脑干听觉诱发电位在后颅凹肿瘤诊断及术中监护的应用

目的：了解脑干听觉诱发电位技术在后颅凹肿瘤诊断及术中监护的意义。方法：对８例后颅凹肿瘤患者进行术前检查，其中２例进行术中监护，对ＢＡＥＰ各波波形、潜伏期、波间期的变化进行分析。结果：Ⅰ、Ⅲ、Ⅴ波潜伏期延长４例；ⅠⅢ、ⅢⅤ或ⅠⅤ波波间期延长５例；波形分化不良，重复性差６例；由于手术操作引起的颅内压变化、脑干出血、缺血、受压均可引起ＢＡＥＰ的变化。结论：ＢＡＥＰ对后颅凹病变的早期诊断、术中重要结构的保护及术后功能的评估有重要意义     

利用磁共振成像实现肿瘤热疗中实时无创测温的方法

肿瘤热疗特别是高强度聚焦超声（HIFU）技术，已成为一种重要且非常具有前景的肿瘤治疗方法，温度是直接决定热疗效果的重要参数，实时准确的进行深部无创测温是目前制约肿瘤热疗进一步发展的一项关键技术。近来利用磁共振成像（MRI）进行无创测温，正受到越来越多的研究者的重视。本文简述了MRI无创测温的三种方法，比较了不同测温原理的特点和适用条件，报道了已有研究发展状况，并介绍了尚待解决的问题。     

Sensitivity Analysis of Respiratory Parameter Estimates in the Constant-Phase Model

The constant-phase model is increasingly used to fit low-frequency respiratory input impedance (Zrs), highlighting the need for a better understanding of the use of the model. Of particular interest is the extent to which Zrs would be affected by changes in parameters of the model, and conversely, how reliable are parameters estimated from model fits to the measured Zrs. We performed sensitivity analysis on respiratory data from 6 adult mice, at functional residual capacity (FRC), total lung capacity (TLC), and during bronchoconstriction, obtained using a 1-25 Hz oscillatory signal. The partial derivatives of Zrs with respect to each parameter were first examined. The limits of the 95% confidence intervals, 2-dimensional pairwise and p-dimensional joint confidence regions were then calculated. It was found that airway resistance was better estimated at FRC, as determined by the confidence region limits, whereas tissue damping and elastance were better estimated at TLC. Airway inertance was poorly estimated at this frequency range, as expected. During methacholine-evoked pulmonary constriction, there was an increase in the uncertainty of airway resistance and tissue damping, but this can be compensated for by using the relative (weighted residuals) in preference over the absolute (unweighted residuals) fitting criterion. These results are consistent with experimental observation and physiological understanding.     

Laboratory and Ambulatory Monitoring of Menopausal Hot Flashes

A large increase in skin conductance activity recorded from the sternum was found during menopausal hot flashes and corresponded well with patient self-reports. The magnitude and time course of this skin conductance change was similar during spontaneous hot flashes recorded in the laboratory, during heat-induced hot flashes, and during those recorded by ambulatory monitoring techniques. This pattern of sternal skin conductance change did not occur in premenopausal women during body heating or ambulatory monitoring. These methods should be useful in research on the etiology and treatment of menopausal hot flashes.     

Cartilage degradation products as markers for evaluation of patients with rheumatic disease

Markers of cartilage degradation hold a great, but so far underutilized potential in the research and clinical management of joint diseases such as osteoarthritis (OA) and rheumatoid arthritis (RA). With the rapid pace of development of such markers, they are likely to emerge as promising clinical tools for several uses. These roles may include: improving preclinical and clinical development in arthritis research; differentiation of patients with high and low turnover states at disease diagnosis; selection of optimal therapy and therapy dose for the individual patient; monitoring disease progression; and predicting disease outcome.This review focuses on the cartilage matrix components and the metabolites from this very special tissue that have been proposed as biochemical markers. Special attention is focused on the challenges facing the development of such markers to the standards required for widespread practical use. Examples are provided on the current use of cartilage derived biochemical markers and perspectives for the future use of markers and required clinical documentation are presented.     

Prognostic value of early somatosensory evoked potentials during carotid surgery: Relationship with electroencephalogram,stump pressure and clinical outcome

Summary The authors have reported on the prognostic value of continuous monitoring of somatosensory evoked potentials (SEP) in a survey of 25 patients who underwent carotid surgery. SEP recordings were correlated with the EEG, stump pressure (SP) values and clinical outcome. A non-cephalic reference was used for SEP recordings to allow the analysis of both subcortical and cortical components. During surgery the conduction time between SEP peaks relating to the subcortical components remained stable or showed minimum variations in all patients. During carotid clamping, SEP variations were observed in 9 out of 25 cases (36%). The application of an intraluminal shunt was accompanied by the return to normal values in 7 out of 9 patients. In the remaining two cases SEP abnormalities continued post-operatively and were accompanied by new neurological deficits. EEG changes during carotid clamping were associated with SEP modifications in 6 out of 7 cases, although they were not always correlated. Results confirm that SEP recordings provide useful data concerning the function of the CNS in anaesthetized patients and that, being sensitive to CBF changes, SEP monitoring acts as an indicator of cerebral ischaemia.Presented in part at the Third International Evoked Potentials Symposium, Berlin-West, September 28th–October 1st, 1986.     

Psychomotor impairment and anticonvulsant therapy in adult epileptic patients

Summary Using a battery of simple tests, psychomotor performance was assessed in 11 healthy subjects, 14 untreated epileptic patients and 66 epileptics on chronic anticonvulsant medication. Significant differences were found between controls and untreated patients for choice reaction time, card sorting and Simple Simon memory game. Treated patients performed less well than both untreated epileptics and controls in choice reaction time (p<0.05; p<0.001), card sorting (p<0.01; p<0.001), Simple Simon (p<0.05; p<0.001) and finger tapping (p<0.05; p<0.001). Patients with centrencephalic epilepsy were slower than those with discrete focal EEG abnormalities in reaction time and card sorting. Patients receiving treatment with carbamazepine, phenytoin or sodium valproate alone all performed similarly to each other and to those patients taking anticonvulsant polypharmacy. Monotherapy patients with potentially toxic plasma anticonvulsant concentrations did no worse than those within or below the therapeutic range. Both the disease and its treatment reduce psychomotor performance. All major anticonvulsants appear to cause a similar degree of impairment across a wide range of concentrations. The effect of chronic anticonvulsant medication on quality of life should not be neglected in the pursuit of perfect seizure control.     

n-Hexane urine elimination and weighted exposure concentration

Summary The concentration of n-hexane in urine was determined in 30 subjects occupationally exposed to n-hexane (median value 59.6 mg/m³) in a shoe factory. The measurement of the substance was performed by means of a Hewlett-Packard 5880 gas chromatograph supplied with a Hewlett-Packard 5970 Mass Selective Detector. The analyses were performed by the head space method (constant volume method, after determination of the urine partition coefficient by the multiple phase equilibration method). The authors found a significant correlation between the n-hexane urine concentrations (g/1, Cu) and the n-hexane environmental concentrations (mg/m³, Ci) (r = 0.84; Cu = 0.0669 x Ci + 0.8396).This work was supported by the research funds given to Fondazione Clinica del Lavoro, Pavia by the Health Council     

某国家级死因监测点漏报调查及死因监测质量评价

目的 了解某国家级死因监测点居民死亡漏报情况,评价死因监测信息系统报告的完整性和准确性。 方法 某国家级死因监测点居民死亡信息来源于泸县3个抽样点。采用随机整群抽样的方法,在泸县抽取3个镇(抽样点)共42个村/社,分别从派出所、社事办、妇幼、村(居委会)等渠道收集抽样点2018—2020年全部人口死亡信息,与“人口死因监测信息管理系统”死亡报告数据进行比较,计算漏报率。对“人口死因监测信息管理系统”中抽样点居民死亡报告卡进行审核,评估死因诊断的可靠性和编码质量。 结果 泸县人群总死亡漏报率为9.38%;2018—2020年,漏报率逐渐下降,分别为18.31%、7.53%、2.16%,年度变化百分比为-11.9%,变化趋势差异有统计学意义(t=-5.175,P＜0.001),抽样点死因诊断可靠性和准确性较高,可靠诊断单位占比81.81%,可靠诊断依据占比75.67%,根本死因编码错误率为0.21%。 结论 泸县死因监测数据质量较好,但仍需进一步降低漏报率,提高死因监测数据的完整性和诊断的可靠性。     

2016—2020学年徐州市泉山区中小学生因病缺课监测结果分析

目的 分析徐州市泉山区中小学生因病缺课情况,为制定疾病预防控制措施、降低学生因病缺课率提供依据。方法 收集2016—2020学年泉山区中小学生因病缺课监测数据,分析不同年份学生因病缺课的流行特征,采用χ2检验进行统计比较。结果 2016—2020学年泉山区学生总因病缺课率为0.15%,呈逐年上升趋势(χ2趋势=21 732.656,P<0.001);总因病缺课率小学生(0.16%)高于初中生(0.11%,χ2=1 419.185,P<0.001)、高中生(0.07%,χ2=2 426.638,P<0.001),初中生高于高中生(χ2=491.878,P<0.001);传染性疾病导致的缺课人次数占因病缺课总人次数的66.05%;学生因病缺课高峰主要集中在11月至次年1月。结论 小学生是缺课的重点关注人群,传染病是中小学生疾病防控工作的重点,应采取综合干预措施,降低学生缺课率,保障学生身体健康。