同种异体肾移植后CD4+、CD8+、CD16+、CD19+、CD56+变化及临床意义

目的了解对比肾移植受者术后体内淋巴细胞免疫表型的变化情况及其临床意义.方法采用多种单克隆抗体及流式细胞仪,对肾移植受者术后的淋巴细胞免疫表型进行了化验监测,分析了淋巴细胞免疫表型变化与免疫用药及并发症的关系.结果移植受者淋巴细胞免疫表型阳性细胞数普遍偏低(P＜0.05),肾移植后顺利恢复组的淋巴细胞免疫表型阳性细胞与健康对照组无差异(P＞0.05),肾移植后并发症组受者CD4+、CD8+阳性细胞数低于临床正常值,NK细胞及CD19+阳性细胞数减少(P＜0.05).肾移植后急排组的NK细胞及CD19+阳性细胞数明显增加,CD4+/CD8+比值偏高(P＜0.05).结论淋巴细胞免疫表型可用于评价移植受者的免疫状态,临床上根据受者的化验结果综合评价受者的免疫抑制状态,并作为调整免疫抑制剂用量的参考指标.     

多普勒超声对高血压患者右室舒张功能的临床研究

目的采用多普勒超声心动图检测三尖瓣口血流有关参数,研究原发性高血压(EH)患者的右室舒张功能及其相关因素.方法43例EH患者,32例正常人,取心尖四腔观,将脉冲多普勒(PWD)取样容积置于三尖瓣口,记录其血流频谱,测量舒张早期E峰流速(E)、舒张晚期A峰流速(E)和E/A比值,舒张早期E波流速积分(EVTI),舒张晚期A波流速积分(AVTI)及EVTI/AVTI比值.结果1.与对照组比较,EH组E波和EVTI下降(P＜0.05),A波和AVTI增加(P＜0.01),E/A与EVTI/AVTI比值降低(P＜0.01);2.EH患者三尖瓣E/A比值(r=0.417,P=0.005)、EVTI/AVTI比值(r=0.557,P=0.0001)与二尖瓣相应指标显著相关;3.EH患者各级血压间这些指标比较无差异(P＞0.05).结论EH患者的右室舒张功能明显下降,与左室舒张功能密切相关,与高血压分级无明显关系.     

不同透析方案对透析患者瘦素水平和营养状况影响的对比研究

目的研究不同透析方案维持透析患者瘦素水平的差别.方法慢性肾衰竭维持血液透析患者65例,分为HD组与HD/HDF组,HD组进行常规碳酸氢盐血液透析,HD/HDF组每周3次常规血液透析同HD组,每月一次血液透析滤过(HDF)代替HD.对两组患者各营养指标进行检测.分别于HD、HDF前抽取自凝血检测瘦素、透析后查瘦素.并于HD、HDF开始5min后留取透析器入口及出口处血标本送检,检测瘦素浓度,计算溶质清除率.血清瘦素浓度测定采用ELISA法.透析后瘦素经超滤量校正,前后配对t检验,P<0.05有显著性差异.结果健康对照组、HD组、HD/HDF组女性瘦素水平显著高于男性.HD前后瘦素水平无显著性差异,HDF后瘦素水平明显下降.透析前HD/HDF组患者瘦素水平高于HD组.HDF中瘦素清除率显著高于HD[(27.6±19.8)ml/min vs (4.87±28.40)ml/min,P<0.001],透析前后下降率HDF组明显高于HD组[(29.33±20.21)% vs (5.14±36)%,P<0.005].HD/HDF组患者血白蛋白、前白蛋白、血红蛋白、体重指数及营养状况调查表积分均优于HD组,并且HD/HDF组EPO用量和输血量低于HD组.结论 HDF能有效清除瘦素,HD不能.一定程度的瘦素水平升高是营养状况改善的表现.     

A Novel Switching Delayed PSO Algorithm for Estimating Unknown Parameters of Lateral Flow Immunoassay

In this paper, the parameter identification problem of the lateral flow immunoassay (LFIA) devices is investigated via a new switching delayed particle swarm optimization (SDPSO) algorithm. By evaluating an evolutionary factor in each generation, the velocity of the particle can adaptively adjust the model according to a Markov chain in the proposed SDPSO method. During the iteration process, the SDPSO can adaptively select the inertia weight, acceleration coefficients, locally best particle pbest and globally best particle gbest in the swarm. It is worth highlighting that the pbest and the gbest can be randomly selected from the corresponding values in the previous iteration. That is, the delayed information of the pbest and the gbest can be exploited to update the particle’s velocity in current iteration according to the evolutionary states. The strategy can not only improve the global search but also enhance the possibility of eventually reaching the gbest. The superiority of the proposed SDPSO is evaluated on a series of unimodal and multimodal benchmark functions. Results demonstrate that the novel SDPSO algorithm outperforms some well-known PSO algorithms in aspects of global search and efficiency of convergence. Finally, the novel SDPSO is successfully exploited to estimate the unknown time-delay parameters of a class of nonlinear state-space LFIA model.     

A Novel Microfluidic Chip for Assessing Dynamic Adhesion Behavior of Cell-Targeting Microbubbles

The primary aim of this study was to develop a microfluidic chip to study the dynamic adhesion behavior of cell-targeted microbubbles. The microfluidic device is composed of polydimethylsiloxane and is fabricated using the soft lithography technique. Each chamber of the microfluidic chip comprises eight U-shaped microsieves, by which various flow velocity distributions are generated. LyP-1-conjugated microbubbles were prepared by coating the surface of the phospholipid shell of microbubbles with LyP-1 peptides via biotin-avidin linkage. Under static conditions, the resulting targeted microbubbles are able to bind onto the surface of cells on incubation with breast cancer cells. Under dynamic fluid conditions, the cell targeting efficiency of the microbubbles was assessed at various flow velocity distributions in a chamber. Accumulation of targeted microbubbles was strongly influenced by flow velocity. Better retention of targeted microbubbles on cell surfaces was achieved at low mean flow velocities (<0.03 cm/s), in agreement with our computer simulation results. In conclusion, our results indicate that the microfluidic system is a useful platform for studying the microbubble-cell adhesive interaction.     

阿加曲班原料药中催化剂钯残留监测方法建立

目的：建立凝血酶抑制剂阿加曲班原料药中催化剂钯的残留量测定方法。方法采用石墨炉原子吸收分光光度法测定阿加曲班中钯的残留量。试验条件：光源为钯空心阴极灯,波长247.6 nm,狭缝0.5 nm,灯电流10 mA,燃烧器高度2 mm,石墨管以横向加热方式,氩气压力0.4 MPa,进样体积20μL,背景校正D2,石墨炉程序升温。结果钯在0.015－0.2μg·mL-1范围内与吸光度呈良好的线性关系（r=0.9996）;检出限为0.00057μg·mL-1;特征浓度为0.00107μg·mL-1;平均回收率为99.8%;RSD 为4.08%（n=9）。结论该方法经方法学验证可用于阿加曲班原料药中痕量钯含量的测定,可为该原料药质量标准的完善提供参考。     

老年退行性钙化瓣膜病64例临床分析

目的：提高对老年退行性钙化瓣膜病（ＳＤＣＶＤ） 的临床认识。方法：回顾分析４１３ 例６０ 岁以上住院病人彩色多普勒超声心动图检查资料，重点分析检出的６４ 例（１５－５ ％ ）ＳＤＣＶＤ 患者的超声及临床资料。结果：ＳＤＣＶＤ 的检出率随年龄增加。主动脉瓣受累率最高，瓣膜功能损害以关闭不全为主。易致心脏扩大（３６－０ ％ ） 及心律失常（５６－３ ％ ） 。常与高血压病及冠心病并存，致临床情况复杂化。结论：本病临床缺乏特征性。建议对６０ 岁以上老年人心脏超声检查应列为常规，以减少漏诊。     

睾丸活组织玻璃压片镜检对无精子症的诊断价值

目的 探讨睾丸活组织压片镜检对无精子症的诊断价值。方法 对30例无精子症患者进行睾丸活组织检查，将取到的睾丸组织分成两等份，一份用Johnsen’s评分法做常规病理组织学检查，另一份组织制备玻璃压片，立刻在倒置显微镜下检查有无精子，对两种方法所得结果进行比较。结果 根据Johnsen’s评分法，30例中11例（36．66％）发现精子，19例（63．33％）未见精子，用玻璃压片法镜检，15例发现精子（50．00％），另15例（50．00％）未见精子，后一方法检出精子率比前者高。结论 玻璃压片法简单易行，比Johnsen’s评分法更能反映睾丸内有无精子，在进行病理学检查的同时做一玻璃压片检查，则能更好的反映睾丸的精子发生情况。     

医院实施平衡记分卡过程中医生文化的作用

本研究表明医生的态度埘于医院绩效的改变是至关重要的。积极的医生文化有助于医院成功实施平衡记分卡。在医院的运营中，承认医生的核心地位，获得医生的支持，对于医院工作的顺利开展是至关重要的。     

脑室注射促甲状腺素释放激素对电针和吗啡镇痛的影响

以辐射热甩尾法测定大鼠痛阈为指标,观察脑室注射三肽-促甲状腺素释放激素(TRH)10μg/20μl对电针(强度为1、2、3伏)大鼠双侧“足三里”、“三阴交”和皮下注射吗啡(2、4、6mg/kg)引起的镇痛效应的影响。实验结果表明,脑室注射TRH不影响正常情况下大鼠的辐射热甩尾反应,但能对抗强度为2、3伏的电针镇痛和剂量为2、4mg/Kg的吗啡镇痛效应。