多通道肺音采集系统设计

目的：设计一种多通道肺音采集系统。方法：系统采用增强型的32位基于ARM核心的微控制器STM32F103ZET6作为核心控制芯片。电容传声器将采集到的肺音信号转换为电信号,设计多路放大滤波电路对肺音电信号进行处理,微控制器通过控制4通道串行输出AD转换芯片ADS8341实现多通道数据采集,采用SD卡作为存储介质用以存储所采集的肺音信号,采用液晶显示器作为人机界面,显示操作提示信息或系统工作状态。结果：可以同时采集1-4通道的肺音数据,采样频率为8789 Hz,数据采样精度为16位,单次可连续存储30s-60s的肺音数据。结论：系统操作简便,体积较小,肺音数据以WAV格式的音频文件存储于SD卡中。计算机可以方便地读取SD卡中肺音数据,进行肺音音频播放,还可以对肺音数据进行进一步的分析处理。系统能准确地采集多通道肺音数据,数据存储快速、可靠,数据读取方便,能满足临床医生采集肺音数据的需求。     

心脉隆注射液对脓毒症休克患者微循环的影响

目的 观察心脉隆注射液对脓毒症休克患者微循环的影响,以了解心脉隆对脓毒症休克患者中的应用效果与价值。方法 选取本院重症监护室诊治的82例脓毒症休克患者为研究对象,随机分为两组,对照组的41例患者进行常规脓毒症休克集束化治疗,治疗组的41例患者在对照组集束化治疗的基础上加心脉隆注射液,比较两组治疗前、治疗后的血流动力学参数(HR、CVP、CO、MAP、SVR)、血流变(全血还原黏度、血细胞比容、纤维蛋白原、血小板聚集率)、微循环灌注指标(氧合指数、血乳酸水平、SCVO₂、Pcv-aCO₂)及28 d生存率。结果 治疗前两组血流动力学参数、血流变及微循环灌注指标,差异均无统计学意义(P> 0.05);而治疗后两组的上述方面检测结果均显著改善,且治疗组的检测结果显著地好于对照组,28 d生存率亦优于对照组,差异均有统计学意义(P <0.05)。结论 心脉隆注射液可显著地改善脓毒症休患者的血流动力学参数,改善血流变及微循环灌注指标,提高28 d生存率。在脓毒症休克患者治疗中具有积极的临床治疗效果。     

Comparative study of the protective effect between Jiawei huanglian jiedu decoction and Huanglian jiedu decoction in septic rats

Background Sepsis is a complex pathophysiologic process, which is the leading cause of death in the world.Many studies have revealed that Chinese medicine has shown tremendous advantages on the treatment of sepsis.Our study aims to explore the effect of Huanglian jiedu decoction and Jiawei huanglian jiedu decoction on organ function in septic rats. Methods SD rats were randomly divided into 7 groups, sham-group, cecal ligation and puncture group(CLP, 18 h/72 h), Jiawei huanglian jiedu decoction group(JW, 18 h/72 h), Huanglian jiedu decoction group(W, 18 h/72 h). Except the Sham group, the rats in other groups received cecal ligation and puncture method to induce sepsis. CLP groups were intragastric administration with normal saline after CLP. Huanglian jiedu decoction and Jiawei huanglian jiedu decoction groups were intragastric administration with Huanglian jiedu decoction and Jiawei huanglian jiedu decoction in the same time points. Glutamic-pyruvic transaminase(ALT), glutamic oxalacetic transaminase(AST), total bilirubin(TBIL), creatinine(Cr), urea, creatine kinase-MB(CK-MB), lactate dehydrogenase(LDH) were detected by biochemical analyzer. Brain natriuretic peptide(BNP),surfactant protein A(SP-A), chemotactic factor for monocyte-1(MCP-1), D-lactic acid(D-LAC), complement5 a, mobility group box-1 protein B1(HMGB-1), interleukin 6(IL-6) were analyzed by enzyme-linked immunosorbent assay(ELISA). Total lung capacity(TLC) and function residual capacity(FRC) were measured by buxco research system. The wet to dry weight ratio(W/D) was tested. Moreover, changes in tissue pathology were evaluated using hematoxylin and eosin(HE) staining and electron microscope. Results The level of AST/ALT in serum was decreased after treatment with Huanglian jiedu decoction and Jiawei huanglian jiedu decoction. Moreover, the level of TLC and FRC was significantly increased, and the level of SP-A, W/D was significantly decreased. In addition, the level of CK-MB, IL-6, HMGB-1 and MCP-1 in serum was decreased. Inflammation fac-tors were positively correlated with lung function, and the cardiac function was positively correlated with the organ function, the differences were statistically significant. In addition, the histological alterations of myocardium,lung and intestine were attenuated after treatment with Huanglian jiedu decoction and Jiawei huanglian jiedu decoction. Conclusion Huanglian jiedu decoction and Jiawei huanglian jiedu decoction can inhibit the inflammatory infiltration of septic rats and improve organ function.     

史载祥教授升陷祛瘀汤加减治疗高血压病气陷血瘀证经验

正现代医学治疗高血压病取得了较好疗效,但因患者的依从性和其不良反应等限制了临床用药。中医药注重整体调节,通过对机体气血、脏腑、阴阳,多层面多靶点发挥作用,使机体恢复"自稳态"而达到治疗目的[1]。1中西医对高血压病机制的认识西医阐述高血压病的机制,主要从应激与交感神经活性亢进与肾素—血管紧张素—醛固酮系统(reninangiotensin-aldosterone system,RAAS)考虑,认为高