乙酸乙酯合成实验方法的改进

对乙酸乙酯合成实验方法进行了改进 ,提出了新的实验操作方案 ,克服了原实验方法的不足 ,显著减少了浓 H2 SO4 的用量 ,从而降低了反应温度 ,避免了实验的炭化现象 ,减少了副产物的发生 ,并提高了产率。     

“健康百年”,百年健康,我们的目标是——不要衰老疾病 只要年轻健康

头发又白了些,皱纹又深了些,眼睛又花了些,骨头又脆了些,夜尿又频繁了些……而这些都无情地提示我们,衰老的步伐加快了,年轻的身影越来越模糊;血糖高了眼睛模糊起来、血压高了头晕乎起来、冠心病发了胸痛了起来……这些都痛苦地纠结我们,疾病已经来到了我们     

养好脾胃，快乐出游

憋了半年多的IT程序猿李明，早在十一放假前就计划好了，自己要去云南一探那巍峨的玉龙雪山。不过在小李踏上云南的第一天，身体就开始给自己闹腾了，拉肚子拉的就跟拧开了水龙头一样，蹲在厕所几乎就站不起来了。这一下子出去游玩儿成了出去看病了。到了当地的医院急诊以后，医生告诉他这是水土不服造成的，在旅游旺季的时候急诊接待了很多像小李这样的水土不服的病人，都是因为肠胃不适……     

乡镇设立卫生防疫站探讨

乡镇设立卫生防疫站,体现了“预防为主”的方针,健全了三级防疫网,壮大了防疫队伍,扩大了卫生防疫工作的服务范围,提高了卫生防疫工作的质量,取得了较好的社效益和经济效益。     

"青霉素前时代"会来到吗

自从有了抗菌药,感染不再是"不治之症"1928年,英国细菌学家亚历山大·弗莱明发现了青霉素,并在1942年成功地治愈了一位脑膜炎患者,从此拉开了人类使用抗生素的序幕.二战大量伤员的感染,促使了青霉素的规模生产.     

浅议门诊药品收费与房药物调配发放的一体化

本文对门诊收费和药房发药过程中存在的问题进行了分析。探讨了门诊药房将收费和发药在门诊药房内实现一体化的可行性。既方便了患者,改善了服务环境;又提高了工作效率,减少了医疗纠纷。     

意外中的意外——潍坊医学院附属医院“错换手术”的前前后后

西谚曰：断了一只铁钉,坏了一块蹄铁;坏了一块蹄铁,伤了一匹战马;伤了一匹战马,折了一个战士;折了一个战士,输了一场战争;输了一场战争,亡了一个帝国。上述意思有时也被表述为“蝴蝶效应”。有时,世界上的大事也许就是这样由一点儿微不足道、偶然发生的小亨引发的,因果之间并不一定有必然的逻辑关系。     

游泳消暑，当心手足口病侵袭

天气闷热的暑假里，游泳戏水是很多儿童的首选消暑方式。小可今年5岁，妈妈带他报了暑假游泳学习班，每天在水里扑腾扑腾可高兴了、可是，才去了两次，小可的手心里就长了几个疱疹，小可妈妈当时没在意，以为是有了湿气才这样的．可是到了第二天早晨，小可嘴里长满了溃疡，张嘴说话都困难，妈妈赶紧带他到医院看病．医生看了小可的情况后，诊断小可是患了手足口病。     

西峡：公务卡“卡”住公务消费腐败

为进一步加强和规范公务支出管理,多年来,河南省西峡县食品药品监督管理局一直实行公务卡支出管理制度,凡具备刷卡条件的．一律要使用公务卡进行结算,避免了公务消费现金支付、先消费后报销的现象,增强了公务消费支付的透明度,减少了现金支付结算,提高了单位财务管理水平,加强了对公务支出过程的监控,从而有效地堵塞了漏洞,避免了腐败现象,累计节约经费30余万元,有力促进了公务行为廉洁高效。     

产科中的人性化护理

人性化服务充分体现了"以人为中心"的护理,改善了医患关系,减少了医患纠纷,提高了孕产妇的信任度和满意度,相应也提高了医院的社会效益和经济效益.     

Influence of cadmium and copper on tissue element levels of pregnant rats

In the current study, we examined the effects of Cd on Cd, Cu, Zn and Fe levels in placenta and maternal and fetal plasma and tissues, the placental weight, total fetal and maternal body weights, and fetal and maternal tissue weights during pregnancy. A total of 21 adult female rats were treated during gestation with drinking water containing one of the following: 70 mg/L of CdCl₂, a combination of 70 mg/L of CdCl₂ and 70 mg/L of CuSO₄, or no addition (control). Placenta Cu and Fe levels, fetal liver and kidney Cu levels, and fetal liver tissue weights were lower in the group administered Cd than in the control group. Also, Cd levels in the placenta, maternal and fetal liver, and maternal kidney were higher in the group treated with Cd than in controls. In the group administered both Cd and Cu, fetal body and tissue weights did not change, but Cd levels in the placenta, maternal and fetal liver, and maternal kidneys were higher than in controls. Zn and Fe levels in the maternal kidney and fetal liver were also lower in this group. Cd exposure during pregnancy resulted in Cd accumulation in maternal and fetal tissues during pregnancy and a decrease in the total weight of fetuses, and the combination of Cd and Cu caused some changes in the both maternal and fetal levels of Cu, Zn, and Fe, but it did not cause changes in the total fetal body weight or the weights of individual tissues.     

Effects of butyltin compounds on mitochondrial respiration and its relation to hepatotoxicity in mice and Guinea pigs.

Because the mechanisms responsible for the difference in toxicity between different experimental animal species remain unclear, the effects of tributyltin chloride (TBTC) and dibutyltin dichloride (DBTC) on mitochondrial respiration were compared among the livers of mice and guinea pigs in vitro and in vivo. Further, the levels of these butyltin compounds and their derivatives in the mitochondrial fractions of the hepatocytes were investigated in these animal species. Administration of TBTC and DBTC to mice resulted in the obvious elevation of serum enzymatic activities, as well as the inhibition of succinate-linked State 3 respiration in hepatic mitochondria at 24 h after administration. On the other hand, these metal compounds failed to induce such hepatotoxicity or to inhibit mitochondrial respiration in guinea pigs. There was no significant difference between mice and guinea pigs in the IC50 (metal concentration observed in 50% inhibition of mitochondrial respiration) of TBTC and DBTC against the succinate-linked State 3 respiration of hepatic mitochondria in vitro, although the mitochondrial respiration of succinate-linked State 3 was inhibited in the liver of mice treated with the metals in vivo. The levels of total butyltin compounds in the mitochondrial fractions of hepatocytes were higher in the mice than in the guinea pigs, and the main butyltin compound in the mitochondrial fractions was DBTC in both species at 24 h after TBTC or DBTC administration. The amount of sulfhydryl groups, which were capable of binding with DBTC, in mice hepatic mitochondria was twice as large as that in guinea pigs, and the affinity of DBTC for the isolated hepatic mitochondria was higher in mice than in guinea pigs in vitro. These results suggested that the induction of hepatotoxicity by TBTC and DBTC in vivo was closely associated with the depression of mitochondrial respiration and that the difference in susceptibility to the metal-induced mitochondrial damages between mice and guinea pigs might result from the high affinity of butyltin compounds, in particular DBTC, for hepatic mitochondria in mice containing higher levels of sulfhydryl groups, compared with guinea pigs.     

糖尿病性偏侧舞蹈症的临床分析

目的探讨糖尿病性偏侧舞蹈症的临床特点、发病机制、影像学改变及预后,防止误诊及漏诊。方法回顾性分析10例糖尿病性偏侧舞蹈症的临床症状、影像学变化、实验室检查结果和治疗经过,并复习相关文献。结果①10例均为未经治疗的糖尿病患者,其中6例为糖尿病非酮症高血糖症,4例为酮症高血糖症。②临床表现;7例为突发起病并以一侧肢体为主的持续性舞蹈样运动,3例为发作性口角抽动伴单肢不自主舞动起病。症状均清醒时出现,睡眠时消失。肌力均为5级,肌张力均正常。③影像学表现:早期CT表现为舞蹈症状对侧的尾状核、壳核和(或)苍白球,丘脑的高密度影像,内囊未受累,并在1个月左右减弱或消失;磁共振(MRI) T_1像为病灶部位的片状高信号,在持续数月后信号减低,T_2则表现为稍低信号或病灶部位区域中心混杂信号而周边高信号,边界清晰,无明显水肿征象。④本组患者均给予氟哌啶醇及氯硝安定等药物治疗并控制血糖,症状均在短期内迅速改善。结论糖尿病性偏侧舞蹈症多见于血糖控制不佳的糖尿病患者,结合特定部位的变化性磁共振成像及肢体舞蹈样动作可以做出诊断。在控制血糖的基础上,应用氟哌啶醇和氯硝安定治疗效果较好。     

中青年血清胆红素轻度增高者胆红素与血糖、血脂及血压的关系

目的观察中青年血清胆红素轻度增高者血糖、血脂及血压水平。方法中青年男女556人,高胆红素组296人,对照组260人。测定两组研究对象血清总胆红素、直接胆红素、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及血压并对数据进行分析。结果男性胆红素高于女性,差异有统计学意义（P〈0．01）。高胆红素组空腹血糖低于对照组,男性二组差异有统计学意义（P〈0．01）,女性二组差异无统计学意义（P〉0．05）。高胆红素组收缩压低于对照组,但差异无统计学意义（P〉0．05）,舒张压高于对照组,且差异有统计学意义（P〈0．05）。高胆红素组男性总胆固醇、甘油三酯高于对照组,高及低密度脂蛋白胆固醇低于对照组,其中高密度脂蛋白胆固醇与对照组差异有统计学意义（P〈0．05）。高胆红素组女性总胆固醇、甘油三酯、高与低密度脂蛋白胆固醇均高于对照组,但差异无统计学意义（P〉0．05）。空腹血糖与男性总胆红素、直及间接胆红素和女性直接胆红素负相关。舒张压与男性总胆红素及直接胆红素和女性总胆红素及间接胆红素正相关;收缩压与男性胆红素不相关,与女性直接胆红素负相关。男性低密度脂蛋白胆固醇、女性总胆固醇、腰围与直接胆红素负相关。男性腰围与总胆红素、间接胆红素正相关。结论胆红素不同形式对空腹血糖均有影响,中青年阶段空腹血糖随着胆红素的增高而降低。胆红素对中青年男女舒张压的维持有一定作用,对收缩压的影响有性别差异,女性胆红素较高者,舒张压较低。中青年男女在高胆红素水平时有较少的心脑血管危险因素。     

Use of M-mode and Doppler echocardiography to investigate the cardiotoxicity of minoxidil in beagle dogs

Doppler and M-mode echocardiography (EC) were used to investigate the effects of minoxidil on the cardiac function of the dog and potentially to clarify the pathogenesis of cardiac lesions, in particular the necrotic lesion in the left ventricle and the haemorrhagic lesion in the right atrium. Groups of three dogs were treated with a single oral dose of 0.5 or 2 mg/kg minoxidil or control vehicle, and M-mode and Doppler parameters were recorded at different time points before as well as 1, 3 and 24 h after treatment. The treatment produced a number of changes in M-mode parameters that indicate an increase in left ventricle contractility, in particular, increases in the percentage of thickening of the left ventricle wall during systole and in ejection fraction, and decrease of systolic volume. There was also a decrease in diastolic volume, which indicates a decrease in filling of the left ventricle probably due to the tachycardia and subsequent decrease in inter-systolic time. Doppler EC showed an increase in the velocity of the aortic flow, which indicates an increase in cardiac contractility. There was also a mild increase in stroke volume, which together with the tachycardia resulted in a marked increase in cardiac output. Together, Doppler and M-mode recordings gave evidence of an increase in the contractility of the left ventricle. This change is consistent with the generally accepted mechanism for the development of the left ventricle lesion induced by minoxidil. Minoxidil also produced changes in atrio-ventricular flows. The velocity and/or acceleration of E- and A-waves of the mitral and tricuspid flows increased, and the E/A ratio decreased. The changes in the E-wave indicate a faster diastole of the ventricle probably to compensate for the decrease in inter-systolic time. The changes in A wave are characteristic of an increased amplitude and velocity of the atrial contraction. This latter change is much more marked for tricuspid than for mitral flow. For both flows the E/A ratio decreased, which indicates that the contraction of the atria plays an increased role in ventricle filling after minoxidil treatment. This stimulation of atrial contraction that we evaluate with Doppler EC may play a key role in the development of the atrial lesion produced by minoxidil. The fact that the change is more marked in the right than in the left atrium may explain why the lesion occurs only in the right atrium in dogs. This study showed, therefore, that Doppler EC associated with M-mode EC is a useful method for obtaining pertinent information on the pathogenesis of the left ventricle lesion induced by haemodynamic mechanisms. Moreover, Doppler EC allowed the assessment of changes in the function of the right atrium that may be involved in the development of the right atrial lesion.     

Subacute toxicity evaluation in rats exposed to concrete and hwangto building environments

This study examined the potential adverse effects of the subacute exposure of rats to concrete and hwangto building environments. Polycarbonate was used as a comparison. Groups of 10 male rats were exposed to polycarbonate, concrete, or hwangto cages for a 4-week period in summer or winter. During the study period, the clinical signs, mortality, skin temperature, body weight, food consumption, ophthalmoscopy, urinalysis, hematology, serum biochemistry, gross findings, organ weights, and histopathology were examined. The concentration of total volatile organic compounds (VOCs), temperature, and relative humidity in the each cages were also measured. There were no exposure-related effects in any group of the study examined in the summer. The temperature, relative humidity, and the concentration of VOCs in the cages were similar in all groups. However, in the winter study, significant differences in several parameters were detected among the groups. In the concrete group, there was an increase in the clinical signs, a reduction in the body weight gain, food intake, and liver weight, an increase in the lung weight, and an increase in the histopathological alterations in the lung and thymus. Infrared thermal analysis showed that the skin temperature of the rats in the concrete group was lower than that in the polycarbonate group. However, in the hwangto group, there was a decrease in the clinical signs and an increase in the body weight, food intake, and the weights of the heart, lung, spleen, and epididymides. Overall, the 4-week exposure of the rats to the concrete building environment had adverse effects on the clinical signs, skin temperature, body weight, and some organs in the winter but not in the summer. On the other hand, the exposure of hwangto building environment did not have any exposure-related adverse effects on the general health parameters and skin temperature in rats.     

Fumonisin B1 Accumulates in Chicken Tissues over Time and This Accumulation Was Reduced by Feeding Algo-Clay

The toxicokinetics of the food and feed contaminant Fumonisin B (FB) are characterized by low oral absorption and rapid plasma elimination. For these reasons, FB is not considered to accumulate in animals. However, recent studies in chicken and turkey showed that, in these species, the hepatic half-elimination time of fumonisin B1 (FB1) was several days, suggesting that FB1 may accumulate in the body. For the present study, 21-day-old chickens received a non-toxic dose of around 20 mg FB1 + FB2/kg of feed to investigate whether FB can accumulate in the body over time. Measurements taken after four and nine days of exposure revealed increased concentrations of sphinganine (Sa) and sphingosine (So) over time in the liver, but no sign of toxicity and no effect on performances were observed at this level of FB in feed. Measurements of FB in tissues showed that FB1 accumulated in chicken livers from four to nine days, with concentrations of 20.3 and 32.1 ng FB1/g observed, respectively, at these two exposure periods. Fumonisin B2 (FB2) also accumulated in the liver, from 0.79 ng/g at four days to 1.38 ng/g at nine days. Although the concentrations of FB found in the muscles was very low, an accumulation of FB1 over time was observed in this tissue, with concentrations of 0.036 and 0.072 ng FB1/g being measured after four and nine days of exposure, respectively. Feeding algo-clay to the chickens reduced the accumulation of FB1 in the liver and muscle by , approximately 40 and 50% on day nine, respectively. By contrast, only a weak non-significant effect was observed on day four. The decrease in the concentration of FB observed in tissues of chickens fed FB plus algo-clay on day nine was accompanied by a decrease in Sa and So contents in the liver compared to the levels of Sa and So measured in chickens fed FB alone. FB1 in the liver and Sa or So contents were correlated in liver tissue, confirming that both FB1 and Sa are suitable biomarkers of FB exposure in chickens. Further studies are necessary to determine whether FB can accumulate at higher levels in chicken tissues with an increase in the time of exposure and in the age of the animals.     

Increase in histidine decarboxylase activity in tissues of mice bearing Colon-26 tumor cells

The changes in histidine decarboxylase (HDC) activity, histamine and tele-methylhistamine contents were examined in tissues of mice after the inoculation of Colon-26 tumor cells subcutaneously into the lower back. The HDC activity in the spleen of mice increased significantly 14 days after the inoculation of Colon-26 and the increase in HDC activity continued for up to 28 days. However, the histamine content in the spleen of tumor-bearing mice was not changed significantly during the observation period. In the following experiments, two subclones of the Colon-26 cell line, cachexia-inducing clone-20 and non cachexia-inducing clone-5, were used and the induction of HDC activity in mice was examined in four tissues, spleen, lung, liver and kidney. Both clone-20 and clone-5 induced the increase in HDC activity to the same extent in the spleen and lung, but not in the liver and kidney. As observed using the Colon-26 original cell line, the histamine contents in the four tissues of tumor-bearing mice were not different from those in the control mice. In contrast, the levels of tele-methylhistamine, one of the major catabolites of histamine, in the tumor-bearing mice increased significantly compared with the control mice in all four tissues examined. There was a correlation between the increase in tele-methylhistamine level and the increase in HDC activity in the tissues. A histological study indicated that the tissue mast cells were not increased in spleen and lung of tumor-bearing mice. These findings indicated that the increase in HDC activity in the spleen and lung occurred in parallel with the growth of inoculated tumor cells in mice and suggested that the cells other than mast cells may be involved in the increase in HDC activity. The tumor-bearing state produced histamine with a high turnover rate in the mouse tissues, especially in the spleen and lung. Received: 30 November 1998 / Accepted: 14 April 1999 / Published online: 2 July 1999     

牛樟叶水提物对D-半乳糖致衰老模型小鼠的作用机制研究

目的探讨牛樟叶水提物(AECL)对D-半乳糖致衰老模型小鼠的作用机制。方法取KM小鼠,于颈背部皮下注射D-半乳糖(100 mg/kg,连续20 d),建立衰老小鼠模型。另取10只同批健康小鼠作为正常对照组(A组);模型小鼠随机分为模型组(B组),阳性对照组(C组,维生素E 200 mg/kg),AECL高、中、低剂量组(D1组、D2组、D3组,生药20,10,5 g/kg),各10只。C组、D1组、D2组、D3组小鼠灌胃给药,每日2次,连续30 d;A组和B组给予等体积生理盐水。末次给药2 h后,剖取肝脏、心脏、肾脏和脑,制备成10%组织匀浆,以酶联免疫吸附(ELISA)法检测上述组织、器官匀浆中超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和谷胱甘肽过氧化物酶(GSH-Px)、一氧化氮(NO)和总抗氧化能力(T-AOC)的水平。结果与A组比较,B组小鼠血清中SOD,GSH-Px,T-AOC水平均显著降低(P<0.05);与B组比较,C组、D1组、D2组小鼠血清中SOD和GSH-Px水平均显著升高(P<0.05),C组、D1组T-AOC水平均显著升高(P<0.05)。与A组比较,B组小鼠肝组织匀浆中SOD和CAT水平均显著降低(P<0.05);与B组比较,C组、D1组、D2组、D3组肝组织匀浆中SOD和CAT水平均显著升高(P<0.05)。与A组比较,B组小鼠肾脏组织匀浆中SOD水平显著降低(P<0.05);与B组比较,C组、D2组SOD水平均显著升高(P<0.05)。与A组比较,B组小鼠心脏组织匀浆中SOD显著降低(P<0.05);与B组比较,C组和D2组SOD均显著升高,D1组CAT水平均显著升高(P<0.05)。与A组比较,B组小鼠脑组织匀浆中SOD,GSH-Px,NO水平均显著降低(P<0.05);与B组比较,C组、D1组NO水平均显著升高(P<0.05)。结论AECL具有延缓衰老的作用,其作用机制可能与改善机体心、脑、肝、肾等器官的抗氧化能力有关。     

莫沙必利联合雷贝拉唑钠治疗反流性食管炎的临床研究

目的研究莫沙必利联合雷贝拉唑钠治疗反流性食管炎的临床疗效。方法选取2014年7月—2015年12月中山市陈星海医院消化内科收治的反流性食管炎患者60例,随机分为对照组和治疗组,每组各30例。对照组口服雷贝拉唑钠肠溶片,1片/次,1次/d。治疗组在对照组治疗基础上口服枸橼酸莫沙必利胶囊,1粒/次,3次/d。两组均连续治疗8周。观察两组的临床疗效,比较两组症状改善情况和内镜分级情况。比较两组一氧化氮(NO)水平变化和复发情况。结果治疗后,对照组和治疗组的总有效率分别为70.00%、93.33%,两组比较差异有统计学意义(P0.05)。治疗后,两组烧心感、反酸、胸骨后灼痛患者例数均显著减少,同组治疗前后差异有统计学意义(P0.05);且治疗组治疗后这些患者例数少于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组内镜0级人数显著增多,Ⅰ级、Ⅲ级人数显著减少,同组治疗前后差异有统计学意义(P0.05);治疗后,治疗组内镜0级人数多于对照组,Ⅱ级、Ⅲ级人数少于对照组,两组比较差异有统计学意义(P0.05)。治疗第4、8周,两组NO水平均较治疗前显著降低,同组治疗前后差异有统计学意义(P0.05);且治疗后治疗组NO低于对照组,两组比较差异有统计学意义(P0.05)。对照组和治疗组的复发率分别为36.36%、7.69%,两组比较差异有统计学意义(P0.05)。结论莫沙必利联合雷贝拉唑治疗反流性食管炎具有较好的临床疗效,可改善患者的临床症状和内镜分级情况,降低NO水平和复发率,具有一定的临床推广应用价值。