俯卧左侧抬高位数字图像对早期贲门癌诊断价值

目的 :研究气钡双对比造影俯卧左侧抬高位数字图像对早期贲门癌的诊断价值。方法 :收集 2 8例经手术和病理证实的早期贲门癌 ,用青岛Ⅲ型双对比用硫酸钡 ,5 0 0mA岛津IDR - 70 0遥控透视数字胃肠机 ,实时采集贲门区多种部位图像 ,着重采集俯卧左侧抬高位胃底贲门区像。结果 :2 8例早期贲门癌在俯卧左侧抬高位像上均能清晰显示该区微小病变。结论 :俯卧左侧抬高位胃底贲门区数字化图像能清晰显示该部位的异常X线征象 ,对早期贲门癌的诊断有积极的价值 ,尤其是癌肿未侵及食道下段时 ,显示病变优于其它摄影部位     

Neuronal mechanisms of two-dimensional orienting movements in the cat. I. A quantitative study of saccades and slow drifts produced in response to the electrical stimulation of the superior colliculus

To evaluate the metrics of rapid eye movements caused by the activation of distinct collicular microzones, the superior colliculus (SC) was electrically stimulated in alert behaving cats while their heads were restrained. A quantitative study of electrically induced rapid eye movements demonstrated that their amplitude and direction depended on the intensity of stimulation, the electrode location, and the initial position of the eyes, while their duration depended on the intensity of stimulation. When detailed quantitative procedures are employed, properties of saccades produced in response to the electrical stimulation of the feline SC resemble those of saccades elicited in response to the electrical stimulation of a variety of primate brain areas. Besides saccades, electrical stimulation of the feline SC gave rise to slow drifts whose amplitude and direction was also influenced by the initial position of the eyes. Because their size depended on the frequency of stimulation and their time course reflected mechanical properties of theoculomotor plant, induced slow drifts could be due to a more or less direct projection of the SC onto extraocular motoneurons. A model that includes such a variety of connections between the SC and extraocular motoneurons is presented and is shown to produce realistic combinations of fast and slow eye movements when its input is a step function of time. The present findings support the notion that an orbital mechanical factor underlies the eye position sensitivity of slow drifts and saccades evoked in response to the electrical stimulation of the SC.     

论药品检验机构在药品监督管理中的法律地位和作用

本文结合我国药品检验机构的现状，从药品检验机构的地位，职能，作用及法律责任等方面谈了学习《药品管理法》的体会。     

放射治疗射野照相用基准标尺板的研制与应用

放射治疗中作射野位置验证时,目前多是利用射野照相底片中,以照射野内及周围的组织结构作为参照,用肉眼与放射治疗计划的照射野作比对,故存在着较大的误差。笔者研制了一种具有“度量”功能的基准标尺板,能有效地减小这种比对误差。本文介绍了这种标尺板的制作与临床应用。     

Influence of Body Position on Defibrillation Thresholds of Nonthoracotomy Implantable Defibrillators:

DFT of Nonthoracotomy Defibrillators. Introduction : Defibrillation thresholds (DFTs) usually are determined with the patient in the supine position. However, patients may be in the upright position when a shock is delivered during follow-up, which may explain some first shock failures observed clinically. This study investigated whether body posture affects defibrillation energy requirements of nonthoracotomy implantable cardioverter defibrillators with biphasic shocks.
Methods and Results : Using a step up-down protocol, DFTs were compared intraindividually in 52 patients ("active-can" systems in 41 patients, two-lead systems in II patients) for the supine and upright positions as achieved by a tilt table. The mean DFT was 7.3 ± 4.2 J in the supine versus 9.2 ± 4.8 J in the upright position (P = 0.002). Repeated comparison in reversed order 3 months after implantation in 22 patients revealed thresholds of 6.2 ± 2.5 J (supine) versus 8.4 ± 3.7 J (upright; P < 0.03) 1 week and 4.4 ± 2.4 J (supine) versus 6.2 ± 4.1 J (upright; P < 0.04) 3 months after implantation. DFTs decreased significantly for both body positions from 1 week to 3 months after implantation (P < 0.04).
Conclusion :(I) DFTs for biphasic shocks delivered by nonthoracotomy defibrillators are higher in the upright compared to the supine body position. (2) Differences remain significant 3 months after implantation. For both body positions, DFT decreases significantly from 1 week to 3 months after implantation. These findings have important implications for programming first shock energy to lower than maximal values or for development of devices with lower maximal stored energy.     

Influence of recording site withing the muscle on motor unit potentials

The influence of the recording site on the motor unit potentials (MUPs) was investigated in the brachial biceps muscle of 8 healthy subjects. The MUPs were recorded with a concentric needle electrode and analyzed with a new decomposition EMG program we call multi-MUP analysis. MUPs had shorter durations and smaller amplitudes at superficial recording sites than at deeper sites in the muscle. This is mainly due to the cannula of the concentric electrode, which records a higher potential at superficial recording sites and partially cancels the recorded potentials from the tip in a differential recording. The MUPs had longer durations and higher amplitudes distally than in the middle of the muscle. The longer durations and spike durations are probably due to increased temporal dispersion at a greater distance from the endplate zone. We do not have an adequate explanation for the larger amplitudes distally in the biceps, they may be due to anatomical factors. To increase the diagnostic sensitivity of quantitative MUP analysis the recordings should be obtained from standardized recording sites. © 1995 John Wiley & Sons, Inc.     

Cardio-respiratory changes with increased intra-bladder pressure in prone position during anesthesia

Twenty non-obese patients, 13–29 years of age, operated on for scoliosis were examined for cardio-respiratory changes that occur during positioning on bolsters, and the effect on the cardio-respiratory system of raised intra-abdominal pressure was evaluated. Hemodynamic and respiratory responses were measured when the position was changed from supine to prone and back to supine during anesthesia. We measured the intra-bladder pressure using a transurethral catheter (IBP) as an index of the intra-abdominal pressure. When the position was changed from supine to prone, the cardiac index (CI) decreased by 10–30% and the systemic vascular resistance index increased by 8–14%. IBP rose significantly (P 0.001), but it remained below 5mmHg. These changes continued to be mild until the patient was returned to the supine position. Pa_{O 2}, A-aD_{O 2}and Qs/Qt remained unchanged. CI decreased significantly (P 0.001) when IBP was increased to 10mmHg by abdominal compression, but was not affected when IBP was increased to only 5mmHg. It was concluded that mild abdominal compression in the prone position during anesthesia has little effect on the cardio-respiratory system in lean young subjects.(Hiraga Y and Hyodo M: Cardio-respiratory changes with increased intra-bladder pressure in prone position during anesthesia. J Anesth 6: 407–413, 1992)     

三组不同分娩体位对孕产妇母儿结局的影响

目的探讨仰卧位、侧卧位和俯卧位三组不同分娩体位对孕产妇母儿结局的影响。方法选择2018年3月-2019年3月在佛山市南海区第六人民医院选择自然分娩的产妇300例,随机分为仰卧位组、侧卧位组和俯卧位组,每组100例。比较三组产妇妊娠结局(顺产率、剖宫产率、第二产程时间、产后2 h出血量)、产妇疼痛及焦虑感和胎儿心率,评价不同的分娩体位对孕产妇的影响。结果比较三组产妇的顺产率,发现俯卧位和侧卧位产妇顺产率均显著高于仰卧位,差异具有统计学意义(P <0.05);比较三组产妇的疼痛及焦虑情况发现,侧卧位和俯卧位分娩可以降低产妇的疼痛感和焦虑感,差异具有统计学意义(P<0.05);比较三组产妇的第二产程时间和产后2 h出血量发现,侧卧位和俯卧位分娩的产妇第二产程时间稍高于仰卧位组产妇,侧卧位和俯卧位分娩的产妇产后2 h出血量稍低于仰卧位组产妇,但差异均无统计学意义(P>0.05);比较三组产妇胎儿胎心正常率发现,侧卧位分娩和俯卧位分娩胎儿胎心正常率显著高于仰卧位,差异具有统计学意义(P <0.05)。结论产妇在第二产程分娩的过程中采取俯卧位和侧卧位分娩,可以提高孕产妇的顺产率,降低产妇分娩过程中的疼痛感和焦虑感,胎儿胎心的正常发生率也显著升高,达到改善孕产妇母儿结局的目的,是促进自然分娩的有效方式,值得在临床上进一步推广应用。     

半卧位与平卧位分娩方式对产程的影响

目的　选择对产程较为有利的卧位分娩方式。方法　将 32 0例单胎头位初产妇 ,随机分为半卧位组 (观察组 )和平卧位组 (对照组 )各 160例进行对照观察。结果　观察组第二产程明显短于对照组 (P <0 .0 1)。结论　采用半卧位式分娩符合产道生理 ,使产轴与胎轴保持一致 ,有利于胎头入盆下降 ,可缩短第二产程。