紫外线照射充氧自血回输对病毒性脑炎患者儿免疫功能的影响

目的：进一步了解紫外线照射充氧自血回输的免疫调节机制。方法：采用紫外线照射充氧自血回输（ＵＢＩＯ）治疗病毒性脑炎患者儿３０例，每隔３日照射１次，３次为１疗程，疗程前后测定Ｔ细胞亚群ＣＤ３、ＣＤ４、ＣＤ６、ＣＤ４／ＣＤ８、Ｂ细胞、ＮＫ细胞、白细胞介素２受体（ＩＬ－２Ｒ）、免疫球蛋白ＩｇＧ、ＩｇＡ、ＡｇＭ的变化。结果：ＵＢＩＯ治疗后ＮＫ细胞、ＩＬ－２、ＣＤ８、Ｂ细胞明显降低，ＣＤ３、ＣＤ４／ＣＤ８比值     

紫外线照射充氧自身血回输对脑梗死病人一氧化氮含量的影响

紫外线照射充氧自身血回输疗法（ＵＢＩＯ）能灭菌消炎,提高氧饱和度、增加组织供氧、改善微循环、提高免疫功能等［１］,我们采用ＵＢＩＯ方法治疗脑梗死病人４８例,并实验观察了治疗前后血浆一氧化氮（ＮＯ）含量变化,现将结果报道如下。１临床资料脑梗死患者４８例...     

紫外线照射充氧自血回输治疗急性心肌梗塞38例

紫外线照射充氧自血回输治疗急性心肌梗塞３８例张光征，张庆芬，徐萍，高文献，闫培泉，尤润生，郭京东紫外线照射充氧自血回输疗法（ＵＢＩＯ）已广泛应用于临床，尤其是缺血缺氧性疾病［１］。１９９２年１２月～１９９５年６月我们采用ＵＢＩＯ治疗急性心肌梗塞（ＡＭ...     

UBIO 治疗肺心病的临床观察及护理

ＵＢＩＯ治疗肺心病的临床观察及护理第四军医大学唐都医院（西安７１００３８）刘春丽ＵＢＩＯ又称光量子自体血回输治疗。ＵＢＩＯ是将患者的静脉血经体外抗凝，紫外线照射和充氧处理以后，再回输给患者的一种自身血液疗法。我科于１９９３年４月－１９９６年１０月，用...     

紫外线照射充氧自血回输对急性脑梗塞患者血液流变学等的影响

为研究紫外线照射充氧自血回输（ＵＢＩＯ）治疗急性脑梗塞的机制，我们选择经头颅ＣＴ证实发病３天以内的脑梗塞患者１２４例，随机分为ＵＢＩＯ组和复方丹参对照组各６２例．疗程１０天。ＵＢＩＯ组治愈率及总有效率分别为３０．６％及８８．７％，对照组为１２．９％及７２．６％，两组差异有显著性。ＵＢＩＯ组治疗后血液流变学指标、脑血流量均有明显改善，差异有显著性，而对照组不明显。ＵＢＩＯ组血小板粘附及聚集功能明显抑制。从而认为紫外线照射充氧自血回输治疗急性脑梗塞效果明显，通过改善血液流变学，提高脑血流量，抑制血小板粘附及聚集功能而实现     

紫外线照射弃氧自血回输对心肌梗塞患者QT离散度等的影响

目的 探讨有效地治疗急性心肌梗塞（ＡＭＩ）的方法。方法 ＡＭＩ患者５４例,随机 紫外线照射充氧自血回输治疗（ＵＢＩＯ）组及常规治疗组各２７例。ＵＢＩＯ组在常规治疗的基础上每日１次采静脉血２００ｍｌ,经紫外线照射度充氧后回输,６ｄ为１疗程,治疗前后分别测定心电图校正的ＱＴ离散度（ＱＴｃｄ）及血浆肿瘤坏死因子（ＴＮＦα）和内皮素（ＥＴ）含量。结果 ＡＭＩ患者ＱＴｃｄ、ＴＮＦα及ＥＴ均较正常组显著增高（Ｐ〈０．０１）。经ＵＢＩＯ治疗后明显下降（Ｐ〈０．０１）。常规治疗组治疗后ＱＴｃｄ下降（Ｐ〈０．０１）,但下降幅度低于ＵＢＩＯ组（Ｐ〈０．０１）。结论 ＡＭＩ患者配合ＵＢＩＯ治疗可取得更佳效果。     

紫热线照射充氧自血中输对冠心病患者血清脂蛋白及载体蛋白的 …

目的：探讨紫外线照射充氧自血回输（ＵＢＩＯ）对血清总胆固醇（Ｔｃｈ）、甘油三酯（ＴＧ）、高密度脂蛋白胆固醇（ＨＤＬ－Ｃ）及其亚组分Ⅱ（ＨＤＬ２－Ｃ）、亚组分Ⅲ（ＨＤＬ３－Ｃ）、低密度脂蛋白胆固醇（ＬＤＬ－Ｃ）、载体蛋白（Ａｐｏ）Ａ１、Ａ２、ｂ１００、Ｃ２、Ｃ３的影响．方法：将冠心病高血脂患者分成两组，对照且２７例，给予硝酸酯类和维生素类药物，ＵＢＩＯ组３２中用光量子疗法。两组患者治疗期间停用其他影     

紫外线照射充氧自血回输对脑梗塞患者血浆内皮素和一氧化氮含量的影响

目的：研究紫外线照射充氧自血回输疗法（ＵＢＩＯ）对脑梗塞患者血浆内皮素（ＥＴ）和一氧化氮（ＮＯ）含量的影响。方法：应用ＵＢＩＯ治疗脑梗塞患者４８例,检测患者治疗前及治疗１疗程后血浆ＥＴ和ＮＯ变化,并与同龄健康查体者２５名进行对照。结果：脑梗塞患者ＵＢＩＯ治疗１疗程后显著降低血浆ＥＴ水平,治疗前后分别为（６０．０３±１９．４０）ｎｇ／ｍｌ,（３８．２９±１７．５０）ｎｇ／ｍｌ,提高ＮＯ含量,治疗前后分别为（３５．９３±９．８０）μｍｏｌ／Ｌ,（５０．０４±１０．９０）μｍｏｌ／Ｌ,并可降低ＥＴ／ＮＯ比值。结论：应用ＵＢＩＯ治疗能有效地改变脑梗塞患者血浆ＥＴ与ＮＯ含量。     

紫外线照射充氧自血回输治疗老年胃十二指肠溃疡临床观察

观察紫外线照射充氧自血回输治疗老年消化溃疡的疗效和机制。方法将６０例老年消化性溃疡患者随机分成二组,３０例采用ＢＵＩＯ疗法并用雷尼替丁,另３０例作为对照组仅服雷尼替丁。ＢＵＩＯ每周３次,４周１疗程。     

紫外线照射充氧自血回输治疗脑梗塞观察红细胞膜Na+-K+-ATP酶的变化

目的：探讨紫外线照射充氧自血回输疗法（ＵＢＩＯ）对脑梗塞治疗作用及其机制。方法：５０例急性脑梗塞患者分为治疗组和对照组,治疗组３０例用ＵＢＩＯ与传统药物联合治疗,对照组２０例仅用传统药物治疗,进行两组疗效比较,同时检测两组患者治疗前后红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性。结果：治疗组的总有效率为９０％,对照组为７５％,经过Ｒｉｄｉｔ法分析,两组差异有显著性（Ｐ＜０．０５）。两组患者红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性明显低于健康人对照组（Ｐ＜０．０１）。ＵＢＩＯ治疗１个疗程患者红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性比治疗前显著增强（Ｐ＜０．００１）,而药物治疗组治疗前后患者红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性无明显变化（Ｐ＞０．０５）。结论：ＵＢＩＯ治疗脑梗塞,疗效显著。其机制可能与ＵＢＩＯ对患者红细胞膜Ｎａ＋－Ｋ＋－ＡＴＰ酶活性增强效应有关。     

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.     

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.     

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.