隐性失血对双侧人工全膝关节同期置换手术的影响

[目的]研究双侧人工全膝关节同期置换术术后隐性失血的相关因素。[方法]对2005年2月～2007年2月44例双侧人工全膝关节同期置换术患者进行回顾性分析，通过Gross方程，根据身高、体重及手术前后的红细胞压积推算术后平均显性失血量及平均隐性失血量。[结果]平均总失血量2065ml，其中显性失血量1198ml，隐性失血量867ml，使用自体血回输患者总失血量为2180ml，隐性失血量为937ml（42％）；未使用自体血回输患者的总失血量是1950ml，隐性失血量是799ml（41％）；两组的隐性失血相比差异无统计学意义。[结论]双侧人工全膝关节同期置换术术后隐性失血量占总失血量的比例较高，且使用自体血回输不能完全满足机体恢复体循环的需要，在围手术期要特别注意及时补充血容量。     

The effect of seamustard on blood lipid profiles and glucose level of rats fed diet with different energy composition

Recently, Korean people are consuming seaweeds almost 3.5 times more now than three decades ago. It is well known that seaweeds contain lots of soluble dietary fiber in addition to micronutrients such as β-carotene, iodine and some bioactive components. Seaweeds are considered to be effective for preventing chronic diseases including obesity, diabetes mellitus, atherosclerosis, cancer or constipation. This study was conducted to investigate the effect of seamustard intake on body weight gain, blood glucose level and lipid profiles in rats fed diets with different energy nutrient composition. Male Sprague-Dawley rats (average initial weight 103.7 g) were divided into groups for two experiments as follows; Control, M2.5 & M5 groups (Exp. I) and M5, M10, HCM5, HCM10, HFM5 & HFM10 groups (Exp. II). The rats were fed diet and water ad libitum for 4 weeks. In general, there was no significant difference in blood glucose and triglyceride concentration among groups. In Exp. I, serum LDL-cholesterol level of rats fed diet with 5% seamustard powder (M5) was significantly lower than that of control group, while HDL-cholesterol level, TC/LDL ratio and weight of adrenal gland were higher. In Exp. II, food intake, body weight gain and EER of high fat diet with 10% seamustard group (HFM10) were the lowest among groups. Except gastrocnemius muscle, all organ weights of HFM10 group were the lowest. Fecal cholesterol excretion and serum LDL-cholesterol concentration of HFM10 group were the highest, while serum HDL-cholesterol level was the lowest among groups. Interestingly, HDL-cholesterol concentration was the highest in HCM5 group among groups. From these results, it was suggested that seamustard intake might be more effective for body weight control, but not for improving blood lipid profiles in high fat diet than in high carbohydrate diet.     

脑瘫患儿脑干听觉诱发电位研究

本文采用日本光电公司生产的 MEB-5304K 诱发电位测定仪,对101名6月-14岁脑瘫患儿和40名正常儿测定了脑干听觉诱发电位(BAEP)。结果表明:给予80dBNHL,20Hz 刺激时 BAEP 异常率为45.54%,随刺激强度减小及刺激重复率增加,BAEP 阳性率提高。BAEP 改变与病情、病型及并发症有关。为脑瘫的发病机理及病理生理学研究提供神经电生理学依据。对脑瘫合并听力障碍者有助于及早选用助听装置,解决其听力障碍问题。     

用视诱发电位和富里叶变换作视力客观估计

目的:研究用图形视觉诱发电位(PVEP)和离散富里叶变换(DFT)作视力客观估计的方法。方法:检测对象为33只正常眼。用翻转频率为10次/秒,条纹张角分别为30、20、18、12、10、6、4和2弧分的垂直方波光栅图形刺激,记录相应的稳态图形视诱发电位。用离散富里叶交换提取WEP频谱中10Hz成分的幅值。以光栅条纹张角为横坐标、相应的VEP频谱幅值为纵坐标作关系曲线,取阈值附近的近似线性部分的数据点作直线回归,用外推法求得阈值和视力。结果:比较VEP所测之视力与用国际标准视力表所测之视力,可见在本研究中70％的受检眼VEP视力估计较准确。结论:用本研究中的VEP技术客观地测量视力可靠性较高。眼科学报1997;13:59～61。     

Prevention of early postmenopausal bone loss using low doses of conjugated estrogens and the non-hormonal,bone-active drug ipriflavone

Hormone replacement therapy is the optimal therapeutic choice for postmenopausal syndrome. While low doses of estrogens (0.3 mg/day of conjugated estrogens) can counteract neurovegetative menopausal symptoms, higher doses (0.625 mg/day of conjugated estrogens) are required to prevent bone loss in postmenopausal women. Experimental and clinical studies have shown that ipriflavone, a non-hormonal isoflavone derivative, is effective in the prevention and treatment of postmenopausal osteoporosis. The aim of the present investigation was to evaluate the efficacy and toler-ability of ipriflavone and very low doses of equine conjugated estrogens on bone loss in early postmenopausal women. Eighty-three healthy postmenopausal women (50.3±0.7 years) were enrolled for this 1-year multicenter study. All subjects were randomly allocated to receive: double placebo (n=24; group A), placebo plus conjugated equine estrogens 0.30 mg/day (n=31; group B) or conjugated equine estrogens 0.30 mg/day plus oral ipriflavone 200 mg tris in die at meals (n=28; group C), according to a double-masked design. Among women who completed the treatment period (valid completers), those of group A showed a progressive decrease in forearm bone density (FBD; measured by dual photon absorptiometry) that reached 1.7% after 12 months. The women in group B maintained their FBD in the first 6 months of treatment but, at the end of the study, showed a bone loss of 1.4% compared with basal values. By contrast, women in group C showed a significant increase in FBD after 1 year of treatment (+5.6%;p<0.01). Bothvalid completers andintention to treat analyses revealed a significant difference (p<0.05) between group A and group C over the study period. None of the treatments produced significant changes of biochemical markers of bone turnover, while hot flushes and other climacteric symptoms were significantly reduced after the sixth month of treatment in women receiving estrogens. Adverse events were generally mild, and did not differ among the groups. The results of this study suggest that low doses of estrogens combined with ipriflavone could represent a new therapeutic approach to the treatment of the postmenopausal syndrome.     

Giving up driving in Alzheimer's disease—an integrative therapeutic approach

For patients with Alzheimer's disease (AD), a recommendation to stop operating a motor vehicle can be a serious event complicated by a loss of self-esteem and personal dignity. Patients are often reluctant to give up an activity so essential, both practically and symbolically, to independent living. We describe here a patient with moderately progressed AD who lacked insight of his need to cease driving. Through an integrative treatment approach, combining behavioral and psychodynamic modalities, we helped him to formulate effective ways of coping with his loss of access to independent transportation. We favor a psychotherapeutic strategy that combines behavioral and managerial measures with dynamic patient interaction, thereby developing the patient's insight of the need to give up driving while fostering his sense of autonomy.     

正常闪光视网膜电图的频域分析

应用快速傅里叶转换技术对正常视网膜电图进行频域分析，发现其ａ、ｂ波的优势频及能量集中在５－７５Ｈｚ；与ＯＰＳ波的分离点为７７ＨＺ，从而提出单纯记录ａ、ｂ波及ＯＰＳ波各自的较理想的通频带。     

Perioperative specific management of blood volume loss in craniosynostosis surgery

Accurate assessment and replacement of blood loss and fluid–electrolyte deficit during craniosynostosis repair is difficult owing to patient size and the diversity of surgical technique. Forty-three patients undergoing primary craniosynostosis repair over a 10-year period were studied retrospectively to determine blood loss and fluid deficit and to assess blood transfusion practices during both intraoperative and postoperative periods. Blood loss was calculated on the basis of estimated red cell mass (ERCM) and fluid-electrolyte imbalance was investigated with blood samplings. Blood transfusion was considered appropriate if the postoperative or posttransfusion ERCM was within 12% of the preoperative value. Estimated fluid requirement (EFR) was used in 4 ml kg^–1 h^–1 except for neonates. Intraoperatively, 80% of all patients were appropriately managed with respect to blood transfusion and EFR. Postoperatively only 20% of the patients receiving transfusions were transfused appropriately. In 23.3% of these patients (10/43) unexpected respiratory distress developed immediately after their recovery from the anesthesia. With the measurement of estimated blood volume and allowable blood loss, appropriate transfusion could be achieved for the successful treatment of the primary craniosynostosis. Received: 16 February 1998     

Pyramidal cells in primary auditory cortex project to cochlear nucleus in rat

Recent work has demonstrated that the auditory cortex in rat sends direct projections to the auditory nuclei of the brainstem, including the cochlear nucleus and superior olive. To determine the cortical origin of the projections to cochlear nucleus, Fast Blue, a retrograde fluorescent tracer, was injected into the cochlear nucleus. Labeled cells in the forebrain were then studied with light microscopy and mapped. The projection was found to originate from large pyramidal neurons in layer V of primary auditory cortex. The projection was predominantly ipsilateral, and no labeled neurons were found in other cortical areas. These data imply that primary auditory cortex exerts influence over ascending auditory information at the earliest stages of the central auditory system.     

炮震性听力损害与焦虑情绪的关系分析

目的探讨炮震性听力损害程度与焦虑情绪的关系.方法对100名新兵炮手实弹训练前后听力检查及心理问卷调查进行分析.结果有14名听力损害;18名有焦虑情绪阳性.结论炮震性听力损害者具有焦虑情绪明显高于无听力损害者.