OPTION 4 PLUS血液凝固分析仪的应用评价

目的 对0PTI0N 4 PLUS血液凝固分析仪在临床应用作初步评价。方法 用校正血浆、质控血浆、新鲜血浆对仪器的几项主要参数进行检测。结果 准确度测定结果PT、APTT、TT、FIB均在质控血浆靶值范围内；混合新鲜血浆测定PT、APTT、FIB的精密度CV％＜2％；FIB有良好的线性Y＝37．134—7．172X；抗干扰试验HGB 5g/L、BIL 15．18μmol/L、脂肪乳0．5％不会影响PT测定结果；肝素0．5μ/ml可使APTT延长。结论 仪器具有高灵敏度、高可靠性、高实用性，各项指标均符合设计要求，适合于各种类型医院使用。     

Comparison of the T-piece resuscitator with other neonatal manual ventilation devices: a qualitative review

Aim

To review the literature surrounding various aspects of T-piece resuscitator use, with particular emphasis on the evidence comparing the device to other manual ventilation devices in neonatal resuscitation.

Data sources

The Medline, EMBASE, Cochrane databases were searched in April 2011. Ongoing trials were identified using www.clinicaltrials.gov and www.controlled-trials.com. Additional studies from reference lists of eligible articles were considered. All studies including T-piece resuscitator use were eligible for inclusion.

Results

Thirty studies were included. There were two randomised controlled trials in newborn infants comparing the devices, one of which addressed short and intermediate term morbidity and mortality outcomes and found no difference between the T-piece resuscitator and self inflating bag. From manikin studies, advantages to the T-piece resuscitator include the delivery of inflating pressures closer to predetermined target pressures with least variation, the ability to provide prolonged inflation breaths and more consistent tidal volumes. Disadvantages include a technically more difficult setup, more time required to adjust pressures during resuscitation, a larger mask leak and less ability to detect changes in compliance.

Conclusions

There is a need for appropriately designed randomised controlled trials in neonates to highlight the efficacy of one device over another. Until these are performed, healthcare providers should be appropriately trained in the use of the device available in their departments, and be aware of its own limitations.     

肺癌患者血清肿瘤标志物与凝血功能变化相关性研究

目的:探讨肺癌患者血清肿瘤标志物和血浆凝血功能变化的相关性及其临床意义。方法:对157例肺癌患者、56例良性肺疾病患者和40例健康人进行回顾性研究,检测血清癌胚抗原（CEA）、神经元特异烯醇化酶（NSE）、细胞角蛋白19片段（CYFRA21-1)以及血浆纤维蛋白原（FIB）、D-二聚体（D-D）、血小板（PLT）,并对检测结果进行统计学分析。结果:肺癌组CEA、NSE、CYFRA21-1、FIB、D-D、PLT水平分别与良性肺疾病组和健康对照组比较差异均有统计学意义(P＜0.05)。肺癌组各指标水平在高分期（III/IV）组中均高于低分期(I+II)组(P＜0.05),除了PLT水平在肺癌高分期（III/IV）组与低分期(I+II)组比较差异无统计学意义（P＞0.05）。CYFRA21-1水平在IVb期肺癌组中高于IVa期组,差异有统计学意义（P＜0.05）;FIB水平与CYFRA21-1以及D-D分别与CEA、NSE、CYFRA21-1呈正相关;CEA对于肺癌诊断敏感性和特异性均最高,六项指标联合检测对肺癌诊断的敏感性(89.2%)和阴性预测值（64.6%）及对于非小细胞肺癌（NSCLC）诊断的曲线下面积（0.832）,均高于任一单项指标检测。结论:联合检测肿瘤标志物和凝血功能变化对肺癌早期诊断和治疗有重要价值,以及有助于预测肺癌患者血栓形成风险,给予早期预防有重要的指导意义。     

血浆纤维蛋白原水平与肺癌临床病理特征及预后的相关性分析

目的 探讨血浆纤维蛋白原水平与肺癌临床病理特征及预后的相关性.方法 回顾性分析120例初治肺癌患者的临床病理资料,设为观察组,另选取100例同期健康体检人群为对照组.比较两组血浆纤维蛋白原(FIB)及D-二聚体(DD)水平,同时分析观察组患者FIB及DD水平与其病理特征的关系,并统计观察组患者生存期与FIB及DD水平的相关性.结果 经研究发现,观察组患者FIB及DD水平明显较对照组高,P＜0.05;观察组患者FIB及DD水平与肿瘤大小、病理类型及临床分期等无明显关联,P ＞0.05.观察组患者生存期与FIB及DD表达水平呈负相关性,P＜0.05.结论 密切关注肺癌患者FIB及DD水平,并加强抗凝治疗,从而对改善其预后具有重要价值.     

Low-symmetry nonlocal transport in microstructured squares of delafossite metals

Intense work studying the ballistic regime of electron transport in two-dimensional systems based on semiconductors and graphene had been thought to have established most of the key experimental facts of the field. In recent years, however, additional forms of ballistic transport have become accessible in the quasi–two-dimensional delafossite metals, whose Fermi wavelength is a factor of 100 shorter than those typically studied in the previous work and whose Fermi surfaces are nearly hexagonal in shape and therefore strongly faceted. This has some profound consequences for results obtained from the classic ballistic transport experiment of studying bend and Hall resistances in mesoscopic squares fabricated from delafossite single crystals. We observe pronounced anisotropies in bend resistances and even a Hall voltage that is strongly asymmetric in magnetic field. Although some of our observations are nonintuitive at first sight, we show that they can be understood within a nonlocal Landauer-Büttiker analysis tailored to the symmetries of the square/hexagonal geometries of our combined device/Fermi surface system. Signatures of nonlocal transport can be resolved for squares of linear dimension of nearly 100 µm, approximately a factor of 15 larger than the bulk mean free path of the crystal from which the device was fabricated.

The ballistic regime, in which the electron mean free path is larger than a characteristic geometric length scale, is an unconventional regime of nonlocal electrical transport that occurs only within ultrapure materials. A common method to examine materials in this regime is to study electrical transport in four-terminal junctions that are smaller than the electron mean free path. Within cross- or square-shaped devices, unconventional effects can occur, such as a negative nonlocal “bend” resistance (1–3) and an enhanced, suppressed, or even negative Hall resistance (4–7). Estimates of the characteristic length scales of the ballistic regime can also be made by examining the suppression of these effects with increasing device size (8–11).The majority of four-terminal ballistic regime studies, however, have concentrated on semiconductor heterostructures (6, 8, 12, 13) or monolayer graphene (14–17) rather than metals, primarily because the electronic mean free path in quasi–two-dimensional metals is typically less than 100 nm. In recent years, however, it has become clear that the delafossite metals PdCoO₂ and PtCoO₂ (18–20) have the potential to be ideal hosts for the study of nonlocal transport effects. Almost uniquely among oxide metals, they have an extremely high purity as grown, with defect levels as low as 1 in 10⁵ in the conducting Pd/Pt layers (21). They also bring the benefit of simplicity, because only one highly dispersive band crosses the Fermi level, giving a single, quasi–two-dimensional Fermi surface as established experimentally by angle-resolved photoemission and measurements of the de Haas–van Alphen effect (22–25). Due to the high purity, momentum-relaxing mean free paths as long as 20 µm can be achieved at low temperature (19, 23, 24, 26), enabling the observation of multiple unconventional transport and quantum interference effects in mesoscopic samples (27–29).For various nonlocal in-plane transport properties, the shape of the Fermi surface of PdCoO₂ has been demonstrated to strongly influence observations. In particular, its nearly hexagonal cross-section leads to a high level of directionality of transport properties once the nonlocal regime is entered at low temperatures (30, 31). This pronounced Fermi surface faceting is one way in which nonlocal transport measurements on delafossite metals differ from those on semiconductor two-dimensional electron gases or monolayer graphene, for both of which Fermi surfaces are close to circular. A second noteworthy feature is that, since the carrier density per layer in the delafossites is metallic (1.5 × 10¹⁵ cm^{– 2}), the Fermi wavelength is two orders of magnitude shorter than that of typical doped semiconductors, placing the delafossites in a new regime of two-dimensional transport. For these reasons it is interesting to make contact between the two fields by performing nonlocal transport measurements in some of the “classic” device geometries of mesoscopic physics, to investigate similarities and differences between the behavior of the delafossite metals and the previously studied low carrier density systems. In this paper we report on experiments designed to do this, studying the bend and Hall resistances of four-terminal microstructured squares.     

川崎病患儿血小板激活参数和凝血功能检测及意义

目的探讨血小板活化及凝血功能检测在川崎病(KD)诊疗中的意义。方法收集川崎病患儿40例于治疗前及治疗后检测平均血小板内容物浓度(MPC)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)、凝血酶原时间(PT);40例健康儿童为对照组。结果 KD组患儿治疗前及治疗后MPC水平显著低于正常对照组(P0.05)。KD组患儿治疗前FIB水平显著高于正常对照组(P0.05),治疗后FIB水平回复正常(P0.05)。其余结果比较,差异均无统计学意义(P0.05)。结论 FIB与活化的血小板相互作用促进了KD急性冠状动脉血栓的形成。KD治疗前MPC降低和FIB增高可作为KD早期辅助诊断的重要指标。在KD诊疗中观测MPC与FIB水平有助于临床及时了解病情,判断预后及转归。     

Risk factors for liver fibrosis among human immunodeficiency virus monoinfected patients using the FIB4 index in Morocco

AIM: To study the prevalence and risk factors of significant hepatic fibrosis in Moroccan human immunodeficiency virus (HIV) monoinfected patients.METHODS: We conducted a cross-sectional study among HIV monoinfected patients (negative for hepatitis B surface antigen and hepatitis C antibody). Clinical and laboratory data were collected from the data base of the Infectious Diseases Unit in Ibn Rochd Hospital Center [age, gender, duration of HIV infection, CD4 T lymphocyte count, HIV viral load, glycemia and current or prior use of antiretroviral and antiretroviral therapy (ART) duration]. The primary outcome was a FIB4 score > 1.45. Multivariable logistic regression identified independent risk factors for FIB4 > 1.45.RESULTS: A FIB4 score > 1.45 was identified in 96 among 619 (15.5%). HIV monoinfected patients followed up between September 1990 and September 2012. Multivariate analysis showed that only a viral load > 75 (OR = 2.23, 95%CI: 1.36-3.67), CD4 > 200 cells/mm³ (OR = 0.39, 95%CI: 0.21-0.72) and age at FIB4 index calculation (OR = 1.10, 95%CI: 1.07-1.13) were independently associated with the occurrence of FIB4 index (> 1.45). Gender, duration of HIV infection, glycemia, use of antiretroviral therapy and ART duration were not associated with significant fibrosis by FIB4.CONCLUSION: FIB4 score > 1.45 was found in 15.5% of Moroccan HIV monoinfected patients. Age, HIV viremia > 75 copies/mL and CD4 count > 200 cells/mm³ are associated with liver fibrosis. Further studies are needed to explore mechanisms for fibrosis in HIV monoinfected patients.