Measurement of free and total hydroxyproline by automated flow injection of serum or urine samples from maintenance hemodialysis patients with renal osteodystrophy

An automated measurement of total and free hydroxyproline in serum or urine is presented that uses flow injection analysis. After exclusion of nonspecific substances, hydroxyproline was oxidized by chloramine- T and L-cysteine with Ehrlich's reagent. The linearity obtained was from 3.8μmole/ L to 1.22 mmole/L with good precision (CV <3%). Comparison of the proposed method with HPLC yielded r = 0.939 as the correlation coefficient. Reference intervals of free and total hydroxyproline are 1.4–9.7 μmole/L, 3.8–27.2 μmole/L for serum, and 10.0–72.5 μmole/L, 25.2–303.6 μmole/L for urine, respectively. Serum free and total hydroxyproline levels in renal osteodystrophy patients on maintenance hemodialysis (N = 71) were significantly higher than in controls (P<0.0001). This method is superior to the use of HPLC with regard to stability of the color reaction. The measurement of serum free and total hydroxyproline is a useful marker for therapeutic observation of renal osteodystrophy patients. © 1994 Wiley-Liss, Inc.     

Do discrepancies in interpersonal perception predict relapse?: A comparison of remitted depressed patients and collaterals

In an effort to examine whether disturbed interpersonal relationships are associated with relapse in depression, discrepancies in self-ratings provided by formerly depressed patients and their collateral informants were compared. Thirty-eight remitted depressed patients and their collateral informants were asked to monitor moods, life events, and stress levels on a bimonthly basis for a 1-year period. It was hypothesized that patient/collateral dyads displaying a greater discrepancy in interpersonal perception would have a higher risk of relapse than dyads who showed more agreement in their ratings. Results indicated that while discrepancies in the perceptions of patients' life events were associated with the duration of a relapse once it occurred, discrepancies were generally not related to the emergence of new episodes of depressive disorder. The implications of these findings for models seeking to integrate cognitive and interpersonal models of depression, through the study of environmentally determined and personally appraised adversity, is discussed.This research was supported by grants to the first and third authors from the Canadian Psychiatric Research Foundation and the Laidlaw Foundation.     

Antigen-specific cytolysis of infected cells in murine candidiasis

Immune L3T4+ and Lyt-2+ lymphocytes play an important role in the acquired resistance of mice to challenge with virulent Candida albicans, and release macrophage-activating cytokines in response to yeast cells in vitro. To determine whether antigen (Ag)-specific cytotoxic T lymphocytes are generated during fungal infection, purified L3T4+ and Lyt-2+ lymphocytes from immunized mice were cultured in the presence of syngeneic accessory cells, Candida Ag, and IL-2. Yeast-infected bone marrow macrophages and peritoneal exudate neutrophils were used as target cells in a standard ⁵¹Cr release assay. Ag-specific, MHC-unrestricted lysis of infected macrophages was evident with immune Lyt-2+ cells after 5–10 days in culture. Under the same experimental conditions, the cytotoxic activity of L3T4+ cells was negligible, but its expression could be induced by the addition of anti-CD3 antibody.Culturing immune Lyt-2+ cells for shorter periods of time (1–2 days) resulted in preferential lysis of infected neutrophils. In addition, at limiting effector cell numbers, Ag-specific MHC-restricted lymphocytes with cytotoxic activity to infected macrophages could be identified. We suggest that C. albicans infection stimulates multiple cytotoxic T-cell precursors with varying recognition stringency, wich may have an important role in antifungal resistance in vivo.     

《中国矫形外科杂志》被引分析研究

目的：分析《中国矫形外科杂志》被引情况，从文献引证角度了解该刊学术水平和期刊质量。方法：利用清华大学同方光盘股份有限公司研制开发的中国医院知识仓库期刊全文数据库中的数据，用定量分析的方法，对《中国矫形外科杂志》被引情况进行统计、分析和研究。结果：总被引2039篇次，被引频次逐年上升。2002年自引率1839％，单篇平均被引1．2次，影响因子0．293。结论：《中国矫形外科杂志》已形成自己的学术风格和专业特点，具有较高的被引率，是我国骨科领域的精品期刊之一。     

肝病患者血清中总胆汁酸测定的意义

采用全自动酶法分析法 ,测定 32 1例各种肝病患者血清总胆汁酸 (TBA)。结果表明 :血清总胆汁酸是一种较灵敏的肝功能指标。在各类肝病中 ,尤其是急性肝炎、肝硬化、肝癌患者的总胆汁酸 (TBA)浓度均明显高于正常对照组 (P<0 .0 1) ,并在肝功能常规指标改变不明显时对肝脏疾病的诊断有一定的价值     

Effect of Omeprazole on Diazepam Disposition in the Rat: in Vitro and in Vivo Studies

Purpose. The inhibitory effects of omeprazole on diazepam metabolism in vitro and in vivo are compared in the rat. Methods. 3-hydroxylation and N-demethylation of diazepam was investigated in the presence of a range of omeprazole concentrations (2-500µM) in hepatic microsomes and hepatocytes. Zero order infusions together with matched bolus doses of omeprazole were used to achieve a range of steady state plasma concentrations (10-50mg/ L) and to study the diazepam-omeprazole interaction in vivo. Results. The 3-hydroxlation pathway was more prone to inhibition (K_Is 108 ± 30 and 28 ± 11 µM in microsomes and hepatocytes, respectively) than the demethylation pathway (K_Is of 226 ± 76 and 59 ± 27 µM in microsomes and hepatocytes, respectively). In both in vitro systems, the mechanism of inhibition was competitive with Km/K_I ratios larger than 1 for the 3HDZ pathway and smaller than 1 for the NDZ pathway. There was an omeprazole concentration dependent decrease in diazepam clearance in vivo which could be modelled using a simple inhibition equation with a K_I of 57µM (19.8mg/L). In contrast there was no statistically significant change in the steady state volume of distribution for diazepam in the presence of omeprazole. Conclusions. The in vivo K_I for the omeprazole: diazepam inhibition interaction shows closer agreement with the K_I values obtained in hepatocytes than with those observed in microsomes.     

Outcome of intracerebral hemorrhage: clinical and CT findings in 326 patients

Clinical symptoms and findings in cranial computed tomography (CT) were evaluated in 326 patients with intracerebral hemorrhage (ICH). Localizations of ICH were the lobes (n = 254), the basal ganglia (n = 46), the pons and brain stem (n = 13) and the cerebellum (n = 8). Multiple hematomas were present in nine patients. An initial coma (n = 225) was most frequent in ICH of the pons (n = 7), cerebellum (n = 6), and the frontal (n = 71) and temporal (n = 66) lobes. Epileptic seizures (n = 70) were most common in hematomas of the frontal (n = 24), temporal (n = 19) and parietal (n = 12) lobes and the basal ganglia (n = 6). A history of hypertension was given in 140 patients; 119 of these had an ICH with a size of ≥3 cm. Mortality (n = 162) was high with ICH in the pons and brain stem (10 out of 13), in the frontal (54 out of 98) and parietal (32 out of 58) lobes and the basal ganglia (n = 23). A size of the ICH of 3 cm or more in cranial CT and an associated ventricular hemorrhage were associated with a bad outcome. An initial disturbance of consciousness was the only reliable clinical predictor of outcome (chi-square, p < 0.001). Katamnestic evaluation of 66 of the 164 survivors after 5.2 years revealed seizures in 20 patients and mild neurological deficits in 41. Another 14 patients were partially, and nine totally dependent Nineteen patients had died in between; there was only one death attributable to another ICH.     

加强保健措施 降低孕产妇死亡率的试点研究

经调查河南省七县1988～04～1989～03孕产妇死亡率为136.1/10万,高于全国平均水平(94.7/10万)。从七县中选择了死亡率偏高的三个县(147.9/10万)为样本.进行厂降低农村孕产妇死亡率保健措施的研究。自1990年4月1日～1992年3月31日。在三县采取了以下保健措施:①加强基层妇幼卫生建设,特别是中心乡卫生院的建设,②整顿和完善三级保健网;③建全孕产妇系统管理制度,高危妊娠筛查,转化和转诊制度,④配备必要设备,建立联合小产院,实行定点接生。两年内孕产妇死亡率,由1989年的147.9/10万下降到67.7/10万,下降幅度为54.44%,最高达72.1%。此工作为实现2000年孕产妇死亡率下降一半的规划目标提供了依据。     

介入治疗并发症的发生与防治

介入治疗是融合了内科药物治疗、外科手术治疗及医学影像学的一种特殊的治疗体系 ,其疗效受到世人瞩目并成为目前发展最为迅速的学科之一。但是 ,再好的方法也会存在不足之处 ,介入治疗也不例外。随着介入治疗在各家医院的普遍应用 ,并发症的发生也会越来越多 ,迫使人们关注这个问题。所谓介入治疗并发症 ,是指因血管造影及 (或 )血管内治疗所引起、需要一定治疗、使病人的治疗复杂化或延长病人住院时间的不良反应 ,就其全身多系统而言 ,介入治疗引发并发症的原因大致可归纳为两个主要因素即介入器材操作和引入人体内的物质(包括介入治疗所…     

从医务人员的证据意识谈举证责任倒置

文章从剖宫产术后伴发腰腿痛病例分析入手，认为举证责任倒置就在我们诊疗工作中，就在我们协调医患关系的过程中。因此需要在临床实践中去感悟举证责任置的深刻含义，从而树立证据意识，做好证据的收集与保存工作，一旦发生诉讼有证为据，并由此提出了“医学证据学”的构想，而医学证据的特点有待进一步深入研究。