电动秋千的研制及其在前庭功能研究中的应用

本文介绍了带转椅的电动秋千的研制及其使用,包括其工作原理、结构与控制系统的设计、主要技术性能及其在前庭功能与空间运动病研究中的应用。多年的实验证明,这台电动秋千设计合理,技术指标先进,使用性能良好,是研究前庭功能和空间运动病的实用设备。     

A neuromuscular monitoring system based on a personal computer

We have developed a computerized neuromuscular monitoring system (NMMS) using commercially available subsystems, i.e., computer equipment, clinical nerve stimulator, force transducer, and strip-chart recorder. This NMMS was developed for acquisition and analysis of data for research and teaching purposes. Computer analysis of the muscle response to stimulation allows graphic and numeric presentation of the twitch response and calculated ratios. Since the system can store and recall data, research data can be accessed for analysis and graphic presentation. An IBM PC/AT computer is used as the central controller and data processor. The computer controls timing of the nerve stimulator output, initiates data acquisition, and adjusts the paper speed of the strip chart recorder. The data processing functions include establishing control response values (when no neuromuscular blockade is present), displaying force versus time and calculated data graphically and numerically, and storing these data for further analysis. The general purpose nature of the computer and strip chart recording equipment allow modification of the system primarily by changes in software. For example, new patterns of nerve stimulation, such as the posttetanic count, can be programmed into the computer system along with appropriate data display and analysis routines. The NMMS has functioned well in the operating room environment. We have had no episodes of electrocautery interference with the computer functions. The automated features have enhanced the utility of the NMMS. The prime advantages of this system are (1) the ability to customize its features by altering its controlling programs, (2) the ready availability of the hardware and software, (3) the general purpose nature of the system, so that it is not limited to this one application, and (4) the adaptable nature of the system.     

52例肺癌患者放疗前肺功能和放疗疗效关系分析

为了探讨放疗前肺功能与放疗疗效的关系，作者于１９８７年１月至１９９０年１２月对５２例无急、慢性呼吸衰竭的肺癌患者在放疗前做了肺功能检测和血气分析，结果表明，放疗前肺功能不能反映肿瘤乏氧程度，也不能作为肿瘤对放疗敏感性的指标，只有直接测量肿瘤原发灶内的乏氧程度才能了解肿瘤对放疗的敏感性，预测放疗的疗效。     

Predictors of Repeat Emergency Department Visits by Elders

Objective: To determine which characteristics of older patients who use a hospital ED are associated with repeat visits during the 90 days following the index visit.
Methods: The study was conducted in the ED of a 400-bed university-affiliated acute care community hospital in Montreal. Patients aged ≥75 years who visited the ED between 08:00 and and 16:00 on a convenience sample of days over an 8-week period (July and August 1994) were assessed using a questionnaire, physical and cognitive status instruments, and a functional problem checklist. The hospital's administrative database was used to identify repeat visits during the 90 days following the ED visit. The representativeness of the sample was assessed by analyses of ED visits made by 4,466 persons aged ≥65 years during a 12-month period (September 1993 to August 1994) using the hospital's administrative database.
Results: 256 patients aged ≥75 years visited the ED during the study period and 167 were assessed. Of these, 54 (32%) were admitted to the hospital. Among the 113 patients released from the ED, 27 (24%) made repeat visits during the next 90 days. In univariate analyses, repeat visits were significantly associated with the number of functional problems, cognitive impairment, and previous ED visits. In multiple logistic regression, male gender, living alone, and number of functional problems were independent predictors of repeat visits. In the administrative data analyses, nighttime arrival to the ED for the index visit was significantly associated with repeat visits.
Conclusions: Self-reported risk factors can help to identify a group of elders likely to make repeated ED visits; the development of a screening instrument incorporating questions on these problems and implementation of appropriate interventions might improve these patients' quality of life and reduce the demand for further ED care in this age group.     

神经衰弱患者免疫功能变化初探

目的观察神经衰弱患者细胞免疫和体液免疫指标的变化。方法以３８例神经衰弱患者为试验组，另设相应年龄段的健康人为对照组，以致敏羊红细胞花环试验直接法、死活菌鉴别染色法、琼脂单扩散法、聚乙二醇浊度法，分别验测了Ｔ细胞亚群、中性粒细胞功能试验、血清ＩｇＧ、ＩｇＡ、ＩｇＭ、Ｃ３、Ｃ４含量及ＣＩＣ测定。两组样品均数采用ｔ检验分析。结果神经衰弱患者外周血ＣＤ＋３％、中性粒细胞吞噬率均显著低于对照组（Ｐ＜０．００１），血清ＩｇＡ水平低于对照组（Ｐ＜０．００１），血清Ｃ４水平显著升高（Ｐ＜０．０５）。结论本病确实存在免疫功能紊乱的现象。     

冠心病患者体外反搏后心功能改变

应用体外反搏治疗33例冠心病患者,治疗前后进行心功能检查比较,结果是肺水指数下降4.19％(P<0.05),心室射血时间增加7.74％(P<0.05),射血流速指数增加5.39％(P>0.05),系统血管阻抗降低16.97％(P<0.001),心排量增加10％(P<0.01),心搏量增加13.32％(P<0.01),心率减慢6.66％(P<0.05),心搏指数增加13.23％(P<0.05),心脏指数增加10.63％(P<0.01),说明心功能检查有较好改善。     

Pathophysiological aspects of predominant preload lowering on pulmonary circulation, gas exchange, and the biventricular function in patients with chronic obstructive lung disease

A group of 21 patients with various degrees of chronic obstructive pulmonary disease underwent radionuclide ventriculography with hemodynamic monitoring to assess the extent to which pulmonary artery pressures and pulmonary vascular resistance can be lowered by the vasodilator molsidomine. Molsidomine (N-carboxy-3-morpholino-sydnonimin-ethylester) is similar to nitroglycerin in its mode of action. After hemodynamic and radionuclide data acquisition, at rest and during submaximal exercise in the steady state, 2 mg molsidomine was injected intravenously. Rest and exercise measurements were repeated 45 min after molsidomine injection. In patients with mild to moderate disease (group 1), pulmonary artery resting pressures decreased by 12% (p less than 0.05) at rest by 22% (p less than 0.01) during exercise after the administration of the drug. Total pulmonary resistance during exercise decreased significantly (p less than 0.01) as a result of marked decrease of pulmonary artery pressure (PAP) compared with a minimal decrease in cardiac index (CI). In patients with severe disease (group 2), only the resting values of PAP decreased while the relationship between pressure and flow was unchanged. During the exercise period, the preload parameters of the right and left ventricles decreased by an average of 30%. With regard to gas exchange, only the arterial PO2 at rest decreased slightly but significantly (p less than 0.05) after molsidomine, while the coefficient of oxygen delivery was not affected by the drug. However, in four patients arterial PO2 was markedly reduced by the drug. Right ventricular ejection fraction increased significantly (p less than 0.01) both at rest and during exercise in group 1 and during exercise in group 2 after administration of molsidomine.(ABSTRACT TRUNCATED AT 250 WORDS)     

Evaluation of left ventricular contractile performance from baseline stress-shortening data in humans: comparison with pharmacological afterload challenge

The purpose of this study was to evaluate whether the baseline stress-shortening data reflect the contractile state adequately and give results comparable to the evaluation of the end-systolic stress-shortening relationships using pharmacological manipulation of afterload. Five groups were studied (total 152 patients): a control group of 30 healthy volunteers, 32 patients after surgical correction of infantile tetralogy of Fallot, 50 patients treated for childhood malignancies with doxorubicin, 17 patients with left ventricular hypertrophy due to systemic hypertension, and 23 patients with congestive cardiomyopathy. In all patients except those with congestive cardiomyopathy, afterload was altered pharmacologically to evaluate the individual stress-shortening relationship. In all patients the baseline stress-shortening data were evaluated, as well as their relative positions to two predefined normal ranges for the relationship between end-systolic stress and shortening. Additionally, a slope value was calculated from the baseline data of the five groups studied and compared with the data obtained by pharmacological afterload increment. Our data show that the comparison of individual baseline data of end-systolic wall stress and fractional shortening with predefined normal ranges for the relationship between end-systolic stress and shortening is inadequate. The appropriate normal range to compare with is the 95% confidence interval of baseline stress-shortening data in normal subjects. Also the calculation of a slope value from the baseline stress-shortening data of a group of patients seems to be inappropriate. Such a slope value does not necessarily reflect the contractile state, as the specific conditions leading to variations of end-systolic wall stress are undefined and not standardized, and the correlation between baseline stress-shortening data depends largely on the influence of the end-systolic dimension on both parameters.     

色甘酸钠混悬气雾剂与茶碱缓释胶囊治疗中度哮喘的比较

８４例中度哮喘病人分成２组。色甘酸钠组（男性２３例，女性２０例，年龄２６±ｓ８ａ）吸入色甘酸钠混悬气雾剂１０．５ｍｇ，ｔｉｄ。茶碱缓释胶囊组（男性２２例，女性１９例，年龄２７±８ａ）口服０．２５ｇ。ｂｉｄ。２组均连续观察３ｍｏ。结果：色甘酸钠在减轻病人慢性症状、改善肺功能和降低气道高反应性等方面优于茶碱缓释胶囊，（Ｐ＜０．０１）。而后药仅可缓解近期症状。     

腹式全子宫切除术不同术式对排便功能影响的探讨

目的:探讨筋膜内和筋膜外全子宫切除术对女性排便功能的影响。方法:76例全子宫切除患者分为筋膜外全切除组(A组)56例,筋膜内全子宫切除组(B组)20例,对两组术后病人的排便次数,难易程度的变化进行分析。结果:76例全子宫切除病人42.1％出现不同程度排便困难,A组52.62%,B组为10%,两组具有显著性差异(P<0.05)。结论:全子宫切除术后可影响女性排便功能,筋膜内全子宫切除术对排便功能影响小,是一种较好手术方式。