Value of ambulatory electrocardiographic monitoring to identify increased risk of sudden death in patients with left ventricular dysfunction and heart failure

To examine the predictive value of ventricular arrhythmias onambulatory electrocardiographic (ECG) monitoring, 211 patientswith left ventricular dysfunction and congestive heart failure(76% men, age 63±4 years, left ventricular ejection fraction0.26 ± 0.10) were studied. During a follow-up of 21 ±11 months, there were 45 cardiac deaths: 22 were due to progressivepump failure and 23 were sudden. Patients with a low left ventricularejection fraction ( 0.27) and ventricular tachycardia on 24h ECG were at higher risk of dying suddenly and from progressivepump failure (both P<0.0001). Patients who died suddenlywere found to have significantly longer (P=0.003) and faster(P=0.029) ventricular tachycardias on their baseline ambulatoryECG, than survivors. This association was not observed in patientswho died of progressive pump failure. Therefore, low left ventricularejection fraction and ventricular tachycardia on 24 h ECG recordingpredict an increased risk of cardiac mortality. Our resultsalso suggest that longer and faster ventricular tachycardiarecorded by 24 h ECG may identify patients at risk of suddendeath, a finding which has not been described before.     

顾乃强乳腺增生病电脑诊疗专家系统的医理设计——附130例临床验证

此专家系统在修善顾博士行医经验和治疗原则的基础上 ,利用多媒体技术 ,结合声频、视频、图片和文本以治疗乳腺增生病。在医疗设计中 ,着重于顾博士的类型识别要点和乳腺增生病的自然规律。尤其 ,此医疗设计阐明了顾博士所总结的有价值的治疗经验 ,以突出此专家系统的科学性、实用性和可操作性。笔者曾将此专家系统应用于临床 1 30份病例的治疗中。其结果表明此专家系统的临床治疗正确率与顾博士临床治疗相对照达 98%。     

山紫菀类药材的性状与显微鉴别(Ⅳ)

继前３报,继续对１１种山紫菀类药材（基源为橐吾属Ｌｉｇｕｌａｒｉａ植物）的生药性状和显微鉴别特征进行报道。     

川芎茶调散及其4种改型制剂的质量分析

目的：考察川芎茶调散改型制剂的质量,分析影响质量的工艺因素。方法：按中国药典检测方法对各制剂所含挥发油及浸出物进行定量分析,并用ＴＬＣ法对各制剂进行川芎、白芷的主成分鉴别。结果：挥发油含量最高为０．４％（散剂、片剂）,最低为０．０８５％（袋泡剂）;醇溶性浸出物最高为１５．７６％（散剂）,最低为１０．２３％（冲剂）;水溶性浸出物最高为２４．８９％（散剂）,最低为１８．４３％（袋泡剂）;袋泡剂中川芎、白芷的ＴＬＣ鉴别为阴性。结论：与散剂相比,４种改型制剂均存在不同程度的质量问题,其中冲剂、袋泡剂各项指标最低,提示单纯以水提取的剂改工艺欠合理     

Perinatal mortality trends in a referral hospital

A comparative study of perinatal mortality patterns over a period was conducted at a teaching hospital of South India. Among the 6,048 babies born from January 1984 to December 1985 (Group A), there were 265 (43.8/1000) still births and 127 (22.0/1000) early neonatal deaths. Three hundred and thirty seven (41/1000) babies were still born and 235 (29.8/1000) early neonatal deaths out of 8,215 deliveries during 1992–93 (Group B). The perinatal mortality rate (PMR) in Group A and B were 57.9/1000 and 57.7/1000 respectively. Unbooked cases accounted for the majority (> 75%) of perinatal deaths during both the periods. The overall mortality rates in unbooked cases were three to four times higher than booked cases. Among the various causes of still births, antepartum haemorrhage and uterine rupture had increased. Septicaemia was the major cause of early neonatal deaths in Group A, but in Group B birth asphyxia and prematurity were the leading causes. Effective interventions like creating awareness among the target population to utilise maternal and child health services and early referral of high risk cases with improved intranatal and perinatal care can decrease the perinatal mortality.     

γ-Glutamyltransferase test as a new tool for identification of seminal stains

Summary A simple qualitative method for identification of seminal stains based on a high activity of -glutamyltransferase (-GTP) in human semen is described. It employs the release of -naphthylamine from N--glutamyl--naphthylamide by the -GTP action; -naphthylamine couples with Fast Garnet GBC salt to produce a strong brownish-red color. The data on its simplicity, specificity, and stability show that the present method is suitable for medicolegal examination of seminal stains as a preliminary test.     

机械传动系统的模糊分析设计

用线性隶属函数、二元相对比较级等确定特征因素的隶属度,构造了不同机械传动类型的模糊子集,取其与待识别模糊子集向量空问的距离均数为贴近度。根据择近原则选择确定机械传动类型。     

一种新的蛇胆掺假品的鉴别

目的 对新发现的一种蛇胆掺假品进行鉴别。方法 采用中国药典收载的TLC法。结果 检出了一种新的蛇胆掺假品——熟地黄提取液。结论 本法可运用于药材鉴别，但不适用于含蛇胆的中成药鉴别。     

板蓝根化学成分研究

 目的从板蓝根中提取分离活性成分。方法板蓝根用95%乙醇渗漉，不同极性溶剂提取，再用硅胶柱色谱分离单体，测定化合物的理化常数和波谱数据，鉴定其化学结构。结果分离得到5个化合物，分别鉴定为：β-谷甾醇(β-sitosterol Ⅰ)，棕榈酸(plamitic acid Ⅱ)，琥珀酸(succinic acid Ⅲ)，胡萝卜苷(daucosterol Ⅳ)和远志醇(polygalitol Ⅴ)。结论化合物Ⅲ，Ⅴ为首次从该植物中分离得到。