顶空气相色谱法测定苯妥英钠中有机溶剂残留量

目的：建立苯妥英钠中甲醇等5种残留溶剂的测定方法.方法：采用顶空毛细管气相色谱法测定,水为溶剂,色谱柱为HP-624（30.0 m × 530 μm,3.00 μm）;载气为氮气;检测器为FID;程序升温,初始温度为40℃,维持5 min,以20℃·min-升温至200℃,保持5 min.结果：测得各残留溶剂的线性关系良好（相关系数＞0.997 2）;平均回收率92.1％～100.9％,检测限为0.5～1.2 μg.结论：该法操作简便,重现性好,结果准确可靠,可用于苯妥英钠中5种残留溶剂的测定.     

Perisynaptic Schwann cells phagocytose nerve terminal debris in a mouse model of Guillain‐Barré syndrome

In mouse models of acute motor axonal neuropathy, anti‐ganglioside antibodies (AGAbs) bind to motor axons, notably the distal nerve, and activate the complement cascade. While complement activation is well studied in this model, the role of inflammatory cells is unknown. Herein we aimed to investigate the contribution of phagocytic cells including macrophages, neutrophils and perisynaptic Schwann cells (pSCs) to distal nerve pathology. To observe this, we first created a subacute injury model of sufficient duration to allow inflammatory cell recruitment. Mice were injected intraperitoneally with an anti‐GD1b monoclonal antibody that binds strongly to mouse motor nerve axons. Subsequently, mice received normal human serum as a source of complement. Dosing was titrated to allow humane survival of mice over a period of 3 days, yet still induce the characteristic neurological impairment. Behaviour and pathology were assessed in vivo using whole‐body plethysmography and post‐sacrifice by immunofluorescence and flow cytometry. ex vivo nerve‐muscle preparations were used to investigate the acute phagocytic role of pSCs following distal nerve injury. Following complement activation at distal intramuscular nerve sites in the diaphragm macrophage localisation or numbers are not altered, nor do they shift to a pro‐ or anti‐inflammatory phenotype. Similarly, neutrophils are not significantly recruited. Instead, ex vivo nerve‐muscle preparations exposed to AGAb plus complement reveal that pSCs rapidly become phagocytic and engulf axonal debris. These data suggest that pSCs, rather than inflammatory cells, are the major cellular vehicle for axonal debris clearance following distal nerve injury, in contrast to larger nerve bundles where macrophage‐mediated clearance predominates.     

急性冠脉综合征患者MIF MMP-9表达及PCI术后动态变化

目的探讨巨噬细胞移动抑制因子（MIF）和基质金属蛋白酶-9（MMP-9）在急性冠脉综合征患者血清中的变化及经皮冠状动脉介入治疗（PCI）对其的影响。方法将120例临床诊断并经冠状动脉造影（CAG）证实的冠心病患者,分为稳定型心绞痛（SAP）组40例,不稳定型心绞痛（UAP）组42例和急性心肌梗死（AMI）组38例,另外选取CAG结果正常的30例患者作为正常对照组。所有患者均于入院次日清晨空腹抽取静脉血5 mL,UAP组和AMI组行PCI术治疗的还分别于术后6 h,1,2,3,7,14,21,28 d采血,采用酶联免疫吸附试验（ELISA）分别检测血清MIF、MMP-9水平。结果 AMI组、UAP组血清MIF、MMP-9水平均显著高于SAP组及对照组（P〈0.01）;不同冠脉病变支数之间血清MIF、MMP-9水平比较差异均无显著性（P〉0.05）;不同冠脉狭窄程度之间血清MIF、MMP-9水平比较差异均无显著性（P〉0.05）;急性冠脉综合征（ACS）患者MIF与MMP-9之间的相关性：ACS患者血清MIF与MMP-9水平呈正相关（r=0.78,P〈0.05）;PCI术后MIF、MMP-9表达水平较术前明显增高：MIF术后2 d达到高峰,然后缓慢下降,28 d回复术前水平;MMP-9术后1 d达到高峰,然后缓慢下降,21 d回复术前水平。结论血清MIF、MMP-9水平与冠脉斑块不稳定性有关,而与冠脉狭窄程度无关,且MIF与MMP-9之间存在正相关;PCI术可能加重了术后冠脉内早期炎症反应。     

低分子肝素钠联合葛根素治疗不稳定型心绞痛临床观察

目的观察低分子肝素钠联合葛根素治疗不稳定型心绞痛的临床疗效。方法将108例确诊为不稳定型心绞痛的患者随机分为治疗组和对照组,每组54例,均给予相同的常规治疗,在此基础上,治疗组加用低分子肝素钠及葛根素,比较2组治疗效果。结果治疗组心绞痛及心电图疗效均明显优于对照组,差异有显著性(P<0.05);治疗组每日硝酸甘油用量显著少于对照组(P<0.01)。结论低分子肝素钠联合葛根素治疗不稳定型心绞痛疗效肯定、安全,优于常规治疗方法。     

模拟高原与高原现场体能及心功能对比探讨

本文对低压舱内模拟快速进入高原和移居高原健康青年战士的体能及心功能之间的关系进行了对比探讨，结果表明：①测试的ＶＯ２ｍａｘ、ＡＴ值和ＰＷＣ（１５０）均随海拔高度的升高而呈线性降低，且三项指标在同海拔高度的降低率近乎一致；②高原现场选用ＰＷＣ（１５０）和ＡＴ替代ＶＯ２ｍａｘ，可避免ＶＯ２ｍａｘ高原应用欠安全性；③移居高原者测试的各项体能指标均明显优于模拟快速进入同高度者；④测试移居高原１．７年者的心功能，提示已基本获得高原适应。     

Glucuronidation as a mechanism of intrinsic drug resistance in colon cancer cells: contribution of drug transport proteins

We have recently shown that drug conjugation catalysed by UDP-glucuronosyltransferases (UGTs) functions as an intrinsic mechanism of resistance to the topoisomerase I inhibitors 7-ethyl-10-hydroxycamptothecin and NU/ICRF 505 in human colon cancer cells and now report on the role of drug transport in this mechanism. The ability of transport proteins to recognise NU/ICRF 505 as a substrate was evaluated in model systems either transfected with breast cancer-resistance protein 1 (Bcrp1), multidrug-resistance protein 2 (Mrp2) or Mrp3, or overexpressing MRP1 or P-170 glycoprotein. Results from chemosensitivity assays suggested that NU/ICRF 505 was not a substrate for any of the above proteins. In drug accumulation studies in human colon cancer cell lines NU/ICRF 505 was taken up avidly and retained in cells lacking UGTs (HCT116), whereas, following equally rapid uptake, it was cleared rapidly from cells displaying UGT activity (HT29) as glucuronide metabolites. HT29 cells were shown to express MRP1 and 3, but not P-170 glycoprotein, MRP2 or breast cancer-resistance protein. The major glucuronide of NU/ICRF 505 inhibited ATP-dependent transport of estradiol 17-beta-glucuronide in Sf9 insect cell membrane vesicles containing MRP1 or MRP3, while co-incubation of HT29 cells with the MRP antagonist, MK571, significantly restored intracellular concentrations of NU/ICRF 505. These data lead us to conclude that the presence of a glucuronide transporter is essential for glucuronidation to represent a major de novo resistance mechanism and that UGTs will contribute more as a primary resistance mechanism when the parent drug (e.g. NU/ICRF 505) is not itself recognised by transport proteins.     

The ability of cone-beam computerized tomography to detect vertical root fractures in endodontically treated and nonendodontically treated teeth: a report of 3 cases

A definitive diagnosis of vertical root fracture (VRFs) is often a challenging task for clinicians. Two-dimensional periapical radiographs (PRs) may be not helpful in such a diagnosis when the x-ray beam is not parallel to the plane of the fracture line. This report presents a set of 3 cases in which 1 endodontically treated and 2 nonendodontically treated mandibular molars were diagnosed with VRFs based on findings from clinical, radiographic, and cone-beam computerized tomographic (CBCT) examinations. After extraction, VRFs were confirmed in all of the teeth. Deep and narrow periodontal pockets were detected in 2 molars. A widening of the root canal space was observed in the PR of 1 molar only, and crown cracks were detected in none of these cases. However, in all 3 molars, fracture lines were visible on the CBCT images. Thus, CBCT provided useful information in diagnosing VRFs in both endodontically treated and nonendodontically treated teeth, especially when VRFs could not be confirmed by clinical findings and PRs.     

心理干预对胃癌患者焦虑和抑郁影响的Meta分析

目的通过循证医学Meta分析评价心理干预对胃癌患者焦虑和抑郁症状的影响。方法计算机检索PubMed、万方、维普、CNKI及中国生物医学等数据库,收集心理干预对胃癌患者焦虑和抑郁影响的临床对照试验,应用Meta分析比较观察组和对照组焦虑自评量表及抑郁自评量表评分的差异,数据采用RevMan 5.1.6和Stata 12.0进行分析,采用加权均数差(WMD)及95%可信区间(95%CI)评价。结果严格根据纳入和排除标准,最终纳入12篇临床对照试验,共计1 082例胃癌患者,其中观察组543例、对照组539例。Meta分析结果,两组干预后抑郁评分(WMD=-1.55,95%CI=-1.73～-1.36,P<0.001)和焦虑评分(WMD=-1.77,95%CI=-1.95～-1.58,P<0.001),显示观察组抑郁、焦虑评分显著低于对照组。结论心理干预可有效改善胃癌患者的焦虑和抑郁。     

血红蛋白水平与围手术期输血对结肠癌患者预后的影响

目的:本研究旨在探讨血红蛋白水平与围手术期输血对结肠癌患者预后的影响。方法:选择2008年10月至2010年12月在我院诊治的210例结肠癌患者作为研究对象,根据围手术期输血情况分为A组(输血量≥5 U)、B组(输血量<5 U)和C组(未输血)。所有患者均行结肠癌D2根治术,根据术前血红蛋白(hemoglobin,Hb)水平将患者分为严重贫血组（<6 g/dl）和非严重贫血组（≥6 g/dl）,并对患者进行术后随访。结果:围手术期输血量与患者年龄、术前Hb水平、TNM分期、肿瘤直径和浸润深度等有关(均P<0.05)。单因素生存分析结果显示,年龄、围手术期输血量、TNM分期、肿瘤直径、组织分化程度、浸润深度与结肠癌患者预后相关(均P<0.05);年龄越大、围手术期输血量越多、TNM分期越晚、肿瘤直径越大、组织分化程度越低、浸润深度越深,则结肠癌患者无病生存期越短;多因素生存分析结果表明,围手术期输血量、肿瘤直径及浸润深度是结肠癌患者预后的独立危险因素(均P<0.05)。结论:围手术期输血与结肠癌患者预后不良密切相关,围手术期输血量越多,结肠癌患者预后效果更差,而术前Hb水平与结肠癌患者预后无明显关系。