自制新荧光剂EPQS的性能测试

作者对自制新荧光剂EPQS进行了性能测试。结果:量子产率为0.21;最大激发波长和荧光波长分别为375nm和484nm,stokes位移109nm;检测生物化合物常用的缓冲溶液对荧光峰位无影响,对荧光强度影响很小;温度的影响也小(18～43℃,FRI61.5～58.1),PH的影响也不大。说明EPQS不仅荧光参数好,而且稳定性也好。适合在较广泛的环境条件下使用。     

金钱白花蛇及其混淆品的鉴别

从原动物形态、药材性状、显微特征及理化方面对金钱白花蛇（银环蛇Ｂｕｎｇａｒｕｓｍｕｌｔｉｃｉｎｃｔｕｓ）及其３种混淆品水赤链游蛇Ｎａｔｒｉｘａｎｍｕｌａｒｉｓ，赤链蛇Ｄｉｎｏｄｏｎｒｕｆｏｚｏｎａｔｕｍ，金环蛇Ｂ．ｆａｓ－ｃｉａｔｕｓ进行了对比鉴别。     

乌司他丁对严重烧伤患者伤后早期心肌损害的防治作用

目的观察乌司他丁（UTI）对烧伤“休克心”的防治作用，探讨其可能的机制。方法选择笔者单位收治的伤后24h内入院、烧伤面积〉50％TBsA的34例特重度烧伤患者，分为烧伤组和UTI治疗组，每组17例。两组患者均进行常规治疗，且UTI治疗组患者入院后立即给予UTI10万U静脉滴注，3次／d，连续7d。于两组患者伤后2、4、7d采血，检测其血浆中性粒细胞弹性蛋白酶（PMN elastase）、心肌肌钙蛋白I（cTnI）含量和心肌型肌酸激酶同工酶（CK—MB）活性，以公认的各指标正常值作参考，并对3项指标进行相关性分析。结果（1）伤后2、4、7d，两组患者血浆PMN elastase及cTnI含量均显著高于正常值（P〈0．01）；UTI治疗组与烧伤组比较，两指标偏低。（2）与正常值比较，伤后2、4、7d烧伤组患者CK—MB活性明显升高（P〈0．01），第4天达高峰；UTI治疗组伤后2、4d CK—MB活性明显高于正常值（P〈0．05或0．01），但与烧伤组比较升幅较小，第7天降至正常值水平（P〉0．05）。（3）34例烧伤患者PMN elastase、cTnI含量及CK—MB活性三者间均呈现显著正相关，前两者的相关系数为0．904，后两者的相关系数为0．922，PMN elastase含量与CK-MB活性的相关系数为0．829（均为P〈0．01）。结论UTI能够显著减轻严重烧伤患者心肌损害的程度，有效抑制PMN elastase的过度释放。     

Optical nano-imaging for the diagnosis of gastrointestinal cancers]

Development of in vivo animal imaging instrumentations and methods contributes to the early diagnosis of cancer. Of variable imaging modalities, in vivo optical imaging such as bioluminescence and fluorescence is one of the best methods to measure molecular change of cancer cells. High sensitivity and relatively low cost of optical method gives benefits to apply for translational research in the field of cancer. Nano-probes to label and detect early cancer cells have been developed by nano-chemists and molecular imaging researchers. Quantum dots made from fluorescent semi-conductors show good advantages in term of imaging probes; high quantum yields, large molar extinction coefficients, size-dependent tunable emission and high photostability. To detect a gastrointestinal (GI) cancer, newly developed endoscopes have been used. Among them, near infrared fluorescence endoscope and confocal endomicroscope are good candidates for clinical application. In animal studies, successful results to detect cancer in gastrointestinal tract have been obtained. Prospect of nanoparticles as optical imaging moiety is promising to detect GI cancers if their toxicity is minimized. Future fluorescence confocal endoscope with safe cancer targeting nanoparticles will be useful for the detection and treatment of GI cancers.     

垂体脓肿的诊断和治疗(14例报告和文献复习)

目的:探讨垂体脓肿的临床特征和治疗。方法:回顾性分析14例垂体脓肿患者的临床表现、影像学特征、诊断和治疗,并结合文献进行分析。结果:14例患者中头痛13例,垂体功能低下6例,视力视野影响6例,多饮多尿3例,发热3例。MRI增强病灶均呈环状强化。11例经蝶手术治疗,3例经开颅手术。术后随访头痛缓解者10例,视力、视野改善者4例,尿崩者2例恢复正常,垂体功能低下者中4例恢复正常,3例开颅手术者中2例复发,再经蝶手术治愈。结论:应用常规CT和MR术前诊断垂体脓肿困难,对鞍区囊性病变应考虑到垂体脓肿的可能。及早手术、正确选择手术入路、围手术期合理应用抗生素和适当的对症治疗是治疗垂体脓肿的关键。     

Solitary Small Hepatic Angiosarcoma: Initial and Follow-up Imaging Findings

We report an uncommon case of solitary, small hepatic angiosarcoma that was initially considered as a hemangioma. We present the imaging findings, with an emphasis on the initial and follow-up CT and MR findings, as well as report on the more suggestive findings of angiosarcoma than those of a hemangioma.     

Access to primary health care for Australian young people: service provider perspectives.

BACKGROUND: To adequately address the complex health needs of young people, their access to services, and the quality of services received, must be improved. AIMS: To explore the barriers to service provision for young people and to identify the training needs of primary healthcare service providers in New South Wales (NSW), Australia. DESIGN OF STUDY: A cross-sectional, qualitative study of the perspectives of a range of health service providers. SETTING: A range of primary healthcare organisations across NSW. METHODS: Samples of general practitioners (GPs), youth health workers, youth health coordinators, and community health centre staff were drawn from urban and rural clusters across NSW. Focus groups and interviews were used to identify barriers to service provision and the training needs of service providers. Data were tape recorded, transcribed, and analysed. RESULTS: Barriers to service provision among GPs and community health centre staff included inadequate time, flexibility, skills, and confidence in working with young people, and poor linkages with other relevant services. Training needs included better knowledge of and skills in adolescent health requirements, working with adolescents, and working with other services. Barriers to service provision for youth health workers and coordinators included lack of financial resources and infrastructure. There were few linkages between groups of service providers. CONCLUSION: Models of service provision that allow stronger linkages between service providers, sufficient time for consultation with young people, adequate training and support of health professionals, and flexibility of service provision, including outreach, should be explored and evaluated.     

改良松解术式治疗耻骨直肠肌综合征的临床观察(附31例报告)

目的:观察改良松解术式治疗耻骨直肠肌综合征的临床效果。方法:2004~2005年采用肛门后横切口耻骨直肠肌全束部分切断术治疗耻骨直肠肌综合征31例。结果:手术总有效率为96·8%。平均住院时间(10·58±2·35)d,平均切口愈合时间(12·16±2·08)d。结论:采用肛门后横切口耻骨直肠肌全束部分切断术的方法疗效确切,具有并发症少、切口愈合时间快和住院时间短的优点。     

The myocardial contractile responses to protamine sulfate and heparin

The administration of protamine sulfate for the reversal of heparin anticoagulation has been associated with adverse hemodynamic changes including hypotension and decreased cardiac output. The possible direct toxic effect of protamine on human right atrial trabeculae contracting isometrically in vitro was studied. Muscles were stimulated to contract at 1 Hz in Tyrode's solution (maintained at 34 degrees C, pH 7.4) into which protamine was continuously added. Following a polynomial regression analysis, a parabolic dose-response curve resulted. The equation was: y = 95.13 + 38.76x - 278.71x2 where y = relative developed force and x = concentration of protamine (milligrams per milliliters) (r = 0.82). The estimated concentration of protamine resulting in 50% developed force was 0.48 mg/ml. In a second series of experiments, protamine was added to the bath along with a neutralizing amount of heparin. This resulted in a limited reduction in the fall of relative developed force. Thus, protamine in high concentrations alone or in complex with heparin has a direct toxic effect on human myocardial muscle mechanics, and care is warranted in its clinical use.     

Do symptoms reflect a change in left ventricular function after aortocoronary bypass grafting in patients with depressed left ventricular function?

Seventy-nine patients with moderate to severe left ventricular dysfunction who underwent aortocoronary bypass grafting between 1971 and 1977 had follow-up heart catheterization at a mean interval of 3 years. Thirty-three patients (42%) had angiographic improvement in left ventricular function at follow-up and 18 (25%) had a decrease in left ventricular end-diastolic pressure. Fifty-eight patients (73%) had improvement in angina of at least one New York Heart Association class at follow-up. There was no correlation between late improvement in left ventricular function and improvement in angina. Improvement in left ventricular function did not correlate with preoperative indices of severity of coronary disease or with indices of completeness of surgical repair.