HPLC-ELSD法测定注射用灯盏花素中甘露醇的含量

目的:建立注射用灯盏花素中甘露醇的含量测定方法。方法:采用HPLC-ELSD法,使用氨基柱,流动相为乙腈-水(83:17);ELSD漂移管温度(85±5)℃;空气流速2.4L·min-1;柱温:30℃。结果:甘露醇在进样量为1.0324～30.972μg时线性关系良好,回归方程为y=1.3121x+11.715,r=0.9995;平均回收率99.24%,RSD为0.04%。结论:该法结果准确,便于操作,可作为注射用灯盏花素中辅料甘露醇的质量控制方法之一。     

Controlling bacterial contamination of dental impression guns

BackgroundDental impression material handgun cartridge dispensers are contaminated easily during clinical use. The authors attempted to quantify contamination by bacteria, including methicillin-resistant Staphylococcus aureus (MRSA), of impression guns used in an academic dental clinic after five infection-prevention protocols were followed.MethodsThe authors obtained samples from four commercially available impression guns at four specific sites (button, handle, latch, trigger) after routine clinical use, disinfection, steam sterilization (also known as autoclaving), steam sterilization followed by use of plastic impression gun covers and steam sterilization followed by use of plastic impression gun covers and disinfection.ResultsThe authors found that after routine clinical use, bacteria—including MRSA—heavily contaminated the impression guns. After the impression guns underwent disinfection, there was a 6 percent decrease in bacterial counts. The use of steam sterilization achieved sterility without harming the impression guns. Use of steam-sterilized impression guns with plastic impression gun covers decreased bacterial isolates by approximately 60 percent. Use of steam-sterilized impression guns plus covers and disinfection resulted in an approximately 95 percent reduction in contamination.ConclusionsThe use of common infection-prevention methods appears to reduce the bacterial counts, including those of MRSA. Bacterial contamination was lowest after steam sterilization, followed by the use of plastic impression gun covers and disinfection.Clinical ImplicationsUse of contaminated impression guns on successive patients could increase the risk of causing cross-transmission of disease. The use of sterilization, plus plastic impression gun covers and disinfection, for impression guns after each use could be an effective and practical infection-control method for dental practices.     

Variation in Osmotic Response to Sustained Mannitol Administration

Background  Osmotic agents such as mannitol remain a mainstay in the management of cerebral edema and raised intracranial pressure. Some patients do not respond to sustained mannitol administration with the expected rise in serum osmolality, and this may correlate with lack of therapeutic efficacy. Objective  To examine the variation in osmotic response to mannitol therapy and identify factors associated with a lack of an osmotic response to sustained mannitol administration. Methods  Data on consecutive patients admitted to a Neurology/Neurosurgery Intensive Care Unit who received scheduled doses of mannitol for at least 48 h were extracted from a prospectively collected database. All patients received intravenous isotonic saline solutions and had serial measurements of serum sodium and osmolality, at least twice daily. Non-responders were defined using two thresholds, a rise in serum sodium of ≤1 or ≤5 mEq/l over the 48-hour period. Results  The cohort included 167 patients the majority with intracerebral and subarachnoid hemorrhage and brain tumors. 73 patients (44%) did not respond to mannitol with a rise in sodium of ≥5 mEq/l, and 37 (22%) did not see a rise of 1 mEq/l over 48 h of treatment. There were minor differences between responders and non-responders (≥5 mEq/l) in terms of age (56 ± 15 vs. 48 ± 14), total mannitol dose (0.9 ± 0.2 vs. 0.7 ± 0.2 g/kg), and cumulative fluid balance at 72 h (91 ± 1653 vs. −610 ± 1692 ml). Multivariate analysis found that younger age, lower weight-adjusted mannitol dose, and more negative fluid balance were associated with lack of osmotic response. Discussion  A substantial proportion of patients receiving sustained mannitol do not manifest the expected osmotic response. This lack of response may correlate with the failure of clinical efficacy seen in a subgroup of patients, who then require alternate agents such as hypertonic saline. This association merits further exploration.     

手术创伤应激下肠黏膜通透性的改变及肠内肠外营养作用的比较

目的研究手术创伤对肠黏膜通透性的影响,并研究肠内和肠外营养对肠黏膜通透性的不同作用.方法 40例腹部手术的患者随机分为肠内营养(EN)组和肠外营养(PN)组,分别于术后3～11d予等氮、等热卡营养支持,并分别于术前1 d、术后7 d和术后12 d,测定口服含乳果糖10 g、甘露醇5 g的测试液后6 h尿中乳果糖和甘露醇排泄率的比值(L/M)变化,用高压液相色谱法测定尿中乳果糖和甘露醇的浓度.结果术前、术后7 d和术后12 d L/M比值EN组分别为0.026±0.01 7、0 059±0.026、0 027±0 017;PN组分别为0 025±0 013、0 080±0.032、0 047±0.021.术后7 d两组L/M比值较术前均显著升高,且PN组明显高于EN组;术后12 d L/M比值PN组仍明显高于术前及EN组,而EN组与术前无明显差异.结论创伤应激早期肠黏膜通透会有明显升高,在创伤的早期需注意维护肠黏膜屏障功能;肠内营养有较好的维护肠黏膜屏障功能的作用.     

甘露醇与尼莫通联合应用对大鼠脑缺血再灌注损伤保护机制的研究

目的探讨甘露醇与尼莫通联合应用对大鼠局灶性脑缺血再灌注损伤的保护机制。方法SD大鼠72只随机等分成假手术组(A组)、局灶性脑缺血再灌注组(B组)、小剂量甘露醇组(C组)、大剂量甘露醇组(D组)、尼莫通组(E组)及甘露醇与尼莫通合用组(F组)6组。采用硝酸还原酶法及末端标记(TUNEL)法分别检测各组大鼠脑组织一氧化氮(NO)含量及神经细胞凋亡数目。结果大鼠脑组织NO含量及神经细胞凋亡数:(1)B组明显高于A、C、D、E及F组(P<0.05～0.01);(2)C组与D组比较差异无显著性(P>0.05);(3)F组明显低于C、D、E组(均P<0.05)。结论不同剂量的甘露醇、尼莫通及两药合用均可通过下调缺血再灌注后脑组织NO含量和减少神经细胞凋亡而发挥脑保护作用,其中两药合用效果最佳。     

654-2与甘露醇促使小儿肺炎啰音吸收25例疗效观察

目的　探讨 6 5 4- 2与甘露醇促使小儿肺炎口罗音吸收的药物机制。方法　 6 5 4- 2 0 3～ 0 5mg/kg ,2次 /d肌注 ,甘露醇 0 5kg ,2次 /d静脉注射 3d ,口罗音消失为有效。结果　 2 5例中 ,中等湿口罗音 15例 ,细湿口罗音 10例 ,均在 3d内消失 ,有效率为 10 0 %。结论　 2药合用有明显的协同作用 ,能提高疗效 ,促使肺部炎症吸收 ,对清除湿口罗音效果显著。     

甘露醇注射液一致性评价有关物质研究

目的 建立甘露醇注射液一致性评价有关物质研究方法.方法 采用高效液相色谱法,RID检测器,强阳离子钙型交换柱(300 mm×7.8 mm),流动相:超纯水,流速为0.5 mL/min,柱温为80℃,检测器温度为40℃.结果 3种已知杂质和甘露醇均能得到有效分离;甘露醇、杂质A、B和C分别在4.32～2003.83 mg/L、5.12～1981.77 mg/L、4.11～1982.61 mg/L和6.92～1947.46 mg/L范围内线性关系良好,r均为1.杂质A、B、C平均回收率分别为102.62％、101.36％、103.11％.结论 本分析方法操作简便、准确、重现性好,可用于甘露醇注射液一致性评价有关物质的测定.