兔膝关节持续被动活动对前交叉韧带重建术后切口局部组织血氧饱和度的影响

目的 探讨膝关节持续被动活动（continuous passive motion, CPM）对兔前交叉韧带重建术后切口局部组织血氧饱和度的影响. 方法 20 只八月龄雄性新西兰大白兔右侧后肢膝关节行自体双股半腱肌腱移植重建前交叉韧带手术,术后随机分为2组：自由活动组（n＝10）和CPM组（n＝10）.自由活动组笼内自由活动;CPM组应用兔膝关节持续被动活动器运动.术后第2天,近红外光技术装置ODISseyTM 局部组织血氧监护仪测量每一来回（屈曲30°～110°）不同CPM速度（分别为2.35°/s、3.2°/s 、8°/s）时的切口局部组织血氧饱和度（tissue oxygen saturation ,StO2）变化,选择最好的CPM范围和速度.分别在术前和术后第2、4、6、8、10、14天观察膝关节CPM不同角度时切口局部组织StO2的变化. 结果 与自由活动组相比,3种速度的CPM在不同屈曲角度下均保持较高的StO2,且有显著性差异（P＜0.05）,不同CPM速度之间StO2有显著性差异（P＜0.05）.每一来回（屈曲30°～110°）运动速度为3.2°/s时保持最高的StO2.在术前和术后第2、4、6、8、10、14天等各时间点,膝关节屈曲30°、60°、90°、110°时StO2均无显著性差异（P＞0.05）,不同的时间点（术前和术后第2、4、6、8、10、14天）切口的StO2差别均有显著统计学意义（P＜0.05）.术后第2～4天最低,然后逐渐上升.术后第2周拆线后,切口愈合良好,没有感染、血肿和切口裂开. 结论 兔膝前交叉韧带重建术后第2天开始进行膝关节CPM（屈曲30°～110°）,可增加切口局部组织血氧饱和度,以3.2°/s的CPM速度最佳.     

An automated on-line method for simultaneous analysis of phenothiazines in human serum by high-performance liquid chromatography/sonic spray ionization mass spectrometry using backflush column switching

An automated on-line method for simultaneous analysis of five phenothiazine drugs by high-performance liquid chromatography (HPLC)/sonic spray ionization mass spectrometry (SSI-MS) has been established, using backflush column switching. A 400-μl portion of serum sample diluted 81-fold with distilled water was subjected to the on-line system. In the system, an Oasis HLB cartridge was used as the precolumn for extraction; large molecules such as proteins in serum were discarded by use of distilled water containing 0.1% formic acid as a mobile phase. After switching a valve, the analytes trapped in the precolumn were eluted in the backflush mode and separated by a Chromolith Performance RP-18e column, which is composed of C₁₈-bonded monolithic silica. The column effluents were then introduced into the SSI-MS. The present method provided successful separation and determination of six phenothiazines including an internal standard. Satisfactory linearities, reproducibility, and sensitivity were obtained at concentration levels that matched the toxic levels of phenothiazines. All drug peaks appeared within 18 min, and the system could be reequilibrated in only about 8 min for the next run. Because of the simplicity and rapidness of the method, it is likely to be useful in the fields of emergency medicine and forensic toxicology.     

Professor Ahmed Shafik (1933–2007)

Most cases of anal abscess are caused by anal fistula and invasion of the surrounding tissues by a mixed colonic flora. Treatment consists of excision of the abscess and, in case of fistula, fistulectomy. Primary anorectal and perianal forms of actinomycosis are very rare and caused by actinomyces, as ubiquitous anaerobics bacterium. We report a case of perianal actinomycosis. The patient had a short history of painless perineal induration without fever and leukocytosis with normal results at routine blood examination. After excision, sulfur granules drained from the cavity and pathological investigations indicated perianal actinomycosis. Appropriate surgery and antibiotic treatment healed the perianal infection. After exclusion of possible diagnoses such as Crohn’s disease, tuberculosis and malignant growths, the rare case of perianal actinomycosis should be considered in the differential diagnosis of painless perianal masses.     

术前无创正压通气治疗对脊柱侧凸患者围手术期肺功能的影响

目的:研究术前使用呼吸机无创正压通气治疗对脊柱侧凸患者围手术期肺功能的影响。方法:将40例Cobb角≥60°、肺功能存在中度以上限制性通气功能障碍、行脊柱侧凸矫形术的脊柱侧凸患者,随机分成A组和B组,每组20例。A组在术前采用BiPAP呼吸机,经用面罩无创正压通气(NIPPV)治疗1个月;B组常规术前准备。观察A组患者治疗前后肺功能的改善及两组患者围手术期肺功能的差异。结果:两组患者性别、年龄、身高、体重、Cobb角度、手术时间、手术径路、融合椎体数等基本情况比较无统计学差异(P>0.05);A组患者经NIPPV治疗后肺活量(VC)、肺活量占预计值的百分比(VC%)、用力肺活量(FVC)、第一秒最大呼气量(FEV1.0)、最大通气量(MVV)和最大通气量占预计值的百分比(MVV%)较治疗前明显改善(P<0.01);两组患者术中氧合指数、术后拔管时间、拔管后15min动脉血气PO2、PCO2比较有显著性差异(P<0.05)。结论:术前无创正压通气治疗可改善脊柱侧凸患者围手术期的肺功能,可缩短手术后气管插管的拔管时间,改善术后通气功能,有助于脊柱侧凸患者手术后早期恢复。     

Stigma rises despite antiretroviral roll-out: A longitudinal analysis in South Africa

Stigma is a recognised problem for effective prevention, treatment, and care of HIV/AIDS. However, few studies have measured changes in the magnitude and character of stigma over time. This paper provides the first quantitative evaluation in Africa of the changing nature of stigma and the potential determinants of these changes. More specifically, it evaluates the dynamic relationship between stigma and (1) increased personal contact with people living with HIV/AIDS and (2) knowing people who died of AIDS. Panel survey data collected in Cape town 2003 and 2006 for 1074 young adults aged 14–22 years were used to evaluate changes in three distinct dimensions of stigma: behavioural intentions towards people living with HIV/AIDS; instrumental stigma; and symbolic stigma. Individual fixed effects regression models are used to evaluate factors that influence stigma over time. Each dimension of stigma increased in the population as a whole, and for all racial and gender sub-groups. Symbolic stigma increased the most, followed by instrumental stigma, while negative behavioural intentions showed a modest increase. Knowing someone who died of AIDS was significantly associated with an increase in instrumental stigma and symbolic stigma, while increased personal contact with people living with HIV/AIDS was not significantly associated with any changes in stigma. Despite interventions, such as public-sector provision of antiretroviral treatment (which some hoped would have reduced stigma), stigma increased among a sample highly targeted with HIV-prevention messages. These findings emphasise that changes in stigma are difficult to predict and thus important to monitor. They also indicate the imperative for renewed efforts to reduce stigma, perhaps through interventions to weaken the association between HIV/AIDS and death, to reduce fear of HIV/AIDS, and to recast HIV as a chronic manageable disease.     

反相高效液相色谱-柱后衍生法分析检测鱿鱼中的生物胺

建立了水产品中多组分生物胺的反相高效液相色谱-柱后衍生-荧光检测方法。采用荧光试剂邻苯二甲醛（OPA）为柱后衍生化试剂,在Capcell Pak MG-C18色谱柱上,通过梯度洗脱使酪胺、腐胺、尸胺、组胺、胍丁胺、精胺和亚精胺等7种生物胺得到良好分离,在给定的浓度范围内,各组分生物胺呈现良好线性相关（R^2〉0.999）。在水产品中添加生物胺混合标准溶液,平均回收率为88.3%～110.1%,相对标准偏差RSD小于10%。结合水产品的感官鉴定、pH值和TVBN值测定等方法检测水产食品的新鲜程度,分析了鱿鱼在不同保藏温度、保藏时间下的生物胺种类及含量的变化。其中胍丁胺和尸胺在鱿鱼的保藏过程中发生最显著变化,可以作为其质量变化的参考指标。     

参附注射液对单侧输尿管梗阻大鼠肾脏肝细胞生长因子表达的影响

目的：探讨单侧输尿管梗阻后大鼠肾间质纤维化发生过程中肝细胞生长因子（HGF）的表达及中药参附注射液对其的影响。方法：采用单侧输尿管结扎（UUO）制造梗阻性肾病模型，将56只大鼠随机分为对照组（假手术组）、手术组（UUO组）和治疗组（UUO＋参附），术后7d、14d观察肾组织病理改变，应用免疫组织化学方法检测肾组织中HGF的表达。结果：与对照组相比，手术组肾间质出现了明显的纤维化，HGF的表达在术后第7天明显增加，第14天较第7天减弱，与手术组相比，治疗组肾间质纤维化明显减轻，而且HGF的表达在术后第7天明显上调，第14天较第7天上调更明显，有统计学差异（P〈0．05）。结论：参附注射液可以上调肾组织HGF的表达，减轻肾小管一间质纤维化，发挥肾保护作用。     

Effect of Solanum trilobatum on hepatic drug metabolising enzymes during diethylnitrosamine-induced hepatocarcinogenesis promoted by Phenobarbital in rat

The present study was aimed to investigate the chemopreventive effects of Solanum trilobatum (ST) extract against diethylnitrosamine (DEN)-induced hepatocarcinogenesis promoted by Phenobarbital (PB) in Wistar rats. Hepatocarcinogenesis was initiated by a single intraperitoneal injection of DEN (200 mg/kg b.w.) and promoted with PB (0.05%) in basal diet. The experimental study extended for periods of 13 and 26 weeks. Alcoholic extract of ST was orally administered for the entire experimental period after initiation along with commencement of promotion. The chemopreventive effect of ST was assessed from the incidence of nodules, drug metabolizing phase I components such as contents of cytochrome P450, cytochrome b(5), activities of NADPH cytochrome c reductase, NADH - cytochrome b(5) reductase and phase II components such as levels of glutathione, activities of UDP-glucuronyl transferase, glutathione S-transferase and gamma-glutamyl transpeptidase in the liver. Lipid peroxidation at basal and prooxidants-induced (NADPH + ADP + Fe and Ascorbate + Fe) states was assessed in the microsomes. Animals administered with ST extract evidenced significant inhibition of tumor nodular incidence in DEN + PB + ST animals compared to DEN + PB animals, with favorable alterations in the hepatic drug-metabolizing phase I and phase II components. Administration of ST inhibited basal and pro-oxidant-induced lipid peroxidation. The present result suggests the probable mediation of chemoprevention by ST against DEN-induced carcinogenesis by the modulation of drug metabolizing components in the liver of treated animals.     

A liquid-scintillation-based primary standardization of Pb

A new radioactivity solution standard of ²¹⁰Pb has been developed and will be disseminated by the National Institute of Standards and Technology (NIST) as standard reference material (SRM) 4337. This new ²¹⁰Pb solution standard is contained in a 5 mL flame-sealed borosilicate glass ampoule, consists of (5.133±0.002) g of a nominal 1 mol L⁻¹ nitric acid solution, has a density of (1.028±0.002) g mL⁻¹ at 20 °C, has carrier ion concentrations of about 11 μg Pb²⁺ and 21 μg Bi³⁺ per gram of solution, and is certified to contain a massic activity (9.037±0.22) kBq g⁻¹ as of the reference time 1200 EST, 15 June 2006. All of the uncertainties cited above correspond to standard uncertainties multiplied by a coverage factor k=2. The standardization for the ²¹⁰Pb content of the solution was based on 4πβ liquid scintillation (LS) measurements using CIEMAT/NIST ³H-standard efficiency tracing (CNET). Confirmatory determinations were also performed by high-resolution HPGe γ-ray spectrometry, by 2π spectrometry with a Si surface barrier detector of separated ²¹⁰Po, and by 4πβ(LS)–γ(NaI) anticoincidence counting.