复方配伍实验研究的问题与展望

以经方的配伍研究为切入点，从实验设计方法、药理学研究、药物化学研究三个角度总结了经方配伍现代实验研究的现状，对中药复方配伍研究的思路与方法进行探讨。提出在实验设计中应突出中医理论的指导；必须选择多项评价指标，谨慎解释实验结果；实验条件必须标准化；药理研究须与物质基础研究相结合；动物研究须与临床研究相结合。     

HPLC法测定胸肋合剂中黄芩苷的含量

目的 测定胸肋合剂中黄芩苷的含量。方法 采用高效液相色谱法，以ODS为色谱柱，甲醇-水-磷酸(45：55：0．21)为流动相，检测波长为280nm。结果 胸肋合剂中黄苓苷的含量在0．160-10．400μg线性关系良好(r=0．9998)。平均回牧率98．20％，RSD=1．48％．结论 本方法测定简便、快速，测定结果准确。     

Effects of ethanol on hippocampal place-cell and interneuron activity

Mounting evidence suggests that ethanol exerts effects on learning and memory by altering cellular activity in the hippocampus and related structures. However, little is actually known regarding ethanol's effects on hippocampal function in awake, freely-behaving animals. The present study examines the effects of ethanol on hippocampal place-cell and interneuron activity in freely-behaving rats. Signals from individual hippocampal neurons were isolated while subjects traversed a symmetric Y-maze for food reward. Following 15 min of baseline recording, subjects were injected with one of four doses of ethanol (0.0, 0.5, 1.0 and 1.5 g/kg), and cellular activity was monitored for a 1-h time period. Following sufficient time for recovery (minimum of 3 h post injection), cellular activity was monitored for an additional 15-min period. Both 1.0 and 1.5 g/kg ethanol potently suppressed the firing of hippocampal place-cells without altering place-field locations. Ethanol did not significantly suppress out-of-field firing rates, leading to a decrease in spatial specificity (i.e. the ratio of in-field/out-of-field firing rates). Interneuron activity was not altered by 1.0 g/kg ethanol, but was occasionally suppressed by 1.5 g/kg ethanol. Results are interpreted in light of recent behavioral and electrophysiological studies examining the effects of ethanol on hippocampal function.     

粗羊毛脂中胆甾醇的分离与精制研究

目的:以粗羊毛脂为原料提取胆甾醇.方法:改进实验流程,以混合溶剂量、混合溶剂比及配合物提取时间为条件,采用正交实验优选胆甾醇提取工艺.结果:确定最佳条件为混合溶剂量120ml,混合溶剂比12:1,配合物提取时间30min.结论:工艺合理,稳定可行.     

Mammographically Occult Asymptomatic Radial Scars/Complex Sclerosing Lesions at Ultrasonography-Guided Core Needle Biopsy: Follow-Up Can Be Recommended

An increasing number of radial scars are detected by ultrasound (US), but their management is controversial. This study investigated the upgrade rate in mammographically occult radial scars/complex sclerosing lesions without epithelial atypia at US-guided 14-gauge core needle biopsy in asymptomatic patients. Nineteen mammographically occult benign radial scars/complex sclerosing lesions (median size, 7 mm; range, 3–23 mm) were included. Patients underwent surgical excision (n = 10) or vacuum-assisted excision, with follow-up US at least 6 mo after benign vacuum-assisted excision results (n = 8), or underwent US follow-up for 2 y after core needle biopsy (n = 1). Any cases with change in diagnosis to high-risk lesions or malignancy at excision were considered upgrades. The upgrade rate was 0.0%. Based on US findings, 15.8% (3/19) were Breast Imaging Reporting and Data System (BI-RADS) category 3, 68.4% (13/19) were BI-RADS category 4a and 15.8% (3/19) were BI-RADS category 4b. Follow-up with US can be considered for mammographically occult benign radial scar/complex sclerosing lesions diagnosed by US core needle biopsy in asymptomatic patients.     

经尿道双极等离子电切治疗复杂性尿道狭窄体会

目的:提高经尿道双极等离子电切治疗复杂性尿道狭窄的治疗效果。方法:采用经尿道双极等离子电切治疗复杂性尿道狭窄104例,并进行术后随访。结果:104例手术均获成功,术后随访96例(3个月～10年),均排尿通畅,Qmax 17～26 ml/s。结论:经尿道双极等离子电切治疗复杂性尿道狭窄疗效确切,术中术后的正确处理是减少并发症、降低复发率、提高疗效的关键。     

Recurrent and migratory reflex sympathetic dystrophy in children

Reflex sympathetic dystrophy is a syndrome characterized by superficial pain and tenderness associated with swelling, vasomotor instability, and dystrophic changes of the skin. In children, it is rarely reported and is felt to have a more benign and self-limited course. This case illustrates that, in children, reflex sympathetic dystrophy can occur without any previous history of trauma, and may be recurrent and migratory. A review of the literature is included. An 11-year-old girl, with no history of trauma, presented in 1992 with spontaneous onset of right leg pain. She was diagnosed with reflex sympathetic dystrophy, and she was treated unsuccessfully with oral medications. Her symptoms then resolved in 2 weeks after receiving epidural anaesthesia and aggressive physical therapy. Over the next 5 years, she presented to the paediatric rehabilitation clinic three times with recurrent RSD in her bilateral arms. The first two times were refractory to conservative management and resolved with four stellate ganglion blocks. The third recurrence persisted with three stellate ganglion blocks and resolved with gabapentin.     

Feasibility of use of magnesium reabsorbable scaffolds in complex coronary artery disease: True bifurcation,multiple overlapping scaffolds and chronic total occlusion treatment

We present first-in-human treatment with bioabsorbable magnesium scaffolds for percutaneous coronary intervention in a patient with nickel allergy. We present images from angiography and optical coherence tomography at three months. We also review the current status of these novel devices.     

The impact of the Major Trauma Network: will trauma units continue to treat complex foot and ankle injuries?

IntroductionApril 1st 2012 saw the introduction of National Trauma Networks in England. The aim to optimise the management of major trauma. Patients with an ISS ≥ 16 would be transferred to the regional Major Trauma Centre (level 1). Our premise was that trauma units (level 2) would no longer manage complex foot and ankle injuries thereby obviating the need for a foot and ankle specialist service.MethodsRetrospective analysis of the epidemiology of foot and ankle injuries, using the Gloucestershire trauma database, from a trauma unit with a population of 750,000. Rates of open fractures, complex foot and ankle injuries and requirement for stabilisation with external fixation were reviewed before and after the introduction of the regional Trauma Network. Secondly, using the Trauma Audit & Research Network (TARN) database, all foot and ankle injuries triaged to the regional Major Trauma Centre (MTC) were reviewed.ResultsIncidence of open foot and ankle injuries was 2.9 per 100,000 per year. There were 5.1% open injuries before the network and 3.2% after (p > 0.05). Frequency of complex foot and ankle injuries was 4.2% before and 7.5% after the network commenced, showing no significant change. There was no statistically significant change in the numbers of patients with complex foot and ankle injuries treated by application of external fixators. Analysis of TARN data revealed that only 18% of patients with foot and ankle injuries taken to the MTC had an ISS ≥ 16. The majority of these patients were identified as requiring plastic surgical intervention for open fractures (69%) or were polytrauma patients (43%). Only 4.5% of patients had isolated, closed foot and ankle injuries.ConclusionWe found that at the trauma unit there was no decrease in the numbers of complex foot and ankle injuries, open fractures, or the applications of external fixators, following the introduction of the Trauma Network. These patients will continue to attend trauma units as they usually have an ISS < 16. Our findings suggest that there is still a need for foot and ankle specialists at trauma units, in order to manage patients with complex foot and ankle injuries.