马蔺子素中残留乙醇、乙酸乙酯的测定

目的应用顶空气相色谱法,对马蔺子素中的残留溶剂乙醇和乙酸乙酯进行测定。方法采用固定相为94%二甲基聚硅氧烷-6%氰丙基苯基,0.53mm×30m,膜厚3.0μm的色谱柱,以氮气为载气,FID检测器,通过外标法计算残留溶剂的含量。结果马蔺子素中有乙醇检出,乙酸乙酯未检出。乙酸乙酯的线性范围:2.22～666μg(r=0.9999);乙醇的线性范围:4.84～484μg(r=0.9998);定量限乙醇为4.8ppm,乙酸乙酯为2.2ppm;检测限乙醇为0.5ppm,乙酸乙酯为0.4ppm。平均回收率乙醇为105.2%,乙酸乙酯为95.2%。结论本方法简便、灵敏度高、重复性好,结果准确。     

肺曲菌病的诊断与治疗(附3例报告)

肺部感染曲霉菌称肺曲菌病。其临床表现与肺炎、肺结核病相似易致误诊。胸部X线检查是最常用的诊断方法,其典型表现为空腔中的球形块影及新月征。痰中找到曲霉菌可确诊,治疗以手术为主,本文结合三例诊治体会,对该病病因、病理、诊断及治疗作了较详尽的描述。     

超声生物显微镜在“三明治”式人羊膜移植治疗难治性青光眼疗效评价中的作用

目的评价超声生物显微镜(UBM)在"三明治"式人羊膜移植术后随访中的作用。方法对49例(50只眼)难治性青光眼行小梁切除联合"三明治"式人羊膜移植术,术后1、3、6、9、12个月行UBM检查滤过泡的形态、滤过泡内腔大小、巩膜瓣下形成液间腔的大小(最大宽和高)、羊膜的变化情况,眼压情况。结果①滤过泡形态:低回声型为50%,高回声型为40%,包裹型为6%,平坦型为4%。②滤过泡内腔大小:术后1个月,最宽处平均为(3.23±0.21)mm,最高处平均为(0.68±0.12)mm,术后3个月,最宽处平均为(3.12±0.16)mm,最高处平均为(0.63±0.12)mm,术后6个月,最宽处平均为(3.04±0.11)mm,最高处平均为(0.59±0.06)mm,术后9个月,最宽处平均为(3.00±0.09)mm,最高处平均为(0.55±0.11)mm,术后12个月,最宽处平均为(2.98±0.11)mm,最高处平均为(0.53±0.20)mm,前9个月比较,最大宽和高差异有统计学意义(P<0.05)。③巩膜瓣下液间腔的大小:术后1个月,最宽处平均为(2.07±0.21)mm,最高处平均为(0.47±0.16)mm,术后3个月,最宽处平均为(2.07±0.13)mm,最高处平均为(0.46±0.20)mm,术后6个月,最宽处平均为(2.06±0.23)mm,最高处平均为(0.45±0.16)mm,术后9个月,最宽处平均为(2.04±0.18)mm,最高处平均为(0.43±0.13)mm,术后12个月,最宽处平均为(2.03±0.22)mm,最高处平均为(0.42±0.27)mm,不同时期比较最大宽和高均无统计学差异(P>0.05)。④羊膜平均存留时间为(8.68±1.10)个月。结论 UBM是一种客观的、有效的随访工具,"三明治"式人羊膜移植术能有效保持滤过道的通畅。     

Clinical pharmacokinetics of some newer diuretics

Several new diuretics have recently been developed. This review summarises the published knowledge about some of them. Azosemide is a loop diuretic. The bioavailability is about 15% and it has a half-life of 2 to 3 hours. Renal and non-renal clearance are 1.32 and 5.4 L/h, respectively. Etozolin is also a loop diuretic. It is rapidly metabolised to the active metabolite, ozolinone. The gastrointestinal uptake of etozolin is almost complete. The plasma half-life of etozolin and ozolinone are 2 and 10 hours, respectively. The compounds are mainly eliminated as metabolites. Renal and liver impairment do not seem to change the pharmacokinetics. Fenquizone has properties similar to the thiazides. The plasma half-life is approximately 17 hours. Apparent volume of distribution averaged 686 L and renal clearance is 7.2 L/h. Indapamide acts predominantly on the proximal segment of the distal tubule and also has direct vasodilatory effects. Gastrointestinal uptake is at least 80%. The drug binds highly to carbonic anhydrases of red blood cells. Protein binding is about 80%, while terminal plasma half-life is 15 hours and the apparent volume of distribution 25 L. Renal clearance is 0.3 L/h and non-renal clearance 0.9 L/h. Several metabolites have been described, of which one major metabolite is pharmacologically active. Muzolimine is a loop diuretic. Its uptake is almost complete, but decreased substantially by food. The protein binding is about 65%, the apparent volume of distribution is about 1 L/kg and average terminal half-life 10 to 20 hours. Elimination is mainly non-renal, and non-renal clearance ranges between 0.5 and 1.32 L/h. The pharmacokinetics of the drug do not seem to be changed in cardiac failure. Terminal plasma half-life is essentially unchanged in patients with renal failure, except in those with very severe reduction of glomerular filtration rate. Piretanide is a loop diuretic which is about 6 times as potent as frusemide (furosemide). Its bioavailability is most likely complete in healthy subjects and in renal patients. Protein binding in healthy subjects is about 95%. The plasma half-life of the drug is about 1 hour and apparent volume of distribution averages about 17 L. Renal and non-renal clearance are about 6 L/h, although renal clearance is decreased in renal failure: this decrease is correlated with glomerular filtration rate. Non-renal clearance is unchanged in renal failure, as is the apparent volume of distribution.(ABSTRACT TRUNCATED AT 400 WORDS)     

Mutagenicity of bromate: implications for cancer risk assessment

Bromate (BrO3-) is a rodent carcinogen that is formed as a drinking water ozone disinfection by-product and also used in some food and consumer products. Therefore, bromate is subject to assessment for its risk to humans. Because the selection of an appropriate model for conducting quantitative cancer risk assessment is based upon an understanding of the chemical's mode-of-action, it is necessary to determine whether the chemical is a mutagenic carcinogen. We present a review of the available information concerning the weight-of-the-evidence that bromate is a mutagenic carcinogen. The evidence indicates that bromate is mutagenic and that this activity is mediated by the formation of oxidative damage to the DNA, thus resulting in chromosomal damage. Not only does bromate induce genetic damage in vitro, it is also demonstrated to induce mutations in the kidney of exposed rats. This is significant because the rat kidney is one of the target tissues for tumor induction. While it is clear that bromate can cause damage in the target tissue, it is not clear whether bromate is a mutagenic carcinogen, that is, whether the observed tumors result from a mutagenic mode-of-action. Further research is needed to clarify bromate's mode-of-action. However, in the absence of additional information, it is reasonable, based on an extensive database, to assume that bromate induces tumors via oxidative damage that causes chromosomal breakage.     

41例小婴儿低血钙引起呼吸紊乱临床分析

目的探讨41例小婴儿低血钙引起呼吸节律紊乱的临床特点及诊疗体会。方法回顾性分析41例呼吸紊乱的患儿临床表现、实验室检查。结果主要表现有,呼吸暂停12例,叹息样呼吸13例,抽泣样呼吸8例,窒息2例,颜面青紫或苍白26例,呼吸心跳骤停2例,四肢肌张力增高3例;血生化检查39例确诊为低血钙,正常2例,血磷升高35例,血钾、钠、氯、镁均正常。结论新生儿或小婴儿皮层各部位之间电活动的兴奋传导功能较差,临床不出现典型惊厥发作,可出现呼吸节律改变。治疗的关键是争取尽早静脉补充钙剂。     

正交法优选阿魏酸钠红外光谱鉴别中压片条件

目的探索一种确定阿魏酸钠红外光谱鉴别中压片最佳条件的科学方法,以获得最佳质量的红外光谱图.方法以阿魏酸钠与溴化钾基质比例、压片压力、压片时间三因素的三个水平,即阿魏酸钠：溴化钾分别为1.0：200、1.5：200、2.0：200,压片压力分别为18MPa、24MPa、30MPa,压片时间分别为2min、3min、4min,按正交设计实验,以输出的红外光谱图的基线值和最强吸收峰的透光率T%为指标,通过极差分析和方差分析,确定影响红外光谱图的主次因素,从而确定压片最佳条件.结果以阿魏酸钠与溴化钾比例为2.0：200,压力为18MPa,压片时间为4min为最佳条件,红外光图谱质量最好,基线在99%透光率以上,最强吸收峰在透光率3%以下.而根据实际情况,最后确定最佳条件为：阿魏酸钠与溴化钾比例为2.0：200,在压力18MPa保持2min.结论正交法优选阿魏酸钠红外光谱鉴别中压片条件,能以较少次数操作获得满意结果,为改变传统经验做法提供了科学的方法.     

The Cenaps model of relapse prevention: basic principles and procedures

Nine basic principles that underlie the Cenaps relapse prevention planning process are described. Each principle is complemented with a procedure or clinical technique that can be used to operationalize that principle with patients: the first principle of self-regulation is operationalized with a procedure for physical, psychological, and social stabilization; the second principle of integration is operationalized by the technique of self-assessment; the third principle of understanding is operationalized by a relapse education procedure; the fourth principle of self-knowledge is operationalized with a procedure of relapse warning-sign identification; the fifth principle of coping skills is operationalized through a procedure of warning-sign management; the sixth principle of change is operationalized in a procedure for reviewing the recovery plan; the seventh principle of awareness is operationalized by a procedure of inventory training; the eighth principle of support is operationalized by the involvement of significant others; and the ninth principle is maintenance, which is operationalized by a comprehensive follow-up plan.     

复方硝酸咪康唑妇科栓的研制与含量测定

目的：制备复方咪康唑妇科栓剂并建立了含量测定方法。方法：以半合成脂肪甘油酯为在质，用熔融法制备，用P－矩阵紫外分光光度法建立了测定含量方法。结果：制备得到的栓剂光滑，极大满足妇科临床用药的要求。结论；制备方法简便、易行。测定方法准确，回收率高（＞98％）。     

胸腔积液致球形肺不张影像分析

目的探讨胸腔积液所致球形肺不张的CT特征。方法采用常规CT和高分辨CT扫描，分析球形肺不张的CT表现，并与穿刺结果及手术结果相对照。结果球形肺不张单发占95．24％，平均年龄24．36岁，大小均值为2．37cm，右叶占59．09％，左叶占40．91％，下叶后外基底段占59．09％。胸膜局限性增厚和与胸膜的锐角夹角出现率为95．45％；彗星尾征出现率为81．82％。结论胸膜局限性增厚、彗星尾征及胸膜的锐角夹角为胸腔积液致球形肺不张最基本的特征。     

Relapse revisited: A critique of current concepts and clinical practice in the management of alcohol problems

How a problem is understood dictates how it is responded to. In this paper the problem of relapse and alcohol dependence is reconsidered. The existing major relapse paradigm is evaluated against the last two decades of research. It is concluded that the available research strongly questions the notion that relapse is an addiction-specific event. Instead, relapse is probably better understood as a complex, generic, human behaviour, undertaken at times by all of us. Given this, it is possible that mainstream psychological theories, such as decision making and attribution theory, are important in coming to any understanding of the phenomenon of relapse. It is also contended that the investigation of relapse is potentially an error of focus. Such study invites the investigation of those who do not succeed in changing behaviour, as against the study of those who do. For those concerned with the treatment of alcohol dependence, studying the successes may be a more informative process than studying the putative failures. Given the burgeoning of research over the past two decades the impact on treatment practice is reviewed. It is concluded that relapse prevention and management is very much on the alcohol-intervention agenda. However, the research evidence to date is consistent with the general psychotherapy literature in that doing something appears better than no intervention, but that an optimum, effective, intervention has yet to be devised.     

碘伏与新洁尔灭消毒效果的实验研究

目的比较临床使用碘伏与新洁尔灭的抗菌效果。方法采用中和试验;定量消毒试验;有机物保护试验;稳定性试验。结果以有效碘为200mg/L的碘伏溶液,对大肠杆菌、金黄色葡萄球菌作用1min,平均杀灭率可达99.90%以上。白色念珠菌作用10min,杀灭率可达99.94%。以有效碘含量5000mg/L的碘伏溶液,对枯草杆菌作用120min,杀灭率可达99.94%。新洁尔灭含量：200mg/L的溶液对大肠杆菌、金黄色葡萄球菌作用10min,平均杀灭率可达99.90%以上。白色念珠菌作用5min,杀灭率可达99.93%。新洁尔灭含量：50000mg/L的溶液,对枯草杆菌作用180min,杀灭率可达93.32%。消毒剂放置室温下较稳定。但有机物的存在可明显减弱其杀菌作用。结论以有效碘伏200mg/L的碘伏溶液作为医院常用皮肤消毒剂,较为理想。     

HIV感染者CD4细胞计数与结核菌素试验结果分析

目的了解HIV感染者CD4细胞计数、结核菌素（PPD）反应及两者的相互影响情况。方法抽取2032例HIV感染者进行CD4细胞计数和5U的PPD试验。结果CD4细胞计数随患者年龄的增加而明显下降，CD4计数小于等于200个/mm^3者占25％，大于等于500个/mm^3者21．4％，位于两者之间者53．6％；PPD反应阳性率14．7％，随年龄的增加而呈上升趋势；CD4细胞计数与PPD反应呈负相关，但无统计学意义（P〉0．05）。结诊HIV感染者中PPD反应阳性率较低；PPD反应与CD4细胞计数呈负相关但无统计学意义（P＞0.05）。     

637例支原体感染耐药性调查分析

目的了解2003年1月～2007年12月以来本院非淋菌性尿道炎(NGU)患者支原体感染及其耐药状况,以便采取有效防治措施。方法对637例NGU门诊患者进行支原体培养,阳性标本再做8种抗生素药敏试验。结果637NGU患者中支原体阳性183例,总感染率为26.6%,其中解脲支原体(Uu)20.1%,人型支原体(Mh)2.0%,Uu和Mh混合感染4.5%。Uu对8种物药物感性最高的是阿奇霉素(98.8%),其次是克拉霉素(92.9%)。耐药性最高为四环素(26.2%),其次是强力霉素(19.6%)红霉素(15.7%)。结论耐药性分析对支原体感染的合理用药有重要临床意义。     

正交法优选氨茶碱注射液红外光谱鉴别中压片条件

目的:探索一种确定氨茶碱注射液红外光谱鉴别中压片最佳条件的科学方法,以获得最理想的红外光谱图。方法:以3因素3水平,即茶碱:溴化钾(mg:mg)分别为5.0:1000、10.0:1000、2.5:1000,压片压力分别为20MPa、24MPa、28MPa,压片时间分别为2min、3min、4min,按正交设计实验,以输出的红外光谱图的基线值和最强吸收峰的透光率T%为指标,应用Excel处理数据,通过极差和方差分析,确定影响红外光谱图的主次因素,从而确定压片最佳条件。结果:以茶碱与溴化钾比例为5.0:1000,压力为24MPa,压片时间为2min为最佳条件,红外光谱图最理想,基线在98%透光率以上,最强吸收峰在透光率为0。结论:正交法优选氨茶碱注射液红外光谱鉴别中压片条件并以Excel处理数据,能方便快捷地获得理想的光谱图,为确定优化条件提供了科学的方法。     

1,2-dibromoethane--a toxicological review

DBE is transported in the UK in road tankers and there is always the possibility of an accident. The consequences could be serious, since this chemical is absorbed by all routes, rapidly penetrates clothing and there is no effective antidote. Severe cases of poisoning are difficult to treat and there is a high mortality. Prevention of exposure is therefore essential.     

The contribution of tryptophan to the regulation of the NAD+ level in mouse liver.

It has been observed that the NAD level is lower in regenerating and growing mouse liver than in resting liver of adult mice. Also it has been found that in proliferating liver the NAD biosynthesis from nicotinamide and nicotinate is unchanged whereas that from tryptophan is reduced. Under these conditions the enzymatic activity of the kynureninase is decreased and the activity of the kynurenine aminotransferase as well as of the tryptophan pyrrolase is not altered. From these and other data of the literature it is concluded that the NAD biosynthesis from tryptophan is important for the regulation of the hepatic NAD level, through this pathway and the NAD degradation nicotinamide is formed which is transported to the non-hepatic tissues to act as a NAD precursor there. The possible interrelation between the NAD metabolism and the DNA synthesis is discussed.     

高效液相色谱法测定通脉颗粒中阿魏酸含量

目的建立测定通脉颗粒中阿魏酸含量的高效液相色谱法。方法色谱柱为Dionex C18柱(250 mm×4.6 mm,5μm),流动相为甲醇-1%醋酸溶液(30∶70),流速为1.0 mL/min,测定波长为321 nm。结果平均回收率为98.72%,RSD为0.73%,阿魏酸质量浓度在0.507～15.210μg/mL范围内与峰面积线性关系良好,系统精密度的RSD为0.01%。结论高效液相色谱法测定通脉颗粒中阿魏酸含量,可用于通脉颗粒的质量控制。     

HPLC柱切换法测定抗癌药米托蒽醌血浆浓度

新抗癌药米托蒽醌治疗剂量低,与血浆蛋白结合率较高,用一般样品预处理技术,操作麻烦费时。本文采用HPLC柱切换技术,以甲醇沉淀血浆蛋白,经超声振荡10 min,以YWG-CN为预处理柱(5cm×4.6 mm ID),水为预处理流动相,在线富集样品;以Shimpack CLC-ODS为分析柱(15cm×6 mm ID),甲醇—乙酸铵缓冲液(0.2 mol/L,pH 1.9)(48:52)为流动相,658 nm检测,内标法定量。净化富集样品操作简便,回收率好(85.5%);米托蒽醌的检测限为0.5 ng。血浆中最低检出浓度为6 ng/ml。日内变异系数为2.8～11%,日间变异系数为4.0～13.8%。在浓度为10～1000 ng/ml血浆范围内,呈线性关系。     

中国阿片类药物依赖治疗回顾

阿片类药物依赖是一种反复发作的脑疾病,是一个涉及到生理、心理、行为的医学和社会问题,其治疗也是一个长期而又艰难的过程。本文系统回顾了中国近15年阿片类药物依赖的各种治疗方法。丁丙诺啡、美沙酮治疗阿片类药物依赖的效果已得到基本的肯定,其中美沙酮维持治疗在中国内地刚刚起步,目前效果比较理想,但远期效果还有待观察。纳曲酮在预防复吸方面具有肯定的疗效。而无论何种治疗手段,辅以社会心理干预均能较好地巩固疗效和预防复吸。