2008—2012年《中华实用儿科临床杂志》载文文献计量分析

目的:分析《中华实用儿科临床杂志》近5年发展情况,为提高该刊质量提供参考依据. 方法:通过"中国生物医学文献数据库"收集该刊2008—2012年的文献题录,采用文献计量学方法,对文献的时间分布、单位分布、作者分布、作者合作情况、单位合作情况、高频关键词、高频主题词等指标进行统计分析. 结果:2008—2012年《中华实用儿科临床杂志》共载文3 459篇,单篇论文的长度在逐年增长;涉及作者13 870位,每篇论文作者平均数量大于4,每篇论文的平均合作单位数量多于1.45,关键词和主题词符合本刊的主题.2008—2010年被引的文献为1 131条,占期间总文献量的62%.结论:2008—2012年发表的论文选择更具有针对性,向着更为合理性的方向发展,研究方法也多采用定量分析方法,并且论文形式多样,文献被引次数越来越多.     

静脉滴注的临床决策

提出了静脉滴注的动力学一般模型，讨论了模型的性质，在给药剂量确定的条件下，探讨了调整滴注速率使治疗效果达到最佳的临床决策方法。     

自血光量子治疗急性脑梗死112例临床观察

目的　探讨自血光量子照射疗法在治疗急性脑梗死时的应用价值.方法　对112例急性脑梗死患者分组进行单纯药物治疗,及药物治疗合并自血光量子照射治疗,对2组患者进行实验室指标评定.结果　药物治疗合并自血光量子照射治疗的患者神经功能缺损程度治疗前后差异非常显著(P<0.01).治疗前与治疗后实验室指标变化有显著差异.结论　自血光量子治疗可使急性缺血性脑血管病神经缺损恢复速度加快,可作为治疗急性缺血性脑血管病的辅助手段.     

Traceable measurements in clinical laboratories

 Reliable, traceable and comparable measurements provide the rational basis for evaluation of the quality of a result and the starting point for recognized laboratory accreditation in any national area. Modern medical diagnostics and treatment involve rapidly rising numbers and types of clinical laboratory measurements, that are reliable. Therefore, the basic principles to be followed to assure the traceability of clinical measurements as required by the Romanian Laws of Metrology are reviewed. Main sources affecting the quality of the unbroken chain of calibrations that relate the measurements back to appropriate measurement standards are discussed. Examples of how to achieve traceable measurements in clinical laboratories are presented. Details of specific uses of reference materials, measuring instruments and standard measurement methods are also discussed. Received: 8 January 1998 · Accepted: 21 April 1998     

Clinical quality vs analytical performance: what are the right targets and target values?

For optimal performance of laboratory tests, testing processes should be designed to provide clinically useful quality and QC procedures should be selected to assure that the necessary clinical quality is achieved in routine production. One important issue is how to define clinical quality. Today’s practice guidelines, quality regulations, and quality standards provide some targets for analytical quality, but they fail to adequately address clinical quality. Target values for precision and accuracy are not the same as clinical quality, though analytical performance certainly contributes to the clinical quality of test results. How can we proceed in our quest to improve quality when there are inconsistencies and inadequacies in the specifications found in practice guidelines, regulations, and standards? Today target values are often being set for the wrong targets. A better approach is possible if we focus on test interpretation guidelines to define clinical quality, then derive specifications for the accuracy and precision that are appropriate for the method, as well the QC rules and numbers of control measurements that are necessary to guarantee the desired quality will be achieved in routine operation of the testing process.     

Towards accreditation of clinical biochemistry in the public sector on the island of Mauritius

Medical laboratories of the public sector as well as of the private sector on the island of Mauritius are preparing for accreditation. The clinical laboratory of the Central Health laboratory of the Ministry of Health and Quality of Life has undergone a pre-assessment by experts of the International Atomic Energy Agency (IAEA) through the aegis of a project targeted to members of the Africa Region. Several shortcomings were identified and respective corrective actions were recommended for implementation within a given time frame. In addition to ensuring the competence of the laboratory, accreditation has various positive aspects such as an increased awareness of the staff to quality and better training opportunities. The pre-assessment exercise has provided a gap analysis, which is an important aspect in the preparation towards accreditation.     

HPLC Method for Determination of Rosiglitazone in Plasma

A fast and sensitive high performance liquid chromatography method for quantitative determination of rosiglitazone in human plasma has been developed. The extraction from plasma was performed using solid-phase extraction (SPE) on C4 silica (100 mg) disposable extraction cartridges (DEC). The separation of rosiglitazone and two metabolites was achieved on a Phenomenex® Synergi 4 µm MAX-RP (150 × 4.6 mm) column, protected by a guard column. The mobile phase was 0.01 M ammonium acetate, pH 7.0 - acetonitrile (65:35, v/v). (3S)-3-OH-quinidine was used as internal standard. The analytes were detected using fluorescence detection. The method was validated. The limit of quantitation was 1 ng mL⁻¹ and the detection limit was 0.25 ng mL⁻¹ for rosiglitazone in human plasma. The recovery was 90% for rosiglitazone. Linearity was observed over a range of 1-1000 ng mL⁻¹ (r²=0.9959). The intra- and inter-day precision (C.V.) did not exceed 8.7 %. Applicability of the method was demonstrated by a clinical pharmacokinetic study. A healthy volunteer received in two separate phases 4 mg and 8 mg rosiglitazone maleate as a single oral dose. Plasma concentrations were measured for 24 h in both phases.     

Small-volume radial flow cell for all-solid-state ion-selective electrodes

A flow cell with a radial distribution of four all-solid-state ion selective electrodes (ISEs), or alternatively three ISEs and one reference electrode, was designed and optimized for mass production. The radial distribution of the electrodes reduces the cell volume and is expected to minimize cross-contamination between different electrodes. Two different cell prototypes were developed and tested for all-solid-state K⁺-ISEs based on a solvent polymeric ion-selective membrane (ISM) and a conducting polymer, poly(3,4-ethylenedioxythiophene), as solid internal contact. In the first prototype, PEDOT was electropolymerized from an aqueous solution of the monomer and the doping ion salt, sodium polystyrenesulfonate (NaPSS). The second prototype employed an aqueous dispersion of PEDOT(PSS) that is commercially available (Baytron P, Bayer AG). Compared to electrochemical synthesis, solution casting of the polymer dispersion was found to be a more advantageous method to deposit the conducting polymer layer aiming at mass production. The resulting prototypes of the flow cell had a small volume (ca. 17-37 μl), which makes them suitable for application in clinical analysis.     

The American (USA) perspective six years after implementation of CLIA'88 (Federal) regulations

 On September 1, 1992 all testing sites in the United States were required to comply with the Clinical Laboratory Improvement Amendments of 1988 (CLIA'88). These regulations, based on both total quality management (TQM) and continuous quality improvement (CQI) principles, reshaped the environment for more than 90% of laboratories. CLIA'88 represented a revolutionary change by imposing universal, uniform regulations based on test complexity for all sites examining materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of disease. CLIA'88 specifies minimum requirements for personnel, quality control, and proficiency testing (PT). In addition, laboratories are required to follow manufacturers' directions and comply with other specified good laboratory practices. PT is mandated for most of the frequently run analyses and quality assurance requirements integrate the principles of CQI as well as TQM into the regulatory process. Biannual inspection is integral to CLIA'88, however, laboratories can choose other federally approved ("deemed") professional organizations, such as the Commission on Office Laboratory Accreditation, the College of American Pathologists, or the Joint Commission on Accreditation of Healthcare Organization, having standards that meet or exceed those of CLIA'88. CLIA'88 has still not been finalized. This article discusses the impact and changes since CLIA's implementation in 1992. Received: 5 October 1998 · Accepted: 20 October 1998