超声弹性成像联合BI-RADS分类在乳腺微小癌诊断中的临床价值

目的:探讨在乳腺微小癌诊断中联合应用超声弹性成像及数据系统(BI-RADS)分类的临床价值.方法:选择2018年3月～2019年3月本院接收的疑似乳腺微小癌的96例患者作为研究对象.均进行超声弹性成像检查、BI-RADS分类,以病理检查结果为诊断金标准,比较单项检查与联合检查的准确率、灵敏度、特异度.结果:数据显示,在...     

小儿清热止咳分散片的填充剂与崩解剂筛选

目的为了制备中药分散片,以小儿清热止咳糖浆方剂为模型药物筛选中药分散片的填充剂和崩解剂。方法以抗张强度、吸湿性和压缩功作为选择填充剂的依据,以吸水性实验、溶胀度实验、空白片崩解时限和加入质量分数为50%浸膏的片剂崩解时限为选择崩解剂的依据。测定发泡量和产气量作为选择泡腾崩解剂的依据。结果综合以抗张强度、吸湿性和压缩功大小,选择乳糖作为分散片的填充剂。溶胀性能优劣顺序是:CMS-Na>L-HPC(信越)>PVPP>MCC101>MCC301>L-HPC(国产)>MCC302>MCC102>滑石粉>干淀粉;吸水性能优劣顺序是:L-HPC(信越)>L-HPC(国产)>CMS-Na>PVPP>MCC302>MCC102>MCC301>MCC101>浸膏;单独使用微晶纤维素或超级崩解剂达不到分散片的质量要求,联用微晶纤维素和超级崩解剂,可以达到分散片质量要求。结论中药分散片的崩解剂可以采用超级崩解剂和微晶纤维素的混合物,泡腾崩解剂选用酒石酸和碳酸氢钠,其摩尔比为1.0∶0.8。     

Real-time Acoustic Elastic Property Monitoring of Compacts During Compaction

A nondestructive, real-time acoustic technique for determining elastic properties of compacts during compaction is presented. An acoustic time-of-flight study was conducted, and the extraction of the linear elastic properties of calcium carbonate compacts was demonstrated. To verify the results of the acoustic experiments, a uniaxial compaction investigation was also carried out using a computer-controlled press with an instrumented die. Good agreement between linear elastic properties determined using both acoustic experiments and compaction force-displacement data was observed. This technique has the potential to be used as a real-time compaction monitoring tool.     

弹力绷带小夹板结合石膏固定A3型桡骨远端骨折观察

目的：探讨弹力绷带小夹板结合石膏固定治疗A3型桡骨远端骨折的临床疗效。方法：2008年5月至2013年6月治疗76例A3型桡骨远端骨折患者,受伤主要原因为跌倒损伤,占98.68％（75／76）。76例骨折均为闭合性损伤。骨折按照AO分型,A3－1型18例,A3－2型23例,A3－3型35例;受伤时间30 min至3 d。骨折整复后应用弹力绷带小夹板结合石膏固定。末次随访时按照Gartland－Werley评分系统及患者主观满意度对腕关节功能进行评价。结果：76例患者全部随访,平均随访时间5.6月（4～8月）。 Gartland－Werley腕关节评分优良率81.58％,患者主观满意度86.84％。结论：弹力绷带小夹板结合石膏固定治疗A3型桡骨远端骨折,具有固定良好,不易松动、移位,腕关节功能恢复好,畸形发生率较低,患者满意度高、痛苦小等特点,值得临床工作者借鉴。     

弹性探条引导放置双管喉罩的作用

目的本研究比较了双管喉罩（LMA-ProSealTM,PLMA）的三种插入方法：徒手置入法、工具置入法和弹性探条引导下置入法的成功率和并发症。方法择期手术患者180例,ASAⅠ或Ⅱ级,随机分为3组,每组60例。Ⅰ组用徒手法,Ⅱ组用器械法,Ⅲ组用探条法。用纤维支气管镜观察PLMA的到位情况。记录拿起喉罩到插管成功到建立气道的时间以及插管次数。记录喉罩上有无染血。术后2h随访,记录咽痛、发声、吞咽困难等并发症。结果一次插管成功率分别为：徒手法85%,器械法88%,探条法100%。探条法的一次插管成功率较其他两组高（P〈0.05）;3次插管成功率分别为徒手法95%,器械法97%,探条法100%;3次的总成功率3组之间差异无统计学意义（P〉0.05）;总的插管时间探条法的时间较短（P〈0.05）;3组的染血率和咽痛率无显著性差异。结论使用喉镜在弹性探条引导下置入双管喉罩（LMA-ProSealTM）的方法比徒手法和器械法更加可靠快捷。     

急性脑梗塞时大脑中动脉生物力学的实验研究

脑梗塞时，大多数病人发生局灶性血管麻痹现象。血管麻痹的范围、程度以及对血管缩舒功能的影响与脑血管阻塞发生的快慢与时间久暂、受阻区域的大小等因素有关。在本实验中结扎狗一侧颈内动脉２４ｈ后，活体测试大脑中动脉的力学性质，其可扩张度明显低于正常对照组，弹性模量明显大于正常对照组。结果提示，急性颈内动脉血流突然阻断发生脑梗塞时，大脑中动脉弹性调节功能将功能下降。     

青光安对抗青光眼术后滤过道瘢痕组织中弹性纤维、MMP-7、TlMP-1的实验研究

目的：通过观察4种青光安有效组份和青光安颗粒剂对抗青光眼术后滤过道瘢痕瘢痕组织中弹性纤维、MMP-7、TIMP-1的影响,来探讨青光安的有效组份和青光安颗粒剂对抗滤过道瘢痕化的作用机制,并对比青光安有效组份与青光安颗粒剂对抗瘢痕化作用的优劣。方法：将青光安4种有效组份与青光安颗粒剂中药混悬液作用于滤过手术后D、E、F、G、H组,通过与A组空白对照组、B组模型组和C组丝裂霉素C组进行比较,观察青光安4种有效组份与青光安中药混悬液对青光眼术后滤过道瘢痕组织中弹性纤维、MMP-7、TIMP-1的影响。结果：C组、E组和H组术前基础眼压与术后第2d;1,2,4 wk的眼压比较,现眼压较其他组回升缓慢,第28 d时仍然是最小值,与其余A、B、D、F、G组比较差异具有统计学意义。弹性纤维面积密度比较：手术组与空白对照组比较,差异均有统计学意义(P<0.05),C组与H组、C组与E组比较,差异无明显统计学意义(P>0.05),H组与E组比较,差异无统计学意义(P>0.05)。其他各组间比较,差异有显著统计学意义(P<0.01)。结论：青光眼术后滤过道瘢痕化,是导致滤过性手术失败的重要原因;青光安有效组份2、青光安混悬液和丝裂霉素C可通过增加MMP-7的表达和抑制弹性纤维、TIMP-1的表达而减少瘢痕组织增生,具有明显的抗青光眼术后滤过道瘢痕化的作用;通过实验观察可初步说明青光安有效组份2与青光安混悬液都具有明显的抑制滤过道瘢痕化的作用,且二者效果持平,青光安中药组略优于青光安有效组份2组。     

Development of a novel method to measure the elastic properties of skin including subcutaneous tissue: New age‐related parameters and scope of application

Background/purpose: We have developed a new apparatus to measure the elastic properties of skin without contact using an air blown technique. Methods: Real‐time measurements of skin movement induced by air blown on the surface were measured at various times. We investigated age‐related changes in the displacement of the skin surface caused by air using various parameters. Ninety‐eight female Japanese volunteers, aged from 10 to 70 years, were used in this study. Results: The maximum distance (the denting state) that cheek skin moved reached 2–5 mm within 10–15 ms. After that, the skin generally recovered to its original state within 40–50 ms. The average maximum speed of movement was 0.49±0.08 (average±SD) m/s and the average recovery speed was 0.25±0.06 m/s. Significant changes with age were not observed in the denting state, but significant correlations with age were observed in the recovery state. The maximum recovery speed decreased significantly with age and the time required for recovery increased significantly with age. Although similar results were obtained at the corner of the mouth or the inner upper arm, different results were obtained at the below eyes and the forehead. Conclusions: This apparatus differs from other conventional instruments in that it measures the elastic properties of skin including subcutaneous tissue without contact.     

弹性止痛枕用于胸部手术切口止痛效果的观察

目的经过循证了解胸部手术切口疼痛产生的原理,观察弹性止痛枕作用于胸部手术切口的止痛效果。方法选择50例在我院行胸部切口手术的患者,根据术后是否使用弹性止痛枕分为实验组(26例)和对照组(24例),对比分析两组研究对象的VAS评分,评价弹性止痛枕对胸部手术切口处止痛的效果。结果实验组中,23例患者术后第7天的VAS评分为(1.85±0.99),而对照组中14例患者的VAS评分为(2.23±1.12)。统计学分析显示实验组明显低于对照组(P<0.035)。结论胸部手术切口使用弹性加压止痛枕是一种有效的物理止痛方法。