Some estrogenic effects of two oral contraceptives consisting of norgestrel and two different doses of ethynylestradiol

Some biological and biochemical effects (i.e. KPI, cervical mucus, SHBG and ceruloplasmin) as well as serum ethynylestradiol and serum norgestrel, following the use of two oral contraceptives containing the same amount of norgestrel (dl-norgestrel 0.5 mg) and either 30 microgram or 50 microgram of ethynylestradiol were compared. There was no difference in the clinical features in either group of patients. There was a statistically significant difference in the levels of unconjugated ethynylestradiol but not in the other biochemical parameters studied. It is concluded that the absence of any such difference might be attributable to the strong antiestrogenic effects of dl-norgestrel.     

Characterization of a human anti-hCG antiserum: A proposed standard for laboratories involved with the development of hCG vaccines

An antiserum (PC-81-1) was obtained fron a man who developed antibodies against hCG during treatment for hypogonadism. The antiserum was unique in that its affinity for hCG was high (> 10¹⁰M⁻¹) and its cross-reaction with hLH and the hCG-subunits was only 1–12.5% and 0.01%, respectively, of intact hCG. We propose that this human antiserum be used as a laboratory standard by investigators who are developing vaccines directed against hCG. The use of this standard in the proposed protocol will permit comparison of titers between laboratories. Lyophilized samples of antiserum PC-81-1 are available on request from the Population Council.     

Disinfection of hands and tubing of CAPD patients

During a 3 month study the effectiveness of two methods of handwashing was assessed in a group of 31 patients undergoing continuous ambulatory peritoneal dialysis. A defined, double rinse with alcohol, prior to bag exchange, was found to be more convenient and significantly more effective than povidone-iodine alone or povidone-iodine followed by alcohol. Spraying the tubing around the bag connector with 70 per cent ethanol reduced the numbers of adherent skin organisms so reducing the likelihood of bacteria being drawn into the dialysate. Although there was no difference in the overall incidence of peritonitis in the two groups of patients studied, there was an unexpected drop in the incidence of peritonitis caused by coagulase-negative skin staphylococci. This was attributed to an overall awareness of the importance of handwashing and aseptic procedures during bag exchange. Monitoring the bacteriology of the catheter exit site may give some prior indication as to the likelihood of subsequent peritonitis especially with Staphylococcus aureus and Gram-negative bacilli.     

社区家庭卫生保健合同服务的持续发展探讨

家庭保健合同服务把治疗、预防保健、康复、健康教育等卫生服务深入居民家庭，抗在民对健诏保健的认识，对预防和控制疾病有着积极使用。目前家庭保健合同现况调查结果表明：答约率低，只占家庭数的１．２％。政府进一步扶持及政策配套，完善、巩固和发展家庭保健合同，从长丰它是一种利国利民的有效卫生服务形式。     

The value of objective measurements to select patients who are malnourished

Several studies have attempted to define nutritional parameters that can be used to select malnourished hospitalised patients for nutritional support. A combination of objective nutritional parameters was evaluated in a group of 50 patients selected for total parenteral nutrition on clinical grounds only and compared with a control group. This control group consisted of 38 patients who were admitted for elective minor surgical procedures such as varicectomy and hernia repair. On a subset of 18 objective nutritional measurements, discriminant analysis was performed. In the evaluation it was shown that a combination of albumin (ALB), prealbumin (PALB), total lymphocyte count (TLC) and the percentage of ideal weight (PIW) was the most useful combination of nutritional tests in discriminating a chosen malnourished (M) group and a control group who were declared not malnourished (NM). With this combination the patients were correctly classified in 93% with a sensitivity of 93% and a specificity of 94%.     

Ascending contamination of a jejunostomy feeding reservoir

In general bacterial contamination of enteral feeding solutions is considered to be exogenous in origin. However, during feeding through catheter jejunostomy another source of contamination seems possible. We describe a patient in whom bacterial contamination of the feeding solution given through a catheter jejunostomy occurred frequently. Microbiological evaluation of several feeding samples showed that with this particular type of catheter enterostomy contamination was dual in origin. A not aseptic manipulation of the feed prior to administration led only to slight contamination. Most of the contamination however was endogenous--ie. ascending from the gut of the patient. In contrast to some previous studies, no clinical or laboratory deterioration could be observed in relation to the contamination. The food value of the feed expressed as the glucose concentration was significantly reduced after contamination with the causative organisms.     

Uptake of [3H] dihydroartemisinine by erythrocytes infected with Plasmodium falciparum in vitro

Artemisinine ( qinghaosu ) was reduced and radio-labelled using tritiated borohydride. The tritiated dihydroartemisinine produced was differentially accumulated from low concentrations in culture medium into erythrocytes infected with Plasmodium falciparum. Uninfected erythrocytes concentrated the drug less than two-fold whereas infected erythrocytes achieved more than 300 times the medium concentration. The uptake process is reversible and saturable, with a dissociation constant (Kd) at the hypothetical receptor of 10.5 nmol.l-1. Competition studies indicate that the receptor is the same as that for artemether , another quinghaosu derivative. Chloroquine showed an interesting partial inhibition of uptake but was unable to release the bound radio-labelled drug from infected cells.     

Activation of immune complement by fly ash particles from coal combustion

The interaction of immune complement with fly ash particles from coal combustion was studied in vitro. Fly ash from different coal combustors was incubated for 1 hr with pooled normal dog serum at 37°C. The serum supematants were assayed for complement by a 50% hemolytic (CH₅₀) endpoint method. Ash produced by burning one type of coal activated complement with up to 70% of the complement activated at 10 mg ash/ml serum. This activation was concentration dependent and a linear dose-response curve was obtained. Heat treatment and surface area measurements, as well as immunofluorescence studies, suggest that the active component(s) is volatile or heat labile, found on the surface of the particles, and removed by saline or water extraction.     

美英两国公立医疗机构职工工资分配制度分析:定位级差和影响因素

课题组通过文献查阅、政府网络搜索等方式收集、归纳整理美英两国公立医疗机构职工收入分配制度的资料．并运用收集到的资料分析了美英两国公立医疗机构职工的工资定位、工资级差、确定工资水平时所考虑的要素．以及具体的方法。分析结果表明．美英两国公立医疗机构职工工资定位较高．级差较大．知识受素对工资水平有着决定作用．两国职工工资水平计算方法可以为中国借鉴。     

综合疗法治疗脑卒中100例疗效观察及综合生活质量评价

目的观察综合疗法治疗脑卒中的疗效以及治疗前后患者的综合生活质量状况。方法将患者随机分为三组,A组100例给予常规治疗,B组100例给予常规治疗＋血栓通治疗,C组100例给予综合疗法治疗。同时将三组患者治疗后第1年作为评价时段,采用综合生活质量评定问卷对各组患者的生活质量进行测评并比较,已进一步验证三组患者采用不同治疗方法的整体疗效以及综合生活质量。结果C组患者整体疗效和综合生活质量较好,B组患者次之,A组最差。结论综合疗法治疗脑卒中的疗效肯定,安全可靠,可明显提高患者的综合生活质量。     

The embryotoxic response produced by inorganic mercury in different strains of hamsters

This report compares the mercury-induced embryotoxicity among one noninbred (LVG) and five inbred (CB, LHC, LSH, MHA, PD4) strains of hamsters. A single dose of mercuric acetate (15 mg/kg, sc) was injected into pregnant hamsters on the morning of the 8th gestation day. Treated and control animals were killed on either the 12th or 15th gestation day and studied for the types and frequency of external and internal abnormalities as well as the incidence of resorption sites. The hamster strains exhibited significant resorption rates as well as a variety of abnormalities including edema, retardation, ventral wall defects, pericardial cavity distention, cleft palate, hydrocephalus, and heart defects. Significant but varied interstrain differences were observed for most of these indicators of mercury-induced embryotoxicity. The results of this study were compared with prior work in which the same hamster strains were exposed to cadmium or lead.     

A choice of diastolic Korotkoff phases in mercury sphygmomanometry of children.

Blood pressure, anthropometric variables, and blood hemoglobin were measured in 3,524 children, ages 5–14 years, of a total geographic community. Six blood pressures were taken on each child by trained observers on mercury sphygmomanometers in a rigid, randomized design. At the end of each examination day, a random sample of children was reexamined by the same observers. Both Korotkoff fourth and fifth phases were recorded, and measurement reliability was systematically maintained. Six percent of the fifth phase pressures were 0 mm Hg. After elimination of the children with recorded fifth phases under 20 mm Hg, the difference between age-specific mean fourth and fifth phase pressures was 16 mm Hg. The standard deviation of the mean difference between station pressures was 8.2 mm Hg for fourth and 12.3 mm Hg for fifth phase, the latter significantly larger than the former. Likewise, the standard deviation of the mean difference (keeping the same examiner) between examined and reexamined pressure was 6 mm Hg for fourth and 9 mm Hg for fifth phase, the latter again significantly larger than the former. In multiple regression analysis with fourth and fifth phase pressure as the respective dependent variables, the significant effects due to the individual examiners averaged 4.7 mm Hg for fourth and 7.5 mm Hg for fifth phase. Despite painstaking efforts, fifth phase measurements did not seem to approach the consistency and replicability of the fourth phase measurements as an index of diastolic blood pressure in children in a survey conducted by trained observers.     

Metabolism, excretion, and tissue distribution of [14C]photodieldrin in nonhuman primates following oral administration and intravenous injection.

Metabolism, excretion, and body distribution of [¹⁴C]photodieldrin were studied in the rhesus monkey (Macaca mulatta) after single intravenous and repeated oral administration. After iv administration about 45 and 34% of the dose were excreted by the male and the female, respectively, during 21 days following dosing. Approximately two-thirds of the excreted radioactivity was detected in the urine. The body distribution showed high concentrations of photodieldrin and/or metabolites in adipose tissue, liver, bile, bone marrow, mesenteric lymph nodes, and adrenal cortex. Analysis of feces and urine showed the presence of several metabolites. The major metabolite was identified by mass spectrometry, infrared spectrometry, and gas chromatographical comparison as trans-photoaldrindiol which appears in the urine as glucuronic acid conjugate and as free metabolite. A second metabolite, occurring in feces and urine, appears to be a monohydroxy substituted derivative of photodieldrin.     

Incorporation of [3H]uridine into RNA under the influence of dieldrin and polychlorinated biphenyls.

The present study was conducted to determine the influence of two organochlorines, i.e., polychlorinated biphenyl (Aroclor 1242) and dieldrin, or RNA synthesis in elicited peritoneal macrophages. Tritiated uridine ([³H]uridine) incorporation into RNA was used as an index of RNA synthesis. RNA synthesis was depressed in macrophages incubated in the presence of dieldrin in both a time- and dose-related manner. The dieldrin-induced inhibition of RNA synthesis was further exacerbated when the macrophages were actively phagocytosing latex particles. Aroclor 1242 similarly inhibited RNA synthesis in resting macrophages; however, inhibition was not seen until a concentration exceeding 7 ppm of Aroclor 1242 was used in the incubation medium. Dieldrin-induced inhibition of RNA synthesis was observed at levels of 1 ppm. The inhibition of RNA synthesis provides a corroborative index to support the hypothesis previously advanced that the observed in vivo organochlorine-induced immune suppression may be macrophage mediated. Since the observed in vivo immune suppression was manifested in the absence of any morphological changes in the target lymphoid-macrophage tissues, a biochemical lesion, perhaps at the level of RNA synthesis, may be a site for the organochlorine-induced immunosuppression.     

Release of norethisterone from a bioabsorbable implant in female bonnet monkeys (Macaca radiata)

Bioabsorbable implants prepared by fusion of 85% norethisterone (NET) and 15% cholesterol were inserted subdermally in four cycling bonnet monkeys (Macaca radiata). No skin reaction or inflammation was observed at the site of implantation. Plasma concentration of norethisterone (NET) measured by radioimmunoassay were monitored for 14 to 16 months at monthly intervals. In the first month weekly samples were analysed. NET was released into circulation within 24 hours after insertion of the implant. In all the monkeys, except one, a sharp rise in NET (1.9 to 20 ng/ml) occurred immediately after insertion. Levels then remained between 1.7 and 0.6 ng/ml for about 4 months. Thereafter they remained steady up to about 9 months in two monkeys and gradually declined to about 0.4 ng/ml in the remaining two. In all except one, there was a sudden burst of NET release between the 10th and 11th month. The hormone almost cleared out of circulation by the 14th to 16th month. Initial menstrual cycles after pellet insertion were disturbed, leading to spotting and irregular bleeding. Regular cycles appeared from 5 to 8 months after the insertion of the implant. These cycles were ovulatory, as determined by the progesterone levels.     

Study of copper,zinc, magnesium and cadmium in ICC patients,parents and siblings

Twenty-seven histopathologically proved cases of Indian childhood cirrhosis (ICC), 13 parents (father and mother) and nine siblings of ICC patients were studied from serum and urinary Cu, Zn, Mg and Cd levels by Atomic Absorption Spectrophotometer (AAS). Milk and drinking water from various sources were analysed for Cu, Zn, Mg and Cd contents, as was milk boiled and stored for up to six hours in various utensils. Serum and urinary Cu excretion were high (P < 0·001) in ICC patients and within normal limits in siblings and parents. In ICC patients most hepatocytes contained multiple, coarse and dark brown orcein staining granules representing Cu associated protein. Serum Zn was low and urinary Zn excretion high in ICC patients (P < 0·001 and P < 0·01 respectively) and within normal limits in siblings and parents. Mg and Cd in serum and urine of ICC patients, siblings and parents were within normal limits. Cu content of milk boiled and stored in peetal (brass) utensils was high and directly related to the duration of storage; there was no change in Cu level in milk boiled and stored in steel and aluminium utensils. Zn, Mg and Cd levels in milk boiled and stored in peetal (brass) utensils remained unchanged. The levels of these elements in drinking water from various sources were also within limits as recommended by WHO 1971. Milk boiled and stored in peetal (brass) utensils seemed to account for increased Cu intake. Excessive Cu intake in ICC should be eliminated by avoiding brass utensils for boiling and storing milk. Some treatment to chelate excess Cu is also warranted.     

Effect of lipid screening on preventive care decisions of nonparticipants

Blood donors with suspected hyperlipidemia were identified by means of a screening test. These individuals were advised to seek confirmation and treatment through the program's free clinic or from their usual source of medical care. A mail questionnaire survey was undertaken to determine the response to notification of those electing not to be evaluated at the program's clinic. A substantial proportion sought confirmatory testing elsewhere and, of those treated, most reported favorable results. Thus cost-benefit analyses of programs of screening and treatment should include benefits from preventive health care instituted by extramural sources as well as by these programs themselves. The findings suggest also certain approaches for enhancing the effectiveness of screening programs.     

A comparison of tunnelled and nontunnelled subclavian vein catheters: a prospective study of complications during parenteral feeding

Forty-four silastic catheters in 38 surgical patients, nursed in general surgical wards, were inserted under aseptic conditions by the infraclavicular subclavian route. The catheters were randomly allocated to non-tunnelled (NT) (n = 24) or tunnelled (T) (n = 20) groups. Catheters were removed on completion of intravenous feeding or clinical suspicion of catheter infection, and the catheter tip and blood samples taken through the catheter and from the peripheral vein were cultured. There was no significant difference between the two groups in terms of bacteriological infection (defined as two or more cultures of the same organism), clinical infection (defined by elevated temperature returning to normal after catheter removal) and combined infection (when both bacteriological and clinical infection co-existed). When the number of infected catheters was related to the duration of catheter insertion, the incidence of combined catheter related sepsis was reduced with tunnelling (NT: one infected catheter per 35 catheter days, T: one infected catheter per 89 catheter days). This study highlights the risks of subclavian vein catheterisation and emphasises the difficulties in defining catheter sepsis but suggests that its incidence may be reduced if skin tunnelling is employed.     

湖北恩施州宽叶缬草含硒量测定

采用原子荧光法测定湖北恩施州3个地区的宽叶缬草及土壤样品的硒含量,发现当地宽叶缬草硒含量明显高于其它地区样品,可作为一项开发成道地药材的依据和有效鉴定评价指标。     

First report of septicaemic melioidosis in Hong Kong

Septicaemia due to Pseudomonas pseudomallei was found in five patients; it complicated pneumonia in three. Four patients were old and had diabetes mellitus; the fifth patient, though young, was immunocompromised by steroid therapy. The clinical features were indistinguishable from those of other Gram-negative septicaemia. Four of the patients died. This was the first report of septicaemic melioidosis in Hong Kong where the disease might be endemic. Soil sampling and serological survey gave further supporting evidence. Early treatment using a bactericidal anti-Pseudomonal cephalosporin, such as ceftazidime, was suggested for this life-threatening infection.