Quantitative computer‐assisted digital‐imaging upper airway analysis for obstructive sleep apnoea*

This was a prospective study of a new objective method which quantitatively analyses the upper airways in patients with obstructive sleep apnoea (OSA). Video‐nasopharyngoscopic examinations of the upper airways of 45 patients were carried out with an endoscopic calibrator. Images of the upper airway during quiet respiration and Mueller's manoeuvre in erect and supine positions were digitized by computer to generate the actual dimensions of obstructive sites. Measurements by the new method were validated by comparing 90 pairs of videoendoscopic images with upper airway magnetic resonance imaging (MRI) measurements at two identical levels. Quantitative precision is 100% for the retropalatal level and 95.6% for the retrolingual level with a tolerance of 0.5 cm² between the two methods. The absolute mean of the difference between the two methods of measurement is 0.08 cm² at the retropalatal level and 0.18 cm² at the retrolingual level. The agreement between the digital‐imaging videoendoscopic and MRI measurements was 93.3% for the retropalatal level and 95.6% for the retrolingual level. Quantitative computer‐assisted digital imaging is a reliable, cost‐effective clinical method of upper airway evaluation in OSA patients. This method allows us to examine the dynamic and static morphology objectively, measure surgical outcomes of upper airway, opening up new avenues for OSA management.     

Euthanasia, Physician Assisted Suicide and Other Methods of Helping Along Death

This paper introduces a series of papers dealing with the topic of euthanasia as an introduction to a variety of attitudes by health-care professionals and philosophers interested in this issue. The lead in paper--and really the lead in idea--stresses the fact that what we are discussing concerns only a minority of people lucky enough to live in conditions of acceptable sanitation and who have access to medical care. The topic of euthanasia and PAS really has three questions: (1) is killing another ever ethically acceptable; (2) is the participation of health professionals ethically different and (3) is it wiser to permit and set criteria (being fully aware of some dangers that lurk in such a move) or to forbid (knowing that it will occur clandestinely and uncontrolled). This paper takes no definite stand although it is very troubled by useless suffering (not only pain) by many who would wish their life and with it their suffering ended.     

影响左向右分流型先心病新生儿撤机成功的多因素分析

目的研究不同因素对左向右分流型先心病新生儿呼吸机撤离(简称撤机)成功率的影响。方法收集左向右分流型先心病机械通气新生儿95例,定义48 h内无需重新插管者属撤机成功。以撤机成功率为因变量,以新生儿胎龄、体重、肺动脉压力水平、肺血流量、缺损大小、缺损类型、合并心衰、肺炎为自变量进行多元线性逐步回归,筛选出可能的影响因素,进一步研究不同影响因素对撤机成功率的影响。结果肺动脉压力、肺血流量大小和缺损类型是影响撤机成功率的重要因素(P均<0．05)。中重度肺动脉高压组的撤机成功率低于轻度肺动脉高压组(P均<0．05),差异有统计学意义。高肺血流量组的撤机成功率低于无高肺血流量组(P均<0．05),差异有统计学意义。联合缺损组的撤机成功率低于单纯缺损组(P均<0．05),差异有统计学意义。结论肺动脉压、肺血流量、缺损类型是影响撤机成功率的重要因素。     

医院药房分装药品信息管理系统的设计与应用

OBJECTIVETo standardize computer assisted management on subpackage drug in hospital pharmacy. METHODSDesign an information management system (IMS) based on Microsoft Visual Foxpro 8.0. The system functions include entry, entering information on subpackage     

99Tcm-MIBI SPECT-CT同机图像融合技术在乳腺肿瘤显像及淋巴结转移判断中的应用

目的 探讨99Tcm-MIBI SPECT-CT同机图像融合技术对于乳腺肿瘤显像及淋巴结转移判断的临床应用价值.方法 对80例女性乳腺肿块患者行99Tcm-MlBI乳腺及腋窝淋巴结平面显像及99Tcm-MIBI SPECT-CT显像.所有患者均有手术后病理检查结果做对照.结果 80例患者中SPECT-CT融合图像对乳腺癌诊断的灵敏度88.2%(45/51),高于平面显像的82.4%(42/51).两者差异有统计学意义(P<0.05).SPECT-CT融合图像对原发性乳腺癌诊断的特异度、准确度分别为93.1%(26/29)、90%(71/80),均高于平面显像的79.3%(23/29)、81.3%(65/80).平面显像检测腋淋巴结的灵敏度77.2%(17/22),特异度86.2%(25/29),准确度82.4%(42/51),SPECT-CT融合图像检测腋淋巴结的灵敏度81.8%(18/22),特异度89.7%(26/29),准确度86.3%(44/51).两者比较差异无统计学意义(P0.05).结论 SPECT-CT图像融合显像技术在乳腺癌诊断的灵敏度、特异度和准确度均高于平面显像.在乳腺癌腋窝淋巴结转移探测方面SPECT/CT图像融合与平面显像相似.     

Detection of peptides covalently modified with multiple fatty acids by MALDI‐TOF mass spectrometry

Abstract: Analysis and characterization of membrane proteins and hydrophobic peptides by matrix‐assisted laser desorption ionization time‐of‐flight (MALDI‐TOF) mass spectrometry (MS) is a considerable challenge because of their lower ionization efficiency. Detergents are used to solubilize hydrophobic peptides and proteins. However, in MALDI‐MS, the presence of detergents can cause considerable loss of signal intensity. The extent of interference depends on the matrix/sample preparation method and experimental conditions. In the present study, we have analyzed the MALDI response of multiple fatty acylated peptides in the presence of the matrices α‐cyano‐4‐hydroxy cinnamic acid (HCCA) and 2,5‐dihydroxy benzoic acid (DHB). The effect of adding the nonionic detergent n‐octylglucoside (OG) was also examined. The presence of OG facilitated detection of tetrapalmitoylated peptide, particularly when HCCA was used as the matrix. When DHB was used as the matrix, good signal intensity was observed in the absence of OG. Lower laser pulse rate in the linear mode of analysis resulted in good signal intensity for the tetrapalmitoylated peptide. Conditions for obtaining good signal intensities for dipalmitoylated and N‐myristoyl peptides with both HCCA and DHB as matrices were also investigated.     

呼吸机相关肺炎的病因及防治对策

目的探讨呼吸机相关肺炎(VAP)的发病原因,以便采取对策进行防治. 方法对185例呼吸机使用患者采用第2、5、7天,第2、3周分别做细菌培养,观察呼吸机运用时间与VAP发病的相关性,并将病原菌加以统计与分析. 结果 VAP发病率为28.1%,使用呼吸机2、5、7 d、第2、3周VAP发病率分别为7.6%、13.5%、21.2%、32.7%、25.0%;52例VAP病原菌共7个种别58株,大多数为耐药菌. 结论使用呼吸机时间长短与VAP发病率密切相关,使用时间愈长发病率愈高,各病区应采取有效对策严密控制VAP的发生与扩散.     

Subjective well-being in infertile couples

The subjective well-being of infertile couples is affected by numerous variables. One hundred and ten infertile couples were investigated using the von Zerssen symptom checklist. With the exception of sterile women of fertile men (group 1: female infertility), women and men in the overall randomized sample and the diagnostic groups (group 2: subfertility of the man; group 3: sterility of both partners; group 4: idiopathic sterility) report fewer general symptoms than the overall population of patients with somatic and psychiatric diseases. Subfertile men show lower rating in the symptom checklist than the norm. Involuntarily childless women express more symptoms than their partners.     

Identification of pathogenic microorganisms directly from positive blood vials by matrix‐assisted laser desorption/ionization time of flight mass spectrometry

Matrix‐assisted laser desorption/ionization time of flight mass spectrometry (MALDI‐TOF MS) is a promising and fast method for identifying fungi and bacteria directly from positive blood cultures. Various pre‐treatment methods for MALDI‐TOF MS identification have been reported for this purpose. In‐house results for identification of bacterial colonies by MALDI‐TOF MS using a cut‐off score of 1.5 did not reduce the diagnostic accuracy compared with the recommended cut‐off score of 1.8. A 3‐month consecutive study of positive blood cultures was carried out in our laboratory to evaluate whether the Sepsityper? Kit (Bruker Daltonics) with Biotyper 2.0 software could be used as a fast diagnostic tool for bacteria and fungi and whether a 1.5 cut‐off score could improve species identification compared with the recommended score of 1.8. Two hundred and fifty‐six positive blood vials from 210 patients and 19 blood vials spiked with fungi were examined. Using the cut‐off score of 1.8, 81% Gram‐negative bacteria were identified to the species level compared to 84% using a cut‐off score of 1.5. For Gram‐positive bacteria 44% were identified to the species level with a cut‐off of 1.8 compared to 55% with the value of 1.5. The overall identification rate was 63% (cut‐off 1.5) and 54% (cut‐off 1.8). Seventy‐seven per cent of fungal species were identified with both log scores. MALDI‐TOF MS was in this study found to be a powerful tool in fast diagnosis of Gram‐negative bacteria and fungi and to a lesser degree of Gram positives. Using 1.5 as cut‐off score increased the diagnosis for both Gram‐positives and ‐negatives bacteria.