卵巢癌患者血清中12种肿瘤标志物的含量检测

目的探讨多肿瘤标志物蛋白芯片诊断系统(C-12)定量测定12种肿瘤标志物在卵巢癌患者血清中的表达情况,并筛选出阳性率较高的若干标志物,为临床诊断提供依据.方法用C-12定量测定36例卵巢癌患者、32例良性卵巢疾病患者和39名正常人血清的12种肿瘤标志物,包括糖链抗原125(CA125)、铁蛋白、癌胚抗原(CEA)、甲胎蛋白(AFP)、糖链抗原199(CA199)、糖链抗原153(CA153)、神经原特异性烯醇化酶(NSE)、糖链抗原242(CA242)、前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、生物激素(HGH)和人绒毛膜促性腺激素(β-HCG).结果卵巢癌组CA125、铁蛋白、CEA的检测结果较其他2组差异有极其显著性(P<0.01),CA199、CA242的检测结果较其他2组差异有显著性(P<0.05).联合检测的灵敏度88.9%,特异性87.3%,阳性预测值为78%,阴性预测值为93.9%,准确度为87.9%,灵敏度从CA125单指标的69.4%提高到88.9%.结论肿瘤标志物CA125、CA199、CA242多指标联合检测提高了恶性卵巢癌诊断阳性率,为处于亚临床期的卵巢癌患者及正常体检人群中卵巢肿瘤的早期检出提供了可靠的检测方法.     

胰腺癌患者血清中12种常见肿瘤标志物的含量表达

目的探讨多肿瘤标志物蛋白芯片诊断系统（C-12）定量测定胰腺癌患者血清中12种肿瘤标志物的表达情况,并筛选出阳性表达情况很好的几种标志物,通过联合检测为临床诊断提供很好的依据。方法用C-12定量测定30例恶性胰腺癌患者、30例良性胰腺疾病患者和30例正常人血清的12种肿瘤标志物,包括癌抗原125、血清铁蛋白、癌胚抗原、甲胎蛋白、糖链抗原19—9、癌抗原15—3、神经原特异性烯醇化酶、糖链抗原242、前列腺特异性抗原、游离前列腺特异性抗原、生长激素、人绒毛膜促性腺激素。结果恶性胰腺癌患者血清12种肿瘤标志物的检测中CA199、CA242、CA125、CEA较其它两组有显著性差异,其总灵敏度88．9％,特异性为86．6％,阳性预测值为75．5％,阴性预测值为91．2％。多种肿瘤标志物的联合检测与CA199单指标检测比较阳性率从60％提高到88．9％。结论肿瘤标志物多指标联合检测,尤其是CA199、CA242、CA125、CEA联合检测提高了恶性胰腺癌诊断阳性率,为那些亚临床期的胰腺癌患者及正常体检人群中胰腺肿瘤的早期筛选提供了可靠的生化检测方法。     

多肿瘤标志物蛋白芯片检测技术对卵巢癌的诊断价值分析

目的 探讨多肿瘤标志物蛋白芯片检测技术对卵巢癌的诊断价值.方法 采用多肿瘤标志物蛋白芯片检测系统,测定卵巢癌患者、良性卵巢疾病患者和健康人血清中的12种肿瘤标志物的水平.结果 卵巢癌组的糖链抗原125(CA125)、癌胚抗原(CEA)、糖链抗原242(CA242)和糖链抗原199(CA199)的血清水平高于其他两组,差...     

血清CEA、CA125、CA199联检在卵巢癌诊断中的应用价值

目的 探讨CEA(癌胚抗原)、CA125(糖链抗原CA125)、CA199(糖链抗原CA199)三种肿瘤标志物在卵巢癌辅助诊断中的应用价值,为临床应用中选择优化合理、经济实用的肿瘤标志物组合提供参考依据.方法 以化学发光标记免疫法测定卵巢癌30例、卵巢良性肿瘤38例、正常对照组35例中CEA、CA125、CA199的含量,比较三种肿瘤标志物单独或联合检测对卵巢癌诊断的敏感性和准确性.结果 卵巢癌组中血清CEA、CA125、CA199含量显著高于卵巢良性肿瘤组及正常对照组(P<0.01).3种肿瘤标志物的联检阳性率为93.3%,显著高于卵巢良性肿瘤组(50.0%)和正常对照组(5.71%)(P均<0.01);联合检测在提高诊断卵巢癌敏感性的同时,特异性有所下降.结论 肿瘤标志物CEA、CA125、CA199联合检测可提高卵巢癌阳性诊断率,减少漏诊率及误诊率,三种肿瘤标志物联检在对卵巢癌有十分重要的诊断价值.     

多肿瘤标志物蛋白芯片检测系统在临床应用中的评价

目的评价多肿瘤标志物蛋白芯片在健康人群的普查、肿瘤的早期诊断及监测预后的应用。方法使用C-12型多肿瘤标志物蛋白芯片检测系统(C-12)测定分析8330例恶性肿瘤患者、9657例良性疾病患者和23531名健康体检者血清12种常见肿瘤标志物:甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199(CA199)、糖类抗原242(CA242)、糖类抗原125(CA125)、糖类抗原153(CA153)、神经元特异性烯醇化酶(NSE)、前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、铁蛋白(FER)、β-人绒毛膜促性腺激素(β-HCG)和人生长激素(HGH)。结果C-12对健康人群肿瘤的检出率为7.03%,恶性肿瘤组的阳性率达85.6%。结论运用C-12联合检测多种肿瘤标志物可以提高恶性肿瘤诊断的敏感性,可应用于预后及疗效观察,对肿瘤高危人群的普查具有一定的指导意义。     

多肿瘤标志物蛋白芯片检测系统在临床应用中的评价

目的 评价多肿瘤标志物蛋白芯片在健康人群的普查、肿瘤的早期诊断及监测预后的应用.方法 使用C-12型多肿瘤标志物蛋白芯片检测系统(C-12)测定分析8 330例恶性肿瘤患者、9 657例良性疾病患者和23 531名健康体检者血清12种常见肿瘤标志物:甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原199 (CA199)、糖类抗原242(CA242)、糖类抗原125(CA125)、糖类抗原153(CA153)、神经元特异性烯醇化酶(NSE)、前列腺特异性抗原(PSA)、游离前列腺特异性抗原(f-PSA)、铁蛋白(FER)、β-人绒毛膜促性腺激素(β-HCG)和人生长激素(HGH).结果 C-12对健康人群肿瘤的检出率为7.03%,恶性肿瘤组的阳性率达85.6%.结论 运用C-12联合检测多种肿瘤标志物可以提高恶性肿瘤诊断的敏感性,可应用于预后及疗效观察,对肿瘤高危人群的普查具有一定的指导意义.     

蛋白芯片检测肿瘤标志物及其与其他方法的比较

目的研究多肿瘤标志物蛋白芯片检测系统(C-12)检测肿瘤标志物的性能及其与国外检测系统的比较。方法分别选用湖州数康生物科技有限公司C-12、Roche Modular E170、Elecsys 2010和Abbott I2000 4种检测系统对甲胎蛋白(AFP)、癌胚抗原(CEA)、前列腺特异性抗原(PSA)、游离PSA(f-PSA)、糖类抗原125(CA125)、糖类抗原153(CA153)、神经元特异性烯醇化酶(NSE)、糖类抗原242(CA242)、人绒毛膜促性腺激素(β-HCG)和糖类抗原199(CA199)临床常见肿瘤标志物进行检测,所测得的数据进行统计学分析。结果C-12与Roche Modular E170、Elecsys 2010和Abbott I2000 4种检测系统在肿瘤标志物的检测中符合率呈显著正相关,而且敏感性、特异性、阳性预测值、阴性预测值等均有很高的一致性。结论C-12与Roche Modular E170、Elecsys 2010和Abbott I2000在检测肿瘤标志物中具有较高的一致性,对肿瘤标志物的检测具有较高的实用价值。     

使用多肿瘤标志物蛋白质芯片诊断系统检测卵巢肿瘤

目的 研究多肿瘤标志物蛋白质芯片诊断系统用于卵巢肿瘤的诊断价值。方法 用多肿瘤标志物蛋白质芯片诊断系统测定分析53例卵巢肿瘤患者，12例良性卵巢囊肿和98份正常对照人群血清的12种常见的肿瘤标志物：甲胎蛋白(AFP)，癌胚抗原(CEA)，神经元特异性烯醇化酶(NSE)，糖原125(CAl25)，糖原153(CAl53)，糖原242(CA242)，糖原：199(CA199)，前列腺特异性抗原(PSA)，游离前列腺特异性抗原(f-PSA)，铁蛋白(FER)，β—人绒毛膜促性腺激素(β—HCG)，人生长激素(HGH)。结果 53例恶性卵巢肿瘤患者血清有44例血清肿瘤标志物为阳性(阳性率为83．0％)，12例良性卵巢囊肿中7例血清肿瘤标志物为阳性(阳性率为58．3％)，98份正常对照血清中有2例血清出现肿瘤标志物(特异性97．9％)。试验还发现在部分卵巢癌患者血清中出现NSE、HGH、PSA和f—PSA。结论 多肿瘤标志物蛋白质芯片诊断系统的应用，对卵巢肿瘤患者术前肿瘤良恶性的判宗右一定的临床商用价值。     

Array-ELISA法和ECLIA法测定六项肿瘤标志物的比较研究

目的分析和评价6项肿瘤标志物测定试剂盒[微阵列酶联免疫法(Array-ELISA)]在肿瘤标志物检测中的应用价值。方法采用Array-ELISA和电化学发光免疫分析法(ECLIA)检测相同标本的6项临床常见肿瘤标志物:甲胎蛋白(AFP)、癌胚抗原(CEA)、前列腺特异性抗原(PSA)、糖类抗原125(CA125)、糖类抗原199(CA199)和糖类抗原153(CA153)。采用受试者工作特征(ROC)曲线进行分析。结果 2种方法检测AFP、CEA、PSA和CA125的阳性率差异无统计学意义(P>0.05),检测CA199和CA153的阳性率差异有统计学意义(P<0.01)。2种方法对AFP、CEA、PSA、CA125和CA199的检测结果总符合率均>85%,仅CA153的总符合率为61.1%。2种方法对6项肿瘤标志物的检测结果显著相关(P<0.01),相关系数(r)为0.695～0.960。2种方法检测AFP、CEA、PSA、CA125和CA199对相关肿瘤诊断的ROC曲线下面积介于0.62～0.99之间;用Array-ELISA检测CA153对乳腺癌诊断的ROC曲线下面积低于ECLIA。结论 Array-ELISA与ECLIA对6项肿瘤标志物的检测结果均有良好一致性,可以引入Array-ELISA检测6项肿瘤标志物作为常规体检项目和筛查项目。     

蛋白芯片检测肿瘤标志物及其与其他方法的比较

目的研究多肿瘤标志物蛋白芯片检测系统（C-12）检测肿瘤标志物的性能及其与国外检测系统的比较。方法分别选用湖州数康生物科技有限公司C-12、Roche Modular E170、Elecsys 2010和Abbott 120004种检测系统对甲胎蛋白（AFP）、癌胚抗原（CEA）、前列腺特异性抗原（PSA）、游离PSA（f-PSA）、糖类抗原125（CA125）、糖类抗原153（CA153）、神经元特异性烯醇化酶（NSE）、糖类抗原242（CA242）、人绒毛膜促性腺激素（β-HCG）和糖类抗原199（CA199）临床常见肿瘤标志物进行检测,所测得的数据进行统计学分析。结果C-12与Roche Modular E170、Elecsys 2010和Abbott I20004种检测系统在肿瘤标志物的检测中符合率呈显著正相关,而且敏感性、特异性、阳性预测值、阴性预测值等均有很高的一致性。结论C-12与Roche Modular E170、Elecsys 2010和Abbott I2000在检测肿瘤标志物中具有较高的一致性,对肿瘤标志物的检测具有较高的实用价值。     

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.     

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.     

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.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.