健康查体者体脂分布与糖脂代谢指标及血压的相关性分析

目的探讨健康查体者体质量指数(BMI)、腰臀比(WHR)、腰围身高比(WHtR)、臀围身高比与糖脂代谢指标及血压的相关性。 方法选取微山县人民医院体检中心2014年1—5月107例健康查体者为研究对象。测量其身高、体质量、空腹血糖(GLU)、血脂及血压(BP),计算不同性别查体者BMI、WHR、WHtR、臀围身高比并与糖脂代谢指标、血压的相关性并进行比较。 结果①男性：BMI与收缩压(SBP)、舒张压(DBP)、平均动脉血压(MAP)、甘油三酯(TG)、胆固醇(CHOL)、低密度脂蛋白(LDL-C)、极低密度脂蛋白(VLDL-C)、高密度脂蛋白(HDL-C)、谷氨酰转肽酶(GGT)、空腹葡萄糖(GLU)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、胰岛素敏感指数(ISI)、胰岛β细胞功能(HOMA-β)的相关系数分别为0.26,0.33,0.32,0.24,0.25,0.36,0.18,－0.15,0.38,0.54,0.61,0.59,－0.59,0.59; WHR与上述指标的相关系数分别为0.12,0.25,0.20,0.43,0.43,0.48,0.34,－0.15,0.36,0.43,0.49,0.55,－0.55,0.40;WHtR与上述指标的相关系数分别为0.32,0.27,0.24,0.25,0.34,0.44,0.22,－0.10,0.30,0.26,0.59,0.57,－0.57,0.54;臀围身高比与上述指标相关系数分别为0.17,0.20,0.20,0.03,0.16,0.26,0.05,－0.03,0.15,0.04,0.46,0.41,－0.41,0.46;②女性：BMI与SBP、DBP、MAP、TG、CHOL、LDL-C、VLDL-C、HDL-C、GGT、GLU、FINS、HOMA-IR、ISI、HOMA-β的相关系数分别为0.21,0.21,0.30,0.38,0.13,0.26,0.27,－0.37,0.49,0.46,0.55,0.55,－0.55,0.47;WHR与上述指标的相关系数分别为0.32,0.17,0.25,0.38,0.16,0.04,0.31,－0.02,0.34,0.15,0.18,0.15,－0.15,0.2;WHtR与上述指标的相关系数分别为0.27,0.16,0.23,0.39,0.16,0.15,0.30,－0.12,0.46,0.33,0.39,0.37,－0.37,0.36;臀围身高比与上述指标相关系数分别为0.12,0.10,0.11,0.30,0.11,0.23,0.20,－0.31,0.47,0.45,0.54,0.55,－0.55,0.47;③男性BMI与血压、糖代谢指标、GGT的相关性和WHR与TG、CHOL、LDL-C、VLDL-C的相关性均有统计学意义(P<0.05)。女性BMI与糖代谢指标、GGT的相关系数大于其他指标(P<0.01)。 结论与其他三种测量指标比较,BMI与糖代谢紊乱及GGT的升高的相关性较显著;WHR与男性TG、CHOL、LDL-C、VLDL-C的相关性较显著。     

Plantes utilis��es en m��decine traditionnelle dans le traitement des maladies cardiovasculaires, en pays Abbey et Krobou, dans le Sud de la C?te-d��Ivoire

The ethnopharmacological study carried out in Agboville (C?te-d??Ivoire) shows that Abbey and Krobou use 52 species of plants, to treat cardiovascular disorders. Drugs (bulb, carpophore, root barks, stem barks, leaves, flowers, fruits, seeds, sclerot, rhizome and tuber) are used to develop 50 medicamentous receipts, by cooking, decoction, expression, infusion, maceration, chewing, kneading, crushing, pulverization, softening, rasping, torrefaction and trituration. For the administration of the medicine, one proceeds by absorption, local application, drink, ingurgitation, bandage and purging. The traditional healers use only natural resources (plants, animals, minerals). The therapeutic effects induced by the plants are the fact of various chemical groups: alkaloids, flavonoides, lectins, mucilages, pectins, polyphenols, polyterpens, mineral salts, sterols, tanins and vitamins).     

二维斑点追踪成像技术评价完全性左束支传导阻滞患者的左心室功能及同步性

目的应用二维斑点追踪成像技术（2D-STI）探讨不同应变模式对完全性左束支传导阻滞（CLBBB）患者左心室收缩功能及同步性的影响。 方法选取2016年4月至2018年4月在中国医科大学附属第一医院接受检查的CLBBB患者90例,根据二维纵向应变特征分为经典型（CPD）组及非CPD型（n-CPD）组,再进一步选取其中左心室射血分数（LVEF）>50%的患者,同上分为CPD组及n-CPD组;另选30名健康人作为健康对照组。对各组均行常规超声心动图及2D-STI检查,测量常规超声心动图参数：左心室舒张末期内径（LVEDD）、左心室舒张末期容积（LVEDV）及LVEF等;测量并计算左心室整体纵向峰值应变（GLS）、左心室流出道与右心室流出道射血前期时间差（IVMD）、基底段和中间段左心室侧壁与室间隔的应变达峰时间延迟（b-Ssl,m-Ssl）以及左心室18节段心肌纵向应变达峰时间的标准差（SDt）。 结果与健康对照组比较,CPD组及n-CPD组LAD、RVBD、E/e′增高,E/A、EDT减低,差异均有统计学意义（t=5.12、3.67、7.29、5.69、5.89、3.15、2.05、5.89、5.22、3.83,P均<0.01）;与n-CPD组比较,CPD组LAD、E/e′增高,E/A减低,差异均有统计学意义（t=8.12、3.24、3.94,P均<0.01）。与健康对照组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=20.38、7.17、7.35、6.50、5.86、10.24、7.15、6.35、11.24、10.99、5.92、6.12,P均<0.001）;与健康对照组比较,n-CPD组QRS、LVEDD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=16.54、1.99、2.12、2.07、5.87、2.53、2.10、5.06、2.68、3.66、2.06、3.62,P均<0.05）;与n-CPD组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,LVEF、左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=4.68、5.96、6.63、5.32、5.01、5.10、5.28、4.86、7.16、4.74、7.20、3.78、3.57,P均<0.001）。进一步选择LVEF>50%的患者进行比较,组间LVEF比较,差异无统计学意义（P>0.05）,与健康对照组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=19.44、4.01、5.21、5.61、4.73、9.19、5.27、3.16、3.25、8.02、4.15、5.42,P均<0.001）;与健康对照组比较,n-CPD组QRS、LVEDD、LVEDV、LVESV、IVMD、b-Ssl、m-Ssl、SDt增高,左心室间隔及总体纵向应变减低,差异均有统计学意义（t=20.68、2.46、3.15、3.10、6.95、3.00、4.59、6.53、3.84、4.05,P均<0.05）;与n-CPD组比较,CPD组QRS、LVEDD、LVESD、LVEDV、LVESV、IVMD、b-Ssl、SDt增高,左心室间隔、侧壁及总体纵向应变减低,差异均有统计学意义（t=2.73、2.13、3.88、3.06、2.19、3.94、3.00、3.25、4.38、2.90、2.30,P均<0.05）。 结论常规超声心动图结合2D-STI技术可早期发现CLBBB患者左心室收缩功能及收缩同步性减低,且CPD型CLBBB较n-CPD型CLBBB进一步减低的现象,可提示临床需密切关注CPD型CLBBB患者,及时进行治疗干预。     

腹腔镜胆囊切除术围手术期微量元素的变化

目的：探讨LC围手术期微量元素的变化,方法：对12例LC病人在术前,术终,术后血清中Ca,Mg,Fe,Zn,Cu,Mn,Se,Cr,CO,Ni,V,Mo,Ba,Al,Sr,Cd,Pb和Se的变化进行动态观察,结果：在检测的18种微量元素中,在术终Ca,Mg,Zn,CU,Mn,Se,Cr等必需微量元素均明显降低（P＜0．05,P＜0．01）,术后第1天,血清中Ca,Mg,Zn,Cu,Mn,Se,Cr均还维持在明显的水平（P＜0．05）,结论：LC对必需的微量元素有明显的影响,术后应注意补充适量的微量元素。     

抗U1核糖核蛋白抗体与系统性红斑狼疮的致病相关性

目的分析抗U1核糖核蛋白(U1RNP)抗体与系统性红斑狼疮(SLE)临床表现及实验室指标的关系,探讨其在SLE发病中的意义。方法回顾性分析161例SLE住院患者病历资料,其中抗U1RNP抗体阳性者69例,分析其主要的临床特征及实验室指标,并与92例同期住院的抗U1RNP抗体阴性者进行比较。结果抗U1RNP抗体阳性的患者抗双链DNA抗体、抗核小体抗体、抗Sm抗体、SSA、抗核糖体P蛋白阳性率较高,更易出现C3下降、C4下降,发热、皮疹、光敏感、雷诺现象、关节炎、白细胞减少的阳性率较高,肾损害阳性率较低,差异均有统计学意义(χ2值分别为10.000、26.152、14.268、15.413、5.339、8.285、6.456、4.376、8.829、4.593、4.573、4.035、4.286、6.212,P均<0.05),两组患者在ANA、抗SSB抗体、抗心磷脂抗体、口腔溃疡、浆膜炎、心包炎、胸膜炎、脱发、神经系统损害、淋巴细胞减少、血小板减少及SLEDAI差异均无统计学意义(P>0.05)。结论抗U1RNP抗体与SLE患者抗双链DNA抗体、抗核小体抗体、抗Sm抗体、SSA、抗核糖体P蛋白高阳性率、C3下降、C4下降及发热、皮疹、光敏感、雷诺现象、关节炎、白细胞减少、肾损害相关,抗U1RNP抗体在SLE的发病中有重要的临床意义。2     

2005 Annual Report of the American Association of Poison Control Centers' national poisoning and exposure database

BACKGROUND: The American Association of Poison Control Centers (AAPCC; http://www.aapcc.org) maintains the national database of information logged by the country's 61 Poison Control Centers (PCCs). Case records in this database are from self-reported calls: they reflect only information provided when the public or healthcare professionals report an actual or potential exposure to a substance (e.g., an ingestion, inhalation, or topical exposure.), or request information/educational materials. Exposures do not necessarily represent a poisoning or overdose. The AAPCC is not able to completely verify the accuracy of every report made to member centers. Additional exposures may go unreported to PCCs, and data referenced from the AAPCC should not be construed to represent the complete incidence of national exposures to any substance(s). U.S. Poison Centers make possible the compilation and reporting of this report through their staffs' meticulous documentation of each case using standardized definitions and compatible computer systems. The 61 participating poison centers in 2005 are: Regional Poison Control Center, Birmingham, AL; Alabama Poison Center, Tuscaloosa, AL; Arizona Poison and Drug Information Center, Tucson, AZ; Banner Poison Control Center, Phoenix, AZ; Arkansas Poison and Drug Information Center, Little Rock, AK; California Poison Control System-Fresno/Madera Division, CA; California Poison Control System-Sacramento Division, CA; California Poison Control System-San Diego Division, CA; California Poison Control System-San Francisco Division, CA; Rocky Mountain Poison and Drug Center, Denver, CO; Connecticut Poison Control Center, Farmington, CT; National Capital Poison Center, Washington, DC; Florida Poison Information Center, Tampa, FL; Florida Poison Information Center, Jacksonville, FL; Florida Poison Information Center, Miami, FL; Georgia Poison Center, Atlanta, GA; Illinois Poison Center, Chicago, IL; Indiana Poison Center, Indianapolis, IN; Iowa Statewide Poison Control Center, Sioux City, IA; Mid-America Poison Control Center, Kansas City, KA; Kentucky Regional Poison Center, Louisville, KY; Louisiana Drug and Poison Information Center, Monroe, LA; Northern New England Poison Center, Portland, ME; Maryland Poison Center, Baltimore, MD; Regional Center for Poison Control and Prevention Serving Massachusetts and Rhode Island, Boston, MA; Children's Hospital of Michigan Regional Poison Control Center, Detroit, MI; DeVos Children's Hospital Regional Poison Center, Grand Rapids, MI; Hennepin Regional Poison Center, Minneapolis, MN; Mississippi Regional Poison Control Center, Jackson, MS; Missouri Regional Poison Center, St Louis, MO; Nebraska Regional Poison Center, Omaha, NE; New Jersey Poison Information and Education System, Newark, NJ; New Mexico Poison and Drug Information Center, Albuquerque, NM; New York City Poison Control Center, New York, NY; Long Island Regional Poison and Drug Information Center, Mineola, NY; Ruth A. Lawrence Poison and Drug Information Center, Rochester, NY; Upstate (formerly Central) New York Poison Center, Syracuse, NY; Western New York Poison Center, Buffalo, NY; Carolinas Poison Center, Charlotte, NC; Cincinnati Drug and Poison Information Center, Cincinnati, OH; Central Ohio Poison Center, Columbus, OH; Greater Cleveland Poison Control Center, Cleveland, OH; Oklahoma Poison Control Center, Oklahoma City, OK; Oregon Poison Center, Portland, OR; Pittsburgh Poison Center, Pittsburgh, PA; The Poison Control Center, Philadelphia, PA; Puerto Rico Poison Center, San Juan, PR; Palmetto Poison Center, Columbia, SC; Tennessee Poison Center, Nashville, TN; Central Texas Poison Center, Temple, TX; North Texas Poison Center, Dallas, TX; Southeast Texas Poison Center, Galveston, TX; Texas Panhandle Poison Center, Amarillo, TX; West Texas Regional Poison Center, El Paso, TX; South Texas Poison Center, San Antonio, TX; Utah Poison Control Center, Salt Lake City, UT; Virginia Poison Center, Richmond, VA; Blue Ridge Poison Center, Charlottesville, VA; Washington Poison Center, Seattle, WA; West Virginia Poison Center, Charleston, WV; Wisconsin Poison Center, Milwaukee, WI.     

Resource Reviews

Book Reviews : TOPICS IN GERONTOLOGY: SELECTED ANNOTATED BIBLIOGRAPHIES Thomas O. Blank (Ed.), Greenwood Publishing Group, 88 Post Road West, West-port, CT 06881, 203/226-3571, 1993, $65, 256 pages, ISBN 0-313-28337-0 Book Reviews : ELDER MISTREATMENT: DECIDING WHO IS AT RISK Tanya Fusco Johnson, Greenwood Publishing Group, 88 Post Road West, West-port, CT 06881, 203/226-3571, 1991, $49.95, 216 pages, ISBN 0-313-26409-0 Book Reviews : NURSING DIAGNOSES AND INTERVENTIONS FOR THE ELDERLY Meridean Maas & Kathleen Buckwalter, Addison-Wesley Nursing, 390 Bridge Parkway, Redwood City, CA 94065, 800/322-1377, 1991, $44.25, 627 pages, ISBN 0-201-12679-6 Book Reviews : COPING WITH CHRONIC ILLNESS: OVERCOMING POWERLESSNESS (2nd ed.) Judith Fitzgerald Miller, F.A. Davis Company, 1915 Arch Street, Philadephia, PA 19103, 800/323-3555, 1992, $24.95, 442 pages, ISBN 0-8036-6192-4 Book Reviews : THE COMPLETE CARE PLAN MANUAL FOR LONG-TERM CARE Connie S. March, American Hospital Publishing, 737 N. Michigan Avenue, Chicago, IL 60611, 800/242-2626, 1992, $29.95 AHA members, $37.95 nonmembers, 143 pages, ISBN 1-55648-085-7 Book Reviews : BASIC GERIATRIC NURSING Gloria Wold, Mosby-Year Book, 11830 Westline Industrial Drive, St. Louis, MO 63146, 800/325-4177, 1993, $23.95 (paperback), 400 pages, ISBN 0-8016-6647-3     

甜菜碱对非酒精性脂肪肝大鼠瘦素影响的研究

目的通过甜菜碱对非酒精性脂肪肝（NASH）大鼠瘦素的实验研究,探讨甜菜碱改善NASH的作用。方法采用高脂肪饲料加入诱导脂肪肝药物丙基硫氧嘧啶饲养方式制作NASH大鼠模型,高、低剂量组分别给予甜菜碱400mg/kg、200mg/kg灌胃,持续12周;实验结束后,腹主动脉取血,采用全自动生化仪测定Glu、ALT、AST、TG、TC,采用双抗体夹心法测定INS、LEP,并计算胰岛素抵抗指数（IRI）。结果与正常组比较,模型组大鼠TC、TG、ALT、AST、Glu、INS、IRI、LEP均明显升高（P〈0.01或P〈0.05）;与模型组比较,高剂量组TC、TG、ALT、AST、Glu、INS、IRI、LEP均明显下降（P〈0.01）,低剂量组ALT、AST、IRI、LEP也下降（P〈0.01或P〈0.05）,而TC、TG、Glu、INS有所下降,但差异无统计学意义。结论甜菜碱可降低血脂、血糖水平,可改善胰岛素抵抗,改善肝功能,作用机制可能与瘦素有关;甜菜碱改善NASH的作用机制也可能与瘦素有关。     

红景天苷对百草枯中毒大鼠肺组织MMP-2及TIMP-1表达的影响

目的探讨红景天苷对百草枯中毒大鼠肺组织中基质金属蛋白酶-2（MMP-2）和组织特异性抑制因子-1（TIMP-1）表达的影响。方法将90只健康清洁级SD大鼠随机分为正常组10只、模型组40只、治疗组40只,后两组以染毒后不同时间又分为四个亚组,每亚组10只。模型组和治疗组制备急性百草枯中毒肺损伤模型,染毒后治疗组腹腔注射红景天苷10 mg/kg,模型组腹腔注射等量0.9%氯化钠溶液,每12小时一次。各组在1 h、6 h、24 h、72 h时间点取材。采用免疫组化法检测各组肺组织MMP-2、TIMP-1蛋白表达;Real-Time PCR法检测MMP-2 mRNA、TIMP mRNA表达。结果百草枯模型组和红景天苷治疗组MMP-2平均光密度值、TIMP-1平均光密度值、MMP-2 mRNA表达均随着时间的延长逐渐升高（t分别=23.50、34.89、59.96、11.40、30.46、19.07;7.50、20.24、24.23、12.75、16.73、3.99;4.98、10.16、16.12、5.17、11.14、5.96;21.73、50.04、58.86、28.31、37.13、8.82;6.05、18.04、19.72、11.99、13.68;3.68、7.83、13.04、4.15、9.36、5.21,P均＜0.05）。与对照组比较,百草枯模型组和红景天苷治疗组在6 h、24 h、72 h的MMP-2平均光密度值、TIMP-1平均光密度值、MMP-2 mRNA、TIMP-1 mRNA表达均明显升高（t分别=37.65、67.01、55.06;24.94、53.76、42.60;9.11、25.94、23.67;5.93、19.63、16.48;15.22、12.94、13.98;9.98、9.62、17.70;15.26、7.74、8.17;13.10、4.32、5.06,P均＜0.05）。与百草枯模型组比较,红景天苷治疗组在6 h、24 h、72 h 的MMP-2平均光密度值、TIMP-1平均光密度值、MMP-2 mRNA、TIMP-1 mRNA均明显降低（t分别=12.71、13.25、12.46;3.18、6.31、7.20;5.24、4.36、4.37;2.16、3.42、3.11,P均＜0.05）。结论红景天苷通过降低MMP-2、TIMP-1及其mRNA的表达,保护百草枯中毒大鼠肺组织。     

Critical issues relating standards for technology to patient safety

The Committee members are: Jerry M. Calkins, PhD MD (Chairman), Dept Anesthesiology, University of Arizona, Maricopa Medical Center, Phoenix, AZ; David W. Arnett, PhD, Puritan Bennett Corporation, Carlsbad, CA; Peter Carstensen, Food and Drug Administration, Rockville, MD; Joseph A. Condurso, North American Drager, Telford, PA; Patrick A. Foster, FFA, Hershey Medical Center, Hershey, PA; Alex Gerwer, San Diego, CA; Michael Good, MD, University of Florida, Gainesville, FL; Ervin Moss, MD, NJSSA, Verona, NJ; Allen K. Ream, MD, PE (Secretary), Stanford University, Woodside, CA; Terry E. Spraker, PhD, Ohmeda, Madison, WI. Address correspondence to Dr Calkins, Department of Anesthesiology, Maricopa Medical Center, 2601 East Roosevelt, PO Box 5099, Phoenix, AZ 85010.     

Diagnosis of hemoglobinopathies: electrophoresis vs. HPLC.

BACKGROUND: Alkaline cellulose acetate and acidic citrate agar electrophoreses are the most widely utilized methods for hemoglobin analysis. However, due to their limited resolution, incorrect or unresolved diagnosis of common hemoglobinopathies are sometimes encountered. METHODS: Isoelectric focusing provides excellent resolution but is labor intensive and lacks accurate quantitation. High-performance liquid chromatographic methods have been developed for either screening or confirmation of hemoglobinopathies with relatively high sensitivity or specificity. Through the years, we have developed, refined and optimized an HPLC procedure using a porous silica coated with polyaspartic acid to improve the elution time of hemoglobin analysis while maintaining the high sensitivity and resolution necessary for both screening and confirmatory purposes. RESULTS: The method is capable of separating more than 45 commonly encountered hemoglobin variants within 12 min. These include Barts, H, A1C, Raleigh, Hope, I, F, Camden, N-Baltimore, I-High Wycombe, I-Paris, J-Baltimore, N-Seattle, Grade, Fannin-Lubbock, Malmo, South Florida, A, Chicago, G-Georgia, Lepore-Baltimore, P-Galveston, G-Coushatta, Lepore-Boston, E, Zurich, Osu Christiansborg, A2, G-Philadelphia, Korle Bu, Russ, E-Saskatoon, Richmond, D-Punjab, Deer Lodge, Koln, Montgomery, S, Q-Thailand, G-San Jose, A2', Hasharon, Q-India, Tampa, Constant Spring, SG-hybrid, C-Harlem, O-Arab, British Columbia, and C. The method provides not only the identification of the aforementioned hemoglobin and variants but also an accurate quantitation of their concentrations, particularly Hb F and A2, which are useful for the diagnosis of HPFH and beta-thalassemia, respectively. CONCLUSIONS: The simplicity of the sample preparation, superior resolution of the method, and accurate quantitation of hemoglobin concentration, combined with complete automation, make this an ideal methodology for the routine diagnosis of hemoglobin disorders in a clinical laboratory.     

Validation of inductively coupled plasma atomic emission spectrometry technique (ICP-AES) for multi-element analysis of trace elements in human serum

The use of inductively coupled plasma atomic emission spectrometry (ICP-AES) for the simultaneous determination of Al, B, Ba, Be, Cd, Co, Cr, Cu, Fe, Li, Mn, Ni, Pb, Se, Sr and Zn in human serum in a clinical laboratory was validated. Samples were digested and then analysed using yttrium as an internal standard and a serum-matched calibration standard. The criteria used to assess the analytical performance of the ICP-AES were detection and quantification limits, linearity, sensitivity, recovery, interference from alkali and acid, trueness and precision. Detection limits were 0.002-0.003 micromol/L for Mn, Sr, Ba, and Cd; 0.014-0.07 micromol/L for Co, Zn, Fe, Be, Li, Pb, Cu, Ni, and Cr; and 0.2-0.9 micromol/L for B, Se, and Al. Trueness, as controlled by analysis of bovine serum certified reference material, was acceptable for Co, Cu, Se and Zn, while Fe was 5.1% and Mn 6.2% below the lowest limit of the certified material interval. We conclude that ICP-AES can be used for multi-element analysis of B, Ba, Cu, Fe, Li, Se, Sr and Zn in serum. Serum levels of Al, Be and Co were below the detection limits while serum levels of Cd, Cr, Ni and Pb were below the quantification limits of the ICP-AES. These trace metals cannot be analysed as routine by the ICP-AES. However, in cases of intoxication with elevated serum concentrations mean recovery of 100+/-10% was obtained at an addition of 2.22 micromol/L for Al, 0.11 micromol/L for Be, 0.03 micromol/L for Co, 0.39 micromol/L for Cr, 0.14 micromol/L for Ni, and 0.12 micromol/L for Pb.     

Pharmacokinetics of trovafloxacin (CP-99,219), a new quinolone, in rats, dogs, and monkeys.

The pharmacokinetics of trovafloxacin [CP-99,219; 7-(3-azabicyclo[3.1.0]hexyl)-naphthyridone] were studied in rats, dogs, and monkeys following oral and intravenous administration. After intravenous dosing, the systemic clearances of trovafloxacin in rats, dogs, and monkeys were 12.5, 11.1, and 7.2 ml/min/kg of body weight, respectively, and the respective volumes of distribution were 0.9, 1.7, and 4.3 liters/kg, with corresponding elimination half-lives of 0.7, 1.8, and 7.0 h. After the administration of oral doses of 50, 20, and 20 mg/kg to rats, dogs, and monkeys serum trovafloxacin concentrations reached a maximum at 0.6, 2.3, and 2.3 h, respectively, with respective maximum concentrations of trovafloxacin in serum of 11.5, 3.5, and 5.2 micrograms/ml; the corresponding elimination half-lives were 2.2, 2.5, and 7.5 h. The oral bioavailability of trovafloxacin was 68, 58, and 85% in rats, dogs, and monkeys, respectively. The binding of trovafloxacin to serum proteins was concentration independent, averaging 92, 75, and 66% for rats, dogs, and monkeys, respectively. Trovafloxacin penetrated well into tissues in dogs. The urinary recoveries of unchanged drug were less than 5% in dogs and monkeys, with or without incubation with alkali or Glusulase (beta-glucuronidase and sulfatase). In rats, 99.8% of the orally administered radioactivity was recovered in feces, while 20.6, 3.4, and 67.1% of the radioactive dose in bile duct-cannulated rats were recovered in feces, urine, and bile, respectively. These results suggest that the elimination of trovafloxacin from rats, and possibly from dogs and monkeys, is primarily through biliary excretion.     

粘质沙雷菌β-内酰胺类耐药基因研究

目的 调查粘质沙雷菌临床分离株β-内酰胺类耐药基因的携带情况,研究其对β-内酰胺类抗菌药物的耐药机制.方法 采用Vitek2-Compact全自动微生物系统对临床分离菌进行鉴定,检出粘质沙雷菌287株,同时进行药敏试验,选出多重耐药粘质沙雷菌135株;采用双纸片确证试验对所有287株粘质沙雷菌进行ESBLs检测、三维试验法检测AmpC酶,采用PCR法对135株多重耐药粘质沙雷菌进行β-内酰胺类抗菌药物相关基因SHV、TEM、OXA、PER、VEB、GES、IMP、VIM、FOX、CTX、KPC、DHA、MOX和oprD2检测.结果 粘质沙雷菌对氨苄西林、头孢曲松、头孢吡肟、头孢噻肟、氨曲南、庆大霉素、环丙沙星以及哌拉西林等临床常用抗菌药物的耐药率较高,耐药率均大于60％,对亚胺培南、美罗培南、舒普深的耐药率较低,耐药率均小于10％.在287株粘质沙雷菌中,共有32株产ES-BLs,检出率为11.1％,产AmpC酶44株,检出率为15.3％,同时产ESBLs和AmpC酶细菌16株,占5.6％;PCR结果显示,在135株多重耐药的粘质沙雷菌中,检出含CTX-M基因菌株91株、TEM基因25株、SHV基因19株、DHA基因48株、KPC基因10株、MOX基因3株、OXA基因1株、oprD2基因7株.结论 本地区粘质沙雷菌多重耐药现象较为严重,其耐药基因型主要为CTX-M型和DHA基因型.     

Challenges of transitioning from a faculty to an administrative role: part 3, from solving problems to managing polarities

Many new nursing leaders assuming deanships, assistant, or interim deanships have limited education, experience, or background to prepare them for the job. To assist new deans and those aspiring to be deans, Jana L. Pressler, PhD, RN, and Carole A. Kenner, PhD, RNC-NIC, FAAN, the editors of this department, address common issues, challenges, and opportunities that face academic executive teams, such as negotiating an executive contract, obtaining faculty lines, building effective work teams, managing difficult employees, and creating nimble organizational structure to respond to changing consumer, healthcare delivery, and community needs. In this article, the editors asked guest author, Dr Cesarina Thompson, to discuss the transition process from faculty to administrative role.     

血清a-L岩藻糖甘酶与血清甲胎蛋白联合检测对原发性肝癌诊断价值的Meta分析

目的系统评价血清a-L岩藻糖甘酶（AFU）与血清甲胎蛋白（AFP）联合检测对原发性肝癌的诊断价值。方法计算机检索Pub Med、EMbase、h e Cochrance Library（2013年第2期）、Wan Fang Data、VIP、CBM、CNKI和超星Medalink数据库,并手工检索相关中文期刊,收集有关AFU与AFP联合检测诊断原发性肝癌的文献,检索时限均为建库至2013年7月。由2位研究者独立按纳入与排除标准筛选文献、提取数据和评价纳入研究的方法学质量后,采用Meta-Di Sc 1.4软件进行Meta分析。结果共纳入20个研究,包括1 350例病例,2 079例对照。Meta分析结果显示：1单独检测AFU：SEN合并=0.76[95%CI（0.74,0.78）]、SPE合并=0.83[95%CI（0.82,0.85）]、＋LR合并=7.09[95%CI（4.34,11.58）]、–LR合并=0.29[95%CI（0.23,0.37）]、DOR合并=26.88[（95%CI（15.04,48.06）]、SROC曲线下面积AUC=0.872 6和Q指数=0.803。2单独检测AFP：SEN合并=0.69[95%CI（0.67,0.72）]、SPE合并=0.88[95%CI（0.86,0.89）]、＋LR合并=7.85[95%CI（5.35,11.50）]、–LR合并=0.35[95%CI（0.30,0.42）]、DOR合并=25.62[95%CI（16.35,40.15）]、SROC曲线下面积AUC=0.805 4和Q指数=0.740 6。3联合检测AFU和AFP：SEN合并=0.85[95%CI（0.83,0.87）]、SPE合并=0.86[95%CI（0.85,0.88）]、＋LR合并=7.16[95%CI（5.15,9.96）]、–LR合并=0.15[95%CI（0.10,0.23）]、DOR合并=54.07[（95%CI（29.85,97.95）]、SROC曲线下面积AUC=0.940 8和Q指数=0.878 5。结论 AFU与AFP联合检测诊断原发性肝癌具有较高的诊断效能。     

Identification of RAPD Markers Associated with Morphological, Biochemical and Ionomic Characteristics in Indian Tomato Genotypes

Random Amplified Polymorphic DNA (RAPD) technique is one of the simplest marker techniques used in the differentiation of organisms. In the present study, 28 Indian tomato genotypes along with morphological, biochemical and ionomic characteristics were subjected to RAPD analysis. Ten random primers were selected from 100 operon primers which produced 88 reproducible bands; 89.8 % (79) of bands were polymorphic and 10.2 % (9) were monomorphic. The total number of markers identified by SMA in different parameters were plant height-06, fruit number-07, fruit cluster-03, fruit weight-03, pH-03, titratable acidity-03, TSS-03, total sugars-07, reducing sugars-06, non-reducing sugars-02, and lycopene-05. In case of macroelements, the total number of markers identified in SMA was P-03, K-05, Ca-06, Mg-03; for microelements, Mn-03, Fe-01, Co-06, Ni-06, Cu-04, Bo-06, Na-04, Mo-07, Cd-02 and Li-06. The total markers associated by SMRA showed the following. Plant height-06, fruit number-11, fruit cluster-06, fruit weight-17, pH-03, titratable acidity-04, TSS-04, total sugars-19, reducing sugars-20, non-reducing sugars-14, lycopene-19, P-13, K-18, Ca-03, Mg-03, Iron-13, Co-04, Ni-13, Cu-16, Zn-26, Bo-22, Na-21, Mo-20, Cd-18 and Li-12. The study suggested that the RAPD markers identified could be used in breeding elite tomato genotypes with good characteristics.     

造血干细胞移植患者移植前后血浆中氨基酸、微量元素及重金属、维生素、类固醇激素的含量检测分析

目的　了解造血干细胞移植患者移植前后血浆中氨基酸、微量元素及重金属、维生素、类固醇激素水平的变化。 方法　选取44 例在河北燕达陆道培医院治疗的患者作为研究对象,按照回输干细胞的时间分为移植前、移植期和移植 后三组,采用质谱法测定三组患者血浆中氨基酸、微量元素及重金属、维生素、类固醇激素含量。结果　与移植前相比, 移植期患者血浆中天冬氨酸（aspartic acid,Asp）、瓜氨酸（citrulline,Cit）、羟脯氨酸（hydroxyproline,Hyp）、镁（Mg）、 砷（As）、维生素D3,5- 甲基四氢叶酸（5-methyltetrahydrofolic acid,5-MTHF）、可的松、皮质酮和氢化可的松浓度 明显较低,锌（Zn）、铬（Cr）和锶（Sr）浓度偏高,差异均具有统计学意义（均P<0.05）;与移植期比较,移植后 患者体内3- 甲基组氨酸（3-methylhistidine,3MHis）、丙氨酸（alanine,Ala）、Cit,甘氨酸（glycine,Gly）、Hyp, 磷酸乙醇胺（phosphoethanolamine,PetN）、肌氨酸（sarcosine,Sar）、Mg,As,硒（Se）、维生素A、维生素E、 维生素K 和5-MTHF 浓度均显著增高,苯丙氨酸（phenylalanine,Phe）和Cr 浓度减少,差异均具有统计学意义（均 P<0.05）。结论　监测造血干细胞移植患者血浆中氨基酸、微量元素及重金属、维生素、类固醇激素含量变化,对血液 病患者有选择的进行营养补充,提高免疫功能及血液病患者的治疗有一定的意义。     

Cytokines and macrophages

Macrophages, within the cytokine network, are a major source of many cytokines involved in immune response, hematopoiesis, inflammation and many other homeostatic processes. Upon stimulation by micro-organisms, microbial products or endogenous factors including cytokines, macrophages can de novo synthesize and release a large variety of cytokines (ie IL-1, IL-Ira, IL-6, IL-8, IL-10, IL-12, TNFα, IFNα, IFNy, MCP-l, MCP-3, MIF, M-CSF, G-CSF, GM-CSF, MIP-l, MIP-2, LIF, OSM, TGFβ). Some cytokines can upregulate the production of cytokines by macrophages (IL-3, GM-CSF, IFNγ) while others can inhibit it (IL-4, IL-10, IL-13, TGFβ). In addition, these cytokines can modulate most of the macrophage functions and cell surface marker expression. Other cytokines (the chemokines such as MCP-1,2,3, MIP-1,2 and RANTES) contribute to the recruitment of circulating monocytes within tissues. It is worth noting that macrophages can be their own source of regulatory cytokines.