Intrauterine penetrating direct fetal head trauma following gunshot injury

Case report An unusual case of an intrauterine penetrating head injury due to a pellet from an airgun is described. A 28-year-old pregnant woman, at term, shot herself intravaginally with a toy BB gun. Following a spontaneous precipitous vaginal delivery, the neonate presented with persistent seizure disorder, meningitis, cerebritis, and a right parietal region scalp swelling. Imaging studies revealed intracranial hemorrhage, and the metallic pellet was adjacent to the right lateral ventricle, which was removed through a parietal craniotomy. Computed tomography of the brain after 1 week demonstrated early abscess formation in the left frontal operculum and a subdural empyema in the posterior fossa. The abscesses were evacuated, and the meningitis was treated vigorously with broad-spectrum antibiotics. Although well for the past 6 years, the child demonstrates significant mental handicap and developmental delay.Discussion The pathogenesis, management, and medicolegal issues pertaining to the above case are discussed, and the relevant literature is briefly reviewed.     

拉米夫啶联合软肝缩脾丸对肝炎患者肝纤维化及肝细胞损伤的作用

目的为探讨拉米夫啶联合软肝缩脾丸治疗对慢性乙型肝炎患者血清肝纤维化指标、B超声像图及肝脏病理组织学的影响。方法随机选择32例慢性乙型肝炎患者作为治疗组,给予口服拉米夫啶0.1g/d,并同时口服软肝缩脾丸8g/次,2次/d,疗程48周;同时设对照组,单服拉米夫啶100mg,1次/d。动态观察服药0、48周患者血清中肝纤维化指标的变化,B型超声图像变化,对其中4例患者治疗前后肝穿活检观察肝组织纤维化程度的改变。结果与对照组相比,治疗组患者血清肝纤维化指标明显下降(P<0.01),B超声像图改变(P<0.05),肝组织纤维化明显减轻。结论拉米夫啶联合软肝缩脾丸治疗慢性乙型肝炎,在抗肝纤维化、减轻肝细胞损伤方面有较佳疗效。     

四物微丸高效液相法指纹图谱的研究

目的:研究四物微丸的色谱指纹图谱测定方法。方法:以梓醇、芍药苷、阿魏酸、川芎嗪为对照品,色谱柱:Alltech Apollo C18色谱柱(250 mm×4.6 mm,5μm);流动相:乙腈-0.1%磷酸溶液(梯度洗脱);柱温:40℃;测定波长:215 nm;分析时间:100 min;流速:1 mL.min-1,研究了四物微丸HPLC指纹图谱。结果:标示出四物微丸有17个共有峰。结论:该方法准确、重复性好,为四物微丸的指纹图谱质量控制提供了依据。     

5-氨基水杨酸pH依赖-时间控制型结肠定位微丸的制备与体外释放研究

目的:制备pH依赖-时间控制型5-氨基水杨酸(5-ASA)结肠定位微丸给药系统。方法:以Eudragit NE30D为时间控释包衣内层,Eudragit S100为pH控释外层,柠檬酸三乙酯为增塑剂,采用流化床喷雾包衣技术,制备pH依赖-时间控制型微丸。采用释放度测定法考察影响药物释放的各种因素。结果:包衣增重是影响药物释放的关键因素,在模拟人体胃肠道pH变化条件下,微丸释放基本符合释放要求,显示了良好的结肠定位效果。结论:通过调整内外层包衣厚度可制备5-氨基水杨酸结肠定位给药微丸。     

左金胃漂浮缓释片中小檗碱、巴马汀、吴茱萸碱和吴茱萸次碱的体外释放规律和机制研究

目的探讨左金胃漂浮缓释片体外多成分释放的规律和机制。方法采用转篮法以人工胃液为介质,以HPLC法测定左金胃漂浮缓释片中小檗碱、巴马汀、吴茱萸碱和吴茱萸次碱在8 h内的体外累积释放率,通过相似因子比较法、Higuchi方程,零级、一级释放方程等释放模型拟合法以及Peppas方程研究左金胃漂浮缓释片多成分释放的规律。结果左金胃漂浮缓释片中4种生物碱的平均释放曲线相互之间的相似因子均大于80%,均以Higuchi释放模型为最佳拟合模型,释放机制均为扩散协同骨架溶蚀作用。结论左金胃漂浮缓释片中生物碱类成分的释放具有均衡缓释性。     

XEDS-mapping for explaining release patterns from single pellets

A common way to formulate controlled-release (CR) pharmaceuticals is to coat pellets of active substance with a polymer film, decrease the size of the pellets and distribute them as multiple-unit dosages in capsules. To increase the understanding of the release mechanism, the pellet shape and surface structure of pellets, before and after release in microtitre plates, have been studied by scanning electron microscope and X-ray energy-dispersive spectrometry. By performing these studies we associate release profiles during the first few hours to the microscopic structure. Pellets were divided into three classes (spherical pellets, dumbbell shaped pellets and twin-pellets) according to pellet form. Cases of burst release occurred for all three shape classes due to “open-window-defects” at the surface. Areas of thinner polymer film in the neck-region of dumbbell shaped pellets broaden the range of intermediate release rates for this pellet shape. The surface of twin pellets and dumbbell shaped pellets showed more defects, which increases the release rates in comparison to spherical pellets. All pellets with high release rates revealed ruptures in the polymer film, whereas only small cracks could be traced for pellets with slow release rates. The information gained is necessary for the development of future formulations and mathematical modelling of release patterns. The pharmaceutical used as model was remoxipride coated with a polymer film of ethyl cellulose and 10 wt.% triethyl citrate.     

寒湿痹片抑制大鼠滑膜增生及相关机制研究

目的:观察寒湿痹片(HSB)对灭活结核分枝杆菌(heat-killed mycobacterium tuberculosis H37Ra.Mtb)诱导SD大鼠类风湿关节炎(Adjuvant-induced rheumatoid arthritis.AA)滑膜损伤的抑制作用及对基质金属蛋白酶MMP-1,MMP-3mRNA表达影响。方法:以Mtb免疫SD大鼠,制备实验性类风湿关节炎模型。采用核酸原位杂交法检测类风湿关节炎大鼠关节滑膜组织中MMP-1、MMP-3mRNA的表达。结果:寒湿痹片对Mtb诱导SD大鼠类风湿关节炎踝关节滑膜损伤具有显著的抑制作用,并减少MMP-1、MMP-3mRNA在滑膜组织中的表达。结论:寒湿痹片抑制实验性类风湿关节炎滑膜损伤,这种作用与减少滑膜组织MMP-1,MMP-3mRNA表达相关。     

卵磷脂花粉片中总黄酮含量测定

目的 建立卵磷脂花粉片中总黄酮的含量测定方法.方法 用索氏提取法,以芦丁为对照品,以亚硝酸钠-硝酸铝-氢氧化钠为显色剂,检测波长为500nm.结果 吸收度A与芦丁的质量浓度C在0～48μg/ml范围内呈良好的线性关系,平均加样回收率为98.7%(RSD:1.41%).结论 该方法操作简单,结果准确,重现性好,为卵磷脂花粉片中有效成分的质量控制提供了一个科学方法.     

牛珀至宝微丸对内毒素休克大鼠肺组织高迁移率族蛋白B1表达的影响

目的：观察牛珀至宝微丸对内毒素休克大鼠肺组织高迁移率族蛋白B1（high-mobility group box-1 protein,HMGB1）表达的影响。 方法：30只SPF级Sprague-Dawley大鼠随机分为正常组、内毒素组和牛珀至宝微丸组。牛珀至宝微丸组大鼠每天以含生药量3mg的牛珀至宝微丸生理盐水悬液3mL灌胃,连续7d,正常组予生理盐水。模型组和牛珀至宝微丸组大鼠用静脉注射内毒素（1.5mg/kg）联合腹腔注射D-氨基半乳糖（100mg/kg）方法建立内毒素休克模型。采用二氨基联苯胺（diaminobenzidine,DAB）显色和异硫氰酸荧光素（fluorescein isothiocyanate,FITC）荧光标记的免疫组织化学染色以及蛋白印迹等方法检测大鼠肺组织内HMGB1的表达。 结果：正常组HMGB1表达较弱,仅有少量细胞呈阳性,阳性部位多在细胞核;内毒素组HMGB1表达增加,阳性部位主要在细胞质;牛珀至宝微丸组HMGB1表达更高,阳性部位主要在细胞核。 结论：牛珀至宝微丸能使HMGB1定位于细胞核内,从而可能避免被分泌出胞,产生毒性,这可能是其治疗感染性休克的作用机制之一。     

九龙丹与日本心丹治疗无痛性心肌缺血的疗效对比研究

目的：比较九龙丹和日本心丹治疗无痛性心肌缺血（ＳＭＩ）的疗效。方法：将３５例ＳＭＩ患者分为①九龙丹组（Ａ组，１８例）：口服九龙丹１粒，每日３次，连服２７日；②日本心丹组（Ｂ组，１７例）：口服日本心丹１粒，每日３次，连服２７日。治疗前后检测：①心率、血压乘积（ＲＰＰ）；②心电图ＳＴ段压低总导联数（ＮＳＴ）、心电图ＳＴ段压低总和（ΣＳＴ）；③每搏输出量（ＳＶ）、每分输出量（ＣＯ）、射血分数（ＥＦ）；④血浆载脂蛋白（ａｐｏＡ１、ａｐｏＢ）；⑤全血粘度（ηｂ）、血浆粘度（ηｐ）、纤维蛋白原（Ｆｉ）。结果：２组患者治疗后ＮＳＴ、ΣＳＴ、ＲＰＰ均降低（Ｐ＜０．０５或Ｐ＜０．０１），ＳＶ、ＣＯ、ＥＦ均升高（Ｐ＜０．０５或Ｐ＜０．０１），其中Ａ组ΣＳＴ、ＲＰＰ降低和ＳＶ、ＥＦ升高均较Ｂ组明显（Ｐ均＜０．０５）；２组患者ａｐｏＡ１、ａｐｏＡ１／ａｐｏＢ升高（Ｐ均＜０．０５），ａｐｏＢ、ηｂ、ηｐ和Ｆｉ均显著降低（Ｐ＜０．０５或Ｐ＜０．０１），其中Ａ组ηｐ较Ｂ组明显降低（Ｐ＜０．０５）。结论：口服九龙丹治疗ＳＭＩ在改善心肌血供，缓解心肌缺血和降低心肌耗氧方面具有较好的疗效。