HPLC法测定地西泮和艾司唑仑的血药浓度

建立ＨＰＬＣ法同时测定地西泮和艾司唑仑血药浓度。方法：以Ｕｌｔｒａｓｐｈｅｒｅ－ＯＤＳ５μｍ４．６ｍｍ＊２５ｃｍ色谱柱为分离柱,流动相：甲醇－乙腈－水（４０：２０：４０）;检测波长为２５４ｎｍ,以外标法峰面积定量。结论本法可用于血药浓度测定。     

Evaluation design of a reactivation care program to prevent functional loss in hospitalised elderly: A cohort study including a randomised controlled trial

Background

Elderly persons admitted to the hospital are at risk for hospital related functional loss. This evaluation aims to compare the effects of different levels of (integrated) health intervention care programs on preventing hospital related functional loss among elderly patients by comparing a new intervention program to two usual care programs.

Methods/Design

This study will include an effect, process and cost evaluation using a mixed methods design of quantitative and qualitative methods. Three hospitals in the Netherlands with different levels of integrated geriatric health care will be evaluated using a quasi-experimental study design. Data collection on outcomes will take place through a prospective cohort study, which will incorporate a nested randomised controlled trial to evaluate the effects of a stay at the centre for prevention and reactivation for patients with complex problems. The study population will consist of elderly persons (65 years or older) at risk for functional loss who are admitted to one of the three hospitals. Data is prospectively collected at time of hospital admission (T0), three months (T1), and twelve months (T2) after hospital admission. Patient and informal caregiver outcomes (e.g. health related quality of life, activities of daily living, burden of care, (re-) admission in hospital or nursing homes, mortality) as well as process measures (e.g. the cooperation and collaboration of multidisciplinary teams, patient and informal caregiver satisfaction with care) will be measured. A qualitative analysis will determine the fidelity of intervention implementation as well as provide further context and explanation for quantitative outcomes. Finally, costs will be determined from a societal viewpoint to allow for cost effectiveness calculations.

Discussion

It is anticipated that higher levels of integrated hospital health care for at risk elderly will result in prevention of loss of functioning and loss of quality of life after hospital discharge as well as in lower burden of care and higher quality of life for informal caregivers. Ultimately, the results of this study may contribute to the implementation of a national integrated health care program to prevent hospital related functional loss among elderly patients.

Trial registration

The Netherlands National Trial Register: NTR2317     

Dual effect of quercetin on rat isolated portal vein smooth muscle contractility

Summary

This study examined the effects of quercetin on spontaneously contracting portal veins isolated from healthy young adult male and female Wistar rats (250–300 g). Quercetin (10^-7–10^-4 M) always produced significant biphasic effects, comprising an initial brief stimulant effect (rise in basal tone), followed by a sustained, longer-lasting secondary relaxant (inhibitory) effect on the venous tissues. The initial brief contractions of the venous muscle preparations were not modified by preincubation of the tissues with prazosin (10^-6 M), suggesting that the initial upsurge in basal tone and increases in contractile frequencies of the venous tissues were probably not mediated via alpha₁-adrenoceptor stimulation. However, preincubation of the tissues with nifedipine (10^-7 M) significantly suppressed (p < 0.05) or attenuated the initial stimulant effect of quercetin, suggesting that the flavonoid might be activating L-type voltage-dependent calcium channels. The vasorelaxant effect of quercetin was partially but not significantly (p > 0.05) inhibited by L-NAME (100 μM) or indomethacin (10 μM), suggesting that the vasorelaxant effect of the flavonoid was unlikely to be mediated via endothelium-dependent relaxing factor (EDRF), or through prostacyclin (PGI₂) pathways. N-p-tosyl-l-phenylalanine-chloromethyl-ketone (TPCK, 3 μM) significantly (p < 0.01) antagonised quercetin-induced relaxations, suggesting that cAMP-dependent protein kinases might have contributed, at least in part, towards the vasorelaxant effect of quercetin on rat isolated portal veins.     

Withdrawing intra-aortic balloon pump support paradoxically improves microvascular flow

Introduction

The Intra-Aortic Balloon Pump (IABP) is frequently used to mechanically support the heart. There is evidence that IABP improves microvascular flow during cardiogenic shock but its influence on the human microcirculation in patients deemed ready for discontinuing IABP support has not yet been studied. Therefore we used sidestream dark field imaging (SDF) to test our hypothesis that human microcirculation remains unaltered with or without IABP support in patients clinically ready for discontinuation of mechanical support.

Methods

We studied 15 ICU patients on IABP therapy. Measurements were performed after the clinical decision was made to remove the balloon catheter. We recorded global hemodynamic parameters and performed venous oximetry during maximal IABP support (1:1) and 10 minutes after temporarily stopping the IABP therapy. At both time points, we also recorded video clips of the sublingual microcirculation. From these we determined indices of microvascular perfusion including perfused vessel density (PVD) and microvascular flow index (MFI).

Results

Ceasing IABP support lowered mean arterial pressure (74 ± 8 to 71 ± 10 mmHg; P = 0.048) and increased diastolic pressure (43 ± 10 to 53 ± 9 mmHg; P = 0.0002). However, at the level of the microcirculation we found an increase of PVD of small vessels <20 μm (5.47 ± 1.76 to 6.63 ± 1.90; P = 0.0039). PVD for vessels >20 μm and MFI for both small and large vessels were unaltered. During the procedure global oxygenation parameters (ScvO₂/SvO₂) remained unchanged.

Conclusions

In patients deemed ready for discontinuing IABP support according to current practice, SDF imaging showed an increase of microcirculatory flow of small vessels after ceasing IABP therapy. This observation may indicate that IABP impairs microvascular perfusion in recovered patients, although this warrants confirmation.     

凝血酶肽促进缺血创面愈合与皮瓣存活的实验研究

目的探讨凝血酶受体激活肽(TP508)对促进缺血创面愈合与皮瓣存活的作用.方法SD大鼠66只,制作部分缺血创面(16只)、完全缺血创面(16只)、正常创面(18只)及皮瓣(16只)模型,每一模型又分为TP508治疗组和等渗盐水对照组.术后第3、7、10、14天,将创面或皮瓣坏死轮廓描记至醋酸纸七,输入计算机求出创面面积或坏死面积.结果术后7 d和14 d,TP508组正常创面面积仅为对照组的73.7%和45.4%.术后7 d,TP508组部分缺血创面面积为(99.8±30.7)mm2,而对照组为(128.0±43.4)mm2.术后第10天,TP508组完全缺血创面面积为(293.0±34.0)mm2,对照组为(352.4±41.2)mm2.术后第7天,TP508组皮瓣坏死面积为对照组皮瓣坏死面积的80.4%,第14天为56.8%.结论 TP508对促进大鼠缺血创面愈合和皮瓣存活均有显著作用.     

静息状态脑功能网络的研究及应用

目的:对静息状态网络的研究方法、初步的研究成果等作以介绍,并结合静息状态网络在阿尔茨海默病早期预警中的应用,介绍静息状态脑网络的应用。资料来源:应用计算机检索PubMed1980-01/2006-12与静息状态网络相关的文献,检索词“restingstate,functional connectivity”,并限定文献语言种类为“English”;同时计算机检索万方数据库1995-01/2006-12有关方面的文献,检索词为“静息,功能连接,阿尔茨海默病”,并限定语言种类为中文。资料选择:对资料进行初审,选取包括静息状态的相关文献,开始查找原文。纳入标准:①有关静息状态脑网络和功能连接的研究。②有关阿尔茨海默病的研究。排除标准:重复研究。资料提炼:共收集到53篇有关静息状态网络方面的研究,排除23篇重复性研究,30篇符合要求。资料综合:近年来,研究者发现大脑处于无任务的静息状态时,仍然存在着某种功能活动。这些现象表明大脑在静息状态时可能存在有组织的网络。这有助于对人脑高级意识和某些认知疾病的研究,因此,有关这方面的工作越来越受到人们的重视。结论:对静息状态网络的本质和规律的研究还很有限,对这个网络所支持的精确的功能还有待于进一步研究。     

种植牙——人类的第三副牙齿

研究显示,若全口无牙,人的全身机能将下降40％～60％,佩戴假牙之后,全身机能也只能恢复到正常的81％-95％．种植牙的诞生为彻底解决缺牙带给患者咀嚼功能和语言发音障碍,影响面容美观和心理伤害等长期困扰其健康和生活质量问题提供了一个重要出路．伴随技术的成熟,种植牙也因此被誉为继乳牙、恒牙之后,人类的第三副牙齿．它是生命科学和材料与工程科学完美结合所诞生的产物,是近半个世纪以来口腔医学献给人类健康的一份厚礼．种植牙作为天然牙齿的替代体,人工牙根可以和牙床完全融合,     

Is permanent congenital facial palsy caused by birth trauma?

OBJECTIVE: To study the relation between traumatic birth and the development of permanent facial palsy in the newborn. DESIGN: Retrospective case control study of children with 'congenital' facial palsy. SETTING: Two tertiary referral centres for patients with facial palsy. SUBJECTS: 61 children with established facial palsy. MAIN OUTCOME MEASURES: Odds ratios of recognised factors for birth injury: maternal primiparity, high birth weight, and the use of obstetric forceps at delivery. RESULTS: 13.2% of those studied had forceps assisted delivery compared to 10.2% in the normal population (odds ratio 1.34; 95% confidence intervals 0.61 to 2.97) 39.6% were born to primiparae compared to a national rate of 36.7% (1.13; 0.65 to 1.96) and only 18.9% weighed more than 3500 g at birth (0.37; 0.19 to 0.74). CONCLUSIONS: There is no association between the development of permanent 'congenital' facial palsy and recognised risk factors for birth injury. These data suggest an intrauterine rather than a traumatic aetiology.