抗心肌缺血药2,6-二甲基-4-双取代苯基-1,4-二氢吡啶-3,5-二羧酸酯的合成

本文报道了9个新的2,6-二甲基-4-双取代苯基-1,4-二氢吡淀-3,5-二羧酸酯的合成。初步药理试验表明:化合物I₆具有较强的抑制KCl诱发兔主动脉条的收缩作用,增加冠脉血流量和心输出量,降低心肌耗氧量;增强小鼠抗缺氧能力;对大鼠心肌缺血有保护作用;能缩小兔缺血心肌再灌流引起的心肌梗塞范围。     

天然有机化合物质谱研究——Ⅺ.苯丙型苷快原子轰击质谱MNa+的MIKES谱

研究了六种苯丙型苷与Na⁺加合离子的快原子轰击质谱(FAB—MS)和质量分离离子动能谱(MIKES)。结果表明:在FAB谱中[M+Na]⁺加合离子的丰度要比[M+H]⁺离子高得多。由此可给出糖苷的分子量信息,[M+Na]⁺离子的MIKES谱可给出糖基序列信息。     

Clinical, brain electric earth map, endothelin and transcranial ultrasonic Doppler findings after hyperbaric oxygen treatment for severe brain injury

Objective　To analyze the effect and mechanism of hyperbaric oxygen (HBO) treatment for severe brain injury (SBI). Methods　Fifty-five patients were divided into a treatment group of 35 patients and a control group of 20 patients. We observed the alterations of clinical, brain electric earth map (BEAM), endothelin (ET) and transcranial ultrasonic Doppler (TCD) findings before and after HBO treatment as well as outcome. Results　In the treatment group, Glasgow coma scale, BEAM and outcome improved after HBO treatment; compared with that of the control group, it showed a significant difference. After one course of treatment, treatment group ET was reduced from 91.24±12.18?ng/L to 68.88±14.37?ng/L (P<0.01); in control group, ET was reduced from 90.78±15.71?ng/L to 83.12±12.22?ng/L, with a statistically significant difference (P<0.05). TCD records of MCA mean velocity (Vm) was reduced from 64.2±4.8?cm/s to 51.6±4.2?cm/s (P<0.01), and a decrease in MCA systolic velocity (Vs) and pulse index (PI) values was statistically significant (P<0.01). Conclusion　HBO treatment can improve the clinical, BEAM and outcome of severely brain injured patients, by decreasing acute stage ET and improving the blood velocity of MCA and decreasing cerebral vascular resistance. HBO treatment can reduce cerebral vascular spasms, cerebral ischemia and hypoxia. One of the important mechanisms of HBO treatment for severe brain injury is the lowering of intracranial pressure.     

Capturing what matters: updating NICE methods guidance on measuring and valuing health

Quality of Life Research - In July 2019, the National Institute for Health and Care Excellence (NICE) initiated a major review of its health technology evaluation methods to update its methods...     

Multimeric structure of platelet factor VIII/von Willebrand factor: the presence of larger multimers and their reassociation with thrombin- stimulated platelets

The multimeric structure of platelet factor VIII/von Willebrand factor (FVIII/vWF) in cell extracts and in collagen and thrombin releasates has been analyzed by SDS polyacrylamide gel electrophoresis followed by detection with 125I-anti-FVIII/vWF. Platelets contained larger multimers than those normally present in plasma. When secreted FVIII/vWF was analyzed, all platelets. In contrast, in thrombin releasates the larger multimers were lost in a manner dependent on divalent cations, time, and thrombin dose. This loss could not be accounted for by modification of FVIII/vWF by thrombin or platelet enzymes since no effect of thrombin on the multimeric structure of FVIII/vWF in the absence of platelets or in the presence of platelet lysates was observed. Large multimers of 125I-labeled purified FVIII/vWF underwent divalent cation-dependent association with platelets in the presence of thrombin, indicating that the loss of FVIII/vWF from thrombin releasates was due to reassociation with the platelet. These studies show a structural difference between platelet and plasma FVIII/vWF that suggests a specific role for platelet FVIII/vWF in hemostasis.     

体外冲击波改善创伤性膝关节功能障碍

目的:比较体外冲击波与关节松动术两种治疗方法对创伤性膝关节功能障碍患者的疗效。方法:选择2004-01/2006-09佛山市第一人民医院收治的63例创伤性膝关节功能障碍患者,随机数字表法随机分为体外冲击波组28例和关节松动术组35例。①治疗方法:体外冲击波组采用骨科冲击波机(深圳慧康医疗器械有限公司)进行体外冲击波治疗,60次/min、强度6～11W/cm2,时间约25min,2次/周,共6次。关节松动术组选用澳式手法和CPM仪治疗,45min/次,次/周,共治疗18次,治疗部位均为患侧膝关节。②评估指标:同时采用测角器评估患者膝关节主动和被动运动时的6关节活动范围变化,并根据关节活动范围变化评估疗效;采用目测类比评分评定活动时疼痛强度;并观察不良事件和副反应。结果:57例患者进入结果分析。①关节活动范围变化:治疗3周后,体外冲击波组膝关节活动度平均增加73.8°,关节松动术组平均增加为35.6°,两者比较差异有非常显著性意义(χ2=26.645P<0.01)。②疼痛评分结果:治疗3周后,体外冲击波组疼痛减轻47.96%,关节松动术组疼痛减轻23.73%,两者比较差异有非常显著性意义(P<0.01)。③疗效:体外冲击波组总有效率100%,关节松动术组总有效率90%。④副反应:体外冲击波组治疗后无任何不良反应,关节松动术组治疗时和后膝关节局部有疼痛剧烈,有6例因此脱落。结论:体外冲击波组治疗创伤性膝关节功能障碍的疗效优于关节松动术组,且膝关节功能障碍改善明显、疗效持久,治疗时患者痛苦少。     

高脂血症阶段自发代谢综合征及2型糖尿病模型大鼠肾小管上皮细胞电压敏感性尿酸盐转运体的表达

目的:观察自发代谢综合征及2型糖尿病动物模型(OLETF大鼠)在高脂血症阶段肾小管上皮细胞电压敏感性尿酸盐转运体的表达。方法:实验于2006-05/10在青岛大学医学院附属医院医学动物实验中心和分子中心实验室完成。选择雄性4周龄OLETF大鼠10只为OLETF组,同系4周龄LETO大鼠(非糖尿病)10只为对照,基础饮食至11周龄。采用定量RT-PCR方法检测电压敏感性尿酸盐转运体在肾皮质中的表达,记录并比较两组大鼠7周龄和11周龄时体质量、体长,及11周龄三酰甘油、总胆固醇、尿酸、肌酐、尿素氮和高密度脂蛋白。结果:20只大鼠均进入结果分析。①7及11周龄时OLETF大鼠体质量大于同龄LETO大鼠[7周龄:(282.42±18.75),(224.58±17.33)g;11周龄:(380.33±30.98),(301.58±25.15)g;P均<0.05],体长也大于同龄LETO大鼠[7周龄:(18.80±0.79),(17.00±0.82)cm,P<0.05;11周龄:(20.08±0.67),(18.17±1.19)cm,P<0.01];但Lee's指数无明显差别。②11周龄时,OLETF大鼠三酰甘油和总胆固醇高于LETO大鼠[(1.24±0.43),(0.41±0.14)mmol/L;(1.92±0.19),(1.46±0.15);P均<0.05];尿酸较LETO组增高,但差异不显著,其他指标两组无明显差别。③OLETF大鼠大鼠电压敏感性尿酸盐转运体mRNA的表达水平低于LETO大鼠(0.32±0.12,1.12±0.63,P<0.05)。结论:OLETF大鼠在高脂血症阶段,随着尿酸的升高,电压敏感性尿酸盐转运体mRNA的表达明显降低,可能通过下调电压敏感性尿酸盐转运体的表达,来调节体内尿酸的排泄,脂代谢紊乱和高尿酸血症可能通过该纽带相联系。     

高龄患者并存病的围手术期处理

1临床资料我院自1998-8/2004-10,共收治70岁以上有并存病的患者52(男34,女18)例,年龄70～87(平均74.2)岁.在52例患者中,肺癌2例,直结肠癌13例,胃食道癌10例,肝脓肿2例,阑尾炎14例,前列腺肥大8例,胆管结石2例,急性胰腺炎1例.