高血压脑出血微创穿刺手术时机对临床预后的影响研究

目的探讨脑出血微创血肿穿刺术治疗的手术时机对临床预后的影响。方法选取157例典型高血压脑出血患者,均行微创钻颅血肿清除术,按手术实施时间分为三组:A组(6h内手术者)53例;B组(7～24h内手术者)60例;C组(>24h手术者)44例。比较三组患者术后1个月的意识恢复、神经功能缺失及死亡情况。结果 A、B两组患者意识恢复良好者多于C组(P<0.05);在患者神经功能缺失评价中,A组患功能缺失低于B、C组(P<0.05),B组低于C组(P<0.05);三组患者死亡事件发生率无显著差异。结论有手术适应证的脑出血患者,在6h内行超早期颅内血肿钻孔抽吸引流术对患者的预后有重要意义。     

临床药代动力学和药效动力学研究中的采样优化方法

采样优化方法在临床药代动力学和药效动力学研究中受到广泛关注.本文综述了D优化法、多元线性回归法、基于最大后验贝叶斯估算法(MAPB)的有限采样法等的原理、步骤及优缺点,并总结了各方法在采样优化估算中每一步骤的特点.本文也列举了重要的应用实例,介绍了可实现其估算分析的统计软件.     

Assessment of the optimal temporal window for intravenous CT cholangiography

The optimal temporal window of intravenous (IV) computed tomography (CT) cholangiography was prospectively determined. Fifteen volunteers (eight women, seven men; mean age, 38 years) underwent dynamic CT cholangiography. Two unenhanced images were acquired at the porta hepatis. Starting 5 min after initiation of IV contrast infusion (20 ml iodipamide meglumine 52%), 15 pairs of images at 5-min intervals were obtained. Attenuation of the extrahepatic bile duct (EBD) and the liver parenchyma was measured. Two readers graded visualization of the higher-order biliary branches. The first biliary opacification in the EBD occurred between 15 and 25 min (mean, 22.3 min ± 3.2) after initiation of the contrast agent. Biliary attenuation plateaued between the 35- and the 75-min time points. Maximum hepatic parenchymal enhancement was 18.5 HU ± 2.7. Twelve subjects demonstrated poor or non-visualization of higher-order biliary branches; three showed good or excellent visualization. Body weight and both biliary attenuation and visualization of the higher-order biliary branches correlated significantly (P<0.05). For peak enhancement of the biliary tree, CT cholangiography should be performed no earlier than 35 min after initiation of IV infusion. For a fixed contrast dose, superior visualization of the biliary system is achieved in subjects with lower body weight.     

The intrinsic value of visual information affects saccade velocities

Let us assume that the purpose of any movement is to position our body in a more advantageous or rewarding state. For example, we might make a saccade to foveate an image because our brain assigns an intrinsic value to the information that it expects to acquire at the endpoint of that saccade. Different images might have different intrinsic values. Optimal control theory predicts that the intrinsic value that the brain assigns to targets of saccades should be reflected in the trajectory of the saccade. That is, in anticipation of foveating a highly valued image, our brain should produce a saccade with a higher velocity and shorter duration. Here, we considered four types of images: faces, objects, inverted faces, and meaningless visual noise. Indeed, we found that reflexive saccades that were made to a laser light in anticipation of viewing an image of a face had the highest velocities and shortest durations. The intrinsic value of visual information appears to have a small but significant influence on the motor commands that guide saccades.     

卵巢癌辅助化疗的研究进展

目前卵巢癌的标准治疗方案是以手术为主,同时辅以术后化疗,手术的目的是尽可能切除肿瘤灶实现满意肿瘤细胞减灭术.当患者出现明显症状时,疾病大多已处于晚期,多数患者无法实行满意肿瘤细胞减灭术;辅助化疗结合间隔手术作为晚期卵巢癌患者的替代治疗方案具有较好的应用前景.本文综述了卵巢癌辅助化疗的研究进展.     

注射用丹参无菌粉末冷冻干燥工艺研究

目的:优化注射用丹参无菌粉末的冷冻干燥工艺,缩短冻干时间。方法:采用单因素试验,对降温方式、药液装量、浓度、预冻时间、压力、升华干燥温度、升华干燥时间、解析干燥温度等参数进行优化,确定最佳冷冻干燥工艺参数。结果:选择浓度为100mg.mL-1,装量为3.480mL,采用阶段性降温方式,预冻时间为120min,压力为5Pa,解析干燥温度为35℃,冷冻干燥总时间为36h。结论:最优参数下产品性状良好,冷冻干燥时间约缩短15h。     

罗哌卡因用于腰椎间盘摘除、腰椎管减压术最佳浓度探讨

目的探讨一种镇痛、肌松效果好,不良反应少,适用于腰椎间盘摘除、腰椎管减压术,椎管内麻醉用药的最佳浓度。方法选择腰椎间盘突出、腰椎管狭窄患者60例,ASA Ⅰ～Ⅱ级,随机分成3组,每组20例,均选择硬膜外麻醉。A组:硬膜外用0.4%罗哌卡因;B组:硬膜外用0.5%罗哌卡因;C组:硬膜外用0.75%罗哌卡因。对麻醉效果欠佳者,静脉滴注芬太尼0.05mg。结果A组患者镇痛效果欠佳,应用芬太尼例数较多;B组患者镇痛效果好,肌松效果满意,不良反应少;C组患者镇痛、肌松效果较强,不良反应多。结论B组药物浓度是腰椎间盘摘除、腰椎管减压术最佳浓度。     

头孢唑肟钠制备条件最优化研究

本文就头孢唑肟钠生产过程中影响其产品质量和收率的各种因素进行了单因素实验和正交实验,旨在获得生产头孢唑肟钠的最佳工艺条件。结果表明:生产头孢唑肟钠的最佳条件为反应温度低于30℃,无水碳酸钠:头孢唑肟酸(质量比)=0.15∶1.0,反应时间2h,结晶前控制pH值为6.7,乙醇:头孢唑肟酸=30ml∶1.0g,乙醇滴加速度450     

卵巢癌初始治疗中手术相关若干问题及临床意义

卵巢癌的初始治疗是影响患者预后的最重要因素.早期卵巢癌要进行全面的开腹分期手术,如初次手术未做到全面分期,应在化疗开始前进行再分期手术.晚期卵巢癌要争取在高级别的妇科肿瘤中心进行初次的满意的肿瘤细胞减灭术,特别要重视上腹部手术,力争做到无肉眼残留病灶.新辅助化疗和间歇性肿瘤细胞减灭术可以选择性地应用于部分晚期不适合直接...