食品中分离的李斯特氏菌的致病基因分析

１９９６—１９９７年作者对全国１２个省市的７类食品共３７４６份进行了李斯特氏菌的污染调查,共分离出李斯特氏菌１６５株。用ＰＣＲ技术对分离菌株中李斯特氏菌的２种主要致病因子李氏溶血素Ｏ和内化素的基因进行了检测,其中５７株仅有内化素基因,２７株同时具有内化素基因和李氏溶血素Ｏ基因。两种致病基因均未检出的共有８１株。本研究说明判断单增李氏菌的主要指标是小鼠毒力试验阳性而不是其溶血反应,同时检测溶血素Ｏ和内化素２种基因对单增李氏菌有鉴别意义。     

止血带带菌情况监测

目的探讨临床使用止血带细菌污染情况,寻找止血带灭菌方法;方法随机抽取各种常用止血带200条分为4组,分别用不同方法消毒后,做细菌培养,数据经X^2检验;结果不经过消毒处理的止血带携带大量的病原菌,经清洗后,细菌数目减少,经消毒液浸泡和煮沸消毒后,达无菌要求,经消毒处理后与没有消毒比较,P<0．0001;结论提出止血带要作消毒处理,并定期更换,是阻断资源性感染的重要连径之一。     

放射状角膜切开手术中微穿孔对角膜内皮的影响

目的：评价放射状角膜切开术（ＲＫ）中微穿孔对术后１年内角膜内皮的影响。方法：应用角膜内皮镜及角膜内皮分析仪研究４８例ＲＫ术中微穿孔和未穿孔眼的角膜内皮形态学变化,分别在术前及术后１、３、６、１２个月行角膜内皮检查及分析。结果：比较手术前后角膜内皮的数量、平均面积、最大面积和最小面积,穿孔眼及未穿孔眼差异无显著性,但内皮细胞面积两组都有扩大的趋势。结论：ＲＫ术后一年内无论微穿孔还是未穿孔眼的角膜内皮     

Nonsurgical management of extradural hematomas in children

With the advent of computerized tomography (CT), an increasing number of patients with only minimal neurological symptoms and no signs of brain herniation are found to harbor subacute or chronic extradural hematomas (EH's). The authors present the cases of 11 symptomatic but neurologically normal children with medium to large EH's managed by close observation. These EH's were discovered 4 hours to 6 days after injury; three were in the posterior fossa, seven over the frontoparietal convexity, and one in the temporal fossa. These clots were followed by serial CT scans. Nine children recovered without surgery from 4 to 18 days after injury, and all had evidence on CT of spontaneous clot resorption. Of these nine EH's, five clots displayed volume expansion from 5 to 16 days after injury before final resorption occurred. Expansion correlated with persistence or increase in symptoms, whereas resorption correlated with improvement. Two patients showed gradual uncal herniation on Days 6 and 8, respectively, presumably during the "expansile phase" of their clots. Both had emergency craniotomy and recovered without morbidity. It is hypothesized that the resorption dynamics of the subacute or chronic EH are similar to that of the chronic subdural hematoma, with predictable volume changes, and the outcome of each lesion depends on the interplay between the patient's intracranial pressure buffering capacity and the rate of volume change. If subtle signs of brain dysfunction are adopted to signal the failure of conservative treatment and the need for craniotomy, these patients may be safely, and many successfully, managed without surgery. Factors that influence outcome of medical treatment include the size, location, configuration, and the rapidity of accumulation of the clot, the presence of associated intradural lesions, the extracranial decompression of blood through skull diastases, and the age of the patient. These factors, the criteria for patient selection, and the indications for immediate operative intervention are discussed.     

蝙蝠葛中的新生物碱——蝙蝠葛新林碱

防已科植物蝙蝠葛(Menispermum daurioum DC.)的根茎,即北豆根,是一种重要的中药,具有清热解毒、消肿止痛等功效。已知含有近二十种生物碱,其中五种属双苄基四氢异喹啉类,即蝙蝠葛碱(dauricine,Ⅰ)、蝙蝠葛诺林碱(daurinoline,Ⅱ)、蝙蝠葛新诺林碱     

Dynamics of drug distribution. I. Role of the second and third curve moments.

Conventionally, the dynamics of distribution in the body is evaluated by the so-called distribution half-life (e.g., t1/2, alpha); but then the mean time of the distribution process is underestimated due to the influence of elimination. By contrast, information about the dynamics of distribution contained in drug disposition curves can be extracted by the second and third curve moments, parameters that are related to the variance (VDRT) and skewness (SDRT) of residence time distributions; whereas the equilibrium state characterized by the volume of distribution (Vss), is determined by the mean residence time (MDRT) or the first curve moment. The approach represents a general noncompartmental analysis that is independent of a detailed structural model or a particular disposition function. Two parameters are introduced to characterize the dynamics of drug distribution: (i) the degree of departure of the system from "well-mixed" behavior of instantaneous distribution equilibrium (related to VDRT) and (ii) the mean time until equilibration is achieved (mean equilibration time, MEQT), which additionally depends on SDRT. Both parameters are quantitative measures of the dynamics of distribution and display explicit physical significance in terms of distribution within the corresponding noneliminating system. It is further shown that the so-called "distribution phase" in biexponential disposition curves is related to a monoexponential mixing curve of its corresponding noneliminating system with an equilibration or mixing half-time, t1/2,M = t1/2,alpha (V beta/Vss*), where Vss* denotes the distribution volume of the noneliminating system. The results are applied to mixing and disposition curves measured for acetaminophen in liver-ligated and intact rats, respectively.     

Hepatic clearance of drugs. II. Experimental evidence for acceptance of the “well-stirred” model over the “parallel tube” model using lidocaine in the perfused rat liverin situ preparation

Theoretical analysis of two models of hepatic drug clearance revealed that one powerful discriminator between them is the effect of changes of hepatic blood flow on either the emergent drug concentration or the availability of a highly extracted compound when operating under linear conditions. Lidocaine (extraction ratio 0.997) was employed in the discriminatory studies. The behavior of this drug under linear conditions (input lidocaine concentrations < 5 mg/ liter) to changes in hepatic blood flow rate (10–16 ml/min per liver) was examined in the perfused rat liver in situpreparation. The steady-state output lidocaine concentration in the blood leaving the liver was predicted better by a well-stirred model than by a parallel tube model. As anticipated, the clearance of a poorly extracted compound, antipyrine (extraction ratio 0.08),was unaltered by changes in hepatic blood flow. These experimental findings, and the data from the literature, point to the acceptance of the well-stirred model, which describes the liver as a well-stirred compartment with the drug in the hepatic venous blood being in equilibrium with that in the liver.Supported in part by National Institutes of Health Grant GM 16496 and the Patent Fund, Graduate Division, University of California, San Francisco.Abstracted in part from a dissertation submitted by K. Sandy Pang to the Graduate Division, University of California, San Francisco, California, in partial fulfillment of the Doctor of Philosophy degree requirements.     

经尿道前列腺汽化与开放性手术对老年前列腺增生患者术后性功能的影响

目的评价经尿道前列腺汽化(TUVP)和开放性手术对老年前列腺增生(BPH)患者术后性功能的影响.方法分别统计分析经尿道前列腺汽化组(TUVP组)、耻骨上经膀胱前列腺切除组(SPP组)和耻骨后保留尿道前列腺切除组(Madigan组)术后6个月、1 2个月勃起障碍(ED)与逆行射精(RE)的发生率.结果术后6个月ED的发生率在TUVP组(n=52)、SPP组(n=46)、Madigan组(n=32)分别为1 3.4%(7/52)、1 5.2%(7/46)、1 2.5%(4/32),术后12个月ED的发生率分别为11.5%(6/52)、1 5.2%(7/46)、1 2.5%(4/32),术后6个月、1 2个月RE的发生率在TUVP组、SPP组、Madigan组分别为46.2%(24/5 2)、39.1%(1 8/46)、9.3%(3/32).结论TUVP与传统开放性手术SPP及Madigan手术相比较对勃起障碍的影响无统计学差异(p＞0.05),但逆行射精的发生率较Madigan手术组高,提示对术后射精功能有较大影响.     

传染性非典型肺炎23例心肌酶学分析

目的描述并分析传染性非典型肺炎的临床表现及心肌酶学改变。方法采集并分析了23例传染性非典型肺炎患者的临床表现及心肌酶学资料,分析死亡组及存活组出现心肌酶升高的比例的差异。结果患者具有肺炎症状体征,还出现心肌酶的升高。CKMB升高的比例存活组为44.4%,死亡组为80.0%,LDH1升高的比例存活组为22.2%,死亡组为80.0%。心肌酶升高的比例死亡组高于存活组,差异具有显著性意义。结论传染性非典型肺炎存在心肌损伤。     

无症状心肌缺血心率变异性分析

目的:探讨无症状心肌缺血的昼夜节律变化与心脏自主神经的关系。方法:对无症状心肌缺血者及健康者均进行24小时动态心电监护,从而分析其心率变异性(HRV)。结果:无症状心肌缺血组的HRV较正常对照组的HRV明显下降(P<0.05);无症状心肌缺血组其白天的HRV较夜间下降更低,存在明显的昼夜节律变化(P<0.05)。结论:无症状心肌缺血的发生与交感神经活性增强、迷走神经活性减低有关,自主神经受损是无症状心肌缺血的一个重要因素。