Magnuson法与Bankart法治疗习惯性肩关节前脱位的疗效比较

目的：比较Magnuson法与Bankart法手术治疗习惯性肩关节前脱位的临床效果。方法回顾性分析2011年1月至2012年10月广州军区广州总医院采用Magnuson法和Bankart法手术治疗的43例习惯性肩关节前脱位患者的临床资料,其中Magnuson组21例、Bankart组22例。观察两组切口长度、术中出血量和手术时间的差异,采用肩关节功能Neer评分评价术前,术后6、12个月的肩关节功能。结果两组切口长度、术中出血量和手术时间比较,差异无统计学意义（P＞0.05）。43例患者均获随访,随访时间11～18个月（平均15.3个月）。末次随访时两组患者均未再次出现肩关节脱位。与术前比较,两组术后6、12个月肩关节功能Neer评分均较术前有明显改善（P＜0.05）。Bankart组术后6个月肩关节功能Neer评分优于Magnuson组（P＜0.05）,但术后12个月两组Neer评分比较,差异无统计学意义（P ＞0.05）。结论对于习惯性肩关节前脱位患者,Bankart法较Magnuson法术后肩关节功能恢复快,但两种术式对肩关节功能的远期改善程度似无明显差别。     

Reliability of assessing the coronal curvature of children with scoliosis by using ultrasound images

Purpose

To investigate the intra- and inter-observer reliability of the coronal curvature asymmetry of children with adolescent idiopathic scoliosis (AIS) using the center of lamina (COL) method on ultrasound (US) images.

Methods

A cadaver spinal column phantom which was manipulated to present 30 scoliotic curves of varying severity of scoliotic deformities was scanned using both the US and laser scanner (LS) systems. Three observers of varying experience and skill measured the coronal curvature using the Cobb method on the LS images and the COL method on the US images. All of the measurements were performed twice, with a 1-week interval to reduce memory bias. The intra-class correlation coefficient (ICC), the mean absolute differences (MAD), and the error index (EI) were calculated to determine the agreement on selecting the end vertebrae. In addition, five AIS subjects were scanned using the US system. One observer measured the coronal curvature on the US images twice, and the measurements were compared with the Cobb angle reported in the clinical records.

Results

In the phantom study, the COL method showed high intra- and inter-observer reliabilities, with all ICC values >0.88. The maximum MAD of the COL measurements between different sessions among all observers was <4.1°. The EI values of the US method had similar end-vertebra selections as the LS method. The results of the pilot study showed a high intra-reliability for the US measurements. The measured difference between the Cobb and COL methods was 0.7° ± 0.5°.

Conclusions

The COL method using US images appears to be a very reliable method for measuring the coronal curvature in AIS without the need to expose the patient to radiation.     

Gross motor skill performance in children with and without visual impairments—Research to practice

The aim of this study was to provide an empirical basis for teaching gross motor skills in children with visual impairments. For this purpose, gross motor skill performance of 23, 6–12 year old, boys and girls who are blind (ICD-10 H54.0) and 28 sighted controls with comparable age and gender characteristics was compared on six locomotor and six object control tasks using the Test of Gross Motor Development-Second Edition. Results indicate that children who are blind perform significantly (p < .05) worse in all assessed locomotor and object control skills, whereby running, leaping, kicking and catching are the most affected skills, and corresponding differences are related to most running, leaping, kicking and catching component. Practical implications are provided.     

Validation of micro-CT against the section method regarding the assessment of marginal leakage of sealants

Background: The aim of this study was to validate the micro‐CT and related software against the section method using the stereomicroscope for marginal leakage assessment along the sealant‐enamel interface. Methods: Pits and fissures of the occlusal surface of 10 teeth were sealed with a resin‐fissure sealant material without acid etching, thermocycled for 5000 cycles, immersed in 50% silver nitrate for three hours and scanned using micro‐CT. Teeth were embedded in epoxy resin and cut in three sections. The middle section was subjected to micro‐CT and stereomicroscopy. Images were taken from the left and right sides of the sealant‐enamel interface at both the left and the right site of the section. Two experienced evaluators assessed marginal leakage. Results: Both assessment instruments observed no leakage in 37 out of the 40 images evaluated. Leakage at the sealant‐enamel interface was observed in three stereomicroscopy images only. A fracture line in the sealant was seen on eight stereomicroscopy images and observed in only two micro‐CT images. Conclusions: The quality of the micro‐CT and related software used in the present study does not qualify it to replace the section method as the gold standard for marginal leakage assessment at the sealant‐enamel interface of permanent teeth.     

4-甲磺酰基苯乙酸的合成工艺研究

目的对4-甲磺酰基苯乙酸的合成工艺进行改进,使其更利于工业化生产。方法以4-甲磺酰基苯乙酮为起始原料,在硅胶固载氟硼酸(HBF4·Si O2)的催化下,合成2-(4-(甲磺酰基)苯基)-1-吗啉代乙硫醇,再经水解得到4-甲磺酰基苯乙酸。结果制得的4-甲磺酰基苯乙酸质量分数为99.8%,总收率约75%。结论改进后的工艺原料便宜易得,反应温度低,时间短,操作简单,更适用于4-甲磺酰基苯乙酸工业化生产。     

白色洗剂《中国药典》2015年版微生物检查的方法适用性研究

目的：建立符合《中国药典》2015年版要求的白色洗剂的微生物检查方法。方法：按照该版药典要求,采用离心沉淀联合薄膜过滤法进行样品前处理,使用5种菌株对白色洗剂进行微生物计数检查和限度菌检查,作为方法适用性验证研究。结果：3个批次的微生物计数检查的5种验证菌株的回收比值均在0.5~2,微生物限度检查的验证菌金黄色葡萄球菌和铜绿假单胞菌均能够检出。结论：白色洗剂的微生物检查方法经验证符合《中国药典》2015年版要求。     

Screening-based approaches to identify small molecules that inhibit protein–protein interactions

Introduction: Protein–protein interactions (PPIs) are very attractive targets for drug development as they play important roles in regulating many aspects of pathophysiologies. It has recently been revealed that the functionally important region of most PPIs is small enough to be modulated by small molecules. Thus, many studies in this field have achieved amazing progress, together with diverse and advanced screening technologies.

Areas covered: This article presents screening technologies to identify small molecule inhibitors of PPIs in addition to discussing the suitability of PPIs as molecular targets. The phases in the processes of selecting compounds are discussed and appropriate steps are proposed, including methodologies to test binding affinity, kinetics, structural analysis, and cellular function.

Expert opinion: Targeting PPIs is still a challenging approach in drug development and relatively few small molecules have reached clinical development. Potential candidates should be assessed and optimized by properly using the multiple assay systems to develop ideal small molecule drugs. Although there remain some barriers to be overcome, small molecule inhibitors of PPIs are fascinating and first-in-class as therapeutic agents to treat various diseases.     

延胡索乙素醇质体的制备及其离体皮肤渗透特性研究

目的制备延胡索乙素(dl-THP)醇质体(ETS),并初步阐明制剂的经皮吸收特性。方法采用乙醇注入-pH梯度主动载药法制备dl-THP ETS,并对其形态、粒径、弹性与包封率等理化性质进行表征;以脂质体(LPS)与酊剂作为参比,采用Franz扩散池考察制剂的离体皮肤渗透特性。结果按优选处方[dl-THP 100 mg,维生素E 1.3 mg,大豆卵磷脂1 200mg,胆固醇120 mg,无水乙醇9 mL,柠檬酸缓冲液(pH 3.0)21 mL,0.1 mol/L NaOH溶液适量(调pH值至5.5)]制得的dl-THP ETS弹性指数为(20.1±1.1)mL,平均粒径为(85.8±0.9)nm,多分散指数为0.082±0.003,包封率为(81.7±3.2)%。dl-THP ETS 24 h的单位面积皮肤累积渗透药物量(Qn)为(2 306.4±592.3)μg/cm~2,与参比制剂LPS[(2 434.2±564.4)μg/cm~2]无显著差异,但约为酊剂[(633.1±218.0)μg/cm~2]的4倍(P0.05);ETS与LPS各时间点样品间的Qn RSD的平均值分别为(28.4±10.9)%、(62.8±44.1)%(P0.05),表明前者样品间的Qn波动比后者小;ETS与LPS的24 h渗透曲线线性拟合的相关系数平均值分别为0.968±0.033与0.882±0.078(P0.05),表明前者渗透过程更符合零级动力学。结论所得的dl-THP ETS弹性高,粒径大小适宜,包封率高,药物经皮渗透速率高且稳定,并符合零级动力学。     

多指标-响应曲面法优选酒炖熟地黄最佳炮制工艺

目的基于响应曲面技术,应用HPLC法定量测定,从多指标、综合评价的角度建立酒炖熟地黄的最佳炮制工艺。方法采用HPLC定量分析,以地黄苷D、益母草苷、5-羟甲基糠醛(5-HMF)和毛蕊花糖苷为评价指标,采用响应曲面设计法考察地黄浸润时间、加黄酒量、炖制时间、干燥温度、干燥时间对酒炖熟地黄炮制工艺的影响,寻找出最佳炮制工艺。结果色谱柱为Tnature-C_(18)柱(250 mm×4.6 mm,5μm),体积流量为1 mL/min,柱温为25℃。地黄苷D和益母草苷定量测定:流动相为乙腈-0.1%磷酸水溶液(4∶96),检测波长为203 nm;5-HMF和毛蕊花糖苷定量测定:流动相为乙腈-0.1%磷酸水溶液,梯度洗脱:0～15 min,11%乙腈;15～15.1 min,11%～16%乙腈;15.1～50 min,16%乙腈;检测波长为334 nm。酒炖熟地黄的最佳工艺为100 kg生地加入黄酒60 kg,浸润12 h,密闭炖制38 h,在76℃干燥33 h。结论所建立的HPLC法稳定可行,适合所选成分的测定。采用响应面法建立的模型相对准确,可以较好地预测4种成分含量;优选的酒炖熟地黄炮制工艺方法可行,为制定熟地黄的质量标准和现代研究提供了科学依据。