A comparison of barbed and smooth sutures for ovine cesarean delivery

Objective

To determine the adequacy of barbed and smooth sutures for closing the uterus and fascia in pregnant ewes.

Methods

Nine ewes that underwent cesarean delivery were randomized to each receive 2 different suture materials for both the uterus and the fascia. The sutures used were: barbed poliglecaprone 25, smooth poliglecaprone 25, braided polyglactin 910, and smooth chromic sutures on the uterus; and barbed polydioxanone (PDO), barbed poliglecaprone 25, braided polyglactin 910, and smooth chromic sutures on the fascia.

Results

In 4 of the ewes, the fascia suture line failed prematurely, leading to dehiscence prior to planned euthanasia and necropsy. The remaining 5 ewes were euthanized on days 2, 7, or 28. All suture materials (smooth and barbed) were adequate for uterine closures. Barbed PDO, smooth poliglecaprone 25, and braided polyglactin 910 were adequate for fascia closures, whereas both barbed poliglecaprone 25 and smooth chromic resulted in premature suture line ruptures and fascia dehiscence.

Conclusion

In a small pilot study, absorbable knotless barbed suture was adequate and equivalent to absorbable knotted smooth suture for closing the uterus following ovine cesarean delivery. On the rectus fascia, however, sutures—whether barbed or smooth—with lower tensile strength resulted in fascial dehiscence.     

Complications following the use of alloplastic materials in urogynecological surgery

Study design

118 patients, who were admitted from 2005 to 2008 to our department due to complications following mesh implantation, were included in a retrospective survey. We investigated patient symptoms, findings and subsequent patient management. There was a re-evaluation of symptoms in a follow-up eight weeks after the revision procedure. Data from our urogynecological file archive were used.

Results

The main complaints were de novo urgency, pain and recurrent urinary tract infections. The main findings were mesh erosion and infections including abscess formations and osteomyelitis. Before being admitted to our department, 42 patients (35.6%) had already undergone at least one intervention. Surgery to overcome complications was performed in our unit after an average time of 27 months. In most cases, mesh removal was necessary.

Conclusions

Surgeons need to be aware of potential mesh complications, which should be managed in referral centres as soon as symptoms arise and should be documented in registers. There is a need for more prospective randomised studies on complications arising from surgery.     

平面型荷电防病毒口罩的结构及性能评价

介绍一种平面型荷电防病毒口罩的结构及基本性能。口罩由过滤层、口罩带及鼻夹组成,过滤层包括保护层、荷电吸附层和致密过滤层。其工作原理是通过正负电荷的相互吸引作用吸附病毒,通过机械截留作用截留微粒。性能检测表明,气流阻力、过滤效率、沾水等级及阻燃性能等性能指标完全符合医用防护口罩技术要求的规定,大肠杆菌噬菌体f2截留率大于99.99%。     

水泥生料生产工人肺脏的病理研究

对５例单纯接触水泥生料粉尘工人尸检肺标本进行病理研究。主要尘性病变为尘斑、灶内的“水泥小体”、灶周肺气肿。部分病例尚有混合尘结节。每例均见慢性支气管炎及轻度间质弥漫纤维化。ＥＤＸＡ、ＳＥＭ、ＳＥＭ－ＥＤＸＡ及Ｘ线衍射方法对病变原位粉尘的元素成份及粉尘晶形进行了分析，并与现场的生料粉尘进行对比分析，结果证明水泥生料粉尘具有致尘肺作用，其病理类型属尘斑－气肿型尘肺，或混合型尘肺。     

刺五加叶总黄酮固体分散体的制备其体外评价

目的：通过制备刺五加叶总黄酮固体分散体,提高其生物利用度。方法：以PEG4000、PEG6000、F68、PVPK30 为载体材料制备4 种不同的固体分散体,筛选最优载体材料,并考察载体用量对溶出度的影响。以芦丁为对照品,亚硝酸钠-硝酸铝-氢氧化钠为显色体系,用紫外分光光度计在500 nm处测定吸光度,考察各比例固体分散体的体外溶出特性。结果：与原料药相比,以PVPK30 为载体材料制得的固体分散体体外释放速率明显提高,并且累积释放度也明显增加。结论：固体分散体能显著提高药物在水中的体外释放度。     

生麦芽联合芒硝用于引产后患者回奶的疗效观察及护理

目的观察生麦芽联合芒硝在中期妊娠引产后回奶中的临床疗效与安全性。方法中期妊娠引产需回奶的患者翅20例,随机分为3组：第1组产后当日服用生麦芽60g＋300mL水煎当茶饮,1剂／d,连服5d并于产后第2天予芒硝250g,分装入2个纱布袋中,均匀地敷于两乳房并包扎,湿硬时更换,连续使用5d。第2组患者口服甲磺酸溴隐亭2．5mg,早晚各1次,连服5d。第3组口服戊酸雌二醇5mg,3次／d,连服3d。观察5d后3组产妇的回奶效果及安全性。结果甲磺酸溴隐亭组回奶效果为90％,戊酸雌二醇组为80％,而生麦芽联合芒硝组为100％。生麦芽联合芒硝组与其他2组比较,差异有统计学意义（P〈0．05）。结论生麦芽联合芒硝的回奶效果较好,且副作用较小。     

叶酸介导靶向高分子造影剂的制备及体外识别研究

目的 合成叶酸介导靶向的聚乳酸共聚物,以其为靶向膜材制备靶向造影剂,表征造影剂性质.方法 以自制的叶酸-脯氨酸-乳酸共聚物(Fa-PLLA-Hpr)为膜材,应用双乳化-冷冻干燥法制备叶酸介导靶向高分子造影剂(MB-Fa-PLLA).采用激光粒径测量仪检测微泡的粒径,通过光镜观察该靶向造影剂(靶向造影剂实验组)对人卵巢癌SKOV3细胞的体外寻靶情况,并与游离叶酸干预组及空白对照组(普通微泡)比较.结果 FT-IR表征了靶向膜材的结构.成功制备叶酸介导靶向聚乳酸共聚物MB-Fa-PLLA.MB-Fa-PLLA在光镜下大小分布均匀,形态圆整,65％的微粒直径分布为500～800 nm,呈单峰分布,其亲水性较普通高分子微泡更好.体外寻靶实验显示,MB-Fa-PLLA可以较多并牢固地聚集到SKOV3细胞表面,而普通微泡未见特异性结合.结论 MB-Fa-PLLA亲水性好,对高表达叶酸受体的SKOV3细胞具有较强特异性亲合力,其有望成为靶向显像叶酸高表达肿瘤的理想造影剂.     

蚕丝磷酸钙涂层支架的制备和性能

目的:通过对蚕丝表面进行磷酸钙涂层,从而增加其成骨效果。方法:将脱胶后的蚕丝放入磷酸钙溶液中,用水热法对蚕丝表面进行矿化,运用扫描电镜、能谱分析仪、X线衍射仪、傅立叶红外对表面改良的蚕丝进行理化性能检测。结果:磷酸钙表面改良处理后磷酸钙均匀涂布于蚕丝表面,矿化蚕丝初始形态并未发生明显改变,表面存在磷酸灰石成分。结论:蚕丝作为一种天然生物纤维,具有良好的生物相容性。经磷酸钙涂层的蚕丝,作为组织工程支架材料具有广阔的发展前景。     

纤维蛋白粘合剂粘贴双层基质透镜行兔板层角膜移植术

目的：研究纤维蛋白粘合剂(FS)粘贴的双层角膜基质透镜体内生物相容性,探讨使用该种材料行角膜移植的可行性。

方法：选取健康清洁级新西兰白兔15只,采用自身对照,以兔右眼为实验眼,左眼为对照眼。实验眼使用FS粘贴的双层角膜基质透镜作为移植材料行板层角膜移植手术,对照眼不进行人工干预。分别于术后7、14、28d使用手持裂隙灯观察双眼角膜情况,并进行生物相容性评分,同时取双眼角膜行HE染色进行组织病理学检测,观察角膜恢复情况。

结果：裂隙灯观察结果显示,至角膜移植术后28d,实验眼角膜上皮生长情况良好,角膜透明度基本恢复,水肿程度减轻,新生血管生长至角膜缘后未加重,未见上皮、内皮排斥线等排斥反应; 对照眼角膜透明,角膜上皮光滑。生物相容性评分结果显示,角膜移植术后实验眼角膜植片水肿程度逐渐减轻,透明度逐渐恢复,排斥反应较小,角膜植片的生物相容性较好; 至术后28d,实验眼和对照眼角膜透明度、水肿程度及新生血管生长程度均无差异(P>0.01)。组织病理学检测结果显示,至角膜移植术后28d,实验眼植片表面有4～5层角膜上皮细胞覆盖,角膜胶原排列整齐、规则,植片内未见明显炎性细胞浸润,双片透镜间分界消失,层间FS被机体完全吸收,植片与植床融合,未见明显分界。

结论：使用FS粘贴的双层角膜基质透镜作为植片行板层角膜移植术后恢复较好,排斥反应较小,生物相容性较好,可用于板层角膜移植。     

MDCT angiography of the pulmonary arteries: intravascular contrast enhancement does not depend on iodine concentration when injecting equal amounts of iodine at standardized iodine delivery rates

To compare the impact of iodine concentration using two different contrast materials (CM) at standardized iodine delivery rate (IDR) and overall iodine load in 16-multidetector-row-CT-angiography (MDCTA) of the pulmonary arteries of 192 patients with known or suspected pulmonary embolism. One hundred three patients (group A) received 148 ml of a CM containing 300 mg iodine/ml (Ultravist 300, BayerScheringPharma) at a flow rate of 4.9 ml/s. Eighty-nine patients (group B) received 120 ml of a CM with a concentration of 370 mg iodine/ml (Ultravist 370) at a flow rate of 4.0 ml/s, resulting in a standardized IDR (approximately 1.5 gI/s) and the same overall amount of iodine (44.4 g). Both CM injections were followed by a saline chaser. Mean density values were determined in the pulmonary trunk, the ascending and the descending aorta, respectively. Applying repeated-measures ANOVA, no statistically significant differences between both MDCTA protocols were found (p = 0.5790): the mean density in the pulmonary trunk was 355 +/- 116 Hounsfield Units (group A) and 358 +/- 115 (group B). The corresponding values for the ascending and descending aorta were 295 +/- 79 (group A) and 284 +/- 65 (group B) as well as 272 +/- 71 and 262 +/- 70. In conclusion, the use of standardized IDR and overall iodine load provides comparable intravascular CM density in pulmonary 16-MDCTA for delivering contrast materials with different iodine concentrations.