The fetal circulation

Accumulating data on the human fetal circulation shows the similarity to the experimental animal physiology, but with important differences. The human fetus seems to circulate less blood through the placenta, shunt less through the ductus venosus and foramen ovale, but direct more blood through the lungs than the fetal sheep. However, there are substantial individual variations and the pattern changes with gestational age. The normalised umbilical blood flow decreases with gestational age, and, at 28 to 32 weeks, a new level of development seems to be reached. At this stage, the shunting through the ductus venosus and the foramen ovale reaches a minimum, and the flow through the lungs a maximum. The ductus venosus and foramen ovale are functionally closely related and represent an important distributional unit for the venous return. The left portal branch represents a venous watershed, and, similarly, the isthmus aorta an arterial watershed. Thus, the fetal central circulation is a very flexible and adaptive circulatory system. The responses to increased afterload, hypoxaemia and acidaemia in the human fetus are equivalent to those found in animal studies: increased ductus venosus and foramen ovale shunting, increased impedance in the lungs, reduced impedance in the brain, increasingly reversed flow in the aortic isthmus and a more prominent coronary blood flow. Copyright © 2004 John Wiley & Sons, Ltd.     

Prenatally diagnosed portocaval shunt and postnatal outcome: a case report

Congenital absence of the portal vein (CAPV) is a rare anomaly in the form of a portocaval shunt, whereby the intestinal and splenic venous drainage bypasses the liver and drains directly into the systemic circulation. We report a case of CAPV diagnosed prenatally after the recognition of a dilated umbilical vein draining directly into a large inferior vena cava (IVC). The IVC then drained into the right atrium of a dilated, hyperdynamic heart. The ductus venosus could not be identified. Repeated postnatal scans showed a gradual disappearance of venous lakes in the region of the porta hepatis and a clear drainage of the splenic vein to the left renal vein and the superior mesenteric vein to the IVC. From birth up to twelve months follow-up there was no evidence of liver dysfunction, encephalopathy or liver lesions. Copyright © 2004 John Wiley & Sons, Ltd.     

空气隙膜蒸馏膜污染控制实验研究

采用空气隙膜蒸馏组件,采用美国进口膜,以自来水、伞盖3号原水和苦咸水为工质,实验分析了膜污染情况,结果显示:料液无旋转时,自来水间歇累计运行32 h后出现污染;质量分数分别为20%和50%的盐水8 h后传质通量降低到最初通量32%和12%;3号原水瞬时产生污染,经砂滤处理后为苦咸水,传质通量比原水提高4倍～5倍,运行8h后通量下降到初始通量的6%。削弱膜污染方法采用最优参数的三向旋转入流组件(α=70°、δ=2 mm、β=45°),自来水进入污染期由32 h推迟到65 h,传质通量比无旋转增大近20%;采用具有分水盘的并接式空气隙膜组件,开槽2 mm膜污染较严重,开槽3 mm的膜通量比无旋转入流传质通量平均增大60%,两种组件设计形式均可提高膜通量,一定程度缓解了膜污染的产生。     

分流两段式土壤渗滤系统脱氮效果及机理研究

为解决传统土壤渗滤系统占地面积过大的问题,采用多级土壤渗滤系统和地下渗滤系统组合的新型两段式污水处理工艺,研究了在高水力负荷0.3m/d条件下分流比对其脱氮效果的影响,并通过实时定量PCR技术对不同层级的脱氮功能基因数量进行检测,进一步探究该系统中微生物脱氮机理.水质监测结果表明,分流措施可以显著提高两段式土壤渗滤系统在高负荷下的脱氮能力,当分流比为1：2时系统污染物去除能力最佳,对化学需氧量（COD）、总磷（TP）、氨氮（NH₄⁺-N）、总氮（TN）的平均去除率分别达到91.16%、96.91%、72.11%和72.27%.脱氮功能基因丰度分析结果表明,多级土壤渗滤系统中的硝化及厌氧氨氧化和地下渗滤系统中的硝化反硝化的耦合作用是该工艺微生物脱氮的主要途径.     

Successful intrauterine shunting of a sacrococcygeal teratoma (SCT) causing fetal bladder obstruction

We report a case of a sacrococcygeal teratoma (SCT) diagnosed at 22 weeks with a substantial intrapelvic cystic extension leading to bladder outlet obstruction and hydronephrosis at 27 weeks. Prenatal percutaneous shunting of the cystic teratoma was performed at 28 weeks to avoid prolonged fetal pelvic compression by the tumour that could have adverse effects by stretching the pelvic plexus and sacral nerves. Urinary dilatation resolved completely after shunting and a 3880 g baby girl was delivered at 39 weeks. The potential benefits of in utero shunting to avoid urological complications of SCTs with intrapelvic extension are discussed. Copyright © 2001 John Wiley & Sons, Ltd.