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Ataxia,acute mountain sickness,and high altitude cerebral edema

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Engineering Sciences 2013年第2期11卷 38-46页

作者： Wu Tianyi ma siqing Bian Huiping Zhang Minming High Altitude Medical Research Institute High Altitude Medical Research Center Tibet University Intensive Care Unit of Qinghai Provincial People's Hospital Department of Inter. Med. Qinghai Cardio-Cerebral-Vascular Hospital Image Division of Qinghai Provincial People's Hospital

Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE). The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness(AMS)and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE. After the earthquake on April 14,2010,approximately 24 080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3 750 ~ 4 568 m,and extremely hardly worked for an emergency treatment after arrival. Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System. 73 % of the rescuers were found to be developed AMS. The incidence of high altitude pulmonary edema(HAPE)and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude. Ataxia sign was measured by simple tests of coordination including a modified Romberg test. The clinical features of 62 patients with HACE were analyzed. It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia(47/62,75.8 %). Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms. The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS. Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3 750~4 568 m. Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases. These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE(28/29). Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.

关键词： Yushu Earthquake ataxia acute mountain sickness high altitude cerebral edema Lake Louise Scoring System

Food-derived bio-functional peptides for the management of hyperuricemia and associated mechanism

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Food Science and Human Wellness 2024年第4期13卷 1767-1786页

作者： Yanxin Wang Mingxia ma Yumeng Huang siqing Fan Jie Peng Shiming Li Xiurong Su Yanbo Wang Chenyang Lu State Key Laboratory for managing Biotic and Chemical Threats to the Quality and Safety of Agro-Products and School of marine Science Ningbo UniversityNingbo 315211China School of Food and Health Beijing Technology and Business UniversityBeijing 100048China Department of Food Science Rutgers UniversityNew BrunswickNJ 08901USA College of Life Sciences Huanggang Normal UniversityHuanggang 438000China Food Safety Key Laboratory of Zhejiang Province School of Food Science and BiotechnologyZhejiang Gongshang UniversityHangzhou 310018China

Hyperuricemia,a metabolic disorder related to uric acid metabolism dysregulation,has become a common metabolic disease worldwide,due to changes in lifestyle and dietary *** recent years,owing to their high activity and few adverse effects,food-derived active peptides used as functional foods against hyperuricemia have attracted increasing *** article aims to focus on the challenge associated with peptide-specific preparation methods development,functional components identification,action mechanism(s)clarification,and bioavailability *** current review proposed recent advances in producing the food-derived peptides with high anti-hyperuricemia activity by protein source screening and matched enzymatic hydrolysis condition adjusting,increased the knowledge about strategies to search antihyperuricemia peptides with definite structure,and emphasized the necessity of combining computer-aided approaches and activity *** addition,novel action mechanism mediated by gut microbiota was discussed,providing different insights from classical ***,considering that little attention was paid previously on the structure-activity relationships of anti-hyperuricemia peptides,we collected the sequences from published studies and make a preliminary summary about the structure-activity relationships,which in turn provided guides for enzymatic hydrolysis optimization and bioavailability ***,this article could promote the development,application and commercialization of food-derived anti-hyperuricemia peptides in the future.

关键词： Hyperuricemia Peptide Enzyme hydrolysis Mechanism Structure-activity relationship Bioavailability

Studies on monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome secondary to high altitude pulmonary edema

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Engineering Sciences 2013年第2期11卷 34-37页

作者： ma siqing Wu Tianyi Cheng Qiang Li Pei Bian Huiping Intensive Care Unit of Qinghai Provincial People's Hospital High Altitude Medical Research Institute High Altitude Medical Research Center Tibet University Qinghai Cardio-Cerebral-Vascular Hospital

To study monitoring hemodynamics and oxygen dynamics of adult respiratory distress syndrome (ARDS) secondary to high altitude pulmonary edema (HAPE),we performed clinic and laboratory studies in 8 patients who preliminarily developed high altitude cerebral edema (HACE) and then ARDS occurred at an altitude of 4 500 m. After an initial emergency treatment on high mountains,all the patients were rapidly transported to a hospital at a lower altitude of 2 808 m. The right cardiac catheterizations were carried out within 5 h after hospitalized. The monitoring hemodynamics and oxygen dynamics were studied via a thermodilution Swan-Gaze catheter. The results showed that before treatments at the beginning of monitoring,there presented a significant pulmonary artery hypertension with a decreased cardiac function,and a lower oxygen metabolism in all the 8 patients. However,after some effective treatments,including mechanical ventilation and using dexamethasone,furosemide,etc,four days later the result of a repeated monitoring showed that their pulmonary artery pressure had been decreased with an improved cardiac function with all the oxygen metabolic indexes increased significantly. Our studies suggested that performing monitoring hemodynamics in patients with ARDS secondary to HAPE will define the clinical therapeutic measures which will benefit the outcome.

关键词： high altitude pulmonary edema adult respiratory distress syndrome monitoring hemodynamics oxygen dynamics

西宁地区严重创伤患者并发成人呼吸窘迫综合征氧动力学变化

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中华创伤杂志 2000年第1期16卷 38-40页

作者：马四清青海省人民医院ICU 西宁810007

目的　探讨西宁地区严重创伤后并发成人呼吸窘迫综合征（ＡＲＤＳ）时氧动力学变化，为治疗提供理论依据。　方法　利用Ｓｗａｎ－Ｇａｎｚ导管及热稀释法心输出量测定技术对２０例ＡＲＤＳ患者进行监测。　结果　（１）监测开始... 详细信息

目的　探讨西宁地区严重创伤后并发成人呼吸窘迫综合征（ＡＲＤＳ）时氧动力学变化，为治疗提供理论依据。　方法　利用Ｓｗａｎ－Ｇａｎｚ导管及热稀释法心输出量测定技术对２０例ＡＲＤＳ患者进行监测。　结果　（１）监测开始１～２ｄ存活组和死亡组的氧输送（ＤＯ２）逐渐上升，氧耗量（ＶＯ２）也随之上升，出现病理性氧供依赖（ｒ＝０．６１７６，Ｐ＜０．０５），两组间比较无显著性差异。（２）抢救４～５ｄ以后，存活组患者ＤＯ２仍继续升高，ＶＯ２也升高（ｒ＝０．６５４７，Ｐ＜０．０５），但当ＤＯ２达到７００ｍｌ·ｍｉｎ－１·ｍ－２时，ＶＯ２上升缓慢，出现“平台效应”，而死亡组尽管临床上最大限度地提高了ＤＯ２，但ＶＯ２仍与ＤＯ２呈病理性依赖（ｒ＝０．７４９３，Ｐ＜０．０５）。（３）两组的氧摄取率（Ｏ２ｅｘｔ）在整个监测期间均处于较低水平。　结论　严重创伤后ＡＲＤＳ患者氧摄取已出现明显障碍，从而导致ＶＯ２对ＤＯ２发生氧供依赖，在治疗中应当将ＤＯ２水平尽可能提高到７００ｍｌ·ｍｉｎ－１·ｍ－２以上。

关键词：呼吸窘迫综合征成人创伤氧动力学

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Journal of Intensive Medicine 2023年第4期3卷 335-344页

作者： Hui Xiang Yuqian Zhao siqing ma Qi Li Kianoush B.Kashani Zhiyong Peng Jianguo Li Bo Hu Department of Critical Care Medicine Zhongnan Hospital of Wuhan UniversityWuhan 430071HubeiChina Clinical Research Center of Hubei Critical Care Medicine Wuhan 430071HubeiChina Department of Critical Care Medicine Qinghai Provincial People's HospitalXining 810007QinghaiChina Division of Pulmonary and Critical Care Medicine Department of MedicineMayo ClinicRochesterMNUSA Division of Nephrology and Hypertension Department of MedicineMayo ClinicRochesterMNUSA

Background The benefits of early use of norepinephrine in endotoxemic shock remain *** aimed to elucidate the effects of different doses of norepinephrine in early-stage endotoxemic shock using a clinically relevant large animal *** Vasodilatory shock was induced by endotoxin bolus in 30 Bama suckling *** included fluid resuscitation and administration of different doses of norepinephrine,to induce return to baseline mean arterial pressure(maP).Fluid management,hemodynamic,microcirculation,inflammation,and organ function variables were *** animals were supported for 6 h after endotoxemic *** Infused fluid volume decreased with increasing norepinephrine *** to baseline maP was achieved more frequently with doses of 0.8µg/kg/min and 1.6µg/kg/min(Pma were higher in animals administered no or 0.2µg/kg/min norepinephrine(Pmall vessel density(PSVD)was higher in those receiving 0.8µg/kg/min(Pmacro-and micro-circulation in early-stage endotoxemic shock is dose-dependent,with very low and very high doses resulting in detrimental *** an appropriate norepinephrine dose was associated with improved tissue perfusion and organ function.

关键词： Norepinephrine Fluid resuscitation Endotoxemic shock Microcirculation Side stream dark-field Pigs

脑出血患者胃粘膜pH值与氧输送变化的临床意义

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中国急救医学 1999年第3期19卷 151-152页

作者：马四清青海省人民医院ICU

目的初步探讨脑出血患者胃粘膜ｐＨ值（ｐＨｉ）及氧输送（ＤＯ２）改变与急性应激性胃粘膜病变（ＡＳＧＬ）的关系。方法对７例脑出血患者进行胃粘膜ｐＨ、ＤＯ２和胃潜血测定。结果成活组４例中，在监测开始时ｐＨｉ与ＤＯ２都在正常... 详细信息

目的初步探讨脑出血患者胃粘膜ｐＨ值（ｐＨｉ）及氧输送（ＤＯ２）改变与急性应激性胃粘膜病变（ＡＳＧＬ）的关系。方法对７例脑出血患者进行胃粘膜ｐＨ、ＤＯ２和胃潜血测定。结果成活组４例中，在监测开始时ｐＨｉ与ＤＯ２都在正常范围内，而死亡３例中ｐＨｉ都明显减低，但ＤＯ２减低不明显。随着治疗，死亡组ｐＨｉ明显下降，与成活组２４小时、４８小时相比，差异显著（Ｐ＜００１）；成活组ＤＯ２逐渐下降，而死亡组ＤＯ２有增高趋势。有４例病人出现了ＡＳＧＬ，死亡组３例均出现了严重的消化道出血。结论监测ｐＨｉ对判断组织氧合及预后有重要意义，与ＤＯ２结合起来对治疗有具体的指导意义。但因ｐＨｉ与ＤＯ２不完全依赖，在部分病人中，仅以提高ＤＯ２为治疗原则是不够的。

关键词：脑出血胃粘膜 PH值氧输送

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急性高原反应发病的危险因素相关研究进展

第三军医大学学报 2019年第8期41卷 723-728页

作者：罗勇军马四清陆军军医大学(第三军医大学)陆军卫勤训练基地军事医学地理学教研室全军战救训练技术与器材研发实验室重庆400038 青海省人民医院重症医学科西宁810007

地理学上把海拔高于1 000 m,地势相对平坦或者有一定起伏的广阔地区称为高原;医学上将海拔高于3 000 m的地方称为高原。未经习服的人员,快速从平原进入高原,会出现呼吸加深加快,心率加快,头痛、头晕,失眠,胃肠胀气、腹泻等症状。

关键词：急性高原反应医学地理高原病危险因素

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高原急性呼吸窘迫综合征诊断与治疗进展

陆军军医大学学报 2019年第8期41卷 729-733页

作者：马四清罗勇军青海省人民医院重症医学科陆军军医大学(第三军医大学)陆军卫勤训练基地军事医学地理学教研室全军战救训练技术与器材研发实验室

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是威胁患者生命,在重症监护病房(intensive care unit,ICU)常见的急性呼吸功能衰竭,病死率高达36%～45%[1]。由于高原急慢性缺氧导致患者诸多生理方面变化,发生在高原的A... 详细信息

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是威胁患者生命,在重症监护病房(intensive care unit,ICU)常见的急性呼吸功能衰竭,病死率高达36%～45%[1]。由于高原急慢性缺氧导致患者诸多生理方面变化,发生在高原的ARDS与平

关键词：急性呼吸窘迫综合征高原病病理生理诊断治疗

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针灸推拿综合治疗颈性眩晕应用价值探讨

大医生 2019年第13期4卷 99-100页

作者：马思清上海中冶医院上海200941

目的观察针灸推拿综合治疗颈性眩晕的疗效。方法选取30例颈性眩晕患者,随机均分为两组,对照组使用天麻素片进行治疗,干预组选择针灸推拿综合治疗,比较两组患者的治疗效果和复发率。结果干预组患者的治疗总有效率明显高于对照组(P<0.05)... 详细信息

目的观察针灸推拿综合治疗颈性眩晕的疗效。方法选取30例颈性眩晕患者,随机均分为两组,对照组使用天麻素片进行治疗,干预组选择针灸推拿综合治疗,比较两组患者的治疗效果和复发率。结果干预组患者的治疗总有效率明显高于对照组(P<0.05),干预组复发率明显低于对照组(P<0.05)。结论针灸推拿综合治疗颈性眩晕效果优于天麻素片,可以提高治疗效果,降低疾病复发率。

关键词：针灸推拿颈性眩晕