenomenon in languages, and is reflected from hearing, vision and sense, i.e. the variation in the three aspects such as phonology, morphology and semantics. This paper focuses on the interpretation of markedness in language use following the three perspectives, i.e. pragmatic interpretation, psychological interpretation and cognitive interpretation, with an aim to define the function of markedness.     

Features of Women's language

Language is a means of verbal communication. People use language to communicate with each other. In the society, no two speakers are exactly alike in the way of speaking. Some differences are due to age, gender, statue and personality. Above all, gender is one of the obvious reasons. The writer of this paper tries to describe the features of women＇s language from these perspectives： pronunciation, intonation, diction, subjects, grammar and discourse. From the discussion of the features of women＇s language, more attention should be paid to language use in social context. What＇s more, the linguistic phenomena in a speaking community can be understood more thoroughly.     

低渗透非均质砂岩油藏启动压力梯度研究

理论推导与室内实验相结合,建立了低渗透非均质砂岩油藏启动压力梯度确定方法。首先借助油藏流场与电场相似的原理,推导了非均质砂岩油藏启动压力梯度计算公式。其次基于稳定流实验方法,建立了非均质砂岩油藏启动压力梯度测试方法。结果表明:低渗透非均质砂岩油藏的启动压力梯度确定遵循两个等效原则。平面非均质油藏的启动压力梯度等于各级渗透率段的启动压力梯度关于长度的加权平均;纵向非均质油藏的启动压力梯度等于各渗透率层的启动压力梯度关于渗透率与渗流面积乘积的加权平均。研究成果可用于有效指导低渗透非均质砂岩油藏的合理井距确定,促进该类油藏的高效开发。     

On Tragic Consciousness In The Works By Ernest Hemingway

As an American modern novelist who were famous in the literary world, Hemingway was not a person who always followed the trend but a sharp observer. At the same time, he was a tragedy maestro, he paid great attention on existence, fate and end-result. The dramatis personae's tragedy of his works was an extreme limit by all means tragedy on the meaning of fearless challenge that failed. The beauty of tragedy was not produced on the destruction of life, but now this kind of value was in the impact activity. They performed for the reader about the tragedy on challenging for the limit and the death.     

Achieving Unusual States of Matter Under High Pressure

正The periodicity of the elements and the non-reactivity of the inner-shell electrons are two related principles of chemistry,rooted in the atomic shell structure.Within compounds,Group I elements,for example,invariably assume the+1 oxidation state,and their chemical properties differ completely from those of the p-block elements.These general rules govern our understanding of chemical structures and reactions.Using first principles calcula-     

Exchange-Correlation and Electronic Excitation Energies from Pairing Matrix Fluctuations

We have developed an adiabatic connection to formulate the ground-state exchange-correlation energy in terms of pairing matrix linear fluctuations.This formulation of the exchange-correlation energy opens a new channel for density functional approximations based on the many-body perturbation theory.We illustrate the potential of such approaches with an approximation based on the particle-particle Random Phase Approximation(pp-RPA).This re-     

Density Functional Theory for the Response of Periodic Systems to Electric Fields Based on the Vector Potential Approach

正The electronic and nuclear(structural/vibrational)response of 1D-3D nanoscale systems to electric fields gives rise to a host of optical,mechanical,spectral,etc.properties that are of high theoretical and applied interest.Due to the computational difficulty of treating such large systems it is convenient to model them as infinite and periodic(at least,in first approximation).The fundamental theoretical/computational problem in doing so is that     

On the Thermodynamic Limit for Responses to Static Electromagnetic Fields

For molecular systems,the quantum-mechanical treatment of their responses to static electromagnetic fields usually employs a scalar-potential treatment of the electric field and a vector-potential treatment of the magnetic field.Although the potential for each field separately is associated with the choice of an(unphysical)origin,the precise choice of the origin for the electrostatic field has little consequences for the results.This is different for the     

Call for Papers

<正>"The Journal of Shanghai Normal University:Mathematics"is published by Shanghai Normal University as regular issues of The Journal of Shanghai Normal University each year from 2014 in English.The editors-in-chief of the issues are professors Yuhao Cong and Maoan Han.The Journal of Shanghai Normal University was started in 1958 with     

Journal of Donghua University ( English Edition) Contents of Volume 31

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