丁公藤碱Ⅱ类似物的合成及其生物活性

本文设计合成了丁公藤碱Ⅱ的C_2脱氧和C_8电子等排类似物。药理结果表明,丁公藤碱Ⅱ的C_2羟基是保持其缩瞳活性的关键部分之一;目的物2和4各自分别具有拟和抗胆碱活性;电子等排目的物16和17既无拟也无抗胆碱作用。     

19. Stichverletzungen der Herzregion - eine Indikation zur Thoracotomie

Zusammenfassung Die Indikation zur Thoracotomie bei breit offenen Verletzungen und großen Blutung ist unumstritten. Diskrete Stichverletzungen verbergen jedoch häufig drohende Perikardtamponaden. Bei stabilen Kreislaufverhältnissen wird durch oberflächliche Wundversorgung wertvolle Zeit verschenkt, die den Erfolg der verzögerten gründlichen Revision der Herzverletzung, die meist ohne Herz-Lungen-Maschine möglich ist, durch Tamponade bedingte ischämische Hirnschädigung limitiert. Das Risiko einer explorativen Thoracotomie ist gegenüber dem Risiko einer plötzlich auftretenden Perikardtamponade bei Stichverletzungen der Herzregion niedrig, so daß die Indikation ur Thoracotomie großzügig gestellt werden sollte.     

Comorbidity,limitations in activities and pain in patients with osteoarthritis of the hip or knee

Background  

This study aims to contribute to the knowledge of the influence of comorbidity in OA. The objectives of the study were (i) to describe the prevalence of comorbidity and (ii) to describe the relationship between comorbidity (morbidity count, severity and the presence of specific diseases) and limitations in activities and pain in elderly patients with knee or hip OA using a comprehensive inventory of comorbidity.     

Tricuspid valve insufficiency in patients with rheumatic mitral valve disease: angiographic diameter of the tricuspid ring and function of the right ventricle

Dilatation of the right ventricle and a consecutive enlargement of the tricuspid valve ring are thought to be the main causes of functional tricuspid regurgitation in patients with rheumatic mitral valve disease. To study the effect of right ventricular dilatation as well as the dimension of the tricuspid valve ring, right ventricular volume indices, ejection fraction, regional shortening, pulmonary artery pressure, and the diameter and systolic shortening of the tricuspid valve were determined in 67 patients with rheumatic mitral valve disease (NYHA class II and III) from biplane ventriculographies. Patients with right ventricular enlargement (greater than 90 ml/m2) were divided into groups with (group IIA) and without (group IIB) tricuspid regurgitation and compared with patients with normal right ventricular size and function without tricuspid regurgitation (group I). There was no difference in the end-diastolic volume index, in the afterload or in the diameter of the tricuspid ring. Right ventricular ejection fraction was decreased in group IIA (51 +/- 9% vs. 59 +/- 10% (IIB) and 61 +/- 6% (control); (p less than 0.05). Regional function was also decreased in group IIA. 73% of the patients with tricuspid regurgitation had right ventricular enlargement, but only 44% of the patients with right ventricular enlargement had tricuspid regurgitation. Thus right ventricular dilatation promotes the development of a tricuspid insufficiency, but is not the only cause. Additional factors like decreased local wall motion, alterations of the valve or the valve apparatus may also account for functional tricuspid regurgitation.