Technology assessment of anaesthesia monitors: problems and future directions

Specific factors have limited the interpretation of studies regarding the efficacy, effectiveness and efficiency of technology in anaesthesia. Some of these problems are reviewed, including the lack of specific outcomes necessitating the use of intermediate measures (e.g., hypoxaemia, myocardial ischaemia), which are not necessarily related to ultimate patient outcomes. This emphasizes the need for anaesthesia investigators to define fundamental issues specifically and design studies accordingly. With respect to anaesthesia monitors, the “lead time” or early warning provided by a monitor relative to that required to alter therapy effectively needs to be defined better and compared with the “lead time” without the monitor. After defining the benefit of a monitor, investigators should analyze the cost relative to alternatives (cost-benefit and cost-effectiveness). A hierarchical model to guide technology assessment is presented that addresses in order, the scientific basis of the technology, and the influence on the patient followed by societal issues. Anaesthetists have relied on traditional methods of technology assessment adopted from other disciplines. These methodologies do not address specific issues related to anaesthesia practice (such as “lead time”). In defining problems specific to the specialty of anaesthesia, new outcome measures that focus on the human factors related to decision-making in the operating room need to be developed. Future evaluations of anaesthesia technology require innovative approaches that address specific anaesthesia-related problems. One such approach is the use of simulation-based studies of response patterns to critical incidents.     

金属换热器传热过程的数学模型及应用

应用蒙特卡洛法仿真辐射式金属换热器内的辐射传热过程，建立了换热器综合传热的数学模型，利用概率论原理，把辐射能迁移过程仿真为一定累积概率分面下的随机过程，该模型能较好地反映换热器内传热过程的真实情况，可以计算出换热器内烟气、筒壁、空气的温度和壁面热流分布，以及研究烟气进口温度、换热器筒径和狭逢宽度对换热效果的影响。     

中医对干燥综合征治法和用药初探

干燥综合是一种全身性自身免疫病,目前西医对本病无疗法。因此探讨中医对本病的治法和用药,提高临床有效率是十分必要的。本文在中医辯证理论的指导下,提出了:益气养阴、养阴清热、琉风清热、养血活血、清热化湿、痹通络等六种治疗方法和用药初探,以供临床参考应用。     

HCV的检测方法

从发现丙型肝炎病毒以来 ,丙肝的检测技术发展迅速 ,灵敏度和特异性都有明显的提高 ,方法学在不断改进完善。笔者就近年来丙型肝炎的实验室检测方法作简要的综述     

人工晶体植入屈光度的术前预选法：眼科超声仪36例对比研究

根据公认的眼科解剖学数据，提出后房型人工晶体植入屈光度的术前预测方法：IOL（D）=1．02（＋21D＋2X）。经人工晶体专用眼科A超36眼实测对比，无显著差异，认为在地市级医院和县级医院后房型人工晶体植入术推广中具有积极意义。     

苯作业工人白细胞降低者的总估校正现患率

选择乡镇工业苯作业工人４次外周血白细胞计数中的间隔半年的两次数据，应用俘获再俘获法，计算其白细胞降低者的总估校正现患率（ＡＣＰＲ）。结果苯接触组为３６．８ｌ％（２９．１４％～４４．４８％），对照组为１２．７１％（７．２０％～１８．２２％）具有显著差异，其相对危险度为２，９。用常规法求得的４次检出率分别是：苯接触组为２６．３７％，１８．７３％，２７．９３％，３６．７６％；对照组为６。８５％，７．３８％，７．９４％，１５．００％。均在其ＡＣＰＲ之９５％可信限内，可见ＡＣＰＲ计算方法简便、结果准确，值得推广。对于稳定的人群，可用其每年一次的健康监护资料计算ＡＣＰＲ。     

Ontogenesis of the pyramidal cell of the mammalian neocortex and developmental cytoarchitectonics: a unifying theory.

The prenatal development of the mammalian neocortex has been analyzed, with the rapid Golgi method, in a variety of experimental animals (hamster, mouse, rat, and cat) and in humans. A new developmental conception of the structural organization of the mammalian neocortex is discussed. Neocortical development begins with the establishment of the primordial plexiform layer (PPL) which precedes and is a prerequisite for the subsequent formation of the cortical plate (CP). The formation of the CP occurs, in its entirety, within the PPL. During its development, three fundamental neuronal events occur: migration, early differentiation, and late maturation. All migrating neurons, travelling on radial glial fibers, reach layer I, develop an apical dendrite, and establish contacts with its elements. These newly differentiated neurons assume similar morphology resembling embryonic pyramidal cells. As such, an early differentiation stage common to all neurons of the CP is established. During the late maturation stage, all CP neurons acquire their specific phenotypic structural and functional features. Only pyramidal neurons retain and expand their original connections with layer I while other neuronal types lose these connections. The pyramidal cell is redefined in developmental terms: the neocortex's pyramidal cell is both structurally and functionally locked into position between layer I and the cortical depth of its soma. During mammalian evolution pyramidal cells are forced to structurally and functionally elongate their apical dendrite outwardly to accommodate an increasing amount of information without losing either their original anchorage to layer I or their cortical depth. This unique property of pyramidal neurons is considered to be a mammalian innovation. Based on these observations, a unifying developmental cytoarchitectonic theory applicable to all mammals is proposed. The theory considers the CP to be a mammalian innovation and to represent a single, stratified, and expanding telencephalic nucleus. The theory envisions the mammalian neocortex as an open biological system capable of progressive expansion by the recruitment and transformation of primitive neurons from upper layer II into pyramidal cells. Hence, the number of pyramidal cell strata increases over the course of mammalian phylogeny. The developmental roles of layer I in the migration of neurons, formation of the CP, unique morphology of pyramidal cells, and overall structural organization of the mammalian neocortex are emphasized.     

线宽增量法及其在生物材料发射光谱分析中的应用

作者利用交流电弧和光栅摄谱仪组装了能够绘制谱线轮廓曲线和准确测定谱线宽度的记录仪,用线宽增量法对生物材料(拟血清)中的主要成分Ca和微量元素Cu进行了测定。与黑度法相比,本实验结果的线性好,误差小,再现性有所提高。这些结果表明,用上述仪器装置和线宽增量法进行生物材料含量分析优于黑度法。     

Path analysis and sib-pair linkage

When the distance between linked loci is expressed in terms of the correlation between the identity-by-descent (idb) values of the loci, then a path model may be used to order loci with data on sib-pairs and their parents. The relationship between the recombination fraction and the correlation coefficient is developed and a method for fitting a covariance matrix predicted by a specific ordering of loci to an observed covariance matrix is proposed. © 1993 Wiley-Liss. Inc.