Time-frequency analysis of heart murmurs. Part II: Optimisation of time-frequency representations and performance evaluation

The basic parameters of the spectrogram, the Choi-Williams, and the Bessel distributions are adjusted to provide the best time-frequency representations (TFRs) of the simulated murmur signals of mitral stenosis, mitral regurgitation, aortic stenosis, aortic regurgitation, and of two musical murmurs. The initial adjustment of the parameters of each TFR technique is performed by computing and minimising the relative averaged absolute error between the frequency contours at −3dB and −10dB of each TFR of the simulated murmurs and those of the theoretical distribution of the same signals. The results show that the spectrogram generally provides very good to excellent performance in representing the TFRs of stenotic and regurgitant murmurs. Improvements provided by the Choi-Williams and the Bessel distributions are minor but not systematic for the two signal-to-noise ratios tested (0 and 30 dB) and for the two frequency contours estimated. The Bessel and the Choi-Williams distributions provide the best performance for the musical murmurs. The study shows that although a single technique cannot be optimal for all six murmurs, the spectrogram using a Hamming window of 30 ms is an acceptable compromise to detect the six simutated heart murmurs.     

恶性梗阻性黄疸的外科姑息治疗

不能切除肿瘤的恶性梗阻性黄疸的外科姑息治疗方法繁多，本文介绍自1989年以来，采取开腹经不同途径的带支撑导管胆肠内引流的方法治疗30例，减黄确切，尚对7例高位胆管癌在解除胆道梗阻的基础上行术后(192)Ir和(60)Co联合放疗，提高了病人生存质量及延长了生命。     

采用一式三份数码对号入座法管理病案号

采用"对号入座法"管理病案号,先把姓名索引卡、病案封面、病案号索引簿预先印上号码.待病人入院,取出相应一式三份号码,做好各种索引.结果,派出的病案号被取出,乘下空白的是未使用.如果旧病友再次入院;就要在病案的姓名索引中或电脑中查找旧号,这样有效地控制重号、漏号.     

隆突性皮纤维肉瘤23例临床分析

本文报告了我科1978～1990年间收治的降突性皮纤维肉瘤23例,均经组织学证实.治疗以手术切除为主,术后局部复发率为65.2%.无一例发生转移.切除不彻底是复发的主要原因.作者指出广泛切除是防止复发的主要措施,手术前后的放疗有可能减少复发.     

中国中原地区33555名妇女妇科疾病发生情况与五种因素关系的调查报告

自１９９２年３月至１９９４年５月，对中原地区４个省２０多个县（市）近２００个单位３３５５５名２０～７５岁的已婚妇女，进行妇科疾病发生情况与年龄、职业、文化、月经、孕产等五种因素关系的调查分析。在３３５５５名妇女中，患病者２２３７０人，总患病率为６６．６７％，查出妇科疾病４２种，计７６９７４例次。结果证明：以２５～３５岁年龄组发病率最高，其中以内生殖器炎症为主；职业以经商者发病率高，特别是性病患者高于其他职业者二倍以上；文化程度以小学、初中者发病率高，尤其宫颈炎更明显；月经情况：随着经前期紧张综合征的加重，更年期综合征发病率增高；孕产次数越多，患病率越高。本次调查未发现宫颈癌，进一步证明我国对妇女保健工作的关心和重视。     

Antithrombotic effect of beta,beta''-monochloromethylene diadenosine 5'',5"''-P1,P4-tetraphosphate.

The feasibility of using beta,beta'-monochloromethylene diadenosine 5',5"'-P1,P4-tetraphosphate (AppCHCl-ppA) as an antithrombotic agent was studied in a rabbit intracarotid cannula thrombosis model previously shown to be sensitive to antiplatelet agents. This analogue, having a P-C-P bridge in place of a P-O-P internucleoside linkage, has been found resistant to phosphodiesterase activity. Rabbits were infused with the dinucleotide at a dose of 50 mg per kg over a 2-hr period, at a controlled rate by pump. A 1-cm length of polyethylene cannula (1 mm i.d.) was tied into the carotid artery. Animals were stable under general anesthesia during the entire period of the experiment. In the control group, 16 of 20 animals formed clots, an incidence of 80%, whereas in the test animals, 6 of the 20 formed clots (30% incidence, P < 0.05). After preincubation of whole blood with 50 microM AppCHClppA at 37 degrees C for up to 3 hr, a consistent suppression of ADP-induced platelet aggregation was observed. The present study suggests that AppCHClppA may be useful as an antithrombotic agent in certain clinical situations, such as hemodialysis, arteriovenous shunts, and introduction of artificial heart valves. It may also possibly prevent extension of recent clots. The toxicity and metabolism of AppCHClppA have, however, yet to be explored.     

Transforming growth factor J3 type II receptor (TGFpRII) mutation in gastric lymphoma without mutator phenotype

A new mutation in the serine-threonine klnase domain of the transforming growth factor β type II receptor (TGFpRII) was found in a case of diffuse, B cell non-Hodgkin's lymphoma of the stomach. A mfssense mutation (ACA to GCA, Thr to Ala) was detected In exon 5, and a wild type allele was also present. This Is the first naturally occurring mutation in the klnase domain of this gene identified in human primary lymphoma. The replication error at three loci was negative, and the poly A tract of exon 3, which is frequently a target of mismatch repair genes, was intact. Malignant lymphoma of B cell origin in the stomach Is an addition to an expanding catalogue of tumors with TGFβRII alterations, and the biological sequelae of the change in the functional domain and the clinical characteristics of the patient in this study are intriguing.     

API2-MALT1融合基因变异体在粘膜相关淋巴组织结外边缘区B细胞淋巴瘤中的分布及凋亡的关系

目的探讨API2-MALT1融合基因变异体在粘膜相关淋巴组织结外边缘区B细胞淋巴瘤(extranodal marginal zone B—cell lymphoma of mucosa—associated lymphoid tissue，MALT)中的分布特点及其转录与肿瘤凋亡的关系。方法将逆转录-聚合酶链反应和巢式聚合酶链式反应结合，检测62例不同部位MALT淋巴瘤中API2-MALT1融合基因的多种变异体；通过TdT介导脱氧核苷酸缺口末端标记技术进行肿瘤细胞的原位凋亡检测；通过逆转录-聚合酶链反应和免疫组化染色检测API2的mRNA和蛋白水平。结果62例MALT淋巴瘤中28例检出API2-MALT1融合基因(45．16％)，为变异体A1446-M1123或A1446-M814，但未检出A1446-M541和A1446-M1150。A1446-M1123(18／28)的检出明显多于A1446-M814(10／28)。融和基因转录在甲状腺MALT淋巴瘤中检出最低，在其它部位的分布无差异。在API2-MALT1^ 组(API2-MALT1mRNA表达阳性组)肿瘤凋亡水平明显高于API2-MALT1^-组(API2-MALT1mRNA表达阴性组)，API2的mRNA和蛋白水平低于阴性组。A1446-M1123^ 与A1446-M814^ 病例之间凋亡和API2的变化无差异。结论MALT淋巴瘤中t(11；18)(q21；q21)的发生有部位差异，A1446-M1123可能是中国人MALT淋巴瘤中API2-MALT1融合基因变异体的主要类型。API2-MALT1融合基因转录与MALT淋巴瘤的凋亡水平和API2的变化有关。