抗高血压新药美林洛尔在大鼠体内的药代动力学和生物利用度

目的建立测定美林洛尔血药浓度的方法,探讨美林洛尔在大鼠体内的药代动力学及生物利用度。方法灌胃和静脉给予大鼠美林洛尔5 mg/kg,采用颈动脉取血并用高效液相-荧光法测定血浆中美林洛尔浓度,应用3P87药动学程序对血药浓度数据进行拟合,计算药代动力学参数,评价其绝对生物利用度。结果美林洛尔在0.02~3.00μg/ml浓度范围内与样品峰面积/内标峰面积呈良好线性关系,其相关系数r=0.9999。提取平均回收率大于80%,日内、日间RSD<10%。大鼠静脉注射美林洛尔后体内药动学符合开放双室模型,其分布相和消除相的半衰期分别为(4.22±5.58)min和(58.53±17.60)min。曲线下面积、中央室分布容积和血浆清除率分别为(133.40±9.27)(μg.min)/ml、(0.27±0.15)L/kg和(7.50±0.53)ml/(g.min)。灌胃给药符合开放单室模型,其达峰时间、最大血药浓度和药时曲线下面积分别为(14.29±3.28)min、(0.64±0.11)μg/ml和(54.35±9.34)(μg.min)/ml。结论建立的高效液相-荧光法专属性强、灵敏度高,可用于美林洛尔的体内定量分析。美林洛尔在大鼠体内的绝对生物利用度为40.74%。     

Perforation of the bowel from intrauterine contraceptive devices: case series and discussion

The intrauterine contraceptive device is used extensively in the female population. Serious complications are rare, but they do occur. We discuss three cases of bowel perforation caused by these devices following their perforation through the uterine wall. It is important that cases of perforation be recognised swiftly and the possibility of involvement of other organs considered.     

两种等离子术式治疗阻塞性睡眠呼吸暂停低通气综合征的疗效比较

目的：比较全麻下等离子刀腭咽成形术与局麻下等离子刀打孔消融＋切割术治疗阻塞性睡眠呼吸暂停低通气综合征（OSAHS）疗效。方法：将55例OSAHS患者随机分为两组，A组25例，B组30例，A组采用气管插管，静脉复合麻醉下行等离子刀腭咽成形术；B组采用局麻下等离子刀打孔消融＋切割术。术后随访6～12个月。结果：术后6个月，A、B两组有效率比较无显著性差异，分别为88％和83．3％，P〉0．05，术后12个月A组有效率明显优于B组，分别为84％和56．6％，P〈0．01。结论：全麻下等离子刀腭咽成形术较局麻下单纯等离子刀打孔消融＋切割术远期疗效好，是一种安全、微创、值得推广的术式。     

Stretch of mammalian nerve in vitro: effect on compound action potentials

Stretch of nerve has been reported to decrease the amplitude of the compound action potential (CAP) with a complete block appearing in approximately 30 minutes. But for the most part, those experiments were carried out in vivo, and it is generally accepted that the failure of responses was due to a closure of vessels supplying the nerve with a resulting ischemia and anoxia. These studies were undertaken to determine if stretch of nerve has effects that are independent of interference with its vascular supply. In the studies, lengths of rat sciatic and dog peroneal nerves were removed and placed in a chamber supplied with oxygen in which their CAPs were continuously elicited and recorded. This in vitro preparation obviated interference with the nerve's metabolism on stretching. We have previously shown that the form change termed 'beading,' appearing within 10 seconds and reversing as quickly on relaxation, can be elicited with tensions of only several grams. We wished to determine if stretch adequate to produce beading could alter CAPs with the same rapidity. Tensions below 2 g had little effect. On applying tensions of 10-100 g, levels well above those needed to bead the fibers, both increases and decreases of CAP amplitude were seen. The changes occurred within 10 seconds of stretch application, the time at which beading arises with stretch. Although the decreases of CAP amplitudes could be accounted for by beading, the degree of CAP change did not correspond to the amount of tension applied. We hypothesize that the constrictions in the beaded fibers increase axial resistivity and diminish local currents so as to block conduction. The lack of an increasing degree of decreased CAP amplitude with increases in tension is ascribed to the inhibition of elongation offered by the collagen fibrils present in nerve. Collagenase applied to nerves allowed a further increase in length, producing a 'hyperbeading,' showing much longer lengths of beading constrictions on stretch. This would further increase axial resistance and is taken to account for the greater decreases of CAP amplitudes seen following collagenase treatment. To account for those cases where increases of CAP amplitude were seen on stretch, we hypothesize that stretch can also cause an increase in the excitability of the nodes. The outcome of stretch in any given nerve would be the resultant of two opposing actions; beading of the internodes causes a decrease of local currents leading to block of CAPs, while an increased excitability of the nodes acts to augment the responses.     

蔡炳勤教授治疗外科术后疑难发热医案三则

蔡炳勤教授为广东省名中医,全国老中医药专家学术经验继承工作指导老师,从事中医外科医、教、研40余年,学验俱丰,在中医外科方面颇有建树,提出许多独到的见解,尤其是疑难杂症的治疗,蔡老认为“善治常者,亦善治其变”。笔者有幸侍诊于侧,聆听教诲,受益匪浅,凡遇临床验案便悉心整理。以     

复方逍遥合剂中黄芩苷的薄层扫描测定

建立了薄层扫描法测定复方逍遥合剂中黄芩苷含量,并采用TLC法对黄柏、白芍、柴胡、贝母等成分进行鉴别.黄芩苷点样量在0.15～0.75μg范围内线性关系良好(r=0.9987),平均回收率99.2%(RSD 1.5%).     

醒脑静注射液质量控制研究

目的:研究醒脑静注射液(麝香、冰片、栀子、郁金)的质量标准.方法:分别以高效液相色谱法和气相色谱法测定了醒脑静注射液中的麝香酮、冰片的含量.结果:麝香酮的平均回收率为98.3%(RSD=0.41%,n=3),冰片的平均回收率为97.7%(RSD=0.54%,n=3).结论:该法重现性好,可有效地控制醒脑静注射液的质量.     

正常与缺血性心肌梗死及心肌肥厚大鼠超声心动图参数变化趋势比较

目的 通过对正常和心血管疾病状态下的大鼠进行连续超声心动图检测,获得客观准确的大鼠心脏超声参数的变化趋势。方法 建立缺血性心肌梗死和压力负荷增高诱导心肌肥厚的大鼠模型,分别在术前、术后1、2和4周进行超声心动图检测,在相同时间点对正常大鼠进行超声心动图检测,并记录超声参数数据。结果 正常大鼠各心脏参数随时间的变化均有所升高,属正常生长状态。心肌梗死大鼠心脏变化以心室重构和功能障碍为主,心室内径和心室容积随时间变化显著增加,射血分数和短轴缩短率显著降低,差异均有统计学意义（P＜0.05）。心肌肥厚大鼠心脏变化以形态改变为主,左室前、后壁厚度随着时间的延长显著增加,收缩末期容积显著下降,射血分数和短轴缩短率代偿性升高,差异均有统计学意义（P＜0.05）。结论 应用超声心动图可获得正常和疾病状态下较为客观准确的大鼠心脏超声数据,为后续应用大鼠实验模型研究各种心血管疾病提供了数据参考。     

伴有面转代偿头位的先天性下直肌麻痹临床特征与手术治疗

目的：描述伴有面转代偿头位的先天性单纯下直肌麻痹患者的临床表现,并分析其手术治疗效果。

方法：回顾性分析2014-05/2018-07伴有明显面转代偿头位的先天性下直肌麻痹患者,手术前后患者面转程度的变化借助骨科量角器来检查,垂直、水平斜视度变化通过三棱镜交替遮盖试验来测量,旋转斜视度变化通过眼底对眼球客观旋转状态评估。下直肌缩短术是主要治疗方案。

结果：在15例研究对象中,有13例行下直肌缩短术或者联合上直肌后徙术术后疗效好,下直肌运动不足明显改善,眼球运动协调,以面转为主的代偿头位消失,垂直、水平、旋转斜视得到矫正; 并得出：每缩短1 mm下直肌可矫正1.54±0.93°内旋斜视。而行下斜肌断腱术治疗的垂直斜视度小的患者,面转改善不理想,仍遗留眼球运动不协调。

结论：先天性单纯的下直肌麻痹以面转代偿头位为主,下直肌缩短术治疗效果好,轻度的过矫及欠矫不影响手术疗效。