乳化剂OP存在下胶束增溶分光光度法测定水中镉

目的：用胶束增溶分光光度法测定水中镉的含量,并比较了乳化剂OP(聚乙二醇辛基苯基醚)和吐温-20(聚氧乙烯山梨醇酐单月桂酸酯)的胶束增溶作用。方法：分别以体积分数为10％OP和体积分数为10％吐温-20为增溶剂,以PAN(1-(2-吡啶偶氮)-2-萘酚)为显色剂,在555nm波长处测定水中镉络合物的吸光度。结果：相同条件下,同浓度的镉络合物用OP的吸光度值是吐温-20的1．6倍,用OP作乳化剂平均回收率为96．5％,平行样品的相对平均偏差为2．57％,标准曲线线性良好,回归系数r=0．999 9,ε=4．6×104L·mol-1·cm-1。结论：乳化剂OP的增溶作用优于吐温-20,此法测定水中痕量镉较好。     

多烯脂肪酸对脑血栓伴高脂血症病人降脂作用的疗效观察

目的：研究多烯脂肪酸胶囊对脑血栓伴高脂血症病人的降脂作用。选血脂康作对照。方法：６０例脑血栓伴高脂血症病人随机分为二组：治疗组（ｎ＝３１）及对照组（ｎ＝２９）。服药前及服药后４周,８周查血脂。结果：⑴服药４周后ＴＣ和ＬＤＬ－Ｃ分别降低２１．０２％和２８．９３％（多烯脂肪酸组）。⑵多烯脂肪酸组降低了３４．０６％的血清ＴＧ水平,效果显,结论：多烯脂肪酸胶囊降ＴＧ和ＬＤＬ－Ｃ水平与血脂康作用相近,其降     

Assessment of Photoinduced Frontal Polymerization Processes for a Stable 1K System

Frontal polymerization (FP) has attracted increasing interest in recent years in various applications. This polymerization method can be very promising for the polymerization of thick materials with high fillers content in the range of 50–80% (weight) by local application of a reasonable amount of energy. In this work, recent advances in controllable and predictive behavior for photoinduced frontal photopolymerization are reported. Here, tert-butyl peroxybenzoate (Luperox-P) is selected to initiate thermal polymerization at depth because its high polymerization ability and its decomposition temperature is in a promising range, i.e., neither extremely high (monomer decomposition) nor very low (storage stability issues). Thermal imaging experiments are used to follow the temperatures in the samples in real time. The number of cured layers and the depth of cure are also determined. This paper investigates various factors such as the contents of both photo and thermal initiators, the light intensity, the fiber contents, the irradiation time, etc., resulting in a statistical design of experiments with the factors: 1) content of Luperox P and 2) the irradiation time used to investigate the influence on photoinduced frontal polymerization. Markedly, FP appears to be fully controllable for a storage-stable, tunable 1K system.     

社区老年高血压病人健康教育近期效果评价

为了解在社区老年高血压患者中进行的联合型健康教育活动的近期效果,作者重复调查了健教组社区老年人有关高血压“知-信-行”的状况,与基线和对照组的情况进行了比较分析。结果表明：本次联合型的健康教育活动使健教组在高血压的相关知识、信念、行为方面均有一定的改善。作者还对这项联合型健康教育活动的可行性及存在的问题进行了讨论。总结了本次研究的体会,并指出了进一步提高这项活动效率、效果的工作重点和建议。     

Poly (triethylenglycol monomethacrylate) and poly(glycerol monomethacrylate) cross-linked gel as potential viscoelastics for intraoperative use

Background: The highly swelling poly(glycerol monomethacrylate) gel (polyGLYMA) and hydrophilic polymer poly(triethylenglycol monomethacrylate (polyTEGMA) were tested as potential viscoelastics for intraopertive use in anterior segment surgery. Methods: PolyGLYMA was implanted into the anterior chamber in 5 rabbits, and 40% polyTEGMA in 16 rabbits. The eyes were enucleated 1 week to 3 months after the operation. The corneal endothelium was examined with specular microscopy, and then the whole eye histopathologically. Results: In all eyes of the polyGLYMA group, the clinical findings were characterized by a marked ciliary injection and severe secondary glaucoma, and the histologic ones by a marked inflammatory infiltration and thickening of Descemet's membrane in the anterior chamber angle. Specular microscopy revealed a decrease in the endothelial cell density and polymorphism of the endothelial cells. In the polyTEGMA group, the anterior segment and the fundus were physiologic all the time, and specular microscopy and histologic findings showed no degenerative and/or inflammatory changes. Conclusions: PolyGLYMA proved unsuitable for intracameral application in rabbits. The new polymer polyTEGMA is characterized by high biologic tolerance after its implantation into the anterior chamber of rabbits. PolyTEGMA 40% might be considered as a potential viscoelastic material in humans.     

In vivo evaluation of a new system for 3D computerized angiography

A new system has been designed and built to validate the concept of 3D computerized angiography (CA). This system can acquire a set of 2D digital subtracted angiography images while rotating around a patient and then, using these images, reconstruct a 3D representation of the opacified vasculature. The design principles and main characteristics of the system are described, with special attention paid to data processing aspects. An initial in vivo evaluation of this system performed on anaesthetized animals and human volunteers is presented. The influence on the quality of the 3D reconstruction of different factors such as volume resolution, estimation method, source trajectory and number of projections is discussed.     

Continent perineal colostomy by transposition of gracilis muscles

We herein present a study conducted on 14 patients presenting cancer of the lower rectum or of the anal canal (10 adenocarcinomas and 4 squamous-cell carcinomas) and submitted to the Miles abdominal perineal resection in which a new perineal sphincter was constructed. PURPOSE: The aim of this study was to evaluate the efficacy of this new perineal sphincter constructed by transposing the gracilis muscles around an orthotopic colostomy in the attempt to avoid a permanent abdominal colostomy. METHODS: In all cases both gracilis muscles were employed. The right one was placed along the posterior wall of the pelvis and fixed to the controlateral ischiatic tuberosity, creating a sling comparable to the levator ani muscles. The left gracilis was passed around the colon and attached to the ipsilateral or controlateral tuberosity according to its length, reconstructing a muscular ring. The entire procedure was performed in one step in nine cases and in more steps in the remaining five. RESULTS: Of the 14 operated patients, 2 died of vascular disease and 1 developed necrosis of the colonic stump which required reconversion to an abdominal colostomy. Of the remaining 11 patients available for long-term evaluations, 8 showed adequate stool control. The remaining three manifested an incomplete level of continence. During the three-year follow-up period, all patients were evaluated by clinical examination, defecography, endoluminal ultrasonography, nuclear magnetic resonance, CT scan, and endoluminal manometry. CONCLUSION: This neosphincter realizes an elastic stenosis responsible for an efficient level of continence. Best results are observed in the young and educated patients submitted to surgery in two steps. Contraindications to this surgery seem to be advanced cancer, old age, and obesity.     

Microscopic endoluminal tumorectomy

PURPOSE: We herein report our experience with transanal endoscopic microsurgery. The new technique combines an endoscopic view and access of the rectum under gas insufflationviaa stereoscopic telescope with all conventional surgical maneuvers such as tissue preparation, coagulation and control of bleeding, irrigation, suction, and, finally, suturing of the parietal defect. METHODS: The main indication for transanal endoscopic microsurgery is the removal of broad-based sessile polyps and excision of early rectal cancers. We performed local excision of pT2, G1-2 adenocarcinomas and excision of advanced rectal cancer in high-risk patients. The reported series includes 35 consecutive patients, who have been enrolled in a prospective clinical trial. Five patients were excluded for different reasons. The patients were submitted to 29 total wall excisions with or without perirectal fat and one mucosectomy. RESULTS: Postoperative histologic examination showed 9 adenomas and 21 adenocarcinomas. Morbidity included 2 (5.6 percent) perioperative and 2 (5.6 percent) late complications. There was no operative mortality and the mean postoperative hospital course was six days. All patients are in follow-up observation with a mean time of 10.3 months. In the group of adenomas and adenocarcinomas, we did not observe local recurrence. CONCLUSIONS: Considering our experience with the overall results reported by other authors, we believe that transanal endoscopic microsurgery is the procedure of choice for the treatment of rectal polyps and early rectal cancers provided strict patient selection criteria are met.     

Admission,recruitment, and retention

As the country strives to produce larger numbers of generalist physicians, considerable controversy has arisen over whether or not generalist applicants can be identified, recruited, and influenced to keep a generalist-oriented commitment throughout medical training. The authors present new and existing data to show that: 1) preadmission (BA/MD or post-baccalaureate) programs can help to identify generalist-oriented students; 2) characteristics determinedat admission to medical school are predictive of future generalist career choice; 3) current inpatient-oriented training programs strongly push students away from a primary care career; 4) women are more likely than men to choose generalist careers, primarily because of those careers’ interpersonal orientation; and 5) residency training programs are able to select applicants likely to become generalists. Therefore, to produce more generalists, attempts should be made to encourage generalist-oriented students to enter medical schools and to revise curricula to focus on outpatient settings in which students can establish effective and satisfying relationships with patients. These strategies are most likely to be successful if enacted within the context of governmental and medical school-based changes that allow for more reimbursement and respect for the generalist disciplines.