HPLC-UV法测定环磷酰胺血药浓度及其临床应用

目的：建立测定环磷酰胺血药浓度的高效液相色谱法。方法：血浆样品经碱性乙腈沉淀蛋白后,以乙腈-水溶液（30∶70）为流动相,流速1.2 mL/min,采用XterraRP18色谱柱分离,在197 nm波长下进行检测,柱温30℃。结果：环磷酰胺在1.0～32.0 mg/L浓度范围内与峰面积呈良好的线性关系（r=0.9999,n=5）,提取回收率90.07%～91.44%,日内、日间精密度（RSD）均〈10%。血浆中环磷酰胺最低检测浓度为0.1 mg/L。结论：本文建立的方法灵敏度高,选择性好,简便、快速、准确,适用于临床样本环磷酰胺的血浆浓度测定和药代动力学研究,可为临床实施个体化给药提供参考。     

全结直肠切除回肠贮袋肛管手缝吻合术在溃疡性结肠炎治疗中的临床价值

目的 评价全结直肠切除回肠贮袋肛管手缝吻合术（HIPAA）治疗溃疡性结肠炎的临床价值.方法 回顾性分析1989年1月至2013年12月天津医科大学总医院收治的191例溃疡性结肠炎患者的临床资料,采用开腹和腹腔镜辅助手术行HIPAA.末次手术后3个月和12个月进行问卷调查,依据24h和夜间排便次数、Bristol粪便分类表和Kirwan分级评价贮袋肛门功能.依据克利夫兰生命质量表评价生命质量;依据贮袋炎活动指数诊断贮袋炎.随访时间截至2014年4月.独立样本比较采用t检验,多组比较采用方差分析,两两比较采用LSD-t检验,计数资料比较采用x2检验.结果 191例患者中有180例行开腹手术,11例行腹腔镜手术.175例行二期手术,9例行一期手术,7例行三期手术.181例采用J型贮袋,9例采用H型贮袋,1例采用W型贮袋.患者无围手术期死亡,术后早期8例患者腹腔感染,7例切口感染,应用抗生素后治愈.术后1～2周发生贮袋吻合口出血4例,吻合口漏4例,给予止血处理后治愈.6例患者术后出现高位肠梗阻,经对应处理后缓解.8例患者发生贮袋炎,经饮食调节或抗生素治疗后缓解.2例患者发生性功能障碍.所有患者获得随访,随访时间1～25年.术后贮袋肛门功能不断改善,术后3个月24 h和夜间排便次数、Bristol粪便分类和Kirwan分级分别为（6.5±2.8）次,（2.9±1.5）次,Ⅳ类86例、Ⅴ类89例、Ⅵ类16例,Ⅰ级160例、Ⅱ级19例、Ⅲ级12例;术后12个月分别为（3.7±1.4）次,（1.3±0.5）次,Ⅳ类107例、Ⅴ类76例、Ⅵ类8例,Ⅰ级177、Ⅱ级8例、Ⅲ级6例,两者比较,差异有统计学意义（=12.36,3.98,x2=7.76,29.27,P＜0.05）.克利夫兰生命质量表评分：术前为（0.37±0.19）分,术后3个月为（0.67±0.16）分,术后12个月为（0.82±0.13）分,3者比较,差异有统计学意义（F=6.011,P＜0.05）.术后3个月与术前和术后12个月比较,差异有统计学意义（t=16.69,10.06,P＜0.05）;术后12?     

低张气充盈法多层螺旋CT增强扫描在胃部病变内镜治疗术前的评估价值

目的探讨低张气充盈法多层螺旋CT增强扫描(EMSCT-LTGF)在胃部病变内镜治疗术前评估的价值。 方法回顾性分析2018年1月至2019年4月临汾市中心医院收治具有完整资料的胃部病变60例,均经手术获得病理结果,包括神经内分泌瘤、息肉、腺瘤、平滑肌瘤、胃肠道间质瘤、脂肪瘤、异位胰腺、外压、胃壁脓肿、胃溃疡等,术前行EMSCT-LTGF评估,并与病理结果对照。 结果与病理结果进行对照后发现,EMSCT-LTGF与胃镜在检出病变溃疡方面的比较差异无统计学意义。EMSCT-LTGF判断病变深度与病理结果比较差异无统计学意义。 结论EMSCT-LTGF在评估胃部病变溃疡、深度、形态、直径、密度、血供、淋巴结及远处脏器转移、邻近结构有无侵犯等方面有较高价值,能够为胃部病变内镜治疗术前提供准确的依据。     

淋巴瘤化疗诱发肝衰竭患者临床特点与预后分析

目的 总结因淋巴瘤化疗后发生肝衰竭患者的病历资料,分析其发生肝衰竭的原因和影响结局的因素,以提高临床诊治能力。方法 采用回顾性分析法总结21例接受化疗的淋巴瘤患者在发生肝衰竭后的临床特点治疗经过和预后变化。结果 在21例患者中,非霍奇金淋巴瘤20例,霍奇金淋巴瘤1例;接受利妥昔单抗和化疗药物化疗;诱发肝衰竭的原因为HBV感染激活12例,药物性肝损伤5例,淋巴瘤肝脏浸润2例,HEV感染2例;常规综合措施护肝治疗,结果11例生存,10例死亡【中位生存时间为14(4～40) d】;单因素分析显示生存与死亡患者血清AST、Cr、INR和MELD评分存在显著性差异(P<0.05),经Cox回归生存分析显示Cr和MELD评分是影响死亡的独立危险因素。结论 淋巴瘤患者在接受化疗期间需密切监测病毒学和肝功能变化,对合并HBV感染者,应及时预防性应用抗病毒药物。     

High-performance yttrium-iron alloy doped Pt-free catalysts on graphene for hydrogen evolution

Research into the preparation and application of metal/graphene nanocomposite materials is an important issue in the field of graphene applications. Metal nanomaterials and graphene materials have many excellent properties and have been perfectly combined into metal/graphene nanocomposite materials. These offer the high catalytic activity of metal nanomaterials and the high specific surface area and favorable electrical conductivity of graphene. The unique advantages can produce synergistic effects and can significantly improve the overall performance of the composite materials. This gives the metal/graphene nanocomposite materials excellent application prospects for hydrogen evolution. Here, we report the preparation of yttrium-doped palladium/iron on graphene (Pd/YFeO₃/^GC) using a simple and efficient method. The catalytic performance of the Pd/YFeO₃/^GC nanocomposites for water electrolysis and hydrogen production was evaluated. The results show that the overpotential for the hydrogen evolution reaction at −10 mA cm⁻² is only 15 mV, which is competitive with Pt/C catalysts. The Pd/YFeO₃/^GC is highly active for hydrogen evolution with an onset potential of −8 mV in 0.5 M H₂SO₄ solution and a Tafel slope of 37 mV dec⁻¹ with a Pd loading of only 20 μg_Pd cm⁻². These results clearly demonstrated that Pd/YFeO₃/^GC is an excellent catalyst for hydrogen evolution.

Research into the preparation and application of metal/graphene nanocomposite materials is an important issue in the field of graphene applications.     

Human Papillomavirus Prevalence in Oropharyngeal Cancer before Vaccine Introduction,United States

We conducted a study to determine prevalence of HPV types in oropharyngeal cancers in the United States and establish a prevaccine baseline for monitoring the impact of vaccination. HPV DNA was extracted from tumor tissue samples from patients in whom cancer was diagnosed during 1995–2005. The samples were obtained from cancer registries and Residual Tissue Repository Program sites in the United States. HPV was detected and typed by using PCR reverse line blot assays. Among 557 invasive oropharyngeal squamous cell carcinomas, 72% were positive for HPV and 62% for vaccine types HPV16 or 18. Prevalence of HPV-16/18 was lower in women (53%) than in men (66%), and lower in non-Hispanic Black patients (31%) than in other racial/ethnic groups (68%–80%). Results indicate that vaccines could prevent most oropharyngeal cancers in the United States, but their effect may vary by demographic variables.     

InVance球部悬吊术治疗前列腺癌根治术后压力性尿失禁

目的评价InVance球部悬吊术治疗前列腺癌根治术后压力性尿失禁的临床效果。方法回顾性分析2005年3月至2011年3月采用InVance球部悬吊术治疗6例前列腺癌根治术后压力性尿失禁患者的临床资料。结果6例手术时间80～120min,出血量20～50ml。术后2d拔除气囊导尿管,切口均Ⅰ期愈合。随访12～29个月,4例治愈,1例改善,1例无效。2例出现暂时性尿潴留,1例出现短期内会阴疼痛。6个月后最大尿流率（15．9±7．7）ml／s,残余尿量0-20ml／s。结论InVance球部悬吊术简单、创伤小、手术并发症少,对前列腺癌根治术后压力性尿失禁有较好疗效。     

慢性心力衰竭患者认知功能状况及其影响因素的调查分析

目的 描述慢性心力衰竭(chronic heart failure,CHF)患者认知功能状况并探讨其影响因素.方法 入选2013年4月至12月北京阜外心血管病医院CHF监护病房及重症监护病房(ICU)住院的CHF患者267例,使用蒙特利尔认知功能评估表(MoCA)进行认知功能评估,并收集相关资料.以患者认知状况为因变量进行非条件logistic回归分析.结果 患者认知评估平均分为(25.22±2.82)分,以＜ 26分作为认知功能受损的界值,37.8％ (101/267)的患者伴有认知功能损伤.其中延迟回忆、语言、视空间与执行功能维度受损最严重.多因素分析结果显示,在对其他因素进行控制后,随年龄增长患者认知功能呈下降趋势(OR=1.09,95％ CI:1.05～1.14),左心室射血分数(LVEF)越高患者认知功能越好(OR =0.97,95％ CI:0.95 ～0.99),规律服药者认知功能好于未规律服药者(OR =3.71,95％ CI:1.40 ～ 10.91),社会支持水平高的患者认知功能优于社会支持低者(OR=0.92,95％ CI:0.88 ～0.96).结论 CHF患者认知损伤发生率较高,年龄、LVEF、规律服药情况及社会支持与CHF患者认知功能有关.