新生儿先天性心脏病监测与随访

目的探讨新生儿先天性心脏病（先心病）的发病情况和预后。方法（1）以彩色多普勒超声心动图配合尸检为主要诊断依据，对1992至1998年我院出生的31493例新生儿进行先心病发病情况前瞻性调查。（2）对1992至1995年出生的先心病患儿，随访3年。结果（1）以彩色多普勒超声心动图配合尸检，结合随访的修正诊断，检得先心病318例，患病率10．10‰。其中非青紫型255例，占80．2％，青紫型63例，占19．8％。室间隔缺损患病率5．14‰居首位。（2）318例先心病中新生儿期死亡35例，病死率11．0％，1992—1995年出生的167例先心病随访3年，死亡38例（22．8％），1岁内占94．7％，0～28d占68．4％。结论新生儿先心病发病率高，新生儿期是先心病死亡高峰年龄。     

新生儿先天性心脏病监测与随访

目的探讨新生儿先天性心脏病(先心病)的发病情况和预后。方法(1)以彩色多普勒超声心动图配合尸检为主要诊断依据,对1992至1998年我院出生的31493例新生儿进行先心病发病情况前瞻性调查。(2)对1992至1995年出生的先心病患儿,随访3年。结果(1)以彩色多普勒超声心动图配合尸检,结合随访的修正诊断,检得先心病318例,患病率10.10‰。其中非青紫型255例,占80.2%,青紫型63例,占19.8%。室间隔缺损患病率5.14‰居首位。(2)318例先心病中新生儿期死亡35例,病死率11.0%,1992—1995年出生的167例先心病随访3年,死亡38例(22.8%),1岁内占94.7%,0～28d占68.4%。结论新生儿先心病发病率高,新生儿期是先心病死亡高峰年龄。     

Semmelweis’ present day follow-up: Updating bacterial sampling and enrichment in clinical hygiene

Potentially dangerous antibiotic resistant contaminants have permanently penetrated at least well-off western populations. The danger is so evident that some hospitals have started to refuse accepting patients who carry such bacteria. Sampling and enrichment measures in hygiene monitoring must be updated as they are corner stones in handling the problems and safeguarding the health care units. Their patients, when exposed to microorganisms are strenuous to treat. Sometimes even this fails, if the infections are spreading in weakened patients. The present review summarizes currently used technologies and the abilities of bacteria to avoid detection. Improved protocols on environmental monitoring in healthcare units are required. They should be comparable with contamination control in industries. Actually these measures in health care should be even stricter because human lives are directly endangered as the resistance of especially elderly patients is low.     

Using uncertain data from body-worn sensors to gain insight into type 1 diabetes

The amount of observational data available for research is growing rapidly with the rise of electronic health records and patient-generated data. However, these data bring new challenges, as data collected outside controlled environments and generated for purposes other than research may be error-prone, biased, or systematically missing. Analysis of these data requires methods that are robust to such challenges, yet methods for causal inference currently only handle uncertainty at the level of causal relationships – rather than variables or specific observations. In contrast, we develop a new approach for causal inference from time series data that allows uncertainty at the level of individual data points, so that inferences depend more strongly on variables and individual observations that are more certain. In the limit, a completely uncertain variable will be treated as if it were not measured. Using simulated data we demonstrate that the approach is more accurate than the state of the art, making substantially fewer false discoveries. Finally, we apply the method to a unique set of data collected from 17 individuals with type 1 diabetes mellitus (T1DM) in free-living conditions over 72 h where glucose levels, insulin dosing, physical activity and sleep are measured using body-worn sensors. These data often have high rates of error that vary across time, but we are able to uncover the relationships such as that between anaerobic activity and hyperglycemia. Ultimately, better modeling of uncertainty may enable better translation of methods to free-living conditions, as well as better use of noisy and uncertain EHR data.     

High‐frequency ventilation with the Dräger Babylog 8000plus: measuring the delivered frequency

Background: Ventilator frequency is one of the determinants of tidal volume delivery during high‐frequency ventilation. Clinicians increasingly use data on ventilator displays to inform their decisions. Aim: To measure the frequencies delivered by the Dräger Babylog 8000plus ventilator when used in high‐frequency mode. Methods: Ventilator waveforms using a test lung were recorded at the full range of settings 5–20 Hz using Spectra software at 1000 Hz. The changes in frequency produced by a 1‐ Hz change in set frequency were calculated. Actual and displayed frequencies were compared. Results: For settings up to 12 Hz, median (range) difference between set and delivered frequencies was 0 (?0.4 to +0.1) Hz. Above 12 Hz, delivered frequency varied by ?0.3 (?1.9 to +0.3) Hz. For 1‐ Hz changes in frequency settings, in the range 5–12 Hz, 1‐ Hz changes produced a change in delivered frequency of 1.0 (0.6–1.4) Hz. Above 12 Hz, the corresponding changes were 0.7 (0–2.9) Hz. The ventilator displays the set frequency during operation rather than the delivered frequency. Conclusion: At 12 Hz and below, the differences between set and delivered frequencies were relatively small compared with those at 13 Hz and higher. Above 13 Hz, the difference between set and delivered frequencies was up to 2.9 Hz. Some frequency setting changes did not result in a change in delivered frequency.     

基于单片机的室内可燃性气体监测仪

【摘要】目的针对空气污染源中的可燃性气体,设计一种室内可燃性气体监测仪,实现实时、自动地监测可燃性气体及变化情况,进而采取通风等措施,减少其危害。方法系统以STCl2C2052AD单片机和高灵敏度半导体空气传感器TGS2600为核心,传感器感知可燃性气体及其浓度并转换为电信号,由信号调理电路放大9．3倍后送人ADC。单片机运用温度补偿算法、等级划分算法等,对数字信号进行分析、处理,通过数码管及LED显示空气质量的等级。采用定量浓度的可燃性气体异丁烷,对室内可燃性气体监测仪的灵敏度进行验证。结果监测仪能准确测出体积分数为O．001％、0．01％的可燃性异丁烷气体。结论室内可燃性气体监测仪能对空气中可燃性气体异丁烷进行实时、定量监测,并划分空气质量等级,具有操作简单、自动监测等特点,既可用于居民室内可燃性气体监测,又可应用于通风换气设备中控制,具有广阔的市场前景。     

甲型肝炎病毒IgM AlphaLISA检测方法的初步建立

目的 建立甲型肝炎病毒抗体IgM的AlphaLISA检测.方法 浓缩甲型肝炎病毒抗原并生物素化,通过dot-Blot法摸索出生物素化的甲型肝炎病毒的最适量为6 × 10-8ng.优化供体珠、受体微珠、血清等实验反应条件,建立了甲型肝炎病毒的AlphaLISA的IgM检测方法.并对23份感染甲型肝炎病毒的IgM阳性患者和70份健康人的血清进行检测.结果 AlphaLISA甲型肝炎病毒的IgM方法检测:灵敏度(真阳性率)为78％;特异度(真阴性率)为98.5％;假阳性率为1％;假阴性率为22％;阳性预测值为95％;阴性预测值为93％;准确度为94％.结论 建立了均相、快速检测AlphaLISA甲型肝炎病毒IgM检测方法并得到初步应用.     

不同类型心脏患者心内直视手术期间呼气末CO2分压与动脉血CO2分压及其差值的变化

目的探讨不同类型心脏患者心内直视手术期间呼气末二氧化碳分压（PETCO2）与动脉血二氧化碳分压（PaCO2）的相关性及二者差值[P（a-ET）、CO2]的临床意义。方法45例患者分成3组，每组15例。A组：左向右分流组；B组：无分流组；C组：右向左分流组。3组分别于术前（T0）、插管后15min（T1）、手术开始时（T2）、转流前（T3）、转流停止后15min（T4）、术毕时（T5）共6个时点，用旁气流法监测PETCO2，同时抽动脉血测定PaCO2，应用直线回归分析3组各时点PETCO2与PaCO2的相关性，同时计算并分析各组不同时点的P（a-ET）CO2。结果（1）A组、B组各时点PETCO2与PaCO2呈正相关，A组r为0．70—0．85（P〈0．01），B组r为0．71—0．79（P〈0．01）；C组麻醉开始至转停后PETCO2与PaCO2均无相关（0．46—0．54，P〉0．05），而到术毕时则呈正相关（r=0．66，P〈0．05）。（2）3组患者转流前的P（a-ET）CO2变化不大，停转流后A组、B组P[a-ET）CO2增加，其中以A组增加较明显（P〈0．01），而C组P（a-ET）CO2显著减少（P〈0．05）。结论无分流或左向右分流心脏患者在体外循环转流前后PETCO2与PaCO2的相关性较好；右向左分流心脏患者转流前的相关性较差，心内畸形纠正后其相关性可发生变化。P（a-ET）CO2在不同的心脏患者之间差异较大，必须与PaCO2相结合，才能正确指导临床。     

心、肺、脑非接触监测研究进展

近年来,生物医学领域非接触监测研究不断发展与进步.对心、肺、脑非接触监测手段的研究现状进行综述.重点分析电容心电图、磁感应、雷达3种非接触式心、肺监测以及非接触式脑部监测相关技术.电容心电图监测心、肺活动利用电极间电容变化效应;磁感应监测心、肺活动利用麦克斯韦原理;雷达监测心、肺活动利用多普勒效应;非接触式脑部监测采用磁感应断层成像技术.在分析各监测原理的基础上,介绍了国内外相应的研究成果,并总结了这些监测手段的优缺点;并对未来新型非接触心、肺、脑监测设备作出了展望.     

Assessment of Standing Aids for the Physically Handicapped

The suitability of four commercially available standing aids was assessed for routine therapy of a group of severely handicapped patients in hospital care. The problems which arose were mainly technical and these are considered. From experience gained during the study the design requirements of an ideal aid for these patients are proposed.