An alternative method of nitrous oxide delivery into a minimal-flow circle breathing system

We have sought to define a way in which nitrous oxide can be safely and universally used at minimal to low flows by utilising a circle system with a controlled leak provided by a standard gas analyser sampling line and a fresh gas supply of 50% nitrous oxide in oxygen, entering from a trunk interposed between the ventilator and the circle system. Although preliminary calculations suggested that this arrangement was likely to work, it was found that 13 of 23 patients studied prospectively developed an inspired oxygen fraction below 0.3. We conclude that, although this arrangement provides a new means of introducing nitrous oxide into the circle breathing system, it does not appear inherently safer or more convenient than the conventional route.     

基于系统输出分布的智能控制

提出了文题所述的控制策略,依据输出分布曲线的特征变量选取方法和依据该项信息的规则控制系统。仿真研究得到了满意的结果。在一个实验性二元精馏塔上用IBM-PC进行试验亦获成功。本法对具有非线性特性的分布参数对象,较常规控制策略有明显的优越性。     

"在线期刊-写作-讨论"结合教学与临床医学教育

以参加教学改革的(01)口腔大专2个班90人为实验组，以采取传统授课方式的(00)口腔大专2个班96人为对照组，实验组采用问卷调查，将实验组和对照组课后对授课内容进行测试的成绩进行横向对比，结果表明与“在线期刊-写作-讨论”结合的临床课教学方式对培养医学生的临床思雄能力、自学能力、解决问题的能力、学生自我表达能力、收集资料能力、文字表达能力等比传统教学方式有明显的提高，对提高临床医学专业专科医学生综合素质有明显的效果。     

两种靶控方法输注异丙酚和瑞芬太尼的安全性和有效性比较

目的 比较靶控血浆浓度和效应室浓度输注异丙酚和瑞芬太尼的安全性及有效性。方法 选择44例腹腔镜胆囊切除的病人,年龄18～65岁,ASA Ⅰ～Ⅱ级,随机分为靶控血浆浓度组(P组)和效应室浓度组(E组)。设定异丙酚和瑞芬太尼的靶浓度分别为4 μg/ml和2 ng/ml。观察给药后意识消失时间、血液动力学变化以及听觉诱发电位指数(AAIs)的变化。术中调整两药靶浓度保持AAIS低于20。记录术毕停药后自主呼吸恢复和睁眼时间和AAIs的恢复。结果 E组意识消失的时间[(0.45±0.10)min]明显短于P组;此时两药的用量也明显高于P组。两组均能引起明显的低血压,但降低程度相似,且均未见严重的心血管副作用。AAIs在意识消失时P组为41±22;E组49±16:但插管时均在20以下。术中血液动力学保持较低水平(P<0.01)。两组的插管评分、麻醉质量评分相似。术后自主呼吸恢复时间和睁眼时间两组均无统计学差异。Aldrate评分及手术结束时疼痛评分差异均无显著性。结论靶控血浆和效应室浓度输注均可达到满意的麻醉效果,但靶控效应室诱导时间更短,且无明显心血管副作用。     

Positive Thinking Among Slot Machine Gamblers: A Case of Maladaptive Coping?

Background  Research has demonstrated that optimism and “positive illusions” can be used a coping mechanism among those facing adversity. Gamblers are a little studied group who also experience adversity and uncertainty. They often feel considerable levels of frustration, guilt, anger and a sense of feeling cheated after making significant losses. In order to deal with such feelings it is hypothesized that these individuals will search for positive consequences from their behaviour in order to offset this negative affect. Objectives  To (1) determine whether after gambling, gamblers compensate and reduce negative affect by identifying positive consequences from experiencing a loss, and (2) identify types of strategies which gamblers employ and consider how these should be classified. Materials and Methods  Eighty-seven regular slot machine gamblers were interviewed in a variety of environments housing slot machines. Each participant was asked a series of questions in a semi-structured format, to explore possible styles of positive thinking. Results  Nine types of ‘positive thinking’ experienced by gamblers were identified. These included Comparative thinking, Prophylactic thinking, Biased frequency thinking, Responsibility avoidance, Chasing Validation, Prioritization, Resourcefulness, Thoughtfulness, and Fear Reduction. Gamblers who were positive thinkers experienced significantly less guilt than non-positive thinkers. Conclusions  While reduction of negative affect may be perceived as positive in many other contexts, it is argued that it may counteract efforts to promote responsible gambling. Clinical implications and directions for future research are discussed.     

Fire in the operating theatre. Evacuation pre–planning may save lives

An operating theatre fire and the steps taken to deal with it are described; the difficulties encountered in evacuating anaesthetised patients are highlighted. Measures which might be taken to prevent recurrence of these problems, and recommendations on the institution of fire drills for the safety of patients and staff are given.     

盐酸维拉帕米自乳化缓释片的研制及释药行为的探讨

目的：探索固体自乳化释放药系统，研制自乳化缓释片，考察体外释药行为。方法：以盐酸维拉帕米（Verpamil Hydrochloride,VH)为模型药物，以吐温80（Tween80），豆磷脂（sbpc)为乳化剂，以羟丙甲纤维素（HPMC），卡波普（carbopol)为骨架材料，制备自乳化缓释片。结果：以含吐温80和豆磷脂10％，羟丙甲纤维素和卡波普30％的处方乳化效果好，体外释药符合要求。结论：通过调节乳化剂和骨架材料的比例，可以获得理想的自乳化固体缓释制剂。     

社区卫生服务信息系统功能建模研究

理顺功能关系、理清业务流程是构建社区卫生服务信息系统的前提和基础,功能建模是理顺功能关系的一个重要手段。在研究现有的各种功能分析方法的基础上,本文以IDEF0模型方法为基础,提出了社区卫生服务信息系统功能建模方法。通过建立功能、数据和约束之间的内在联系,为系统的功能设计和数据分析提供了基础。     

Polynomial matrix solution of H2 optimal control problem for state‐space systems

A polynomial matrix solution to the H₂ output feedback optimal control problems is obtained for systems represented in state‐equation form. The proof does not invoke the separation principle but is obtained in the z‐domain. The cost function includes weighted states, which allows the so‐called standard system model problem to be solved. This encompasses the class of inferential control problems. The results also enable the two‐degree‐of‐freedom optimal control solution properties to be explored. Copyright © 2002 John Wiley & Sons, Ltd.