琥珀胆碱引起血清肌酸激酶升高以及药物予处理对其的影响

<正> 肌酸激酶(CK)作为临床诊断心肌疾患的主要指标已被公认,但麻醉时使用去极化肌松药琥珀胆碱因肌颤可引起肌酸激酶增高,如何减少此种影响,国外有人对此进行了研究,而国内尚未见报道。本文对50例使用琥珀胆碱后血清肌酸激酶的变化及应用安定、咪唑安定及潘库溴胺等三种药物予处理后,CK 变化进行观察,现将结果报告如下:     

电力系统混沌振荡的分析与控制

针对二阶电力混沌振荡系统,利用分岔图、Lyapunov指数以及相轨迹对电磁干扰与电荷干扰等因素进行分析,研究系统对电磁干扰参数的敏感性,并运用Melnikov方法研究了系统发生Smale马蹄混沌振荡的条件.最后基于H∞鲁棒理论,设计一种状态反馈控制器,消除了电力系统混沌振荡,该方法抑制了抖动现象,缩短了控制时间以及参数过大对系统冲击.仿真结果证明了控制器的有效性,易在工程中得以应用.     

脑电双频谱指数导向的镇静在股动脉入路经导管主动脉瓣植入术中的应用（英文）

目的:探讨脑电双频谱指数(BIS)导向的镇静在股动脉入路经导管主动脉瓣植入术(TAVI)中的可行性和有效性。创新点:由于TAVI患者高龄、心功能差、合并症多,加上导管室布局不利于麻醉操作,实施镇静难度很大。我们利用目前常用的镇静监测手段BIS来实施导向镇静,有效地实现了深度可控的镇静,减少了并发症。方法:回顾了本中心所有经股动脉入路的113名TAVI患者(图1)。将患者分为两组,其中36名患者进行了全身麻醉,77名患者施行了BIS导向的镇静。两组患者的术前一般情况的差别不显著(表1)。术中资料显示,BIS导向的镇静组较全身麻醉组手术时间更短、失血更少、输血制品和血管活性药使用更少(表2)。术后的资料显示,两组的30天死亡率差异不显著,而BIS导向的镇静组有更短的住院时间和更少的肺部并发症(表3)。结论:BIS导向的镇静在股动脉入路TAVI是安全可行的。各个临床中心可根据自身经验选择最合适的麻醉方法。     

基于支持向量机的汽车故障预测贝叶斯网络推理系统研究

相较于传统的汽车故障诊断,汽车故障预测通过对汽车运行状态数据的分析,实现对汽车未来发生故障的可能性和故障类型进行预测和分析,充分保证汽车行驶的安全。通过对汽车故障类型和特点的深入研究,在已有的故障预测技术的基础上,设计了一种数据驱动的故障预测推理系统。该系统利用支持向量机完成对汽车不同类型故障的分类,结合贝叶斯推理网络,实现对当前汽车状态的综合分析,得出汽车在未来发生不同类型故障的概率,进而完成对汽车故障的预测。最后,编写软件实现汽车故障预测系统。     

上证综合指数波动情况研究——基于滚动窗口的马尔科夫链预测模型

文章运用基于滚动窗口的马尔科夫链预测模型,对上证综指的变动进行研究,创新的给出概率转移矩阵、极限概率以及预测准确率的时变特征,并给出马尔科夫链预测模型的最优窗口长度和状态定义阀值。研究揭示,大盘波动幅度与大盘的极限概率有着密切的关系;股指期货推出后大盘平盘概率占据主导地位,平稳性显著提高,马尔科夫链预测模型的预测准确率也有了较大提高。     

例析神经系统受损引起的几种疾病

一、植物人 一些人大脑皮层功能严重受损,处于不可逆的深昏迷状态,并丧失意识活动,但皮质下中枢可维持自主呼吸运动和心跳,此种状态称“植物状态”,处于此种状态的患者称“植物人”。     

概率教学的非知识技能意义浅析

基础教育数学《课程标准》明确提出了统计与概率的教育目标,即“统计与概率主要研究现实生活中的数据和客观世界中的随机现象,它通过对数据收集、整理、描述和分析以及对事件发生可能性的刻画,来帮助人们做出合理的判断和预测。”其目的就在于培养学生以随机观点来理解丰富多彩的现实世界,用科学态度看待社会,形成数学思考和分析的意识,提高解决问题的能力。本文通过对概率教学的非知识技能意义的讨论分析,使我们进一步认识开设此课程的重要性。     

“可能性”教学策略之我见

数学教材中的“可能性”内容是统计与概率板块的重要组成部分.它主要研究现实生活中的数据和客观世界中的随机现象以及事物发生的概率,它通过对数据收集、整理、描述和分析以及对事件发生可能性的刻画,来帮助人们作出合理的推断和预测.     

基于随机过程的中长期降水预测模型

降水状态的规律性隐藏在历史数据中,可用状态转移频率替代状态的转移概率。不同时段状态对预测的状态影响权重不相同,可用降水序列的自相关系数定量描述,由此建立基于随机过程的中长期降水预测模型,可预测年降水状态及相应的降水量范围。     

基于自适应IMM的足球直接任意球运行轨迹预测模型

针对传统轨迹预测模型由于对目标运行状态响应迟缓导致轨迹偏移较大,预测结果不准确的问题,提出基于自适应IMM的足球直接任意球运行轨迹预测模型.通过分析足球直接任意球特点,确定运行参数,以参数作为输入,获取不同时刻的足球直接任意球运行状态估计值,利用自适应IMM算法计算目标状态估计值的概率密度函数,得到目标的预测概率,依据...     

Is right ventricular mid-septal pacing superior to apical pacing in patients with high degree atrio-ventricular block and moderately depressed left ventricular function?

Objective

We are aimed to investigate whether right ventricular mid-septal pacing (RVMSP) is superior to conventional right ventricular apical pacing (RVAP) in improving clinical functional capacity and left ventricular ejection fraction (LVEF) for patients with high-degree atrio-ventricular block and moderately depressed left ventricle (LV) function.

Methods

Ninety-two patients with high-degree atrio-ventricular block and moderately reduced LVEF (ranging from 35% to 50%) were randomly allocated to RVMSP (n=45) and RVAP (n=47). New York Heart Association (NYHA) functional class, echocardiographic LVEF, and distance during a 6-min walk test (6MWT) were determined at 18 months after pacemaker implantation. Serum levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured using an enzyme-linked immunosorbent assay (ELISA) kit.

Results

Compared with baseline, NYHA functional class remained unchanged at 18 months, distance during 6MWT (485 m vs. 517 m) and LVEF (36.7% vs. 41.8%) were increased, but BNP levels were reduced (2352 pg/ml vs. 710 pg/ml) in the RVMSP group compared with those in the RVAP group, especially in patients with LVEF 35%–40% (for all comparisons, P<0.05). However, clinical function capacity and LV function measurements were not significantly changed in patients with RVAP, despite the pacing measurements being similar in both groups, such as R-wave amplitude and capture threshold.

Conclusions

RVMSP provides a better clinical utility, compared with RVAP, in patients with high-degree atrioventricular block and moderately depressed LV function whose LVEF levels ranged from 35% to 40%.     

萎叶提取物增强5-氟尿嘧啶对结肠癌细胞HT29和HCT116的生长抑制作用

研究目的：探讨萎叶（PB）提取物对5-氟尿嘧啶（5-FU）抑制结肠癌细胞HT29和HCT116生长的影响。研究方法：HT29和HCT116细胞分别给予PB、5-FU以及两种药物联合治疗24小时,应用等效线图法分析PB和5-FU的药效学相互作用,AnnexinV／PI染色法检测HT29和HCT116细胞的凋丁L=情况,高效液相色谱法排除PB和5-FU间任何可能的相互化学作用。重要结论：联合PB,低剂量5-FU可以在短时间内起到细胞毒作用,而单独应用PB或5-FU治疗较联合治疗可以诱导更多细胞发生凋亡。进一步采用等效线图法分析显示PB和5-Fu的联合作用在抑制结肠癌细胞HT29和HCT116的生长中分别体现出协同和拮抗作用。因此可以认为在HT29细胞中,PB使得较低剂量5-FU发挥最大抑制结肠癌细胞生长效果,然而在HCT116细胞中,PB没有显著降低5-FU的药物浓度,说明PB和5-FU的相互作用不仅仅体现在诱导细胞凋亡方面。     

Novel mutation c.980_983delATTA compound with c.986C>A mutation of the FRMD7 gene in a Chinese family with X-linked idiopathic congenital nystagmus

Objective

To screen mutations in FERM domain-containing protein 7 (FRMD7) gene in two Chinese families with X-linked idiopathic congenital nystagmus (XLICN).

Methods

Common ophthalmic data and peripheral blood of two Chinese XLICN families (families A and B) were collected after informed consent. Genomic DNA was prepared from the peripheral blood of members of the two families and from 100 normal controls. Mutations in the FRMD7 gene were determined by directly sequencing polymerase chain reaction (PCR) products.

Results

We identified a novel mutation c.980_983delATTA compound with c.986C>A mutation in the 11th exon of FRMD7 in family B, and a previously reported splicing mutation c.782G>C (p.R261G) in family A. The mutations were detected in patients and female carriers, while they were absent in other relatives or in the 100 normal controls.

Conclusions

Our results expand the spectrum of FRMD7 mutations in association with XLICN, and further confirm that the mutations of FRMD7 are the underlying molecular mechanism for XLICN.     

Association between mandibular posterior alveolar morphology and growth pattern in a Chinese population with normal occlusion

Objective:To investigate the relationship between growth patterns and mandibular posterior tooth-alveolar bone complex morphology in a Chinese population with normal occlusion.Methods:Forty-five patients with normal occlusion(23 males,22 females) were included in this study.Among these patients,20 displayed the vertical growth pattern,and 20 had the horizontal growth pattern,while the remaining patients displayed the average growth pattern.All of the patients underwent dental cone beam computed tomography(CBCT),which included the region of the mandibular posterior teeth and the alveolar.A linear regression analysis and a correlation analysis between the facial height index(FHI) and the alveolar bone morphology were performed.Results:The inclination of the molars,the thickness of the cortical bone,and the height of the mandibular bone differed significantly between patients with the horizontal growth pattern and those with the vertical growth pattern(P<0.05).Significant positive correlations were found between:the FHI and the inclination of the molars;the FHI and the thickness of the cortical bone;and the FHI and the height of the mandibular bone.Conclusions:The mandibular posterior tooth-alveolar bone complex morphology may be affected by growth patterns.     

Anethum graveolens Linn. (dill) extract enhances the mounting frequency and level of testicular tyrosine protein phosphorylation in rats

Objective:To investigate the effect of Anethum graveolens(AG) extracts on the mounting frequency,histology of testis and epididymis,and sperm physiology.Methods:Male rats induced by cold immobilization before treating with vehicle or AG extracts [50,150,and 450 mg/kg body weight(BW)] via gastric tube for consecutive 1,7,and 14 d were examined for mounting frequency,testicular phosphorylation level by immunoblotting,sperm concentration,sperm acrosome reaction,and histological structures of testis and epididymis,respectively.Results:AG(50 mg/kg BW) significantly increased the mounting frequency on Days 1 and 7 compared to the control group.Additionally,rat testis treated with 50 mg/kg BW AG showed high levels of phosphorylated proteins as compared with the control group.In histological analyses,AG extract did not affect the sperm concentration,acrosome reaction,and histological structures of testis and epididymis.Conclusions:AG extract enhances the aphrodisiac activity and is not harmful to sperm and male reproductive organs.     

Should few retrieved oocytes be as an indication for intracytoplasmic sperm injection?

Objective

To reevaluate whether relatively few oocytes obtained in one cycle are an indication for intracytoplasmic sperm injection (ICSI).

Methods

A total of 406 cycles with three or fewer retrieved oocytes performed in 396 non-male infertile couples were retrospectively reviewed. Cycles were classified into three groups by different fertilization techniques: the in vitro fertilization (IVF) group, insemination with conventional IVF; the ICSI group, insemination with ICSI though semen parameters were normal; and the rescue ICSI group, re-insemination with ICSI after conventional IVF failure.

Results

The ICSI group resulted in higher normal fertilization compared with the conventional IVF group. Correspondingly, the cycle cancellation rate was decreased in the ICSI group, though it was not statistically significant. The clinical pregnancy rate and implantation rate were lower in the ICSI group compared with the conventional IVF group. Rescue ICSI was a method to avert total fertilization failure in conventional IVF, increasing fertilization and ensuring embryo availability for transfer, but the normal fertilization was the lowest due to delayed insemination and the chance of pregnancy was very little.

Conclusions

Obtaining only few oocytes in one cycle is not considered as an indication for ICSI when the sperm sample is apparently normal. Rescue ICSI is either not recommended if conventional insemination fails. Such patients should not be subjected to the unnecessary costs and potential risks of ICSI.     

矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性相关（英文）

目的:探讨在肾功能正常或轻度受损(肾小球滤过率≥60 ml/(min·1.73 m2))人群中矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性是否相关。创新点:以具有代表性和临床价值的肾功能正常或轻度受损人群为研究对象,首次尝试通过骨转换生物标志物检测探讨钙化性主动脉瓣疾病的可能机制。方法:入选260例经超声心动图诊断钙化性主动脉瓣疾病患者(164例钙化性主动脉瓣硬化,96例钙化性主动脉瓣狭窄)和164例年龄及性别匹配对照组人群,检测矿物质代谢和骨转换生化标志物,应用多因素回归分析矿物质代谢与钙化性主动脉瓣疾病的发生和严重性的关系,并初步探讨可能机制。结果显示,从对照组到钙化性主动脉瓣硬化至狭窄患者,血钙、血磷、碱性磷酸酶和甲状旁腺素(i PTH)水平进行性升高,25羟-维生素D(25-OHD)水平进行性降低,各组间差异具有统计学显著性(P<0.001);同样,骨转换生化标志物骨钙素(BGP)、I型前胶原N端前肽(PINP)和β-胶原特殊序列(β-CTx)水平进行性升高,各组间差异具有统计学显著性(P<0.001)。在钙化性主动脉瓣狭窄患者中,i PTH水平与跨瓣峰值流速和平均跨瓣压差显著正相关,25-OHD则显著负相关。经校正相关因素后,多因素回归分析显示,血钙、血磷、碱性磷酸酶和i PTH水平升高及25-OHD水平下降和钙化性主动脉瓣疾病的发生和严重性密切相关。结论:矿物质代谢紊乱与钙化性主动脉瓣疾病的发生和严重性密切相关,异常骨转换可能是其发生机制。     

伴发ATTR型淀粉样沉积的骨关节炎患者的临床和生物学特征分析(英文)简

Objective： Our aim was to investigate clinical and laboratory characteristics of osteoarthritic patients who had amyloid deposition in their knee joints. Methods： Synovial membranes were obtained from 36 patients with knee osteoarthritis （OA） who underwent joint replacement surgery. From this sample, the diagnosis of amyloid was deter- mined by Congo red staining, which demonstrated apple-green birefringence under a polarized microscope. All syn- ovial membranes were immunohistochemically characterized for the expressions of amyloid immunoglobulin light chain （AL-K and AL-,k）, serum amyloid-A （SAA）, amyloidogenic transthyretin （ATTR）, and amyloidogenic 152- microglobulin （A152M）. Matrix-assisted laser desorption-ionizaton/time of flight mass spectrometry （MALDI-TOF MS） was used to analyze transthyretin （TTR） isoforms in the serum of each patient. Results： Nine cases （25%） were found to be amyloid-positive. Immunohistochemicaliy, eight cases （88.9%） had ATTR deposition, and one sample （11.1%） was shown to be AL-K-positive. MALDI-TOF MS identified that the TTR in the serum of the patients was unmodified wild-type TTR, TTR-Cys-S-S-Cys, and TTR-Cys-S-S-CysGly. The age at surgery and the disease duration were sig- nificantly higher in the ATTR-positive group than in the ATTR-negative group. Knee score and function score were significantly lower in the ATTR-positive group than in the ATTR-negative group. Conclusions： Amyloid deposition in synovial membranes of OA patients was found to be ATTR and AL-K. TTR in the serum of the patients was unmodified wild-type TTR together with two isoforms. The high age at surgery, long disease duration, and a deteriorated knee function were associated with ATTR amyloid deposition in the osteoarthritic knee joints.     

Complex coronary lesions and rotational atherectomy: one hospital’s experience

Objective

To evaluate the safety and effectiveness of rotational atherectomy followed by drug eluting stent (DES) implantation in patients with complex coronary lesions.

Methods

From August 2006 to August 2012, 253 consecutive patients with 289 lesions and who underwent rotational atherectomy in our center were enrolled in this study.

Results

The overall procedure success rate was 98% with the cost of two (0.8%) coronary perforations, three (1.2%) dissections, five (2.0%) slow flows or no flows, three (1.2%) peri-procedure myocardial infarctions, and two (0.8%) in hospital deaths. During follow-up (mean three years), one (0.4%) patient died, two (0.8%) patients had acute myocardial infarction, 14 (5.5%) had restenosis, and target lesion revascularization occurred in eight patients (3.2%).

Conclusions

Rotational atherectomy followed by DES implantation is a safe and effective technique for patients with complex coronary lesions, especially calcified and non-dilatable lesions.     

早期经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留(英文)

研究目的:探讨早期经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留的适应症及其对近距离照射治疗疗效的影响。创新要点:前列腺癌近距离照射治疗已经成为75岁以上患者的首选,前列腺癌近距离照射治疗术后尿潴留发生率为1.5%~22.0%。经尿道前列腺电切常用于药物治疗无效的反复尿潴留患者,且手术时机多在近距离照射治疗术后6个月以后。经尿道前列腺隧道式电切治疗前列腺癌近距离照射治疗术后尿潴留可在6个月内进行,患者尿道症状从IV(出现尿潴留,需要导尿)下降为0级(没有症状)或I级(轻度,中度尿频,2~3次/晚),较术前改善明显,且对近距离照射治疗疗效无明显影响。研究方法:浙江大学医学院附属邵逸夫医院2009年2月至2013年7月间所有接受前列腺癌近距离照射治疗的病例共190例,其中9例(4.7%)患者术后出现反复尿潴留,且早期行经尿道前列腺隧道式电切术治疗,回顾分析其临床资料。重要结论:前列腺癌近距离照射治疗术后反复尿潴留,在严格防护下早期行经尿道前列腺隧道式电切是安全有效的,且电切后对近距离照射治疗疗效无明显影响。