LK-D智能型六合治疗仪与安定联合应用于分娩镇痛的临床观察

目的：探讨用六合治疗仪与安定联合应用于分娩镇痛的方法及效果观察。方法：70例正常分娩的妇女。随机分为：（1）联合使用六合治疗仪与安定组；（2）单纯使用安定组（对照组）各35例。全部病例在宫口开大3cm时进行分娩镇痛和监测。结果：六合治疗仪镇痛效果明显有于对照组，与对照组相比有显著性差异（P〈0．05），产程正常；而对照组病人产程相对延长，自然分娩率降低，助产和手术率高。新生儿Apgar评分低，存在新生儿缺氧情况。产后出血情况两组基本相同。结论：六合治疗仪与安定联合进行分娩镇痛，与单纯安定相比，提高了无痛率。增加了分娩的安全性，缩短了产程。是一种分娩镇痛的良好方法。     

韩氏穴位神经刺激仪（HANS）应用于腹部手术病人术后PCEA镇？…

本研究根据一定频率的经皮电刺激可促使中枢神经系统释放阿片肽的原理，应用韩氏穴位神经刺激仪（ＨＡＮＳ）辅助腹部手术病人术后硬膜外腔吗啡自控镇痛２０例（ＨＡＮＳ组）与单纯术后硬膜外腔吗啡自控镇痛２０例（对照组）比较。结果表明：吗啡和量ＨＡＮＳ组１５０±１９２．６μｇ与对照组４６５±４７８．２μｇ相比有显著性差异（Ｐ〈０．０５），镇痛效果ＶＡＳ评分ＨＡＮＳ组０．５±０．５１分与对照组０．９±０．６４分相     

术前HANS对剖宫产术中及术后病人的镇痛作用

目的：观察术前应用韩氏穴位神经刺激仪（ＨＡＮＳ）对术后病人自控硬膜外镇痛（ＰＣＥＡ）效果、镇痛药用量及不良反应的影响。方法：选取ＡＳＡⅠ级剖宫产产妇４０例。ＨＡＮＳ组（ＨＡＮＳ＋ＰＣＥＡ组）２０例：术前应用ＨＡＮＳ且术后进行ＰＣＥＡ;对照组（ＰＣＥＡ组）２０例：单纯术后ＰＣＥＡ。ＨＡＮＳ采用ＤＤ波（２／１００Ｈｚ）刺激３０ｍｉｎ后切皮。记录切开腹膜、分离膀胱反折、婴儿娩出、清理宫腔、探查附件、术后     

预先应用HANS的超前镇痛作用及对机体内分泌功能影响的临？…

目的：观察预先应用韩氏神经穴位刺激仪（ＨＡＮＳ）的超前镇痛作用及对机体内分泌功能的影响。方法：妇科择期手术病人３０例,ＡＳＡＩ－ＩＩ级,随机分为两组,各１５例,ＨＡＮＳ组预先应用ＨＡＮＳ行超前镇痛,对照组不做超前镇痛。观察两组硬膜外吗啡术后镇痛的时程,静息及运动时的ＶＡＳ,加用镇痛药的次数及血浆儿茶酚胺含量的变化。结果：（１）两组硬膜外吗啡术后镇痛的时程及静息时的ＶＡＳ无显著性差异（Ｐ〉０．０５）     

韩氏穴位神经刺激仪与丁丙诺啡联合应用应用治疗72例海洛？…

韩氏仪（ＨＡＮＳ）可促进中枢神经系统释放内源性阿片肽，使阿片类依赖者的戒断症状得到缓解。本工作用盐酸丁丙诺啡（Ｂｕｐｒｅｎｉｏｒｐｈｉｎｅ Ｈｙｄｒｏｃｈｕｌｏｒｉｄｅ，Ｂｕｐ）替代疗法对７２例男性海洛因依赖者进行治疗，其中３６例（联合组）从第４天开始联合应用ＨＡＮＳ治疗，每天１次（３０ｍｉｎ）；另３６例作为对照组（不加ＨＡＮＳ仪）连续使用Ｂｕｐ７天。就脱瘾治疗的时间、丁丙诺啡及麻醉镇痛催眠药物的     

韩氏穴位神经刺激仪（HANS）应用于人工流产术镇痛的临床研究

１００名行人工流产术的门诊早孕者，随机分为ＨＡＮＳ组和对照组各５０例者ＨＡＮＳ人流术镇痛的临床研究。结果显示：扩张宫颈和吸宫时ＨＡＮＳ组的疼痛评分都明显低于对照组。中度以上疼痛发生率，ＨＡＮＳ组也明显低于对照组，表明ＨＡＮＳ应用于人流术有明显镇痛效果。另外，ＨＡＮＳ组人流综合征的不良反应低于对照组：呕吐发生率分别为０：１２％；恶心发生率为８％：２２％，均有显著意义。     

跨皮电刺激辅以局麻用于甲状腺手术麻醉效果的观察

选择９０例甲状腺手术的患者，随机分为ＨＡＮＳ加局麻醉组（ＨＡＮＳ）组、局麻组和颈丛神经阻滞组三组，每组３０例。结果ＨＡＮＳ组的麻醉效果明显优于局麻组，而与颈丛组的效果基本相同。ＨＡＮＳ组的局麻药用量明显减少，与局麻组和颈丛上比有非常显著性差异。结论：ＨＡＮＳ组的镇痛效果良好，并且局麻药的用量明显减少，且操作简便，安全可靠。     

韩氏穴位神经刺激仪辅助硬膜外麻醉用于急性阑尾炎手术的临？…

目的：观察普通外科急性阑尾炎病人在硬膜外麻醉时应用韩氏穴位神经刺激仪（ＨＡＮＳ）观察是否能减轻内脏牵拉反应及相应的血糖变化。结果：硬膜外麻醉加ＨＡＮＳ组及硬膜外麻醉对照组各５例。＋ＨＡＮＳ组有６０％（９／１５）的病人不出现牵拉反应,明显高于对照组１３．３％（２／１５）,两组差异非常显著（Ｐ〈０．０１）;＋ＨＡＮＳ组术中需追加哌替啶的病例１３．３％（２／１５）显著少于对照组５３％（８／１５）（Ｐ〈０     

应用HANS辅助硬膜外麻醉预防剖宫产内脏牵拉痛的临床研究

为探讨韩氏穴位神经刺激仪（ＨＡＮＳ）应用于剖宫产麻醉，是否能起到辅助麻醉，预防剖宫产时内脏牵拉前的作用。随机选择ＡＳＡ Ⅰ级急中择期剖宫产产妇４０例，分为两组：Ⅰ组（ＨＡＮＳ）组２０例，ＨＡＮＳ加硬膜外麻醉。Ⅱ组（对照组）２０例，单纯应用硬膜外麻醉。ＨＡＮＳ组将ＨＡＮＳ两对电极分别置于双侧足三里、三阴交穴位。频率１００Ｈｚ，强度为１０￣１５ｍＡ等幅刺激。诱导时间为１５￣２０分钟，持续３０￣７０分钟     

体表电刺激在正常和麻醉状态下肌松作用的研究

目的：应用韩氏穴位神经刺激仪（ＨＡＮＳ）进行１００Ｈｚ体表电刺激,观察是否有肌松作用。方法和结果：（１）抬腿读秒试验：健康自愿受试者２０例,分别在０Ｈｚ、２Ｈｚ、１００Ｈｚ和２／１００ＨｚＨＡＮＳ刺激前后进行４５°抬腿试验。发现２／１００Ｈｚ和１００ＨｚＨＡＮＳ刺激３０ｍｉｎ后抬腿时间较刺激前减少２０．７％和４０．９％（Ｐ＜０．０５和Ｐ＜０．０１）;（２）临床麻醉观察：选择需全麻的腹部手术ＡＳＡⅠ～Ⅱ级患者６０例,随机分成ＨＡＮＳ组（静脉全麻＋ＨＡＮＳ）和对照组（单纯静脉全麻）,每组３０例。两组的首次全麻药和肌松药的用量及一般麻醉方法均一致,并全程进行肌松和生命体征监测,当肌松的ＴＲ值＞０．２５或麻醉机气道压力＞２ｋＰａ时,追加首次肌松药和全麻药量的半量,使手术始终处于良好的肌松和平稳的麻醉状态。ＨＡＮＳ组于全麻诱导前２０ｍｉｎ开始１００ＨｚＨＡＮＳ体表电刺激。结果表明,ＨＡＮＳ组的肌松药用量较对照组减少３５％（Ｐ＜０．０１）,全麻药较对照组减少２０％（Ｐ＜０．０５）。结论：健康受试者抬腿读秒试验和腹部手术临床麻醉的观察结果表明,ＨＡＮＳ确有明显的肌松作用,具有临床应用前景。     

环胞霉素A、亲合素和钙调磷酸酶复合物的结构特性与免疫抑制及其毒理作用机理

钙调磷酸酶（calcineurin，CN）是亲免素（immunophilin）-免疫抑制药物（immunosuppressant）复合物-环胞霉素A（cyclosporin A，CsA）、环胞霉素A亲合素（cyclophilin，CyP）和FK506结合蛋白（FK506-bindingprotein，FK BP-506）、FK506的共同靶目标。这些药物蛋白的复合物都能特异地抑制CN的生物活性，但是两种结构完全不同的亲免素-免疫抑制药物复合物为何能够作用同一靶目标目前仍不清楚。     

TOXINS AND ANTITOXINS--SNAKE VENOMS AND ANTIVENINS

A specific antivenin against crotalus venom can be prepared bv the immunization of goats. A specific antivenin against water moccasin venom can be produced by the immunization of goats with this venom, modified by hydrochloric acid. Immunization with the unmodified venom is very difficult. The toxicity of crotalus venom is diminished more than fifty percent. by passage through a Chamberland filter. There is a simple relation between the toxicity and the body weight for guinea-pigs weighing from 250 to 500 grams. Smaller guinea-pigs (125 grams) are comparatively less resistant. The toxicity is smaller by subcutaneous than by intraperitoneal injection (guinea-pigs), or by intravenous injection (rabbits). White rats are very resistant. The toxicity of cobra venom is not measurably diminished by filtration through a Chamberland filter. The relation between the amount of venom and the corresponding time of death is very regular, and can be expressed by a curve of asymptotic nature. Lecithin does not increase the toxicity. The tracings representing toxin-antitoxin neutralization for the three venoms (crotalus, cobra and moccasin) show deviation from the straight line. This deviation is most pronounced for the toxic quota of the venoms. The tracing representing crotalus venomantivenin neutralization, determined on guinea-pigs, can, within errors of experiment, be expressed by the equation: Free toxin · Free antitoxin = K · toxin-antitoxin. The corresponding tracing determined on rabbits is somewhat different, but both tracings are much more markedly curved than that for cobra venom-antivenin. The neutralization tracing of water moccasin venom shows the peculiarity, that small amounts of antivenin decrease the toxicity to a minimum, but the toxicity is again increased by further addition of antitoxin. The tracing representing neutralization of the haemolysins of the three venoms are different from the tracings of neutralization of the toxins, and approach very closely to a straight line. Still, in all instances, the determinations with great concentrations of antilysin show pronounced deviation, perhaps due to some dissociation of the toxin-antitoxin combination.     

HEPATITIS AND HIV: INTERRELATIONSHIP AND INTERACTIONS

SUMMARY Hepatitis in the context of HIV infection is commonplace, but the causative agent is not always readily identifiable. This review highlights the differential diagnosis of hepatitis in that context, examining the interrelationships and interactions between the four main hepatitis viruses and HIV.     

LEUCOPROTEASE AND ANTI-LEUCOPROTEASE OF MAMMALS AND OF BIRDS

The inhibiting action of the blood serum upon the enzyme of the polynuclear leucocytes, leucoprotease, is exerted by the albumin fraction of the serum. The albumin fraction contains no proteolytic enzymes. The globulin fraction of the serum contains no anti-enzyme for leucoprotease; it contains, on the contrary, an enzyme which digests proteids in a neutral or alkaline medium. This enzyme resembles leucoprotease which is present in the polynuclear leucocytes of an inflammatory exudate and in the bone marrow from which these cells are derived, and is doubtless identical with the similar enzyme occurring in smaller quantity in the spleen. This enzyme which is present in the blood serum is held in check by its anti-enzyme, but the latter is in such excess that the serum as a whole is capable of checking the action of leucoprotease when added in considerable quantity. Leucoprotease of one mammalian species is inhibited by sera of other mammalian species, but the anti-enzymotic activity of various sera differs; the anti-enzyme of the rabbit''s serum is stronger than that of dog''s serum, when tested either with dog''s or with rabbit''s leucoprotease. The co-existence in the rabbit of leucoprotease with feeble strength and anti-body of great activity may explain the absence in these animals of typical suppuration with liquefaction of tissues. The serum of birds which have been tested, namely, pigeon and hen, almost completely fails to inhibit mammalian leucoprotease (of dog). The polynuclear leucocytes, the bone marrow and the spleen of the hen do not contain an enzyme resembling leucoprotease of mammals. The absence of anti-enzyme in the serum is associated with absence of a corresponding enzyme in the leucocytes.     

HYPERVENTILATION AND DIZZINESS: CASE REPORTS AND MANAGEMENT

SUMMARY Dizziness is a common symptom in patients presenting to an otorhinolaryngologist. Hyperventilation accounts for up to 5% of cases with dizziness and is a contributory factor in a further 20% of cases. Six cases of dizziness due to hyperventilation are presented to illustrate the authors' simple management policy. A high index of suspicion in the absence of an organic cause of dizziness and a simple provocation test will identify these cases. Management is aimed at demonstrating resting hypocapnia, investigations to exclude organic causes of hyperventilation and rehabilitation in collaboration with a clinical psychologist ensures the appropriate treatment for the dizziness and can avoid the development of chronic somatisation behaviours.     

CELL-MEDIATED IMMUNITY AGAINST BESNOITIA AND TOXOPLASMA IN SPECIFICALLY AND CROSS-IMMUNIZED HAMSTERS AND IN CULTURES

The capacity of hamster peritoneal cell populations to control viability and growth of Besnoitia and Toxoplasma organisms was assessed in vivo and in vitro. Immunized hamsters reduced the homologous organisms 100- to 10,000-fold over a 5-day period, but the heterologous infection increased 100- to 1,000-fold in numbers, similar as in the nonimmune controls. Passively administered antibody was ineffective although lytic cofactors were supplied by hamsters. In cultures, peritoneal cells from Besnoitia-immune hamsters delayed the growth of homologous parasites to an average of 38.5 h per division; however, in Toxoplasma-immune and nonimmune cells, Besnoitia divided every 12.8 h. Specificity of immunity was pronounced against both infections. With cross-infections, Toxoplasma-immune cultures did not effectively delay Besnoitia growth; however, Besnoitia-immune cultures reduced Toxoplasma growth by one-half. Co-cultivation experiments demonstrated that specifically committed lymphocytes could instruct macrophages to reduce the homologous organism 10-fold, whereas heterologous organisms were reduced only 2-fold. Lymphocyte supernatants initiated hypersensitivity as indicated by macrophage activation and giant cell formation in culture. However, these supernatants did not transfer infection immunity. Lymphokines could account for the hypersensitivity phenomena, but cell-mediated infection immunity in this model required close lymphocyte-macrophage proximity. These studies indicate that a number of distinct processes including delayed hypersensitivity, macrophage activation, and specific cellular immunity are acting simultaneously during latent Besnoitia infection of hamsters. All three processes are mediated by lymphoid cells and appear to be specifically induced. Although activated macrophages develop some heightened nonspecific capabilities, these were several orders of magnitude below the specific effects.     

宫颈及盆腔解脲支原体、沙眼衣原体感染与输卵管性不孕

目的　探讨女性宫颈及盆腔解脲支原体 (UU)和沙眼衣原体 (CT)感染与输卵管性不孕的关系及其感染特点。方法　应用聚合酶链反应 (PCR)法对接受腹腔镜检查的 36例输卵管性不孕患者 (不孕组 )和 2 3例正常生育患者 (对照组 )进行宫颈分泌物和盆腔液体UU、CT检测 ;应用腹腔镜了解输卵管粘连及阻塞程度。结果　两组宫颈分泌物UU阳性率分别为 30 .6 %、8.7% ,两者相比有显著性差异 (P <0 .0 5 ) ;宫颈分泌物CT阳性率两者比较无显著性差异 ;两组盆腔液体UU、CT阳性率相比较无显著性差异 (P >0 .0 5 ) ;不孕组UU阳性患者输卵管周围轻度以下粘连占 5 0 % ,但输卵管阻塞率为 87.5 % ,同组UU阴性患者输卵管周围中、重度粘连占 79.2 % ,输卵管阻塞率为 6 4 .6 % ,两组粘连程度及阻塞率相比均有显著性差异 (P <0 .0 5 )。结论　女性生殖道UU感染与输卵管性不孕相关 ;UU、CT感染症状隐匿 ,但输卵管腔损害明显