小剂量人重组红细胞生成素不同给药途径治疗慢性肾衰贫血临床观察

目的:观察小剂量人类重组红细胞生成素 (rhu -Epo)皮下注射与静脉注射两种给药途径对慢性肾衰贫血的疗效。探索更为有效、安全、经济的给药途径。方法 :用随机数字表法将20例慢性肾功能衰竭贫血病人分为两组 :分别采用皮下注射 (治疗组 )与静脉注射 (对照组 )两种给药途径 ,比较两种不同给药途径疗效的差异。结果 :两组病人RBC、Hb、Hct均有明显上升 ,与治疗前比较差别均有很显著性 (P<0.01)。6周内两组之间比较差别无显著性 (P>0.05)。皮下注射组治疗后2周与6周RBC、Hb、Hct差别有很显著性 (P<0.01)。两组均有血压增高。结论 :小剂量rhu -Epo皮下注射与静脉注射均能有效改善慢性肾衰病人的贫血,两种给药途径相比较,皮下注射更安全、经济、适用。     

前列地尔脂微球载体注射液对大鼠小肠淤血性损伤的保护作用

目的:研究前列地尔脂微球载体注射液(Lipo-PGE1)对大鼠小肠淤血性损伤的保护作用.方法:SD大鼠45只,随机分成3组(n=15):模型组、给药组(Lipo-PGE1干预)和伪手术组.采用阻断门静脉45 min和开放60min的方法建立大鼠小肠淤血性损伤模型,伪手术组只作开腹及解剖门静脉等操作,不阻断门静脉.给药组于阻断门静脉前5 min,阻断即刻、开放后5 min分别静脉注射Lipo-PGE10.5 mL(0.2μg),其余两组相应时间点分别注射同样剂量生理氯化钠溶液.门静脉开放60 min后取小肠标本作病理检查及髓过氧化物酶(MPO)活性、丙二醛(MDA)含量和Na /K -ATP酶活力测定.取材后向小肠内注入5%葡萄糖溶液2 mL,分别测定0,15,30,45和60 min门静脉血糖浓度.结果:假手术组肠黏膜基本正常,而模型组小肠黏膜明显损伤,且葡萄糖吸收曲线低平,吸收峰延迟,MPO活性和MDA含量显著升高,Na /K -ATP酶活力显著降低.给药组小肠黏膜损伤程度较模型组显著减轻,葡萄糖吸收曲线介于假手术组和模型组之间,吸收峰同假手术组,MPO活性和MDA含量较模型组降低,Na /K -ATP酶活力显著升高.结论:Lipo-PGE1可减轻小肠的淤血性损伤并在一定程度上保护其吸收功能,这可能与其能减轻中性粒细胞在淤血时肠组织浸润、减少氧自由基释放从而减轻脂质过氧化损伤有关.     

Massive Subcutaneous Emphysema in Robotic Sacrocolpopexy

The advent of robotic surgery has increased the popularity of laparoscopic sacrocolpopexy. Carbon dioxide insufflation, an essential component of laparoscopy, may rarely cause massive subcutaneous emphysema, which may be coincident with life-threatening situations such as hypercarbia, pneumothorax, and pneumomediastinum. Although the literature contains several reports of massive subcutaneous emphysema after a variety of laparoscopic procedures, we were not able to identify any report of this complication associated with laparoscopic or robotic sacrocolpopexy. Massive subcutaneous emphysema occurred in 3 women after robotic sacrocolpopexy in our practice. The patients had remarkable but reversible physical deformities lasting up to 1 week. A valveless endoscopic dynamic pressure system was used in all 3 of our cases. Our objective is to define the risk of massive subcutaneous emphysema during robotic sacrocolpopexy in light of these cases and discuss probable predisposing factors including the use of valveless endoscopic dynamic pressure trocars.     

Standardized Ultrasound Measurement of Subcutaneous Fat Patterning: High Reliability and Accuracy in Groups Ranging from Lean to Obese

A recently standardized ultrasound technique for measuring subcutaneous adipose tissue (SAT) was applied to normal-weight, overweight and obese persons. Eight measurement sites were used: upper abdomen, lower abdomen, erector spinae, distal triceps, brachioradialis, lateral thigh, front thigh and medial calf. Fat compression was avoided. Fat patterning in 38 participants (body mass index: 18.6–40.3 kgm^?2; SAT thickness sums from eight sites: 12–245 mm) was evaluated using a software specifically designed for semi-automatic multiple thickness measurements in SAT (sound speed: 1450 m/s) that also quantifies embedded fibrous structures. With respect to ultrasound intra-observer results, the correlation coefficient ρ = 0.999 (p < 0.01), standard error of the estimate = 1.1 mm and 95% of measurements were within ±2.2 mm. For the normal-weight subgroup, the median measurement deviation was 0.43 mm (1.1% of mean thickness), and for the obese/overweight subgroup it was 0.89 mm (0.5%). The eight sites used here are suggested to represent inter-individual differences in SAT patterning. High measurement accuracy and reliability can be obtained in all groups, from lean to overweight and obese, provided that measurers are trained appropriately.     

Subcutaneous Tissue Mechanical Behavior is Linear and Viscoelastic Under Uniaxial Tension

Subcutaneous tissue is part of a bodywide network of “loose” connective tissue including interstitial connective tissues separating muscles and surrounding all nerves and blood vessels. Despite its ubiquitous presence in the body and its potential importance in a variety of therapies utilizing mechanical stretch, as well as normal movement and exercise, very little is known about loose connective tissue's biomechanical behavior. This study aimed to determine elastic and viscoelastic mechanical properties of ex-vivo rat subcutaneous tissue in uniaxial tension with incremental stress relaxation experiments. The elastic response of the tissue was linear, with instantaneous and equilibrium tensile moduli of 4.77 kPa and 2.75 kPa, respectively. Using a 5 parameter Maxwell solid model, material parameters μ₁ = 0.95 ± 0.24 Ns/m and μ₂ = 8.49 ± 2.42 Ns/m defined coefficients of viscosity related to time constants τ_1M = 3.83 ± 0.15 sec and τ_2M = 30.15 ± 3.16 sec, respectively. Using a continuous relaxation function, parameters C = 0.25 ± 0.12, τ_1C = 1.86 ± 0.34 sec, and τ_2C = 110.40 ± 25.59 sec defined the magnitude and frequency limits of the relaxation spectrum. This study provides baseline information for the stress-strain behaviors of subcutaneous connective tissue. Our results underscore the differences in mechanical behaviors between loose and high-load bearing connective tissues and suggest that loose connective tissues may function to transmit mechanical signals to and from the abundant fibroblasts, immune, vascular, and neural cells present within these tissues.     

胰岛素泵联合小剂量胰岛素静脉滴注治疗糖尿病酮症酸中毒18例临床观察

目的观察胰岛素泵联合胰岛素滴注治疗酮症酸中毒﹙DKA﹚的疗效。方法将2008年4月～2011年6月收治的DKA患者36例分为治疗组18和对照组18例,治疗组给予胰岛素泵全程治疗,结合小剂量胰岛素持续点滴,对照组给予小剂量胰岛素治疗。比较两组患者血糖变化、DKA纠正时间及住院时间。结果治疗组血糖下降相对稳定,酸中毒纠正时间短于对照组,且无反复;治疗过程中治疗组未出现低血糖,对照组出现3例;住院时间治疗组短于对照组。结论胰岛素泵联合胰岛素滴注治疗酮症酸中毒安全有效。     

De Garengeot hernia with perforated appendicitis and a groin subcutaneous abscess: A case report

IntroductionDe Garengeot hernia is rare. Although previous reports have suggested various surgical options according to patient condition, comorbidities, surgeon preference, and clinical findings during surgery, a treatment strategy has not been established.Presentation of caseAn 81-year-old woman presented with an irreducible tender mass that was subsequently diagnosed as an incarcerated femoral hernia with a subcutaneous abscess in the right groin. Intraoperative findings revealed a necrotic and perforated appendix strangulated by the femoral ring for which an appendectomy and herniorrhaphy was performed concurrently through the hernia sac. The subcutaneous abscess cavity was washed thoroughly and a drainage tube was placed within it. The patient recovered uneventfully.DiscussionWe suggest that the approach through the inguinal incision in both appendectomy and herniorrhaphy with drainage may be useful in avoiding intra-abdominal contamination in cases of de Garengeot hernia with subcutaneous abscess.ConclusionHere, we described a case of de Garengeot hernia with a subcutaneous abscess in the groin. Clinicians should consider de Garengeot hernia in patients with a groin hernia, make an early diagnosis, and promptly provide surgical treatment to reduce the risk of complications.     

Mometasone furoate monohydrate nasal spray for the treatment of nasal congestion in allergic rhinitis

Allergic rhinitis (AR) affects an estimated 20–40 million Americans annually. It is a multifaceted condition comprising a range of symptoms, including nasal congestion, arguably the most bothersome symptom. Of the various types of medications available for the treatment of AR, intranasal corticosteroids are considered the most effective. Mometasone furoate nasal spray is an intranasal corticosteroid with anti-inflammatory properties. It is indicated for the treatment of the nasal symptoms of seasonal AR and perennial AR in adults and children, for the prophylaxis of nasal symptoms of seasonal AR and for the treatment of nasal polyps. Numerous clinical trials have demonstrated that mometasone furoate nasal spray effectively relieves nasal congestion in adults and children with AR, while providing excellent safety and tolerability.