Intracranial arachnoid cysts and obstetric anesthesia: Two case reports

Two cases of patients in whom neuraxial anesthesia was planned for labor and delivery and who had a pre-existing intracranial arachnoid cyst are reported. Anesthesia was used in one patient and was uneventful. The pathophysiology of these cysts and factors which can precipitate the occurrence of symptoms, are reviewed and cases previously described in the literature are examined. Management should be individualized and based on evaluation of preexisting neurological symptoms. In most cases and although CT scan and MRI images may show an intracranial cyst with impressive development, patients remain asymptomatic and neuraxial regional anesthesia can be used safely, provided the patient has agreed and the neurologist in charge has been informed.     

Does an interspinous device (Coflex?) improve the outcome of decompressive surgery in lumbar spinal stenosis? One-year follow up of a prospective case control study of 60 patients

A number of interspinous process devices have recently been introduced to the lumbar spinal market as an alternative to conventional surgical procedures in the treatment of symptomatic lumbar stenosis. One of those “dynamic” devices is the Coflex™ device which has been already implanted worldwide more than 14,000 times. The aim of implanting this interspinous device is to unload the facet joints, restore foraminal height and provide stability in order to improve the clinical outcome of surgery. Published information is limited, and there are so far no data of comparison between the implant and traditional surgical approaches such as laminotomy. The purpose of our prospective study is to evaluate the surgical outcome of decompressive surgery in comparison to decompressive surgery and additional implantation of the Coflex™ interspinous Device. 60 patients who were all treated in the Spine Center of Klinikum Neustadt, Germany for a one or two level symptomatic LSS with decompressive surgery were included. Two groups were built. In Group one (UD) we treated 30 patients with decompression surgery alone and group two (CO) in 30 patients a Coflex™ device was additional implanted. Pre- and postoperatively disability and pain scores were measured using the Oswestry disability index (ODI), the Roland–Morris score (RMS), the visual analogue scale (VAS) and the pain-free walking distance (WD). Patients underwent postoperative assessments 3, 6 and 12 month including the above-mentioned scores as well as patient satisfaction. In both groups we could see a significant improve (p < 0.001) in the clinical outcome assessed in the ODI, in the RMS for evaluation of back pain, in the VAS and in the pain-free WD at all times of reinvestigation compared to base line. At 1-year follow up there were no statistically differences between both groups in all ascertained parameters including patient satisfaction and subjective operation decision. Because there is no current evidence of the efficacy of the Coflex™ device we need further data from randomized controlled studies for defining the indications for theses procedures. To the best of our knowledge this is the first prospective controlled study which compares surgical decompression of lumbar spinal stenosis with additional implanting of an interspinous Coflex™ device in the treatment of symptomatic LSS.     

地诺前列酮与缩宫素用于足月妊娠引产效果的临床观察

目的：探讨地诺前列酮用于足月妊娠促宫颈成熟及引产的有效性及安全性。方法：选择220例足月妊娠单胎头位、无引产禁忌的初产妇和经产妇,采用双盲对照研究的方法随机分为两组,观察组110例采用阴道后穹隆放置地诺前列酮1枚引产,对照组110例以缩宫素静滴引产,对两组宫颈成熟Bishop评分,对产程的影响,引产成功率,阴道分娩率及对胎儿和新生儿的影响进行比较。结果：观察组促宫颈成熟效果明显优于对照组（P〈0.01）;用药至临产的时间观察组显著短于对照组（P〈0.01）;观察组12h临产率为67.3%,24h临产率为87.3%,对照组12h临产率为46.4%,24h临产率为70.0%,两组比较,差异有统计学意义（P〈0.01）;观察组引产成功率高于对照组,观察组阴道分娩率为65.5%,对照阴道分娩率为51.8%,两组差异有统计学意义（P〈0.05）;对母婴的影响两组差异无统计学意义。结论：地诺前列酮用于初产妇和经产妇的促宫颈成熟及诱发宫缩作用优于缩宫素,它可以显著提高宫颈Bishop评分,从而提高阴道分娩率,促进自然分娩,临床应用简便、安全、有效,值得产科临床推广使用。     

银仙通肺宝颗粒中岩白菜素的提取工艺优选

目的:考察银仙通肺宝颗粒中岩白菜素的最佳提取工艺。方法:通过正交试验,以岩白菜素的含量为指标,考察乙醇体积分数、乙醇用量、渗漉液的流速对提取效果的影响。结果:银仙通肺宝颗粒中岩白菜素的最佳提取工艺为加60%乙醇渗漉,收集10倍量渗漉液,渗漉流速为5 mL.min-1.kg-1。结论:该提取工艺科学、合理、可行。     

凉粉草总黄酮提取工艺优化

目的:研究凉粉草中总黄酮的最佳提取工艺。方法:对凉粉草药材采用乙醇回流提取的方法,以槲皮苷为指标,利用分光光度仪测定总黄酮吸光度进行指标控制,采用L9(34)正交实验设计法筛选最佳提取工艺参数。结果:凉粉草总黄酮的最佳提取工艺为10倍量50%乙醇,回流提取2次,每次45 min。结论:本提取工艺方法简单、合理稳定,是凉粉草中总黄酮的最佳提取工艺。     

壮药解毒抗白颗粒提取工艺研究

目的:优选壮药解毒抗白颗粒最佳提取工艺研究。方法:以壮药解毒抗白颗粒主要有效成分野黄芩苷作为评价指标,采用正交试验法,优选提取工艺。结果:最佳提取工艺为:药材适度粉碎成后,先加12倍量50%乙醇浸泡0.5 h后,回流提取1.5 h,再用8倍量50%乙醇回流提取1.0 h。结论:正交设计试验优选的提取条件稳定、合理、经济。     

中药微丸在缓控释制剂中的应用

总结近几年来中药微丸分类、辅料和制备工艺方面的研究进展,并查阅近年国内外中药微丸的文献资料40余篇。从微丸的分类、制备、辅料及亟待解决的问题等方面对其分析归纳,并对中药微丸的发展前景进行了展望。结果认为中药微丸具有辅料易得、制备工艺灵活等特点,在制备中药复方制剂方面有独特优势,在缓控释制剂方面具有实用和开发价值。     

丹蛭降糖胶囊提取工艺的优选

目的优选丹蛭降糖胶囊的最佳提取工艺。方法采用直接水蒸气蒸馏法提取出牡丹皮中丹皮酚成分,再将其药渣与其他药味混合,选择三因素三水平正交试验,以出膏率、多糖、芍药苷含量为考察指标,对提取次数、提取时间、加水量进行考察。结果确定的最佳提取工艺为：加10倍量水提取3次,每次1．5h。结论此工艺可作为丹蛭降糖胶囊的提取工艺,方法简便,结果稳定。