The novel infra‐pectineal buttress plates used for internal fixation of elderly quadrilateral surface involved acetabular fractures

ObjectivesIn geriatric acetabular fractures, the quadrilateral surface (QLS) was frequently involved in acetabular fracture patterns and accompanied by medial displacement. It was important to buttress the medial displaced QLS and reconstruct the congruity of the affected acetabulum. To evaluate the clinical effectiveness of the novel infra‐pectineal quadrilateral surface buttress plates for the treatment of geriatric acetabular fractures.MethodsTwenty‐three geriatric patients who were treated for acetabular fractures involving QLS with the novel infra‐pectineal buttress plates (NIBP) through a single supra‐ilioinguinal approach between January 2015 and June 2019 were retrospectively analyzed; all patients received at least 1 year''s follow‐up. All patients were aged ≥60 years old and including 18 males and five females. Radiologic and clinical outcomes of patients involved in the study were collated and analyzed according to the Matta scoring system and the Merle D''Aubigné–Postel scoring system. The functional recovery scoring was compared using q‐test.ResultsAll 23 consecutive patients had relatively satisfactory clinical treatment effectiveness. Average ages, length of incision, operation time, and intraoperative blood loss were 69.8 ± 6.1 years, 12.1 ± 2.6 cm, 166.5 ± 43.5 min, and 500 (500,700) ml, respectively. According to the Matta scoring system, 14 cases of reduction were graded as excellent, five as good, and four as fair. At the last follow‐up, the clinical outcome evaluation was excellent in 13 cases, good in seven cases, and poor in three cases with the use of the Merle D''Aubigné–Postel scoring system. The difference of modified Merle D''Aubigne‐Postel score at 3 months, 6 months and last follow up was statistically significant (F = 21.56, p < 0.05). Postoperative lateral femoral cutaneous nerve injury occurred in three patients and heterotopic ossification occurred in one patient.ConclusionsFor the treatment of geriatric acetabular fractures, the NIBP could provide stable and effective fixation to the QLS involved acetabular fractures, and related satisfactory clinical results with few complications were noted.     

208例糖尿病周围神经病变使用托玛琳后的动态观察

目的 观察托玛琳的远红外线、负离子等作用,寻求保健新用途,扩展托玛琳健康寝具的适用范围.方法 采用问卷调查及运动障碍、反射异常、皮肤肌肉异常、运动觉、触觉、痛觉和温度觉的临床检查方法.结果 使用1年后,轻、中度患者临床症状均有改善,轻度患者改善非常显著.其中病程越短效果越好,以疼痛、发热、感觉减退、麻木、夜袭和运动异常改善显著.另外发现震动觉、痛觉和温度觉是本病检查的敏感指标.结论 托玛琳寝具可以改善糖尿病周围神经病变的症状和体征,不失为改善糖尿病周围神经病变的简单有效的新方法.认为这可能与托玛琳产生的远红外线及负离子改善微循环、促进代谢等功能有关.     

黄柏总生物碱提取工艺的优化研究

目的研究黄柏总生物碱的最佳提取工艺。方法以酸性染料比色法测定总生物碱含量,采用正交表L9(34)考察乙醇浓度、物料比、提取时间、提取次数4个因素对其影响。结果最佳工艺为:16倍量的70%乙醇,提取3次,每次60min。结论本工艺测定方法可行,为大批量黄柏提取生物碱提供了理论依据。     

酸吸入致肺损伤对大鼠肺骨形态生发蛋白-4基因表达的影响

目的观察酸吸入致急性肺损伤（ALI）对大鼠肺骨形态生发蛋白-4（BMP-4）mRNA表达的影响。方法HCL（pH=1．5）滴入制备大鼠ALI模型,6小时后处死取肺组织标本,采用RT-PCR方法检测BMP-4 mRNA表达水平。结果对照组BMP-4 mRNA表达水平为0．76±0．06;ALI组为0．87±0．14,较对照组显著升高。结论酸吸入致大鼠ALI使肺组织BMP-4 mRNA的表达受诱导而上调,BMP-4 mRNA表达的改变可能与ALI的发生发展有关。     

人工晶体开孔孔径对晶体变形及前房内流场影响的数值模拟研究

目的 研究不同人工晶体(implantable collamer lens,ICL)开孔孔径对晶体变形和前房内流场的影响。 方法 从医工结合角度出发,采用流固耦合数值模拟方法,研究人工晶体不同开孔孔径对其变形及眼内房水流场(流量、速度场、压力场、温度场)的影响。 结果 流体动力学方面,房水通过 ICL 中央孔的房水流量从大到小对应的孔径依次为 0. 36、0. 40、0. 30、0. 20、0. 10 mm,该流量与孔径呈非线性关系。 后房压力略高于前房,前后房压差随孔径增大逐渐降低。 眼内温度分布对孔径的影响并不敏感。 固体静力学方面,0. 36 mm 孔径的 ICL 变形量最小,其变形量受房水通过中央孔的流量所主导,该流量越大,ICL 的变形越小。 结论 本文综合流体动力学和固体静力学分析,验证了现有 0. 36 mm 孔径的合理性,并提出理想的孔径范围为 d≥0. 36 mm。 研究结果有助于探明 ICL 的失效机制,提高临床手术的成功率,为未来人工晶体的国产化提供经验。     

医疗失效模式与效应分析在药物基因实验质量管理的应用与实践

目的 通过应用医疗失效模式与效应分析(healthfailure mode and effect analysis,HFMEA),预防药物基因实验的风险事件,提高药物基因实验的操作质量。方法 药学实验室成立失效模式与影响分析(failuremodeandeffectanalysis,FMEA)活动小组,采用头脑风暴法,借助HFMEA模式,识别及分析药物基因实验过程前、中、后可能存在的操作、仪器及环境对药物基因实验质控造成的风险事件,同时制定相对应的解决方案。结果 开展HFMEA活动后,预防与补救了药物基因实验前、中、后的风险事件产生,风险系数值由总分值1 375分降至62.36分,降幅为95.47%(P<0.01);活动小组成员在品管手法、解决问题能力、沟通配合、积极性等方面得到了显著提高。结论 HFMEA活动有助于降低药物基因实验产生风险事件的频次,有效提升实验室的质量管理。     

天山岩黄芪根中多糖的提取及含量测定

目的 研究天山岩黄芪根中多糖的含量。方法 采用分光光度法测定天山岩黄芪根中多糖的含量,以葡萄糖为对照品,以苯酚-浓硫酸为显色剂,在486 nm处测定样品溶液的吸光度。结果 标准曲线为A=51.654C＋0.037 2,r=0.999 8,RSD为1.28%,1.50%。结论 该方法操作简单,灵敏度高。     

调免Ⅰ号治疗自身免疫性肝炎的临床观察

为观察调免Ⅰ号对自身免疫性肝炎的治疗作用。24例自身免疫性肝炎患者随机分为调免Ⅰ号治疗组与激素对照组,疗程3个月,结果：自身免疫性肝炎患者服用调免Ⅰ号后,自觉症状,体征,肝功能,各项免疫指标较治疗前明显改善。总有效率达91.66%,与激素联合硫唑嘌磷治疗的对照组作用相近。提示具有化瘀补虚,解毒养阴疏肝作用的调免Ⅰ号对自身免疫性肝炎具有良好的治疗作用。     

Regulation of PPAR-γ activity in lipid-laden hepatocytes affects macrophage polarization and inflammation in nonalcoholic fatty liver disease

BACKGROUNDLipid metabolism disorder and inflammatory-immune activation are vital triggers in the pathogenesis of nonalcoholic fatty liver disease (NAFLD). Various studies have shown that PPAR-γ exerts potent anti-inflammatory and immunomodulatory properties. However, little is known about the regulation of PPAR-γ activity in modulating cell crosstalk in NAFLD.AIMTo investigate whether the regulation of PPAR-γ activity in lipid-laden hepatocytes affects macrophage polarization and inflammation.METHODSPrimary hepatocytes were isolated from wild-type C57BL6/J mice or hepatocyte-specific PPAR-γ knockout mice and incubated with free fatty acids (FFAs). Macrophages were incubated with conditioned medium (CM) from lipid-laden hepatocytes with or without a PPAR-γ agonist. Wild-type C57BL/6J mice were fed a high-fat (HF) diet and administered rosiglitazone.RESULTSPrimary hepatocytes exhibited significant lipid deposition and increased ROS production after incubation with FFAs. CM from lipid-laden hepatocytes promoted macrophage polarization to the M1 type and activation of the TLR4/NF-κB pathway. A PPAR-γ agonist ameliorated oxidative stress and NLRP3 inflammasome activation in lipid-laden hepatocytes and subsequently prevented M1 macrophage polarization. Hepatocyte-specific PPAR-γ deficiency aggravated oxidative stress and NLRP3 inflammasome activation in lipid-laden hepatocytes, which further promoted M1 macrophage polarization. Rosiglitazone administration improved oxidative stress and NLRP3 inflammasome activation in HF diet-induced NAFLD mice in vivo.CONCLUSIONUpregulation of PPAR-γ activity in hepatocytes alleviated NAFLD by modulating the crosstalk between hepatocytes and macrophages via the reactive oxygen species-NLRP3-IL-1β pathway.     

葛根素纳米结构脂质载体的制备及理化性质考察

目的:制备用于脑靶向给药的葛根素纳米结构脂质载体(Pue-NLC)并考察其理化性质.方法:采用乳化-超声分散法制备Pue-NLC;以包封率为指标,通过正交试验考察固体脂质材料用量、豆磷脂与泊洛沙姆-188的比例、脂质材料与乳化剂的比例及药物用量对处方工艺的影响,确定最佳制备工艺;通过透射电镜观察粒子形态,分别用Zeta电位及粒度分析仪测定表面电位和粒径,离心超滤法测定包封率,透析法考察其体外释药特性,HPLC测定葛根素含量.结果:最佳制备工艺为脂质材料用量400 mg,豆磷脂与泊洛沙姆-188的比例1:3,脂质材料与乳化剂的比例为1:2,药物用量10 mg.制备的Pue-NLC外形呈类圆球状,粒径分布均匀,平均粒径(89±7)nm,包封率(91.33±1.2)％,平均Zeta电位(-22±0.4)mV;Pue-NLC中葛根素在24 h累积释放率69.25％,且无突释效应.结论:采用乳化-超声分散法制备的Pue-NLC粒径大小分布均匀,药物包封率高,具有明显的缓释效果.