固载去甲万古霉素缓释微球补片对切口疝金黄色葡萄球菌感染的预防作用

目的补片修补切口疝术后可能发生感染,采用载药补片预防感染是解决方法之一。通过制备大鼠切口疝金黄色葡萄球菌感染模型,观察固载去甲万古霉素缓释微球聚丙烯补片修补切口疝术后对感染的预防作用。方法采用复乳溶剂挥发法制备去甲万古霉素缓释微球,并将其固载至聚丙烯补片(50 mg/片)。扫描电镜观察去甲万古霉素缓释微球形态,采用高效液相色谱法检测微球中去甲万古霉素含量以及补片中去甲万古霉素释放率。取健康10～11周龄雄性SD大鼠40只,体重200～250 g;制备切口疝金黄色葡萄球菌感染模型,分别植入固载去甲万古霉素缓释微球聚丙烯补片(实验组,n=20)和聚丙烯补片(对照组,n=20)。术后观察两组大鼠切口愈合情况,3周时处死大鼠取补片及周围组织进行组织学观察,并进行炎症程度分级。结果扫描电镜观察示去甲万古霉素缓释微球形态完整,表面平滑;微球粒径较均一,64%微球粒径位于60～100μm;去甲万古霉素载药量为19.79%。固载去甲万古霉素缓释微球聚丙烯补片表面均匀,载药量为(7.90±0.85)mg/cm2,去甲万古霉素体外释放达28 d以上,累计释放率达72.6%。两组大鼠术后均存活至实验完成。22只大鼠切口发生感染,其中实验组2只(10%),对照组20只(100%);两组感染率比较,差异有统计学意义(χ2=32.727 3,P=0.000 0)。实验组镜下见局部炎性反应不明显,炎症程度分级Ⅰ级16只,Ⅱ级4只;对照组补片有大量炎性细胞浸润,炎症程度分级Ⅱ级3只,Ⅲ级17只。两组炎症程度分级比较,差异有统计学意义(Z=32.314,P=0.000)。结论固载去甲万古霉素缓释微球聚丙烯补片对大鼠切口疝金黄色葡萄球菌污染具有抗感染作用。     

顶空毛细管气相色谱法测定富马酸喹硫平中残留溶剂

目的 建立富马酸喹硫平中残留溶剂乙醇、甲苯的气相色谱测定方法.方法 采用DB-624弹性石英毛细管柱(30 m×0.53 mm×3.0 μm),载气为氮气,氢火焰离子化检测器,进样口温度为180 ℃,检测器温度为300 ℃.柱温采用程序升温:初始温度为50 ℃,保持5 min,然后以8 ℃/min的速率升至130 ℃,保持5 min;流速为2 mL/min.分流比为1∶60,以80%乙腈为样品的溶剂.结果 使用该方法乙醇、甲苯得到了较好的分离与测定;回收率分别为95.72%和88.59%,相对标准偏差(RSD)分别为2.4%和4.3%;精密度RSD分别为1.1%和4.0%.结论 该方法简便、准确、可靠,可用于药品检验中富马酸喹硫平中残留溶剂的测定.     

富马酸伊布利特中有机溶剂残留量的顶空毛细管GC测定

建立了顶空毛细管GC法同时测定富马酸伊布利特中甲醇、乙醇、二氯甲烷、丙酮、乙醚、四氢呋喃、吡啶7种有机溶剂的残留量。采用HP-1毛细管柱,FID检测器,水为溶剂。平均回收率分别为99.1%、98.9%、100.5%、97.9%、97.2%、98.6%、100.7%;RSD分别为1.84%、1.43%、1.66%、1.64%、1.99%、1.28%、3.52%。     

Low frequency of somatic mutations in the FH/multiple cutaneous leiomyomatosis gene in sporadic leiomyosarcomas and uterine leiomyomas

Germline mutations in the fumarate hydratase gene at 1q43 predispose to dominantly inherited skin and uterine leiomyomata and leiomyosarcomas. The enzyme, which is a component of the tricarboxylic acid cycle, acts as a tumour suppressor. To evaluate fumarate hydratase in respective sporadic tumours, we analysed a series of 26 leiomyosarcomas and 129 uterine leiomyomas (from 21 patients) for somatic mutations in fumarate hydratase and allelic imbalance around 1q43. None of the 26 leiomyosarcomas harboured somatic mutations in fumarate hydratase. Fifty per cent of leiomysarcomas tested showed evidence of allelic imbalance at 1q, but this was not confined to the vicinity of fumarate hydratase. Only 5% (seven out of 129) of the leiomyomas showed allele imbalance at 1q42-q43 and no somatic mutations in fumarate hydratase were observed. Our findings indicate that mutations in fumarate hydratase do not play a major role in the development of sporadic leiomyosarcomas or uterine leiomyomas     

北五味子化学成分研究

目的对北五味子进行进一步化学研究。方法采用色谱和光谱法分离鉴定北五味子的化学成分。结果分离得到四个化合物,分别鉴定为甘五酸(ganwuwe izic ac id,Ⅰ),富马酸单乙酯(mono-ethyl fum arate,Ⅱ),二十四烷酸(tetracosanoicac id,Ⅲ),内消旋二氢愈疮木酸(m eso-d ihydroguaiaretic ac id,Ⅳ)。结论Ⅰ,Ⅱ,Ⅲ均为首次从该植物中分离得到,Ⅳ的13CNMR数据为首次报道。     

Dermatomyositis exacerbated by abdominal Marlex® mesh implantation: Adjuvant effect?

Summary We describe a 35-year-old woman with dermatomyositis, who four months after implantation of abdominal Marlex® mesh, developed a severe exacerbation of her disease with muscle weakness, elevated acute-phase reactants, a high level of muscle enzymes, and the appearance of dermal lesions with calcinosis. The Marlex® mesh implant may have triggered the flare-up of her underlying autoimmune disorder.     

Tension-free repair versus modified Bassini technique (Andrews technique) for strangulated inguinal hernia: a comparative study

Background: To compare tension-free hernia repair to a modified Bassini technique (Andrews technique) used to treat complicated inguinal hernia.Methods: In the period 1990–2004, 75 patients were submitted to emergency operation because of strangulated inguinal hernia. 33 patients underwent tension-free repair utilizing a polypropylene mesh (group A), whereas the remaining 42 patients underwent a modified Bassini technique (group B).Results: Mean operative time was significantly longer for group B (91.5±9.3 min vs 75.7±10.5 min, p<0.05). Postoperative hospital stay was also significantly longer in group B compared to group A (10.3±3.4 days vs 4.5±2.1 days, p<0.01). Postoperative complication rate did not differ significantly between the two groups (5/33, 15.1% vs 5/42, 11.9%, p=n.s.). No mesh had to be removed. At follow-up (mean 9±4.2 years), there was one recurrence in group A (1/33, 3%) and two recurrences in group B (2/42, 4.7%) (p=n.s.).Conclusion: The presence of a strangulated inguinal hernia cannot be considered a contraindication for the use of a prosthetic mesh.     

The susceptibility of prosthetic biomaterials to infection

Background Despite the use of a sterile technique and the administration of prophylactic antibiotics during surgical procedures, mesh infection continues to complicate the use of biomaterials. The purpose of this study was to compare the susceptibility to infection of prosthetic biomaterials in a live-animal model.Methods The following seven prosthetic mesh biomaterials were used in this study. Expanded polytetrafluoroethylene (ePTFE) with silver/chlorhexidine (DM+), ePTFE (DM), porcine intestinal submucosa (S), polypropylene (M), ePTFE/polypropylene (X), hyaluronate/carboxymethylcellulose/polypropylene (SM), and human acellular dermal matrix (A). Lewis rats (n = 108) underwent creation of a single ventral hernia; 105 of them were repaired with a different mesh (2-cm² piece). Twelve pieces of each mesh were inoculated at the time of hernia repair with 10⁸ Staphylococcus aureus (n = 84). Three pieces of each mesh were placed without bacterial inoculation (n = 21). In three animals, no mesh was placed; instead, the peritoneum of the hernia defect was inoculated (n = 3). After 5 days, the animals were killed and the mesh was explanted (peritoneum for the nonmesh control). The mesh was vortex-washed and incubated in tryptic soy broth. Bacterial counts were determined using serial dilutions and spot plates and quantified in colony-forming units (CFU) per square centimeter of mesh present in the vortex wash fluid (wash count) and the soy broth (broth count). Data are presented as the mean log₁₀, with analysis of variance (ANOVA) and Tukey’s test used to determine significance (p < 0.05).Results The DM+ material had no detectable live bacteria in the wash or broth counts in 10 of 12 tested samples (p = 0.05). Of the samples that showed bacterial growth, the peritoneum control group had a lower wash count than A (p = 0.05) and the lowest broth count of all the materials except for DM+ (p = 0.05). In addition, SM had a significantly lower wash count than A (p = 0.05), with no broth count difference. In regard to wash and broth counts, DM, M, X, SM, S, and A were no different (p = NS).Conclusions The DM+ material was the least susceptible to infection. Impregnation with silver/chlorhexidine killed the inoculated bacteria, preventing their proliferation on the mesh surface. Other than DM+, native peritoneal tissue appears to be the least susceptible to infection. Silver/chlorhexidine appears to be an effective bactericidal agent for use with mesh biomaterials.Presented at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Denver, CO, USA, 31 March-3 April 2004     

An ambispective observational study in the safety and efficacy of posterior colporrhaphy with composite Vicryl-Prolene mesh

There is increasing evidence to show that the use of surgical meshes reduces recurrence rates of hernia repair and anterior vaginal wall prolapse. The aim of this study was to determine the safety and efficacy of posterior colporrhaphy with mesh in patients with posterior vaginal prolapse. An ambispective observational study involving 90 patients was conducted with retrospective chart review and prospective subjective and objective assessments at the end of a 1-year study period. Apart from 2 of 90 (2.2%) minor hematoma incidents, there was no other major perioperative morbidity. Prevalence of common prolapse complaints of vaginal lump sensation, constipation, defecation difficulty and dyspareunia all improved significantly postoperatively (p<0.001). Surgical correction was achieved in 27 of 31 (83.9%) at 6 months and beyond. There was no mesh infection but minor vaginal mesh protrusion was found in 7 of 90 (7.8%) patients at 6–12 weeks and 4 of 31 (12.9%) patients at 6 months and beyond. All these were treated easily with trimming without the need of mesh removal. We conclude that posterior colporrhaphy with mesh is effective in treating posterior vaginal prolapse in short term.Editorial Comment: This study reflects the authors experience in using a Vicryl-Prolene mesh, Vypro II, for treatment of rectocele in 90 patients. No serious operative or postoperative complications occurred. The most common minor complication was vaginal mesh protrusion, with a 9 of the 90 being found with this problem; all but 1 of these were resolved with a simple clinic procedure. In a group of 31 patients followed for at least 6 months, the authors note a 16% recurrence rate of rectocele. In a questionnaire given after the surgeries, comparing pre-op and post-op symptoms, 63–79% of the respondents felt improved, depending on the symptom. The authors feel that vaginal colporrhaphy with Vicryl-Prolene mesh will prove to be more efficacious than the existing popular approaches, including site-specific defect repair. Clearly, randomized controlled studies with longer follow-up comparing this method with other colporrhaphy techniques will be needed to validate this assumptionAn erratum to this article can be found at