5-Br-PADAP自动化分析法测定血清铜

目的　建立简便和灵敏的双试剂自动化分析法测定血清铜。方法　在混合表面活性剂存在下,用2-(5-溴-2-吡啶偶氮)-5-二乙氨基酚(5-Br-PADAP)作显色剂测定血清铜。结果　该法线性范围0～80μmol/L,平均回收率为100.5%,批内变异系数(CV)和批间变异系数分别为0.019与0.024,与原子吸收分光光度法比较具有良好的相关性(Y＝0.991 0X+0.092 3,r＝0.992 3和P＞0.05)。120例健康人血清铜含量为11.52～21.96 μmol/L(±2s）。结论　双试剂自动化分析法测定血清铜方法简便、灵敏可靠,适合临床应用。     

血清铁5-Br-PADAP直接光度法自动分析试剂盒的研究与评价

目的　研制、评价血清铁 5 - Br- PADAP自动分析法试剂盒。方法　在表面活性剂存在下 ,用 2 - ( 5 -溴 - 2 -吡啶偶氮 ) - 5 -二乙氨基酚 ( 5 - Br- PADAP)作显色剂双试剂两点终点法测定血清铁。结果　该法线性范围 0～ 85 μmol/L,平均回收率为 99.7% ,批内变异系数 ( CV)和批间变异系数分别为 0 .0 1 4%～0 .0 1 6%和 0 .0 1 6%～ 0 .0 2 5 % ,与原子吸收分光光度法比较具有良好的相关性 ,Y=0 .9939X+ 0 .1 1 69,r= 0 .9889,P>0 .0 5。 1 0 7例健康人血清铁含量为 9.2 2～ 2 9.62 μmol/L( x± 2 s)。结论　用该试剂盒双试剂自动化分析法测定血清铁方法简便、灵敏可靠 ,适合临床应用     

Nitro-PAPS直接光度法测定血清锌

目的建立一种快速、简便、灵敏的血清锌分光光度测定法。方法在非离子型表面活性剂Tween-80及TritonX-100存在下,用水溶性试剂2-(5-硝基-2-吡啶偶氮)-5-[N-正丙基-N-(3-磺酸丙基)氨基]苯酚二钠(简称N itro-PAPS)作显色剂直接光度法测定血清锌。结果本法显色络合物最大吸收波长为580 nm,线性范围达71.2μmol/L,表观摩尔吸光度为1.38×105L/(mol.cm),回收率为98.2%~101.9%,批内变异系数(CV)为2.4%,批间CV为3.5%,与原子吸收分光光度法(AAS)比较,Y=0.997X 0.17,P>0.05,r=0.9913,60例健康人血清锌含量为(9.3~20.9)μmol/L(x-±2s)。结论本法血清用量少,不必去蛋白,具有操作快速、简便、结果灵敏可靠等优点,适用于血清锌的手工测定和自动分析。     

WST-3比色法测定糖化血清蛋白

目的 建立简便、灵敏、试剂稳定性好的比色法测定糖化血清蛋白.方法 在表面活性剂存在下,以WST-3为显色剂测定糖化血清蛋白的含量.结果 该法线性范围0～1000 μmol/L,平均回收率为100.8%,批内变异系数(CV)和批间变异系数分别为2.0%、3.5%,与酶法测定试剂比较具有良好的相关性,线性回归方程和相关系数分别为Y=1.04X-1.95,r=0.9956,P＞0.05.85例健康人糖化血清蛋白为199.20～289.00μmol/L(-x±2s).结论 该法具有快速、简便、灵敏可靠等优点,适合临床应用.     

新的高灵敏分光光度法在血清铁测定中的应用

目的　建立一种快速、简便、高灵敏测定血清铁的新方法。方法　在非离子型表面活性剂聚氧乙烯月桂醚 (Brij 35 )及聚氧乙烯异辛基苯基醚 (TritonX 10 0 )存在下 ,用水溶性试剂 2 (5 硝基 2 吡啶偶氮 ) 5 [N 正丙基 N (3 磺酸丙基 )氨基 ]苯酚 (简称Nitro PAPS)作显色剂直接光度法测定血清铁。结果　该方法测定血清铁 ,显色络合物最大吸收波长为 5 90nm ,线性范围达 10 7 4 μmol/L ,表观摩尔吸光系数为 1 0 3× 10 5L/(mol/cm)。回收率为 97 9%～ 10 2 2 % ,批内变异系数 (CV)为2 4 %～ 3 5 % ,批间变异系数 (CV)为 2 9%～ 3 7% ,与亚铁嗪分光光度法比较相关良好 ,Y =0 992X 0 12 ,r=0 9883,P >0 0 5。 85名健康成年人血清铁含量为 (11 2～ 2 8 4 ) μmol/L ( x±2s)。结论　该法血清用量少 ,不必去蛋白 ,具有操作快速、简便、结果灵敏可靠等优点 ,适用于血清铁的手工测定和自动分析     

新的5-Br-PADAP光度法测定血清锌

目的建立快速、简便、灵敏的分光光度法测定血清锌。方法锌与5-Br-PADAP及Tri-tonX-100在pH8.0缓冲溶液中生成红色配合物,测定吸光度(A1),加入掩蔽剂后再测定吸光度(A2),吸光度下降值(△A=A2-A1)与锌离子浓度成正比。结果锌络合物最大吸收波长为558nm,线性范围0～50.0μmol/L,摩尔吸光数为1.31×105L.mol-1.cm-1。回收率为100.1%,批内变异系数(CV)为2.1%,批间变异系数为3.0%,与原子吸收分光光度法(X)比较具有良好的相关性,Y=1.018X-0.226,r=0.9921,P>0.05。结论本法测定血清锌不必去蛋白、用血量少、方法简便、灵敏可靠,适合临床应用。     

血清钙的偶氮氯膦I测定法

目的　建立一种简便、灵敏、试剂稳定的分光光度法测定血清钙。方法　用国产试剂偶氮氯膦Ⅰ作显色剂测定血清钙。结果　显色络合物最大吸收波长为 5 80nm ,线性范围达 4 5mmol/L ,摩尔吸光系数为 7 72× 10 3 L·mol 1·cm 1。回收率为98 3%～ 10 1 3%,批内变异系数和批间变异系数分别为 1 87%与 2 13%,与原子吸收分光光度法Y比较具有良好的相关性 ,Y =1.0 75X - 0 .12 0 ,r =0 .984.Mg2 + 3mmol/L、Cu2 + 、Fe3 + 、Zn2 + 各 10 0 μmol/L、胆红素 2 80 μmol/L甘油三酯 4 8mmol/L、血红蛋白 2 5 g/L以下对本法测定结果无影响。 结论　该方法具有快速、简便、灵敏可靠等优点 ,适合于临床应用。     

血清铁自动分析法试剂盒的研制与评价:Nitro-PAPS直接光度法

目的 研制、评价血清铁Nitro-PAPS自动分析法试剂盒。方法 在表面活性剂存在下，用2-（5-硝基-2-吡啶偶氮）-5-[N-正丙基-N-（3-磺酸丙基）氨基]苯酚二钠（Nitro-PAPS）作显色剂双试剂两点终点法测定血清铁。结果 该方法显色络合物最大吸收波长为591nm，线性范围达85μmol／L，表观摩尔吸光数为1．11×10^5L·mol^-1，回收率为98．5％-104．1％，批内变异系数（CV）和批间变异系数分别为0．021和0．035，与原子吸收分光光度法（AAS）比较相关良好，Y=0．997X-0．223，r=0．9786，P〉0．05，224例健康人血清铁含量为（10．83—29．07）,μmol／L（±2s）。结论 用本试剂龠双试剂自动化分析法测定血清铁方法简便、灵敏可靠，适合临床应用。     

新的5-Br-PADAP光度法测定血清锌

目的建立快速、简便、灵敏的分光光度法测定血清锌.方法锌与5-Br-PADAP及Tri-tonX-100在pH8.0缓冲溶液中生成红色配合物,测定吸光度(A1),加入掩蔽剂后再测定吸光度(A2),吸光度下降值(△A=A2-A1)与锌离子浓度成正比.结果锌络合物最大吸收波长为558nm,线性范围0～50.0μmol/L,摩尔吸光数为1.31×105Lmol-1.cm-1.回收率为100.1%,批内变异系数(CV)为2.1%,批间变异系数为3.0%,与原子吸收分光光度法(X)比较具有良好的相关性,Y=1.018X-0.226,r=0.9921,P＞0.05.结论本法测定血清锌不必去蛋白、用血量少、方法简便、灵敏可靠,适合临床应用.     

水溶性新显色剂5-Br-PADCAP直接光度法测定血清铜试剂盒的研制与评价

目的研制、评价5-Br-PADCAP直接光度法测定血清铜试剂盒.方法在表面活性剂存在下,用2-(5-溴-2-吡啶偶氮)-5-[(N,N-二羧基甲基)氨基]苯酚(5-Br-PADCAP)作显色剂手工分析法和自动分析法测定血清铜.结果该法线性范围0～50μmol/L,手工分析法和自动分析法平均回收率为100.2%和101.0%,批内变异系数(CV)和批间变异系数分别为0.029、0.023和0.044、0.042,手工分析法和自动分析法分别与原子吸收分光光度法比较均具有良好的相关性,线性回归方程和相关系数分别为Y=0.9911X+0.372,r=0.9711和Y=0.9905X+0.342,r=0.9807.269例健康人血清铜含量分别为11.37～21.83μmol/L和11.03～21.57μmol/L (x±2s).结论用5-Br-PADCAP直接光度法试剂盒采用水溶性色原测定血清铜,方法简便,适合临床推广应用.     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.     

Evidence-Based Pain Management and Palliative Care in Issue Four for 2009 of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly. Issue 4 for 2009 contains 4027 complete reviews, 1906 protocols for reviews in production, and 11447 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 600,000 randomized controlled trials, and 12,200 cited papers in the Cochrane methodology register. The health technology assessment database contains over 7500 citations. This edition of the Library contains 90 new reviews, of which 19 have potential relevance for practitioners in pain and palliative medicine.     

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs.     

护理干预对面部中重度寻常型痤疮的临床疗效影响分析

目的研究护理干预对面部中重度寻常型痤疮的临床疗效影响。方法选取本院在2014年4月~2016年7月诊治的136例面部中重度寻常型痤疮患者,随机分为研究组与对照组,每组68例;所有患者均依据其情况给予对应的治疗,其中对照组在治疗期间给予常规护理,研究组在对照组的基础上再给予综合性护理干预,比较两组的治疗效果及护理满意度情况等。结果患者在接受治疗和护理后,研究组中度与重度患者的治疗效果较对照组均明显提高(P0.05),研究组护理满意度较对照组明显增高(P0.05)。结论对面部中重度寻常型痤疮患者在其治疗期间给予综合性护理干预,具有良好的效果。