生脉注射液对慢性心力衰竭患者凝血功能的影响

目的研究大剂量生脉注射液对慢性心功能衰竭（简称心衰）患者凝血功能的影响。方法将60例慢性心衰患者随机分为治疗组（即生脉注射液组）和对照组，每组各30例，治疗组给予生脉注射液加西药常规治疗，对照组仅西药常规治疗，观察用药前后心功能改善程度及血浆P-选择素、血管性血友病因子（vWF）和D-二聚体水平的变化。结果治疗组临床显效率与总有效率明显高于对照组。心是患者血浆P-选择素、vWF和D-二聚体水平明显高于健康人，治疗后两组患者血浆P-选择素、vWF和D-二聚体水平均下降，治疗组优于对照组。结论慢性心衰患者，体内存在着高凝状态，大剂量生脉注射液可改善慢性心衰患者的凝血功能，可能在一定程度上减少心衰患者血栓事件的发生和发展？     

新型经皮渗透促进剂的研究进展

介绍国内外近年来报道的新型经皮渗透促进剂的研究与开发进展,重点介绍若干具代表性的新合成的化合物以及新发现的天然产物,包括内酰胺类、糖苷类、氨基酸衍生物、聚合物、挥发油和酶类等,为合成和发现更加安全、高效的促渗剂提供线索.     

水面长航舰载保存血液生化指标的实验研究

目的探讨和观察经水面长航舰载保存血液出海前后对生化指标的影响与变化。方法随机采集和制备WB、AS-RBC和LP-RBC各18人份(200ml)。每份血液各等分为4袋,配对设计为实验组(A区、B区和C区)与对照组。分别于长航前和长航后进行血液生化指标检测。结果①K+和P3+浓度在三种血液制品的实验组与对照组各观察点的结果均随保存血液时间的延长而增高(P<0.05或P<0.01);Na+浓度由长航前的水平而逐步降低(P<0.01);P3+、Mg2+实验组和对照组较长航前增高,Cl-、Ca2+的含量与长航前没有显著变化;②LDH、AST、CKP和HBDH结果实验组和对照组均呈递增趋势,AKP结果实验组和对照组均呈下降表现,ALT与GGT结果在长航前后变化不明显;③Glu指标减低,UA呈上升趋势。结论长航对血液保存有一定的影响,但总的变化趋势与常规(4±2)℃血库冰箱保存相似。此项研究对于我们进一步探索海上血液保障与运输以及血液海上救护均具有十分重要的实用和军事价值。     

Juvenile Myoclonic Epilepsy: Factors of Error Involved in the Diagnosis and Treatment

Juvenile myoclonic epilepsy (JME), a common form of idiopathic generalized epilepsy, has a distinct clinical and electroencephalographic profile. Often JME is not recognized, with serious consequences on the sufferers. We examined factors contributing to the missed diagnosis even in an epilepsy clinic. Of 70 JME patients, 66 (91.4%) were not diagnosed on referral and 22 (33%) were not initially recognized in the epilepsy clinic. The correct diagnosis was established after a mean of 8.3 +/- 5.5 years from disease onset and an interval of 17.7 +/- 10.4 months from first evaluation in the epilepsy clinic. Myoclonic jerks, the hallmark of the disease, were not usually reported by patients. Similarly, relevant questioning may not be included in the history. Absence seizures antedating jerks by many years, myoclonic jerks reported as unilateral, generalized tonic-clonic seizures occurring during sleep and focal EEG abnormalities are other factors contributing to not recognizing JME. Our study reemphasizes the need to have not only a correct seizure diagnosis but also a correct epilepsy-disease diagnosis.     

羟乙基淀粉130/0.4对非体外循环冠状动脉搭桥术患者凝血功能的影响

目的比较非体外循环冠状动脉搭桥术(0PCAB)中临床剂量的羟乙基淀粉(HES)130／0．4和琥珀酰明胶对凝血功能的影响。方法选择24例美国麻醉医师协会(ASA)分级Ⅱ～Ⅲ级、择期行OPCAB的患者,随机均分为琥珀酰明胶组(GEL组)和HES组。分别于麻醉诱导前(T0)、术毕即时(T1)和术后24 h(T2)测定血小板计数、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)和D-二聚体等凝血功能指标。记录术中失血量、术后24 h内的胸管引流量和输血量。结果两组间手术时间、术中补液量、术中出血量和24 h胸管引流量的差异均无显著性(P值均>0．05)。两组间T0、T1和T2时间点的血小板计数、PT、APTT、Fib及D-二聚体的差异均无显著性(P值均>0．05)。结论临床剂量的HES 130／0．4与琥珀酰明胶对OPCAB患者凝血功能的影响无明显差异,可安全应用于OPCAB的容量治疗。     

胸腰椎压缩性骨折的护理要点

胸腰椎压缩性骨折的护理要点福建漳州市中医院（３６３０００）郭燕玲，陈联源我院自１９８９年来对胸腰椎压缩性骨折实行辨证护理，收到满意效果，介绍如下。常规护理：屈曲型胸腰椎压缩性骨折，令病人仰卧在硬板床上，骨折处垫一软枕头，在耐受的情况下逐渐增加枕头高度...     

地尔硫卓的合成

重点介绍了地尔硫的化学合成和拆分方法，以及近年来在其不对称合成领域的进展。     

替硝唑葡萄糖注射液的稳定性研究

采用反相ＨＰＬＣ法测定替硝唑葡萄糖注射液中替硝唑的含量，用加温加速实验研究该制剂的热稳定动力学。结果表明，替硝唑的热降解反应为一级动力学过程，在５０、６５、８０、９５℃时的降解速度常数分别为５．５８×１０－４、２．６６×１０－３、８．１０×１０－３、２．８２×１０－２ｄ－１，为８．３年，半衰期为３９．５年。     

P1 blood group antigen expression and epidemic hemolytic uremic syndrome

P1 blood group positivity has been postulated as a host factor which may provide protection against the development of post-enteropathic hemolytic uremic syndrome (HUS). In this study, blood group status in 20 Inuit survivors ofEscherichia coli 0157: H7-associated HUS was compared with age-and sex-matched controls from the same community who had experienced uncomplicated diarrheal illness due to the same pathogen. Of 20 HUS survivors, 6 were P1 antigen positive compared with 8 of the 20 controls (P=0.7). We conclude that P1 antigen positivity was not protective against HUS in this population. Further studies of this condition to clarify the role of host factors in verotoxin-induced endothelial damage are indicated.     

The Effect of Total Blood Exchange with PHP Solution on Cardiac Xenotransplantation

Abstract: Prevention of hyperacute rejection is a difficult and unsolved problem in xenotransplantation. Natural antibodies and complement activation have been known to play an important role in the xenotransplantation between discordant species pairs. In the present study, total blood exchange (TBE) was performed with pyridox-alated-hemoglobin-polyoxyethylene conjugate (PHP) solution (Ajinomoto Co., Inc., Kawasaki, Japan) before cardiac xenotransplantation in order to remove the immunoglobulins and prolong xenograft survival time. Guinea pigs and rats were used as the discordant species combination for donor and recipient. Two groups were established: Group 1, untreated control (n = 8) and Group 2, TBT with PHP solution (n = 8). The exchange blood transfusion was carried out at the rate of 15–20 ml/h utilizing PHP solution using a blood pump. After the blood exchange was processed, hematocrit (Ht) levels dropped to 4 or 5%, and a cardiac xenotransplantation was performed within 24 h. The levels of serum IgA, IgM, and IgG were decreased to less than 25, 25, and 10% of the base line, respectively, after blood exchange. A mean xenograft survival time in Group 2 was prolonged to 472 ± 74 min and to 10.4 ± 1.8 min in Group 1 (p < 0.01). A titer of the anti-guinea pig lymphocytotoxic antibody in rat serum was decreased to almost nil. The data from this study suggest that total blood exchange with PHP solution may be useful in preoperative removal of xenograft antibodies in xenotransplantation.