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规范化管理在产科的临床效果应用

目的　探讨规范化管理在产科应用中的临床效果。 方法　将观察组规范化管理后2010年1月－12月的1 415例孕产妇与对照组开展规范化管理前2009年1月－12月的1 172例孕产妇的分娩方式、产后情况以及产妇对医院护理工作满意度进行对比分析。 结果　观察组剖宫产率比对照组降低，差异有统计学意义（P＜0.01）；观察组并发症发生率明显低于对照组（P＜0.01），观察组的纯母乳喂养率及对护理工作的满意度则高于对照组（P＜0.01），平均住院日观察组则比对照组短（P＜0.01）。 结论　规范产科管理，可以提高产科救治能力及产科工作质量，降低剖宫产率及医疗风险，从而保障母婴安全及健康。

中医学术流派的形成与运气大司天理论

从运气学说的大司天理论，探讨中医各学派创始人物与运气大司天的关系，发现中医各学派学术思想的形成不是偶然，与其所处大司天的特性密切相关。大司天的更替变化，可能是中医七大主要学派创始人学术思想形成的主要根源。这一结果显示了运气学说大司天的重要价值；提示其在学习和继承各学派经验时，如果能明了各学派创始医家当时所处大司天的运气特征，不仅能更好地理解前贤的学术思想，还可以深化解读中医不同学术思想的源流。

The Change of Serum Copper and Zinc Levels in Patients with Chronic Obstructive Pulmonary Disease and Its Function

目的　探讨慢性阻塞性肺疾病（COPD）患者中微量元素铜和锌与炎症介质的关系。 方法　2010年11月－2011年3月间测量15例COPD急性加重期患者入院时及治疗后和13例健康者为对照组的血清铜、锌、C反应蛋白（CRP）、白介素-6（IL-6），血浆中金属硫蛋白，以及氧化应激产物丙二醛的浓度变化。并对铜、锌浓度变化与CRP、IL-6进行相关分析。 结果　COPD组血清中铜浓度、CRP、IL-6水平高于对照组（P＜0.05），同时急性加重期患者血清中铜的浓度、CRP、IL-6水平以及丙二醛值高于缓解期患者（P＜0.05）。而急性加重期患者血清中锌浓度低于缓解期组和对照组（P＜0.05）。血浆中抗氧化物质金属硫蛋白在三组间差异无统计学意义（P＞0.05）。在微量元素与炎症因子的相关分析中发现，铜与CRP（r=0.602，P＜0.001）、IL-6（r=0.533，P＜0.001）呈正相关，锌与IL-6呈负相关（r=?0.336，P＜0.05）。 结论　在COPD氧化应激发病机制中，铜可能发挥促氧化应激的作用，而锌可能发挥抗氧化应激的作用。微量元素稳态的紊乱有可能是COPD急性加重的危险因素。

Efficacy and Safety of Demethylation Agents for Middle/High-risk Patients with Myelodysplastic Syndrome: A Systematic Review

ObjectiveTo systematically review the effectiveness and safety of demethylation agents in patients with myelodysplastic syndrome. MethodsRandomized controlled trials (RCTs) about demethylation agents in treating myelodysplastic syndrome was electronically searched in PubMed, EMbase, The Cochrane Library (Issue 3, 2013), Web of Science, CNKI, VIP, WanFang Data and CBM from inception to March 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of the included studies. Meta-analysis was performed using RevMan 5.1 software. ResultsA total of 4 studies involving 816 patients were finally included. The results of meta-analysis showed that:for patients with myelodysplastic syndrome at middle/advanced stage, compared with the best supportive treatment plan, demethylation agents improved complete remission (CR) (OR=19.14, 95%CI 5.33 to 68.7, P < 0.000 01), partial remission (PR) (OR=20.63, 95%CI 5.76 to 73.93, P < 0.000 01), hematological improvement (HI) (OR=3.58, 95%CI 2.40 to 5.34, P < 0.000 01), and the incidences of Grade Ⅲ or Ⅳ neutropenia (OR=3.82, 95%CI 2.67 to 5.47, P < 0.000 01), Grade Ⅲ or Ⅳ thrombocytopenia (OR=3.98, 95%CI 2.55 to 6.23, P < 0.000 01), and mortalities (OR=0.52, 95%CI 0.35 to 0.77, P < 0.000 01), all with significant differences; and part of patients suffered from Grade Ⅲ or Ⅳ thrombocytopenia and tolerable adverse reaction caused by non-hematologic change. ConclusionCurrent evidence suggests that demethylation agents in treating myelodysplastic syndrome have apparently curative effects. Besides, it could prolong the time of turning into acute myelocytic leukemia, reduce mortalities, and improve patients' quality of life.

肺移植术后新型冠状病毒感染继发急性结肠假性梗阻一例报告并文献复习

目的 对1例肺移植术后新型冠状病毒（简称新冠病毒）新冠病毒感染诱发急性结肠假性梗阻的典型病例进行总结分析，提高对该病的认识。方法 回顾性分析1例肺移植受者感染新冠病毒后继发急性结肠假性梗阻（acute colonic pseudo-obstruction，ACPO）的临床资料，并以“急性结肠假性梗阻”、“新冠病毒”、“新型冠状病毒”为中文检索词，以“acute colonic pseudo-obstruction”、“COVID-19”、“severe acute respiratory syndrome-coronavirus-2”、“SARS-COV-2”为英文检索词分别检索中国知网、万方、Pubmed数据库，对入组患者的临床特征、诊疗经过及转归情况进行总结。结果 共检索出相关文献8篇，入组新冠病毒感染后继发ACPO的病例13例。14例患者中男11例，女3例，年龄38～87，中位年龄62.7岁。最主要的临床症状为腹胀（85.7%，11/14），其次是腹痛（57.1%，8/14）、腹泻（50.0%，7/14）。影像学特征主要为结肠扩张（100%，13/13），少数可出现结肠壁炎性水肿和渗出，甚至结肠穿孔。治疗上，100%（13/13）采取了肠道休息、维持水电解质平衡及胃肠减压的内科综合治疗，76.9%（10/13）进行了灌肠排气，38.5%（5/13）行结肠镜减压，23.1%（3/13）予新斯的明药物治疗，7.7%（1/13）行急诊剖腹手术。预后方面，66.7%（8/12）治愈，33.3%（4/12）死亡，死因均为感染性休克，其中2例未提及预后。结论 新冠病毒感染并发ACPO虽然少见，但病死率高。对感染新冠病毒后继发结肠扩张的患者，需高度警惕ACPO可能。

A Wireless Smart Home System Based on Brain-computer Interface of Steady State Visual Evoked Potential

Brain-computer interface (BCI) system is a system that achieves communication and control among humans and computers and other electronic equipment with the electroencephalogram (EEG) signals. This paper describes the working theory of the wireless smart home system based on the BCI technology. We started to get the steady-state visual evoked potential (SSVEP) using the single chip microcomputer and the visual stimulation which composed by LED lamp to stimulate human eyes. Then, through building the power spectral transformation on the LabVIEW platform, we processed timely those EEG signals under different frequency stimulation so as to transfer them to different instructions. Those instructions could be received by the wireless transceiver equipment to control the household appliances and to achieve the intelligent control towards the specified devices. The experimental results showed that the correct rate for the 10 subjects reached 100%, and the control time of average single device was 4 seconds, thus this design could totally achieve the original purpose of smart home system.

心脏手术后非闭塞性肠系膜缺血合并自发性肠穿孔一例

Study on feature modulation of electroencephalogram induced by motor imagery under multi-modal stimulation

Event-related desynchronization (ERD) is the basic feature of electroencephalogram (EEG), and the brain-computer interface based on motor imagery (MI-BCI) with the foundation of the analysis of ERD is of great significance in motor function recovery. The valid ERD characteristics extracted from EEG are the key to the performance of the BCI, so the study of which kind of stimulation mode can prompt subjects to generate more obvious characteristics of ERD is crucial. Four different stimulation modes are designed in this paper, and the effects of motion imagery tasks under static text stimulation, grip video stimulation, serial motion video stimulation of fingers as well as serial motion video stimulation of fingers with sound on the characteristics of ERD are analyzed. Combining the analysis of time-frequency spectrum, the power spectral density curve, ERD value and brain topographic map, it is shown that the ERD under serial motion video stimulation of fingers and serial motion video stimulation of fingers with sound modes is much stronger and has wider range of activation, and the BCI based on the analysis of ERD will have a better effect on practical application. As a result, the recognition and acceptance of the users of BCI system are improved in some extent.

Research on feature classification of lower limb motion imagination based on electrical stimulation to enhance rehabilitation

Motor imaging therapy is of great significance to the rehabilitation of patients with stroke or motor dysfunction, but there are few studies on lower limb motor imagination. When electrical stimulation is applied to the posterior tibial nerve of the ankle, the steady-state somatosensory evoked potentials (SSSEP) can be induced at the electrical stimulation frequency. In order to better realize the classification of lower extremity motor imagination, improve the classification effect, and enrich the instruction set of lower extremity motor imagination, this paper designs two experimental paradigms: Motor imaging (MI) paradigm and Hybrid paradigm. The Hybrid paradigm contains electrical stimulation assistance. Ten healthy college students were recruited to complete the unilateral movement imagination task of left and right foot in two paradigms. Through time-frequency analysis and classification accuracy analysis, it is found that compared with MI paradigm, Hybrid paradigm could get obvious SSSEP and ERD features. The average classification accuracy of subjects in the Hybrid paradigm was 78.61%, which was obviously higher than the MI paradigm. It proves that electrical stimulation has a positive role in promoting the classification training of lower limb motor imagination.

Research on the Roles of Homocysteine Transsulfuration Pathway, Vitamin B6 and Endogenous Hydrogen Sulfide in Treating Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

目的　研究同型半胱氨酸转硫途径、维生素B6及内源性硫化氢在慢性阻塞性肺疾病急性加重期（AECOPD）中的作用。 方法　2010年2月－4月间筛选AECOPD患者16例和健康志愿者（对照组）13例，测定AECOPD患者加重期、缓解期及对照组的肺功能、血清硫化氢（H2S）、丙二醛（MDA）、叶酸、维生素B12、C反应蛋白、白介素6、血浆同型半胱氨酸、胱硫醚、半胱氨酸和维生素B6的浓度。计算半胱氨酸转化率（半胱氨酸浓度/胱硫醚浓度）与胱硫醚转化率（胱硫醚浓度/同型半胱氨酸浓度）参与分析。 结果　① 加重期血清MDA水平[（7.3 ± 5.1）nmol/L ]比缓解期[（3.0 ± 1.4）nmol/L ]和对照组[（3.0 ± 2.2）nmol/L ]均升高（P＜0.01）；血清MDA水平与第1秒用力呼气容积/用力肺活量（FEV1/FVC）、第1秒用力呼气容积占预计值百分比（FEV1%预计值）呈负相关。② 加重期血清H2S水平与血浆维生素B6水平较缓解期与对照组降低（P＜0.01）；缓解期血清H2S水平[（47.2 ±5.1） μmol/L ]高于对照组[（38.8 ± 2.1） μmol/L ]，P＜0.01；血清H2S水平、血浆维生素B6水平均与FEV1%预计值呈正相关（r=0.651、0.680，P＜0.01），均与血清MDA水平呈负相关（r=-0.334、-0.448，P＜0.05）。③ 加重期半胱氨酸转化率（3.97 ± 2.41）低于缓解期（5.92 ± 2.18）与对照组（6.14 ± 3.15）差异有统计学意义（P＜0.05）；而胱硫醚转化率则相反。④ 叶酸与维生素B12水平各组间均无差异。 结论　提高AECOPD患者维生素B6及H2S浓度可能能促使AECOPD患者向稳定状态转归，减轻氧化应激损伤。维生素B6与H2S可能成为AECOPD患者的一个新的治疗点。Objective To study the roles of homocysteine (Hcy) transsulfuration pathway, Vitamin B6 and endogenous hydrogen sulfide in treating patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods　Sixteen AECOPD patients and 13 healthy controls (Control group) from February to April 2010 were recruited in this study. Lung function, serum hydrogen sulfide (H2S), malondialdehyde (MDA), folate, vitamin B12, C-reactive protein (CRP), interleukin-6 (IL-6), Hcy, cystathionine, cystein (Cys) and vitamin B6 were all measured for all the patients in the acute exacerbation period and alleviation period and healthy controls. The conversion rate of Cys (expressed as Cys/cystathionine) and the conversion rate of cystathionine (expressed as cystathionine/Hcy) were calculated for analysis. Results　Serum MDA level for patients in the acute exacerbation period (AE period) [(7.3 ± 5.1) nmol/L] was significantly higher than that in the alleviation period [(3.0 ± 1.4) nmol/L] and in the healthy controls [(3.0 ± 2.2) nmol/L] (P ＜ 0.01). Serum MDA level was negatively correlated with percentage of FEV1 in predicted FEV1 (FEV1% pred) and FEV1/FVC. Serum H2S level and plasma vitamin B6 level for patients in the AE period were significantly lower than those in the alleviation period and in the healthy controls (P ＜ 0.01), and serum H2S level was significantly higher in the alleviation period [(47.2 ± 5.1) μmol/L] than in the controls [(38.8 ± 2.1) μmol/L] (P ＜ 0.01). Both serum H2S and plasma vitamin B6 levels were correlated positively with FEV1% pred for patients in the AE period and healthy controls (r=0.651, 0.680; P ＜ 0.01), but negatively correlated with serum MDA level (r=-0.334, -0.448; P ＜ 0.05). The conversion rate of Cys for patients in the AE period (3.97 ± 2.41) was significantly lower than that in the alleviation period (5.92 ± 2.18) and the control group (6.14 ± 3.15) (P ＜ 0.05), but the conversion rate of cystathionine was just the opposite (P ＜ 0.05). There were no significant differences in the levels of serum folate and vitamin B12 among the three groups. Conclusion　Raising the Vitamin B6 and H2S level may facilitate stabilizing of conditions in patients with AECOPD and reduce oxidative stress. Therefore, it may become a new treatment method for AECOPD.