羟丙甲纤维素滴眼液工艺改进

目的:提高羟丙甲纤维素滴眼液的可见异物合格率。方法:通过正交试验设计进行工艺改进。结果:羟丙甲纤维素滴眼液工艺调整为:溶解温度90-95℃,冷却时间为1.5小时,静置8小时后,可见异物合格率由原来的34.67%提高至70%以上。     

超声引导单击冷循环射频消融治疗肝癌的临床研究

目的探讨超声引导单击冷循环射频消融（cooling cycle radio frequency Ablation,RFA）治疗肝癌的疗效。方法对124例肝癌患者的146个肿瘤在超声引导下行多点扇形立体定位法经皮穿刺RFA治疗,在局部或硬膜外麻醉后,将射频电极穿刺肿瘤至肿瘤底部,根据肿瘤大小由深至浅进行消融治疗,每点治疗5～12min,当肿瘤完全被强回声覆盖超出正常肝组织0．5cm时停止治疗,封闭针道。治疗后15min行超声造影（CEUS）,判断肿瘤是否完全灭活,如果造影显示灭活不完全,可重复以上治疗;治疗后1个月行增强CT（CECT）或CEUS评估治疗效果。结果本组治疗后1个月CECT复查146个肿瘤,肿瘤内无强化者为125例（85．62％）,其中〈3cm者125例,-5cm者34例（85.00％）,～6cm者34例（80．95％）,-10cm者13例（81．25％）。CEUS复查126个肿瘤,肿瘤内无增强者106例（84．13％）,其中〈3．0cm者31例（86．11％）,-5cm者31例（85．29％）,-6cm者35例（83．33％）,-10cm者3例（78．57％）。CECT与CEUS比较,差异无显著性。结论超声引导单极冷循环RFA治疗肝癌疗效可靠,安全性高、适应范围广、创伤小、提高了较大肝癌灭活率。     

NB—UVB照射联合中药对寻常型银屑病血热型患者IL-17、IL-22、IL-23的影响

目的：观察窄谱中波紫外线（NB—UVB）照射联合中药对寻常型银屑病血热型患者的血清白介素（IL）-17、IL-22、IL-23的影响。方法：40例寻常型银屑病血热型患者随机分为中药组和联合组各20例。中药组采用1：2服凉血活血汤治疗,联合组在中药组治疗基础上采用NB—UVB照射治疗。采用ELISA法对40例患者治疗前后和10例对照组的健康志愿者血清中的IL-17、IL-22、IL-23水平进行检测。结果：治疗前中药组、联合组IL-17、IL-22、IL-23水平均显著高于对照组,差异均有非常显著性意义（P〈0．01）。中药组、联合组治疗前后自身IL-17、IL-22、IL-23水平比较,差异均有非常显著性意义（P〈0．01）。治疗后中药组、联合组3项指标分别与对照组比较,差异均有非常显著性意义（P〈0．01）;中药组、联合组治疗后3项指标比较,差异有非常显著性意义（P〈0．01）。结论：NB—UVB照射联合中药对寻常型银屑病血热型患者的免疫功能有一定影响,且优于单纯中药治疗。     

Cooling of the burn wound: the ideal temperature of the coolant

BACKGROUND: The beneficial effects of cooling a fresh burn wound were well demonstrated. However, there are still conflicting reports as to the optimum temperature of coolant, duration of application and effects in limiting tissue damage. A study was undertaken to investigate this, the importance of the temperature of, and the time period of application of the coolant. MATERIALS AND METHODS: Four identical deep dermal wounds were created on the back of 10 anaesthetised pigs. Each animal served as an independent experimental model. The effectiveness of cooling was monitored by measuring intradermal temperatures. The animals were divided into two groups; using ice water and tap water as the coolants. In each pig one wound was not cooled (wound 1). Three were cooled; one immediately for 30 min in group 1 and for 4 h in group 2 (wound 2). The other two wounds were cooled after 30 min for 30 min and 3 h (wounds 3 and 4, respectively). RESULTS: It was found that the temperature of the coolant was crucial. When ice water of 1-8 degrees C (group 1) was used more necrosis than in the wounds that were not cooled was seen. When tap water was used at 12-18 degrees C (group 2) it was demonstrated clinically and histologically that the cooled wounds had less necrosis than the uncooled wounds and thus healed faster. In group 2 the beneficial effects of cooling were still present when delayed for half an hour. CONCLUSION: First aid cooling of a burn wound with tap water is an effective method of minimising the damage sustained during a burn, and is universally and immediately available. Ice water cooling is associated with an increase in tissue damage.     

Factors influencing development of residual stresses during crystallization firing in a novel lithium silicate glass-ceramic

ObjectiveDevelopment of residual stresses is a potential source of premature fractures in glassy materials, being of special interest in novel lithium silicate glass-ceramics that require a crystallization firing to achieve their final mechanical properties. The aim of this work was to assess the influence of various firing tray systems and the application of different cooling protocols on the development of residual stresses in Suprinity PC crowns. Their effect on the in vitro lifetime of the restorations was also studied.MethodsThirty crowns were milled out of Suprinity PC blocks and crystallized using one of five different commercial firing tray systems (n = 6). Samples in each group were cooled following a fast (FC = 5.5 °C/s), a slow (SC = 0.4 °C/s) or the manufacturer’s reference cooling (REF ). Obtained crowns were sagittally or transversally sectioned and the magnitude and distribution of residual stresses was determined using the light birefringence method. Extra crowns of three of the subgroups (n = 8) were produced and submitted to chewing simulation for 10⁶ cycles or until fracture ensued.ResultsAverage residual stresses ranged between 0 and 1.5 MPa (peaks of 5 MPa). Highest stress magnitudes were observed at the support areas of groups using firing pins, leading to thermal cracks in FC samples and premature failures in the REF subgroup. The use of fibrous pads and firing pastes limited the development of residual stresses, whereas application of SC regimes extended the lifetime of the restorations.SignificanceDevelopment of residual stresses during crystallization firing in lithium silicate glass-ceramics results critical for their mechanical performance and should be therefore avoided by ensuring a homogenous cooling of the structures.     

一种新型低温静脉输液装置对中枢性高热患者的降温效果及安全性研究

背景　物理降温方法是中枢性高热患者的主要降温方法,目前临床上常用的物理降温方法效果报道不一,且存在较明显的并发症。目的　探讨一种新型低温静脉输液装置（国家实用新型专利,专利号：ZL 2014 2 0070586.4）对中枢性高热患者进行物理降温治疗的效果及安全性。方法　选取2015-2019年佛山市中医院重症医学科收治的中枢性高热患者93例,采用随机数字表法将其分为对照组（n=29）、普通静脉降温组（n=32）和应用降温装置组（n=32）。对照组给予基础治疗及体表物理降温,普通静脉降温组在对照组的基础上予以静脉输注低温液体（由冰箱冷藏4 ℃）,应用降温装置组则在对照组的基础上采用新型低温静脉输液装置输注室温液体。检测三组患者治疗前、治疗24 h及治疗48 h后的凝血功能指标：纤维蛋白原（FbgC）、活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）及血小板计数（PLT）;观察寒战、心律失常、皮肤受损等并发症发生率;测量治疗前及治疗2、4、8、12、24、48 h的肛温;评估治疗1周后格拉斯哥昏迷量表（GCS）评分;电话随访患者治疗28 d病死率。结果　治疗方法和时间对FbgC、APTT、PT及PLT不存在交互作用（P>0.05）;治疗方法和时间对FbgC、APTT、PT及PLT主效应均不显著（P>0.05）。应用降温装置组寒战发生率低于对照组和普通静脉降温组,皮肤受损发生率低于对照组（P<0.017）。治疗方法和时间对肛温存在交互作用（P<0.05）;治疗方法和时间对肛温主效应均显著（P<0.05）;其中应用降温装置组治疗2、4、8、12、24、48 h的肛温均低于对照组和普通静脉降温组（P<0.05）。治疗1周后应用降温装置组GCS评分高于对照组和普通静脉降温组（P<0.05）。三组患者治疗28 d病死率比较,差异无统计学意义（P>0.05）。结论　采用新型低温静脉输液装置对中枢性高热患者进行物理降温治疗具有快速且稳定的降温效果,且其并发症发生率低,可广泛应用于临床降温治疗。     

Scalp cooling to prevent chemotherapy-induced alopecia

Chemotherapy-induced alopecia causes an important impact on cancer patients and its risk of persistence is currently a considerable issue in cancer survivors. Of the various interventions proposed for the prevention of chemotherapy-induced alopecia, scalp cooling has emerged as an effective and safe strategy. This paper aims to provide an overview on scalp cooling and chemotherapy-induced alopecia prevention.     

清洗后空调冷却塔嗜肺军团菌阳性原因探讨及对策

目的对广州市清洗前、后的空调冷却塔进行嗜肺军团菌的采样检测和调查分析,探讨清洗后冷却塔水嗜肺军团菌阳性的原因,为防控提供依据。方法对广州市25个空调冷却塔于清洗前、后进行嗜肺军团菌检测;对军团菌阳性的冷却塔进行现场调查分析。结果 25个空调冷却塔清洗前嗜肺军团菌阳性率为76.0%,清洗后阳性率为68.0%,清洗前后差异无统计学意义（χ2=0.40,P〉0.05）。结论不能定期清洗冷却塔、冷却塔清洗过程不规范以及清洗机构素质不高是清洗后冷却塔嗜肺军团菌阳性的主要原因,应采取综合措施降低嗜肺军团菌污染的危险。     

Cooling properties of everyday liquids

Objective

To examine the cooling properties of a variety of ‘everyday’ hot liquids within the context of scald injuries in the United Kingdom.

Methods

The temperature of common hot liquids, including water, tea, coffee and various other liquids (i.e. takeaway coffees, “Indian tea”, chicken curries, hot milk and oil) were recorded over a time period, using digital cooking thermometers.

Results

Minimal difference was detected between the cooling rates of hot water, coffee and tea. Indian tea cooled at a slower rate. The speed at which milk cooled was less than other liquids and the higher the fat content the slower it cooled. Takeaway beverages had a lower starting temperature and retained heat for substantially longer periods. The assessment of cooking oil revealed intense heat production and prolonged cooling.

Conclusion

The authors propose that if a patient is exposed to a ‘common’ scalding agent that has been cooling for 10 min or less then the temperature of that fluid is likely to be greater than 60 °C and therefore capable of causing a burn within seconds of exposure. Furthermore, most liquids tested take between 15 and 30 min to reach a “safe temperature” below 53 °C.