丹参病毒病病原鉴定研究

目的 鉴定我国中草药丹参病毒病的病原及其种类。方法 从自然感染引起花叶、矮化、褪绿和斑驳的丹参植株上分离病毒病原，进行生物学接种、电镜观察、双抗体夹心酶联免疫吸附测定、逆转录聚合酶链式反应及基因克隆和序列分析。结果 通过指示植物症状、电镜下病毒粒体形状和血清学反应发现病毒分离物与黄瓜花叶病毒有较近的亲缘关系，初步将该病毒分离物鉴定为黄瓜花叶病毒。通过逆转录聚合酶链式反应及基因克隆和序列分析，证明该病毒分离物为一个黄瓜花叶病毒新株系。结论 感染丹参的病毒病原为黄瓜花叶病毒，这是首次在我国中草药丹参上发现黄瓜花叶病毒。     

Skin replacement with biological and biosynthetic materials following burn injury

Autotransplantation is currently regarded as the optimal skin replacement method, sufficient donor site, however, is often not available in extensively burned patients. Intensive research and development of skin replacement products is conducted worldwide in order to decrease the size of the required donor site. Short- and long-term wound coverage is made possible by temporary synthetic and non-synthetic skin substitutes. Autografts and cultured epithelial autografts are used for permanent skin substitution. Until this is possible, the barrier function of the skin is provided by bio-engineered temporary skin substitutes. Some products and methods are currently available in Hungary, while others are still in the introductory phase. In order to provide an overview, authors summarize the skin replacement methods and compare the different skin replacement products used worldwide from the perspective of the burn surgeon. The use of new methods to be introduced in the near future needs to be rationalized due to financial considerations.     

软骨块内固定术结合持续被动活动治疗新鲜髌骨软骨骨折

目的 探讨新鲜髌骨软骨骨折的治疗方法。方法 对新鲜髌骨软骨骨折１１例,施行骨折的游离软骨块复位内固定,术后应用持续被动活动装置活动膝关节５周。结果 经平均２８个月的随访,１１例中,术后膝关节功能优９例,良１例,优良率９０．９％。结论新鲜髌骨软骨骨折采用游离软骨块复位内固定和ＣＰＭ治疗是可行的,疗效满意。     

靶音识别作业对脑波α段频率涨落特征的影响

目的 研究靶音识别作业对脑波α段频率涨落特征的影响及各优势成分的作业相关变化。方法被试为21名右利手、听力及EEG正常男性(25—35岁),记录被试闭眼状态下安静及靶音识别作业过程中的12导EEG信号,利用脑波频率涨落分析技术分析8、9、10、11、12、13Hz 6个频率成分的优势涨落特征。结果 靶音识别作业导致脑波α段频率涨落竞争结构中的主涨落成分向高频方向发展．9-10Hz优势显著下降,11—13Hz优势显著增加,各频率成分在频率竞争结构中的地位和相互作用改变：同时。作业相关的优势成分快化与各被试静态EEG有关,即围绕静态EEG功谱峰值频率,较高频率成分优势几率明显增加,较低频率成分优势几率则明显减少。结论 靶音识别作业导致脑波α段频率涨落特征的显著改变可能反映了与作业负荷有关的脑一般机能状态的增强,因此脑波α段频率涨落分析技术可能有助于作业负荷的总体及个别评价。     

Adsorptive stripping voltammetric methods for determination of aripiprazole

Anodic behavior of aripiprazole (ARP) was studied using electrochemical methods. Charge transfer, diffusion and surface coverage coefficients of adsorbed molecules and the number of electrons transferred in electrode mechanisms were calculated for quasi-reversible and adsorption-controlled electrochemical oxidation of ARP at 1.15 V versus Ag/AgCl at pH 4.0 in Britton–Robinson buffer (BR) on glassy carbon electrode. Voltammetric methods for direct determination of ARP in pharmaceutical dosage forms and biological samples were developed. Linearity range is found as from 11.4 μM (5.11 mg/L) to 157 μM (70.41 mg/L) without stripping mode and it is found as from 0.221 μM (0.10 mg/L) to 13.6 μM (6.10 mg/L) with stripping mode. Limit of detection (LOD) was found to be 0.11 μM (0.05 mg/L) in stripping voltammetry. Methods were successfully applied to assay the drug in tablets, human serum and human urine with good recoveries between 95.0% and 104.6% with relative standard deviation less than 10%.     

Diltiazem provides higher internal mammary artery flow than nitroglycerin during coronary artery bypass grafting surgery.

OBJECTIVES: Perioperative internal mammary artery (IMA) vasospasm in patients undergoing coronary artery bypass grafting (CABG) surgery may lead to morbidity and mortality. Surgical stimulus is one of the common causes of IMA vasospasm. Preventive measures, beside treatment should be taken into consideration to obtain vasospasm free IMA. The effect of a pharmacologic agent on IMA flow when it is administered before harvesting the artery has not been documented. We designed a prospective randomized clinical study to compare the IMA free blood flows in patients receiving either diltiazem or nitroglycerin, starting infusion of study drugs before a surgical stimulus was applied to the IMA region and continuing throughout the isolation period. METHODS: Sixty patients undergoing elective CABG surgery with the left IMA received diltiazem (n=30, 0.05-0.1 mg/kg per hour) or nitroglycerin (n=30, 0.25-2.5 microg/kg per minute) in a randomized manner. Infusions of study drugs were started before applying a surgical stimulus to the IMA region and continued throughout the harvesting period. The first free flow was measured after IMA was cut above its bifurcation and the second after its distal segment was resected. Heart rate, temperature, mean arterial and central venous pressures were recorded. Data were analyzed with Student's t-test and Fischer's exact test. RESULTS: Preoperative and hemodynamic data were similar between the groups. The means of first and second IMA flows in patients treated with diltiazem (53.8+/-30.1 and 72.3+/-35.4 ml/min) were significantly higher than in those treated with nitroglycerin (25.7+/-16.2 and 48.9+/-23.8 ml/min; P=0.000, 0.004, respectively). IMA flows significantly increased after distal segment resection both in diltiazem (34%) and nitroglycerin groups (90%; P= 0.000, 0.000, respectively). CONCLUSIONS: Diltiazem infusion which started prior to harvesting provided higher IMA blood flow compared to nitroglycerin infusion. Considering the percentage of increases in flows after resection of distal segment, the most prone part to vasospasm, we assume that a certain amount of spasm occurred in IMA in spite of infusion of study drugs, such that less with diltiazem and more with nitroglycerin. Diltiazem plays more important role than nitroglycerin in the prevention of vasospasm.     

杭州市2009-2011年儿童急性下呼吸道感染病原菌分布及耐药性分析

急性下呼吸道感染是儿童常见病和多发病,一般以细菌感染多见,但病原菌分布特点随着年代而不断变迁.为调查儿童下呼吸道感染病原菌的种类及耐药情况,我们对2009年11月-2011年10月收治杭州市第一人民医院儿科的急性下呼吸道感染患儿进行痰培养,对其病原菌分布及耐药情况进行统计分析.     

冯氏脊柱定点旋转复位法调整胸椎治疗肩周炎临床观察

肩关节周围炎(简称肩周炎)是临床的常见病,好发于中老年人.常因外感风寒、潮湿、外力受伤等因素,致使肩关节囊、肩袖、韧带、肌肉、肌腱发生慢性无菌性炎症,其主要症状为肩部疼痛和肩关节活动受限.2008年5月-2011年9月笔者通过PALM触诊仪测定肩周炎患者双侧肩关节三维位置的差异[l],采用北京空军总医院冯氏脊柱定点旋转复位法调整胸椎,促进患者双侧肩关节三维位置对称的改善,并结合肩关节旋转袖相关肌肉的手法松解,治疗肩周炎100例,取得满意疗效,现报道如下.     

Crush Stenting With Drug‐Eluting Stents: Relevance of Coronary Bifurcation Lesion Location on Angiographic and Clinical Outcomes

Background

Data on the relevance of the location of coronary bifurcation lesions treated by crush stenting with outcomes were limited.

Hypothesis

We hypothesized that the location of the bifurcation lesion correlated with clinical outcome.

Method

A total of 212 patients with 230 true bifurcation lesions treated by crush stenting with drug‐eluting stents (DES) were assessed prospectively. Surveillance quantitative angiographies were indexed at 8 months after procedure. Primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction, and target lesion revascularization (TLR).

Results

Patients in the distal right coronary artery (RCAd) group were characterized by higher proportions of prior myocardial infarction and very tortuous lesions. However, lesions in the RCAd group, compared to those of other groups, had the lowest late lumen loss, with resultant lowest incidence of MACE at a mean follow‐up of 268±35 days. Independent predictors of MACE included unsatisfied kissing (KUS; hazard ratio [HR]: 12.14, 95% confidence interval [CI]: 4.01–12.10, P = .001) and non‐RCA lesion (HR: 20.69, 95% CI: 5.05–22.38, P = .001), while those of TLR were KUS (HR: 10.21, 95% CI: 0.01–0.34, P = .002), bifurcation angle (HR: 4.728, 95% CI: 2.541–4.109, P = .001), and non‐RCA lesion (HR: 16.05, 95%CI: 1.01–4.83, P = .001).

Conclusions

Classical crush stenting with drug‐eluting stents is associated with significantly better outcomes in RCAd. Quality of kissing inflation is mandatory to improve outcome. Copyright © 2009 Wiley Periodicals, Inc.