青皮总黄酮的提取工艺与测定

目的 研究青皮总黄酮的提取工艺与含量测定的方法.方法 采用正交实验筛选青皮总黄酮的最佳提取工艺,用紫外分光光度法测定总黄酮.结果 青皮总黄酮的最佳提取条件为60℃,pH4.0,加15倍的Ca(OH)2饱和溶液,浸提1 h×3.以橙皮苷为对照测定总黄酮,橙皮苷线性范围为2.640～42.240 μg · ml-1(r=0.9999).该工艺得到的青皮总黄酮含量为6.11%.结论 所建方法快速、简便,可用于青皮药材的质量控制.     

不同麻醉方案对 TKA 术后深静脉血栓发生的影响

目的：对照研究连续硬膜外麻醉（CEA）和全身麻醉下人工全膝关节置换术（TKA）后深静脉血栓（DVT）的发生率,并探析其各自的临床意义。方法：分析2013年4月～2015年5月在我院接受治疗的68例患者的临床资料。将入选者随机分成 CEA 组和全麻组两组,各34例。比较两组患者的一般资料、术前术后的相关指标以及术前凝血、血小板相关指标以及 DVT 的发生率。结果：两组患者的一般资料无统计学差异。两组患者术中、术后的相关指标间差异均不明显。两组患者术前凝血与血小板比较无统计学差异。DVT 的总发生率为19.1％（13/68）,其中单纯远端血栓有12例,近端血栓有1例,无肺栓塞及髂静脉血栓患者。CEA 组的 DVT 发生率明显低于全麻组。结论：CEA 可以显著降低 TKA 后 DVT 的发生率,疗效显著。     

Initial satisfying experience of total retroperitoneal laparoscopic radical nephroureterectomy: a retrospective comparative research

BackgroundRadical nephroureterectomy (RNU) is the principal method for treatment of high-risk upper urinary tract urothelial carcinoma (UTUC). The transperitoneal approach is associated with poor disease progression, but the distal ureter-bladder cuff (DUBC) resection through retroperitoneal laparoscopic approach is difficult. This study proposed a modulated RNU technique, namely, total retroperitoneal laparoscopic radical nephroureterectomy (tRLRNU), with its advantages of DUBC resection and requiring fewer trocars etc. The efficiency, safety, and short-term impacts were retrospectively compared with total transperitoneal laparoscopic radical nephroureterectomy (tTLRNU).MethodsTotal of 12 patients who received tRLRNU and 28 patients who received tTLRNU were enrolled. The choice of surgical approach was random and their data were retrospectively analyzed. During tRLRNU, the laparoscope was versed towards the caudal direction and a retroperitoneal laparoscopic ureterectomy was performed. The bladder cuff was entirely transected and the bladder incision was sutured. The tRLRNU cases were compared with the tTLRNU cases in terms of general clinical data, pathologic parameters, peri-operative parameters, adjuvant therapy, and short-term outcomes. The independent samples t-tests, chi-square tests, and Fischer exact tests were used to analyze the differences.ResultsThere were no significant differences in the basic patient characteristics between the 2 groups. The data were comparable. There were significantly fewer trocars utilized in tRLRNU group compared to tTLRNU group (P=0.0008). tRLRNU group experienced less blood loss (98.33±61.32 versus 170.71±121.32 mL; P=0.017), smaller drainage volume (182.08±163.60 versus 1,924.82±3,370.02 mL; P=0.011), and shorter extubation time (5.67±1.07 versus 8.57±6.96 days; P=0.040) compared to tRLRNU group. There were no statistically differences in the other peri-operative parameters, including whole operation time, transfusion, visceral and vascular injuries, open conversion, post-operative bleeding, recovery time of intestinal function, and discharge time. The patient outcomes in tTLRNU group at 6 months were significantly worse than that of tRLRNU group by comparing progression-free survival, progression survival and mortality (P=0.039).ConclusionsThe tRLRNU was potentially safer, minimally invasive, and more effective compared to the tTLRNU. Due to the small sample size, short follow-up time and no randomization of the study, future comparative studies are warranted to further analyze long-term outcomes of tRLRNU.     

Total arch replacement using frozen elephant trunk technique with Frozenix for distal aortic arch aneurysms

Open in a separate window OBJECTIVESTotal arch replacement (TAR) using an endovascular approach has been initially introduced as the frozen elephant trunk technique (FET). In our institute, TAR using the FET with Frozenix has been used as the first-line treatment for distal aortic arch aneurysms since 2014. This study aimed to evaluate the early and long-term outcomes and demonstrate the efficacy of this procedure.METHODSBetween 2014 and 2021, 121 consecutive patients were treated with TAR using the FET with Frozenix for distal aortic arch aneurysms. Early and long-term outcomes were retrospectively analysed.RESULTSThe 30-day mortality rate was 2.5% (3/121). Of postoperative complications, paraplegia due to spinal cord injury occurred in 2 (1.7%) patients, stroke in 12 (9.9%) and acute renal failure in 10 (8.3%). At follow-up, 23 secondary aortic interventions were required and 8 (6.6%) patients underwent intended secondary thoracic endovascular aortic repair for residual descending aortic aneurysm. Late and aortic-related deaths occurred in 16 (13.2%) and 4 (3.3%) patients, respectively. The overall long-term survival rates at 1, 3 and 5 years were 87.6%, 83.1% and 65.4%, respectively, while the rates of freedom from aortic-related death at 1, 3 and 5 years were 95.7%, 95.7% and 84.8%, respectively.CONCLUSIONSTAR using the FET with Frozenix for distal aortic arch aneurysms has acceptable early mortality and morbidity. Spinal cord injury and paraplegia occur less frequently than previously reported. The technique has satisfactory long-term survival and freedom from aortic-related death.     

Direct visualization of glucagon‐like peptide‐1 secretion by fluorescent fusion proteins

Live‐cell imaging with fluorescent proteins (FPs) is a powerful tool for investigating the exocytosis processes of hormones. However, the secretion process of glucagon‐like peptide‐1 (GLP‐1) has not been visualized by FPs, which might be because tagging FPs inhibits GLP‐1 synthesis through the post‐translational processing from proglucagon. Here, we have developed FP‐tagged GLP‐1 by inserting FPs into the middle of GLP‐1 and adding the proglucagon signal peptide. Confocal imaging confirmed that GLP‐1 fused to FPs with high folding efficiency showed granular structure, in which secretory vesicle markers colocalized. The fluorescence intensity of FP in the culture supernatant from cells treated with KCl or forskolin was significantly increased compared with those from untreated cells. Furthermore, FP‐tagged GLP‐1 enables direct visualization of stimulation‐dependent exocytosis of GLP‐1 at a single granule resolution with total internal reflection fluorescence microscopy. FP‐tagged GLP‐1 might facilitate the screening of GLP‐1 secretagogues and the discovery of new antidiabetic drugs.     

Single-stage repair for ascending aortic aneurysm,artery stenosis and occlusion of neck vessels caused by Takayasu arteritis

Takayasu arteritis results in a variety of vascular symptoms, and there are some cases in which progressive vascular lesions require surgical intervention. We present a case with ascending aortic aneurysm, right common carotid artery stenosis, left common carotid artery occlusion and left subclavian artery stenosis caused by Takayasu arteritis that was successfully treated with total arch replacement and ascending aorta to right internal carotid artery bypass.     

白芍总甙对局灶性脑缺血大鼠脑组织炎症信号表达的影响

目的观察白芍总甙对局灶性脑缺血(Focal Cerebral ischemic,FCI)大鼠脑组织Toll样受体4(TLR4)基因表达的作用。方法参照longa等方法制成大鼠局灶性大脑中动脉梗死(MCAO)模型,将80只SD雄性大鼠随机分为假手术组,溶剂组,白芍总甙低、高两个剂量组,采用RT-PCR法检测缺血灶周围脑组织TLR4基因表达水平。结果生理盐水组TLR4基因相对表达均明显高于假手术组(P<0.01);白芍总甙中高剂量组TLR4相对表达量明显低于生理盐水组(P<0.01)。结论生理盐水组大鼠缺血灶周围脑组织TLR4基因高表达,白芍总甙对TLR4表达有抑制作用,这可能是其抗炎作用的机理之一。     

静脉用药调配中心全静脉营养液处方分析

目的对郑州人民医院近3个月全肠道外营养液（TPN）处方设计进行分析,为TPN临床合理应用提供参考。方法汇总郑州人民医院近3个月TPN处方并就其配方的成分组成进行统计分析。结果郑州人民医院近3个月TPN处方669张,设计基本合理,但仍存在非蛋白热卡不足、含氮量偏低等问题,经审核排除不合格用药处方张数55张,占总处方数的8.22%。结论临床医生应针对患者的营养状况准确,合理的设计TPN配方,提高临床营养治疗的安全性和有效性,同时药师应通过审方来进一步保证处方的合理性。     

股骨远端髓外与髓内定位截骨对全膝关节置换术后失血影响的回顾性研究

背景:全膝关节置换术是治疗终末期膝关节疾病的有效方法,然而很多患者因为术后失血而发生急性失血性贫血,失血过多者还需输血治疗.这不仅影响膝关节功能康复,还可能引起各种并发症及相关问题.目的:探讨股骨远端髓外定位截骨是否能够减少初次单侧全膝关节置换术后失血.方法:选取2015年1月至2017年12月248例行初次单侧全膝关...     

构建成人高等医学教育教学质量管理与监控体系

本文在分析全面质量管理(total quality management,TQM)内涵的基础上,借鉴TQM的质量第一、系统管理、过程控制、预防为主和不断改进的核心理念与工作思路,提出了构建南华大学成人高等医学教育教学质量管理与监控体系研究方案.同时,对该质量管理体系的研究任务与目标、基本构建框架与管理要素以及运行该质量管理体系的保障机制等问题进行了初步研究与实践.