高效液相色谱法测定右旋儿茶素血浆浓度及药代动力学参数

本文建立了体液中右旋儿茶素的RP-HPLC测定方法。采用C_(18)键合相硅胶为填料的固相提取柱进行样品预处理,右旋儿茶素的提取回收率为79.8%.应用二极管阵列检测器对色谱峰纯度进行鉴定。该法精密度好,方法回收率近100%,日内、日间的变异系数为2.4～5.6%,血浓69.6～1160 ng/ml范围内呈线性关系,r=0.9993。家兔静注右旋儿茶素18mg/kg,其药代动力学过程符合二室模型,分布相半衰期为0.129 h,消除相半衰期为1.19h。     

Update on the management of obesity

This article updates a paper published in this journal more than a decade ago. We detail the ensuing decade's developments in the treatment of obesity, reviewing innovations, established techniques, and the current status of behavior modification. We evaluate newer developments, such as anorectic drugs, very low calorie diets, and intragastric balloon bezoars, and we describe other approaches to the treatment of obesity, such as residential and comprehensive outpatient programs. We conclude by recommending a multidisciplinary approach to this complex problem.     

Plasmids of Ewingella americana: supplementary epidemiologic markers in an outbreak of pseudobacteremia.

During an outbreak of pseudobacteremia in a children's hospital, Ewingella americana was found in blood cultures from 20 patients. E. americana was inoculated into blood culture bottles at the time of specimen collection due to cross contamination from nonsterile, citrated blood collection tubes used for coagulation studies. Antimicrobial susceptibility testing and plasmid profiling were used to assess the association between patient isolates and isolates from unused blood collection tubes. All E. americana isolates had similar antibiograms (i.e., resistance only to cephalothin) when tested at 37 degrees C. However, when the same isolates were tested for antimicrobial susceptibility at 25 degrees C, a different antibiogram (i.e., resistance to chloramphenicol, ampicillin, and cephalothin) was found. The majority of these isolates also demonstrated a unique four-plasmid profile (130, 56, 4.6, and 3.1 megadaltons), and two of these plasmids (130 and 56 megadaltons) were characterized as temperature-sensitive plasmids. An epidemiologic link between outbreak-associated isolates obtained from different time periods in the outbreak was supported by evidence of a significant trend in the ability of the outbreak-associated isolates to reduce nitrate, together with the presence of the resistance antibiogram at 25 degrees C and the demonstration of the unique four-plasmid profile.     

Unusual Enterobacteriaceae: H2S+ Shigella sonnei, one authentic and one false positive due to contamination with the obligate anaerobe Eubacterium lentum.

A mixture of Shigella sonnei and Eubacterium lentum produced H2S in triple sugar iron agar; however, neither produced any in pure culture. A second culture of S. sonnei, isolated in Japan, is thought to be the first documented H2S+ Shigella.     

Case study: a treatment approach for a resistant knee extension contracture

A function-limiting knee extension contracture following an intra-articular femur fracture was treated with traditional conservative and surgical intervention without satisfactory results. A new treatment program was planned which included a combination of heat, ice, prolonged passive stretch, and exercise. The patient regained functional knee flexion and was able to return to preinjury athletic activities. The treatment protocol described offers a time consuming, but effective approach to treating knee extension contractures resistant to surgical and traditional conservative management. J Orthop Sports Phys Ther 1986;7(4):159-162.     

An audit of occupational medicine consultation records

There is a need to develop and test methods of audit of theconsultation process in occupational medicine and to draw conclusionsfrom the findings. An external audit was carried out on 313randomly selected consultation records from the occupationalhealth services of three health boards over a 26-month period.Additionally, nine months after the date of the first externallyaudited sample, a prospective internal audit was commenced withinone board. In 58 of the consultations selected (19 per cent),audit was not possible mainly because records could not be found.In an appreciable proportion of the rest, there were shortcomingsin the referral record or in the consultation record. The consultationrecords of ‘career’ occupational physicians werebetter than those of ‘non-career’ physicians, especiallyin recording specific diagnoses (91 per cent vs. 67 per cent;P<0.0001) and in conclusions regarding occupational implications(86 per cent vs. 74 per cent; P<0.0001). Multivariate regressionsshowed a highly significant improvement associated with prospectiveinternal audit in one item, namely the record of occupationalimplications. However, the magnitude of this difference beforeand after audit was smaller than the independent differencearising from the career status of the physicians. The valueof medical audit in improving quality of care and educationin occupational medicine is discussed.     

Radiologically placed temporary hepatic artery catheter for treatment of liver cancer

Hepatic artery infusion (HAI) chemotherapy is associated with higher response rates compared to systemic chemotherapy in those patients with unresectable liver malignancies. Operative hepatic artery catheter (HAC) insertion has significant morbidity and mortality, especially in patients with high‐volume disease, some of whom may not respond to HAI chemotherapy. We report our experience in 45 patients with high‐volume liver disease who were initially treated with HAI chemotherapy via a radiologically placed temporary HAC to try to select the responders who then went on to have an operative HAC. In these 45 patients who had 62 radiologically placed HAC, we found very few major complications, and certainly no complications such as cholecystitis, vascular or malperfusion problems.