心脏电复律19例临床总结

作者自1991—1994年对19例异位性快速心律失常病人,行27次电转复,其中房颤9例,室性心动过速1例(8次),室上性心动过速6例,房扑1例,预激综合征2例,室颤1例,除1例房颤未转复外,余均转复。转复成功率为96.7％,无一例并发症发生,特总结如下: 1 资料和方法 1.1 病例选择 所有患者均按我们沿用的选择标准,     

阵发性折返性室上性窄QRS波心动过速终止后倒置T波的临床意义

研究阵发性折返性室上性窄QaS波心动过速终止后倒置T波的临床意义．对71例自发折返性室上性窄QRs波心动过速终止后倒置T波的患者行运动心电图试验、运动铊心肌灌注显像夏冠状动脉造影．结果：心动过速终止后，30例出现倒置T波，3例呈铊阳性改变的病例冠状动脉造影显示1支血管管腔直径≥75％的明显狭窄，但均无冠心病的临床表现．结论：阵发性折返性室上性窄QaS波心动过速终止后倒置T波代表一种常见的现象，可能持续存在一段时间，根据常见的临床和心电图指标不能预测其是否发生．冠心病似乎不是这种复极异常的原因．     

苏武拒降

律曰：“苏君，律前负汉归匈奴，幸蒙大恩，赐号称王，拥众数万，马畜弥山，富贵如此。苏君今日降，明日复然。空以身膏草野谁复知之?”武不应。律曰：“君因我降，与君为兄弟；今不听吾计，后虽欲复见我，尚可得乎?”武骂律曰：“汝为人臣子，     

苏武拒降

律日：“苏君，律前负汉归匈奴，幸蒙大恩，赐号称王，拥众数万，马畜弥山，富贵如此。苏君今日降，明日复然。空以身膏草野谁复知之?”武不应。律日：“君因我降，与君为兄弟；今不听吾计，后虽欲复见我，尚可得乎?”武骂律日：“汝为人臣子，     

静脉注射胺碘酮治疗急性心肌梗死伴持续性室速和室颤

目的：观察静脉注射胺碘酮治疗急性心肌梗死伴持续性室速和室颤的疗效。方法：对急性心肌梗死突然发作持续性室速和室颤的9例患者,在非同步电转复的同时静脉注射胺碘酮150mg,无效者10min后再重复一次,继之以0.5-1.5mg/min静点维持24-36h,同时口服胺碘酮,观察其疗效和副作用。结果：9例病人在用药的24h内持续性室速和室颤全部得到控制,1例出现一过性窦缓,无1例死亡。结论：初步观察认为静注胺碘酮治疗急性心肌梗死并持续性室速和室颤安全有效,可提高急性心肌梗死的抢救成功率。     

静注胺碘酮急诊治疗持续性室性快速心律失常

本文报道静脉胺碘酮急诊治疗一组伴血液动力学不稳定的难治性,持续性室性快速心律失常。研究结果显示静脉用该药可有效控制难治性高度恶性的室性心律失常,而且其副作用较少,患者易子耐受,安全性相对较好,可推荐为急诊治疗和预防致命性室性快速心律失常的又一选择药物。     

新一轮历史课程和社会科课程改革的新理念

我国新一轮基础教育课程改革的背景，缘于我国基础教育的质量同21世纪经济社会发展要求的差距和矛盾，同时也为了和世界基础教育课程改革同步。我国新一轮基础教育历史和社会科课程改革的理念可概括为：课程目标和理念强调态度、价值观、技能、知识目标并重；构建新的课程内容体系；注重学习方式的改变；建立发展性评价体系。     

参数未知超混沌Lorenz系统的反同步研究

通过自适应控制法设计合适的控制器和参数自适应律,实现含未知参数的超混沌Lorenz系统的反同步控制,并利用Lyapunov稳定性理论证明了反同步误差系统是全局渐近稳定的。Maflab数值仿真结果表明,所选择的控制器和参数自适应律能有效地实现超混沌系统的反同步。     

线程技术在MIDP移动设备中的实现

线程在支持J2ME的手机应用程序的实现中存在两个问题：1．J2SE中THREAD类的方法不能全部兼容；2．CLDC的配置资源非常有限．文中介绍了MIDP移动设备中线程实现的特点：提出了线程启动、停止的方法；解决了线程同步的问题，最后研究了线程间等待和通知的机制。     

存在扰动情况下一类混沌系统的同步

根据一类混沌系统的结构和Lyapunov稳定性理论，讨论一类混沌系统在有参数和外部扰动情况下的同步问题．在驱动系统参数已知和未知两种不同的情况下，分别设计了适当的控制器以及参数自适应律实现了一类混沌系统的同步．以Arneod。系统为例进行了数值仿真，结果表明这些控制器及参数自适应律是有效的和可行的．     

膀胱肿瘤电切术和膀胱部分切除术术后护理比较

目的:探讨膀胱肿瘤电切术和膀胱部分切除术术后护理方法.方法:对150例膀胱肿瘤术后并发症分类总结,观察治疗效果.结果:两种手术术后并发症发生率不同.结论:膀胱开放手术与电切术术后护理应有不同的侧重.     

胎儿窘迫40例胎心监护分析

[目的]分析各种类型的胎儿监护结果与胎儿窘迫的关系及对手术产率的影响.[方法]选取2003年~2004年40例胎儿窘迫病例(均≥37周),对其胎心监护结果进行分析.[结果]34例发生于产程各阶段,胎心监护图型分别是晚期减速和变异减速、早期减速、轻度心动过速、轻度心动过缓.各监护图型对应的羊水污染程度具有显著差异(P<0.05),剖宫产率、Apgar≤7分无显著差异(P>0.05).[结论]晚期减速和变异减速是胎儿宫内缺氧的表现,需立即或及时终止妊娠.早期减速、轻度心动过速、轻度心动过缓出现在产程中是胎儿对暂时性缺氧反应良好的表现,临床上一般不需特殊处理,但心动过缓和心动过速伴基线变异减少或消失则提示胎儿窘迫,需及时处理.胎心监护对剖宫产率有一定影响,对于胎儿窘迫诊断可根据胎心监护结合胎儿头皮血气分析综合判断结果更准确.     

What is the current level of knowledge and confidence of mainstream school SENCOs in sensory integration theory and using sensory strategies within education?

The aims of the study were: to identify the number of SENCOs who have received specific training on sensory integration. To determine the understanding of the eight senses and sensory integration theory and sensory strategies. Determine any common gaps in knowledge or misconceptions. Fifty-five surveys were completed. 40% of respondents had received training on sensory processing. There was a significant chi-squared correlation between those that had received training and those that stated they did not know or made guesses about what the vestibular and proprioceptive senses are important for. There was a correlation between those that had received training and those that had good knowledge of the signs of sensory hyper-responsivity. There was no statistical significance of increased knowledge on sensory hypo-responsivity between those who had and had not received training. SENCOs who rated their school as being sensory-friendly had a greater understanding of what sensory integration is important for. Pertinently, those who rated their school as being ‘sensory-friendly’ (45.5%) were 8.5 times more likely to know sensory integration is needed for self-regulation. A number of recommendations are made including the need for greater collaboration between therapists and teachers to increase understanding of sensory integration and the impact of this on a child's education and wellbeing at school. Sensory strategy programmes are to be written with teaching staff and not given by the therapist in an ‘expert’ role. Sensory integration awareness training, including why and how to utilise sensory strategies, is to be encompassed in the SENCO national qualification.     

加强心理护理对促进分娩的意义

目的:通过对110例心理护理分娩产妇的临床观察，探讨心理护理对分娩的影响。方法：正常足月妊娠，无产科手术指症及妊娠合并症并发症的初产妇220例，随机分为心理护理且和一般护理组，每组各110例，结果：心理护理的产妇、产程，剖宫产率及新生儿窒息率明显低于对照组。结论：适时恰当的心理护理能够缩短产程，促进顺利分娩，减少剖宫产及新生儿窒息率。     

论检察机关如何应对最高人民法院《关于办理刑事案件排除非法证据若干问题的规定》的出台对刑事案件发回重审的影响

多次、反复、随意发回重审问题一直是中国司法审判中存在的问题,而最高人民法院《关于办理刑事案件排除非法证据若干问题的规定》的出台增加了需要发回重审的刑事案件的数量,包括：二审法院对排除非法证据的请求不予理睬应当发回重审;二审法院对排除非法证据的请求不置可否,而实际上会以事实不清、证据不足为由发回重审;一审法院没有支持排除非法证据的请求,而二审法院认为应当排除的,取证行为严重侵害被追诉人宪法权利的情况下,应发回重审;一审法院支持排除非法证据的请求,而二审法院认为不应当排除的,一审法院没有对证据进行质证的情况下,案件应发回重审。对此,检察机关应当建立检察机关内部、外部的联动沟通机制,强化检察机关的法律监督职责,加强对公安机关侦查程序合法性的监督以及法院可能滥用发回重审裁量权的监督。     

The impact of peer support schemes on pupils' perceptions of bullying,aggression and safety at school

The research was carried out in four secondary schools, two with a peer support system and two without, and involved a total of 931 pupils (49.5% males and 50.5% females). Participants were aged between 11 and 15 years of age, mean age 12.8 years. The aims were: to compare the perceptions of safety on the part of older and younger pupils in secondary schools with and without a system of peer support in place; to find out if there are differences in perceptions of safety within peer support schools on the part of those who are aware of the existence of a peer support service in their school and those who are not aware; and to find out if pupils in peer support schools are more likely to tell someone about school violence and bullying than those in schools without peer support. The results indicate very little difference between pupil perceptions of safety in schools with and schools without a peer support system in place. In fact, older pupils in the schools without peer support responded that they felt safer than pupils in schools with a peer support system in toilets and lessons. However, within the peer support schools there were significant differences in perceptions of safety between the substantial minority of pupils who were unaware that their school had a peer support system and those who were aware of it. The pupils who were aware felt safer in lessons, perceived school as a friendlier place to be, and worried significantly less about being bullied in comparison with those who were unaware. They were also much more likely to tell someone when bad things happened at school. The results are discussed in the light of previous research in the field and some recommendations are made for the practice of peer support.     

米非司酮配伍米索前列醇用于中期妊娠引产

目的:口服米非司酮进行中期妊娠引产,可提高引产的简单性、安全性及减少术后并发症,减轻患者的痛苦及经济负担.方法:选择要求终止中期妊娠的妇女100例,分为用药组和对照组各50例,进行分析、对比.结果:两组均能一次性成功.但用药组出血量及所用时间明显少于对照组,且术后并发症少.结论:本文通过使用利凡诺羊膜腔穿刺与口服米非司酮在中期妊娠引产中的数据对比,分析了米非司酮药物作用和特点,建议临床推广.     

保险机制介入国家助学贷款管理的探讨

国家助学贷款是我国政府为资助高等院校经济困难学生,顺利完成学业而建立的一项资助政策。这项政策已经资助了数百万学子完成学业。然而在过去的几年中,助学贷款的实施产生了许多如贷款拖欠率高、银行惜贷等问题,国家助学贷款还远远不能满足广大贫困生群体的需求。而将保险机制引入国家助学贷款管理,可以充分发挥保险的社会管理功能,从而实现国家助学贷款的顺利实施。     

一次性使用持续注入器持续输注氯普鲁卡因在硬膜外麻醉中的临床应用

①目的:探讨一次性使用持续注入器输注氯普鲁卡因在硬膜外麻醉中的效果,以积累临床经验,指导临床工作.②方法:选取90例硬膜外麻醉的患者,随机分为两组,观察组(45例)应用一次性使用持续注入器持续输注氯普鲁卡因,对照组(45例)应用一次性使用持续注入器持续输注利多卡因.③结果:实验组在麻醉起效时间、痛觉消失时间及运动阻滞时间明显短于对照组,实验组低血压的发生率明显高于对照组.④结论:氯普鲁卡因用于硬膜外麻醉,麻醉效果较好,适合持续输注,但要警惕低血压的发生.     

Prenatal diagnosis of congenital fetal heart abnormalities and clinical analysis

INTRODUCTION Congenital heart disease (CHD) is the most common congenital disorder resulting in significant prenatal and postnatal morbidity and mortality (Gil- lum, 1994; Gembruch, 1997) and is believed to be a multifactorial disorder arising from the combined effect of genetic predisposition and environmental factors. Prenatal diagnosis of CHD is very important for both fetal prognosis and decreasing economic burden of family and society. It was demonstratedt t - l t recently that fe…