姜黄色素-共聚维酮共研磨粉体性质及溶出度研究

目的 以姜黄色素为模型药物，考察辅料共聚维酮在共研磨过程中的应用特性及共研磨产物提高难溶性药物姜黄色素体外溶出方面的可行性。方法 采用共研磨法，在姜黄色素粉末中分别加入0%、1%、3%共聚维酮，制成不同比例的共研磨物，通过激光粒度仪及扫描电子显微镜（SEM）对其粒径形态进行考察；运用差示扫描量热法（DSC）、SEM和X射线粉末衍射法（XRPD）鉴别药物在共研磨物中的物相状态；测定姜黄色素原料药、物理混合物和共研磨物在2种溶出介质中的体外溶出度，并考察其加速稳定性。结果 与原料药相比，共聚维酮共研磨物粉末粒径减小，吸湿性和DSC无明显变化；XRPD中姜黄色素主要峰强度有所减弱，结晶度降低；共研磨物中姜黄色素的主要成分溶出度显著提高，在加速条件下放置3个月后溶出未发生变化，稳定性较好。结论 共聚维酮作为新型辅料，其与姜黄色素共研磨后得到的产物能有效改善难溶性药物姜黄色素的溶出度，且稳定性较好；为提高难溶性药物的溶解度和口服生物利用度提供了一种可行的策略。     

制何首乌的炮制方法探索

目的:考察黑豆汁炖制时间对制何首乌外观性状及各类有效成分含量变化规律的影响。方法:采用HPLC同时测定不同炮制时间制何首乌样品中二苯乙烯苷、大黄素、大黄素甲醚、大黄素-8-O-β-D-葡萄糖苷、大黄素甲醚-8-O-葡萄糖苷的含量,选择Agilent ZORBAX Extend-C_(18)色谱柱(4. 6 mm×250 mm,5μm),甲醇(A)-水(B)为流动相梯度洗脱(0～30 min,5%～100%A; 30～40 min,100%A),流速1. 0 mL·min~(-1),柱温35℃,检测波长280 nm。结果:随炖制时间的增加,二苯乙烯苷含量逐渐降低,与8 h时相比,至64 h时含量降低76%;大黄素-8-O-β-D-葡萄糖苷和大黄素甲醚-8-O-葡萄糖苷2种蒽醌苷含量先上升后下降,至24 h时达最高值,炖制40 h时降至与8 h近似的水平,之后略有波动;大黄素、大黄素甲醚2种蒽醌苷元含量先上升后下降,炖制32 h时达最大值,之后缓慢降低并趋于稳定。结论:炖制时间对制何首乌中各类成分含量的影响显著,且变化趋势不尽相同,应规范制何首乌饮片的炮制时间;同时,仅以二苯乙烯苷及蒽醌类成分作为制何首乌的指标性成分依据不够充分,应考虑增加多糖类等质量控制指标。     

医学检验实习中引入PBL教学法的应用分析

在医学检验本科实习生的临床实习中开展PBL教学的研究,探讨其教学效果。对2016-2018年的42名医学检验本科实习生在临床传统的实习教学基础上,引入PBL教学模式,探讨PBL教学核心的"以学生为中心,以问题为中心"的教学方法在临床实习应用实施。发现其能提高学生的学习积极性,增强学生对专业知识的掌握,提高学生的临床思维能力,以及扩展学生的临床知识等方面有着积极的意义,对在医学检验的临床实习中加强理论联系实践,提高学生的综合分析能力是行之有效的方法,值得推广。     

镫骨骨质缺损对听力传导影响的有限元分析

目的建立完善的鼓膜-听骨链模型,利用有限元初步探讨镫骨前、后脚骨质缺损对听力传导的影响。方法实验数据源于对一名无中耳病史的成年男性左侧颞骨进行Micro-CT扫描,在医学影像处理软件Mimics上进行三维重建,利用Geomagic形成需要的曲面,最后在SolidWorks上将成型的鼓膜-听骨链模型进行切割组装,建立正常听骨链模型以及镫骨前、后脚骨质缺损模型,利用模型分析骨质缺损对听力传导的影响。结果建立的鼓膜-听骨链模型镫骨足板频振曲线符合相关文献报道,在镫骨前、后脚骨质缺损病理模型下,曲线与正常中耳模型曲线接近。结论利用多软件综合处理,可建立可信度较高的中耳听骨链模型;有限元模拟分析结果显示,镫骨前、后脚缺损部分骨质,未对听力传导产生明显影响。     

Finite Neuron Method and Convergence Analysis

We study a family of $H^m$-conforming piecewise polynomials based on the artificial neural network, referred to as the finite neuron method (FNM), for numerical solution of $2m$-th-order partial differential equations in$\mathbb{R}^d$ for any $m,d≥1$ and then provide convergence analysis for this method. Given a general domain Ω$⊂\mathbb{R}^d$ and a partition$\mathcal{T}_h$ of Ω, it is still an open problem in general how to construct a conforming finite element subspace of $H^m$(Ω) that has adequate approximation properties. By using techniques from artificial neural networks, we construct a family of $H^m$-conforming functions consisting of piecewise polynomials of degree $k$ for any $k≥m$ and we further obtain the error estimate when they are applied to solve the elliptic boundary value problem of any order in any dimension. For example, the error estimates that $‖u−u_N‖_{H^m(\rm{Ω})}=\mathcal{O}(N^{−\frac{1}{2}−\frac{1}{d}})$ is obtained for the error between the exact solution $u$ and the finite neuron approximation $u_N$. A discussion is also provided on the difference and relationship between the finite neuron method and finite element methods (FEM). For example, for the finite neuron method, the underlying finite element grids are not given a priori and the discrete solution can be obtained by only solving a non-linear and non-convex optimization problem. Despite the many desirable theoretical properties of the finite neuron method analyzed in the paper, its practical value requires further investigation as the aforementioned underlying non-linear and non-convex optimization problem can be expensive and challenging to solve. For completeness and the convenience of the reader, some basic known results and their proofs are introduced.     

Increasing suction pressure during endotracheal suctioning increases the volume of suctioned secretions,but not procedure-related complications: A comparative study in open system endotracheal suctioning

ObjectivesTo compare the effect of three different suction pressures (80 mmHg, 150 mmHg, 250 mmHg) with the open system suction method in terms of the volume of secretions and complications development in intubated intensive care patients.Research methodology/designThis study was planned as a prospective, experimental, self-controlled design. The study sample included 47 patients. Data were collected using a data collection and patient follow-up form from patient records.SettingSingle adult intensive care unit in a university hospital.ResultsFifty five percent of the patients were male, 61.7% were older than 65 years and 38.32% had lung infection. The amount of suctioned secretions tended to increase significantly with increasing negative pressure and there was a significant difference between the pressures in terms of the median volume of suctioned secretions (p < 0.001). There was no significant difference between the suction pressures in terms of oxygen desaturation, hypertension rates (p > 0.05). Tachycardia, bradycardia, hypoxaemia, tracheal mucosal damage or mucosal bleeding were not observed during suctioning with three different suction pressures.ConclusionIt may be assumed that 250 mmHg suction pressure, via compliance with open system suction method related procedures, is being more effective and equally safe for secretion cleaning in comparison to the 80 and 150 mmHg suction pressures.     

针刀松解寰枕筋膜治疗颈源性眩晕的疗效研究

目的:研究针刀松解寰枕筋膜治疗颈源性眩晕的疗效。方法:选取2017年1月至2018年1月佛山市健翔医院收治的颈源性眩晕患者96例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组48例。对照组患者给予3次/周针灸、局部按摩治疗,观察组患者给予1次/周的针刀松解寰枕筋膜治疗,均治疗3周。依照《颈性眩晕评估量表(ESCV)》分析2组患者治疗前后颈性眩晕评分变化、椎动脉血流动力学变化,比较2组患者血清中内皮源性超极化因子(EDHF)的含量和一氧化氮(NO)水平,统计2组患者的治疗有效率、眩晕症状缓解时间及生命质量变化。结果:观察组患者治疗后总有效率为97.92%高于对照组的81.25%(P<0.05),眩晕有效缓解时间明显缩短,眩晕评分显著高于对照组(P<0.05);观察组患者治疗后椎动脉的平均血流、收缩期血流、舒张期血流速度、血清中NO及EDHF水平明显上升,血管搏动指数显著下降(P<0.05);生命质量评分显著升高(P<0.05)。结论:针刀松解寰枕筋膜能够通过改善颈源性眩晕患者的椎动脉血流动力学,有效治疗患者的颈源性眩晕。     

Insights from examination of hearts from adults dying suddenly to the understanding of congenital cardiac malformations

Congenital heart disease is a rare but important finding in adults who experience sudden death. Examination of the congenitally malformed heart has historically been considered esoteric and best left to those with expertise. The Cardiac Risk in the Young cardiovascular pathology laboratory based at St George's University of London has now received over 6,000 cases. Of these, 21 congenitally malformed hearts were retained for research and educational purposes. Hearts were assessed using sequential segmental analysis, and causes of death were adjudicated based on thorough macroscopic examination and histology. Congenital malformations that were encountered included atrial septal defects, ventricular septal defects, tetralogy of Fallot, and transposition of the great arteries in both its regular and congenitally corrected variants. Findings also included hearts with mirror-imaged and isomeric atrial appendages. Direct causes of death included myocardial fibrosis, pulmonary hypertension, and hemorrhage. A small but notable proportion did not reveal a substrate for arrhythmia, raising the question of whether the terminal event was due to the congenital heart disease itself, or an underlying channelopathy. Here, we demonstrate the value of simple sequential segmental analysis in describing and categorizing the cases, with the concept of the “morphological method” serving to identify the distinguishing features of the cardiac components. Clin. Anat. 33:394–404, 2020. © 2019 Wiley Periodicals, Inc.     

微课在胸腔外科临床教学中的应用及效果

传统的胸腔外科教学存在课堂教学课时分配有限、病种较多而课堂教学难以全面覆盖、实践教学水平参差不齐、"大教材"更新难以同步等诸多问题。空军军医大学第二附属医院胸腔外科将微课教学逐渐应用于胸外科教学工作的各个层面当中，如本科生辅助课堂教学及临床技能培训、基层及进修医生培训、研究生教育等，取得了良好的教学效果。