Determination of total CO2 in plasma by automated flow-injection analysis.

We describe a procedure for measuring total CO2 in plasma, based on the principles of the flow-injection analysis technique, which makes use of unsegmented fast-flowing reagent streams, as developed by R?zi?ka and co-workers. The further methodological design resembles the silicone-rubber membrane technique of Kenny and Cheng. CO2 in the sample is released by reaction with H2SO4. Appropriate amounts of CO2 permeate through the membrane that separates the acid reagent streams and a buffered cresol-red indicator system. The experimental set-up and functioning of this system are described.     

Electrochemical enzyme immunoassay for phenytoin by flow-injection analysis incorporating a redox coupling agent

Using phenytoin as a model analyte, we demonstrate an electrochemical enzyme immunoassay based on flow-injection analysis and incorporating 2,6-dichloroindophenol (DCIP) as a redox coupling agent. DCIP reacts with NADH to form NAD+ and DCIPH2, the reduced form of the coupling agent. The production of DCIPH2 is monitored at +250 mV vs Ag/AgCl. This low applied potential improves selectivity in the biological matrix, differentiating against components that are oxidizable at the more-positive potentials required for direct electrochemical detection of NADH. The kinetics-based assay also eliminates other common interferences, mainly from ascorbic acid and glutathione. This system does not require precolumns or analytical columns for isolation of the NADH response. Good agreement with a routine clinical laboratory procedure for phenytoin is obtained for clinical samples (r = 0.95), illustrating the feasibility of such an approach.     

情绪障碍儿童人格特征的对照分析

目的:采用问卷测量法分析儿童情绪障碍的个性特征。并与同龄正常儿童对比。方法:病例组为2003-09/2004-09在首都医科大学附属北京儿童医院就诊并全部接受微量生物电脑导入刺激治疗的30例情绪障碍儿童。对照组选取北京市某中学初一年级平均年龄为12岁的健康儿童30例。家长全面知情同意。采用个别和团体施测法,使用儿童艾森克人格问卷对各组儿童进行人格测评,艾森克人格问卷包括精神质、内外向、神经质、情绪的稳定性和掩饰性4个维度。各维度分用标准分(T)表示,以标准分38.5和61.5为划分界。由儿童自己填写问卷,年龄较小,阅读能力较差者,由心理评估人员阅读,儿童自己选择答案。结果均输入软件进行分析评价和保存。并与对照组及常模进行比较。结果:病例组发放问卷30份,收回合格问卷30份,有效率100%。对照组发放问卷35份,收回有效问卷30例,有效率86%。①与对照组相比,病例组的艾森克人格问卷内外向维度(E)分低,神经质维度(N)分高,差异有极其显著性意义(P<0.001)。②病例组与对照组男女之间艾森克人格问卷维度比较无差异。所设对照组与全国常模比较也无差异。③情绪障碍儿童人格特征更多倾向于内倾、情绪不稳定和抑郁质,分别占80%,90%,73%,显著高于对照组,差异极其显著(χ2=17.333,31.729,31.729,P<0.001)。结论:情绪障碍儿童的个性多为极端内向,情绪不稳定,属于抑郁质。这些不良人格特征阻碍儿童健康发展并且可诱发多种心理和精神疾病。但发育性的儿童个体,其人格处于发展过程中,具有可塑性。有针对性地教育引导,及早了解儿童的内心活动,可使其负性情绪及时有效的得到宣泄。良好的环境和教育,可以减少和消除由遗传造成不良人格特征的影响,促进儿童正常人格特质的形成和发展。     

Repair of dentine-related lesions without a drill or injection

For covering the shortages of traditional treatments, a novel and non-invasive system was developed with the simple adaption of nature''s own repair process, while an extrinsic electric field was introduced to improve its remineralization kinetics. In an in vivo study, acid-etched rabbit dentine was used to evaluate the remineralization efficacy and safety of the system. The exposed dentine tubules were fully occluded after 5 hours/1.0 mA and 8 hours/0.5 mA of remineralization. After 5 hours of remineralization (1.0 mA), the micro-hardness of the demineralized dentine was fully recovered, equal to native rabbit dentine. Haematoxylin–eosin staining demonstrated no obvious inflammatory reaction. This study provides a feasible solution to realize rapid repair of dentine.

For covering the shortages of traditional treatments, a novel and non-invasive system was developed with the simple adaption of nature''s own repair process, while an extrinsic electric field was introduced to improve its remineralization kinetics.     

Competitive heterogeneous enzyme immunoassay for theophylline by flow-injection analysis with electrochemical detection of p-aminophenol

A competitive enzyme-linked immunoabsorbent assay based on the flow-injection amperometric detection of p-aminophenol has been investigated with use of the materials and general procedure of a commercial kit for the determination of theophylline in human serum. The antibody is immobilized on glass beads, and the enzyme label is alkaline phosphatase (EC 3.1.3.1). The high currents generated during the electrochemical detection allowed a rapid (35 min) and simple determination of theophylline throughout its therapeutic range (10-20 mg/L) and also in the subtherapeutic range (detection limit of about 80 micrograms/L).     

银杏达莫与丹参注射剂对照急性脑梗死的Meta分析

背景:丹参注射剂和银杏达莫是治疗脑梗死的常用中药制剂.近年来,多篇临床研究证实银杏达莫治疗脑梗死的效果优于丹参注射剂.但由于病例数少,影响实验的可信度.目的:评价银杏达莫与丹参注射剂治疗急性脑梗死的临床疗效.方法:全面检索中国医院数字图书馆和万方数据库1998-01/2010-02发表的关于银杏达莫与丹参注射剂对照治疗急性脑梗死的随机对照临床试验.纳入符合1995年第4次全国脑血管病学术会议修订的脑梗死诊断标准,并经头颅CT或MRI扫描证实为急性脑梗死的患者.排除没有基础治疗,诊疗方法中含有其他影响疗效观察的因素或联合用药对结果有明显影响的研究.按Cochrane 协作网的质量评价纳入研究的方法学质量,运用Jadad评分标准评价纳入文献的方法学质量,用ReviewManager 5.0软件进行荟萃分析.临床评价指标包括治疗总有效率、血液流变学指标变化、神经功能缺损评分比较.结果与结论:共纳入15个随机对照研究,包括1 614例患者.Meta分析结果显示,银杏达莫治疗急性脑梗死临床有效率明显高于丹参注射剂(OR=3.70,95%CI:2.81～4.88,P < 0.01),改善血液流变学的作用明显强于丹参注射剂,血浆黏度效应值(SMD=-1.01,95%CI:-1.69～-0.32,P < 0.01),红细胞聚集指数效应值(SMD=-0.25,95%CI:-0.36～-0.14,P < 0.01);对神经功能缺损的恢复也明显强于丹参注射剂(SMD=-0.73,95%CI:-0.88～-0.59,P < 0.01).说明银杏达莫治疗急性脑梗死的疗效优于丹参注射剂.     

Brain metastasis: analysis of patients without known cancer

Our retrospective review of the charts of patients receiving radiation therapy for brain metastasis revealed that one third presented neurologic symptoms without prior diagnosis of cancer. Lung cancer was detected in two thirds of this group, and in one third, the primary site remained unknown. There was good clinical and CT correlation.     

Automated fluoroimmunoassay of theophylline and valproic acid by flow-injection analysis with use of HPLC instruments

For automated determination of theophylline and valproic acid by use of Ames' fluoroimmunoassays we used a high-pressure liquid-chromatographic system consisting of a pump, a robotic unit (Gilson 231/401, to prepare and inject the samples into the flowing carrier), and a fluorometer with a 10-microL flow cell. Results correlated well with those of conventional liquid- and gas-chromatography (r less than 0.96). The between-run CV is about 5%. In comparison with the manual method, the volume of reagents (and thus the cost per analysis) was decreased by eightfold.     

容易误诊的无呼吸道症状的老年人肺炎

随着社会人口的老龄化,老年肺炎越来越受到临床重视.老年肺炎患者绝大多数仍以呼吸道症状为主要特征,但是呼吸道症状完全缺如的肺炎也并不少见,因此,提高对无呼吸道症状的老年肺炎的认识是早期诊断治疗的关键.我院1997年2月～2000年2月收治老年人肺炎64例,其中无呼吸道症状者18例,占28.1%,现分析如下.     

Manipulation under anesthesia for frozen shoulder with and without steroid injection

OBJECTIVE: To study the effect of manipulating a shoulder with adhesive capsulitis (frozen shoulder) under anesthesia with and without corticosteroid injection. DESIGN: Randomized trial. SETTING: Hospital. PARTICIPANTS: Twenty-four patients referred for manipulation of a frozen shoulder. INTERVENTION: The patients were randomized into 2 groups. One group received an injection of corticosteroid and manipulation; the other was only administered manipulation during anesthesia. MAIN OUTCOME MEASURES: The degree of shoulder mobility and pain before and after the manipulation. RESULTS: Manipulation under anesthesia increased the mobility of the affected shoulder. Injection with lidocaine and betamethason did not enhance the effect of the manipulation. CONCLUSION: Manipulation under anesthesia without intraarticular corticosteroids is recommended as the therapy for frozen shoulder.     

Patient-controlled analgesia versus conventional intramuscular injection: a cost effectiveness analysis

BACKGROUND: In previous studies comparing patient-controlled-analgesia and intramuscular pain management have been unable to provide conclusive evidence of the benefits of either method of postoperative pain control. AIM: The purpose of the study was to compare the efficacy and cost-effectiveness of intravenous patient-controlled-analgesia with intermittent intramuscular morphine for Chinese women in the first 24 hours following elective gynaecological surgery. METHODS: A randomized control design was used. The main outcomes were level of pain and cost for the two types of pain management. Participants indicated their level of pain at rest and when deep breathing or coughing on a 100 mm Visual Analogue Scale, on seven occasions within 24 postoperative hours. Costs for the two types of pain management were based on the costs of equipment, drugs and nursing time. RESULTS: A total of 125 women participated in the study. Mean pain level over the 24 hours in the patient-controlled-analgesia group was significantly lower than in the intramuscular group (P < 0.001). Mean pain level over the seven occasions for the patient-controlled-analgesia group was 11.83 points (95% CI 7.14-16.52) lower when at rest and 11.73 points (95% CI 5.96-17.50) lower during motion than the intramuscular group. Cost per patient was $81.10 (Hong Kong) higher for patient-controlled-analgesia than for intramuscular pain management. Women in the patient-controlled-analgesia group had significantly greater satisfaction with pain management than those in the intramuscular group (P < 0.001), but reported significantly more episodes of nausea (P < 0.05). CONCLUSIONS: While patient-controlled-analgesia was more costly, it was also more effective than conventional on-demand intramuscular opioid injections after laparotomy for gynaecological surgery.     

Targeted mutagenesis: analysis of phenotype without germ line transmission.

The available techniques for directed gene manipulation in the mouse are unprecedented in any multicellular organism and make the mouse an invaluable tool for unraveling all aspects of mammalian biology. To realize fully the potential of these genetic tools requires that phenotypic analysis be efficient, rapid, and complete. Genetic chimeras and mosaics, in which mutant cells are mixed with wild-type cells, can be used to augment standard analysis of intact mutant animals and alleviate the time required and the expense involved in generating and maintaining multiple strains of mutant mice.     

Migraine without aura: genome-wide association analysis identifies several novel susceptibility

We discuss the comments on our article “Sleep quality, arousal and pain thresholds in migraineurs. A blinded controlled polysomnographic study” published in JHP 2013 Feb 14;14(1):12. We hypothesize that migraineurs need more sleep than healthy controls and more sleep than they manage to achieve. Some migraineurs probably have a decreased ability to process incoming stimuli. Increased spontaneous pain may follow either sleep restriction or sleep disturbance. A comparison of migraineurs with attack onset related to sleep, migraineurs with attack onset not related to sleep and controls will be reported in another paper.

     

红外热像图评估腰大肌肌沟注入空气对神经阻滞药物扩散范围及止痛效果的作用

背景:红外热像学利用红外线辐射成像原理观察人体表面温度变化,从而反映人体生理病理现象.目的:应用红外热像图评估比较腰大肌肌沟注入与不注入空气行利多卡因阻滞药物扩散范围及止痛效果.设计、时间及地点:同期非随机分组对照观察,于2005年在延边医学院附属医院完成.对象:选择2005-01/12延边医学院附属医院疼痛科住院的L3～S1腰椎间盘突出引起坐骨神经痛而未达到手术指征的32例患者.分为不注空气组15例,注空气组17例,2组患者在性别、年龄方面差异无显著性(P>0.05).方法:两组患者均在CT引导下行腰大肌肌沟利多卡因阻滞.CT扫描确认针尖的位置在腰大肌肌沟后,注气组回抽无液无血时推注20mL的空气,两组患者均给予15g/L利多卡因20mL缓慢推注.1次/d,12d为1个疗程.主要观察指标:①观察进针深度、药物扩散范围及治疗前、推药后20min和疗程结束后采用红外热像图仪测试双下肢温差.②治疗前后采用目测类比评分(VAS)法进行疼痛评分.结果:①男性和女性进针深度差异无显著性意义[(6.2±0.7)cm,(5.8±0.6)cm, P>0.051.②CT扫描观察注空气组药物扩散范围大于不注空气组(P<0.01).③不注空气组双下肢温差治疗前、推药后20min及疗程结束后差异均有显著性意义[依次为(0.69±0.66),(0.33±0.14),(0.34±0.16)℃,P<0.0⑤;注空气组双下肢温差治疗前、推药后20min和疗程结束后差异均有显著性意义(依次为(0.53±0.19),(0.32±0.21),(0.24±0.14)℃,P<0.05);两组之间治疗后差异均无显著性意义(P>0.05).④两组治疗后VAS评分均较治疗前明显下降,(P<0.05),治疗后组间比较差异无显著性意义(P>0.05).结论:注入和不注入空气行腰大肌肌沟神经阻滞治疗坐骨神经痛,药物扩散范围有差异性,但疗效无明显差异.     

早期康复治疗对无并发症急性心肌梗死患者QT间期离散度的影响

目的探讨早期康复治疗对无合并症急性心肌梗死 (acute myocardial infarction ,AMI )患者 QT间期离散度( QTd)的影响. 方法 113例研究对象前瞻性随机分为早期康复治疗组 (组 1, 54例 )及对照组 (组 2, 59例 ). 2组主要基线资料具可比性.组 1采用早期康复治疗方案,组 2采用传统康复方案.所有研究对象分别在入院当时 [平均( 9.3± 1.9) h]第 1周末、第 2周末、第 3周末记录标准 12导联心电图. QT 间期的测量从 QRS 波起点至 T波终点,同一导联测量 3个心动周期,取其平均值.不同导联最大减去最小 QT值为 QTd 值. 结果早期康复组入院当时、第 1 周末、第 2 周末、第 3周末 QTd[分别为 (64± 14)ms,(46± 15)ms,(43± 12)ms,(39± 13)ms]与对照组 [分别为 (67± 12)ms,(48± 16)ms,(41± 13)ms,(40± 15)ms]比较统计学上无显著性差异( t分别为 0.81,0.68,0.85,0.38, P >0.05). 结论无合并症 AMI 患者实行早期康复治疗不影响 QTd 值,因而不影响心肌电稳定性,提示该组患者早期康复治疗安全可行.