Polythioethers with Controlled α,ω‐End Groups Prepared by Visible Light Induced Thiol–Ene Click Polymerization of Dithiol and Divinyl Ether with 4‐(N,N‐diphenylamino)benzaldehyde as Organocatalyst

This study reports a step‐growth click‐polymerization of 1,4‐benzenedimethane (BDMT) and diethylene glycol divinyl ether (DEGVE) with 4‐(N,N‐diphenylamino)‐benzaldehyde (DPAB) as a photoredox catalyst under irradiation of visible light. DPAB exhibits a strong UV–vis absorption at 350 nm and a strong fluorescence emission at 480 nm in anisole. There is a strong fluorescence quenching between BDMT and DPAB. The molecular weight of the polythiolether can be controlled by reaction time and monomer feed ratios. More importantly, α,ω‐dithiol and α,ω‐divinyl telechelic polythiolether oligomers are successfully synthesized by simply changing the molar ratios of BDMT to DEGVE. ¹H NMR and MALDI‐TOF MS spectra demonstrate that the oligomers have high end group fidelity. In addition, strong fluorescence is observed when the α,ω‐dithiol terminated polythiolether adds with N‐(1‐pyrenyl) maleimide, indicating that the as‐prepared polythiolether bears reactive thiol end groups. Furthermore, high molecular weight polythiolether are prepared by chain extension with reactive polythiolether oligomers as macro‐monomers. For example, α,ω‐divinyl oligomer (M_n = 2000 g mol^?1) could further react with α,ω‐dithiol oligomer (M_n = 2400 g mol^?1) to form high molecular weight polythiolether (M_n = 6000 g mol^?1).     

States of Water in Hydrogels Containing with Glyceryl Methacrylate

Hydrogel materials were prepared by thermopolymerization with different content of glyceryl methacrylate and hydroxyethyl methacrylate. The different states of water in swelling hydrogels were described and studied by differential scanning calorimetry （DSC）. It was found that the hydrophilicity of GMA was stronger than HEMA, the water content and bound water of GMA hydrogel are higher than HEMA hydrogel. With the increase of GMA content, the content of free water in hydrogel increased. When GMA content was lower than 50%, the increase of GMA content also increased the content of bound water; but when GMA content was higher than 50%, the increase of GMA content decreased the content of bound water, which was caused by the chain hydrogen bond formed on the GMA chain with hydroxyl group each other.     

沙培林腔内注射对乳腺癌改良根治术后皮下积液的疗效

目的:观察沙培林腔内注射治疗乳腺癌改良根治术后皮下积液的疗效及安全性。方法:选择行乳腺癌改良根治术后发生皮下积液患者60例,随机分为观察组和对照组,每组30例。观察组行抽净积液后腔内注射沙培林混合液,3h后抽净药液,再用绷带加压包扎积液创面;对照组仅以50%葡萄糖腔内注射,其余步骤相同。观察两组皮下积液改善的效果以及发热和局部皮肤坏死等不良反应。结果:治疗前两组积液量差异无统计学意义(164.45±36.22ml vs 172.41±45.37ml,P0.05);第一次治疗后和第二次治疗后,观察组积液量均少于对照组(55.43±36.29ml vs 132.31±41.65ml,18.39±15.47ml vs 69.42±38.75ml;P0.05),积液完全消失时间(3.22±0.64天vs11.84±1.83天)明显短于对照组(P0.05)。两组发热率均为3.33%(1/30),差异无统计学意义(P0.05),均未发生皮肤坏死事件。结论:局部腔内注射沙培林可很快减少乳腺癌改良根治术后皮下积液,且使用方便、安全。     

电化学发光免疫分析24小时尿游离皮质醇的方法学验证

目的 应用电化学发光免疫分析法（ECLIA）和化学发光免疫测定法（CUA）测定24小时尿游离皮质醇（UFC）,比较方法的相关性,拟用ECLIA替代CLIA检测UFC,并对ECLIA进行系统评价及建立本实验室的参考区间.方法 采用ECLIA萃取法和CLIA萃取法检测24例住院患者24小时尿液,对其结果进行相关性比较.收集87例正常人24小时尿液,用ECLIA检测其尿中游离皮质醇含量,建立参考区间,验证其系统性能,包括精密度、功能灵敏度和分析测量线性范围.结果 ECLIA萃取法和CLIA萃取法比较r=0.9724,P＜0.001,两者有相关性;ECLIA萃取法批内差异高值3.30％,低值4.52％,批间差异高值4.69％,低值6.55％;分析测量范围：0.053 ～ 58.91 μg/dL,R2=0.9882,y=1.0344X＋0.8466;功能灵敏度为0.05μg/dL;以第97.5％位数为参考上限,第2.5％位数为参考下限,建立的参考区间为30.1 ～129.1 μg/24h.结论 ECLIA萃取法具有合适的精密度、线性,可准确反映机体24小时尿游离皮质醇的分泌情况.     

Long‐term experience of steroid‐free pediatric renal transplantation: Effects on graft function,body mass index,and longitudinal growth

Increased focus on the potential negative side effects of steroid usage in pediatric transplantation has led to steroid minimization or steroid‐free transplantation. In this study, we report results after complete steroid avoidance in renal transplantation in the period 1994–2009. We evaluate the effects of complete steroid avoidance on allograft function, BMI, and linear growth. The majority of transplanted children were induced with antithymocyte globulin and immunosuppressed with a calcineurin inhibitor and mycophenolate mofetil. Steroids were given only when rejection occurred or due to comorbidities. Anthropometric data were collected from 65 transplantations in 60 children. Patient survival was 93%; graft survival was 81% after five yr (N = 42) and 63% after 10 yr (N = 16). Acute rejection within the first year of transplantation was 9%. The distribution of the children's BMI before transplantation was normal; the mean BMI‐SDS was 0.21 before transplantation, and this value remained stable during the next five yr. Post‐transplantation the children demonstrated significant improved growth as the mean height‐SDS increased significantly from ?1.7 to ?1.1. Catch‐up growth was most pronounced in the youngest (< six yr). Steroid‐free immunosuppression in pediatric renal transplantation is safe and protects against steroid‐induced obesity and short stature.     

An Evaluation of the Accuracy of Labeling of Percent Sodium Hypochlorite on Various Commercial and Professional Sources: Is Sodium Hypochlorite from These Sources Equally Suitable for Endodontic Irrigation?

Introduction

The shelf life of sodium hypochlorite (NaOCl) is limited, and a previous article showed that there can be a discrepancy between the expected concentration of free available chlorine (FAC) and the actual FAC concentration in NaOCl solutions intended for endodontic irrigation. The current study investigates the FAC content of domestic and professional NaOCls and evaluates the influences of dilution and storage on FAC concentration.

Methods

First, domestic and professional NaOCls not obtained from manufacturers were iodometrically titrated. Then, NaOCls were diluted with demineralized water or tap water and stored at 4°C or 18°C and analyzed at baseline and 2 and 22 weeks. Statistical analyses included paired samples, independent samples t tests and repeated multivariate analysis of variance. Correlations were calculated with the Pearson or Spearman rank correlation test. A P < .05 was considered significant.

Results

Label specifications of domestic NaOCl were very imprecise (ie, <5% NaOCl). Domestic NaOCl contained 1.8%–3.5% NaOCl (w/v). Professional NaOCl varied from 14.3% relative less FAC than specified on the label to 23.5% relative more FAC than specified. After 22 weeks, the relative average loss of FAC in all conditions was 5.4% FAC (P = .002). Dilution, diluents, or storage temperature had no effect on the decline of FAC caused by aging.

Conclusions

There is a great variation in NaOCl concentrations, with domestic NaOCl being the least accurate. NaOCl can be stored up to 5 months. The FAC concentration of domestic NaOCl is unpredictable, and, therefore, it appears less suitable for clinical application as root canal irrigant.     

The effect of early detection of anterolateral thigh free flap crisis on the salvage success rate,based on 10 years of experience and 1072 flaps

The aim of this study was to assess the effectiveness of early exploration of anterolateral thigh (ALT) free flap compromise in head and neck reconstruction and to correlate this with the salvage success rate. The perioperative data of 1051 patients with 1072 ALT flap reconstructions were reviewed retrospectively for the period January 2002 to December 2012. Outcome measures included ethnicity, defect type, incidence and timing of flap compromise, type of flap compromise, causes of vascular occlusion, and salvage rate. The success rate of free flap reconstruction was 97.3% (1043/1072). Of the 29 failures, 21 were complete and eight were partial failures (10–40% of the flap). Venous occlusions occurred in 39 flaps (83.0%) and arterial occlusions in five flaps (17.0%). Six cases were detected within 8 h postoperatively, 13 at 8–16 h postoperatively, seven at 16–24 h postoperatively, and 18 at 24–48 h postoperatively, with respective salvage rates of 66.7%, 61.5%, 28.6%, and 22.2%; three cases detected after 48 h failed. The salvage rate at ≤16 h (62.2%) was much higher than that at >16 h (21.4%, P = 0.0039). Early detection, re-exploration, and effective handling of the flap crisis increases the rate of flap salvage tremendously.     

超声刀在颈淋巴清扫术中的临床应用

目的 :探讨超声刀技术在口腔颌面头颈部鳞癌施行颈淋巴清扫术中的临床应用价值和手术技巧。方法 :2007-02—2012-12期间,随机交叉选取口腔黏膜鳞状细胞癌432例患者,分为超声刀组(216例)和电刀组(216例)。比较2组的手术时间、失血量、术后24h引流量、术后住院天数以及术后并发症的发生等项目。结果:与电刀组相比较,超声刀组在手术时间、术中失血量、24h引流量、住院天数等方面具有明显优势,经统计学分析,P<0.05为差异有统计学意义。结论:应用超声刀技术施行颈淋巴清扫术,具有传统高频电刀所不具有的组织分离和切割、凝固止血三种功能合一体的优点,实用手术技巧与超声刀技术联合应用,可使颈淋巴清扫完全达到根治性要求。是一种值得临床推广,且有应用前景的颈淋巴清扫治疗策略。