‘Ammonia,lactate and blood gases – A user's guide’

Basic biochemical tests are frequently obtained in acutely unwell neonates and children, as well as in some elective situations. Correct interpretation can be invaluable in identifying rare inherited primary metabolic disorders, but secondary causes of hyperammonaemia, elevated blood lactate or blood gas derangement are more common and require appropriate treatment of the underlying cause. This Personal Practice guide provides an overview of these tests and their interpretation.     

中药延胡索的炮制研究

本文采用容量法及电位测定法分别测定了延胡索生品及醋炒、醋蒸、醋煮、酒炒和盐炒5种延胡索炮制品中的总生物碱含量,另采用薄层扫描法及紫外分光光度法测定上述6种样品中的延胡索乙素含量,并对各种样品进行了小白鼠止痛试验。实验结果表明,延胡索用醋炮制或用酒炮制均能提高其水煎液中总生物碱和延胡索乙素的煎出量,并能增强其止痛作用,其中醋制法较为显著。实验结果与临床上多用醋制延胡索入药的经验相符合。     

恒定分压CO2对羟基磷灰石溶解度的影响

[目的]应用固体滴定技术监测羟基磷灰石(Hydroxyaptite,HA)的溶解平衡过程,观察组织液生理浓度CO2对羟基磷灰石溶解度的影响.[方法]在恒温水浴系统中以HA为固体滴定物.测试液为KCl溶液(0.1 mol/L),并引入恒定分压的CO2(占空气体积比为3.5%±0.1%).半导体二极管激光为发射光源,散射光源探测器用于监测HA的溶解平衡过程并判断超越溶解平衡点所出现的沉淀(合共17次滴定终点).固体滴定总量用于代表溶解度等温线上的数据点.[结果]引入恒定分压CO2后测定的HA在KCl溶液中的溶解度高于其在KCl溶液中所得50倍以上.[结论]固体滴定技术利于监测HA的溶解平衡过程.溶液体系中CO2增加HA的溶解度.推测该现象与CO2-3形成的复合物密切相关.     

Measurement in clinical trials: A neglected issue for statisticians?

Biostatisticians have frequently uncritically accepted the measurements provided by their medical colleagues engaged in clinical research. Such measures often involve considerable loss of information. Particularly, unfortunate is the widespread use of the so‐called ‘responder analysis’, which may involve not only a loss of information through dichotomization, but also extravagant and unjustified causal inference regarding individual treatment effects at the patient level, and, increasingly, the use of the so‐called number needed to treat scale of measurement. Other problems involve inefficient use of baseline measurements, the use of covariates measured after the start of treatment, the interpretation of titrations and composite response measures. Many of these bad practices are becoming enshrined in the regulatory guidance to the pharmaceutical industry. We consider the losses involved in inappropriate measures and suggest that statisticians should pay more attention to this aspect of their work. Copyright © 2009 John Wiley & Sons, Ltd.     

微机判断血气的程序设计和临床应用

将肺心病、慢性肾炎等338例次的血气分析结果输入计算机,应用我们设计的多结果血气判断微机程序判断酸碱紊乱状态,其结果与人工综合判断结果完全相符。而单结果计算机判断和单纯人工判断的结果与人工综合判断结果的符合率分别为88.2％和87.3％。表明多结果计算机判断程序能有效地避免误判、漏判。     

野菊花中刺槐甙的库伦滴定法

野菊花Chrysanthemum indicum L.是一种常用中草药,对防治流行性脑脊髓膜炎、流感、高血压、肝炎、痢疾、痈疖疗疮有一定作用。最近还报道野菊花栓剂可用于治疗前列腺炎等症。野菊花的化学成分,据报道含有黄酮类化合物,已知的有刺槐甙(acaciin),水解后得刺槐素(acacetin),分子结构式为     

Methionine-induced acidosis in the weanling rat

Whole body balances of non-metabolizable base (NB) were studied in weanling rats fed a cereal-based diet with or without added l -methionine. In response to l -methionine loading (2.5 mmol day^-1) the rats exhibited a significant reduction in rates of food intake (109 vs. 160 g per 8 days) and body growth (3 vs. 52 g per 8 days); fractional oxidation of absorbed dietary amino acid sulphur increased from 0.28 to 0.64; and mean urinary sulphate excretion increased from 2.3 to 14.8 mmol per 8 days. Mean rates of renal excretion of NB and filtered titratable organic acid decreased from 20 to ?11 mmol per 8 days and from 22 to 8 mmol per 8 days. Balances of calcium and NB remained at reference values despite a decrease in whole blood ‘base excess’ from ?1.0 to ?6.4 mmol 1–¹. The concentration of NB in plasma rose but slightly. It is concluded that L-methionine loading in the weanling rat leads to extracellular non-carbonic acidosis subject to renal compensation. This acidosis is due not to retention of H⁺ released by ionization of endogenous sulphuric acid but possibly to accumulation of (acid) organic metabolites of methionine which are efficiently conserved by the kidneys. The rise in sulphuric acid production leads to an adaptive decrease in fractional reabsorption of filtered sulphate. Even during inhibited growth, absorbed dietary NB is retained and deposited in the skeleton, probably as calcium carbonate.     

Titration of Power Output During Radiofrequency Catheter Ablation of Atrioventricular Nodal Reentrant Tachycardia

Radiofrequency lesions in the anterior, superior aspect of the tricuspid annulus result in selective elimination of fast pathway function in patients with typical atrioventricular (AV) nodal reentry tachycardia. This technique is simple and effective, but has been associated with a significant risk of inadvertent complete AV block. The purpose of this study was to compare the safety and effectiveness of two different techniques for radiofrequency catheter ablation of the fast AV nodal pathway. Initially, a fixed power output was used at each target site. This method was compared retrospectively to a newer technique where power output was gradually incremented at each site. Radiofrequency power was initially applied at 10 watts for 10–15 seconds. If no junctional ectopy or a change in PR intervoi was seen, power output was incremented by 2 to 4 watts every 10 to 15 seconds up to a maximum of 30 watts. Thirty seven of 38 (96%) patients treated using this incremental power output were cured of their AV nodal reentry tachycardia. None of these patients developed inadvertent complete AV block. In contrast, 92% of historic controls treated with a fixed power output between 20 and 30 watts achieved a primary success and nine of these 89 (10%) historic controls developed inadvertent complete AV block (P = 0.04). There was no difference in the amplitudes of atrial, His, or ventricular electrograms at the effective sites between the two groups. Conclusions: (1) the anterior approach to radiofrequency catheter ablation of typical AV nodal reentry is associated with a significant risk of inadvertent complete AV block if a fixed power output is used; (2) starting at low power and gradually incrementing the output during radiofrequency energy application reduces the risk of complete AV block; (3) this incremental technique does not compromise efficacy.     

碱性脂肪酶测定方法的探讨

对碱性脂肪酶酶活的测定方法进行了研究，对反应底物及其形态、反应的酸碱度、温度、稳定时间等条件进行了对比和选择。     

Bovine colostrum supplementation does not affect plasma buffer capacity or haemoglobin content in elite female rowers

It has been reported that bovine colostrum (BC) supplementation improves buffer capacity () during exercise, but whether the improvement results from changes in tissue and/or blood buffer systems has not been determined. The purpose of the present study was to examine the effect of supplementation with BC on blood buffer systems. Thirteen elite females rowers were supplemented with 60 g·day^–1 of either BC (n=6) or whey protein (WP, n=7) during 9 weeks of pre-competition training in a randomised, double-blind, placebo-controlled, parallel design. All subjects undertook the study as a group and completed the same training program. Resting haemoglobin (Hb) concentration and plasma buffer capacity (p) (determined by titration with HCl) were measured pre- and post-supplementation. There were no differences in macronutrient intakes (P>0.56) or training volumes (P>0.99) between BC and WP during the study period. There were no differences in Hb [BC 13.28 (0.28) mg·dl^–1, WP 13.70 (0.26) mg·dl^–1; P=0.45] or p [BC 14.8 (1.1) nmol HCl·ml^–1·pH^–1, WP 14.8 (0.5) nmol HCl·ml^–1·pH^–1; P=0.68] between groups at week 0. p increased in both groups during the study period (P<0.001), but the increases were not significantly different between groups (P=0.52). Hb did not change significantly in either group (P=0.35). These data indicate that supplementation with BC does not affect p or Hb. We therefore suggest that adaptations in tissue buffer systems are responsible for the previously reported increases in buffer capacity that result from BC supplementation.