统一规范辨证体系的研究概况

阐述了近年来辨证体系的统一规范研究工作的概况，外感疾病辨证体系统一论旨在对外感病的各种辨证方法进行统一规范，而内伤与外感疾病辨证体系论旨在把历代各种辨证方法进行统一规范，本文还指出统一规范辨证体系研究的必要性，存在的问题和今后的努力方向。     

PET Mapping of Extrastriatal D2-like Dopamine Receptors in the Human Brain Using an Anatomic Standardization Technique and [C]FLB 457

The Computerized Brain Atlas (CBA) transforms PET images of individual subjects into a standard brain anatomy. We have previously applied this to PET images with [¹¹C]raclopride and confirmed that the D2 dopamine receptors in the striatum can be evaluated accurately with a standard brain anatomy. There is growing evidence that extrastriatal D2 receptors, in spite of their low density, have pathophysiological significance for schizophrenia. We used the CBA to explore the extrastriatal distribution of D2 receptors in 13 healthy subjects using [¹¹C]FLB 457, a substituted benzamide with very high affinity for D2 and D3 receptors. There was good agreement between the specific binding ratios from CBA quantification of standardized images and those from region-of-interest analyses of original images. The highest levels of binding were observed in the putamen and caudate nucleus, followed by the globus pallidus and nucleus accumbens. Besides the basal ganglia, the hypothalamus and nucleus ruber also showed high levels of binding. Intermediate levels were found in the substantia nigra, nucleus subthalami, amygdala, and thalamus. Interestingly, there was very heterogeneous binding among the thalamic nuclei. The anterior and mediodorsal nuclei showed relatively high binding. The cerebral cortices showed lower levels with significant regional differences. Binding was highest in the temporal cortex and hippocampus followed by the anterior cingulate gyrus, and the parietal and frontal cortices, but was lowest in the occipital cortex. The use of CBA for analysis of [¹¹C]FLB 457 binding makes it possible to build a normal database for the extrastriatal D2 receptors in the living human brain. The heterogeneous distribution of D2 receptors provides an attractive opportunity for new research on the pathophysiology and drug treatment of schizophrenia.     

The Compton source efficiency tracing method in liquid scintillation counting: A new standardization method using a TDCR counter with a Compton spectrometer

We describe a new standardization method in liquid scintillation counting based on the use of a temporary virtual tracer source created inside the scintillator by Compton interaction. The Compton tracer source is measured by the triple coincidence liquid scintillation counter after selection of the Compton events by a gamma-ray detector. The paper describes the principle of the method, the experimental setup and presents the results obtained by this method for the standardization of a ³H solution. These results are compared with those obtained using the classical triple to double coincidence ratio method. Possible application of this new method for international comparisons is addressed.     

国内医院信息系统标准化存在的问题及解决方案

标准化问题目前已成为医院信息系统建设的一个主要障碍.就此情况,本文分析讨论了国内医院信息系统标准化过程中存在的问题及其原因,并针对如何加强医院信息系统标准化建设提出了一系列建议.     

Standardization of light transmittance aggregometry for monitoring antiplatelet therapy: an adjustment for platelet count is not necessary

Summary. Background: Light transmittance aggregometry (LTA) is considered to be the ‘gold standard’ of platelet function testing. As LTA has been poorly standardized, we analyzed the results of LTA in healthy subjects and patients with antiplatelet therapy using different concentrations of agonists and performing tests in non‐adjusted and platelet count‐adjusted platelet‐rich plasma (PRP). Methods: LTA was performed in 20 healthy subjects and in patients treated with aspirin (n = 30) or clopidogrel (n = 30) monotherapy, as well as in patients on combination therapy (n = 20), using arachidonic acid (ARA 0.25 and 0.5 mg mL⁻¹) and adenosine diphosphate (ADP 2 and 5 μm ) as agonists and performing platelet function tests in non‐adjusted and platelet count (250 nL⁻¹ ± 10%)‐adjusted PRP. Results: The overall platelet aggregation response is decreased after adjusting the PRP for platelet count compared with measurements in unadjusted PRP. The variability of aggregation results is high in adjusted PRP in the subgroup of healthy subjects, ranging from 9.2–95.3% (5th–95th percentile) relative to 77.6–95.5% in non‐adjusted PRP when determining maximum aggregation to ARA 0.5 mg mL⁻¹. Late aggregation using ADP 2 μm ranges from 3.8–89.9% in adjusted PRP compared with 42.9–92.5% in non‐adjusted PRP. Maximum aggregation using ARA 0.5 mg mL⁻¹ in non‐adjusted PRP differentiates between aspirin‐treated patients and healthy controls well, whereas late aggregation using ADP 2 μm in non‐adjusted PRP offers the best discrimination between clopidogrel‐treated patients and healthy controls. Conclusion: Adjustment of PRP for platelet count does not provide any advantage and therefore the time‐consuming process of platelet count adjustment is not necessary.     

检验结果互认的思考：可能出现的误区和改善措施

摘要：推进检验结果互认是深化医改的重要组成部分，是医联体同质化管理的重要举措。在检验结果互认工作的多个重要因素中，该文通过聚焦“区域内标准化”，分析相关行政工作中可能出现的“教条化”、“自由化”2个潜在的误区，结合相关工作经验，提出改善措施，希望可以对实现区域检验结果互认有所贡献。     

从微脉源流考探讨中医脉诊术语国际标准化问题

伴随世界卫生组织《国际疾病分类第十一次修订本》中首次纳入有关传统医学细节,中国传统医学进一步走向世界。目前中医药国际教育、学术交流以及诊断相关产品的国际贸易,在国际医药市场上需求很大。然而中医诊断名词术语标准尚未建立,导致中医在展现自身独特优势,深入科学研究、国际推广以及相关产品研究及贸易等方面受到限制。如果中医药名词术语没有标准,中医药则很难在国际上深入推广,而研制名词术语标准,需要加强考证研究,对术语相关典籍进行归纳整理,理清脉络,为术语规范化提供有力支撑。故笔者通过对微脉的文献考证浅谈中医脉诊术语国际标准化问题。     

Second international collaborative study evaluating performance characteristics of methods measuring the von Willebrand factor cleaving protease (ADAMTS-13)

Summary.  Background:  Over the last 4 years ADAMTS-13 measurement underwent dramatic progress with newer and simpler methods. Aims:  Blind evaluation of newer methods for their performance characteristics. Design:  The literature was searched for new methods and the authors invited to join the evaluation. Participants were provided with a set of 60 coded frozen plasmas that were prepared centrally by dilutions of one ADAMTS-13-deficient plasma (arbitrarily set at 0%) into one normal-pooled plasma (set at 100%). There were six different test plasmas ranging from 100% to 0%. Each plasma was tested 'blind' 10 times by each method and results expressed as percentage vs. the local and the common standard provided by the organizer. Results:  There were eight functional and three antigen assays. Linearity of observed-vs.-expected ADAMTS-13 levels assessed as r ² ranged from 0.931 to 0.998. Between-run reproducibility expressed as the (mean) CV for repeated measurements was below 10% for three methods, 10–15% for five methods and up to 20% for the remaining three. F -values (analysis of variance) calculated to assess the capacity to distinguish between ADAMTS-13 levels (the higher the F -value, the better the capacity) ranged from 3965 to 137. Between-method variability (CV) amounted to 24.8% when calculated vs. the local and to 20.5% when calculated vs. the common standard. Comparative analysis showed that functional assays employing modified von Willebrand factor peptides as substrate for ADAMTS-13 offer the best performance characteristics. Conclusions:  New assays for ADAMTS-13 have the potential to make the investigation/management of patients with thrombotic microangiopathies much easier than in the past.     

Collaborative field study on the utility of a BDD factor VIII concentrate standard in the estimation of BDDr Factor VIII:C activity in hemophilic plasma using one‐stage clotting assays

Summary. Advances in production technologies of factor (F)VIII concentrates during the last two decades has resulted in very pure and safe products. In assessment of recombinant FVIII:C, inconsistent assay values are found comparing one‐stage assays with two‐stage (e.g. amidolytic) methods. Such discrepancies have been quite prominent in the case of a B‐domain deleted recombinant FVIII (BDDrFVIII, ReFacto^®). In order to alleviate this assay variance, a product‐specific reference standard [the ReFacto Laboratory Standard? (RLS)], was established for laboratory use with either one‐stage clotting or chromogenic substrate assays for the measurement of FVIII:C in ReFacto‐containing patient samples. The primary objective of the current study was to assess, under field laboratory conditions, the accuracy and precision of the one‐stage clotting assay for the determination of FVIII:C in ReFacto‐containing samples employing the new concentrate standard. A secondary goal was to assess whether use of the RLS would minimize the discrepancy between one‐stage clotting and chromogenic substrate assays. Thirty‐one clinical laboratories worldwide participated in the study of severe‐hemophilic plasma (SHP) samples that had been spiked with ReFacto to target levels of 0.9, 0.6 and 0.2 IU mL^?1. FVIII:C levels were determined against both the RLS and the local in‐house plasma standard (IHS). The results showed good agreement between laboratories in FVIII:C levels obtained by one‐stage clotting assays utilizing the RLS, and a good degree of accuracy was found compared with the intended target values. Consistent with previously published data, a discrepancy of approximately 30% was observed between one‐stage clotting and chromogenic potencies when the IHS was used as the calibrator. The discrepancy between one‐stage and chromogenic assay methodologies was significantly reduced when the RLS was employed as calibrator in the one‐stage assay. In conclusion, the study demonstrates that accurate and precise FVIII:C results can be obtained for ReFacto‐containing SHP samples by clinical laboratories using a product‐specific standard in one‐stage clotting assays. In addition, the product‐specific reference standard significantly reduced the discrepancy between the one‐stage clotting and the chromogenic substrate assay for ReFacto.