姜黄素光度法测定硼量国际标准的共同试验

用国际标准草案[1 ] (DIS)与现行国家标准 (GB)方法相对照 ,对硼的测定条件进行试验、验证。采用盐酸 -硝酸溶解试样 ,在 2 90℃以硫酸 -磷酸分解硼化物 ,在乙酸缓冲溶液中 ,硼与姜黄素生成有色络合物 ,ε543=1.2× 10 5,用本方法测定的硼量与全硼标准值基本相等 ,方法的准确度及重复性较好 ,对DIS与GB的差别进行了探讨 ,提出了改进意见。     

Diagnostic strategy in rheumatology

Nowadays, rheumatology is primarily understood as arthrology. In special diagnostics at first an articular process is to be ascertained or excluded, the arthralgia is to be separated from the objectifyable arthritic syndrome and this must be more enclosed by simple findings of the anamnesis and the physical examination. The tentative diagnosis which is present after this already in the vast majority of cases must be confirmed by aimed laboratory and X-ray diagnostics. Some guiding principles concerning the X-ray examination, state and perspectives of articular scintigraphy, arthroscopy, thermography and relevant genetic research are reported.     

Immunologic tests in rheumatology

LEARNING OBJECTIVES: Reading this article will familiarize the reader with the application and interpretation of different autoantibody tests used in rheumatology. DATA SOURCES: Recent rheumatologic textbooks, relevant review articles, and seminal articles in English regarding specific tests. RESULTS: An understanding of this review should enable the reader to approach diagnostic testing systematically in a patient with a suspected connective tissue disease. CONCLUSIONS: The proper use and interpretation of appropriate immunologic tests are important in the diagnosis and treatment of patients with connective tissue diseases.     

Clinical immunology in rheumatology

When the Institute of Rheumatology, USSR Ministry of Health, was founded, its first director Academician A. I. Nesterov set up an immunological laboratory to attack the problems of immunodiagnosis and pathogenesis of rheumatism. Since 1958 studies of systemic diseases of connective tissue and autoimmunity under the supervision of Prof. V. A. Nasonova have been under way. Radioisotopic, enzyme immunofluorescence diagnostic assays for antinuclear antibodies (ANA) have been developed. Jointly with Czechoslovakia and the USA, the Institute of Rheumatology standardized the definitions of ANA. The laboratory have proposed the guidelines of the USSR Ministry of Health for immunodiagnosis of rheumatic diseases (RD). For immunodiagnosis, immunofluorescence, enzyme immunoassays, gel precipitation, back electrophoresis, radial immunodiffusion are widely used to measure the concentrations of anticardiolipin antibodies, mitochondrial antibodies, neutrophilic antibodies. The clinical and immunological subtypes of diffuse connective tissue diseases have been identified and characterized. Mixed connective tissue disease, poststreptococcal arthritis are described. The laboratory equipment for polymerase chain reaction permits DNA diagnosis.     

MRI and ultrasound in rheumatology

Technical innovations and software improvements in magnetic resonance imaging (MRI) and high-resolution sonography (US) have definitely influenced the diagnostic imaging of rheumatic diseases. For MRI, improvements in surface coils, dedicated low-field systems (0.2 T), and software improvements (shorter acquisition times and refinements of fat suppressing techniques) must be mentioned. For sonography, the main innovations concern the development of higher transducer frequencies (7-15 Mhz) and power Doppler imaging. Clinical evaluations have shown that MRI and US are most useful in cases of suspected rheumatic disease with negative plain film radiographs and for documenting the course of the disease, diagnosing of early rheumatoid arthritis, making a differential diagnosis in clinically unclear rheumatic diseases, investigating vascularization, and quantifying pannus formation. In order to improve diagnostic efficacy the role of MRI and US in the management of patients with rheumatic disease should be reconsidered.     

Interdisciplinary collaboration

This quasiexperimental study investigated interdisciplinary collaboration over a 16-month period on units using different collaborative practice strategies. Measures of collaboration and perceived physician involvement in collaborative practice were completed by 335 licensed staff members working on seven general adult units in an acute care hospital located in an academic medical center. Data were collected at two time points: in 1993 and 1995. A small but statistically significant decline in collaboration was found (p = 0.01) over the 16-month period. Analysis of variance revealed a significant difference (p = 0.03) in collaboration related to the method used to develop collaborative paths. Post hoc Tukey's test indicated that the presence of a case manager without collaborative paths did show higher levels of collaboration (p = 0.05). Regardless of the strategy used, perceived high physician involvement was related to greater collaboration than perceived low involvement with differences increasing over time (p = 0.02). These findings suggest the importance of perceived physician involvement in collaborative practice to interdisciplinary collaboration.     

Complicated gastroduodenal ulcers in rheumatology patients

An analysis of observations of 250 patients with different rheumatological diseases has shown that 18% of the patients had ulcer disease with complications. The greatest risk of bleedings and perforations took place during the first year of treatment with nonsteroidal antiinflammatory drugs. The main risk factors of complications were determined. They are: male sex, high parameters of gastric secretion.     

Experience with collaboration

Experience with collaboration