股骨近端锁定钢板治疗老年股骨粗隆骨折疗效分析

目的：对股骨近端锁定钢板治疗老年股骨粗隆骨折疗效进行分析和探讨。方法对我院收治的80例老年股骨粗隆骨折患者的临床资料进行回顾性分析,按照手术方式分为对照组以及观察组,每组患者各有40例。采用动力髋螺钉固定治疗的为对照组,采用股骨近端锁定钢板治疗的为观察组,对两组的手术指标和治疗效果进行对比。结果在愈合时间、术中出血量、总有效率以及手术时间等各项指标上,相对于对照组患者而言,观察组患者明显要优,两组患者比较差异有统计学意义（P＜0.05）。结论在针对老年股骨粗隆骨折患者进行治疗的时候,采用股骨近端锁定钢板的治疗方式具有比较理想的治疗效果,值得在临床上推广和应用。     

锁定加压解剖钢板治疗老年股骨粗隆间粉碎性骨折

目的观察锁定加压解剖钢板内固定治疗老年股骨粗隆间粉碎骨折的临床效果。方法取股骨上段外侧入路,采用切开复位锁定加压解剖钢板治疗老年粗隆间粉碎性骨折18例。结果术后随诊6～16个月,按髋关节功能评分标准（Harris）评定：优12例、良5例、可1例,优良率94.4%。结论锁定加压钢板治疗老年股骨粗隆间粉碎性骨折具有手术创伤小、操作方便、血供破坏少、固定牢固、可早期功能锻炼等优点。     

股骨近端带锁髓内针对股骨粗隆间粉碎性骨折的疗效分析

目的针对采用股骨近端带锁髓内针（proximal femoral nail,PFN）治疗股骨粗隆间粉碎性骨折进行术后疗效分析。方法对本院2007年6月～2011年6月205例股骨粗隆粉碎性骨折患者随机分组,分别行PFN、动力髋关节螺钉（dynamic hip screw,DHS）、γ钉、股骨近端锁定钢板（proximal femur locking plate,PFLP）治疗,观察其疗效。结果经术后6～23个月的随访,PFN优良率为98.1%,DHS优良率为87.2%,γ钉优良率为90.2%,PFLP优良率为84.9%,差异有统计学意义（P〈0.05）。结论 PFN股骨近端髓内针对于股骨粉碎性骨折的作用是值得肯定和推广的,尤其适用于股骨粗隆间粉碎性骨折。     

股骨远端锁定钛板固定联合植骨手术治疗股骨远端粉碎性骨折的临床研究

目的探讨锁定钛板联合植骨手术治疗股骨远端粉碎性骨折的临床效果。方法回顾性分析本院自2009年11月～2013年6月收治的108例股骨远端骨折的临床资料,根据患者骨折的情况选择不同的固定装置,分为锁定钛板固定联合植骨手术治疗组（实验组,58例）、AO解剖钢板联合植骨手术治疗组（对照组,50例）分析两组患者手术时间、出血量、骨折愈合时间、愈合率及膝关节的功能等进行统计学分析,比较两组治疗效果。结果所有患者术后随访6～30个月,实验组与对照组患者的手术时间、出血量比较差异无统计学意义（P〉0.05）;两组愈合时间分别为（22.57±1.98）w、（25.13±1.56）w,差异有统计学意义（P〈0.05）,实验组愈合率较高,两组膝关节功能优良率分别为89.66%（52/58）、78.00%（39/50）,差异有统计学意义（P〈0.05）。结论锁定钛板固定联合植骨手术治疗股骨远端粉碎性骨折取得较好的临床效果,植骨手术操作简单,安全性较高,可以减轻患者的经济负担,是临床上值得推广的股骨远端粉碎性骨折的最佳治疗手段。     

动力髋螺钉和解剖型锁定钢板治疗股骨粗隆间骨折的疗效观察

目的比较动力髋螺钉和解剖型锁定钢板治疗股骨粗隆间骨折的疗效,为股骨粗隆间骨折内固定治疗选择提供依据。方法回顾分析60例符合入组标准的股骨粗隆间骨折患者的病例资料,按手术方式的不同分为动力髋螺钉组(30例)和解剖型锁定钢板组(30例),分别行动力髋螺钉和解剖型锁定钢板治疗,比较两组患者手术时间、术中出血量、术后引流量、骨折愈合时间、术后并发症及术后髋关节功能差异。结果解剖型锁定钢板组优24例,良4例,中1例,差1例;动力髋螺钉组优21例,良6例,中2例,差1例,两组疗效比较差异有统计学意义(P<0.05)。解剖型锁定钢板组并发症发生率为3.33%(1/30);动力髋螺钉组并发症发生率为23.33%(7/30)。解剖型锁定钢板组手术时间、术中出血、术后引流量、骨折愈合时间少于动力髋螺钉组,差异均有统计学意义(P<0.05)。结论动力髋螺钉和解剖型锁定钢板治疗股骨粗隆间骨折的临床疗效相当,但解剖型锁定钢板具有操作简单、创伤小、固定牢靠、骨折愈合快、并发症少的优点,尤其适用股骨粗隆粉碎性骨折患者,值得临床推广使用。     

两种方法治疗股骨干粉碎性骨折的疗效观察

目的：观察两种不同方法治疗股骨干粉碎性骨折的临床疗效。方法：将2008年1月～2009年1月在本院住院治疗的股骨干粉碎性骨折患者60例,随机分为观察组和对照组,每组各30例。对照组给予加压钢板内固定治疗,观察组给予交锁髓内钉内固定治疗。结果：观察组患者手术时间、骨折愈合时间明显少于对照组,两组比较差异有统计学意义（P〈0.05）。观察组患者术中出血量明显少于对照组,两组比较差异有统计学意义（P〈0.05）。观察组并发症发生率为6.67%,对照组为33.33%,两组比较差异有统计学意义（P〈0.05）。结论：交锁髓内钉内固定治疗股骨干粉碎性骨折效果优于加压钢板内固定,值得临床应用。     

微创切开复位锁定钢板内固定联合植骨术治疗股骨髁间粉碎性骨折的效果

目的分析微创切开复位锁定钢板内固定结合植骨术在股骨髁间粉碎性骨折治疗中的应用效果。方法随机抽选荆州市第三人民医院2018年5月至2019年12月接收的70例股骨髁间粉碎性骨折患者,依据随机数字表法分为对照组(35例,普通钢板内固定治疗)与观察组(35例,微创切开复位锁定钢板内固定结合植骨术治疗),对两组治疗效果进行对比。结果膝关节功能优良率方面,观察组为94.29%,高于对照组的74.29%,差异有统计学意义(P 0.05);并发症发生率方面,观察组为2.86%,低于对照组的17.14%,差异有统计学意义(P 0.05);股骨力线成角及股骨远端关节面台阶方面,观察组均低于对照组,差异有统计学意义(P 0.05)。结论股骨髁间粉碎性骨折临床治疗过程中,结合微创切开复位锁定钢板内固定与植骨术治疗,不仅可以增强膝关节功能,同时能够尽量避免并发症的发生,值得临床采纳、推广。     

普通钢板与锁定钢板治疗老年桡骨远端粉碎骨折的疗效比较

目的观察并比较普通钢板与锁定钢板治疗老年桡骨远端粉碎骨折的疗效。方法将50例桡骨远端粉碎性骨折老年患者,随机分为两组,普通钢板组20例采用普通钢板固定治疗,锁定钢板组30例采用锁定钢板固定治疗,比较两组的临床疗效,对不同钢板的固定效果进行评估。结果随访后,在骨功能评价项目中,锁定钢板组优13例（43.33%）,良13例（43.33%）,优良率为86.67%;而普通钢板组为3例（15.00%）,8例（40.00%）及55.00%,锁定钢板组的优良率明显高于普通钢板组,差异具有统计学意义（P〈0.05）;在影像学评估项目中,锁定钢板组优12例（40.00%）,良15例（50.00%）,优良率为90.00%;而普通钢板组为2例（10.00%）,10例（50.00%）及60.00%,锁定钢板组的优良率明显高于普通钢板组,差异具有统计学意义（P〈0.05）。结论锁定钢板治疗老年桡骨远端粉碎骨折的疗效优于普通钢板,值得临床应用及推广。     

锁定加压钢板治疗老年股骨粗隆间骨折的疗效观察

目的观察锁定加压钢板治疗老年股骨粗隆间骨折的临床疗效。方法51例老年股骨粗隆间骨折患者随机分为治疗组26例和对照组25例,对照组采用动力髋螺钉治疗,治疗组采用锁定加压钢板治疗,记录2组患者手术时间、术中出血量、负重时间、住院时间、骨折愈合时间,比较2组临床疗效与并发症发生情况。结果治疗组优良率为92.3%高于对照组的80.0%,差异有统计学意义（P〈0.05）。治疗组手术时间、住院时间、负重时间及骨折愈合时间均短于对照组,且治疗组术中出血量少于对照组,并发症发生率低于对照组,差异均有统计学意义（P〈0.05）。结论锁定加压钢板治疗老年股骨粗隆间骨折安全有效,可有效减少并发症。     

股骨粗隆间粉碎性骨折不同内固定的临床疗效观察

目的观察并比较分析股骨粗隆间粉碎性骨折不同内固定临床疗效。方法在此次研究中选取我院在2015年6月至2018年5月收治的138例股骨粗隆间粉碎性骨折患者为研究对象,随机分为两组,每组69例,分为观察组和对照组,其中观察组给予PNF内固定治疗,对照组给予DHS内固定治疗,而后进行对比研究。结果观察组患者治疗后总有效率为91.30%明显高于对照组69.57%,组间数据对比差异明显,通过对两组数据对比和分析,计数材料经卡方检验,得到P<0.05,说明经统计学处理差异有显著性。结论对股骨粗隆间粉碎性骨折患者采用PNF的效果更加显著,有助于提高疗效,帮助股骨粗隆间粉碎性骨折患者的股骨功能恢复,减少治疗时间和出血量,因此对股骨粗隆间粉碎性骨折患者采用PNF内固定的治疗方法值得推广和应用。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Polymorphisms in genes involved in neurotransmission in relation to smoking

Smoking behavior is influenced by both genetic and environmental factors. The genetic contribution to smoking behavior is at least as great as its contribution to alcoholism. Much progress has been achieved in genomic research related to cigarette-smoking within recent years. Linkage studies indicate that there are several loci linked to smoking, and candidate genes that are related to neurotransmission have been examined. Possible associated genes include cytochrome P450 subfamily polypeptide 6 (CYP2A6), dopamine D₁, D₂, and D₄ receptors, dopamine transporter, and serotonin transporter genes. There are other important candidate genes but studies evaluating the link with smoking have not been reported. These include genes encoding the dopamine D₃ and D₅ receptors, serotonin receptors, tyrosine hydroxylase, trytophan 2,3-dioxygenase, opioid receptors, and cannabinoid receptors. Since smoking-related factors are extremely complex, studies of diverse populations and of many aspects of smoking behavior including initiation, maintenance, cessation, relapse, and influence of environmental factors are needed to identify smoking-associated genes. We now review genetic polymorphisms reported to be involved in neurotransmission in relation to smoking.     

Tramadol concentrations in blood and in cerebrospinal fluid in a neonate

Based on blood and cerebrospinal fluid samples collected in a full-term neonate, the penetration of tramadol in the central nervous system is described. Following intravenous administration of tramadol, a lag time of about 4 h was observed until full blood–brain equilibration was achieved. This pharmacokinetic observation is in line with a recent pharmacodynamic evaluation of the central opioid effects of tramadol in adults.     

Disease control in asthmatic children seen in private practice in Switzerland

ABSTRACT

Background: Asthma is the most common chronic childhood disease in Switzerland with a prevalence of 10%. Asthma has a high economic burden accounting for high medical costs. Assessment of disease control is likely to be of help in the implementation of strategies to improve asthma. Therefore, we aimed to evaluate asthma control and therapy regimens among children in private practice.

Methods: We assessed asthma control as well as therapy regimens in 575 asthmatic children in an experience programme in Switzerland by using an abbreviated questionnaire based on the asthma control questionnaire and the child health questionnaire on Visit 1 and Visit 2.

Results: Good asthma control at Visit 1 was only present in 25.7% of asthmatic children. Occasional asthma symptoms, limitation of physical activity, nocturnal awakening and anxiety of the parent was present in 80.5%, 41.2%, 46.8% and 57% of the children, respectively. After adjustment of therapy regimens at Visit 1, mainly by adding a leukotriene receptor antagonist, asthma control was reported to be much better in 53.4% of the children at Visit 2.

Conclusions: As asthma control is inadequately achieved within a major portion of asthmatic children, it is imperative to find measures to improve asthma control and hence, to reduce the burden of disease.