偶氮氯膦I测定血清钙

目的：建立灵敏度高、选择性好、试剂稳定的血清钙测定方法。方法：在pH9.6的2－氨基－2－甲基－1，3－丙二醇（AMP）缓冲介质中，以偶氮氯膦I作显色剂，8－羟基喹啉－5－磺酸为掩蔽剂，分光光度法测定血清钙。对反应条件和方法性能进行系统研究。结果：该方法显色络合物最大吸收波长为580nm，线性血清钙。对反应条件和方法性能进行系统研究。结果：该方法显色络 的最大吸收波长为580nm，线性范围达5．0mmol/L，回收率为98．8％－99．1％，平均99．0％。批内变异系数（CV）和批间变异系数（CV）分别为0．95％和1．74％。与邻甲酚酞络合酮（OCPC）（X1）比较：Y＝1．003X1－0．036，r=0.996;与偶氮肿Ⅲ（X2）比较：Y＝1.001X2-0.030,r=0.997；与酶速率（X3）法比较：Y＝0.999X3-0.045,r=0.998。在血清胆红素高达412μmol/L,血红蛋白7g/L，镁2．59mmol/L及Intralipid高达8g/L时均对该法无显著干扰。结论：该法具有简便、快速、试剂稳定和灵敏可靠的优点，适合血清钙的手工测定和自动分析。     

用伊红Y测定脑脊液蛋白的实验研究

[目的]建立一种简便、快速、准确的分光光度法测定脑脊液蛋白。[方法]在非离子去垢剂Brij-35存在下，用伊红Y溶液作显色剂，直接光度测定。[结果]该法所生成的颜色复合物最大吸收峰为540nm，显色l0min后趋向稳定，可达2h。线性范围达1000mg／L，回收率平均值为97．4％，精密度良好，批内精度CV％为0．92％-3．35％，批间精度CV％1．37％-3．26％。[结论]该法简便、快速，所需样本量小，不需特殊试剂和仪器，适宜临床常规测定。     

低密度脂蛋白胆固醇(LDL-C)表面活性剂法检测试剂的研制

目的 研制低密度脂蛋白胆固醇（LDL-C）表面活性剂直接消除法测定试剂。方法低密度脂蛋白（LDL）与试剂Ⅰ中的表面活性剂Ⅰ形成稳定复合物，而非LDL中胆固醇被胆固醇酶、过氧化物酶消除，反应5min后，加入试剂Ⅰ，与表面活性剂Ⅱ和色原反应，LDL释放胆固醇并显色，LDL的浓度与呈色的深浅成正比。结果LDL-C检测试剂：在方法性能测定中，在2min的测定时间内，LDL-C浓度5．0mmol／L-27．0 mmol／L范围内，线性关系良好（r=0．9912），特异性良好，平均回收率为99．52％，LDL-C低、中、高值血清标本的批内和批间变异系数（CV）分别为2．6％-3．3％和3．5％-4．2％，乳糜微粒、胆红素和血红蛋白等于扰不明显；方法对比实验表明，其与PVS沉淀法、Friedewald公式法及其日本第一化学试剂相关良好，r值分别为0．967，0．9913，0．9779。结论 LDL-C检测试剂各项指标符合临床要求。     

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。     

中华医学会检验学会血脂测定推荐方法二、血清总胆固醇酶法测定（草案）

中华医学会检验学会血脂测定推荐方法二、血清总胆固醇酶法测定（草案）引言血清（血浆）胆固醇（ｃｈｏｌ）测定的历史已逾百年，方法种类繁多。化学法大部用有机溶剂提取血清中的ｃｈｏｌ，用特殊试剂显色，然后比色测定。主要显色反应有Ｌｉｅｂｅｒｍａｎｎ－Ｂｕｒｃ...     

血清总唾液酸快速测定的单一试剂研制

目的建立简便、快速的血清总唾液测定方法。方法以间苯二酚为显色物质;Fe3+为增色剂;盐酸溶液为反应介质,将上述组份按最佳浓度配制成检测血清总唾液酸的‘单一试剂’并对其进行方法学评价。结果‘单一试剂’法测定血清总唾液酸的线性为156～2500mg/L,批间CV为3.78%,批内CV为2.89%,平均回收率96.9%,显色反应后1小时内呈色稳定,轻度溶血和高血糖症对本法测定无影响,测定结果与硫代巴比妥酸法一致(P>0.05,t=1.24)。结论‘单一试剂’法测定血清唾液酸具有简便、快速、准确的特点,是血清唾液酸化学测定法的又一简便方法。     

血清总唾液酸快速测定的单一试剂研制

目的建市简便、快速的血清总唾液测定方法.方法以间苯二酚为显色物质;Fe3+为增色剂;盐酸溶液为反应介质,将上述组份按最佳浓度配制成检测血清总唾液酸的‘单一试剂'并对其进行方法学评价.结果‘单一试剂'法测定血清总唾液酸的线性为156～2500mg/L,批间CV为3.78%,批内CV为2.89%.平均回收率96.9%,显色反应后1小时内呈色稳定,轻度溶血和高血糖症对本法测定无影响,测定结果与硫代巴比妥酸法一致(P＞0.05,t=1.24).结论‘单一试剂'法测定血清唾液酸具有简便、快速、准确的特点,是血清唾液酸化学测定法的又一简便方法.     

国产化学氧化法(综合氧化剂)测胆红素试剂盒的质量评估

目的 评价化学氧化法（综合氧化剂）测定血清中总胆红素和直接胆红素。方法 通过测定精密性、准确性、各种干扰和与钒酸试剂法的相关试验。结果 总、直胆精密度分别为批内CV1．01％与3．24％，日间CV为1．58％与2．31％；平均回收率总胆为100．8％，直胆为104．5％，与日本钒酸氧化法共测40例相关性为：总胆Y（综）＝1．05X（钒）－2．53，r=0.9992;直胆Y（综）＝1．19X（钒）－4．56，r=0.9985。Hb浓度＜300mg/dl，脂血在Intralipos指数5以下不受干扰。结论 该法简单、快速、稳定、完全适应临床使用。     

血清胆红素水平对均相法测定HDL—C的影响

高密度脂蛋白胆固醇（HDL－C）水平低下是冠心病发病的危险因素之一，而高HDL－C被认为是负危险因子，具有保护性。近年来国内外纷纷采用酶试剂对均相法（homogeneous assay）[1、2]或称直接法direct method）测定HDL－C，本法具有简便、快速、能进行自动化分析等优点。但是，高胆红素血症对于酶法测定HDL－C具有明显的负干扰[3]。本文采用均相法测定高胆红素血症患者血清中HDL－C，并与选择遮蔽法测定结果进行比较分析。 1 材料与方法 1．1 标本 空腹抽取静脉血，离心后收集血清（无溶血、无脂浊）并分装2管，一份于当日测定总胆…     

液体单试剂酶法测定血清碳酸氢根

目的建立一种稳定的单试剂酶法测定血清碳酸氢根（HCO3^-）。方法利用自配单试剂建立了两点法的检测方法，可满足全自动和手工测定，用Bayer 1650生化仪对本方法进行方法学评价。结果本法的线性范围可达50mmol／L，批内变异系数（CV）为2．48％，批间CV为3．24％，平均回收率102．8％，与血气分析仪（X）相关良好，Y=1．019X-0．745，r=0．9903，黄疸、脂血、溶血标本对结果几乎无影响，健康人静脉血HCO3^-浓度为21．5～32．3mmol／L。结论本法操作简便、反应特异、灵敏准确、试剂较稳定，适用临床检测。     

Guns and Knives in New Mexico: Patterns of Penetrating Trauma, 1978–1993

Objective: To identify patterns of nonfatal and fatal penetrating trauma among children and adults in New Mexico using ED and medical examiner data.
Methods: The authors retrospectively sampled in 5-year intervals all victims of penetrating trauma who presented to either the state Level-1 trauma center or the state medical examiner from a 16-year period (1978–1993). Rates of nonfatal and fatal firearm and stabbing injury were compared for children and adults.
Results: Rates of nonfatal injury were similar (firearm, 34.3 per 100,000 person-years; stabbing, 35.1). However, rates of fatal injury were significantly different (firearm, 21.9; stabbing, 2.7; relative risk: 8.2; 95% confidence interval: 5.4, 12.5). From 1978 to 1993, nonfatal injury rates increased for children (p = 0.0043) and adults (p < 0.0001), while fatal penetrating injury remained constant. The increase in nonfatal injury in children resulted from increased firearm injury rates. In adults, both stabbing and firearm nonfatal injury rates increased.
Conclusions: Nonfatal injury data suggest that nonfatal violence has increased; fatal injury data suggest that violent death rates have remained constant. Injury patterns vary by age, mechanism of trauma, and data source. These results suggest that ED and medical examiner data differ and that both are needed to guide injury prevention programs.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

Systematic Reviews Published in the January 2011 Issue of The Cochrane Library

ABSTRACT

The Cochrane Library of Systematic Reviews is published quarterly as a DVD and monthly online. The January 2011 issue (first quarterly DVD for 2011) contains 4515 complete reviews, 1985 protocols for reviews in production, and 13,521 one-page summaries of systematic reviews published in the general medical literature. In addition, there are citations of 641,000 randomized controlled trials, and 14,018 cited papers in the Cochrane methodology register. The health technology assessment database contains over 9300 citations. One hundred and seven new reviews have been published in the last 3 months, of which five have potential relevance for practitioners in pain and palliative medicine.     

Interprofessional approaches to creating safe,high quality health care

Three supplementary perspectives are presented arguing that interprofessional collaboration is both necessary and desirable. Nonetheless, there are often too many serious intra-professional barriers and obstacles to interprofessional collaboration to make it successful. Some of these barriers, it is argued and illustrated, are found in the multiple ways in which professional identity is tacitly acquired and embodied in the practitioners' habitual, everyday practice. The paper then explores ways in which reflection, especially Second order reflection, can help to elucidate and overcome these obstacles, as well as increasing professional adaptability and competence.     

Prise en charge des entorses externes de cheville : étude clinique préliminaire sur l’efficacité du dispositif Myolux™

Ankle sprains are the most common injury of the musculoskeletal system and are associated with significant societal and economic impacts. It has been proven that classical therapeutic strategies may not be effective in preventing recurrent injuries: the recurrence rates reported in the literature can reach 73%. In order to provide an effective rehabilitation solution, a destabilizing orthosis was developed. This device is equipped with a mechanical articulator reproducing the subtalar mechanics and placed under the heel. In this paper, we present the main results of a preliminary clinical study conducted between 2004 and 2007. All subjects included in this study were treated with the abovementioned orthosis during 10 rehabilitation sessions of 30 minutes each. Data show a relatively low recurrence rate of 12% for the overall population. Moreover, it's of primary importance to note that this satisfactory ratio is largely reduced (3% of recurrence rate) for the 29 patients who performed one training session per month after the 10th initial rehabilitation sessions. Hence, the destabilizing orthosis appears to be an effective solution to prevent recurrent ankle sprains. However, joint protection requires long-term and regular training sessions. This result has motivated the development of a similar device allowing patients to perform training sessions at home. Finally, data obtained in this study are promising awaiting the final results of the comparative, multicentric and independent clinical trials currently managed by the Hospices Civils de Lyon.     

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.     

Modified micro-superior percutaneously-assisted total hip: early experiences & case reports

Because of the extensile nature and familiarity of the standard posterior-lateral approach to the hip, a family of "micro-posterior" approaches has been developed. This family includes the Percutaneously-Assisted Total Hip (PATH) approach, the Supercapsular (SuperCap) approach and a newer hybrid approach, the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach. Such approaches should ideally provide a continuum for the surgeon: from a "micro" (external rotator sparing) posterior approach, to a "mini" (external rotator sacrificing) posterior approach, to a standard posterior approach. This could keep a surgeon within his comfort zone during the learning curve of the procedure, while leaving options for complicated reconstructions for the more practiced micro-posterior surgeons. This paper details one author's experiences utilizing this combined approach, as well as permutations of this entire micro-posterior family of approaches as applied to more complex hip reconstructions.