Amphiphilic block copolymers bearing six-membered ortho ester ring in side chains as potential drug carriers: synthesis,characterization, and in vivo toxicity evaluation

A new type of amphiphilic block copolymers, poly(ethylene glycol)-block-poly(2-methyl-acrylicacid 2-methoxy-5-methyl-[1,3]dioxin-5-ylmethyl ester) (PEG-b-PMME), bearing acid-labile six-membered ortho ester rings in side chains was synthesized by reversible addition–fragmentation chain-transfer polymerization, and the influence of chain length of the hydrophobic PMME block on micelle properties was investigated. The PEG-b-PMME micelles were stable in aqueous buffer at physiological pH with a low critical micelle concentration. Nile Red as a model drug was encapsulated into the micelles to explore the release profiles. The Nile Red-loaded polymeric micelles showed rapid release of Nile Red in weakly acidic environments (pH 5) but slow release under physiological condition (pH 7.4), due to different hydrolysis rate of ortho ester side chains of PEG-b-PMME. The Paclitaxel (PTX)-loaded micelles retained potency in killing lung cancer cells (A549), compared with the free PTX. No obvious toxicity was found in vitro and in vivo after intraperitoneal injection of the micelles, which confirms that the PEG-b-PMME micelles with unique acid-labile characteristic have great potential as nano-scaled carriers for drug delivery.     

舌下腺癌在多形性腺瘤中1例

发生于舌下腺的癌在多形性腺瘤中极为罕见。本文报道 1例发生于舌下腺的腺样囊性癌在多形性腺瘤的病例。     

Changes in life quality following third molar surgery--the immediate postoperative period

OBJECTIVES: This study describes patients' perceptions of changes in oral health related quality of life (OHQOL) in the early postoperative period following third molar surgery. METHODS: One hundred patients were enrolled in a prospective cohort study of the surgical removal of lower third molars under local anaesthetic. Two specific oral health related quality of life measures, OHIP-14 and OHQoLUK, were administered to the study group prior to surgery. Standardized surgical and analgesic protocols were followed. Patients kept a diary of changes in life quality each postoperative day (POD) for 7 days, completing both OHIP-14 and OHQoLUK daily. RESULTS: Both oral health related quality of life measures identified a significant deterioration in quality of life on POD1 (P<0.01) and this remained evident on POD2 (P<0.01), POD3 (P<0.01), POD4 (P<0.01) and POD5 (P<0.05). By POD6 and POD7 there was no significant difference in quality of life compared with preoperative status (P>0.05). Deterioration in life quality over the study period was associated with postoperative clinical findings (P<0.05): swelling and trismus. CONCLUSION: The study concludes that there is a significant deterioration in oral health related quality of life in the immediate postoperative period following third molar surgery; particularly during the first five days. This is associated with postoperative clinical findings. This has implication for patients deciding on third molar surgery and informed consent.     

采集大隐静脉为冠状动脉旁路移植桥血管:间断小切口与传统长切口的优缺点比较

背景:在冠状动脉旁路移植过程中,大隐静脉仍为最常用的桥血管材料,但采集难度较高.目的:探讨冠状动脉旁路移植中使用间断小切口及传统长切口采集大隐静脉的优缺点.方法:纳入258例采集大隐静脉的冠状动脉旁路移植患者,其中间断小切口法采集大隐静脉112例,传统长切口法146例.观察采集大骆静脉时间、切口长度、缝合时间、总手术时间及术后切口并发症发生率.结果:间断小切口组采集大隐静脉时间长于传统长切口组(P<0.05).切口长度、缝合时间明显短于传统长切口组(P<0.01),总手术时间两组比较,差异无显著性意义(P0.05).术后12 d腿部切口间断小切口组并发症发生率明显小于传统长切口 组(P<0.01),在合并糖尿病患者中,传统长切口组腿部切口并发症发生率明显高于间断小切口组(P<0.01).提示,虽然间断小切口采集大隐静脉时间较长,但腿部并发症发生率明显减少,尤其适合于冠心病合并糖尿病患者.     

大连獐子岛地区2型糖尿病及糖调节受损者907例特征分析

目的:了解大连獐子岛地区2型糖尿病及糖调节受损的患病情况及危险因素,为制定适宜的干预措施提供依据. 方法:2007年采用整群随机抽样的方法对大连獐子岛地区的907例18岁以上常住居民进行横断面调查.采用问卷调查、体格测量、食物摄入频率和回顾性膳食调查;空腹静脉采血测定血尿酸、空腹及餐后2 h血糖、血总胆固醇、血三酰甘油,血清胰岛素等生化及免疫指标. 结果:问卷回收率为95.9%.大连獐子岛地区2型糖尿病及糖调节受损的患病率分别为11.36%,37.38%,男性及女性上述两指标比较差异无显著性意义(P > 0.05),而在糖尿病的患病居民中,仅有29.13%的人知道自己患病.2型糖尿病和糖调节受损的患病率均随年龄的增长而增加(P < 0.01).多因素非条件Logistic回归分析结果显示:年龄、文化程度、饮酒和高胆固醇血症与糖调节受损的发生有关;而年龄、文化程度、高三酰甘油血症、高胆固醇血症、BMI和高血压可增加糖尿病的危险性. 结论:大连獐子岛地区2型糖尿病和糖调节受损的患病率较高,而糖尿病的知晓率低,且与多种因素有关,应采取综合性措施进行防治,以降低患病率.     

组织工程化类金刚石膜复合材料与人血管内皮细胞的相容性研究

目的:验证纳米相类金刚石薄膜复合材料与人血管内皮细胞相容性,为组织上程化机械瓣膜材料的构建提供依据.方法:利用脉冲激光沉积法在人工心脏机械瓣膜上沉积纳米相类金刚石薄膜,将人脐静脉血管内皮细胞与纳米相类金刚石薄膜复合材料体外复合培养.倒置显微镜及扫描电镜观察细胞在材料表面的生长、附着情况;MTT法检测细胞在材料上增殖情况;同时分别测定人脐静脉血管内皮细胞在类金刚石溥膜材料和空白对照组中一氧化氮及前列环素分泌水平,以评价其活性.结果:人脐静脉血管内皮细胞能在纳米相类金刚石薄膜复合材料上良好地黏附、增殖、生长.人脐静脉血管内皮细胞分泌一氧化氮和前列环素水平在类金刚石薄膜材料和空白对照组没有显著性差异(P>0.05),说明纳米相类金刚石薄膜材料对人脐静脉血管内皮细胞的活性没有影响.结论;纳米相类金刚石薄膜复合材料具有良好的细胞相容性,有可能作为组织工程化机械瓣膜材料.     

小梁切开联合小梁切除术32例围术期护理

目的:探讨小梁切开联合小梁切除术治疗先天性青光眼患儿的围术期护理方法.方法:对32例(61眼)先天性青光眼患儿行小梁切开联合小梁切除术,并给予精心术前、术后护理.结果:本组最后一次随访时平均眼压为(15.2±5.5)mm Hg,眼压控制成功率达94.0%.前房出血发生率为45.0%,均于术后5 d内吸收.术后无浅前房、虹膜粘连 、晶状体浑浊及眼内感染发生.结论:加强小梁切开联合小梁切除术治疗先天性青光眼患儿的围术期护理可有效提高手术成功率、减少并发症发生.     

后路减压侧块螺钉置入内固定治疗颈椎多节段后纵韧带钙化:5年36例资料回顾

背景:后路减压侧块螺钉固定能够解除骨化灶对脊髓、神经根的压迫,扩大椎管矢状径,同时重建该区域的稳定.目的:验证应用后路减压、侧块螺钉置入内固定治疗颈椎多节段后纵韧带骨化症5年36例资料的临床疗效.方法:36例患者为3个节段9例,4个节段20例,5个节段7例.结果与结论:随访6~26个月,JOA评分由内固定前平均5.2分提高到 10.2分.颈椎生理曲度由内固定前平均(3.6±0.5) mm提高到内固定后(9.1±0.7) mm,内固定物无松动.提示此方法治疗既能后方直接减压又能前方间接置入减压,既能恢复颈椎生理曲度,又能提供坚强的内固定效应.     

羊水过多孕妇行超声引导下脐静脉穿刺术的护理

目的总结羊水过多孕妇行超声引导下脐静脉穿刺的护理经验。方法对128例行超声引导下脐静脉穿刺的羊水过多孕妇,术前做好心理护理,术中监测孕妇的反应和胎心率情况,术后密切观察病情,加强并发症观察与预防。结果 128例孕妇有127例1次穿刺成功,成功率为99.2%;另1例为2次穿刺成功。3例发生胎心率过缓,经对症治疗后,症状缓解。所有孕妇均未发生早产、死胎、宫内感染等并发症。结论减轻孕妇心理压力,密切观察病情,预防并发症的发生,对提高手术成功率及降低术后并发症的发生具有重要意义。     

缝合锚弹性固定生理重建修复下胫腓联合损伤

背景：目前下胫腓联合损伤传统手术方法创伤大,不能很好地完成韧带的修复,而缝合锚对于韧带修复、重建韧带与骨连接有较为明确的疗效。目的：观察缝合锚技术治疗下胫腓联合损伤的生物力学性能,并与拉力螺钉内固定对比。方法：采集8具新鲜踝关节标本,运用生物力学实验行应力分析,分别应用缝合锚技术、拉力螺钉内固定治疗下胫腓联合损伤,比较2种方案的应力强度、刚度和稳定性等生物力学性能。结果与结论：应用缝合锚技术治疗下胫腓联合损伤的强度、刚度和稳定性等生物力学性能优于拉力螺钉内固定,两者强度和刚度值相比差异有显著性意义(P<0.05);而应力遮挡率缝合锚技术比拉力螺钉小,差异有显著性意义(P <0.05);下胫腓联合分离位移缝合锚技术比拉力螺钉小,差异亦有显著性意义(P <0.05)。结果表明采用缝合锚技术能实现弹性固定生理重建的目的,不但固定强度高稳定可靠,而且创伤小,无需二次取出手术,是治疗下胫腓联合损伤一种优良的微创方法。