Menstrual-Linked Asthma

This study was conducted to determine the occurrence of menstrual-linked asthma (MLA) in India in 100 consecutive female asthmatics in the reproductive age group. The patients were required to respond to a questionnaire concerning the relationship between their asthma and the menstrual cycle. Twenty-three patients had subjective perception of deterioration in symptoms of asthma in relation to the menstrual cycle. Ten patients from both groups were also required to maintain a daily peak expiratory flow rate (PEFR) diary for 2 consecutive menstrual cycles. The mean total duration of illness in patients with MLA was significantly longer than in patients without cyclic exacerbation. Cough and breathlessness were also significantly more severe as was the disease. This was evidenced by the more frequent emergency room visits and hospitalizations in these patients. Menstrual-linked worsening of asthma was most common in the premenstrual week (17 patients). In 8 of these 17 patients, this phenomenon continued to occur during the menstrual week also. Interestingly, 1 patient complained of deterioration of asthma 2 days after menstruation was over. Such an observation is yet to be recorded. Fourteen patients reported an increase in symptoms with almost every cycle while 3 had worsening related to specific season only. Sixteen patients often required extra medication during the premenstrual and/or menstrual weeks. A significant association was also observed between severity of premenstrual syndrome and MLA. The mean PEFR values over 2 cycles revealed a significant fall in the morning as well as evening values in the premenstrual and menstrual weeks as compared to the midcycle week in patients with MLA. This fall was maximal in the premenstrual week. Such a fall was not observed in asthmatics without menstrual exacerbation of symptoms. MLA was detected in about a fourth of the female asthmatics in India and it appears to represent a more severe form of the disease. This study also documented that MLA was associated with an increase in airway resistance and was not simply due to an increased perception of symptoms during the premenstrual or menstrual weeks.     

The effect of preconceptional multivitamin supplementation on the menstrual cycle

The database of the Hungarian randomised controlled trial of periconceptional multivitamin supplementation for the prevention of neural-tube defects was used to evaluate the length of the pre- and postovulatory phases of the menstrual cycle before and during multivitamin supplementation. The female cycle was more regular (i.e., the variance was lower) during the multivitamin supplementation.     

人左、右心室阻抗微分心动图的比较研究

作者利用Ⅱ导心电图、心音图、颈动脉搏动图、右（或左）心室阻抗微分心动图同步描记的方法。对人左、右心室阻抗微分心动图进行了比较分析。结果显示:人的左、右心室阻抗微分心动图图形相似，波形稳定，转折明显，均有清晰的生理标志点。两种图形各相应生理标志点在时相上存在着区别．且人的左、右心室阻抗微分心动图能分别反映人的左、右心室收缩和舒张过程，说明利用人的左、右心室阻抗微分心动图能分别测定人的左、右心室收缩时间间期与舒张时间间期值，鉴别和评定左、右心室的功能。     

Exteroceptive suppression periods in jaw-closing muscles. Variability and relation to experimental pain and sustained muscle contraction

The duration of the late exteroceptive suppression period (ES₂) of temporal muscle EMG activity has been reported to be reduced in patients suffering from chronic tension-type headache. Methods of recording and analysing ES₂ have varied between centers and reproducibility of results within subjects , although insufficiently studied, has generally been poor. ES₂ was investigated in 30 healthy subjects, using a computerized technique of recording, rectifying and averaging the EMG signals. Hour to hour and week to week variations of ES₂ durations were calculated, and the influence of pain during a cold pressor test and of sustained muscle contraction on ES₂ durations was investigated. The intra-individual variation of ES₂ durations was 16.0% from hour to hour and 20.7% from week to week. The inter-individual variation was 36.7%. The present method for analysis of ES₂ periods proved to be reliable, as the intra-observer variation was 4.2% and the inter-observer variation 4.6%. ES₂ periods were significantly shorter on the first compared to the second day of examination ( p = 0.006) and during experimental pain ( p = 0.0005). We recommend the use of the computerized averaging technique in future studies and caution against the dependence of results upon factors such as conditioning and pain.     

中西医结合促进上腹部手术后恢复的临床研究

目的:比较上腹部手术后常规西医处理与常规西医处理加早期中药治疗的疗效。方法:上腹部手术134例,随机分为对照组58例,治疗组76例。对照组采用术后西医常规处理方法治疗,治疗组76例在对照组治疗方法的基础上,术后8h开始胃管注入赤甘汤,分别观察其术后康复情况。结果:治疗组肠呜音恢复时间、肛门排气时间、排便时间、肠粘连、体温恢复正常、伤口疼痛消失及住院时间,均明显优于对照组(P<0.05),两组差异有统计学意义。结论:中西医结合治疗能有效促进上腹部术后恢复。     

不同类型高危儿早期干预的临床研究

目的 探索早期干预对窒息、高胆、早产三类高危儿智力发育改善的效果，寻找更合适的早期干预措施。方法 将三类高危儿分为干预组及对照组，同时随机选取正常对照组进行随访。干预组采用鲍秀兰教授“0～3岁”早期干预方案训练，各组均在6个月、1岁时分别采用婴幼儿智能发育量表(CDCC)进行智力发育测评，结果用MDI、PDI表示。结果 (1)6个月龄时MDI各干预组与对照组间有显著性差异，窒息组、早产组与正常组间亦有显著性差异；高胆组与正常组间无差异；PDI窒息组中干预组与对照组之间有显著差异(P＜0．01)，高胆组、早产组均无差异(P＞0．05)。(2)1岁时MDI和PDI结果一致，干预组与对照组间比较窒息组、高胆组有显著差异，早产组无差异；窒息组、高胆组干预组与正常组比较无差异，对照组和早产组与正常组比较均有显著差异(P＜0．01)。(3)所有干预组测评分值均高于对照组，6个月与1岁之间比较有显著差异，各观察组间比较有显著性差异(P＜0．01)。结论 三类高危儿早期干预效果差异较大，干预组均较对照组分值高，早期干预有改善智力发育的作用；三类高危儿中，窒息组、高胆组效果最好，均达到或超过正常水平。所有未干预组均不及正常水平；早期干预对足月高危儿效果显著，对早产儿欠佳，远期效果尚需进一步随访观察。     

心脏移植术后肾功能衰竭的围手术期处理(附2例报告)

目的报告2例原位心脏移植术后肾功能衰竭的发生及治疗经过,探讨其围手术期处理的初步经验和要点.方法我院自2000年12月一2002年12月共对4例终末期心脏病患者施行同种异体原位心脏移植术,4例均为男性,采用标准原位心脏移植术,术后应用三联免疫治疗的方法抗排异.结果4例患者均获得手术成功,术后未发现超急性排斥反应或急性排斥反应,2例术后1周左右并发急性肾功能衰竭,应用床边连续肾脏替代(CRRT)治疗后,1例存活22d,1例完全康复,随访半年患者心功能恢复Ⅰ～Ⅱ级(NYHA),生活质量良好.结论心脏移植手术后肾功能损害较常见,围手术期的肾功能保护非常重要,如符合手术指征,及早手术治疗是抢救成功的关键.     

围手术期抗生素的合理应用

近年来,由于抗生素的滥用导致外科术后感染率明显上升,同时,在医院环境诱导了对抗生素耐药菌株的产生或引起细菌或霉菌的二从感染.为了有效地降低术后感染率,减少抗生素药物的副反应,自2001年1月份开始,我们采用围手术期抗生素的合理运用,与以往同期相比,骨科术后感染率明显下降,副反应减少.……     

慢性肾功能不全患者行冠状动脉搭桥术围术期处理

目的：探讨慢性肾功能不全患行冠状动脉搭桥术的安全性。方法：回顾性分析1996年6月至2001年6月收治的15例慢性肾功能不全患行冠状动脉搭桥术的临床资料，并复习献。结果：9例患术后早期肾功能指标较术前差；6例患术后早期肾功能技术前无明显变化。围术期腹透4例，血透2例，其中1例行术中血透，肾功能指标均有所改善。全组无术中死亡，1例枚后第三天死于多器官功能衰竭。结论：术前肾功能不全的患，经过积极的术中及围术期处理，大多可以安全渡过肾功能衰竭关，接受冠状动脉搭桥术，达到改善症状延长生命的目的。     

青滕碱对豚鼠心肌动作电位和收缩力的影响

青藤碱2.7μmol/L以上,呈浓度依赖性地降低豚鼠乳头肌收缩力,延长动作电位时程和有效不应期。小剂量时,青藤碱能降低动作电位0相上升最大速率;较大剂量时,动作电位幅度也降低。用TTX处理豚鼠乳头肌所致的慢反应电位,青藤碱能够抑制。此外,青藤碱能对抗乙酰胆碱缩短豚鼠左房肌动作电位时程的作用。结果提示:青藤碱对Na⁺,Ca²⁺和K⁺的跨膜转运均有抑制作用。