青霉素配伍利多卡因后的药物动力学研究

本文报道青霉素配伍利多卡因后的药物动力学及生物利用度研究结果,证明利多卡因对青霉素的生物利用度无影响,且可促进青霉素的吸收,为良好的青霉素无痛溶媒,建议推广使用。     

100例SARS患者外周血T淋巴细胞亚群分析

目的 :探讨SARS患者外周血T淋巴细胞亚群变化。方法 :采用流式细胞仪检测10 0例SARS住院患者外周血T淋巴细胞亚群。结果 :与正常组比较 ,SARS组白细胞总数显著下降 ,淋巴细胞百分数和绝对数显著下降 ,粒细胞绝对数显著下降 ,CD3 、CD4 、CD8 细胞绝对数显著下降 ,CD4 细胞百分数 ,CD8 细胞百分数及CD4 /CD8 比值差异无统计学意义。比较SARS患者各病程CD3 、CD4 、CD8 ,于病程第一至第三周较第四周下降明显 (P <0 .0 5 ) ,病程第一至第三周之间差别无显著性 (P >0 .0 5 ) ;结论 :SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制有一定意义。     

银杏叶提取物联合盐酸文拉法辛对抑郁大鼠海马nNOS蛋白表达及NO水平的影响

目的 :探讨抑郁症脑损伤的机制 ,研究银杏叶提取物 (EGb)及合成抗抑郁药盐酸文拉法辛(Venlafaxine)对抑郁大鼠的抗脑损伤及神经元保护作用。方法 :慢性应激建立大鼠抑郁模型。将 84只雄性大鼠分为正常对照组、抑郁模型组和不同治疗组。快速断头法处死 ,取海马后一侧进行免疫组化反应 ,观察海马CA3区nNOS蛋白的表达 ;另一侧检测NO含量 ;同时测定血清中NO含量。结果 :抑郁模型组海马nNOS表达增加 ,海马及血清中NO含量增加 ,P <0 0 1;联合用药组海马nNOS表达下降 ,海马及血清中NO含量减少 ,P <0 0 1。结论 :慢性应激增加海马nNOS表达 ;EGb有减轻神经元损伤 ,保护神经元的作用 ,其与Venlafaxine合用可能会达到对抑郁进行多靶点、多层次的治疗 ,弥补单一用药的不足。     

强的松对大白鼠心肺肝脾肾影响的病理改变

为了解强的松对心肺肝脾肾影响的病理改变,应用正常Wistar大白鼠28只,分实验组及对照组各14只。实验组给予相当于人2mg/kg.d等效剂量的强的松片剂溶入当日饮水中,对照组饮自来水,共10周,之后解剖光镜见对照组心肺肝脾肾及实验组心肺均无异常。实验组肝肾轻度充血,脾充血明显,且见较多舍铁血黄素沉着,以红髓边缘明显。证实常规剂量的强的松对肝脾肾也有一定不良影响,应用激素时要注意及时调整剂量和给药方式与时间,尽量减少副作用。     

郑州市4123名中学生吸烟状况调查

目的：了解郑州市中学生吸烟状况。方法：采用问卷法对６所中学４１２３名学生进行吸烟状况调查。结果：中学生总吸烟率为４５１６％（１８６２／４１２３）。其中,高中组吸烟率（５０４９％）高于初中组（３９４９％）,男生吸烟率（７０１９％）明显高于女生（３１５％）,且中学生吸烟的严重性随年龄的增加而增加;父母的文化程度、周围人群的吸烟情况与学生吸烟率有密切关系。结论：中学生吸烟问题较重,为保护中学生的身心健康应大力开展卫生宣教。     

Gehalt an Glykolyse-Zwischenstoffen,Diphosphopyridinnucleotid, Adenosintriphosphat,Brenztraubensäure und anorganischem Phosphat in bestrahlten Tumorzellen nach Brenztraubensäure-Zusatz

Zusammenfassung Zellen des Yoshita-Ascitessarkoms wurden mit 25 kr bestrahlt und sofort nach der Bestrahlung mit und ohne Pyruvatzusatz zum Suspensionsmedium unter anaeroben Bedingungen inkubiert. Die bekannte Hemmung der Glykolyse in den Ansätzen mit Brenztraubensäure ist dabei weitgehend aufgehoben; in den Zellen fand sich ein signifikant höherer DPN-Gehalt. Durch Bestimmung von Glykolyse-Zwischenstoffen und ATP konnte nachgewiesen werden, daß der geringe DPN-Anstieg ausreicht, um die Triosephosphatdehydrogenierung auf die Höhe der Kontrollen zu beschleunigen. Damit war gezeigt, daß nur geringe Änderungen der DPN-Konzentration die Triosephosphatdehydrogenierung steuern.

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Summary Cells of the Yoshida ascites sarcoma were irradiated with 25 kr and immediately thereafter were incubated under anaerobic conditions with and without pyruvic acid being added to the suspension medium. Thereby the known inhibition of glycolysis in the suspensions due to pyruvic acid was eliminated. There was a significantly increased content of DPN in the cells. By determining the intermediate products of glycolysis and ATP, it could be shown that the slight increase in DPN sufficed to accelerate the triose-phosphate dehydrogenation to the level of the controls. It was shown thereby, that only slight changes in the concentration of DPN regulated the triose-phosphate dehydrogenation.

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Mit 4 Textabbildungen

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Die Untersuchungen wurden mit Unterstützung der Deutschen Forschungsgemeinschaft durchgeführt.

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Herrn Prof. Butenandt zum 60. Geburtstag gewidmet.     

再生障碍性贫血治疗中若干问题的管见

再生障碍性贫血不同地区、不同学者的不同治疗方法,反映了人们对疾病的不同的认识,主流意见一是从肾辨证立论,二是综合脏腑、阴阳、气血、病因辨证用药.急慢性再障病理特点和临床表现的不同是中医辨证治疗的基础.治用四联生血汤补肾益肾,健脾资料,清热解毒,活血化瘀.     

小儿脑瘫的推拿治疗

目的:观察推拿手法治疗小儿脑瘫的疗效.方法:选取背腰部穴区、头颈部穴区、四肢部穴区进行手法治疗;益气健脑、理筋整复.及早发现,及早诊断、及早治疗,达最佳治疗效果.结果:推拿手法可益气通经,健脑补肾,改善头部血液循环,促进血栓吸收,达到治病效果.结论:推拿手法治疗小儿脑瘫可以起到较好的效果,值得推广.     

Improved Survival for Rural Trauma Patients Transported by Helicopter to a Verified Trauma Center: A Propensity Score Analysis

Objectives

Recent studies using advanced statistical methods to control for confounders have demonstrated an association between helicopter transport (HT) versus ground ambulance transport (GT) in terms of improved survival for adult trauma patients. The aim of this study was to apply a methodologically vigorous approach to determine if HT is associated with a survival benefit for when trauma patients are transported to a verified trauma center in a rural setting.

Methods

The ascertainment of trauma patients age ≥ 15 years (n = 469 cases) by HT and (n = 580 cases) by GT between 1999 and 2012 was restricted to the scene of injury in a rural area of 10 to 35 miles from the trauma center. The propensity score (PS) was determined using data including demographics, prehospital physiology, intubation, total prehospital time, and injury severity. The PS matching was performed with different calipers to select a higher percentage of matches of HT compared to GT patients. The outcome of interest was survival to discharge from hospital. Identical logistic regression analysis was done taking into account for each matched design to select an appropriate effect estimate and confidence interval (CI) controlling for initial vital signs in the emergency department, the need for urgent surgery, intensive care unit admission, and mechanical ventilation.

Results

Unadjusted mortalities for HT compared to GT were 7.7 and 5.3%, respectively (p > 0.05). The adjusted rates were 4.0% for HT and 7.6% for GT (p < 0.05). In a PS well‐matched data set, HT was associated with a 2.69‐fold increase in odds of survival compared to GT patients (adjusted odds ratio = 2.69; 95% CI = 1.21–5.97).

Conclusions

In a rural setting, we demonstrated improved survival associated with HT compared to GT for scene transportation of adult trauma patients to a verified Level II trauma center using an advanced methodologic approach, which included adjustment for transport distance. The implication of survival benefit to rural population is discussed. We recommend larger studies with multiple trauma systems need to be repeated using similar study methodology to substantiate our findings.