基于WHO-FICs架构智力残疾儿童青少年身体活动与运动康复的健康结局：系统综述的系统综述

目的 基于世界卫生组织国际分类家族(WHO-FICs)构建智力残疾儿童青少年参与身体活动和运动康复的健康和功能结局的研究架构,系统分析智力残疾儿童青少年的主要健康与功能障碍表现、参与身体活动的方案以及健康和功能结局。 方法 运用《国际疾病分类第十一次修订本》(ICD-11)和《国际功能、残疾和健康分类》(ICF),对智力残疾儿童青少年身体活动干预方案以及健康与功能结局进行系统分析,构建智力残疾儿童青少年健康与功能状况、身体活动干预方案以及健康与功能结局架构。检索Scopus、PubMed、Embase、Web of Science、中国知网、维普、万方数据,收集建库至2022年8月18日公开发表的智力残疾儿童青少年参与身体活动与运动康复的健康及功能结局的系统综述,进行系统综述。 结果 最终纳入系统综述8篇,来自5个国家,包括190项随机对照试验和7 011例参与者,研究领域主要涉及智力障碍、儿童神经病学、康复科学、残疾与健康、适应性体育、特殊教育等,发表时间集中在2018年至2022年。常见的健康状况主要有唐氏综合征、孤独症谱系障碍、脆性X综合征、Prade-Willi综合征、智力障碍、认知障碍;身体活动干预形式分为体适能类、技能类和活动类3类,活动频率每周1~5次,活动强度为中-高强度,持续时间1周~1.5年;健康结局体现在智力功能和适应性行为、身体活动、心理行为健康与社会适应、整体生活质量和福祉方面。 结论 基于WHO-FICs构建了智力残疾儿童青少年参与身体活动和运动康复的健康效果的理论架构。智力残疾儿童青少年主要功能障碍表现为智力功能和适应性行为、活动和心理健康、生活质量和福祉3个层面。其中智力功能和适应性行为层面涉及概念性技能、社交性技能和实践性技能,活动和参与层面表现为低体育活动参与度、久坐和肥胖,活动能力低,没有发展基本运动能力和身体素质。生活质量和福祉层面涉及情绪和情感、自尊、一般自我概念、幸福感、友谊、与他人的关系或社会成熟度、生活质量和福祉等。身体活动方式可以分为体适能类、技能类和运动项目类。主要健康和功能结局主要表现在三个领域：智力功能与适应性行为,活动和参与以及心理行为健康与社会适应、生活质量和福祉。在智力功能和适应性行为领域,主要健康结局涉及认知功能(执行功能、认知可塑性、工作记忆等)、心理功能(情绪自我控制、自我价值和自尊)。在活动和参与领域,主要健康结局涉及体适能(肌力和肌耐力、速度、灵敏性)和动作技能(基本动作技能、平衡、核心稳定性),提高体育活动参与度,促进其更好地适应与赋能(社交、亲社会行为等),达成健康目标(降低疾病风险、缓解焦虑和抑郁、肥胖管理)。在心理行为健康与社会适应、生活质量和福祉领域,参与身体活动与运动康复可以提升儿童青少年整体的生活质量和福祉。     

Comparison of the postantibiotic and postantibiotic sub-MIC effects of levofloxacin and ciprofloxacin on Staphylococcus aureus and Streptococcus pneumoniae.

The postantibiotic subminimum inhibitory concentration effect (PA SME) may simulate in vivo drug exposure more accurately than the postantibiotic effect (PAE) since subinhibitory concentrations of drug persist between antibiotic dosings. In this study, we compared the PAEs and PA SMEs of levofloxacin and ciprofloxacin for clinical isolates of fluoroquinolone-susceptible Staphylococcus aureus and Streptococcus pneumoniae. At two times the MIC, PAEs of levofloxacin were an average of 0.6 h longer than the PAEs obtained for ciprofloxacin for methicillin-susceptible and methicillin-resistant S. aureus strains. The PAEs of levofloxacin and ciprofloxacin ranged from 1.8 to 3.1 and 1.1 to 2.4 h, respectively. Continued exposure of the methicillin-resistant strain to 1/16, 1/8, and 1/4 the MIC resulted in PA SMEs of 6.5, 15.3, and >22.3 h, respectively, for levofloxacin and 3.8, 8.0, and 12.3 h, respectively, for ciprofloxacin. For isolates of S. pneumoniae, at two times the MIC of both fluoroquinolones, the average PAEs of levofloxacin and ciprofloxacin were equivalent: 1.3 h for the penicillin-susceptible isolate and 0.6 h for the penicillin-resistant isolate. Continued exposure of the penicillin-susceptible S. pneumoniae strain to 1/16, 1/8, and 1/4 the MIC resulted in average PA SMEs of 1.0, 1.4, and 2.8 h, respectively, for levofloxacin and 1.8, 2.0, and 2.5 h, respectively, for ciprofloxacin. Continued exposure of penicillin-resistant S. pneumoniae to 1/16, 1/8, and 1/4 the MIC of the same fluoroquinolones resulted in average PA SMEs of 0.6, 1.1, and 2.9 h, respectively, for levofloxacin and 0.6, 1.1, and 1.5 h, respectively, for ciprofloxacin. The PA SMEs observed demonstrate the superior activity of levofloxacin against methicillin-susceptible or methicillin-resistant S. aureus. Although PAEs were similar for the penicillin-susceptible and penicillin-resistant S. pneumoniae strains, the PA SME of levofloxacin at one-fourth the MIC was longer for penicillin-resistant S. pneumoniae.     

基于ICF成年人休闲体育活动改善心理健康、生活质量和福祉的系统综述

目的 基于《国际功能、残疾和健康分类》(ICF)的理论与方法,建立成年人休闲体育活动和康复体育活动架构,对成年人的休闲体育活动和康复体育活动文献进行系统综述。方法 采用主题检索方式,检索建库至2021年6月30日Web of Science、PubMed、中国知网、万方数据库中身体活动领域成年人休闲体育活动和心理健康的相关文献,提取文献内容,对成年人休闲体育活动改善心理健康、生活质量和福祉的效果进行综述。结果 共返回文献1856篇,最终纳入23篇。主要来源于医学、公共健康、康复、身体锻炼等领域期刊,研究方法主要为问卷调查法、测量法、访谈法等。研究涉及的休闲体育活动形式主要为闲暇身体活动、闲暇娱乐活动、非闲暇身体活动、非闲暇娱乐活动。根据ICF架构,休闲体育活动促进成年人心理健康的效果主要体现在身体功能(b1精神功能、b152情绪功能、b140注意力功能、b144记忆功能、b163基本认知功能、b126气质和人格功能、b134睡眠功能、b130能量和驱力功能、b122整体心理社会功能、b180自身体验和时间体验功能以及b139其他特指和未特指的整体精神功能)和活动与参与(d6家庭生活,d7人际交往和人际关系,d8主要生活领域,d9社区、社会和公民生活);具体表现为缓解倦怠、焦虑、压力感、抑郁症状,降低抑郁风险,提高记忆力和执行功能,缓解注意力疲劳,提高生命活力和自尊,增加积极、乐观情绪,减少消极情绪,降低精神障碍和失眠风险,促进睡眠,提高主观幸福感、生活满意度和生活质量等。休闲体育活动改善与健康相关的生活质量,提高健康和福祉。影响成年人休闲体育的活动和参与的因素主要有环境因素和个人因素,包括e3支持和相互关系,e4态度,e5服务、体制和政策,具体表现为工作负荷、积极情感、社会支持、情感支持等。结论 休闲体育活动改善心理健康、生活质量和福祉的效果主要体现在缓解焦虑、抑郁等情绪,减少抑郁症风险;改善认知功能、睡眠状况;提高幸福感、生活满意度和生活质量等。将休闲体育活动作为康复体育活动的重要组成部分,使人们通过身体活动达到保健康复、娱乐放松,提高身心健康的效果;扩大心理健康保健、提高生活质量和福祉,有助于实现联合国2030可持续发展目标三：确保健康的生活方式,促进各年龄段人群的福祉。     

Ergonomics of medical lasers: operator's viewpoint

Lasers are instruments that may enhance the surgeon's ability to perform surgery. Many medical lasers sit unused. Lack of use is associated with "user unfriendliness." Nurses and surgeons often cite factors such as complexity, location, and types of controls, and content of displays. Other factors such as culture-ethnology and its relationship to command words and symbols, affect understandability of controls, displays, and user friendliness. Laser designers and engineers must analyze the interaction between laser users and products. Laser design and operation must coincide with specific needs and expectations of the nurses and physicians. Poor design and engineering compromises result in nonuse of expensive instrumentation, products which are ineffective for clinical use, and could potentially increase the risk of possible injury to patients and staff. This discussion of the design and operation of medical laser systems, presents the advantages and disadvantages of several laser systems. User interfaces for controls: color, function, touch activation, labels and size, sound cues, laser activation, type and amount of feedback information during operation; design of storage for accessories, and need for features such as pulsing, and milliwatts will be discussed. We will present what we consider to be an ideal laser system.     

Pragmatic utility: using analytical questions to explore the concept of ethical sensitivity

Ethical sensitivity is the means and capacity through which professionals strive to understand and compassionately respond to those in their care. As a transdisciplinary concept, ethical sensitivity can facilitate knowledge development across disciplines. To clarify and reduce ambiguities, the concept of ethical sensitivity was analyzed using the pragmatic utility method. With this method, the investigator uses analytical questions arising from in-depth understanding of the literature to synthesize data, to push beyond the limits of isolated findings and individual disciplines, to identify shared knowledge, and to provide new insights, lines of questioning, and direction. In this article, the role, technique, results, advantages, and limitations of the pragmatic utility method are elucidated. Characteristics of ethical sensitivity are its (a) preconditions of suffering and vulnerability cues, uncertainty, relationships characterized by receptivity and responsiveness, and courage; (b) attributes of moral perception, affectivity, and dividing loyalties; and (c) outcomes of client comfort and well-being, professional learning and self-transcendence, and integrity-preserving compromise. Use of the pragmatic utility method enhanced comprehension, meaning, relevance, and dimensions of the concept of ethical sensitivity as conveyed in the academic literature of selected professional disciplines.     

基于ICF-CY影响青少年久坐行为相关环境因素Scoping综述

目的 基于《国际功能、残疾和健康分类(儿童青少年版)》(ICF-CY)的理论与方法,分析青少年久坐行为相关环境影响因素的内容与结构,并对相关文献中涉及的问题进行Scoping综述。方法 采用Scoping综述方法,以中国知网、万方数据库、Web of Science核心合集为检索库,英文检索时间为建库至2020年1月31日,中文检索截止时间为建库至2020年4月20日,采用主题检索方式检索与青少年久坐相关的文献。提取文献内容,包括作者、国家、发表时间、发表期刊、研究目的、研究对象和年龄、数据收集工具以及主要研究结果和结论。结果 共检索文献3217篇,最终纳入21篇,主要来自8个国家,多数文献源于公共健康、公共卫生相关主题期刊,研究主要集中在2015年至2019年,研究方法多为调查法,对久坐行为的测量包括问卷和客观测量。根据ICF-CY环境因素架构,共得到17个影响因素,具有促进或障碍作用的因素共14个,其中用品和技术9项(e150、e160、e110、e115、e120、e125、e140、e165、e130),包括社区居所/锻炼场所设计、街道/土地利用,学校灵活学习空间、可调节高度课桌,家庭娱乐/运动设备;自然环境和对环境的人为改变2项(e225、e245),包括温度、湿度、季节、降雨量、日照时长;支持和相互联系3项(e310、e320、e325),包括家人、朋友、同伴活动参与/支持程度。态度,服务、体制和政策两个类目的研究较少。土地混合利用率、步行设施完善程度、感知邻里美学程度、行人/汽车交通安全程度、可调节桌椅设施与灵活教学空间的使用程度等指标越好,青少年久坐时间越短;家庭娱乐设备越多、街道连通性越高、日照时长较短、气候条件越差,青少年久坐时间越长。家人、朋友及同伴活动支持程度,空气质量,客观测量的社区居所/邻里等指标对青少年久坐行为的影响还有待进一步检验。结论 基于ICF-CY环境类目架构,影响青少年久坐行为的环境因素包括用品和技术、自然环境和对环境的人为改变以及支持和相互联系三大类。为使青少年养成健康生活方式,减少久坐时间,应从上述三类因素入手,消除消极环境因素的影响。     

Correlative imaging of the spatio-angular dynamics of biological systems with multimodal instant polarization microscope

The spatial and angular organization of biological macromolecules is a key determinant, as well as informative readout, of their function. Correlative imaging of the dynamic spatio-angular architecture of cells and organelles is valuable, but remains challenging with current methods. Correlative imaging of spatio-angular dynamics requires fast polarization-, depth-, and wavelength-diverse measurement of intrinsic optical properties and fluorescent labels. We report a multimodal instant polarization microscope (miPolScope) that combines a broadband polarization-resolved detector, automation, and reconstruction algorithms to enable label-free imaging of phase, retardance, and orientation, multiplexed with fluorescence imaging of concentration, anisotropy, and orientation of molecules at diffraction-limited resolution and high speed. miPolScope enabled multimodal imaging of myofibril architecture and contractile activity of beating cardiomyocytes, cell and organelle architecture of live HEK293T and U2OS cells, and density and anisotropy of white and grey matter of mouse brain tissue across the visible spectrum. We anticipate these developments in joint quantitative imaging of density and anisotropy to enable new studies in tissue pathology, mechanobiology, and imaging-based screens.     

Managing the symptoms of multiple sclerosis: a multimodal approach

BACKGROUND: Patients with multiple sclerosis (MS) may experience numerous symptoms, including spasticity, fatigue, cognitive dysfunction, depression, bladder dysfunction, bowel dysfunction, sexual dysfunction, and pain. OBJECTIVE: This article reviews the pharmacologic and nonpharmacologic interventions used to manage the symptoms of MS and discusses how interventions for a particular MS symptom may have an impact on other symptoms. METHODS: The English-language literature was reviewed through November 2005 using MEDLINE and the Cochrane Database of Systematic Reviews, with no restriction on year. The search terms included multiple sclerosis, disease-modifying therapies, adverse events, and combinations of multiple sclerosis with terms such as spasticity, fatigue, depression, mood disorders, pain, bladder dysfunction, bowel dysfunction, sexual dysfunction, cognitive dysfunction, and quality of life. RESULTS: The numerous options for the treatment of MS symptoms have shown varying degrees of efficacy and tolerability. Certain symptoms, if left untreated, may precipitate exacerbation of others. For example, spasticity may lead to pain and bladder and bowel dysfunction, whereas fatigue can compromise cognitive function. Similarly, the adverse effects of treatments for certain symptoms may further compromise other aspects of function. For example, the use of antidepressants may lead to sexual dysfunction, and treatments for spasticity and pain may cause sedation, which can worsen fatigue, cognitive dysfunction, and depressed mood. CONCLUSIONS: MS is associated with numerous symptoms that can be adversely affected by each other and by therapeutic interventions. Careful clinical monitoring and individualization of pharmacologic and non-pharmacologic therapies are recommended to manage the symptoms of MS, with the goals of improving or maintaining function and preserving the patient's quality of life.     

基于ICF-CY儿童青少年身体活动指南的内容分析与比较

目的 比较国内外儿童青少年身体活动指南的政策背景和理论依据、活动方式和活动量、收益以及影响因素,为相关指南的制定和实施提供理论依据和方法指导。 方法 运用《国际功能、残疾和健康分类(儿童和青少年版)》(ICF-CY)的分类架构对世界卫生组织、中国、美国、澳大利亚、加拿大(2套)等颁布的6套儿童青少年身体活动指南进行内容解析和编码。对指南的政策背景、理论依据、循证方法、推荐活动方式、活动量、收益以及影响因素进行内容分析。 结果 6套指南均依据相关国家的健康政策和身体活动与健康的理论;推荐的主要活动方式包括体适能、技能和运动项目三大类,推荐的活动量为每天至少60 min中等强度或高强度活动,每周至少3次高强度或增强骨骼肌肉功能的活动。身体活动有助于发展和改善身体功能,提升活动和参与水平,同时有助于形成良好的生活习惯,建立健康的生活方式,并改善相关环境因素。 结论 ICF-CY的理论架构、术语和编码是儿童青少年身体活动指南内容分析的有效工具。国内外儿童青少年身体活动指南均有其健康发展的政策背景和健康相关的理论依据。儿童青少年的身体活动有体适能、技能和运动项目三大类,且各指南推荐了中、高强度的活动量。身体活动有助于形成良好的运动习惯,形成积极的生活方式。为了促进儿童青少年的身体活动,需要建立适宜的环境,包括：产品和技术;自然环境和对环境的人为改变;支持和相互联系;态度;服务、体制和政策。     

应用“以药测机”理论研究2型糖尿病3期不同病机

目的:应用“以药测机”理论分析2型糖尿病3期的不同病机。方法:通过检索近10年分别治疗2型糖尿病前期、糖尿病期及糖尿病并发症期的文献,经过统计分析治疗疾病3期的不同药物分类、功效主治、性味归经的频次与频率,再通过药物的性质反推出疾病的病机。结果:糖尿病前期共检出中药369频次:以补虚药(105频次)与清热药(69频次)为主;功效以补虚、清热、利水渗湿、解表为主,频率为62.6%;药性以寒凉为主,频率为43.75%;五味以甘、苦、辛为主,频率为81.5%。归经以肝、脾、肾、肺、胃为主,频率为79.7%。糖尿病期共检出中药262频次:以补虚药(97频次)与清热药(78频次)为主;功效以补虚、清热、利水渗湿、活血化瘀为主,频率为80.5%;药性以寒凉为主,频率为67.06%;五味以甘、苦、辛为主,频率为87.5%;归经以肝、肺、脾、胃、肾为主,频率为79.1%。糖尿病并发症期共检出中药380频次:以补虚药(121频次)与活血化瘀药(87频次)为主;功效以补虚、活血化瘀、清热、解表为主,频率为73.9%;药性以温热为主,频率为58.2%;五味以甘、苦、辛为主,频率为83.2%;归经以肝、脾、肺、肾、胃为主,频率为80.8%。结论:糖尿病前期及糖尿病期治以清热益气养阴为主,且解表与利水渗湿并举。糖尿病并发症期治以益气补血、活血化瘀为主,且息风止痉与祛风寒湿并举。总体上以调理肝脾、补益肺肾治其本,重用清热、利水、行气、凉血、活血类药物治其标。从病机上看,糖尿病前期及糖尿病期的病机主要是气阴两虚、肺脾失调。随着疾病进展,“瘀”逐渐加重。当疾病发展成为并发症期时,其病机主要为气血两虚,痰瘀互结,肝肾失调。     

原发性甲状腺淋巴瘤与甲状腺未分化癌的临床、超声及病理特征对照分析

目的探讨原发性甲状腺淋巴瘤（PTL）和甲状腺未分化癌（ATC）在临床、超声及病理上的差异,以提高超声医师对两者的认识及诊断准确率。 方法选取2008年1月至2017年8月经手术病理或穿刺活检证实的PTL患者41例,其中,男性11例,女性30例,年龄28~81岁,平均年龄（60.8±12.5）岁;另选取同期经手术病理证实的ATC患者16例,其中,男性7例,女性9例,年龄18~88岁,平均年龄（65.1±15.1）岁。对照分析两组患者的临床、超声及病理特征。PTL组和ATC组患者年龄及病灶最大径比较,采用两独立样本t检验;临床资料包括性别、颈部肿块短期增大、吞咽困难、呼吸困难、声音嘶哑、远处转移以及超声表现包括边界、边缘、回声水平、条索样或网格样高回声、钙化、囊性变、后方回声增强、血流、颈部淋巴结肿大的比较,采用χ²检验及Fisher确切概率法;采用受试者工作特征（ROC）曲线评价超声特征的诊断效能。 结果临床特征对比结果：PTL组患者声音嘶哑、远处转移的发生率均低于ATC组,两组比较,差异均有统计学意义（P均<0.05）;两组患者在年龄、性别、颈部肿块短期内迅速增大、呼吸困难、吞咽困难等方面,差异均无统计学意义（P均>0.05）。超声特征对比,PTL组极低回声、条索样或网格样高回声、后方回声增强较ATC组多见,钙化、囊性变较ATC组少见,以上各项两组比较,差异均有统计学意义（P均<0.05）。两组患者在病灶大小,边界,边缘,血流,颈部淋巴结肿大等方面,差异均无统计学意义（P均>0.05）。ROC曲线分析显示,极低回声、条索样高回声、后方回声增强、缺乏钙化及缺乏囊性变诊断PTL的敏感度分别为61.7%、74.5%、89.4%、100.0%、100.0%,特异度分别为81.0%、81.0%、100.0%、57.1%、33.3%,ROC曲线下面积分别为0.713、0.777、0.947、0.786、0.677。病理特征对比结果：PTL为单克隆性增殖,瘤细胞大小、形态较一致,间质纤维化较多见。ATC具有显著的结构及细胞异型性,癌细胞大小不等,明显多形性,可有不同程度的肿瘤性坏死。 结论PTL与ATC的临床表现相似;病理特征具有显著差异;超声表现均有一定特征性,超声特征如极低回声、条索或网格样高回声、后方回声增强、缺乏钙化及囊性变有助于两者的鉴别诊断。     

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.     

汉语语义能力测验的编制及临床价值

目的编制汉语语义能力测验,并评价该测验的应用价值。方法45 例正常被试者和100 例脑损伤患者完成汉语语义能力测验。以正常被试为基础,计算敏感性、特异性和约登指数。结果测验总分敏感性0.96,5 个任务的敏感性分别为0.78、0.68、0.66、0.72 和0.64;特异性分别为0.96、0.96、0.98、0.96 和1.00;约登指数分别为0.60、0.46、0.42、0.39 和0.50。结论汉语语义能力测验具有良好的诊断和甄别语义损伤的能力,具有临床和科研应用价值。     

Pharmacokinetics and tolerability of teicoplanin in healthy volunteers after single increasing doses.

In this double-blind, randomized study, five healthy subjects per group received doses of 15, 20, or 25 mg of teicoplanin per kg of body weight, and one subject per group received a 0.9% NaCl placebo as single intravenous infusion over 30 min. Serial blood samples and urine were collected for 13 days postadministration, and concentrations of teicoplanin were determined by microbiological assay. The pharmacokinetic data were analyzed by noncompartmental and compartmental analyses. Laboratory safety tests, audiometry, and serum creatinine clearance measurements were done prior to day 1 and on days 2 and 14. In the three groups, peak levels at the end of the infusion averaged 194, 197, and 253 mg/liter, respectively. Mean concentrations in plasma 24 h after the administration were 10.5, 13.6, and 19.8 mg/liter, respectively. Mean values of volume of distribution at steady state were 0.80, 0.87, and 0.87 liters/kg, respectively. Terminal half-lives averaged 88, 83, and 92 h. Mean total clearance values were 10.9, 11.0, and 11.3 mg/h/kg, respectively, with renal clearance accounting for 75, 81, and 78%, respectively, of the total. The 13-day cumulative mean urinary recovery ranged from 71 to 78% of the dose within the groups. The pharmacokinetics of teicoplanin appears to be linear in the range of administered doses. Teicoplanin was generally well tolerated. Side effects, appearing in five subjects, were represented by fevers, chills, and skin reactions; these adverse reactions were mild, but one episode of rash necessitated the interruption of infusion, and one episode of chills necessitated treatment with corticosteroids. There was no indication of drug-related modifications of laboratory test results.     

Discovery of the causative organism of Weil's disease: historical view

On January 20, 1915, Inada and Ido announced the discovery of the causative agent of Weil's disease. Subsequently, on February 13, 1915, they published the first paper on the discovery of the causative organism (a new species of Spirochaeta) of Weil's disease. Besides discovering the causative organsim of the disease, Inada and colleagues clarified the pure culture in medium, and determined the source and route of the infection, its pathology and morbid anatomy; the distribution of the organism in various organs and tissues; the excretion of the spirochete, and its division, filterability, and morphological characteristics; and the clinical picture, laboratory findings, diagnosis, prophylaxis, and treatment of the disease. These studies were conducted by Inada, Ido, Kaneko, Hoki, and Ito, in the years 1914 to 1915. In the early investigation of leptospirosis, Inada and colleagues played a prominent part. We would like to remember these remarkably complete and definitive original achievements on leptospirosis made by Inada and colleagues. Received: August 21, 2000 / Accepted: December 12, 2000     

64层螺旋CT血管成像技术对主动脉夹层的显示能力

目的 评价MPR、CPR、VR、MIP和SSD后处理技术对主动脉夹层的破VI、内膜瓣和真、假腔的显示能力。方法39例拟诊为主动脉病变的患者作为本课题的研究对象，采用团注追踪法对所有患者行64层螺旋CT增强扫描，以3．5～4ml／s速率分别注射100ml非离子型对比剂和40～50ml生理盐水。39例病人均行MPR、CPR、VR、MIP和SSD重组，分别计算各种方法对破口、内膜瓣和真、假腔的显示率，以及显示破口的敏感性、特异性和准确性。结果MPR、CPR、VR和SSD对破口的显示率分别为80．9％、85．7％、19％和9．5％，对内膜瓣的显示率均为100％。MIP不能直接显示破口和内膜瓣。MPR、CPR、VR和SSD对真、假腔的显示率均为100％，MIP为76．2％。结论MPR和CPR对主动脉夹层显示的最好，VR和SSD次之，MIP最差。MPR和CPR显示主动脉夹层破口的敏感性、特异性、准确性明显高于VR和SSD。     

洗脱条件及其因素对凝血酶原复合物有效成分的影响

目的探讨洗脱条件及其因素对凝血酶原复合物(PCC)中凝血因子(F)Ⅱ、Ⅶ、Ⅸ、Ⅹ及蛋白(P)C、S、Z、抗凝血酶(AT)8种有效成分收率及比活的影响。方法选择洗脱条件中柠檬酸钠、NaCl、pH 3种可变因素,每因素取3水平,根据正交表配制不同洗脱体系;采用DEAE-Sephadex A-50凝胶,相同平衡、洗涤条件及上述不同洗脱体系,批式吸附法制备PCC浓缩物;检测浓缩物中8种成分的活性或含量,获得各成分的收率及比活;正交试验分析不同洗脱条件及其因素对8种成分收率及比活的影响。结果不同洗脱条件8种成分收率及比活有一定差异,2.4 mol/L NaCl条件比活总体较高。在所考察范围内,柠檬酸钠对FⅡ、FⅨ、FⅩ、PC、AT收率和PC、PS、AT比活有较大影响;NaCl对FⅦ、FⅩ、PS、PZ收率和FⅡ、FⅦ、FⅨ、FⅩ、PZ比活有较大影响。不同水平条件,柠檬酸钠及NaCl含量越高,4种凝血因子收率与比活越高,但对4种抗凝蛋白收率及比活影响无规律;pH6.6水平,4种凝血因子收率较高,pH6.9,其比活较高,pH对4种抗凝蛋白收率与比活的影响无规律。结论洗脱条件中高浓度的NaCl可提高PCC的整体比活;低浓度的柠檬酸钠对PCC有效成分收率及比活也有较大影响;pH对PCC中凝血因子(FⅡ,Ⅶ,Ⅸ,Ⅹ)收率及比活的影响分别有共性,对抗凝蛋白(PC,PS,PZ,AT)的影响则无规律。     

正确掌握老年病人的合理用药

老年人随着年龄的不断增长，各器官功能的逐渐减退，对药物的吸收、分布、代谢、排泄及其作用与青年人相比都有很大差异，又由于体弱多病，用药种类较多，药物的不良反应也随之增加。老年病人用药必须严格遵照药物的体内过程及药物代谢动力学理论，结合患者的生理、病理条件，合理使用药物，以取得最佳的疗效。正确掌握合理有效的用药，要结合老年人年高、体弱、多病的特点，选择最佳剂量、时间，合理的配伍和用药方法。既要考虑药物有效性、合理性和安全性，又要权衡药物疗效、配伍禁忌。临床医师必需要以对病人健康极端负责的精神，精通业务，通晓药理及有关知识，慎重、准确地使用药物，尽量避免药物不良反应的产生。确保老年病人的用药安全和疗效。     

Quick Reference Guide for Clinicians Managing Early HIV Infection

This Quick Reference Guide for Clinicians contains highlights from the Clinical Practice Guideline on Evaluation and Management of Early HIV Infection , which was developed by a private-sector panel of health care providers and consumers. Selected aspects of evaluating and managing patients, both adults and children, who are in the early stages of human immunodeficiency virus infection are presented. Topics covered include disclosure of HIV status, monitoring of CD4 lymphocyte counts, prevention of Pneumocystis carinii pneumonia and infection with Mycobacterium tuberculosis , initiation of antiretroviral therapy, treatment of syphilis, eye and oral care, performance of Papanicolaou smears. diagnosis of HIV infection in infants and children, preventive therapy for PCP and assessment of neurologic problems in HIV-infected children, pregnancy counseling, and development of a comprehensive case management system. Algorithms are included that show the sequence of events related to evaluating and managing early HIV infection in adults and children, as well as drug dosing tables for antiretroviral. PCP, and M. tuberculosis therapies. This Quick Reference Guide for Clinicians contains excerpts from the Clinical Practice Guideline , but users should not rely on these excerpts alone. Clinicians should refer to the complete Clinical Practice Guideline for more detailed analysis and discussion of the available research, critical evaluation of the assumptions and knowledge of the field, health care decision making, and references.     

不同吸附体系及因素水平对PCC中4类抗凝蛋白的影响研究

目的 探讨不同吸附体系及其柠檬酸钠、氯化钠、pH、电导4因素对凝血酶原复合物(PCC)中蛋白C、蛋白S、蛋白Z、抗凝血酶收率及比活的影响.方法 选择柠檬酸钠、氯化钠、pH3因素3水平设计正交试验,配制9种PCC平衡吸附体系;凝胶平衡后,吸附血浆,洗涤、洗脱,制备PCC浓缩物;测定浓缩物中蛋白C和S、抗凝血酶活性、蛋白Z含量、总体积及蛋白浓度,获得四类抗凝蛋白收率及比活,比较不同吸附体系收率、比活总趋势;利用正交试验直观分析法分析柠檬酸钠、氯化钠、pH对蛋白C、S和Z收率及比活的影响;测定吸附体系电导率,分析电导率与4类抗凝蛋白收率及比活的关系.结果 不同吸附体系4类抗凝蛋白收率及比活有较大差异,抗凝血酶二者均极低.柠檬酸钠对蛋白C收率及比活、蛋白S收率影响较大;pH对蛋白S比活、蛋白Z收率及比活影响极差分别为:0.120、6.847、0.716,高于其他因素;氯化钠对其影响均最小.柠檬酸钠浓度越低,蛋白C收率及比活越高,蛋白S收率则越低,0.015 mol/L水平蛋白Z收率为49.11％,高于其他水平,而蛋白S和Z比活最低;pH越低,蛋白Z收率则越高,pH7.0水平蛋白C和S收率及比活、蛋白Z比活最高;氯化钠浓度0.075 mol/L水平,蛋白C收率及比活、蛋白S和Z比活分别为:29.37％、0.533 IU/mg、0.401 IU/mg、2.362 μg/mg,均高于其他水平,而蛋白S、Z收率最低.不同电导率条件,蛋白C收率及蛋白Z比活变化较大,其中蛋白Z与S收率、蛋白Z与S比活、蛋白C收率与比活变化趋势基本一致;(10.00±0.20) ms/cm条件,蛋白C、S和Z比活较高.结论 不同吸附体系抗凝血酶收率及比活均极低,蛋白C、S和Z收率及比活间无规律性.氯化钠对蛋白C、S和Z收率及比活影响较小,柠檬酸钠、氯化钠、pH不同水平对蛋白C、S和Z收率影响效应无共性,0.01 mol/L柠檬酸钠,0.075 mol/L氯化钠、pH7.0水平蛋白C、S和Z比活最佳.电导率与四类抗凝蛋白收率及比活间无线性关系.