外伤性血气胸中心静脉导管置管引流术的护理

目的 探讨中心静脉导管胸腔闭式引流术在外伤性血气胸患者的临床疗效及护理体会.方法 对62例外伤性血气胸的患者采用中心静脉导管胸腔闭式引流法治疗血气胸,护理并观察患者疗效及并发症.结果 本组病例患者疼痛少,引流口创伤小、愈合佳,血气胸吸收满意.结论 中心静脉导管胸腔闭式引流术对外伤性血气胸的治疗有积极的作用,可减轻患者的痛苦,利于血气胸吸收,缩短住院时间,值得临床推广.     

中医药治疗慢性乙肝的几个关键性问题

围绕慢性乙肝这一严重影响人类公共卫生的重大社会问题,开展中医药治疗的研究与探索,首先应肯定中医药治疗CHB具有临床疗效及优势,使其成为治疗CHB的主要方法;继而采用健康教育与药物治疗相结合,运用正确的中医认识和思维方法,结合生物医学的最新研究进展,根据病证结合的方法进行分阶段治疗;并选择宏观症状的改善和微观检查指标的应答及生存质量的提高为观察指标,合理而有效的评价其临床疗效。     

运动疗法在冠心病康复中运用的研究进展

<正>随着人们生活水平的提高,冠心病(CHD)的发病率和病死率呈上升趋势,给社会和家庭造成严重的经济负担。冠心病的治疗方法主要包括药物治疗、介入治疗、手术治疗、康复治疗等。其中运动疗法是心脏康复最经典、最主要的手段,自面世以来已有半个多世纪的历史,其内容、方案和作用已为临床所公认。我国现代心脏康复医学是从20世纪80年     

胆盐/磷脂混合胶束对疏水性天然药物增溶性能的研究

目的:研究胆盐/磷脂混合胶束(BS/PC-MM)体系对疏水性天然药物的增溶能力及影响因素。方法:选择不同纯度的大豆磷脂(SPC)、蛋黄磷脂(EPC)与高纯度的胆酸盐制备胆盐/磷脂混合胶束(BS/PC-MM)。以透光率方法测定胆酸盐对磷脂的溶解能力,以20(S)人参皂苷Rg3、Rh2、黄芪甲苷、20(S)原人参二醇、原人参三醇和呋喃二烯为疏水性模型药物,考察了SDC/SPC-MM对药物的增溶特性。结果:高纯度的大豆磷脂和蛋黄磷脂适合制备成澄明的BS/PC-MM溶液。胆酸盐对磷脂的增溶能力为,脱氧胆酸钠>胆酸钠,胆酸盐对蛋黄磷脂的溶解度增加略高于大豆磷脂。20(S)原人参二醇、原人参三醇和呋喃二烯与SPC的亲和性较高。而20(S)人参皂苷Rh2、Rg3和黄芪甲苷与SDC的亲和性强,SDC/SPC-MM的脂质总质量增加,疏水性药物的溶解度提高。结论:胆盐/磷脂混合胶束(BS/PC-MM)对疏水性药物具有较好的溶解度,增溶能力受药物的理化性质和混合胶束的组成影响,可成为疏水性药物的非肠道给药新型载体。     

木耳菌丝体及其醇提物的药理作用

木耳菌丝体小鼠ip给药能明显提高外周血T淋巴细胞百分率,使环磷酰胺引起的半数溶血值HC₅₀减少恢复正常;其醇提物体内外均能明显抑制ADP诱导大鼠血小板聚集作用,缩短小鼠红细胞电泳时间。     

Arthroscopic Management of Giant Meniscal Cysts Among Young Patients: An Average Three‐Year MRI Follow‐Up

ObjectiveTo describe an arthroscopic technique for giant meniscal cyst excision with preservation of the functional meniscus, report the short‐ and medium‐term outcomes, and assess magnetic resonance imaging (MRI) for follow‐up imaging evaluations.MethodsA total of 54 consecutive patients with symptomatic meniscal cysts were admitted to the Second Xiangya Hospital of Central South University between 2014 and 2019. Nine patients with giant meniscus cysts (six females and three males) were included in this study. The age range of the patients was 6–34 years. All patients underwent a complete physical examination, X‐ray, Doppler ultrasound, and MRI of the knee preoperatively. After an arthroscopic diagnosis of a meniscal rupture with a giant meniscal cyst, partial meniscectomy, ablation of the cyst, and suturing of the retainable meniscus were performed. Lysholm and International Knee Documentation Committee (IKDC) scores were used preoperatively and at the most recent follow‐up. Clinical outcomes were classified into four categories: excellent, good, fair, and poor. During the last visit, all patients underwent MRI to assess the recurrence of the cyst and meniscal suture healing.ResultsPreoperative MRI and arthroscopic examination revealed giant meniscal cysts combined with meniscal tears and congenital discoid meniscus, and all giant meniscal cysts occurred in the lateral meniscus. The main types of meniscal tears were horizontal and complex tears. The cysts were unicystic in one case and multicystic in eight cases. The mean size of the cysts on the MRI was 5.86 cm × 2.24 cm × 2.48 cm. The mean follow‐up periods were 37.5 (19–60) months. Clinical outcomes were excellent in six patients and good in three patients. The postoperative scores were significantly improved compared to the preoperative scores (Lysholm: 90.78 ± 4.60 vs. 54.56 ± 7.25; IKDC: 96.2 ± 3.46 vs. 61.69 ± 3.36; p <0.01). No recurrence of the cyst was indicated on the MRI, and there was good healing of the torn meniscus.ConclusionsArthroscopic cystectomy combined with the meniscus suture technique was effective to eradicate residual cyst cavities, and traffic orifices be highly recommended.     

Preparation,characterization and in vitro study of bellidifolin nano-micelles

Bellidifolin (BEL), a xanthone compound, has significant therapeutic effectiveness in cardiac diseases such as arrhythmias. However, BEL is limited in clinical applications by its hydrophobicity. In this work, we used BEL as the active pharmaceutical ingredient (API), and polyethylene glycol 15-hydroxy stearate (Kolliphor HS15) as the carrier to prepare BEL nano-micelles by a solvent-volatilization method. According to an analysis by differential scanning calorimetry (DSC), BEL was successfully encapsulated in HS15 as BEL nano-micelles with a 90% encapsulation rate, and particle size was 12.60 ± 0.074 nm in the shape of a sphere and electric potential was −4.76 ± 4.47 mV with good stability and sustained release characteristics. In addition, compared with free drugs, these nano-micelles can increase cellular uptake capacity, inhibit the proliferation of human cardiac fibroblasts, and down-regulate the expression of Smad-2, α-SMA, Collagen I, and Collagen III proteins in myocardial cells to improve myocardial fibrosis. In conclusion, the BEL nano-micelles can provide a new way for the theoretical basis for the clinical application of anti-cardiac fibrosis.

Bellidifolin (BEL), a xanthone compound, has significant therapeutic effectiveness in cardiac diseases such as arrhythmias.     

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.     

男男性行为者艾滋病暴露前预防用药性行为去抑制化情况

目的：了解男男性行为者（men who have sex with men,MSM）在参加暴露前预防用药（pre-exposure prophylaxis,PrEP）临床试验中是否存在性行为去抑制化现象及其影响因素。方法：采用非概率抽样法招募并筛选出108名MSM,随机分为77名服用药物组和31名空白对照组,第12、24、36、48周进行临床随访和问卷调查,问卷调查主要包括社会人口学特征,艾滋病相关知识、态度和行为等相关情况。采用单因素和多因素的广义估计方程分析MSM在参与PrEP中是否存在性行为去抑制化现象及其影响因素。结果：药物服用组MSM在参与PrEP的第12、24、36、48周的性伴个数中位数分别为1（0,6）、1（0,6）、1（0,10）、1（0,3）、1（0,3）,高危性行为次数中位数分别为1（0,26）、1.5（0,8）、1（0,12）、1（0,9）、2（0,30）;空白对照组性伴个数中位数分别为1（0,21）、1（0,2）、1（0,3）、1（0,3）、1（0,3）,高危性行为次数中位数分别为1（0,9）、1（0,6）、0.5（0,15）、0（0,10）、1（0,10）;多因素广义估计方程分析发现MSM在参与PrEP过程中性伴个数及高危性行为次数均没有发生改变（Z=-0.24,P=0.811;Z=0.93,P=0.355）,性行为方式为“1”和“0.5”的较性行为方式为“0”的拥有更多的性伴（Z=2.47,P=0.014;Z=2.24,P=0.025）;发生过商业性行为的MSM较没有发生过的拥有较少的性伴和高危性行为（Z=-2.82,P=0.005;Z=-2.28,P=0.023）;已婚较离异MSM发生较少的高危性行为次数（Z=-2.34,P=0.019）。结论：本研究中暂未发现PrEP中存在性行为去抑制化现象,性行为方式为“1”和“0.5”的MSM拥有较多性伴,是后期随访中的重点管理人群。还需进一步加强对艾滋病相关知识的科普。