THE CANTON CONFERFNCE

Elsewhere in this number of the JOURNAL we present a copy of the proposed programme for the Chinese Medical Association Conference t。 be held in Canton from the lst to the 8th of November this year. This Conference will be one of more than usuaI interest as the date of the Conference corresponds with the centenary of the opening of the first modern hospital in China and the programme allows for the celebra- tion of this event. Actually this is to be done in the most practical man- ner possible by the formal opening of a new Canton hospital to carry on into the new centur.y the aims and ideals of the earIier.institutions. Opportunity aIso will be taken for the laying of the Foundation Stone of a New Medical School to be known as the Sun Yat Sen Medical School. The famous leader was himself a student in the former Canton hospital and by happy circumstance it is found possible to unite with the open- ing of the new place the celebration of the 50th Anniversary of Dr. Sun''s entry into the old hospital as a medical student. Such a combined celebration must be unique and advantage should be taken of it to ensure a large and representative meeting.     

EDITORIAL

Microbial infection involved in the formation process of atherosclerosisand became a new risk factor of ischemic heart and brain vesseldiseases. Dr. Jinliang Wang summarizes the recent new evidencesabout Microbial Infection and Atherosclerosis The conflicts andproblems to be solved about this subject were also mentioned. C-reactive protein (CRP) is one of the acute phase protein, whoseserum concentration changes rapidly in response to a variety ofinflammatory states. Recent perspective study and epidemiologicaldata suggest that sensitive CRP assays will play an increasing rolein the risk evaluation for CHD. Dr. Youren Wei introduces The     

In Vitro Evaluation of Decellularized Porcine Heart Valve Matrix Fixed by Epoxy Chloropropane

Heart valve diseases have a significant high mortality, and the valve replacement using glutaraldehyde crosslinked porcine heart valves is one of the main curing techniques. But its application is limited due to poor durability, calcification of the valves and immunogenic reactions. The aim of this study was to evaluate the crosslinking effect of epoxy chloropropane （EC） on porcine heart valve matrix. After crosslinking of the decellularized porcine aortic heart valves by EC, the tensile strength, the in vitro enzymatic degradation resistance, platelet adhesion, and cellular compatibility were examined. The results showed that the tensile strength of EC or glutaraldehyde crosslinked valve matrix was higher than that of non-crosslinked valve matrix. Furthermore, platelet adhesion, and the cellular compatibility of EC crosslinked valve were significantly superior to its glutaraldehyde-fixed counterparts. In vitro enzymatic degradation revealed that crosslinked matrix could resist the enzymatic hydrolysis, and the resistant capacity was approximately the same as glutaraldehyde crosslinked valve matrix. This study shows that EC can crosslink porcine heart valves effectively without toxicity. Our results suggested that this method might be a useful approach for preparation of bioprosthetic heart valve.     

Integration of Chinese Medicine with Western Medicine Could Lead to Future Medicine: Molecular Module Medicine

The development of an effective classification method for human health conditions is essential for precise diagnosis and delivery of tailored therapy to individuals. Contemporary classification of disease systems has properties that limit its information content and usability. Chinese medicine pattern classification has been incorporated with disease classification, and this integrated classification method became more precise because of the increased understanding of the molecular mechanisms. However, we are still facing the complexity of diseases and patterns in the classification of health conditions. With continuing advances in omics methodologies and instrumentation, we are proposing a new classification approach: molecular module classification, which is applying molecular modules to classifying human health status. The initiative would be precisely defining the health status, providing accurate diagnoses, optimizing the therapeutics and improving new drugdiscovery strategy. Therefore, there would be no current disease diagnosis, no disease pattern classification, and in the future, a new medicine based on this classification, molecular module medicine, could redefine health statuses and reshape the clinical practice.     

A SIPLE METHOD FOR TERSTING TESTING ANTIGENIC VARIATION OF INFLUENZA VIRUS ANTIGENICITY

A simple racthod for detecting antigenic variation of influenza virus is descnbed. Con- valescent sera af infant patients of 6 months to lyz years of age were used to perform hemagglu- t,ination inhibition test (HI) against newly isolates and typical strains of influenza A virus isolated during the past few years. The ex- istence of any new influenza variants could be readily shown with a rise of H羔 titers. The method is simple, rapid, highly specific and easy. Apparatus required are available in most of the regional anti-epidcrnic stations of this country. The stepladder curve produccd by the re- sults of this method graphicaXy illustrates the main course of antigenic variation of influenza A virus from 1968-1975.     

Ache： The Speech of a Body

The goal of this paper is to show that the suffering, associated with the body through the medical discourse, acquires a new statute with the psychoanalysis, which brings to the discursive field a new ethics - the ethics of desire. We want to evidence something beyond the physical suffering and the organic symptoms. In this manner, we have the perspective of a new view that shows the suffering as a language who needs be heard. It is a matter of substantiating the existence of something that lies beyond the physical suffering and the organic symptoms. In this way, we confront a new perspective that states that the falling ill, this discomfort of the individual with his own body, does not necessarily begs for a cure; the overt suffering needs to be listened to in another dimension taking as a reference an other knowledge. Retaking the question of the medical speech, it＇s worthy of evidence that the psychoanalysis signals that not always the solicitation of the patient to the doctor is about a cure solicitation. The demand of the subject will cannot be able to fit with what it desires. One evidences that, many times, the patient don＇t ask for to the doctor that cures him, ask for that it＇s certified as sick, ask for a surgery to occupy the sick person place. Thus, not always is about a demand for cure; albeit asking for being cured something it will be able to indicate that it wants to occupy the sick person place. We ought to situate the unconscious desire that expresses the obscure side of existence： pain promoted to the icon of lust, by the negation of the painful sensation and by the posture of the subject whilst observing the pain, leading to states of ecstasy.     

New approach for new target: adaptive servo-ventilation on Cheyne-Stokes respiration in congestive heart failure

Cheyne-Stokes respiration with central sleep apnea （CSR-CSA） occurs when periods of hyperventilation with waxing/waning tidal volume alternated with periods of central hypopnea/apnea. It is present in approximately 40 percent of patients with severe congestive heart failure （CHF）. CSR-CSA may contribute to the progression of heart failure by causing repetitive arterial oxygen desaturation, sleep fragmentation, increased left ventricular afterload, activation of sympathetic nervous system, and oscillations in heart rate and blood pressure. There are evidences indicating that CSR-CSA is associated with a remarkable increase in mortality and is also an independent risk factor for cardiac transplantation; furthermore, treatment of CSR-CSA in combination with optimal medical therapy may influence the course of chronic heart failure, improve quality of life and the survival of patients. The paper by Zhang et al^2 highlights the importance of recognizing this pathological breathing pattern as a potential therapeutic target.     

医用英语选读(十)

<正> The main functions of the lung are to supply the body with oxygen and get rid of excess carbon dioxide. In so far as expired air is usually warmer than inspired air and is saturated with water vapour normal respiration is associated with some heat loss. In quiet respiration about 500 ml of air are breathed in and out in each respiratory cycle. If the respiratory rate is about 18 per minute the volume of air entering and leaving thelungs is about 9L per minute. This Can be encreased by deeper and more vapid breathing to 150 L per minute. Slow, deep breathing is much more efficient than rapid, shallow breathing for increasing the amount of oxygen available to the body.     

A NEW METHOD OF IMAGE PROCESSING TECHNIQUE APPLIED TO CHROMOSOME RECOGNITION AND COUNTING

This paper describes a new method based on Four Neighbor Distance Transformation (FNDT) and Equal Diagonal Algorithm (EDA) to extract the medial axis and locate the centromere of the chromosome Compared to the Classical Thinning Algorithm and Four Neighbor Distance Transformation, the new method (FNDT-DEA) is more noise-tolerant, simpler in programming and faster in execution. The FDNTEDA provides the connective and one-pixel thick medial axis representing the length of chromosome. The Crofton directive parameters were used in the algorithm to locate the centromere in some chromosome. The number of chromosomes in a given cell is obtained with calculating either the Euler Number or the clase-curve's subset. An intergroups classifier has also been designed. The FNDT-DEA gave results quite similar to those given with human assessment. It was concluded that this new method, FNDT-EDA, is appropriate for microcomputer-based analyzing the human chromosomes.     

A new embedding method for tendon suturing.

A new embedding method in tendon suture was designed for interembedding of tendon ends to obtain interlock and strengthen antitension strength. Experiments showed that the embedding method might result in greater antitension strength than the conventional end-to-end method (Bunnell's method) or weaving method. Statistically, difference was significant. Dynamic studies on tendon healing showed that a prominent reaction of surrounding tissues occurred in 3 to 5 days after operation. In this period the antitension strength is likely to decrease and be broken with a rate of 28.1% in Bunnell's method, 5.25% in weaving method and 0% in embedding method. Clinically, the embedding method has been used in 125 cases of tendon-broken repair in which a 87.8% of good and excellent effect was resulted.

     

Relationship between action potential duration of ventricular cells and heart rate of rabbit under natural breathing

Summary The ECG and transmembrane action potentials of the ventricular cells of 40 albino rabbits at various heart rates under natural breathing were simultaneously recorded. After statistical analysis of the records of 126 units, quantitative relationships between action potential durations (APDs) and heart rates were found and regression equations were obtained by linear regression. In order to eliminate the effect of heart rates on APDs, the correction formulas on APDs were also worked out. After correction the effect of sinus cycle length (SCL) on APDs could be eliminated. This study has provided a practical method for the study of the effect of different agents on the APDs of ventricular cells under more natural condition. Though the regression equations and correction formulas can only be applied in rabbits under natural breathing, this method might be adopted to work out the corresponding regression equations and correction formulas for other experimental animals. Therefore it has practical significance in a rather broad field.     

Independent predictors of cardiac parasympathetic dysfunction in type 2 diabetes mellitus

INTRODUCTION: Although the clinical implications of diabetic autonomic neuropathy have been described, the clinical determinants of parasympathetic dysfunction in type 2 diabetes mellitus are not clear. We investigated the clinical determinants of heart rate response to deep breathing in type 2 diabetes mellitus. METHODS: This study involved 207 randomly selected patients with type 2 diabetes mellitus and 141 healthy controls. Heart rate response to deep breathing was measured in all the subjects. Heart rate response to Valsalva manoeuvre and active standing was measured in lesser numbers. Data analysis was done using unpaired Student's t-test, Pearson's correlation test and multiple regression. RESULTS: Heart rate response to deep breathing, Valsalva manoeuvre and active standing was lower in patients with diabetes mellitus than in controls (p-value is less than 0.0001, 0.01 and 0.01, respectively). Age, female gender and presence of somatic neuropathy were the independent predictors of reduced heart rate response to deep breathing (p-value is 0.001). Independent positive correlation was found between resting heart rate and heart response to deep breathing (p-value is 0.02). Factors associated with depressed heart rate response to deep breathing, but not independently predictive, were duration of diabetes mellitus, presence of hypertension, coronary artery disease, foot ulcer and retinopathy. Mean heart rate response to deep breathing of 47 patients with diabetes mellitus free of all complications was lower compared to controls (p-value is less than 0.01). CONCLUSION: Our data suggests that parasympathetic dysfunction mainly coexists with somatic neuropathy. It may be isolated, or precede detection of other complications. Age and female gender are the other predictors of reduced heart rate response to deep breathing in type 2 diabetes mellitus.     

Impact of heart failure on quality of sleep

Chronic heart failure is an important health problem associated with a high mortality and morbidity. Appropriate treatment reduces mortality and leads to improved exercise tolerance but many patients report poor quality of sleep. Sleep studies of patients with heart failure suggest that sleep disordered breathing is experienced in 50% of patients and is a powerful predictor of poor prognosis. Sleep disordered breathing broadly comprises obstructive sleep apnoea, when upper airway instability causes mechanical obstruction to breathing; and central sleep apnoea, characterised by an absence of ventilatory effort. Sleep disordered breathing occurring in patients with heart failure is in most part attributable to central sleep apnoea and reflects uncompensated instability of the ventilatory feedback mechanism.     

雷达式非接触检测中呼吸和心跳信号分离算法的研究

为了有效地从生物雷达的体动信号中分离出呼吸和心跳信号,实现生理特征参数（呼吸率和心率）实时监测,本文在自适应噪声抵消模型的基础上,提取呼吸信号的谐波组合作为模型的参考输入,将生物雷达检测到的体动信号作为模型的原始输入,构建了一套适用于生物雷达检测中分离呼吸、心跳信号的自适应谐波抵消算法。仿真实验结果表明,该算法简单、易于实现,能够实时地分离呼吸和心跳信号。     

Relationship between action potential duration of ventricular cells and heart rate in dog under natural breathing

Summary The ECG and transmembrane action potentials of the ventricular cells of 12 mongrel dogs at various heart rates under pentobarbital anesthesia and spontaneous breathing were simultaneously recorded. After statistical analysis of the records of 139 units, quantitative relationship between action potential durations (APDs) and heart rate, between QT intervals and heart rate, and between APD₉₀ and QT interval were recognized and regression equations were worked out by linear regression. The regression coefficients indicated that the relationship between APD₉₀, APD₅₀, QT interval and heart rate and that between APD₉₀ and QT interval were highly significant. In order to eliminate the effect of heart rate on APDs and QT interval, the correction formulas for heart rate on APDs and QT interval were worked out. After correction, the effect of heart rate on APDs and QT interval could be eliminated. This paper presents a practical method for the study of the effect of different agents on the APDs of ventricular cells and QT interval under spontaneous breathing.     

呼吸机治疗中呼气末正压在急性左心衰竭中的应用

呼吸机已经成为抢救重症急性左心功能衰竭(左心衰)的有效措施,通气模式多采用呼气末正压辅助治疗,作者综述了呼气末正压发生机制及背景、对重症急性左心衰竭患者病理生理上的影响,以及探讨利用无创心功能监测仪监测血流动力学参数,进而辅助对血流动力学不稳定患者选择最佳呼气末正压。     

家兔心室肌细胞动作电位时间与心率关系的探讨

在麻醉后自然呼吸条件下同步记录了40只家兔不同心率时的心电图和心室肌细胞的跨膜动作电位。对126个单位的记录进行了测量和统计学分析后,找出了动作电位时间(APD)与窦性心周期时间(SCL)之间的定量关系,求出了相应的直线回归方程式。利用这些方程式可消除SCL对APD的影响,从而可以研究某些因素是直接影响APD,还是通过SCL间接影响APD,因此具有一定的实用价值。     

16层螺旋CT冠状动脉成像质量与护理干预

目的 探讨护理干预在16层螺旋CT冠状动脉成像中的作用.方法 对我院2005年11月-2007年4月行16层螺旋CT冠状动脉成像的450例患者检查前实施相关护理措施.结果 419例患者心率被控制在70次以下.16层螺旋CT冠状动脉成像的影像质量受心率、心率波动幅度和呼吸幅度影响.有效的护理干预能帮助降低心率和心率波动幅度,平缓呼吸幅度.结论 有效的护理干预有助于改善影像质量,对冠状动脉CTA成功检查非常重要.     

血浆NT—proBNP水平在急诊呼吸困难鉴别诊断中的应用

呼吸困难是充血性心力衰竭（CHF）的主要症状之一,也是某些肺部疾病的临床表现之一,寻找一种简单、快速、有效的检测方法对其作出正确的鉴别诊断在临床上具有重要意义。N-末端脑利钠肽（NT-pmBNP）主要由心室肌合成分泌,同时在心功能不完整时其水平会有所变化,可以为鉴别心脏功能是否完整提供依据,同时为鉴别区分上述两种呼吸困难致病原因提供了一定的依据。