桡动脉穿刺置管监测血压的临床应用

近年来,我们在临床中采用桡动脉置管法持续监测动脉压,既减轻了反复抽动脉血给病人造成的痛苦,同时监测了心输出量和动脉血气分析,收到满意效果。现报道如下。 1 资料与方法 1.1 一般资料:本组34例中,男19例,女15例,年龄21～76岁。休克11例,呼衰8例,嗜咯细胞     

1982—1991年怀柔县碘盐含碘量监测分析

１９８２～１９９１年怀柔县碘盐含碘量监测分析汪永义兰义新王炳春怀柔县是地方性甲状腺肿和地方性克汀病等碘缺乏病的重病区。１９７６年全县普查地方性甲状腺肿和地方性克汀病，其患病率分别为１２．７５％和０．１６％。我们自１９８２年起对怀柔县的碘盐进行含碘量的...     

象形排班法

象形排班法,是在传统的排班基础上加以发挥和突破。此种排班法是应用象形图形,利用多色彩笔绘制成各种不同班次。采用象形图方法表达事物的内涵,既直观易懂,又不受国籍与文字的限制。象形排班法分周表、月表、季表、年表四种。     

Low tolerability of carbamazepine in psychiatric patients may restrict its clinical usefulness

There are reports of prophylactic efficacy of carbamazepine (CBZ) in manic depres sives when compared with placebo and chlorpromazine. Following a successful open pilot study by one of the authors, an attempt was made to compare carbamazepine and lithium carbonate in a double-blind, crossover trial, each patient being assigned to take each drug for 9 months in random order. However, of the first 14 patients to take carbamazepine four were withdrawn because of drug rashes and another two because of other adverse effects. The trial was discontinued, and a casenotes survey of 50 consecutive psychiatric patients who had been prescribed carbamazepine for mood disorders was then carried out, to establish the tolerability of the drug in clinical practice. Of these, 22 per cent had suffered dizziness, nausea or unsteadiness despite slow introduction of doses. Drug rashes occurred in 16 per cent of patients within the two weeks of starting treatment. A further 14 per cent had other unwanted effects. In total, 36 per cent of the patients had the drug stopped because of adverse effects. With regard to efficacy, in those taking the drug for more than 4 weeks, clinicians reported a definite or probable advantageous effect in 62 per cent of the sample, definite or probable lack of effect in 19 per cent and no opinion in 19 per cent. This low tolerability is not in accordance with previous reports of 2-6 per cent incidence of drug rashes and 10 per cent overall intolerance in neurological patients. We conclude that tolerability is a major drawback to the use of carbamazepine in some groups of psychiatric patients, although all the side- effects were reversible. However, clinical impressions suggested that in a number of patients no other therapeutic strategy was as effective in preventing mood swings.     

Cancer pain control by infusion techniques in the home situation in the Northern Netherlands: an innovative project on the use of medical technology in the home situation

Since 1982, 229 terminally ill cancer pain patients were treated by the administration of epidural opioids. An adequate level of aid was provided by the coordinated efforts of the patients' general practitioner, the district nurse, and the anesthesiologist. Based on 9 yr of experience with this model, a project on quality improvement and organization of cancer pain control by infusion techniques in the home situation was proposed. The purpose of the study is to create a nationwide organization for cancer pain control for terminal patients on a home-care basis. Specially trained ambulatory field teams will be set up to collect and process the information necessary to make protocols and instructions.     

An electrophysiological investigation of the relationship between conceptual fluency and familiarity

Brain potentials associated with the manipulation of conceptual fluency in a recognition memory paradigm were recorded. Enhanced fluency was associated with attenuation of the N400 and an increased rate of subjects' endorsing both studied and non-studied items as having been studied ("old" responses) in the recognition test. Differences were also found in latencies previously associated with post-retrieval processing, such that in the setting of enhanced fluency (1) non-studied items were associated with a positive wave from 800 to 1600 ms and (2) items endorsed as "new" were more positive than those endorsed as "old" from 1200 to 1600 ms. The effects on the N400 may be related to the impact of fluency on familiarity, whereas later processing may be involved in the attribution of fluency to prior experience.     

Deletion of Mycobacterium tuberculosis sigma factor E results in delayed time to death with bacterial persistence in the lungs of aerosol-infected mice

The stress-induced extracytoplasmic sigma factor E (SigE) of Mycobacterium tuberculosis shows increased expression after heat shock, sodium dodecyl sulfate treatment, and oxidative stress, as well as after phagocytosis in macrophages. We report that deletion of sigE results in delayed lethality in mice without a significant reduction of bacterial numbers in lungs.     

The interferon in TLR signaling: more than just antiviral

The Toll-like receptor (TLR) system is responsible for the recognition of infectious agents leading to initiation of the primary innate, and later adaptive, immune response. Genetic technologies have enabled the discovery of new factors involved in these systems, their genetic manipulation and the global analyses of their effects on gene expression. Furthermore, this increased understanding has resulted in the need to reassess our preconceptions about the functions of well-known molecules. For example, type I interferons (IFNs), which were discovered as antiviral proteins, are now known to be produced in response to TLR activation by many pathogens, including bacteria. Should we be surprised? Has the inflammatory response unexpectedly highjacked the body's antiviral system? Or are we too easily blinkered by preconceptions from how a compound was discovered?     

In vivo protein synthetic rates of atrial, ventricular, and pulmonary tissue proteins in aortic constriction, goldblatt, and bromoethylamine models of hypertension

Changes in tissue protein synthesis in hypertension have usually been measured in vitro in heart from acutely hypertensive rats without consideration of changes in atrial or pulmonary tissue or changes occurring in long-standing hypertension. The objective of the study was to investigate the in vivo changes in cardiopulmonary protein synthesis in three different rat models of chronic hypertension. Hypertension in aortic constriction, the Goldblatt model, and the bromoethylamine model were induced in rats for 30 days. At the end of the experimental period, in vivo rates of protein synthesis were measured with a flooding dose of [3H]phenylalanine (a method which effectively considers precursor pools). Concomitant measurements included quantification of contractile protein and RNA and DNA contents. Indices of protein breakdown were also assessed by selective measurement of protease activities. At the end of 30 days, aortic constriction induced marked increases in protein contents of the left ventricle, septum, left atria, and lungs. Accompanying changes included concomitant increases in RNA and DNA contents. Left ventricular myofibrillary, sarcoplasmic, and stromal protein contents increased in the aortic constriction model. Less marked changes occurred in the Goldblatt model, though the left atria were not significantly affected. In contrast, the bromoethylamine model had no effect on the protein or RNA contents of any region. In all cardiac regions of all three models, fractional rates of protein synthesis were not significantly affected. However, protein synthesis increased in the lungs of both the Goldblatt and bromoethylamine models at 30 days. Protease activities were decreased in the left ventricles of all three models at 30 days, with lysosomal protease activities declining in the aortic constriction model and cytoplasmic protease activities declining in the other two models. The failure of chronic hypertension to increase ventricular synthesis rates may represent inherent limitations in the time frame for measuring protein synthesis in vivo. However, at earlier time points (i.e., 10 days), the aortic constriction model was characterized by marked increases in left ventricular and atrial protein contents, RNA contents, and fractional rates of protein synthesis. This was consistent with the supposition that, in acute phases of hypertrophy, rates of protein synthesis increase, whereas in established hypertrophy, synthesis rates remain unchanged or decrease. The applicability of the aortic constriction model was investigated by examining the effects of the angiotensin converting enzyme inhibitor lisinopril (5 mg/kg/day). After 30 days treatment, lisinopril impeded the increase in left ventricular mixed and myofibrillar proteins. This effect was accompanied by an apparent increase in protein synthesis. In conclusion, although all three chronic models are able to induce hypertension, varying degrees of hypertrophy develop, which are more pronounced in the aortic constriction model. Accompanying changes include hypertrophy in the atria, reduced rates of ventricular proteolytic activity, and altered rates of protein metabolism in the lungs.