星点设计–效应面法优化川芎提取工艺

目的 采用星点设计效应面法优化川芎中阿魏酸和藁本内酯的提取工艺。方法 以川芎药材中阿魏酸、藁本内酯的质量分数为考察指标,考察乙醇体积分数、提取温度以及提取时间对提取工艺的影响,对结果进行二项式拟合,用效应面法选择较佳工艺条件,并进行预测分析。结果 确定较优提取工艺为83 ℃下,14倍量73%乙醇提取2次,每次2 h,含量实际值与预测值偏差为?1.37%。结论 星点设计效应面法优化川芎提取工艺,方法简便,结果可靠,预测性良好。     

Healing of Post-Extraction Sockets Filled with Anorganic Bovine Bone and Covered with a Xenogeneic Collagen Matrix. Radiological 2D and 3D Results of a Pilot Study to Assess Dimensional Stability

Analysis of short-term results regarding dimensional stability of post-extraction sockets managed via a preservation protocol using deproteinized bovine bone matrix and a xenogeneic collagen matrix. Materials and methods Fifteen patients needing extraction of one single-rooted premolar tooth were treated in a pilot study. Five patients were treated in each centre. After tooth extraction, sockets were filled with anorganic bovine bone matrix and covered with a xenogeneic collagen matrix. Six months later, implants were placed. Dimensional changes in the treated sites were digitally evaluated using the best-fit superimposition of pre-and post-socket preservation models. Results After six months of healing, the vertical reduction of the grafted sites was 0.31 ± 0.24 mm (p < 0.001). Volumetric analysis of superimposed models showed an average palatal-lingual contraction of 0.33 ± 0.51 mm³ (p = 0.02). At the vestibular level, the average contraction was found to be 0.8 ± 0.3 mm³ (p < 0.001). Finally, the analysis of linear variations in the treated sites on a single sagittal section at the crystal level, and at 3 and 7 mm apically respect to the crest, both towards the vestibule and palate, generally showed more marked resorption at the crestal level compared to apical measurements. Conclusion: The clinical protocol herein employed for socket preservation showed a positive effect in preventing the physiological post-extraction remodeling.     

Surgical septal myectomy outcome for obstructive hypertrophic cardiomyopathy after alcohol septal ablation

BackgroundAlthough surgical treatment of residual obstruction after alcohol septal ablation (ASA) is often challenging in patients with obstructive hypertrophic cardiomyopathy (OHCM) there are very few relevant clinical reports. Thus, outcomes of surgical septal myectomy (SSM) in this subgroup of patients remain to be determined. Therefore, this study aimed to determine the surgical and follow-up outcomes in patients with OHCM exhibiting residual obstruction after ASA.MethodsWe collected case data for 62 patients with OHCM and residual obstruction after ASA who underwent SSM at Fuwai Hospital between January 2002 and June 2019. Propensity score matching with patients having had a myectomy as the only invasive procedure—was conducted in a 1:2 ratio. Echocardiography parameters, surgery results, and follow-up outcomes were compared between the groups.ResultsThe prior ASA group had a higher incidence of complete atrioventricular block (AVB) and subsequently postoperative permanent pacemaker (PPM) implantation than the primary myectomy group (9.7% vs. 1.6%, P=0.01). Two patients died within 30 days after surgery in the prior ASA group, and one patient died in the primary myectomy group, with an operative mortality rate of 3.2% and 0.8%, respectively (P=0.2). The 5-year event-free survival rate was 86.0% in the prior ASA group (median follow-up period: 3.2 years; mean: 3.9±2.6 years; maximum, 10.6 years) and 88.5% in the primary myectomy group (median follow-up period: 2.4 years; mean 2.8±1.7 years; maximum, 9.1 years) (P=0.2). During follow-up, four of 62 (6.5%) patients in the prior ASA group and one of 124 (0.8%) patients in the primary myectomy group progressed to advanced heart failure (P=0.025).ConclusionsPatients with OHCM following ASA are at an increased risk of developing AVB after SSM. Their surgical outcomes, and long-term survival rate were satisfactory and, osimilar to those for patients having had a myectomy as the only invasive procedure. In addition, they had an increased risk of advanced heart failure after SSM in the present study.     

腹腔镜结直肠癌NOSES术中左结肠动脉的外科解剖与保留技巧

目的观察腹腔镜结直肠癌经自然腔道取标本手术（NOSES）中左结肠动脉（LCA）的外科解剖,探讨保留LCA的手术技巧及临床疗效。 方法回顾性分析2017年1月至2021年12月于四川省肿瘤医院施行腹腔镜下保留LCA的结直肠癌NOSES手术85例患者的临床资料,其中54例术中对LCA的外科解剖进行了观察与记录,结合手术录像分析LCA的外科走行与解剖分型,探讨保留LCA的操作技巧和临床效果。 结果所有病例LCA均从肠系膜下动脉（IMA）左侧发出,LCA发出处至IMA根部的平均距离为（3.5±1.1）cm;75.9%（41/54）病例LCA向外走行时自肠系膜下静脉（IMV）前方与其相交,24.1%（13/54）自IMV后方与其相交;LCA自IMA单独发出者（Ⅰ型）23例（42.6%）,LCA与乙状结肠动脉（SA）两支共干者（Ⅱ型）9例（16.7%）,LCA与SA、直肠上动脉（SRA）三支共干者（Ⅲ型）19例（35.2%）,LCA、SRA与两支或两支以上SA多支共干者（Ⅳ型）3例（5.6%）,本组未见LCA缺如病例。85例患者均顺利完成手术,其中2例（2.4%）术后出现了吻合口漏,1例经保守治疗痊愈,1例进行了回肠造瘘手术;无围手术期死亡病例;术后平均住院时间（10.4±3.4）d。 结论LCA的外科走行多样,解剖变异复杂;腹腔镜下保留LCA需要较高的手术技巧、精细解剖、耐心操作。腹腔镜结直肠癌术中保留LCA操作与NOSES技术相结合,有望将损伤控制、功能保护、微创治疗的外科理念发挥到极致。     

三孔法腹腔镜结直肠癌NOSES术

目的探讨三孔法腹腔镜结直肠癌经自然腔道取标本手术（NOSES）的临床可行性。 方法回顾分析中山大学附属第一医院本医疗组2021年10月至2021年12月采用单人三孔腹腔镜乙状结肠癌或高位直肠癌根治术（NOSES术）的8例患者临床资料,分析手术时间、术中出血量、术后排气时间、术中淋巴结清扫数量、术后并发症、住院时间等情况。 结果8例患者均顺利完成手术,平均手术时间（170.3±38.6）分钟,平均术中出血量（43.8±11.9）mL,平均术后排气时间（42.0±24.9）小时,平均淋巴结清扫数量（13.6±9.5）颗,平均住院时间（13.4±3.9）天,术后无并发症发生。 结论由1名外科医生和1名扶镜手实施的三孔腹腔镜手术似乎是治疗结直肠癌患者的一种可行且安全的手术选择,能达到相同的根治效果,并发症并未增多。     

Analysis of dextromethorphan and dextrorphan in decomposed skeletal tissues by microwave assisted extraction,microplate solid‐phase extraction and gas chromatography‐ mass spectrometry (MAE‐MPSPE‐GCMS)

Analysis of decomposed skeletal tissues for dextromethorphan (DXM) and dextrorphan (DXT) using microwave assisted extraction (MAE), microplate solid‐phase extraction (MPSPE) and gas chromatography‐mass spectrometry (GC‐MS) is described. Rats (n = 3) received 100 mg/kg DXM (i.p.) and were euthanized by CO₂ asphyxiation roughly 20 min post‐dose. Remains decomposed to skeleton outdoors and vertebral bones were recovered, cleaned, and pulverized. Pulverized bone underwent MAE using methanol as an extraction solvent in a closed microwave system, followed by MPSPE and GC‐MS. Analyte stability under MAE conditions was assessed and found to be stable for at least 60 min irradiation time. The majority (>90%) of each analyte was recovered after 15 min. The MPSPE‐GCMS method was fit to a quadratic response (R² > 0.99), over the concentration range 10?10 000 ng?mL^‐1, with coefficients of variation <20% in triplicate analysis. The MPSPE‐GCMS method displayed a limit of detection of 10 ng?mL^‐1 for both analytes. Following MAE for 60 min (80 °C, 1200 W), MPSPE‐GCMS analysis of vertebral bone of DXM‐exposed rats detected both analytes in all samples (DXM: 0.9‐1.5 µg?g^‐1; DXT: 0.5‐1.8 µg?g^‐1). Copyright © 2014 John Wiley & Sons, Ltd.     

复方槐花颗粒中槐花和侧柏叶总黄酮提取工艺的优化

目的 优选复方槐花颗粒中槐花和侧柏叶总黄酮最佳提取工艺。方法 采用超声浸提法对复方槐花颗粒中槐花和侧柏叶总黄酮进行提取,以乙醇体积分数、超声功率、超声时间和料液比为考察因素,通过单因素试验和正交优选,确定较优提取工艺,并与常规的热回流提取法进行比较研究。结果 超声浸提法最佳提取工艺条件为：用60%乙醇,在料液比1:10和超声功率40kHz条件下超声波辅助连续提取2次,每次15min,槐花和侧柏叶总黄酮提取率可达93.31%。结论 该工艺研究为复方槐花颗粒中槐花和侧柏叶总黄酮共提提供一种新方法和思路,具有耗时短、能耗低、溶剂用量少和提取效率高等优势。     

Biological Safety Evaluation and Surface Modification of Biocompatible Ti–15Zr–4Nb Alloy

We performed biological safety evaluation tests of three Ti–Zr alloys under accelerated extraction condition. We also conducted histopathological analysis of long-term implantation of pure V, Al, Ni, Zr, Nb, and Ta metals as well as Ni–Ti and high-V-containing Ti–15V–3Al–3Sn alloys in rats. The effect of the dental implant (screw) shape on morphometrical parameters was investigated using rabbits. Moreover, we examined the maximum pullout properties of grit-blasted Ti–Zr alloys after their implantation in rabbits. The biological safety evaluation tests of three Ti–Zr alloys (Ti–15Zr–4Nb, Ti–15Zr–4Nb–1Ta, and Ti–15Zr–4Nb–4Ta) showed no adverse (negative) effects of either normal or accelerated extraction. No bone was formed around the pure V and Ni implants. The Al, Zr, Nb, and Ni–Ti implants were surrounded by new bone. The new bone formed around Ti–Ni and high-V-containing Ti alloys tended to be thinner than that formed around Ti–Zr and Ti–6Al–4V alloys. The rate of bone formation on the threaded portion in the Ti–15Zr–4Nb–4Ta dental implant was the same as that on a smooth surface. The maximum pullout loads of the grit- and shot-blasted Ti–Zr alloys increased linearly with implantation period in rabbits. The pullout load of grit-blasted Ti–Zr alloy rods was higher than that of shot-blasted ones. The surface roughness (Ra) and area ratio of residual Al₂O₃ particles of the Ti–15Zr–4Nb alloy surface grit-blasted with Al₂O₃ particles were the same as those of the grit-blasted Alloclassic stem surface. It was clarified that the grit-blasted Ti–15Zr–4Nb alloy could be used for artificial hip joint stems.     

关于中药复方制剂醇沉含醇量的调研

对22个已上市中药大生产中醇沉上清液的实际含醇量情况进行了调研。调研结果显示,中药醇沉的实际含醇量普遍高于质量标准规定的目标含醇量。同品种不同批次之间的醇沉含醇量也存在一定差异。实际醇沉含醇量与目标含醇量之差可能与具体品种、企业醇沉加醇量的确定方法及具体操作等有关。对调研结果进行了分析并提出建议:(1)对中药质量标准"制法"项下规定的醇沉目标含醇量的含义进行明确解释,统一认识;(2)应明确中药新药醇沉加醇量的确定方法及在线控制指标;(3)在工艺验证时用药典法测定醇沉上清液的实际含醇量,确认按确定的方法生产能否使醇沉实际含醇量达到预期目标;(4)中药新药的醇沉工艺应进行系统研究,并在"生产现场检查生产工艺"中明确醇沉加醇量的确定方法等。