LC-ESI-MS/MS法测定草棉花瓣提取物中组氨酸的含量

目的:建立测定草棉花瓣提取物中组氨酸含量的方法。方法:采用高效液相色谱-电喷雾串联质谱法。色谱柱为Altima HP HILIC(150mm×2.1mm×3.0μm),流动相为甲醇-0.1%甲酸溶液(10∶90),流速为0.20mL·min-1,柱温为室温;离子源为ESI,正离子扫描,多反应离子监测模式,用于定量分析的离子反应为m/z156.4→m/z110.1。结果:组氨酸检测浓度在0.05135～0.61620μg·mL-1范围内与峰面积积分值呈良好线性关系(r=0.9995);平均加样回收率为99.8%,RSD=1.5%(n=9)。结论:本方法准确、灵敏度高、重复性好,可用于草棉花瓣提取物的质量控制。     

Remote Cerebellar Hemorrhage and Iliofemoral Vein Thrombosis After Supratentorial Craniotomy

Introduction  Cerebellar hemorrhage following supratentorial craniotomy is rare. Its clinical symptoms are often mild and transient. Discussion  Here, we report a case of cerebellar hemorrhage associated with iliofemoral vein thrombosis as a complication of anterior temporal lobectomy and amygdalohippocampectomy for refractory medial temporal epilepsy.     

The multistage use of buccal mucosa grafts for complex hypospadias: histological changes

PURPOSE: We report our experience using buccal mucosa in the multistage repair of complex hypospadias, and the observed histological changes. MATERIALS AND METHODS: We evaluated 31 patients (14 adults and 17 children). A total of 19 patients presented after failed hypospadias repair with deficient ventral skin, 5 presented with scrotal hypospadias and 7 presented with perineal hypospadias. Patients who had previously undergone hypospadias repair had 3 to 7 failed trials. Two stage buccal mucosa graft was performed using the Bracka technique. In the first stage residual fibrosis was released, the glans was split and the buccal mucosa graft was sutured to the ventral surface of the penis to form a future urethral plate. Second stage reconstruction was performed after 6 months with interposed scrotal dartos tissue. Buccal mucosa was histologically studied before grafting, and at 6 months after graft uptake and exposure to the air. RESULTS: Buccal mucosa free graft showed excellent uptake within 5 days in all cases. At 6 months the buccal mucosa was well vascularized and pliable. Minute fistulas occurred in 3 cases (9.7%), which were closed at a later stage. Histological analysis of buccal mucosa tissues before and after graft and prolonged exposure to the air (more than 6 months) was conducted. The buccal mucosa displayed epithelial hyperplasia with mild and focal keratinization. The lamina propria was slightly edematous and minimally infiltrated by mononuclear inflammatory cells. The lamina propria papillae were elongated, extending to 75% of the mucosal thickness compared to the normal buccal mucosa. The buccal mucosal graft displayed good vascularization, similar to that of the normal mucosa. CONCLUSIONS: Multistage repair using buccal mucosa is an excellent option for urethral reconstruction. It guarantees excellent graft uptake and good vasculature, which improves success. It also provides supple tissue for glanular and urethral reconstruction in cases of severe complex hypospadias.     

Epileptic nystagmus in a patient with nonconvulsive status epilepticus.

Epileptic nystagmus (EN) is a rare form of rhythmic eye oscillations occurring during seizure activity. Not only convulsive states, but also nonconvulsive status may represent with EN and this phenomenon may be the only motor manifestation of seizure activity. Epileptic activation of a cortical saccade region may be distinguished from activation of a cortical pursuit region clinically as activation of pursuit regions results in nystagmus slow phases that bring the eyes across the midline. Horizontal EN results most commonly from seizure activity involving the occipital cortex. In this report, horizontal EN in a patient with nonconvulsive status epilepticus (NCSE) is described with clinical, radiological and electrophysiological findings that occur probably due to posterior leukoencephalopathy syndrome.     

Effect of a Practice Guideline for Emergency Department Care of Falls in Elder Patients on Subsequent Falls and Hospitalizations for Injuries

OBJECTIVE: To determine the effect of a practice guideline for the ED management of falls in community-dwelling elders on selected health outcomes. METHODS: The experimental design was a prepost-intervention comparison with one-year pre- and post-intervention phases. The guideline was presented to emergency physicians and nurses during a two-week interval between these two periods. The intervention also included health information provided to the subjects and a one-time educational intervention directed at primary care providers. The number of falls in the year following the ED visit was determined by telephone interview. The number of hospitalizations for falls was determined from the HMO database of all health care encounters. RESULTS: 1,899 patients were eligible for the study; 1,140 pre-intervention and 759 post-intervention patients. Of these, 1,504 (79%) were interviewed by telephone 12 to 15 months after their initial ED visits. Eighteen percent of the pre-intervention and 21% of the post-intervention subjects reported at least one fall in the 12 months following their ED visits (p = 0.162). The rate of falls per 100 patient years was 36.2 in both groups. Three percent of both groups were hospitalized at least once for a fall in the year following their ED visits. One percent in each group were hospitalized for a hip fracture. CONCLUSIONS: The attempted implementation of a practice guideline for the ED management of falls in community-dwelling elders did not result in a reduction in total falls, or in hospitalizations for falls, injuries, or fractures.     

Ein experimenteller Beitrag zur Frage des localen Meteorismus bei Darmocclusion

Ohne Zusammenfassung (Fortsetzung folgt.)     

The course of pregnancy among mothers above 35 years and its outcome in Kafr-El-Zayat.

A group of pregnant mothers above 35 years old were collected from the MCH centre in Kafr-El Zayat during a period of 10 months (82). A control group of mothers aged 20-30 years old were also selected during the same period (62). Those with specific diseases from both groups were excluded. During the repeated visits of those mothers to the MCH centre they were subjected to complete history taking, physical examination plus urine analysis & haemoglobin levelling. A special visit was performed by the researcher to the mothers on 7th day after labour to report on the outcome of labour. The present study revealed significant differences between mothers over 35 years and those of 20-30 years in the course of pregnancy, labour and their outcomes where the former group showed greater tendency to be at a higher risk.     

Cytoreductive nephrectomy in the elderly patient: the M. D. Anderson Cancer Center experience

PURPOSE: Cytoreductive nephrectomy as part of a multidisciplinary approach may be considered in patients with metastatic renal cell carcinoma. The benefit in the elderly population (75 years or older) is unclear. We reviewed our experience to help determine if it is of benefit in this patient population. MATERIALS AND METHODS: Of 404 patients undergoing cytoreductive nephrectomy from 1995 and 2005 we identified 24 elderly patients. Outcomes in these elderly patients were analyzed and compared to outcomes in the remaining 380 who were younger than 75 years. RESULTS: Median age in the elderly and younger groups was 77.5 and 57.0 years, respectively. Performance status, sex distribution, and tumor histology, stage, grade and size were comparable. Estimated blood loss, transfusion rates, surgical times and hospital stay were similar in the 2 groups. There were 5 perioperative deaths (21%) in elderly patients compared to 4 (1.1%) in younger patients (p<0.01). Estimated blood loss, units transfused and surgical time were greater in the patients who died perioperatively (p<0.05). Median survival was 16.6 months in the elderly group, which did not differ statistically from the 13.7 months in the younger group. CONCLUSIONS: Cytoreductive nephrectomy in the elderly population can be associated with the potential for significant morbidity and mortality. Despite this and as part of a multidisciplinary approach it may provide potential survival as well as other benefits, which may justify it in highly select and highly motivated patients who are 75 years or older. However, it must be performed carefully with realistic expectations on behalf of the patient and urologist.