胶体金法与液相色谱-质谱法MDMA检测比较

目的：通过胶体金法对药物滥用患者尿液中3,4-亚甲基二氧基甲基苯丙胺（MDMA）及代谢产物进行检测,并与液相色谱一质谱法检测结果进行比较以验证其检测效果。方法：选取广州市脑科医院物质依赖科收治的药物滥用患者,分别采用胶体金法和液相色谱一质谱法检测其尿液中MDMA及相关成分,计算分析胶体金法检测试剂的灵敏度、特异度、Youden指数与总符合率。结果：在以液相色谱-质谱法为金标准的检测结果对比中,胶体金法检测试剂的灵敏度100．00％,特异度98．88％,Youden指数0．9888,样本检测总符合率98．97％,Kappa=0．936,P=0．00。结论：与液相色谱-质谱法相比较,胶体金法具有操作简便、直观、快速、省时的特点,其特异性、敏感性较高,具有良好的检测效果。     

奥沙利铂杂质研究进展

以近年来国内外研究文献为基础,对奥沙利铂及其制剂杂质来源、杂质控制、制剂的稳定性等进行综述。奥沙利铂及其制剂的主要杂质为草酸、杂质B、C、D以及杂质E。杂质由合成工艺带入,同时原料及制剂在放置过程中均可降解产生上述杂质。为确保临床用药的安全有效,奥沙利铂及其制剂的杂质需要分别进行控制。     

注射用唑来膦酸的细菌内毒素检查

目的建立注射用唑来膦酸细菌内毒素检查方法。方法根据2010年版《中国药典》（二部）附录收载的细菌内毒素检查方法进行试验。结果注射用唑来膦酸稀释至0.0033mg.mL-1溶液,用标示灵敏度0.25EU.mL-1的鲎试剂检测细菌内毒素,无干扰因素影响。结论注射用唑来膦酸可应用鲎试剂进行细菌内毒素法检查,细菌内毒素限度确定为75Eu.mg-1。     

阿胶、藕节、天花粉等氨基酸薄层层析方法研究与改进

目的改善和提高氨基酸薄层层析的分离效果。方法采用盐酸﹕水（1：1）提取,以正丙醇-36%乙酸（7：3）为展开剂,含1%茚三酮的丙酮溶液为显色剂,105℃加热显色至斑点显色清晰。结果色谱斑点清晰,分离理想,各斑点Rf值适中。结论本方法较《中华人民共和国药典》中关于氨基酸的薄层层析的方法简单,重复性好,具有较好的可行性和实用性。     

HPLC法测定尼莫地平缓释片中尼莫地平含量

目的建立尼莫地平缓释片中尼莫地平的含量测定方法。方法以C18色谱柱为分析柱,乙腈-甲醇-水（40：30：30）（v/v）为流动相,检测波长为237nm。结果尼莫地平的检测线性范围为2～40μg/mL,回收率为99.81%,RSD值为1.24%。结论本方法简便、快速、稳定、重复性好,可用于尼莫地平缓释片的质量控制。     

环氧合酶-2表达水平和前列腺癌进展相关关系的研究

目的检测环氧合酶-2在前列腺癌中的表达,并探讨其与前列腺癌临床病理因素及预后的关系。方法采用免疫组织化学SP法,检测120例前列腺癌及20例前列腺增生组织(对照组)中环氧合酶-2的表达,分析检测指标与前列腺癌发病情况的相关性。结果前列腺癌组织中环氧合酶-2表达阳性率明显高于对照组。结论环氧合酶-2具有促进肿瘤细胞转化、增殖、迁移的作用,对于环氧合酶-2的检测有助于前列腺癌患者的预后评估。     

四川地区成人血清缺血修饰清蛋白参考区间的建立

目的建立四川地区成人血清缺血修饰清蛋白(IMA)的参考区间。方法选择四川地区800名健康体检者,采用游离钴比色法测定IMA的含量,利用百分位数法(非参数法)评估参考区间,以97.5%百分位数作为单侧参考区间上限。结果 (1)男、女两组IMA水平分别为小于78.1U/mL和小于77.5U/mL,两组差异无统计学意义(P>0.05);(2)Ⅰ组血清IMA水平为小于77.3U/mL,Ⅱ组血清IMA水平为小于77.6U/mL,Ⅲ组血清IMA水平为小于78.4U/mL。3组之间两两比较,差异均无统计学意义(P>0.05)。结论四川地区成人血清IMA的参考区间是小于77.8U/mL,与性别、年龄无关。     

Impact of the ABCDE triage in primary care emergency department on the number of patient visits to different parts of the health care system in Espoo City

Background

Many Finnish emergency departments (ED) serve both primary and secondary health care patients and are therefore referred to as combined emergency departments. Primary care doctors are responsible for the initial assessment and treatment. They, thereby, also regulate referral and access to secondary care. Primary health care EDs are easy for the public to access, leading to non-acute patient visits to the emergency department. This has caused increased queues and unnecessary difficulties in providing immediate treatment for urgent patients. The primary aim of this study was to assess whether the flow of patients was changed by implementing the ABCDE-triage system in the EDs of Espoo City, Finland.

Methods

The numbers of monthly visits to doctors were recorded before and after intervention in Espoo primary care EDs. To study if the implementation of the triage system redirects patients to other health services, the numbers of monthly visits to doctors were also scored in the private health care, the public sector health services of Espoo primary care during office hours and local secondary health care ED (Jorvi hospital). A face-to-face triage system was applied in the primary care EDs as an attempt to provide immediate treatment for the most acute patients. It is based on the letters A (patient sent directly to secondary care), B (to be examined within 10 min), C (to be examined within 1 h), D (to be examined within 2 h) and E (no need for immediate treatment) for assessing the urgency of patients' treatment needs. The first step was an initial patient assessment by a health care professional (triage nurse). The introduction of this triage system was combined with information to the public on the "correct" use of emergency services.

Results

After implementation of the ABCDE-triage system the number of patient visits to a primary care doctor decreased by up to 24% (962 visits/month) as compared to the three previous years in the EDs. The Number of visits to public sector GPs during office hours did not alter. Implementation of ABCDE-triage combined with public guidance was associated with decreased total number of doctor visits in public health care. During same period, the number of patient visits in the private health care increased. Simultaneously, the number of doctor visits in secondary health care ED did not alter.

Conclusions

The present ABCDE-triage system combined with public guidance may reduce patient visits to primary health care EDs but not to the secondary health care EDs. Limiting the access of less urgent patients to ED may redirect the demands of patients to private sector rather than office hours GP services.     

HPLC法测定华山参滴丸中东莨菪碱、阿托品及东莨菪内酯的含量

目的:建立HPLC法测定华山参滴丸中东莨菪碱、阿托品及东莨菪内酯的含量。方法:采用资生堂CAPCELL-PAK C18(4.6 mm×250 mm,5μm)色谱柱,以乙腈-甲醇-磷酸氢二钠缓冲液(15∶4∶81)为流动相,流速1.0 mL·min-1,东莨菪碱、阿托品检测波长210 nm(0～15 min),东莨菪内酯检测波长为344 nm(15.1～30 min),柱温30℃。结果:东莨菪碱、阿托品及东莨菪内酯的线性范围分别为0.04～3.95,0.04～4.10,0.05～0.54μg(r=0.9999);平均回收率(n=6)分别为97.58%(RSD=1.3%),98.65%(RSD=1.3%),98.42%(RSD=1.8%)。结论:本文方法简便、准确,可以用于华山参滴丸中东莨菪碱、阿托品及东莨菪内酯的含量测定。     

免疫亲和净化-液相色谱-串联质谱测定中成药中14个真菌毒素

目的:建立同时测定中成药中黄曲霉毒素B1、B2、G1、G2,HT-2毒素,T-2毒素,赭曲霉毒素A,伏马毒素B1、B2,玉米赤霉烯酮,α-玉米赤霉烯醇,β-玉米赤霉烯醇,α-玉米赤霉醇以及β-玉米赤霉醇共14个真菌毒素的测定方法。方法:采用PBS溶液和70%甲醇-PBS溶液依次提取样品中真菌毒素,提取液经多功能免疫亲和柱净化,0.1%吐温-PBS溶液和水依次淋洗,甲醇洗脱,氮气流下浓缩定容,测定时采用Waters Xterra C18MS(100 mm×2.1 mm,3.5μm)分析柱,0.3 mL·min-1的流速,梯度洗脱,质谱测定采用多反应监测(MRM)模式。结果:14个真菌毒素的最小检出浓度(LOQ)为1.0～5.0μg·kg-1;4个中成药基质的3个不同水平的添加回收率(n=6)为75.7%～97.9%,RSD为5.3%～13.8%。结论:本方法采用了多功能免疫亲和柱净化,质谱定性定量,加快了检测速度,降低了中成药复杂基体的干扰,方法检测限满足了国内外中成药多个真菌毒素限量控制要求。