ICU应用微量泵中心静脉高浓度补钾有效性及安全性评价

目的探讨ICU-应用微量泵中心静脉高浓度补钾的有效性及安全性。方法回顾性分析ICU发生低钾血症78例患者的临床资料。随机分为常规组和高浓度组,每组各39例,补钾均在心电监护下进行。常规组钾浓度为40mmol／L,补钾速度为10～20mmol／h;高浓度组钾浓度为100～300mmol／L,补钾速度为加～200mmol／h,同时计算达到目标血钾浓度所需补钾量,监测两组血钾浓度、每小时尿量、达到目标血钾浓度所需时间及患者局部不良反应。结果两组患者治疗前均存在低钾血症,设定目标血钾浓度为4．0mmol／L,两组治疗前血钾浓度、所需补钾量比较差异无统计学意义,分别为（2．9±0．2）、（3．0±0．2）mmol／L和（85．2±8．7）、（92．3±7．6）mmol。常规组与高浓度组相比达到目标血钾浓度所需时间较长[（17.25±4．49）h比（5．67±0．75）h,P〈0．01]。结论在ICU严密监护下应用微量泵中心静脉高浓度补钾安全、有效．有一定的临床廊用价值。     

Influence of Test Specimen Geometry on Probability of Failure of Composites Based on Weibull Weakest Link Theory

This paper presents an analytical model that quantifies the stress ratio between two test specimens for the same probability of failure based on the Weibull weakest link theory. The model takes into account the test specimen geometry, i.e., its shape and volume, and the related non-constant stress state along the specimen. The proposed model is a valuable tool for quantifying the effect of a change of specimen geometry on the probability of failure. This is essential to distinguish size scaling from the actual improvement in measured strength when specimen geometry is optimized, aiming for failure in the gauge section. For unidirectional carbon fibre composites with Weibull modulus m in the range 10–40, it can be calculated by the model that strength measured with a straight-sided specimen will be 1–2% lower than the strength measured with a specific waisted butterfly-shaped specimen solely due to the difference in test specimen shape and volume.     

应用表面等离子体共振生物传感器快速检测厌氧菌的研究

目的建立基于表面等离子体共振(SPR)生物传感器的核酸检测技术,为实时、在线检测微生物奠定技术基础。方法应用SPR生物传感器实时在线分析系统,在传感器表面固定探针分子,对溶液中的靶序列进行杂交检测,研究该检测方法的灵敏度、特异性及可重复性等。结果试验中建立的核酸检测方法能够实现对靶序列的实时检测,检测下限达4×102CFU/ml。结论该试验建立的核酸检测方法,具有灵敏度高、特异性强、可重复性好等优点,SPR传感器技术在核酸杂交检测工作中有着广阔的应用前景。     

Hunt-Hess高分级颅内动脉瘤的血管内栓塞治疗

目的 探讨Hunt-Hess高分级颅内动脉瘤血管内栓塞治疗的临床疗效及应用价值.方法 2001年5月至2010年2月采用血管内栓塞治疗87例颅内动脉瘤,Hunt-Hess Ⅳ级77例,Ⅴ级10例.以格拉斯哥预后分级(GOS)评估预后.结果 随访3个月至9年.GOS结果:Ⅰ级25例,Ⅱ级5例,Ⅲ级9例,Ⅳ级12例,Ⅴ级36例,预后良好率55.17%(48/87),病死率28.74%(25/87).47例早期(发病后3 d内)治疗患者预后良好率61.70%(29/47),病死率25.53%(12/47);40例中晚期(发病后3d及以后)治疗患者预后良好率47.50%(19/40),病死率32.50%(13/40).早期治疗患者和中晚期治疗患者预后良好率和病死率比较差异均无统计学意义(P＞0.05).87例患者均能成功栓塞治疗,技术并发症8例.脑血管造影发现血管痉挛1O例.结论 血管内栓塞是治疗Hunt-Hess高分级颅内动脉瘤有效方法,早期治疗可行、有效,能通过减少动脉瘤再破裂出血和防治血管痉挛提高预后.

Abstract：

Objective To explore the clinical therapeutic efficacy and value of endovascular embolization treatment for Hunt-Hess poor-grade intracranial aneurysms. Methods Eighty-seven patients with Hunt-Hess grade Ⅳ - Ⅴ intracranial aneurysrns were treated with endovascular embolization from May 2001 to February 2010,77 patients were grade Ⅳ and 10 patients were grade Ⅴ. Outcomes were assessed by using the Glasgow outcome scale (GOS). Results Follow-up time was from 3 months to 9 years. The therapeutic efficacy was as following according to GOS: 25 patients were grade Ⅰ , 5 patients were grade Ⅱ , 9 patients were grade Ⅲ , 12 patients were grade Ⅳ ,and 36 patients were grade Ⅴ. There were 55.17%(48/87) favorable outcome rate and 28.74% (25/87) mortality rate in all patients. There were 61.70%(29/47) favorable outcome rate and 25.53%(12/47) mortality rate in early stage treatment patients (diseased within 3 d), otherwise there were 47.50% (19/40) favorable outcome rate and 32.50%(13/40) mortality rate in medium and late stage treatment patients (diseased 3 d or later). There were no statistically significance in favorable outcome rate and mortality rate between them (P > 0.05). All the patients were embolized successfully ,technical complications occurred in 8 patients, 10 patients were found angiographic evidence of vasospasm. Conclusions Endovascular embolization is an effective method for treating Hunt-Hess poorgrade intracranial aneurysms. Early stage treatment is a feasible option because it can improve prognosis by reducing rebleeding and vasospasm.     

碘普罗胺诱发脑病1例报告

患者,男,42岁,因"发作性晕厥10+个月,胸闷20+d,胸痛10+d"入院.诊断为肥厚型心肌病,既往无高血压、糖尿病病史.为了解左室流出道压差及冠脉情况,予以左室心导管检查及冠脉造影术,心导管经右侧桡动脉入路,共使用碘质量浓度为370 mg I/mL的碘普罗胺200 mL,术后患者出现以剧烈头痛、皮质盲、神经精神症状...     

多药耐药大肠杆菌对4种消毒剂的抗性研究

[目的]调查多药耐药大肠杆菌对临床常用消毒剂的抗性,为合理选择敏感、高效能的消毒剂提供参考依据。[方法]收集某医院临床分离出的多药耐药大肠杆菌,利用纸片琼脂扩散法和营养肉汤稀释法分别测定其对医院常用消毒剂的最低抑菌浓度（minimum inhibitory concentration,MIC）,并用标准菌作为对照。[结果]不同消毒剂对多药耐药大肠杆菌的MIC值与产品推荐浓度存在差异,安尔碘Ⅱ型皮肤消毒剂（有效碘）为（17.5±6.8）mg/L,洁芙柔消毒凝胶（DP300）为（2.9±1.8）mg/L;3M爱护佳免洗手消毒液（葡萄糖酸氯己定）为（145.8±85.4）mg/L,绿莎新爱尔施牌消毒片（有效氯）为（2 611.7±1 083.0）mg/L。[结论]4种消毒剂对多药耐药大肠杆菌的实际使用浓度与推荐浓度存在差异,调整消毒剂使用浓度,对延缓细菌抗性的产生、控制医院感染有重要意义。     

Two Approaches to Incorporate Clinical Data Uncertainty into Multiple Criteria Decision Analysis for Benefit-Risk Assessment of Medicinal Products

BackgroundThe Problem formulation, Objectives, Alternatives, Consequences, Trade-offs, Uncertainties, Risk attitude, and Linked decisions (PrOACT-URL) framework and multiple criteria decision analysis (MCDA) have been recommended by the European Medicines Agency for structured benefit-risk assessment of medicinal products undergoing regulatory review.ObjectiveThe objective of this article was to provide solutions to incorporate the uncertainty from clinical data into the MCDA model when evaluating the overall benefit-risk profiles among different treatment options.MethodsTwo statistical approaches, the δ-method approach and the Monte-Carlo approach, were proposed to construct the confidence interval of the overall benefit-risk score from the MCDA model as well as other probabilistic measures for comparing the benefit-risk profiles between treatment options. Both approaches can incorporate the correlation structure between clinical parameters (criteria) in the MCDA model and are straightforward to implement.ResultsThe two proposed approaches were applied to a case study to evaluate the benefit-risk profile of an add-on therapy for rheumatoid arthritis (drug X) relative to placebo. It demonstrated a straightforward way to quantify the impact of the uncertainty from clinical data to the benefit-risk assessment and enabled statistical inference on evaluating the overall benefit-risk profiles among different treatment options.ConclusionsThe δ-method approach provides a closed form to quantify the variability of the overall benefit-risk score in the MCDA model, whereas the Monte-Carlo approach is more computationally intensive but can yield its true sampling distribution for statistical inference. The obtained confidence intervals and other probabilistic measures from the two approaches enhance the benefit-risk decision making of medicinal products.     

临床试验统计分析报告通用的SAS生成方法

目的应用SAS软件编制不受变量类型及数量限制的、用于生成临床试验统计分析报告的通用程序。方法为了解决不同类型的变量同时分析、不同来源的结果同时表述的问题，分别提出了应用宏变量定义矩阵标识以及按照给定算法合并输出数据集的方法。结果通过矩阵标识的建立，将离散变量和连续变量的统计分析结合到一起，使得一次同时分析的变量数在理论上达到无穷。通过所给出的算法，将来自不同SAS过程的分析结果合并到一起，使表格式样的自由性多样性得以实现。结论使用所提出的生成统计分析报告的通用办法，使得统计分析结果的表述更加灵活、适应性更强。     

河北省草原鼢鼠寄生蚤及流行病学意义的研究

目的调查了解河北省草原鼢鼠寄生蚤种类、组成及其染疫情况,及时掌握其在鼠间鼠疫流行时的地位和参与程度,为更好地控制鼠间鼠疫提供科学依据。方法以挖掘法捕获草原鼢鼠,采集其体外寄生蚤进行分类,分离鼠疫菌。结果共发现蚤类3科7属9种;细菌学检验草原鼢鼠111只,蚤细菌培养68组715匹,未分离到鼠疫菌;血清学检验血清88份,未发现鼠疫菌特异抗体。结论凶双蚤为草原鼢鼠的主要寄生蚤,同时携带多种自然染疫的蚤种,有可能参与鼠疫流行。     

蛋白芯片技术与口岸卫生检疫

〔目的〕探讨蛋白芯片技术应用于口岸卫生检疫的前景。〔方法〕对蛋白芯片原理、制备、技术特点及其最新研究进展进行分析,同时结合口岸卫生检疫工作的内容及特点,对蛋白芯片应用于口岸卫生检疫的前景进行探讨。〔结果〕蛋白芯片具有操作简便、通量高、信息量大等技术特点,有利于“大通关”建设。蛋白芯片技术在出入境人员健康体检及传染病的监测方面应用前景广阔。〔结论〕蛋白芯片作为一项新技术具有较广的应用前景,在许多领域得到研究应用,口岸卫生检疫应积极引进并开发适用于自身特点的蛋白芯片技术。