青年女性血沉正常参考值与中国地理因素的主成分分析

目的为制定青年女性血沉正常参考值的统一标准提供科学依据.方法收集了中国158个单位用温氏法测定的9873例健康青年女性血沉正常参考值,研究了其与地理因素的关系.结果通过偏相关分析,发现海拔高度是影响青年女性血沉正常参考值的最主要因素,随着海拔高度的逐渐增大,青年女性血沉正常参考值在逐渐的减小,偏相关系数ry1,2345=-0.413,相关性最显著.用主成分回归分析的方法推导出一个回归方程y=13.30-0.002699x1-0.0004561x2+0.1151x3-0.09108x4-0.0008783x5±4.37.结论如果知道了中国某地的地理因素,就可以用回归方程估算这个地区的青年女性血沉正常参考值.依据青年女性血沉正常参考值与地理因素的依赖关系把中国分为青藏区,西南区,西北区,东南区,华北区,东北区等六个区.     

中年女性血沉正常参考值与海拔高度的曲线模型分析

目的 为制定中国中年女性血沉正常参考值的统一标准提供科学依据。方法 收集了中国291个单位用温氏法测定的20028例健康中年女性血沉正常参考值,用曲线回归分析的方法研究了其与海拔高度之间的关系。结果 发现随着海拔高度的逐渐增大,而中年女性血沉正常参考值按指数律在逐渐减少,相关性很显著(R=0.673);推导出了一个曲线回归模型:=21.98e~(0.000305)±4.88。结论 如果知道了中国某地的海拔高度,就可以用该回归模型估算这个地区的中年女性血沉正常参考值。依据中年女性血沉正常参考值与地理因素的依赖关系把中国分为青藏区、中部区、东部区等三个区。     

中国中年男性红细胞压积比正常参考值与海拔高度的曲线模式分析

目的　为制定中国中年男性红细胞压积比正常参考值的统一标准提供科学依据。方法　收集了中国 380个单位用温氏法测定的 32 4 75例健康中年男性红细胞压积比正常参考值 ,用曲线回归分析的方法研究了其与海拔高度之间的关系。结果　发现随着海拔高度的逐渐增大 ,中年男性红细胞压积比正常参考值按指数律也在逐渐的增大 ,相关性很显著 ( R=0 .91 1 ) ;推导出了一个曲线回归模型 :Y=44.8×1 .0 0 0 67X± 2 .4。结论　如果知道了中国某地的海拔高度 ,就可以用回归模型估算这个地区的中年男性红细胞压积比正常参考值。依据中年男性红细胞压积比正常参考值与地理因素的依赖关系把中国分为青藏区、中部区、东部区等三区。     

中国中年男性血红蛋白参考值与海拔高度的曲线模型分析

目的为制定中国中年男性血红蛋白参考值的统一标准提供科学依据。方法收集了中国299个单位用氰化高铁血红蛋白（HiCN）法测定的35815例健康中年男性血红蛋白参考值,用曲线回归分析的方法研究了其与海拔高度之间的关系。结果随着海拔高度的逐渐增大,中年男性血红蛋白参考值按指数律也在逐渐地增大,相关性很显著（R=0．852,F=785．55,P=0．0000）;推导出了一个指数曲线模型：P=141．4e^0.00005499X±19．1。结论如果知道了中国某地的海拔高度,就可以用这个指数曲线模型计算这个地区的中年男性血红蛋白参考值。依据中年男性血红蛋白参考值与地理因素的依赖关系把中国分为青藏区、中部区、东部区。     

青年女性全血黏度(5.75s-1)参考值的地理分布

目的 为制定中国青年女性全血黏度(5.75s-1)参考值的统一标准提供科学依据.方法 收集了中国95个单位测定的7,767名健康青年女性全血黏度(5.75s-1)参考值,运用相关分析和回归分析的方法,研究了其与7项地理因素的关系.结果 发现青年女性全血黏度(5.75s-1)参考值与中国地理因素之间有很显著的相关关系(F=42.580,P=0.000).用逐步回归分析的方法推导出了一个回归方程:(Y)=27.26+0.003474X1-0.002915X2-0.1717X4+0.003248X5+0.5131X7±2.04.在以上的回归方程中,(Y)是青年女性全血黏度(5.75s-1)参考值(mPa.s),X1是海拔高度(m),X2是年日照时数(h),X4是年平均相对湿度(%),X5是年降水量(mm),X7是年平均风速(m/s);2.04是剩余标准差的值.结论 如果知道了中国某地的地理因素,就可以用回归方程计算这个地区的青年女性全血黏度(5.75s-1)参考值.依据青年女性全血黏度(5.75s-1)参考值与地理因素的依赖关系,把中国分为八个区.     

中国女性婴儿血红蛋白参考值与其地理因素

目的 为制定中国女性婴儿血红蛋白参考值的统一标准提供科学依据.方法 收集了中国40个单位用氰化高铁血红蛋白(HiCN)法测定的3 771例女性婴儿血红蛋白参考值,运用相关分析和回归分析的方法,研究了其与地理因素的关系.结果 发现女性婴儿血红蛋白参考值与中国地理因素之间有很显著的相关关系(F=8.54).用逐步回归分析的方法推导出了一个回归方程:(Y)=163.3+0.006 483 X1-0.935 0X3 +0.016 94X5±19.8.结论 如果知道了中国某地的地理因素,就可以用回归方程估算这个地区的血红蛋白参考值.依据血红蛋白参考值与地理因素的依赖关系把中国分为青藏区、西南区、西北区、东南区、华北区、东北区六个区.     

老年前期男性红细胞压积正常参考值与中国地理因素的岭回归分析

目的为制定中国老年前期男性红细胞压积正常参考值的统一标准提供科学依据。方法收集了中国270个地区用温氏法(Wintrobe)测定的28,803例健康老年前期男性红细胞压积正常参考值,并对其与地理因素的关系进行了研究。结果发现海拔高度是影响老年前期男性红细胞压积正常参考值最主要的因素,随着海拔高度的逐渐增大,老年前期男性红细胞压积正常参考值也在逐渐地增大,相关性很显著(r=0.898)。用岭回归分析的方法推导出了一个回归方程:Y^=45.76 0.002790X1 0.0008400X2-0.04548X3-0.002060X4 0.0006100X5±4.51。结论如果知道了中国某地的地理因素,就可以用回归方程估算这个地区的老年前期男性红细胞压积正常参考值。依据老年前期男性红细胞压积正常参考值与地理因素的依赖关系把中国分为青藏区,西南区,西北区,东南区,华北区,东北区等六个区。     

中国健康老年前期男性血沉参考值与地理因素的关系

为制定中国健康老年前期男性血沉参考值（温氏法）的统一标准提供科学依据，收集了中国各地用温氏法测定的健康老年前期男性血沉参考值，并对其与地理因素的关系进行了研究，发现海拔高度是影响健康老年前期男性血沉参考值最主要的因素，随着海拔高度的逐渐增大，健康前期男性血沉参考值在逐渐的减小，相关性很显著，用逐步回归分析的方法推导出了一个回归方程，如果知道了中国某地的地理因素，就可以用回归方程估算这个地区的健康     

中国青年女性红细胞压积参考值与地理因素的关系

为制定中国青年女性红细胞压积参考值的统一标准提供科学依据。收集了中国１３３个地区用Ｗｉｎｔｒｏｂｅ法测定的８４８６名年龄在１８岁至２５岁的健康青年女性红细胞压积参考值,并对其与地理因素的关系进行了研究。结果发现海拔高度是影响青年女性红细胞压积参考值最主要的因素。随着海拔高度的逐渐增大,青年女性红细胞压积参考值也在逐渐增大,相关性很显著（ｒ＝０．９０６）。作者认为依据青年女性红细胞压积参考值与地理因素的关系,可按青藏区、西南区、西北区、东南区、华北区和东北区等６个区分别给出不同区域女青年红细胞压积…     

中国女性幼儿红细胞计数正常参考值的地理分布规律

目的为制定中国女性幼儿红细胞计数正常参考值的统一标准提供科学依据。方法收集了中国71个单位用显微镜计数法测定的13 114例女性幼儿红细胞计数正常参考值,运用相关分析和回归分析的方法,研究其与八个地理因素的关系。结果发现女性幼儿红细胞计数正常参考值与中国地理因素之间有很显著的相关关系(F=64.29,P=0.000)。用逐步回归分析的方法推导出了一个回归方程:Y=7.10-0.074 5X4-0.028 6X5-0.014 4X6 0.000 479X7-0.085 3X8±0.28。结论如果知道了中国某地的地理因素,就可以用回归方程计算这个地区的女性幼儿红细胞计数正常参考值。依据女性幼儿红细胞计数正常参考值与地理因素的依赖关系,把中国分为八个区。     

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.