Inter- and Intraindividual Variations in Shortening of Ventricular Effective Refractory Period After an Abrupt Decrease in Pacing Cycle Length

After an abrupt decrease in pacing cycle length (PCL), the ventricular effective refractory period (VERP) shortens. The pacing protocol needed to determine accurate and reproducible values for the VERP during this process is elaborate and time consuming. In this study, steady-state values of VERP at 800 and 350 msec PCL and dynamic values of VERP due to an abrupt change in PCL from 800 to 350 msec were determined. This was done for 11 different dogs to test the interindividual variation and repetitively in the same dog to test the intraindividual variation. The results for steady-state and dynamic values of the VERP show a wide range for both groups. This means that accurate prediction of steady-state and dynamic values of VERP based on previous measurements is not possible.     

对间日疟病程初期原虫密度的观察

滇南的实验结果显示，人工接种当地间日疟原虫子孢子后，经短潜伏期发病的３８名志愿者，首次见虫时间为８－１３ｄ，首次见虫和临床初发时的原虫密度分别为０．２－１．６和０．６－４０４０个／μｌ。造成如此明显差异的原因，似与虫现期和临床初发间的时间距离密切有关，表现为感染后临床初发的时间越早，多数病例于首次见虫时的原虫密度越低，反之则高。文中讨论了这一问题在病原生物学和流行病学上的重要性。     

Oral and Intravenous Amiodarone for Atrial Fibrillation-Flutter

Amiodrone is a benytfuran derivative with class III anti arrhythmic effects. It has also been reported to convert atrial fibrillation and flutter to sinus rhythm and is highly effective for the prevention of atrial fibrillation (especially of the paroxysmal form) with an overall efficacy in the range of 70–50%. This high degree of efficacy was obtained in a majority of patients who had already failed various conventional anti arrhythmic agents. The mechanism of arrhythmia termination by intravenous amiodarone is not clear. The slowing in ventricular response, which most probably improves cardiac hemodynamics, has an indirect salutary effect. Despite the fact that none of the published reports on intravenous amiodarone used a placebo control group, these studies suggest that intravenous amiodarone has an important role in the acute treatment of atrial fibrilation with fast ventricular response.     

Bovine β-Lactoglobulin in the Human Milk

ABSTRACT. Human milk samples ( n =232) collected during the whole lactation period from 25 healthy, Swedish mothers were analyzed by radioimmunologic method for content of bovine β-lacto-globulin. Detectable amounts (5-800 μ/1) were found in 93 of 232 milk samples (40%). Six mothers had no detectable β-lactoglobulin in their breast milk on any occasion. Two mothers had measurable /Mactoglobulin in all their milk samples. No correlation was found between daily cow's milk intake and concentration of β-lactoglobulin in the milk samples. Six mothers with allergic symptoms such as asthma, hay-fever, eczema all had detectable amounts of β-lactoglobulin in their milk. Of 19 mothers without allergy, 13 had detectable amounts. This difference did not show statistical significance. The presence of symptoms in the infant such as diarrhoea, vomiting, colic, exanthema was significantly correlated to high levels of β-lactoglobulin in the milk. Bovine β-lactoglobulin was also detected in 7 of 13 serum samples. The two mothers with detectable β-lactoglobulin in all milk samples had the highest serum values, and their infants suffered from gastro-intestinal symptoms, weight decline and exanthema.     

个体化营养治疗对消化系统手术围手术期患者营养状况的影响

目的 探讨个体化营养治疗对存在营养风险的消化系统手术围手术期患者营养状况的影响。方法 本研究为前瞻性、随机对照临床试验。对择期行消化系统手术的患者进行营养风险筛查，将存在营养风险、筛选合格且签署知情同意书的231例患者随机分为研究组（n=115）和对照组（n=116），分别给予个体化营养治疗和非个体化营养治疗15 d（术前5 d至术后9 d）。采集基线数据，分别于入组时及营养治疗第5天、第9天、第15天采集患者空腹静脉血，测量患者BMI、血清总蛋白、血清白蛋白、血清前白蛋白、血糖、总胆固醇、三酰甘油、淋巴细胞计数及白细胞计数等指标。结果 最终纳入患者217例（研究组112例、对照组105例），中途退出14例（6.1%）。（1）组内比较：研究组患者在入组时及营养治疗第5天、第9天、第15天时血清总蛋白、血清白蛋白、血清前白蛋白均呈先上升后下降再上升趋势（P均<0.05），淋巴细胞计数、白细胞计数均呈先下降后上升趋势（P均<0.05），但均在正常范围内；对照组患者在入组时及营养治疗第5天、第9天、第15天时血清白蛋白呈先下降后上升趋势（P<0.05），血清前白蛋白、淋巴细胞计数呈先上升后下降再上升趋势（P均<0.05），但均在正常范围内；其余指标组内比较差异均无统计学意义（P均>0.05）。（2）组间比较：研究组患者血清总蛋白和血清白蛋白水平均高于对照组（P均<0.05）；术前1 d（营养治疗第5天）研究组白细胞计数低于对照组，但术后第9天（营养治疗第15天）研究组白细胞计数高于对照组（P<0.05）；其余指标组间比较差异均无统计学意义（P均>0.05）。（3）分组与时间交互效应：组间比较的结果表明时间因素不影响营养和免疫相关指标（P>0.05）。结论 个体化营养治疗有利于改善存在营养风险的消化系统手术围手术期患者的营养状况。     

实验性眩晕动物模型的建立

目的 建立一种操作简单，切实可行的实验性眩晕动物模型，以便于抗眩晕药物的研究。方法 选用昆明种小鼠，通过训练使其建立起逃避电击反射，然后通过旋转使动物产生眩晕，以旋转后逃避电击反射完成所需的时间（潜伏期）作为衡量眩晕时间长短的指标。结果 用天麻素，盐酸地芬尼多及对照组对该方法进行验证。结果显示，该模型能有效地反映以上抗眩晕药物及对照组的药效作用。结论 该模型能够很好地反映动物眩晕程度及眩晕时间的变化，可有效地应用于抗眩晕药物的研究。     

Relation of supplementary feeding to resumptions of menstruation and ovulation in lactating postpartum women

Background Resumption of menstrual cycles is one of the indicators for restoration of reproductive capability in postpartum women. However, menstruation does not necessarily mean that ovulation has taken place. The aim of this study was to investigate the relation of supplementary feeding to return of menstruation and ovulation after delivery. Methods A questionnaire was used to obtain data from 101 breastfeeding mothers. The following elements were analyzed: age, education level, breastfeeding practice, time of return of menstruation, contraceptive practice, and starting time of supplementary feeding during the lactation at intervals of 6 weeks to 18 months after delivery. The ovulation was continuously monitored by ultrasonography and basal body temperature (BBT) measurement.Results By ultrasonography, 53 of the 101 women (52.5%) had the first ovulation (follicle &gt;1.8 cm in diameter) within 154 days after delivery on average, among whom 11 (10.9%, 11/101) had restoration of ovulation within 4 months and 42 (41.6%, 42/101) had it after 4 months. In women with follicles &gt;1.8 cm in diameter (n=53), the menstruation resumed (138±84) days after delivery, and the supplementary feeding was started at (4.0±1.1) months, which were significantly earlier than those in the women with follicular diameter &lt;1.7 cm (n=48; (293±88) days, (5.1±1.3) months; t=9.003, P&lt;0.01 and t=4.566, P&lt;0.01). In the women with follicles &gt;1.8 cm in diameter, 30 had return of menstruation before the end of ultrasonographic monitoring, while only 8 in the women with follicular diameter &lt;1.7 cm had menstrual resumption at the same time (χ&sup2;=16.91, P&lt;0.01). The starting time of supplementary feeding was positively correlated with the time of the restoration of menstruation (n=100, r=0.4764, P&lt;0.01) and first ovulation after delivery (n=53, r=0.5554, P&lt;0.01). In this series, no woman had pregnancy within 18 months postpartum.Conclusion Supplementary feeding can affect the restoration of menstrual cycles and ovulation in lactating postpartum women.     

量化脑电分析方法及其在癫痫易发作期检测中的应用

对于癫痫患者,癫痫易发作期(seizure vulnerable period,SVP)的检测有助于预测癫痫发作并采取相应的治疗和抑制措施.本文采用量化脑电分析方法研究癫痫易发作期的临床诊断价值.对经过带通滤波预处理的量化脑电信号分析得到反映大脑状态的线性特征量(过零率和谱距)和非线性特征量(最大Lyapunov 指数、复杂度、相位同步和互信息),以及比较不同导联之间的特征差异,并将它们应用于慢性颞叶癲痫大鼠模型长时程连续脑电数据和癫痫病人临床脑电数据的分析.癫痫易发作期与正常状态期间对比,分析单个导联特征量变化趋势得到最大Lyapunov指数、复杂度和过零率的值下降,而相位同步、互信息和谱距的值上升;选择两个合适的导联,分析不同导联之间的特征差异是最大Lyapunov指数、复杂度、相位同步、互信息和过零率差异减小或趋于一致,而谱距的差异增大.结果表明量化脑电特征量可以反映癫痫易发作期相对正常状态期间的变化,并且有些特征变化在每次集中发作的第一次发作之前较长的一段时间内就开始了,即进入癲痫易发作期的时刻相对第一次发作时刻在时间上具有一个提前量,这个时间提前量为临床处置提供了前提.     

Mothers' health and work-related factors at 11 weeks postpartum

PURPOSE Many new mothers return to work soon after childbirth. This study examines personal and work-related factors associated with the postpartum health of employed women 11 weeks after childbirth.METHODS Using a prospective cohort design, we recruited 817 Minnesota mothers into the study while they were hospitalized for childbirth in 2001. Telephone interviews were conducted at 5 and 11 weeks postpartum. Eligible women were 18 years or older, employed, and spoke English and gave birth to a singleton infant. Multivariate models using instrumental variables (2-stage least squares) were used to estimate personal and employment characteristics associated with women’s physical and mental health and postpartum symptoms.RESULTS At 11 weeks postpartum, 661 participants (81% of enrollees) completed a full interview, and 50% of participants had returned to work. On average, women reported 4.1 (SD 3.2) childbirth-related symptoms, most frequently fatigue (43%). Factors significantly associated with better health outcomes included better preconception health, the absence of prenatal mood problems, more control over work and home activities, more social support at work and home, and less job stress.CONCLUSIONS The findings suggest postpartum women need to be evaluated regarding their fatigue levels and mental and physical symptoms. Women whose fatigue or postpartum symptoms limit daily role function may find it helpful to have health care clinicians counsel them on strategies to decrease job stress, increase social support at work and home, and certify their use of intermittent family and medical leave to help them manage their symptoms.     

AAI监测下不同麻醉镇静深度对肿瘤患者围术期炎性因子的影响

目的:探讨不同镇静麻醉深度对肿瘤患者围术期炎性细胞因子的影响,为肿瘤患者选择适宜的麻醉深度,减少围术期炎症反应维护术后免疫力,保护患者免疫功能,提供依据。方法:选择2017年08月-2019年01月我院普外科择期行消化道肿瘤根治性切除患者66例,年龄34~88岁,体重40~95 kg,采用随机数字表法,将患者随机分为3组。应用听觉诱发电位指数（AAI）监测镇静麻醉深度,分为浅镇静麻醉组(AAI值在40-30范围内)、深镇静麻醉组(AAI值在29-20范围内)、传统麻醉组,根据血压、心率波动及制动、流泪、呛咳等指标及麻醉医师的经验调控镇静麻醉深度。分别于手术开始前即刻（T1）、手术开始后2 h（T2）、手术后24 h（T3）、手术后48 h（T4）及72 h（T5）时点检测患者血清白介素-2(IL-2 )、白介素-4(IL-4)和肿瘤坏死因子(TNF-α)浓度。结果:组间比较,IL-2血浆浓度T1时点浅麻醉组与传统组比较,浅麻醉组明显降低（P＜0.05）;T4和T5时点深麻醉组与传统组比较,深麻醉组明显降低（P＜0.05）,其余时点比较无统计学差异。IL-4血浆浓度比较,T2和T4时点浅麻醉组与传统组比较,浅麻醉组明显降低（P＜0.05）;T4时点浅麻醉组与深麻醉组比较,深麻醉组明显升高（P＜0.05）。TNF-α血浆浓度比较,T1、T2和T4时点浅麻醉组与传统组比较,浅麻醉组明显降低（P＜0.05）,T1时点浅麻醉组与深麻醉组比较,深麻醉组明显升高（P＜0.05）。结论:浅镇静麻醉即AAI值在40-30范围比深镇静麻醉即AAI值在29-20时可以更好的保护肿瘤患者围术期Th1细胞介导的细胞免疫功能,降低IL-4对细胞免疫的抑制作用,控制过度的炎症反应,保护患者免疫状态,帮助患者更好的康复。