柄果花椒酰胺的化学结构

前文报道从湖南地区采集的芸香科植物柄果花椒(Zanthoxylum podocarpum Hemsl.)树皮中分离并经鉴定的结晶有β-香树脂醇、β-谷甾醇、ι-芝麻素、ι-细辛素、新棒状花椒酰胺、新木脂体柄果脂素和山萮酸为主的混合脂肪酸等。并从该植物中分得另一结晶(Ⅸ),本文报道结晶(Ⅸ)的化学结构。     

Prevalence of coeliac disease in diabetic children and their first-degree relatives in West Algeria: screening with serological markers

Atypical and relatively silent forms of coeliac disease (CD) have been described in insulin-dependent diabetes mellitus (IDDM). Our aim was to evaluate the prevalence of CD-IDDM with serological markers and to investigate the presence of CD in the IDDM first-degree relatives. During 1993 94 we explored 116 IDDM patients reported as new cases and 381 first-degree relatives of IDDM patients. Determination of IgA and IgG antigliadin antibodies (AGA) and IgA antiendomysium antibodies (AEA) was made. Jejunal biopsy was performed in symptomatic patients or in those with positive serological markers, (i) Nineteen IDDM-CD were identified and 5 were suspected. Thus, the prevalence of CD in IDDM patients was between 16.4 and 20%. AGA and/or AEA were abnormal in 13 and normal in 5. Sensitivity was 80% for the three tests when used simultaneously and specificity was 100%. (ii) In the family study, 26 sera of asymptomatic first-degree relatives of IDDM patients were positive for at least one of the serological markers; 13 of them had villous atrophy. Systematic serological screening in IDDM allowed us to detect CD and evaluate the true incidence.     

多培沙明,非诺多泮和丙卡特罗对心肌缺血时电生理变化影响的比较

新型多巴胺受体激动剂多培沙明(DPX)能显著减轻缺氧和缺血豚鼠心室乳头肌静息电位,动作电位幅度和O相除极速度的降低程度及动作电位时程的缩短程度,其减轻作用明显大于非诺多泮(FODA)和丙卡特罗(PCTR)。DPX能使缺氧时缩短的有效不应期(ERP)延长,而使缺血时延长的ERP缩短,其程度明显大于FODA与PCTR。提示DPX抗缺血性心律失常的作用优于其他类型的多巴胺激动剂。     

应用国产神经节苷脂改善帕金森病患者临床症状的时间及效果：多地区、多中心6344例回顾性分析

目的:观察口服国产神经节苷脂对帕金森病患者临床症状的改善时间及效果。方法:于2001-01/2005-01通过脑病防治健康教育计划小组选取帕金森患者,包括黑龙江、河北、山东、河南、北京、江苏、甘肃、青海、贵州、福建、湖南、山西、湖北、四川、重庆、江西、上海、云南等地区共6344例患者,均符合《实用神经病学》有关帕金森病的诊断及分类标准,纳入口服神经节苷脂≥10mg/d,服用1个月以上且知情同意者。患者口服国产神经节苷脂口服液进行神经功能康复,每支含神经节苷脂(内含单唾液酸四己糖神经节苷脂1(占21%)、二唾液酸四已糖神经节苷脂1a(占40%)、二唾液酸四已糖神经节苷脂1b(占16%)、三唾液酸四已糖神经节苷脂1b(占19%))0.25g/L,每天早上空腹2支,晚上睡前2支或每晚临睡前4支服用。3个月为1个治疗周期,患者服用两三个周期,个别病程时间长者服用4个周期以上。服用过程中进行定期随访,观察帕金森患者在震颤、肌强直、运动迟缓、姿势异常等方面的改善情况。疗效评估:对患者服用国产神经节苷脂口服液后3个月、6个月、9个月、1年的病情改善情况进行观察。显效为震颤和肌强直消失,姿势异常消失,渐停止服用多巴胺制剂等药物;好转为上述症状减轻,多巴胺制剂等药物减少使用;无效为上述症状无改善。结果:符合纳入标准者5937例,全部进入结果分析,无脱落。不同服药时间帕金森病患者临床症状的改善情况:服用国产神经节苷脂1￣3个月有效者669例,服用4￣6个月有效者941例,服用7￣12个月有效者1713例,总有效率为56%。结论:国产神经节苷脂能有效改善帕金森患者震颤、肌强直、运动迟缓、姿势异常等临床症状,长期服用效果更好。     

纳米晶胶原基骨材料在骨科疾病中的应用

目的:观察纳米晶胶原基骨材料(简称人工骨)植入后骨愈合的时间和骨修复效果,探讨人工骨在骨科临床的应用范围。方法:于2003-03/2005-03选择江苏大学附属医院骨科收治的骨折后骨缺损患者32例,骨不连患者5例,骨肿瘤患者4例,腰椎峡部裂患者4例。均符合本临床试验所制定的诊断标准,并经X射线片确诊,患者均知情同意。①骨折后骨缺损患者:均为四肢各部位粉碎性骨折,经切开复位后有骨缺损,采用人工骨植入骨缺损处。②骨不连患者:将骨折端瘢痕及硬化骨切除、髓腔打通后,植入人工骨。③良性骨肿瘤患者:将病骨刮除后植入人工骨。④腰椎峡部裂患者:在减压,RF复位、内固定后有2例行自体骨与人工骨混合植入,1例左侧行自体骨、右侧行人工骨植入,另1例在原来行自体骨植骨基础上因愈合欠牢固,而在原植骨处加植人工骨。结果:42例患者获得随访。①骨折后骨缺损患者29例,25例在术后2～7个月先后达临床愈合。另4例中,1例尺骨缺损植人工骨处术后2年尚无骨痂形成,术后2年9个月骨缺损处愈合;1例胫骨中上段粉碎骨折于术后15个月见原骨缺损植人工骨处骨痂形成不多。其余2例为术后过早负重,发生钢板断裂,给予重新手术复位、固定。②骨不连患者5例,有2例于术后9个月愈合,3例单纯植人工骨者未愈,其中2例再手术行自体骨移植,术后1年愈合。③良性骨肿瘤患者4例,骨囊肿2例术后未见复发。骨纤维结构不良2例,术后再次手术,改行自体骨移植。④腰椎峡部裂患者4例,3例术前腰腿痛症状消失,复查X射线片见原峡部断裂影消失。1例仍感下肢麻痛,复查X射线片见植骨愈合欠佳。结论:纳米晶胶原基骨材料具有良好的生物相容性及生物可降解性能,植入体内具有良好的骨传导作用,可用于四肢粉碎性骨折所致的骨缺损;因其不具备骨诱导成分,对于骨不连、良性骨肿瘤等所致骨缺损,宜将纳米晶胶原基骨材料和自体骨混合使用。     

Postoperative cognitive dysfunction (POCD): strategy of prevention, assessment and management

The femoral neck fracture is a major cause of morbidity and mortality in the elderly. The etiology of cognitive impairment observed in this population of aged patient seems to be multifactorial. In the strategy of prevention, elderly patient must have the clearer information dealing with the postoperative cognitive dysfunction. This would reduce the incidence of POCD and some cognitive complaints, which often reflect the anxiety of the elderly patient facing the possibility of cognitive impairment. During the anaesthesia consultation, it seems important to assess the cognitive function of this elderly patient (like using neuropsycholgical scale as the MMSE) and to identify associated risk factors of cognitive dysfunction. The management of cognitive disorders should be multidisciplinary, the anesthesiologist being the main referent, in collaboration with the geriatrician and the surgeon. In the clinical setting of femoral neck fracture in the elderly, this multimodal management (pain, nutrition, functional rehabilitation to make these patients autonomous as quickly as possible), seems to improve the functional prognosis and to have the observed POCD decreased.     

Dysfonctions cognitives postopératoires : stratégie de prévention, de dépistage et de prise en charge

The femoral neck fracture is a major cause of morbidity and mortality in the elderly. The etiology of cognitive impairment observed in this population of aged patient seems to be multifactorial. In the strategy of prevention, elderly patient must have the clearer information dealing with the postoperative cognitive dysfunction. This would reduce the incidence of POCD and some cognitive complaints, which often reflect the anxiety of the elderly patient facing the possibility of cognitive impairment. During the anaesthesia consultation, it seems important to assess the cognitive function of this elderly patient (like using neuropsycholgical scale as the MMSE) and to identify associated risk factors of cognitive dysfunction. The management of cognitive disorders should be multidisciplinary, the anesthesiologist being the main referent, in collaboration with the geriatrician and the surgeon. In the clinical setting of femoral neck fracture in the elderly, this multimodal management (pain, nutrition, functional rehabilitation to make these patients autonomous as quickly as possible), seems to improve the functional prognosis and to have the observed POCD decreased.     

天然有机化合物质谱研究——Ⅺ.苯丙型苷快原子轰击质谱MNa+的MIKES谱

研究了六种苯丙型苷与Na⁺加合离子的快原子轰击质谱(FAB—MS)和质量分离离子动能谱(MIKES)。结果表明:在FAB谱中[M+Na]⁺加合离子的丰度要比[M+H]⁺离子高得多。由此可给出糖苷的分子量信息,[M+Na]⁺离子的MIKES谱可给出糖基序列信息。     

Experimental research on production and uptake sites of TNFα in rats with acute hemorrhagic necrotic pancreatitis

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Lymphotropic herpesviruses in allogeneic bone marrow transplantation

Human herpesvirus-6 (HHV-6), human herpesvirus-7 (HHV-7), Epstein-Barr virus (EBV), and human cytomegalovirus (CMV) DNA were repeatedly assayed in peripheral blood leukocytes from 37 allogeneic bone marrow transplant (BMT) patients by polymerase chain reaction. Before BMT, HHV- 6 DNA was detected in 8 (22%) patients. HHV-7, EBV, and CMV DNA were detected in 21 (57%), 10 (27%), and 1 (3%) patient, respectively. After BMT, HHV-6 DNA was detected in 26 (70%), HHV-7 in 21 (57%), EBV in 28 (76%), and CMV in 21 (57%) patients. Thirty-two (87%) patients were positive with more than one virus. HHV-6, HHV-7, and EBV DNA were found earlier than CMV DNA in most patients after BMT. The proportions of HHV- 6-positive samples during the first 3 months after BMT were higher in the patients with either delayed granulocyte engraftment (P = .04, Fisher's exact test) or delayed platelet engraftment (P = .001, Fisher's exact test). The HHV-6 DNA in samples from the patients with delayed engraftment was confirmed to be variant B. The detection of any lymphotropic herpesvirus was not related to the development of acute graft-versus-host disease (aGVHD). High-dose acyclovir (ACV) prophylaxis significantly (P < .01) reduced the proportion of HHV-6- positive samples and tended to lower HHV-6 DNA levels (P = .06). Our data indicate that HHV-6 variant B can inhibit marrow engraftment and that high-dose ACV may be beneficial to engraftment after BMT by preventing HHV-6 reactivation. No relation between the proportions of HHV-7-, EBV-, and CMV-positive samples in the first 3 months and engraftment or aGVHD was found.