液膜法提取发酵液中的苯丙氨酸 Ⅱ.操作工艺条件

从芫花Ｄａｐｈｎｅ ｇｅｎｋｗａ条的乙酸乙酯可溶部分分到３个结果性化合物，借助于波谱分析手段推断出Ⅱ为西瑞香素，Ⅲ为ｄａｐｈｎｏｄｏｒｉｎ Ｂ。     

带血管甲状腺-甲状旁腺移植术5例报告

用带血管的胎儿甲状旁腺移植术治疗甲状旁腺机能低下症,共行手术6次(腹腔内移植5次,股三角区移植1次),6次中有3例术后发生4次排斥反应。经1年8月至3.5年随防,疗效显著者2例,有效2例,失败1例。本文讨论了有关甲状旁腺移植的手术方法、注意事项、免疫抑制剂应用等问题。     

System for prostate brachytherapy and biopsy in a standard 1.5 T MRI scanner.

A technique for transperineal high-dose-rate (HDR) prostate brachytherapy and needle biopsy in a standard 1.5 T MRI scanner is demonstrated. In each of eight procedures (in four patients with intermediate to high risk localized prostate cancer), four MRI-guided transperineal prostate biopsies were obtained followed by placement of 14-15 hollow transperineal catheters for HDR brachytherapy. Mean needle-placement accuracy was 2.1 mm, 95% of needle-placement errors were less than 4.0 mm, and the maximum needle-placement error was 4.4 mm. In addition to guiding the placement of biopsy needles and brachytherapy catheters, MR images were also used for brachytherapy treatment planning and optimization. Because 1.5 T MR images are directly acquired during the interventional procedure, dependence on deformable registration is reduced and online image quality is maximized.     

Carotid intima-media thickness in Parkinson's disease.

There have been a few studies and inconsistent results regarding the coincidence of Parkinson's disease (PD) and atherosclerotic diseases, such as cerebrovascular disease. Carotid intima-media thickness (IMT) is a known marker for subclinical atherosclerosis. The aim of this study was to investigate the carotid IMT between PD patients and controls. We studied 43 patients with PD and 86 matched controls. The carotid IMT in PD patients was significantly smaller than in controls (0.796 +/- 0.179 mm vs. 0.913 +/- 0.237 mm, P < 0.05). In multivariate analysis, the carotid IMT was inversely associated with the duration of levodopa medication and the severity of PD. These results suggest that PD patients have a lower risk of atherosclerosis.     

Factors Affecting Cardiac Catheterization Rates in Elders with Acute Coronary Syndromes

Background: Elder patients with acute coronary syndromes (ACS) are less likely to receive cardiac catheterization. The reasons for this are unclear.
Objectives: To assess whether elder patients who had a documented history of dementia, lived in extended care facilities, or had do not intubate–do not resuscitate (DNR-DNI) advance directives were less likely to receive cardiac catheterization, despite having ACS with high-risk features.
Methods: This was a medical record review conducted at an urban teaching hospital. DNR-DNI status before hospitalization, extended care facility (nursing home or assisted living) residence, and a previous diagnosis of dementia were obtained from the medical record. Patients 65 years and older who presented to the emergency department with acute myocardial infarction or with unstable angina with ST segment deviation were included. Univariate and multivariate logistic regression were performed, and odds ratios (ORs) were reported with their 95% confidence intervals (CIs).
Results: Of the 201 eligible patients, 66 (32.8%) patients did not undergo cardiac catheterization. In the univariate analysis, patients who had dementia, resided in extended care facilities, or were DNR-DNI were less likely to receive cardiac catheterization. Only extended care facility residence (OR, 0.18; 95% CI = 0.04 to 0.83) and DNR-DNI status (OR, 0.19; 95% CI = 0.04 to 0.92) remained significantly associated with decreased cardiac catheterization in the multivariate analysis.
Conclusions: Elder patients with ACS residing in extended care facilities or who are DNR-DNI are less likely to receive cardiac catheterization. Future studies concerning the quality of ACS care for elders should take these variables into account.     

特素联合卡铂治疗晚期非小细胞肺癌28例临床研究

目的 评价特素（紫杉醇注射液）联合卡铂（伯尔定）方案治疗晚期非小细胞肺癌（NSCLC）的疗效和不良反应.方法 收集我院2004年3月～2006年12月收治的Ⅲb～Ⅳ期的NSCLC患者28例,进行特素（紫杉醇注射液）联合卡铂（伯尔定）化疗.全部患者均有可测量的指标.给药方法：特素135～175mg/m2d1＋卡铂5mg·ml^-1·min^-1d2,静脉注射,28天为一周期.结果 全组总有效率50.0%,Ⅲb期有效率62.5%,Ⅳ期有效率45.0%.化疗副反应主要是骨髓抑制及消化道反应,其中Ⅲ～Ⅳ度分别为24.0%、10.7%.结论 特素联合卡铂治疗晚期非小细胞肺癌治疗有效,耐受性良好.     

青年维持性血液透析患者心血管疾病调查及危险因素分析

目的调查青年维持性血液透析（MHD）患者心血管疾病的发病情况和病变特点，并探讨其危险因素。方法采用横断面研究。MHD患者98例，以45岁为界分为青年组（47例）和中老年组（51例）。收集患者临床资料和生化指标。心脏超声检查测量心脏腔径及心功能参数。分析青年组患者心脏结构和功能异常的患病率、病变特点及其影响因素。结果（1）47例青年患者中有30例（63．8％）存在心脏结构异常，主要表现为左心室肥厚、左心房增大和瓣膜反流，患病率分别为61．7％、38．3％和34．0％。（2）青年组患者向心性肥厚的患病率为86．2％，离心性肥厚的患病率为13．8％，与中老年组相比，差异有统计学意义（P〈0．05）。（3）与无心脏病变青年MHD患者相比，伴心脏病变者的超滤量、收缩压、血磷和甲状旁腺激素明显增高，而Kt／V、血红蛋白和血清白蛋白明显降低，差异有统计学意义（P〈0．05）。Logistic回归分析结果显示，超滤量、收缩压、血红蛋白和血甲状旁腺激素是青年MHD患者并发心脏病变的独立危险因素。结论青年MHD患者心血管疾病的患病率较高，主要表现为左心室肥厚、左房增大和瓣膜反流。超滤量、收缩压、血红蛋白和血甲状旁腺激素水平可能是影响青年MHD患者并发心脏病变的独立危险因素。     

导航在长骨干骨折髓内钉固定中的应用

目的阐述透视导航技术在长骨干(股骨和胫骨)骨折,特别是在术中远端交锁髓内钉固定中的应用。探索在导航条件下术中应用髓内钉图像库开展远端交锁固定的可行性。此外,医用机器人的开发旨在被进一步用来改善手术程序的精确性。方法导航手术下,55例行股骨远端交锁钉固定和36例行胫骨远端交锁钉固定。其中13例术中应用图像库开展远端交锁固定。结果远端交锁固定成功率为97%。结论透视导航在长骨干骨折术中,使远端髓内交锁钉固定成功率增高。图像库的应用可以进一步减少患者和手术人员的X线辐射剂量。     

微小切口胆囊切除术2260例效果观察

目的 总结微小切口胆囊切除术治疗胆道系统疾病的经验。方法 对2002-2004年连续收治的2260例胆囊、胆道系统疾病实施微小切口手术的临床观察资料进行回顾性分析。结果 本组2260例微小切口胆囊切除术的患者无一例因手术原因死亡；术后无残留小胆囊；无胆汁漏及腹腔脓肿，亦无伤口全层裂开及切口疝形成。结论 该术式损伤小、局部显露清楚、不易发生副损伤，可同时行胆总管探查术，特殊情况下可随时改变手术方式。     

氯沙坦心衰生存研究（ELITE Ⅱ）：氯沙坦和卡托普利对心衰相关预后和症状的作用比较氯沙坦心衰生存研究（ELITE Ⅱ）：氯沙坦和卡托普利对心衰相关预后和症状的作用比较

背景：利用血管紧张素转换酶抑制剂阻断肾素-血管紧张素系统可以改善心衰（HF）患者的预后和症状。在ELITEⅡ研究中，比较了氯沙坦和卡托普利对心衰患者死亡率、发病率以及功能状态方面的作用。方法和结果：总共3152例年龄≥60岁、NYHA心功能分级为Ⅱ-Ⅳ级、射血分数≤40％的HF患者入选研究，接受氯沙坦50mg1次／d或卡托普利50mg3次／d。判断预后的指标包括：全因或HF相关的死亡、住院和停止治疗；NYHA分级的变化；生活质量（QoL）。各治疗组问HF相关预后无显著性差异。两组的NYHA分级得到了相似的改善（P〈0．01）。观察1856例患者的QoL发现，1343例患者至少存活1年以上；两组中1年存活者的QoL均得到了改善（与基线相比，P〈0．001）。