HPLC法测定藏药石榴莲花散中鞣花酸和胡椒碱的含量

目的:建立高效液相色谱法测定藏药石榴莲花散中鞣花酸和胡椒碱含量的方法。方法:采用HPLC法对制剂中石榴子和诃子的鞣花酸进行含量测定;采用HPLC法对制剂中荜茇的胡椒碱进行含量测定。结果:鞣花酸在5.065～25.325μg呈良好线性关系(r=0.9999),平均回收率为98.2%,RSD=2.8%(n=6);胡椒碱在10.414～52.071μg呈良好线性关系(r=1.0000),平均回收率为99.4%,RSD=1.1%(n=6)。结论:该方法简便、准确、重复性好,专属性高,结果可靠,可有效控制石榴莲花散中鞣花酸和胡椒碱成分的质量。     

结核分支杆菌药敏试验结果分析

目的了解本市结核分支杆菌耐药状况,为选择更为有效合理的抗结核病药物治疗提供依据。方法采用比例法对317株痰培养阳性的结核分支杆菌标本进行药物敏感实验。结果 317株结核分支杆菌中,226株(71.29%)对6种抗结核药全部敏感,91株耐药,总耐药率为28.70%。其中单耐药42株,单耐药率13.25%,多耐药25株,多耐药率7.89%,耐多药24株,耐多药率为7.57%;而复治患者耐药率和耐多药率都明显高于初治患者(χ~2=7.347,P0.01)(χ~2=9.132,P0.01)。结论本市结核病患者的耐药状况较严重(特别是复治组患者),应进一步加强结核病临床治疗的规范用药,控制耐药菌株的增加。     

探讨手术时使用电解水洗手的消毒效果——与以往洗手法进行的比较研究试验

强酸性电解水在其所含次氯酸成分的作用下，具有强力而广泛的抗菌效果；然而，受需要生成装置进行供给等原因的限制，目前的现状是人们在医疗领域对它的认识并不充分，使用范围还很有限。不过在提倡改善医疗环境的今天，在临床上使用对活体刺激小、不会污染环境的强酸性电解水代替以往的消毒药剂，仍然具有包括经济效益在内的重大意义。     

Effect of moxibustion stimulation on repair of injured gastric mucosa after common peroneal nerve transection

Objective

To investigate the protective effect of moxibustion in initiating the endogenous protection information on gastric mucosa, and its relationship with the pathway of common peroneal nerve.

Methods

Forty-eight Sprague-Dawley (SD) rats were randomly divided into a normal group (group A), a model group (group B), a moxibustion model group (group C) and a moxibustion model plus surgery group (group D), 12 in each group. Except for group A, rats in the other groups were treated with dehydrated ethanol and aspirin to prepare gastric mucosal damage model. The rats in group B were not treated with any interventions; rats in group C received moxibustion at Zusanli (ST 36), twice a day for continuous 3 d. The rats in group D were subjected to preparing the gastric mucosal damage model after the common peroneal nerve transection, followed by moxibustion at Zusanli (ST 36). After a 3-day intervention, ulcer index (UI) in each group was observed, and the levels of gastric mucosa-related repair cytokines of tumor necrosis factor-α (TNF-α), interleukin-4 (IL-4) and heat shock protein 70 (HSP70) were detected.

Results

Compared with group A, the pathological changes and UI of group B were worse (P=0.000), but TNF-α in serum and tissue was changed significantly (P=0.000, P=0.002), IL-4 in serum and tissue was improved significantly (P=0.000, P=0.000). Compared with group B, TNF-α and IL-4 in group C and group D were significantly improved (TNF-α: P=0.003, P=0.016; IL-4: P=0.000, P=0.002). Compared with group C, the changes of UI in group B and group D were poor (both P=0.000); the levels of TNF-α and IL-4 in serum were significantly decreased (TNF-α: P=0.000, P=0.025; IL-4: P=0.000, P=0.034); and tissue HSP70 levels were decreased significantly (P=0.000, P=0.033).

Conclusion

Zusanli (ST 36) can transmit information through the pathway of common peroneal nerve, regulate the release of gastric mucosal protective factors, and up-regulate the expression of cytothesis-related proteins, so as to achieve the effect in repairing gastric mucosa.

     

重视耳鼻咽喉头颈外科住院医师的肿瘤学培训

耳鼻咽喉头颈外科住院医师的肿瘤学理论和实践能力普遍比较欠缺,重视临床实习中的肿瘤学培训,是临床教师的重要职责和要求。笔者团队针对头颈肿瘤外科专业临床实习的特点,结合住院医师的实际情况与需求,通过改进临床教学内容和方法,对提高住院医师培训质量进行了探索,收到了良好的效果。     

子痫前期血清脂联素反常升高与瘦素水平改变的相关性

目的探讨血清脂联素、瘦素和可溶性瘦素受体水平在子痫前期患者中的变化及其意义。方法采用酶联免疫吸附试验方法检测38例子痫前期患者和42例正常妊娠（对照组）血清脂联素、瘦素和可溶性瘦素受体水平，并计算游离瘦素指数值（瘦素／可溶性瘦素受体）。结果子痫前期患者血清脂联素、瘦素和游离瘦素指数分别为1691，7μg／ml、37．5ng／ml和0．95，明显高于对照组（分别为689，4μg／ml、19．3ng／ml和0．49），但两组别间可溶性瘦素受体水平则未见明显差异（分别为35．0ng／ml和42，2ng／ml）。在脂联素和瘦素、可溶性瘦素受体及游离瘦素水平间并未见明显相关，子痫前期患者脂联素、瘦素和游离瘦素的ROC曲线下面积均低于0.5。结论子痫前期患者血清脂联素水平存在明显的反常升高，瘦素的生物利用度也明显提高，可能与子痫前期的发生发展有关。     

支撑喉镜下气管内镜辅助成人气管异物取出术的围术期安全管理

目的　探讨支撑喉镜下气管内镜辅助成人气管异物取出术的安全性和注意事项。方法　在手术医师、麻醉医师和护士熟练配合下,于支撑喉镜下置入气管内镜,直视下将气管异物取出,避免周围黏膜损伤。结果　手术野清晰,气管异物顺利迅速取出,未出现并发症。结论  支撑喉镜下气管内镜明视下气管异物取出,围术期护理措施及手术配合为异物取出提供安全保障,临床经验值得推广。     

慢性腹透患者透析充分性和营养状况的临床评估

本文对53例慢性腹透（PD）患者通过测定整体尿素清除率（KT／V）、肌酐清除率（Ccr）、蛋白分解代谢率（PCR）、标准蛋白分解代谢率（nPCR）、白蛋白（ALB）、臂肌面积（AMA）来观察腹透的充分性和有关营养状况．结果表明：①KT／V与Ccr有显著相关性（r=067，P＜0．01），其中KT／V＜1．4的16例，Ccr＜50／周14例（占28.3％）；②KT／V、Ccr与PCR、nPCR有显著相关性（r=0．36～0．72，P＜0．01），W、Ts、AMA与PCR有显著相关性（r=0．29～0．27，P＜0．05）；③高龄者、近期透析者ALB偏低．提示KT／V、Ccr是了解透析充分性、调节透析量的有效手段．PCR、nPCR在评估PD患者营养状态中，肥胖及消瘦者可影响nPCR的结果．