AVL945型血气分析仪故障排除一例

ＡＶＬ９４５型血气分析仪故障排除一例解放军二六０医院安香莲，李学军（０５００４１）故障现象：系统停止工作，该机自检系统显示检查ＳＴ３电磁阀。分析与检修：通过检查ＳＴ３电磁阀下面的液路管道，未发现问题。做测试程序ＭＣＤＥ５－４－３，检查ＳＴ３的动作，交...     

振动刺激试验在评价胎儿宫内状态中的应用

无负荷试验（ＮＳＴ）是产前监测胎儿宫内状态的一个重要手段，已被广泛应用于临床。但是，当胎儿处于睡眠状态或母亲服用某些镇静药物时，会出现假阴性使ＮＳＴ的监测时间延长，检查次数增加。近年来，一些国内外学者利用声音刺激或振动声音刺激来改变胎儿的睡眠－觉醒周期，引起胎儿心率改变，以便减少ＮＳＴ的假阴性率。但是，这种胎心率的改变是纯声音还是振动或声音和振动共同作用引起的，目前尚有争论。我们于１９９５年采用日本トイツ株式会社生产的胎儿振动刺激装置ＴＲ－３０及测试技术，在预试验１２０余例的基础上对我院住院孕妇４５例进行了ＮＳＴ／ＣＳＴ与振动刺激试验（ＶｉｒｂｒｏｓｔｉｍｕｌａｔｉｏｎｔｅｓｔＶＳＴ）的对比试验。结果表明，宫内状态良好的胎儿刺激后１ｍｉｎ内均出现胎心率加速、基线上升、变异增加等反应。５ｍｉｎ后大部分恢复到刺激前基线水平。对ＮＳＴ／ＣＳＴ（激惹试验）阳性组和阴性组分别行ＶＳＴ，结果表明，联合使用时ＮＳＴ／ＣＳＴ阴性组的假阴性率降低６９．６％，并且可以明显缩短监护时间。说明单纯的振动刺激可以鉴别胎儿处于生理睡眠状态的ＮＳＴ假阴性和缺氧状态下的ＮＳＴ阴性，提高产前胎儿监护的质量。     

用计算机辅助精子分析系统测定TCDD对大鼠精子运动能力的影响

利用计算机辅助的精子分析系统（ＣＡＳＡ）研究了２,３,７,８—四氯二苯－Ｐ－二口恶口英（ＴＣＤＤ）对大鼠精子运动能力的影响。给２１天龄幼鼠腹腔注射ＴＣＤＤ０．１、１．０和５．０μｇ／ｋｇ,对照组注射等量体积的溶媒。在性成熟后（９０天）,用扩散法收集附睾尾精子,测定其运行速度（ＶＣＬ、ＶＳＬ、ＶＡＰ）、运动方式（ＳＴＲ、ＬＩＮ、ＢＣＦ、ＡＬＨ、ＭＡＤ等）及活动精子的比率（Ｍｏｔ％）。结果表明,ＴＣＤＤ１．０μｇ／ｋｇ组,精子的运动速度明显低于对照组（ＶＣＬＰ＜０．０５;ＶＡＰ、ＶＳＬ、ＢＣＦＰ＜０．０１）,０．５μｇ／ｋｇ时精子的运动速度、及前向性和直线性运动性能均明显降低（Ｐ＜０．０１）,活动精子的比率也明显低于对照组（Ｐ＜０．０１）。本研究结果为ＴＣＤＤ的男性生殖毒理学研究,以及ＣＡＳＡ在男性生殖毒理学研究中的应用提供了进一步参考依据     

四川省部分地区主粮中杂色曲霉菌及其毒素的污染调查

通过对四川省部分地区大米和小麦两种主粮中杂色曲霉菌（Ａ．ｖ）和杂色曲霉素（ＳＴ）污染调查，结果表明在大米和小麦中，Ａ．ｖ污染率分别为５．５％和１０．５％；ＳＴ污染率为５３．４％和６５．８％；ＳＴ平均含量为１５．５μｇ／ｋｇ和５８．６μｇ／ｋｇ。对不同地区和不同贮藏期粮食进行分析，Ａ．ｖ检出率越高，粮食中ＳＴ污染率和含量越高；贮藏期延长，Ａ．ｖ和ＳＴ检出率及ＳＴ含量增高。实验产毒表明所有Ａ．ｖ菌株均能产生ＳＴ，平均产毒量达７１９０．２μｇ／ｋｇ，证实Ａ．ｖ是ＳＴ形成的主要菌种     

CT多幅相机开机后不能正常进行自检故障一例

故障现象：开机后照相机无任何反应,不能自检,不能装载。故障检修：本着由简到繁的原则,首先检查了直流电压和全部保险丝。（１）;保险丝全部正常。（２）：电压＋８．５Ｖ、一８．５Ｖ、＋５５Ｖ、＋１８．５Ｖ、一１８．５Ｖ、＋２４Ｖ均都在正常工作范围内。观察２Ｊ４、２Ｊ５电路板上的ＬＥＤ的状态,也未见明显变化。在正常工作时开机后,装载暗盒的Ｘ——平台和Ｙ——平台得到Ｊ４板（ＰＯＳＩＴＩＯＮＧＥＮＥＲＡＴＯＲＢＯＡＲＤ位置发生器控制板）发给２Ｊ２板（ＶＥＲＩＴＣＡＬＳＴＥＰＰＩＮＧＭＯＴＯＲＬＯＧＩＣＢＯＡ…     

新型双泵复苏术的基础研究

下半身序贯按压引起的动脉血返流到主动脉有一定的延时，本文探讨ＶＤＶＥＳＴ－ＣＰＲ的最佳配合方式。９条室颤犬，配伍组试验设计，随机化安排ＶＥＳＴ－ＣＰＲ和十种ＶＥＳＴ与下半身按压要与合时相的ＶＤＶＥＳＴ－ＣＰＲ先后顺序，结果表明，辅以下半身按压的双泵复苏术血液动力学效果改善，在胸部按压期辅以下半身按压改善收缩压为主，而胸部胺压放松期辅以下半身按压以改善舒张压为主，最佳的配合方式是胸部按压末期辅以下半     

8800CT GANTRY停止在HOME位置故障的检修

故障现象：扫描中ＧＡＮＲＹ突然停止在１２：００的位置。手动控制和计算机控制均失灵。ＯＤＣ台上的ＣＲＴ上显示“ＳＴＡＲＴＳＣＡＮＳＥＱＥＢＣＥＥＲ－ＲＯＲ”,“ＳＴＲＳＣＮＣＡＬＬＥＲＲＯＲ”。故障检修与分析：在首先测量床台主电源的工作电压＋２４Ｖ、＋５Ｖ、±１５Ｖ均正常。将功能控制开关置于ＳＥＲＶＩＣＥ档。分别操作ＣＷ、ＣＣＷ。ＦＡＳＴ、ＳＬＯＷ等各个开关,ＧＡＮＴＲＹ均不能动作。退回到“Ｒ”级,调出ＴＡＢＴＥＳＴ软件用计算机指令进行各种操作控制。无论是ＣＷ,ＣＣＷ还是不能动作。证明在硬件控制电…     

计算机内窥镜彩色图像管理系统的研制及应用

本文介绍了由计算机、多媒体视频采集卡、热升华打印机作为硬件环境，以中文ＳＩＮＤＯＷＳ、ＦＯＸＰＲＯ２．５、ＶＩＳＵＡＬＣ＋＋、ＰＨＯＴＯＳＴＹＬＡＲ作为软件开发环境，组成的集视频彩色图像采集、综合管理、热升华打印于一体的真彩色图像管理系统。     

合肥地区献血员感染HBV和HCV危险因素的多因素分析

用ＥＬＩＳＡ法检测了合肥地区１４４０名献血员抗ＨＣＶ和乙肝五项指标，抗ＨＣＶ阳性率为５５％；ＨＢｓＡｇ携带率为１５％，ＨＢＶ总感染率４３７％。分别以抗ＨＣＶ阳性与感染过ＨＢＶ的献血员为病例，以抗ＨＣＶ阴性与未感染ＨＢＶ的献血员为对照进行了ＨＣＶ和ＨＢＶ感染危险因素的单因素和多因素分析。结果显示，ＡＬＴ、献血次数、献血量、文化程度、献血员心理和输血史与ＨＣＶ感染有关；血型、家庭人口数和家庭子女数与ＨＢＶ感染有关。     

CT机准直器故障检修一例

故障现象：开机后用５ｍｍ设置扫描正常，但转换到１０ｍｍ层厚作扫描准备时，机器很长时间不能完成准备且自动废止，文本显示器上报出“准直器２．５分后仍在移动”。分析检修：打开机架前盖板，观察准直器运动情况，正常时上准直器是根据设置接孔径、层厚、滤过的顺序工作，而此时发现孔径电机运动完后层厚及滤过却不动，且准直源板上两个绿色指示灯只有一个亮。首先用备用准直源板进行换板测试，故障依旧，可排除板上故障。用万用表测量层厚电机（直流ＳＶ）电源输入端，可量到５Ｖ电压，说明层厚电机有故障，关机并拆机检查，发现有一侧…     

uCareRG10型情景动态监测仪在心血管病早期预警的研究

目的：心血管系统是由自主神经调控的复杂动态系统,通过使用人体传感网络技术进行有情景动态监测,以此实现心血管病的早期预警。方法：通过人体传感网络技术10个健康人进行有情景动态监测。对研究对象进行心电图自动分类;分析被测者的活动情景信息,并进行运动分类;并对动态心率变异性使用运动信息分割心率时间序列;检测运动中的心脏动态变化评估和sT段特征度量。结果：建立了心电图自动分类数据模型和通过人体传感网络技术提取活动特征做出运动分类的数据模型;健康人不同运动下下的心率变异性表现为运动强度大,心率变异性小的规律;ST方差随运动强度的增加而增加,经心率修正后仍然如此,而运动对健康人的sT段偏移影响不大。结论：通过有情景动态监测和基于动态系统理论的有情景数据融合方法来评估心血管系统功能是有效的。     

Septal Q wave responses to exertion in the diagnosis of proximal stenosis of the anterior descending coronary artery

In 29 patients with coronary artery disease (CAD) involving the proximal segment of left anterior descending coronary artery (LAD) and in 25 patients with normal coronary anatomy (control group) Q wave amplitude changes were studied in response to exercise with bicycle and treadmill. Decrease of the Q wave amplitude was observed only in the patient group. Increase in amplitude was found only in the control group. The sensitivity of bicycle test for a significant ST segment depression was 51.7%. The same value, obtained by treadmill exercise was 50%. When either a significant ST depression or decrease of Q wave amplitude was evaluated as an abnormal response to exercise, the sensitivity was 62% (bicycle) and 65% (treadmill). Taking both ST segment depression and reduction of Q wave amplitude, an increased sensitivity of exercise ECG examination can ben attained.     

Angina pectoris, provocable by exercise, and silent myocardial ischemia in the light of results of coronary angiography]

Correlation between coronary anatomy and the presence or absence of chest pain was studied during bicycle exercise testing in 101 patients. All of them had significant ST segment depression during the stress test. ECG changes were accompanied by chest pain in 66 patients (group A). 35 patients were free of symptoms (group B). Coronary arteriography showed significant stenosis of one or more coronary artery branch in 50 patients of group A, and in 24 patients of group B, the difference was not significant statistically. The presence or absence of chest pain weren't valuable markers in the differential diagnosis of true and false positive ST segment depression. Frequency of three-vessel disease was significantly higher in group A (14 cases), than in the other group (1 case). In conclusion, if a significant ST segment depression occurs during exercise stress either with or without anginal pain coronary arteriography is recommended to perform.     

Symptomless abnormalities. Minor ECG abnormalities

The implications of the minor ECG abnormalities that I have dealt with may be categorized as follows. Innocent: 1. Sinus arrhythmia, with or without nodal escape beats 2. Atrial extrasystoles 3. Incomplete right bundle-branch block 4. Parabolic depression of the ST segment in association with a rapid heart rate 5. Elevation of the ST segment in the right precordial leads 6. Positive/negative T waves in the transitional zone. Not necessarily indicating disease: 1. Ventricular indicating disease: 1. Ventricular extrasystoles 2. Complete right bundle-branch block 3. Left anterior or posterior hemiblock 4. Abnormally directed T-wave vectors. Probably indicating disease: 1. Plane or downward-sloping ST depression, at rest or on exercise, of more than 1 mm 2. Pyramidal arrowhead T waves, with or without an abnormally directed T-wave vector 3. Negative/positive T waves in leads facing the left ventricle 4. Inverted U waves. It is clear that careful assessment must be made before minor ECG abnormalities in presumptively normal individuals are accepted as indicators of the presence of heart disease.     

A nineteen-year cohort study on the relationship of electrocardiographic findings to all cause mortality among subjects in the national survey on circulatory disorders, NIPPON DATA80

BACKGROUND: Electrocardiogram (ECG) is one of the most popular tools for daily clinics and health checkup, and has been used for the National Survey on Circulatory Disorders to assess the health status in Japanese people. The meaningfulness to predict mortality from all causes among people with ECG abnormality is to be clarified using national samples. METHODS: ECG findings recorded among 9,638 subjects for National Survey on Circulatory Disorders 1980 in Japan, were classified using the Minnesota Codes (mc). Their relationships to all cause mortality over 19 years were examined using Cox proportional hazard models adjusting for sex, age, systolic blood pressure, blood glucose, and smoking habits. RESULTS: Subjects with abnormal Q-QS findings showed significantly high hazard ratios ( 3.71(mc1-1) and 1.57 (mc1-3)) for mortality to the subjects who were free from any major ECG findings. Hazard ratios were 1.37 (mc2-1) to 4.16 (mc2-5) for axis deviation, and 1.34 (mc3-1) to 1.35 (mc3-3) for left high R waves. Those were 1.63 (mc4-3) to 2.59 (mc4-1) for ST depression, and 1.54 (mc5-3) to 2.33 (mc5-1) for T abnormality. The lower the second number of the Minnesota Codes was, the higher hazard ratio was observed in the Q-QS, ST, T codes. The hazard ratios of junction-type ST depression (mc4-4), and low T waves (mc5-4, 5-5) were not significant. CONCLUSIONS: ECG findings defined by the Minnesota Codes were useful to predict the risk for mortality from all causes even after adjusting for the other major risk factors, and the results supported a usefulness of the ECG for health check-ups.     

运动心电图预测高原心肌低氧证价值的研究

目的：探讨运动平板实验预测高原心肌低氧证的价值。方法：平原建设者进人海拔2808m地区（n=572）经医学体检合格、常规心电图（采用PHILIPS Tage Writer300pi检测）完全正常者随机选员（n=323）进行标准化Bruce方案运动平板实验（采用蓝港运动负荷心电分析系统），尔后全体进入海拔5000m高原施工6个月期间再用常规心电图5次检测，验证缺血性心电图患病率与运动平板实验阳性率的吻合性。结果：在海拔2808m地区进行运动平板实验预测海拔5000m地区劳动者高原心肌低氧证心电图改变，有极高的总患病符合率（0．92），较高的特异度（0．87）、真实度（0．80）和阴性预测值（0．86），中等度的阳性预测值（0．60）、灵敏度（0．59）和似然比（4．43和0．48）；运动心电图结论与高原心肌低氧证心电图结论有良好的回归拟合优度（P〈0．001），运动心电图阳性率和高原心肌低氧证心电图阳性率还分别与运动后舒张压和运动前舒张压密切相关（均P〈0．001）。结论：运动心电图对高原心肌低氧证有较好的预测价值，具有实用性。     

几种冠心病诊断技术在高校保健中的应用

介绍了几种冠心病的诊断技术,分析并比较了它们在冠心病诊断中的作用。在有症状患者的不典型静息ECG中,应对其T波(如TV1>TV5),ST段变化、PtfV1、双峰P波等作用仔细比较分析,以免漏诊;结合运动ECG、HFECG、心电图Nehb导联、头胸导联ECG、DCG等多种手段综合分析。以期给高校医疗保健工作者提供参考。     

静息心电图正常的劳累性心绞痛

目的探讨劳累性心绞痛患者中，静息心电图正常的发生率厦产生原因。方法205例经冠状动脉造影证实为冠状动脉病变的劳累性心绞痛患者，分为心电图异常组和心电图正常组，对心电图正常组患者进行体袁心电图、Hoher、平板运动试验检查。结果静息心电图正常者83例，其中Holter检查ST—TCMV5呈缺血型者23例，平板运动试验阳性厦可疑阳性共46例，单支冠状动脉轻度狭窄和三支冠状动脉重度狭窄并侧支循环病例中。心电图正常组的例数多于心电图异常组（P均〈0．05）。静息心电图正常的劳累性心绞痛发生率为40．48％。结论病变冠状动脉主要在单支轻度狭窄及三支重度狭窄并侧支循环血管。     

ST segment depression in hypertensive patients: A comparison of exercise test versus Holter ECG

Introduction:

This study compared ST segment depression (ST depression) during cycle ergometry (ergometry) versus simultaneous 24-hour ambulatory blood pressure measurement and electrocardiogram recording (24-h ABPM/ECG) during everyday life.

Methods:

In a German multicenter study, ergometry and 24-h ABPM/ECG records of 239 hypertensive patients were retrospectively analyzed. ST depression was defined as an ST segment depression (1 mm limb or chest recordings V1 to V6) in an incremental cycle ergometry, or 1 mm in the 24-h ABPM/ECG recording under everyday conditions. Blood pressure parameters at the onset of ST depression in the context of the respective method were compared.

Results:

18 patients had ST depression only in ergometry (group B), 23 had ST depression only during 24-h ABPM/ECG monitoring (group C) and 28 patients had ST depression with both methods (group D). Group A had no ST depression with any method. In group D, at the onset of ST depression with 24-h ABPM/ECG investigation, all parameters except diastolic blood pressure were significantly lower compared with the corresponding parameters at the onset of ST depression with ergometry (systolic blood pressure: 148 ± 19 vers 188 ± 35 mmHg, p × 0.001; heart rate: 93 ± 12 vs 120 ± 21 beat/min, p < 0.0001; double product: 13,714 ± 2315 vs 22,992 ± 3,985 mmHg/min), p < 0.0001).

Conclusion:

ST depressions during everyday life detected by 24-h ABPM/ECG are characterized by a substantially lower triggering threshold for blood pressure level parameters compared with ergometry. The two methods detecting ischemia do not replace but complement each other.     

高频稳态噪声对心血管系统影响的调查

目的 观察高频稳态噪声对心血管系统的影响。方法 测量噪声作业女工的血压、心率、心律、QRS间期、ST段改变、Q—T间期等参数。结果 工龄小于15年的噪声组窦性心动过速、窦性心律不齐、束支传导阻滞与对照组比较差异有显著性，血压升高及其他心电图参数变化不明显；工龄大于和等于15年噪声组窦性心动过缓，血压升高、QRS时间延长、ST段改变、Q—T间期延长、左心室高电压与对照组比较差异有显著性。结论 接触高频稳态噪声可对心血管系统产生不良影响，影响的范围和程度与接触时间有关。