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Success Story of a Low Cost Intra-Dermal Rabies Vaccination (IDRV) Clinic-Lessons Learnt over Five Years of 12,000 Patient Vaccinations “Without Failure” at DDU Hospital Shimla, Himachal Pradesh, India <br/>—“Saving a Drop of Rabies Vaccine and Immunoglobulins” 12 Innovations to Make Himachal Pradesh Rabies Free State by 2020

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World Journal of Vaccines 2015年第3期5卷 129-139页

作者： Omesh Kumar Bharti Shampur Narayan Madhusudana Ashok Kale Pyare Lal Gaunta Laxman Singh Chaudhry Jitender Kumar Nirmal Gupta Dropda Shyam Faculty Epidemiologist State Institute of Health & Family Welfare Parimahal Shimla India Professor of Neurovirology Head WHO Collaborating Centre for Reference and Research on Rabies Department of Neurovirology NIMHANS Bangalore India Professor Department of Community Medicine Dr. Ulhas Patil Medical College & Hospital Jalgaon India Rtd. Sr. Medical Superintendent DDU Hospital Shimla India Associate Professor Department of Pediatrics Indira Gandhi Medical College Shimla India Staff Nurse Anti-Rabies Clinic and Research Centre (ARC&RC) DDU Hospital Shimla India Multi Purpose Health Worker (MPW) previously at Anti-Rabies Clinic and Research Centre DDU Hospital Shimla India

Background: Rabies is a dreaded disease and an estimated 55,000 people die of rabies every year. Himachal Pradesh is in the North bordering China and is predominantly rural and hilly. Villages are near forests, where wild reservoirs of rabies exist. Since health facilities are not accessible easily, we need to innovate on existing schedules of rabies vaccination keeping in view the compliance of the patients and affordability so as to give them the best possible option of treatment. In the year 2006 and 2007, we, at DDU Hospital Shimla, experienced a severe shortage of rabies vaccine and patients were running from pillar to post to fetch rabies vaccine. At the same time, we learnt that some of the patients died because either they were not able to purchase the vaccine, mostly because of its high cost, $35, or they ignored the animal bites and did not seek the treatment. Since last year, we have been experiencing non-availability of rabies immunoglobulins (RIGs) in the market and have to innovate new schedules and techniques to save lives of the patients. Methods: During shortage of rabies vaccine in 2008, we contemplated to start a low cost intra-dermal (ID) clinic so as to make rabies vaccine affordable as intramuscular (IM) vaccination cost five times more than ID vaccination. But, there were three main hurdles. One hurdle was the non-availability of rabies vaccine vials having written on them “For IM/ID use” and another hurdle was only fewer animal bite patients attending the DDU Hospital, sometimes only one or two per day, which was insufficient to open a vaccine vial and distribute among them. The third problem being faced was reluctance of the hospital doctors to prescribe ID vaccine as this was not the practice at higher teaching institutions, including medical colleges. We contacted a vaccine company and few vials labeled as “For IM/ID use” were sourced from Mumbai (1200 km away from here). We asked the Chief Medical Officer, Shimla district to write a lette

关键词： Intradermal Rabies Vaccination Local RIGs Infiltration Local Innovations Rabid Animals RIGs Scarcity One Health Zoonosis

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以小脑受累为主的登革热脑炎的MRI及CT表现(附8例报告)

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国际医学放射学杂志 2015年第3期 290-290页

作者： V.Hegde Z.Aziz S.Kumar M.Bhat C.Prasad A.K.Gupta 亓昌珍 Department of Neuroimaging and Interventional Radiology National Institute of Mental Health and NeurosciencesHosur RoadBangalore 560029 Karnataka India

目的中枢神经系统登革热感染是一种罕见的疾病,脑实质受侵的类型尚未见有详细描述。本研究报道8例登革热脑炎的MRI表现特点。资料与方法回顾性收集已经

关键词：登革热病毒病 CT 脑炎 MRI 小脑

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Multi-link Vision and MiniVision stent registry in Asian patients with coronary artery disease:a prospective,multi-center study

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Chinese Medical Journal 2007年第12期120卷 1093-1096页

作者： XU Ya-wei WEI Yi-dong TANG Kai CHEN Yan-qing LI Wei-ming YU Xue-jing QIN Yong-wen QI Guo-xian QU Peng HOU Yu-qing Ashok Jain Parvez Grant Gudapati Ramesh Basavappa Ramesh Chumpol Piamsomboon Srun Kuanprasert Hyeon-Cheol Gwon Yoon Haeng Cho Haizal Haroon Kamar HUANG Cong-xin Department of Cardiology Renmin Hospital of Wuhan University Wuhan 430063 China Department of Cardiology Shanghai Tenth People＇s Hospital Tongji University Shanghai 200072 China Department of Cardiology Chang Hai Hospital Shanghai 200000 China Department of Cardiology First Affilated Hospital Chinese Medical University Shenyang 110000 China Department of Cardiology Second Affiliated Hospital Dalian Medical University Dalian 116000 China Department of Cardiology Nanfang Hospital Guangzhou 510000 China SDMH Jaipur India Ruby Hall Clinic Pune India Ushamullapudi Cardiac Center Hyderabad India Sri Jayadeva Institute of Cardiology Bangalore India Phramongkutklao Hospital （Army hospital） Bangkok Thailand Maharaj Nakorn Chiang Mai Hospital Chiang Mai University Thailand Samsung Medical Center Seoul Wonju Christian Hospital - Yonsei University Seoul University Malaya Medical Center Kuala Lumpur Malaysia

Background Recent studies have showed that the fine mesh stents are associated with a significant reduction in both clinical and angiographic re-stenosis of the coronary arteries. To maintain a very satisfactory radio-opacity using the stents, Guidant of the USA has designed a new type of bare metal stents （BMS）-Multi-link （ML） Vision / ML MiniVision stents. The clinical outcomes of Asian patients with coronary artery disease （CAD） after implanting the Multi-link Vision or MiniVision stent were investigated in this study. Methods An observational, prospective, multi-center, non-randomized post marketing registry was conducted to demonstrate the efficacy of the BMS- ML Vision / ML MiniVision stents. The primary end point of the registry was clinical target lesion revascularization （TLR） at a 6-month follow-up. The major secondary end points included the rate of major adverse cardiac events （MACE） and serious adverse events （SAE） in hospital and at 6 months; and the rate of clinical TLR as a function of the type of angina. A total of 429 Asian people with 449 lesions from 14 centers were selected for this study, The average reference diameter of the lesions was （3.0±0.5） mm, and the mean length was （15.7±5.0） mm. Results The successful rate of the procedure was 99.3%. Twenty-five percent of the lesions were treated by direct stenting without pre-dilation. Eighty-six percent of the lesions were implanted with ML Vision stent. After the 6-month follow-up, the rate of clinical TLR was 1.4%. The MACE, SAE and target vessel revascularization （TVR） were 6.8%, 3.5% and 1.4% respectively. Conclusion The current registry showed the excellent 6-month clinical outcomes of ML Vision/ML MiniVision stents in Asian patients with CAD.

关键词： bare metal stents registry study Asian population

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Psychiatric morbidities in respiratory disorders:a cross sectional report providing insight into consultation-liaison psychiatry services in India

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Psychosomatic Medicine Research 2023年第1期5卷 6-10页

作者： Roshan Sutar Santosh Kumar Chaturvedi Akshata Jayachamarajapura Shivananjaiah Department of Psychiatry All India Institute of Medical Sciences(AIIMS)BhopalMadhya Pradesh 462026India Leicestershire Partnership NHS Trust Leicester LE48BLUK SDS TRC and Rajiv Gandhi Institute of chest diseases bangalore Karnataka 560011India.

Background:Respiratory disorders are among the leading disorders contributing to extensive morbidity and mortality *** variants,like Chronic Obstructive Pulmonary Diseases(COPD)in developed and developing countries,as well as infectious causes,like Tuberculosis(TB)in developing countries,contribute to significant disease *** literature points towards the coexistence of psychiatric disorders with respiratory disorders responsible for poorer *** the extensive burden of respiratory disorders and the presence of concurrent psychiatric disorders,studies focusing on their prevalence are limited in ***:A cross-sectional psychiatric screening was carried out on sequential patients attending the tertiary respiratory unit over eight *** screened positive were interviewed in detail for psychiatric diagnosis and challenges in the management were *** diagnosis,pulmonary TB and medical comorbidity were assessed for correlation with demographic and clinical variables and analyzed by using the Chi-square test and logistic regression method using SPSS version ***:Psychiatric morbidity was present in 100 out of 350 patients(28.57%).Tuberculosis was the most common diagnosis(46%)in subjects attending the respiratory clinic services while common mental disorders like depression,anxiety,and insomnia were the most common psychiatric concern(88%)in this ***:Psychiatric disorders and medical morbidities are common in patients with respiratory *** factors determine the treatment adherence in both respiratory and psychiatric *** for psychiatric disorders with the help of a consultation-liaison psychiatrist in respiratory units is *** studies should focus on developing dedicated psychiatry services to enhance overall outcomes in patients with respiratory disorders.

关键词： psychiatric morbidity depression tuberculosis consultation-liaison psychiatry respiratory disorders psychosomatic

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The Tomato Hybrid Proline-rich Protein regulates the abscission zone competence to respond to ethylene signals

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Horticulture Research 2018年第1期5卷 528-544页

作者： Srivignesh Sundaresan Sonia Philosoph-Hadas Chao Ma Cai-Zhong Jiang Joseph Riov Raja Mugasimangalam Betina Kochanek Shoshana Salim Michael SReid Shimon Meir Department of Postharvest Science of Fresh Produce Agricultural Research Organization(ARO)The Volcani CenterRishon LeZiyonIsrael The Robert H.Smith Institute of Plant Sciences and Genetics in Agriculture The Robert H.Smith Faculty of AgricultureFood and EnvironmentThe Hebrew University of JerusalemRehovotIsrael Department of Plant Sciences University of CaliforniaDavisCAUSA Crops Pathology&Genetic Research Unit USDA-ARSDavisCAUSA Department of Bioinformatics QTLomics Technologies Pvt.LtdBangaloreIndia Department of Nano Science and Technology Tamil Nadu Agricultural UniversityCoimbatoreIndia Beijing Key Laboratory of Development and Quality Control of Ornamental Crops Department of Ornamental HorticultureChina Agricultural UniversityBeijingChina

The Tomato Hybrid Proline-rich Protein(THyPRP)gene was specifically expressed in the tomato(Solanum lycopersicum)flower abscission zone(FAZ),and its stable antisense silencing under the control of an abscission zone(AZ)-specific promoter,Tomato Abscission Polygalacturonase4,significantly inhibited tomato pedicel abscission following flower *** understanding the THyPRP role in regulating pedicel abscission,a transcriptomic analysis of the FAZ of THyPRP-silenced plants was performed,using a newly developed AZ-specific tomato microarray *** expression of THyPRP in the silenced plants was already observed before abscission induction,resulting in FAZ-specific altered gene expression of transcription factors,epigenetic modifiers,post-translational regulators,and *** data demonstrate that the effect of THyPRP silencing on pedicel abscission was not mediated by its effect on auxin balance,but by decreased ethylene biosynthesis and ***,THyPRP silencing revealed new players,which were demonstrated for the first time to be involved in regulating pedicel abscission *** include:gibberellin perception,Ca2+-Calmodulin signaling,Serpins and Small Ubiquitin-related Modifier proteins involved in post-translational modifications,Synthaxin and SNARE-like proteins,which participate in exocytosis,a process necessary for cell *** changes,occurring in the silenced plants early after flower removal,inhibited and/or delayed the acquisition of the competence of the FAZ cells to respond to ethylene *** results suggest that THyPRP acts as a master regulator of flower abscission in tomato,predominantly by playing a role in the regulation of the FAZ cell competence to respond to ethylene signals.

关键词： Hybrid inhibited competence

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Meta-analysis of T-wave indices for risk stratification in myocardial infarction

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Journal of Geriatric Cardiology 2017年第12期14卷 776-779页

作者： Gary Tse Cheuk Wai Wong Meng-Qi GONG Lei MENG Konstantinos P Letsas Guang-Ping LI Paula Whittaker Aishwarya Bhardwaj Abhishek C Sawant William KK Wu Sunny Hei Wong Jayaprakash Shenthar Lap Ah Tse Martin CS Wong Adrian Baranchuk Gan-Xin YAN Tong LIU Department of Medicine and Therapeutics Faculty of Medicine Chinese University ofHong Kong Hong Kong China Li Ka Shing Institute of Health Sciences Faculty of Medicine Chinese University ofHong Kong Hong Kong China Li Ka Shing Faculty of Medicine The University of Hong Kong Hong Kong China Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease Department of Cardiology Tianjin Institute of Cardiology Second Hospital of Tianjin Medical University Tianjin China Second Department of Cardiology Laboratory of Cardiac Electrophysiology 'Evangelismos' General Hospital of Athens Athens Greece Division of Population Health Health Services Research and Primary Care School of Health Sciences University of Manchester United Kingdom Division of Cardiology Department of Internal Medicine State University of New York at Buffalo USA Department of Anaesthesia and Intensive Care State Key Laboratory of Digestive Disease LKS Institute of Health Sciences The Chinese University of Hong Kong Hong Kong China Electrophysiology Unit Sri Jayadeva Institute of Cardiovascular Sciences and Research B G Road 9th Block Jayanagar Bangalore India JC School of Public Health and Primary Care The Chinese University of Hong Kong Hong Kong China Division of Cardiology Kingston General Hospital Queen 's University Kingston Ontario Canada Lankenau Institute for Medical Research and Lankenau Medical Center Wynnewood Pennsylvania USA Beijing Anzhen Hospital Capital Medical University Beijing China

Ventricular tachy-arrhythmias are the commonest cause of sudden cardiac death in patients with ischemie heart dis- ease. It is estimated that up to 20% patients with acute myocardial infarction suffer from these *** i... 详细信息

关键词： Myocardial infarction Repolarization Sudden death Tpeak-Tend Tpeak-Tend/QT

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Using data from‘visible’populations to estimate the size and importance of‘hidden’populations in an epidemic:A modelling technique

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Infectious Disease Modelling 2020年第1期5卷 798-813页

作者： Anna M.Foss Holly J.Prudden Kate M.Mitchell Michael Pickles Reynold Washington Anna E.Phillips Michel Alary Marie-Claude Boily Stephen Moses Charlotte H.Watts Peter T.Vickerman Department of Global Health and Development and Centre for Mathematical Modelling of Infectious Diseases London School of Hygiene and Tropical Medicine15-17 Tavistock PlaceLondonWC1H 9SHUK Department of Infectious Disease Epidemiology School of Public HealthImperial College LondonMedical School BuildingSt Mary’s CampusNorfolk PlaceLondonW21PGUK St John’s Research Institute 100 Feet RoadJohn NagarKoramangalaBangalore560034KarnatakaIndia Department of Community Health Sciences Max Rady College of MedicineRady Faculty of Health SciencesUniversity of ManitobaS113-750 Bannatyne AvenueWinnipegManitobaR3E 0W3Canada Centre de recherche du CHU de Québec-UniversitéLaval 1050 Chemin Ste-FoyQuébec(Qc)G1S 4L8Canada Département de médecine sociale et préventive Facultéde médecineUniversitéLaval1050avenue de la MédecineQuébec(Qc)G1V 0A6Canada

We used reported behavioural data from cisgender men who have sex with men and transgender women(MSM/TGW)in bangalore,mainly collected from‘hot-spot’locations that attract MSM/TGW,to illustrate a technique to deal with potential issues with the representativeness of this sample.A deterministic dynamic model of HIV transmission was developed,incorporating three subgroups of MSM/TGW,grouped according to their reported predominant sexual role(insertive,receptive or versatile).Using mathematical modelling and data triangulation for‘balancing’numbers of partners and role preferences,we compared three different approaches to determine if our technique could be useful for inferring characteristics of a more‘hidden’insertive MSM subpopulation,and explored their potential importance for the HIV *** for 2009 across all three approaches suggest that HIV prevalence among insertive MSM was likely to be less than half that recorded in the surveys(4.5e6.5%versus 13.1%),but that the relative size of this subgroup was over four times larger(61e69%of all MSM/TGW versus 15%).We infer that the insertive MSM accounted for 10e20%of all prevalent HIV infections among urban males aged *** modelling can be used with data on‘visible’MSM/TGW to provide insights into the characteristics of‘hidden’MSM.A greater understanding of the sexual behaviour of all MSM/TGW is important for effective HIV *** broadly,a hidden subgroup with a lower infectious disease prevalence than more visible subgroups,has the potential to contain more infections,if the hidden subgroup is considerably larger in size.

关键词： HIV Infectious diseases Mathematical modelling Men who have sex with men Transgender women India

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Theco-thecal bypass technique elucidating a novel procedure and perspective on treatment of post-arachnoiditis syringomyelia:A case report

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World Journal of Surgical Procedures 2021年第1期11卷 1-9页

作者： Mrudul Bhatjiwale Mohinish Bhatjiwale Department of Neurosurgery Narayana Health CityBangalore 560099KarnatakaIndia Neurological Science Neuro Health FoundationMumbai 400091India Department of Neurosurgery Rotary Medical CenterMumbai 400068India Department of Neurosurgery Manav Kalyan Kendra&Navneet Hitech HospitalsMumbai 400068India Department of Neurosurgery Neuro Health FoundationMumbai 400091India

BACKGROUND Post-arachnoiditis syringomyelia is a condition in which there is an intraspinal cerebrospinal fluid(CSF)blockade due to arachnoidal adhesions and *** many of the techniques currently in use,namely,the theco-peritoneal,syringo-pleural,syringo-peritoneal,and syringo-subarachnoid shunts,are effective,the results are often *** SUMMARY A 36-year-old man with a past history of pulmonary tuberculosis,presented with progressive paraesthesia in the feet and progressive paraparesis along with constipation,difficulty in micturition,and decreased *** was bedridden a month before *** resonance imaging revealed a dorsal multiloculated syrinx from D3-D10 vertebral *** underwent a D1-2 to D11 theco-thecal shunt bilaterally to abolish the CSF gradient across the level of the *** was no direct surgical handling of the spinal cord *** the 15-mo follow up,the patient had significant improvement in his symptoms and *** We present a novel technique aimed at correcting the primary cause of a postarachnoiditis syrinx,the subarachnoid cerebrospinal flow obstruction or block,which we believe is simple and effective,involves minimal handling of the normal neural structures,and attempts to restore the physiology of CSF flow across the obstruction,with favorable clinical results.

关键词： Syringomyelia Tubercular Arachnoiditis Adhesiolysis Minimally invasive Cerebrospinal fluid Case report

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Garcinol sensitizes human head and neck carcinoma to cisplatin in a xenograft mouse model despite downregulation of proliferative biomarkers

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中国药理学与毒理学杂志 2015年第S1期29卷 80-80页

作者： Feng Li Muthu K. Shanmugam Kodappully Sivaraman Siveen Fan Wang Tina H. Ong Ser Yue Loo Mahadeva M.M. Swamy Somnath Mandal Alan Prem Kumar Boon Cher Goh Tapas Kundu Kwang Seok Ahn Ling Zhi Wang Kam Man Hui Gautam Sethi Department of Pharmacology Yong Loo Lin School of Medicine National University of Singapore Singapore 117957 Cancer Science Institute of Singapore Centre for Translational Medicine Singapore 117957 Division of Cellular and Molecular Research Humphrey Oei Institute of Cancer Research National Cancer Centre Singapore 169610 Genome Institute of Singapore Agency for Science Technology and Research (A*STAR) Singapore Jawaharlal Nehru Centre for Advanced Scientific Research Molecular Biology and Genetics Unit Transcription and Disease Laboratory Bangalore 560064 India School of Biomedical Sciences Faculty of Health Sciences Curtin University Western Australia 6009 Australia Department of Biological Sciences University of North Texas Denton Texas 76203 Department of Haematology-Oncology National University Health System Singapore 117957 College of Korean Medicine Kyung Hee University Seoul 130-701 Republic of Korea

OBJECTIVE Platinum compounds such as cisplatin and carboplatin are frequently used as the first-line chemotherapy for the treatment of the head and neck squamous cell carcinoma(HNSCC).In the present study,we investigated whether garcinol,apolyisoprenylated benzophenone can chemosensitize HNSCC to *** The effect of garcinol and cisplatin on HNSCC was assessed by MTT,Western blotting,real time PCR,FACS,immunohistochemistry,DNA binding assay and xenograft mouse *** We found that garcinol inhibited the viability of a panel of diverse HNSCC cell lines,enhanced the apoptotic effect of cisplatin,suppressed constitutive as well as cisplatin-induced NF-κB activation,and downregulated the expression of various oncogenic gene products(cyclin D1,Bcl-2,survivin and VEGF).In vivo study showed that administration of garcinol alone(0.5 mg·kg-1,ip five times/week)significantly suppressed the growth of the tumor,and this effect was further increased by *** the markers of proliferation index(Ki-67)and microvessel density(CD31)were downregulated in tumor tissues by the combination of cisplatin and *** pharmacokinetic results of garcinol indicated that good systemic exposure was achievable after ip administration of garcinol at 0.5and 2mg·kg-1 with mean peak concentration(cmax)of 1825.4 and 6635.7nmol·L-1 in the mouse serum,*** Overall,our results suggest that garcinol can indeed potentiate the effects of cisplatin by negative regulation of various inflammatory and proliferative biomarkers.

关键词： HNSCC chemoresistance NF-κB proliferation garcinol

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过度通气能够改善幕上开颅术的手术条件吗？一项多中心随机交叉试验研究

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麻醉与镇痛 2009年第3期5卷 17-27页

作者： Adrian W. Gelb Rosemary A. Craen G. S. Umamaheswara Rao K. R. Madhusudan Reddy Joseph Megyesi Bibek Mohanty Hari H. Dash Kai C. Choi Mathew T.V. Chan 谢珺田(译) Department of Anesthesia and Perioperative Care University of California at San Francisco San Francisco California Department of Anesthesia and Perioperative Medicine University of Western Ontario Canada Departments of Anesthesia and Neuroanaesthesia National Institute of Mental Health and Neurosdences Bangalore India Department of Neurosurgery University of Western Ontario Canada Department of Neuroanesthesiology All India Institute of Medical Sdences Delhi India Centre for Epidemiology and Biostatistics The Chinese University of Hong Kong Hong Kong Spedal Administrative Region Department of Anaesthesia and Intensive Care CUHK Brain Tumor Center The Chinese University of Hong Kong Prince of Wales Hospital Hong Kong Special Administrative Region 不详

背景过度通气作为神经外科手术麻醉中的重要方法，其有效性还缺乏验证。我们在由手术医师评估脑肿胀分级和测定颅内压（ICP）的条件下，选择中度低碳酸血症和正常血液碳酸数值两种情况对接受开颅手术的幕上脑肿瘤患者进行一项双周期随... 详细信息

背景过度通气作为神经外科手术麻醉中的重要方法，其有效性还缺乏验证。我们在由手术医师评估脑肿胀分级和测定颅内压（ICP）的条件下，选择中度低碳酸血症和正常血液碳酸数值两种情况对接受开颅手术的幕上脑肿瘤患者进行一项双周期随机交叉试验研究。方法275例幕上脑肿瘤患者随机接受以下治疗程序：一是过度通气（动脉二氧化碳分压，PaCO2=25±2mmHg）继以正常通气（动脉二氧化碳分压，PaCO2=37±2mmHg）；二是正常通气继以过度通气。通气和呼气末CO2分压保持稳定20分钟。患者随机接受丙泊酚输注或异氟烷吸入麻醉。在每一试验阶段末由不了解治疗程序的手术医师测定ICP，并以4级评定方法评估脑肿胀分级。结果以通用估计方程模型分析，我们发现过度通气降低了45％脑肿胀加重的风险，P=0．004，95％可信区间为22％-61％，需要治疗患者数为8。过度通气期间ICP均数±标准差为12．3±8．1mmHg，低于正常通气时的16．2±9．6mmHg，P〈0．001。麻醉方式对脑肿胀评估和ICP无影响。结论对幕上脑肿瘤患者而言，手术中过度通气可改善与ICP降低相关的由手术医师评估的脑肿胀程度。

关键词：试验研究随机手术条件动脉二氧化碳分压开颅术多中心呼气末CO2分压过度通气

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