如何解决临床实习与患者隐私权保护的予盾

针对当前临床实习与患者隐私权保护矛盾的日渐激烈现象,以临床实习医生365人为对象进行调查分析研究,提出解决矛盾的办法.     

Catastrophic Periprosthetic Osteolysis in Total Hip Arthroplasty at 20 Years: A Case Report and Literature Review

BackgroundPeriprosthetic osteolysis is a serious complication following total hip arthroplasty (THA). However, most orthopedic surgeons only focus on bone loss and hip reconstruction. Thus, it was required to understand the treatment algorithm for periprosthetic osteolysis integrally.Case PresentationA 52‐year‐old Asian male presented with chronic hip pain. A mass appeared on the medial side of the proximal left thigh at more than 20 years after bilateral THA. Radiographs revealed catastrophic periprosthetic osteolysis, especially on the acetabular side. Large amounts of necrotic tissue and bloody fluids were thoroughly debrided during revision THA. A modular hemipelvic prosthesis was used for revision of the left hip. Four years later, the patient presented with right hip pain, where a mass appeared on the medial side of the proximal right thigh. A primary acetabular implant with augment was used for revision of the right hip. Laboratory evaluation of bloody fluid retrieved from surgery revealed elevated levels of inflammatory markers.ConclusionInflammatory responses to polyethylene wear debris can lead to severe bone resorption and aseptic loosening in the long‐term following THA. Therefore, in spite of revision THA, interrupting the cascade inflammatory might be the treatment principle for periprosthetic osteolysis.     

愈合时间和微动效应对种植义齿形成骨性结合的影响

种植体与周围骨组织界面之间形成骨性结合是种植体在颌骨中获得稳定固位的组织学基础,而种植体植入颌骨后的无负荷愈合时间和种植体的微动效应是决定骨性结合能否形成的关键因素,相关的研究也一直是种植义齿研究领域的热点之一.本文对种植义齿愈合时间以及微动效应的研究进程和相关理论的发展进行了综述.     

美容相关眼部损伤急性期的临床表现

目的：探讨美容相关眼部损伤急性期的临床表现。

方法： 回顾性研究。收集2016-04/2021-10因美容导致的眼部损伤患者53例89眼,分析患者急性期的临床特征,包括性别、年龄、受伤眼别、临床表现、致伤原因、治疗过程及预后。

结果：纳入53例89眼患者均为女性,年龄22-45(平均28.4±6.7)岁。单眼损伤17例,双眼损伤36例。2种或2种以上眼部损伤可累及同一眼。导致眼部损伤的主要美容操作包括：纹眼线38眼(43%); 嫁接睫毛18眼(20%); 去除假睫毛11眼(12%); 涂睫毛膏8眼(9%); 双重睑手术6眼(7%); 其他8眼(9%)。主要眼部损伤类型包括：角膜损伤56眼(63%); 眼睑接触性皮炎26眼(29%); 结膜炎19眼(21%); 眼睑反应性水肿13眼(15%); 眼表异物12眼(14%); 睑缘细菌性感染10眼(11%); 其他5眼(6%),这其中包括因眼周注射玻尿酸导致视网膜中央动脉阻塞1眼(1%)。74眼经过正规治疗可在1-2 wk内痊愈,3眼出现丝状角膜炎,视网膜中央动脉阻塞1眼预后差。

结论：美容相关眼部损伤见于中青年女性,引发眼部损伤最常见的美容操作是纹眼线,最主要损伤类型为角膜损伤。美容相关眼部损伤多数可以预防,治疗方法有效且总体预后良好。     

酸枣仁中黄酮类镇静催眠有效成分的研究

本文对辽宁产的酸枣仁中的黄酮类成分进行了初步研究,从中分离出一种淡黄色无定形粉末,经鉴定为黄酮碳甙(spinosin)。动物实验证明,酸枣仁中镇静催眠作用的成分不仅是皂甙成分,黄酮也是主要成分之一。     

Pharmacokinetic comparisons of berberine and palmatine in normal and metabolic syndrome rats

Ethnopharmacological relevance

San-Huang formula is a popular traditional Chinese medicine (TCM) preparation to replenish Qi, resolve phlegm, dissipate blood stasis, and therapy metabolic syndrome in China. Metabolic syndrome, which is accompanied by Qi and blood stasis, mainly arises from spleen deficiency in essence. There is limited information available for differences of pharmacokinetic properties of San-Huang formula between normal and metabolic syndrome rats. The present study was conducted to compare the pharmacokinetics of berberine as well as palmatine in normal and metabolic syndrome rats following oral administration of San-Huang formula extract.

Materials and methods

The animals were orally administered with San-Huang formula extract with the equivalent dose of 60.4 and 12.5 mg/kg for berberine and palmatine, respectively. The blood samples were collected according to the time schedule. The concentrations of berberine and palmatine in rat plasma were determined by LC–ESI/MS. Various pharmacokinetic parameters were estimated from the plasma concentration versus time data using non-compartmental methods.

Results

It was found that AUC_0−t, C_max, Vd and CL of berberine and palmatine in metabolic syndrome rats were significantly different (P<0.05) from normal rats.

Conclusions

The results indicated that berberine and palmatine have higher uptake and slower elimination in the rats with metabolic syndrome, which suggests that the rate and extent of drug metabolism were altered in metabolic syndrome rats.     

Elucidating the mechanism of nucleation inhibition of pathology crystallization of gout based on the evidence from amorphous form and in solution

The first gout attack in a hyperuricaemic patient may be regarded as a nucleation event which is caused by monosodium urate monohydrate (MSUM) deposition in the synovial fluid. The effect of Tailor-Made Inhibition (TMI) may be effective as drugs for the prevention of aberrant nucleation and crystallization. Therefore, the understanding of the underlying mechanisms in inhibiting the MSUM nucleation by TMI has proven to be of great significance. Yet most of the published studies about nucleation inhibition have tended to focus on simpler molecular models with a hydrogen-bonded acceptor and donor, which may be not suitable for the uric acid molecule with multiple hydrogen-bonded acceptors and donors under physiological conditions. Herein, the mechanisms of nucleation inhibition of MSUM were explored in a simulated biological environment (0.15 M Na⁺ and pH 7.40) in the presence and absence of TMI. And the evidence of nucleation inhibition by TMI in solution and the amorphous form of MSUM was investigated by HNMR, IR, Raman, PXRD, Dynamic light scattering (DLS), induction time measurements, and density functional theory (DFT) calculations. Results showed that the inhibition comes from a combination of kinetic and thermodynamic effects, with an impact of kinetics as the TMI inhibition effects far exceeded what could be accounted for by changes in usual factors of classical nucleation theory. The data demonstrated that the complex between urate and TMI disturbed the formation of two-dimensional sheets of sodion and purine rings parallel to the (011) plane and further impeded the formation of a three-dimensional structure with aromatic stacking interactions in solution. To our knowledge, the nucleation inhibition of TMI is achieved by suppressing interplanar stacking, which is a mechanism proposed for the first time.

Xanthine, a tailor-made inhibitor, could suppress nucleation in the crystallization of gout pathology by blocking the dominant interplanar accumulation in a solution.     

薄层扫描色谱法测定洗剂中苯甲酸苄酯与邻苯二甲酸二丁酯的含量

采用双波长薄层色谱扫描法同时测定复方苯甲酸苄酯洗剂中苯甲酸苄酯与邻苯二甲酸二丁酯的含量，点样后能将本品中两个有效成分很好地分离，在ＧＦ２５４板上，经甲苯∶二氯甲烷（２∶１）混合溶剂展开，反射锯齿扫描测定，λｓ２３５ｎｍ，λＲ２６０ｎｍ，以外标两点法定量。苯甲酸苄酯与苯二甲酸二丁酯测定的线性范围分别为６．０～３０．０μｇ和１０．０～５０．０μｇ。方法可行，结果满意。     

气传花粉播报平台在过敏性鼻炎预防治疗中的应用研究

目的 利用气传花粉播报平台进行花粉浓度播报及AR防治措施普及,结合相关数据分析,为患者对疾病的防治提供指导。方法 于2019及2020年的3～10月进行花粉采集及阅片计数,通过播报平台进行花粉浓度日播报,统计同期AR患者门诊就诊情况及平台用户流量,分析以上数据寻找本地区花粉分布规律与AR患者就诊相关性,为今后指导患者预防治疗打好前期工作基础。结果 呼和浩特地区花粉浓度存在春季和夏秋季两个高峰期,浓度变化趋势与门诊AR就诊人次及平台用户流量呈正相关。结论 借助本地区建立的气传花粉播报平台,在发布实时花粉浓度预警的同时可以指导AR患者及时采取预防性治疗,对减轻症状,降低严重并发症起到较好辅助作用。     

GOS Ameliorates Nonalcoholic Fatty Liver Disease Induced by High Fat and High Sugar Diet through Lipid Metabolism and Intestinal Microbes

The treatment of nonalcoholic fatty liver disease (NAFLD) remains very challenging. This study investigated the therapeutic effect of galactose oligosaccharide (GOS), an important prebiotic, on NAFLD through in vivo and in vitro experiments and preliminarily explored the mechanism by which GOS improves liver lipid metabolism and inflammation through liver and intestinal microbiological analysis. The results of mouse liver lipidomics showed that GOS could promote body thermogenesis in mice with high-fat and high-sugar diet (HFHSD)-induced NAFLD, regulate lipolysis in liver fat cells, and accelerate glycine and cholesterol metabolism. GOS dose-dependently reduced the contents of total cholesterol (TC) and triglyceride (TG) in cells and reduced the accumulation of lipid droplets in cells. GOS also reduced the Firmicutes/Bacteroidetes ratio and altered the composition of the intestinal microbiota in mice fed a HFHSD. GOS can improve liver lipid metabolism and intestinal structure of NAFLD. These results provide a theoretical and experimental basis supporting the use of GOS as a health food with anti-NAFLD functions.