Urine test strips: reliability of semi-quantitative findings under tropical conditions

Semi-quantitative urinalysis with urine reagent strips (URS) for erythrocyturia (EU), leucocyturia (LU) and proteinuria (PU) was performed in Congolese and Sudanese school children withSchistosoma haematobium and/orS.mansoni infection. Quantitative urinalysis was performed on the same specimen using microscopy and a Neubauer counting chamber for EU and LU and the Coomassie blue dye-binding assay for PU. Microscopically detectable EU of more than 10 cells/l was found in 63% of all samples and LU of more than 20 cells/l was found in 60% of all samples. With the Coomassie blue method, PU of more than 150 mg/l was detected in 51% of all samples. URS gave positive results of grade 1–3 for EU in 69% of all samples, for LU in 63% of all samples and for PU in 66% of all samples. The sensitivity and specificity of URS compared with standard reference methods were as follows: EU 95% and 75%, LU 81% and 81% and PU 90% and 56%. When the results of all three test were combined, URS differentiated abnormal from normal urine specimens with a sensitivity of 94% and a specificity of 70%. Median quantitative results showed a good correlation with semiquantitative URS readings for all parameters, but there was a wide range of URS scores.We concluded that URS sensitively detect urinary abnormalities and thus may be used as a general screening method under field conditions when more specific methods cannot be performed. In the hospital laboratory,urine microscopy with a counting chamber would be preferred to URS as a sole method for EU and LU detection; URS is useful for the detection of PU in the tropical hospital laboratory where an appropriate quantitative method with a better specificity may not be available.     

祛瘀法治疗疮疡病的临床体会

运用祛瘀法为主，结合清热、化湿、养阴、理气法以及祛腐、生肌、拖线、灌注等内外合治法，治疗臁疮、窦瘘、脱疽、股肿等疮疡疾病，并附验案四则。     

Synthesis and physico‐chemical properties of peptides in soil humic substances

Abstract: Soil humic substances (HS) are heterologous, polydispersive, and multi‐functional organometallic macromolecules ubiquitous in soils and sediments. They are key players in the maintenance of the belowground ecosystems and in the bioavailability of both organic and inorganic contaminants. It is widely assumed that the peptidic substructures of HS are readily degraded and therefore do not contribute significantly to interactions with contaminants such as toxic metals. To investigate the turnover of humified peptides, laboratory soil aging experiments were conducted with ¹³C‐glucose or ¹⁵N‐nitrate for 8.5 months. Evidence for random‐coil peptidic structures in the labeled HS was obtained from 2‐D nuclear magnetic resonance (NMR), pyrolysis gas chromatography‐mass spectrometry (pyro‐GC‐MS), and circular dichroism data. Interaction of metals with the peptidic carbonyls of labeled HS was rationalized from the solid‐state NMR data. Detailed ¹³C and ¹⁵N labeling patterns of amino acid residues in the acid hydrolysates of HS acquired from NMR and GC‐MS revealed two pools of peptides, i.e. one extant (unlabeled) and the other, newly humified with little isotopic scrambling (fully labeled). The persistence of pre‐existing peptidic structures indicates their resistance to degradation while the presence of fully labeled peptidic amino acids suggests wholesale incorporation of newly synthesized peptides into HS. These findings are contrary to the general notion that humified peptides are readily degraded.     

不同截囊方式所致晶状体后囊破裂的比较

目的　比较开罐式截囊与连续环形撕囊术中后囊破裂的原因和发生率。方法　将作者 4年来手术的 13 3眼白内障按时间顺序分为A组和B组。A组行开罐式截囊 ;B组行连续环形撕囊 ,其它步骤相同。分别统计后囊破裂的例数和原因。结果　后囊破裂共 14眼 ,其中A组 10眼 ,发生率 10 75 % ;B组 4眼 ,发生率 10 0 0 %。两组发生率的差异无显著意义 ( χ2=0 0 16,P >0 5 0 )。结论　后囊破裂与截囊方式无关。     

膝前框形钢丝内固定治疗髌骨骨折

目的探讨采用钢丝环扎 膝前方框形张力带钢丝内固定法治疗髌骨骨折的经验和临床效果.方法对35例髌骨骨折应用此方法治疗,基中男性24例,女性11例,30例获得3～24个月随访.结果优19例,良10例,可1例,优良率96.7%.术后未出现骨折再移位,无伤口感染.愈合时间6～12周.结论该方法符合生物力学原理,操作简便,适应证广,能早期关节活动,是治疗髌骨骨折的理想方法之一.     

Assessment of duodenal circular drainage operations to treat superior mesenteric artery syndrome

To assess the clinical value of duodenal circular drainage operation to treat superior mesenteric artery syndrome(SMAS). Methods Forty two cases of SMAS were treated with duodenal circular drainage operation from 1959 to 2001. Clinical data were analyzed retrospectively. Results In this group,37 cases were treated with duodenal circular drainage operation,and had good effect after follow- up of 1～15 years,the other 5 cases were first treated with anterior repositioning of the duodenum (1 case),gastrojejunostomy (1 case) ,duodeojejunostomy (2 cases) .subtotal gastrectomy and Billroth Ⅱ gastrqjejunostomy( 1 case), but vomiting was not relieved until duodenal circular drainage operation was performed again. Follow-up of 9～10 years revealed good effect. Conclusion In SMAS, if the reversed peristalsis is stronger and continuous,and vomiting appears frequently, the symptom can not be relieved even if the obstruction of duodenum is removed by operation. The key treatment is the relief of reversed peristalsis. Only the duodenal circular drainage operation could resolve the drainage direction of duodenal content and relieve the symptom of vomiting.     

Effectiveness of a new triple-row circular stapler in reducing the risk of colorectal anastomotic leakage: A historical control and propensity score–matched study

Anastomotic leakage (AL) after colorectal surgery is a serious complication. This study aimed to evaluate the effectiveness of the EEA™ circular stapler, a new triple-row circular stapler (TCS), relative to a conventional, double-row circular stapler (DCS).A total of 285 patients who underwent anastomosis with the double stapling technique at the Tokyo Medical University Hospital between 2017 and 2021 were included in this nonrandomized clinical trial with historical controls using a propensity score (PS) analysis. The primary endpoint was the risk of AL.We performed a 1:2 PS matching analysis. Before case matching, AL occurred in 15 (7.4%) and 2 (2.4%) patients in the DCS and TCS groups, respectively, with no significant difference (P = .17). After case matching, AL occurred in 13 patients (11.6%) and 1 patient (1.8%) in the DCS and TCS groups, respectively, revealing a significant difference (P = .04). Cox models were created by applying PS to adjust for group differences via regression adjustment. Odds ratios for AL in the DCS group versus the TCS group were 0.31 (95% confidence interval [CI]: 0.07–1.38) in the entire cohort, 0.15 (95% CI: 0.02–0.64) in the regression adjustment cohort, and 0.14 (95% CI: 0.02–1.09) in the 1:2 PS-matched cohort.PS analysis of clinical data suggested that the use of TCS contributes to a reduced risk of AL after colorectal anastomosis CTwith the double stapling technique.     

Small envelope protein E of SARS：cloning,expression, purification, CD determination, and bioinformatics analysis

AIM:To obtain the pure sample of SARS small envelope E protein (SARS E protein), study its properties and analyze its possible functions. METHODS: The plasmid of SARS E protein was constructed by the polymerase chain reaction (PCR), and the protein was expressed in the E coli strain. The secondary structure feature of the protein was determined by circular dichroism (CD) technique. The possible functions of this protein were annotated by bioinformatics methods, and its possible three-dimensional model was constructed by molecular modeling. RESULTS: The pure sample of SARS E protein was obtained. The secondary structure feature derived from CD determination is similar to that from the secondary structure prediction. Bioinformatics analysis indicated that the key residues of SARS E protein were much conserved compared to the E proteins of other coronaviruses. In particular, the primary amino acid sequence of SARS E protien is much more similar to that of murine hepatitis virus(MHV) and other mammal coronaviruses. The transmembrane (TM) segment of the SARS E protein is relatively more conserved in the whole protein than other regions. CONCLUSION: The success of expressing the SARS E protein is a good starting point for investigating the structure and functions of this protein and SARS coronavirus itself as well. The SARS E protein may fold in water solution in a similar way as it in membrane-water mixed environment. It is possible that β-sheet I of the SARS E protein interacts with the membrane surface via hydrogen bonding, this β-sheet may uncoil to a random structure in water solution.     

豚鼠、大鼠和小鼠胃窦黏膜中胃泌素免疫反应细胞的形态学观察

目的　了解胃泌素免疫反应细胞 (Gas -IR细胞 )在豚鼠、大鼠和小鼠胃窦黏膜中的形态和分布。方法　用免疫组织化学方法结合图像分析技术研究豚鼠、大鼠和小鼠胃窦黏膜中Gas-IR细胞的数目和细胞的灰度。结果　 3种动物胃窦黏膜中Gas -IR细胞主要分布于腺上皮细胞间 ,在黏膜上皮中均未见到Gas -IR细胞。豚鼠胃窦黏膜Gas-IR细胞主要散布于管状腺细胞和基部粘液性腺泡交界处 ,偶见于基部粘液性腺泡中 ;细胞较大 ,多为圆形、卵圆形或梨形。在大鼠胃窦黏膜中 ,Gas-IR细胞主要分布于幽门腺的中、下 1/3处 ,细胞大小不等 ,形态多样 ,可见细胞发出细长的胞质突起 ,伸向邻近细胞或腺腔。而小鼠胃窦黏膜中Gas -IR细胞主要集中分布于幽门腺的基部 ,细胞较小 ,也可看到胞质突起。Gas-IR细胞的数目及细胞平均灰度值在豚鼠胃窦黏膜比大鼠、小鼠胃窦黏膜少 (P <0 .0 1)。结论　胃窦黏膜中Gas -IR细胞的形态分布及数量在豚鼠、大鼠和小鼠之间存在差异。