Smart wearable devices play an increasingly important role in physiological monitoring and disease prevention because they are portable, real-time, dynamic and continuous.The popularization of smart wearable devices among people under high-altitude environment would be beneficial for the prevention for heart and brain diseases related to high altitude. The current review comprehensively elucidates the effects of high-altitude environment on the heart and brain of different population and experimental subjects, the characteristics and applications of different types of wearable devices, and the limitations and challenges for their application. By emphasizing their application values, this review provides practical reference information for the prevention of high-altitude disease and the protection of life and health.
【摘要】 目的 探討高原地區橈神經損傷的治療效果，并總結影響療效的因素。 方法 回顧性分析2005年6月-2010年6月收治的橈神經損傷并有完整隨訪資料的54例患者，其中男40例，女14例；年齡8～69歲，平均32.6歲。開放性損傷5例，閉合性損傷49例；左側26例，右側28例。受傷原因:刀傷5例，醫源性損傷（手術牽拉傷、被鋼板擠壓傷）10例，肱骨干骨折合并橈神經損傷39例。神經損傷類型:橈神經完全斷裂12例；大部分斷裂15例；挫傷27例，挫傷長度1.5~4.5 cm。所有患者均有典型的感覺及運動功能障。采用神經吻合修復27 例，神經松解減壓27例。骨折均用鋼板內固定。 結果 所有患者手術均順利，術后切口均I期愈合，無手術相關并發癥發生。54例均獲隨訪16~24個月，平均18個月。骨折于術后8～14個月達臨床愈合。末次隨訪時根據中華醫學會手外科上肢周圍神經功能評定標準，神經吻合的27例中，獲優14例，良8例，差5例；神經松解減壓術治療的27例均獲優。總優良率為91%。 結論 上臂橈神經損傷宜早期手術修復，神經吻合的療效較神經松解減壓術差。【Abstract】 Objective To explore the therapeutic effect on radial nerve injuries in plateau area, and to analyze the influencing factors. Methods The clinical data of 54 patients with radial nerve injuries who were treated between June 2005 and June 2010 were retrospectively analyzed. The patients included 40 males and 14 females and aged 8-69 years (averaged 32.6 years old). Of these 54 patients, 5 were open injuries, 49 were closed injuries; 26 were on the left side, and 28 were on the right sides. Causes of injuries included: 5 direct cut injuries, 10 iatrogenic injuries (including traction injuries and crush injuries by steel plates), and 39 humeral shaft fracture and radial nerve injuries. Types of nerve injuries included: 12 complete radial neurotmesis, 15 partial radial neurotmesis, and 27 radial contusions (with contusion length ranged 1.5-4.5 cm). All patients had radial nerve injuries experienced significant motor dysfunctions. Among these patients, 27 underwent nerve anastomosis, the remaining 27 were treated by nerve decompression; all fractures were treated with internal fixation with steel plates. Results During the average follow-up of 18 months (16-24 months), all 54 patients completely recovered from radial nerve injuries without any complications. The time for fracture healing ranged 8-14 months. According to the evaluation standards for radial nerve functional recovery, developed by the Chinese Medical Association, among the 27 cases treated by nerve anastomosis, 14 were “optimal”, 8 were “fair”, and 5 were “bad”; and all 27 cases treated by nerve decompression were “optimal”. Conclusion It is suggested to have early surgical treatment for the upper arm radical nerve injuries. The nerve decompression had better curative effects than the nerve anastomosis does.
Basing on the special geographical environment, population, economic level and medical conditions of the areas along the plateau railway, as well as the policy requirements of primary healthcare institutions in China, combining the reality and early practice of the areas along the plateau railway in China, the High Altitude Medicine Committee of Sichuan Medical Association gathered the experts in the field of high altitude medicine in China, and launched the Expert Consensus on Basic Requirements for Primary Healthcare Institutions in Areas Along the Plateau Railway. Its content covers the scale and layout, infrastructure, personnel allocation and service capacity, material allocation of primary healthcare institutions in areas along the plateau railway, and provides professional guidance for primary healthcare institutions in these areas.
目的:研究低氧性肺動脈高壓大鼠對實驗性紅細胞增多的適應。方法:健康SD大鼠28只,體重200～250 g,隨機分為4組:常氧對照組（N）、單純低氧組（H）、低氧+低劑量人重組促紅細胞生成素（rEPO） 600 u/kg（H+E1）組、低氧+高劑量rEPO 1200 u/kg（H+E2）組,每組7只大鼠。除常氧對照組外各低氧組大鼠均缺氧21 d,每日8 h。其中后兩組每周腹部皮下注射不同劑量的rEPO三次。取血樣測定紅細胞數、全血粘度及紅細胞變形指數；頸外靜脈插管測定平均肺動脈壓力；光鏡觀察反映肺動脈重構程度的形態學參數肺小動脈管壁厚度百分比、肺非肌性小動脈肌化程度。結果:①隨著rEPO注射劑量的增加,紅細胞、全血粘度有不同程度的增高；②全血粘度增高的同時紅細胞變形指數也相應地增加；③隨著rEPO劑量的增加,平均肺動脈壓力逐漸增高,但是肺血管重構程度反而有所緩解。結論:實驗性紅細胞增多通過改變紅細胞變形性和緩解肺血管重構程度來阻遏低氧性肺動脈高壓的進一步發展。
【摘要】 目的 探討高原地區腹腔鏡膽囊切除術（laparoscopic cholecystectomy，LC）患者的特點，以便更好地進行圍手術期處理。 方法 對2009年2月-2010年5月收治的長期生活在西藏高原地區的患者（高原組）367例和非高原地區患者（非高原地區組）167例的一般資料、術前診斷、合并癥情況進行回顧性分析，兩組患者性別、年齡及病程比較，差異無統計學意義（Pgt;0.05），有可比性。兩組患者診斷均以膽囊結石為主，其次為膽囊息肉，診斷構成比較，差異無統計學意義（Pgt;0.05）；兩組患者合并癥比較，高原組患者高血壓、冠心病、血紅蛋白增多癥及竇性心動過緩的發生率高于非高原地區組（Plt;0.05）；肺部疾病、肝硬化、糖尿病及腦梗死的發生率兩組患者比較差異無統計學意義（Pgt;0.05）。兩組患者均采用常規LC進行治療，對兩組患者術后臨床結果、并發癥等進行統計學分析。 結果 高原組患者手術中轉開腹率（7.1%）高于非高原地區組（2.4%）患者（Plt;0.05）；高原組患者較非高原地區組患者住院時間長、手術時間長、術中出血量多（Plt;0.05）；術后并發癥比較差異無統計學意義（Pgt;0.05）。 結論 高原地區LC患者宜及時中轉開腹，其圍手術期處理得當將有助于減少術后并發癥的發生。【Abstract】 Objective To explore the characteristics of patients undergoing laparoscopic cholecystectomy in highland area, in order to carry out better perioperative management. Methods We collected and analyzed the general information, preoperative diagnosis and complications of 367 patients living in highland area and 167 patients living in inland between February 2009 and May 2010. There was no significant difference between the two groups in sex, age and course of disease (Pgt;0.05). Cholecystolithiasis was the main disease followed by gallbladder polyps, and there was no difference between them in the kind of diseases (Pgt;0.05). The incidence of hypertension, coronary heart disease, hereditary persistence of fetal hemoglobin and sinus bradycardia was higher in patients in highland area than that in patients in non-highland area (Plt;0.05). There was no significant difference in the incidence of lung disease, liver cirrhosis, diabetes mellitus and cerebral infarction between the two groups (Pgt;0.05). Conventional laparoscopic cholecystectomy was conducted in both two groups. Comparative analysis of treatment outcome and postoperative complications was done. Results The rate of conversion from laparoscopic surgery to laparotomy in Tibetan patients (7.1%) was higher than that in patients in non-highland area (2.4%) (Plt;0.05). Hospitalization time, operation time and blood loss in Tibetan patients were significantly higher than those in patients in non-highland area (Plt;0.05), but there was no significant difference in postoperative complications between the two groups of patients (Pgt;0.05). Conclusions Laparoscopic cholecystectomy for patients in highlardarea should be converted to laparotomy when necessary. Appropriate perioperative management is helpful in reducing the incidence of postoperative complications.
Objective To explore the clinical characteristics of patients with combined use of ≥2 kinds of anti-seizure medications in Tibetan plateau. Methods Epilepsy patients who were hospitalized in the People’s Hospital of Tibet Autonomous Region from September 2018 to September 2023 and used ≥2 kinds of anti-seizure medications in combination were selected. Their demographic data such as gender, age, and ethnicity, as well as diagnostic information, medication and other clinical data were collected, and relevant demographic and clinical characteristics were analyzed. In the later stage, telephone follow-up was used to record medication and epileptic seizure control. Results A total of 2295 patients with epilepsy were included, of which 142 (6.2%) met the inclusion criteria, of which 133 (93.7%) were Tibetans. There were more males than females (86 vs. 56, P<0.05), and more minors and young patients than middle-aged and elderly patients (106 vs. 36, P<0.05). 87.3% of the patients underwent magnetic resonance imaging (MRI) or computed tomography (CT), and 71.1% of the patients were abnormal. The main cause of epilepsy was structural etiology (84/142, 59.2%). The most common combination was two drugs (127/142, 89.4%). The largest proportion of combination was sodium valproate and levetiracetam (46/142, 32.4%). After standardized multi-drug combination therapy, the average frequency of epilepsy seizures was significantly reduced compared with the baseline, and the difference was statistically significant (P<0.05). Among the 98 patients aged ≥14 years, 15 cases (15.3%) had drug-refractory epilepsy, 18 cases (18.4%) had seizures controlled by standardized combination medication, 16 cases (16.3%) had seizures controlled by reducing combination medication to a single drug, 5 cases (5.1%) had good control and had stopped medication, 3 cases (3.1%) had frequent epileptic seizures due to poor medication compliance, 15 cases (15.3%) had irregular medication, 17 cases (17.3%) died, and 9 cases (9.2%) were lost. Conclusion The proportion of epilepsy treated with multiple drugs and refractory to drugs was lower than the conclusion of previous studies, and the anti-epileptic effect of multiple drugs was positive. Structural causes (stroke, etc.) are the main causes of epilepsy, and brain parasitic infection is a unique factor of high-altitude epilepsy. Strengthening the standardized use of drugs will help improve the treatment status and prognosis of patients.
In 2019, the American Wilderness Medical Society updated and released a new version of the practice guidelines based on the practice guidelines for the prevention and treatment of acute altitude illness first published in 2010 and updated in 2014. This article interprets the guidelines, focusing on effective measures to prevent and treat different forms of acute altitude illness, as well as suggestions for specific methods to manage the disease, with a view to providing help for clinicians in better practice.