正交试验法优选心脑安胶囊提取工艺

用正交试验法对心脑安胶囊的制备工艺进行了探讨。用正丁醇浸出物含量为指标,考察了加水量、浸泡时间、煎煮时间、煎煮次数４种因素对其提取效果的影响。结果表明,加水量的多少是影响切药材煎煮效果的主要因素,为了保证有效成分的煎出,心脑安胶囊拟采用１３倍量水,浸泡１２ｈ,煎煮２次,每次１．５ｈ为宜。     

现代信息技术对高校图书馆的影响与对策

现代信息技术的应用为我国高校图书馆事业的发展创造了机遇,同时也向图书馆传统服务方式、馆员队伍提出了挑战。本文论述了面向知识经济与现代信息技术的挑战,高校图书馆建设与发展趋势及应采取的对策。     

Diagnosing,discarding, or de-VUSsing: A practical guide to (un)targeted metabolomics as variant-transcending functional tests

PurposeFor patients with inherited metabolic disorders (IMDs), any diagnostic delay should be avoided because early initiation of personalized treatment could prevent irreversible health damage. To improve diagnostic interpretation of genetic data, gene function tests can be valuable assets. For IMDs, variant-transcending functional tests are readily available through (un)targeted metabolomics assays. To support the application of metabolomics for this purpose, we developed a gene-based guide to select functional tests to either confirm or exclude an IMD diagnosis.MethodsUsing information from a diagnostic IMD exome panel, Kyoto Encyclopedia of Genes and Genomes, and Inborn Errors of Metabolism Knowledgebase, we compiled a guide for metabolomics-based gene function tests. From our practical experience with this guide, we retrospectively selected illustrative cases for whom combined metabolomic/genomic testing improved diagnostic success and evaluated the effect hereof on clinical management.ResultsThe guide contains 2047 metabolism-associated genes for which a validated or putative variant-transcending gene function test is available. We present 16 patients for whom metabolomic testing either confirmed or ruled out the presence of a second pathogenic variant, validated or ruled out pathogenicity of variants of uncertain significance, or identified a diagnosis initially missed by genetic analysis.ConclusionMetabolomics-based gene function tests provide additional value in the diagnostic trajectory of patients with suspected IMD by enhancing and accelerating diagnostic success.     

Percutaneous retrieval of an impacted ureteric T-tube

An impacted ureteric T-tube was removed percutaneously, using an Amplatz goose-neck snare. This new snare has advantages over conventional snares, particularly in situation where atraumatic manipulation is essential. Correspondence to: R. D. Edwards     

Bone scan of hemodialysis patients with secondary hyperparathyroidism before and after parathyroidectomy

Renal osteodystrophy (ROD) accompanied by long-term hemodialysis patients with chronic renal failure includes several forms of disorders of mineral and skeletal metabolism such as osteitis fibrosa attributed to secondary hyperparathyroidism, osteomalasia and adynamic bone disease. Bone scan is performed to detect of the mainly pathophysiology of ROD. We investigated bone scan of 25 hemodialysis patients with secondary hyperparathyroidism diagnosed clinically before and after parathyroidectomy (PTX). Before PTX an diffusely high accumulation of bone seeking agent in the whole skeleton especially skull in all patients (100%), vertebra in 24 out of 25 (96%), patella in 24/25 (96%), limbs in 23/25 (92%), sternum in 19/25 (76%), sacrum in 18/25 (72%) and costochondral junctions in 14/25 (56%) was noted in these patients. The radionuclide activity of the calvaria, maxilla and mandible in the skull was prominently high. Fourteen patients had an equally high activity in the calvaria, maxilla and mandible, 6 patients had higher activity in the maxilla and mandible than that of calvaria and 5 patients had higher in the calvaria than that of maxilla and mandible. After PTX the changes in the skull were obvious in 19 patients who showed a more markedly decreased in activity of the maxilla and mandible than that of the calvaria. In 3 patients showed a more markedly decreased in activity of the calvaria than that of the maxilla and mandible. Another 3 demonstrated equally decreased in activity in the calvaria, maxilla and mandible. It became clear that the highest activity of the skull was shown in all patients and the therapeutic changes of the skull are the most pronounced in maxilla and mandible in this study.     

Detection of a rare point mutation in Ki-ras of a human bladder cancer xenograft by polymerase chain reaction and direct sequencing

Summary This paper represents the first report of a codon 59 mutation in Ki-ras from a spontaneous human transitional cell carcinoma of the bladder. Point mutations have the potential to activate the ras genes if they occur in critical coding regions. These include the sequences of codons 12, 13, 59, 61 and 63. Mutations in codons 12, 13 and 61 have been reported in a wide variety of human cancers, including transitional cell carcinoma of the bladder. However mutations in codon 59 have been reported only in retroviral Ki-ras and as a result of in vitro mutagenesis experiments. We have used the polymerase chain reaction and direct sequencing to detect mutations of Ki-ras, and allele-specific restriction analysis to detect mutations of N-ras in xenografts and continuous cell lines established from bladder cancer biopsies of ten different patients as well as in direct biopsy specimens from five human bladder tumours. For studies of Ki-ras, a 139 bp fragment which spanned the critical codons 12 and 13 and a 128 bp fragment that spanned the sequences of codon 59, 61 and 63 were enzymatically amplified and then sequenced. No N-ras mutations were detected. A heterozygous mutation of Ki-ras at codon 59 GCA G/ACA was detected in one line. This mutation is being expressed and appears stable as it was detected over several xenograft passages and was present in paraffin-embedded tissue from the primary tumour of the patient. The biological significance of the mutation in bladder cancer is currently under study.     

Digital psychiatry

The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer-based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer-reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health-care industry. Patient-physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in-person office-based therapy to digital clinical products, from in-person library search and classroom didactic instruction to interactive on-line searches and distance learning. In this time of value migration, psychiatrists have to determine what their 'distinctive competence' is and where best to add value in the health-care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world.     

DNA测序建立甘肃当归、大黄种子rRNA基因图谱的研究

目的：对甘肃地道性中药材当归、大黄种子中rRNA基因内转录间隔区进行碱基序列测定，以期建立从分子水平对中草药种子进行鉴定的一种新方法。方法：提取当归、大黄种子中核DNA，利用特异性引物对其rRNA基因内转录间隔区进行套式PCR扩增，并将扩增产物进行碱基序列测定。结果：经琼脂糖凝胶电泳证实：以上述方法可获得当归、大黄种子DNA中rRNA基因内转录间隔区PCR扩增产物；并经测序后得到了当归、大黄种子rRNA基因内转录间隔区的碱基序列，且具有明显的差异和可对比性。结论：不同植物性中药材种子rRNA基因内转录间隔区碱基序列可做为从分子水平进行鉴定的标记。