不同单位保种的S180细胞核型及DNA含量的比较研究

对四个单位保种的S180 细胞经KM 小鼠腹腔传代,体外培养加秋水仙碱,涂片、染色后,显微镜下计数染色体数目:腹水传代的S180 细胞,用70 % 乙醇固定,流式细胞仪测DNA 含量。结果如下:本学部( 本部) ,中国医学科学院药物所( 药物所) ,武汉大学保种中心( 武汉大学) 和北京市肿瘤所( 肿瘤所) 保种的S180 细胞株,其染色体均数分别为62-8 ±22-8 ,69-1 ±21-2,39-9 ±8-26 ,58-7±9-75 条。四单位S180 细胞株染色体数做方差分析表明,除肿瘤所与本部外,其它两单位比较均有显著统计学差异(P< 0-01) 。直方图分析显示主流染色体范围分别为56 ～60 ,61 ～65,41 ～45,61 ～65 条。流式细胞术DNA 含量分析表明肿瘤所S180 DNA含量最多,武汉大学保种的S180 细胞的DNA含量最少。这些结果均证明四个单位的S180 细胞株在一些方面已出现显著差异。     

家庭环境因素对青少年精神分裂症的影响

目的 探讨精神分裂症和家庭环境的关系。方法 用自编“家庭环境调查问卷”、修订的父母养育方式评价量表（ＥＭＢＵ）对８２例青少年患者和８２个正常青少年家庭进行调查,用Ｃａｍｂｅｒｗｅｌｌ家庭会谈表（ＣＦＩ）评定患者亲属的情感表达（ＥＥ）水平。结果 （１）病例组父母关系、亲子关系差,父母有不良行为习惯者多（Ｐ〈０．０５）;家庭性患者父母文化水平低、经济收入低、健康状况差（Ｐ〈０．０１）。（２）病例组父母     

浅谈医院门诊部工作的主要特点与基本要求

翔实地阐述了门诊工作的特点：服务对象与病种的复杂性及心态的多样性;医疗质量监控缺乏系统必 ;病人就诊高峰的相对集中性;门诊诊治工作的时效性与风险性;急诊抢救工作的突发性与应性;门诊业务工作的多元性、专业性和服务保障工作的整体性;门诊部管理职能的双重性,同时提出了相应的基本要求。     

Pharmacokinetic Analysis and Antiepileptic Activity of Tetra-Methylcyclopropane Analogues of Valpromide

Purpose. The described structure pharmacokinetic pharmacodynamic relationships (SPPR) study explored the utilization of tetramethylcyclopropane analogues of valpromide (VPD), or tetra-methylcyclopropane carboxamide derivatives of valproic acid (VPA) as new antiepileptics. Methods. The study was carried out by investigating the pharmacokinetics in dogs and pharmacodynamics (anticonvulsant activity and neurotoxicity) of the following three cyclopropane analogues of VPD: 2,2,3,3-tetramethylcyclopropane carboxamide (TMCD), N-methyl TMCD (M-TMCD) and N-[(2,2,3,3-tetramethylcyclopropyl)carbonyl]-glycinamide (TMC-GLD). Results. The three investigated compounds showed a good anticonvulsant profile in mice and rats due to the fact that they were metabolically stable VPD analogues which were not biotransformed to their non-active acid, 2,2,3,3-tetramethylcyclopropane carboxylic acid (TMCA). M-TMCD was metabolized to TMCD and TMC-GLD underwent partial biotransformation to its glycine analogue N-[(2,2,3,3-tetramethylcyclopropyl)carbonyl]-glycine (TMC-GLN). Unlike TMC-GLN, the above mentioned amides had low clearance and a relatively long half life. Conclusions. In contrast to VPD which is biotransformed to VPA, the aforementioned cyclopropane derivatives were found to be stable to amide-acid biotransformation. TMCD and M-TMCD show that cyclic analogues of VPD, like its aliphatic isomers, must have either two substitutions at the position to the carbonyl, such as in the case of TMCD, or a substitution in the and in the positions like in the VPD isomer, valnoctamide (VCD). This paper discusses the antiepileptic potential of tetramethylcyclopropane analogues of VPD which are in animal models more potent than VPA and may be non-teratogenic and non-hepatotoxic.     

反复流产患者的中医护理对策

目的 :探讨结合现代护理观为指导的具有中医特色的整体护理模式。方法 :运用中医基础理论知识 ,针对引起反复流产患者的病因 ,将患者主要分为内分泌异常型、免疫异常型、生殖道异常型、感染型、全身性疾病影响型、染色体异常型施以护理。结果 :依据不同证型 ,有的放矢的实施护理 ,使患者明确了引起反复流产的根本原因、治疗措施、注意事项、预防保健方法 ,消除了紧张、恐惧、焦虑等心理障碍 ,树立了再次妊娠的信心 ,提高了妊娠成功率     

Outcome of fetuses with heart disease diagnosed in utero

OBJECTIVE—To review the outcomes of 193 fetuses with cardiac abnormalities detected by echocardiography.METHODS—A total of 422 fetuses between 16 and 41 gestational weeks, referred to paediatric cardiologists for detailed echocardiography, were included in this study.RESULTS—Structural heart defects were found in 55 (28%), isolated arrhythmia in 105 (54%), and other non-structural abnormalities (dilated cardiomyopathy, hypertrophic cardiomyopathy, aneurysm of the foramen ovale, isolated pericardial effusion or echogenic foci) in 33 (17%) of 193 fetuses. Total mortality was 26%. The prognosis was poor in fetuses with structural heart defects; 37 of 55 cases (67%) died in utero or postnatally. Chromosomal abnormality was associated with structural heart defect in 38% of fetuses, of whom 38% died. Among fetuses with isolated arrhythmia survival was 95%. Poor outcome was associated with complete heart block (n=14) in 2 (14%) fetuses with hydrops and heart rate of less than 55 per minute, and with supraventricular tachycardia (n=21) in three (14%) neonates delivered prematurely at a mean gestational age of 33 weeks. Furthermore, nine of 12 fetuses (75%) with structural heart defects and arrhythmia died. Among fetuses with non-structural cardiac abnormalities, survival was 73%. Poor outcome was evident in fetuses with dilated cardiomyopathy in eight of 13 (62%) and with hypertrophic cardiomyopathy in one of eight (13%) of cases.CONCLUSIONS—Factors associated with a poor prognosis were: structural heart defect associated with chromosomal abnormality or arrhythmia, congestive heart failure associated with supraventricular tachycardia or complete heart block, especially if delivery occurs preterm; and fetal hydrops with congestive heart failure and atrioventricular valve regurgitation.     

许树化学成分研究

目的研究许树Clerodendrum inerme的化学成分。方法利用硅胶柱色谱进行分离和纯化,通过光谱分析鉴定结构。结果分离到8个化合物,鉴定为木栓酮(friedelin,Ⅰ)、豆甾醇(stigmasterol,Ⅱ)、白桦酸(betulinicacid,Ⅲ)、金合欢素(acacetin,Ⅲ)、丁香酸(syringicacid,Ⅳ)、对甲氧基苯甲酸(Ⅴ)、芹菜素(apigenin,Ⅵ)和胡萝卜苷(daucosterol,Ⅶ)。结论化合物Ⅱ、Ⅲ、Ⅳ、Ⅳ、Ⅶ为首次从该植物中分离得到。     

Evaluation of three risk scores to predict postoperative nausea and vomiting

BACKGROUND: So far there are three different scores to predict postoperative vomiting (PV: Apfel et al., 1998) or postoperative nausea and vomiting (PONV: Koivuranta et al., 1997; Palazzo and Evans, 1993). All three scores used logistic regression analysis to identify and create weights for the risk factors for PV or PONV. In short, these were sex, age, history of previous PONV, motion sickness, duration of anaesthesia, and use of postoperative opioids. However, an external evaluation and a comparison of these scores has not been performed so far. METHODS: Patients undergoing a variety of surgical procedures under general anaesthesia were studied prospectively. Preoperatively, they completed a questionnaire concerning potential risk factors for the occurrence of PV or PONV implemented in the three risk scores. Balanced anaesthesia (induction agent, nondepolarising neuromuscular blocker, opioid, and inhalation agent in nitrous oxide/oxygen) was performed. No intravenous anaesthesia or any antiemetic prophylaxis was applied. Postoperatively, the patients were observed in the recovery room for the occurrence of PV and PONV and were visited twice on the ward within the 24-h observation period. Both the patients and the nursing staff were asked whether PV or PONV was present. The severity of PONV was categorised using a standardised scoring algorithm. A total of 1,444 patients was finally included into the analysis. Using information of the predicted risk for the individual patients and the actual occurrence of PV or PONV, Receiver Operator Characteristics (ROC-curves) were drawn. The area under each ROC-curve was calculated as a means of the predictive properties of each score and was compared for statistical differences. RESULTS: For prediction of PONV (any severity) the AUC-values (AUC=area under the curve) and the corresponding 95%-confidence intervals were: Apfel: 0.70 (0.67-0.72); Koivuranta: 0.71 (0.69-0.73); Palazzo: 0.68 (0.65-0.70). For prediction of PV: Apfel: 0.73 (0.71-0.75); Koivuranta: 0.73 (0.70-0.75); Palazzo: 0.68 (0.65-0.70). Thus, all three scores appeared to have a moderate accuracy as measured by the AUC. The score of Koivuranta predicts PONV (P=0.007) and also PV (P=0.002) significantly better than Palazzo's score. Furthermore, for predicting of PV the score of Apfel was also superior to Palazzo's score (P=0.005). All three scores predict PV with the same accuracy as PONV. CONCLUSION: The occurrence of PV and PONV in patients undergoing surgery under balanced anaesthesia can be predicted with moderate but acceptable accuracy using one of the available risk scores, regardless of local surgical or anaesthesiological circumstances. For clinical practice, we recommend the score published by Koivuranta, since its calculation is very simple.