银黄口服液联合头孢唑林钠治疗老年急性上呼吸道感染的临床研究

目的评价银黄口服液联合头孢唑林钠治疗老年急性上呼吸道感染的临床疗效。方法选取2016年9月—2017年9月四川大学华西医院收治的161例老年急性上呼吸道感染患者,根据用药差别分成对照组(80例)和治疗组(81例)。对照组患者静脉滴注注射用头孢唑林钠,1.0 g注射用头孢唑林钠溶于250 mL生理盐水,2次/d。治疗组患者在对照组治疗基础上口服银黄口服液,10 mL/次,3次/d。两组患者均连续治疗7 d。观察两组的临床疗效,比较两组患者临床症状消失时间、症状评分、血清鳞状细胞癌抗原(SCC)、超敏C反应蛋白(hs-CRP)及白细胞百分比的情况。结果治疗后,对照组和治疗组的总有效率分别是86.25%、96.30%,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者血清SCC、hs-CRP及淋巴细胞百分比水平均较治疗前明显降低,同组治疗前后比较差异有统计学意义(P0.05);治疗后治疗组SCC、hs-CRP及淋巴细胞百分比显著低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组患者退热时间、咽喉肿胀消退时间均明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患者症状积分均较治疗前显著降低,同组治疗前后比较差异有统计学意义(P0.05);治疗后治疗组症状积分显著低于对照组,两组比较差异具有统计学意义(P0.05)。结论银黄口服液联合头孢唑林钠治疗老年急性上呼吸道感染具有较好的临床疗效,能显著改善患者临床症状,减轻患者炎症程度,具有一定的临床推广应用价值。     

Orthodontic parotitis: a rare complication from an orthodontic appliance

Abstract

A case is presented of a 14-year-old female undergoing orthodontic fixed appliance treatment who presented with right facial swelling in the parotid region. An initial diagnosis of acute infective parotitis was made by her primary care clinician. However, after clinical examination and ultrasonographic imaging, a diagnosis of salivary stasis secondary to inflammatory occlusion of Stensen’s ductal orifice was made. The ductal orifice had been traumatized by the adjacent orthodontic appliance. This has not been described before in the literature. The differential diagnosis of parotid enlargement in children is discussed.     

两步法根管预备预防根管治疗期间急症的临床研究

目的：旨在探讨两步法根管预备和常规一次根管预备对于根管治疗期间急症的影响效果。方法：选择120例慢性根尖周炎患者,随机分为两组,采用两种方法进行根管预备,观察术后急症的发生率。结果：共19例患牙发生根管治疗诊问急症,其中常规根管预备组15牙（19％）、两步法根管预备组4牙（5．5％）,两组比较有显著性差异（P〈0．05）。两步法根管预备的总有效率为94．5％,常规根管预备组为81％,两组差异显著（P〈0．05）。结论：两步法根管预备可以减少术后肿胀等临床急症,临床应用前景广阔。     

Phosphorylation of rat aquaporin‐4 at Ser111 is not required for channel gating

Aquaporin 4 (AQP4) is the predominant water channel in the mammalian brain and is mainly expressed in the perivascular glial endfeet at the brain‐blood interface. AQP4 has been described as an important entry and exit site for water during formation of brain edema and regulation of AQP4 is therefore of therapeutic interest. Phosphorylation of some aquaporins has been proposed to regulate their water permeability via gating of the channel itself. Protein kinase (PK)‐dependent phosphorylation of Ser¹¹¹ has been reported to increase the water permeability of AQP4 expressed in an astrocytic cell line. This possibility was, however, questioned based on the crystal structure of the human AQP4. Our study aimed to resolve if Ser¹¹¹ was indeed a site involved in phosphorylation‐mediated gating of AQP4. The water permeability of AQP4‐expressing Xenopus oocytes was not altered by a range of activators and inhibitors of PKG and PKA. Mutation of Ser¹¹¹ to alanine or aspartate (to prevent or mimic phosphorylation) did not change the water permeability of AQP4. PKG activation had no effect on the water permeability of AQP4 in primary cultures of rat astrocytes. Molecular dynamics simulations of a phosphorylation of AQP4.Ser¹¹¹ recorded no phosphorylation‐induced change in water permeability. A phospho‐specific antibody, exclusively recognizing AQP4 when phosphorylated on Ser¹¹¹, failed to detect phosphorylation in cell lysate of rat brain stimulated by conditions proposed to induce phosphorylation of this residue. Thus, our data indicate a lack of phosphorylation of Ser¹¹¹ and of phosphorylation‐dependent gating of AQP4.     

黏膜下注射不同剂量地塞米松改善下颌第三磨牙拔除术后症状的疗效观察

目的研究不同剂量地塞米松黏膜下注射对下颌第三磨牙拔除术后症状的临床疗效。方法选取2016年8月—2016年11月复旦大学附属中山医院和上海市静安区牙病防治所收治的拔除下颌第三磨牙患者156例,随机分为对照组(53例)、地塞米松4 mg组(51例)和地塞米松8 mg组(52例)。对照组术前于下颌第三磨牙黏膜周围1 cm范围内注射生理盐水。地塞米松4 mg组术前于下颌第三磨牙黏膜周围1 cm范围内注射地塞米松磷酸钠注射液4 mg。地塞米松8 mg组术前于下颌第三磨牙黏膜周围1 cm范围内注射地塞米松磷酸钠注射液8 mg。观察3组的第三磨牙拔除术后症状严重度(Po SSe)量表评分,比较3组的术后肿胀程度和最大张口程度。结果治疗后,地塞米松4 mg组和地塞米松8 mg组饮食、言语、肿胀、疼痛、日常生活评分和总评分明显低于对照组,3组比较差异有统计学意义(P0.05);且地塞米松8 mg组这些观察指标下降程度明显优于地塞米松4 mg组,两组比较差异具有统计学意义(P0.05)。治疗后,地塞米松8 mg组1级肿胀占比明显高于对照组和地塞米松4 mg组,而3、4级肿胀明显低于对照组和地塞米松4 mg组,3组比较差异具有统计学意义(P0.05)。术后1周,地塞米松4 mg组和地塞米松8 mg组最大张口程度明显大于对照组,3组比较差异具有统计学意义(P0.05)。结论黏膜下注射地塞米松可改善下颌第三磨牙拔除术后症状,可减少术后肿胀程度,增加术后1周最大张口程度,且地塞米松8 mg优于地塞米松4 mg,具有一定的临床推广应用价值。     

芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折的疗效观察

目的探讨芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折的临床疗效。方法选取2015年10月—2016年12月高唐县人民医院收治的中老年桡骨远端骨折患者116例,随机分为对照组和治疗组,每组各58例。对照组静脉滴注骨瓜提取物注射液,50 mg加入5%葡萄糖溶液250 m L中,1次/d;治疗组在对照组的基础上口服芪骨胶囊,3粒/次,3次/d。两组均持续治疗4周。观察两组的临床疗效,同时比较两组治疗前后VAS评分、肿胀程度及其疼痛缓解、肿胀消除和骨折愈合的时间。结果治疗后,两组总有效率比较差异不具有统计学意义。治疗1、4周后,两组患者VAS评分和肿胀程度评分均显著降低,同组治疗前后比较差异具有统计学意义(P0.05);且治疗1周后治疗组的上述评分明显低于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,治疗组疼痛缓解时间、消肿时间以及骨折愈合时间均较对照组明显缩短,两组比较差异具有统计学意义(P0.05)。结论芪骨胶囊联合骨瓜提取物注射液治疗中老年不稳定型桡骨远端骨折能有效减轻患者疼痛和肿胀情况,缩短止痛、消肿以及骨折愈合的时间,具有一定的推广应用价值。     

生物黏附性三七总皂苷-白及多糖-海藻酸钠复合微球的制备及表征

目的利用白及多糖(BSP)的生物黏附性,与海藻酸钠(SA)混合作为复合载体,以具有缓释特性的三七总皂苷(PNS)分散体作为包封药物,制备具有生物黏附性的PNS-BSP-SA复合微球。方法采用离子交联法制备微球,通过单因素试验和正交设计考察并优化处方工艺。通过扫描电镜(SEM)、粒径分布、差示扫描量热法(DSC)分析、溶胀性能测定、体外黏附性能评价、体外释放研究对微球进行表征。结果 PNS-BSP-SA复合微球圆整度较好,表面粗糙不平有褶皱,粒径分布较窄,PNS原料药以无定形状态均匀分散于微球中。最佳处方工艺制备的微球工艺稳定,重现性较好,与直接加入PNS原料药制备的微球相比,PNS分散体微球的载药量、包封率和得率均明显增加,分别为10.34%、51.25%、82.21%,而PNS原料药微球的载药量、包封率、得率分别为4.04%、12.16%、61.35%。BSP的加入增加了SA微球的溶胀性能,明显增加了其在大鼠胃部的滞留率。PNS-BSP-SA复合微球中人参皂苷Rg1的释放较PNS原料药缓慢。结论 BSP增加了微球的生物黏附性,将PNS制备为分散体,提高了微球的载药量、包封率和得率,并使微球具有一定的缓释性能。     

Hemodynamic alterations following a cerebellar arteriovenous malformation resection: Case report and densitometric quantitative analysis from CT imaging

BackgroundCerebellar arteriovenous malformations (cAVMs) are rare and challenging lesions with an aggressive natural history. The mechanisms whereby a patient can worsen clinically after a supratentorial AVM resection include an acute alteration in cerebral hemodynamics, which is a known cause of postoperative hyperemia, edema and/or hemorrhage. These phenomena has not been described for cAVMS. Moreover, the underlying pathophysiology of edema and hemorrhage after AVM resection still remains controversial.MethodsWe report a patient that presented an abrupt neurological deterioration after cAVM surgical resection. Emergent external ventricular drainage to treat incipient hydrocephalus only partially reverted the patient's deterioration. Consecutive post-surgery CT images revealed fourth ventricle compression secondary to cerebellar swelling that concurred with a new neurological deterioration. Densitometric analysis was performed in these CT images to reveal the nature of these changes as well as their evolution over time.ResultsImportantly, we demonstrated a dynamic increase in the cerebellum mean density at the interval of Hounsfield values which correspond to hyperemia values. These changes were dynamic, and when hyperemia resolved and cerebellar density returned to basal levels, the fourth ventricle re-expanded and the patient neurologically recovered.ConclusionsThis study demonstrated the utility of quantitative CT image analysis in the context of hemodynamic alterations following cAVM resection. Densitometric CT analysis demonstrated that hyperemic changes, but not ischemic ones, were time-dependent and were responsible for swelling and hemorrhage that conditioned neurological status and patient's evolution.     

精子尾部卷曲试验与精子低渗肿胀试验的共性与特性

探讨了精子尾部卷曲试验与精子低渗肿胀试验的关系。两种实验原理相同，实验条件（渗量、离子浓度）不同，实验结果存在一定差异。对９５例生育和不育男性精液检查结果表明：精子卷尾率与精子尾总肿胀率呈高度正相关（ｒ＝０．９１２）；精子卷尾率与精子低渗肿胀试验ｇ型精子率比较呈极显著差异（Ｐ＜０．００１）；精子卷尾率、精子低渗总肿胀率与精子活率呈高度正相关（ｒ分别为０．９６３和０．９３２）；生育组与不育组比较精子卷尾率、精子总肿胀率及ｇ型精子率均呈显著性差异（Ｐ＜０．０１）。采用精子卷尾率结合低渗肿胀试验ｇ型精子率综合评估精子的活动功能对男性不育症的实验诊断具有良好的应用价值。     

Pediatric granulomatous orchitis: Case report and review of the literature

An 11‐year‐old boy presented with fever and abdominal pain, and was diagnosed with retroperitoneal lymphadenitis. At the same time, a painless right scrotal mass was observed. On imaging the testis and the epididymal mass both had abundant blood flow, although tumor markers were negative. Although the right testis had shrunk after antibiotic treatment, swelling was persistent and incisional biopsy was therefore performed, resulting in diagnosis of granulomatous orchitis (GO). No recurrence was found. In cases of scrotal swelling in both the testis and the epididymis of an older child, it is necessary to consider the possibility of inflammatory GO, and orchiectomy should not be performed without careful consideration.