深圳宝安3～7岁健康幼儿血清糖、离子、非蛋白含氮类化合物表达水平观察

目的观察深圳宝安3～7岁健康幼儿血清糖、离子、非蛋白含氮类化合物表达水平。方法采用OLRPUSAU-640全自动生化仪及OLRPUS诊断试剂、东欧生物诊断试荆，检测316例体检健康幼儿血清中Ca^＋＋、Mg^＋＋、P^＋＋＋、GLU、BUN、Cr、UA的含量。结果①．1组与4组及2组与3、4组Ca^＋＋组间方差分析，差异有统计学意义，P〈0.05。②．1组与2、3、4组Cr组间方差分析，差异有统计学意义P〈0．05。而Mg^＋＋、P^＋＋＋、GLU、BUN、UA组间方差分析差异无统计学意义，P〉0．05。结论笔者证实了3～4岁健康幼儿与6～7岁健康幼儿及4～5岁健康幼儿与5～7岁健康幼儿血清Ca^＋＋表达水平有差异。也证实了3～4岁健康幼儿与4～7健康幼儿Cr含量存在差异。由此可见，3～7岁健康幼儿建立自己的参考值是必要的。     

心导纳微分环,肺导纳微分环最大向量正常值及其临床意义

本文报道３－５０岁２１４例心导纳微分环（ＣＡＤＬ）和肺导纳微分环（ＰＡＤＬ）最大向量振幅及方位正常值，结果随增龄变化振幅递减，方位递增，多数男＞女，部分组间有差异。４８例左向右分流先心病环体最大向量与肺动脉压之间呈平行关系，并探讨其临床意义。     

健康成人135例心率变异性时域分析

目的：探讨国人心率变异时域分析各项指标的正常值。方法：应用清华－西安兰港监测系统对１３５例１８～７９岁健康成人连续２４ｈ动态心电图监测。结果：①心率变异性时域：ＳＤＮＮ、ＳＤＳＤ、ＳＤＡＮＮ、ＲＭＳＳＤ、ＰＮＮ５０分别为１２９．５２±２７．２５ｍｓ；２１．１８±８．２０ｍｓ；１１４．７８±２６．８４ｍｓ；３１．３６±１２．６７ｍｓ；８．５０ ± ７．８０ｍｓ，所测得正常值范围与国内外研究结果相似。②１８～３５岁组、３６～５９岁组，均与≥６０岁组有非常显著的差异（Ｐ＜０．０１，或Ｐ＜０．０５）。③各年龄组男女间ＳＤＮＮ、ＳＤＳＤ、ＰＮＮ５０无显著差异（Ｐ＞０．０５），但ＳＤＡＮＮ男性较女性大（Ｐ＜０．０５）；女性ＲＭＳＳＤ较男性大（Ｐ＜０．０５）。结论：ＳＤＮＮ＞１００ｍｓ；ＳＤＳＤ＞１２ｍｓ；ＳＤＡＮＮ＞８７ｍｓ；ＲＭＳＳＤ＞１８ｍｓ；ＰＮＮ５０＞０．７％可作为ＨＲＶ时域分析参考正常值。     

50岁以上正常人左室舒张期彩色多普勒血流频谱参数变化的研究

目的探讨５０岁以上正常人左室舒张期脉冲多普勒频谱的参数变化情况。方法选择一年半时间内受检的所有５０岁以上正常人４７５例，按每１０岁为一组分４组进行分析。受检者取左侧卧位，常规显示心尖四腔心切面，取样容积置于二尖瓣尖，使声束与二尖瓣血流方向夹角＜１５°，以连续三个心动周期的平均值分别测量Ｅ峰、Ａ峰、Ｅ／Ａ及Ｅ峰减速时间并统计。结果发现Ｅ峰高于正常值低限的例数、平均Ｅ峰血流速度以及Ｅ／Ａ均随着年龄的增加而下降，Ｅ峰减速时间则随着增龄而增加。结论左室舒张期血流频谱的所有参数与年龄有显著的相关性，明显随着增龄而变化，并且有其规律性。     

彩色多普勒超声对感染性休克患者急性肾损伤的预测价值

背景 感染性休克患者存在肾脏血液灌注异常,严重时可诱发急性肾损伤(AKI),严重威胁患者生命安全;彩色多普勒超声(CDU)可用于评估肾脏血流变化,但有关其在感染性休克患者AKI评估中价值的研究较少。目的 通过CDU评价感染性休克患者AKI的发生情况及其血流动力学改变。方法 选取2019年6月至2021年7月徐州市中心医院收治的105例确诊为感染性休克的患者并纳入感染组,选取同期健康体检者58例并纳入对照组,收集受试者一般资料。采用CDU检查受试者肾脏血流动力学指标[肾动脉管腔内径(D)、收缩期血流峰值速度(Vs)、舒张末期血流速度(Vd)、阻力指数(RI)、搏动指数(PI)],比较感染组与对照组的一般资料及肾脏血流动力学指标。根据感染组患者入院72 h内发生AKI与否将其分为AKI组及非AKI组,比较AKI组与非AKI组肾脏血流动力学指标。应用受试者工作特征(ROC)曲线分析肾脏血流动力学指标对感染性休克患者发生AKI的预测价值。应用单因素分析及多因素Logistic回归分析探讨感染性休克患者发生AKI的影响因素。以AKI由轻到重的程度将患者分为AKIⅠ组、AKIⅡ组、AKIⅢ组,比较...     

踝肱指数和肱踝动脉脉搏波速度与血管舒张功能联合载脂蛋白B与载脂蛋白A-1比值对中青年冠心病血瘀证的预测价值研究

背景 冠心病属中医“胸痹心痛”范畴,其证候分布以血瘀证最为多见,与老年人相比,中青年血瘀证的发生率更高。本研究在团队前期研究基础上进行拓展,首次运用动脉弹性和血管内皮功能检测联合载脂蛋白比值诊断中青年冠心病血瘀证,旨在为早期发现中青年冠心病血瘀证提供新思路,也可为优化补充冠心病血瘀证的诊断标准提供参考。目的 探讨踝肱指数(ABI)、肱踝动脉脉搏波速度(baPWV)、血管舒张功能(FMD)联合载脂蛋白B与载脂蛋白A-1比值(apoB/apoA-1)与中青年冠心病血瘀证的关系及其预测价值。方法 选取2016年12月至2021年12月于中日友好医院中西医结合心脏内科住院治疗的中青年(<50岁)冠心病患者,并根据《冠心病血瘀证诊断标准》分为血瘀证组和非血瘀证组。收集患者首次冠状动脉造影前的ABI、baPWV、FMD和apoB/apoA-1等临床资料。采用多因素Logistic回归分析构建中青年冠心病患者血瘀证的预测模型,并采用受试者工作特征(ROC)曲线进行预测价值评价。结果 本研究共纳入中青年冠心病患者206例,其中血瘀证组127例,非血瘀证组79例。多因素Logistic回归分析结果...     

基于FT-CMR的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能分析

目的 探讨分析基于心脏磁共振特征追踪技术(FT-CMR)的心脏功能评估参数对心房颤动冷冻球囊消融患者治疗后复发的预测效能。方法 选取2019年6月至2020年12月收治的126例预行冷冻球囊消融术的心房颤动患者为研究对象,术前均进行心脏磁共振检查,根据术后6个月内患者有无复发将其分为窦性心律组72例和房颤复发组54例。比较两组患者左心房应变及应变率参数,采用FT-CMR评估患者心脏功能,并进行单因素、多因素logistic回归分析,探讨FT-CMR心脏功能评估参数对心房颤动冷冻球囊消融术后复发的预测价值。结果 房颤复发组患者女性、高血压、糖尿病、非阵发性心房颤动比例显著高于窦性心律组(P<0.05)。房颤复发组患者左心房总应变(Es)、左心房正向应变率峰值(SRs)、左心房被动应变(Ee)、心室舒张早期负向应变率峰值(SRe)、左心房整体纵向应变(PLAS)参数值低于窦性心律组(P<0.05)。Logistic多因素回归分析结果显示,性别(OR=3.511,95%CI:1.036～11.906)、PLAS(OR=1.089,95%CI:1.039～1.141)是心房颤动冷冻...     

CO2 dissociation curves of oxygenated whole blood obtained at rest and in exercise

Summary In vitro CO₂ dissociation curves for oxygenated whole blood were determined in 19 healthy male subjects at rest and during submaximal and maximal bicycle work. Hemoglobin concentration and blood lactate increased with increasing work load and accordingly buffer value of the whole blood increased while bicarbonate and Base Excess (BE) decreased, resulting in a downward shift of the CO₂ dissociation curve during exercise. Despite the marked increase in buffer values of the blood, the slopes of the CO₂ dissociation curves during exercise were found to be about the same as those obtained at rest. It was inferred that the increasing effect of increased buffer value, on the dissociation slope, was essentially compensated by the decreasing effect of diminished bicarbonate content. The advantages of this relatively constant CO₂ dissociation slope for the indirect measurement of cardiac output by the Fick principle are discussed.     

CORRELATION OF SKIN POTENTIAL AND SKIN RESISTANCE MEASURES

Simultaneous measurements of skin potential (SP) and skin resistance (SR) obtained from 20 male and 20 female adult subjects during 2 sessions held 2 to 9 days apart were used in studying (1) the correlation of change measurements and prestimulus level in the two measures, and (2) the amount of correlation between SP and SR using both simple difference and residual change scores in which the regression of poststimulus values on initial level (prestimulus) has been controlled. Correlations within Ss and correlations among Ss showed large individual variability, correlation differences between males and females, and high correlation between SP and SR change scores. Although the law of initial value (LIV) seemed to have little applicability to the measurement of electrodermal responses, the results underscored the need to control for contamination of change measures by initial level regardless of direction.     

Andrology: Acrosome reaction inducibility predicts fertilization success at in-vitro fertilization

We prospectively studied the ability of acrosome reaction (AR)inducibility to predict fertilization success in a group of232 infertile patients presenting sequentially for in-vitrofertilization (IVF). The median percentage of eggs fertilizedfor the overall patient population was 25% (interquartile range5–58%), with one to 29 oocytes available for insemination(median, five oocytes). The median percentage of eggs fertilizedat IVF increased as the percentage of spermatozoa able to undergoAR became greater: spermatozoa with a failed AR (5%) fertilizedonly 12% of eggs, while spermatozoa with AR values>9% fertilized50% of eggs. The assay had a specificity of 0.75, a sensitivityof 0.55 and an odds ratio of 2.9; thus, AR-positive patientsare 2.9 times more likely to achieve fertilization than patientswith a failed AR. Receiver operator characteristic (ROC) curveswere constructed for AR, sperm concentration and percentageof normal forms in semen. All three parameters proved to bepotentially useful in predicting the occurrence of fertilization,although AR and morphology appeared to be better than spermconcentration by ROC analysis. Patients were divided into fourclearly defined subgroups according to their traditional semencharacteristics, including morphology. The median percentageof eggs fertilized decreased as traditional semen characteristicsdeteriorated, from a median of 46% for patients with excellentsperm concentration, motility and morphology, to a median of29% for patients with suboptimal semen quality and a medianof 0% for patients with severely impaired semen. Within eachpatient subgroup, the median percentage of eggs fertilized was3-to 4-fold higher for individuals with a positive AR than forthose with a failed AR, indicating that AR has a greater effecton fertilization rate than traditional semen parameters includingmorphology. We now recognize that some men with good semen characteristicshave an unexpectedly poor AR and a markedly reduced fertilizationrate, while other men with poor traditional semen characteristicsunexpectedly retain AR and perform relatively well at IVF. Bycontrast to AR, morphology seemed to have little effect on fertilizationsuccess (two-way analysis of variance not significant). Thewife's age and oocyte quality were evenly distributed amongthe different patient subgroups, indicating that differencesin fertilization rate could not be attributed to either parameter.Our data indicate that AR has a much higher predictive valuefor IVF success than traditional semen parameters includingmorphology. We propose that AR assessment is a clinically usefuldiagnostic tool in determining a patient's likelihood of achievingfertilization at IVF.