白花前胡中前胡香豆素D和前胡香豆素E的分离和鉴定

从中药白花前胡(Peucedanum Praeruptorum Dunn)根中分到5个化合物,经理化常数、波谱数据及化学反应分别鉴定为前胡香豆素D(I),Pd-Ib(II),前胡香豆素E(III),nodakenetin(IV)和scopoletin(V)。其中化合物I和III为两个新化合物,与巳知化合物凯林内酯的化学沟通确定了其绝对构型,其化学结构分别为3'(S),4'(S)-二乙酰氧基-3',4'-二氢邪蒿内酯(I)和3'(R)-惕各酰氧基-4'-酮基-3',4'-二氢邪蒿内酯(III)。化合物IV和V为首次从该植物中分离得到。通过DEPT,¹H-¹HCOSY和¹³C-¹HCOSY等实验归属了II的碳氢信号。     

Clinical diagnosis of carpal tunnel syndrome: a systematic review.

The purposes of this systematic review were to examine the properties of clinical tests used in the diagnosis of carpal tunnel syndrome (CTS) and to provide estimates of their sensitivity and specificity. A literature search was conducted using two databases-PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL)-from 1986 to June 2003, and hand-searching reference lists of retrieved articles. Two reviewers evaluated the papers for quality using an evaluation tool developed by one of the authors. Estimates of sensitivity and specificity were determined by averaging values across studies weighted by sample size. Although 60 studies were reviewed in detail, many were of poor quality (mean quality score was 6.6 of 12, with only 15 of 60 obtaining a score of 8 or greater). The most frequently studied test was Phalen's, with an overall estimate of 68% sensitivity and 73% specificity. Next was Tinel's, with estimates of 50% and 77%, and then carpal compression, with estimates of 64% and 83% for sensitivity and specificity, respectively. Two-point discrimination and testing of atrophy or strength of the abductor pollicis brevis proved to be specific but not very sensitive. The estimates determined in this review should help therapists choose clinical tests with the appropriate balance of sensitivity and specificity required for diagnosing carpal tunnel syndrome in their specific clinical environments.     

Paraneoplastic cerebellar degeneration associated with Hodgkin's disease

Summary A case of paraneoplastic cerebellar degeneration (PCD) associated with Hodgkin's disease is presented. The features that make this case particularly interesting are the simultaneous occurrence of PCD with a relapse of Hodgkin's disease, which has been present for 17 years, and the arrested progression of cerebellar dysfunction after a subacute onset. Cerebellar atrophy was revealed by computed tomography and magnetic resonance imaging. In contrast to two previously reported cases, anti-Purkinje-cell antibodies were not detected.     

Pelvic examination training for interns: a randomized controlled trial.

PURPOSE: To evaluate the effectiveness of pelvic examination training for internal medicine interns conducted by instructors who also serve as models for the examination. METHOD: In 2001, 80 interns from three university internal medicine residencies completed questionnaires about their experiences with pelvic examinations. Interns who were available for training underwent baseline assessment of their pelvic examination skills and were randomized to training or to a control group that received only educational literature. Skills were assessed with a 29-item checklist at baseline and at follow-up by evaluators blinded to group assignment, and interrater agreement was estimated by review of audiotapes. RESULTS: Seventy-two interns were randomized and underwent baseline skills assessment. Seventy interns returned for follow-up assessment after approximately 14 weeks (range, 10-17 weeks). The 39 interns randomized to training and 33 randomized to the control group did not differ with respect to age, gender, or prior pelvic examination training. In both groups there was substantial variability in skills at baseline, with graduates of U.S. medical schools scoring significantly higher than did graduates of non-U.S. medical schools (0.66 versus 0.41, p < 10(-5)). Interns randomized to training had significantly higher scores at follow-up than did interns in the control group (0.79 versus 0.57, p < 10(-6)). For seven items verifiable by audiotape, interrater agreement was good (overall kappa, 0.54; range among items, 0.3-0.85). CONCLUSION: Specialized trainers can reliably evaluate and improve the pelvic examination skills of interns, and improvements are demonstrable three months after training. Further research is needed to ascertain whether training efficiency can be improved and to measure the impact of training on patient satisfaction and clinical outcomes.     

Comparison of Phaconit Rollable IOL with Acrylic Foldable IOL

Background

Phaconit or ultra micro incision phacoemulsification cataract surgery involves phacoemulsification through a 0.9 millimetre sleeveless phaco tip and irrigating chopper followed by implantation of a rollable intraocular lens. The procedure leads to negligible astigmatism and faster visual recovery as compared to phacoemulsification with a foldable intraocular lens.

Methods

This prospective study analysed 80 cases of sub millimetre phaconit surgery with implantation of rollable intraocular lenses(IOL) in 40 cases and acrylic foldable IOL in the remaining 40 cases. Evaluation of efficacy and adaptability of procedure, equipment settings, operative constraints, postoperative complications, keratometric and topographic evaluation of induced astigmatism with visual outcome and patient''s rehabilitation were studied.

Results

The intraoperative complications were surge/ chamber collapse in 16 (20%), iris chaffing in one and corneal burns in two cases. All cases had an induced astigmatism of less than or equal to ± 0.25 D in four to six weeks after rollable IOL and ± 0.5 D to ± 0.75 D after acrylic IOL implantation. All patients had best-corrected visual acuity of 6/6 by third post operative day.

Conclusion

Phaconit with rollable IOL is a perfect blend of surgical skill, application of technology and ultra thin IOL.Key Words: Phaconit, Ultra micro phaco, Submillimetre incision, Rollable IOL implantation     

Testing Multiple Psychological Processes for Common Neural Mechanisms Using EEG and Independent Component Analysis

Temporal independent component analysis (ICA) is applied to an electrophysiological signal mixture (such as an EEG recording) to disentangle the independent neural source signals—independent components—underlying said signal mixture. When applied to scalp EEG, ICA is most commonly used either as a pre-processing step (e.g., to isolate physiological processes from non-physiological artifacts), or as a data-reduction step (i.e., to focus on one specific neural process with increased signal-to-noise ratio). However, ICA can be used in an even more powerful way that fundamentally expands the inferential utility of scalp EEG. The core assumption of EEG-ICA—namely, that individual independent components represent separable neural processes—can be leveraged to derive the following inferential logic: If a specific independent component shows activity related to multiple psychological processes within the same dataset (e.g., elicited by different experimental events), it follows that those psychological processes involve a common, non-separable neural mechanism. As such, this logic allows testing a class of hypotheses that is beyond the reach of regular EEG analyses techniques, thereby crucially increasing the inferential utility of the EEG. In the current article, this logic will be referred to as the ‘common independent process identification’ (CIPI) approach. This article aims to provide a tutorial into the application of this powerful approach, targeted at researchers that have a basic understanding of standard EEG analysis. Furthermore, the article aims to exemplify the usage of CIPI by outlining recent studies that successfully applied this approach to test neural theories of mental functions.     

It's not too late: The onset of the frontocentral P3 indexes successful response inhibition in the stop‐signal paradigm

The frontocentral P3 event‐related potential has been proposed as a neural marker of response inhibition. However, this association is disputed: some argue that P3 latency is too late relative to the timing of action stopping (stop‐signal reaction time; SSRT) to index response inhibition. We tested whether P3 onset latency is a marker of response inhibition, and whether it coincides with the timing predicted by neurocomputational models. We measured EEG in 62 participants during the stop‐signal task, and used independent component analysis and permutation statistics to measure the P3 onset in each participant. We show that P3 onset latency is shorter when stopping is successful, that it is highly correlated with SSRT, and that it coincides with the purported timing of the inhibition process (towards the end of SSRT). These results demonstrate the utility of P3 onset latency as a noninvasive, temporally precise neural marker of the response inhibition process.