奥美拉唑预防治疗喉部分切除术后喉腔肉芽的疗效分析

目的 观察喉部分切除术后口服奥美拉唑肠溶胶囊预防喉腔肉芽形成的疗效。方法 选取我院2017年1月—2022年5月收治的74例行喉部分切除术患者,将其随机分为对照组和实验组两组。对照组47例,出院后常规给予预防性抗感染治疗;实验组27例,出院后除预防性抗感染治疗外再加用口服奥美拉唑肠溶胶囊治疗,每日口服1次,每次20 mg,连用1个月。随访观察两组喉腔肉芽情况。结果 术后1个月电子喉镜显示经过奥美拉唑肠溶胶囊预防治疗后喉腔肉芽的发生率降低,与对照组相比,两者之间差异具有统计学意义(P<0.05)。结论 喉腔肉芽是喉部分切除术后常见的并发症之一,口服奥美拉唑肠溶胶囊可能是喉部分切除术后预防喉腔肉芽形成的有效治疗方案。     

Diagnosis and management of placenta accreta

The diagnosis of placenta accreta begins with clinical suspicion in patients at risk. Ultrasound and Doppler are first-choice diagnostic methods because of their accessibility and high sensitivity. Placental MRI is an accurate method of topographic stratification that makes it possible to define anatomy, to plan the surgical approach and to consider other therapeutic possibilities. Management of placenta percreta involves great technical dexterity and significant clinical support. The main challenges include controlling the haemorrhage and dissection of the invaded tissues. Nowadays, there are two treatment options: caesarean hysterectomy or a conservative approach. With the latter, there is a choice between leaving the placenta in situ and waiting for its later resolution, and a one-step surgery that addresses the problems of invasion, vascular control and myometrial damage in a single surgical act.     

Combining formulation and process aspects for optimizing the high-shear wet granulation of common drugs

The purpose of this research was to determine the effects of some important drug properties (such as particle size distribution, hygroscopicity and solubility) and process variables on the granule growth behaviour and final drug distribution in high shear wet granulation. Results have been analyzed in the light of widely accepted theories and some recently developed approaches.A mixture composed of drug, some excipients and a dry binder was processed using a lab-scale high-shear mixer. Three common active pharmaceutical ingredients (paracetamol, caffeine and acetylsalicylic acid) were used within the initial formulation. Drug load was 50% (on weight basis).Influences of drug particle properties (e.g. particle size and shape, hygroscopicity) on the granule growth behaviour were evaluated. Particle size distribution (PSD) and granule morphology were monitored during the entire process through sieve analysis and scanning electron microscope (SEM) image analysis. Resistance of the wet mass to mixing was furthermore measured using the impeller torque monitoring technique. The observed differences in the granule growth behaviour as well as the discrepancies between the actual and the ideal drug content in the final granules have been interpreted in terms of dimensionless quantity (spray flux number, bed penetration time) and related to torque measurements. Analysis highlighted the role of liquid distribution on the process. It was demonstrated that where the liquid penetration time was higher (e.g. paracetamol-based formulations), the liquid distribution was poorer leading to retarded granule growth and selective agglomeration. On the other hand where penetration time was lower (e.g. acetylsalicylic acid-based formulations), the growth was much faster but uniformity content problem arose because of the onset of crushing and layering phenomena.     

Periodontal tissue healing following flap surgery using an Er:YAG laser in dogs

BACKGROUND AND OBJECTIVES: The purpose of this study was to compare periodontal tissue healing following flap surgery using an Er:YAG laser with that of conventional surgery. STUDY DESIGN/MATERIALS AND METHODS: Bilateral premolars with experimentally induced periodontitis in six dogs were treated by periodontal flap surgery. Degranulation and root debridement in the furcation were performed using an Er:YAG laser or curet. At 3 months postsurgery, animals were sacrificed and decalcified specimens were prepared for histological and histometric analysis. RESULTS: Degranulation and root debridement were effectively performed with an Er:YAG laser without major thermal damage and significantly faster than with a curet. Histologically, the amount of newly formed bone was significantly greater in the laser group than in the curet group, although both groups showed similar amounts of cementum formation and connective tissue attachment. CONCLUSIONS: The Er:YAG laser irradiation can be safely and effectively utilized in periodontal flap surgery, and has the potential to promote new bone formation.     

大鼠蛛网膜颗粒在颅内分布及三维结构

目的 观察大鼠蛛网膜颗粒(AG)在颅内的分布规律及其三维结构.方法 将24只成年Wistar大鼠分为3组,分别进行活体状态下亚甲蓝枕大池蛛网膜下腔注射、蛛网膜颗粒光学显微镜观察、扫描电镜检查.结果 大鼠AG主要位于横窦两侧的中部偏内的位置,大部分成簇状生长,表面覆盖有形状各异的内皮细胞,在内皮细胞间可见到少数小孔和较大的裂隙.结论 大鼠的AG与人类的颗粒无论是形态还是运行机制,均有相似之处,可用来制作研究脑脊液运行相关的动物模型.     

兰索拉唑双相释药微丸胶囊的制备

目的：研究兰索拉唑双相释药微丸胶囊剂的制备方法。方法采用离心造粒法制备兰索拉唑含药微丸,用流化床包衣法分别制备兰索拉唑肠溶微丸和肠溶脉冲微丸,然后将两种微丸按固定比例填充至空心胶囊内。用体外释放度法观察肠溶微丸累计释放量。结果优化处方：载药丸心中碳酸镁用量15%,低取代羟丙纤维素（L-HPC）用量20%;肠溶微丸中隔离衣层增重9%~10%,肠溶衣层增重＞41%;肠溶脉冲微丸溶胀层包衣增重50%~60%,控释层包衣增重50%,肠溶衣层增重＞41%,后干燥时间为4h。结论以肠溶微丸技术制备兰索拉唑双相释药微丸胶囊,工艺可行,重复性良好,质量稳定可靠。     

Effect of three interventional bronchoscopic methods on tracheal stenosis and the formation of granulation tissues in dogs

Background Therapeutic approaches for tracheal stenosis caused by the formation of exuberant granulation tissues usually include electrocautery, mechanical dilation, laser therapy, argon plasma coagulation （APC）, cryotherapy and stent placement. However, restenosis after stent insertion remains a significant limitation. We examined the efficacy of three different approaches, including induction of mechanical lesions, APC performed with different powers or durations and cryotherapy, to identify the method that limited the formation of granulation tissue. Methods Twelve specially bred research mongrel dogs were divided into three groups. In group 1 （four dogs） mild （procedure 1; two dogs） or moderate （procedure 2; two dogs） damage was induced mechanically. Group 2 （six dogs） received APC at different powers or durations （procedure 3：30 W, 1 cm/s; procedure 4：30 W, 2 cm/s; procedure 5：25 W, 3 cm/s）. Group 3 （two dogs） received cryotherapy （procedure 6： two freeze-thaw cycles of 30 seconds）. Uncovered self-expandable metallic stents were inserted in all dogs to maintain a continuous stimulus to the trachea mucosa. Dogs were monitored for 4 weeks and the relationship between granulation tissue proliferation and method used was analyzed. Results In group 1, granulation tissue growth increased with more severe mechanical damage. The growth of granulation tissue in group 2 was more pronounced than in group 1, and both dogs in procedure 3 died because of severe stenosis. In this group, the formation of granulation tissue decreased with decreasing power and duration. In group 3, no obvious granulation tissue was found at week 4. Conclusions Lesions and stimuli from a foreign body （the stent） are two important factors that lead to overgrowth of granulation tissue. Thermal lesions, such as APC, seem to induce greater granulation tissue growth and cartilage damage compared with mechanical and cryotherapy lesions. Cryotherapy in combination with mechanical dilation may be a safe and effective treatment method for managing tracheal stenosis caused by the formation of granulation tissue.     

成纤维细胞生长因子促进小鼠皮肤创伤愈合的研究

于小鼠背部皮肤制成手术切割伤口，实验组外敷成纤维细胞生长因子（ｆｉｂｒｏｂｌａｓｔｇｒｏｗｔｈｆａｃｔｏｒ，ＦＧＦ）溶液（含ＦＧＦ３００μｇ／ｍｌ，肝素１００μｇ／ｍｌ）０．５ｍｌ，对照组敷生理盐水０．５ｍｌ，无菌纱布包扎，每日一次。术后１、３、５、７、１０ｄ观察伤口愈合情况。结果显示，实验组毛细血管和成纤维细胞较对照组明显增生，并提前２～３ｄ达高峰，表明ＦＧＦ强有力地促进肉芽组织增生和伤口愈合。     

祛瘀生肌法对SD大鼠糖尿病溃疡创面修复MAPK信号通路相关基因的调控作用

目的:探讨祛瘀生肌中药对糖尿病难愈合性创面修复MAPK信号通路相关基因的调控作用。方法:以糖尿病溃疡创面为研究平台,将SD大鼠随机分为正常创面组、糖尿病溃疡模型组及生肌化瘀1(生肌方与化瘀方2∶1)、生肌化瘀2(生肌方与化瘀方1∶1)、生肌化瘀3(生肌方与化瘀方1∶2)方组,除正常组外,其余4组以腹腔注射链脲佐菌素(STZ)法制备糖尿病模型。每组给予相应干预措施后,采用Real-Time PCR技术检测MAPK信号通路应激活化蛋白激酶(JNK)、活化蛋白激酶磷酸酶(MKP)以及磷酸化p38、p53、p21 mRNA表达及分布规律。结果:与糖尿病溃疡模型组比较,祛瘀生肌中药组均可下调成模第7、11、15天MKP、JNK mRNA表达,上调p53、p38 mRNA表达,p21 mRNA表达没有明显改变,且各组间无明显的作用规律。结论:MAPK信号通路在促进糖尿病溃疡创面愈合中发挥重要的作用,祛瘀生肌中药可调控MAKP通路相关基因。