RP-HPLC法测定家兔血浆中甲苯喹哌浓度和药代动力学参数

本文建立了以紫外230nm波长检测的反相高效液相色谱法(RP-HPLC)测定家兔血浆中甲苯喹派浓度。填料使用LiChrosorb RP-C18,流动相为甲醇—水—三乙胺—磷酸(63:37:1:0.8 v/v),血样(或尿样)经碱化后用乙醚提取,再以0.2 mol/L硫酸回提,进样。方法回收率为99.84±3.10(SD)%;天内、天间精密度平均CV为4.12%及3.95%(n=5);最低检测限3ng.经提取的标准线性浓度在25～2000 ng/ml范围内,Y=0.002865X-0.01346,r=0.9999,内源性物质及可能的合并用药不干扰色谱测定。文内用质谱法鉴定血样中甲苯喹哌色谱峰纯度,并由尿样分析对其主要代谢物予以初步验证。本法可应用于药代动力学参数测定。家兔按8mg/kg静注后,药—时曲线符合二室模型T_1/2=4.8008±1.1522(SD)h。     

Legionella infection with acute renal failure and thrombocytopenia mimicking allograft rejection

A patient is described who developed cavitary Legionella pneumonia 2 weeks after kidney transplantation. The initial pulmonary symptoms were followed by severe thrombocytopenia and acute renal failure. Although acute irreversible graft rejection was suspected, this was not supported by the pathology findings in the resected kidney, which were compatible with tubular damage. We presume that the extrapulmonary symptoms were caused by Legionellosis.     

Utility of DRG and ICD-9-CM classification codes for the study of transfusion issues. Transfusions in patients with digestive diseases

Red cell transfusions in all patients within specific medical or surgical diagnosis-related groups (DRGs) and International Classification of Diseases (ICD-9-CM) classes were analyzed by a unique body of data that combined abstracted patient discharge records with the numbers of red cell units transfused. Informative measures of transfusion practice within an ICD-9-CM class were the proportion of patients transfused, the mean units transfused per patient, and the ratio of standard deviation to the mean of units transfused. Transfusion frequency plots (percentage of patients against units of red cells transfused per patient) revealed the existence of a modal transfusion frequency, as well as an asymmetric tail on the high frequency side. These and other features make it possible to characterize transfusion practice in specific ICD-9-CM classes. The mean units of red cells transfused for all patients in a DRG is a measure of blood resource utilization and should be useful in planning to meet future needs.     

Oocyte retrieval in an in vitro fertilization-embryo transfer program: comparison of four methods

The records of 191 patients involved in 316 treatment cycles over 3 years in an in vitro fertilization-embryo transfer program were reviewed. Follicular aspiration, oocyte retrieval, pregnancy rates, technical difficulty, and complications were compared in four oocyte retrieval methods: 117 laparoscopic retrievals, 116 ultrasound (US)-guided percutaneous transvesical retrievals, 43 US-guided transvaginal retrievals, and 40 combined US and laparoscopic retrievals. The mean number of aspirated follicles (9.14) was greatest in the transvaginal retrieval group, but the ratio of oocytes to punctured follicles was not statistically greater in any of the groups. The overall clinical pregnancy rate per cycle was highest in the transvaginal retrieval group: 12 of 43 cycles resulted in pregnancy, or 27.9%. The number of delivered babies (16.3%) was also highest in the transvaginal retrieval group. US-guided transvaginal oocyte retrieval is recommended as the method of choice.     

Percutaneous transluminal renal angioplasty: initial and long-term results

Renal artery stenosis in 201 patients with hypertension was treated with percutaneous transluminal renal angioplasty (PTRA). A total of 213 procedures were performed as treatment of 262 separate stenosis. The stenosis was caused by atherosclerosis in 134 cases and by fibromuscular dysplasia (FMD) in 52 cases; the cause was indeterminate in 27 cases. Of the 213 procedures, 172 were successful or resulted in improvement, for a technical success rate of 80.8%. The initial clinical results could be evaluated in 210 cases; cure or improvement was achieved in 80%. There were 23 cases in which neither technical nor clinical success was achieved. Data on the remaining 187 cases were the basis of this long-term follow-up study. The cumulative patency rate at 5 years was 80% in the atherosclerosis group, 89% in the FMD group, and 74% in the indeterminate group. The mortality was less than 1%. Because spasm occurred in 33 cases, causing an infarction in ten instances, antispasmodic medication seems warranted. These long-term results indicate that PTRA is the treatment of choice in patients with renovascular hypertension.     

Chronic traumatic diaphragmatic hernia: the significance of pleural effusion

Five patients with chronic traumatic diaphragmatic hernia presented with symptoms of acute intestinal obstruction and unilateral pleural effusion. In each case, infarcted herniated abdominal structures were found at surgery. The presence of an ipsilateral pleural effusion is an important radiographic sign, which may indicate strangulation in patients with chronic traumatic diaphragmatic hernia.