基于80C196KC单片机的便携式家庭心/电血压监护仪的研制

应用80C196KC构成一个循环存储8小时心电数据的便携式心电／血压监护仪,其核心单元是80C196KC单片机,还包括Flash Memory（闪速存储器）存贮模块,Socket Modem通讯模块,薄膜键盘,血压数据接口,液晶显示模块和电源转换模块。其特点是集心电图采集、分析、存储和显示等功能于一体,实现动态心电分析监护及心律失常的识别和报警,并把出现病变时的心电、血压数据通过电话线传到医院中心站,接收返回医嘱。心电信号实时自动分析系统包括QRS复合波的实时检测算法和心律失常自动分析软件,可以显示心电波,心率（HR）和早搏（室早、房早）累积数;自动识别6种心律失常报警。通过对MIT心电数据库的部分数据进行测试,结果表明仪器硬件设计合理,心电分析算法和疾病判出的实时性和准确性基本满足要求,其中QRS波群检出正确率为99.9%,停搏、漏搏和心动过速过缓检出的准确率均在98％以上,而早搏（室早、房早）和R on T检出的准确率在95％以上。     

一种基于函数逼近原理的心电图P波识别的研究

提出了一种基于曲线拟合来识别心电图中Ｐ波的方法。实验表明，用二次曲线逼近方法识别Ｐ波，确定Ｐ波起止点的方法简便实用，ＭＩＴ心电数据检验正确率达９９％。     

基于微机的心电信号实时自动分析系统

作者介绍了在３８６微机上研制开发的心电信号实时自动分析系统，着重介绍了ＱＲＳ复合波的帝时检测算法和心律失常自动分析软件。该系统能实时显示任一导联心电波形，同时显示心率（ＨＲ）和早搏（ＰＶＣ）累积数；能自动识别十余种心律失常并报警；具有ＳＴ段分析功能，能实时检测ＳＴ段电平和斜率，经用美国ＭＩＴ心电数据库的部分数据对该系统进行测试，准确率达９５％以上。     

10例阿尔茨海默型老年痴呆事件相关电位的初步研究

对１０例临床诊断为阿尔茨海默型老年痴呆（ＳＤＡＴ）的患者及１９例正常人进行听觉事件相关电位（ＥＲＰ）检测，同时还观察ＳＤＡＴ患者体外反搏治疗前后ＥＲＰ的变化。发现患者组Ｎ１波潜伏期明显延长，Ｐ３波出现率低仅４％（正常青年组１００％，老年组８０％）。Ｐ３潜伏期显著延长，波幅明显降低。体外反搏治疗后，患者组Ｎ１波潜伏期明显缩短，Ｐ３波出现率升至８０％。     

脉搏波传播和血管顺应性对体循环和肺循环系统血流特性和心室功率的影响

本文采用耦合模型研究脉搏波传播和血管顺应性对体循环和肺循环血流特性和心室功率的影响。左心室和右心室均采用Ｅ－Ｒ模型,后负荷系统对于体动脉和肺动脉分别采用Ｔ－Ｙ管模型和稍微不对称Ｔ管模型,应用脉冲响应法将二者耦合起来。选取生理范围的参数,计算了两个系统的每搏输出量（ＳＶ）、每搏输出功（ＳＷ）、定常功率（Ｗs）、脉动功率（Ｗo)和总功率（Ｗt）等。详细分析了血管顺应性、脉搏波波速等对这些参量的影响。得到的主要结果是脉动功率对参数的变化比定常功率更敏感。因此,脉动功率百分比或许是评估心室效率的一个较好参数之一。     

ECG信号的小波变换检测方法

本文反小波变换应用于ＥＣＧ信号的ＱＲＳ波检测。利用二进样条小波对信号按Ｍａｌｌａｔ算法进行变换：从二进小波变换的等效滤波器的角度，分析了信号奇异点（Ｒ峰点）与其小波变换模极大值对的零交叉点的关系。在检测中运用了一系列策略以增强算法的抗干扰能力、提高ＱＲＳ波的正确检测率。经ＭＩＴ／ＢＩＨ标准心电数据库检测验证，ＱＲＳ波正确检测率高达９９．８％。     

侵袭性骨肿瘤中RB基因及其蛋白产物表达的研究

目的探讨抑癌基因ＲＢ的改变与骨肿瘤的关系。方法采用地高辛标记的ＲＢｃＤＮＡ探针对３４例侵袭性骨肿瘤组织及同体正常软组织进行ＳｏｕｔｈｅｒｎＢｌｏｔ检测，同时应用ＬＳＡＢ免疫组化法对９９例侵袭性骨肿瘤及１４例瘤旁软组织进行ＲＢ蛋白表达的检测。结果２１例骨肉瘤中有９例可检出ＲＢ基因的结构异常（４２．９％），ＲＢ蛋白的缺失仅在２６．９％（７／２６）的骨肉瘤和２１．７％（５／２３）的软骨肉瘤中检测到，良性的骨巨细胞瘤和软骨母细胞瘤中未检出ＲＢ蛋白的缺失，其二者差异有意义（Ｐ＜０．０５）；分化差、异型性明显的骨肉瘤细胞其ＲＢ蛋白表达为阴性，低分化的软骨肉瘤及间叶性软骨肉瘤其ＲＢ蛋白亦多为阴性。结论ＲＢ基因结构的异常、ＲＢ蛋白的缺失，可能与骨的恶性肿瘤的发生及其演进有关。     

恶性小圆形细胞肿瘤的鉴别诊断：附79例免疫组化回顾性研究

应用免疫组化ＬＳＡＢ法，对原病理诊断意见分岐的７９例恶性小圆细胞肿瘤（ＭＳＲＣＴ）进行免疫组化鉴别诊断研究。结果除１例仍不能分类外，其余７８例（占９９％）得到明确诊断。其中有恶性淋巴瘤、未分化癌、胚胎性横纹肌肉瘤、无色素性恶、神经母细胞瘤、精原细胞瘤、骨原细胞瘤、骨外尤文瘤及未分化肉瘤。结果表明，采用多种肿瘤标志物联合标记是对不同组织起源而形态相近ＭＳＲＣＴ鉴别诊断的有效方法。     

散发性戊型肝炎病毒部分核苷酸序列分析

目的为阐明戊型肝炎病毒（ＨＥＶ）毒株的地理分布、流行特征以及研制血清学诊断试剂和基因工程疫苗提供资料。方法选择１例浙江仙居山区散发性ＨＥ患者，从其血清中分离ＨＥＶＲＮＡ，通过逆转录－套式聚合酶链反应法（ＲＴ－ｎＰＣＲ），扩增该散发性ＨＥＶ（Ｚ－３３株）ＯＲＦ２区部分ｃＤＮＡ片段（４９７ｂｐ），然后进行直接序列分析，并与ＨＥＶ各主要代表株序列作比较。结果Ｚ－３３株与新疆流行株ＣＨ１．１的核苷酸及氨基酸序列同源性分别为９６．７％及９８．２％；与缅甸流行株的同源性分别为９４．２％及９９．１％；与缅甸散发株的同源性分别为９５．２％及９９．１％，与墨西哥株的同源性分别为８１．８％及９４．５％。结论浙江仙居散发性ＨＥＶＺ－３３株和新疆流行株ＣＨ１．１一样，与ＨＥＶ缅甸株可能为同一亚型。     

IST支原体培养与PCR解脲支原体检测方法的比较

目的：比较分析ＰＣＲ解脲支原体检测法与ＩＳＴ支原体培养法的结果及两种方法的优缺点。方法：同时采集８８例临床上诊断为非淋菌性尿道炎（ＮＧＵ）、阴道炎患者分泌物标本两份,分别用ＩＳＴ支原体培养法和ＰＣＲ解脲支原体（Ｕｕ）检测法进行对照实验和分析。结果：ＩＳＴ支原体培养法Ｕｕ阳性２５例（２８．９４％）,人型支原体（Ｍｈ）１例（１．１４％）,Ｕｕ＋Ｍｈ５例（５．６８％）。ＰＣＲ检测Ｕｕ阳性３０例（３４．０４％）,其中男性５例ＰＣＲ检测Ｕｕ为阳性,而ＩＳＴ支原体培养法为阴性;女性３例ＰＣＲ检测Ｕｕ阴性,培养法为阳性。两种方法的Ｕｕ阳性率经统计学ｘ２检验（Ｐ＞０．０５）无显著性差别。结论：ＩＳＴ支原体培养法与ＰＣＲ检测Ｕｕ法均能适用于临床Ｕｕ的检测。ＩＳＴ支原体培养法操作简便,不需要特殊仪器;能进行支原体的种类鉴别;有参考病理阈值并可同时做药敏实验,特别适合基层医院的支原体检测工作。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.