不同产地冻干地黄中5种重金属及有害元素的含量测定

摘 要 目的： 用火焰原子吸收分光光度计和原子双道荧光光度计分别对不同产地冻干地黄中的Pb、Cd、Cu、As和Hg 5种重金属和有害元素进行检测。方法: 采用硝酸-高氯酸对样品进行消化后,采用原子吸收分光光度法测定Pb、Cd和Cu含量,采用原子荧光光度法测定As和Hg的含量。 结果: 各元素线性关系良好,相关系数均大于0.997 4,平均回收率为97.88%～100.90%,RSD为0.019%～4.20%（n=6）,同时发现10批样品中的4批样品部分重金属和有害元素超过《中国药典》限量标准。 结论:该方法准确度高,操作简便,快捷,适用于冻干地黄中重金属和有害元素的测定。     

Foreign body in ocular coats causing a pseudo optic nerve head shadow

Small intraocular foreign body in the outer coats of the eye may be wrongly interpreted as optic nerve head on ultrasound imaging. Such errors can be avoided by performing multiple sonography scans in different axes.     

头孢哌酮/舒巴坦治疗耐药菌与二重感染患者的疗效评价

目的研究应用头孢哌酮/舒巴坦治疗耐药菌及二重感染患者进行的临床效果。方法回顾性分析2012年9月-2013年9月应用头孢哌酮/舒巴坦进行治疗的294例耐药菌感染患者及二重感染患者临床资料,采用SPSS 19.0软件进行统计处理。结果共培养出336株病原菌,革兰阴性菌267株占79.46%,革兰阳性菌69株占20.54%;革兰阴性菌对头孢哌酮/舒巴坦敏感率达79.78%;革兰阳性菌对头孢哌酮/舒巴坦敏感率达82.61%;127例二重感染患者培养出病原菌201株,均为革兰阴性菌,其对头孢哌酮/舒巴坦敏感率达80.10%。结论应用头孢哌酮/舒巴坦对耐药菌及二重感染患者进行治疗,效果显著。     

Dental and medical dual qualification in Oral and Maxillofacial Surgery: a global identity

The argument of whether or not Oral and Maxillofacial Surgery (OMFS) should have both dental and medical core education in the training pathway remains an issue of debate and contention to date. The mid-90s witnessed a gradual trend internationally towards a dual qualification which has slowed down or come to a standstill the last 10 years. This has been more evident in rapidly growing nations in the Middle East/North Africa and Asian subcontinent regions. The maxillofacial identity of a dual degree is being questioned in OMFS-pioneering countries, such as the United Kingdom (UK), which has played a role in the domination of the single degree pathway globally. In this mini review, we will attempt to shed light on the aforementioned regions and put forward a more global role the UK can play in standardising education and training while addressing the cost burden of the dual qualification pathway.     

Dose‐Intensified Granulocyte‐Monocyte Apheresis in Therapy Refractory Ulcerative Colitis

Granulocyte‐monocyte apheresis (GMA) is an emerging therapeutic option in active course of ulcerative colitis (UC). Appropriate GMA dose, including total number, frequency, and duration of the individual GMA session, is a matter of debate. It was the aim of the present study to evaluate the efficacy of a dose‐intensified GMA regimen in patients with moderately to severely active UC. A prospective open‐label, single‐center study was performed in 10 patients with active UC (Rachmilewitz Clinical Activity Index [CAI] ≥ 8 points; Rachmilewitz Endoscopic Index ≥ 7 points). Patients had failed to improve after treatment with steroids and/or immunomodulators. GMA was performed twice weekly for 2 h to a maximum of 10 sessions. In each GMA session, the adsorber was changed after 1 h of treatment time. Four patients achieved remission with a CAI ≤ 4 points. Three patients had a response with an improvement of CAI of ≥3 points. Three patients showed no benefit from GMA. The quality of life score determined by the inflammatory bowel disease questionnaire‐Deutschland increased by 26 points in median. First and second filters had similar efficiency in granulocyte and monocyte adsorption. No major adverse effects were observed. Dose‐intensified GMA as reported in this study provided an encouraging short‐term response rate of 70% in patients with moderately to severely active UC not responding to standard steroid or immunomodulator therapy. Although all patients relapsed not later than 16 weeks, GMA might be useful to reduce steroid and immunomodulator usage, or to delay surgery in this patient group.     

Double orifice mitral valve; a coincidental finding.

A double orifice mitral valve (DOMV) represents a rare congenital malformation characterised by two valve orifices with two separate subvalvular apparatus. This case demonstrates the necessity of careful imaging of the mitral valve apparatus, not only in patients with atrioventricular septal defects, but also in patients with congenital left obstructive heart disease.     

Markers of potential malignancy in chronic hyperplastic candidiasis

Aim: To examine the presence of markers associated with malignancy, including p53, p21 cyclin‐dependent kinase inhibitor 1A, murine double minutes‐2, and others, in chronic hyperplastic candidiasis. Methods: Immunohistochemical methods were used to examine the expression of p53, murine double minutes‐2, p21 cyclin‐dependent kinase inhibitor 1A, metallothionein, and proliferating cell nuclear antigen in 42 chronic hyperplastic candidiasis lesions and 11 non‐infected control tissues. Terminal deoxynucleotidyl transferase‐mediated digoxigenin‐dUTP nick‐end labeling was used to examine apoptosis, which was correlated with p53 expression. These markers were measured in lesions of chronic hyperplastic candidiasis that did not show any epithelial dysplasia or histological signs of malignancy. Results: p53 scores were higher in chronic hyperplastic candidiasis than in controls (P = 0.0046). Murine double‐minutes 2 levels were not elevated. p21 cyclin‐dependent kinase inhibitor 1A was increased in parabasal (P < 0.0001) and basal epithelial cells. Chronic hyperplastic candidiasis lesions showed a similar basal/parabasal metallothionein staining pattern to that seen in normal squamous epithelium. Proliferating cell nuclear antigen was increased (P = 0.0007), as was apoptosis (P = 0.0033). Conclusion: Increased p53 in oral chronic hyperplastic candidiasis suggests an increased potential for malignant change in the epithelium, above that of normal tissues. Further functional investigation is required, as well as clinical follow‐up studies.     

Clinical definition of the axillary vein and experience with blind axillary puncture

The prevalence of congenital anomalies of the coronary arteries (CAAs) is reported to be approximately 0.2-1.4% of the general population. Of them, The double right coronary artery (RCA) is one of the rarest coronary anomalies. Nonetheless, there is no consensus of the definition of a double RCA until now. Several concepts have been proposed in order to define what is and is not a double RCA. So far, it was been reported 37 times and in 44 cases after a comprehensive literature search through the PubMed database, using the keywords “double right coronary artery,” “duplicated right coronary artery,” “dual right coronary artery” and “split right coronary artery.” Most of the published articles (28 of 37 articles) used the name “double right coronary artery.” Nevertheless, some investigators contended that a split RCA is anatomically the same anomaly as the improperly named “double right coronary artery”. The debate between those who favor “double RCA” and those who favor “split RCA” indicate the need for a consensus regarding the nomenclature as well diagnostic criteria of such coronary anomalies. It is the time we need to reach a consensus of the nomenclature of this congenital coronary anomaly.     

Double Common Bile Duct: A Case Report

The aim of our study is to present a case of double common bile duct. Specifically, we found a common bile duct that was divided into two distinct ducts, one the main and the other the accessory duct, during its course downwards. The two bile ducts had a parallel course emerging from the common bile duct after its formation and reuniting just above the head of the pancreas. Finally, they drained into the second portion of the duodenum at the site of major duodenal papilla. This anomaly is of great importance because the duplication of the common bile duct can lead to severe intraoperative injury to one of the two common bile ducts, which can be mistaken for the cystic duct and be ligated. Moreover, we present the relative international literature and the clinical significance of our finding.