Effects of Amiodarone on Transmural Dispersion of Ventricular Effective Refractory Periods across Myocardial Layers in the Normal and Hypertrophic Canine Heart

Recently studies have been focused on the re-lationship between the ventricular arrhythmia andthe transmural dispersion of ventricular effectiverefractory periods (ERPs) aross the three myocar-dial layers (epi myocardium, midmyocardium andendomyocardium) . Amiodarone is one of the mostwidely used antiarrhythmia drugs in clinical prac-tice . This study examined the effect of amiodaroneon ERPs-dispersion across three myocardial layersof normal and hypertrophic hearts of dogs beforeand after ma…     

Heart Monitoring Garments Using Textile Electrodes for Healthcare Applications

We measured the electrical activity signals of the heart through vital signs monitoring garments that have textile electrodes in conductive yarns while the subject is in stable and dynamic motion conditions. To measure the electrical activity signals of the heart during daily activities, four types of monitoring garment were proposed. Two experiments were carried out as follows: the first experiment sought to discover which garment led to the least displacement of the textile electrode from its originally intended location on the wearer’s body. In the second, we measured and compared the electrical activity signals of the heart between the wearer’s stable and dynamic motion states. The results indicated that the most appropriate type of garment sensing-wise was the “cross-type”, and it seems to stabilize the electrode’s position more effectively. The value of SNR of ECG signals for the “cross-type” garment is the highest. Compared to the “chest-belt-type” garment, which has already been marketed commercially, the “cross-type” garment was more efficient and suitable for heart activity monitoring.     

An experimental study of using “tendon bridge” or “tendon tunnel” as a conduit for nerve regeneration

In our experiments, a “tendon bridge” or a “tendon tunnel” was used as a conduit to repair the defect of a peripheral nerve in rabbits. A gap of about 1 cm was made on the deep peroneal nerve in each animal. In group 1, the tendon of anterior tibial muscle was isolated near the severed nerve, and a segment of half cross section of tendon was removed in ladder-shaped reversed fashion. The proximal and distal nerve stump were sutured respectively to the tendon by 11/0 atraumatic sutures under surgical microscope. In group 2, the nerve stumps were sutured to the tendon of anterior tibial muscle without cutting the tendon, but the tendon was dissected free and turned to form a tunnel wrapping the gap in between the nerve stumps. The results showed that a gap of 1 cm of the deep peroneal nerve might be repaired by both methods, but the results of using “tendon tunnel” in group 2 were much better than those of using “tendon bridge” in group 1.     

Lipopolysaccharide ＂Two-hit＂ Induced Refractory Hypoxemia Acute Respiratory Distress Model in Rats

To establish a stable and reliable model of refractory hypoxemia acute respiratory distress syndrome （ARDS） and examine its pathological mechanisms, a total of 144 healthy male Wistar rats were randomized into 4 groups： group Ⅰ （saline control group）, group Ⅱ （LPS intravenous ＂single-hit＂ group）, group Ⅲ （LPS intratracheal ＂single-hit＂ group） and Group IV （LPS ＂two-hit＂ group）. Rats were intravenously injected or intratracheally instilled with a large dose of LPS （10 mg/kg in 0.5 mL） to simulate a single attack of ARDS, or intraperitoneally injected with a small dose of LPS （1 mg/kg） followed by tracheal instillation with median dose of LPS （5 mg/kg） to establish a ＂two-hit＂ model. Rats in each group were monitored by arterial blood gas analysis and visual inspection for three consecutive days. Arterial blood gas values, lung wet/dry weight ratio and pathological pulmonary changes were analyzed to determine the effects of each ALI/ARDS model. Concentrations of TNF-α, IL-1 and IL-10 in the bronchoalveolar lavage fluid （BALF） and blood plasma were meastired by using enzyme-linked immunosorbent assays （ELISA）. Our resulsts showed that single LPS-stimulation, whether through intravenous injection or tracheal instillation, could only induce ALl and temporary hypoxemia in rats. A two-hit LPS stimulation induces prolonged hypoxemia and specific pulmonary injury in rats, and is therefore a more ideal approximation of ARDS in the animal model. The pathogenesis of LPS two-hit-induced ARDS is associated with an uncontrolled systemic inflammatory response and inflammatory injury. It is concluded that the rat ARDS model produced by our LPS two-hit method is more stable and reliable than previous models, and closer to the diagnostic criteria of ARDS, and better mimics the pathological process of ARDS.     

Syphilis,psychiatry and offending behaviour: clinical cases from nineteenth-century Ireland

Background  Syphilis presented substantial challenges to nineteenth-century medical and psychiatric services. Aims  To illustrate the clinical course and diagnostic challenges associated with neurosyphilis in nineteenth-century Ireland. Method  This paper uses original archival material from the Central Criminal Lunatic Asylum, Dublin to present clinical cases and inform a discussion of related issues. Results  Mr A, a 34-year-old banker convicted of “felonious entry”, demonstrated many psychiatric and neurological features of neurosyphilis (“general paralysis of the insane”); he soon became “feeble”, “paralytic” and “demented”, and died within 2 years. The case of Mr B, a 38-year-old game-keeper convicted of “attempting to upset trains”, illustrates diagnostic dilemmas associated with neurosyphilis, especially when complicated by evidence of tuberculosis (“scrofulous diathesis”). Conclusions  The clinical and diagnostic challenges presented by syphilis have changed over the past century, but these cases, combined with recent evidence of syphilis outbreaks, highlight ongoing needs for clinical and epidemiological vigilance.     

A Proposed Instrument for the Assessment of Job Satisfaction in Greek Mental NHS Hospitals

Since its introduction in 1983, the Greek NHS is under an almost constant reform, aiming improvement on the efficiency and the quality of provided services. The national program of psychiatric reform “Psychargos” introduced new models of therapeutic approach to the care of the mentally ill, that required expansion of the existing roles and development of new roles of the healthcare staff. Consequently, the efficient management of the healthcare workforce in Greek mental facilities was identified as a primary determinant of the successful implementation of the program. Primary objective of this study was the development of a research framework for the assessment of job satisfaction in Greek Mental Health Hospitals. Among the objectives was the evaluation of the capacity of the underlying motivators and hygiene factors and the identification of potential correlations of the global job satisfaction and the motivation and retention factors with the demographic, social and occupational characteristics of the employees. A custom questionnaire was developed, based on Herzberg two-factor theory, after a systematic review of the relevant literature. The instrument was constructed by two parts and 37 items. Ten items addressed the sociodemographic characteristics of the subjects, while the remaining 27 items were distributed in 11 subscales which addressed the global satisfaction index and the “retention” and the “motivation” variables. The instrument was validated by means of the Cronbach alpha for each subscale and by confirmatory factor analysis. The study was conducted at the Public Mental Hospital of Chania (PMHC). From the 300 employees of the PMHC, 133 subjects successfully responded to the questionnaire (response rate, 44.3%). In accordance to former surveys, subjects presented average scores in the global satisfaction index (GSI). The professional category of the employee was identified as the primary determinant of the GSI. Nurses presented statistically significant lower scores in comparison to the rest of the employees. Strong Pearson correlations were detected between GSI and “working conditions”, “interpersonal relations”, “organization”, “salary” and “supervision” factors. The retention factors presented stronger impact on GSI in comparison to the motivation ones. The results of the study indicate that the proposed instrument presents satisfactory validity and reliability for the assessment of job satisfaction in Greek mental NHS hospitals.     

Use of RSS Feeds for the Implementation of Clinical Reminder

A computer-based reminder system can help physicians get right information and make right decisions in daily clinical work in time. This study presents a RSS-based Clinical Reminding System (RCRS) designed for reminding clinicians to deal with their varied unfinished clinical works. The RCRS was implemented in a hospital to automatically generate messages for every clinician on the basis of clinical information gathered from the hospital information system (HIS) and send them by RSS feed. In order to allow all physicians to participate in the project, the RCRS was integrated with the Computerized Physician Order Entry (COPE) system to provide messages whenever a clinician logs in the HIS; the connection on screen lets the clinician easily make some response. The system can help clinicians focus on patient care without keeping track of the schedule of clinical chores stored in various systems. Two physicians, also directors from Clinical Informatics Research & Development Center (CIRD) who were appointed as project leaders of the RCRS project who went through the entire development process were chosen as interviewees to obtain a preliminary evaluation of the system. The results show the “Information Content” of this system was suggested to be modified, and “Information Accuracy”, “Formats”, “Ease of use” and “Timeliness” of the system were appropriate to meet the system design purposes.     

Clinical observation of 50 cases of Pityriasis Rosea treated by traditional Chinese medicine

Summary Pityriasis Rosea is a common skin disease. We assume that the disease is due to “windy heat being depressed in the muscles and skin, and being blocked under the skin and outside of the muscles and prolonged blockage caused pathological changes of the skin” and the therapeutic methods ought to be “relieving internal heat, antitoxication, vigor of the blood state and removing the wind” of a series of 50 cases so treated, 49 made practically favorable response.     

The Evaluation of Psychopharmacological Enhancers Beyond a Normative “Natural”–“Artificial” Dichotomy

The extra-therapeutic use of psychotropic drugs to improve cognition and to enhance mood has been the subject of controversial discussion in bioethics, in medicine but also in public for many years. Concerns over a liberal dealing with pharmacological enhancers are raised not only from a biomedical–pharmacological perspective, but particularly from an ethical one. Within these ethical concerns, there is one objection about the normative differentiation between “natural” and “artificial” enhancers, which is theoretically indeed widely discredited in bioethics, which has, however, entrenched itself in such a persistent way in everyday moral consciousness that it keeps a crucial influence on the assessment of pharmacological enhancers made by the public and medical professionals. This paper tries to first show why a normative differentiation between “natural” and “artificial” enhancers is highly problematic. In a second step, the resulting implications for our current dealing with pharmacological enhancers shall be examined. In a specific comparison of synthetic pharmaceuticals (modafinil, SSRIs) with phytopharmaceuticals (ginkgo biloba, St. John’s wort) and other already established enhancers (alcohol, caffeine), argumentative inconsistencies are pointed out which, at least partly, result from a rationally untenable preference for the “natural” over the “artificial”. Therefore, it is conclusively argued the case for an unprejudiced assessment of pharmacological enhancers beyond a “natural”–“artificial” dichotomy, which equally takes into account biomedical and ethical aspects. The goal is to reach a coherent dealing with pharmacological enhancement in the long run.     

网络成瘾患者冲动控制功能的事件相关电位研究

目的 通过对网络成瘾(IAD)个体执行视觉反应/不反应(Go/No-go)任务的事件相关电位特征检测,探讨IAD冲动控制功能缺陷的发生机制.方法 符合修订的Young网络成瘾诊断问卷(YDQ)IAD标准的26例患者作为研究组,与研究组匹配性别、年龄的26例健康人作为对照组.Go/No-go任务刺激由8个不同的双数字组成.刺激反应时间1000ms,刺激间隔1500ms.记录被试者执行任务时的脑电图.Barratt-11冲动性量表(BIS-11)评估被试者冲动性.应用BESA 5.2.0软件离线分析No-go刺激的N2波幅.结果 IAD组BIS-11总分、注意因子分、运动因子分[分别为(77.32±7.53)分,(32.04±2.34)分,(23.31±2.94)分]明显高于对照组[分别为(72.79±5.73)分,(30.27±1.85)分,(22.05±2.20)分](P＜0.05),2组计划因子分差异无统计学意义(P＞0.05);IAD组错误率(0.042±0.007)明显高于对照组(0.015±0.006),而正确率(0.902±0.003)明显低于对照组(0.914±0.003)(均P＜0.05).重复测量的方差分析表明No-go刺激的ERP N2波幅在组间、前额电极位点以及组间×前额电极位点显示主效应(组间:F=3953,df=1,P=0.000;前额电极位点:F=541,df=9,P=0.000,组间×前额电极位点:F=306,df=9,P=0.000);组间、头皮中心电极位点以及组间×头皮中心电极位点显示主效应(组间:F=9074,df=1,P=0.000;前额电极位点:F=163,df=9,P=0.000,组间×前额电极位点:F=73,df=9,P=0.000);IAD N2波幅比对照组低.结论 IAD具有冲动控制障碍谱系的神经心理与ERP的特征,支持IAD是一种冲动控制障碍或与之相关疾病的假设.     

ENGLISH TRANSLATION OF CHINESE MEDICINE——Concerning the Use of Western Medical Terms to Represent Traditional Chinese Medical Concepts：Answer to Prof. XIE and His Colleagues

This paper strongly rejects the notion that the use of biomedical terms to represent traditional Chinese medical concepts is helpful to the internationalization of Chinese medicine. It further argues that this practice destroys the integrity and independence of Chinese medical concepts. Taking the term 风火眼 fěng huǒ yǎn as an example, it shows that the biomedical term ＂acute conjunctivitis＂ often suggested as the translation for this term is unsatisfactory, because （ 1 ） the clinical reference is not identical, （2） it introduces the concepts of ＂conjunctiva＂ and ＂inflammation＂, which are not Chinese medical concepts, and （3） destroys the Chinese medical concepts ＂wind＂ and ＂fire＂ expressed in the Chinese, which reflect the way the disease is traditionally diagnosed and treated. While for English readers not familiar with Chinese medicine, ＂acute conjunctivitis＂ may be immediately intelligible, for those seeking a deep understanding of the subject, the literal translation （loan translation） ＂wind-fire eye＂ is much more helpful. This paper supports these arguments with numerous other examples.     

The Adoption of Mobile Health Management Services: An Empirical Study

As their populations age, many countries are facing the increasing economic pressure of providing healthcare to their people. In Taiwan, this problem is exacerbated by an increasing rate of obesity and obesity-related conditions. Encouraging the adoption of personal health management services is one way to maintain current levels of personal health and to efficiently manage the distribution of healthcare resources. This study introduces Mobile Health Management Services (MHMS) and employs the Technology Acceptance Model (TAM) to explore the intention of students in Executive Master of Business Management programs to adopt mobile health management technology. Partial least squares (PLS) was used to analyze the collected data, and the results revealed that “perceived usefulness” and “attitude” significantly affected the behavioral intention of adopting MHMS. Both “perceived ease of use” and “perceived usefulness,” significantly affected “attitude,” and “perceived ease of use” significantly affected “perceived usefulness” as well. The results also show that the determinants of intention toward MHMS differed with age; young adults had higher intention to adopt MHMS to manage their personal health. Therefore, relevant governmental agencies may profitably promote the management of personal health among this population. Successful promotion of personal health management will contribute to increases in both the level of general health and the efficient management of healthcare resources.     

Is simple nephrectomy truly simple? Comparison with the radical alternative

Background  

The Oxford English dictionary defines the term “simple” as “easily done” and “uncomplicated”. We tested the validity of this terminology in relation to open nephrectomy surgery.     

事件相关电位检测与认知功能评价的相关性分析

对认知功能评估量表（MoCA）与事件相关电位（ERPs）成分进行相关性分析,寻找认知功能评价客观指标。方法采用MoCA 评价认知功能,三刺激oddball 范式进行ERPs 分析,分析MoCA 得分与ERPs成分波幅与潜伏期的关系。结果对68 例中老年人被试的相关分析显示,失匹配负波潜伏期及波幅与MoCA得分无相关性（p >0.05）,新异P300（P3a）潜伏期与MoCA 得分呈负相关（r =-0.427,p =0.000）,P3a 波幅与MoCA得分呈负相关（r =-0.314,p=0.009）。结论可以通过检测ERPs的P3a成分来反映总体认知功能,作为认知功能检查的客观指标。     

Effect of “Jia Wei Fo Shou San” on erythrocyte membrane calcium, zinc concentration in pregnant rats with asymmetrical intrauterine growth retardation induced by passive smoking

Summary Using experimental model of pregnant rats with asymmetrical intrauterine fetal growth retardation induced by passive smoking, the effects of natural herb “Jia Wei Fo Shou San” on erythrocyte membrane calcium, zinc concentration were observed by atomic absorption spectrophotometry. The results showed that the mean fetal birth weight, zinc concentration of erythrocyte membrane were found to be decreased in the model group as compared with the control group. (P<0. 01, F<0. 01). On the other hand, the element of calcium onto erythrocyte membrane were higher in model group than that in control group (F<0. 05). These changes were significantly mild in the treated group and were similar to those of the control group (P>0. 05). Furthermore, our findings indicated that the zinc concentration of erythrocyte membrane seems to be positively correlated with the birth weight (F<0. 01). Calcium composition of red cell membrane showed a significant negative relation to the birth weight (P>0. 05). Our results provided an experimental evidence that normal concentrations of calcium and zinc onto erythrocyte play an important part in fetal growth. One of the mechanisms of “Jia Wei Fo Shou San” in improving fetal growth may have something to do with modulation of erythrocyte calcium, zinc element, thereby protecting bio-functions of erythrocyte and promoting blood circulation. This project is supported by the National Natural SciencesFoundation of China. No. 39270826.     

原发性青光眼彩色图形翻转视觉诱发电位的表现

目的:探讨彩色图形视觉诱发电位(color pattern reversal visual evoked potential,CPR-VEP)在不同时间频率时对原发性青光眼诊断的敏感性,寻找最佳时间频率参数及色彩参数.方法:采用法国Métrovision公司生产的Vision Monitor视觉电生理仪对41例(70眼)青光眼患者(青光眼组)和13例(26眼)正常人(正常对照组)在不同时间频率(1,2,4,8,16,32 Hz)及色彩刺激(黑/白、红/绿、蓝/黄)下记录CPR-VEP的变化,比较P100的波幅值.结果:(1)正常对照组黑/白刺激下CPR-VEP P100波幅-时间频率曲线的波幅值随着时间频率的增加而下降明显;红/绿及蓝/黄刺激下2 Hz及8 Hz处波幅增高.(2)青光眼组CPR-VEP P100波幅-时间频率曲线的波幅值随着时间频率的增加而下降明显,但在8 Hz处波幅明显增高;除32 Hz及红/绿刺激下的1 Hz外,不同时间频率的色彩刺激下CPR-VEP P100与Hum-phmy视野平均缺损(mean defect,MD)值呈显著相关关系,以8 Hz的频率及蓝/黄刺激下的2 Hz和16 Hz相关性较大.(3)青光眼组与正常对照组P100波幅具有差异,3种色彩刺激在8 Hz处差别大.结论:CPR-VEP P100的波幅变化在一定程度上能客观反映青光眼患者的视功能损害,3种色彩刺激在8 Hz及蓝/黄刺激在2 Hz和16 Hz处具有较高的价值.     

Characterizing Cancer Information Systems

The objective is to determine the extent to which information systems (IS) for cancer are unique and necessary. Via an analysis of Medical Subject Headings used to index relevant literature and other bibliometric techniques, cancer IS are compared and contrasted with IS of other specialties. Cancer IS are relatively little discussed and primarily connect radiation equipment with the radiation oncology staff. By contrast, clinical laboratory and radiology IS are frequently discussed and connect specialized equipment to the hospital. A “Specialty Need” model accounts for these patterns and says that the “need for a specialty IS” is proportional to the “uniqueness of the specialty tools” plus the “degree to which the information from those tools is needed throughout the particular health care entity.”     

眼动训练对轻度认知功能障碍老人视觉注意事件相关电位的影响

目的 探讨眼动训练对轻度认知功能障碍老人视觉注意事件相关电位(ERP)的影响.方法 将48名轻度认知障碍老人分别进行眼动训练、手指操训练和空白处理3个月,利用事件相关电位技术(e-vent-related potentials,ERPs)对训练后老人进行检测,分析比较靶刺激P3b和新异刺激P3a的波幅和潜伏期.结果 训练后,新异刺激早成分P1波幅组别主效应显著(P＜0.05),眼动训练组[(6.78±1.55)μV]和手指操训练组[(5.43±1.47)μV]较空白对照组[(3.09±0.98)μV]波幅增大,主要表现在额区.靶刺激早成分P1波幅组别主效应显著(P＜0.05),眼动训练组[(6.75±2.01)μV]高于手指操训练组[(4.12±1.33)μV]和空白对照组[(3.45±1.01)μV].P3a波幅组别主效应显著(P＜0.05),眼动训练组P3a波幅[(10.19±3.09)μV]较手指操训练组[(7.57±2.66)μV]和空白对照组[(6.06±2.03)μV]增大(P＜0.05,P＜0.05),主要表现在额区.P3a潜伏期组别主效应显著(P＜0.05),眼动训练组P3a潜伏期[(390.67±55.03)ms]较手指操训练组[(428.55±48.68)ms]和空白对照组[(435.89±59.21)ms]提前,主要表现在额区和中央顶区.结论 眼动训练可以提高MCI患者的非选择性注意力,手指操训练对视觉注意力的影响不显著.

Abstract：

Objective To study the visual attention of mild cognitive impairment patients (MCI)by eyes movement training. Meathods 48 mild cognitive impairment patients were divided into eye movement training group,finger training group and untreated control group by single-blind randomized block method. Then they were trained respectively three months. Event-related potentials (ERPs) were used to measure the face recognition of them before and after training. The amplitude and latency of P3b elicited by target stimuli and P3a elicited by new stimuli of the three said groups were compared and contrasted. Results After training,the amplitude of P1 elicted by novelty stimulus were larger in eye movement training group( (6.78 ± 1.55 ) μV) and in finger training group ( ( 5.43 ± 1.47 ) μV) than untreated control group ( ( 3.09 ± 0.98 ) μV) significantly, especially in the frontal area. The amplitude of P1 elicted by target stimulus were larger in eye movement training group( (6.75 ±2.01 ) μV)than in finger training group( (4.12 ± 1.33 )μV)and untreated control group( (3.45 ± 1.01 )μV)significantly, especially in the frontal area. The amplitude of P3a were larger in eye movement training group( ( 10. 19 ± 3.09)μV ) than in finger training group ( ( 7.57 ± 2.66 ) μV ) and untreated control group ( ( 6.06 ± 2.03 ) μV ) (P ＜ 0.05,P＜0.05) significantly,especially in the frontal area. The latency of P3a were earlier in eye movement training group( (390.67 ±55.03 ) ms) compared to finger training group( (428.55 ± 48.68 ) ms) and untreated control group( (435.89 ± 59.21 )ms)significantly, especially in the frontal region and central parietal area. Conclusion Eyes movement can improve the MCI patients' non-selective attention function, especially in frontal area.The finger execrises have no significant effect on visual attention.     

Effect of Tiaoxin Recipe on spatial memory and energy metabolism of oxidation injured Alzheimers disease rats

Objective: To observe the effect of Tiaoxin Recipe (TXR) on the spatial memory, brain mitochondrial energy metabolism of oxidation injured Alzheimer’s disease (AD) rats, and to explore the mechanism of TXR in treating AD.Methods: Eighty-eight SD rats were randomly divided into five groups (normal group, operative group, “AD” model group, TXR group and Aricept group). An oxygen free radical generation system (dihydroxy fumaric acid-trichloroferric-adenosine diphosphate, DHF-FeCl₃-ADP) was used to create oxidation injured rat models mimic to AD; spatial learning and memory impairment (Morris water maze method), the activity of Succinate-oxidase, NADH-oxidase, CytC-oxidase (Clark oxygen electrode method) and the expression of cytochrome oxidase (CO) II mRNA (in situ hybridization method) were observed.Results: Compared with the normal group, the spatial memory, activity of CytCoxidase and COII mRNA expression of oxidation injured “AD” rats were obviously decreased; TXR, however, could improve these functions in “AD” rat models obviously.Conclusion: The mechanism of the action of TXR in treating AD was partly related to its effect on anti-oxidation which could improve brain mitochondrial energy metabolism. This program was supported by National Natural Science Foundation of China (No. 39830450)     

The effects of “Huoxuequyu” decoction on lipid peroxidation in IUGR rats

Summary The rats exposed to passive smoking were used as the animal model to further study the pathogenesis of IUGR and the effects of “Huoxuequyu” decoction. The results showed that the mean birth-weight of fetus and SOD activity of placenta and plasma in model rats Were significantly reduced, and LPO levels of placenta and plasma were significantly increased. We found that the mean birthweight and SOD activity in treated group were higher than that in model group, and LPO levels of placenta and plasma were lower in treated group than that in model group and there was no difference in SOD activity and LPO levels of placenta and plasma as well as the mean birthweight between treated group and control group, indicating that “Huoxuequyu” decoction can protect placenta and plasma against lipid peroxidation, and improve the blood circulation of uteroplacenta, thus contributing to the increase of the mean birth-weight.