应用脉冲多普勒估测右心室dp／dtmax方法的评价

目的通过动物实验及临床研究评价右心室射血期肺动脉脉冲多普勒频谱参数估测右心室收缩功能的可行性。方法6条健康犬及25例先心病患儿。1.在右心室正性肌力及改变前后负荷干预下,观察实验犬血流频谱最高速度（Vp）、加速时间（AT）、平均加速度（Am）及Vp2／AT等肺动脉射血期脉冲多普勒参数与右心室dp／dtmax的关系。2.测算先心病患儿上述各肺动脉射血期血流频谱参数并与心导管造影术中右室dp／dtmax测值比较。结果1．实验犬中仅Vp及Vp2／AT在右心室正性肌力及前后负荷干预下始终与右室dp／dtmax呈高度相关。2先心病患者肺动脉血流Vp、Am及Vp2／AT与右心室dp／dtmax成非常显著相关。结论右室Vp及Vp2／AT可用于右空心肌收缩力的估测。     

Comparison of air-displacement plethysmography with hydrostatic weighing and bioelectrical impedance analysis for the assessment of body composition in healthy adults

BACKGROUND: Over the past decade, considerable attention has been paid to accurately measuring body composition in diverse populations. Recently, the use of air-displacement plethysmography (AP) was proposed as an accurate, comfortable, and accessible method of body-composition analysis. OBJECTIVE: The purpose of this study was to compare measurements of percentage body fat (%BF) by AP and 2 other established techniques, hydrostatic weighing (HW) and bioelectrical impedance analysis (BIA), in adults. DESIGN: The sample consisted of healthy men (n = 23) and women (n = 24). %BF was measured by AP, HW, and BIA. RESULTS: In the total group, %BF(AP) (25.0+/-8.9%) was not significantly different from %BF(HW) (25.1+/-7.7%) or %BF(BIA) (23.9+/-7.7%), and %BF(AP) was significantly correlated with %BF(HW) (r = 0.944, P < 0.001) and with %BF(BIA) (r = 0.859, P < 0.01). Compared with HW, AP underestimated %BF in men (by -1.24+/-3.12%) but overestimated %BF in women (by 1.02+/-2.48%), indicating a significant sex effect (P < 0.05). The differences in estimation between AP and BIA and between BIA and HW were not significantly different between the sexes. CONCLUSION: AP is an accurate method for assessing body composition in healthy adults. Future studies should assess further the cause of the individual variations with this new method.     

Plutonium fecal and urinary excretion functions: derivation from a systemic whole-body retention function.

Liver-bile secretion directly influences the content of plutonium in feces. To assess the reliability of plutonium metabolic models and to improve the accuracy of interpreting plutonium fecal data, we developed a compartmental model that simulates the metabolism of plutonium in humans. With this model, we can describe the transport of plutonium contaminants in the systemic organs and tissues of the body, including fecal and urine excretions, without using elaborate kinetic information. The parameter values of the models, which describe the translocation rates and recycling of plutonium in the body, can be derived from a multi-term exponential systemic function for whole-body retention. The analytical derivations and algorithms for solving translocation parameter values are established for the model and illustrated by applying them to the biokinetics and bioassay of plutonium. This study describes how to (1) design a physiological model for incorporating liver biliary secretion and for obtaining a fecal-excretion function, (2) develop an analytical solution for identifying the translocation-parameter values incorporating the recycling of plutonium in the body, and (3) derive a set of urinary and fecal excretion-functions from a published systemic whole-body retention function, generally acknowledged to be accurate, as a real and practical example.     

Regulatory T cells in experimental allergic encephalomyelitis. I. Frequency and specificity analysis in normal and immune rats of a T cell subset that inhibits disease

We have shown previously that administration of myelin basic protein (MBP)-reactive T cells to naive Lewis rats induces not only autoimmune encephalomyelitis (EAE) but also a near total resistance to subsequent disease. By isolating the effector cells that are responsible for the resistance, we demonstrated that disease protection paralleled with increased numbers of a CD8+ regulatory T cell (RTC) subset and that co-injection of this RTC subset with encephalitogenic T cells aborted the pathogenic activity of the latter cells. Here, we show that a radio-sensitive splenic population of RTC also exists in naive rats that can be recruited and activated to inhibit the onset of secondary episodes of adoptive EAE. In co-transfer experiments, this protective RTC subpopulation can be isolated to neutralize the pathogenic activity of stimulatory MBP-reactive T cells in vivo. We show that the frequency of RTC with specificity for MBP-reactive T cells in naive rats is two orders of magnitude higher than the frequency of MBP-specific precursors, the activity of RTC increases substantially with age and RTC frequencies increase as a consequence of immunization with MBP-reactive cells lines. In specificity studies, we show that RTC isolated from naive rats and RTC from animals primed with one MBP-reactive cell line show cross-reactive responses to a variety of different MBP-reactive T cell lines. However, following repeated stimulation with a given MBP line, these RTC display a more limited, clonotypic response to the selecting line and assume a uniform CD8 phenotype. Finally, functional studies with RTC indicate that proliferative and lytic specificities do not necessarily correlate and that activated rat RTC are especially lytic for a Fas-sensitive murine cell line.     

"三线防控"模式在新冠肺炎疫情期间妇产科患者门诊就诊管理实践探讨

目的探讨新冠肺炎疫情期间"三线防控"模式在广州医科大学附属第三医院妇产科门诊的实践成效。 方法自新冠肺炎疫情以来，我院妇产科门诊自主制定了"三线防控"模式并常态化实施，采用回顾性研究方法分析2021年3月至8月广州市荔湾区疫情前后我院妇产科普通门诊、急诊及发热门诊的患者就诊情况，重点分析5~6月普通门诊中发现健康码异常或流行病学史的漏诊率、普通门诊的实际就诊率及候诊时间、患者满意度、发热门诊会诊率、妇科门诊手术情况、产科患者收住院情况等，同比2020年及2019年5~6月我院妇产科患者就诊情况变化。 结果在2021年广州市荔湾区疫情期间的5~6月，我院妇产科门诊累计预检分诊33 782例，其中黄码患者73例，健康码正常但流行病学史疑似患者108例，最终确诊新冠肺炎患者0例。2021年5月患者就诊同比2020年上升了6.09%，但较疫情前的2019年下降11.6%；6月患者就诊同比2019年及2020年分别明显下降了40.73%及41.51%。2021年5月21日至7月2日妇产科普通门诊患者的实际就诊率平均为90.8%，呈逐渐增长的趋势。2021年5~6月妇产科门诊手术总数为2501例，总收住院人数为1286例，收住院患者中持有72 h有效新冠核酸阴性结果的占比100%，隔离病房的收治情况为0；患者的就诊满意度平均高达8.76分。 结论"三线防控"管理模式，建立有效的普通门诊应急反应体系，保障了不同状况、不同需求的患者得到及时诊治，为广大患者安全就医提供了坚实的保障，并获得较高的满意度。     

依拉地平治疗原发性高血压

本报告了依拉地平（isradipine）治疗30例原发性高血压的临床效果及安全性。观察期限6周,结果显示依拉地平1.25mg,每日2次,有14例病人获得满意的疗效,卧位血压由165.5±3.2/100.9±2.9mmHg降至146.1±1.2/89.1±2.5mmHg。11例病人服用剂量增至2.5mg,每日2次,卧位血压降至148.6±4.1/91.5±2.2mmHg。3例加服马来酸依那普利10mg,每日2次,血压降至152.5±2.3/94.9±5.6mmHg。2例病人降压效果不明显。单用依拉地平治疗高血压总有效率为83.3%,副作用较少,并随用药时间的延长而消失。     

鼻腔鼻窦非上皮源性恶性肿瘤7例报告

报告鼻腔鼻窦非上皮源性恶性肿瘤７ 例,其中恶性黑色素瘤２ 例,恶性神经鞘瘤２ 例,非霍奇金氏淋巴瘤２ 例,平滑肌肉瘤１ 例。因鼻腔鼻窦恶性黑色素瘤罕见,故易误诊,其中１ 例因高度疑为此病,经病检证实,及时准确切除了瘤体,术后存活５ 年余;恶性神经鞘瘤临床确诊主要依靠病检,诊断平滑肌肉瘤则需结合免疫组化检测,随免疫组化的开展,非霍奇金氏淋巴瘤的临床与病理诊断符合率已有提高,前三者治疗以手术切除为主,非霍奇金氏淋巴瘤则可先化疗再局部放疗。     

用鼻内窥镜诊治干酪性上颌窦炎

用鼻内窥镜诊断和治疗干酪性上颌窦炎２０ 例,２ 例因息肉复发及下鼻甲肥厚效果不理想,余者皆恢复良好。鼻内窥镜下诊断本病准确、直观,治疗的关键是建立鼻腔、鼻窦的良好通气和引流。     

甲苯咪唑微丸质量标准的研究

目的：建立对甲苯咪唑微丸进行定性鉴别和含量测定的方法。方法：采用薄层层析法进行定性鉴别,用紫外分光光度法进行含量测定。结果：含量测定方法平均回收率为１００．６％ , Ｒ Ｓ Ｄ＝ １．７２％ 。结论：所用方法简便可靠,可控制甲苯咪唑微丸的质量。