毛细管气相色谱法测定血中甲胺磷及灌流吸附毒物的清除率

目的研究血中甲胺磷的分析方法及血样灌流吸附后对毒物的定量清除率。方法采用HA230树脂吸附柱对中毒血样进行灌流吸附,将吸附后血样经乙酸乙酯萃取后,用火焰光度检测的毛细管气相色谱法测定其含量并计算清除率。结果分析方法的检出限为0.05ng,低、中、高三种浓度的加标回收率为94.3%~102.7%,相对标准偏差为4.38%~5.12%。灌流吸附后血中毒物的清除效率为60.6%~73.4%。结论用HA230树脂吸附剂进行血液的灌流吸附,能清除大部分毒物,迅速降低血中甲胺磷浓度。对抢救重度甲胺磷中毒的危重病人有重要价值。     

HA230树脂和包膜活性炭灌流吸附剂清除甲基对硫磷比较

目的比较HA230树脂和包膜活性炭对血液中甲基对硫磷的灌流清除率。方法采用HA230树脂和包膜活性炭吸附柱分别对甲基对硫磷中毒血样进行灌流吸附,灌流后血样经乙酸乙酯萃取后,用毛细管气相色谱法(火焰光度检测)测定毒物残留量并计算清除率。结果每毫升血甲基对硫磷加标量为30g,吸附剂用量80mg时,HA230树脂的清除率约为97%并接近平台,包膜活性炭清除率约为80%,但用量120mg时,包膜活性炭清除率可达96%,并呈现平台。结论HA230树脂与包膜活性炭均能迅速有效地清除血中大部分甲基对硫磷,但HA230树脂的清除率高于包膜活性炭,清除效果更佳。     

敌敌畏中毒血液灌流毒物的定量清除效率

目的定量研究敌敌畏中毒血液灌流吸附毒物的清除效率。方法采用HA230树脂吸附柱对中毒血样进行灌流吸附,将灌流吸附后血样经乙酸乙酯萃取后,用气相色谱法测定其含量。结果方法的加标回收率为89．3％-96．6％,RSD为4．82％～5．99％。经HA230型树脂灌流吸附,血中敌敌畏清除效率为67．1％～84．7％。结论血液经HA230型树脂灌流吸附,能清除大部分毒物,迅速降低血中敌敌畏的浓度,对抢救重度敌敌畏中毒的危重病人有重要价值。     

两种吸附剂血液灌流对丙溴磷的灌流清除率的影响

目的探讨包膜活性炭和HA230树脂对丙溴磷的灌流清除率,并比较其清除效果。方法分别用包膜活性炭和HA230树脂对中毒血样进行灌流吸附,将吸附后血样经乙酸乙酯萃取后,用毛细管气相色谱法检测并计算清除率。结果分析方法的检出限为0.8ng,低、中、高3种浓度的加标回收率为95.1%~101.2%,相对标准偏差为1.11%~10.97%。灌流吸附后血中丙溴磷的清除效率在包膜活性炭为78.2%~85.8%,在HA230吸附树脂为84.5%~93.8%。结论用包膜活性炭和HA230树脂吸附剂进行血液灌流,均能迅速降低血中丙溴磷浓度。     

HA230树脂灌流吸附后血中灭多威的清除效率

目的研究血中灭多威的分析方法及血样灌流吸附后对毒物的定量清除率。方法采用HA230树脂灌流装置对中毒血样进行灌流吸附,将吸附后血样经乙酸乙酯萃取后,用带有紫外检测器的高效液相色谱法测定其含量并计算清除率。结果分析方法的检出限为0.02 ng,低、中、高3种浓度的加标回收率为93.32%～103.24%,相对标准偏差为2.63%～4.88%。灌流吸附后血中毒物的清除效率为98.68%～99.64%。结论用HA230树脂吸附剂进行血液的灌流吸附,能清除大部分毒物,迅速降低血中灭多威的浓度,对抢救重度灭多威中毒的危重病人有重要价值。     

不同吸附剂对血甲基对硫磷灌流清除率的实验研究

目的比较HA230树脂、包膜活性炭、三菱化学SP825树脂和AmberliteXAD16树脂做灌流吸附材料对中毒血样中甲基对硫磷的灌流清除率。方法中毒血样反复流经装有吸附剂的灌流柱,灌流后血样用乙酸乙酯萃取净化,毛细管气相色谱法（火焰光度检测器）测定甲基对硫磷残留量,计算清除率。结果血液中甲基对硫磷浓度较低时,4种吸附剂均有较高的清除率;随着毒物浓度增加,清除率下降,但三菱化学SP825树脂的清除率优于其它3种吸附剂。当每毫升血甲基对硫磷加标量为30μg,吸附剂用量80mg时,三菱化学SP825树脂、HA230树脂和AmberliteXAD16树脂清除率接近,分别为98.6%、97.0%和98.2%,呈现平台趋势;而包膜活性炭120mg用量时,清除率可达96.0%,并可出现近似呈现平台现象,表明对甲基对硫磷的清除已近完全。结论 4种吸附剂中,三菱化学SP825树脂对血中甲基对硫磷清除效果最佳,HA230树脂次之,包膜活性炭和AmberliteXAD16树脂清除效果较前两种吸附剂稍差。     

包膜活性炭血液灌流吸附甲胺磷的实验研究

目的探讨包膜活性炭对血液中甲胺磷的清除效率,并与HA230树脂比较。方法采用包膜活性炭吸附柱对中毒血样进行灌流吸附,将吸附后血样经乙酸乙酯萃取后,用毛细管气相色谱法测定其含量并计算清除率。结果分析方法的检出限为0.05ng,低、中、高三种浓度的加标回收率为92.9%～102.3%,相对标准偏差为4.92%～9.17%。灌流吸附后血中毒物的清除率为92.6%～98.3%。结论用包膜活性炭吸附剂进行血液的灌流吸附,能清除大部分毒物,迅速降低血中甲胺磷浓度。对抢救重度甲胺磷中毒的危重病人有重要价值。     

毛细管气相色谱法测定血中有机磷混配农药及灌流清除效率的实验研究

目的研究血中有机磷混配农药的气相色谱检测方法及血液灌流对毒物的定量清除效率。方法模拟临床血液灌流装置,对含有机磷混配农药的血样进行灌流吸附,用毛细管气相色谱法测定混配农药各单体的残留量。结果低、中、高三种浓度的加标回收率为89.3%~104.4%,相对标准偏差为2.2%~11.6%。灌流前敌敌畏浓度为9.84μg/ml,甲基对硫磷为9.96μg/ml,在灌流3.0h后,血中残留敌敌畏浓度和清除速率分别是0.68μg/ml~1.59μg/ml、13.7μg/min~15.2μg/min;甲基对硫磷分别为0.20μg/ml~0.59μg/ml、15.6μg/min~16.1μg/min。结论包膜活性炭血液灌流能清除血液中大部分农药,迅速降低血中混配农药各单体的浓度。但是要根据中毒程度选择合适的灌流时间和包膜活性炭用量。     

血液灌流治疗有机磷中毒对硫线磷及硫酸阿托品吸附作用的实验研究

目的定量研究血液灌流对有机磷农药硫线磷和其解毒药阿托品的吸附作用。方法模拟临床血液灌流装置,对含硫线磷和硫酸阿托品的血样进行灌流吸附,分别用毛细管气相色谱法和高效液相色谱法测定硫线磷和硫酸阿托品的残留量。结果吸附剂用量为0．5g、1．0g、1．5g,包膜活性炭在灌流2．0h后硫线磷的清除率均能达到90％以上,硫酸阿托品的清除率依次为61．9％、84．9％、88．9％;HA230树脂在灌流1．5h后硫线磷清除率都达到90％以上,硫酸阿托品的清除率也依次高达88．0％、97．2％、98．4％;包膜活性炭灌流3．0h后,硫酸阿托品与硫线磷的比值最高为HP前10．1倍,而HA230树脂最高为HP前6．7倍。结论包膜活性炭和HA230吸附树脂血液灌流1．5h～2．0h均能清除血中大部分硫线磷,而且均能增加血中硫酸阿托品和硫线磷浓度的比值。     

HA280树脂血液灌流治疗系统性红斑狼疮30例临床观察

目的应用HA280树脂血液灌流器,对系统性红斑狼疮(SLE)患者进行血液灌流治疗,以清除炎症性细胞因子,使血液得到净化而治疗疾病.方法将患者动脉血液流经血液灌流仪,以保温(38℃左右)和保持流速(200ml/min)进入HA280树脂血液灌流器,在罐内经吸附后由静脉回输入体内,灌流1次需2~2.5h.结果30例 SLE患者灌流治疗后发热、乏力、关节痛症状改善,l月后多项检测异常指标皆达正常参考值内.血中有形成份红细胞、白细胞、血小板正常者无影响,因免疫原性减少者逐渐恢复正常.30例SLE患者随访12~36个月,与未用此法治疗的对比组30例SLE患者相比,复发率显著下降(P<0.01).结论用HA280树脂血液灌流器进行血液灌流的治疗方法,疗效好,安全可靠,值得临床运用推广.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.