成人股骨中下段的解剖学与扁弧形长针的设计应用

目的:通过对成人股骨远端解剖学参数测量及股骨骨髓腔观测,为扁弧形长针的设计及治疗股骨远端骨折提供形态学基础.方法:选用成人干燥股骨60根,平均分为2组,一组测量股骨长度、内外侧髁、内外上髁等有关数据,另一组测量股骨的密质厚度、髓腔内径及髓腔狭窄区、最远端断面皮质骨侧缘切线与中轴线所形成的夹角,并对测量结果进行统计分析.结果:股骨内侧髁宽度为(47.41±3.44)mm;股骨外侧髁宽度为(33.77±4.79)mm;股骨髁干角96.32°±2.30°;远端松质骨的长度为(50.00±7.90)mm;股骨干长度为(382±8.00)mm.成人股骨髓腔形态复杂,近远端呈漏斗状,而中间非松质骨部呈类柱体,中上段1/3部位最为狭窄,远端呈冠状面宽,而非松质骨部呈矢状面宽,且股骨髓腔具有一向前弧度.结论:股骨远端解剖学参数和股骨髓腔形态特点为扁弧形长针的设计研制和临床应用提供了解剖学依据;扁弧形长针其形态结构特点与髓腔顺应性好,可有效抗分离移位、抗旋转,操作简单,成本低廉,是治疗股骨远端骨折的有效内固定器械之一.     

The Role of Non-invasive Ventilation and Factors Predicting Extubation Outcome in Myasthenic Crisis

Introduction  Myasthenic crisis is a great threat to patients with myasthenia gravis. Usage of non-invasive ventilation (NIV) to prevent intubation and timing of extubating of patients in myasthenic crisis are important issues though not well documented. Methods  To explore the factors predicting NIV success and extubation outcome in myasthenic crisis, we reviewed the records of 41 episodes of myasthenia crisis. Results  NIV was applied to 14 episodes of myasthenic crisis and eight (57.1%) of them were successfully prevented from intubation. An Acute Physiology and Chronic Health Evaluation (APACHE) II score of <6 and a serum bicarbonate level of <30 mmol/l were independent predictors of NIV success. For patients undergoing invasive mechanical ventilation, extubation failure was observed in 13 (39.4%) of 33 episodes, and the most common cause was sputum impaction due to a poor cough strength (61.5%). A maximal expiratory pressure (Pemax) of ≥40 cmH₂O was a good predictor of extubation success. Extubation failure led to poorer outcomes. Conclusions  NIV may be applied to those patients with a low APACHE II score and a lesser degree of metabolic compensation for respiratory acidosis. For patients undergoing invasive mechanical ventilation, extubation failure is associated with significant in-hospital morbidity in myasthenic crisis. Adequate levels of Pemax and cough strength correlate significantly with extubation success.     

术后早期肠动力功能障碍临床分析(附27例临床报告)

目的 探讨早期肠动力功能障碍的临床特点及治疗方法.方法 回顾性分析27例术后早期肠动力功能障碍患者的临床资料,本文病例均采取保守治疗,主要措施为禁食、胃肠减压、肠外营养支持治疗,配合应用胃肠动力药物、中药及激素.结果 全部病例经保守治疗后痊愈,症状缓解时间3～20 d,平均7 d.结论 CT检查对早期炎性肠梗阻的诊断具...     

经阴道超声对妊娠药物流产者子宫动脉血流的检测价值分析

目的 探讨经阴道超声对妊娠药物流产者子宫动脉血流的检测价值,为早期预测流产效果提供参考.方法 选取64例妊娠流产者,其中完全流产20例,不完全流产32例,流产失败12例.应用二维超声观察流产后子宫内妊娠囊的形态结构,用经阴道超声检测子宫动脉血流动力学参数.结果 超声检查结果显示,与不完全流产、流产失败者比较,完全流产者子宫动脉舒张末期流速(PDV)显著降低,阻力指数(RI)、搏动指数(PI)显著上升,差异有统计学意义(P＜0.05).结论 经阴道超声检测流产者子宫动脉血流参数,可能成为药物流产是否能完全流产的一项筛选指标;同时也提示子宫血供越好,流产不全乃至流产失败的可能性越大.     

挤出滚圆法制备吲哚美辛缓释微丸

目的:制备吲哚美辛(IMC)缓释微丸并考察其体外释放行为。方法:采用挤出滚圆法制备微丸,以微丸收率为考察指标,优选挤出速率、滚圆速度和滚圆时间参数水平;以体外释药曲线为考察指标,崩解剂微晶纤维素(MCC)、骨架材料羟丙甲基纤维素(HPMC)和润湿剂水的处方用量为因素,设计单因素试验筛选辅料处方,并进行处方验证试验及其释药机制研究。结果:优选的较佳工艺参数为挤出速度65r.min-1、滚圆速度650r.min-1、滚圆时间3min;优选的处方为MCC19、HPMC20、水6mL;验证试验表明所制得的IMC缓释微丸释放度重现性好且符合缓释制剂的要求,其释药机制为药物扩散和骨架溶蚀的混合型机制。结论:挤出滚圆法制备IMC缓释微丸方法可行,且制剂具有良好的体外缓释效果。     

Thrombosis preventive potential of chicory coffee consumption: a clinical study

The protective effects of plant polyphenol intake on cardiovascular morbidity and mortality are widely acknowledged. Caffeine‐free chicory coffee is a rich source of plant phenolics, including caffeic acid, which inhibits in vitro platelet aggregation, and also phenylpyruvate tautomerase enzymatic activity of the proinflammatory cytokine, macrophage migration inhibitory factor (MIF). To assess whether chicory coffee consumption might confer cardiovascular benefits a clinical intervention study was performed with 27 healthy volunteers, who consumed 300 mL chicory coffee every day for 1 week. The dietary intervention produced variable effects on platelet aggregation, depending on the inducer used for the aggregation test. Whole blood and plasma viscosity were both significantly decreased, along with serum MIF levels, after 1 week of chicory coffee consumption. Moreover, significant improvements were seen in red blood cell deformability. No changes in hematocrit, fibrinogen level or red blood cell counts were detected. The full spectrum of these effects is unlikely to be attributable to a single compound present in chicory coffee, nevertheless, the phenolics, including caffeic acid, are expected to play a substantial role. In conclusion, our study offers an encouraging starting‐point to delineate the antithrombotic and antiinflammatory effects of phenolic compounds found in chicory coffee. Copyright © 2011 John Wiley & Sons, Ltd.     

综合刺营放血疗法治疗声带黏膜下出血的临床研究

目的:观察综合刺营放血疗法治疗声带黏膜下出血(脏腑郁热证)的临床疗效、不良反应,对其有效性和安全性作出评价。方法:将60例患者随机分为试验组和对照组各30例,试验组采用综合刺营放血疗法治疗(用三棱针快速点刺拇指三商穴和耳轮三点放血),每日1次,连续治疗7 d;对照组采用超声雾化吸入治疗,每次15 min,每日1次,连续治疗7 d。观察两组的疗效、治疗前后症状体征积分的变化、治疗前后嗓音声学参数的变化及观察试验组治疗结束后的安全性。结果:试验组愈显率为90%(27/30),对照组为60%(18/30),试验组与对照组的愈显率比较差异有统计学意义(P<0.01)。试验组、对照组治疗后症状体征积分及嗓音声学各项参数均较治疗前明显改善(P<0.01,P<0.05),且试验组治疗后症状体征积分的改善程度优于对照组(P<0.05)。试验组30例患者治疗后无任何不良反应,所有病例安全性评价为1级。结论:综合刺营放血疗法治疗声带黏膜下出血疗效显著,优于西医常规治疗,且安全、简便、无毒副作用。     

Solubility study of phytochemical cross-linking agents on dentin stiffness

Objectives

The effects of interactions between cross-linking proanthocyanidins (PA) in polar solvents and type-I collagen of demineralized dentin were investigated.

Methods

Three PA-rich extracts, two from grape seed (GSEP and GSES) and one from cocoa (COE), were dissolved (water, ethanol:water and acetone:water) and analyzed for their ability to increase the modulus of elasticity of demineralized dentin. Sound dentin beams (0.5 mm × 1.7 mm × 7 mm) were fully demineralized and divided into 12 groups according to the type of cross-linking agent and solvents used. Specimens were immersed in the respective solutions and tested at baseline, 10, 30, 60, 120 and 240 min.

Results

The elastic modulus (EM) of dentin was significantly increased by the PA treatment regardless of time (p < 0.05 for all times). The extracts showed different solubility in different solvents. GSEP showed the highest increase in EM when diluted in distilled water and acetone at all exposure times. Both GSEs showed superior results when diluted in distilled water and after 4 h of treatment, while COE produced strongest enhancement when dissolved in ethanol:water.

Conclusions

The results indicates that herbal extraction process and other pharmacognostic parameters have an important influence on extract solubility as well as constitution and, consequently, on the PA–dentin matrix interaction.