C型臂X线机维修二例

本文介绍了C型臂X线机的计算机控制方面及其他电器元件方面二例故障维修。     

静脉与硬膜外PCA用于剖宫产术后镇痛的对比观察

目的：比较自控静脉镇痛（PCIA）和自控硬膜外镇痛（PCEA）用于剖宫产术后镇痛的有效性、安全性及不良反应。方法：选择剖宫产术后病人90例，随机分为PCIA组、PCEA组和对照组，每组30例。PCIA组和PCEA组术后立即使用自控镇痛（PCA）泵．对照组则不用任何药物镇痛。采用视觉模拟评分法（VAS）对术后1、4、8、24、48h各时间段进行镇痛效果评价和镇静评分并同时观察病人术后肠蠕动恢复情况、拔尿管后排尿情况、子宫复旧情况及产后出血、恶心呕吐、皮肤瘙痒、呼吸抑制等不良反应。结果：同一时间段PCIA组与PCEA组VAS评分比较无显著差异（P〉0．05）．但均小于对照组（P〈0．01）；术后肠蠕动恢复时间、子宫复旧情况、产后出血及恶心、呕吐、皮肤瘙痒、嗜睡等不良反应发生率三组比较无显著差异（P〉0．05）；拔尿管后排尿困难发生率PCIA组明显低于PCEA组（P〈0．05）；呼吸循环抑制PCEA组多于PCIA组，但差异不显著（P〉0．05）。结论：PCIA组与PCEA组均有良好的术后镇痛效果．但PCIA组拔尿管后排尿困难的发生率低．对呼吸循环影响小，镇痛质量优于PCEA组。     

胆囊切除术后黄疸的诊断及防治

目的:探讨胆囊切除术后黄疸的诊断和治疗。方法:回顾性分析32例胆囊切除术后黄疸病人的临床资料。结果:经B超、肝功检测、ERCP和手术证实:(1)肝外胆管损伤18例。(2)残留结石9例。(3)肝细胞性2例。(4)溶血性黄疸1例。(5)毛细胆管炎1例。(6)引流不当1例。结论:黄疸病因复杂,要全面分析病情,正确判断,术前充分准备,选择合理手术方法,提高手术质量,术中必要检查,恰当引流,并做好围手术期保肝治疗,可减少术后黄疸发生。     

复方对乙酰氨基酚胶囊治疗感冒发热、疼痛的疗效和安全性

目的:评价复方对乙酰氨基酚治疗由感冒引起的发热疼痛的效果及安全性。方法:随机双盲双模拟对照研究。入选139例,完成135例,其中A组(试验组n=68)服用复方对乙酰氨基酚胶囊+模拟片;B组(对照组n=67)服用对乙酰氨基酚片+模拟胶囊。2组按入组顺序服药,每日3次,疗程均为3~5d。观察2组疗效和不良反应。结果:试验组痊愈率为74 %,有效率达96 %,对照组痊愈率为69 %,有效率达91 % (P>0. 05),对发热和头痛的临床症状2组均有改善,试验组68例发热病人中有97 %病人恢复正常, 62例头痛病人有95 %的病人恢复正常;对照组65例发热病人和头痛病人分别有92 %和91 %恢复正常。试验组不良反应发生率为2 % (1 /68),对照组为3 % (2 /67) (P>0. 05)。未出现严重及预料之外的不良反应。结论:复方对乙酰氨基酚对治疗感冒具有明显的效果。2药的疗效相仿,无明显不良反应。     

聚己内酯的细胞毒性和动物急性毒性实验

目的:研究聚己内酯(PCL)对L 929细胞生长抑制作用的影响及其对小鼠急性毒性的作用.方法:采用四甲基偶氮唑盐(MTT)比色法和吖啶橙荧光染色法研究不同浓度的PCL浸提液对L 929细胞生长抑制的影响;选用清洁级昆明种小鼠进行了动物急性毒性实验研究.结果:不同浓度的PCL浸提液对L 929细胞在2,4,7 d显示毒性级别分别为1级,0级,0级,PCL各处理组细胞与正常对照组细胞的凋亡指数差异无显著性.日给药量20 g·kg-1时,给药组小鼠行为活动正常,与对照组小鼠的体重相比差异无显著性.结论:高分子材料PCL符合生物体应用的基本要求,安全无毒有较佳的生物相容性.25%PCL混悬液小鼠灌胃给药,对小鼠基本无毒.     

超声波作用下NaBH4/ZrCl4还原9(E)-红霉素肟制备9(S)-红霉胺

9(S)-红霉胺是合成地红霉素和CP-544372的中间体，此化合物可在超声波的作用下利用NaBH4／ZrCl4于室温下还原9(E)-红霉素肟制得，收率为69％，其结构经IR、NMR和MS确证。该方法是制备9(S)-红霉胺的方便、有效的途径。     

花椒及其混淆品的rDNA ITS区序列分析与鉴别

目的研究不同居群的花椒及其混淆品的rDNA ITS区碱基序列的特征及其差异，为花椒的鉴别提供可靠的分子标记。方法运用PCR产物直接测序和克隆测序法对甘肃、陕西、四川、河北等7个花椒居群及3个混淆种的rDNA ITS区(包括ITS1，5.8S，ITS2)碱基序列进行序列测定。结果首次报道花椒ITS区的碱基序列，序列总长度为619-620 bp，长度变异较少，与混淆种长度仅相差4 bp。花椒各居群中，rDNA ITS区碱基序列有15个变异位点、12个信息位点、3个特异性识别位点。与混淆品间的碱基差异则较为显著，多达71个变异位点，有4个花椒特异性识别位点。结论依据花椒ITS区的序列特征可准确鉴别各居群的花椒及其混淆品；亲缘关系密切的花椒居群在地理位置上也非常靠近；rDNA ITS序列特征可作为花椒种内和种间鉴别的有效分子标记。     

正交试验法优选于氏萎胃宁提取工艺

目的建立于氏萎胃宁处方中提取药材的提取工艺.方法采用正交实验,考察不同条件下芍药苷的提取量,以确定于氏萎胃宁的最佳提取工艺.结果筛选出的最佳提取方法为A2B2C3D2,即乙醇浓度5 5%,溶剂用量18倍,每次提取1.5h,提取2次最佳.结论乙醇浓度、提取时间、提取次数、溶剂倍数对提取结果均有显著影响.     

2013～2018年安徽省老年肺结核疫情特征分析

目的分析2013～2018年安徽省老年肺结核疫情特征,为制定老年肺结核防治策略提供参考依据。方法采用描述性流行病学研究方法,分析2013～2018年安徽省老年肺结核患者疫情特征。结果 2013～2018年,安徽省活动性肺结核年平均登记率老年人高于全人群(χ~2=55. 061,P <0. 001);涂阳肺结核年平均登记率老年人高于全人群(χ~2=21. 840,P <0. 001),老年复治涂阳占全省复治涂阳的42. 42%(3 379/7 965);老年肺结核男女性别比为3. 32∶1;安徽省所辖16个市以亳州、铜陵、池州老年肺结核年平均登记率最高。结论安徽省老年肺结核疫情高于全人群,男性高于女性,亳州、铜陵、池州老年肺结核疫情重,需加强重点人群和重点地区的结核病防治工作。     

Individual and joint effects of borderline ankle-brachial index and high plasma total homocysteine on all-cause death in hypertensive adults

BACKGROUNDThe cardiovascular hazards of total homocysteine (tHcy) are long known. In addition, despite the acknowledgment on the importance of low ankle-brachial index (ABI) (< 0.9), borderline ABI (0.91-0.99) was once commonly overlooked. This study aims to explore the independent and joint effect of tHcy level and borderline ABI on all-cause death in hypertensive population.METHODSThis study included 10,538 participants from China H-type Hypertension Registry Study. ABI was described into two groups: normal ABI (1.00-1.40) and borderline ABI. tHcy level was also divided into two groups: < 15.02 and ≥ 15.02 μmo/L. Four groups were analyzed, using COX proportional hazard regression model, separately and pairwise to observe the independent and joint effect on all-cause death.RESULTSA total of 126 (1.2%) deaths were observed in the 1.7 years follow-up time. Borderline ABI has a higher predicted risk of death than normal ABI (HR = 1.87, 95%CI: 1.17-3.00) after adjusting for potential covariates. Compare with tHcy level < 15.02 μmo/L (low tHcy), those with tHcy ≥ 15.02 μmo/L (high tHcy) had higher risk to event outcome (HR = 1.99, 95% CI: 1.30-3.05). According to the cumulative hazard curve, group with borderline ABI and high tHcy level has significantly higher altitude and larger increasing rate over follow-up period compare to other groups. Among those with borderline ABI, participants with high tHcy had higher death risk than those with low tHcy, nevertheless, no significant different between borderline and normal ABI among those with low tHcy levels.CONCLUSIONSBorderline ABI and tHcy level both have independent predictive value on all-cause death. The combined group of borderline ABI and high tHcy has highest risk factor of outcomes, which suggested the mutual additive value of borderline ABI and tHcy. More attention should be given to the importance of borderline ABI in hypertensive population, especially with elevated tHcy level.

Homocysteine (Hcy) is a sulfur-containing, non-proteinogenic amino acid synthesized through the transmethylation of amino acid methionine from one-carbon metabolism. Elevated plasma total homocysteine (tHcy) level is associated with endothelial dysfunction, increased blood coagulation, and metabolic disturbance, promoting cardiovascular diseases, stroke, and coronary artery disease.^[1,2] Notably, patients with high Hcy levels and concomitant hypertension were suggested to be at particularly higher risk.^[3] Moreover, increasing studies have explored a positive association between advanced Hcy level with all-cause mortality. According to a recent dose-response meta-analysis, for each 5-μmol/L increment of tHcy levels, the risk for all-cause mortality increased by 33.6%.^[4]The ankle-brachial index (ABI) is an effective, well-established measure that is commonly used in the diagnosis of peripheral artery disease (PAD),^[5] meanwhile was well studied as an important indicator of atherosclerosis and CVD events.^[6] Although ankle-brachial index (ABI) ≤ 0.90 has been recognized as the threshold value for abnormal/low ABI, which was proven to increase the risk of all-cause mortality,^[7] a study from the American Heart Association has suggested ABI between 0.91 and 1.00 should be considered as “borderline area” in terms of cardiovascular risks,^[8] considering of prior probability and sensitivity of ABI calculation. Emerging studies have aimed to explore the predictive value of borderline ABI,^[9-11] however, controversy remains because of limited and inconsistent data. The current study aimed to explore the individual and joint effect of borderline ABI and tHcy on all-cause mortality among hypertensive adults. Although ABI level ≤ 0.90 has been and is going to remain significant in clinical practice, we believe broader concern should be placed on borderline ABI, especially for its value in risk differentiation and identification. To the best of our knowledge, there are no similar previous studies.