3283例健康体检者血清AFP水平和血脂指标的相关性分析

目的 探讨体检人群甲胎蛋白（AFP）升高与血脂六项的关系。方法 选取2020年4月至2021年8月3 283例健康体检者作为研究对象,采集基线资料、总胆固醇（Total cholesterol,TC）、甘油三酯（Triglyceride,TG）、高度脂蛋白（High lipoprotein,HDL）、低密度脂蛋白（Low density lipoprotein,LDL）、载脂蛋白A(Apolipoprotein A,APOA)和载脂蛋白B(Apolipoprotein B,APOB)共计6项血脂指标以及甲胎蛋白（AFP）。依据AFP不同浓度进行分组,比较组间血脂六项水平差异,同时分析AFP水平与血脂六项的相关性;应用Logistic回归分析筛选出影响AFP升高的危险因素;同时比较AFP在血脂异常组和正常组间的水平差异。结果 TC、TG、LDL和APOB 4项血脂指标随着AFP浓度的增加出现了异常率和异常水平的明显上升,差异均具有统计学意义（P<0.05）;Spearman相关性分析显示,AFP与TC、TG、HDL、LDL、APOA、APOB均呈正相关（r=0.120、0.090、...     

更年期女性脂蛋白(a)及血脂水平的检测及意义

目的：观察更年期女性脂蛋白（a）[Lp(a)]及血脂水平与女性心脑血管病发生、发展的关系。方法：研究对象为更年期女性247例，其中绝经前106例，绝经后141例；心脑血管病127例，对照组为健康体检者120例。测定空腹静脉血中Lp(a)、总胆固醇（TC）、载脂蛋白B（APOB）、甘油三酯（TG）、高密度脂蛋白（HDL－C）、低密度脂蛋白（LDL－C），将各指标分绝经前与绝经后组、心脑血管病组与对照组分别比较。结果：心脑血管病组Lp(a)、TC、TG、APOB、LDL－C均高于对照组，而HDL－C、HDL－C／TC则低于对照组。绝经后组Lp(a)、TC、LDL－C、APOB显著高于绝经前组，而HDL－C／TC低于绝经前组。结论：女性绝经后，血清Lp(a)、TC、LDL－C、APOB增高，而HDL－C／TC较绝经前降低，便增加 了更年期女性心脑血管病发生、发展的危险性。     

血液灌流对Lp(a)的影响

目的观察血液灌流对血液透析患者血脂[Lp(a)]的影响.方法选取多个血液净化中心血液透析患者40例,比较单次血液透析串联血液灌流前后患者血脂的变化.结果慢性肾衰竭患者多数存在血脂代谢的紊乱,血液灌流后血Lp(a)以及甘油三酯(TG)的浓度下降,高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、载脂蛋白A(APOA)、载脂蛋白B(APOB)、总胆固醇(TC)的浓度无明显变化.结论血液灌流可以降低维持性血液透析患者的Lp(a)及TG,改善其脂代谢紊乱.     

肝癌患者血脂及总胆汁酸检测的临床意义

目的 :探讨肝癌患者血脂及总胆汁酸水平的变化及其临床意义。方法 :测定 40例肝癌患者总胆固醇 (TC)、甘油三脂(TG)、高密度脂蛋白 (HDL -C)、低密度脂蛋白 (LDL -C)、载脂蛋白A1(APOA1)、载脂蛋白B(APOB)、脂蛋白a[LP(a) ]及总胆汁酸 (TBA)水平 ,并以 90例健康人作为对照。结果 :肝癌患者各项指标水平 ( x±s)分别为TC 3 .85± 1.16,TG 1.0 5± 0 .63 ,HDL -C 0 .91± 0 .5 1,LDL -C 2 .74± 0 .88,APOA10 .73± 0 .3 5 ,APOB 0 .87± 0 .3 4,LP(a) 78.2 6± 5 5 .48,TBA 2 9.3 2± 10 .17,对照组各项指标为TC 4.2 8± 0 .72 ,TG1.98± 1.5 8,HDL -C 1.3 1± 0 .2 8,LDL -C2 .96± 0 .67,APOA11.3 5± 0 .2 0 ,APOB 0 .91±0 .2 9,LP(a) 15 3 .63± 112 .65 ,TBA 8.0 2± 2 .15 ,经统计学处理表明TC、TG、APOA1、HDL -C、LP(a)均低于对照组 ,TBA高于对照组 ,而LDL -C、APOB与对照组比较无显著性差异。结论 :肝癌患者存在血脂水平的代谢紊乱 ;检测肝癌患者的血脂及总胆汁酸水平 ,对于观察病情具有实用的临床意义。     

三峡库区腹地重庆市奉节县公务员血脂水平调查

目的了解三峡库区腹地重庆市奉节县公务员血脂水平,探讨保障公务员健康的有效途径。方法奉节县人民医院健康体检的公务员空腹采取静脉血,用日立7080型全自动生化分析仪测定血清三酰甘油（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL—C）浓度,并与性别、分年龄段等因素进行相关分析。结果各年龄组男性TG浓度均高于对应组女性。TC浓度在20～29、30～39、40-49年龄段时男性高于女性,50岁后无显著性差别;HDL—C各年龄组女性均高于男性。LDL-C各年龄组男性均高于女性。高脂血症比率男性普遍高于女性。结论男性公务员患心脑血管疾病的风险高于女性。     

青年脑梗死患者血脂与血液流变学测定的意义

目的探讨青年人脑梗死患者血脂及血流变学的改变及其临床意义。方法青年人脑梗死60例,对照组30例。测定胆固醇等血脂及血流变学共17项指标。结果卒中组高密度脂蛋白(HDL)、载脂蛋白A1(ApoA1)均极显著降低,而全血高切黏度、血浆比黏度、血球压积(HCT)、全血高切还原黏度、纤维蛋白原含量均显著高于对照组。Logistic回归分析显示HCT、血浆比黏度、HDL为有意义变量。结论青年人脑梗死患者存在血脂及血液流变学的异常。     

血液流变学指标与胆固醇、甘油三酯水平在不同年龄组中的相关性分析

目的 探讨血液流变学指标与胆固醇、甘油三酯水平的相关性.方法 选择排除心脑血管疾病、糖尿病等基础疾病的31～60岁的体检人员.血液流变学指标增高,女性257人,男性455人.胆固醇指标增高,女性512人,男性1,145人.甘油三酯指标增高,女性642人,男性2,032人.结果 31～40岁组血液流变学指标较其它两组增高明显;41～50岁组胆固醇、甘油三酯较其它两组增高明显.血液流变学指标与胆固醇、甘油三酯增高没有明显的统计学意义.结论 血液流变学指标与胆固醇、甘油三酯水平没有明显的相关性.     

分析血脂检验对糖尿病患者的临床诊断价值

目的:探讨分析血脂检验各项指标对糖尿病患者的临床诊断的意义.为临床诊断疾病提供依据.方法:选取本社区20132014年糖尿病患者40例作为观察组,选取同期体检正常血糖患者40例作为对照组,观察两组受检者总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和载脂蛋白的水平.结果:观察组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)以及载脂蛋白apoB含量高于对照组,具有统计学意义(P＜0.05),观察组高密度脂蛋白(HDL)以及载脂蛋白apoAⅠ低于对照组,具有统计学意义(P＜0.05).结论:血脂检测对于诊断糖尿病具有临床意义.可以作为临床辅助诊断方法.     

高血压患者血脂血糖及血流变学指标分析

目的分析高血压患者血脂、血糖及血流变学指标的特点。方法将300例确诊为高血压病的患者设为观察组,进行血脂、血糖及血流变学指标检测,与对照组250例对比分析。结果观察组男女甘油三酯(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白B100(APOB1)与对照组比较,差异有显著性意义(P<0.001);观察组男性全血粘度、红细胞压积与对照组比较,差异有显著性意义(P<0.001);观察组女性血糖(G Iu)、血浆粘度、血沉、纤维蛋白原、红细胞电泳时间与对照组比较差异有显著性意义(P<0.01)。结论定期对高血压患者进行血脂、血糖及血流变学指标监测,对临床降压、调脂,改善血液流变性,预防心血管事件的发生具有重要意义。     

深圳市7300例体检人群血脂异常流行病学调查分析

目的 了解深圳市健康体检人群血脂水平的现状,为血脂异常防治工作提供科学依据.方法 选择7 300例来我院特诊门诊进行高级体检的人群,采用酶法-终点法检测其空腹血脂水平并进行分析,比较血脂异常患病率的情况及不同年龄、性别间的血脂水平差别.结果 (1)血脂异常的总患病率为53.45％,男性为78.64％,女性为28.26％,男、女性别间血脂异常患病率差异有统计学意义(P ＜0.001);TC、TG、LDL -C、HDL -C患病率分别为21.45％、37.01％、34.12％、14.32％,以31 ～40岁、41～50岁组患病率较高;(2)血总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL- C)的总体水平分别为(5.26±0.81)、(1.86±1.72)、(3.04±0.57)、(1.06±0.20),男性的TC、TG、LDL -C水平高于女性,而女性的HDL -C水平则略高于男性;(3)不同性别及不同年龄组的血脂水平比较,有显著性差异(P ＜0.001).结论深圳市体检人群血脂异常人群主要分布在31 ～40岁、41～ 50岁组,应关注这一人群的宣传教育及干预,有针对性的采取有效措施,最大限度地预防心血管疾病的发生.     

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.