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目的研究独活凝胶贴膏穴位贴敷治疗类风湿关节炎(RA)模型家兔的药物代谢动力学(PK)与药物效应动力学(PD)。方法取10只健康新西兰雌性家兔,2只作为正常对照组;其余8只家兔肩胛区注射卵清蛋白佐剂构建RA模型,随机分为模型组(空白凝胶贴膏)和穴位给药组(独活凝胶贴膏),各4只。采用微透析取样技术对模型家兔的关节腔液取样,采用超高效液相色谱-串联质谱(UPLC-MS/MS)法测定关节腔液中独活有效成分二氢欧山芹醇当归酸酯和蛇床子素的含量,并建立PK参数;采用酶联免疫吸附(ELISA)法测定血清中白细胞介素1β(IL-1β)、肿瘤坏死因子-α(TNF-α)的水平,并计算抑制率,作为PD指标;采用WinNonlin ExamplesGuide 5.2.1软件拟合PK-PD模型。结果穴位给药组家兔关节腔液中蛇床子素一级吸收速率常数(k01)为0.22 h-1,一级消除速率常数(k10)为0.10 h-1,0~14 h的血药浓度-时间曲线下面积(AUC_(0~14 h))为6584.18(ng?h)/mL,吸收相半衰期(k01_LH)为2.54 h,消除相半衰期(k10_LH)为5.89 h,达峰时间(tmax)为5.70 h,达峰浓度(Cmax)为454.31 ng/mL;关节腔液中二氢欧山芹醇当归酸酯k01为0.20 h-1,k10为0.12 h-1,AUC_(0~14 h)为2185.67(ng?h)/mL,k01_HL为2.69 h,k10_HL为5.94 h,tmax为6.52 h,Cmax为150.53 ng/mL。穴位给药组家兔血清中IL-1β和TNF-α水平建立的抑制百分数(EIR)与药效中效应室浓度(Ce)的PK-PD模型方程分别为EIR=91.72Ce/598.35+Ce,EIR=95.72 Ce/568.08+Ce。结论蛇床子素和二氢欧山芹醇当归酸酯在RA模型家兔体内的PK行为与药效紧密联系,独活凝胶贴膏经穴位给药可达到预期疗效。 相似文献
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《Enfermería clínica》2022,32(3):171-183
IntroductionAgeing is a period of physical and psychological changes. Inactivity is one of the biggest problems among the older adult population increasing the risk of sarcopenia and chronic diseases. Physical activity is an effective intervention to improve health outcomes. In recent years, there has been an increase in the use of technology, with health technology tools (ICT) appearing as an intervention to increase physical activity and improve associated health problems.ObjectiveIn this review, we evaluated the effectiveness of health technology to increase physical activity and to improve cardiovascular parameters in older adults.MethodologyStudies with a great variety of health technology tools to increase physical activity levels, and that evaluated the effect of that increase on cardiovascular parameters were included by searching the main databases.ResultsEleven studies reporting the use of a variety of ICT tools were included in this review. Despite these differences, the effectiveness of health technology tool interventions has been demonstrated in increasing physical activity and reducing cardiovascular parameters.DiscussionThe lack of adherence of older adults to health technology would be a disadvantage, but it has been shown that younger older adults are more familiar with health technology tools and the number using them is increasing.ConclusionHealth technology tools show effectiveness in increasing physical activity in older adults and improving cardiovascular parameters. 相似文献
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Involuntary sterilization is a violation of human rights and grounds for asylum in the United States. Forensic medical evaluations can be useful in documenting this form of persecution and supporting asylees’ claims for immigration relief. We conducted a retrospective case analysis of the personal and medical affidavits of 14 asylum-seeking women from four Latin America countries who all reported they had been involuntarily sterilized. Sixty-four percent said that “consent” was coerced; the remainder were unaware of having been sterilized at the time of the procedure. In all cases, findings on hysterosalpingogram were consistent with sterilization, revealing that all 14 had undergone a tubal ligation. Eighty-six percent of the women had been sterilized at the time of childbirth. The healthcare providers involved in the 14 cases failed to obtain informed consent, misled patients about sterilization, engaged in discriminatory behavior, and/or breached patient confidentiality regarding their HIV-status. All 14 asylum cases were defensive; of the 7 cases (50%) that have been decided to date, 100% have been granted asylum. 相似文献
5.
《Clínica e investigación en ginecología y obstetricia》2022,49(4):100770
IntroductionMultiple and specifically monochorionic diamniotic (MCDA) pregnancies are related to maternal and foetal complications. The aim of this study is to evaluate obstetric and perinatal outcomes of MCDA after assisted reproductive techniques (ART).MethodsThis is a case-control study comparing 23 MCDA twin pregnancies after ART (ART-MCDA) and 75 spontaneous MCDA (sMCDA). Maternal, obstetric, foetal, and perinatal outcomes variables including maternal age, prematurity, TTTS, sIUGR, TAPS, PROM, and neonatal weight were compared.Resultsmean maternal age is higher in the ART-MCDA pregnancies, 38.0 ± .6 (OR = 1.32(1.13–1.53)). Neonates weighing between 1500 and 2500 g are more frequent in the sMCDA group and those weighing >2500 g in the ART group (OR = 0.47(0.22–0.97)). Foetuses born at between 32 and 37 weeks are more frequent in sMCDA pregnancies and those born >37 in the TRA group (OR = 0.27(0.09–0.80)). These differences are lost when we adjust the results by maternal age. There were no differences in maternal, obstetric, or foetal complications.ConclusionsART-MCDA are not associated with a higher number of maternal, obstetric or foetal complications if they are adjusted by maternal age. When they are not adjusted by maternal age, there would be better outcomes such as premature and neonatal weight in the ART group. 相似文献
6.
《Journal of cranio-maxillo-facial surgery》2022,50(7):590-598
This study evaluates the impact of tooth-borne Surgically Assisted Rapid Mandibular Expansion (SARME) on the temporomandibular joint (TMJ) function and condylar morphology.Medical records of patients who received a SARME between 2014 and 2018 are retrospectively reviewed concerning functional problems. Morphological changes of the condyles are analyzed by means of surface registration of 3D reconstructed CBCT scans preoperatively and one-year postoperatively, and correlated to functional outcome.In 68 patients data are complete. The risk of TMJ dysfunction is slightly increased from 18 to 25% at a mean of 14 months after SARME. This is attributed to an increase in the number of minor problems (75–82%). The presence of complaints before SARME is the only identifiable risk factor for also having complaints after the intervention (p = 0.0019). In one patient with pre-existent TMJ dysfunction complaints deteriorated after SARME. After SARME no cases of extended condylar resorption are described. There is no correlation between morphological condylar changes and the prevalence of TMJ dysfunction (p = 0.7121 for appositional and p = 0.3038 for resorptive changes). However, appositional and resorptive changes at the condylar head appear to correlate with growth potential, based on age, gender and skeletal deformity (p < 0.0001 and p = 0.0154 respectively).Within the limitations of the study it seems that SARME does not have a negative impact on TMJ function or condylar integrity and, therefore, the choice for or against this approach can be made without considering consequences for TMJ a major issue for the decision. 相似文献
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目的分析辅助生殖技术(ART)对儿童智能发育的影响。方法选取2019年2—5月通过ART出生的70例6个月~6岁儿童为ART组,同期自然受孕的70例儿童为对照组。评估儿童智能发育情况,0~4岁儿童采用Gesell幼儿发育量表评估,4岁以上儿童采用韦氏智力量表评估。结果ART组出生时剖宫产比例、双/多胎妊娠比例均高于对照组,差异均有统计学意义(P=0.032,χ2=6.907;P=0.027,χ2=7.341)。ART组和对照组大运动能力评分分别为(86.33±10.00)分和(70.13±10.22)分,差异有统计学意义(t=-3.674,P=0.001)。两组4岁以上儿童韦氏智力量表评分比较差异均无统计学意义(均P>0.05)。相关性分析显示:ART与保胎史无交互作用(F=0.545,P=0.470)。结论ART对子代相对安全,没有对子代的智能发育状况产生明显不良影响,但是不排除早期语言、运动能力发展受限对长远发育结局的影响。 相似文献
9.
目的:探讨术前不同瞳孔参数对伴老视的近视飞秒激光辅助的准分子激光角膜原位磨镶术(FSLASIK)后视力的影响。方法:前瞻性病例对照研究。选取2020年1—12月于广西壮族自治区柳州市 工人医院连续就诊的中度近视合并老视患者60例(120眼)。患者在中间视觉环境(1 cd/m2)按瞳孔大 小分为3组:小瞳孔(SPG)组(≤5.5 mm)、中瞳孔(MPG)组(5.6~6.4 mm)和大瞳孔(LPG)组 (≥6.5 mm)。各组分别于术前,术后1个月、3个月、6个月均行视力、瞳孔反应以及像差检查,比 较3组裸眼视力(UCVA)、近视力(UCNVA)、瞳孔反应以及像差。采用重复测量方差分析比较不同 时间点瞳孔参数、视力、像差的变化,术前不同组间各瞳孔反射参数比较采用ANOVA方差分析。结 果:术后3、6个月时MPG组和SPG组的UCVA高于LPG组(术后3个月:F=10.62,P<0.001;F=14.21, P<0.001;术后6个月:F=14.88,P<0.001;F=14.81,P<0.001);SPG组和MPG组的UCNVA均优于 LPG组(术后3个月:F=37.62,P<0.001;F=25.62,P<0.001;术后6个月:F=37.60,P<0.001;F=38.11, P<0.001)。在术后6个月的随访中,MPG组患者的满意度高于LPG组和SPG组。术后1、3、6个月, MPG组和SPG组患者的收缩幅度、收缩速度和瞳孔收缩持续时间均优于LPG组,差异均有统计学意 义(均P<0.001);瞳孔扩张潜伏期MPG组和SPG组优于LPG组,差异有统计学意义(P<0.05);扩张持 续时间和扩张速度在3组患者间比较差异无统计学意义;3组患者垂直彗差(C7),水平彗差(C8)和 球差(C12)均增加,LPG组患者增加最多,差异有统计学意义(P<0.001)。结论:老视激光屈光手术 后6个月,中、小瞳孔大小的患者均可以获得更好的视觉质量。 相似文献
10.
目的 在肺癌微波消融治疗中探究基于CT的三维数字化导航技术的应用价值。方法 回顾性分析我院收治的92例肺癌患者,随机进行三维数字化导航微波消融或传统CT引导下微波消融,分为三维导航组和传统组,依据肿瘤位置、大小(最大径差值≤2 mm)及微波消融条件不同两两配对,共46对,比较2组手术时间、微波针穿刺次数、CT剂量指数、术中并发症发生率、术后病灶控制情况。结果 三维导航组与传统组的手术时间分别为(30.07 ± 6.36)min、(47.20 ± 9.65)min、穿刺次数分别为(1.72 ± 0.69)次、(7.13 ± 3.00)次、CT剂量指数分别为(11.16 ± 2.20)mGy、(26.67 ± 8.72)mGy、术中并发症发生率分别为10.87%、34.78%,以上3个指标三维导航组均低于传统组,三维导航组治疗有效率(93.48%)高于传统组(71.74%),差异均有统计学意义(P < 0.05)。结论 CT引导下利用三维数字化导航技术行肺癌微波消融治疗,使介入穿刺手术的操作更加精准安全。 相似文献