In vitro study and semiempirical model for aerosol delivery control during mechanical ventilation

The object of this study was to evaluate in vitro the influence of various ventilatory parameters on the delivery of synchronized nebulization of terbutaline during mechanical ventilation and to determine a semiempirical model to control the quantity of aerosol delivered into the patients lung. An ATOMISOR NL9 M jet nebulizer (La Diffusion Technique Française, France) was filled with terbutaline (Bricanyl, Astra-Zeneca, Sweden) and connected to the inspiratory line of a Horus ventilator (Taema, France). Nebulization was synchronized with the inspiratory phase. We assessed at the end of the endotracheal tube the quantity of terbutaline (terbutaline mass output) and the volume median diameter (VMD) by diffraction-laser method. There was a negative correlation between terbutaline mass output and inspiratory air flow ( r =–0.95, p <0.0001) and between VMD and inspiratory air flow ( r =–0.96, p <0.0001). Moreover, positive end-expiratory pressure levels between 0 cm and 8 cm of water did not significantly change the terbutaline output mass ( p =0.22). Total nebulization time and terbutaline mass output calculated by the mathematical model showed good agreement with experimental data. In conclusion, our semiempirical model allows calculation of the duration of the nebulization required to deliver a given mass of terbutaline into patient lungs.This revised version was published online in May 2005 with a corrected section heading.     

小腿假肢对线对静态站立时下肢受力的影响

目的:研究小腿截肢患者站立状态下假肢对线对下肢受力特性的影响.方法:以假肢侧承重线和重力线作为评价指标,改变假肢矢状面和额状面的对线,采用激光测力平台测量患者静态站立时残侧承重线和重力线的位置,研究下肢受力状况的变化.结果:假肢侧承重线受踝关节对线的影响大于腿管对线调节的影响,并且力线随腿管与接受腔的前倾而前移,而额状面对线的影响很小;矢状面内重力线主要受踝关节对线调节的影响,并且与变化角近似正比例相关.结论:矢状面假肢对线调整对残侧下肢受力状况的影响较大,而额状面的对线调整影响较小.     

乳癖散结胶囊中挥发油的提取及包合工艺研究

目的：优选乳癖散结胶囊中挥发油的提取与包合工艺.方法：采用水蒸气蒸馏法提取挥发油,以提取量为指标,通过单因素试验考察药材粉碎度、提取时间对提取工艺的影响;采用饱和水溶液法包合挥发油,以包合率为指标,通过正交试验考察挥发油与β-环糊精（β-CD）的比例、包合温度和时间对包合工艺的影响.结果：最佳提取工艺为药材粉碎成最粗粉（通过10目筛）,提取3h;最佳包合工艺为β-环糊精和挥发油的比例为4∶0.5 （g∶ ml）,包合温度45℃,包合时间1.5h.结论：优选的挥发油提取与包合工艺条件稳定可行,为其生产提供参考依据.     

2013年我院门急诊中成药不合理用药处方分析

目的：了解我院门急诊中成药用药情况,促进临床合理用药.方法：采用回顾性调查方法,对我院2013年1-12月每月200张门急诊处方用药情况进行汇总,对不合理用药处方进行归纳分析.结果：不合格处方占总处方的5.41％,其中不规范处方占52.31％,用药不适宜处方占40.77％,超常处方占6.92％;主要表现为联合、重复、遴选药物不适宜及无适应证用药等.结论：通过处方点评查找存在的不合理用药现象,医务部门针对不合理情况进行干预,临床药师参与日常临床用药指导,以促进我院中成药临床合理应用.     

Comparison of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease

Purpose

The purpose of this study was to compare the clinical and radiological outcomes of minimally invasive versus open transforaminal lumbar interbody fusion in two-level degenerative lumbar disease.

Methods

We conducted a prospective cohort study of 82 patients, who underwent two-level minimally invasive or open transforaminal lumbar interbody fusion (TLIF) from March 2010 to December 2011. Forty-four patients underwent minimally invasive transforaminal lumbar interbody fusion (MITLIF) (group A) and 38 patients underwent the traditional open TLIF (group B). Demographic data and clinical characteristics were comparable between the two groups before surgery (p > 0.05). Peri-operative data, clinical and radiological outcomes between the two groups were compared.

Results

The mean follow-up period was 20.6 ± 4.5 months for group A and 20.0 ± 3.3 months for group B (p > 0.05). No significant difference existed in operating time between the two group (p > 0.05). X-ray exposure time was significantly longer for MITLIF compared to open cases. Intra-operative blood loss and duration of postoperatively hospital stay of group A were significantly superior to those of group B (p < 0.05). On postoperative day three, MITLIF patients had significantly less pain compared to patients with the open procedure. No statistical difference existed in pre-operative and latest VAS value of back pain (VAS-BP) and leg pain (VAS-LP), pre-operative and latest ODI between the two groups. The fusion rate of the two groups was similar (p < 0.05). Complications included small dural tear, superficial wound infection and overlong screws. When comparing the total complications, no significant difference existed between the groups (p > 0.05).

Conclusions

MITLIF offers several potential advantages including postoperative back pain and leg pain, intra-operative blood loss, transfusion and duration of hospital stay postoperatively in treating two-level lumbar degenerative disease. However, it required much more radiation exposure.     

Pulsed 808-nm infrared laser stimulation of the auditory nerve in guinea pig cochlea

Pulsed near-infrared radiation has been proposed as an alternative stimulus for auditory nerve stimulation and could be potentially used in the design of cochlear implant. Although the infrared with high absorption coefficient of water (i.e., wavelength ranged from 1.8 to 2.2 μm) has been widely investigated, the lymph in the cochlea absorbs most of the infrared energies, and only a small part can arrive at the target auditory nerves. The present study is aimed to test whether the short-wavelength near-infrared irradiation with lower absorption coefficients can penetrate the lymph fluid to stimulate the auditory nerves. An 808-nm near-infrared laser was chosen to stimulate the auditory nerve in the guinea pig cochlea. The infrared pulse was delivered by an optical fiber that was surgically inserted near the round window membrane and oriented toward the spiral ganglion cells in the basal turn of the cochlea. The 2-Hz infrared pulses were used to stimulate the cochlea before and after the deafness with different pulse durations (100–1,000 μs). Optically evoked compound action potentials (oCAPs) were recorded during the infrared radiation. We successfully recorded oCAPs from both normal hearing animals and deafened animals. The oCAP amplitude increased with the infrared radiation energy. The preliminary experiment suggests that the near-infrared with lower absorption coefficients can effectively pass through the lymph filled in the cochlea and stimulate the auditory nerve. Further studies will optimize the deafness animal model and determine the optimal stimulation parameters.