中西医结合治疗膝关节骨性关节炎32例

目的:观察"输液式"关节冲洗配合中药内服外洗治疗膝关节骨性关节炎的疗效。方法:采用关节冲洗配合内服仙灵骨葆及外用中药熏洗治疗膝关节骨性关节炎32例。结果:32例经治疗总有效率为93%。结论:"输液式"关节冲洗术配合中药内服外洗治疗膝骨性关节炎创伤小、操作简便、安全可靠、疗效肯定。     

品管圈在降低长期卧床老年鼻饲患者误吸中的应用效果分析

目的 探讨品管圈活动在降低长期卧床老年鼻饲患者误吸中的效果.方法 成立品管圈小组、确定活动主题为降低长期卧床老年鼻饲患者误吸的发生率,通过现状调查与原因分析,按照80/20定律选定真因,通过头脑风暴法找出对策:自制并应用床头角度测量仪;辅导员做留置胃管置入长度相关护理新进展培训;圈长做鼻饲注食量、注食速度标准化讲座;提高床头抬高角度的精确性;提高护士置入胃管长度的正确性;提高护士宣教能力及患者家属(护工)的依从性.结果 根据误吸判断指标比较活动前后误吸的发生率,长期卧床老年鼻饲患者误吸的发生率由活动前77.0％降至21.1％.结论 品管圈活动不仅降低了长期卧床老年鼻饲患者误吸的发生率,还提高了圈员的工作积极性、团队意识、解决问题能力.     

Nasal delivery of insulin using chitosan microspheres

Nasal delivery of insulin is an alternative route for administration of this drug. The objective of this study was preparation of chitosan microspheres for insulin nasal delivery. After preparation of insulin chitosan microspheres by emulsification-cross linking process, the effect of chitosan quantity (200–400?mg), cross-linker type (ascorbic acid or ascorbyl palmitate) and amount (70–140?mg) were studied on the morphology, particle size, loading efficiency, flow and release of insulin from the microspheres by a factorial design. Optimized formulation was administered nasally in four groups of diabetic rats and their serum insulin levels were analysed by the insulin enzyme immunoassay kit and the serum glucose by the glucose oxidase kits. Insulin loading in microspheres was between 4.7–6.4% w/w, preparation efficiency more than 65% and mean particle size was 20–45?µm. In most cases, drug released followed a Higuchi model. Ascorbic acid caused an increase in stability, particle size and T_50% while decreased the loading efficiency and production efficiency. Increasing the chitosan content, increased particle size, flow and insulin release rate form the microspheres. The increase of cross-linking percentage decreased the flow and size of the microspheres while increase of cross-linking percentage promoted the stability and decreased DE₈% of insulin. Microspheres containing 400?mg of chitosan and 70?mg ascorbyl palmitate caused a 67% reduction of blood glucose compared to i.v. route and absolute bioavaliability of insulin was 44%. The results showed that chitosan microspheres of insulin are absorbable from nasal route.     

基于控墒补灌的春小麦滴灌制度研究

为优化北疆绿洲区滴灌春小麦的灌溉制度,采用控墒补灌法研究了不同灌水量对滴灌春小麦光合特征、干物质分配及水分利用效率的影响。结果表明,拔节～开花期小麦株高、干物质积累量和叶面积指数均随着灌水量的增加显著（P<0.05）升高。小麦旗叶各时期净光合（Pn）、气孔导度（Gs）和蒸腾速率（Tr）增加显著（P<0.05）升高,而胞间CO₂浓度（Ci）变化趋势相反;过量灌溉T5各时期Gs均有所降低,Pn和Tr成熟期下降显著（P<0.05）;亏缺灌溉（T1）Pn峰值提前至孕穗期,各时期WUE均最低、LS最高。干物质向籽粒的分配、花前同化物转运率和对籽粒的贡献率随墒度随灌水量增加显著（P<0.05）降低。二次曲线拟合表明,灌水量为371 mm时可取得7 450 kg·hm^-2的高产,灌溉频率约每7 d灌1次是本地区春小麦的最佳灌溉方案。     

Insulin Containing Nanocomplexes Formed by Self-Assembly from Biodegradable Amine-Modified Poly(Vinyl Alcohol)-Graft-Poly(<Emphasis Type="SmallCaps">l</Emphasis>-Lactide): Bioavailability and Nasal Tolerability in Rats

Purpose The bioavailability and local tolerability of insulin containing nanocomplexes from amine-modified poly(vinyl alcohol)-graft-poly(l-lactide) were studied in rats. Histology of the nasal epithelium was studied to document integrity of the mucosa. Methods Nanocomplexes (NC) were prepared by spontaneous self-assembly of insulin and the water-soluble amphiphilic polymer. Changes in blood glucose and insulin blood concentration were monitored in anesthetized rats using a glucose meter and enzyme-linked immunosorbent assay, respectively. Histological sections of the nasal cavity were examined after H&E staining by light microscopy. Results NC reduced blood glucose level in fasted healthy rats by 20% after 50–80 min and in streptozotocin induced diabetic rats by 30% within 75–95 min compared to basal levels. In both animal models significant concentrations of human insulin were detected, with relative bioavailabilities F_rel of 2.8 up to 8.3%. The more hydrophobic, lactic acid grafted polyester were more effective at a threefold higher polymer concentration, increasing the relative bioavailability F_rel of a 5 IU/kg dose from 2.8 to 5.7%. Histological examination of the nasal mucosa after 4 h showed no signs of toxicity at the site of nasal administration. Conclusions These results demonstrate that the NC significantly enhanced insulin absorption, suggesting that amphiphilic biodegradable comb-polymers offer a promising approach for nasal peptide delivery.     

鼻腔扩容术的临床疗效观察

目的评价鼻腔扩容术治疗OSAHS患者主客观症状的改善情况。方法观察30例行鼻腔扩容术的成年OSAHS患者,所有患者于术前进行多道睡眠图（PSG）描记,鼻声反射和鼻阻力测试等鼻功能检查,填写白天嗜睡主观评分Epworth嗜睡量表（Epworth sleepiness score,ESS）、鼻塞主观视觉模拟量表（visual analogue scale,VAS）评分、鼾声评分量表,以上主客观检查于鼻腔手术后3个月重复记录。所有患者接受鼻腔扩容术（鼻中隔三线减张成形术、双侧下鼻甲外移、双侧中鼻甲内移和双侧中鼻道鼻窦对称性开放）。结果鼻腔扩容术后患者鼻腔总阻力显著降低[（0.89±0.23）kPa·s/L vs（0.29±0.12）kPa·s/L,P〈0.01],鼻塞VAS评分显著降低[8.2±1.1 vs 2.1±0.73,P〈0.01],白天嗜睡ESS评分显著降低（12.7±1.2 vs 8.6±2.9,P〈0.01）,打鼾程度减轻（62.2±25.6 vs 45.6±18.6,P〈0.01）。轻度OSAHS患者呼吸暂停低通气指数（apnea and hypopnea index,AHI）较术前显著下降（P〈0.05）,觉醒指数较术前显著下降（P〈0.01）,最低动脉血氧饱和度（lowest SaO2,LSaO2）较术前显著升高（P〈0.01）。中度和重度OSAHS患者的AHI指数、觉醒指数、LSaO2均较术前无显著改变（P〉0.05）。LSaO2、睡眠结构各阶段的比例、快动眼睡眠阶段的长度在所有OSAHS患者均没有显著变化（P〉0.05）。30例OSAHS患者鼻腔扩容术的总体有效率为26.7%。结论鼻腔扩容手术可以改善OSAHS患者鼻塞及白天嗜睡、睡眠打鼾等相关睡眠主观症状,并在一定程度上改善OSAHS患者的阻塞性睡眠呼吸暂停的严重程度,应适当选择其手术适应证。     

下鼻甲肥大对功能性溢泪影响的分析

目的探讨下鼻甲肥大与功能性溢泪的关系及临床治疗价值。方法 11例下鼻甲肥大伴溢泪患者中,7例同时伴鼻中隔偏曲,术前完善检查,并利用CT泪囊造影术和三维重建,排除溢泪的眼部疾病,行下鼻甲减容术伴或不伴鼻中隔偏曲矫正术,观察疗效。术后随访12个月。结果 11例患者中8例(72.7%)溢泪症状消失,3例(27.3%)溢泪症状好转。7例患者术后鼻中隔均居中,下鼻甲明显缩小。其中鼻塞痊愈10例(90.9%),好转1例(9.1%)。结论下鼻甲肥大为功能性溢泪的一个重要的原因,对其进行治疗可治愈或改善功能性溢泪。     

高效液相色谱法测定复方环麻喷鼻剂中主要成分的含量

目的:探讨用高效液相色谱法(HPLC法)测定复方环麻喷鼻剂中主要成分含量的方法.方法:采用Hypersil-0DS C18色谱柱(250 mm×4.6 mm,5μm),以0.02 mol/L磷酸二氢钾溶液-甲醇-10 mmol/L四丁基溴化铵溶液(60:40:5,用磷酸调节pH值至3.2)为流动相,检测波长为258 nm.结果:线性范围环丙沙星为4.8～24 μg/mL,盐酸麻黄碱为16～μg/mL;环丙沙星的平均回收率为99.4%,RSD为1.4%;盐酸麻黄碱平均回收率为101.3%,RSD为0.9%;精密度的RSD环丙沙星为0.9%,盐酸麻黄碱为1.1%.结论:HPLC法灵敏、准确,可用于复方环麻喷鼻剂的含量测定.     

甘辛喷雾剂的鼻黏膜纤毛毒性评价

目的:确定适宜的药物浓度,评价甘辛喷雾剂及处方各组分对鼻黏膜纤毛功能的影响.方法:用光学显微镜观察离体蛙口腔上腭纤毛在药物溶液作用下持续摆动时间,以此作为指标考查不同药物浓度和组分对蛙口腔黏膜纤毛功能的影响.结果:4%甘辛喷雾剂对纤毛运动影响最小,与对照组药物相比,4%甘辛喷雾剂和处方中各组分对蛙口腔黏膜纤毛的影响弱于滴通鼻炎水(P＜0.01).结论:甘辛喷雾剂对鼻黏膜纤毛的功能无明显损伤作用.     

miR-21在脂多糖诱导的人鼻黏膜上皮细胞中表达变化及作用机制

目的探讨微RNA-21(miR-21)在脂多糖诱导的人鼻黏膜上皮细胞(HNEpC)中表达变化及可能的作用机制。方法应用脂多糖诱导建立HNEpC炎症反应细胞模型,分别应用荧光定量PCR(qRT-PCR)和蛋白免疫印迹法检测炎症细胞模型建立前后miR-21和磷酸酶及张力蛋白同源物(PTEN)蛋白的表达水平变化。取脂多糖诱导的HNEpC细胞,分为miR-21抑制物组和阴性对照组,应用脂质体转染法分别将miR-21抑制物和阴性对照物转染入2组HNEpC细胞,比较转染后2组细胞中miR-21和PTEN蛋白的表达、细胞增殖活性和凋亡率以及细胞上清液中TNF-α、IL-1β、IL-6和IL-10的水平。结果脂多糖诱导的HNEpC细胞中miR-21表达水平增高(P <0.05),PTEN蛋白的表达水平降低(P <0.05)。miR-21抑制物组细胞中miR-21表达水平低于阴性对照组(P <0.05),转染后24、48、72 h后的吸光度值均低于阴性对照组(P均<0.05),凋亡率高于阴性对照组(P <0.05),并且细胞上清液中TNF-α、IL-1β及IL-6水平均低于...