应用可回收与非回收弹簧圈装置堵塞动脉导管未闭的比较

目的比较应用可回收（ｄｅｔａｃｈａｂｌｅｃｏｉｌ）与非回收弹簧圈（ｎｏｎｄｅｔａｃｈａｂｌｅｃｏｉｌ）堵塞动脉导管未闭（ＰＤＡ）的效果，并探讨影响效果的因素。方法经导管堵塞１８例ＰＤＡ患儿，男４例，女１４例；年龄３～１２岁。ＰＤＡ最狭窄处直径为１．２～３．６ｍｍ（平均２．３ｍｍ）。其中３例ＰＤＡ外科结扎后再通，１例ＰＤＡ伴肺动脉瓣狭窄。结果１８例患儿中７例应用非回收弹簧圈堵塞法，其中５例获成功；１１例应用可回收弹簧圈装置，堵塞均获成功，其中９例应用双圆锥形弹簧圈，另２例采用Ｃｏｏｋ可回收弹簧圈。彩色多普勒显示９例堵塞术２４小时后无分流，２例随访发现极少量分流。结论应用可回收弹簧圈堵塞ＰＤＡ，其效果优于非回收弹簧圈；可适用未经手术及外科结扎后再通的ＰＤＡ患儿。该法简便、有效、安全、并发症少，为堵塞中小型（直径≤３．５ｍｍ）ＰＤＡ值得推荐的方法     

Therapeutic potential of oxazole scaffold: a patent review (2006–2017)

ABSTRACT

Introduction: Oxazoles are oxygen and nitrogen containing five membered heterocyclic ring systems that are present in various anticancer, antimicrobial, antihyperglycemic, anti-inflammatory agents etc. of natural origin. These pharmacologically active oxazole derivatives have attracted numerous researchers to explore this scaffold for the design and development of newer potential therapeutic agents. A large number of synthetic oxazole containing molecules have been reported over the period that exhibited wide spectrum of pharmacological profiles. Some of them have shown promising therapeutic potential and have qualified for both preclinical and clinical evaluations.

Areas covered: In this review, the patents (published during 2006–2017) focusing on the biological potential of oxazoles have been covered. Therapeutic applications and various techniques/assays employed for the in vitro/in vivo evaluation of patented derivatives have been discussed majorly.

Expert opinion: Chemically oxazole offers three positions for substitution. These substituted oxazole derivatives of natural as well as synthetic origin have numerous pharmacological applications including anticancer, anti-Alzheimer’s, anti-hyperglycemic, anti-inflammatory, antibacterial etc. Their pharmacological actions are mainly mediated through enzyme/receptor involved in the particular disease. The flexible nature of this ligand for various molecular level targets (enzyme/receptor) make this heterocylce an attractive scaffold for development of effective and clinically relevant oxazole containing therapeutic agents.     

cTEE、cTCD及TEE对卵圆孔未闭的临床诊断价值

目的：探讨经胸右心声学造影（cTTE）、经颅多普勒发泡试验（cTCD）及食道心超（TEE）等检查对卵圆孔未闭（PFO）的诊断价值。方法：回顾性分析比较140例温州医科大学附属第一医院成功行PFO封堵术患者（A组）与右心导管检查未见PFO患者（B组）的临床资料,包括临床基线资料、cTTE、cTCD及TEE。比较两组间在cTTE、cTCD分流量大小、TEE卵圆孔大小差异及cTTE气泡出现的时间差异,并绘制这些指标诊断PFO的ROC曲线。结果：cTTE下A组与B组比中-大量分流占比更大。在静息状态、瓦氏动作后和总评分情况下A组中-大量分流占比均显著大于B组（67.35%vs. 42.86%,P=0.04;100.00%vs. 71.42%,P<0.001;81.63%vs. 51.43%,P=0.004）。c TCD下A组与B组相比中-大量分流占比更大（75.90%vs. 19.35%,P <0.001）。TEE下A组与B组相比PFO裂隙更大（2.18±0.78 vs. 1.19±0.78,P<0.001）。用cTTE、cTCD、TEE等指标做PFO诊断的ROC曲线,结果提...     

通心络胶囊治疗短暂性脑缺血发作临床观察

目的：观察通心络胶囊治疗短暂性脑缺血发作（ TIA）的临床疗效。方法将72例TIA患者随机分为2组,对照组36例予曲克芦丁片治疗,治疗组36例予通心络胶囊治疗。比较2组治疗前后血脂指标变化,左侧椎动脉、右侧椎动脉和基底动脉血流速度变化。结果治疗组治疗后血脂指标,左侧椎动脉、右侧椎动脉及基底动脉血流速度均较本组治疗前改善（P ＜0．05）,且2组组间比较差异均有统计学意义（P ＜0．05）,治疗组改善优于对照组。结论通心络胶囊可调节 TIA 患者血脂,改善血液流速,降低患者发展为脑梗死的风险。     

从专利角度分析药物技术创新现状及研发思路——以低分子量肝素为例

本文对低分子量肝素的全球和中国的专利申请在技术上进行了分析,从专利技术的角度提出了关于低分子量肝素特别是依诺肝素、达肝素、那屈肝素的创新研发的建议。     

药品知识产权国际保护的中庸之道

药品知识产权国际保护中存在着多重权利冲突，其中最为突出的就是专利权与生命健康权的对立。试从伦理的角度来审视药品知识产权，以中庸之道来解决药品知识产权国际保护中的权利冲突与道德困境。一方面，作为私权与财产权的药品专利权并没有与更优于它的其他权利发生冲突时，应该保护药品专利权并努力促使这一权利得以实现；另一方面，当药品专利权与位阶上更优于它的生命健康权相冲突时，专利权应让位与生命健康权，作出必要的自我牺牲。在具体实践中，药品知识产权国际保护应尊重差别原则，建立相应的专利药品价格差别制度，高扬救死扶伤的人道精神以维护生命健康权。     

金凤丸联合重组人生长激素改善薄型子宫内膜不孕患者子宫内膜容受性

目的:观察中成药金凤丸联合重组人生长激素(rhGH)对薄型子宫内膜不孕患者子宫内膜容受性的临床疗效.方法:收集2018年12月—2019年12月在中国人民解放军联勤保障部队第九八〇医院生殖医学科就诊的薄型子宫内膜合并不孕患者80例,采用金凤丸联合rhGH预处理的薄型子宫内膜不孕患者(40例)作为观察组;仅常规处理者作为...     

Vascular air embolism during percutaneous nephrolithotomy without pneumopyelogram: a case report of successful rescue

Vascular air embolism (VAE) is a rare complication of percutaneous nephrolithotomy. Paradoxical air embolization resulting from VAE may be more likely to occur in patients with an atrial-septal defect, such as patent foramen ovale. Here, the case of a female patient with VAE that occurred during percutaneous nephrolithotomy is presented. Although the patient was diagnosed with patent foramen ovale, she recovered well without any severe paradoxical air embolization symptoms. To our knowledge, this is the first report of VAE with paradoxical air embolization that occurred in a patient with patent foramen ovale during percutaneous nephrolithotomy that was conducted without pneumopyelography.     

Transcatheter closure of inferior sinus venosus defect using a patent ductus arteriosus occluder following simulation with a 3D-printed model

BackgroundTranscatheter closure of inferior sinus venosus defect (ISVD) is still contraindication. To explore whether transcatheter closure with patent ductus arteriosus (PDA) occluders is possible for ISVD.MethodsFrom June 2014 to March 2021, 12 patients were recruited diagnosed as <25 mm ISVD. The three-dimensional printing (3DP) heart model was produced based on multi-slice computed tomography (MSCT) scans. Preoperative closure simulation was planned on the personalized 3D model for each patient. Follow-up including electrocardiography (ECG), transthoracic echocardiography (TTE), and X-ray was traced.Results3DP models of 12 patients were successfully printed. Twelve patients had been diagnosed with <25 mm ISVD and 4 of them had another secundum atrial septal defect (ASD). All patients were produced interventional therapy successfully. PDA occluder was implanted to closed ISVD, and ASD was closed using ASD occluder simultaneously. The average diameter of ISVD measured by TTE was (12.67±3.80), and the average diameter of sagittal axes and longitudinal axes measured by the 3D-printed model was (17.08±3.20) and (18.42±4.62) mm, respectively. The average size of PDA (diameter of pulmonary artery side) was (28.17±3.35) mm. Compared with the preoperative, the X-ray cardiothoracic ratio (0.51±0.04 vs. 0.47±0.06, P=0.007) and the right ventricle anterior-posterior diameter (31.17±5.65 vs. 24.58±3.75 mm, P<0.001) of postoperative was significantly decreased. During the average (47.75±27.52) months follow-up, it has achieved satisfying results, and there were no severe adverse events such as device transposition, death, and pericardial tamponade occurred.ConclusionsAssisting by 3D heart model, transcatheter closure of ISVD with PDA occluder had an excellent outcome. This method provides a new considerable treatment strategy for ISVD.