Use of an artificial neural network to analyse an ECG with QS complex in V1–2 leads

A feed-forward neural network with back-propagation algorithm is used to distinguish anterior wall myocardial infarction (AI) and non-infarction based on analysis of computerised electrocardiograms. Data used in the study are from 132 patients diagnosed as having AI by automated electrocardiograph analysis. Their ECGs show an abnormal Q-wave (or QS complex) or small R progression in leads V₁ and V₂. However, 66 of them are diagnosed as old AI from the history, physical examination, echocardiogram and other laboratory data, whereas the other 66 are not. The network is trained with the data from half of the AI and non-infarction patients, respectively. The diagnostic accuracy rate is then tested with the remaining 66 patients (33 infarction, 33 non-infarction) who have not been exposed to the network. The neural network correctly identifies 90.2% of the patients with AI and 93.3% of the patients without infarction. The neural network is capable of diagnosing anterior wall myocardial infarction better than a computer electrocardiograph.     

大鼠脑突触质膜糖皮质激素受体的研究

用改进的蔗糖密度梯度超速离心法从大鼠脑匀浆物中制备出突触质膜，其中不含胞液成份，用放射配体结合法，以［￣３Ｈ］皮质酮作为标记配体测得突触质膜上有皮质酮特异结合部位，其结合的饱和曲线呈“Ｓ”形，用Ｓｃａｔｃｈａｒｄ作图呈一条向上凸的曲线，表明受体结合过程中有正协同作用，蛋白的结合容量（Ｒ０）为（４５０．２０±５８．６０）ｐｍｏｌ／ｇ，平衡解离常数（ｋｄ）为（１６０．２５±２８．２０）ｎｍｏｌ／Ｌ。取代结合实验表明，［￣３Ｈ］皮质酮结合部位有相当显著的配体结合特异性。按结合力大小排列为：醛固酮＞皮质酮≈皮质醇＞孕酮＞睾酮≈雌二醇＞地塞米松。结果提示脑突触质膜上存在糖皮质激素膜受体。     

厌氧菌感染46例临床分析

本文对46例厌氧菌感染的临床特点进行了分析。病例中败血症、原发性腹膜炎各19例,肝脏肿8例。厌氮菌培养阳性63株,其频数依次为脆弱类杆菌(39.7％)、消化球菌、真杆菌、产黑色素类杆菌等。46例中细菌混合感染占45.65％,均为多种细菌反复感染或同时感染。厌氧菌感染多系继发性的内源性感染,为医院内感染重要病原菌之一。     

模式翻转刺激视觉诱发电位及其噪声

叙述了视觉诱发电位及其研究的意义。并通过头实验获得正常人的视觉诱发电位曲线。然后在理论上论证了用叠加相干平均信号处理的技术。最后,较详细而全面地阐述了模式翻转刺激视觉诱发电位的可能噪声来源及其影响,并简述了如何正确使用和研制视觉诱发电位仪和刺激器。     

模拟高原大鼠梭曼中毒血液单胺类递质的变化

本研究采用荧光分光光度仪检测了模拟４０００ｍ高原大鼠复合梭曼中毒后不 清中５－羟色胺（５－ＨＴ）、５－羟吲哚乙酸（５－ＨＩＡＡ）、去甲肾上腺素（ＮＥ）、肾上腺素（Ｅ）和多巴胺（ＤＡ）等５种单胺物质的含量。结果表明：大鼠在模拟高的状态和复合中一道因中单胺物质的含量民平原对照相比，以及７２μｇ／ｋｇ中毒组与５６μｇ／ｋｇ中毒组和高原对照组相比，明显同（Ｐ〈０．０１）。提示高原复合梭曼中体内单胺类物质的     

Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions.

Cardiovascular disease is the leading cause of death among women in the U.S., exceeding breast cancer mortality in women of all ages. Women present with cardiovascular disease a decade after men, and this has been attributed to the protective effect of female ovarian sex hormones that is lost after menopause. Animal and observational studies have shown beneficial effects of hormone therapy when it is initiated early in the perimenopausal period or before the development of significant atherosclerosis. However, randomized, placebo-controlled trials in older women have not shown any benefit in either primary prevention or secondary prevention of cardiovascular events, with a concerning trend toward harm. This review outlines the lessons learned from the basic science, animal, observational, and randomized trials, and then summarizes yet-unanswered questions of hormone therapy and cardiovascular risk.     

Chest pain of esophageal origin

Chest pain is a cause of significant anxiety in a patient. Even those who have no evidence of cardiac disease may have many visits to the emergency department and even repeated hospitalizations because of chest pain. Atypical chest pain is now the commonest reason for patients to be referred for esophageal manometry studies. The development of provocative studies has led both to an increased demonstration of esophageal origin of chest pain, as well as an increased awareness of the complexity of the esophageal response to a variety of stimuli. The possibility of a generalized smooth muscle disorder has been considered on the basis of studies demonstrating that many patients with microvascular angina have esophageal motor disorders. This review examines some of the issues related to the use of provocative agents to study patients with chest pain, in addition to briefly reviewing gastroesophageal reflux disease and esophageal mucosal disorders.     

Placenta increta in the second trimester of pregnancy: report of a case

A rare case of placenta increta in the second trimester of pregnancy is reported. The patient was at 15 weeks gestation when the pregnancy, which had been complicated by a maternal rubella infection, was terminated at a regional hospital. However, vaginal bleeding persisted after the operation in spite of medication to control bleeding. Curettage of the uterine cavity one month later failed to reveal any retained placental tissue or other pathology. Therefore, an exploratory laparotomy was performed, yet nothing particular was found in the peritoneal cavity. So, the patient was transferred to our department. Sonography revealed a lower uterine mass of 4.0 x 3.3 cm in size. A persistently low serum hCG titer was also found. Placenta accreta was highly suspected. Three doses of methotrexate were given to control bleeding, yet without results. Hysterectomy was finally performed. A histological study revealed placenta increta.     

上位腰椎压缩性损伤的振动评价

目的：为探讨胸腰段脊柱在损伤前后的动力学响应特性，利用振动分析对前屈型压缩后节段腰椎的损伤情况进行了即刻评价。方法：在７例成人胸１２至腰１节段脊柱标本上，先测试正常标本的频幅响应曲线，压缩致破坏后再测试损伤标本的频幅响应特性并加以比较。结果：频幅响应曲线显示，损伤后在上／下方向的主频率显著前移（ｐ＜０．０５），前／后和左／右方向上仅存在前移趋势。将腰椎标本简化为单自由度系统，主频的前移即意味着材料刚度的下降。结论：本实验证实振动在腰椎压缩性损伤的即刻评价中具有一定的意义。     

Phase I/II dose-escalation study of liarozole in patients with stage D,hormone-refractory carcinoma of the prostate

Background: Liarozole binds to the cytochrome P-450-dependent hydroxylating enzymes involved in steroid biosynthesis and retinoic acid catabolism. This phase I study investigated the clinical/endocrine toxicity profile of liarozole and determined the maximally tolerated dose (MTD) in hormone-refractory prostate cancer patients. Methods: Groups of five patients were treated with oral liarozole caplets, starting at 37.5 mg twice daily. The dose was doubled for each subsequent group until the MTD was reached, after which, an additional 18 patients were entered into the MTD-1 dose stratum. The long-term safety of liarozole was assessed based on treatment-emergent signs and symptoms and clinically significant laboratory results. Results: Thirty-eight patients were enrolled. The MTD was determined to be 300 mg twice daily. Side effects that defined the MTD included lethargy, somnolence, body rash, and paresthesias. Two deaths occurred during the trial (pneumonia and myocardial infarction). Four patients had a >50% decrease in prostate-specific antigen (PSA) levels (two at 150 mg, two at 300 mg). Of nine patients with measurable disease, two had partial responses. Conclusions: Liarozole was generally well tolerated with no evidence of adrenal insufficiency. Preliminary evidence of activity in this indication was observed based on dose-dependent decreases in PSA levels and improvement in soft-tissue metastasis. Presented at the 46th Annual Cancer Symposium of The Society of Surgical Oncology, Los Angeles, March 18–21, 1993.