肠道门诊分离副溶血弧菌的毒力及耐药特征分析

目的了解肠道门诊分离的副溶血弧菌的抗生素耐药性和毒力基因的携带情况。方法收集分离自2014～2016年首都医科大学附属北京友谊医院肠道门诊腹泻患者粪便的副溶血弧菌,分析其流行病学特征,采用Kirby-Bauer纸片法检测其对16种抗生素的耐药性,采用荧光PCR检测耐热直接溶血素基因(tdh)和耐热相关溶血素基因(trh)的携带情况。结果从临床标本中分离出副溶血弧菌122株,阳性检出率为4.5%。毒力基因检测显示,44.3%菌株tdh单一阳性,4.9%菌株trh单一阳性,11.5%菌株tdh和trh均阳性,39.3%菌株未检出tdh和trh。药敏试验结果显示,副溶血弧菌对氨苄西林、链霉素和磺胺异口恶唑的耐药率高,分别为70.5%、59.8%和60.7%,对头孢吡肟、卡那霉素和环丙沙星敏感度下降,头孢吡肟从83.3%下降到55.2%,卡那霉素从44.4%下降到12.0%,环丙沙星从66.7%下降到29.9%,对萘啶酸、氯霉素、强力霉素、复方新诺明等均敏感。34.4%的菌株为多重耐药菌,以对链霉素、磺胺异口恶唑、氨苄西林耐药最为常见。结论肠道门诊分离的副溶血弧菌tdh+trh+和tdh-trh-的菌株比率增加,对抗生素的敏感性下降,应加强副溶血弧菌的病原学监测,指导临床合理用药。     

浙江省宁波地区腹泻患者中副溶血性弧菌检测与分析

目的 了解腹泻患者中副溶血性弧菌(Vibrio parahaemolyticus,VP)携带、消长情况,建立分子溯源方法,发现流行优势型,分析疾病诱发因素,为控制副溶血性弧菌引起的食物中毒提供依据。 方法 腹泻患者中副溶血性弧菌分离采用筛检法;采用API生化鉴定系统进行菌株鉴定;用血清凝集试验对菌株进行血清分群;药敏试验采用K-B法;利用脉冲场凝胶电泳(pulsed field gel electrophoresis,PFGE)进行分子分型;聚合酶链反应(polymerase chain reaction,PCR)检测细菌毒力基因。 结果 从6216份腹泻患者标本中检出副溶血性弧菌901株,占检出致病菌的63.45%。副溶血性弧菌生物学性状典型,对氨苄西林等青霉素类抗生素的耐药率高,但对其他大多数抗生素敏感。480株副溶血性弧菌分成6个血清群,O∶3血清群占72.71%,为流行优势群。根据PFGE图谱带型变化可分为19个不同的型别,其中食物中毒来源的菌株PFGE带型集中。tdh毒力基因阳性的副溶血性弧菌396株,阳性率为70.71%;trh毒力基因阳性的副溶血性弧菌79株,阳性率为14.11%;tdh、trh毒力基因均阳性的副溶血性弧菌18株,阳性率为3.21%;tdh阳性的副溶血性弧菌中有365株神奈川试验阳性,占73.14%。 结论 宁波地区腹泻患者由副溶血性弧菌引起的比例较高,O3血清群为优势血清群。PFGE分型方法准确性、特异性高、重复性好、结果容易判读,分型效果更为明显,食物中毒来源的菌株带型集中,可用于确定菌株间的聚集性关系,提示传染源和传播途径,明确食物中毒是否为同一起暴发事件。患者中分离到的副溶血性弧菌大多数为带毒株,具有致病能力,与海产品和环境株不同,可用-内酰胺类、氨基糖苷类、喹诺酮类等抗生素作为临床治疗用药。     

宁波地区腹泻患者副溶血弧菌毒力基因及耐药性分析

目的分析宁波地区腹泻患者副溶血弧菌毒力基因、Ⅲ型分泌系统(T3SS)及其耐药情况。方法收集分离自腹泻患者粪便样本的副溶血弧菌49株,采用聚合酶链反应(PCR)检测其毒力基因tdh、trh和T3SS1、T3SS2,采用纸片扩散法检测分离的菌株对17种常用抗菌药物的敏感性。结果 49株副溶血弧菌中有48株tdh阳性,1株trh阳性,47株tdh(+)trh(-),1株tdh(+)trh(+),1株tdh(-)trh(-);49株副溶血弧菌均携带T3SS1基因,47株携带T3SS2α基因,1株携带T3SS2β基因。副溶血弧菌对氨苄西林的耐药率最高(75.5%),对三代头孢、四环素类抗菌药物的敏感性较高,对头孢吡肟、左氧氟沙星和碳氢酶烯类抗菌药物(亚胺培南、美洛培南)的敏感性为100%。结论宁波地区腹泻患者副溶血弧菌毒力基因携带率高,对常见抗菌药物较敏感,应及时监测其耐药率变化,指导临床合理用药。     

我国东南沿海地区副溶血弧菌O3:K6血清型耐药分析

目的 对分离自我国东南沿海地区的77株O3:K6血清型副溶血弧菌携带毒力基因情况及其耐药状况进行分析。方法 对2002-2016年分离自上海市、深圳市、江苏省、浙江省的77株O3:K6型副溶血弧菌tdh和trh基因进行PCR扩增检测,并用K-B纸片法检测菌株对15种抗生素的药敏情况。结果 77株O3:K6型副溶血弧菌tdh和trh基因的携带率分别为94.81%和1.30%。受试菌株对氨苄西林、链霉素、卡那霉素、磺胺异恶唑、环丙沙星的敏感率较低,分别为7.79%、18.18%、31.17%、49.35%、54.55%,其中对氨苄西林、磺胺异恶唑和链霉素的耐药率最高,分别为84.42%、36.36%、32.47%;对头孢曲松、头孢西丁、头孢吡肟、庆大霉素、阿奇霉素的敏感率较高,分别为96.10%、87.01%、81.82%、97.40%、93.51%;所有菌株对亚胺培南、复方新诺明、萘啶酸、多西环素、氯霉素均敏感。本研究中共分离到11株多药耐药菌株,全部为致病株,多药耐药率高达14.29%。结论 我国东南沿海地区分离的77株O3:K6型副溶血弧菌tdh携带率较高,trh携带率较低;对氨苄西林、磺胺异恶唑、氨基糖苷类、环丙沙星的敏感性较差,对其他临床常用抗生素比较敏感,同时存在多药耐药现象。     

基于多重PCR的副溶血弧菌大流行菌群及其毒力基因检测方法的建立与评价

目的 基于多重聚合酶链反应（PCR）建立一种快速方便的检测副溶血弧菌大流行菌群及其毒力基因的方法。方法 结合副溶血弧菌大流行菌群的群特异鉴定方法GS-PCR,与副溶血弧菌致病相关的耐热直接溶血素基因（tdh）和耐热直接溶血素相关溶血素基因（trh）序列设计引物,建立并优化多重PCR检测方法。用已知的大流行菌株和非大流行临床分离株,对其进行特异性、灵敏度等性能的评价。并对224株食品分离株和3株临床分离株副溶血弧菌进行了再鉴定。结果 副溶血弧菌大流行菌群有群特异PCR标识基因和tdh扩增条带。而其他细菌扩增结果呈阴性。检测灵敏度可达到105 CFU/ml。对实验室保存的224株食品分离株和3株临床分离株进行再鉴定表明,其中5株为副溶血弧菌大流行菌群,其中3株为tdh阳性、trh阴性,2株tdh、trh均阴性。结论 本研究所建立的多重PCR方法特异性好、灵敏度高。为副溶血弧菌大流行菌群及其毒力基因的快速大规模检测提供良好的技术支持。     

两种核酸检测法在副溶血性弧菌耐热直接溶血素和不耐热溶血毒素中的应用评估

目的 比较CPA-核酸试纸条法与荧光定量PCR法检测副溶血性弧菌（VP）的tlh种特异性基因和tdh毒力基因的灵敏度与特异性。方法 采用CPA-核酸试纸条法和荧光定量PCR法同时对655株不同来源的VP菌株进行tlh、tdh基因检测。结果 CPA-核酸试纸条法与荧光定量PCR法检测结果相同,VP菌株的tlh基因检测阳性率均为100%（655/655）。两种方法对tdh基因的检测结果也完全一致,tdh基因临床株与海产品株阳性检测率均分别为95.8%（207/216）与2.27%（10/439）。CPA-核酸试纸条法对tlh、tdh基因检测具有高度特异性,灵敏度可达6.2103 cfu/ml菌液,从核酸制备至完成检测最快仅需1 h。结论 VP临床株与涉水产品分离株普遍携带tlh种特异性基因,而tdh毒力基因主要存在于临床标本而在涉水产品株极少存在,可采用敏感、特异的CPA-核酸试纸条法,做VP腹泻患者的床边诊断以及食物中毒事故现场的快速检测。     

一起副溶血性弧菌引起食物中毒实验室溯源检测

目的 分析一起食物中毒中分离的副溶血性弧菌(Vibrio parahaemolyticus,Vp)的血清群分布、毒力基因携带情况及分子分型特征,为溯源提供依据。 方法 血清凝集试验检测菌株血清型别,多重PCR方法检测Vp三种毒力基因tdh(耐热直接溶血素),trh(相对耐热直接溶血素)与tlh(不耐热溶血素)的携带情况。肠道细菌重复基因间共同序列(enterobacterial repetitive intergenic consensus sequence,ERIC)PCR分型技术分析不同来源菌株基因型特征。 结果 24株分离株中主要血清群为O3:K6(33.3%),均携带tlh基因、均不携带trh基因。66.7%(16/24)的菌株携带tdh基因,O3:K6血清群菌株均携带tdh基因。ERIC PCR分型分为3个克隆群:E1群包括4株O1,2株O2,O4、O5各1株,E2群包括3株O1,2株O5,O2、O4、O10各1株;E3群包括8株O3。 结论 该起食物中毒是由多种型别Vp引起。主要血清群为O3:K6,在食品与患者中都分离出该血清群的菌株,经ERIC分型,这些菌株来自同一个克隆群。除O3血清群外,从食品、加工存放食品的器具及患者中分离出其他不同血清群Vp,经ERIC分型,不同血清群分为2大克隆群,提示此次食物中毒的传染源可能与食品、加工存放食品器具污染Vp相关。     

tdh+与tdh?副溶血弧菌耐药表型与基因型差异分析

  目的  描述tdh+与tdh?副溶血弧菌表型与基因型耐药差异,分析耐药基因型与耐药表型之间的关系。  方法  采用K-B纸片法检测208株tdh+与73株tdh?副溶血弧菌对临床及水产养殖中常用的7类16种抗生素的敏感性,使用新一代测序技术获得实验菌株的全基因序列,通过序列比对分析基因组中耐药基因及耐药相关基因突变情况。 分析耐药表型与基因型之间的关系。  结果  tdh+菌株和tdh?菌株对亚胺培南均100%敏感。 tdh+菌株对头孢吡肟、阿奇霉素耐药率（0.48%、8.65%）高于tdh?菌株（0.00%、4.11%）;tdh?菌株对氨苄西林、头孢西汀、头孢曲松、环丙沙星、萘啶酸、链霉素、卡那霉素、庆大霉素、磺胺甲恶唑、复方新诺明、四环素、多西环素、氯霉素耐药率均高于tdh+菌株。 tdh?菌株的多重耐药率（34.25%）高于tdh+菌株（19.23%）。 耐药基因共检出5类7种,其中β-内酰胺类bla_CARB基因在所有的tdh+菌株和tdh?菌株均检出;四环素类tet（34）基因在tdh+与tdh?菌株基因携带率分别为99.52%、98.63%;喹诺酮类耐药基因qnrS5 仅在tdh+菌株中检出;tdh?菌株中叶酸代谢抑制类（sul2）、四环素类［tet（35）、tet（59）］、苯丙醇类（floR）耐药基因检出率高于tdh+菌株。 共在14株（tdh+9株,tdh?5株）细菌中检索出6种耐药基因点突变方式,均为编码16S rRNA的rrs基因突变。  结论  tdh?副溶血弧菌耐药现象较tdh+副溶血弧菌更为严重; 16S rRNA的rrs基因突变是除aph（3'）-Ib、aac（3）-Ⅱ、aac（6’） -I、aph（3'）-Id等耐药基因外副溶血弧菌对氨基糖胺类药物耐药的主要机制之一;副溶血弧菌中,可用bla_CARB耐药基因存在情况预测副溶血弧菌氨苄西林耐药表型;除此之外其余抗生素耐药表型与其对应耐药基因之间未见明确的对应的关系。     

副溶血弧菌病原学流行规律以及特征分析

目的 对宁波市镇海区腹泻患者副溶血性弧菌(VP)流行病学规律以及特征进行分析,从中发现其病原生物学特性并观察患者发生VP感染的危险因素,为控制VP引起的食物中毒提供参考数据。方法 选取2020年1月至2022年2月期间收集腹泻患者粪便标本共515份,共检测出VP菌株共121株(占比23.49%),对VP菌株进行血清分群分析,采用PCR方法对VP菌株中tdh和trh毒力基因进行检测,并完成药敏试验。观察VP感染患者血清分群结果,其毒力基因检测结果及药敏试验结果,观察121例VP感染患者的临床特征,采用二元Logistic回归分析发生VP感染的危险因素。结果 121株分离自患者粪便的副溶血性弧菌经血清凝集后显示O3群-共97株(占比80.17%),O4群共21株(占比17.36%),O10群发现2株(占比1.65%),O8群发现1株(占比0.83%);121株菌株毒力基因tdh均为阳性,trh均为阴性;VP菌株对氨苄西林(AMP)耐药率最高为85.12%,其他三代头孢菌素、氟喹诺酮类比较敏感分别为100%。收集VP菌株对应患者的临床资料情况,存在87.60%的VP感染患者排泄粪便呈水样,2...     

广东省江门市一起副溶血弧菌食物中毒分离株的病原学特征分析

目的 分析广东省江门市2017年某公司发生的一起副溶血弧菌食物中毒分离株的血清型别、耐药表型和分子特征。方法 对该起食物中毒事件分离到的15株副溶血弧菌进行血清学分型,抗生素敏感性检测,耐热直接溶血毒素基因（tdh）、耐热相关溶血毒素基因（trh）、GS-PCR和orf8基因的PCR检测,脉冲场凝胶电泳（PFGE）分子分型分析。结果 15株副溶血弧菌分离株经生化鉴定、血清学鉴定为O3:K6型;抗生素敏感性分析显示,所有菌株均对氨苄西林和头孢唑啉耐药,对其他抗生素敏感;毒力基因PCR检测结果显示,所有菌株均为tdh+trh-型菌株,并且携带GS-PCR和orf8基因;14株病例分离株和1株食物分离株经限制性内切酶（NotⅠ、SfiⅠ）酶切后的PFGE指纹图谱高度相似,仅存在2条带的差异。结论 该起食物中毒的病原体为O3:K6型副溶血弧菌,携带tdh、GS-PCR和orf8基因,具有共同的耐药表型和遗传特征,此次食物中毒事件由2种克隆群的副溶血弧菌引起。     

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.     

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.     

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.     

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.     

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.