Arthroscopic chondrectomy as a treatment of cartilage lesions

Although favorable effects of débridement with chondrectomy and drilling or abrasion have been reported in treating of cartilage lesions in the knee joint; however, in most cases an additional intervention is generally performed during arthroscopy. We studied 53 consecutive patients with solitary chondral lesions in the weight-bearing part of the knee and treated 86 cartilage lesions by arthroscopic débridement, including a detailed removal of damaged or undermined cartilage. We evaluated the postoperative course by questionnaire (mean follow-up 6.5 years, response rate 83%). All patients reported a positive effect of chondrectomy: 69% considered the knee considerably better or cured and 77% regarded the effect as permanent. There was no complication of the arthroscopies performed, and no patient noted any deterioration in the condition. We therefore recommend routine chondrectomy of cartilage lesions when these are found during an arthroscopy.     

d-生物素的立体专一性全合成研究

对confaione的d-生物素(1)全合成进行了改进,从半胱氨酸计算,总收率3.7%。5与4-溴代三苯膦丁酸甲酯进行Wittig-Schlosser缩合反应可立体专一性地转化成反式-烯(6)。以叠氮三甲基硅烷代替叠氮化锂亲核进攻9分子中C3-溴原子,可显著地提高顺式-叠氮内酰胺10的收率。     

柱切换HPLC法测定豚鼠体内诺氟沙星银解离物诺氟沙星的浓度

用柱切换HPLC法建立了豚鼠血浆和皮下组织液中诺氟沙星银体内主要解离物诺氟沙星的测定方法。预处理柱为μ-BondapakC₁₈,37～50μm,50mm×5mmID;分析柱为YWG-C₁₈,10μm,150mm×5mmID。预处理流动相为0.008mo1/L磷酸缓冲液,流速为3ml/min;分析流动相为甲醇—0.008mol/L磷酸缓冲液—0.05mol/L四丁基溴化铵(25:75:4)。紫外检测波长为280nm。皮下组织液及血浆中的线性范围分别为100～3200ng/ml(r=0.9999)和2～128μg/ml(r=0.9999);最低检测浓度分别为10ng/ml和0.25μg/ml,方法的平均回收率为102%,日内及日间偏差均小于7%。     

Evaluation of a new device for measuring oral mucosal surface friction

Abstract – For the objective measurement of oral mucosal dryness or moisture, a device registering oral mucosal surface slide friction has been developed. Two prototypes, Probe I and Probe II, have been tested. Probe I was constructed for initial testing of the method and was based on easily accessible electrical components. Probe I was computerized and developed for more accurate registration and also for easy handling. Reliability and validity tests were carried out on Probe I as well as on Probe II. In repeated in vitro measurements, the probes showed good reproducibility. Validity was assessed on healthy subjects injected with methylscopolamine nitrate submucosally in the labial sulcus. All subjects experienced a pronounced oral mucosal dryness within half an hour. Registration with the surface slide friction device showed maximum friction values 1-2 h after injection. These reliability and validity tests gave good results for both Probe I and Probe II, but Probe II had several practical advantages over Probe I. Both probes were considerably more sensitive to changes of the oral mucosal surface than the previously used simple friction test using the back of a mouth mirror.     

双能X射线骨密度仪测量不同个体腰椎椎骨骨面积、骨矿含量的精度差异

目的：对不同个体椎骨短期精度进行观察,发现骨质疏松的严重程度不同其短期精度不同。分析DPX-MD双能X射线骨密度仪测量不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的短期精密度,了解上述指标对骨矿含量或骨密度测定的影响,以便为骨矿含量或骨密度检测质量控制和减少误差提供依据。 方法：实验于2004-05/2006-12在川北医学院人体解剖实验室与川北医学院附属医院内分泌科骨密度室完成。①对象：铝体模;3个活体椎体（38岁骨密度正常男性;40岁骨质疏松症男性;62岁轻微骨量减少女性）;1个带软组织的死体椎体（由川北医学院人体解剖实验室提供）。②方法及评估：采用美国Lunar公司生产的DPX-MD双能X射线骨密度仪测量各椎体的椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽。3次/d,连续测定5d。铝体模和死体椎体两端均用小木块固定在6.5cm的高度,放在15cm的水浴中,为减少误差由一人操作。由不同椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽可得到各自的变异系数。 结果：①腰椎各椎体和L2～4的骨矿含量的变异系数：各椎体或L2～4骨矿含量变异系数从正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大。②各椎体和L2～4的椎骨面积、椎体宽、椎体高的变异系数：椎骨面积、椎体宽的值从铝体模、正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大,尤其是轻微骨量减少女性椎体与死体椎体较大;椎体高的变异系数以骨质疏松症男性椎体与轻微骨量减少女性椎体较大,尤其是轻微骨量减少女性椎体的变异系数最大。 结论：不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的精度不同,对骨密度测定的影响不同。椎间隙欠清楚者由于椎体分椎线难于确定,椎体高度的测定对骨密度测定影响较椎间隙清楚者大;有骨质增生和骨质疏松越严重者由于椎体边缘线难于确定,椎体宽度的测定对骨密度测定影响较无骨质增生和骨密度正常者大;有骨质增生存在和骨质疏松越严重,骨面积的测定对骨密度测定影响越大;骨质疏松越严重,骨矿含量测定对骨密度测定影响越大。     

重庆居民与流动人口结核病就诊及诊断的延迟因素：隐蔽性调查分析

目的:调查重庆居民及流动人口结核病就诊及诊断延迟情况,探索在其过程中存在的问题,分析问题产生的原因。方法:在重庆市主城区按照经济发展水平的不同选取了两个区Y和J,采用方便抽样的方法在Y区抽取了一家综合性医院的呼吸科门诊R,在J区抽取了一家综合性医院的一般基层门诊P,于2005-10-10/14和2005-10-17/21,采用隐蔽性观察法对门诊情况进行了观察,主要观察医生和患者的相关语言、行为,了解结核病就诊及诊断延迟情况。实验得到了利物浦大学热带医学院伦理委员会的许可,并通过了重庆市卫生局的批准。资料分析采用主题框架分析法。结果:重庆居民和流动人口都存在结核病就诊延迟的情况,主要与患者的经济状况、健康意识和社会支持等因素有关;医院在结核病的诊断方面具备基本的技术和条件,诊断延迟则主要与医务人员对结核病的意识和责任心有关;另外患者自身在诊疗过程中的中途退出现象不容忽视,也是导致延迟的一个重要因素。结论:一方面综合医院缺乏对结核病患者的管理措施和意识,对结核患者重治轻管,另一方面特殊人群的患者卫生保健支付能力差,缺乏相关结核病防控知识,应依据目前的形势对相关领域进行政策倾斜和调控,积极开展对人群行之有效的健康教育。