采收期对杭白菊4个主栽品种功效成分的影响

为了揭示采收期对杭白菊4个主栽品种主要功效成分的影响,确定最佳采收期,采集杭白菊4个主栽品种花蕾、胎菊、幼菊、全菊4个时期16个样品,采用紫外-可见分光光度计法测定总黄酮含量;以反相高效液相色谱法测定绿原酸、木犀草苷、3,5-O-双咖啡酰基奎宁酸含量.结果表明杭白菊4个主栽品种不同采收期采收对其主要功效成分有显著影响,总黄酮和绿原酸含量在花蕾期最高,胎菊期次之;木犀草苷含量胎菊期最高,幼菊期次之;3,5-O-双咖啡酰基奎宁酸含量胎菊期最高,花蕾期次之;4个品种单花质量从花蕾期到全菊期均显著增加,全菊最高.综合功效成分与采收期的关系,杭白菊4个主栽品种均在胎菊期采收最佳.     

Angioplasty and stenting for the occluded internal carotid artery

To investigate the feasibility and efficacy of angioplasty and stenting for symptomatic occlusion of carotid artery. From December 2004 to June 2009, 17 patients with progressive or reoccurred ischemic stroke or repeated transient ischemic attack resulted from the total occluded carotid artery underwent angioplasty and stenting were reviewed. All patients with successful procedure were followed up. Clinic and angiography data were documented prospectively. The median time from symptoms onset to procedure was 23 days (range 3–94 days). Twelve of the 17 patients (70%) were obtained technique success. Eight patients were observed the collapse of internal carotid artery between occluded location to origin of ophthalmic artery after the occlusion was patent. Two patients had clots which were solved with urokinase. The collapsed internal carotid artery was improved markedly in the compute tomography angiograph 7 days after the procedure. No any complications related procedures occurred. One patient died from myocardial infarct and one suffered from ischemic minor stroke in brainstem for a median follow-up of 346.5 days. One of 9 patients (11.1%) was observed in-stent stenosis in the follow-up angiography. Angioplasty and stenting was a potential alternative therapy for symptomatic occlusion of carotid artery. Further study is required to determine the safety of this treatment.     

Oral ginseng formulae for stable chronic obstructive pulmonary disease: a systematic review

Ginseng alone or combined with other herbs has been increasingly used for chronic obstructive pulmonary disease (COPD). This review aims to evaluate the effectiveness and safety of oral Ginseng formulae for stable COPD. Four English databases and three Chinese databases were searched to identify randomized controlled trials. Methodological quality was assessed by Cochrane risk of bias and Jadad's scale. Data were analyzed using Review Manager 5.0. Twelve studies overall of low quality, involving 1560 participants were included. Results of three studies showed a mean difference (MD) of 0.30 (95%CI 0.02 to 0.58) for forced expiratory volume in 1 s (FEV(1)) improvement of Ginseng formulae versus placebo control. Findings of three studies revealed an MD of 9.43 (95%CI 3.64 to 15.21) of FEV(1) % predicted between Ginseng formulae and placebo control. Quality of life (Qol) measured by St. George's Respiratory Questionnaire was improved (MD -10.32, 95%CI -14.99 to -5.65) with Ginseng formulae plus pharmacotherapy versus pharmacotherapy alone in one study. There were no severe adverse events reported. Ginseng formulae for stable COPD patients show promising evidence of lung functions and Qol improvement. However, the degree of benefit is uncertain due to potential risk of bias of the included studies.     

Risk factors associated with haemodynamic depression during and after carotid artery stenting

We aimed to investigate the risk factors for haemodynamic depression (HD) during and after carotid artery stenting (CAS). A total of 251 patients with CAS, enrolled between June 2004 and December 2008, were divided into two groups according to periprocedure observations: (i) a group with HD (systolic blood pressure < 90 mmHg and heart beat rate < 50/ beats per minute); and (ii) a group without (non-HD). The risk factors for HD were analysed by univariate analysis and a logistic regression model. The univariate analysis of variance showed that the following factors were significantly associated with HD in patients with CAS: severe calcified plaque, stenosis greater than 70%, distance from the carotid bifurcation to the maximum stenotic lesion of <10 mm, balloon dilation lasting more than 5 s with a pressure of more than 8 atmospheres (atm), multiple balloon dilations, balloon length, balloon diameter, and bilateral stenting. The results of the logistic regression model analysis showed that the following were independent risk factors for HD during and after CAS: the degree of stenosis, severe calcified plaque, bilateral stenting and a balloon dilation pressure of >8 atm. We concluded that patients with stenosis > 70%, severe calcified plaque, bilateral stenting and a balloon dilation pressure > 8 atm may be more likely to develop HD during and after CAS.     

缺血性卒中血管内治疗的现状与展望

经过20余年的发展,脑血管内治疗技术在应用材料和临床经验上已取得了显著的进步。一些相关随机对照临床试验的中远期随访结果亦相继公布,为脑血管病的血管内治疗提供了重要证据。介入治疗技术在急性缺血性卒中后血管再通方面的应用研究尤其发展迅速,笔者拟就血管内治疗技术在缺血性脑血管病中的治疗现状和发展趋势进行简要综述。     

Anterior limb lesions in bilateral internal capsules and memory function in patients with refractory obsessive-compulsive disorder

BACKGROUND: Previous studies have shown that lesions in the anterior limb of the internal capsule contribute to obsessive-compulsive symptoms in patients with refractory obsessive-compulsive disorder (OCD). However, few reports have addressed the effects of lesions in the anterior limb of the internal capsule on cognition, learning, and memory functions in patients with refractory OCD.OBJECTIVE: To investigate the degree of damage to memory tasks in refractory OCD patients following lesions to the anterior limb of the internal capsule. DESIGN, TIME AND SETTING: A case-controlled, observational study was performed at the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008. PARTICIPANTS: A total of 10 refractory OCD patients were admitted to the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008 and were recruited for this study. The OCD patients were of equal gender, with an average age of (25.1 ± 9.6) years. An additional 10 healthy volunteers were enrolled from a community of Shanghai City as controls; they were of equal gender and aged (25.1 ± 8.6) years. METHODS: A total of 10 refractory OCD patients were subjected to lesions in the anterior limbs of the bilateral internal capsules. Wechsler Memory Scale-Chinese Revision (WMS-CR, as a task of explicit memory) and the Nissen Version (serial reaction time task) software (SRTT, as a task of implicit memory) were applied to determine memory functions and learning performance in pre- and post-operative OCD patients and controls. MAIN OUTCOME MEASURES: WMS scores, reaction time in SRTT, and Yale-Brown obsessive compulsive scale scores were measured in pre- and post-operative OCD patients and controls. RESULTS: Compared to controls, the pre-operative OCD patients exhibited reduced memory task scores (P = 0.005), whereas scores for reciting numbers of backwards digits were greater (P = 0.000). Figure recall and associative memory were less in OCD patients at 1 week following surgery than in the pre-operative OCD patients (P = 0.042, P = 0.002, respectively). Reaction time in implicit SRTT was significantly longer in pre-operative OCD patients compared with controls and post-operative OCD patients (P = 0.01, P = 0.03, respectively). These results suggested ameliorated SRTT following neurosurgery. Yale-Brown Obsessive Compulsive Scale results revealed significantly improved OCD following lesions in the internal capsule (P = 0.04). Some post-operative OCD patients suffered from deficits in short-term memory and implicit memory. CONCLUSION: Lesions in anterior limbs of bilateral internal capsules improve obsessive- compulsive symptoms and implicit memory in OCD patients, but result in aggravated short-term memory deficits.     

保留内置物清创联合真空负压封闭引流治疗早发性腰椎融合术后感染

目的回顾分析保留内置物清创联合真空负压封闭引流治疗早发性腰椎融合术后感染的疗效。方法785例腰椎后路融合病例中术后早发性深部伤口感染6例,均为术后30d内出现发热、疼痛加重等症状,并伴有炎性指标升高,均采用保留内置物,彻底清创后持续冲洗负压引流,抗炎治疗。结果清创术后腰痛即明显缓解,体温下降,2周左右伤口渗液停止,疼痛消失,血常规和C反应蛋白检查结果正常,血沉明显下降。随访平均35．3个月,末次随访时X线片提示腰椎植骨融合。JOA评分改善率为82．2％。结论对于早发性腰椎融合术后感染病例,进行积极清创手术,保留内置物联合真空负压封闭引流能够及时控制感染,是一种较为有效的处理。日服抗生素抑菌治疗可以降低清创术术后感染复发。     

Improved sensitivity of vaginal self-collection and high-risk human papillomavirus testing

Self-collected vaginal specimens tested for high-risk human papillomavirus (HR-HPV) have been shown to be less sensitive for the detection of cervical intraepithelial neoplasia or cancer (≥CIN 3) than physician-collected endocervical specimens. To increase the sensitivity of self-collected specimens, we studied a self-sampling device designed to obtain a larger specimen from the upper vagina (POI/NIH self-sampler) and a more sensitive polymerase chain reaction (PCR)-based HR-HPV assay. Women (10,000) were screened with cervical cytology and HR-HPV testing of vaginal self-collected and endocervical physician-collected specimens. Women were randomly assigned to use either a novel self-collection device (POI/NIH self-sampler) or conical-shaped brush (Qiagen). The self-collected and clinician-collected specimens were assayed by Cervista (Hologic) and the research only PCR-based matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF). Women with any abnormal screening test underwent colposcopy and biopsy. Women (8,556), mean age of 38.9, had complete data; 1.6% had ≥ CIN 3. For either HR-HPV assay, the sensitivity was similar for the two self-collection devices. Tested with Cervista, the sensitivity for ≥CIN 3 of self-collected specimens was 70.9% and for endocervical specimens was 95.0% (p = 0.0001). Tested with MALDI-TOF, the sensitivity for ≥CIN 3 of self-collected specimens was 94.3% and for endocervical specimens was also 94.3% (p = 1.0). A self-collected sample using a PCR-based assay with the capability of very high throughput has similar sensitivity as a direct endocervical specimen obtained by a physician. Large population-based screening "events" in low-resource settings could be achieved by promoting self-collection and centralized high-throughput, low-cost testing by PCR-based MALDI-TOF.     

转型期基层医院生存与发展研究（二）——区域间基层医院比较研究

以基层医院为龙头的三级医疗网覆盖了全国约70%的人群,基层医院改革的成功与否,将直接影响到新医改的最终结果。本文以事实和数据为基础,从经济收入、运营指标、人员结构、学科建设、科学研究等方面,对以经济区域为划分的东、中、西部地区基层医院的生存现状与发展前景进行深入描述和比较。结果表明：①东部地区基层医院生存现状优势最大,近三年各项指标均稳步增长;②中部地区基层医院与东部相比仍有一定差距,近三年重点进行医院人才、科研等基础建设;③西部地区基层医院基础最为薄弱,近三年来在运营及经济方面增长较快,有很大的发展空间。     

呼吸频率及潮气量对老年CO2气腹患者呼吸功能及胃黏膜pH值变化的预测价值

目的研究呼吸频率及潮气量在腹腔镜胆囊切除中CO₂气腹对老年患者呼吸功能及胃黏膜pH值(pHi)的影响。 方法42例腹腔镜胆囊切除CO₂气腹的老年患者(≥65岁),在全麻CO₂气腹压力为13mmHg(1mmHg＝0.133kPa),依术中呼吸频率、潮气量分为A、B组。A组22例(呼吸频率12次/min,潮气量9ml/kg),B组20例(呼吸频率14次/min,潮气量7ml/kg),分别于气腹前(T1)、气腹后20min (T2)、气腹结束后20min(T3)监测气道压力峰值(PPEAK)、呼气末CO₂分压(P_ETCO₂)及pHi值。 结果A、B两组在PPEAK、P_ETCO₂及pHi参数方面各组组间T2同节点比较,差异有统计学意义[(分别为(25.68±2.61)mmHg,(22.03±4.12)mmHg;t＝3.46 ,P<0.05;(35.68±1.61)mmHg,(33.09±1.12)mmHg;t＝5.99 ,P<0.05;(7.08±0.08)mmHg,(7.26±0.05)mmHg;t＝8.64,P<0.05]。 结论使用适当的高通气频率、低潮气量通气方法,对CO₂气腹腹腔镜胆囊切除老年患者的呼吸功能及胃黏膜pH值具有正向作用。