Numerical analysis of stress distribution in the upper arm tissues under an inflatable cuff: Implications for noninvasive blood pressure measurement

An inflatable cuff wrapped around the upper arm is widely used in noninvasive blood pressure measurement. However, the mechanical interaction between cuff and arm tissues, a factor that potentially affects the accuracy of noninvasive blood pressure measurement, remains rarely addressed. In the present study, finite element (FE) mod-els were constructed to quantify intra-arm stresses generated by cuff compression, aiming to provide some theoretical evi-dence for identifying factors of importance for blood pressure measurement or explaining clinical observations. Obtained results showed that the simulated tissue stresses were highly sensitive to the distribution of cuff pressure on the arm sur-face and the contact condition between muscle and bone. In contrast, the magnitude of cuff pressure and small variations in elastic properties of arm soft tissues had little influence on the efficiency of pressure transmission in arm tissues. In par-ticular, it was found that a thickened subcutaneous fat layer in obese subjects significantly reduced the effective pres-sure transmitted to the brachial artery, which may explain why blood pressure overestimation occurs more frequently in obese subjects in noninvasive blood pressure measurement.     

去甲万古霉素群体药代动力学与药效学优化研究

目的研究去甲万古霉素群体药代动力学指标差异,对患者进行药效学优化。方法选取2015年1月至2015年12月268例感染患者,将其按照年龄分为中青年组和老年组,每组各134例,采用群体药代动力学和药效学优化公式进行计算,分析患者上述指标差异。结果青年组与老年组的群体药代动力学各项指标差异明显具有统计学意义(P0.05)。结论感染患者通过去甲万古霉素药物治疗疗效确切,对革兰阳性菌的杀灭作用明显,采用群体药代动力学和药效学研究后发现,AUC24/MIC能够作为去甲万古霉素的应用指标,并以此指导临床用药效果显著,值得临床应用推广。     

Some Observations on the Spectrophotometry Determination of Di-And Trihydric Phenols by Edta Titration

Abstract

Novel reaction between trioxalatoferrate (III) complex (A) and some di- and trihydric phenols were studied and found to form interesting mixed ligand chelates of iron (III) in the ratio 1:2:1 (Fe : oxalate : phenol) forming blue to violet colors at pH 4.0 to 6.5 and λ_max = 580 to 590 nm. These reactions were used for indirect volumetric and spectrophotometric microdetermination of catechol (PC), pyrogallol (PG), dopamine hydrochloride (DHCl), adrenaline hydrogen tartrate (AHT) and sulbutamol sulfate (SS) via EDTA titration using complex (A) as an indicator. PC, DHC1 and PG were determined by EDTA titration within the concentration ranges of 0.55-2.2, 0.95-3.79 and 0.65-2.52 μg ml^?1, respectively. AHT was determined in the concentration range of 96 to 204 μg ml^?1 and SS was also determined in the range 5.75 to 57.7 μg ml^?1. Adrenaline in ampoules coming from two Egyptian companies: sulbutamol in sulbovent liquids, and dopamine in five urine samples of Egyptian tumor patients, was also determined using the suggested procedure with high accuracy.     

随机服务时间下异质患者门诊预约调度优化

考虑随机服务时间与行为特征互不相同的异质患者,建立随机混合整数规划模型对门诊预约调度问题展开研究。首先在给定服务顺序的假设下求解了两个患者的预约调度问题;在此基础上,设计启发式算法对多个患者预约方案和服务顺序同时进行优化。数值结果表明:当患者服务时间为独立同分布的随机变量时,患者预约时间间隔呈现先增加后减少的圆顶形状;当患者服务时间服从不同分布时,通过与样本平均近似方法对比,验证了启发式算法的计算效率和有效性。     

加权季节性指数法及其应用

预测医院季度出院人数季度变动趋势;加权季节性指数法;用加权季节性指数法进行季度变动趋势的定量预测与分析,对历史数据样本数量要求不多,并且计算简便;计算结果更具客观性、真实性.     

基于Markov Chain Monte Carlo模型对医院出院病人调查表数据缺失的填补与分析

目的对医院出院病人调查表普遍存在的数据缺失进行填补与分析,以保证统计调查表的质量,为医院以及上级卫生部门了解现状,进行预策和决策提供技术支持和质量保证。方法运用SAS9.1,采用多重填补方法Markov Chain Monte Carlo(MCMC)模型对缺失数据进行多次填补并综合分析。结果MCMC填补10次的结果最优。结论(Multiple Imputation)MI方法在解决医院出院病人调查表数据缺失时有优势,发挥空间较大,且填补效率较高。     

老年抑郁症患者预后相关因素研究

目的探讨影响老年抑郁症患者预后的相关因素。方法收集住院或门诊就诊的87例老年抑郁症患者的一般资料,并进行生活事件量表（LES）、艾森克人格问卷（EPQ）、简易智力状态检查表（MMSE）和社会支持评定量表（SSRS）等因子评定,采用大体功能评定量表（GAS）评定老年抑郁症患者的预后疗效,并根据GAS分值分组,GAS≤60分视为预后差,作为研究组;GAS＞60分视为预后好,作为对照组。通过logistic回归分析,探讨影响老年抑郁症患者预后的相关因素。结果87例老年抑郁症患者中疗效差者占37.9%。两组患者在起病形式、治疗是否恰当、治疗依从性、合并慢性躯体疾病、负性生活事件值、对社会支持的利用度、EPQ的N维度分值及MMSE总分等因子方面的差异均有统计学意义（均P＜0.05）,经多元logistic回归分析发现,影响老年抑郁症预后的主要因素为：治疗依从性、慢性躯体疾病、EPQ标准N维度分值、合并精神病症状及对支持的利用度。结论老年抑郁症患者的预后可能受精神病理学、神经心理学和家庭社会等多种因素的影响,应从多方位着手,降低复发率,提高生活质量。     

The Weight-Bearing Rate on the Paretic Limb of Cerebrovascular Hemiplegic Patients Necessary for an Independent Obstacle Negotiation Gait

Purpose: The obstacle negotiation gait (ONG) is a fundamental activity of daily living. In cerebrovascular hemiplegic patients (stroke patients), the weight-bearing rate (WBR) on the paretic limb necessary for an independent ONG was studied. Methods: One hundred and seventeen stroke patients were involved. The patients'' average age at the time of the study was 67 years, and the average time from stroke onset was 102 days. There were 68 men and 49 women. Seventy patients were right hemiplegics, and 47 were left hemiplegics. The correlations between ONG and age, sex, body mass index (BMI), time from stroke onset, muscle strength of both the paretic and non-paretic limbs, Brunnstrom stage of the lower limbs, deep sensation, and the WBR on both the paretic and non-paretic limbs were studied. Patients who could perform ONG independently and safely were categorized as the independent group (IG), and those who needed observation or any assistance were categorized as the dependent group (DG). Results: The BMI, muscle strength of both the paretic and non-paretic limbs, Brunnstrom stage of the lower limbs, deep sensation and the WBR for both the paretic and non-paretic limbs were significantly different between the IG and DG groups. In particular, the WBR on the paretic limb was found to correlate significantly with the ONG, and a WBR value of 80.5% on the paretic limb gave a clear cut-off value. Conclusion: Although multiple factors influenced the ONG of stroke patients, the WBR on the paretic limb was the most influential.     

Determination of Guanidino Compounds in Serum by Micellar Electrokinetic Capillary Chromatography Using Benzoin as the Derivatizing Reagent

An analytical procedure has been evolved for the determination of seven guanidino compounds; guanidine (G), methylguanidine (MG), guanidinoacetic acid (GAA), guanidinopropionic acid (GPA), guanidinobutyric acid (GBA), arginine (Arg), and guanidinosuccinic acid (GSA) by micellar electrokinetic capillary chromatography (MEKC) within 6 min using benzoin as derivatizing reagent. Sodium dodecyl sulfate (SDS) was used as the micellar medium in a sodium tetraborate (0.1 M) buffer at pH 8.5. Uncoated fused silica capillary was used with an effective length of 39 cm and 75 μm id. Applied voltage was 25 kV and photo diode array detection was set at 228 nm. Linear calibrations obtained from 0.057 to 14.11 μmol/L and limits of detection (LOD) were within 0.019–0.03 μmol/L. The derivatization and separation was repeatable with relative standard deviation (RSD) within 1.9–3.8%. Serum of healthy volunteers and uremic patients was analyzed and amounts found in uremic patients were G 1.98–3.03, MG 1.21–1.79, GAA 3.67–6.09, GPA 1.17–1.37, GBA 1.29–1.46, Arg 9.49–19.17, and GSA 6.83–10.91 μmol/L with RSD (n = 4) within 1.3–4.5%. The amount of guanidino compounds was higher in uremic patients than in healthy volunteers.     

质子转移反应质谱对肺癌患者呼气中特征性VOCs的筛选及研究

利用质子转移反应质谱(PTR-MS)对40名肺癌患者、32名健康志愿者呼出气体中的挥发性有机物(VOCs)进行检测,Mann-Whitney秩和检验与多因素logistic回归的结果表明,呼气中VOC 33、VOC 39、VOC 45可能为肺癌人群的呼气标志物,同时VOC 45在小细胞肺癌和非小细胞肺癌患者之间存在显著差异。以肺癌人群的呼气标志物作为自变量,采用二元logistic回归分析和Fisher判别分析分别建立肺癌预测模型。logistic回归模型的受试者工作曲线下面积(AUC)达到0.878,灵敏度和特异性分别为85.5%和63.5%。Fisher判别模型的受试者工作曲线下面积(AUC)达到0.822,灵敏度和特异性分别为82.5%和62.5%。两种模型对肺癌的预测均具有统计学意义。