一阶导数光谱法测定丙吡胺尿药浓度及其缓释片的相对生物利用度

本文报道了用导数光谱法测定磷酸丙吡胺的尿药浓度,本方法能消除尿中杂质干扰,测定结果准确。6名受试者交叉口服磷酸丙吡胺缓释片和普通片,测得尿药浓度计算消除速度常数K,排泄速率(Δx/Δt)_(max) 所需时间,证明缓稀片药物排泄慢,药效维持时间长,且缓释片的相对生物利用度与普通片基本相同。     

Evaluation of renal first pass blood flow with a functional image technique in hypertensive patients

The renal circulation of patients with essential hypertension and renovascular hypertension was evaluated using ^99mTc-DTPA. The first renal peak count (the first C_max; FC_max), time phase distribution (the first T_max; FT_max), and blood velocity (the FC_max/FT_max) were calculated by digital imaging. This yields a visual image of the renal circulation. We consider that the increase in the renal first pass blood flow in patients with essential hypertension is best observed pixel by pixel. The FC_max and FC_max/FT_max images before and after treatment by percutaneous transluminal renal angioplasty in patients with renovascular hypertension clearly show its therapeutic effect. The FI technique, therefore, has the advantage that it can be performed at the same time as the conventional routine examinations of renal function. This makes it very useful clinically.     

混合牙列期提前拔除下颌第一乳磨牙对继承恒牙萌出的影响

目的 探索提前拔除下颌第一乳磨牙对加速继承恒牙萌出的影响，产生有利于序列拔牙的萌出顺序。方法 筛选13例牙列拥挤的患儿，当其下颌第一双尖牙根长超过1／2时，拔除一侧的下颌第一乳磨牙。用患儿的对侧牙做对照组。结果 拔牙侧有9例患儿第一双尖牙先于尖牙萌出，4例患儿尖牙先于第一双尖牙萌出；对照侧尖牙均先于第一双尖牙萌出。结论 提前拔除下颌第一乳磨牙，可使第一双尖牙先于尖牙萌出。但在第一双尖牙被阻碍或尖牙无阻碍的情况下．难以达到促萌目的。     

Application of trans-abdominal chorionic villus sampling in prenatal diagnosis of chromosomal diseases in first trimester of gestation

Objective:To evaluate the feasibility and safety of prenatal diagnosis by traneabdominal chorionic villus sam-pling(TA-CVS)via the guidance of B-mode ultrasound in the first trimester of gestation.To explore the technique of long time culture and chromosome preparation of villi in early pregnancy.To evaluate the feasibility of the above techniques in the application of the prenatal cytogenetic diagnosis.Methods:One hundred and thirty-five singleton pregnancies at risk were referred from January 2001 to Decem-ber 2007.Results:The average maternal age was 35.2 years.TA-CVS was performed in the 10～13th weeks of gestation and the average gestational age was 10.89 weeks.All attempts at sampling were successful.The rate of operation-associated fetal loss was 0.74%.The failure rate of prenatal diagnosis because of inadequate amount of specimen was 0.The average culture time was 5-7 days.The success rate of the cell culture was 98.5%.No maternal con-temination and bacterial contamination happened.Fifteen cases of abnormal karyotype and one case of confined pla-cantel mosaiciem were diagnosed.Conclusion:TA-CVS appears to be safe and feasible and might to be offered in the prenatal diagnosis in the first trimester of gestation.The technique of long time culture and chromosome preparation of villi is stable and reliable.It is feasible to apply these techniques in the clinical practice of prenatal cytogenetic diagnose in the early pregnancy.     

两步极体活检对小鼠卵母细胞体外受精和胚胎发育的影响

目的评价两步活检一、二极体对小鼠卵母细胞体外受精(IVF)和相应胚胎发育的影响。方法8～12周龄雌、雄昆明小鼠。雌鼠促排卵,取成熟卵母细胞行卵胞浆内单精子注射(ICSI),序贯培养胚胎至囊胚孵出。分别于ICSI后激光透明带打孔活检第一极体,两步活检一、二极体,在受精后打孔同时活检一、二极体。比较各处理组与对照组受精、卵裂、优质胚胎、囊胚形成、扩张和孵出情况。结果两步活检一、二极体和同时活检一、二极体受精率、卵裂率、优质胚胎率和囊胚形成率与对照组均无明显差异。启动孵出率明显高于对照组;完全孵出率虽高于对照组,但无统计学意义。结论一、二极体活检不影响小鼠卵母细胞IVF和相应胚胎发育,而且可能有助于胚胎孵出,是安全可行的植入前遗传学诊断(PGD)活检取材方法,以两步活检法为最佳极体活检方案。     

第一、二鳃弓综合征颜面不对称的整形外科矫治

目的探讨第一、二鳃弓综合征面部不对称畸形的整形外科矫治方法。方法根据第一、二鳃弓综合征患者临床及X线所示面部双侧不对称情况,采用健侧下颌骨外板去除、颧骨截骨降低;患侧下颌体、颧骨应用健侧下颌骨外板贴附植骨或高密度多孔聚乙烯(Medpor)假体置入等术式,配合颏部水平截骨颏成形术,以缩小面部双侧宽度的差异,矫治颜面不对称畸形。结果共矫治23例,经6个月至3年的术后随访观察,双侧面部宽度差异明显缩小,正面观面部不对称明显改善。结论第一、二鳃弓综合征面部骨骼发育畸形是三维方向的,双侧面骨宽度的差异,是造成正面观面部不对称的重要因素,根据受术者的具体情况,采用以上术式的组合,扩充患侧或同时缩窄健侧骨骼,进行面部骨性支架重建,可以取得良好的矫治效果。     

急性中毒病例流行病学特征及救治对策

目的研究安徽省肥西县急性中毒病例的临床特点和发病规律,为更有效地提高该地区急性中毒患者的抢救成功率和做好中毒防范工作提供科学依据。方法采取分层随机整群抽样方法随机抽取肥西县县级综合医院、乡镇中心卫生院、乡镇普通卫生院各一所,研究这3所医院2006年1月1日~2008年12月31日就诊的所有初诊中毒患者。结果共报告有效病例798例,其中男性481名,女性317名,性别比1.52∶1,平均年龄为（37.96±15.78）岁,中毒发生时间多集中在13~14点（19.30%）和20~21点（22.81%）,中毒就诊时间平均为1.85 h,中毒死亡率为3.38%。结论急性中毒发生率、死亡率高,急救医务人员应采取针对性和预防性措施,提高救治成功率。     

Michaelis—Menten兼有一级消除动力学模型平均稳态时的一些特性

本文将Rowland等人的二房室模型中的消除过程扩展成米氏兼一级消除过程。据此,推导出达到稳态浓度的时间、血药浓度-时间曲线下面积和生物利用度的公式;进而得到平均清除率和剂量间的关系以及剂量与平均清除率和血浆浓度呈线性关系的结论。     

腹部多脏器损伤的救治

报告了腹部多脏器损伤１５８例的救治情况。致伤因素中交通事故和高空坠落伤占６７．０％，抢救存活１３２例，存活率８３．５％；死亡２６例，病死率１６．５％。作者分析了病死率与致伤暴力强、现场急救延误、就诊时间及受伤的脏器数的密切关系。作者认为院前救护、院内正确诊断、及时治疗、果断手术是抢救成功的重要环节；术中应仔细探查、止血，术后应注意防治多脏器衰竭的发生。