Impedance plethysmography in human limbs

Electrode design and electrode positioning are important factors in blood flow measurements using impedance plethysmography. Optimal electrode type and accurate positioning will decrease measurement errors and improve the signal-to-noise-ratio. Disk electrodes were found to be superior to tape electrodes because of their better skin-electrode stability and because they prevent limb compression. The distance between current electrodes and potential electrodes should be greater than 2·3 R (disk electrodes) and 1·5 R (tape electrodes) to avoid the influence of the so-called diffusion resistance (R is the radius of the limb at the electrode site).     

Noise characteristics of stainless-steel surface electrodes

Bioelectric events measured with surface electrodes are subject to noise components which may be significant in comparison with low-level biological signals such as evoked neuroelectric potentials, and myoelectric potentials. In an effort to better understand noise arising from these electrodes, electrode and measurement system noise is modelled. The effect of electrode surface area on electrode impedance and noise is studied using circular stainless-steel electrodes of varying diameters. The main contributions of the work are the development of a model for stainless-steel electrode noise as a function of electrode area, and demonstrating that, for the band-width of interest to evoked neuroelectric and myoelectric signals (8–10 000 Hz), the primary noise components are thermal and amplifier current generated. The magnitudes of both of these depend on the electrode impedance magnitude. Electrode impedance is shown to be a power function of both electrode diameter and frequency, consistent with a capacitive electrode model.     

长圆针治疗继发性腰椎间盘脱出综合征1396例止痛疗效观察

目的:探讨治疗继发性腰椎间盘脱出综合征疼痛的新疗法.方法:将1396例继发性腰椎间盘脱出综合征患者用经筋辨证方法,循足三阴、三阳经筋查取结筋病灶点,采用长圆针以解结法治疗.结果:治愈(完全止痛)1145例,占81.7%;好转227例,占16.2%;无效29例,占2.1%.有效率97.9%.结论:长圆针治疗继发性腰椎间盘脱出综合征具有良好的止痛效应.     

Acupuncture treatment of 32 cases of lumbar intervertebral disc protrusion

Yaoyangguan (GV 3), Shiqizhui (Ex-B 8) and Yanglingquan (GB 34) were selected as main points and a three-part needle insertion technique was used to treat 32 cases of lumbar intervertebral disc protrusion. The curative rate was 96.9%. Deep puncture is the key to the treatment. Author: Chen Feng(1962-), male, junior consultant doctor Translator: Wang Si-you     

头孢西丁纸片法检测mecA基因介导的MRS

目的评价应用头孢西丁纸片扩散法检测mecA基因介导的耐甲氧西林葡萄球菌(MRS)。方法分别用头孢西丁纸片法扩散法、苯唑西林纸片扩散法、苯唑西林琼脂稀释法、VITEK微生物自动分析系统及聚合酶链反应(PCR)mecA基因检测4种方法对MRS进行检测比较,最低抑菌浓度(MIC)测定应用VITEK微生物自动分析系统GPS卡。结果96株葡萄球菌属(金黄色葡萄球菌16株、凝固酶阴性葡萄球菌80株)中苯唑西林纸片法扩散法、苯唑西林琼脂稀释法、VITEK微生物自动分析系统3种方法检出MRS菌株54株(金黄色葡萄球菌2株、凝固酶阴性葡萄球菌52株),而PCR法检出mecA基因48株(金黄色葡萄球菌2株、凝固酶阴性葡萄球菌46株),头孢西丁纸片法扩散法与PCR法一致。结论头孢西丁纸片扩散法与mecA基因检测法高度一致,是筛选和确认mecA基因介导的MRS一种可靠的方法。     

Evaluation of Disk carbapenemase test using improved disks for rapid detection and differentiation of clinical isolates of carbapenemase-producing Enterobacterales

ObjectivesRapid detection of carbapenemase-producing Enterobacterales (CPE) is important to control spread of the resistance. We previously reported that imipenem disks prepared from injectable imipenem-cilastatin could rapidly detect KPC- and NDM-type carbapenemases. In the present study, we evaluated performance of disks of IPM and combined disks of imipenem-tazobactam and imipenem-EDTA, which were prepared from powders of imipenem and inhibitors.MethodsIsolates of Enterobacterales were recovered from specimens of patients at a tertiary care hospital in Korea during January 2017 and March 2018. Routine CPE detection was performed by the CPE surveillance personnel whereas evaluation of the Disk carbapenemase test (DCT) was performed by the other personnel without knowing the results of surveillance. The DCT was carried out by pressing disks on to colonies and rehydrating in Petri plates and observing color change.ResultsThe DCT differentiated 688 of 694 (sensitivity 99.1%) carbapenemase-producing isolates in 2.5–20 min: 630 with KPC, 51 with NDM, three with IMP, one with VIM, two with KPC and IMP, and one with NDM and OXA-181. The DCT failed to detect six OXA- 48-like enzyme-producing isolates, but the modified method using 96-well flat-bottom microplates with mineral oil cover detected all 29 OXA-48-like enzyme-producing isolates in 20–120 min. The DCT was negative for all 440 ertapenem-nonsusceptible, carbapenemase gene-negative isolates (specificity 100%).ConclusionThe procedure of DCT is simple and can differentiate isolates of Enterobacterales with KPC-, NDM-, IMP- and VIM-type carbapenemases rapidly, and the modified DCT can detect isolates with OXA-48-like enzymes rapidly.     

Synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion: Disk preservation for spontaneous anatomical recovery

Synovial chondromatosis (SC) of the temporomandibular joint is a pseudoneoplastic condition characterized by benign cartilaginous metaplasia of synovial tissue mesenchymal residues with intra-articular nodule formation. TMJ involvement is rare. Interposition of loose bodies in the articular space can generate pressure, leading to glenoid fossa erosion with intracranial extension.The aim of this study was to present six SC cases with intracranial extension treated using a surgical procedure.All the patients were treated with open surgery. The superior compartment of the TMJ was opened widely to carefully remove the metaplasic mass. Temporal synovectomy was then performed. Attention was paid to preserving the integrity of the articular disc. The exposed dura mater was also preserved. No material was used to reconstruct the gap in the glenoid fossa.A 1-year follow-up showed no swelling or pain. Patients demonstrated good recovery of mouth opening, with improvement over previous mouth limitations. Morphological studies, performed using MRI and CT, showed complete anatomical recovery of the TMJ and total bone reconstruction of the glenoid fossa.Simple removal of intra-articular nodules, with TMJ arthroplasty and articular disk preservation, represents an efficient treatment option for full anatomical and functional recovery in synovial chondromatosis of the temporomandibular joint with glenoid fossa erosion of less than 1 cm².     

Short-term effects of electronic and tobacco cigarettes on exhaled nitric oxide

The objective of this study was to compare the short-term respiratory effects due to the inhalation of electronic and conventional tobacco cigarette-generated mainstream aerosols through the measurement of the exhaled nitric oxide (eNO). To this purpose, twenty-five smokers were asked to smoke a conventional cigarette and to vape an electronic cigarette (with and without nicotine), and an electronic cigarette without liquid (control session).     

检测常见酵母菌耐药性的纸片法和微量稀释法比较

目的用纸片法和微量稀释法检测痰液标本分离酵母菌的耐药性并比较两者符合率,试找出一种适用于临床实验室的简便方法。方法采用丹麦ROSCO公司抗真菌药敏纸片法检测痰液标本分离的86株常见酵母菌对5种抗真菌药物的敏感性,同时用法国生物梅里埃公司ATB FUNGUS 2念珠菌药敏板条测定4种抗真菌药物的最小抑菌浓度,对结果进行分析。结果两性霉素B、氟胞嘧啶、氟康唑2种方法完全符合率分别为95.3%、95.3%和88.4%,未出现一种方法敏感而另一种方法耐药的严重错误现象;对86株痰液标本分离常见酵母菌的耐药性进行分析,两性霉素B、制霉菌素和氟胞嘧啶的敏感率高,分别为95.4%、98.8%、95.3%,伊曲康唑的耐药率最高(15.1%)。结论纸片法和微量稀释法相比有很好的一致性,且抗真菌药敏纸片种类多,便于随时根据临床所需增加单个药敏结果,易于在各临床实验室开展。酵母菌唑类抗真菌药物的耐药现象日益严重,应加强酵母菌的耐药性监测。