维拉帕米对失血性休克犬心脏的保护作用及机制

杂种犬１１只，由股动脉放血使平均动脉压（ＭＡＰ）维持在６．０ｋＰａ９０ｍｉｎ后回输全部血液，继续观察１５０ｍｉｎ。在休克３０ｍｉｎ后，对照组和维拉帕米处理组（Ｖｅｒ组）分别静脉滴注生理盐水和Ｖｅｒ溶液［（１０μｇ／ｋｇ·ｍｉｎ）１５ｍｉｎ］，液体总量为３ｍｌ／ｋｇ。对照组犬在失血后心率（ＨＲ）加快，左室ｄｐ／ｄｔｍａｘ显著降低，回输血液后ＭＡＰ虽有回升，但仍低于基础值，左室ｄｐ／ｄｔｍａｘ无明显改善；Ｖｅｒ使休克犬ＨＲ减慢，血液回输后ＭＡＰ缓慢恢复至基础值，左室ｄｐ／ｄｔｍａｘ显著高于对照组；电镜观察可见对照组心肌肌原纤维和线粒体等有明显的损伤，而Ｖｅｒ组心肌超微结构基本正常。结果还显示：Ｖｅｒ组犬心肌中丙二醛含量、黄嘌呤氧化酶活性低于对照组，而超氧化物歧化酶活性高于对照组。结果表明：Ｖｅｒ对失血性休克犬的心脏具有保护作用，其机制可能与其阻滞膜Ｃａ２＋内流、抑制脂质过氧化有关。     

脑室注射促甲状腺素释放激素对电针镇痛及脑内亮氨酸脑啡肽含量的影响

实验用大鼠76只,用辐射热-甩尾法测痛,以电针后痛阈变化的百分率评价镇痛效应;用放射免疫分析法测定脑内L-Enk含量。发现脑室注入三肽-促甲状腺素释放激素(TRH)后,能显著降低电针镇痛效果;提高丘脑内L-Enk含量,但痛阈与脑内L-Enk含量的变化无相关关系。本文证明,TRH在电针镇痛过程中是对抗作用。已知针刺镇痛与脑内多种神经质和肽类有关,在不利于针刺镇痛的因素中,TRH是新添的“一员”。     

Gründe für die Ablehnung behördlicher Empfehlungen und Maßnahmen zum Schutz vor SARS-CoV-2 – eine qualitative Studie auf Basis von Beiträgen in sozialen Medien

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Um die Ausbreitung von SARS-CoV‑2 (schweres akutes Atemwegssyndrom-Coronavirus-Typ 2) zu verlangsamen, haben Bund...     

蒙药毛勒日—达布斯—4汤中微量元素及氨基酸含量的测定

目的：测定蒙药毛勒日-达布斯-4汤中微量元素和氨基酸的含量。方法：用原子吸收分光光度计,测定蒙药毛勒日-达布斯-4汤中几种重要的微量元素含量;用氨基酸自动分析仪测定氨基酸的含量。结果与结论：蒙药毛勒日-达布斯-4汤中含有较高的Mn、Fe、Zn和Mg;含有17种氨基酸,包括7种人体必需氨基酸,氨基酸总量为4.615%（mg/g）。     

雷公藤多甙片加益肾活血法治疗IgM相关性肾小球疾病

目的探讨IgM相关性肾小球疾病的治疗。方法53例患者分为雷公藤多甙片组(A组)和雷公藤多甙片＋中药益肾活血(B组)治疗,疗程2个月。结果两组治疗前后尿蛋白均下降（P＜0．05）,组间比较则B组降低更明显(P＜0．05)。尿红细胞均有减少,A组P＞0．05,B组P＜0．05;组间比较P＜0．05。结论雷公藤多甙片＋中药益肾活血法治疗IgM相关性肾小球疾病较单用雷公藤多甙片疗效显著提高。认为辨病辨证相结合组方用药,能够提高疗效。     

黄芪多糖对糖尿病大鼠微血管病变的作用及机制的研究

目的：探讨黄芪多糖（APS）对糖尿病大鼠微血管病变的影响以及对糖尿病的治疗作用及机制。方法：成年,健康SD大鼠40只,雌雄不限,分成四组：正常对照组,糖尿病组（腹腔注射四氧嘧啶200mg/kg),APS组（造模成功后用APS治疗）,优降糖组（造模成功后用优降糖治疗）。治疗两周时测一次血糖,四周后,测血糖;颈动脉取血测定血清胰素水平,NO和MDA含量。应用形态定量的方法比较各组的心肌病理变化。结果：腹腔注射alloxan(200mg/kg)后的SD大鼠血糖浓度显升高,血清NO,MDA,胰岛素水平明显改变。APS治疗四周后,血糖浓度明显下降,与优降糖治疗组无明显差异,血清NO较未治疗组明显升高（P＜0．01）,血清MDA较未治疗组明显减少（P＜0．01）,血清胰岛素水平升高（P＜0．05）,光镜下观察,糖尿病大鼠的心肌毛细血管数量减少,基底膜增厚,微血管与心肌纤维的比率显减低,这些改变都可被APS改善.结论：APS有降低血糖和保护血管内皮细胞的作用,这可能与APS减轻氧自由基的损伤,影响NO的产生以及促进胰岛B细胞的损伤的恢复有关。     

制备工艺对ATO超细粉体导电性能的影响

采用化学共沉淀法制备锑掺杂二氧化锡（ATO）超细导电粉体,研究了反应温度,滴定终点pH值,掺锑量及锻炼温度对粉体导电性的影响,并对实验结果进行了讨论。     

Problems for clinical judgement: 4. Surviving in the report card era

HEALTH CARE REPORT CARDS INVOLVE COMPARISONS of health care systems, hospitals or clinicians on performance measures. They are going to be an important feature of medical care in Canada in the new millennium as patients demand more information about their medical care. Although many clinicians are aware of this growing trend, they may not be prepared for all of its implications. In this article, we provide some historical background on health care report cards and describe a number of strategies to help clinicians survive and thrive in the report card era. We offer a number of tips ranging from knowing your outcomes first to proactively getting involved in developing report cards.     

尿液结合性胆红素的纯化

OBJECTIVES: To develop a simple, practical method with fine yield and purity for separating conjugated bilirubin(Bc) from a sustainable and facile material in order that it could serve as a calibrator for total and direct bilirubin determination. METHODS: Isolating Bc from urine of patients with obstructive jaundice by CHCl3: CH3CH2OH(1:1, V/V) followed by CNBr activated Sepharose 4B-HAS affinity chromatography, we analyzed the products by the use of Doumas J-G diazo method and HPLC, respectively. RESULTS: Determined by J-G diazo method, the crude product extracted by CHCl3: CH3CH2OH(1:1, V/V) yields 90.2 +/- 5.4%(n = 3) of urine Bc, the ratio of Bc to total dry weight being 67.9 +/- 6.4%(n = 3). The final product purified by affinity chromatography with the ratio of separation of 1.5, 1.737 and analyzed by HPLC has the yield of 46.9% and purity of 94.7%(BDG of 76.2%, BMG of 18.5%). CONCLUSION: The above data demonstrate that urine conjugated bilirubin can be successfully purified by CHCl3: CH3CH2OH extraction followed by Sephrose-HSA affinity chromatography with sufficient purity and output.     

Ductal Prostate Cancers Demonstrate Poor Outcomes with Conventional Therapies

BackgroundDuctal prostate adenocarcinoma (DAC) is a rare, aggressive, histologic variant of prostate cancer that is treated with conventional therapies, similar to high-risk prostate adenocarcinoma (PAC).ObjectiveTo assess the outcomes of men undergoing definitive therapy for DAC or high-risk PAC and to explore the effects of androgen deprivation therapy (ADT) in improving the outcomes of DAC.Design, setting, and participantsA single-center retrospective review of all patients with cT1–4/N0–1 DAC from 2005 to 2018 was performed. Those undergoing radical prostatectomy (RP) or radiotherapy (RTx) for DAC were compared with cohorts of high-risk PAC patients.Outcome measurements and statistical analysisMetastasis-free survival (MFS) and overall survival (OS) rates were analyzed using Kaplan-Meier and Cox regression models.Results and limitationsA total of 228 men with DAC were identified; 163 underwent RP, 34 underwent RTx, and 31 had neoadjuvant therapy prior to RP. In this study, 163 DAC patients and 155 PAC patients undergoing RP were compared. Similarly, 34 DAC patients and 74 PAC patients undergoing RTx were compared. DAC patients undergoing RP or RTx had worse 5-yr MFS (75% vs 95% and 62% vs 93%, respectively, p < 0.001) and 5-yr OS (88% vs 97% and 82% vs 100%, respectively, p < 0.05) compared with PAC patients. In the 76 men who received adjuvant/salvage ADT after RP, DAC also had worse MFS and OS than PAC (p < 0.01). A genomic analysis revealed that 10/11 (91%) DACs treated with ADT had intrinsic upregulation of androgen-resistant pathways. Further, none of the DAC patients (0/15) who received only neoadjuvant ADT prior to RP had any pathologic downgrading. The retrospective nature was a limitation.ConclusionsMen undergoing RP or RTx for DAC had worse outcomes than PAC patients, regardless of the treatment modality. Upregulation of several intrinsic resistance pathways in DAC rendered ADT less effective. Further evaluation of the underlying biology of DAC with clinical trials is needed.Patient summaryThis study demonstrated worse outcomes among patients with ductal adenocarcinoma of the prostate than among high-grade prostate adenocarcinoma patients, regardless of the treatment modality.