高压静电治疗高血压病58例效果分析

目的观察高压静电对高血压患血压、血脂、血液流变学的影响及治疗的安全性。方法５８例高血压病患均采用ＮＸ９０００型静电治疗仪治疗，平均治疗８周，其中１１例患治疗前后查血液流变学、血旨，统计结果采用成对资料的ｔ检验。结果总有效率８６．２１％，安全系数１００％。血液流变学检查结果，血浆粘度、全血低切、全血高切、低切还原、高切还原粘度均下降；血脂检查结果，ＨＤＬ－Ｃ、ＬＤＬ－Ｃ和ａｐｏＡ１均增加，以上     

高压静电治疗对Ⅱ型糖尿病患者血液流变学的影响

目的：研究高压静电治疗对Ⅱ型糖尿病患者血液流变学的影响。方法：选择确诊的Ⅱ型糖尿病患者,分成药物治疗组（２５ 例） 和静电药物治疗组（３０ 例,加静电治疗）。结果：治疗后静电药物治疗组较药物治疗组低切还原粘变、全血高切还原粘度（Ｐ均＜ ０．００１）、血沉方程Ｋ值、血沉、空腹血糖和甘油三酯（Ｐ均＜０．０５）有明显下降。结论：高压静电治疗能明显改善糖尿病患者的血液流变学     

冠心病患者血液流变性研究

目的用血液流变学探讨冠心病发病机制。方法分析了68例冠心病患者血液流变学伞血高切粘度,全血低切粘度,血浆粘度,红细胞压积,全血高切还原粘度,全血低切还原粘度,红细胞变形指数,红细胞聚集指数及体外血栓形成指标变化;与68例健康人比较。结果冠心病患者血液流变学全血高切粘度,全血低切粘度,血浆粘度,红细胞压积,全血高切还原粘度,全血低切还原粘度,红细胞变形指数,红细胞聚集指数均高于正常人。体外血栓形成指标:血栓长度、血栓湿重、血栓干重也明显大于健康人。结论血液粘度增高是冠心病的诱因,也是其结果;调整冠心病患者血液流变学指标,有益于冠心病患者治疗;健康人定期检测血液流变学指标,有利于预防冠心病的发生。     

高压静电治疗对Ⅱ型糖尿病患者血液流变学的影响

目的：研究高压静电治疗对Ⅱ型糖尿病患血液流变学的影响。方法：选择确诊的Ⅱ型糖尿病患．分成药物治疗组(25例)和静电药物治疗组(30例，加静电治疗)。结果：治疗后静电药物治疗组较药物治疗组低切还原粘变、全血高切还原粘度(P均<0.001)、血沉方程K值、血沉、空腹血糖和甘油三酯(P均<0.05)有明显下降。结论：高压静电治疗能明显改善糖尿病患的血液流变学。     

血磁疗对脑血管病人血液流变学及血脂的影响

目的　通过对脑血管病人进行血液磁极化治疗,观察对治疗前后血液流变学及血脂各项指标的影响。方法　运用血液磁极化疗法共治疗了4 2例脑血管病人,将治疗前后血液流变学及血脂的各项指标进行统计学处理。结果　治疗前后血液流变学及血脂各项指标中的全血粘度(高切、中切、低切)、血浆粘度、红细胞压积、全血还原粘度、红细胞聚集指数、红细胞变形指数、红细胞计数、红细胞电泳时间、胆固醇、血浆甘油三酯均有统计学意义(P <0 .0 1)。结论　血液磁极化疗法能够明显地改善血脂和血液流变学的多项指标。     

脂肪肝病人血液流变学的临床观察

目的对临床确诊的脂肪肝病人,同时伴有甘油三酯增高者,比较其血液流变学各参数的变化,以探讨对临床脂肪肝诊断的实用价值.方法分别测定86例患者的全血粘度、血浆粘度、甘油三酯等9项血液流变学指标.结果 86例脂肪肝病人全血粘度(高切、低切)、红细胞电泳时间及甘油三酯同时增高者61例,占70.9%.全血粘度(高切、中切、低切)、血浆粘度、全血还原粘度、红细胞聚集指数、红细胞电泳时间、甘油三酯同时增高者19例,占22.1%.单纯全血粘度低切增高者6例,占7%.结论脂肪肝病人血液流变学各参数的影响主要是全血粘度及红细胞电泳时间有明显的改变,甘油三酯的增高对血浆粘度及全血还原粘度影响不太明显.可作为临床对脂肪肝病人辅助诊断检查的一项重要参考指标.     

甲状腺功能亢进患者手术前后血液流变学和血脂的变化

目的分析32例甲状腺功能亢进患者手术前后血液流变学和血脂的变化方法收集2000年1月-2004年12月对32例甲状腺功能亢进病例，分别测定手术前后甲状腺功能、血液流变学和血脂的变化结果手术后，随着甲状腺激素的降低，全血高切粘度、全血低切粘度、血浆粘度、高切还原粘度、低切还原粘度、红细胞刚性指数、聚集指数和纤维蛋白原都低于术前组：术后胆同醇、低密度脂蛋白水平比手术前有明显升高，而甘油三酯、高密度脂蛋白的变化不明显结论甲亢手术后，可明显缓解血液的高凝高粘状态，有利于防止各种并发症。     

妊娠高血压综合征患者血液流变学指标的变化及临床研究价值分析

目的观察妊娠高血压综合征患者的血液流变学指标的变化以及临床研究价值。方法随机选择2013年1月-2015年12月在我院进行妊高症检查及治疗的患者60例作为观察组。选择同一时期的同一妊娠周期的健康妊娠妇女60例作为对照组,对比观察组与对照组、轻中重度妊高症患者之间以及观察组患者治疗前后全血高切粘度、全血低切粘度、血浆粘度、红细胞压积、血沉、高切还原粘度、低切还原粘度、纤维蛋白原、总蛋白以及白蛋白的变化情况。结果对照组和观察组血液流变学指标比较后发现,两组血沉指标无统计学差异(P0.05),观察组的全血高切粘度、全血低切粘度、血浆粘度、红细胞压积、高切还原粘度、低切还原粘度均高于对照组,且随着病情加重指标明显升高,在治疗后明显降低;而总蛋白、白蛋白均低于对照组且随着病情加重指标明显降低,在治疗后明显升高,均具有统计学差异(P0.05)。结论妊高症的患者血液流变学呈现出粘滞性高的特点,并且随着病情的加重而增高,随着病情的减轻而降低,这为妊高症疗效的判定、治疗方案的确立以及预后的评估提供了可靠依据。     

50例2型糖尿病患者血液流变学检测分析

50例糖尿病患者组与对照组血液流变学主要参数相比较、全血粘度高、中、低切，血液屈服应力、卡森粘度等均显著增大（P〈0．01）；血浆粘度、红细胞聚积指数、红细胞电泳时间、全血高切还原粘度、全血中切还原粘度等差异均有显著性（P〈0．05）。     

2型糖尿病合并急性脑梗塞超早期血液流变学及血脂变化的临床研究

目的探讨2型糖尿病(T2DM)合并急性脑梗塞(ACI)患者超早期的血液流变学及血脂变化.方法回顾性统计56例T2DM患者(其中合并ACI者20例,无ACI者36例)的血脂、空腹血糖(FBG)及血液流变学检测结果.结果 T2DM并ACI组TC、LDL-C、TG及FBG明显高于T2DM组、正常对照组(P<0.01),T2DM组TG、FBG和LDL-C明显高于正常组(P<0.01,0.05).T2DM并ACI组和T2DM组全血粘度高切、低切、还原粘度、血浆粘度、RBC电泳时间、纤维蛋白原明显高于正常对照组(P<0.01),血沉及方程K值有不同程度增加,而ACI组全血粘度高切、低切、还原粘度及血浆粘度、RBC电泳时间高于T2DM组(P<0.05).FBG与红细胞压积(Hct)、全血粘度高切、低切、全血还原粘度、血浆粘度、RBC电泳时间、纤维蛋白原呈非常显著正相关(P<0.01);而与血沉方程K值、RBC聚集指数呈显著正相关(P<0.05);LDL-C、TG与全血粘度高切、低切、还原粘度、血浆粘度、RBC电泳时间呈非常显著正相关(P<0.01);调整年龄、病程并再分别调整血糖、血脂计算血液流变学各指标与血脂、血糖之间的偏相关系数,结果显示血浆粘度与TC、TG呈正相关(r=0.389、0.347,P= 0.004、0.011);FBG与高切、低切、RBC电泳时间呈正相关(r=0.380、0.358、0.381,P=0.006、0.01、0.006),而与血沉呈负相关(r=-0.394,P=0.004).回归分析结果显示血浆粘度、LDL-C、TG、FBG是糖尿病合并脑梗塞的危险因素,TG、FBG是糖尿病的危险因素.结论 T2DM在发生ACI之前就已存在血脂、血糖及血液流变学异常,血液流变学改变可能为T2DM和脑梗塞的共同病理生理基础,因此有效地控制血脂、血糖,纠正糖脂代谢紊乱,改善血液流变学状态,是预防T2DM发生脑梗塞的关键.     

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.