从“脾脉相关”论治心律失常

脾生营卫、气化通脉,血脉和依赖于脾胃生化,血脉利依赖于脾胃运化。脾失所化,则脉道失濡,心神失养;脾失所运,则痰瘀内生,心神受扰。治疗心律失常当以脾胃生化和运化为基础,补虚泻实,以复脉律。从“脾脉相关”的角度揭示心律失常的本质,体现中医学气血理论特色,为临床辨治提供新思路与新方法。

慢性肾衰肾功能改变与脉图变化的相关性的临床研究

目的:观察慢性肾衰患者肾功能损害与脉图变化的相关性。方法:采取临床调查研究方法,选取慢性肾衰患者为研究观察组,设立正常人为对照组,观察慢性肾衰患者的脉图改变特点及其与肾功能损害的相关性。结果:慢性肾衰患者脉图参数h3/h1、W1/t、A、t5/t4和Scr/Bun有明显的相关性:参数h3/h1、W1/t、A与肾功能变化呈正相关,t5/t4与肾功能变化呈负相关。结论:CRF肾功能改变与脉图参数之间有一定的相关性,可作为临床诊治CRF提供一定的客观依据。

预防性护理在重症监护室中心静脉置管相关性感染患者中的应用效果

目的探讨预防性护理在重症监护室中心静脉置管相关性感染患者中的应用效果。方法选取2017年1月~2018年8月我院收治的78例重症监护室中心静脉置管患者作为研究对象,采用随机数字表法将其分为常规护理组与预防性护理组,每组各39例。常规护理组患者采用常规护理措施,预防性护理组患者采用预防性护理措施。比较两组患者的护理满意度和重症监护室中心静脉置管的时间、置管过程患者的躁动评分;比较两组患者护理前后的炎症指标(白介素-6、白介素-8)、心率水平和心理焦虑评分;比较两组患者置管相关性感染的总发生率。结果预防性护理组患者的护理满意度高于常规护理组,差异有统计学意义(P<0.05)。入院时,两组患者的白介素-6、白介素-8、心率水平和心理焦虑评分比较,差异无统计学意义(P>0.05);出院时,预防性护理组患者的白介素-6、白介素-8、心率水平和心理焦虑评分低于常规护理组,差异有统计学意义(P<0.05)。预防性护理组患者的重症监护室中心静脉置管时间长于常规护理组,置管过程中,预防性护理组患者的躁动评分低于常规护理组,差异有统计学意义(P<0.05);预防性护理组患者的置管相关性感染总发生率低于常规护理组,差异有统计学意义(P<0.05)。结论重症监护室中心静脉置管患者实施预防性护理措施的效果理想,值得临床推广应用。

水中目标回波亮点时空相关与脉间相关特性研究

信号相关分析是时域和空域中一种基本的、但又是重要的信号分析方法。本文介绍了水下目标回波时空相关特性分析和脉间相关特性分析的基本原理 ,并给出了高频回波测试系统获取的海试数据的处理结果。

161例大学生四脉相关因素调查分析

目的讨论大学生溢、紊、聚、覆脉出现的频率以及影响因素。方法收集161例大学生的脉象、性别、气质类型、90项症状清单(Symptom Check List 90,简称SCL-90)评分进行统计分析。结果溢脉最多,聚脉次之,覆脉又次之,紊脉最少。左右手脉象出现频率无差异(P>0.05),男女生左手及右手脉象出现频率无差异(P>0.05)。各脉均未出现在所有气质类型中。左聚脉组、左复合脉组、左其他脉组SCL-90评分高于全国常模。左平脉组与左聚脉组、左平脉组与左其他脉组、左溢脉组与左聚脉组、左溢脉组与左其他脉组SCL-90评分有差异(P<0.05),其余各组之间无差异(P>0.05)。结论大学生四脉的出现与左右手及性别关系不大,受气质类型影响,可反映受试者的心理状态。

胃肠外科术后中心静脉导管相关性感染的病原菌特点和药敏试验结果分析

目的:探讨胃肠外科术后中心静脉导管相关性感染的病原菌特点和药敏试验结果。方法:选取我院2012年4月~2016年5月收治的498例行胃肠术并实施中心静脉置管操作的患者,对其临床病历加以回顾筛查,并对细菌培养以及药敏试验结果进行详细分析。结果:498例行胃肠术患者共计39例发生中心静脉导管相关性感染,病原菌培养51株。革兰阳性菌27例,占比52.94%;革兰阴性菌19例,占比37.25%;真菌5例,占比9.81%。万古霉素、替考拉尼及利奈唑胺对革兰阳性菌效用良好;亚胺培南、左氧氟沙星、舒巴坦以及阿米卡星对革兰阴性菌疗效显著。结论:胃肠术后患者发生中心静脉导管相关性感染的病原菌以革兰阳性菌为主,医护人员必须根据药敏试验结果选用合适的抗生素及时防控和治疗。

高层建筑结构风荷载及其动态响应研究

为了解决风致高层建筑振动问题,以山西省阳泉市某高层建筑为研究对象,运用数值计算的方法获得风荷载的时程曲线,并分析高层建筑的层间位移、基底剪力、风振系数等风振动态响应参数。结果表明,基于相关脉动风速AR模型的风速时程模拟功率谱与目标功率谱呈现出良好的一致性,模拟功率谱数据具有较好的稳定性;高层建筑的顺风向层间位移角随着楼层高度呈现先迅速增加,后趋于稳定并略有减小的变化趋势,横风向层间位移角波动较小,顺风向层间位移角远大于横风向层间位移角;顺风向和横风向基底剪力均呈现剧烈的波动,具有很强的随机性,顺风向基底剪力远大于横风向基底剪力;高层建筑顺风向的风振系数呈现“弓”状非线性变化,而横风向的风振系数则呈现近线性的变化趋势。

辨沉紧脉与滑数脉

在临床中,脉为沉滑而数,症见口干、舌红、苔黄腻、溲黄或见下痢脓血,按湿热论治,用清利解毒处方而不愈者,屡见不鲜。这是因为,除对症的辨证有误外,更重要的是对脉性的把握不准。作者通过临床观察,凡原被诊为脉滑数者,许多病例并非有数有滑的脉象,而只是有一种弦急紧迫弹指感。据此,往往混淆了滑数与急紧间的区别,而出现诊脉中的判断错误,最终影响了临床疗效。作者多年在对脾肾阳虚病及结肠炎和杂病的诊治中,

风速水平空间相关性对长横担输电塔风效应的影响

以沿海某220 kV长横担角钢输电塔为原型,考虑沿横担向的脉动风速非完全相关性,采用谐波叠加法模拟该输电塔的风速时程,并基于准定常假定进行输电塔风振时域分析,得到了结构的风振响应和杆件内力。研究表明:考虑脉动风速水平向空间相关性后,横担产生显著的转角,塔头具有明显的扭转振动,并导致塔头的斜材内力增幅明显;然而,由于风速空间相关性的引入,顺风向整体脉动风载有所减小,使得全塔的风振系数减小,尤其是塔身的风振系数减幅明显。因此,长横担输电塔设计中应考虑风速水平向空间相关性对风效应的影响。

一种连续多脉冲相参海杂波的仿真方法

目前,海杂波的电磁特性研究主要分别在幅度统计特性和功率谱特性两方面进行,这已不能满足海杂波背景下开展相参积累研究时对仿真数据的需求,完全随机产生的海尖峰也与实际场景不符。本文针对海杂波仿真面临的问题,开展了连续多脉冲相参海杂波的仿真方法研究,给出了一种包含海尖峰重排、脉间相关处理和谱型滤波等过程的仿真方法。并对仿真模型获得数据与实测数据比较分析。实验结果表明,本文给出的方法可以很好地描述海杂波的幅度分布、多普勒以及相关特性,可以作为进一步开展海面回波相参积累研究的仿真数据来源。

从“脾脉相关”理论论治缺血性脑卒中

关于中风,古人多提及脉道不通,文章基于脾与脉同气于营卫,结合文献中中风病治疗以及实验研究的启示提出了"脾脉相关"理论,认为脾为至阴、统血濡脉,脾生营卫、气化通脉,脾气散精、行津润脉是脾脉相关的深层机制,缺血性脑卒中之病机可为脾气亏虚、脉失温润,营卫失和、脉道不利,脾不散精、脉失润通。从脾脉相关的角度揭示缺血性脑卒中之脑脉血液循环障碍的病变本质,凸显中医学脏腑相关的理论内涵,也为缺血性脑卒中等血脉病的临床辨治提供新的思路与方法。

Measurement of spatiotemporal characteristics of femtosecond laser pulses by a modified single-shot autocorrelation

To overcome the shortcomings of the single-shot autocorrelation SSA where only one pulse width is obtained when the SSA is applied to measure the pulse width of ultrashort laser pulses a modified SSA for measuring the spatiotemporal characteristics of ultrashort laser pulses at different spatial positions is proposed. The spatiotemporal characteristics of femtosecond laser pulses output from the Ti sapphire regenerative amplifier system are experimentally measured by the proposed method. It was found that the complex spatial characteristics are measured accurately.The pulse widths at different spatial positions are various which obey the Gaussian distribution.The pulse width at the same spatial position becomes narrow with the increase in input average power when femtosecond laser pulses pass through a carbon disulfide CS2 nonlinear medium.The experimental results verify that the proposed method is valid for measuring the spatiotemporal characteristics of ultrashort laser pulses at different spatial positions.

浮针治疗颈肩综合征与脉象相关性研究

目的:观察颈肩综合征患者经浮针治疗前后寸脉压力波和声波的变化,并探究疼痛症状和脉搏波的相关性。方法:共纳入2019年11月—2021年1月右侧颈肩不适的颈肩综合症患者50例,进行1次浮针治疗,使用道生压力波脉诊仪和声波脉诊探测系统采集治疗前后双侧寸脉的压力波和声波。比较治疗前后压力波参数、声波时频域特征的差异,并分析与疼痛症状的相关性。结果:治疗前PRI感觉项评分与右寸h5正相关(P<0.05);PRI情感项评分与右寸t1、右寸第2层声波阳性波数、左寸h5正相关(P<0.05),与右寸h3、h4、As及左寸t4负相关(P<0.05,P<0.01);VAS评分与右寸h1、h2、h3、h4、As、Ad、A负相关(P<0.05,P<0.01),与右寸第1、2层声波阳性波数正相关(P<0.05,P<0.01);PPI评分与右寸第1、2、5层声波阳性波数正相关(P<0.05,P<0.01),与右寸h3、h4及左寸h1、h2负相关(P<0.05,P<0.01)。治疗后患者VAS、PPI、PRI评分均降低(P<0.01),右寸t5、t及左寸h1、h3、h4、t5增高(P<0.05,P<0.01),右寸h5、脉数、第1-5层声波多尺度熵(MSE)值减小(P<0.01),左寸h2,第3、4、5层声波MSE值减小(P<0.01)。结论:浮针治疗颈肩综合症可以影响寸脉脉搏波,寸脉可以反映颈肩综合症疼痛程度。

Study of androgen and atherosclerosis in old-age male

Objective： To observe the difference of androgen and inflammatory cytokines level in atherosclerosis and analyse their relations. Method： Both carotid arteries and arteries of lower extremity were subjected to ultrasonic examination by Doppier＇s method. Those with much atheromatous plaque formation were ranged into case group, and those with normal result formed control group. Total, free testosterone and estradiol were assayed by radioimmunoassay. C reactive protein （CRP） was assayed by nepheloturbidity. Tumor necrosis factor-α（TNF-α）, lnterleukin-6 （IL-6）, lnterleukin-8 （IL-8）, lnterleukin-10 （IL-10）, Interleukin-18 （IL-18）, soluble intercellular adhesion molecule-1 （sICAM-1） and soluble vascular cell adhesion molecule-1 （sVCAM-1） were assayed by ELISA. The mean difference between two groups and the correlation between free testosterone and cytokines were analysed. Results： Free testosterone was （6.337±3.371） pg/L in case group and （11.375±4.733）pg/L in control group, P〈0.01. No differences were found in total testosterone and estradiol. CRP was （27.294±10.238）mg/L in case group and （12.843±6.318） mg/L in control group, P〈0.01. IL-6 was （41.700±31.385）pg/L in case group and （25.396±20.772）pg/L in control group, P〈0.05. IL-8 was （89.249±58.357）pg/L in case group and （67.873±31.227）pg/L in control group, P〈0.05. sICAM-1 was （470.491±134.078）pg/L in case group and （368.487±97.183）pg/L in control group, P〈0.01. sVCAM-1 was （537.808±213.172）pg/L in case group and （457.275±157.273）pg/L in control group, P〈0.05. There were no differences in TNF-α, IL-10 and IL-18. Correlation analysis showed that FT （free testosterone） had negative correlation with CRP, IL-6 and sICAM-1. Among them FT had well correlation with CRP, correlation index was -0.678. Conclusion： Free testosterone was in negative correlation with atherosclerosis in old-age male. Free testosterone may have the role of anti-atherosclerosis, and this effect was not achieved by its transformation to estradiol. Low tree testosterone level was followed by increased level of inflammatory cytokines. Low free testosterones coexist with inflammation and they both affect the process of atherosclerosis in old-age male.

随机时变浅海声信道的匹配方法

首先研究对解卷积求信道冲击响应匹配方法,在具有相对稳定多途的信道结构模型下,由计算机模拟分析其性能;其次用简化的匹配方法——脉间相关法对实际的海上声传播信号进行计算机处理分析;最后由微处理器等构成了一个用脉间相关法实现匹配的实时信号处理系统,结果表明,由计算机模拟的修正匹配滤波器性能优于常规匹配滤波器;脉冲相关法简化的匹配方法优于拷贝相关器;所设计的系统能实现对信号的实时处理;对随机时变浅海声信道具有较好的匹配能力;检测概率较高而虚警概率趋于零。

Is portal vein cavernous transformation a component of congenital hepatic fibrosis?

Congenital hepatic fibrosis (CHF) is an autosomal recessive disorder that belongs to the family of fibropolycystic liver diseases. This family includes a spectrum of disorders which are usually found in combination with each other and are usually inherited. Clinically fibropolycystic diseases have three effects being present in different proportions, those of a space occupying lesion, of portal hypertension and of cholangitis. In most patients, the first manifestations of CHF are signs and symptoms related to portal hypertension such as splenomegaly and varices. Portal hypertension in these patients has been attributed to the hypoplasia or compression of the portal vein radicles in the fibrous bands. Cavernous transformation of the portal vein (CTPV) is a relatively rare condition resulting from extrahepatic portal vein obstruction with recanalization or collateral vein formation to bypass the obstruction. It has been found that patients with CHF having an accompanying CTPV have relatively large splenomegaly and suffers more frequent episodes of bleeding from esophageal varices.We believe that CTPV is a congenital component of CHF and also one of the important causative factors of portal hypertension in these patients.

DETECTING TECHNIQUE OF WEAK PERIODIC PULSE SIGNAL VIA SYNTHESIS OF CROSS-CORRELATION AND CHAOTIC SYSTEM

In this letter, with the synthesis of usual cross-correlation detecting method andchaotic detecting method, a new detecting system for the weak periodic pulse signal is constituted,in which the two methods can play respective preponderance. Theoretical analyses and simulationstudies have shown that the detecting system is very sensitive to the periodic pulse signal understrong noise background and has exceedingly powerful capability of suppressing complex noise.

IN PATIENTS WITH HYPERTENSIVE LEFT VENTRICULAR HYPERTROPHY AND CORONARY HEART DISEASE,CORONARY FLOW RESERVE IS SIMILARLY IMPAIRED

Coronary blood flow reserve (CFR) was assessed by transesophageal Doppler echocardiography in normal subjects (group A. n=20),hypertensive non-left ventricular hypertrophy (non-LVH)Patients (group B,n=22). hypertensive patients with LVH(group C.n=32)and coronary heart disease patients (group D. n=33) with the volume sample placed at the bifurcation of the left main and left main and left descending coronary artery. Coronary blood flow velocity (CBFV)was evaluated at rest.2 minutes after dipyridamole (0. 56mg/kg. i. v.) . and 2 minutes after aminophylline i.v. The ratio of dipyridamole to rest maximal diastolic velocity (D/R PDV) was considered the index of coronary blood flow reserve.It was found that D/R PDV was significantly less in groups C and D compared with that in groups A and B (D PDC,1.84±0. 57. 1. 57±0. 41 versus 2.59±0.70 and 2.22+0.58,respectively),with no difference in D/R PDV between groups C and D.Twenty-four out of 32 patients in group C with D/R PDV were less than 2.0 compared to 29 out of 33 patients in group D (P>0.05).Significant negative correlation was found between D/R PDV. D/R PSV and interseptal thickness. left ventricular mass index in hypertensive patients.These data show that impaired CFR in hypertensive patients with LVH is comparable to that in patients with coronary heart disease.

Positive correlation between plasma PCSK9 and tissue factors levels in patients with angiographically diagnosed coronary artery disease and diabetes mellitus

Background Pro-protein convertase subtilisin/kexin type 9 （PCSK9） is a secreted protein that influences plasma levels of low-density lipoprotein cholesterol （LDL-C）. Both oxidized LDL and tissue factor （TF） contributed to the development of prothrombofic state. The pre- sent study aims to explore the relationship between plasma level of PCSK9 and that of TF in patient with coronary artery disease （CAD）. Methods From July 2013 to March 2014, we enrolled 197 consecutive patients who underwent coronary angiography because of suspected CAD at Beijing Anzhen Hospital in this study. All patients had no history of using lipid-lowering medication. Of these 197 patients （1B 1 male and 66 female, mean age 56.9 ± 11.8 years）, 81 had angiographically diagnosed CAD. Clinical data were collected. Plasma PCSK9 and TF were measured using enzyme-linked immunosorbent assay （ELISA）. Levels of plasma PCSK9 and TF were compared and their correlation analyzed among different patient groups. Results Both plasma levels of PCSK9 （279.8 ± 60.4μg/L vs. 216.5 ± 45.3μg/L, P 〈 0.01） and TF （156.4 ± 26.6 μg/mL vs. 112.1 ± 38.3 μg/L, P 〈 0.01） were significantly higher in patients with CAD, as compared with those with- out CAD. Correlation analysis showed plasma level of PCSK9 was significantly correlated with that of TF in both patients with and without CAD. However, multivariate regression analysis after adjustment for age, gender, smoking, alcohol, hypertension and hyperlipidemia showed that only in CAD patients with type 2 diabetes mellitus, there was significant positive correlation between plasma levels of PCSK9 and TF （β = 0.353, P 〈 0.01）. Coneluslons The plasma level of PCSK9 is independently and positively associated with that of TF in CAD patients with diabetes mellitus, but not in those without diabetes mellitus. Further study is needed to investigate the underlying mechanism.

Life detection and location methods using UWB impulse radar in a coal mine

An ultra-wideband impulse radar was studied for the detection of buried life in coal mines. An improved Empirical Mode Decomposition (EMD) method based on a cross-correlation filter was proposed for reduction of multipath and noise interference. Multipath interference was first removed by cross-corre- lation filtering. Then the delays of each pulse in every echo were summed. An EMD algorithm was used for noise reduction for the total delay of each echo. The corresponding EMD results of every echo were then summed and averaged. Finally, evidence for the existence of buried life and their position were obtained from amplitude-frequency curves of the averaged EMD results. Detailed simulation experi- ments are presented to validate the effectiveness of this proposed method. The experimental results show that this method can efficiently eliminate multipath interference and reduce noise interference in echoes, which makes detection and location of buried life in coal mines more accurate.