心室晚电位检测中消除振铃方法的研究

ＦＧＩＲ作者着重研究了心室晚电位（简称ＶＬＰ）检测中，进行带通滤波时，振铃现象对晚电位检测的影响及消除。我们采用双向滤波、最小相移滤波及ＦＩＲ滤波等方法探讨了振铃对ＶＬＰ的影响，比较了各种方法对振铃的抑制作用。为了考察各种方法对ＶＬＰ检出能力，作者采用了在相干平均后的心电波形上桑加与真实情况一致的仿真ＶＬＰ形的方法，比较了上述方法对ＶＬＰ的检出作用，并在证实了传统双向滤波对振铃作用的基础上，从理论     

经食管电生理检查中的裂隙现象

在165例食管电生理检查中发现39例患者存在心脏传导系统多部位的裂隙现象共46例次(占24%),其中7例同时发生在2个部位.根据发生部位的不同试将其分成6型,探讨其发生部位及产生机理.     

槐花对家兔体外心房肌的作用

目的 :观察槐花对家兔体外心房肌生理特性的影响 ,并探讨其作用机制。方法 :运用体外心脏实验法 ,摘取家兔心房肌 ,观察测定给药前后体外心房肌的收缩力、心率、功能性不应期、静息后加强及正性阶梯效应的变化。结果 :槐花煎液能显著降低心肌收缩力、减慢心率 ,阿托品可抑制槐花的负性心率作用 ,但不能抑制其负性肌力作用 ;槐花煎液可显著减弱家兔体外左心房肌的正性阶梯作用 ,并显著延长功能性不应期 ,但不影响静息后加强效应。结论 :槐花对心肌具有负性肌力和负性频率作用 ,其作用机制与其抑制胞外 Ca2 +跨膜内流有关。     

丹红注射液对冠状动脉慢血流现象的疗效观察

目的:观察丹红注射液治疗冠状动脉慢血流现象(CSFP)的临床疗效,探讨丹红注射液改善冠脉微循环障碍的可能机制。方法:64例冠脉造影有CSFP及运动负荷试验阳性患者,随机分为观察组(n=32)和对照组(n=32)进行治疗,对照组给予常规药物,观察组在对照组治疗基础上加用丹红注射液。治疗10天后,观察两组临床疗效及血清内皮素-1(ET-1)、血栓调节蛋白(TM)及超敏C-反应蛋白(hs-CRP)水平变化。结果:治疗前,两组各项观察指标差异无统计学意义(P0.05)。治疗10天后,观察组心绞痛缓解总有效率、心电图改善总有效率及运动负荷试验的运动总时间及运动至ST段压低0.1mV的时间均明显高于对照组(90.62%vs 68.75%、84.37%vs 59.37%、441.06±50.61svs 405.03±49.25s、304.53±43.24svs 260.53±49.02s)(P0.01);两组患者治疗后的血清ET-1、TM、hs-CRP水平均较同组治疗前显著降低(P0.01),观察组各项指标较对照组下降更明显(P0.01)。结论:丹红注射液可通过改善血管内皮功能及减轻炎症反应,有效治疗CSFP。     

Evidence for dissolution rate-limited absorption of COL-3, a matrix metalloproteinase inhibitor,leading to the irregular absorption profile in rats after oral administration

Purpose. This study was undertaken to elucidate the underlying mechanism of the irregular absorption profiles of COL-3, a matrix metalloproteinase inhibitor, with a double- or plateau-peak concentration after a single oral dose administration of COL-3 suspension to rats. Methods. The gastrointestinal absorption profiles of COL-3 in rats were assessed by comparing serum drug concentration curves after the following various modes of drug administration: oral and intraduodenal doses, oral doses of COL-3 in fine and coarse suspensions, intraduodenal dosing to the bile-duct intact and cannulated (BDC) rats, and oral doses with and without food. In addition, the biliary excretion of COL-3 in the BDC rats was examined. Results. Neither variable gastric emptying nor enterohepatic recycling was the source of the irregular gastrointestinal absorption of COL-3 in rats. Reduction in particle size, presence of food and endogenous bile emerged as the determinants of the oral absorption of COL-3 by enhancing the dissolution of the solid drug in the gastrointestinal fluids. Flip-flop of the absorption and elimination rate constants was noted only for COL-3 after intraduodenal administration of the coarse suspension to the BDC rats with the bile flow diverged out of the body. Conclusions. Variability in dissolution rate-limited absorption was the main cause of the irregular absorption of COL-3 after oral administration of its solid dosage form.     

The new TNM classification of lymph node metastasis minimises stage migration problems in gastric cancer patients

The present study aimed at investigating whether in gastric cancer patients stage migration occurs with extension of lymphadenectomy, when node metastases are staged according to the new pN classification (UICC 1997). The investigation involved 921 patients, who underwent R0 gastric resection for gastric cancer between 1988 and 1998 in three different Italian centres: Verona (n=236), Forlì (n=409), Siena (n=276). The relation among lymphadenectomy and pN category was assessed by Kendall's partial rank-order correlation coefficient, controlling for depth of tumour invasion. A direct evaluation of the Will Rogers phenomenon was accomplished in the Verona series, by comparing the number of positive nodes actually observed with the number of positive nodes which would have been retrieved by a less extended lymphadenectomy (D1). The number of positive nodes increased remarkably with the enlargement of lymphadenectomy, especially in pT2 patients (from 2.2+/-3.9 in D1 to 3.9+/-5.0 in D3) and in pT3/pT4 patients (from 5.1+/-5.9 in D1 to 11.3+/-12.6 in D3). Non-parametric statistics highlighted a weak (Kendall's partial T=0.128) but significant (P<0.001) correlation between pN category and extension of lymphadenectomy. In the direct analysis of the Verona series, 22 patients out of 230 (9.6%) migrated to a lower pN tier when ignoring positive nodes retrieved from the second and third level. This percentage increased to 39.1% (90 out of 230) when adopting the TNM 87 classification. In conclusion stage migration is of minor importance in gastric cancer patients, staged according to the new pN classification.     

Reliability of vacuum phenomenon in the sacroiliac joint as a sign of traumatic injury

Objective: To determine whether a vacuum phenomenon in the sacroiliac joint is a reliable sign of pelvic injury in trauma patients. Materials and methods: Prospective data were collected over a 1-year period for 107 patients with pelvic trauma and 104 nontrauma patients. Age ranges were 13–93 years in the trauma group and 19–83 years in the nontrauma group. All the patients had pelvic CT scans. The cases were assessed with regard to gas in the sacroiliac joint, osseous pelvic injuries, and mechanism of injury, and demographic data were analyzed. Injuries were caused by motor vehicle accidents in 67 cases, pedestrians being struck by a motor vehicle in 20, falling from a height in 18, gunshot wound in 1, and crush injury in 1. The indications for CT scan in the nontrauma patients were pain in 33 cases, infection in 31, cancer in 29, transplant in 5, bleeding in 4, and abnormal liver function tests in 2. Results: Gas in the sacroiliac joint was present in 11 out of 107 trauma patients (10%) and 12 out of 104 nontrauma patients (12%). There was no statistical difference in the incidence of the vacuum phenomenon between the two patient populations according to the Χ² test. Degenerative sacroiliac changes were evident in 18 out of 107 trauma patients (17%) and 32 out of 104 nontrauma patients (41%). Conclusion: Gas in the sacroiliac joint is not a reliable indicator of sacroiliac joint injury. Electronic Publication     

Cardiac surgery in a child with sacral and intrasacral haemangioma

A 23-month-old female with giant sacral (S1-S5) and intrasacral (L4-S5) haemangioma, lipomyeloschisis and a tethered cord presented for correction of a sinus venosus atrial septal defect. Angiography revealed a large perisacral hypervascular mass with large veins and an intraspinal extension. The patient had a neurogenic bladder and left extremity weakness due to spinal cord compression. The potential for additional neurological injury secondary to bleeding, venous congestion, ischaemia and steal phenomenon during cardiopulmonary bypass is discussed.     

腰椎小关节真空现象的CT诊断意义

提出腰椎小关节真空现象在ＣＴ诊断意义中的一种新观点。材料与方法：分析９例腰椎小关节真空现象的ＣＴ片及腰椎侧位片的表现。结果；其中７例均有相关椎体的前滑脱。结论；腰椎小关节真空现象不仅仅是关节软骨退行性变的表现，更是腰椎滑脱的征象。     

A Case of Superficial Spreading Melanoma In situ 2.5 mm in Diameter

A 60-year-old woman with superficial spreading melanoma in situ, measuring 2.5 mm in diameter, was examined. She had noticed a very small pigmented lesion 1.2 mm in diameter on her left lower leg in April of 1989. By April of 1990, it had grown to 2.5 mm in diameter. Its edge was irregular, and its color was variegated black to brown. Skin surface markings had disappeared in the center portion. Histopathologically, the lesion was asymmetrical. Atypical large cells nested in the lower epidermis and were scattered singly in the mid and upper epidermis, as seen in Paget's disease. At the periphery of the lesion, single large tumor cells were scattered in the mid epidermis. The tumor cells reacted to monoclonal anti-melanoma antibody HMB-45.