多指标综合加权评分法优选桑蒂复肝胶囊的提取工艺

目的优选桑蒂复肝胶囊的提取工艺。方法以加水量、煎煮次数、煎煮时间为考察因素,用L9(34)正交试验表安排试验,以盐酸小檗碱含量、干膏收率、黏度值为考察指标,采用综合加权评分法进行数据分析,优选工艺条件。结果最佳提取工艺为:药材用10倍量水,煎煮2次,每次2 h。结论该提取工艺客观可行、稳定合理,可为工业化生产提供理论依据。     

The sarcomeric Z-disc: a nodal point in signalling and disease

The perception of the Z-disc in striated muscle has undergone significant changes in the past decade. Traditionally, the Z-disc has been viewed as a passive constituent of the sarcomere, which is important only for the cross-linking of thin filaments and transmission of force generated by the myofilaments. The recent discovery of multiple novel molecular components, however, has shed light on an emerging role for the Z-disc in signal transduction in both cardiac and skeletal muscles. Strikingly, mutations in several Z-disc proteins have been shown to cause cardiomyopathies and/or muscular dystrophies. In addition, the elusive cardiac stretch receptor appears to localize to the Z-disc. Various signalling molecules have been shown to interact with Z-disc proteins, several of which shuttle between the Z-disc and other cellular compartments such as the nucleus, underlining the dynamic nature of Z-disc-dependent signalling. In this review, we provide a systematic view on the currently known Z-disc components and the functional significance of the Z-disc as an interface between biomechanical sensing and signalling in cardiac and skeletal muscle functions and diseases.     

牵张刺激对乳大鼠心房肌细胞瞬时外向钾电流和内向整流钾电流的影响

 目的：探究牵张刺激对乳鼠心房肌细胞瞬时外向钾电流（Ito）、内向整流钾电流（IK1）和动作电位时程（APD）的影响。方法：取1日龄SD乳大鼠心脏,分离、消化获得心房肌细胞。于细胞牵引装置培养24 h分组：对照组不予牵张刺激;牵张组予增加12%硅胶膜面积牵张刺激24 h。膜片钳全细胞记录方法记录细胞膜Ito、IK1和APD的变化。结果：在+60 mV刺激电压水平,牵张组Ito密度与对照组相比明显降低［(16±04）pA/pF vs (121±29) pA/pF,P<001］。在-120 mV刺激电压下,牵张组IK1密度较对照组增大［（-108± 08） pA/pF vs (-88±09)pA/pF,P<001］。牵张组动作电位复极50%（APD50）和复极90％（APD90）均较对照组明显缩短［(105±14）ms vs (155±24) ms,(300± 28) ms vs (563±36) ms,P<001］。结论：牵张刺激可降低乳大鼠心房肌细胞Ito密度,增大IK1密度,缩短APD,这可能是压力负荷增大致心房电重构的基础之一。     

护理标识在临床工作中的应用探讨

目的探讨护理标识在临床工作中的应用效果。方法随机抽取2010年1月～12月50例患者作为护理标识前组，2011年1月～12月60例患者作为护理标识后组，评估两组患者满意度，护理不良事件发生率。结果标识前组患者满意度为78.0％，标识后组为93．3％；标识前组不良事件发生率为20．o％，标识后组为3．3％，两组比较有显著性差异（P〈0.05）。结论护理标识能显著地减少不良事件，增加患者的满意度，提高护理质量，可应用于临床护理工作中。     

乙肝病毒标志阴性慢性病毒性肝炎患者HBV-DNA及肝组织中HBsAg、HBcAg检测的临床意义

目的:探讨HDVM阴性慢性肝炎患者血清HBV-DNA及组织中HBsAg、HBcAg检测的临床意义。方法:对24例原因不明的慢性肝炎患者应用酶联免疫,吸附试验(ELISA法)检测血清HBV-M(HBsAG、抗HBS、HBcAg、抗HBc、抗HBc),抗HAV-IGM,抗HCV-IgMI、gG,抗HDV-IgMI、GG,抗HEV-IGMI、GG,抗EBV-IGM,抗CMV-IgM,抗TTV-IgM:应用荧光定量聚合酶链反应(FQ-PCR)技术对患者进行血清中乙型肝炎病毒基因(HBVDNA)定量检测;应用免疫组化法,通过肝组织活检测定患者肝组织中HBsAg、HBcAg的表达情况。结果:24例HBVM阴性肝病患者中,6例可检测到HBV-DNA,其中5例肝组织中HBsAG、HBcAg同时阳性,1例HBsAg(+)、HBcAg(-);18例血清HBV-DNA阴性患者中用肝组织活检者3例,其中1例肝组织中HBsAg、HBcAg同时阳性。结论:HBVM阴性不能排除乙型肝炎病毒感染,应结合血清HBV-DNA测定及肝组织中HBcAg、HBcAg的检测,以防漏诊、误诊。     

脐血乙肝指标与预防接种失败的关系

目的 探讨新生儿脐血血清学、病毒学指标与乙肝预防接种失败的关系。方法 应用ELISA法检测HBV慢性感染产妇所产新生儿脐血的HBV血清学标志物，应用FQPCR法检测HBVDNA。结果 “大三阳”产妇婴儿脐血中HBVDNA阳性率较“小三阳”产妇高（X^2=5．52，P〈0.025）。脐血HBsAg（＋）、抗-HBc IgM（＋）、HBeAg（＋）、HBVDNA（＋）是影响新生儿常规预防接种失败的危险因素（OR值分别为10、45、15.56、51．6和95％CI分别为2.64～37.93、7．69～263．21、4．45～54．40和14．72～180．83）。结论 对脐血中HBsAg阳性、抗-HBc IgM阳性、HBeAg（＋）或HBVDNA阳性的新生儿应进一步采取更积极有效的干预措施。对HBV慢性感染产妇脐血进行HBVm及HBVDNA筛查有实际意义。     

乙型肝炎病毒前S1抗原与HBV DNA及HBeAg关系

目的　探讨乙型肝炎病毒 (HBV)前S1抗原 (PreS1Ag)与HBVDNA和HBeAg之间的关系 ,以评价其在乙肝诊疗中的作用。方法　用ELISA法对 2 2 5例HBeAg阳性标本进行PreS1Ag和HBV血清标志物的检测 ,用PCR-ELISA法测定HBVDNA。结果　PreS1Ag在HBVDNA和HBsAg阳性组织中的检出率均明显高于相应的阴性组(均为P <0 0 1)。HBeAg阴性组中PreS1Ag的检出率为 4 3 0 % ,PreS1Ag与HBVDNA的符合率为 70 6 % ,与HBeAg的符合率为 6 8 4 %。结论　PreS1Ag与HBVDNA、HBeAg呈良好的相关性。作为反映HBV感染和复制的指标 ,PreS1Ag较HBeAg更敏感。     

System identification of human stretch reflex dynamics: Tibialis anterior

Summary System identification methods have shown that the stretch reflex in the human ankle extensor (triceps surae, TS) may be modeled as velocity feedback via a single, short latency pathway containing a uni-directional rate-sensitive nonlinearity. Evidence of differences in the reflex organization in flexors and extensors led us to use the same methods to examine stretch reflexes in the ankle flexor (tibialis anterior, TA). Five normal subjects maintained a tonic contraction of TA while subjected to repeated, stochastic perturbations of ankle position. Position, torque, and smoothed, rectified EMGs from TA and TS were recorded and ensemble averaged over 25 stimulus presentations. Linear impulse response functions relating TA EMG to ankle velocity were then determined. The results confirmed the existence of significant differences between stretch reflexes in TA and TS. In particular: 1. TA impulse response functions were characterized by two distinct peaks of excitation separated by a period of inhibition. The impulse response function amplitude increased with increasing mean torque and decreased with displacement amplitude although the sensitivity of the two peaks to these changes was different. This was interpreted as suggesting that TA stretch reflexes involve two separate pathways both involving muscle spindle information. 2. TA stretch reflexes modulate tonic activity much less than do those in TS. 3. The strong uni-directional rate-sensitive nonlinearity seen in TS was not present in TA. The functional significance of these differences remains to be determined.     

Separable least squares identification of nonlinear Hammerstein models: application to stretch reflex dynamics

The Hammerstein cascade, consisting of a zero-memory nonlinearity followed by a linear filter, is often used to model nonlinear biological systems. This structure can represent some high-order nonlinear systems accurately with relatively few parameters. However, it is not possible, in general, to estimate the parameters of a Hammerstein cascade in closed form. The most effective method available to date uses an iterative approach, which alternates between estimating the linear element from a crosscorrelation, and then fitting a polynomial to the nonlinearity via linear regression. This paper proposes the use of separable least squares optimization methods to estimate the linear and nonlinear elements simultaneously in a least squares framework. A separable least squares algorithm for the identification of Hammerstein cascades is developed and used to analyze stretch reflex electromyogram data from two experimental subjects. The results show that in each case the proposed algorithm produced a better model, in that it predicted the systems response to novel inputs more accurately, than did models estimated using the traditional iterative algorithm. Monte-Carlo simulations demonstrated that when the input is a non-Gaussian, nonwhite signal, as is often the case experimentally, the traditional iterative identification approach produces biased models, whereas the separable least squares approach proposed in this paper does not. © 2001 Biomedical Engineering Society. PAC01: 8719Ff, 8719Nn, 8710+e     

地佐辛与芬太尼预防阑尾切除术牵拉反应的疗效及安全性比较

目的:探讨地佐辛与芬太尼预防阑尾切除术牵拉反应的疗效及安全性。方法:90例硬膜外阻滞下行阑尾切除术的患者随机分为地佐辛组和芬太尼组,均采用常规硬膜外阻滞麻醉,地佐辛组切皮前静注地佐辛0.1mg·kg-1,微泵维持至术毕,维持剂量1.5~2μg·kg-1·min-1,芬太尼组切皮前静注芬太尼1μg·kg-1,微泵维持至手术结束,维持剂量0.2~0.3μg·kg-1·min-1。观察并比较手术前(T0)、切皮时(T1)、牵拉阑尾时(T2)及手术结束时(T3)两组患者生命体征(SBP、DBP、HR、Sp O2)的变化。同时观察两组患者手术时牵拉反应及术后不良反应发生情况。结果:地佐辛组T1、T2、T3时HR、SBP、DBP、Sp O2与T0时比较无明显变化(P>0.05)。芬太尼组T1、T2、T3时HR、SBP、DBP较T0时明显升高(P<0.05或P<0.01),而Sp O2明显降低(P<0.05或P<0.01)。芬太尼组T1、T2、T3时HR、SBP、DBP均较地佐辛组升高(P<0.05或P<0.01),而Sp O2较地佐辛组降低(P<0.05或P<0.01)。地佐辛组术中牵拉反应发生率及不良反应发生率均低于芬太尼组(P<0.05)。结论:硬膜外阻滞下阑尾切除术术中辅助使用地佐辛能取得较芬太尼更佳的疗效,患者生命体征稳定,牵拉反应和不良反应少,是一种安全有效的麻醉方式。