薄层扫描法检测血清、尿中磺胺甲唑和甲氧苄氨嘧啶

本文建立了血清、尿中ＳＭＺ和ＴＭＰ的薄层扫描定性定量检测方法。血清和尿中ＳＭＺ的线性检测范围为４～１２８μｇ／ｍｌ，最小检出浓度为１．６μｇ／ｍｌ；ＴＭＰ的线性检测范围为１～３２μｇ／ｍｌ，最小检出浓度为０．８μｇ／ｍｌ。     

Emphysematous cystitis.

Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. We report two cases of emphysematous cystitis of the urinary bladder in a 67-year-old and a 63-year-old women. They presented with bladder irritation symptoms such as dysuria, hematuria and frequency. Urinalysis showed pyuria. Cystoscopic examination revealed that bladder mucosa was studded with vesicles varying in size and arranged in clumps. CT scans of the pelvis showed mottled gas bubbles within the bladder. They were treated with antibiotics. Four days after the treatment, the symptoms subsided and plain abdominal film showed no evidence of gas shadows in the pelvic cavity.     

Analysis of clonality by X chromosome inactivation in uterine cervix cancer.

The determination of a unicellular or a multicellular origin of a tumor is an important due for understanding its etiology. To investigate this issue, we performed clonality assay of cervix cancer using polymerase chain reaction based on highly polymorphic locus of the androgen receptor gene, in which methylation of DNA correlates with inactivation of X chromosome. DNA samples were obtained from formalin-fixed, paraffin-embedded tissue of 20 invasive epidermoid carcinomas and 10 carcinoma in situ. Seven of ten carcinoma in situ, heterozygous for the androgen receptor locus, were monoclonal pattern. Among twenty invasive epidermoid carcinomas, eighteen of which showed heterozygous, twelve were monoclonal pattern and six were polyclonal pattern. We conclude that carcinoma in situ arises from a single cell. In invasive epidermoid carcinoma, most cases were monoclonal, although some cases were polyclonal. These suggest that invasive carcinoma of the cervix does not always arise from a single cell, but may arise from several cells with different mechanisms.     

Neurogenic bladder after operation of rectal cancer

Of the patients who had had a urodynamic examination during the five year period from 1982 to 1987 in our clinic, 48 patients underwent operations for rectal cancer prior to the study. In 35 of them, the operation mode was known. If the pelvic nerve is damaged by operative modes for rectal cancer, urinary disturbances of severe kinds may occur. In spite of such disturbances, 71.4% of those who had had excision of the low anterior part and 51.9% of those with Miles' operation could be weaned from the clean intermittent self-catheterization and take up spontaneous urination. Even in patients who developed severe dysuria, if catheterized at an early stage, many of them could urinate by abdominal pressure with in several months after operation, without the aid of a catheter. This transition took place mostly within one year after operation. When a patient develops dysuria after radical surgery for rectum cancer, treatment mainly with self-catheterization is an effective method at present.     

Epoxyalkanoyls as novel ACE inhibitors

The epoxyalkanoyl derivatives were designed and synthesized as ACE inhibitors. Coupling of unsaturated carboxylic acids with amino acids and following epoxidation with dimethyldioxirane gave the epoxyalkanoyls with high yield. The inhibitory activity of synthesized compounds on angiotensin converting enzyme was IC₅₀ values of 0.06≈5.5 μM.     

有机药物化学中不对称合成手性产率及其随温度变化规律的研究

本文首次用分子力学计算产物或过渡态分子内张力能来估算热力学或动力学,控制不对称合成反应生成的立体异构体的相对比例,并从热力学上推导了这一比例随温度变化公式,而且从实验上得到证明,在有机或药物化学最富有挑战性的领域——不对称合成中具有重要的理论和实际意义。     

小儿静脉输液渗漏相关因素的调查分析及预防对策

目的 了解引起小儿输液渗漏的相关因素，尝试建立防治小儿静脉输液渗漏的护理干预模式。方法 选取年龄≤6岁的2546倒住院患儿作为观察对象，对其输液的全过程进行追踪观察，渗漏病例详细记录渗漏发生时间、药物、输液工具、血管状况、渗漏范围及症状。结果 127倒患儿在静脉滴注过程中或拔针后出现渗漏，其中75例（59．06％）因患儿异常哭闹或家长无意碰撞、牵拉引起；18例（14．17％）因药物因素引起；15例（11．81％）因血管选择不当引起；13例（10．24％）因穿刺部位固定不稳固或方法不正确引起；6例（4．72％）因拔针按压方法不正确引起。渗漏多发生在输液开始120min后。结论 需改良常规穿刺、固定方法，有计划地合理使用静脉，加强家长输液知识教育及输液过程巡视，以减少小儿静脉输液渗漏的发生。     

Outcome after traumatic frontal intracerebral haemorrhage: a comparison of unilateral and bilateral haematomas

Frontal intracerebral haemorrhage (ICH) is a common result of cranial trauma. Outcome differences between bilateral and unilateral frontal ICH are not well studied but would be valuable to predict prognosis in clinical practice. Two aims are proposed in this study: first to compare the risk of developing delayed ICH after bilateral or unilateral frontal ICH, and second to determine the variables helpful to predict outcome according to the Glasgow Outcome Scale (GOS). Between January 1993 and December 1997, 694 consecutive patients with traumatic ICH were admitted to the Chang Gung Medical Center within 24 h of the trauma. Patients with ICH in sites other than the frontal lobes were excluded. A total of 161 cases (mean age 46.3+/-20.3 years), including 57 bilateral (mean age 52.5+/-18.7 years) and 104 unilateral (mean age 42.9+/-20.5 years) traumatic frontal ICH were studied. Twenty-eight of 57 patients (49%) with bifrontal ICH versus 17 of 104 patients (16%) with unilateral frontal ICH had a further, delayed ICH. In 42 of 45 patients (93%) with delayed ICH, this occurred within 5 days of the initial trauma. Multivariate logistic regression was used to select significant predictors of outcome. We found that delayed ICH (p<0.001), age (p=0.004) and mechanism of injury (p=0.001) explained the worse outcome in patients with bifrontal ICH. The best-fitting logistic regression model included three variables: delayed ICH (p=0.011), initial GCS (p=0.023), and a sum score of clinical and radiological variables (p=0.003). Bifrontal ICH tended to occur in older patients after a fall and was associated with a higher risk of developing delayed ICH or brain stem compression compared to unilateral ICH damage. Using these three variables - delayed ICH, initial GCS, and the sum score - in a logistical regression model is useful to predict outcome in patients with traumatic frontal ICH and may aid patient management.     

降血糖药用植物资源概述

糖尿病是威胁人类健康的四大致死疾病之一.据统计目前全球有2型糖尿病患者1.3亿,我国达4 000万人,预测到2025年,全球将增至3亿人,目前尚无根治办法.近年来,医药界在降血糖药用植物研究方面做了诸多工作,现作一概述.