早期糖尿病视网膜病变的视网膜电图分析

目的 分析早期糖尿病视网膜病变(DR)的闪光视网膜电图(F—ERG)和视网膜电图震荡电位(OPs)各参数的变化特点，寻找反映早期DR的敏感指标。方法 对16例(32只眼)正常人进行OPs和F-ERG检测。对27例(53只眼)糖尿病病人进行眼底荧光血管造影(FFA)、OPs和F—ERG检测。结果 OPs中Os波幅、O4波幅、OPs总波幅及F-ERG中b波峰潜时较其他指标敏感，其中O4波幅和b波峰潜时为最敏感指标，但均不能反映早期DR的严重程度。结论 OPs的O4波幅和F—ERG的b波峰潜时可作为早期糖尿病视网膜病变诊断的敏感指标。     

高血压性视网膜病变的视觉电生理改变探讨

目的：探讨高血压性视网膜病变的闪光视网膜电网（FERG）,振荡电位（OPs)改变,方法：比较正常对照组15例30只眼和不同眼底分毋组的原发性高血压病患者,共49例98只眼的FERG,OPs的变化。结果：1．FERG：a波潜伏期：对照组与I级组相比差异无显著性,与Ⅱ,Ⅲ级组相比差异均有显著性;I级组与Ⅱ级组间差异无显著性,但I级与Ⅲ级,Ⅱ级与Ⅲ级组间差异均有显著性;a波振幅：对照组与I级组间差异无显著性,与其他各组间差异均有显著性;各级患者组间差异均有显著性;b波潜伏期,除I级与II级组间差异无显著性外,其余各组间差异均显著;b波振幅;除对照组与I级组间差异无显著性外,其余各组间差异均有显著性,2．OPs潜伏期：对照组各子波与I级组以及OP1,OP4及Ⅱ级组间差异无显著性,与其他各组间差异均有显著性,I级各子波与II级组间差异无显著性,与Ⅲ级组间差异显著,Ⅱ级与Ⅲ级组间差异显著。OPs振幅：对照组OP3与I级组间差异无显著性,其余比较差异均有显著性,除I级与Ⅱ级组间的OP4振幅差异无显著性外,各级患者组间的各子波振幅以及总振幅差异均有显著性。结论：FERG,OPs可作为高血压性视网膜病变及其严重程度的客观定量指标。     

用 Flash模拟枸橼酸钠注射液浓度的实验

通过应用Flash模拟医用化学实验-离子交换法,测定枸橼酸钠注射液浓度的制作过程,介绍了运动动画、形变动画、关键帧动画和文字处理及声音配置等操作步骤。     

超声心动图辅助教学系统的研发与应用

根据超声心动图学的教学特点,应用Adobe Flash CS5为开发工具,以权威性专业协会组织最新颁布的指南或建议为蓝本,设计开发集图、文、动画、视频为一体的交互式超声心动图辅助教学系统.经实践表明,该系统能够提高超声心动图教学的质量和效果,具有较高的推广应用价值.     

Cost-Effective Isolation of a Process Impurity of Pregabalin

Cost-effective isolation methods were developed on preparative HPLC, flash LC, and simulated moving bed (SMB) to prepare the process impurity, 3-(aminomethyl)-5-methylhex-4-enoic acid (4-ene impurity), of pregabalin. By a thorough experimental study on the different isolation techniques available, it was concluded that SMB was the most cost-effective. Hence, it was a continuous chromatography that utilized the advantage of SMB so that a high quantity of the impurity was generated in a short period of time. SMB was equipped with eight reversed-phased columns and was used to separate the process impurity of pregabalin. The effects of flow rate in zone 2 (Q2) and 3 (Q3), as well as switching time, on the operating performance parameters like purity, productivity, and desorbent consumption were studied. Operating conditions leading to more than 90% purity in the raffinate outlet stream were identified, together with those achieving optimal performance. All of these developed methods are novel, cost-effective, and can be applied to the isolation of other process- and stability-related impurities of pregabalin.     

Measurement of the Hydrostatic Pressures of the Cochlear Compartments

A micropressure transducer (sensitive to 0.1 cm H₂O) utilizing a manual servo nulling system and a micropipette (tip diameter 12–20 μm) was designed in order to measure endolymphatic and perilymphatic hydrostatic pressures in the inner ear of the guinea pig. Perilymphatic pressures were measured through the round window membrane in animals in which the ossicular structures had been removed and in those in which the middle ear structures were intact. Endolylnphatic pressures were measured after removal of the middle ear structures. There was a significant (p < 0.001) difference between perilymphatic pressures in the presence (4.7 ± 0.36 cm H₂0) and absence (2.43 ± 0.22 cm H₂0) of the middle ear structures. The endolymphatic pressure was 0.00 cm H₂0 when measured through the basilar membrane after disruption of the scala tympani, and was 3.34 ± 0.57 when monitored through the spiral ligament and stria vascularis. In order to verify the accuracy of these measurements, we monitored pressures in animals whose perilymphatic pressures were artificially maintained by an external source. Recoveries were always 95–100% of the artificially applied pressure. The injection of purified cholera toxin into the scala media through the basilar membrane resulted in a significant (p < 0.001) increase in endolymphatic pressure.     

Nephron injury induced by diagnostic ultrasound imaging at high mechanical index with gas body contrast agent

The right kidney of anesthetized rats was imaged with intermittent diagnostic ultrasound (1.5 MHz; 1-s trigger interval) under exposure conditions simulating those encountered in human perfusion imaging. The rats were infused intravenously with 10 microL/kg/min Definity (Bristol-Myers Squibb Medical Imaging, Inc., N. Billerica, MA, USA) while being exposed to mechanical index (MI) values of up to 1.5 for 1 min. Suprathreshold MI values ruptured glomerular capillaries, resulting in blood filling Bowman's space and proximal convoluted tubules of many nephrons. The re-establishment of a pressure gradient after hemostasis caused the uninjured portions of the glomerular capillaries to resume the production of urinary filtrate, which washed some or all of the erythrocytes out of Bowman's space and cleared blood cells from some nephrons into urine within six hours. However, many of the injured nephrons remained plugged with tightly packed red cell casts 24 h after imaging and also showed degeneration of tubular epithelium, indicative of acute tubular necrosis. The additional damage caused by the extravasated blood amplified that caused by the original cavitating gas body. Human nephrons are virtually identical to those of the rat and so it is probable that similar glomerular capillary rupture followed by transient blockage and/or epithelial degeneration will occur after clinical exposures using similar high MI intermittent imaging with gas body contrast agents. The detection of blood in postimaging urine samples using standard hematuria tests would confirm whether or not clinical protocols need to be developed to avoid this potential for iatrogenic injury.     

1型糖尿病患者血糖波动的影响因素研究

背景1型糖尿病（T1DM）患病率逐年增加,其自身免疫的特性易导致患者出现胰腺β细胞破坏和胰岛素缺乏症,进而使患者血糖不易达标。目的应用瞬感扫描式血糖监测系统（FGMS）探讨T1DM患者血糖波动的影响因素,为未来临床采取针对性降糖治疗措施提供依据。方法应用便利抽样法选取2019年5月至2020年4月南京医科大学附属淮安第一医院收治的85例T1DM患者作为研究对象。收集患者性别、年龄、糖尿病病程、婚姻状况、文化程度、吸烟、饮酒等基线资料,测定体质指数（BMI）、腰臀比（WHR）、血压（BP）、糖化血红蛋白（HbA1c）、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（HDL-C）、估算肾小球滤过率（eGFR）和尿微量白蛋白/尿肌酐比值（UACR）等临床资料,依据患者平均血糖波动幅度（MAGE）是否高于总体均值0.82 mmol/L将患者分为血糖波动高组与血糖波动低组,评估糖尿病自我管理行为量表（SDSCA）总分及糖尿病授权简化量表（DES-SF）总分,采用多元线性回归分析探讨T1DM患者血糖波动的影响因素。结果两组患者年龄、糖尿病病程、HbA1c、TG、UACR、平均血糖浓度（MEAN）、血糖标准差（SD）、血糖在正常范围内时间（TIR）、DES-SF得分和SDSCA得分比较,差异均有统计学意义（P<0.05）。多元线性回归分析结果显示,年龄是MEAN（β=-0.272,P=0.019）、SD（β=-0.300,P=0.009）、MAGE（β=-0.254,P=0.007）的影响因素;糖尿病病程是MEAN（β=0.466,P=0.029）的影响因素;HbA1c是MEAN（β=0.416,P<0.001）、SD（β=0.330,P=0.004）、TIR（β=-0.287,P=0.014）、MAGE（β=0.182,P<0.001）的影响因素;UACR是SD（β=0.264,P=0.040）、TIR（β=-0.350,P=0.006）、MAGE（β=0.236,P=0.009）的影响因素;SDSCA总分是MEAN（β=0.416,P<0.001）、SD（β=0.330,P=0.004）、TIR（β=-0.287,P=0.014）的影响因素;DES-SF总分是MEAN（β=-0.271,P=0.045）、TIR（β=0.865,P=0.016）的影响因素。结论T1DM患者血糖波动的影响因素包括年龄、糖尿病病程、HbA1c、UACR、自我管理行为以及自我管理潜能,临床应根据这些因素为患者制订个体化降糖策略,从而减少患者的血糖波动,延缓并发症的发生、发展。