血浆中去甲地西泮及代谢物奥沙西泮的HPLC测定方法和大鼠口服药代动力学

采用高效液相色谱法测定去甲地西泮(去甲安定)及其代谢产物奥沙西泮。以RP-C₁₈为固定相,乙腈—0.01mol·L^-1醋酸钠(pH3.8,33.3:66.6)为流动相,地西泮为内标物,紫外波长240nm处定量测定。去甲地西泮、奥沙西泮和内标物的保留时间分别为2.8min,4.85min和8.5min;绝对回收率分别为74%,86%和86%。奥沙西泮在35.3～2260ng·ml^-1,去甲地西泮在20～2560ng·ml^-1血浆浓度范围内线性关系良好,r=0.9997和r=0.9998。二药的最低检测浓度分别为10ng·ml、和7ng·ml^-1;日内和日间相对标准偏差(RSD)均分别小于6%和10%(n=5)。多种常用药物对样品的色谱峰无干扰。并用此法研究了大鼠单次口服去甲地西泮的药代动力学。     

Drainage of pelvic abscesses through the greater sciatic foramen

A computed tomographic (CT) guided transgluteal approach through the greater sciatic foramen was used to drain pelvic abscesses and fluid collections in 21 patients. Ideal catheter placement should traverse the lower portion of the greater sciatic foramen at the level of the sacrospinous ligament. This avoids the vascular and neural elements that are located slightly cephalad at the level of the piriformis muscle. Percutaneous drainage through this approach was successful in avoiding surgery in 17 patients (81%). Pain was the most common complication and was generally associated with a more cephalad approach, transgressing the piriformis and the sacral plexus. CT-guided percutaneous drainage of pelvic abscesses through the greater sciatic foramen should be used when the more standard transperitoneal approach is not possible.     

小檗碱对局灶性脑缺血大鼠血小板聚集及血浆TXB2和6-keto-PGF1a水平的影响

以大鼠可逆性大脑中动脉梗塞(MCAO)致局灶性脑缺血为模型,观察小檗碱对大鼠MCAO24h后血小板粘附、聚集、血栓形成及血浆TXB2和PGI₂生成的影响。结果表明,小檗碱20mg·kg^-1·d^-1ipl,3或5d,明显降低MCAo24h后血小板粘附性及ADP、胶原和花生四烯酸诱导的血小板聚集率,抑制血浆TXB₂水平。同剂量ip3或5d,则抑制血栓形成。提示小檗碱可能通过其抗血小板粘附和聚集及影响花生四烯酸代谢而发挥抗脑缺血作用。     

Spontaneous Peritonitis in Cirrhotic Hospital In-patients: Retrospective Analysis of 101 Cases

One hundred and one patients with cirrhosis resulting from alcoholabuse, admitted to Broussais University Hospital, Paris, betweenJanuary, 1986 and December, 1989 were assessed for infectionof the ascitic fluid using clinical and cytobacteriologicalcriteria. All of 46 patients (45.5%) with clinical signs andsymptoms of peritonitis had an ascitic fluid polymorphonuclear(PMN) count > 250 cells/mm³. Bacteria could be isolated fromthe ascitic fluid of 23 patients (50%). Twenty-six bacterialstrains were isolated(there was more than one strain in twosamples). Escherichia coli was found in 14 cases. It is noteworthythat no anaerobes were grown. Mortality, biochemical parametersand clinical features correlated significantly with an asciticfluid PMN count > 250 cells/mm³. High mortality correlatedwith a PMN count > 1000 cells/mm³ (70% vs. 33%).     

缺血后适应的研究与进展

目的:缺血后适应即冠状动脉再灌注开始时对冠脉进行短暂、重复的开通及再闭过程,随后恢复冠状动脉血流,对缺血再灌注心脏有显著保护作用。总结并分析缺血后适应对缺血再灌注心脏的保护作用及其机制。资料来源:应用计算机检索Medline1986-01/2006-05关于缺血后适应的文章。检索词“myocardial protection,Ischemic postconditioning,Ischemia-reperfusion injury”并限定文章的语种类为English。资料选择:对资料进行初审,纳入标准:关于缺血后适应机制及心脏保护作用的研究。排除标准:重复性研究。资料提炼:共收集到符合上述要求的文献51篇,排除21篇重复性研究。30篇符合纳入标准:其中26篇关于缺血后适应的研究,4篇关于缺血后适应的综述。资料综合:缺血后适应对心脏的保护作用包括缩小心肌梗死面积、对抗心律失常等。缺血后适应对心脏的保护作用的机制涉及腺苷、一氧化氮、线粒体ATP敏感K通道、再灌注损伤存活激酶通路、线粒体可渗透转运孔隙等许多方面和信号传导途径。结论:缺血后适应现象已经被许多独立的实验室应用大、小动物在体和体外模型及细胞培养模型所观察。与缺血预适应相比,缺血后适应可能会有更广阔的临床应用前景,其机制需进一步研究。     

河北省4个地区广泛焦虑症的流行病学调查

目的:了解广泛焦虑症的患病率及人口学特点。方法:于2004-10/2005-03随机抽取河北省邯郸、保定、秦皇岛、承德4个地级市18岁以上人口进行全省精神疾病流行病学现场抽样调查工作,总样本24000人。调查筛选工具采用改编后的一般健康问卷12项,以《DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查》病人版为调查的诊断工具。根据被调查者一般健康问卷12项总分,把被调查者分为高危人群、中危人群、低危人群3类。根据预试验调查结果确定三段危险人群的分界分:总分≥4分属于高危人群,高危人群全部进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查;总分为2分或3分即属中危人群,中危人群约40%需进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查,总分为0分或1分即属低危人群,低危人群中10%需进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查。改编后的一般健康问卷12项分数及内容不变,另外增加8个问题均为高危因素,并进行DSM-Ⅳ-TR轴Ⅰ障碍定式临床检查。结果:①实际完成调查20716人,其中男10343人(49.9%),女10373人(50.1%)。共诊断焦虑症患者127例。②按高中低危因素调整后时点患病率为7.69/1000(95%CI6.50/1000～8.88/1000)。城市患病率4.87/1000,农村患病率8.10/1000,两者差异无显著性意义(u=1.78,P>0.05)。女性患病率明显高于男性,差异有显著性意义(分别为10.42/1000,4.97/1000,u=4.49,P<0.01),男女患病率比例为1:2.10。按不同年龄阶段的人口计算出各年龄段的时点患病率,20～29岁患病率较低(3.17/1000),50～59岁患病率较高(15.56/1000)。③通过12个因素的Logistic回归分析发现,影响广泛焦虑症的危险因素有年龄50～59岁(OR=1.713);保护性因素男性(OR=0.431),年龄20～29岁(OR=0.393),收入10001～20000元(OR=0.568),收入20001～40000元(OR=0.117)。结论:广泛焦虑症的流行病学特征为女性、中老年人患病率较高,男性、青年、收入中等者患病率较低。     

Hypoxic hepatitis in children after cardiac surgery

<正>To the Editor: Hypoxic hepatitis(HH), also known as ischemic hepatitis or shock liver, is a liver injury characterized by necrosis of centrilobular hepatocytes with a rapid increase in serum aminotransferase levels. The incidence rate of HH among patients in the intensive care unit(ICU) was found to be 0.9%-11.9% [1]. Occurrence of HH appears to have a significant impact on the clinical outcome.