反相高效液相色谱法同时测定马钱子酊中士的宁和二甲氧基士的宁的含量

目的：建立马钱子酊中士的宁和二甲氧基士的宁（马钱子碱）的含量测定方法。方法：采用反相高效液相色谱法以甲醇-乙腈-水-冰醋酸（35：40：25：0.5）为流动相，Zorbax SB-C18 ODS(4.6mmx 250mm，5цm)为分析柱，紫外线测定波长为254nm。结果：二甲氧基士的宁线性范围为0.05-0.45цg，r=0.9997，测量平均回收率为99.4%，RSD为2.2%；士的宁线性范围为0.06-0.54цg，r=0.9994，测量平均回收率为101.3%，RSD为1.22%。结论：本法简便，快速，灵敏。     

老年高血压患者心律失常与血浆儿茶酚胺关系的探讨

观察了老年期与老年前期高血压病患者心律失常的发生情况及与血浆儿茶酚胺（ＣＡ）的关系。结果表明，老年期高血压患者室性心律失常的发生率较老年前期组显著增多；血浆去甲肾上腺素（ＮＥ）、肾上腺素（Ｅ）含量较老年前期组显著增高；血浆ＮＥ与２４ｈ室性早搏（ＶＰＣ）总数显著正相关（ｒ＝０．３５６，Ｐ＜０．０１）。经卡托普利治疗后，血浆ＮＥ、Ｅ均显著下降，室性心律失常的发生率显著减低。本文结果提示，交感－肾上腺素     

6%羟乙基淀粉130/0.4对患者硬膜外复合全麻诱导期肺循环的影响

Objective To observe the effect of pulmonary circulation by 6% hydroxyethyl starch 130/0.4 during induction period from epidural block combined with general anesthesia. Methods Twenty-six hepatobiliary surgical patients with ASA Ⅰ-Ⅱ, aged 32 y-59 y, weighing 54 kg-73 kg, were randomized into 2 groups(n=13): hydroxyethyl starch 130/0.4 group(HS)and complex acetic acid Ringer's solution (RL). Above-mentioned solutions were infused 7 ml/kg respectively before induction. The pulmonary circulation hemodynamic parameters such as pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure(MPAP), pulmonary artery wedge pressure(PAWP), pulmonary vascular resistance(PVR) and right ventricular stroke work(RVSW) were recorded at base value(T0), 10 min after infusion(T1), 5 min after induction(T2), 5 rain after intubation(T3), 10 rain after intubation(T4)and 20 min after intubation(T5). Results PASP、PADP、MPAP、PAWP and CVP were significantly higher in group HS at T, than the values at T0 (P<0.05); PVR in group HS was obviously lower from T1 to T5 than the value at To (P<0.05 or P<0.01); RVSW was significantly higher in two groups at T1 than base value (P<0.05), but that in group HS was lower than base value (P<0.05 or P<0.01); HR obviously decreased in two groups from T2 to T5 as compared with the value at T0 (P<0.05); MAP was lower from T3 to T5 than the value at To (P<0.05 or P<0.01). PVR was obviously lower in group HS from T1 to T5 than that in group RL (P<0.05 or P<0.01); MAP obviously increased from T2 to T5 in group HS as compared with the value in group RL(P<0.05 or P<0.01). Conclusion 6% hydroxyethyl starch 130/0.4 can obviously reduce PVR during induction pe-riod from epidural block combined with general anesthesia. In all, there is no effect on pulmonary circulation by 6% hydroxyethyl starch 130/0.4.     

医疗队抗击新型冠状病毒肺炎疫情救援物资筹备及管理

2019年12月以来,湖北武汉连续发生多例原因不明肺炎,随着新型冠状病毒疫情的发展与蔓延,全国各地医护人员奔赴武汉投入抗疫之战。2020年1月24日,笔者作为海军军医大学赴武汉医疗队的一员,积极投入此次紧急医学救援一线。由所在医院医务处牵头,护理处、院务处、医学工程科、感控办多部门协同,医疗队医护骨干全程参与,在接到紧急出动救援命令12小时内,快速、有序、高效地完成医院赴武汉医疗队有关物资的准备工作,本文就疫情的物资筹备的经验进行探讨。     

五分类血液分析仪白细胞分类参数的校准及验证

[目的]对五分类血液细胞分析仪的白细胞分类计数(DIFF)部分进行校准,使检测的结果准确可靠.[方法]采用兰盲法用手工对新鲜全血进行定值,再用该手工定值的新鲜全血对XE-2100五分类血液细胞分析仪的DIFF参数进行校准.[结果]手工分类靶值的均值NEUT%、LYMPH%.MONO%、EO%、BASO%分别是68.0、25.1、3.8、2.9和0.2,仪器检测总的均值分别是66.4、25.5、4.6、3.0和0.5.二者分类计数结果比较,均在可信允许范围内.[结论]人工对新鲜全血进行定值,所定靶值正确与否直接影响仪器分类参数校准的效果.参与人员必须具备责任心强、工作经验丰富等高素质、且经过严格的相关培训并相对固定,才能保证校准结果的准确性.     

手术治疗痉挛性斜颈25例

痉挛性斜颈（spasmodic torticollis，ST）是最常见的局限性肌张力障碍，其发病机制尚未明确。颈神经根切断术和副神经微血管减压术治疗痉挛性斜颈已取得一定的疗效。但这2种手术方法各有利弊，我们总结分析后，开展了副神经微血管减压术结合颈神经根切断术治疗痉挛性斜颈25例，现将结果报告如下。     

6%羟乙基淀粉130/0.4对患者硬膜外复合全麻诱导期肺循环的影响

Objective To observe the effect of pulmonary circulation by 6% hydroxyethyl starch 130/0.4 during induction period from epidural block combined with general anesthesia. Methods Twenty-six hepatobiliary surgical patients with ASA Ⅰ-Ⅱ, aged 32 y-59 y, weighing 54 kg-73 kg, were randomized into 2 groups(n=13): hydroxyethyl starch 130/0.4 group(HS)and complex acetic acid Ringer's solution (RL). Above-mentioned solutions were infused 7 ml/kg respectively before induction. The pulmonary circulation hemodynamic parameters such as pulmonary arterial systolic pressure (PASP), pulmonary arterial diastolic pressure (PADP), mean pulmonary artery pressure(MPAP), pulmonary artery wedge pressure(PAWP), pulmonary vascular resistance(PVR) and right ventricular stroke work(RVSW) were recorded at base value(T0), 10 min after infusion(T1), 5 min after induction(T2), 5 rain after intubation(T3), 10 rain after intubation(T4)and 20 min after intubation(T5). Results PASP、PADP、MPAP、PAWP and CVP were significantly higher in group HS at T, than the values at T0 (P<0.05); PVR in group HS was obviously lower from T1 to T5 than the value at To (P<0.05 or P<0.01); RVSW was significantly higher in two groups at T1 than base value (P<0.05), but that in group HS was lower than base value (P<0.05 or P<0.01); HR obviously decreased in two groups from T2 to T5 as compared with the value at T0 (P<0.05); MAP was lower from T3 to T5 than the value at To (P<0.05 or P<0.01). PVR was obviously lower in group HS from T1 to T5 than that in group RL (P<0.05 or P<0.01); MAP obviously increased from T2 to T5 in group HS as compared with the value in group RL(P<0.05 or P<0.01). Conclusion 6% hydroxyethyl starch 130/0.4 can obviously reduce PVR during induction pe-riod from epidural block combined with general anesthesia. In all, there is no effect on pulmonary circulation by 6% hydroxyethyl starch 130/0.4.     

颅内巨大动静脉畸形的治疗及其并发症防治

目的探讨颅内巨大动静脉畸形(arteriovenous malforation,AVM)的治疗及其防治并发症的有效方法。方法回顾性分析2011.4~2014.4以手术切除为主,联合栓塞及伽玛刀治疗的18例巨大AVM患者的临床资料。结果无死亡病例,有2例术前昏迷的患者,术后昏迷程度减轻。格拉斯哥预后(GOS),5分12例,4分3例,3分1例,2分2例。结论根据患者的临床资料,制定个体化的治疗方案,重视细节,采用手术切除联合术前栓塞或/和术后放疗可以有效地降低颅内巨大AVM的手术并发症。     

格拉司琼在贴片中的含量测定和体外释放度研究

目的:建立测定格拉司琼贴片含量的HPLC法,并测定其体外释放度。方法:采用HPLC法测定格拉司琼的含量,色谱柱为Luna-CN柱(150 mm×4.6 mm,5μm),流动相为甲醇-乙酸铵缓冲液49∶51(用三乙胺和乙酸调pH至6.0),流速1.0 ml/min,检测波长302 nm,柱温30℃。结果:格拉司琼在0.267～66.80μg/ml范围内线性关系良好(r=0.999 9)。精密度和稳定性良好,高、中、低浓度(16.46、13.72和10.98μg/ml)的回收率分别为(99.03±0.54)%、(97.82±0.23)%和(100.11±0.43)%(n=3)。格拉司琼贴片在24 h内累积释放度为(90.52±2.14)%。结论:本研究建立的HPLC法重现性好,灵敏度高,专属性强,可用于格拉司琼贴片的质量控制。格拉司琼贴片体外释放行为良好。