创伤后重型急性弥漫性脑肿胀临床治疗策略

目的 探讨重型创伤后急性弥漫性脑肿胀（PADBS）患者保守治疗与手术治疗的疗效。方法 分析 2016年1月—2019年12月该院神经外科收治的44例重型PADBS患者，根据治疗方式分为手术组和保守治疗组，统计入院时格拉斯哥昏迷量表（GCS）评分、头颅CT检查情况、伤后6个月格拉斯哥预后量表（GOS）评分等资料。结果 两组患者入院时年龄、性别及GCS评分比较，差异无统计学意义（P>0.05）。两组患者伤后6个月时GOS评分比较，差异无统计学意义（P>0.05），但两组住院时间比较，差异有统计学意义（P<0.05），手术组长于保守治疗组。结论 重型PADBS在无瞳孔变化及GCS评分下降的情况下，可密切观察病情下选择保守治疗。     

High-Pressure Water Swelling Sealant Injection Injury to the Hand: a Case Report and Review of the Literature

High-pressure injection injuries (HPII) caused by water swelling sealant are rare at present. The patient generally has small-sized skin lesions, and the misleadingly benign presentation may cause delayed treatment at the early stage of management. In addition, radiographic examination may be underestimated. Subsequently, the inadequate surgical intervention may cause tissue necrosis and poor prognosis. Furthermore, the early recognition of water swelling sealant injected into tissue and emergent surgical intervention are the key to successful management for the patient with HPII caused by injecting water swelling sealant to tissue.     

活血利水法在骨伤科疾病中的应用

基于骨伤疾病瘀血内阻的重要病机和现代医家"治血重治水"的学术观点,探索概括了活血利水法在骨伤疾病中的应用现状,结合现代医学的认识,全方位分析了活血利水法的优势和缺点。活血利水法可应用于骨折、筋伤等骨伤科大部分疾病及骨伤科疾病的围手术期,能改善肢体肿胀,促进伤口愈合,便于患者早期功能康复,但目前的临床应用尚缺乏统一的规范和标准,且处方不良反应尚未完全阐明。     

新癀片用于口腔种植牙术后肿胀疼痛中的治疗效果观察

目的：探析口腔种植牙术后肿胀疼痛采取新癀片进行治疗的效果及对炎性因子的影响。方法：选取2015年1月至2019年12月北京中医药大学东直门医院收治的口腔种植牙术后肿胀疼痛患者300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150例，对照组采用红霉素治疗，观察组采用新癀片联合红霉素治疗，比较2组患者术后肿胀和术后疼痛持续时间、牙槽骨吸收量、种植牙功能、种植体唇侧骨厚度、周围边缘骨吸收量、炎性反应因子水平、治疗优良率等指标。结果：与对照组比较，观察组术后肿胀持续时间、术后疼痛持续时间明显较短（P<0.05）；观察组种植牙功能评分等明显高于对照组（P<0.05）；观察组种植体唇侧骨厚度、周围边缘骨吸收量与对照组比较有明显差别（P<0.05）；观察组CPR、IL-6、PCT等炎性反应因子水平明显较低（P<0.05）；观察组治疗总有效率明显高于对照组（P<0.05）。结论：口腔种植牙术后肿胀疼痛应用新癀片进行治疗，能获得较为理想的效果，改善炎性反应因子水平，有着极大的推广价值。     

重型颅脑损伤的手术治疗

目的探讨重型颅脑损伤梯度减压的手术方法对预防术中脑膨出、降低死亡率及致残率的效果。方法对100例重型颅脑损伤患者采用分次减压手术方式及去骨瓣后，硬膜与颞肌筋膜瓣减张缝闭硬膜切口方法。结果40例脑肿胀患者术中脑嘭出6例占15．0％，死亡19例占47．5％；60例脑内血肿病人未发生脑膨出，死亡12例占20％。结论脑外伤后脑血管调节麻痹及血肿压迫继发脑水肿易造成脑膨出.术中分次减压降低了骨窗部位脑组织的顺应性，从而降低了局部的压力梯度，避免脑血管急性扩张，能有效防止脑膨出，降低死亡率及致残率。     

软胶囊崩解迟缓现象影响因素研究

目的：研究储存条件以及软胶囊处方对明胶胶片稳定性的影响，探讨软胶囊崩解迟缓的原因。方法：制备明胶胶片模拟软胶囊囊壳，采用溶胀动力学法测定明胶胶片平衡溶胀量(Seq)，同时测定软胶囊内容物溶媒PEG400中甲醛含量。以上述结果为指标，考察不同储存条件与胶囊处方对明胶胶片交联程度的影响。结果：空白明胶胶片在40℃条件下Seq与对照组具有极显著性差异，PEG400中甲醛含量增加。含有甘油、山梨醇、二氧化钛等辅料的胶片浸泡在PEG400中后Seq与对照组具有极显著性差异，PEG400中甲醛含量量著增加。加速条件下含有抗氧剂的胶片Seq与PEG400中甲醛含量变化不大。结论：在考察的储存条件中，温度对软胶囊稳定性影响较大。含有一些常用辅料的明胶胶片易受PEG400中外源性醛类杂质的影响，Seq降低。低沮保存、纯化辅料以及添加抗氧剂有助于缓解软胶囊崩解迟缓现象的发生。     

应用人精子头-尾膜完整性试验对生育力组及不育组精液的评价

目的应用人精子头-尾膜完整性试验,比较生育力组与不育组男性精液4种精子膜完整性类型的差异.方法精液标本分为生育力组(n=32)和不育组(n=50),采用"低渗肿胀-伊红拒染"结合试验,检测人精子头-尾膜完整性.结果头膜尾膜均损伤的Ⅰ型精子和头膜损伤-尾膜完整的Ⅲ型精子,生育组和不育组存在明显差异(P<0.01);头膜完整-尾膜损伤的Ⅱ型精子,生育组和不育组无明显差异(P>0.05);头膜-尾膜均完整的Ⅳ型精子,生育组明显高于不育组(P<0.01);Ⅳ型精子率与生育组精子活动率(n=32, r=0.82,P<0.01)和不育组精子活动率(n=50,r=0.80,P<0.01)均呈显著相关性.结论生育组具有较多头膜-尾膜均完整的精子."低渗肿胀-伊红拒染"结合试验能够清晰显示包括过渡型膜损伤的4种膜完整性类型的精子,精子头-尾膜完整性可以作为评价精子生理学的一项检测指标.     

An evaluation of the hypo-osmotic sperm swelling test as a predictor of fertilizing capacity in vitro

The ability of sperm to swell in hypo-osmotic conditions was examined in 211 semen samples from the partners of patients about to undergo oocyte retrieval for in-vitro fertilization (IVF). The test was performed using aliquots of semen, the remainder of which was then prepared for IVF. No significant difference was found, in either the percentage of swollen sperm or the type of swelling response, between samples that achieved fertilization in vitro and those that did not, or between any of the diagnostic categories of infertility (tubal damage, unexplained infertility, oligospermia). In samples which achieved fertilization in vitro there were correlations between sperm swelling and sperm motility (r = -0.51) and abnormal morphology (r = 0.33), but no such correlations were demonstrated in samples that failed to achieve fertilization. Moreover, there was no significant difference between the percentage of swollen sperm in semen (mean motility 64%), in samples immediately after preparation for IVF (mean motility 96%) or in capacitated sperm 24 h after preparation (mean motility 91%). These results demonstrate that the hypo-osmotic sperm swelling test does not assist in the prediction of the fertilizing capacity of human sperm in vitro.     

钕激光照射对大鼠肿瘤生长的抑制作用

目的:研究钕激光照射对大鼠肿瘤生长的抑制作用.方法:采用钕激光在实验组荷瘤大鼠的肿瘤区及其肿瘤区周围进行照射,并观察抑制肿瘤的效果.结果:实验组大鼠肿瘤体的生长速度明显慢于对照组大鼠肿瘤体的生长速度.结论:用钕激光照射对抑制癌肿瘤的生长速度有明显的作用.     

Zero-Order Release Formulation of Oxprenolol Hydrochloride with Swelling and Erosion Control

Zero-order release of oxprenolol hydrochloride was obtained by controlling the swelling and erosion of the matrix. This formulation involves only mixing of drug, hydroxypropylmethylcellulose (HPMC), and sodium carboxymethylcellulose (Na CMC) at the ratio of 1:0.4:1.6, respectively, and compressing the mixture directly into tablets. The in vitro release pattern from this optimized matrix tablet was reproducible. Accelerated stability studies revealed that the optimized formulation remains stable for an approximately 2-year shelf life. This sustained-release (SR) tablet was evaluated in dogs, and for comparison a conventional (CV) formulation was also given at the same dose level. Plasma oxprenolol levels were monitored by a sensitive and specific high-performance liquid chromatographic (HPLC) method. Significant differences in the pharmacokinetic parameters, i.e., lower C _max, higher values of t _max, MRT, AUC, and plasma concentration at 24 hr, and nearly constant plasma levels over 12 hr, indicated that the SR matrix tablet is superior to the CV rapid-releasing formulation. The in vitro release parameters and in vivo pharmacokinetics correlated well.