Delivery during extracorporeal membrane oxygenation (ECMO) support of pregnant woman with severe respiratory distress syndrome caused by influenza: a case report and review of the literature

Objective: To report a case of labour induction during extracorporeal membrane oxygenation (ECMO) support in a patient with acute respiratory distress syndrome (ARDS) caused by influenza and review of the literature.

Methods: Case report and the literature search of all English articles on delivery while on ECMO in patients with ARDS caused by influenza.

Results: A 25-year-old pregnant woman was initiated with ECMO due to severe ARDS caused by influenza A (H1N1) virus. When the patient had symptoms of colporrhagia and uterine contractions, the medical team decided to start labour induction while on ECMO. There were in total five case reports identified. Maternal oxygenation was improved after delivery and ECMO was successfully discontinued.

Conclusions: Maternal oxygenation was improved after delivery, which may be beneficial to reduce the duration of ECMO. Caesarean section (CS) may be the most used mode and labour induction could be another option. The procedure should be performed by an experienced ECMO team, cooperating with the obstetrician, anaesthesiologist, and ICU doctors.     

铜绿假单胞菌噬菌体PaP3生物学特性的研究

目的测定铜绿假单胞菌噬菌体PaP3的最佳感染复数、一步生长曲线和吸附K值及交叉吸附K值等基本生物学特性。方法按照感染复数（MOI）分别为0．0001、0．001、0．01、0．1、1和10加入噬菌体纯培养液和宿主菌，充分裂解细菌后，测定噬菌体滴度；以MOI=10的比例加入噬菌体及宿主菌，进行一步生长实验；纯化PaP3颗粒，免疫家兔，获得抗血清，通过中和反应实验测定PaP3和其抗血清之间的吸附反应常数K值。同时，利用抗血清交叉中和试验确定本室分离的三株噬菌体之间的血清学关系。结果当MOI=0．001时PaP3感染其宿主菌产生的子代噬菌体滴度最高；根据一步生长实验结果绘制一步生长曲线；通过血清交叉中和反应得出不同的吸附常数。结论PaP3最佳感染复数为0．001，感染宿主菌的潜伏期是20min，爆发期是60min，平均爆发量约为31，其抗血清反应的吸附常数K值为262。     

四论音乐心理学在精神病医院中的地位

目的对综合的行为分析的理论和治疗的应用研究段计进行论证。方法音乐心理学是周用桓辩院模式的理论基础。“税书”是医疗、教育、工疗和娱疗的新四结合治疗的灵魂。结果音乐心理行为治疗促进了病房秩序，方便了譬疗工作的开展井有益于精神康复，提高了患者的自信心．强化了正常行为。结论音乐心理行为治疗是公认的行之有效的康复治疗的方法之一。可帮助慢性精神分裂症患者接受正常社会生活和唤醒他们潜在的正常精神功能。     

Dexamethasone treatment attenuates early seawater instillation-induced acute lung injury in rabbits.

There is very little evidence on the value of giving corticoids in cases of seawater drowning induced acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Therefore, this study aimed to investigate whether dexamethasone treatment can attenuate seawater instillation-induced acute lung injury in rabbits. Seawater (4 ml/kg body weight) was instilled into the lower trachea of ventilated, anesthetized rabbits. Then these rabbits were assigned randomly 20 min later to receive intravenous injection of 1mg/kg body weight of dexamethasone (dissolving in 2 ml of normal saline) or 2 ml of normal saline. All animals demonstrated immediate drops in arterial oxygen tension (PaO2) and the total thoracic compliance, which were significantly improved after 2 h of dexamethasone treatment. Histopathological study also indicated that dexamethasone treatment markedly attenuated lung histopathological changes, alveolar hemorrhage and inflammatory cells infiltration with evidence of decreasing of myeloperoxidase (MPO) activity and tumor necrosis factor-alpha (TNF-alpha) concentration in lung tissue. In addition, dexamethasone treatment reduced extravascular lung water and lung epithelial-endothelial barrier permeability, up-regulated the expression of surfactant protein-A (SP-A) and alpha-epithelial Na+ channel, and increased Na+/K+-adenosine triphosphatase (Na+/K+-ATPase) activity and Na+/K+-ATPase-alpha1 protein abundance. Thus, these data indicate that dexamethasone treatment might be of benefit in patients with seawater aspiration-induced ALI.     

药品压价只能是权宜之计

现在我们确实面临很多问题,百姓对看病贵的反应,除了百姓的直觉外还有一些指标可以反映,如国内外公认的费用水平衡量指标:卫生费用占本国GDP的百分比,目前我国卫生费用已经占到GDP的5％左右,是历史上的最高点了。但是和一些发达国家比,我们国家的卫生费用水平还是偏低的,大家普遍认为7％至 8％是相对合理的水平。     

不同无性系杜仲含胶细胞密度的动态研究

文章通过对不同无性系杜仲叶中含胶细胞密度的测量,对其生长动态作了分析研究,结论如下:不同无性系含胶细胞的密度在七月中旬达到最大;在同一引种地的雌雄株之间,雄株含胶细胞的密度不完全小于雌株。     

心肺转流时间对氧代谢的影响

目的对心脏瓣膜手术病人麻醉与手术期间的氧代谢进行测定,探讨心肺转流(CPB)时间对其后氧代谢的影响。方法选择36例择期行心脏瓣膜手术病人,根据CPB时间,将病人分为S组(CPB≤150 min)和L组(CPB>150 min)。采用Swan-Ganz导管技术及反向Fick检测方法对麻醉手术期间的氧代谢进行测定。检测时点为麻醉前、CPB前、CPB停止10 min和60 min。结果麻醉前两组的pH、PaCO2、PaO2等血气参数维持在正常范围,但氧供(DO2)减少,氧摄取率(O2ER)增加。CPB前,两组病人DO2显著降低(P<0.05),S组的氧耗(VO2)显著降低(P<0.05)。CPB后10min到60 min期间,DO2、VO2显著增加(P<0.05),L组O2ER显著增加(P<0.05)。CPB后10 min和60 min,两组的pH、PaCO2及PaO2等虽与麻醉前比较有显著改变,但两组的变化是一致的。CPB后10 min两组的心指数(CI)较麻醉前和CPB前有极显著升高(P<0.01)。CPB后L组的VO2有增高趋势(P<0.05),O2ER明显大于S组。结论CPB对其后氧代谢有明显影响,随着CPB时间延长,CPB后氧代谢障碍更显著。     

下肢慢性缺血性疾病的外科治疗及评价

下肢慢性缺血主要为下肢动脉硬化闭塞症所致，其他因素有多发性大动脉炎、血栓闭塞性脉管炎、糖尿病等。由于社会环境的变迁，人口迅速老龄化等因素，该病的发病率逐年增加。本文就下肢慢性缺血性疾病的外科治疗方法进展及疗效评价做一介绍。     

《新方八阵》补真阴与补真阳用药关联性研究

用方剂计量学研究中的关联性分析法对《新方八阵》中补真阴、补真阳药物的应用与其他医家进行比较，印证了景岳重视阴中求阳、阳中求阴的思想，为方剂比较研究中关联指数与关联性分析的具体化内容之一。