突发传染病：人类当前必须面对的危险

上世纪有许多重大灾难是由病原体引起的，人类在发现并消除这些病原体方面取得了巨大进展，以致于美国公共卫生局局长（US Surgeon General）在1967年宣布人类在对抗传染病的战争中已经取得胜利。然而，这个论断为时过早。上世纪60年代以来，传染病的浪潮一波未平一波又起，人们这才如梦初醒。尽管人类在抗生素和疫苗领域里已取得斐然成就，     

宫内窘迫与新生儿窒息的关系

目的 为减少新生儿窒息的发生率,降低围产儿死亡率和减少新生儿伤残率。方法 对1997年1～7月在我院出生的宫内窘迫新生儿120例、新生儿窒息97例进行分析。结果 有宫内窘迫史的胎儿娩出时窒息的发生率明显高于无宫内窘迫的胎儿(P<0.01)。结论 宫内窘迫是造成新生儿窒息的主要原因之一。     

脑梗塞急性期血浆血栓三项含量变化

目的探讨血小板活化与脑梗塞之间的关系。方法用酶联免疫吸附法对脑梗塞急性期患者进行了血浆血小板α颗粒膜蛋白-140(GMP-140)、6-酮前列腺素F1α(6-K-PGF1α)和血栓素B2(TXB2)含量测定,并观察动态变化。结果脑梗塞急性期血浆GMP-140和TXB2含量明显高于对照组,而6-K-PGF1α含量明显低于对照组。脑梗塞急性期血浆GMP-140在1～5天显著增高,10天后开始减少,14天以后与对照组相比,无显著性差异。而血浆6-K-PGF1α在1～5天显著降低,10天后开始增高,14天以后与对照组相比无显著性差异,而血浆TXB2在1～14天与对照组相比均有非常显著性差异。结论脑梗塞发病10天内,体内血小板不仅代谢旺盛,同时血小板释放反应较多,血小板活化程度显著增强。脑梗塞发生10天后,体内血小板仅有代谢旺盛,释放反应显著减少。     

Prospective versus retrospective ECG gating for dual source CT of the coronary stent: Comparison of image quality, accuracy, and radiation dose

Objective

To compare image quality, diagnostic accuracy and radiation dose of prospective and retrospective electrocardiogram (ECG) gated dual source computed tomography (DSCT) for the evaluation of the coronary stent, using conventional coronary angiography (CA) as a standard reference.

Design, setting and patients

Sixty patients (heart rates ≤70 bpm) with previous stent implantation who were scheduled for CA were divided in two groups, receiving either prospective or retrospective ECG gated DSCT separately. Two reviewers scored coronary stent image quality and evaluated stent lumen.

Results

There was no significant difference in image quality between the two groups. In the prospective group, there were 86.4% (51/59) stents with interpretable images, in the retrospective group, there were 87.5% (49/56) stents with interpretable images. Image quality was not influenced by age, body mass index or heart rate in either group, but heart rate variability had a weak impact on the image quality of the prospective group. Image noise was higher in the prospective group, but this difference reached statistical significance only by using a smooth kernel reconstruction. Per-stent based sensitivity, specificity, and positive and negative predictive value were 100%, 84.1%, 68.2%, and 100%, respectively, in the prospective CT angiography group and 94.4%, 86.8%, 77.3%, and 97.1%, respectively, in the retrospective CT angiography group. There was a significant difference in the effective radiation dose between the two groups, mean effective dose in the prospective and retrospective group was 2.2 ± 0.5 mSv (1.5-3.2 mSv) and 14.6 ± 3.3 mSv (10.0-20.4 mSv) (p < .001) respectively.

Conclusions

Compared with retrospective CT angiography, prospective CT angiography has a similar performance in assessing coronary stent patency, but a lower effective dose in selected patients with regular heart rates ≤70 bpm.     

血小板相关指数与溶栓后急性脑卒中患者预后的关系

目的?研究血小板体积相关指数(platelet volume indices, PVIs)、中性粒细胞/淋巴细胞比率(neutrophil to lymphocyte ratio,NLR)以及这些参数的组合与接受静脉溶栓后的急性缺血性脑卒中(acute ischemic stroke,AIS)患者神经功能预后的关系。方法?回顾性研究2016年1月至2019年1月北京大学人民医院急诊科符合AIS诊断标准的147例静脉溶栓患者。根据3个月后随访结果,将研究人群依据MRS评分(modified rank in scale,MRS),分为MRS≤2和MRS≥3两组,比较两组患者的一般资料、既往病史、实验室检查结果等。采用Logistic回归分析溶栓后AIS患者神经功能预后不良的危险因素。结果?NLR(OR=1.045, 95%CI:1.032~2.350, P=0.032),平均血小板体积(mean platelet volume, MPV)(OR=4.212, 95%CI:1.074~16.513, P=0.039),MPV×NLR/血小板计数(PLT)(OR=5.711,95%CI:1.342~24.298, P=0.018),血小板分布宽度(platelet distribution width, PDW)(OR=1.015, 95%CI:1.001~2.372, P=0.032),美国国立卫生研究院中风量表(NIHSS)评分(OR=1.266, 95%CI:1.111~1.443, P<0.01)是接受静脉溶栓治疗后AIS患者神经功能预后不良的影响因素。结论?NLR、MPV、MPV×NLR/PLT、PDW、NIHSS评分是溶栓后急性缺血性脑卒中神经功能预后不良的危险因素。MPV×NLR/PLT可以较好地预测3个月后AIS神经功能严重程度。     

Comparative study of pharmacokinetics and tissue distribution of osthole in rats after oral administration of pure osthole and Libanotis buchtormensis supercritical extract

Ethnopharmacological relevance

Libanotis buchtormensis is the source of an important traditional medicine from Shaanxi province of China used in the treatment of many illnesses. Libanotis buchtormensis supercritical extract (LBSE) has analgesic, sedative and anti-inflammatory qualities. Osthole is one of the major bioactive components of LBSE; it is known for its significant anti-tumor, analgesic, and anti-inflammatory properties, it also alleviates hyperglycemia.

Aim of the study

The purpose of the present study was to compare the pharmacokinetics and tissue distribution of osthole in Sprague-Dawley (SD) rats after oral administration of pure osthole and LBSE. The two preparations were administered at the same osthole dose (approximately 130 mg/kg). The results should provide some guidance for the clinical applications of Libanotis buchtormensis.

Materials and methods

Comparative pharmacokinetics and tissue distribution of osthole in SD rats after oral administration of pure osthole and LBSE were analyzed using reversed-phase high-performance liquid chromatography (RP-HPLC). All pharmacokinetic data were analyzed using 3P97 software. Samples of blood and internal organs (heart, liver, spleen, lungs and kidney) were collected and pretreated according to the experimental schedule. After pretreatment, plasma and tissue samples were extracted using ether–ethyl acetate mixture (3:1, v/v). The concentration of osthole in the plasma and tissues were determined using the RP-HPLC method.

Results

The procedure described in this paper shows good precision and stability and is suitable for the osthole assays in biological samples. We found that the average plasma concentration-time profile of osthole after oral administration of osthole and LBSE showed a single peak. There were also clear differences between plasma concentrations of osthole after oral administration of pure osthole and LBSE. Non-osthole ingredients in LBSE showed some pharmacokinetic interactions with osthole and hence decreased its absorption levels (p<0.05). Our results show different tissue distribution of osthole in the single and composite administration regimens.

Conclusions

This study compares the pharmacokinetic characteristics and tissue distribution of osthole in rats after oral administration of pure osthole and LBSE; the results might be useful in clinical application of this traditional Chinese herbal medicine.     

尿中氚化水及有机氚浓度的测定方法及结果比较

目的为涉氚工作人员摄入体内的氚寻找一种快速、方便而又可靠的常规监测方法。方法采用常规蒸馏脱色、高锰酸钾祛色蒸馏法、双氧水氧化脱色和过硫酸钾氧化法四种方法预处理尿样后进行液闪测量,统计分析四者测量结果。结果经上述四种不同尿样预处理后测得的尿氚结果有显著性差异,不是所有方法均可用于核设施工作人员及涉氚工作人员体内氚化水及有机氚的检测。结论从测量结果来看,高锰酸钾祛色蒸馏法适合对氚化水的测量;过硫酸钾氧化法更加适合用于总氚的测定。在需要快速处理大批量样品的时候,可使用双氧水氧化法。     

冠心病群组管理的实施效果观察

目的探讨群组管理对冠心病( CHD)患者进行干预的临床应用效果。方法选取118例CHD患者,随机分为对照组和试验组,对照组58例,试验组60例。对照组采用常规护理,试验组在对照组的基础上采用群组管理干预,观察两组患者疾病相关知识的掌握及治疗的依从性,检测血脂水平的变化,并用焦虑自评量表( SAS)对两组患者进行评估。结果试验组实施干预后,疾病知识及危险因素的掌握好于对照组,差异具有统计学意义(P<0.05),而自救知识掌握情况两组比较差异无统计学意义(P>0.05);试验组的治疗依从性及血脂水平的改善好于对照组;试验组SAS评分降低优于对照组,差异均具有统计学意义( P<0.01)。结论群组管理能有效提高CHD患者对疾病相关知识的掌握及治疗的依从性,减轻患者的焦虑情绪,提高治疗效果。     

基质金属蛋白酶-9在狼疮性肾炎肾组织中的表达及其意义

目的 研究基质金属蛋白酶-9（Matrix Metalloproteinase-9,MMP-9）在狼疮性肾炎（Lupus Nephritis,LN）肾组织中的表达,探讨与临床表现、肾脏病理之间的关系。方法 采用非生物素免疫组化二步法,对31例LN患者肾组织MMP-9的水平进行检测,并结合临床及肾脏病理进行统计学分析。结果LN组MMP-9表达水平较正常对照组显著增高（P〈0.01）,各型LN亚组MMP-9表达强度具有统计学意义（P〈0.05）。LN肾小球MMP-9水平与血清肌酐、24h尿蛋白定量、SLEDAI、RAI呈正相关（P〈0.05）。结论 LN肾组织MMP-9的表达与肾脏病理类型相关,LN肾小球MMP-9表达水平不仅可反映患者的肾功能状态,还可反映SLE的疾病活动程度及LN肾组织病理活动程度。