A novel gastroretentive porous microparticle for anti-Helicobacter pylori therapy: Preparation, in vitro and in vivo evaluation

Gastroretentive drug delivery system is a promising option for the treatment of Helicobacter pylori infection, which can prolong gastric residence time and supply high drug concentration in the stomach. In the present study, a low density system of metronidazole-loaded porous Eudragit^® RS microparticle with high drug loading capacity (>25%) was fabricated via electrospray method. The porous structure and size distribution of microparticles were affected by polymer concentration and flow rate of solution. FTIR and XRD analyses indicated that drug has been entrapped into the porous microparticles. In addition, sustained release profiles and slight cytotoxicity in vitro were detected. Gamma scintigraphy study in vivo demonstrated that ¹³¹I-labeled microparticles retained in stomach for over 8 h, and about 65.50% radioactive counts were finally detected in the region of interest. The biodistribution study confirmed that hotspot of radioactivity was remaining in the stomach. Furthermore, metronidazole-loaded porous microparticles can eradicate H. pylori completely with lower dose and administration frequency of antibiotic compared with pure drug, which were also more helpful for the healing of mucosal damages. These results suggest that prepared porous microparticle has the potential to provide better treatment for H. pylori infection.     

4例外伤性小肠破裂CT漏诊原因分析

目的 熟悉小肠破裂CT征象以提高综合分析能力.方法 回顾性分析经手术证实4例外伤性小肠破裂患者的CT图像.结果 原因分析4例患者均出现大网膜、系膜改变,以及腹盆腔积液.腹腔微量积气2例.肠壁增厚2例.结论 充分认识外伤性小肠破裂的CT征象有助于提高诊断的准确率并减少漏诊,为临床及时救治提供重要的影像学依据.     

胰腺分裂症的内镜诊治方法及临床价值

目的探讨胰腺分裂症(PD)内镜诊治的常规及补救方法、临床疗效和安全性。方法回顾性分析该院2014年1月-2016年12月经内镜下逆行胰胆管造影(ERCP)诊治的17例PD患者的临床病历资料,并电话回访患者症状改善及术后恢复情况。结果 17例PD患者,仅1例进行了再次内镜下治疗,共进行内镜下治疗18例次。内镜下治疗常规策略包括:副乳头括约肌切开术(MiES)、副胰管支架置入术(EDSi)及副乳头括约肌扩张术(MiED)。术中16例次手术过程顺利,2例次经过困难,但最终采用补救方法联合超声内镜(EUS)对接技术使手术成功。术后并发出血1例次,并发支架相关性胰腺炎2例次,无穿孔和发热等其他并发症发生。17例患者无1例失访,随访时间(16.3±9.4)个月,所有患者术后腹痛视觉模拟评分(VAS)较术前明显改善[(2.0±1.2)vs(7.0±1.8)分],差异有统计学意义(P 0.05)。结论内镜诊治PD具有安全、有效、创伤及并发症少等特点,可明显改善患者临床症状,值得临床推广。根据临床情况可选择常规方法诊治,对于插管困难患者,可联合EUS通过对接技术进行补救诊治。     

Radiologic impact on operative access to a retrorectal cyst

Diverse incisions have been used to excise retrorectal lesions. Operative access must be planned with regard to level and type of lesion, and prevention of postoperative complications. In this case, pelvic contrast CT scan conclusively showed communication between the rectum and a retrorectal cyst-hamartoma. A potential rectocutaneous fistula through the previously planned parasacrococcygeal incision was avoided by this preoperative documentation.