Prenatal Sonography in Suspected Proximal Gastrointestinal Obstructions: Diagnostic Accuracy and Neonatal Outcomes

BackgroundThe purpose of this study was to assess diagnostic accuracy and neonatal outcomes in fetuses with a suspected proximal gastrointestinal obstruction (GIO).MethodsAfter IRB approval, a retrospective chart review was conducted on prenatally suspected and/or postnatally confirmed cases of proximal GIO at a tertiary care facility (2012–2022). Maternal-fetal records were queried for presence of a double bubble ± polyhydramnios, and neonatal outcomes were assessed to calculate the diagnostic accuracy of fetal sonography.ResultsAmong 56 confirmed cases, the median birthweight and gestational age at birth were 2550 g [interquartile range (IQR) 2028–3012] and 37 weeks (IQR 34–38), respectively. There was one (2%) false-positive and three (6%) false-negatives by ultrasound. Double bubble had a sensitivity, specificity, positive predictive value, and negative predictive value for proximal GIO of 85%, 98%, 98%, and 83%, respectively. Pathologies included 49 (88%) with duodenal obstruction/annular pancreas, three (5%) with malrotation, and three (5%) with jejunal atresia. The median postoperative length of stay was 27 days (IQR 19–42). Cardiac anomalies were associated with significantly higher complications (45% vs 17%, p = 0.030).ConclusionsIn this contemporary series, fetal sonography has high diagnostic accuracy for detecting proximal gastrointestinal obstruction. These data are informative for pediatric surgeons in prenatal counseling and preoperative discussions with families.Level of EvidenceDiagnostic Study, Level III.     

Effects of box handle position and carrying range on bi-manual carrying capacity for females

This study utilizes a psychophysical approach to examine the effects on carrying capacity for bi-manual carrying tasks involving different handle positions and carrying ranges. A total of 16 female subjects participated in the experiment in groups of two people, and each group of subjects performed the tasks in a random order with 12 different combinations of carrying task. The independent variables are handle position (upper, middle, lower) and carrying range (F–F: floor height carried to floor height, F–W: floor height carried to waist height, W–W: waist height carried to waist height, W–F: waist height carried to floor height), the dependent variable is the maximum acceptable carried weight (MAWC), heart rate (HR), and the rating of perceived exertion (RPE). The results show that the handle position has a significant effect on MAWC and overall RPE but no significant effect on HR. Carrying range has a significant effect on the MAWC and HR, but no significant effect on overall HR. The handle position and carrying range have a significant interaction on the MAWC and HR. The RPE for different body parts shows significant differences, and the hands feel the most tired. Overall, this study confirms that the lower handle position with the W–W carrying range is the best combination for a two-person carrying task.     

对血清蛋白白球比值参考范围的修改及其临床应用

目的探讨血清蛋白白球比值(A／G)的参考范围和A／G在计算过程中产生的误差对临床应用的影响。方法①选取健康查体人员统计其A／G参考范围；②从理论上分析A／G计算误差的存在。结果①以统计结果的2s置信区间作为A／G的参考范围是1.1～2.2；②A／G计算值的误差会远大于相应总蛋白和白蛋白的测定误差。结论A／G较合适的参考范围为1.1～2.2,并且在临床应用中仍可根据实际情况降低其范围的下限。     

薄壁构件的高温低周疲劳寿命的预测与验证

提出了文题的计算模型,它采用非线性弹塑性蠕变有限元法,计算构件危险点在高温及周期保载的交变载荷谱作用下的应力应变响应,以应变范围区分法累积损伤,从而求出构件的疲劳寿命,并以带孔矩形薄板为例作了计算与验证,结果吻合较好,可供工程应用。     

The nocturnal jejunal migrating motor complex: defining normal ranges by study of 51 healthy adult volunteers and meta-analysis

Interdigestive human small bowel motility is characterized by the migrating motor complex (MMC). The aims of this study were to: (i) establish the normal range of variables of the nocturnal jejunal MMC and (ii) incorporate these data in a subsequent meta-analysis. Eighty-one recordings were performed by prolonged (24 h) ambulatory manometry in 51 subjects in two centres. Quantitative analysis was undertaken of 419 Phase III and 332 Phase II episodes. Adjusted mean values of seven variables were calculated using a mixed-effects model. Meta-analysis of pooled published data to generate a reliable 95% reference range was also performed. Adjusted mean values and confidence intervals are presented for all seven variables. Intrasubject variances were large in comparison with intersubject. Meta-analysis of 19 studies (356 pooled patients) meeting inclusion criteria produced wide reference ranges. At least five such ranges are useful for the detection of abnormality in the individual. This is the largest study of normal volunteers presented to date, with ranges for many variables produced using appropriate statistical methodology. A model for definition of abnormality has been proposed. We recommend that these data may be used by investigators in this field as a complement to other existing indicators of small bowel dysmotility.     

Central effects of systemic lidocaine mediated by glycine spinal receptors: an iontophoretic study in the rat spinal cord

The objective of this investigation was to demonstrate the possible interactions of systemic lidocaine (lido) with inhibitory receptors in the spinal cord. In the lumbar dorsal horn of anesthetized and curarized rats, 60 physiologically identified, wide dynamic range (WDR) neurons, were recorded extracellularly. Glutamate, glycine and its selective antagonist, strychnine, were iontophoretically applied onto the neurons either singularly or concurrently. The effects of systemic lido on the drug-induced frequency changes and the interaction with the glycine receptors, using strychnine as a probe, were studied. It was consistently found that (i) lido (3–4 mg/kg) inhibited the excitatory responses to iontophoretic glutamate, (ii) this inhibition was significantly antagonized by concurrent iontophoretic strychnine, (iii) iontophoretic glycine induced comparable glutamate inhibition that was reversed by strychnine. In contrast, no effect on glutamate-induced excitations was observed when lido was applied by micropressure or a different local anesthetic was systemically administered. The results suggest that central inhibitory effects of lido could by mediated by spinal strychnine-sensitive glycine receptors, activated by lido itself or possibly by its glycine residue-bearing metabolites.     

高频宽增益小信号放大器的设计及在医用超声功率计中的应用

介绍供医用超声功率计用的两种高频、宽增益的小信号放大器，并比较了它们彼此的优缺点。     

UF-100型全自动尿液沉渣检测仪测定参考范围调查

目的　确定UF - 10 0型全自动尿液沉渣检测仪检测健康人尿沉渣检测的参考值范围。方法　用UF - 10 0型全自动尿液沉渣检测仪随机检测 5 2 0例健康人不离心尿液标本 ,对尿液沉渣进行分析。结果　尿液中红细胞 (RBC)、白细胞 (WBC)、上皮细胞 (EC)、管型 (CAST)各年龄组之间检测值经 F 检验 ,差异无显著意义 (P >0 .0 5 ) ,但男、女性别之间差异有显著意义 (P <0 .0 5 )。结论　尿液RBC、WBC、EC的多少与年龄无关 ,但与性别有关。健康人参考值的确立 ,为尿液常规检验定量标准化和临床应用提供了依据     

老年男性2型糖尿病患者目标范围内时间与长期血糖变异性的关系研究

背景 目标范围内时间(TIR)作为血糖管理的新指标,与短期血糖波动相关,是否与长期血糖变异性相关尚不清楚。目的 探讨老年男性2型糖尿病患者TIR与长期随访期间糖化血红蛋白(HbA_1c)变异系数、HbA_1c变异性评分(HVS)的关系。方法 选取2007年1月至2011年1月在解放军总医院第二医学中心住院行动态血糖监测(CGM)的老年男性2型糖尿病患者200例,根据患者基线TIR水平,将其分为TIR≥85%组(n=141)和TIR<85%组(n=59)。对受试者随访观察(12.5±1.1)年,比较两组长期随访期间HbA_1c变异系数和HVS。采用Pearson相关、多元线性回归分析TIR与HbA_1c变异系数、HVS的关系。结果 TIR<85%组患者的长期HbA_1c变异系数[(9.7±3.8)%比(8.2±4.5)%,P=0.028)]、HVS[(48.7±20.4)分比(32.5±20.8)分,P<0.001)]均明显高于TIR≥85%组。Pearson相关分析结果...