可乐定透皮贴剂体外透皮性能研究

目的:研究可乐定透皮贴剂体外透皮性能.方法:用离体豚鼠皮肤为透皮屏障,采用改进Franz扩散池,比较康倍得公司研制的可乐定透皮贴剂(C-TTS)、美国的可乐定透皮贴剂(Catapres-TTS)和国内的可乐定透皮贴剂(N-TTS)的体外透皮性能.检测方法为高效液相色谱法.结果:C-TTS与Catapres-TTS两种贴剂体外经皮渗透曲线符合零级方程(Q=kt),两者透皮速率无显著性差异(P>0.05);N-TTS体外经皮渗透曲线符合Ritger-peppas方程(Q=ktm),其透皮速率与C-TTS比较有显著性差异(P<0.01).3种样品试验结束揭去贴片后,皮肤中有一定的药物残留量,并且残留量与贴片面积呈线性关系.结论:C-TTS可以维持7d的恒定经皮渗透,与Catapres-TTS体外透皮行为相似.     

盐酸多塞平乳膏人体透皮吸收试验

目的 :比较进口与国产5 %盐酸多塞平乳膏的人体透皮吸收效果。方法 :采用高效液相色谱法测定血药浓度 ,8位健康男性受试者按交叉试验设计 ,以进口的5 %盐酸多塞平乳膏为对照品 ,对比研究国产5 %盐酸多塞平乳膏的人体透皮吸收效果。结果 :连续8d于受试者前臂皮肤涂抹相同剂量的盐酸多塞平乳膏试验品和对照品后进行测定 ,两组血药浓度均较低 ,无显著性差异。结论 :国产5 %盐酸多塞平乳膏的人体透皮吸收效果可达国外同类品种水平 ,且安全、有效     

Radiologic percutaneous gastrostomy: Results in 56 patients with head and neck cancer

Objective: The establishment of a direct enteral feeding route is critical in the overall treatment of many patients with head and neck cancer. Use of radiologic percutaneous gastrostomy (RPG), the newest technique for gaining enteral access, has not been studied in such patients extensively. This study evaluated the indications, technique, success rate, and complications associated with RPG in patients with head and neck cancer. Study Design: Retrospective. Methods: A comprehensive chart review was undertaken of 56 patients with head and neck cancer treated at a tertiary care institution who had undergone successful or attempted RPG at some point during their treatment course. Results: Most study patients had advanced oropharyngeal squamous cell carcinoma. The most frequent indications for RPG were dysphagia/aspiration following tumor resection (n = 26) and dysphagia following completion of single- or combined-modality therapy (n = 22). The success rate of attempted RPGs was 98.2%. The overall complication rate for RPG was 12.7% (10.9% minor and 1.8% major). Conclusions: RPG is a valuable tool for establishing enteral nutrition in patients with head and neck cancer. Advantages of RPG include high success rate despite obstructing lesions, low complication rate, time efficiency and scheduling ease compared with intraoperative percutaneous gastrostomy (PEG) by a second team, no reported tumor seeding of the tube site, and the fact that postoperative RPG allows for more accurate selection of patients who require a gastrostomy tube.     

Performing Testicular or Epididymal Sperm Retrieval Prior to the Injection of hCG

Purpose: Our purpose was to determine the feasibility and efficacy of performing testicular or epididymal sperm retrieval prior to the injection of human chorionic gonadotropin (hCG). Methods: This report deals with 87 sperm-positive percutaneous epididymal sperm aspiration (PESA), percutaneous testicular sperm aspiration (PTSA), or testicular sperm extraction (TESE) cycles. All sperm retrieval procedures were performed prior to administration of hCG to the women. Retrieved spermatozoa were cultured in vitro in simple medium for approximately 40 hr prior to intracyto-plasmic sperm injection. Results: In all but one cycle in which TESE was performed for nonobstructive azoospermia, motile sperm were available for ICSI. The overall fertilization rate was 53%. Pregnancy rate per transfer and implantation rate per embryo were 41.2 and 15.7%, respectively. Conclusions: Satisfactory fertilization and pregnancy rates can be achieved when PESA, PTSA, or TESE is performed prior to the injection of hCG followed by in vitro culture of spermatozoa approximately 40 hr before ICSI. Scheduling of testicular or epididymal sperm retrieval cases in this way appears to ease the workload on laboratory and operating room personnel. Furthermore, withholding hCG when sperm is absent may obviate the unnecessary risk of ovarian hyperstimulation when spermatozoa cannot be retrieved.     

急性心肌梗死后延迟PTCA对左室功能的影响

目的：评价延迟性经皮冠状动脉腔内成形术（PTCA）对急性心肌梗死后左心功能和心脏事件的影响。方法i86例急性心肌梗死患者平均1周后接受PTCA治疗（介入组），并在住院和随访期间行超声心动图检查及记录心脏事件的发生率，且与30例行药物治疗者（对照组）进行比较。结果：介入组术前29例心功能不全患者和57例心功能正常患者6个月后左室舒张末内径和左室射血分数均有提高，心脏事件发生率低，且与对照组比较心功能也有改善，差别有统计学意义。前壁心肌梗死和梗死相关动脉的开通是心功能的独立预测因子。结论：延迟性PTCA能改善心肌梗死患者的左心功能，减低近中期心衰的发生。     

直接经皮冠状动脉成形术治疗老年急性心肌梗死

目的观察直接经皮冠状动脉成形术（PTCA）治疗老年（≥70岁）急性心肌梗死的临床疗效。方法对70例发病时间12h以内，70岁及以上急性心肌梗死患者行直接PTCA（必要时冠脉内植入支架）；并随机选择同期72例发病时间12h以内，未行溶栓或PTCA的70岁及以上急性心肌梗死患者进行比较和1年随访。结果治疗组中68例患者术后即刻血流皆达TIMIⅡ～Ⅲ级，手术成功率97．14％，治愈率98.57％，1年内梗塞后心绞痛发生率18．57％，因心脏原因再住院率21．43％；对照组死亡9例，治愈率87．50％，1年内梗塞后心绞痛发生率33．33％，因心脏原因再住院率43．06％，两组差异有显著意义。1年随访治疗组心功能明显较对照组为优。结论直接PTCA治疗老年（≥70岁）急性心肌梗死治愈率高，能更好地消除梗塞后心绞痛，保护患者心功能，减少心血管事件。     

经皮肾微创穿刺造瘘治疗输尿管上段结石

目的　探讨经皮肾微创穿刺取石术治疗输尿管上段结石的方法和疗效。方法　回顾性分析 12 6例采用经皮肾微创穿刺治疗输尿管上段结石的临床资料。采用B超引导经皮肾穿刺建立 16～ 18F大小皮肾通道 ,使用 8 9.8F输尿管肾镜 ,结合电子弹道碎石、MCC电脑灌注泵进行手术。结果　 12 6例均Ⅰ期取石术 ,结石取净率 10 0 % ,手术时间 2 5～ 75min ,平均 5 0min ,手术后住院时间平均 5 .5d。并发输尿管梗阻 3例。结论　经皮肾微创穿刺取石术治疗输尿管上段结石疗效确切 ,具有创伤小、康复快的优点 ,单用B超引导建立皮肾通道即可 ,值得推广应用     

透皮促透剂对复方酮康唑乳膏体外透皮吸收的影响

目的：观察不同促透剂对复方酮康唑乳膏中酮康唑在体外透皮作用的影响。方法：采用改良的简单小室装置，以离体鼠皮为透皮屏障，用高效液相色谱法(HPLC)测定含量，计算累积透皮吸收百分率。结果：5种促透使用方法对乳膏中酮康唑均有促透作用。结论：5种促透使用方法最好的为3%双戊烯(DP)＋1.5%氮酮(azone)，然后依次是3%DP、3%薄荷醇(M)、1.5%DP＋1.5%M、2%azone。     

经皮器械件软组织固定罩材料制备及组织学评价

目的针对植入性经皮器件生物密封，采用在皮下安装软组织固定罩设计，对周围组织起固定作用，降低经皮密封部位软组织在界面处的应力，为生物密封提供条件。软组织固定罩材料及结构几何特征对于其周围软组织生长的影响与固定作用是应首先进行研究重要问题。方法本文选取了5种不同表面结构以及不同几何结构特征的样品植入动物皮下软组织，对植入后三个时间段的软组织的生长和表面结合情况进行观察和评价。结果纯钛表面等离子涂层处理明显较好．其次为阳极氧化处理、酸碱处理，及纯钛，较差的是超高分子量聚乙烯。孔间距对软组织在孔中的生长无明显影响。样品植入60d之内，孔径和孔深度对软组织的生长有一定的影响，但90d时，这种差别已明显减小。结论选取表面喷涂羟磷灰石涂层的钛为制作材料，90d为植入愈合期，作为用于经皮组织固定罩设计的重要参数。     

急性心肌梗死介入治疗研究进展

经皮冠状动脉介入治疗(PCI)已广泛应用于急性心肌梗死(AMI)病人,临床疗效良好。它可分为直接PCI、立即PCI、延迟PCI、挽救性PCI等,近年还诞生了易化PCI等新的介入治疗方法。本文就上述介入治疗方法的最新进展作一综述。