Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation. Results of a randomized, double-blind, controlled study

OBJECTIVE: To assess the effects of dobutamine at a rate of 5 micrograms/kg/min on hemodynamics and gastric intramucosal acidosis in patients with hyperdynamic septic shock treated with epinephrine. DESIGN: A prospective, interventional, clinical trial. SETTING: An adult, 16-bed medical/surgical intensive care unit of a university hospital. PATIENTS: Twenty septic shock patients with a mean arterial pressure of > 75 mm Hg and a cardiac index of > 3.5 L/min/m2. INTERVENTIONS: After baseline measurements (H0), each patient received dobutamine at a rate of 5 micrograms/kg/min. Baseline measurements included: hemodynamic parameters, tonometric parameters, arterial and mixed venous gases, and arterial lactate concentrations. These measurements were repeated after 1 (H1), 2 (H2), and 3 (H3) hrs. After H2 measurements, dobutamine was stopped. The patients were separated into two groups according to their PCO2 gap (tonometer PCO2-PaCO2). The increased PCO2 gap group was defined by a PCO2 gap > 8 torr (> 1.1 kPa) (n = 13), and the normal PCO2 gap group by a PCO2 gap < or = 8 torr (< or = 1.1 kPa)(n = 7). MEASUREMENTS AND MAIN RESULTS: Dobutamine at 5 micrograms/kg/min had no significant effects on mean arterial pressure, heart rate, cardiac index, systemic vascular resistance, oxygen delivery, and oxygen consumption in epinephrine-treated septic shock. No patients developed arrhythmia or electrocardiographic signs of myocardial ischemia. During dobutamine infusion, arterial lactate concentration decreased from 5.1 +/- 0.4 in the increased PCO2 gap group and 4.2 +/- 0.4 in the normal PCO2 gap group to 3.9 +/- 0.3 and 3.5 +/- 0.3 mmol/L, respectively (p < .01). The PCO2 gap decreased and gastric intramucosal pH increased in the increased PCO2 gap group from 12 +/- 0.8 (1.6 +/- 0.1 kPa) to 3.5 +/- 0.8 torr (0.5 +/- 0.1 kPa) (p < .01) and from 7.11 +/- 0.03 to 7.18 +/- 0.02 (p < .01), respectively, and did not change in the normal PCO2 gap group. After stopping dobutamine infusion, the PCO2 gap and intramucosal pH returned to baseline values in the increased PCO2 gap group. CONCLUSION: The addition of 5 micrograms/kg/min of dobutamine added to epinephrine in hyperdynamic septic shock selectively improved the adequacy of gastric mucosal perfusion without modification in systemic hemodynamics.     

用流式细胞术检测γ射线诱发淋巴细胞γ-H2AX与照射剂量的关系

本研究使用流式细胞术检测了外周血淋巴细胞γ-H2AX表达水平,探讨了该方法用于辐射生物剂量估算的可能性。采集健康人外周血,进行体外60Coγ射线照射,利用γ-H2AX特异性抗体对淋巴细胞进行间接免疫荧光标记,采用流式细胞仪分析淋巴细胞中γ-H2AX的几何平均荧光强度值,并计算出相对荧光强度;比较了仪器类型和参数设定对上述两项指标的影响,以上述两项指标分别建立照射后30 min的剂量-效应曲线并进行对比。结果显示:参数设定和仪器类型均明显影响60Coγ射线照射后γ-H2AX几何平均荧光强度,而对相对荧光强度无显著影响。因此,用流式细胞仪分析γ-H2AX的相对荧光强度,较好地解决了实验的稳定性和重复性问题,有望成为一种估算辐射生物剂量的新方法。     

Photon energy absorption parameters for composite mixtures with boron compounds

Boron compounds that are used in the manufacturing of a variety of products are introduced to the environment in the form of waste. The radiation shielding measurements of mixtures that contain boron compounds is considered to be a topic of concern. The mass attenuation coefficients of (PbO and K₂B₄O₇⋅4H₂O) and (PbO and H₃BO₃) as functions of their changing contents have been measured in the X-ray energy range from 25.191 to 57.903 keV. These values are used to determine the effective atomic number of mixtures. The γ-rays emitted from an Am²⁴¹ annular source have been sent to secondary sources whose characteristic X-rays have been used for transmission arrangement. The characteristic X-rays of the secondary sources have been counted by a Si(Li) detector with a resolution of 149 eV at 5.9 keV. Also, the total effective atomic number of each mixture was determined by using the mixture rule. The measured values were compared with theoretically calculated values.     

ATP hydrolysis induces an intermediate conformational state in GroEL

The conformational properties of the molecular chaperone GroEL in the presence of ATP, its non-hydrolyzable analog 5'-adenylimidodiphosphate (AMP-PNP), and ADP have been analyzed by differential scanning calorimetry (DSC), Fourier-transform infra-red (FT-IR) and fluorescence spectroscopy. Nucleotide binding to one ring promotes a decrease in the Tm value of the GroEL thermal transition that is reversed when both rings are filled with nucleotide, indicating that the sequential occupation of the two protein rings by these nucleotides has different effects on the GroEL thermal denaturation process. In addition, ATP induces a conformational change in GroEL characterized by (a) the appearance of a reversible low temperature endotherm in the DSC profiles of the protein, and (b) an enhanced binding of the hydrophobic probe 8-anilino-naphthalene-1-sulfonate (ANS), which strictly depends on ATP hydrolysis. The similar sensitivity to K+ of the temperature range where activation of the GroEL ATPase activity, the low temperature endotherm, and the increase of the ANS fluorescence are abserved strongly indicates the existence of a conformational state of GroEL during ATP hydrolysis, different from that generated on ADP or AMP-PNP binding. To achieve this intermediate conformation, GroEL mainly modifies its tertiary and quaternary structures, leading to an increased exposure of hydrophobic surfaces, with minor rearrangements of its secondary structure.     

三钢客户管理策略的实践与探索

客户是企业的重要资源,必须进行科学有效的管理.结合三钢实践,从客户数据库管理、处理客户的投诉、培育重点客户、忠诚客户、改进与客户的关系等方面入手,探讨分析了钢铁企业客户管理的具体策略.     

Development of Water Quality Indexes to Identify Pollutants in Vietnam’s Surface Water

This study presents the first water quality indexes developed to evaluate surface water in Vietnam. The basic water quality index (WQIB) can be effectively used to evaluate the spatial and temporal variations of surface water quality as well as to identify water pollutants. The overall water quality index (WQIO) can provide additional information, particularly on toxic substances contributing to water pollution. The water quality indexes developed for this paper were applied to the national surface-water quality monitoring data taken from 1999 to 2007. Water pollutants were classified into three subcategories: organic and nutrients, particulates, and bacteria. Surface water in northern and central Vietnam was poor in quality and contained organic matter, nutrients, and bacteria. Water in the southern part was mainly polluted by bacteria. Trend analysis results reveal a deterioration in water quality in those provinces under pressure from rapid population growth, urbanization, and industrialization. Vietnam has established an official policy to ensure comprehensive nationwide water quality monitoring by 2020. The implementation of water quality indexes may provide the guiding data for sustainable water-resources management in Vietnam.     

Transitional cell carcinoma of the bladder in patients under 30 years of age

Large haemorrhagic and necrotic cutaneous lesions developed after two low dose (5 mg) methotrexate injections in a patient suffering from long standing rheumatoid arthritis. Differential clinical diagnosis included factitia dermatitis, infectious processes, pyoderma gangrenosum, rheumatoid neutrophilic dermatitis, necrotizing arteritis and vasculitis. Histological and direct immunofluorescent examinations of skin biopsies supported the diagnosis of leucocytoclastic vasculitis. We discuss the respective roles of methotrexate and rheumatoid arthritis in the outbreak of leucocytoclastic vasculitis. Hypersensitivity is strongly suspected.     

大硐室软弱围岩变形特征及其监测预报

阐述了软弱岩体内开挖大型硐室过程中，围岩的变形特征及其规律，根据位移速度和最大位移量的极限值，成功地进行了监测预报，取得了满意的结果。对矿山地下工程有一定的指导意义。     

电子束在硅中的能量损耗

利用矩法对能量从0.5～8 MeV的电子束在硅中的能量损耗分布作了理论计算。并对相应的轫致辐射能损分布作了近似计算。得到了硅中吸收剂量对深度的分布。