超声心动图对儿童完全性肺静脉异位引流诊断价值的探讨

目的　旨在评价超声心动图对完全性肺静脉异位引流 (TAPVD)的诊断价值。方法　对 1987年 9月至2 0 0 2年 11月收治的TAPVD患儿 70例进行分析。均有完整的临床及超声心动图资料 ,其中 35例施行了手术治疗。结果　 70例TAPVD的解剖分型为 :心内型 5 2例、心上型 16例、心下型 2例 ,未发现混合型。 35例施行手术 ,32例与术前超声心动图的诊断一致 ;3例与超声心动图诊断不完全一致 ,其超声心动图诊断分别为 :三房心伴继发孔房缺、左房隔膜伴继发孔房缺、原发孔房缺伴卵圆孔未闭 ,而手术结果均显示为心内型TAPVD伴继发孔房缺。结论　超声心动图检查是诊断TAPVD重要且准确的方法 ,并能确定其分型 ,提供精确的解剖及血流动力学资料。在应用超声心动图诊断TAPVD时 ,应注意与三房心、左房隔膜等疾病进行鉴别。     

注射用通脉灵质量标准研究

目的：对注射用通脉灵进行质量标准的研究。方法：采用薄层层析法对处方中药材进行了定性鉴别，并采用分光光度法对总黄酮进行了含量测定，采用比色法对总皂苷进行了含量测定。结果：薄层色谱分离效果好，两种方法回收率RSD均小于3％。结论：该方法较简单，重现性好，可作该制剂质量控制标准。     

镫骨全切除和吸引噪声对豚鼠耳蜗功能与超微结构的影响

本实验应用耳蜗电图和扫描、透射电镜等技术观察了6组(44只)豚鼠镫骨全切除后,前庭窗开放时间的长短和听泡内使用吸引器对耳蜗功能和超微结构的影响程度.结果如下:①随前庭窗开放时间的延长、复合蜗神经动作电位(compound action potential.CAP)反应阈进行性提高,开放180min可导致底回部分外毛细胞变性或破坏;②镫骨全切除后,听泡内较长时间地(60min)应用吸引器可引起CAP明显阈移和耳蜗底回部分外毛细胞的不可逆病变;③镫骨未切除时,听泡内吸引60min,仅引起CAP阈移,但外毛细胞未见损伤.结果提示:术中长时间开放前庭窗和鼓室内应用吸引器可能是引起镫骨全切除术后感音神经性聋的因素之一,但鼓室成形术中鼓室内吸引噪声可能因其强度不够大,不足以引起术后感音神经性聋.     

In vitro measurements of aerodynamic characteristics of an improved tracheostoma valve for laryngectomees

Tracheostoma valves are often required in the rehabilitation process of speech after total laryngectomy. Patients are thus able to speak without using their hands to close the tracheostoma. The improved Groningen tracheostoma valve consists of a “cough” valve with an integrated (“speech”) valve, which closes for phonation. The cough valve opens as the result of pressure produced by the lungs during a cough. The speech valve closes by the airflow produced by the lungs, thus directing air from the lungs into the esophagus at a deliberately chosen moment. An experimental setup with a computer-based acquisition program was developed to measure the pressure at which the cough valve opened and the flow at which the speech valve closed. In addition, the airflow resistance coefficient of the tracheostoma valve was defined and measured with an open speech valve. Both dry air from a cylinder and humid expired air were used. Results showed a pressure range of 1–7 kPa to open the cough valve and a flow range of 1.2–2.7 l/s to close the speech valve. These values were readily attained during speech, while the flow range occurred above values reached in quiet breathing. The device appeared to function well in physiological ranges and was optimally adjustable to an individual setting. No significant differences were measured between air from a cylinder and humid expired air. Findings showed that methods used to obtain results could be employed as a reference method for comparing aerodynamic characteristics of tracheostoma valves. Received: 13 February 1997 / Accepted: 16 September 1997     

正交实验法优选鹿角的水提工艺

目的：研究鹿角水煎煮工艺．优选最佳提取工艺条件。方法：以浸出物及总氮为检测指标，用正交实验考察3种因素(加水量、煎煮次数、煎煮时间)对其含量的影响。结果：鹿角的最佳提取工艺条件为加8倍量水，煎煮3次，3h／次。结论：制备工艺合理。     

原发性高血压患者瘦素及神经肽Y与血脂的关系

目的　研究原发性高血压患者瘦素及神经肽Y与血脂的相互关系。方法　对 116例原发性高血压患者及 2 6例健康对照者采用放免分析法测量瘦素 (LE)及神经肽Y(NPY)浓度 ,并同时测定血总胆固醇 (CH)、甘油三脂 (TG)及高密度脂蛋白胆固醇(HDL)浓度。结果　高血压组体重指数 (BMI)、血CH、TG、NPY及LEP浓度均显著高于正常对照组 ,而HDL浓度则显著低于正常对照组 (P均 <0 0 1)。相关分析显示 ,LE浓度与收缩压、舒张压、BMI、血CH、TG及NPY浓度呈显著正相关 (P均 <0 0 5 )。结论　血浆瘦素浓度升高可能是原发性高血压发病患机制之一 ,并通过神经肽Y的作用与原发性高血压患者发生血脂紊乱及肥胖有关     

优化枳椇子的提取工艺

目的　确定枳椇子干浸膏的最佳提取工艺?椒ā∫愿山嗟寐屎透山嘀凶芑仆课副?,对索式提取器提取的方法、渗滤法和浸渍法进行筛选。结果　渗滤法出膏率和干浸膏中黄酮含量最高,索式提取次之,浸渍法出膏率和干浸膏中黄酮含量最低。结论　渗滤法提取干浸膏简单易行,成本低廉,适合批量生产。     

差示分光光度法测定复方刺梨合剂中总黄酮的含量

目的 测定复方刺梨合剂中的总黄酮含量;方法 采用差示分光光度法,在392nm波长下样品不经分离直接测定;结果 线性范围5.06～50.60μg·mL-1,回归方程A=5.84×10-4+0.01321C,r=0.9996,平均回收率99.59%,RSD=1.49%.结论 所建方法 快速、简便、准确,适用于复方刺梨合剂的质量控制.     

Clinical Outcomes of Revision Total Knee Arthroplasty after High Tibial Osteotomy and Unicompartmental Knee Arthroplasty: A Systematic Review and Meta‐Analysis

As more high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are performed, orthopaedic surgeons realize that more HTO and UKA failures will require revision to total knee arthroplasty (TKA) in the future. To systematically evaluate the clinical outcomes of TKA after HTO and TKA after UKA, the Embase, PubMed, Ovid, Web of Science, and Cochrane Library databases were searched for studies investigating revision TKA after HTO and UKA published up to June 2021. RevMan version 5.3 was used to perform the meta‐analysis. The revision TKA after HTO and revision TKA after UKA groups were compared in terms of operative time, range of motion (ROM), knee score, postoperative complications, postoperative infection, revision, and revision implants used. Nine studies were ultimately included in the meta‐analysis. Results revealed that the knee score for the revision TKA after HTO group was better than that of the revision TKA after UKA group (MD 4.50 [95% CI 0.80–8.20]; p = 0.02). The revision TKA after HTO group had a lower revision rate (OR 0.65 [95% CI 0.55–0.78]; p < 0.00001) and fewer revision implants used (OR 0.11 [95% CI 0.05–0.23]; p < 0.00001). There were no statistical differences in operation time (MD ‐2.00 [95% CI −11.22 to 7.21]; p = 0.67), ROM (MD ‐0.04 [95% CI ‐3.69–3.61]; p = 0.98), postoperative complications (OR 1.41 [95% CI 0.77–2.60]; p = 0.27), or postoperative infections (OR 0.89 [95% CI 0.61–1.29]; p = 0.53). To conclude, the revision rate of revision TKA after UKA was greater, and more revision implants were required. It is important for orthopaedic surgeons to preserve bone during primary UKA.     

Catastrophic Periprosthetic Osteolysis in Total Hip Arthroplasty at 20 Years: A Case Report and Literature Review

BackgroundPeriprosthetic osteolysis is a serious complication following total hip arthroplasty (THA). However, most orthopedic surgeons only focus on bone loss and hip reconstruction. Thus, it was required to understand the treatment algorithm for periprosthetic osteolysis integrally.Case PresentationA 52‐year‐old Asian male presented with chronic hip pain. A mass appeared on the medial side of the proximal left thigh at more than 20 years after bilateral THA. Radiographs revealed catastrophic periprosthetic osteolysis, especially on the acetabular side. Large amounts of necrotic tissue and bloody fluids were thoroughly debrided during revision THA. A modular hemipelvic prosthesis was used for revision of the left hip. Four years later, the patient presented with right hip pain, where a mass appeared on the medial side of the proximal right thigh. A primary acetabular implant with augment was used for revision of the right hip. Laboratory evaluation of bloody fluid retrieved from surgery revealed elevated levels of inflammatory markers.ConclusionInflammatory responses to polyethylene wear debris can lead to severe bone resorption and aseptic loosening in the long‐term following THA. Therefore, in spite of revision THA, interrupting the cascade inflammatory might be the treatment principle for periprosthetic osteolysis.