基于MATLAB胎儿心电实时显示

文章介绍了从母亲体中采集到的心电信号，利用MATLAB软件对采集到的心电信号进行准确的数据实时处理，分离出胎儿心电（ECG）信号，实验结果表明，这种方法有一定的实用性。     

布比卡因对维吾尔族手术患者心肌酶谱的影响

目的观察全麻硬膜外布比卡因复合麻醉对维吾尔族上腹部手术患者心肌酶谱的影响。方法随机将择期行上腹部手术维吾尔族患者30例分为两组(每组15例),均先行T8～9或T9～10间隙硬膜外穿刺并置管,成功后用芬太尼2μg/kg、维库溴铵0.1mg/kg、咪唑安定0.15mg/kg、异丙酚2mg/kg诱导行气管插管,用异氟醚吸入和异丙酚3mg·kg-1·h-1恒速输注维持麻醉。A组手术切皮前由硬膜外导管分次注入0.5%布比卡因1.8mg/kg,用量(17.0±3.2)ml[(82.5±12.6)mg];B组注入1.6%利多卡因、0.16%丁卡因合剂(16.0±4.6)ml。分别监测术前(T0)、全麻诱导后(T1)、插管后5min(T2)及术毕(T3)的血流动力学和心肌酶谱的变化。结果两组谷草转氨酶(GOT)和肌酸磷酸激酶(CPK)在术毕较对照值明显升高(P<0.05或P<0.01);A组乳酸脱氢酶(LDH)在插管后5min及术毕较B组明显升高(P<0.05或P<0.01),其余指标均在正常范围。结论全麻复合硬膜外布比卡因阻滞麻醉对行上腹部手术的维吾尔族患者的心肌酶无明显影响。     

森田疗法对疑病症治疗康复作用的研究

目的：研究森田疗法对疑病症的治疗康复作用。方法：对符合CCMD－2－R疑病症诊断标准的病例50例，应用分阶段作业治疗的森田疗法。疗程为12－14周。疗前疗后进行明尼芬达多项个性量表（MMPI）测验及疗效评定。疗后半年进行病例随访。结果：疗前疑病症患者的MMPI平均以Hs、D、Hy、Pt最高，呈1－2－3－7型测图，另有Pd、Pa、Sc量表也 明显高于常模；疗上述量表均显著下降，下降幅度最大的仍是1，2，3，7量表。本研究对疑病症的痊显率为78％。半年后的复发率为13．95％。结论：森田疗法对疑病症治疗康复作用优，值得推广应用。     

Rb基因对人视网膜母细胞瘤株SO-Rb50的影响

目的：探讨视网膜母细胞瘤（Rb）的发生与Rb基因（Rb1）缺失、失活等异常的关系。方法：用逆转录病毒载体pDOR与全长4．7kb野生型Rb1cDNA构建逆转录病毒表达载体pDOR－Rb1+。用脂质体介导法将pDOR－Rb1+转入CRIP包装细胞系。结果：实验产生了0．5X105Cfu具有一次感染能力的重组逆转病毒。利用该病毒感染SO-Rb50，经G418筛选，获得了抗G418细胞群体。运用PCR及Southern杂交技术对转染细胞进行检测，结果表明该抗G418细胞中有完整的外源Rb1存在。Northern杂交发现其Rb1mRNA表达水平有所提高。对细胞群体生长速率、软琼脂集落形成能力的测定表明，外源Rb1的表达使SO-Rb50在软琼脂中集落形成能力降低，而群体生长速率无明显影响。结论：外源Rb1对SO-Rb50恶性表型有一定影响。     

麻风病患者外周血相关免疫功能测定的临床意义

目的探讨麻风病患者外周血相关免疫分子的变化和临床意义。方法应用流式细胞分析仪，以荧光标记的鼠抗人单克隆抗体对16例麻风病患者外周血淋巴细胞CD3／CD4／CD8、CD3／CD(16 56)(NK)和CD3／HLA-DR进行测定。结果16例患者发病初期外周血淋巴细胞亚群中CD3^ ／CD4^ 、CD3^ ／HLA-DR^-检测值和CD4／CD8比值均分别低于健康组相应参数的下限，CD3^ ／CD(16 56)^ 和CD3^ ／HLA-DR^ 检测值分别高于健康组相应参数的上限、NK的检测值在正常范围内。13例患者治疗病情稳定后2-4周，CD3^ ／CD4^ 、CD3^ ／HLA-DR^-的检测值和CD4／CD8比值均逐步增高，CD3^ ／CD(16 56)^ 、CD3^ ／CD8^ 和CD3^ ／HLA-DR^ 稍有增高或变化不明显，NK的检测值稍有增高；3例患者病情波动时CD3^ ／CD4^ 、CD3^ ／HLA-DR^-检测值和CD4／CD8比值较稳定期明显下降，而活化T淋巴细胞CD3^ ／CD(16 56)^ 、CD3^ ／HLA-DR^ 和NK细胞的检测值较稳定期明显增高2倍以上。结论通过外周血相关免疫分子的动态观察，有助于检测病情变化，时及时治疗和评价疗效有重要意义。     

生殖激素检测在男性不育症诊断中的意义

本文报道了我院对３１５例男性不育症患者在第一次就诊时进行血清生殖激素ＦＳＨ、ＬＨ、Ｔ、ＰＲＬ、Ｅ２水平的检测，并进行详细的病史询问、常规体检和精液分析等检查。结果显示血清Ｔ值在不同的精子密度层次的男性不育症患者均呈正态分布。睾丸容积减少，ＦＳＨ、ＬＨ上升，Ｔ／ＬＨ下降，提示睾丸功能损害，并且Ｔ／ＬＨ的比值更能反映间质细胞的功能。血清ＰＲＬ和Ｅ２值在诊断高催乳素血症不育有意义，但在男性生育者和不生育者之间无明显差别。而且ＦＳＨ值在鉴别睾丸原发性与梗阻性无精子症是一项重要指标。作者讨论了血清生殖激素测定在不育症诊断中、在判定睾丸功能的损害程度中的意义。     

Release of Proinflammatory Cytokines During Pediatric Cardiopulmonary Bypass: Heparin-Bonded Versus Nonbonded Oxygenators

Background. Heparin bonding of the cardiopulmonary bypass (CPB) circuit may be associated with a reduced inflammatory response and improved clinical outcome. The relative contribution of a heparin-bonded oxygenator (ie, >80% of circuit surface area) to these effects was assessed in a group of pediatric patients.

Methods. Twenty-one pediatric patients undergoing CPB operations were assigned randomly to receive either a heparin-bonded oxygenator (group H, n = 11) or a nonbonded oxygenator (group C, n = 10) in otherwise nonbonded circuits. The two groups were similar in pathology, age, weight, CPB time, and cross-clamp time. Plasma levels of the cytokines tumor necrosis factor-, interleukin-6, and interleukin-8, as well as terminal complement complex, neutrophils, and elastase, were analyzed before, during, and after CPB.

Results. Significant levels of tumor necrosis factor- were not detected in either group. Plasma levels of all other markers increased during and after CPB compared with baseline. Plasma levels of interleukin-6 peaked in both groups 2 hours after the administration of protamine but remained significantly higher in group C 24 hours after operation. Plasma concentrations of interleukin-8 peaked at similar levels in both groups 30 minutes after protamine administration and returned to baseline thereafter. Levels of terminal complement complex and elastase peaked in both groups 30 minutes after protamine administration. Plasma levels of terminal complement complex were significantly higher at the end of CPB and after protamine administration in group C. Elastase levels were significantly higher 2 and 24 hours after CPB in group C. The ventilation time of patients in group H was significantly lower than that of patients in group C: 10 (range, 3 to 24) versus 22 (range, 7 to 24) hours, respectively (p < 0.01).

Conclusions. The present study confirms the proinflammatory nature of pediatric operations and demonstrates a lessened systemic inflammatory response with the use of heparin-bonded oxygenators. This is achieved without bonding of the entire circuit, which could have significant cost-benefit implications by negating the need for custom-built heparin-bonded circuitry.     

体感诱发电位在椎管内占位显微手术中的监测

目的　评价体感诱发电位 (SEP)在神经外科脊髓疾病显微手术中的监测作用 ,避免或减少医源性脊髓损伤。方法　 2 8例病人行术前、术中SEP全程监测 ,包括脊髓SEP(SSEP)及皮层SEP(CSEP) ,术中及时把监测信息反馈给术者。并将术中监测结果与术后疗效对照分析。结果　椎管内占位手术在行髓内肿瘤切除时最易引发SEP波幅降低及潜时延长。术中监测按Frankel分级D、E级患者波幅较基准电位下降不超过 50 % ,潜伏期延长不超过7% ;B、C级患者波幅较基准电位下降不超过 40 % ,潜伏期延长不超过 5 %。术后不会引起脊髓功能不可逆损害。结论　脊髓手术时行SSEP和CSEP联合监测可及时反映出脊髓功能的变化 ,提高术者术中操作的安全性 ,避免或减少术后并发症     

腹腔镜阑尾切除术219例临床应用体会

目的：总结腹腔镜阑尾切除术的临床应用体会。方法：回顾性分析219例接受腹腔镜阑尾切除术的患者资料。结果：219例中，215例行腹腔镜阑尾切除术，4例行腹腔镜阑尾周围脓肿引流术。手术均顺利完成，无1例中转开腹，术后无1例发生切口感染、肠粘连、肠梗阻、腹腔残余脓肿形成等并发症，全部治愈出院。结论：腹腔镜阑尾切除术具有创伤小、恢复快、住院时间短、术野清晰、探查范围广、并发症少等优点，尤其在术前诊断不明确时可弥补开腹阑尾切除术的不足，值得进一步推广。