泽它洗剂中4—氯—3，5—二甲苯酚柱切换HPLC法测定

用柱换HPLC法快速测定泽它洗剂中4－氯－3，5－二甲酚含量。以含量内标羟苯甲酸丙酯的甲醇，超声提取泽它洗剂，离心后取上清液直接进样。预柱为YWGC18（10um），分析柱为Shim-pack CLC-ODS(5um），流动相均为甲醇－水（70：30），检测波长280nm。平均加样回收率为99.84％，RSD＝0.79%.     

高效液相色谱法测定尿中2—硫代噻唑烷—4—羧酸浓度

本文报道了用高效液相色谱(HPLC)法测定尿中2-硫代噻唑烷-4_羧酸(TTCA),选用Spherisorbs ODS 2色谱柱。TTCA浓度在0～120ng范围内为直线相关,γ-0.999。本法回收率为72.9％,最低检出量4ng。30名不接触CS_2者尿样中有23名可检出TTCA占76.7％,与15名接触CS_2 10mg/m~3以下的工人尿中TTOA测得值比较,经两样本等级和检验有统计显著性。初步得出本法的特异度为97％、敏感度为73％。     

Comparison of drug susceptibility between Escherichia coli detected in stool cultures of patients undergoing transrectal prostate needle biopsy and Escherichia coli in hospital-wide urine antibiograms

A prostate biopsy is essential for prostate cancer diagnosis. However, infections are one of the biopsy-associated complications, and post-biopsy fever is estimated to occur in approximately 1% of all cases. It may thus be beneficial to perform a rectal swab culture before a transrectal prostate biopsy to confirm the presence of resistant bacteria and select preventive antibacterial agents according to the drug susceptibility results. This study aimed to determine whether there is a difference between the drug susceptibility of bacteria detected in the stool of patients who were scheduled to undergo prostate biopsy and the hospital-wide urine antibiogram. Patients suspected of having prostate cancer who underwent transrectal prostate biopsy via transrectal ultrasonography between August 1, 2016, and June 30, 2020, were included in this study. Stool samples were collected and cultured before biopsy. Overall, 99 patients underwent prostate biopsy, and of these, culture results were available for 81 patients (81.8%). Escherichia coli was detected in 74.0% (60 samples) of the stool culture samples, of which 4 samples were extended-spectrum β-lactamase-producing types. We found greater susceptibility of Escherichia coli to ampicillin, fluoroquinolones, sulfamethoxazole/trimethoprim, and cefixime in the stool culture antibiogram than in the hospital-wide urine antibiogram. We also found a significantly low incidence of ESBL-positive Escherichia coli in the stool culture antibiogram with p-values of 0.009, 0.007, and 0.03 compared to the hospital-wide urine antibiograms for 2017, 2018, and 2019, respectively. Stool culture of prostate cancer patients undergoing biopsy may provide useful information for selecting prophylactic antimicrobial agents.     

Two-center clinical evaluation of a new automated fluorometric immunoassay for the quantitative analysis of total betaeta-human chorionic gonadotropin

OBJECTIVES: This study evaluated the quantitative total betahCG assay on the Stratus CS point-of-care instrument at two medical centers. DESIGN AND METHODS: Analytical sensitivity, linearity, within-run and total imprecision, interferences, dilution recovery, method comparison (Dimension RxL), comparison of matched heparinized whole blood and plasma samples, and determination of the normal reference interval were studied. RESULTS: Analytical sensitivity was <0.5 IU/L. The assay's linear range was 0 to 1250 IU/L; the clinical reportable range was up to 50,000 IU/L. Within-run imprecision (CV) at both low (<20 IU/L) and elevated (760 IU/L) betahCG concentrations were <4%. Total imprecision for three QC levels and two pools were <4%. Method comparison showed Stratus CS betahCG = 0.98 +/- 0.01* Dimension RxL hCG -0.11 +/- 2.69 (n = 136; r = 0.996; Sy/x = 27.7). Matched heparinized whole blood/plasma sample-comparison showed: whole blood = 1.05*Plasma + 0.37 +/- 1.29 (n = 41; r = 1.000; Sy/x = 7.57). Mean dilution recovery was 99% (range: 95% to 103%). None of the 52 drugs tested, lipemia, icterus, hemolysis, LH, FSH, TSH, hGH or prolactin represented a significant interference with the assay. Reference intervals were <0.5 IU/L for males (n = 123) and <3.0 IU/L for nonpregnant females (n = 120). CONCLUSIONS: The Stratus CS betahCG test offers the advantage of quantitative measurement of total betahCG in whole blood at the point of care and is suitable for clinical use.     

不同吸痰方式对急性呼吸窘迫综合征血流动力学影响的实验研究

目的研究更适宜急性呼吸窘迫综合征(ARDS)机械通气气管内吸痰的方式。方法采用静脉注射油酸制备动物ARDS模型;每只犬随机选择使用开放式气管内吸痰(OS)和密闭式气管内吸痰(CS)2种吸痰方式。于吸痰前后记录血流动力学等监测指标的数据。结果OS和CS后,犬平均肺动脉压(MPAP)与吸痰前比较均明显升高(P<0.05);OS后平均动脉压(MAP)显著升高(P<0.05)。结论OS、CS均可影响血流动力学的稳定。本研究提示,在护理工作中,对ARDS机械通气者应重视吸痰引起的继发性损害,加强吸痰前后血流动力学等监测。     

Single-centre experience with coronary sinus lead stability and long-term pacing parameters.

AIMS: To compare both short- and long-term stability and pacing parameters of CS leads. Long-term maintenance of coronary sinus (CS) pacing lead position has not yet been assessed by serial X-ray digital imaging. METHODS AND RESULTS: Using X-ray digital imaging in anteroposterior and left lateral views, we performed analysis of the CS lead position at the end of the implantation procedure, 48 h following implantation and after 12 months in 93 consecutive patients. Attain OTW leads, QuickSite leads and EasyTrak leads were implanted in 44, 12 and 37 cases, respectively. X-ray detectable late CS lead dislodgement was observed in 8 cases (8.6%) during 12-months follow-up. Dislodgment was once accompanied by loss of capture and need for repositioning. Another two major dislodgements occurred without any threshold change. Five (5.4%) minor dislocations occurred with either a decrease or an increase in pacing threshold. Left ventricular (LV) pacing threshold was changed by >or= 1 V after 12 months in 14 patients (15%) when compared to values 48 h after implantation. All but one case of >or= 1 V threshold change (either positive or negative) occurred without any radiological evidence of lead displacement. LV pacing threshold was significantly higher than RV pacing threshold at both baseline and during follow-up. Leads from all three manufacturers had comparable pacing thresholds 12 months following implantation. CONCLUSION: The position of CS leads may change during 1-year follow-up. However, it rarely required reoperation in the selected group of patients. Long-term pacing parameters between different manufacturers are comparable. Increase in pacing threshold is not a reliable marker of CS lead dislodgement.     

PADI4 polymorphisms and the functional haplotype are associated with increased rheumatoid arthritis susceptibility: A replication study in a Southern Mexican population

Rheumatoid arthritis (RA) is a common autoimmune disease with a complex genetic background. The peptidyl arginine deiminase type IV (PADI4) gene has been associated with RA susceptibility in several populations. We addressed the relationship between three exonic PADI4 gene single nucleotide polymorphisms (SNPs) PADI4_89 (rs11203366), PADI4_90 (rs11203367) and PADI4_92 (rs874881) and related haplotypes with RA in a population from Southern México. This study included 200 RA patients and 200 control subjects. The SNPs were evaluated using the polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) technique, and antibodies to cyclic citrullinated peptides (anti-CCP) were measured by enzyme-linked immunosorbent assay (ELISA). In this population, the minor alleles of PADI4_891G, PADI4_901T and PADI4_921G gene polymorphisms were associated with RA susceptibility (OR = 1.34, p = 0.04; OR = 1.35, p = 0.03; OR = 1.34, p = 0.04; respectively). The GTG haplotype was also significantly associated with RA (OR = 2.27 95%CI = 1.18–4.41; p = 0.008), but did not show association with levels of anti-CCP antibodies and clinical parameters. In conclusion, our replication study in a Southern Mexican population suggests that PADI4 individual polymorphisms and the related susceptibility haplotype (GTG) are also genetic risk markers for RA.     

剖宫产术后再次妊娠产妇的分娩方式选择逐步判别的临床分析

目的探讨CS风险系数表用于剖宫产后再次妊娠产妇分娩方式的选择及其判别中的价值。方法对某院97例剖宫产史足月分娩产妇采用CS风险系数表进行阴道分娩风险值预测,观察不同预测值下阴道试产的结局。结果 (1)分娩前胎儿性别全部按照男性计算,风险值﹤20%阴道试产成功率100.00%,20%～40%阴道试产成功率86.36%,﹥40%阴道试产成功率56.25%;分娩后根据实际新生儿性别矫正CS风险值,﹤20%阴道试产成功率100.00%,20%～40%阴道试产成功率89.74%,﹥40%阴道试产成功率50.00%;(2)试产失败组与试产成功组在胎儿窘迫、新生儿窒息发生率方面差异无统计学意义(P﹥0.05),出血量、住院天数、住院费用方面差异有统计学意义(P﹤0.05);(3)阴道试产失败产妇剖宫产原因胎儿窘迫占23.08%,滞产占69.23%,先兆子宫破裂占7.69%。结论利用CS风险系数表预测有剖宫产史再次妊娠产妇阴道试产风险,风险值﹤20%阴道试产基本均可成功,﹥40%阴道分娩成功率非常小,不建议考虑阴道试产。