渗透促进剂对川乌总生物碱和新乌头碱透皮吸收的影响

目的 研究各种促渗剂对乌头总碱和新乌头碱透皮吸收的影响.方法 采用改良的Franz扩散池,以生理盐水为接收介质,以大鼠离体背部皮肤为透皮屏障,计算不同浓度单元促透剂和不同组合促透剂作用下乌头总碱和新乌头碱的累积渗透量Q及相关参数.结果 不同促渗剂对乌头总碱和新乌头碱都有不同程度的促渗作用.结论 1%月桂氮(卓)酮+10%丙二醇的促渗效果最好,为乌头总碱透皮吸收制剂处方的优化提供依据.     

恶性血液病自体造血干细胞移植后DC-CIK细胞预防复发探讨

目的探讨恶性血液病自体造血干细胞移植后应用树突状细胞-细胞因子诱导的杀伤细胞(DC-CIK)预防复发的效果。方法12例恶性血液病病人自体造血干细胞移植后静脉输注及腹股沟注射DC-CIK细胞2～3次,观察疾病的复发情况以及DC-CIK细胞输注后的副作用。结果7例持续完全缓解(CR),中位CR期44(32～56)月。4例死亡,其中3例复发。结论DC-CIK细胞治疗可能有助于清除微小残留病,预防疾病复发,延长病人生存期,且副作用小,临床可以选用DC-CIK细胞预防自体造血干细胞移植后恶性血液病的复发。     

Effect of intracoronary administration of anisodamine on slow reflow phenomenon following primary percutaneous coronary intervention in patients with acute myocardial infarction

Background Many basic and clinical studies have proved that anisodamine can produce significant effect on relieving microvascular spasm, improving and dredging the coronary microcirculation. It may be beneficial to the improvement of slow-reflow phenomenon (SRP) following percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). So we investigated the effect of intracoronary administration of anisodamine on SRP of infarct related artery (IRA) following primary PCI in patients with ST segment elevated acute myocardial infarction (STEAMI). Methods Twenty-one patients with SRP from a total of 148 STEAMI patients accepted primary PCI were enrolled into this study from September 2004 to December 2005. When SRP happened, nitroglycerin (200 µg) was “bolus” injected firstly into IRA to exclude the spasm of epicardial artery and identify SRP as well as a baseline and self-control agent following PCI. Ten minutes later, 1000 µg of anisodamine was injected into IRA with SRP at 200 µg/s, while the coronary angiography (CAG) was taken before and at 1st, 3rd and 10th minute after administration of nitroglycerin or anisodamine, respectively. The corrected TIMI frame count (cTFC), TIMI myocardial perfusion grade (TMPG) and the diameter of IRA were calculated and analyzed by Gibson’s TIMI frame count method using quantitative computer angiography (QCA) system to evaluate the influence of anisodamine on coronary flow and vessel lumen. In the meantime the invasive hemodynamic parameters of intracoronary and systemic artery (systolic, diastolic and mean pressure) and electrocardiogram (ECG) were measured and monitored. The changes of ventricular performance parameters and the adverse reaction were evaluated and followed-up at 1 month post-PCI. Results No significant changes in cTFCs and TMPGs were found at 1st, 3rd and 10th minute after intracoronary administration of nitroglycerin as compared with the baseline control (P＞0.05). cTFCs were decreased by 58.3%, 56.2%, and 54.6%, respectively (P<0.001), and TMPGs were increased from 1.13±0.21 grade to 2.03±0.32, 2.65±0.45 and 2.51±0.57 grades (P<0.05) at 1st, 3rd and 10th minute after intracoronary administration of anisodamine as compared with those after intracoronary administration of nitroglycerine, respectively. The average coronary blood flow of TIMI grade was improved from 1.76±0.43 to 2.71±0.46 (P<0.05) while the diameter of middle segment in re-patented coronary artery was slightly increased from (3.20±0.40) mm to (3.40±0.50) mm at the 3rd minute after intracoronary administration of anisodamine (P＞0.05) as compared with those of nitroglycerine control. The systolic, diastolic and mean pressures of intracoronary artery after intracoronary administration of anisodamine increased from 115 to 123, 75 to 84, 88 to 95 mmHg (P<0.05), respectively, along with the rise of heart rate from 68 to 84 beats per minute (P<0.05). There were no significant changes in intervals of PR, QT and QRS (P＞0.05) and no any severe fast arrhythmia after intracoronary administration of anisodamine. The ventricular performance parameters were significantly improved and no major adverse cardiovascular events (MACE) were found during follow-up at 1 month post-PCI. Conclusions Intracoronary administration of 1000 µg anisodamine is effictive in reversing SRP following PCI in STEAMI patients, especially it is suitable for SRP patients with bradycardia or hypotension.     

皮鼓"反取皮"法在皮肤缺损修复中的应用

各种原因所致的皮肤坏死和缺损,使皮肤与筋膜间产生广泛撕脱和潜行剥离,破坏了支配皮肤的血供,若处理不当会造成皮肤全部坏死、感染、败血症、肢体残废,甚至死亡。我科自1995年以来,采用皮鼓“反取皮”法治疗,获得良好的效果,现报告如下。?1　资料和方法1.1　一般资料　共50例,男32例,女18例。年龄5～48岁,平均25.5岁。致伤原因:车祸18例,机械传送带损伤11例,滚筒挤压伤10例,灼伤后瘢痕挛缩11例。损伤性质:辗挫伤14例,挤压伤10例,撕脱伤15例,灼伤后瘢痕挛缩11例。并发症有:休克15例,开放性骨折脱位10例,外伤性截肢2例,内脏损伤1例。皮肤缺损…     

4种保存液对静脉桥管收缩和舒张功能的影响

目的:比较自体全血(WB)、普通盐溶液(NSS)、生理盐溶液(PSS)和Wisconsin液(UWS)4种保存液对兔股静脉内皮细胞和血管平滑肌细胞功能的影响。方法:5只成年家兔离体股静脉分离后,分别在4种保存液中保存3h。然后将静脉分别悬挂于含有WB、NSS、PSS和UWS的组织槽中作张力测定,并记录以下各个张力反应强度数值:①对递增浓度(10-8～10-4M)的去甲肾上腺素(NE)的收缩反应。②对递增浓度(20～100mM)的氯化钾(KCl)的收缩反应。③用KCl预收缩后,对递增浓度(10-7～10-4M)的血管扩张剂罂粟碱的舒张反应。④用NE预收缩后,对钙离子导入剂A23187(10-5M)的舒张反应。结果:①保存于4种液体中的静脉对血管去甲肾上腺素(10-8～10-4M)的收缩反应表现出相似的敏感性及强度。②保存于WB及NSS液中的静脉与保存于PSS液及UWS液中的静脉比较,前两者对递增浓度的KCl(20～100mM)的收缩反应显著低于后两者。③保存于WB及NSS液中的静脉与保存于PSS和UWS液中的静脉相比,前两者对递增浓度的罂粟碱(10-7～10-4M)的舒张反应显著低于后两者。④在WB液中保存的静脉环对钙离子导入剂A23187(10-5M)诱导的舒张反应的程度明显低于其余3组。结论:保存于NSS液及WB液中的静脉桥管的内皮细胞和血管平滑肌细胞的活性受到了损伤,收缩及舒张功能受到损害;PSS液及UWS液可较好地保护静脉桥管的内皮细胞和血管平滑肌细胞的活性。     

经皮椎体后凸成形术的研究应用进展

近年来,经皮椎体成形术（pereutarmous vertebroplasty,PVP）和应用的经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩骨折、椎体血管瘤、转移瘤等获得了显著的临床疗效。与经皮椎体成形术相比,经皮椎体后凸成形术能纠正病椎的后凸畸形,并在椎体内形成一个空腔,可在低压下注入粘稠度较高的骨水泥,明显降低了骨水泥渗漏率,提高了临床疗效。目前,应用球囊扩张的椎体后凸成形术已在欧美国家得到重视并广泛应用,初步临床报道效果满意,我国现在也开展了此类手术并获得了成功。     

髋关节腔、股骨颈髓腔自体骨髓移植药液灌注并中医药治疗在股骨头坏死术后的临床应用(附17例报告)

目的:髋关节腔、股骨颈髓腔自体骨髓移植药液灌注并中医药治疗在股骨头坏死术后的临床应用,探索力学刺激的影响。方法:自2005年~2011年采用开放和微创术式治疗股骨头缺血性坏死患者17例(23髋),年龄19~60岁,平均22.4岁,ARCO分期为ⅠA期3例,ⅡA期8例,ⅡC期3例,ⅢA期3例。全部病例均行自体骨髓移植并药液局部灌注在血管束植入、骨移植及微创术后的应用,术后随访1~7年,根据手术前后Harris评分变化,X线影像学表现随访观察。结果:术后患者Harris评分变化均提高35.71分(平均术前56.29分,术后92分),影像学表现17例保持稳定。结论:自体骨髓移植药液局部灌注并中药治疗在股骨头缺血性坏死术后的应用,操作简单,取材方便,无排异反应。术后恢复快,力学刺激对成骨、成软骨、新生血管形成有一定促进作用。     

HPV DNA自体采样检测用于宫颈癌的初筛

美国《J Natl Cancer Inst》近期发表并推荐阅读的中国学者赵方辉等的研究显示,HPV DNA自体采样检测可作为目前资源欠发达地区宫颈癌初筛的手段或补充。该研究对1999-2007年间5项基于中国人群的宫颈癌筛查大样本研究进行了汇总分析,共13140名17～56岁女性接受了HPV DNA自体采样、医师采样检测以及液基细胞学(liquidbased cytology test,LBC)和醋酸染色肉眼观察法     

自体骨髓干细胞移植治疗系统性红斑狼疮的临床研究

目的：探讨自体骨髓干细胞移植(ABMSCT)对系统性红斑狼疮(SLE)的临床疗效。方法：3例患者采集自体骨髓移植CD34 造血干细胞，预处理用环磷酰胺(CTX)60mg,／kg连续2天静滴，马法兰140mg／m。分次口服，抗CD3、CD8单抗各5mg/天连续5天静滴，用惠尔血(G-CSF)协助造血及免疫重建，用间接免疫荧光法检测抗核抗体、放免法测抗DNA抗体、流式细胞仪测淋巴细胞亚群，观察ABMSCT前后临床表现和免疫学指标的变化。结果：ABMSCT后患者的临床症状明显缓解，异常免疫学指标恢复正常，抗体全部转阴。结论：ABMSCT对SLE有较好的近期疗效，远期疗效还需长期随访。     

不同促渗剂对秦皮甲素乳膏透皮吸收的影响

目的：制备秦皮甲素乳膏,并通过动物离体透皮吸收实验,选择秦皮甲素乳膏中最佳透皮吸收促渗剂。方法：采用透皮扩散装置,以生理盐水为接收介质,以小鼠离体腹部皮肤为透皮屏障,优选出最佳的透皮吸收促渗剂。结果：最优的透皮吸收促渗剂为5％冰片,最佳处方的动力学方程为：y=0．668x＋1．8256,r=0.9991。结论：5％的冰片作为秦皮甲素乳膏的透皮吸收促渗剂具有良好的效果。