载药涤纶血管材料去甲万古霉素含量和体外释药量测定方法

目的:建立优化的载药涤纶血管材料去甲万古霉素含量及体外释放量测定方法。方法:将载药涤纶血管材料浸泡于磷酸生理盐水缓冲液中振荡实现体外释放,采用改进的高效液相色谱法(HPLC),法测定载药涤纶材料去甲万古霉素含量和体外释药量:色谱柱为 luna C18 柱(5μm, 250mm×4.6mm);流动相为三乙胺缓冲液(pH3.2) 乙腈 四氢呋喃(92∶7∶1);流速为 1.0ml /min;检测波长为 254nm。结果:去甲万古霉素浓度在10~80μg /ml范围内线性关系良好(r=0.99999);平均回收率为 99.3%(RSD=0.56%);定量限为0.1ng。结论:优化的载药涤纶血管材料去甲万古霉素含量和体外释药量 HPLC测定法专属性强,结果准确,灵敏度高。     

去甲万古霉素载药涤纶血管材料的研制

目的探讨去甲万古霉素载药涤纶血管材料(NV-DP)的制备,并对其形态特征、载药量、体外释药性能和有机溶剂残留量进行观察。方法以聚乳酸为载体采用乳剂溶剂挥发法制备去甲万古霉素聚乳酸微球;以乙烯醋酸乙烯共聚物为支撑剂将微球固载至涤纶材料制备NV-DP;采用高效液相色谱法(HPLC)测定去甲万古霉素(NV)含量和体外释药量;采用气相色谱法(GC)测定二氯甲烷残留量。结果微球平均粒径和载药量分别为30.7μm和(0.2533±0.0025)g/cm2;微球被成功地固载至涤纶材料,载药量为(0.24645±0.00061)g/cm2;NV-DP均匀,厚度为0.18mm;NV自NV-DP缓慢释放超过20d;二氯甲烷残留为0.0031%。结论NVDP壁薄,载药量大,在体外能够实现长时间释药,有机溶剂残留未超标。提示该载药血管材料适合用于制备抗感染血管移植物。     

固载去甲万古霉素缓释微球补片对切口疝金黄色葡萄球菌感染的预防作用

目的补片修补切口疝术后可能发生感染,采用载药补片预防感染是解决方法之一。通过制备大鼠切口疝金黄色葡萄球菌感染模型,观察固载去甲万古霉素缓释微球聚丙烯补片修补切口疝术后对感染的预防作用。方法采用复乳溶剂挥发法制备去甲万古霉素缓释微球,并将其固载至聚丙烯补片(50 mg/片)。扫描电镜观察去甲万古霉素缓释微球形态,采用高效液相色谱法检测微球中去甲万古霉素含量以及补片中去甲万古霉素释放率。取健康10～11周龄雄性SD大鼠40只,体重200～250 g;制备切口疝金黄色葡萄球菌感染模型,分别植入固载去甲万古霉素缓释微球聚丙烯补片(实验组,n=20)和聚丙烯补片(对照组,n=20)。术后观察两组大鼠切口愈合情况,3周时处死大鼠取补片及周围组织进行组织学观察,并进行炎症程度分级。结果扫描电镜观察示去甲万古霉素缓释微球形态完整,表面平滑;微球粒径较均一,64%微球粒径位于60～100μm;去甲万古霉素载药量为19.79%。固载去甲万古霉素缓释微球聚丙烯补片表面均匀,载药量为(7.90±0.85)mg/cm2,去甲万古霉素体外释放达28 d以上,累计释放率达72.6%。两组大鼠术后均存活至实验完成。22只大鼠切口发生感染,其中实验组2只(10%),对照组20只(100%);两组感染率比较,差异有统计学意义(χ2=32.727 3,P=0.000 0)。实验组镜下见局部炎性反应不明显,炎症程度分级Ⅰ级16只,Ⅱ级4只;对照组补片有大量炎性细胞浸润,炎症程度分级Ⅱ级3只,Ⅲ级17只。两组炎症程度分级比较,差异有统计学意义(Z=32.314,P=0.000)。结论固载去甲万古霉素缓释微球聚丙烯补片对大鼠切口疝金黄色葡萄球菌污染具有抗感染作用。     

利福平联合左氧氟沙星与万古霉素对MRSA、MRCNS体外抗菌活性研究

目的分析骨科内置物术后感染病原菌检测结果及利福平联合万古霉素与左氧氟沙星对MRSA、MRCNS体外抗菌活性的效果。方法对60例骨科内置物后发生感染患者的病原菌进行分析。选取耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)感染患者各20例。观察利福平联合万古霉素和左氧氟沙星对MRCNS和MRSA的抗菌效果。结果骨科内置物术后感染病原菌常见的有MRSA、MRCNS、格兰阴性杆菌、假单胞菌、厌氧菌、棒状杆菌属、肠球菌等。利福平与左氧氟沙星联合对抑菌浓度指数为0.5、0.25的菌株显示具有协同主要功能,利福平联合万古霉素对抑菌浓度指数单位0.5、0.37的菌株显示具有协同作用。2组抗菌剂联合对MRCNS和MRSA的效果比较,差异无统计学意义(P0.05)。结论利福平联合万古霉素与左氧氟沙星对MRSA、MRCNS具有良好的体外抗菌活性,能有效治疗细菌生物造成的感染。     

许旺细胞在人工神经支架材料上三维培养的体外活性研究

目的　探讨许旺细胞在组织工程支架材料上体外三维培养的生长活性。　方法　对聚羟基乙酸和聚乳酸的共聚物细丝支架进行生物学修饰 ,把原代培养的许旺细胞悬液接种在支架材料上 ,用MTT法、单细胞凝胶电泳法及显微分光光度和显微图像联合法测定许旺细胞的生长活性。　结果　聚羟基乙酸和聚乳酸的共聚物细丝支架上的许旺细胞各项活性指标与正常培养的许旺细胞比较 ,差异无显著性 (P >0 0 5 ) ,实验组许旺细胞DNA无损伤。　结论　聚羟基乙酸和聚乳酸的共聚物细丝适于构建具有许旺细胞活性的组织工程化人工神经。     

载银纳米抗菌复合骨填充材料体外抗菌性能及生物相容性研究

[目的]探讨载银纳米抗菌复合骨填充材料其体外抗菌性能及生物相容性。[方法]采用抑菌环试验、菌落数试验检测材料对金黄色葡萄球菌及大肠杆菌的体外抗菌效果,采用扫描电镜观察材料对金黄色葡萄球菌及大肠杆菌的抗粘附效果。并采用MTT法检测细胞毒性及急性溶血实验评价载银纳米抗菌复合骨填充材料的生物相容性。[结果]抑菌环试验显示第1 d时载银纳米抗菌复合骨填充材料对金黄色葡萄球菌和大肠杆菌的抑菌环直径均最大,分别为(23.6±1.14)mm和(18.8±0.84)mm,随后抑菌环直径随时间延长而缩小,抑菌环在金黄色葡萄球菌和大肠杆菌中的持续时间分别为33、24 d;菌落数试验显示细菌与载银纳米抗菌复合骨填充材料接触24 h后,对金黄色葡萄球菌和大肠杆菌的抗菌率分别为94.18%和85.96%;扫描电镜发现实验组材料表面黏附的细菌明显少于对照组。MTT法测定示载银纳米抗菌复合骨填充材料毒性分级为1级,急性溶血实验示载银纳米抗菌复合骨填充材料溶血率为0.28%。[结论]载银纳米抗菌复合骨填充材料有良好的生物相容性,对金黄色葡萄球菌及大肠杆菌有明显抗菌作用,无明显细胞毒性和红细胞破坏性。     

纳米晶体银离子敷料对烧伤感染常见耐药病原菌的体外抗菌活性

一、材料与方法 1．抗菌材料及菌株：纳米晶体银离子敷料（商品名：爱银康、Acticoat）为英国施乐辉有限公司产品，批号66000791。实验用菌株由我院检验科提供，为分离自烧伤病房的多重耐药病原菌，包括甲氧西林耐药金黄色葡萄球菌（MRSA）、铜绿假单胞菌（PAE）、大肠杆菌（ECO）、肺炎克雷伯菌（KPN）各1株。     

人参总皂甙对肾结石体外冲击波碎石后血管活性物质的调控作用

目的探讨人参总皂甙对肾结石体外冲击波碎石（ESWL）后血管活性物质的调控作用。方法选择单侧肾盂或肾盏结石患者40例,随机分为用药组和对照组,采用水囊式JT-Ⅱ型碎石机,工作电压为10.5～12.0kV,冲击2300～2500次,用药组碎石前15min滴注人参总皂甙20g,对照组仅滴生理盐水,碎石前后测定血栓素（TXA2）、前列环素（PGI2）和内皮素-1（ET-1）。结果 ESWL后6h,TXB2在用药组（1317.6±118.7)ng/L和对照组(2476.5±132.6)ng/L达最高峰,两组比较差异有非常显著性(P<0.01);PGF1α在用药组术后24h(2243.6±212.4)ng/L达高峰,对照组术后24h(1168.6±157.4)ng/L,两组比较差异有非常显著性(P<0.01）,ET-1在术后6h达高峰,用药组(668.9±72.5)ng/L和对照组(1016.8±137.5)ng/L比较差异有非常显著性(P<0.01）。结论人参总皂甙通过调控ESWL后血管活性物质的水平达到扩张血管、疏通微循环及保护肾功能的作用。     

嗜铬细胞瘤的分型和围手术期血管活性药的选用

测定血浆或尿液中的儿茶酚胺既是诊断嗜铬细胞瘤的特异方法,也可根据分泌胺类物质的不同对其进行分型,指导麻醉及围手术期治疗。本文回顾性总结我院自1988年1月至1998年12月进行的45例肿瘤切除术的麻醉,通过患者尿液儿茶酚胺浓度与ＢＰ和ＨＲ的关系,探讨嗜铬细胞瘤麻醉和围手术     

肝硬变门静脉高压症患者血浆血管活性肠肽水平的测定与研究

目的：研究肝硬变门静脉高压症患者血中血管活性肠肽水平的变化。方法：以放射免疫分析法测定32例肝硬变门静脉高压症患者和对照组30例无肝脏和胰腺疾病的胆结石患者的门静脉、外周静脉和动脉血中的血管活性肠肽水平。结果：肝硬变组与对照组血管活性肠肽水平的比较结果为：门静脉：104±41／71±19（P＜0．01）；外周静脉：89±24／50±18（P＜0．01）；动脉：86±21／46±15（P＜0．01）。结论：肝硬变门静脉高压症患者门静脉、外周静脉和动脉血中血管活性肠肽水平明显高于对照组。     

A five-to seven-year experience with externally-supported Dacron prostheses in axillofemoral and femoropopliteal bypass

We have examined the clinical results of 56 externally-supported (EXS) Dacron grafts in the axillofemoral position and 117 in the femoropopliteal position. Results have been analyzed from two perspectives: primary patency concerns only those grafts that had never occluded; extended patency refers to all open grafts including those whose continued patency is the result of thrombectomy. The 5-to 7-year life-table patency rates are: axillofemoral 8 mm and 6 mm bypass: primary 75% and extended 97%; above-knee femoropopliteal 6 mm bypass: primary 78% and extended 93%; below-knee 6 mm femoropopliteal bypass: primary 41% and extended 91%. In contrast, the results for the 5 mm grafts used for femoropopliteal bypass were inferior to the 6 mm grafts: femoropopliteal 5 mm bypasses had an above-knee primary patency rate of 44% and an extended rate of 55%, with a below-knee primary patency rate of 15% and an extended rate of 32%. Rendering the noncrimped porous Dacron prosthesis kink and compression resistant by an external support coil appears to increase its potential for successful use, especially in 8 mm axillofemoral and 6 mm femoropopliteal bypasses. Presented to the Western Vascular Society, January 1986, Laguna Niguel, California.     

An in vitro methodology for evaluating the mechanical properties of aortic vascular prostheses

The main problem in the replacement of pathological segments of the aorta with vascular prostheses consists of matching the fluid admittance of the host artery and the graft. This mismatch results from the different compliance between natural and prosthetic vessels and from the plastic dilatation of the prosthesis diameter that occurs after implantation. An experimental procedure was set up for evaluating the mechanical properties of aortic vascular prostheses. An MTS 858 MiniBionix testing machine was equipped with a purposely designed testing apparatus, which allows loading a ring-shaped prosthesis specimen with forces that can be related easily to the transmural pressure acting on the prostheses in vivo. The reference pressure waveforms are simulated from a lumped parameter model of the cardiovascular system. Preliminary tests on 3 different (woven, warp knitted, and carbon-coated warp knitted fabric) aortic prostheses point out a good reproducibility of the results. The fabric strongly affects the circumferential elasticity and the dimensional stability of the graft. Simulation of hypertension promotes larger diameter dilatation and reduction in compliance. Agreement between in vitro and clinical diameter measurements has been assessed for 8 prosthesis samples and found to be adequate. This method is thus a potentially useful means for preclinical evaluation of compliance of vascular prostheses for the purpose of matching to native vessels.     

盐酸格拉司琼体外抑菌作用的实验研究

目的观察盐酸格拉司琼在体外对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌抑菌作用的影响。方法将盐酸格拉司琼注射液用无菌生理盐水稀释至终浓度分别为0.5、0.25、0.125和0.0625 mg/mL,与大肠埃希杆菌、金黄色葡萄球菌、和铜绿假单胞菌培养,每个实验重复三遍,所有菌株的稀释的系列测定均进行两次。结果格拉司琼对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌均有明显的抑菌作用,格拉司琼对大肠埃希菌的抑菌作用随着格拉司琼浓度的增加而增加,至0.0625 mg/mL时仍有明显的抑菌作用(P<0.05)。格拉司琼对金黄色葡萄球菌和铜绿假单胞菌的抑菌作用在格拉司琼浓度为0.125 mg/mL时消失。结论格拉司琼在体外可以抑制大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌的生长,对于预防麻醉相关的感染可能有一定的临床意义。     

盐酸昂丹司琼体外抑菌作用的实验研究

目的观察盐酸昂丹司琼在体外对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌抑菌作用的影响。。方法将盐酸昂丹司琼注射液用无菌生理盐水稀释至终浓度分别为0.5、0.25、0.125和0.0625 mg/mL,与大肠埃希杆菌、金黄色葡萄球菌、和铜绿假单胞菌培养,每个实验重复三遍,所有菌株的稀释的系列测定均进行两次。结果昂丹司琼对大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌均有明显的抑菌作用,昂丹司琼对大肠埃希菌的抑菌作用随着昂丹司琼浓度的增加而增加,至0.0625 mg/mL时仍有明显的抑菌作用(P<0.05)。昂丹司琼对金黄色葡萄球菌和铜绿假单胞菌的抑菌作用在昂丹司琼浓度为0.125 mg/mL时消失。结论昂丹司琼在体外可以抑制大肠埃希菌、金黄色葡萄球菌、铜绿假单胞菌的生长,对于预防麻醉相关的感染可能有一定的临床意义。     

Experimental evaluation of ten clinically used arterial prostheses

The arterial grafts currently in use are classified into five basic categories; 10 different commercially available prostheses were chosen to represent these categories. The Vascutek and Bionit are made from knitted Dacron and have medium porosity, requiring preclotting by the surgeon. The DeBakey Soft Woven and Plasma TFE grafts are made from woven Dacron and have low porosity, not requiring preclotting under most circumstances. Also studied were woven and knitted grafts with leakage resistance referred to as impervious Dacron grafts: the Vascutek Gelseal, the Bard Albumin Coated DeBakey Vasculour II, the Microvel with Hemashield, and the albumin saturated, autoclaved DeBakey Soft Woven graft. Gore-Tex and Impra are expanded polytetrafluoroethylene grafts which do not require preclotting. For each type, five grafts 6 cm long and 8 mm in diameter were implanted in the descending thoracic aorta of healthy adult dogs for 16 weeks. The physical characteristics, biocompatibility, and healing patterns varied according to the structure and treatment of the grafts. Pretreatment with biomaterials during manufacture is quite effective in preventing transinterstices blood loss during implantation, but results in altered physical qualities, increased thrombogenicity and delayed healing in comparison to the effects of preclotting with autogenous blood at the time of implantation.     

The evolution of a clinically relevant experimental model for the realistic evaluation of long-length (80-cm) arterial prostheses

A new carotid-femoral experimental model has been developed which has significant clinical relevance to human limb salvage bypass grafting in the areas of graft length, hemodynamics and tissue environment. More significantly, the graft healing pattern observed with this model is similar to what is seen in humans. Therefore, this experimental model provides a challenging and critical site for dynamic healing studies and comparisons of different types of vascular prostheses.     

含与不含乙二酸四乙酸二钠丙泊酚体外抑菌作用研究

目的比较含和不含乙二酸四乙酸二钠(EDTA)的丙泊酚对医院内感染常见细菌的生长抑制作用。方法实验分为四组:A组使用含0.005%EDTA丙泊酚注射液,B组使用不含EDTA丙泊酚注射液,C组使用不含EDTA丙泊酚中/长链脂肪乳注射液,D组使用无菌生理盐水。将甲氧西林敏感、耐药金黄色葡萄球菌、表皮葡萄球菌;万古霉素敏感、耐药屎肠球菌;产与不产超广谱β-内酰胺酶大肠埃希菌、肺炎克雷伯菌以及亚胺培南敏感、耐药铜绿假单胞菌、鲍曼不动杆菌等16株细菌分别与上述液体混合孵育,比较6、12、24和48h孵育后菌落数与起始菌落数的差值。采用菌落计数法绘制细菌生长曲线,统计分析采用协方差分析模型。结果所测16株细菌接种量在101～102CFU/ml和105～106CFU/ml时,室温(22.5℃)孵育情况下,A组对所测菌株均有很好抑菌作用,经48h孵育,活菌数量较起始时普遍减少,且基本没有增加。特别对于大肠埃希菌,活菌数量可下降2个log值以上。A组在各时点均明显优于B、C、D三组(P<0.0001)。结论含EDTA丙泊酚体外可有效抑制医院内感染常见细菌的生长,提示含EDTA丙泊酚比不含EDTA的丙泊酚可能更有效减少麻醉相关的感染。     

注射人绒毛膜促性腺激素与否对体外受精周期中改行未成熟卵体外培养结局的影响

目的探讨不育患者在常规体外受精一胚胎移植（IVF-ET）周期中改行未成熟卵体外培养（IVM）,取卵前注射人绒毛膜促性腺激素（hCG）与否对其实验室及临床结局的影响。方法回顾分析2008年1月至2010年11月在温州医学院附属第一医院生殖医学中心行常规IVF治疗的138个周期,在促排卵5～7d后,双侧卵泡数目≥20个,或用药8～13d后,卵泡发育缓慢且两侧卵泡数目≥15个,最大卵泡直径平均≤12mm,根据患者意愿,停药改行IVM治疗,其中63个周期在取卵前12h注射hCG（A组）,75个周期未注射hCG（B组）。比较两组的实验室及临床结局。结果A组的卵成熟率（64．56％）显著高于B组（56．3％）,但是平均获卵数（8．42±0．52）个低于B组（11．32±0．82）个,差异均有统计学意义（P〈0．05）。两组的受精率、卵裂率、移植率、临床妊娠率、流产率,多胎妊娠率比较均无统计学差异（P〉0．05）。结论常规IVF周期改行IVM后可以获得良好的妊娠结局,取卵前注射hCG虽然可以提高卵子的成熟率,但并不能提高妊娠结局。     

Scintigraphy with Tc,Ga and In in painful total hip prostheses

Summary A series of 40 patients were studied, who were operated upon for a painful total hip prosthesis, half of which were infected. In each case, preoperative scintigraphy was performed using Tc99, Ga67 and In111. The images obtained with Tc and Ga were compared with those of In111 and analysed with respect to sensitivity, specificity, accuracy and the predictive value of a positive or negative test. In111 had a predictive value of more than 90% and showed greater reliability in the diagnosis of an infection as the cause of a painful total hip prosthesis.

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Résumé Etude d'une série de 40 malades, opérés en raison de douleurs après arthroplastie totale de hanche. La moitié d'entre elles étaient infectées. On avait effectué dans chaque cas, avant l'intervention, une scintigraphie au Tc⁹⁹, au Ga⁶⁷ et à l'In¹¹¹. Les images obtenues avec le Tc⁹⁹ et le Ga⁶⁷ ont été comparées à celles de l'In¹¹¹ et analysées en ce qui concerne la sensibilité, la spécificité, l'exactitude et la valeur prédictive d'une réponse positive ou négative. Celle-ci est supérieure à 90% avec l'In¹¹¹, qui se montre l'examen le plus fiable pour le diagnostic d'infection en présence d'une prothèse totale douloureuse.