岩黄连脱氢卡维丁体外抑制Tca8113增殖及对端粒酶活性影响的研究

目的：研究中草药岩黄连脱氢卡维丁（Tetradehydroscoulerine，YHL－1）对人舌鳞状细胞癌Tca8113细胞增殖的抑制作用，及其对端粒酶活性和端粒酶催化亚基（hTERT）表达的影响，探讨其抗癌机制。方法：采用噻唑蓝比色法（MTT法）检测不同浓度的YHL-1对Tca8113细胞增殖的影响，同时以TRAP—ELISA法检测Tca8113细胞端粒酶活性改变情况，并用Western blotting法半定量检测端粒酶hTERT的表达。结果：YHL-1能明显抑制Tca8113细胞增殖，且随时间延长和药物浓度的增高，抑制作用增强。72h时，0．200、0．100、0．050、0．025 g／LYHL-1组细胞增殖抑制率分别为（64．1±1．5）％、（47．3±3．3）％、（35．6±5．0）％、（31．8±5．87）％。72 h时，0．100、0．050 g／L组端粒酶活性和hTERT蛋白含量均低于空白对照组（P〈0．05）。结论：岩黄连脱氢卡维丁可以明显抑制Tca8113细胞的增殖，并显著降低其端粒酶活性及hTERT的表达，这可能是其抗舌癌的机制之一。     

ICU非计划性拔管重置气管插管的相关因素及防范措施

目的探讨ICU非计划性拔管重置气管插管的相关因素。方法随机将非计划性拔管中病例以24 h内是否重置管分为重置组和非重置管组,将非计划性拔管病例重置管组与未重置管组病人的年龄、疾病诊断、APACHEII、给氧浓度、氧合指数、镇静约束等因素进行比较。结果疾病诊断为呼吸衰竭、APACHEII≥10分、给氧浓度>40%、氧合指数<200、未使用镇静剂和约束带的病人为拔管后重新置管的高危人群。两组比较差异均有统计学意义。结论ICU的医护工作者必须加强对这些高危人群的关注,及时采取恰当有效的防范措施,降低非计划性拔管率和重置管率,真正保证ICU气管插管病人的安全。     

股二头肌长头肌皮瓣高压氧喷气式气垫综合治疗复杂性坐骨结节压疮

目的观察股二头肌长头肌皮瓣、高压氧及术后应用喷气式气垫综合治疗复杂性坐骨结节压疮的临床疗效。方法对16例坐骨结节压疮患者应用股二头肌长头肌皮瓣修复,联合高压氧治疗及术后长期应用喷气式气垫。结果 16例患者中14例一期愈合,1例肌皮瓣近臀侧边缘少量透明状液体渗出,经换药14 d愈合并拆线,1例肌皮瓣近臀侧皮肤拆线后裂开,经换药28 d后瘢痕愈合。所有患者坚持应用喷气式气垫床,2～7年随访无一例复发。结论股二头肌长头肌皮瓣修复坐骨结节压疮联合高压氧及术后坚持气垫床根治复杂性坐骨结节压疮疗效确切。     

白及花与块茎石油醚部位成分分析及其生物活性的比较研究

目的 分析白及花和块茎石油醚部位成分及生物活性。方法 以石油醚（60~90℃）为提取溶剂,采用索氏提取法提取白及花和块茎脂溶性成分,采用GC-MS分析其化学成分,通过滤纸片扩散法、CCK8法和分光光度法分别对其进行抑菌、抗肿瘤和α-淀粉酶抑制作用研究,通过检测DPPH自由基、ABTS自由基和羟自由基的清除率考察其体外抗氧化活性。结果 白及花和块茎中共鉴定出20种石油醚部位成分,其中花11种,块茎19种,共有成分10种,α-乙酰基-γ-丁内酯（15.20%,21.84%）和苄醇（12.07%,24.10%）为主要成分。白及花中石油醚部位成分的抑菌活性高于块茎,对枯草芽孢杆菌效果最好,最小抑菌浓度和最小杀菌浓度分别为0.41,0.51 g·L^-1和0.53,0.66 g·L^-1。当质量浓度为5.0 mg·mL^-1时,白及块茎石油醚部位成分对A₅₄₉细胞的抑制率为29.451%,高于花中石油醚部位成分27.621%的抑制率,前者对α-淀粉酶的IC₅₀为1.819 mg·mL^-1,后者的IC₅₀为2.028 mg·mL^-1。两者对DPPH自由基、ABTS自由基和羟自由基的清除率均随质量浓度的增大而增大,当浓度达到1.0 mg·mL^-1时,前者对ABTS自由基和羟自由基的清除率分别为99.67%和92.22%,高于后者90.07%和38.11%的清除率,后者对DPPH自由基的清除率为31.23%,高于前者18.94%的清除率,两者均低于Vc的清除率。结论 白及花和块茎中石油醚部位成分主要为酯类和醇类,2种石油醚部位成分均具有一定的生物活性,具有潜在的药用价值,并可为白及花的资源开发提供参考。     

附子多糖预防高胆固醇血症的作用及其对肝脏CYP7α-1表达的影响

目的: 探讨附子多糖(FPS)预防高胆固醇血症的作用及其对肝脏胆固醇7α-羟化酶(CYP7α-1)表达的影响。方法: SPF级雄性Wistar大鼠50只,体重100 g,随机分为正常组(control)、高胆固醇组(HC)和HC+附子多糖(HC+FPS)低、中、高3个剂量组,每组10只,分别给予正常、高胆固醇及高胆固醇加附子多糖(224、448和896mg·kg^-1·d^-1 )饮食,持续2周,检测各组的血脂水平;观察control组、HC组和HC+FPS(224 mg·kg^-1·d^-1)组大鼠的体重、进食量和粪便量的变化,实验结束后取3组大鼠的肝脏行HE染色;并检测3组大鼠肝脏羟甲基戊二酰辅酶A(HMG-CoA)还原酶mRNA水平、CYP7α-1 mRNA和蛋白水平以及粪便总胆汁酸含量等方面的改变。结果: 附子多糖能显著抑制高胆固醇血症大鼠血清中总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)的水平(P<0.05);HC+FPS组大鼠肝细胞脂肪变性较HC组轻微;real-time PCR和Western blotting结果显示附子多糖能显著上调高胆固醇大鼠肝脏CYP7α-1 mRNA水平和蛋白表达并明显降低HMG-CoA还原酶的mRNA水平(P<0.01);HC组大鼠粪便中胆汁酸的含量增多而HC+FPS组进一步增加(P<0.05)。结论: 附子多糖具有明显的降血胆固醇作用,其机制与上调CYP7α-1 mRNA及蛋白水平和下调大鼠肝脏HMG-CoA还原酶mRNA水平有关。     

95％酒精用于导管内壁快速干燥的小窍门

各种非一次性导管在使用后，传统方法是清洗、清洁、消毒、晾干备用，在晾干这一环节上，由于一般导管长度≥30cm，采用传统自然晾干法，水份在导管内不易蒸发，需要时间长，在晾干过程中易造成再次污染，影响消毒质量，而且晾干不彻底，导管内壁末完全干燥，更易滋生霉菌。针对此种情况，我们现采用95％酒精注入导管快速干燥方法，     

Placement of Brånemark implants in the maxillary tuber region: anatomical considerations, surgical technique and long-term results

Background: Fixture placement in the tuber area is one way to overcome the problem of insufficient bone volume for routine implant surgery in the posterior maxilla due to severe resorption of jawbone and an extensive enlargement of the maxillary sinus. However, little is known about the long‐term results. Purpose: The aim of this study was to retrospectively evaluate the survival rate and marginal bone conditions at fixtures placed in the tuber region of the maxilla. Material and methods: Twenty‐one patients previously treated with at least one implant in the tuber region of the maxilla were included in this retrospective analysis. A total of 23 standard Brånemark System fixtures with a turned surface had been surgically placed in the tuber regions and 71 additional implants in adjacent areas to support fixed dental bridges. All implants were allowed to heal for 6–8 months before abutment connection and following prosthetic treatment. The patients were radiographed after 1–12 years for evaluation of marginal bone levels. In addition, the relation between the apex of the fixture in the tuberosity area and the posterior border of the maxilla was measured. Results: Twenty of the 21 patients representing 22 tuber and 64 additional implants were radiographically evaluated. No implants in the tuber areas were lost during the follow‐up whereas two fixtures in the anterior region had to be removed, one before loading and the other after 4 years of loading not interfering with the prosthesis stability. The mean marginal bone level at tuber implants was situated on average 1.6 mm (SD 1.1, n=22) from the abutment‐fixture junction, whilst the other implants showed an average bone level of 1.9 mm (SD 0.8, n=64). The results were similar when comparing partially and totally edentulous patients. Conclusion: The present retrospective study shows good clinical outcome with standard Brånemark fixtures placed in the tuber region of the posterior maxilla using a two‐stage procedure. In appropriate cases where bone of adequate volume and density is available, our data indicate that the technique can be used as an alternative to more extensive surgery and especially to the sinus lift procedure. However, prospective comparative studies are needed in order to evaluate the efficacy of the described technique for this purpose.     

锁骨下静脉置管术后更换敷料时间的探讨

目的 探讨锁骨下静涠主后穿刺点更换敷料的间隔时间与感染的关系。方法 对２４０例置管病人进行分组比较，观察不同间隔时间更换敷料后穿刺点皮肤是否有感染，并进行统计。结果 更换敷料的间隔时间不同，感染率不同。结论 间隔时间为２天更换敷料最为适宜，感染率低。