HPLC法同时测定补骨脂药材中6种成分的含量

目的:建立同时测定补骨脂药材中6种成分含量的方法。方法:采用高效液相色谱法同时分析补骨脂中补骨脂素、异补骨脂素、补骨脂甲素、补骨脂异黄酮、补骨脂定和补骨脂查耳酮6种成分。用AlltechC18(4.6mm×250mm,5μm)色谱柱,1%冰醋酸溶液和乙腈为流动相,采用梯度洗脱,流速1.0ml/min,检测波长245nm。结果:6种成分线性关系良好,r>0.9991,平均加样回收率均大于95.0%,RSD均小于3.0%。结论:该方法适用于补骨脂药材中6种成分的同时测定,可作为药材质量的综合评价方法。     

Spinal pseudoarthrosis: a rare complication in psoriatic arthritis.

Discovertebral erosion with pseudoarthrosis is a well-known complication in ankylosing spondylitis but it is seldom mentioned in psoriatic arthritis. We report a 53-year-old woman with an 8-year history of psoriatic arthritis who developed severe low back pain followed by sudden onset of numbness in the lower limbs, weakness and dysesthesia. Abnormal contour of L1 and L2 vertebrae and intervertebral disc space was noted during radiologic examination. Pseudoarthrosis was suspected based on extensive osseous resorption and reactive sclerosis about the discovertebral junction on magnetic resonance imaging study. She underwent emergency operation due to spinal instability with neurologic deficit. Pseudoarthrosis was confirmed intraoperatively. No evidence of infection or neoplasms was found. This case shows that pseudoarthrosis can be complicated in patients with psoriatic arthritis, and this possibility should be considered in patients with previously quiescent disease.     

Evaluation of unpredictable critical conditions of patients treated in the observation unit of the Emergency Department

We evaluated unpredictable critical conditions of patients treated in the Emergency Department (ED) observation unit, who were transferred into the emergency resuscitation room from January 1 through June 30, 2001. A total of 175 patients were observed for the following critical conditions: dyspnea (51 patients; 29.14%), hypotension (28; 16.00%), chest pain (18; 10.29%), dysrhythmia (15; 8.57%), hematemesis (15; 8.57%), altered mental status (12; 6.85%), shock (10; 5.71%), coma (8; 4.57%), apnea (5; 2.86%), hematochezia (3; 1.72%), seizure (3; 1.72%), and others (7; 4.00%). The 27 patients who had cardiopulmonary resuscitation (CPR), endotracheal tube intubation, or cardioversion/defibrillation in the ED suffered an in-ED mortality of 25.9% (7) and an in-hospital mortality of 59.2% (16). The remaining 148 patients who received appropriate treatment, except for the above, had a lower in-hospital mortality (20.28%, 30 patients) (p < 0.05). We should limit the number of patients in the observation unit to avoid overloading, and classify patients according to their clinical conditions. We should determine whether or not they have definite diagnoses or are waiting for hospital admission while receiving simple treatments. The observation unit must be provided with well-trained staff and suitable physical facilities with support services, and rapid specialty consultations must be available.     

Effects of bihemispheric transcranial direct current stimulation on motor recovery in subacute stroke patients: a double-blind,randomized sham-controlled trial

Persons with Parkinson’s disease (PD) often exhibit difficulties with dexterity during the performance of activities of daily living (ADL), inter alia due to dysfunctional supplementary motor area (SMA). Combined intermittent theta-burst stimulation (iTBS) over the SMA followed by video game-based training (VBT) may therefore improve dexterity related ADL. The VBT may induce high flow levels related to high performance during the training. The aim of this study is to evaluate the feasibility of a combined iTBS-VBT intervention in persons with PD. A total of nine persons with PD (mean age 63.3?±?8.76 years) with self-reported difficulties with dexterity related ADL were included in this pilot iTBS-VBT study. All participants received either iTBS or sham stimulation over the SMA followed by a 45-min VBT, three times a week for a total of three weeks. Feasibility was measured by means of the adherence rate and the system usability (System Usability Scale). Moreover, flow was measured after the last VBT session. Adherence rate was excellent with 100%. High system usability scores (i.e., mean 80%, range 55–97.5) and a significant Spearman’s correlation with the Flow State Scale (r?=?.762, p?=?.017) further point to the high feasibility of the VBT. Neither demographic variables nor difficulties in dexterity related ADL affected the usability of the VBT. This study demonstrates the high feasibility of a combined iTBS-VBT intervention. Moreover, the level of self-reported usability was related to flow experience. Whether this kind of combined iTBS-VBT intervention improves dexterity will be evaluated in a randomized controlled trial. Trial registration clincaltrials.gov NCT04699149, date of registration 1. June 2021     

轻度胃肠炎伴婴幼儿良性惊厥患儿血清硫化氢水平变化的研究

目的 研究轻度胃肠炎伴婴幼儿良性惊厥(BICE)患儿血清硫化氢(H2S)水平的变化及意义.方法 选择住院治疗的42 例BICE 患儿为观察组,同期因单纯急性胃肠炎入院治疗的46 例患儿为对照组.使用分光光度计法检测其血清H2S 水平.结果 观察组患儿血清H2S 水平显著低于对照组(28±12 μmol/L vs45±10 μmol/L,P<0.O1).惊厥发作次数≥ 2 次患儿血清H2S 水平显著低于发作次数<2 次患儿(P<0.O5).BICE 患儿惊厥发作次数与血清H2S 水平呈负相关(r=-0.485,P=0.001);惊厥持续时间≥ 5 min 组患儿的发作时间与血清H2S 水平呈负相关(r=-0.736,P=0.004).结论 内源性H2S 水平的降低可能是BICE 患儿发病原因之一;血清H2S 水平下降程度与惊厥发生的次数及发作超过5 min 的持续时间有关,其临床意义有待于更多的研究证实.     

Baseline hyponatremia does not predict two-year mortality in patients with chronic peritoneal dialysis

Purpose: Hyponatremia is a common electrolyte abnormality in a variety of medical conditions. Lower predialysis serum sodium concentration is associated with an increased risk of death in oligoanuric patients on hemodialysis. However, whether hyponatremia affects the short-term mortality in chronic peritoneal dialysis (CPD) patients remains unclear. Methods: We conducted a cross-sectional and two-year follow-up review retrospectively, and 318 patients with CPD were enrolled in a medical center. Serum sodium levels were measured at baseline and categorized as quartile of Na: quartile 1 (124–135?mEq/L), quartile 2 (136–139), quartile 3 (140–141) and quartile 4 (142–148). Mortality and cause of death were recorded for longitudinal analyses. Results: The patients with higher quartile (higher serum sodium) had a trend of lower age, peritoneal dialysis (PD) duration, co-morbidity index, D/P Cr and white blood cell counts and higher renal Kt/Vurea (Kt/V) and serum albumin level. Stepwise multiple linear regression analysis showed that serum sodium level was positively associated with albumin, residual renal Kt/V and negatively associated with age and PD duration in CPD patients. After two-year follow-up, stepwise multivariate Cox proportional hazards model demonstrated that age, co-morbidity index and serum albumin were the significant risk factors for all-cause two-year mortality, but not serum sodium levels. Conclusions: Serum sodium level in CPD patients is associated with nutritional status, residual renal function and duration of PD. However, baseline serum sodium level is not an independent predictor of two-year mortality in CPD patients.     

Chylothorax Complicating Video-Assisted Thoracoscopic Surgery for Non-small Cell Lung Cancer

Background

Chylothorax is an infrequent but well-known complication in lung cancer surgery. Previous published studies on this topic are limited, and thoracotomy has been the main surgical approach for treatment. However, chylothorax after lung cancer surgery performed solely by video-assisted thoracoscopic surgery (VATS) has rarely been investigated. The purpose of this study is to evaluate chylothorax after VATS for lung cancer.

Methods

The records of 776 patients with primary non-small-cell lung cancer (NSCLC) who underwent VATS for pulmonary resection and mediastinal lymph node dissection (MLND) at our hospital from January 2010 to August 2013 were retrospectively reviewed. Twenty patients with chylothorax (2.58 %) were included in the analysis.

Results

The 20 patients with chylothorax were all treated conservatively, but five patients (25 %) subsequently required reoperation for chylothorax. In patients with pleural drainage of less than 400 ml the first postoperative day, the chylothorax resolved with conservative treatment. Chylothorax also resolved in patients with pleural drainage of more than 400 ml the first or second postoperative day if drainage was less than 400 ml on postoperative day 4 and thereafter. Reoperations were required in cases with an increasing amount of pleural drainage on postoperative day 4 and thereafter.

Conclusions

Most of the chylothorax following VATS for lung cancer can be treated conservatively. However, the timing of surgical intervention for chylothorax following VATS for lung cancer can be earlier if pleural drainage does not show a trend toward decreasing with conservative treatment.     

坎替沙坦抑制大鼠去窦弓神经引起的心血管肥大

目的:研究新型AT_1受体拮抗剂坎替沙坦对大鼠去窦弓神经(SAD)引起的心血管肥大的作用及其可能机制.方法:长期治疗时,大鼠SAD术后从食物中给予坎替沙坦(6 mg·kg~(-1)·d~(-1))16周.急性治疗时,大鼠 SAD术后第 30大经胃内单次给坎替沙坦 3 mg/kg.结果:SAD大鼠坎替沙坦治疗组的左心室和主动脉肥厚指数明显低于未治疗组,相当于或低于正常水平.SAD引起的心肌肥大、纤维化、心肌内小动脉和主动脉管壁增厚以及血管内弹力膜破坏几乎被坎替沙坦完全抑制.治疗后血浆血管紧张素Ⅱ浓度明 显升高,与心血管肥厚指数呈负相关.坎替沙坦单次给药后3小时观察期内,SAD大鼠血压及其波动性维持在较低水平.结论:坎替沙坦能有效抑制SAD引起的心血管肥厚.这种心血管保护作用除与已知机制有关外,还可能与其上调循环血管紧张素Ⅱ和稳定血压有关.