BACKGROUND; In recent years, extracorporeal liver per- fusion (ECLP) has been regarded as a treatment of acute liver failure ( ALF ); but the system of ECLP has many problems. The purpose of this experiment was to det...BACKGROUND; In recent years, extracorporeal liver per- fusion (ECLP) has been regarded as a treatment of acute liver failure ( ALF ); but the system of ECLP has many problems. The purpose of this experiment was to detect the factors affecting the system of ECLP and to establish a sta- ble and effective system of ECLP. METHODS; Livers were harvested from health pigs, ac- cording to the different styles of perfusion and oxygena- tion, which were randomly divided into 3 groups. The liv- ers in group A (n =4) were subjected to single portal vein perfusion, oxygenating perfusion blood; the livers in group B (n =4) to dual ( portal vein and hepatic artery) vessel perfusion, oxygenating blood, together; and the livers in group C ( n = 4) to dual (portal vein and hepatic artery) vessel perfusion, but oxygenating blood, separately. The perfusion time, the data of bile production, and hemody- namic parameters of extracorporeal livers in each group were tested. The histological examination of liver tissues from each group was performed at the end of perfusion. RESULTS: The perfusion time of the liver in group A is significantly shorter than in groups B and C (P<0.05). At 1 , 3 , 6 hours after perfusion, the data of bile production and hemodynamic parameters of livers in group A were sta- tistically different from those of livers in groups B and C (P<0.05). At 1, 3, 6 hours after perfusion, the data of group B were not statistically different from those of livers in group C (P>0.05). But at 12 hours after perfusion, the data of group B were statistically different from those of liv- ers in group C (P<0.01). CONCLUSION: The system of ECLP, which is performed by dual ( portal vein and hepatic artery) vessel perfusionand oxygenating blood separately, is more stable and effec- tive to keep the function of extracorporeal liver.展开更多
[目的]探讨ICU气管插管病人吸痰前进行无菌生理盐水灌注对病人生命体征的影响。[方法]通过检索PubMed、Embase、Cochrane Central Register of Controlled Trials,CINAHL,中国期刊全文数据库(CNKI)和万方数据库等资源,收集吸痰前进行无...[目的]探讨ICU气管插管病人吸痰前进行无菌生理盐水灌注对病人生命体征的影响。[方法]通过检索PubMed、Embase、Cochrane Central Register of Controlled Trials,CINAHL,中国期刊全文数据库(CNKI)和万方数据库等资源,收集吸痰前进行无菌生理盐水灌注对于ICU气管插管病人生命体征影响的随机对照试验,并进行文献质量评价和数据提取,结局指标包括心率、血氧饱和度、血压。[结果]最终纳入5项研究,文献证据质量大多为中等。Meta分析结果显示:与对照组相比,吸痰前进行无菌生理盐水灌注,不仅降低了吸痰后即时血氧饱和度,同时还降低了吸痰后2min以及5min的血氧饱和度,差异有统计学意义(P<0.01)。此外,吸痰前进行无菌生理盐水灌注对心率以及收缩压的影响并无统计学意义(P>0.05)。[结论]ICU气管插管病人吸痰前进行无菌生理盐水灌注并不一定能让病人获益。未来研究中仍然要克服相应的方法学缺陷。展开更多
A new fully digital and home-built NMR (Nuclear Magnetic Resonance) spectrometer working at very-low magnetic field (4.5 mT) is presented. This spectrometer was initially dedicated for the in situ measurement of the a...A new fully digital and home-built NMR (Nuclear Magnetic Resonance) spectrometer working at very-low magnetic field (4.5 mT) is presented. This spectrometer was initially dedicated for the in situ measurement of the absolute polarization of hyperpolarized 129Xe. It allows detection and acquisition of NMR signals of proton (1H) at 190 kHz and of hyperpolarized xenon-129 (HP 129Xe) at 50 kHz. In this new NMR instrument, we replaced as much analog electronics as possible by digital electronic and software. Except for the power amplifier and the preamplifier, the whole system is digital. The transmitter is based on the use of a Direct Digital Synthesizer (DDS) board. The receiving board allows direct digitalization of the NMR signals thanks to an 8-bits analog-to-digital converter (ADC) clocked at 100 MHz. Decimation is preformed to dramatically improve the ADC resolution so as the final achieved effective resolution could be as high as 14-bits at 5 MHz sampling frequency. NMR signals are then digitally downconverted (DDC). Low-pass decimation filtering is applied on the base-band signals (I/Q) to enhance much more the dynamic range. The system requires little hardware. The transmitter and the receiver are controlled using Labview environment. It is a versatile, flexible and easy-to-replicate system. This was actually one of underlying ideas behind this development. Both 1H and hyperpolarized 129Xe NMR signals were successfully acquired. The system is used for the measurement of the absolute polarization of hyperpolarized 129Xe in hyperpolarizing experiments for the brain perfusion measurements. The high degree of flexibility of this new design allows its use for a large palette of other potential applications.展开更多
Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI ...Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spectrum of disorders in prerenal chronic liver disease, and acute tubular necrosis (ATN) are the two most common causes of AKI in patients with chronic liver disease and cirrhosis. Differentiating these conditions is essential due to the differences in treatment. Prerenal AKI, a more benign disorder, responds well to plasma volume expansion, while ATN requires more specific renal support and is associated with substantial mortality. HRS–AKI is a facet of these two conditions, which are characterized by a dysregulation of the immune response. Recently, there has been progress in better defining this clinical entity, and studies have begun to address optimal care. The present review synopsizes the current diagnostic criteria, pathophysiology, and treatment modalities of HRS–AKI and as well as AKI in other chronic liver diseases (non-HRS–AKI) so that early recognition of HRS–AKI and the appropriate management can be established.展开更多
基金This study was supported by grants from the National High Technology Re-search and Development Program Foundation of China(863 Program) ( No.2001AA216071 )and from the Science & Technology Development Founda-tion of Tianjin Health Bureau ( Vo. 2002KY35).
文摘BACKGROUND; In recent years, extracorporeal liver per- fusion (ECLP) has been regarded as a treatment of acute liver failure ( ALF ); but the system of ECLP has many problems. The purpose of this experiment was to detect the factors affecting the system of ECLP and to establish a sta- ble and effective system of ECLP. METHODS; Livers were harvested from health pigs, ac- cording to the different styles of perfusion and oxygena- tion, which were randomly divided into 3 groups. The liv- ers in group A (n =4) were subjected to single portal vein perfusion, oxygenating perfusion blood; the livers in group B (n =4) to dual ( portal vein and hepatic artery) vessel perfusion, oxygenating blood, together; and the livers in group C ( n = 4) to dual (portal vein and hepatic artery) vessel perfusion, but oxygenating blood, separately. The perfusion time, the data of bile production, and hemody- namic parameters of extracorporeal livers in each group were tested. The histological examination of liver tissues from each group was performed at the end of perfusion. RESULTS: The perfusion time of the liver in group A is significantly shorter than in groups B and C (P<0.05). At 1 , 3 , 6 hours after perfusion, the data of bile production and hemodynamic parameters of livers in group A were sta- tistically different from those of livers in groups B and C (P<0.05). At 1, 3, 6 hours after perfusion, the data of group B were not statistically different from those of livers in group C (P>0.05). But at 12 hours after perfusion, the data of group B were statistically different from those of liv- ers in group C (P<0.01). CONCLUSION: The system of ECLP, which is performed by dual ( portal vein and hepatic artery) vessel perfusionand oxygenating blood separately, is more stable and effec- tive to keep the function of extracorporeal liver.
文摘[目的]探讨ICU气管插管病人吸痰前进行无菌生理盐水灌注对病人生命体征的影响。[方法]通过检索PubMed、Embase、Cochrane Central Register of Controlled Trials,CINAHL,中国期刊全文数据库(CNKI)和万方数据库等资源,收集吸痰前进行无菌生理盐水灌注对于ICU气管插管病人生命体征影响的随机对照试验,并进行文献质量评价和数据提取,结局指标包括心率、血氧饱和度、血压。[结果]最终纳入5项研究,文献证据质量大多为中等。Meta分析结果显示:与对照组相比,吸痰前进行无菌生理盐水灌注,不仅降低了吸痰后即时血氧饱和度,同时还降低了吸痰后2min以及5min的血氧饱和度,差异有统计学意义(P<0.01)。此外,吸痰前进行无菌生理盐水灌注对心率以及收缩压的影响并无统计学意义(P>0.05)。[结论]ICU气管插管病人吸痰前进行无菌生理盐水灌注并不一定能让病人获益。未来研究中仍然要克服相应的方法学缺陷。
文摘A new fully digital and home-built NMR (Nuclear Magnetic Resonance) spectrometer working at very-low magnetic field (4.5 mT) is presented. This spectrometer was initially dedicated for the in situ measurement of the absolute polarization of hyperpolarized 129Xe. It allows detection and acquisition of NMR signals of proton (1H) at 190 kHz and of hyperpolarized xenon-129 (HP 129Xe) at 50 kHz. In this new NMR instrument, we replaced as much analog electronics as possible by digital electronic and software. Except for the power amplifier and the preamplifier, the whole system is digital. The transmitter is based on the use of a Direct Digital Synthesizer (DDS) board. The receiving board allows direct digitalization of the NMR signals thanks to an 8-bits analog-to-digital converter (ADC) clocked at 100 MHz. Decimation is preformed to dramatically improve the ADC resolution so as the final achieved effective resolution could be as high as 14-bits at 5 MHz sampling frequency. NMR signals are then digitally downconverted (DDC). Low-pass decimation filtering is applied on the base-band signals (I/Q) to enhance much more the dynamic range. The system requires little hardware. The transmitter and the receiver are controlled using Labview environment. It is a versatile, flexible and easy-to-replicate system. This was actually one of underlying ideas behind this development. Both 1H and hyperpolarized 129Xe NMR signals were successfully acquired. The system is used for the measurement of the absolute polarization of hyperpolarized 129Xe in hyperpolarizing experiments for the brain perfusion measurements. The high degree of flexibility of this new design allows its use for a large palette of other potential applications.
文摘Acute kidney injury (AKI) is a common complication of liver cirrhosis and is of the utmost clinical and prognostic relevance. Patients with cirrhosis, especially decompensated cirrhosis, are more prone to develop AKI than those without cirrhosis. The hepatorenal syndrome type of AKI (HRS–AKI), a spectrum of disorders in prerenal chronic liver disease, and acute tubular necrosis (ATN) are the two most common causes of AKI in patients with chronic liver disease and cirrhosis. Differentiating these conditions is essential due to the differences in treatment. Prerenal AKI, a more benign disorder, responds well to plasma volume expansion, while ATN requires more specific renal support and is associated with substantial mortality. HRS–AKI is a facet of these two conditions, which are characterized by a dysregulation of the immune response. Recently, there has been progress in better defining this clinical entity, and studies have begun to address optimal care. The present review synopsizes the current diagnostic criteria, pathophysiology, and treatment modalities of HRS–AKI and as well as AKI in other chronic liver diseases (non-HRS–AKI) so that early recognition of HRS–AKI and the appropriate management can be established.
