Arthroscopic chondrectomy as a treatment of cartilage lesions

Although favorable effects of débridement with chondrectomy and drilling or abrasion have been reported in treating of cartilage lesions in the knee joint; however, in most cases an additional intervention is generally performed during arthroscopy. We studied 53 consecutive patients with solitary chondral lesions in the weight-bearing part of the knee and treated 86 cartilage lesions by arthroscopic débridement, including a detailed removal of damaged or undermined cartilage. We evaluated the postoperative course by questionnaire (mean follow-up 6.5 years, response rate 83%). All patients reported a positive effect of chondrectomy: 69% considered the knee considerably better or cured and 77% regarded the effect as permanent. There was no complication of the arthroscopies performed, and no patient noted any deterioration in the condition. We therefore recommend routine chondrectomy of cartilage lesions when these are found during an arthroscopy.     

d-生物素的立体专一性全合成研究

对confaione的d-生物素(1)全合成进行了改进,从半胱氨酸计算,总收率3.7%。5与4-溴代三苯膦丁酸甲酯进行Wittig-Schlosser缩合反应可立体专一性地转化成反式-烯(6)。以叠氮三甲基硅烷代替叠氮化锂亲核进攻9分子中C3-溴原子,可显著地提高顺式-叠氮内酰胺10的收率。     

柱切换HPLC法测定豚鼠体内诺氟沙星银解离物诺氟沙星的浓度

用柱切换HPLC法建立了豚鼠血浆和皮下组织液中诺氟沙星银体内主要解离物诺氟沙星的测定方法。预处理柱为μ-BondapakC₁₈,37～50μm,50mm×5mmID;分析柱为YWG-C₁₈,10μm,150mm×5mmID。预处理流动相为0.008mo1/L磷酸缓冲液,流速为3ml/min;分析流动相为甲醇—0.008mol/L磷酸缓冲液—0.05mol/L四丁基溴化铵(25:75:4)。紫外检测波长为280nm。皮下组织液及血浆中的线性范围分别为100～3200ng/ml(r=0.9999)和2～128μg/ml(r=0.9999);最低检测浓度分别为10ng/ml和0.25μg/ml,方法的平均回收率为102%,日内及日间偏差均小于7%。     

Evaluation of a new device for measuring oral mucosal surface friction

Abstract – For the objective measurement of oral mucosal dryness or moisture, a device registering oral mucosal surface slide friction has been developed. Two prototypes, Probe I and Probe II, have been tested. Probe I was constructed for initial testing of the method and was based on easily accessible electrical components. Probe I was computerized and developed for more accurate registration and also for easy handling. Reliability and validity tests were carried out on Probe I as well as on Probe II. In repeated in vitro measurements, the probes showed good reproducibility. Validity was assessed on healthy subjects injected with methylscopolamine nitrate submucosally in the labial sulcus. All subjects experienced a pronounced oral mucosal dryness within half an hour. Registration with the surface slide friction device showed maximum friction values 1-2 h after injection. These reliability and validity tests gave good results for both Probe I and Probe II, but Probe II had several practical advantages over Probe I. Both probes were considerably more sensitive to changes of the oral mucosal surface than the previously used simple friction test using the back of a mouth mirror.     

Establishing principles for migraine management in primary care

Published guidelines for the management of migraine in primary care were evaluated by an international advisory board of headache specialists, to establish evidence-based principles of migraine management that could be recommended for international use. Twelve principles of migraine management were identified, covering screening, diagnosis, management and treatments: Almost all headaches are benign/primary and can be managed by all practising clinicians. Use questions/a questionnaire to assess the impact on daily living and everyday activities, for diagnostic screening and to aid management decisions. Share migraine management between the clinician and the patient. Provide individualised care for migraine and encourage patients to manage their migraine. Follow up patients, preferably with migraine calendars or diaries. Regularly re-evaluate the success of therapy using specific outcome measures and monitor the use of acute and prophylactic medications regularly. Adapt migraine management to changes that occur in the illness and its presentation over the years. Provide acute medication to all migraine patients and recommend it is taken at the appropriate time, during the attack. Provide rescue medication/symptomatic treatment for when the initial therapy fails. Offer to prescribe prophylactic medications, as well as lifestyle changes, to patients who have four or more migraine attacks per month or who are resistant to acute medications. Consider concurrent co-morbidities in the choice of appropriate prophylactic medication. Work with the patient to achieve comfort with mutually agreed upon treatment and ensure that it is practical for their lifestyle and headache presentation. Using these principles, practising clinicians can screen and diagnose their headache patients effectively and manage their migraine patients over the long-term natural history of the migraine process. In this way, the majority of migraine patients can be well treated in primary care, ensuring a structured and individualised approach to headache management, and conserving valuable healthcare resources.     

双能X射线骨密度仪测量不同个体腰椎椎骨骨面积、骨矿含量的精度差异

目的：对不同个体椎骨短期精度进行观察,发现骨质疏松的严重程度不同其短期精度不同。分析DPX-MD双能X射线骨密度仪测量不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的短期精密度,了解上述指标对骨矿含量或骨密度测定的影响,以便为骨矿含量或骨密度检测质量控制和减少误差提供依据。 方法：实验于2004-05/2006-12在川北医学院人体解剖实验室与川北医学院附属医院内分泌科骨密度室完成。①对象：铝体模;3个活体椎体（38岁骨密度正常男性;40岁骨质疏松症男性;62岁轻微骨量减少女性）;1个带软组织的死体椎体（由川北医学院人体解剖实验室提供）。②方法及评估：采用美国Lunar公司生产的DPX-MD双能X射线骨密度仪测量各椎体的椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽。3次/d,连续测定5d。铝体模和死体椎体两端均用小木块固定在6.5cm的高度,放在15cm的水浴中,为减少误差由一人操作。由不同椎骨面积、骨矿含量、椎体宽、椎体高及骨矿含量/椎体宽可得到各自的变异系数。 结果：①腰椎各椎体和L2～4的骨矿含量的变异系数：各椎体或L2～4骨矿含量变异系数从正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大。②各椎体和L2～4的椎骨面积、椎体宽、椎体高的变异系数：椎骨面积、椎体宽的值从铝体模、正常男性椎体、骨质疏松症男性椎体、轻微骨量减少女性椎体与死体椎体呈依次增大,尤其是轻微骨量减少女性椎体与死体椎体较大;椎体高的变异系数以骨质疏松症男性椎体与轻微骨量减少女性椎体较大,尤其是轻微骨量减少女性椎体的变异系数最大。 结论：不同个体椎骨骨面积、骨矿含量、椎体宽、椎体高的精度不同,对骨密度测定的影响不同。椎间隙欠清楚者由于椎体分椎线难于确定,椎体高度的测定对骨密度测定影响较椎间隙清楚者大;有骨质增生和骨质疏松越严重者由于椎体边缘线难于确定,椎体宽度的测定对骨密度测定影响较无骨质增生和骨密度正常者大;有骨质增生存在和骨质疏松越严重,骨面积的测定对骨密度测定影响越大;骨质疏松越严重,骨矿含量测定对骨密度测定影响越大。