目的探讨小主动脉瓣环（直径≤19mm）患者行St．Jude Medical Regent（SJM Regent）瓣膜置换术后的心功能改变，研究是否存在植入瓣膜与患者不匹配（Prosthesis-Patient Mismatch，PPM）现象．以及是否有行主动脉瓣瓣环扩大术的必要。方...目的探讨小主动脉瓣环（直径≤19mm）患者行St．Jude Medical Regent（SJM Regent）瓣膜置换术后的心功能改变，研究是否存在植入瓣膜与患者不匹配（Prosthesis-Patient Mismatch，PPM）现象．以及是否有行主动脉瓣瓣环扩大术的必要。方法2004年3月-2005年3月，22例主动脉瓣环直径≤19mm患者置换SJM Regent机械瓣，用彩色多普勒超声仪对左心功能进行术前、术后监测．并与22例置换St．Jude Medical Hemodynamic Plus Series（SJMHP）机械瓣及22例置换外径23mm常规机械瓣患者进行对比。结果置换SJM Regent机械瓣膜患者术后的左心功能指标较术前明显好转，左室射血分数、左室缩短分数、瓣膜有效开口面积／体表面积之比（EOA指数）明显上升，左室重量指数及主动脉跨瓣压差也有不同程度降低。左心功能各项指标改善明显好于置换SJMHP机械瓣患者．部分指标接近或好于置换外径23mm瓣膜者。结论对于小主动脉瓣环患者．置换Regent机械瓣后指标已经接近或达到置换外径23mm常规瓣膜者，无PPM现象，大部分患者无须行主动脉瓣瓣环扩大术。展开更多
目的分析我院的44例小主动脉瓣环(直径≤17mm)患者行St Jude Medica Regent瓣膜置换术后心功能等改变,探讨是否存在植入瓣膜与患者不匹配现象。方法2007年10月至2009年3月,我院有44例小主动脉瓣环(直径≦17mm)患者,置换17mm St Jude Med...目的分析我院的44例小主动脉瓣环(直径≤17mm)患者行St Jude Medica Regent瓣膜置换术后心功能等改变,探讨是否存在植入瓣膜与患者不匹配现象。方法2007年10月至2009年3月,我院有44例小主动脉瓣环(直径≦17mm)患者,置换17mm St Jude Medica Regent机械瓣膜组;随机选择同期44例直径为21mm患者,置换21mm St Jude机械瓣膜组。术后随访两组患者的临床症状、体征,心电图、超声心电图等指标,采用SPSS13.0统计软件进行比较分析。结果17mm St Jude Medica Regent机械瓣膜组中,心电图检查8例有ST段改变,术后3例仍存在胸闷症状,偶尔有胸痛不适3例;术后心功能Ⅱ级8例、Ⅲ级4例。21mm St Jude机械瓣膜组术后心电图检查6例有ST段改变,2例有胸闷症状,偶尔有胸痛不适2例;术后心功能Ⅱ级11例,Ⅲ级2例,两组间比较差异无统计学意义(P=0.32)。两组患者术后左心室舒张期末内径、左心室后壁厚度、左心室重量指数、主动脉跨瓣压差等均较术前明显改善(P<0.05),左心室射血分数(LVEF)术后6～12月与术前比较明显提高(P<0.05),但两组间比较差异无统计学意义((P>0.05)。结论对于体重较轻(≤60kg)、体表面积较小(≤1.6cm2)的小主动脉瓣环患者,置换17mm St Jude Medical Regent机械瓣后,能取得较好的效果,部分指标已经接近或达到置换外径21mm St Jude机械瓣膜组,无明显PPM现象,无须行主动脉瓣环扩大术。展开更多
A novel method for the determination of vitamin C（Vc） is proposed in this article. After the reaction with Folin-Ciocalteau reagent at ambient temperature, Vc solution was scanned at 750--1100 nm, and its first-orde...A novel method for the determination of vitamin C（Vc） is proposed in this article. After the reaction with Folin-Ciocalteau reagent at ambient temperature, Vc solution was scanned at 750--1100 nm, and its first-order derivative spectrum were obtained from the original spectrum. The values of derivative selected at 995 nm were used for determination. It was proved that Vc could quickly react with Folin-Ciocalteau reagent within 5 min and the product was quite stable for a long time. The conditions required for this method is not very complicated, its precision and accuracy are similar to those of the iodometric titration described in Chinese Pharmacopoeia, and the limit of detection is 0.312 μg/mL. The determination of the results of vitamin C tablet, pill, and injection demonstrates that this method has wide pharmaceutical applications.展开更多
[ Objective ] The study aimed to discuss the optimal conditions for the treatment of enzymolysis wastewater by centrifugation - coagu- lation - Fenton reagent oxidation - adsorption process. [ Metbod] According to the...[ Objective ] The study aimed to discuss the optimal conditions for the treatment of enzymolysis wastewater by centrifugation - coagu- lation - Fenton reagent oxidation - adsorption process. [ Metbod] According to the water-quality characteristics of wastewater from a heparin so- dium production factory of Jiangsu Province, enzymolysis wastewater was segregated from intestinal lavage wastewater and treated through cen- trifugation- coagulation- Fenton reagent oxidation-adsorption process, and the optimal technical parameters were determined. E Resultl After enzymolysis wastewater was centrifuged at a speed of 4 000 rpm, 0.6 g/L CTS as the coagulant was added to the supematant. Hereafter, pH of the coagulated effluent was adjusted to 3, and then 1.5% （V/V） H2O2 was added to the coagulated effluent; a certain amount of ferrous sul- fate （n H2O2-.n FeSO4 . 7H2O =8：1 ） was added to the mixture; the reaction conducted for 30 min, and then solution pH was adjusted to about 9. Finally, the oxidized effluent flowed through a resin red until the adsorptive capacity reached 240 BV, and COD of the effluent water was lower than 100 mg/L, meeting the Grade-I standard of Comprehensive Discharge Standard of Sewage （GB8978-1996）. [Condusio] The research could provide a new process for the treatment of enzymolysis wastewater.展开更多
目的回顾性分析188例成年人小主动脉瓣环(瓣环直径≤21 mm)人工机械瓣膜置换术后患者的疗效及心功能的变化,探讨3种机械瓣替换术后是否存在植入瓣膜与患者不匹配(PPM)现象。方法选择南京中医药大学附属医院心胸外科188例植入小主动脉瓣...目的回顾性分析188例成年人小主动脉瓣环(瓣环直径≤21 mm)人工机械瓣膜置换术后患者的疗效及心功能的变化,探讨3种机械瓣替换术后是否存在植入瓣膜与患者不匹配(PPM)现象。方法选择南京中医药大学附属医院心胸外科188例植入小主动脉瓣环(直径16~21 mm)成年患者(占所有主动脉瓣置换患者的45.83%),其中男性96例,女性92例;年龄17~72岁,平均年龄51.12岁。主动脉瓣二叶畸形10例,单纯主动脉瓣狭窄27例,单纯主动脉瓣关闭不全46例,二尖瓣联合主动脉瓣病变96例,感染性心内膜炎9例;其中20例置换17 mm SJ Regent机械瓣,45例置换19 mm SJ Regent机械瓣,30例置换21 mm SJ Regent机械瓣,31例置换Carbio-S 19 mm机械瓣,20例置换Carbio-S21 mm机械瓣,10例置换16 mm over-line Sorin机械瓣,16例置换18 mm over-line Sorin机械瓣,16例置换20 mm overline Sorin机械瓣。采用彩色多普勒超声心动图分别于术前、术后1周、术后3个月和1年,检测患者的左心室舒张末期内径、收缩末期内径、室间隔及左心室后壁厚度、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)和主动脉瓣跨瓣压差的变化,观察左心室质量指数变化情况,并进行各组比较分析。结果全组患者无手术死亡,围术期死亡2例,术后1年内不明原因猝死3例,其余183例患者均随访1年以上。参考各瓣膜厂家提供的有效瓣口面积指数(EOAI),该研究组无重度PPM,所有患者EOAI均大于0.65 cm^2/m^2,EOAI在0.65~0.85 cm^2/m^2(中度PPM)患者占35.14%,EOAI>0.85 cm^2/m^2占64.86%,EOAI与主动脉瓣跨瓣压差之间无明显相关性;术后所有患者心功能均较术前提高2~3级。术后3个月至1年内平均LVEF和LVFS均在正常范围。术后各组患者3个月至1年左心室平均内径均恢复至正常范围。术后1周平均左心室质量指数为90.35 g/m^2,较术前(101.48 g/m^2)下降显著(P<0.05),随访3个月到1年无显著变化;所有患者术后1周~1年内主动脉瓣跨瓣平均压差2.92 k Pa(21.92 mm Hg),各组患者术后1周随访至术后1年,主动脉瓣跨瓣压差均无显著变化。5组患者(16 mm over-line Sorin机械瓣组、20 mm over-line Sorin机械瓣组、17 mm SJ Regent机械瓣组、Carbio-S 19 mm机械瓣组、Carbio-S 21 mm机械瓣组)术后1年内主动脉瓣跨瓣压差与其他3组相比明显增大,组间差异有统计学意义(P<0.05);其中16 mm over-line Sorin机械瓣组跨瓣压差最大。所有患者均未发现有PPM现象发生。结论采用中国市场上来自不同厂家的各种直径的主动脉瓣机械瓣膜置换术后未见明显PPM现象,左心室质量指数及主动脉跨瓣压差术后均在比较理想的范围;不同厂家的各种型号的人工主动脉机械瓣可以满足绝大多数成年小主动脉瓣环患者主动脉瓣置换的需求,大部分患者无须行主动脉瓣环扩大术或采用其他术式。展开更多
Rh(Ⅲ)-catalyzed, chelation-assisted oxidative C-H imidation of arenes with N-H imide have been realized using PhI(OAc)2 as an oxidant. This transformation exhibits a broad substrate scope and tolerates various functi...Rh(Ⅲ)-catalyzed, chelation-assisted oxidative C-H imidation of arenes with N-H imide have been realized using PhI(OAc)2 as an oxidant. This transformation exhibits a broad substrate scope and tolerates various functional groups. The reaction proceeded via in situ generation of an iodine(Ⅲ) imido. DFT calculations suggest that this oxidative imidaton system proceeds via a Rh(Ⅲ)-Rh(Ⅴ)-Rh(Ⅲ) pathway.展开更多
文摘目的探讨小主动脉瓣环（直径≤19mm）患者行St．Jude Medical Regent（SJM Regent）瓣膜置换术后的心功能改变，研究是否存在植入瓣膜与患者不匹配（Prosthesis-Patient Mismatch，PPM）现象．以及是否有行主动脉瓣瓣环扩大术的必要。方法2004年3月-2005年3月，22例主动脉瓣环直径≤19mm患者置换SJM Regent机械瓣，用彩色多普勒超声仪对左心功能进行术前、术后监测．并与22例置换St．Jude Medical Hemodynamic Plus Series（SJMHP）机械瓣及22例置换外径23mm常规机械瓣患者进行对比。结果置换SJM Regent机械瓣膜患者术后的左心功能指标较术前明显好转，左室射血分数、左室缩短分数、瓣膜有效开口面积／体表面积之比（EOA指数）明显上升，左室重量指数及主动脉跨瓣压差也有不同程度降低。左心功能各项指标改善明显好于置换SJMHP机械瓣患者．部分指标接近或好于置换外径23mm瓣膜者。结论对于小主动脉瓣环患者．置换Regent机械瓣后指标已经接近或达到置换外径23mm常规瓣膜者，无PPM现象，大部分患者无须行主动脉瓣瓣环扩大术。
文摘目的分析我院的44例小主动脉瓣环(直径≤17mm)患者行St Jude Medica Regent瓣膜置换术后心功能等改变,探讨是否存在植入瓣膜与患者不匹配现象。方法2007年10月至2009年3月,我院有44例小主动脉瓣环(直径≦17mm)患者,置换17mm St Jude Medica Regent机械瓣膜组;随机选择同期44例直径为21mm患者,置换21mm St Jude机械瓣膜组。术后随访两组患者的临床症状、体征,心电图、超声心电图等指标,采用SPSS13.0统计软件进行比较分析。结果17mm St Jude Medica Regent机械瓣膜组中,心电图检查8例有ST段改变,术后3例仍存在胸闷症状,偶尔有胸痛不适3例;术后心功能Ⅱ级8例、Ⅲ级4例。21mm St Jude机械瓣膜组术后心电图检查6例有ST段改变,2例有胸闷症状,偶尔有胸痛不适2例;术后心功能Ⅱ级11例,Ⅲ级2例,两组间比较差异无统计学意义(P=0.32)。两组患者术后左心室舒张期末内径、左心室后壁厚度、左心室重量指数、主动脉跨瓣压差等均较术前明显改善(P<0.05),左心室射血分数(LVEF)术后6～12月与术前比较明显提高(P<0.05),但两组间比较差异无统计学意义((P>0.05)。结论对于体重较轻(≤60kg)、体表面积较小(≤1.6cm2)的小主动脉瓣环患者,置换17mm St Jude Medical Regent机械瓣后,能取得较好的效果,部分指标已经接近或达到置换外径21mm St Jude机械瓣膜组,无明显PPM现象,无须行主动脉瓣环扩大术。
基金Natural Science Foundation of Jilin Province, China(No.200305502)
文摘A novel method for the determination of vitamin C（Vc） is proposed in this article. After the reaction with Folin-Ciocalteau reagent at ambient temperature, Vc solution was scanned at 750--1100 nm, and its first-order derivative spectrum were obtained from the original spectrum. The values of derivative selected at 995 nm were used for determination. It was proved that Vc could quickly react with Folin-Ciocalteau reagent within 5 min and the product was quite stable for a long time. The conditions required for this method is not very complicated, its precision and accuracy are similar to those of the iodometric titration described in Chinese Pharmacopoeia, and the limit of detection is 0.312 μg/mL. The determination of the results of vitamin C tablet, pill, and injection demonstrates that this method has wide pharmaceutical applications.
基金Supported by the Project of Practical Innovation Training Program of Undergraduates in Jiangsu Province in 2012(232)Project of Visiting Engineers of Nanjing College of Chemical Technology in 2012
文摘[ Objective ] The study aimed to discuss the optimal conditions for the treatment of enzymolysis wastewater by centrifugation - coagu- lation - Fenton reagent oxidation - adsorption process. [ Metbod] According to the water-quality characteristics of wastewater from a heparin so- dium production factory of Jiangsu Province, enzymolysis wastewater was segregated from intestinal lavage wastewater and treated through cen- trifugation- coagulation- Fenton reagent oxidation-adsorption process, and the optimal technical parameters were determined. E Resultl After enzymolysis wastewater was centrifuged at a speed of 4 000 rpm, 0.6 g/L CTS as the coagulant was added to the supematant. Hereafter, pH of the coagulated effluent was adjusted to 3, and then 1.5% （V/V） H2O2 was added to the coagulated effluent; a certain amount of ferrous sul- fate （n H2O2-.n FeSO4 . 7H2O =8：1 ） was added to the mixture; the reaction conducted for 30 min, and then solution pH was adjusted to about 9. Finally, the oxidized effluent flowed through a resin red until the adsorptive capacity reached 240 BV, and COD of the effluent water was lower than 100 mg/L, meeting the Grade-I standard of Comprehensive Discharge Standard of Sewage （GB8978-1996）. [Condusio] The research could provide a new process for the treatment of enzymolysis wastewater.
文摘目的回顾性分析188例成年人小主动脉瓣环(瓣环直径≤21 mm)人工机械瓣膜置换术后患者的疗效及心功能的变化,探讨3种机械瓣替换术后是否存在植入瓣膜与患者不匹配(PPM)现象。方法选择南京中医药大学附属医院心胸外科188例植入小主动脉瓣环(直径16~21 mm)成年患者(占所有主动脉瓣置换患者的45.83%),其中男性96例,女性92例;年龄17~72岁,平均年龄51.12岁。主动脉瓣二叶畸形10例,单纯主动脉瓣狭窄27例,单纯主动脉瓣关闭不全46例,二尖瓣联合主动脉瓣病变96例,感染性心内膜炎9例;其中20例置换17 mm SJ Regent机械瓣,45例置换19 mm SJ Regent机械瓣,30例置换21 mm SJ Regent机械瓣,31例置换Carbio-S 19 mm机械瓣,20例置换Carbio-S21 mm机械瓣,10例置换16 mm over-line Sorin机械瓣,16例置换18 mm over-line Sorin机械瓣,16例置换20 mm overline Sorin机械瓣。采用彩色多普勒超声心动图分别于术前、术后1周、术后3个月和1年,检测患者的左心室舒张末期内径、收缩末期内径、室间隔及左心室后壁厚度、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)和主动脉瓣跨瓣压差的变化,观察左心室质量指数变化情况,并进行各组比较分析。结果全组患者无手术死亡,围术期死亡2例,术后1年内不明原因猝死3例,其余183例患者均随访1年以上。参考各瓣膜厂家提供的有效瓣口面积指数(EOAI),该研究组无重度PPM,所有患者EOAI均大于0.65 cm^2/m^2,EOAI在0.65~0.85 cm^2/m^2(中度PPM)患者占35.14%,EOAI>0.85 cm^2/m^2占64.86%,EOAI与主动脉瓣跨瓣压差之间无明显相关性;术后所有患者心功能均较术前提高2~3级。术后3个月至1年内平均LVEF和LVFS均在正常范围。术后各组患者3个月至1年左心室平均内径均恢复至正常范围。术后1周平均左心室质量指数为90.35 g/m^2,较术前(101.48 g/m^2)下降显著(P<0.05),随访3个月到1年无显著变化;所有患者术后1周~1年内主动脉瓣跨瓣平均压差2.92 k Pa(21.92 mm Hg),各组患者术后1周随访至术后1年,主动脉瓣跨瓣压差均无显著变化。5组患者(16 mm over-line Sorin机械瓣组、20 mm over-line Sorin机械瓣组、17 mm SJ Regent机械瓣组、Carbio-S 19 mm机械瓣组、Carbio-S 21 mm机械瓣组)术后1年内主动脉瓣跨瓣压差与其他3组相比明显增大,组间差异有统计学意义(P<0.05);其中16 mm over-line Sorin机械瓣组跨瓣压差最大。所有患者均未发现有PPM现象发生。结论采用中国市场上来自不同厂家的各种直径的主动脉瓣机械瓣膜置换术后未见明显PPM现象,左心室质量指数及主动脉跨瓣压差术后均在比较理想的范围;不同厂家的各种型号的人工主动脉机械瓣可以满足绝大多数成年小主动脉瓣环患者主动脉瓣置换的需求,大部分患者无须行主动脉瓣环扩大术或采用其他术式。
文摘Rh(Ⅲ)-catalyzed, chelation-assisted oxidative C-H imidation of arenes with N-H imide have been realized using PhI(OAc)2 as an oxidant. This transformation exhibits a broad substrate scope and tolerates various functional groups. The reaction proceeded via in situ generation of an iodine(Ⅲ) imido. DFT calculations suggest that this oxidative imidaton system proceeds via a Rh(Ⅲ)-Rh(Ⅴ)-Rh(Ⅲ) pathway.
