真皮下血管网皮瓣修复感染创面的研究

目的：探讨真皮下血管网皮瓣的抗菌能力和临床修复感染创面的应用。方法：以家猪为实验动物，在臀部两侧分别形成传统的岛状皮瓣和真皮下血管网岛状皮瓣，用细菌计数、吖啶橙荧光染色测定白细胞吞噬指数和白细胞内杀菌率等方法，进行对比。结果：真皮下血管网岛状皮瓣的抗菌力明显降低。 １９８９年起临床应用 ５例，创面彻底清创后用吻合血管的真皮下血管网游离皮瓣修复，全部成活。结论：该皮瓣抗菌力虽低于传统皮瓣，但仍可用于修复感染创面。     

用神经网络法预测药物在体透过人皮肤的渗透性

目的：预测药物在体透过人皮肤的渗透性。方法：以正辛醇／水分配系数(logP)、分子体积(V)、氢键酸度(∑β2^H)和氢键碱度(∑β2^H)等理化参数作为输入层神经元，以药物在一定时间内在体透过人皮肤的透过比的对数值(R，透过量／未透过量)作为输出层神经元，建立起合适的BP(Back—propagation)神经网络。结果：17个药物在一定时间内在体透过人皮肤的透过比的神经网络计算值和实测值均相当符合。结论：用BP神经网络法可以较好地预测药物在体透过人皮肤的渗透性。     

应用计算机网络系统提高门急诊管理水平

作者介绍的门急诊计算机管理网络系统，应用软件使用ＦＯＸＰＲＯ２．５ＦＯＲＤＯＳ语言，在两台网络服务器之间应用镜像技术，门诊号的录入使用光笔和条形码技术，实行划价、收费一体化，采用星型拓扑网络结构，保证了网络的先进性、安全性、稳定性和可扩充性。网络系统实现挂号、划价收费、调剂、药品使用管理、工作量统计及经济核算的全程闭环管理格局，有效地堵塞了管理和经济上的漏洞，提高了工作效率和管理水平。该系统已正常运行了１２个月，并通过省级科技成果鉴定。     

Heterogeneity of Red Blood Cell Velocity in Skeletal Muscle Decreases with Increased Flow

Objective: Effective material exchange between blood and tissue depends on the heterogeneity of microvascular flow. The objective was to address inconsistencies between intravital studies regarding this dependency. We tested the hypothesis that heterogeneity of red blood cell velocity (V_RBC) in capillary beds varies with the strength of metabolic stimulus and with capillary bed geometry. Methods: We used videomicroscopy to measure V_RBC in a bed of 10–24 capillaries at the surface of extensor digitorum longus (EDL) muscle in anesthetized rats. The coefficient of variation (CV = standard deviation/mean; an index of spatial heterogeneity) was computed in the same bed before and after (i) 1, 2, 4, or 8 Hz supramaximal muscle contraction or (ii) adenosine superfusion (10^?7–10^?3 M). Beds with or without arteriolar—venular capillary shunts were used. Results: Although control V_RBC differed between beds (shunt: 232 μm/s; no shunt: 130 μm/s), the percentage increases in postcontraction V_RBC did not (range: 111–326%). In both beds, control CV varied greatly (overall range: 28–117%) and 2–8 Hz muscle contractions reduced CV significantly by 25%. Similar results were obtained for adenosine. In confirmatory experiments using the rat cremaster muscle, contractions (4 Hz) and adenosine (10^?4 M) also reduced CV. Based on all data, CV = 63–0.022 V_RBC (r = 0.82, P < 0.001). Conclusions: The heterogeneity of V_RBC decreased with metabolic stress, regardless of capillary bed geometry. We propose that both the large variability in control CV and the relatively shallow dependence of CV on velocity could be responsible for the present inconsistencies between intravital studies.     

Autonomy in the Rehabilitation of Stroke Patients in Nursing Homes. A Concept Analysis

This article presents a concept analysis of autonomy in relation to the rehabilitation of stroke patients. Analysis of the results of a literature survey provided three important concepts of autonomy in the field of biomedical ethics: self-governance, self-realization and actual autonomy. These concepts are compared with concepts from caring sciences and summarized in a table. The results indicate the importance of the social environment (formal and informal caregivers) for the restoration of autonomy. Because of the patient's condition and context, a social concept of autonomy makes more sense in the rehabilitation of stroke patients in nursing homes than does an individual concept. The concept analysis sheds light on the fact that the majority of studies regarding patient autonomy are primarily based on theoretical reflections, not on empirical studies. More research is warranted to gather information on how patients themselves consider and appreciate autonomy during rehabilitation, to explore the views of stroke patients' formal and informal caregivers and to investigate whether a social concept of autonomy is suitable for all phases of rehabilitation. Concerning the practice of rehabilitation, no definite conclusion can be given as yet.     

山丘型血吸虫病流行区小环境改造的费用-效果分析

山丘型血吸虫病流行区因地制宜进行沟渠硬化、沼泽地改塘等小环境改造措施后，钉螺面积减少了６６．１６％，活螺密度、活螺框出现率分别下降了７６．５４％和７６．１３％，阳性螺密度下降了１００％；居民血吸虫病患病率略有下降，１４岁以下人群感染率为０，无急性感染发生。而实施药物灭螺的对照组９年来钉螺面积仅下降了２７．６２％，活螺密度及活螺框出现率分别上升了２６．３５％和１５１．０１％，是小环境改造点的９．８４倍和１１．１３倍，同时居民血吸虫病患病率较１９８７年上升了３７．４４％，１４岁以下人群感染率为１．２１％，并有零星急性感染病例发生。小环境改造一次性投资费用高于药物灭螺，但与农田水利相结合的小环境改造措施能够产生一定的间接经济效益，因此远期效果仍将优于药物灭螺。     

A neural network confirms that physical exercise reverses EEG changes in depressed rats

The use of an artificial neural network (ANN) system to differentiate the EEG power density spectra in depressed from normal rats was tried. The beneficial effects of chronic physical exercise in reducing the effects of stress and therefore depression was also to be tested in animals by the same method. In this study, rats were divided into 4 groups, subjected to (i) chronic stress (D group); (ii) chronic exercise by treadmill running (EO group); (iii) exercise with stress (ES group) and (iv) handling (C group). The prefrontal cortical EEG, EMG and EOG were recorded simultaneously on paper and the digitized EEG signals were also stored in the hard-disk of a PC-AT through an ADC. After filtering the digitize signals, the EEG power spectra were calculated by an FFT routine. Three successive 4 s artefact-free epochs were averaged. The REM and NREM sleep periods as well as the awake period signals were analyzed separately. The FFT values from each of the 3 states, in the 4 groups of animals were tested by an ANN with 30 first layer neurons and a 2nd layer of a majority-vote-taker. The ANN could distinguish the depressed from the normal rats' EEG very well in REM (99%) sleep, NREM (95%) sleep and awake (81%) states. In most of the cases it identified the exercised rats' EEG as normal.     

The effect of design of residential homes in creating dependency among confused elderly residents: A study of elderly demented residents and their ability to find their way around homes for the elderly

A study of 13 homes for elderly people examining the effect of the environment on demented residents looked into the complexity of the design from the residents' point of view. Two principal tools were used in this investigation: ‘route diagrams’, which describe a resident's use of the home, and a measure devised to indicate each resident's ability to find her way around the home. These are described and the relationship between them explored. From this the following tentative conclusions are drawn:

• (i) The variables that influence a resident's ability to find her way around differ between group and communally designed homes.
• (ii) It would appear that group homes provide a more favourable design, especially in the case of physically frail demented elderly people.
• (iii) In group homes, the level of lighting is an important aid to a demented person in finding her way around.
• (iv) In communal homes, residents seem most able to find their way around homes that have been adapted from older premises.
• (v) In both types of home, ‘meaningful decision points’ can be seen as aids to a resident finding her way around.

     

兔耳纯静脉皮瓣血流量和血管网面密度观测

目的:观测纯静脉皮瓣术后血流量和血管网面密度变化。方法:利用家兔耳背设计纯静脉皮瓣和动脉皮瓣模型①观测术后血流量;②墨汁灌注后软蜡厚蜡切片,图像分析血管网面密度。结果:①纯静脉皮瓣术后48h血流量最低,第14d恢复至术前65%。②纯静脉皮瓣术后第1～7d的血管网面密度高于动脉皮瓣(P<0.05)。结论:纯静脉皮瓣术后血流量及血管网密度变化与动脉皮瓣不同。     

Auditory evoked potentials to tones and syllables in adults: evidence of specific influence on N250 wave

Brain-derived neurotrophic factor (BDNF) is involved in the differentiation and the survival of neurons. It has also been shown to be associated with the regrowth of neurons of damaged spinal cord and the modulation of ionic currents by acting on sodium channels and NMDA receptors through tyrosine kinase B (TrkB) receptors. We investigated the effects of BDNF on rhythm generation induced by disinhibition in dissociated cultures from embryonic rat spinal cord (E14), with extracellular multisite recordings (MultiElectrode Arrays, MEAs) or intracellular patch-clamp recordings. Exogenous BDNF had only minor effects on the bursting by increasing the activity during the burst. This increase of activity is suggested to be mediated by a potentiation of the postsynaptic NMDA receptors because it has been found that BDNF potentiates the NMDA-evoked depolarization in cultures incubated with BDNF for 10 min. Possible direct effects of BDNF on sodium channels were also investigated by local application of BDNF to the soma of patched neurons but no depolarization was observed. Long-term application of BDNF strongly decreased the activity during the burst and also the number of active electrodes, possibly due to a decrease in network density.