7-(4,7-二取代香豆素-3-乙酰氨基)头孢菌素的合成

本文根据构效关系,设计并合成了17个7-(4,7-二取代香豆素-3-乙酰氨基)头孢菌素衍生物。其缩合方法采用酰氯法、Vilsmeier试剂法及混合酐法。初步体外抑菌试验表明,化合物对革兰氏阳性菌和少数革兰氏阴性菌有较强的抗菌作用。进一步药理试验尚在进行。     

Dural fistulas involving the cavernous sinus: results of treatment in 30 patients

Thirty symptomatic indirect carotid cavernous fistulas were treated between 1978 and 1986 with a variety of treatment modalities. Combined carotid artery and jugular vein compression resulted in a complete cure in seven of 23 patients (30%) and improvement in one additional patient. There were no complications from this treatment, which is performed by the patient on an outpatient basis. Patients in whom carotid jugular compression therapy failed or who demonstrated cortical venous drainage or visual decline were treated with intravascular embolization. Embolization resulted in complete cure in 17 of 22 (77%) and improvement in four of 22 (18%). One patient required surgical excision of the involved dura after embolization to achieve complete cure. There was one permanent complication (stroke), which resulted in mild weakness caused by clot formation on a catheter.     

7-(1,7-双取代-1,4-二氢-4-酮-1,8-萘啶-3-甲酰氨基)头孢菌素的合成

本文报道了以1,7-双取代-1,4-二氢-4-酮-1,8-萘啶-3-羧酸,用混合酸酐法与7-ACA,7-ADCA,7-ACT和7-ACD缩合,合成了24个1,7-双取代-1,4-二氢-4-酮-1,8-萘啶-3-甲酰胺头孢菌素衍生物,通过葡聚糖凝胶(Sephadex LH-20)及离心薄层层析纯化精制,得到纯品。体外抑菌试验结果表明:大多数新头孢菌素衍生物对革兰氏阳性菌具有较好的抗菌作用。尚有一些新头孢菌素衍生物对某些革兰氏阴性菌具有中等敏感程度。     

Early Postinterventional Stent Stenosis of a Ductus Stent Implanted for Palliation in a Newborn with Pulmonary Atresia with Intact Ventricular Septum: Successful Management with Bailout Stenting

A newborn with pulmonary atresia with intact ventricular septum (PA-IVS) was treated with radiofrequency current perforation of the atretic pulmonary valve. As the right ventricle was hypoplastic (z-value of the tricuspid valve: —4) the arterial duct was stented with a Gianturco-Roubin GR II stent. Early postinterventionally, the patient became cyunotic and compromised blood flow across the stented ductus arteriosus despite adequate stent position was detected echographically. The newborn was treated successfully with the implantation of a Palmaz stent (Johnson & Johnson Interventional Systems, Warren, NJ, USA) into the obstructed Gianturco-Roubin GR II stent. The Gianturco-Roubin GR II stents might be associated with the risk of early stent stenosis after implantation in actively contracting tissues like the ductus arteriosus. In patients with early stent stenosis after ductal stenting, bailout implantation of a subsequent stent can be performed. Transcatheter procedures can be effective means for therapy of PA-IVS . (J Interven Cardiol 2000;13:39–44)     

人尿中几种雄激素及蛋白同化激素的HPLC测定

对HPLC分离及定量测定人尿中雄激素及蛋白同化激素的方法进行了初步研究。确定了六种甾体激素的分离条件及内标定量方法。固定相为C₈键合硅胶,甲醇—乙腈—水(4:5:6)恒溶剂洗脱,程序流速。紫外检测器波长254 nm。检测限可至1 ng以下。本法采用Sep-Pak C₁₈小柱进行尿样净化,回收率高而且稳定。操作简便快速。对尿样中甾体葡萄糖醛酸甙结合物的酶促水解条件也进行了初步探索。     

脱氢氯甲睾酮人体内代谢研究

本文叙述了用GC-MS联用技术研究脱氢氯甲睾酮人体内代谢的方法。尿样中的甾体化合物经大孔树脂吸附提取后,酶解。浓缩并衍生化,进行GC-MS分析。在服药后8～30h的尿样中,检出了脱氢氯甲睾酮原型,并发现了七个代谢产物。分析色谱和质谱数据,得到了这些代谢物的结构及其浓度变化趋势,推测了脱氢氯甲睾酮可能的体内代谢模式,确定了筛检尿中脱氢氯甲睾酮的特定代谢物和特征检测离子,比较了不同的样品处理方法对分析结果的影响。     

Suprapancreatic biliary obstruction: CT evaluation

In a 5-year period, 92 patients with biliary obstruction proximal to the pancreatic segment were evaluated with computed tomography (CT). Seventy-three were judged to have technically optimal studies. Observations of the level of obstruction were compared with data from 50 percutaneous transhepatic cholangiograms; CT data enabled the level of obstruction to be correctly predicted in 46. CT enabled correct prediction of the distribution of obstructing lesions in all 18 patients with intrahepatic obstruction. Forty-four of the 73 patients had pathologic examination of the porta hepatitis. CT findings of obstructing mass and lesser omental nodes resulted in correct prediction of malignancy in 25 (92%) of 27 patients; the absence of such findings enabled correct prediction of benign disease in 13 (77%) of 17 individuals. CT is most valuable as a noninvasive means of planning surgical or radiologic drainage procedures in patients with biliary obstruction.     

Non-drug related asystole associated with anaesthetic induction

A patient is presented where routine venepuncture associated with anaesthetic induction resulted in bradycardia and asystole. The case highlights the need for special caution with, and ECG monitoring throughout induction for, patients with a history of syncope. It also demonstrates the need for caution when attributing cardiovascular events during induction to the effect of the induction agents used.