中医儿科技术方法操作规范——小儿针灸疗法（征求意见稿）

为规范小儿针灸技术方法,提出小儿毫针刺法、三棱针疗法、刺四缝疗法、艾灸疗法的操作规范。     

网织红细胞多参数在肝硬化中的变化及意义

目的探讨网织红细胞各参数在不同程度肝硬化（HC）患者的变化及临床意义。方法收集确诊的90例不同原因引起HC患者：按Child—pugh分级标准分A级25例（A组），B级30例（B组），C级35例（C组）：200例体检健康者为正常对照组。在Couher-Gens全自动化血液分析仪测定红细胞计数（RBC）、血红蛋白（Hgb）、平均红细胞体积（MCV）、红细胞体积分布宽度（RDW）、网织红细胞百分比（RET％）、未成熟网织红细胞指数（IRF）、平均网织红细胞体积（MRV）。并将各组的变化进行比较分析。结果随着肝硬化进程IRF、RDW、RET％显著地升高，而MRV、MCV也升高，但变化不大，RBC、Hgb则较明显地下降；和对照组相比较，A组中其他指标无变化，IRF则显著性升高（P〈0．05）；与A组相比较，B组和C组中IRF比其他指标（P〈0．05和P〈0．01）更有显著性变化（P〈0．01和P〈0．001）。结论网织红细胞参数测定有助于早期判断红细胞的活动度，作为反映肝硬化患者骨髓造血功能的新型指标，而IRF为更灵敏，更早的指标，有助于肝硬化的早期论断和对盆血的早期治疗。     

Multivariate model specification for fMRI data

We present a general method-denoted MoDef-to help specify (or define) the model used to analyze brain imaging data. This method is based on the use of the multivariate linear model on a training data set. We show that when the a priori knowledge about the expected brain response is not too precise, the method allows for the specification of a model that yields a better sensitivity in the statistical results. This obviously relies on the validity of the a priori information, in our case the representativity of the training set, an issue addressed using a cross-validation technique. We propose a fast implementation that allows the use of the method on large data sets as found with functional Magnetic Resonance Images. An example of application is given on an experimental fMRI data set that includes nine subjects who performed a mental computation task. Results show that the method increases the statistical sensitivity of fMRI analyses.     

医院医学工程科技术管理规范专题六医院医疗器械账目财务统计管理技术规范探讨

目的：针对医院医疗器械账目财务统计管理的技术规范展开探讨,细化财务管理的规范内容。方法：从技术角度阐述医疗设备、耗材的入、出库统计和设备、器材的维修费用统计等的管理规范。结果：它方便了数据查询、统计、上报和详细了解全院设备、耗材的使用情况及维修情况。结论：它能够使医学工程学科的工作更具有前瞻性、规律性、自主性和确定性。     

Nutrients, bioactive non-nutrients and anti-nutrients in potatoes

Globally, potatoes account for only about 2% of the food energy supply, yet they are the predominant staple for many countries. In developed countries, potatoes account for 540 kJ (130 kcal) per person per day, while in developing countries, it is only 170 kJ (42 kcal) per person per day. In addition to energy, which is derived almost entirely from their carbohydrate content, many varieties of potatoes contribute nutritionally important amounts of dietary fibre (up to 3.3%), ascorbic acid (up to 42 mg/100 g), potassium (up to 693.8 mg/100 g), total carotenoids (up to 2700 mcg/100 g), and antioxidant phenols such as chlorogenic acid (up to 1570 mcg/100 g) and its polymers, and anti-nutrients such as α-solanine (0.001–47.2 mg/100 g); and lesser amounts of protein (0.85–4.2%), amino acids, other minerals and vitamins, and other beneficial and harmful bioactive components. Nutrient content depends on a number of factors, with variety being among the most important. Potato biodiversity is vast, with more than 4000 known varieties. Most belong to the species Solanum tuberosum, but another 10 species are cultivated and 200 wild species have been identified. Modern agricultural practices and climate change are contributing to the loss of potato biodiversity, and thus the loss of the genes coding for nutrient biosynthetic pathways. Knowledge of differences in nutrient composition of potatoes related to their genetic diversity will help guide strategies that may contribute to reducing biodiversity loss and improving food and nutrition security.     

Blood Glucose Monitor Performance: A Review of Standards and Statistics Used to Describe Blood Glucose Monitor Performance

Glucose performance is reviewed in the context of total error, which includes error from all sources, not just analytical. Many standards require less than 100% of results to be within specific tolerance limits. Analytical error represents the difference between tested glucose and reference method glucose. Medical errors include analytical errors whose magnitude is great enough to likely result in patient harm. The 95% requirements of International Organization for Standardization 15197 and others make little sense, as up to 5% of results can be medically unacceptable. The current American Diabetes Association standard lacks a specification for user error. Error grids can meaningfully specify allowable glucose error. Infrequently, glucose meters do not provide a glucose result; such an occurrence can be devastating when associated with a life-threatening event. Nonreporting failures are ignored by standards. Estimates of analytical error can be classified into the four following categories: imprecision, random patient interferences, protocol-independent bias, and protocol-dependent bias. Methods to estimate total error are parametric, nonparametric, modeling, or direct. The Westgard method underestimates total error by failing to account for random patient interferences. Lawton''s method is a more complete model. Bland–Altman, mountain plots, and error grids are direct methods and are easier to use as they do not require modeling. Three types of protocols can be used to estimate glucose errors: method comparison, special studies and risk management, and monitoring performance of meters in the field. Current standards for glucose meter performance are inadequate. The level of performance required in regulatory standards should be based on clinical needs but can only deal with currently achievable performance. Clinical standards state what is needed, whether it can be achieved or not. Rational regulatory decisions about glucose monitors should be based on robust statistical analyses of performance.     

Temporal reduction of LATS kinases in the early preimplantation embryo prevents ICM lineage differentiation

Cellular localization of the Yes-associated protein (YAP) is dependent on large tumor suppressor (LATS) kinase activity and initiates lineage specification in the preimplantation embryo. We temporally reduced LATS activity to disrupt this early event, allowing its reactivation at later stages. This interference resulted in an irreversible lineage misspecification and aberrant polarization of the inner cell mass (ICM). Complementation experiments revealed that neither epiblast nor primitive endoderm can be established from these ICMs. We therefore conclude that precisely timed YAP localization in early morulae is essential to prevent trophectoderm marker expression in, and lineage specification of, the ICM.     

高频电刀质量检测规范技术要求探讨

目的：探讨《高频电刀质量检测技术规范（试行）》部分技术要求的合理性。方法：针对在用设备的检测不合格率偏高,结合设备原理探讨《高频电刀质量检测技术规范（试行）》的部分条款及技术要求的合理性。结果：《高频电刀质量检测技术规范（试行）》测试方法和要求存在不完善之处。结论：建议对规范进行修改,并提出修改建议以利于测试工作的正常进行。     

日本汉方药与我国中成药用药指导比较分析

随着《中医药法》的出台,经典名方制剂的应用引起各家企业的重视。目前经典名方制剂相关研究主要集中于产业、专利、质量、临床等方面,缺乏对于普及应用方面的整体研究,其中制剂说明书方面的研究作为应用研究的一个环节也越来越受到关注。分析我国现有的关于中成药说明书研究的文献,多数研究以定性分析为主,缺乏具体样本的统计分析以及数据对比和具体建议。研究了128品目的日本汉方制剂说明书及相关用药指导,具体分析了日本汉方制剂和我国中成药在中药经典名方的选择、说明书内容以及目录索引和指导手册方面的差异,并进行了初步的分析探讨,提出了在经典名方目录的确立、用药说明书内容以及索引方式的改善、整体指导手册及应用数据库的确立3个方面的具体建议,以对我国中药经典名方的应用和发展提供参考依据。     

规范发育行为儿科门诊

发育行为儿科门诊既要遵循儿科的基本程序,也要进行多维度的评估包括生长测量、行为观察、发育和心理测试等。然后根据诊断标准(DSM-5、ICD-10、DSM-PC等)和临床特征做出诊断,并要在诊断过程中注意4个方面:功能损害、综合分析评估结果、发育年龄与行为及共病。最后进行干预和治疗,诸如行为矫正、家庭干预、药物治疗、心理治疗、康复等。