Safety and efficacy of oral nemonoxacin versus levofloxacin in treatment of community-acquired pneumonia: A phase 3, multicenter,randomized, double-blind,double-dummy,active-controlled,non-inferiority trial

Background/Purpose

Nemonoxacin is a novel nonfluorinated quinolone with excellent in vitro activity against most pathogens in community-acquired pneumonia (CAP), especially Gram-positive isolates. The purpose of this study was to assess the efficacy and safety of nemonoxacin compared with levofloxacin in patients with CAP.

人体肠道生物力学特性的研究

为探讨人体肠道的生物力学特性，采用电子拉伸机对人体肠道进行一维拉伸试验。结果表明，人体肠道应力-应变关系为指数函数关系。人体肠道各段的指数系数a值接近，但材料常数C有一定的差异，说明肠道各段应力-应变趋势是一致的。在一定应力下，肠道各段轴向与环向的相对伸长率是不同的，表明人体肠道具有各向异性的特性。在一定应变下，肠道各段的增量弹性模量不同，结肠增量弹性模量相对较小，因而更容易发生变形。本研究为肠道内窥镜机器人的研制提供了理论基础。     

Optimal freezing and thawing for the survival of periphheral nerves in severed rabbit limbs

This study aimed to investigate the optimal freezing and thawing procedures for the survival of peripheral nerves in severed rabbit limbs. Twenty New Zealand White rabbits were randomized into four groups: normal control, slow-freezing fast-thawing, slow-freezing slow-thawing, fast-freezing fast-thawing, with five animals in each group. The hind limbs of the rabbits were severed at 1 cm above the knee joint. The severed limbs were cryopreserved with various freezing and thawing procedures. The sciatic nerves were harvested and trypsinized into single nerve fibers for morphological evaluation. The cell viability of the nerve fibers was examined by staining with Calcein-AM and propidium iodide. The fluorescent intensity of the nerve fibers was measured with a laser scanning confocal microscope. The morphology of the nerve fibers in the slow-freezing fast-thawing group was very similar with that of the normal control group, with only mild demyelination. The slow-freezing fast-thawing group and slow-freezing slow-thawing group showed severely damaged nerve fibers. The fluorescent intensities of the nerve fibers was significantly different among the four groups, with a decreasing order of normal control, slow-freezing fast-thawing, slow-freezing slow-thawing, and fast-freezing fast-thawing (P < 0.05). Of the various cryopreservative procedures, slow-freezing fast thawing has the minimal effects on the survival of nerve fibers in severed rabbit limbs.     

尺神经前移在肱骨髁间骨折手术治疗中的应用

目的初步探讨尺神经前移在肱骨远端髁间骨折治疗中的手术方法及效果。方法 29例C型肱骨髁间骨折患者切开复位内固定后全部进行尺神经预见性前移。结果 29例随访患者中追踪8~38个月,平均18个月,术后2~4个月骨折全部愈合。按照Mayo肘关节功能评分标准,优良率79.3%,尺神经功能情况根据Asami评价标准,优19例（65.5%）,良7例（24.1%）,一般2例（6.9%）,差1例（3.4%）,其中3例功能不满意者均为术前既有尺神经损伤症状。结论尺神经前移可作为肱骨远端髁间型骨折手术治疗中的常规治疗方法,可有效避免尺神经麻痹现象发生。     

面罩机械通气治疗急性Ⅱ型呼吸衰竭18例临床分析

目的　分析面罩机械通气 (MMV)治疗急性Ⅱ型呼吸衰竭的疗效。方法　对 18例急性Ⅱ型呼吸衰竭患者采用同步间歇性指令通气 (SIMV) +压力支持通气 (PSV ) +呼气末正压通气(PEEP)或PSV +PEEP通气方式进行面罩机械通气 ,并观测通气前后动脉血气变化。结果　通气治疗前后动脉血气比较 ,通气后pH、PO2 和SaO2 明显回升 (P <0 .0 5～P <0 .0 1) ,PCO2 明显回降(P <0 .0 1)。 18例患者中 ,12例好转出院 ,6例因通气失败死亡。结论　面罩机械通气是治疗急性Ⅱ型呼吸衰竭的重要手段之一。     

植入性医用耗材溯源规范化管理的探讨

目的:探讨如何在生产和运输环节,医院内部物流及使用环节中规范植入性医用耗材的管理。方法:针对植入性医用耗材的特殊性和高风险性特点,依照国家的相关法规,依托信息化条件,规范植入性医用耗材原材料、产品加工、销售、仓储运输以及患者使用环节的追踪溯源,并对植入性医用耗材溯源规范化管理进行探讨。结果:建立植入性医用耗材各个环节的溯源管理流程,形成植入性医用耗材规范化管理模式,通过不完整信息快速检索实现双向溯源,从而有效控制植入性医用耗材的不良事件发生,降低医疗风险。结论:通过探讨为植入性医用耗材溯源制定相关的规范化管理标准提供参考。     

Nd:YAG激光在牙周治疗中的即刻镇痛及短期脱敏作用的研究

目的:研究脉冲式掺钕钇铝石榴石(neodymium:yttrium aluminum garnet,Nd:YAG)激光在牙周治疗过程中的即刻镇痛作用及脱敏效果。方法:对36例慢性牙周炎患者进行龈上洁治,1周后通过掷硬币方法,随机选择患者口腔左右侧分别作为对照组:即单纯龈下刮治及根面平整组(scaling and root planing,SRP)和实验组:即SRP前后均使用Nd:YAG激光照射组。两组进行治疗后即刻应用视觉模拟评分法(visual analogue scale,VAS)对患者进行疼痛度评分;术前、术后1周、术后1个月对患者进行牙本质敏感程度测试。结果:实验组VAS(1.72±0.62)值明显低于对照组(5.34±0.56),其差异有统计学意义(P<0.05);术后1周,对照组牙本质过敏率(69.11%)明显高于术前(27.94%),实验组(11.76%)明显低于术前(52.94%),差异均有统计学意义。术后1个月,对照组牙本质过敏率(30.88%)和术前(27.94%)差异无统计学意义,实验组(8.82%)和术前(52.94%)差异有统计学意义。对于术前过敏的牙齿,术后1周,术后1个月实验组牙本质过敏的改善有效率(91.67%、83.33%)明显高于对照组(5.26%、11.76%)。结论:Nd:YAG激光在辅助SRP进行牙周非手术治疗中可起到一定的镇痛作用和短期的抗过敏作用。     

机器人在胰十二指肠切除术的应用与展望

微创外科的概念自1984年诞生以来,取得了蓬勃发展,但以腹腔镜为代表的微创外科由于其自身瓶颈难以完成胰十二指肠切除术等复杂、大型手术。随着工业化和信息化科技的进步,机器人手术系统应运而生。目前机器人已逐渐应用到心胸外科、普通外科、妇科、骨科、神经外科等。本文就机器人外科的历史及其在胰十二指肠切除术中的应用做一综述,并对机器人外科进行展望。