失血性休克复苏及监测指标研究进展

创伤、失血性休克是一古老的临床研究课题。不仅在平时常见，更重要的是与战伤救治密切相关。尽管近10年来取得了一些进展，但复苏时机、复苏目标、液体种类的选择、复苏后继续生命支持以及监测技术等仍是临床以及研究人员面临的重大挑战。本文将就近年来有关上述问题的最新研究进展进行分析和讨论，以期提高对该复杂综合征的认识，为今后的研究提供帮助。     

EFFECT OF CIGARETTE SMOKING ON THE FREQUENCY OF VENTRICULAR PREMATURE COMPLEXES IN NORMAL SUBJECTS

1. Ambulatory ECG monitoring was undertaken in healthy cigarette smokers (33) and non-smokers (20) of similar age (21-66 years). 2. The frequency of ventricular premature complexes (VPC) was less in habitual smokers (P less than 0.05; Mann-Whitney rank test) and an average of more than 1 VPC per hour occurred in a higher proportion of non-smokers than smokers: eight of 20 (40%) vs two of 33 (6%) (P less than 0.01; Chi-square test).     

Reversal of profound paralysis: use of large doses of edrophonium to antagonize vecuronium and pancuronium induced neuromuscular blockade

The ability to evoke reversal of dense vecuronium- and pancuronium-induced paralysis (T1 10% of control) with edrophonium 1.0 mg.kg-1 was studied using train-of-four nerve stimulation and electromyographic monitoring. Two different end-points, train-of-four ratios of 0.5 and 0.7, were used to define "adequate reversal", and the results for both relaxants were compared. Reversal was reliable and rapid for vecuronium if either ratio was used with times of 2.8 (1.5) and 9 (3) min required to achieve ratios of 0.5 and 0.7, respectively. However, if the block was due to pancuronium, reversal was unreliable with 2 of 9 and 4 of 9 patients not achieving ratios of 0.5 and 0.7, respectively. Reversal was also markedly prolonged in this group with a mean time of 37 (23) min to achieve a ratio of 0.7, and in almost half these patients a supplementary dose of edrophonium was required.     

肝癌肺癌患者的头发分析

本文通过２８例正常人及２８例癌症病患者的头发的分析，得出癌症病患者的头发区别于正常人的头发的特征是：癌症病患者的头发中含有微量元素Ａｓ、Ｎｉ、Ｍｎ。     

EEG enhancement during electrosurgery using an optical fibre

The paper considers the limiting factors in EEG enhancement in the presence of electrosurgery interference and presents a design for a useful fibre-optic EEG monitoring instrument which is free from such problems as electrical shock (micro and macroshock), patient burns and susceptibility to electrosurgery interference associated with conventional EEG monitors.     

Design of a multichannel solid-state recorder and its application to temperature measurement

The development of a multichannel unconstrained memory system for monitoring physiological information is described. The system comprises a portable recorder, worn by the subject, to detect and store data in memory and a readout unit for transferring the data to a microcomputer. Using the microcomputer, the physiological data are displayed, retrieved and analysed. The portable recorder consists of a memory control unit, an instrumentation unit, an LCD timer and batteries. In the memory-control unit the data are transferred to EPROM (erasable programmable read-only memory), which is a nonvolatile memory. This memory, removed from the protable recorder, can be delivered to the laboratory and its contents analysed without interrupting the field experiment. In connection with the instrumentation unit, an 8-channel skin thermometer was designed and tested. It was accurate to within ±0.08°C compared with a standard thermometer.     

Embryo donation: attitudes toward donation procedures and factors predicting willingness to donate

BACKGROUND: The aim of the study was to assess infertile couples' attitudes toward the procedures of embryo donation (ED) and to identify factors predicting interest in donation. METHODS: Fifty-one couples who had received IVF treatment and had subsequently had embryos cryopreserved for >3 years were located and sent written information about the procedures for ED and possible implications of donation. A total of 49 couples agreed to participate in the study with 36 women and 31 men subsequently returning questionnaires describing their reasons for not claiming unused embryos and attitudes towards ED. RESULTS: Patients were supportive of donor screening procedures, but less comfortable sharing non-identifying information. Comfort levels declined as information became increasingly personal. Support for unconditional (i.e. the donation of embryos without conditions attached) and conditional (i.e. where couples could limit the donation of their embryos to persons/couples according to their preferences) models of donation was highly polarized and a substantial minority expressed strong opposition to each model. Willingness to donate was associated with greater comfort about disclosing personal information, a desire to know the outcome of donation and willingness to have future contact with a child, but not with current family size. CONCLUSIONS: Comfort in sharing information with a recipient couple is more important than acceptance of screening procedures, or attainment of family size goals in predicting willingness to donate embryos. Offering the option of conditional donation could increase the acceptability of ED for some patients.     

Regulation and selection of patients

During the past decades health legislation and regulation have been on the increase in most industrialized countries. The growing role of government in the provision and financing of health care, the need to correct given aspects of health care and the mandate to protect the underprivileged have been some of the many reasons for increased regulation. Different regulatory approaches and their respective advantages and disadvantages are reviewed in this paper. Particular attention is given to the crucial issue of how to regulate the access to scarce resources and how to cope within a legislative approach with the resulting patient selection.