AlEtCl2／t—BuCl引发α—蒎烯阳离子阳合的反应研究

在实验室绝热反应器中进行了乙苯脱氢制苯乙烯的反应动力学研究。根据不同反应机理，提出五种反应模型，经残差分析及模拟计算规律与实验规律的比较，确定Ｃａｒｒａ双曲模型为最佳反应动力学模型。通过对实验数据的回归拟合，经参数估计求得了速率方程的频率因子和活化能。     

Clinical response to local delivery of tetracycline in relation to overall and local periodontal conditions

Abstract The purpose of this study was to determine the clinical response to local delivery of tetracycline in relation to clinical and microbiological conditions of the other teeth. 4 deep pockets were monitored in 19 subjects with multiple deep periodontal lesions and high counts of P. gingivalis. In 9 patients (XT) only 2 of the selected lesions were treated by placement of tetracycline fibers (Actisite®). while the rest of the dentition was left untreated. In the other 10 patients, all teeth were supragingivally scaled and then treated by application of polymeric tetracycline HCl containing fibers, the whole dentition was subject to full mouth scaling and root planing, and the patients rinsed with 0.2% chlorhexidine (FT). A significant reduction in mean PPD was observed in all treated sites after two months. This reduction was maintained over the following 4 months. The magnitude of the effect was significantly greater in the FT group (1.74 mm) than in the LT group (0.88 mm). The mean attachment level changes were similar after 2 months in locally and fully treated subjects. A tendency of relapse was noted for treated sites in LT patients from month 2 to 6. A level of statistical significance was not reached for this effect. Data from measurements recorded at 6 sites around all teeth in the full mouth treated patients were analyzed using multiple linear regression. This analysis showed local changes in PPD and AL were significantly and strongly correlated with the baseline value of the respective parameter at the same site. In addition, more pocket depth reduction was noted if a site was not bleeding on probing at 6 months, if the location of a site was not approximal and if the tooth was not a second molar. Sites located on second molars showed also less AL gain than sites located on other teeth. Smokers showed significantly less reduction in PPD and significantly less AL gain. Furthermore, if subjects had a high % of pockets deeper than 4 mm at baseline they showed significantly less attachment gain.     

Blood gas and ventilatory parameters in predicting survival in congenital diaphragmatic hernia

Blood gas analysis can be used to reliably predict outcome in infants with congenital diaphragmatic hernia (CDH) both before and after surgical repair, providing these values are indexed to some measurement of alveolar ventilation. Until recently there has been difficulty in interpreting some of the published data because of differing sampling sites and the fact that ventilatory parameters, which have major influences on all blood gas values in this anomaly, were not included. Application of this information enables us to identify infants with similar degrees of severity of CDH in order to evaluate the efficacy of novel forms of therapy and to determine whether they represent a genuine advance in management where more conventional forms of treatment have failed.     

The Evaluation of Routine Andrological Parameters in Human Semen/Auswertung der Routine-Parameter der Andrologie am Sperma

A study was carried out to evaluate the andrological parameters in 540 human semen specimens divided into groups according to sperm counts. The parameters were: motility percentage and grade, percentage of viability and of morphologically normal sperm and immature cells. The Duncan multiple range test and the Kruskal-Wallis test with multiple comparison of ranks were used in the statistical analyses. Of particular interest, among other our findings, were the significant differences obtained by comparing the group with sperm counts up to 5 x 10(6) per ml semen and that with counts ranging from 5.1 to 10 x 10(6) per ml semen. This was true for all parameters with the exception of semen volume. Comparison of the oligozoospermic groups (up to 20 x 10(6)/ml) with those having higher sperm counts also showed significant differences. There was a trend towards improvement of the examined parameters with the increase in sperm density, but with a remarkable heterogeneity particularly within the oligozoospermic groups. In all groups motility, viability and morphological normality of sperm showed a positive correlation with each other. "Normal values" of the parameters studied could be derived from scatterplot charts over the entire range of sperm counts and from the statistical evaluation of the grouped material.     

11项心功能指标的计算方法及微机处理

本文用OMEGA 500型Υ相机和MCS 560计算系统,即SPECT,R波门控采集心血池图象,在此基础上进行曲线分析,编制BASIC程序计算11项心功能指标。临床应用结果表明:PFR、LVFF、FFR是舒张期功能的优选指标,其它指标对心功能评价也都有显著意义。     

病房康复延伸护理对脑卒中迟缓性偏瘫患者三维步态时空参数的影响

目的:观察病房康复延伸护理对脑卒中迟缓性偏瘫患者三维步态时空参数的影响。方法:将60例脑卒中迟缓性偏瘫患者随机分为常规护理组(A组,n=30)、病房康复延伸护理组(B组,n=30)两组,予以相应的方法治疗8周,评估治疗前后两组患者三维步态时空参数。结果:与治疗前相比,治疗后两组患者的步长、步幅、步速、步频、支撑相、双支撑相等参数及B组摆动相均有不同程度的改善(P<0.05); A组摆动相和步宽及B组步宽的变化差异无统计学意义(P>0.05)。与治疗后A组比较,治疗后B组的步长、步幅、步速、步频、支撑相、双支撑相等参数改善较为明显(P<0.05),步宽和摆动相的改善差异无统计学意义(P>0.05)。结论:病房康复延伸护理能改善脑卒中迟缓性偏瘫患者三维步态时空参数,具有临床意义。     

方剑乔教授针药结合治疗类风湿性关节炎的临床思辨特色与治疗经验

[目的] 介绍方剑乔教授针药结合治疗类风湿性关节炎的临床思辨特色及其临证经验。[方法] 通过整理、回顾、分析方教授治疗类风湿性关节炎的相关文献及医案,从中医病因病机和治则治法等方面,总结归纳方教授治疗类风湿性关节炎的学术经验,并列举医案一则予以佐证。[结果] 临床思辨上,方教授认为“痰、瘀、虚交错”为该病的基本病机,治疗宜针药结合,主要起到同效相须、异效互补和反效制约的作用。临证治疗上,方教授强调,针刺宜整体治疗与局部穴位兼顾,须重视经络辨证。合理应用电针,疼痛急性发作期电针频率多选择“先高后低”,先100 Hz/10～15 min,后2 Hz/30 min;慢性疼痛期电针治疗多选择疏密波(2/100 Hz)。用药强调精准辨证,在该病四种基本证型的基础上提出了阴虚湿热兼证的概念,确立了滋阴清热、通络止痛的治疗大法。倡导适时采用经皮穴位电刺激治疗,其操作简单,携带方便,在镇痛方面具有明显的优势。所举病案采用西药甲氨蝶呤片抑制免疫,稳定病情;中药以祛风除湿为主,佐以藤类药通络行窜、祛风止痛;电针治疗选择频率为2/100 Hz的疏密波调和气血、通络止痛。经治疗后,患者症状缓解,相关指标趋于正常。[结论] 方剑乔教授根据本病的病因病机及临床特点进行辨证论治,针药并重,中西医取长补短,临床特色鲜明,治疗效果显著,值得临床借鉴和推广。     

Takayasu arteritis: Follow-up studies for 20 years

We reviewed retrospectively 126 (5 male, 121 female) patients suffering from Takayasu arteritis who had been treated in our clinics from 1971 to 1990. The patients' ages ranged from 19 to 80yrs old (1990) with a mean age of 48.7 ± 11.8 years. HLA typing analysis in 98 patients revealed that 45 patients (47%) were confirmed as carrying the Bw52 antigen, a high result that is statistically significant as compared with that in healthy Japanese. Arteriograms (performed in 75 patients) revealed that 28 patients (37%) were affected in the aorta and its main branches by this disease (type IV by Nasu's classification) and 23 patients (31%) were affected only in the main branches (type I). The C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) improved significantly from 2.55 ± 0.28(+) and 57.0 ± 5.69 mm/hr to 0.53 ± 0.12(+) and 31.2 ± 3.45 mm/hr, respectively after treatment including steroid and antiplatelet therapy (P < 0.01).=" patients=" with=" bw52=" exhibited=" more=" severe=" inflammatory=" conditions=" than=" those=" without=" bw52.=" lung=" scintillations=" performed=" in=" 81=" patients=" showed=" pulmonary=" arterial=" lesions=" in=" 50=" patients=" (62%).=" echocardiograms=" revealed=" aortic=" regurgitation=" (ar)=" in=" 44=" patients=" (35%),=" with=" a=" significant=" difference=" noted=" between=" the=" bw52=" positive=" group=" and=" the=" bw52=" negative=" group=" [29/40=" (73%)=" versus=" 11/47=" (23%),=">P < 0.001].=" patients=" with=" bw52=" were=" prescribed=" higher=" doses=" of=" steroids=">P < 0.05)=" for=" longer=" periods=">P < 0.01)=" than=" those=" without=" bw52.=" of=" 11=" patients=" who=" died=" during=" our=" study=" period,=" 7=" died=" of=" cardiac=" complications,=" all=" of=" whom=" were=" suffering=" from=" ar.=" hla=" analysis=" performed=" in=" 6=" of=" these=" 7=" patients=" revealed=" that=" all=" carried=" the=" bw52=" antigen.=" in=" conclusion,=" the=" retrospective=" survey=" revealed=" that=" patients=" carrying=" the=" bw52=" antigen=" showed=" more=" severe=" inflammatory=" conditions=" and=" progressed=" more=" rapidly=" to=" complications=" and=" the=" fatal=" morbid=" condition,=" as=" compared=" with=" those=" without=" bw52.=" this=" suggests=" the=" important=" role=" of=" gene=" disequilibrium=" with=" this=" hla=">     

New spectral detection and elimination test algorithms of ECG and EOG artefacts in neonatal EEG recordings

New methods for the detection of ECG and EOG artefacts in the EEG are introduced, which can also be used for the evaluation of the quality of the elimination procedure. These algorithms are based on the estimation of the power or coherence spectrum by means of FFT. The advantage of this method is that the EEG spectrum is monitored by the test algorithm. The spectrum will be plotted if no influence of the ECG and EOG can be found. On the other hand, if artefacts are detected the correction of the EEG time series will be carried out and the spectrum of the corrected EEG time series will be plotted after repeated monitoring by the test algorithm.     

The external laryngeal nerve: surgical and anatomic considerations. Report of 50 total thyroidectomies

This surgical anatomy study aimed to evaluate the possibility of identifying the external laryngeal nerve during thyroid surgery and the possible variations of nerves at risk. Fifty patients underwent total thyroidectomies during a period of 12 months. Using a neurostimulator, the distal motor branch of the external laryngeal nerve was searched. Electrical stimulation of a nervous branch aimed to provoke a global contraction of the cricothyroid in order to identify with certitude the external laryngeal nerve. The external laryngeal nerve was identified in 20% of cases. Its course was, with almost equal frequency, either (1) between the vessels of the superior thyroid pedicle or (2) superficial and anterior to the fascia of the cricothyroid muscle. The external laryngeal nerve is hard to find during thyroid surgery, even with a neurostimulator. It can be vulnerable during thyroid surgery but only in cases of anatomic variations. Searching for the nerve systematically during thyroid surgery does not seem to be useful. Several precautions when dissecting the superior pole of the thyroid gland seem to be necessary and sufficient to respect the external laryngeal nerve.