中药内服外用治疗小儿疱疹性咽峡炎58例临床观察

目的观察银花解毒口服液口服联合开喉剑口腔喷雾剂外喷治疗小儿疱疹性咽峡炎的临床疗效。方法选取2017年7月至2018年7月襄阳市中医医院儿科确诊的疱疹性咽峡炎患儿98例,按照随机数字表法分为治疗组58例和对照组40例。在对症、支持治疗的基础上,对照组予阿糖腺苷静脉滴注,治疗组予银花解毒口服液口服联合开喉剑喷雾剂外喷,连续治疗5 d后,比较2组的中医证候总评分、总有效率及临床症状消失时间。结果对照组总有效率为77.5%(31/40),治疗组为96.6%(56/58),2组比较,差异有统计学意义(P<0.05)。治疗前,2组中医证候总积分比较,差异无统计学意义(P>0.05),具有可比性。治疗后,2组中医证候总积分均明显下降,与同组治疗前比较,差异有统计学意义(P<0.05),且治疗组下降更显著(P<0.05)。治疗组热退、疱疹消失时间均明显短于对照组,差异有统计学意义(P<0.05)。结论银花解毒口服液口服联合开喉剑口腔喷雾剂外喷治疗小儿疱疹性咽峡炎,能有效减轻患儿临床症状,缩短病程,疗效显著,值得临床推广应用。     

壳聚糖抗菌成膜喷剂预防老年病人牵引床复位手术相关性皮肤损伤的效果观察

目的:探讨壳聚糖抗菌成膜喷剂在老年股骨粗隆间骨折行牵引床复位手术所致皮肤压力性损伤预防中的应用效果。方法:选取2018年12月—2019年12月丹阳市人民医院创伤骨科收治的60例择期行牵引床下股骨粗隆间骨折闭合复位防旋股骨近端髓内钉(PFNA)内固定术病人,按照随机数字表法将其分为试验组与对照组,各30例。试验组病人在大腿内侧上1/3及会阴部喷壳聚糖抗菌成膜喷剂后会阴柱包棉垫,对照组病人会阴柱包裹棉垫,对比两组病人术后即刻、30 min、2 h、24 h、72 h会阴部受压部位皮肤情况及两组病人舒适度。结果:试验组皮肤保护效果及舒达度优于对照组,差异均有统计学意义(P<0.05)。结论:在老年股骨粗隆间骨折行牵引床复位手术会阴部使用壳聚糖抗菌成膜喷剂可预防或减少皮肤压力性损伤的发生,提高病人舒适度。     

The pathology of lethal exposure to the Riot Control Agents: Towards a forensics-based methodology for determining misuse

The aim of this is to review deaths associated with the use of Riot Control Agents (RCAs) and to assess how the presenting pathologies is such cases may better inform cause of death conclusions upon autopsy. We also sought to present which additional steps should be added to the Minnesota protocol and the European harmonization of medico-legal autopsy rules in suspected cases of deaths associated with the use of RCAs.We included 10 lethal cases in our study. In three cases, RCAs were found to be the sole cause of death, in three cases RCAs were ruled a secondary cause of death due asphyxia or asthma subsequent to exposure to RCAs and in four cases RCAs were contributory factors to death. In three cases the responsible agents were identified as Chloroacetophenone (CN), Chlorobenzylidene malononitrile (CS) and Oleoresin capsicum (OC) and in the remaining 7 cases, the agent was OC alone.As there are no specific findings in suspected cases of death associated with RCA use, establishing cause of death and whether RCAs are the sole cause or only a contributory factor will be based on the elimination of other possible causes of death. For this reason, a specifically structured autopsy is essential. This specifically structured autopsy should contain basic principles of the Minnesota Protocol and the European harmonization of medico-legal autopsy rules with the following additional steps taken: examination of clothing, eyes, and skin; examination of pharyngeal, tracheobronchial, and eusophegeal mucosas; and a thorough recording of the steps taken by the party conducting the arrest, including other possible causes of in-custody death, as well as a detailed medical history of the deceased.     

两种方式注射治疗非静脉曲张性上消化道大出血的疗效研究

目的探讨胃镜下去甲肾上腺素药物喷洒与肾上腺素注射治疗非静脉曲张性上消化道大出血的疗效。方法 160例符合纳入标准的非静脉曲张性上消化道大出血患者按治疗方案分为药物喷洒组(80例)和药物注射组(80例)。所有患者均给予上消化道大出血的常规治疗。药物喷洒组患者在胃镜下给予去甲肾上腺素喷洒治疗,而药物注射组在胃镜下给予肾上腺素注射治疗。观察两组患者治疗疗效、止血时间、再出血率及不良反应发生情况。结果药物注射组的治疗总有效率为95.0%,明显高于药物喷洒组的80.0%(P0.05)。与药物喷洒组相比,药物注射组的止血时间明显缩短,再出血率明显降低(均P0.05)。治疗过程中,两组均未发生严重不良反应,其不良反应发生率在两组间比较差异无统计学意义(P0.05)。结论胃镜下肾上腺素注射是非静脉曲张性上消化道大出血的有效治疗方案,可以提高治疗有效率,缩短止血时间,且不良反应轻,疗效优于去甲肾上腺素喷洒治疗,临床上值得进一步研究。     

婴儿面罩在超高龄气管切开脱机患者雾化中的效果观察

目的：探讨超高龄气管切开患者脱机期间雾化吸入的最佳方案。方法选择我科60例超高龄气管切开患者,脱机期间分为两组,试验组采用婴儿面罩雾化器,调氧流量6~8L/min,取面罩盖于气切口,调绑带松紧度并固定于患者颈部给予雾化吸入;对照组采用口含式雾化器。调氧流量6~8L/min给予雾化吸入。结果试验组用婴儿面罩雾化,湿化效果明显优于直接将雾化器连接在气管切开处,雾化不良反应明显减少,未发生药液倾倒。同时减轻护理工作量,提高患者满意度,差异有统计学意义(P<0．05)。结论应用婴儿面罩进行雾化治疗,能充分发挥湿化效果,减少患者对冷雾化气体的刺激反应,效果满意,值得推广。     

A Pathway toward a New Era of Open-Cell Polyurethane Foams—Influence of Bio-Polyols Derived from Used Cooking Oil on Foams Properties

In order to create greener polyurethane (PUR) foams, modified used cooking oils (UCO) were applied as starting resources for the synthesis of bio-polyols. The bio-polyols were produced using transesterification of UCO with diethylene glycol (UCO_DEG) and triethanolamine (UCO_TEA). Next, open-cell PUR foams were synthesized by replacing 20, 40, 60, 80 and 100% of the petrochemical polyol with the bio-polyol UCO_DEG or UCO_TEA. It was observed that an increasing bio-polyol content (up to 60%) led to an increase of the closed cell content. However, a further increase in the bio-polyol content up to 100% resulted in foam cell opening. The bio-foams obtained in the experiment had an apparent density of 13–18 kg/m³. The coefficient of thermal conductivity was determined at three different average temperatures: 10, 0 and −10 °C. The PUR bio-foams modified with bio-polyol UCO_TEA had lower values of thermal conductivity, regardless of the average temperature (35.99–39.57 mW/m·K) than the foams modified with bio-polyol UCO_DEG (36.95–43.78 mW/m·K). The compressive strength of most of the bio-foams was characterized by a higher value than the compressive strength of the reference material (without bio-polyol). Finally, it was observed that the bio-materials exhibited dimensional stability at 70 °C.     

Development and Characterization of “Green Open-Cell Polyurethane Foams” with Reduced Flammability

This work presents the cell structure and selected properties of polyurethane (PUR) foams, based on two types of hydroxylated used cooking oil and additionally modified with three different flame retardants. Bio-polyols from municipal waste oil with different chemical structures were obtained by transesterification with triethanolamine (UCO_TEA) and diethylene glycol (UCO_DEG). Next, these bio-polyols were used to prepare open-cell polyurethane foams of very low apparent densities for thermal insulation applications. In order to obtain foams with reduced flammability, the PUR systems were modified with different amounts (10–30 parts per hundred polyol by weight—php) of flame retardants: TCPP (tris(1-chloro-2-propyl)phosphate), TEP (triethyl phosphate), and DMPP (dimethyl propylphosphonate). The flame retardants caused a decrease of the PUR formulations reactivity. The apparent densities of all the foams were comparable in the range 12–15 kg/m³. The lowest coefficients of thermal conductivity were measured for the open-cell PUR foams modified with DMPP. The lowest values of heat release rate were found for the foams based on the UCO_TEA and UCO_DEG bio-polyols that were modified with 30 php of DMPP.     

Overcoming Poor Tabletability of Bulky Absorption Enhancers by Spray Drying Technology

Absorption enhancers are often a major component of solid oral peptide formulations as compared to the active pharmaceutical ingredient and excipients. This commonly results in poor tabletability that is hard to mitigate in direct compaction by addition of small amounts of excipients. To improve the tabletability of bulky absorption enhancers, the model absorption enhancers, sodium cholate and deoxycholic acid, were co–spray-dried with hydroxypropyl methylcellulose E5, where the percentage of absorption enhancers was not lower than 90% (w/w). The physicochemical properties of the resulting powders were assessed by laser diffraction, scanning electron microscopy, X-ray powder diffraction, thermogravimetric analysis, and differential scanning calorimetry. The powders were compressed into tablets, and the tabletability was evaluated. Co–spray drying with 10% of hydroxypropyl methylcellulose significantly improved the tabletability of the both absorption enhancers. Moreover, it was demonstrated that small particle size and amorphous state rather than high moisture content contributed to the improved tabletability of the spray-dried powders. The study suggests that spray drying technology can be promising to overcome the poor tabletability of oral peptide formulation consisting of large amounts of absorption enhancers.     

着色氧化锆材料喷雾造粒浆料的制备

目的：研究氧化锆材料浆料流变特性,浆料中固含量、聚乙烯醇（PVA）含量和球磨时问对氧化锆喷雾造粒浆料的影响。方法：选取浆料固含量（30wt％、40wt％、50wt％）,PVA加入量（1wt％、2wt％、3wt％）,球磨时间（8h、16h、24h）作为氧化锆材料制备浆料的生产条件,以浆料的平均粘度和沉降度为评价指标。采用三因素三水平正交实验设计,优选出制备氧化锆浆料的最佳工艺组合。结果：优选出的最佳工艺组合结果为浆料固含量为50wt％,PVA加入量为3wt％,球磨时间为24h。结论：通过最佳工艺得到了高固含量、低粘度、稳定性好、着色剂分散均匀的氧化锆喷雾造粒浆料。     

Evaluation of Spironolactone Solid Dispersions Prepared by Co-Spray Drying With Soluplus® and Polyvinylpyrrolidone and Influence of Tableting on Drug Release

Solid dispersions of spironolactone with Soluplus^® and polyvinylpyrrolidone were prepared by spray drying according to a mixture experimental design and evaluated for moisture content, particle size, drug solubility, crystallinity (powder X-ray diffraction and differential scanning calorimetry), and physicochemical interactions (Fourier-transform infrared spectroscopy, Raman). In vitro dissolution was evaluated for the spray dried product itself and after compression into tablets, and prediction models were derived using multiple linear regression analysis. The spray dried products consisted of amorphous drug, indicated by the absence of crystalline powder X-ray diffraction peaks. Amorphization and interactions impacted changes in the Fourier-transform infrared spectroscopy spectra in the ranges 2900-3000 cm^?1 (C-H) and 1600-1800 cm^?1 (C=O) and caused merging at 1690 cm^?1 (C=O of lactone) and 1670 cm^?1 (C=O of thioacetyl group). In the Raman spectra, amorphization and interactions resulted in disappearance of peak at 1690 cm^?1 (C=O) and merging of peaks at 582 and 600 cm^?1 (C-S). Hydrogen bonding between the thioacetyl group of the drug with the hydroxyl groups of Soluplus^® caused marked suppression of the peak at 1190 cm^?1 (R-C(=O)-S vibration). Amorphization and interactions resulted in improved solubility and dissolution which was greatest for drug/Soluplus^® ratio 1:4 and was also demonstrated in the corresponding tablets.