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四国团团 用用回国
C e n tra l Ne rv o us S y s te m 目
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f b e la (p e r }in E EG i s
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口 】
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t li a rc p re sc r 1t in a ll
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864 · A C o m p le t e R e v i e w o f S h o r t S u b le c t

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w or k M gh a ]t it u dc a lm o st e q u a
c o m es fro m e la s tic e n e r gy ] o u tp u t e v e n a
t
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f S h o r t S u b je c t
1 A Co m p le t e R e v i e w o

il t se a le v e l bu t e v e n w e ll a c c l im a t iz e d lo w la n de r c a n alm o st
to g a in e t l Lr y l u n g s (A E D C A } n e v e r a c h ie v e this
du r i ng
m pr es s u r e vo l um e cu r v e s t ha t t he l un g fol l ow s
d if fe T h is b e h a io u r is k l a
i n fl a tio n & d e f la tio n a r e re n t v

hy s te r e s ís Th e lu n g v o lu m e a t a n y gi v e n p r e s s u r e
is l a r ge tha n d u r in g i n f la t i o n Pre s su re
d u r i n g d e fl a t i o n r

f lu n g is n o n li n e a r w ith the lu n g
v o lu m e c u r v e o

be c o m in g s t if f e r a t h ig h v o lu m es

ie t br th in & w he n p r es su re is p lo tt e d a ga in st
1 ïn q u ea

v o lu m e i t fo rm s a hy s te r e s is lo o p ra t h e r t h a n a s tr a i g ht
l in e b eca u s e in tr a p u le u ra 1 p r e ss u r e c h a n g e s 1l t l u n g
2 4 D
v o lu m e c ha n g Ls d u r in g in s p ir a t io n & e x p i r a ti o n A r e a A
I n t r a p Fe u r a l p r e s s u r e (m m H g)
A X BY A re e s e n ts 11o / 1 e l a s t i t r k do ).e r e
q u ir e d t o o v e r
pr
lu isc o s ity & a ir w a r e s is ta n c e Re la u t io n Pr u is u r c c u r v e IPI o f C hea t
co m e n g v y
R e si st an c e t o ai r t 1t o t 1 em e nt i s r e l at i ue 1 u s B na + B t t ur i ng
i n
1 i e t b r e a t h i l .g W h e n a r o w b e c o m e s t u r bu l e n t
t u
s

i
l u r in g ra p i d b r e a t h i n g t h e e n e r gy r e q u i r e d to m o v e a i r is

t
gr ea er t h a n w h e n t h e f l o w i s l a m i n a r T o t a l 1u o r k o f

q u i e t b r e a t hi n g is 0 3 0 8 k g m / m i n 1u b i c lt r is es
m a r k e d l y d u r i l 1g e r e r r i s e Q a n d i n d i s e a s { s s u c h a s

em phv s em a a st hm a & CH F
W h en ov e r st r e t =h e tl ,
e s p i r a t or y mu s c l es co n l mc t 1ui l l ï
Zu U 2 0
le s s s t r r t 1g t l 1 bec o f a t i q u e & f a i l (d l t l e n g t h t e n s i o n
m e Tra m m t 1r a l p- æ (c m F I )
r e la ti o n s hi p ) le a d i n g t o i n a d e q u a t e v e n t i l a t i o n

Co m p Ha n c e

B i e C hr o n ic br o n c h itis (A n sw e r o f e x c lu sio n ) 1R IT / Be r r t e &L1r yâp¢, 31 3 2 G a b r i ¬ l p 18 2 8 3 1o 1111 w es t M p gg 1t

G u y t o +1 1 1/ e 1} 4 73 7J G【
ïn o l 1g Z ll p 5 9 5 9 T/
C o 呷 l i a 11c e (S t r e t c h a b i l i t y )
C h a n g e i n l u n g v o l u 1n e p e r u n it c ha n g e i n d i s t e n d i n g (a i r w a y ) p r e s s u r e o e
r e a c h e q u i l ib D u m ) i s k l a l u n g
lu n
g (i f e n o u g h t i m e i s a l l o w e d t o
c o m p l ia n c e So t h e v o l u m e c h a n g e p e r u n i t p r e s s u r e c ha n ge o r (v o lu m e

c h a n ge r e s t i l t in g f r o m 1 c m H z o c h a n ge i n p r e s s u re ) o r th e s lo pe o f

Pr essB1r eyol e c u r v e is k l a c o m plia n c e

I t is n o rm a l ly m ea su re d in the p r es su r e r a n ge w h e r e t he r e la x a ti o n

pr e s s 11r e c u r v e is s e e p e s t Be c a u s e o f h y s t e r e s is c a u s e d b y s u r f a c t a n t t h e
t
tle f l a ci o n P V c u r v e is u s e d f o r m e a s u r e m e n t A n d l u n g c o m p l i a n c e i s t h e

Æo p e o f lin e bl w an y tw o p o in t s o n d e f la tio n l im b o f pr essu r e v o l t 1m e iF R c

lo o p 25
RV

T - - (c m Ha O )

To ha n g e
m e a st° e (o r
pr e s s u r e c
u r a r e c ha n ge in n gs ) ple i pr essu lu
eso p h a g e a l b a l l o o n c o n n e c t e d t o p r e s s t 1r e t r a n s d u c e r i s u s e d . w h i c h i s a n
e x c e l le n t s u r r o
g a te m a r k e r f o r pl e u r a i p r e s s u r e E s o p h a g e a l p r e s s u r e is TLC
n o t id e n t i c a l t o i n t r a le u r l
p a r e s s u r e b u t r e f le c t s i b ress u re c ha n e fa ir l
p p g y
w e ll H o w ev e r th e t is
m easu rem e n n o t re li abl e in s u pin e p o s i ti o n b/ o
in t e r fe r e n ce by t h e i gh t f
w e o m e d ia s t in al s tr u c tu r es
U n it f
o co m pl i a n ce is m L (o li t e r ) p e r c m H z o T h e c o f l
p l ia n
r m c e o n or m a
hu m a n (b o t h ) l u n g is 0 20 m H 1 o ( 2o 0 m u c m H o ) h ic h m e a n s ev e
2 ,
w rY
tim t h e tr
e
p u lm o n a r y p r e s su r e in c r e a s e s 1 c m H o th e lu n
a n s

w i ll e x
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a
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p t ) i s a m e a s u r e o f t h e e <a s t i c r o e r t ie s (o r
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lu n g is d is t e n d e d H i h
g v a l u e r e f e r s t o a l u n g t h a t i s r ea d il di s t e J ï d e d a n d T - - (c m W )
l m u o o 1n 1i a n æ m e a n s a t if f y
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 113

eq u i r e d fo r a u n it o f ir f lo
r a w ) is a dyn a m ic ra t he r tha n s t t ic m e a su re m e n t t ha t t a k in to
p lia t the
l c co u n
H o w e v e r ,
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p s o n lu n g v o lu m e an d p a tie n t w ith o 1Bt ! t Bn g h f t s t1 pp r o x i 11m t¬ 1y ï u l !í i
c o n i p ! 1n Bc e o f
in s p i r a to r y c o m p lia n c e (m ea su r e d du in
r
g in n a t io n ) T hc co m
p lia n c e {ì f r es p ir a t o q s y s te m (c o bin p d l u
m n g & th o rd x i is

a t high lu n g v o l u me s la n d h igh e x a j
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it lu f lu
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per u n v o m e o n
g ( l el a s p e c i f i c c o m l i a n n
s ]o p t o f c u r v e [ n r th i s r e a s o n c o m l i
p ce ) is m ga su n 1 t o k 11o p an c e
w i n t r i n s i c t t, r » t i c r o e r t i e
p p s o f l u n g tis s u s

Co m pl ia n ce D e cr e a se d i e cu rv e s h if te d
P u rm o Bm r y i nt erst i ri al j i brosi ss c o m p l ia n ce In cr ea se d i e c u r v e s h if t e d
1n t e r s t i t i a ï l u n g disea se
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n o í M )r \\ al >LW]i
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1n o rm r u e n o BBs *
y Du rin g a n a st hm
p r B s s 1t r e } Q a it t ta ck

li lu n g re m a in s u n v e n t i l a te d f o lu d
r n g Pr i Lr + 1" t e i 1 11v
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D d d t 1¬ t a tQ (c a u s in
e c r ea s e s BB n
g in c rea w L t s u r fa c e t c n s i u n
a n J a lv e o la r a t e l e c ba s i s )
D e fo rm i ti e s o f tho r a x e g k y p ho s is t tl l i o s is
Pa r a ly s i s t \ f r es
p ir a h ì F m u sc lt s

Ple u ra i c f fu s io n pn e u m t» / hv tl r o l he m » tho r ax

Ve n t il a t i o n & Pe r fu s io n

74 B i e V e i 1t il a ti o n Pe r f u s io n m is m atc h 1R F H t 1r r i s o 11 1 6 / p g 15 0 3 15 0 4 C 【ï n a l1 g 2 l e pg 6 62 , 6 6 3 】

ism t c h th e O tain d in the a lv e o li c a r +n o f be t m n s n ri t t e d Io t e r ie s T h i s l e a d s t o

perf
e ar
ln v m ti l a t i o n u s io n m a co n

d 0 te n s io n
a c cu m u la t i o n o f 0 2 i n t il e a 1u eo 1i Q, c a u sin g in cr e ase 2

V e 11t i 1a ti o N P e r f u s io n Ra t io =
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y b lo r w n g a m v en o n
p u ln l o n a r u L
The ti o
f p u lm o n a r v e n t i l a t i o n tL 1
ra a y
di v id e d b y 5 5 L I m i n p u lm o n a r y b lo o d f lo w )

Ve n ü l a t io n Mi n i m u m
pp p Fi heent i l at i on o f a n
ûX & % .

r a < g gg l u s is r e du ce d A

PO 1 f a l l s b e c au se o : le s s
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t he ba s e s t o t h
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C a r d io v a s c u la r Sy s te m =

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v es s e sl , l a r g e r p u 1m o n a F v e s s e l s & e v e n c h a m b ¢ r s o t h e a r t Th a t g r e a t r r t h e M SF P ( e g 1 4 ) t h e g r e u ! e r i l t e t i g h t t r e s s w i t h w h i c h

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54 D i e Pe r i ph e r a l res is ta n c e x c a r diac o u tp u t [ R e l G a r1o ï 1g 2 4 e P 590 1

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RV R Rv R Re s i s t a n ce to v e n o u s r et ur n

55 A i e A u s cu l t a bo r y g a p t w Ga n o n g 24 e P 5 90 m a u d lu t r i 5 / F P 2 10 1

Blo o d Pt e s s u r e

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A i e 6 H o u rs IR Q G a n o n g 2 2i e P 5 1 6 1

The a v e r age h a l f l i fe o f n e u m p hi t s in t h e c i r c u la t i o n i s 6 H o u r s
To m a in t a i n n o r m a l c ir c u l a t in g b lo o d l e v e l p r o d u c t i o n o f 100 b i l l i o n n eu t r o p h il s l day is n e c e s sa r y
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F 《c f o r ? i s i t ï u o l n e d i n e M n ih s fc p a t 1n oq y a M 和村 o r s 8, 9, 11 a M 12 are im o 1o e d i n ex tr lk s fc pa thtuï w s f co q g u 1a t i o n Q
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o w a v e e o se c re t io n i s b r o u 吕h t a bo t by
4 N o r m a l =Ps t r ic ju ic e co n ta i n s a ll exn r Bl (A 1 1 9 9 5 ) A Neu ra l f a c to r s (A [ 9 1) =1 Ë
A N \ D U Ho l fa c t o
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B Pa r ie t a 1 c e ll D D Co lo ie c a ses
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b W n ic h o f t he f o l l o w i n g e y m e s is s ta b le t idi c p H A D n o l:d e p e n d o n Gast r i c
a a c o ts m o ti ]i t ! D
A Pe p s ín (A 1 u 7 ) D B In crea s e d b y D is t e n s i o n
D
B T q F6 i n D C In crea s e d by A ce t y lc h o l i n e D
C Ch y m o tn p sin D D Im ea s e d
b y c h o le c ys to kin in D
Ca r bo x y pe ptida se k 18 A fter a m ea l Dc h in ca r bo hydr a te in su li n se cre tio n is
7 Pe p s i n o ge n is a c t iv a t e d b y U 1 93 1 s ti m u l a te d b y
ani er 0 3 Þv B OS)
A En ter o ki n a se D A CC K
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C TFT s in j C V IP
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D Ch y m o tr y psin D D G L P 1 17 3 6 ) a m ide D
ß C hym tr y p in ge n i n ti v a te d in t o c h y m o tr 19 M 0o r gu la to
o s o ac yps in b y a r e r o f i n be r d i g e s t i v e m y o e l e c tr ic c o m p l e x e s
A Tn p in (A ï IM S 90 ) D A V IP : T N 0 4 SG P G I 03 U P 0 5) D
B Pe p sin D B G IP
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9 Pa n cre a ti c se c r e ti o n c o n t a in ( PG 1 9 2 ) E G RP D
A 丁叮 p s i n D 20 WWC h o f t he se s ta te m ts t
e n ar e co r re c r e ga r d i n g a c i d
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D Pe p s i n D B Se c r e t i n d e cr e a se s ac id s ec r e t i o n D
E Re n in D C H 2 blo c ke r s decr ea se id tio
a c sec r e n D
10 A ll o f t h e fo ll o w in g sec ted pr o e n zym e form D T t a l a c i d s e c r e Ei o n r e f l e
a r e r e ex ce pt o x ts fu n c t io n a l p a r ie t a t e ] l
A T q ps in (D e l h i 96) D m a ss D
B Ch y m o l: r s in E 5o
yp D m a to st a ti n in c r e a se s a c id se c r e t i n n k

D R i b o n u c le a s e D A S t io n
T r e s es w i t h w re t in D
11 Fo l l o w i n g a r e g a a h o i n t e s t i r 1a l h o r m o n es ex ce pt B H 2 blo c ke r s p re v e n t r e ] Ca D
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C Fa t D D Ro to r s yn dr o m e D
D B il e D E Ne o n a ta l h e p a ti ti s k
42 Be st s ti m u li f o r C CK secr e ti o n i s 54 A bn o r m a l i t is s y n th e s i s f u n c tio n o f 1i v er
A A c id W 9 A M U 99) D /; t PT ( PG I D e c 0 6) D
B Pro t e in D B H }r er b i [i r u bin e m ia D
C Bile D C A c u te pha s e re ac ta n t D
D Fa t a D KUPf ! D
43 Fa t i n t h e d u de lu (A I 2 0 0 0 1
o n u m m e n
Mo t a
A St i m u l a t e s g a l l b ]a t l d e r c o n t r a c tio n
55 Sm a n t e s t i n a l p e r î s t a ] s i s +s
ll i c o n tr o l l e d by
B I n h i b i t s g a l l b ]a d tï e r c o n t r t io n pJ l
a c D
A M y e n t r ic pl e x u s (K e r t 11a 9 4) D
C I n h i bi t s C C K s e c r e t i o n 【
】
D Re l e a ses Se c r e tin
B M e iss n c r s p le x u s Æ L
D C V D
a gu s 11 c r v e
44 C C K PZ ca u se s a ll o f t h e f o ll o in g
w ex ce pt
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r a sym D
r co n t r a e tio n ( A ï t 999 1o 56 Pa c er na k c f th e G I T îs l o ca te d i n
r o {P G T I u n ¬ 9 81
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A C a r d ia c e n < a f s t o m a c h k
C In c r ea se d ga st1in sec r e t io n a
B Lon g m u sc le o f sm a ll i n te s tin e D
D D ecr ea s ed to l v e r e so p h a ge a l s p hi n i c t o r D
:
D Cen t r a t c o n tr o l o f C BD o r i gin a
A G as tr in (A t 1 9 98 ) D

C Vagus D
D
A sc gm e n t a tî o n ( p G 1 l u u e 9 8) a
Æ o ly c y s to k in in D m
a u s tr a lio n s D >

46 M o s t /m p o r ta n t s tim u la n t f o r b il e s e cr e ti o n is :
C M i gr a to ry m o to r c o m p le x es (M M Q D £
口
.
:
" C h o ]e c y s t o k i n i n (A 11M S g T A 19 7 j i p m er 99) ° . ' '" ti '
' '" , . . s m . " d b' ' " c W .
A A 1. a l i n e co n t e n t o f s m a l l i n te s t i n e D
C Bile a c id D B H y pe r o s m o la r i ty o f c h ym e ( PG í D e c 9 8 ) D
D Bi te sa lt D C D is te n s io n o f du o de n u m D
47 B i l ir u bin is se cr e te d by I AL1I M S M n y 9 5 )
A Bi l e s a l t s . 59 h . , . f' ' " g d_ ' ' " ' '" 1' ' " t" gas M .
°

«& K otj
c s e c r e t in D A p du f p r o te in d ig es ti o in the
m c ts o n cl u o d en u m D
D CC K D D u o de n a l t] is t e m i o n

D
A CC K f PG 1 l u iïe 28 )D D Ho r m o n es
a
B Se c r e t i n D 60 En te rog a s t r i c r e f l e x ïs c a u s e by a ll e x ce pt
C G a s tr i n D A D u o Lt ° n u m d i s t ° n s i o n D
D En t e r o ga s tr o n e D B 八 ] k 1 l i t t e p H i n LI Lm d c n u m
D
49 B i l +r u b i n i s d e r i v e d f r o m (P G 1 11i I re 0 21 C l ncn?, l t ' t t u s m o l a l i t o l e h i m
y e D
A M y o g lo b:n D D n \n I C D
8 H e m o gl o b i n D 61 > »c t o r s r e s i bl e f o r cau sin
po n s g d ia r r h o ea a fte r v ago to m y a r e
(P G T l u n e 9 8 )
D Ch o l e s t e r o l D A Ra p i ga s t r i c e m p t y i n g O
E A m in o ac ids 11 Iì w o ac i 1l i t y i n d u o d e n u m D
5o B il e id ha d e te r g e n t a c ti o n du c to c Br r
a c s a e g u ]a r p c r i s t a ]s i s D
A Fo rm a t io n o f so a p (n 1M s ì r t rr c 9 7 ) D D N o n e
D
B Fo r m a t io n o f z w i t te r ío n D 62 ' 1a x i m u n i p o s tpr a n d i a ] m o t i 1i t y i s se en in :
C J\ mphi pat hi c n a t u r e o f bile ac 0d s D A A scen d in g c o lo n (A U M S M a y 1 1 N o u 0 8 ) D
D Fo rm a tio n o f m e d iu m c h a i n t r i g ] y c e r 0d e s D B T r a n sv e r se c o lo n a
U iiiii T C De s c e n cl i n g c olo n D
D Si g m o id c o lo n
51 Fu n c ti o n o f h e p a t ic s t e ]l a [ e c e l l s i s l a r e D
63 WWi e d in g igm id
A Fo r m a t iu n o f s in u s o íds ( p G1 / 1r r 1e o 1) D o s o osco p y i f th e r e c h 1m is i n fl a te d w ith
B v it A s to r a D gas in crease
p e r ìs ta ls i s i s s een ïn
ge
A W h o le colo n
(A IUM S A y 0 1) k
C In c r e a se s blo o d pe r fu s io n D
B Pr o x im a ] co lon D
D p ha go c y t o s i s D
52 Liv r s y n th e s i z e s ll C D is ta l co lon D
e a e x ce pt <A 1LM S M a y 0 4
A D W h o le in te s t in e a
co m pl e m e n t c o m po n e n t 0

D l m m u n o
g lo b u l i n a 64 The a m o u n t o f w a te r a b s o r b e d i n t h e i n te s t i n e in a ay is

53 Co n ju ga te d hyper b ilir u bin e m i a +n i n f a n c y is seen in A 5 l 0t (A 11M S D e c 95 1 D

A G i tb c r t s y n d r o m e (P G J D e r 0 6) D B 1 10E a
B C r i g g ] e r n a jj a r s y n d r o m e D C J O II t D
C D u b i n jo h n s o n s y n d r o m e D D ß ti t D
190
191
 192

An s w e Æ 1m t i o m

J
S a l iv a

1 A i e Sa l i v a

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