RP-HPLC法测定钩吻生物碱

用RP-HPLC法分离和测定了钩吻碱甲(G),钩吻碱戊(F),胡蔓藤碱丙(D)、胡蔓藤碱乙(B)及胡蔓藤碱甲(A)。用常山碱为内标。分析柱C₁₈,甲醇—水—正丁胺(78:22:0.1 V/V)为流动相,流速1.0 ml/min,检测波长256 nm。线性范围0.02～0.12μg,相关系数r=0.9835～0.9977,回收率95.01～99.70%。本方法简便、灵敏、重现性好,为生产及临床用药提供质量控制依据。     

苦木中生物碱测定方法的研究

本文报道了在高效硅胶薄层上用氯仿(水饱和)—甲醇(40:0.5)展开系统,分离了苦木中三种咔巴林生物碱(Ⅰ,Ⅲ,Ⅳ)及一种铁屎米酮生物碱(Ⅱ)。用甲酸处理后,薄层扫描法测定。本法决速、灵敏,检出限度可达1×10^-8g,各生物碱的线性范围为0.05～0.3μg,并用此法测定了十一个不同地区及不同部位的苦木生药中的生物碱含量。     

Smallpox: residual antibody after vaccination

Of all the microorganisms and toxins, poxviruses (Orthopoxvirus) have the greatest potential for use by terrorists. These viruses can spread rapidly through the environment following initial infection. In 1980, the World Health Organization Eradication Program discontinued vaccination for smallpox and declared that the disease had been eliminated. With the threat of smallpox virus as a bioterrorism weapon, questions have been asked about the persistence of protection (as offered by antibodies) following vaccination with vaccinia virus vaccine. To address this, sera from 204 adults vaccinated as children were tested by enzyme immunoassay (EIA) for the presence of vaccinia virus antibody. Of the 204 individuals whose sera were examined for the presence of vaccinia antibody, 165 (80.9%) had been vaccinated once and 39 (19.1%) had been vaccinated at least twice. Of the 165 sera from individuals vaccinated once, 112 (67.9%) were positive. Of the 39 sera from individuals vaccinated more than once, 31 (79.5%) were positive. The presence of a vaccination scar at the time of blood collection was not determined. Fifty-six nonvaccinated individuals, under 30 years of age, were tested by EIA; four of these (7.1%) were positive for vaccinia virus antibody by EIA. Forty-four EIA-positive and 16 EIA-negative sera were also tested by serum neutralization (SN) as a comparison with the EIA test results; one serum (negative by EIA) was SN positive. No attempt was made to ascertain any demographics other than age (date of birth) and "remembered" times of vaccination.     

Displaced intra-articular calcaneal fractures: variables predicting late subtalar fusion

OBJECTIVE: The goal of the current study was to analyze the prospective clinical outcome of patients who failed closed or open treatment of a displaced intra-articular calcaneal fracture. This cohort of patients required a secondary subtalar fusion by distraction bone-block arthrodesis. DESIGN: Review of prospective, randomized trial database. SETTING: Four level I trauma centers. PATIENTS: Between April 1, 1991 and December 31, 1997, 424 patients with 471 displaced intra-articular calcaneal fractures were involved in a large, multicenter, randomized trial. Forty-four patients who required subtalar fusion following initial treatment of a displaced intra-articular calcaneal fracture were compared to the population of patients who did not require subtalar fusion. The variables compared between the two groups included B?hler angles, two computed tomography classification systems, and clinical scores including SF-36, visual analogue score, and oral analogue score. INTERVENTION: Subtalar distraction bone-block arthrodesis with tricortical bone graft was used in all 45 feet. MAIN OUTCOME MEASUREMENTS: The following were examined: x-ray fracture classification, specifically B?hler angles and Essex-Lopresti classification; computed tomography classification, specifically Sanders and Crosby; clinical scores, specifically validated visual analogue score, general health survey scores, oral analogue score, and other factors (i.e., patient demographics including age, sex, profession, smoking history, and Worker's Compensation Board involvement. RESULTS: Initial treatment of the 44 patients in our study was nonoperative in 37 (84%) patients and operative (open reduction and internal fixation) in 7 (16%) (1 patient had bilateral heel fractures). Patients requiring fusion differed demographically from those patients not requiring fusion. Mean age was 39 years in both the fusion and nonfusion group. The fusion group had 97% males, whereas the nonfusion group had 89% males. Sixty-four percent of the fusion patients were Worker's Compensation Board claims, whereas 35% of the nonfusion group were Worker's Compensation Board claims. Of those that required fusion, 77% were heavy laborers. On average, the fusion group had a B?hler angle 15 degrees less than the nonfusion group. Forty-six percent of the fusion patients were Sanders-type IV initial fractures. Logistic regression analysis revealed that the primary predictors of requiring fusion were Worker's Compensation Board status (odds ratio = 3.03, 95% confidence interval = 1.41-6.57), Sanders-type IV (odds ratio = 5.48, 95% confidence interval = 1.57-19.18), B?hler angle <0 degrees (odds ratio = 10.64-95% confidence interval = 1.33-85.17), and nonoperative initial treatment (odds ratio = 5.86-95% confidence interval = 2.33-14.67). CONCLUSION: These data suggest that the amount of initial injury involved with the calcaneal fracture is the primary prognostic determinant of long-term patient outcome. B?hler angle on presentation of <0 degrees was 10 times more likely to require a secondary subtalar fusion than a B?hler angle on presentation of >15 degrees. Sanders-type IV calcaneal fractures were 5.5 times more likely to be fused than a simple Sanders type II fracture. Worker's Compensation Board patients were three times more likely to be fused than non-Worker's Compensation Board patients. Nonoperative care was six times more likely to lead to a late fusion as compared to open reduction and internal fixation treatment. Late fusion provided relief from pain and improved function as evidenced by an improvement in visual analogue score postsurgery. This study demonstrates that there is a distinct patient group with a displaced intra-articular calcaneal fracture who are at high risk of subtalar fusion. These include male Worker's Compensation Board patients who participate in heavy labor work with a fracture pattern with B?hler angle less than 0 degrees. If their initial treatment was nonoperative, the likelihood of requiring late subtalar fusion was significantly increased. Initial open reductional open reduction and internal fixation of patients with displaced intra-articular calcaneal fracture minimized the likelihood that subtalar fusion would be required.     

长春市儿童医院1998～2001年轮状病毒哨点监测分析

目的 为在中国开发和应用轮状病毒疫苗提供流行病学背景资料。方法 以医院为基础的哨点监测,在长春市儿童医院5岁以下腹泻患儿中进行,收集患儿临床资料和粪便标本,轮状病毒检测用聚丙烯酰胺凝胶电泳(PAGE)和／或酶联免疫吸附试验(ELISA),毒株分型用ELISA和／或逆转录-聚合酶链反应(RT—PCR)。所有资料录入计算机进行数据分析。结果 3年监测中共调查2343例腹泻患儿,收集便样1211份,轮状病毒检出率门诊患儿和住院患儿分别为31．0％和52．9％。轮状病毒感染95．0％发生于2岁以下儿童。每年寒冷季节流行(11月到次年3月)。流行的轮状病毒G血清型依次为G1(82．4％)、G2(5．0％)、G3(3．3％)和G4(0．9％),P基因型以P[8]和P[4]为常见。共检出9种P～G结合的毒株,其中世界常见的4种流行株占75．6％。结论 轮状病毒流行毒株呈现超常多样性,轮状病毒是长春地区儿童重症腹泻的主要原因。