探讨邻苯二甲醛对消化内镜模拟现场消毒效果观察

目的研究分析邻苯二甲醛(OPA)对消化内镜模拟现场的杀毒灭菌效果。方法使用悬液杀菌试验方法和模拟现场消毒试验方法,对邻苯二甲醛对消化内镜的杀毒效果进行观察和分析。结果邻苯二甲醛消毒液中的邻苯二甲醛原液含量为5500 mg/L。把邻苯二甲醛消毒液中原液浓度含量为2500 mg/L对悬液中的大肠杆菌、铜绿假单胞菌和葡萄球菌进行杀毒三分钟,杀灭对数值5.0。邻苯二甲醛消毒液中原液浓度含量为2800 mg/L对悬液中的白色念珠菌以及龟分枝杆菌脓肿亚种进行杀毒三分钟,杀灭对数值4.0。对悬液内的脊髓灰质炎病毒的灭活对值数4.0。将邻苯二甲醛原液浓度为5500 mg/L的消毒液,在消化内镜上作用20分钟,对消化内镜模拟管腔中的铜绿假单胞菌的杀灭对数值5.0。结论邻苯二甲醛消毒液能够快速有效地杀灭悬液内的细菌和病毒,消化内镜模拟现场消毒取得的效果较好。     

邻苯二甲醛和过氧乙酸对电子鼻咽喉镜消毒效果比较

目的比较临床上常见的两种消毒剂对电子鼻咽喉镜的实际灭菌效果和安全性。方法选用门诊使用后的电子喉镜按规范方法清洗后,按照国家相关卫生行业标准的要求,分别用邻苯二甲醛、过氧乙酸两种消毒剂对喉镜进行消毒,检测喉镜表面几种常见致病菌的杀灭效果,以及消毒后内镜内腔的菌落总数。结果过氧乙酸灭菌高效、广谱,作用时间短,虽然对生物膜有清洁去除作用,但对喉镜腐蚀性强,对洗消人员危害性大。并且作为高危物品不宜储存。邻苯二甲醛消毒效果与过氧乙酸相当,并具有广谱、高效和低腐蚀性的优点,同时具有刺激性小、稳定性好等自身特点。结论采用邻苯二甲醛进行电子喉镜消毒,既可达到预期消毒效果,也降低了消洗人员的职业暴露和消毒液残留对患者粘膜的影响,因此在临床使用中,邻苯二甲醛更加值得推广。     

艾叶复方消毒剂杀菌效果的实验观察

目的：观察以艾叶中草药提取复方消毒剂的杀菌效果及有机物的影响。方法：按《消毒技术规范》规定的方法分组、操作与判断试验结果。结果：作用５ｍｉｎ，可将淋球菌，大肠杆菌，金黄色葡萄球菌，绿脓杆菌，白色念珠菌杀灭９９．９９％，受有机物影响小；且该消毒剂将电话机与冰箱门把表面喷湿，可杀灭自然菌９９．８３％，结论：艾叶复方消毒剂具有良好杀菌效果。     

血清胆固醇单一试剂法与邻苯二甲醛法的应用比较

血清胆固醇测定醋研硫酸单一试剂直接显色法具有许多优点。重要性和回收率都比较好，呈色稳定性也比较满意，特介绍如下。1操作方法取试管两支，于测定管中加入血清0．05ml，于标准管中加入标准液0．05ml，再各加入单一侧剂3ml，置37℃10分钟以722分光度计波长620毫微米，以水调零进行比色，根据光密度由标准曲线查得结果，或根据式。一胆固醇mg％XO60259一胆固醇13mol／I，。邻苯二甲醛直接显色法。试剂：①邻苯二甲醛贮存液：溶解100mg邻苯二甲醛于10Oml冰醋酸中。②邻苯二甲醛应用液：取上述贮存液100ml，乙酸乙酯100ml，无水乙醇IO0m…     

多重耐药鲍曼不动杆菌对戊二醛消毒剂的敏感性

目的：探讨鲍曼不动杆菌对消毒剂的敏感性,为医院消毒措施提供参考依据。方法采用消毒剂对细菌最低杀菌浓度（ MBC）和最低抑菌浓度（ MIC）的检测方法,评估鲍曼不动杆菌对3种消毒剂的敏感性。采用PCR方法检测耐消毒剂基因qacEΔ1－sull。结果邻苯二甲醛消毒剂、纯戊二醛消毒剂、2％强化戊二醛消毒剂对多重耐药鲍曼不动杆菌的MBC值分别为500、20000、2500 mg／L,MIC值分别为250、5000、315 mg／L。邻苯二甲醛消毒剂、纯戊二醛消毒剂、2％强化戊二醛消毒剂对敏感鲍曼不动杆菌的MBC值分别为250、10000、1250 mg／L,MIC值分别为125、2500、78 mg／L。邻苯二甲醛消毒剂、纯戊二醛消毒剂、2％强化戊二醛消毒剂对质控菌ATCC27853、ATCC25922的MBC值分别2500、10000、1250 mg／L,MIC值分别为125、2500、78 mg／L。 PCR方法检测到7株多重耐药鲍曼不动杆菌含有耐消毒剂基因qacEΔ1－sull,5株敏感鲍曼不动杆菌和质控菌株未检测出耐消毒剂基因qacEΔ1－sull。结论2％强化戊二醛消毒剂对多重耐药鲍曼不动杆菌的MIC值和MBC值较敏感鲍曼不动杆菌、标准菌株明显升高,多重耐药鲍曼不动杆菌对消毒剂抗性的产生与耐消毒剂基因qacEΔ1－sull有关。     

金瓢虫牌灭菌泡腾片杀菌效果的实验室研究

目的：了解金瓢虫牌灭菌片杀菌作用，对其做出科学评价，更好地指导临床使用该药。方法：采用中和剂鉴定试验、定量杀菌试验、HBsAg抗原性破坏试验、现场试验。结果：1％硫代硫酸钠能中和该消毒剂；60mg/L、80mg/L、100mg/L有效氯，作用5min，10min，20min对细菌繁殖体，平均杀灭率分别为99.90％-100％。600mg/L，800mg/L，100mg/1，有效氯，作用5min，10min，20min，40min对细菌芽胞，平均杀灭率为96.06％-100％。结论：杀灭细菌繁殖体，杀灭率达99.90％所需最低浓度为60mg/L，最短作用时间5min，杀灭率达100％所需最低浓度为100mg/L，最短作用时间20min。杀灭细菌芽胞，杀灭率达99.90％％所需最低浓度为600mg/L，最短作用时间20min，杀灭率达100％所需最低浓度为1000mg/L，最短作用时间40min。     

强力杀菌消毒剂杀灭微生物效果的试验观察

目的　观察强力杀菌消毒剂杀灭微生物的效果。方法　用含不同浓度二氧化氯的强力杀菌消毒剂对悬液中的微生物作用不同时间。结果　 5 0mg L二氧化氯的强力杀菌消毒剂对金黄色葡萄球菌作用 10min ,4 0mg L的二氧化氯消毒剂对大肠杆菌作用 10min ,5 0mg L二氧化氯的消毒剂对白色念珠菌作用 15min ,含 30 0mg L二氧化氯的消毒剂对枯草杆菌黑色变种芽孢作用 2 0min ,杀菌率均为10 0 % ;含 2 0 0mg L二氧化氯的强力杀菌消毒剂作用 2 0min ,可将HBsAg抗原性完全破坏。结论　强力杀菌消毒剂具有较强杀灭微生物的作用 ,其杀菌效果随二氧化氯浓度的增加与时间的延长而增强     

一种中药复方消毒剂杀灭微生物效果的实验研究

考察由苦参、黄柏、大桉叶、蛇床子等中草药制成的中药复方消毒剂的杀菌作用。载体浸泡定量杀菌试验表明，以其1／2稀释液，对金黄色葡萄球菌作用10min，杀菌率为99．98％；以其1／4稀释液，对大肠杆菌作用20min，杀菌率为99．95％；以其1／2稀释液,对白色念珠菌作用20min，杀菌率为99．93％。菌悬液含25％和50％小牛血清对其杀菌效果无影响。该消毒剂小于54℃温度放置14d（有效期一年试验），杀菌效果基本不足。     

稀释吉尔碘皮肤黏膜消毒剂临床效果评价

目的研究吉尔碘皮肤黏膜消毒剂在临床应用的可行性。方法用化学滴定法和对细菌、真菌的杀灭试验，观察1：4稀释吉尔碘皮肤黏膜消毒剂的有效使用时间。结果1：4稀释后存放29d，有效成分下降9．86％视为合格。存放33d有效成分下降11．30％，视为该消毒剂失效。第29天对金黄色葡萄球菌的杀灭率1min仍为100％；对抵抗力较强的白色念珠菌5min杀灭率99．9％，视为可达到消毒效果。结论1：4（1000mg／L）稀释吉尔碘皮肤黏膜消毒剂用于皮肤黏膜消毒效果显著。     

一种含氯消毒剂杀灭细菌芽胞及稳定性的实验

目的：以悬液定量杀菌试验观察一种含氯消毒剂对杀灭细菌芽胞的效果及稳定性。方法：用原浓度为6．47％的含氯消毒剂,以悬液定量杀菌试验对枯草杆菌黑色变种芽胞进行杀灭效果观察。结果：观察以浓度为含有效氯6000 mg/L的消毒液对枯草杆菌黑色变种芽胞作用15分钟杀灭率达100％;浓度为含有效氯4000 mg/L对枯草杆菌黑色变种芽胞作用15分钟,杀灭率均达100％;浓度为含有效氯2000 mg/L对枯草杆菌黑色变种芽胞作用20分钟,杀灭率均达100％。芽胞悬液中含25％或50％小牛血清时作用40分钟或80分钟杀灭率达100％。结论：该含氯消毒剂性能稳定,可有效杀灭细菌芽胞。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.