高效液相色谱法测定峰丁麻滴眼剂中盐酸麻黄碱含量

目的　建立高效液相色谱法测定蜂丁麻滴眼剂中盐酸麻黄碱含量的方法。　方法　采用YWGC18分析色谱柱 ( 4 6mmID× 2 5 0mm ,粒径 10 μm) ,C18保护柱 ( 4 6mmID× 5mm ,粒径 10 μm) ,流动相 10 %乙腈 ( 0 5 %三乙胺 ,磷酸调pH3 0 ) ,流速 1 0ml/min ,检测波长 2 0 8nm ,测定对照品和样品色谱图 ,记录盐酸麻黄碱色谱峰面积 ,计算其含量。　结果　盐酸麻黄碱的理论板数为 10 0 0 0。回归方程 :y =90 5 878 16 15 1738x ,r=0 9999,线性范围 0 4 0 32～ 1 6 13μg。平均回收率为 99 2 % (RSD1 6 % )。　结论　该法操作简便 ,结果准确 ,可用于测定蜂丁麻滴眼剂中盐酸麻黄碱的含量     

音乐疗法在婴儿吸痰中的应用研究

目的　采用音乐疗法减轻患儿吸痰时的烦躁、哭闹，减轻氧的消耗，缓解缺氧情况。方法 采用实验性研究设计，选择北京儿童医院ICU病房住院的52名需吸痰患儿为研究对象，选择背景音乐为节奏舒缓的钢琴曲。记录有与无背景音乐时吸痰前后患儿的经皮氧饱和度和心率的变化。结果 对同一患儿进行了干预前后的分析比较，有与无背景音乐下吸痰患儿经皮氧饱和度、心率有显著性差异。结论 音乐疗法对于缓解ICU吸痰患儿缺氧是一种有效干预手段。     

Parkinson''''s Disease and Smoking: An Integral Part of PD''''s Etiological Study

INTRODUCTION Parkinson抯 disease (PD), a debilitating neurodegenerative disorder, is featured with bradykinesia, resting, muscular rigidity, gait disturbances, and postural reflex impairment[1]. PD is rare before age of 50 years, but it increases dramatically with older ages, with peak onset occurring during the age of 70-85 years. In the United States, prevalence of PD in all age groups is approximately 150 per 100 000 and is roughly 30 per 100 000 at age of less than 50 years and 800 …     

Avoidance of Nitrous Oxide for Patients Undergoing Major Surgery: A Randomized Controlled Trial

Background: Nitrous oxide is widely used in anesthesia, often administered at an inspired concentration around 70%. Although nitrous oxide interferes with vitamin B12, folate metabolism, and deoxyribonucleic acid synthesis and prevents the use of high inspired oxygen concentrations, the consequences of these effects are unclear.

Methods: Patients having major surgery expected to last at least 2 h were randomly assigned to nitrous oxide-free (80% oxygen, 20% nitrogen) or nitrous oxide-based (70% N2O, 30% oxygen) anesthesia. Patients and observers were blind to group identity. The primary endpoint was duration of hospital stay. Secondary endpoints included duration of intensive care stay and postoperative complications; the latter included severe nausea and vomiting, and the following major complications: pneumonia, pneumothorax, pulmonary embolism, wound infection, myocardial infarction, venous thromboembolism, stroke, awareness, and death within 30 days of surgery.

Results: Of 3,187 eligible patients, 2,050 consenting patients were recruited. Patients in the nitrous oxide-free group had significantly lower rates of major complications (odds ratio, 0.71; 95% confidence interval, 0.56-0.89; P = 0.003) and severe nausea and vomiting (odds ratio, 0.40; 95% confidence interval, 0.31-0.51; P < 0.001), but median duration of hospital stay did not differ substantially between groups (7.0 vs. 7.1 days; P = 0.06). Among patients admitted to the intensive care unit postoperatively, those in the nitrous oxide-free group were more likely to be discharged from the unit on any given day than those in the nitrous oxide group (hazard ratio, 1.35; 95% confidence interval, 1.05-1.73; P = 0.02).     

Prospective Open-Label Study of Botulinum Toxin Type A in Patients with Axillary Hyperhidrosis: Effects on Functional Impairment and Quality of Life

BACKGROUND: Patients with primary axillary hyperhidrosis experience substantial functional impairment and reduced health-related quality of life (HRQOL). Few studies have comprehensively evaluated the effects of botulinum toxin type A (BoNT-A) on these symptoms. OBJECTIVE: To prospectively assess the effects of BoNT-A on functional impairment associated with primary axillary hyperhidrosis. METHODS: Patients treated with BoNT-A 50 U per axilla at baseline were assessed 4 and 12 weeks later. Outcome measures included functional impairment as assessed by the Hyperhidrosis Disease Severity Scale and the Hyperhidrosis Impact Questionnaire and dermatology-specific HRQOL as assessed by the Dermatology Life Quality Index. RESULTS: At weeks 4 and 12 after BoNT-A treatment, 85% and 90% of patients achieved the a priori definition of treatment responder. Patients reported less occupational and emotional impairment, spent less time managing their hyperhidrosis, and had fewer difficulties in social situations. Adverse events were uncommon (5.5%), were mild, and did not require treatment. At study end, 53% of patients reported no dermatology-specific HRQOL impairment and 90% were satisfied with treatment. CONCLUSIONS: Significant, meaningful, rapid, and durable reductions in disease severity and functional impairment, as well as improvements in HRQOL, were seen following BoNT-A treatment. BoNT-A was safe and well tolerated, producing high levels of patient satisfaction.     

Current practice patterns in pancreatic surgery: Results of a multi-institutional analysis of seven large surgical departments in germany with 1454 pancreatic head resections, 1999 to 2004 (german advanced surgical treatment study group)

Despite decreasing mortality rates, morbidity is still high after pancreatic head resection. Comparative data in the United States and Europe show a relationship between hospital volume and mortality. Treatment strategies vary frequently, partially because of the lack of evidence-based data. We performed a multi-institutional analysis in Germany evaluating current numbers, indications, techniques, and complication rates of pancreatic head resection. Questionnaires were completed by seven high-volume surgical departments regarding quantitative and qualitative aspects of pancreatic head resections in the period from 1999 to 2004 (five prospective and two retrospective institutional databases). A total of 1454 pancreatic head resections (944 for malignancy) were reported. Mean annual hospital volume ranged from 14 to 52 (10 to 43 in malignancy). Mortality was between 1.1% and 4.8%, morbidity was between 24% and 46%, and pancreatic leakage was between 9% and 20%. In malignant disease, all centers perform standard lymphadenectomy and regard arterial infiltration as a contraindication for resection. However, the rate of portal vein resection varied from 0% to 28%. No consensus is seen on the type of surgery for malignancy and chronic pancreatitis. After resection for pancreatic cancer less than one fourth of the patients receive adjuvant therapy. The results of our analysis in Germany confirm that pancreatic head resection can be performed with low mortality in specialized units. Variations in indications, operative technique, and perioperative care may demonstrate the lack of evidence-based data and/or personal and institutional experience. The low number of patients receiving adjuvant therapy after resection of pancreatic cancer suggests that more efforts must be made to establish novel adjuvant therapies under randomized study conditions. Presented at the Forty-Sixth Annual Meeting of The Society for Surgery of the Alimentary Tract, Chicago, Illinois, May 14–18, 2005 (oral presentation).     

Comment on the 'pilot' GRACIA-2 randomized trial: reply

We thank Dr Villata et al. for their thought-provoking comments.Their concern about the suitableness to choose combined endpointsin clinical trials deserves some comment.