四季鹅下丘脑单位放电的研究

实验利用慢性微电极技术观察了清醒活动四季鹅(产蛋期鹅和休产期鹅)下丘脑细胞自发放电及第Ⅱ脑室注入去甲肾上腺素(NE)对单位放电的影响.结果表明无论是产蛋期鹅还是休产期鹅.其下丘脑放电均以中频为主,但产蛋期鹅高频放电高于休产期鹅.放电有单个连续、束状、组群式等3种形式,无论是产蛋期鹅还是休产期鹅,其下丘脑均以单个连续放电为主,但产蛋期鹅组群式放电高于休产期鹅.第Ⅱ脑室注入NE后,75%的单位放电数增加,25%的单位放电数减少.     

An experience of renal replacement therapy in a combined neonatal and paediatric intensive care unit of Hong Kong

Intensive care services are expensive. The experience of developing a combined paediatric and neonatal intensive care unit (ICU) in a regional hospital is reported with reference to the provision of renal support for the critically ill patients. The combined unit is staffed by a team of paediatric intensivists, each of whom has special interest in a subspecialty, including cardiology, respiratory medicine, nephrology and neonatology. In the past 7 years, renal replacement therapy (peritoneal dialysis and haemofiltration) was provided to 40 patients, with comparable mortality and complication rates to other reports. This arrangement has been feasible and might be more efficient than running separate paediatric and neonatal ICUs or combining the paediatric ICU with the adult ICU.     

The Effect of 50 Hz External Electrical Interference on Implanted Cardiac Pacemakers

The effects of injected 50 Hz alternating current on the function of cardiac pacemakers has been observed in 18 patients with implanted unipolar VVI units. Current, in the range 0-600 microA was applied via electrodes attached to the patients' upper body and feet and fed from a specially designed current injection unit at the bedside. Most implanted pacemakers reverted to interference mode in the current range 29-250 microA. At current levels just below the reversion current all units developed irregular and inappropriate pacing. This current level was pacemaker dependent and varied in the range 27-246 microA. The total reversion current depended on the location of the injecting electrodes and on the patients' posture. The sensitivity of the units to injected interference was increased by deep inspiration. Temporary pacing catheters fitted to an additional ten patients were used to monitor the interference voltage which would be sensed by an implanted unit. This voltage was similarly dependent on patient posture and on deep respiration. Current injection has proved to be a safe, controllable and reproducible method of testing the sensitivity of implanted pacemakers to 50 Hz external interference.     

加速创建爱婴医院进程 积极推广母乳喂养

为加速创建爱婴医院进程,昆明市妇幼保健院率先在全省开展了创建爱婴医院工作。他们大胆改革产科制度,实行母婴同室,建立健全了各项规章制度,实行母乳喂养系列化服务。     

Unilateral lesion of the nigrostriatal pathway decreases the firing rate and alters the firing pattern of globus pallidus neurons in the rat

Activities of spontaneously firing neurons in the globus pallidus of intact rats and rats that survived unilateral lesions of the nigrostriatal pathway for 3 days, 1 week, or 6-11 weeks were compared. No significant differences in neuronal firing rate, firing pattern, and number of cells per pass were observed between chloral hydrate-anesthetized control and lesioned animals. However, in locally anesthetized animals, pallidal cells fired significantly faster than in chloral hydrate-anesthetized animals, and the lesion caused a decrease in the firing rates of pallidal cells 1 week and 6-9 weeks postlesion. In addition, significant differences in the firing pattern of pallidal cells, as determined by the ratio of the mean to median interspike intervals, were seen between locally anesthetized controls and animals surviving 3 days, 1 week, and 6-9 weeks postlesion. This altered firing pattern tended to return to normal with time. The number of cells per pass was not significantly altered by the lesion. Data from this study suggest that, in locally anesthetized animals, the removal of the tonic dopaminergic input to the basal ganglia causes pallidal cells to decrease their firing rates in a time-dependent fashion and causes reversable firing pattern changes. This suggests that tonically active dopamine neurons, probably acting through the striatopallidal pathway, regulate the firing rate and mechanisms controlling the temporal ordering of spontaneous discharges of globus pallidus neurons.     

The relationship between receptor-effector unit heterogeneity and the shape of the concentration-effect profile: Pharmacodynamic implications

The apparent concentration-effect relationship is the ensemble of many effector units (such as individual cells or channels) that do not always exhibit a uniform stimulus-effect relationship. This concept is substantiated by many observations of heterogeneity in receptor-effector populations including hormone secreting cells, response to hormonal stimuli, activity pattern of second messengers, stimulus-evoked synaptic currents, and single ion channels. The relationship between drug concentration and magnitude of pharmacologic response is commonly described by the sigmoidalE _max model which was derived from the Hill equation. The sigmoidicity factor (N) in this model is assumed to be a pure mathematical parameter without physiological connotations. This work demonstrates that the numerical value ofN (measured empirically) is the product of two factors: (i) the degree of heterogeneity of the effector subunits, i.e., the elemental component that upon drug stimulus contributes its pharmacological effect independently and does not interact with other subunits (it could range from a single receptor up to a whole tissue), and (ii) value ofN ^*—the shape factor of the subunits' concentration-effect relationship. A special case of this approach occurs whenN ^*>5, which is an on-off case. HereN is determined by the distribution (density equation) of the subunit values. In case of heterogeneity of the microparameters of the effector subunits the apparentN will always have a lower value thanN ^*. According to this theory it can be concluded that without knowledge of the distribution of the microparameters no mechanistic interpretation can be deduced from the apparentN value. If in the futureN ^* can be determined by theoretical or experimental methods, the distribution function relatingN ^* toN can be calculated. The relevance of this theory is increased in view of the progress being made in advanced research techniques which may enable us to determine the concentration-effect relationship at the level of the individual effector unit.     

特殊药品管理方法探讨

笔者结合单位的做法和体会,对医疗单位等在特殊药品使用管理中存在的问题,提出特殊药品的管理应法制化、职责化、程序化、档案化及提高业务素质、奖优罚劣的管理方法。     

连续四年ICU病房院内感染病原菌的耐药性分析

目的 :了解我院重症监护病房 (ICU)院内感染病原菌的耐药性变化趋势。方法 :对我院 ICU2 0 0 0年 1月至 2 0 0 3年 12月院内感染的各类感染标本中分离的 74 1株病原菌加以整理分析 ,并按美国国家临床实验室标准委员会 (NCCL s)标准进行药敏试验 ,并对其耐药性进行分析。结果 :分离出的菌株以革兰阴性杆菌为主 ,其次是革兰阳性球菌、真菌 ,分别占 6 2 % ,2 9% ,9% ,感染部位以肺部最多 5 5 1株 (74 .4 % ) ,泌尿道感染 5 0株 (6 .7% ) ,引起败血症35株 (4.7% ) ,来自各种体液 (胸、腹水、胆汁 ) 5 2株 (7.0 % ) ,来自各种引流液和伤口分泌物 2 5株 (3.4 % ) ,静脉导管13株 (1.8% ) ,其他 15株 (2 .0 % )。革兰阴性杆菌以非发酵菌为主 ,其中铜绿假单胞菌 135株 (18.2 % )、嗜麦芽窄食单胞菌 38株 (5 .1% )、不动杆菌属 37株 (4.9% )及其他非发酵菌 5 7株 (7.7% ) ,其次大肠埃希菌 91株 (12 .3% )、肺炎克雷伯菌 5 3株 (7.2 % )、肠杆菌属 33株 (4.5 % )、其他肠杆菌科 17株 (2 .3% )。铜绿假单胞菌对亚胺培南的耐药率达 4 1.0 % ,呈多重耐药 ,阴沟肠杆菌对头孢他啶、氨曲南的耐药率达 6 0 .0 %、73.3% ,大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶 (ESBL s)的发生率分别是 4 1.0 %、4 5 .0 % ,亚胺培南?     

太钢1998～2002年放射工作人员个人剂量监测分析

目的为进一步调查太钢放射工作人员外照射剂量大小，以评价太钢近几年来放射管理和放射防护效果，降低放射危害，保护放射工作人员身体健康。方法根据GB5294-85《放射工作人员个人剂量监测方法》将1998-2002年在太钢从事放射的工作人员分为4组：医用X射线、工业X射线、工业γ射线和医用同位素组，进行外照射个人剂量监测，并计算1998-2002年各年度平均年剂量当量。每年监测4个周期，每个周期为3个月，并对监测结果进行分析。结果①5个年度平均年剂量当量为1．46mSv，1998年最高，从2000年起有逐渐下降的趋势；并且除2002年与2000、2001年比较，U检验差异无统计学意义外，其余各年度之间比较，差异均有统计学意义（P〈0．01）；②1998-2002年各工种之间年个人剂量当量监测结果，以工业γ射线组均值最低，医用X射线组最高。U检验，工业γ射线组与其他3个组比较，差异有统计学意义（P〈0．01），医用X射线组与工业X射线组比较，差异亦有统计学意义；③1998-2002年各年度年个人有效剂量频数分组分布，〈1mSv／a组占受检总数的27.11％，〉5mSv／a的占0．31％，〈5mSv／a的占99．69％。经χ^2检验，各年度之间比较，差异有统计学意义（χ^2=377．33，P〈0．01）；④各工种个人剂量当量分组频数分布情况：〈1mSv／a占受检总数的26．49％，1-2mSv／a组占59．89％．2-3mSv／a占10．52％，〈5mSv／a的占99．69％，〉5mSv／a仅3例，为医用X线组。各工种之间比较，χ^2检验有统计学意义（χ^2=1030．79，P〈0．001）。结论1998-2002年平均剂量当量远低于国家标准，并逐年下降，说明近5年太钢加强放射工作人员的健康和防护设施管理的工作，放射工作环境是安全的。     

Methods of single unit recording from medullary neural substrates in awake, behaving guinea pigs

An electrophysiological procedure that permits extracellular single neuronal recording in the medulla of unanesthetized, freely behaving animals is described. System components consist of 1) a flexible, single-strand microwire as recording electrode; 2) a miniature, skull-mounted miniature microdrive used for isolation of single unit activity; and 3) a head-mounted voltage follower that conditions and stabilizes the neuronal signals prior to amplification and transmission for further processing. A unique advantage of this procedure is the latitude and provision for microwire replacement in the event that multiple penetrations are desired or the tip of the microwire recording electrode is insulated as a result of gliomatosis. With minor modification, this technique can be used for single unit recording virtually anywhere along the supra-segmental neuraxis. Technical aspects of this procedure, together with details of design and fabrication of implantable devices, chronic instrumentation procedure, and potentials for other chronic applications, are discussed.