显微外科技术治疗周围神经嵌压症

目的 :为探讨显微外科技术治疗周围神经嵌压症的疗效。方法 :采用显微外科技术对各部位周围神经嵌压症 2 5例进行神经内外松解术。结果 :2 5例周围神经嵌压症患者术后症状、体征及肌电图检查均较术前明显改善 ,疗效满意。结论 :显微外科技术是治疗周围神经嵌压症的一种有效方法。     

Flexor Tenosynovectomy for Recurrent Carpal Tunnel Syndrome: A Retrospective Case Series of 108 Hands

Background: The etiology of recurrent carpal tunnel syndrome (CTS) is unclear, and outcomes following secondary surgery in this demographic have been poorer than primary surgery. Fibrosis and hypertrophy have been identified in the flexor tenosynovium in these patients. The authors use flexor tenosynovectomy (FTS) for recurrent CTS after primary carpal tunnel release and present a review of these patients. Methods: A retrospective chart review was performed of 108 cases of FTS for recurrent CTS from 1995 to 2015 by 4 attending surgeons at one institution. Demographic information, symptoms, and outcomes were among the data recorded. A phone survey was conducted on available patients where the shortened version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and satisfaction were assessed. Results: Average office follow-up was 12 months. Average age was 57.5 years. A total of 104 (96%) reported symptom improvement and 48 (44%) reported complete symptom resolution. Forty patients were available for long-term follow-up at an average 6.75 years postoperatively via phone interview. Average QuickDASH score was 31.2 in these patients. Thirty-six (90%) of 40 patients were initially satisfied at last office visit, and 31 (78%) of 40 were satisfied at average 6.9 years, a maintenance of satisfaction of 86%. Satisfied patients were older (58 years) than unsatisfied patients (51 years). Conclusion: Both long-term satisfaction and QuickDASH scores in our cohort are consistent with or better than published results from nerve-shielding procedures. The authors believe a decrease in both carpal tunnel volume and potential adhesions of fibrotic or inflammatory synovium contributes to the benefits of this procedure. This remains our procedure of choice for recurrent CTS.     

The popliteal entrapment syndrome

Summary Five examples of the popliteal entrapment syndrome have been reported in 4 patients aged between 17 and 41. The diagnosis in each case was made pre-operatively. The anatomical anomalies consisted in three instances of an abnormally high insertion of the inner gemellus (medial head of gastrocnemius) muscle tendon with the artery located twice in front and once in the middle of the tendon, in another instance compression was due to a hypertrophic musculus plantaris and finally, in the last instance, the anomalies were caused by abnormal fibrous bands. In two instances the artery was thrombosed, in three it was compressed in an intermittent fashion. The patients responded well to treatment, by a graft in the case of thrombosis, and by sectioning the abnormal insertions of the gemellus muscle or the fibrous bands in the others. The frequency of these different anatomical types, the relative evolutivity and the embryological hypotheses are studied in the 111 cases recorded in the literature between 1970 and 1983.

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Le piège poplité

Résumé Cinq cas de poplitées piégées sont rapportés chez 4 patients dont l'âge était compris entre 17 et 41 ans. Le diagnostic a été fait dans chaque cas en pré-opératoire. Les anomalies anatomiques consistaient trois fois en une insertion anormalement haute du tendon du jumeau interne, l'artère siégeant 2 fois en avant et 1 fois au milieu du tendon, dans un cas en une compression par un muscle plantaire grêle hypertrophique, enfin dans le dernier cas, il s'agissait de bandes fibreuses anormales. Dans 2 cas, l'artère était thrombosée, dans 3 cas, elle était comprimée de façon intermittente. Les patients ont été traités avec succès par pontage en cas de thrombose, et par section des insertions anormales du jumeau interne ou des bandes fibreuses dans les autres cas. La fréquence des différents types anatomiques, l'évolutivité relative, et les hypothèses embryogénétiques sont étudiées à partir de 111 autres cas rapportés dans la littérature entre 1970 et 1983.

     

硫唑嘌呤脂质体的研制

目的 :优选硫唑嘌呤脂质体的处方和制备工艺 ,并评价其质量。方法 :采用薄膜 -振荡分散法制备硫唑嘌呤脂质体 ,以正交试验法优选出制备硫唑嘌呤脂质体的最佳工艺条件。用滴定法测其包封率 ,显微镜法观察其形态 ,测量粒径和粒度分布。结果 :制备的脂质体的包封率达到49 19 % ,透射电子显微镜下观察脂质体为粒径均匀的球状或近球状的多室脂质体 ,小于2 4μm的粒子占78 17 %。结论 :优选得到的脂质体处方和制备工艺合理、稳定     

灯盏花素纳米脂质体包封率测定方法研究

灯盏花素(breviscapine)是菊科植物短葶飞蓬(Erigeron breviscapus(vant.)Hand-Mazz)中提取的黄酮类有效成分。临床多用于治疗脑梗死、脑血栓、脑出血等。将药物制成脂质体,能帮助药物进入脑部,提高治疗指数。灯盏花素水溶性较差,直接溶于注射用水有一定困难,将其制成脂质体可以解决其难溶问题,提高药物稳定性及载药量,同时提高药物的靶向性及疗效。包封率是脂质体质量评定的重要指标,本实验建立了灯盏花素纳米脂质体包封率的测定方法,该法操作简单、可行、准确性较好。     

高效液相色谱法测定洛莫司汀脂质体药物含量及包封率

目的:建立测定洛莫司汀脂质体药物含量及包封率的RP-HPLC法。方法:采用Diamonsil~(TM)C_(18)柱(250mm×4.6mm,5μm);流动相:乙腈-0.05mol·L~(-1)磷酸二氢铵溶液-三乙胺(60∶40∶0.2,磷酸调pH为3.5);柱温:室温;流速:1.0mL·min~(-1);紫外检测波长:232nm。采用Sephadex G-50分离洛莫司汀脂质体中的游离药物。结果:在本色谱条件下洛莫司汀与辅料及溶剂峰分离良好,洛莫司汀在4.0-48.0μ·mL~(-1)范围内线性关系良好(r=1.0,n=5),回收率在98.0%-101.0%之间,日内RSD及日间RSD均小于2%(n=5)。结论:说明该方法准确可靠、简单快速,可用于洛莫司汀脂质体含量及包封率的测定。     

注射用紫杉醇脂质纳米粒的制备、体外释放及体内药动学研究

 目的 制备注射用紫杉醇脂质纳米粒,并考察其理化性质、体外释放及体内药动学性质。 方法 采用高压乳匀结合冷冻干燥工艺制备注射用紫杉醇脂质纳米粒;考察脂质纳米粒形态、粒径分布、载药量及超滤离心法测定包封率;考察了制剂的稳定性和安全性;以市售紫杉醇注射液为对照,考察其体外释放特性及大鼠体内药动学行为。 结果 注射用紫杉醇脂质纳米粒的平均粒径为 25.6 nm ;包封率为（ 99.55 ± 0.25 ） % ,载药量为（ 1.37 ± 0.78 ） % ;与 5% 葡萄糖溶液或 0.9%NaCl 注射液配伍 8 h 内稳定;安全性良好,无溶血现象;在 0.8 mol·L^-1 水杨酸钠溶液中 24 h 的累积释放百分率分别为 99.8% 和 99.9% ,释放行为符合一级动力学方程;紫杉醇注射液与脂质纳米粒溶液在大鼠体内的平均滞留时间 (mean residence time , MRT) 分别为 1.10 和 1.85 h ,两者 24 h 内药 - 时曲线下面积 (AUC) 分别为 6.78 和 33.6 mg·h·L^-1 。 结论 采用高压乳匀 - 冷冻干燥工艺制备注射用紫杉醇脂质纳米粒,对纳米粒起到了很好的保护作用,避免了药物的渗漏;载药量和包封率较高,粒径分布均匀;与注射液相比,脂质纳米粒的体外释放显著慢于注射液,具有缓释效果。     

草乌甲素多囊脂质体包封率的测定

目的:建立测定草乌甲素多囊脂质体包封率的方法。方法:采用离心法分离草乌甲素多囊脂质体,HPLC测定总药量和游离草乌甲素量并计算样品包封率。结果:低速离心时,转速不影响包封率的测定;3批样品的平均包封率为87.12%。结论:离心法操作简单、准确,可用于测定草乌甲素多囊脂质体的包封率。     

Box-Behnken设计法优化奥沙利铂脂质体的处方工艺

目的 采用Box-Behnken实验设计法优化奥沙利铂（oxaliplatin,Ox）脂质体的制备工艺。方法 以磷脂质量浓度（X1）、磷脂与Ox质量比（X2）和磷脂与胆固醇质量比（X3）为考察对象,以包封率（Y）为评价指标,采用三因素三水平的Box-Behnken实验设计筛选奥沙利铂脂质体最佳的处方。结果 最优处方是磷脂质量浓度为10.20g·L1,磷脂与药物的质量比为31∶1,脂质体膜材料中磷脂与胆固醇质量比为3.8∶1。包封率的预测值与理论值偏差较小。结论 Box-Behnken实验设计法可用于奥沙利铂脂质体的处方优化。     

冻融法制备5-氟尿嘧啶脂质体及其稳定性考察

采用反相蒸发法制备 5 氟尿嘧啶脂质体制剂 .结合冻融法 ,可使 5 氟尿嘧啶的包封率达(45 31± 0 2 0 85 ) % .离心加速实验和 ζ电位的测定进一步验证了冻融法可使脂质体稳定性提高 .