Small diameter versus conventional laparoscopy: a prospective, self- controlled study

The objective of this study was to determine visual quality, diagnostic accuracy, and surgical merits of small diameter laparoscopy (SDL). Thirty-seven patients were randomly selected. The indications for laparoscopy were infertility, desire for tubal sterilization or chronic pelvic pain. Patients underwent SDL, followed by conventional laparoscopy (CL) as a control under general anaesthesia. Findings at operation were compared. The mean time for diagnostic work-up was longer with SDL than CL, 11.7 +/- 5.6 versus 7.6 +/- 3.2 min respectively (P < 0.04). Visual quality was scored from 4 to 1 by the operator; mean visual quality, mean endometriosis score and mean adnexal adhesions score were slightly lower with SDL than CL. Sensitivity of SDL in diagnosing endometriosis, adhesions, ovarian, uterine and pouch of Douglas lesions were 71, 58, 81, 89 and 73% respectively; specificity was 100, 96, 100, 100, 100% in the same order. Suction irrigation, cyst aspiration, tissue biopsies, simple adhesiolysis, tubal ligation and cauterization were easily performed with SDL. We conclude that SDL seems a good alternative to CL in diagnosing macro-pelvic anatomy and coarse pelvic pathologies and may also be good in performing surgical procedures such as: tubal ligation, biopsies and differential diagnosis of pelvic fluids. But SDL must be used cautiously in micro-oriented, functional conditions such as infertility, pelvic pain, endometriosis and adhesion scoring or treatment. SDL may be regarded as a less invasive but less sensitive tool with limited surgical merits.      

盐酸苯乙哌啶和dl-15甲基PGF_(2α)甲酯对大鼠卵巢黄体细胞的影响

盐酸苯乙哌啶(R1132)10μg/ml或dl-15甲基PGF_(2α)甲酯(PG05)5或10μg/ml在体外能明显抑制黄体细胞对hCG的反应性,使孕酮分泌下降。假孕大鼠po R1132 10 mg/kg或Sc PG 05 5.1 mg/kg不影响卵巢孕酮分泌,合并给药后却能使其降低。R1132无抗孕酮作用。卵巢分泌孕酮减少可能是抗早孕的主要原因.假孕大鼠po R1132 50 mg/kg或sc PG050.5 mg/kg可抑制卵巢腺苷环化酶的活性.该酶可能是R1132或PG05在大鼠抗早孕作用的重要靶酶。     

尿液中利尿剂、丙磺舒、咖啡因、匹莫林的固相提取和HPLC初筛分析

A solid-phase extraction and reversed phase high performance liquidchromatographic method(RP-HPLC) was developed for the rapid determination of 13 diuretics (bel-onging to five different pharmacological groups) ,probenecid, caffeine and pemoline in urine. Two mlurine sample was first adsorbed on a XAD-2 column, then eluted with ether--ethyl acetate(l: 1).The eluate was evaporated to dryness and reconstituted in methanol. The methanolic solution wasinjected into a HP LiChrosorb RP-18 column, using phosphate buffer (pH 3) and acetonitrile as the mo-bile phase and monitored at 216 nm, 230 nm, and 275 nm on a diode array ultraviolet detector. Theextraction recoveries of 16 drugs were above 75%. The limits of detection ranged from 0. 3～3.0μg/ml of urine. All drugs were separately administered to healthy volunteers, positive urine sampleswere collected, and urinary excretion--time curves of some drugs were reported.     

盐城市2009-2018年居民全死因死亡与减寿分析

目的 分析2009-2018年10年期间盐城市居民死因及其对寿命的影响等,为制定疾病预防控制措施提供依据。方法 分析2009-2018年盐城市居民死亡资料,计算粗死亡率、标化死亡率、去死因期望寿命和潜在寿命损失年指标。结果 2009-2018年10年盐城市居民平均粗死亡率、标化死亡率分别为661.65/10万、359.41/10万。男女第1位死因为恶性肿瘤（262.91/10万、162.74/10万）、第2位为脑血管病（135.78/10万、148.50/10万）、第3位为呼吸系统疾病（103.68/10万、99.27/10万）、第4位为心脏病（76.52/10万、86.60/10万）、第5位为损伤和中毒（67.80/10万、38.81/10万）。对期望寿命影响最大的是恶性肿瘤和脑血管疾病,去除后寿命分别增加了3.94岁、2.97岁。结论 恶性肿瘤、脑血管疾病、呼吸系统疾病、心脏病、损伤和中毒等慢性疾病是影响健康导致死亡的主要因素。慢性病的预防控制和管理是将来疾控工作的重点,提示要加强慢性病的危险因素调查研究,大力开展健康教育和健康促进工作,从而提高居民的期望寿命和健康水平。     

联合术式治疗女性出口处梗阻性便秘57例

1临床资料我们1999-06/2004-10收治女性出口处梗阻性便秘176例,其中耻骨直肠肌肥厚、直肠黏膜内脱垂、直肠前突三者并存57例,占32.4%,均为经产妇;年龄26～76岁,分娩1～5胎;病程1～32 a.合理的肠道及阴道准备,体位为膀胱截石位.用络合碘消毒阴道及肛管直肠腔.     

Inhibitory activity of xanthine oxidase by fractions Crateva adansonii

ObjectiveTo study the inhibitory effect of various extracts from Crateva adansonii (C. adansonii) used traditionally against several inflammatory diseases such as rheumatism, arthritis, and gout, was investigated on purified bovine milk xanthine oxidase (XO) activity.MethodsXanthine oxidase inhibitory activity was assayed spectrophotometrically and the degree of enzyme inhibition was determined by measuring the increase in absorbance at 295 nm associated with uric acid formation. Enzyme kinetics was carried out using Lineweaver-Burk plots using xanthine as the substrate.ResultsAmong the fractions tested, the chloroform fraction exhibited highest potency (IC₅₀ 20.2±1.6 μg/mL) followed by the petroleum ether (IC₅₀ 30.1±2.2 μg/mL), ethyl acetate (IC₅₀ 43.9±1.4 μg/mL) and residual (IC₅₀ 98.0±3.3 μg/mL) fractions. The IC₅₀ value of allopurinol used, as the standard was 5.7±0.3 μg/mL.ConclusionsEnzyme inhibition mechanism indicated that the mode of inhibition was of a mixed type. Our findings suggest that the therapeutic use of these plants may be due to the observed Xanthine oxidase inhibition, thereby supporting their use in traditional folk medicine against inflammatory-related diseases, in particular, gout.     

重症监护病房革兰阴性菌耐药现状研究

目的：了解我院重症监护病房分离菌株对常用抗生素的耐药现状。方法：采用琼脂双倍稀释法测定从我院重症监护病房分离的230株革兰阴性菌的最低抑菌浓度（MIC），并采用抑制剂增强的纸片扩散法测定大肠埃希菌和肺炎克雷伯菌超广谱β－内酰胺酶（ESBLs)。结果：50株肺炎克雷伯菌和17株大肠埃希菌中ESBLs阳性率为62．1％。阴沟肠杆菌、产ESBLs的大肠埃希菌和肺炎克雷伯菌对三代头孢、庆大霉素、阿米卡星的耐药率≥50％。而对碳青霉烯类非常敏感。铜绿假单胞菌对各种抗菌药物均有一定的耐药性。嗜麦芽寡养单胞菌对碳青霉烯类耐药率达100％。结论：受试的230株革兰阴性菌对三代头孢、复合青霉素、氨基糖苷类和环丙沙星的总耐药率≥30％。CPZ／SB和头孢吡肟、碳青霉烯类耐药率较低。     

Comparison of amoxicillin with second and third generation cephalosporins in the treatment of acute otitis media

The aim of the present study was to compare the efficacy and the tolerability of three different antibiotic regimens for the treatment of acute otitis media in paediatric patients. 75 children, age range 6 months-6 years, divided into three groups, were involved in the study, each group consisting of 25 randomly assigned children (Group 1, amoxicillin 40 mg/kg tid per os for 10 days; Group 2, cefuroxime axetil 30 mg/kg bid per os for 10 days; ceftriaxone 50 mg/kg single-dose i.m.). No statistically significant difference was noted in the clinical efficacy among the different groups. Although amoxicillin is the drug of choice in paediatric otitis media, single dose ceftriaxone might be considered as an interesting alternative regimen when ease of administration and cost of therapy are considered.