近年来,纳米载体因其高效、特异、可控的特点正被用于多种经皮递药应用的研究中.而微针作为一种物理增强技术,与传统给药相比,已显示出明显的促渗作用,与纳米载体联合应用可改善药物的皮肤保留能力,产生协同作用,在不损伤皮肤的情况下提升药物的经皮转运,从而延长或增强药物的释放,促进药物的高效应用.笔者从微针和纳米载体的特点出发,简要阐述应用于不同疾病的研究现状,表明纳米载体与微针的联合应用在经皮递药方面具有广泛的应用前景.

与传统的口服和肠外给药途径相比,经皮给药系统作为一种非侵入性替代方法非常有吸引力.特别对于儿童患者,它有助于克服该群体特有的问题,如吞咽困难、口服制剂的适口性以及与针头相关的恐惧和疼痛.然而,儿童的皮肤屏障功能有效地限制了药物的经皮吸收.微针可突破皮肤最外层的角质层,增加经皮给药的药量.过去几十年,以微针为基础药物输送系统的研究取得了显著进展.与微针相关的研究论文呈指数级激增.本文概括了微针的分类及特点,讨论了微针在儿童经皮递药中的研究进展,最后对微针介导的儿童经皮递药的未来前景进行了简要展望.

口腔黏膜给药系统是近年来发展的一种新型给药系统,与传统的口服给药途径相比,可以避免胃肠道酶代谢、酸降解及肝脏首过作用,进而提高药物生物利用度,发挥局部或全身治疗和预防作用.但是口腔黏膜的物理屏障会限制药物的吸收,而微针可突破该障碍,改善药物的渗透.本文简述了口腔黏膜给药的优缺点,介绍了微针的分类及国内微针企业的发展情况,讨论了微针在口腔黏膜给药系统的研究进展,以期有更多新的口腔黏膜制剂推向市场.

吸入粉雾剂是改善肺部疾病治疗的研究热点,具有上市产品多、生产工艺成熟、颗粒影响因素多、晶型转化因素多、颗粒表面物性变化等特点.目前,吸入粉雾剂存在产品效用、贮藏及生产工艺因素的关联研究不系统等问题,本文对近年来肺部吸入粉雾剂制备新技术(喷雾冷冻干燥技术、微流控-喷雾技术、模板打印技术)及粉体颗粒物理化学表征新技术(反向气相色谱、原子力显微镜测定技术、能量色散X射线光谱技术、飞行时间-离子质谱法等)进行综述,以期对该剂型的研发提供新的借鉴.

近年来,随着计算机断层扫描(CT)成像技术及其他影像技术的发展,对造影剂的要求也越来越高.开发提高成像能力和检测准确性,融合多种成像技术的新型造影剂已成为当前的研究热点之一.本文综述了近年靶向和多模态CT造影剂在肿瘤诊断中的研究进展.

微针作为一种新型药物递送系统,可克服大多数药物理化性质和皮肤屏障的限制,并具有微创、无痛等特点,已被用于皮肤癌的治疗研究中.近几年,国内外研究者已经探究了微针辅助的聚合物、光热、基因、免疫等多种方案在皮肤癌治疗方面的应用.本文阐述了微针制剂的特点及应用的效果,以期为微针药物递送系统的开发及临床应用提供更多参考.

Objective To investigate the clinical value of the color Doppler ultrasonography combined with plasma D-dimer determination in the diagnosis of lower extremity deep venous thrombosis(DVT). Methods The plasma D-dimer in 300 patients with suspected lower extremity DVT after operation was determined at different stages. And color Doppler ultrasonography was performedon. The results of the following limb venography were taken as a gold standard,the sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of each method alone or the combination of the two methods for the diagnosis of DVT were calculated and compared. Results The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of color Doppler in diagnosis of DVT were 95.8%,99.6%,98.6%,99.0% and 98.7%, respectively. The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of the individual plasma D-Dimer polymers were 97.2%,87.2%,70.7%,98.7%and 89.7%.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy were 98.6%,100%,99.6%,100%,and 99.7%with the combination of the two methods. The plasma D-dimer in patients with mixed type and central type DVT was higher than that of peripheral type(all P<0.05). The content of D-dimer in patients with acute and subacute DVT was higher than that in chronic phase(all P<0.05). Conclusion The application of color Doppler ultrasonography combined with plasma D-dimer determination has high sensitivity and specificity in the diagnosis of DVT,which has high clinical value.

目的 评价不同模式术中护理对高龄膝关节置换术患者的影响.方法 将按方便抽样法获取的高龄人工全膝关节置换术(TKR)患者70例纳入研究,以贯序法分组,A组执行常规手术室护理配合,B组通过建立标准化的手术室询证护理程序,为患者提供深层次护理支持;比较两组手术平均用时、术中失血量等术中指标及术后并发症情况,加强术后回访,调查患者满意度.结果 两组手术平均用时、术中失血量等指标近似,差异无统计学意义(P>0.05),与A组比较,B组术后并发症降低,患者对手术室护理满意度评价提升,组间差异均有统计学意义(P<0.05或0.01).结论 在为高龄高危患者行膝关节置换手术时,提供以标准化的手术室询证护理程序,有利于提高手术室护理质量,从而保证手术结局.

Objective To investigate the relationship between methylenetetrahydrofolate reductase( MTHFR)gene C677T、A1298C polymorphisms and osteoporosis in Mongolian postmenopausal women. Methods One hundred and fifty post-menopausal female patients with osteoporosiswere enrolled. one hundred and forty-five contrasts were healthy Mongolian postm-enopausal women outpatients matched with age to conduct a case-control study. Bone mineral density(BMD)at lumbar spine, femoral neck,trochanter and Ward's triangle were measured by dual-energy X-ray absorptiometry(DEXA). The T value is less than or equal to -2. 5 for the diagnosis of osteoporosis;-2. 5≤T≤ -1. 0 for bone decreased;the T≥ - 1. 0 content of normal bone. and MTHFR gene polymorphism measurement were performed to all subjects. Results The frequencies of MTHFR C677T Genotype CC、CT and TT in osteoprosis group were 29. 3% ,44. 0% and 27. 7% ,respectively,in the contrasts group. The frequen-cies of MTHFR were 42. 8% 、44. 8% and 12. 4% . the difference between groups was statistically significant(P = 0. 017). The frequencies of T allelic genes was 48. 7% in osteoporosis group,evidently higer than that in contrast group(34. 8% ,P =0. 005). T was the risk factor of osteoporosis(OR =1. 77,95% CI =1. 18 ~2. 64,P =0. 001). Comparing to the CC,TT genotype carriers loose osteoporosis risk increases to 3. 15 times(95% CI =1. 45 ~6. 86,P =0. 004). On the otherside,Polymorphism of MTHFR A 1298C on the occurrence of postmenopausal osteoporosis had no significant effect(P =0. 513). The effect was more obvious in 60 years of age or elder and high BMI in women. Conclusion The MTHFR C677T polymorphism may contribute to the suscepti-bility of osteoporosis in Mongolian postmenopausal women.

目的 探讨和总结氯胺酮麻醉前后的护理措施.方法 针对60例氯胺酮麻醉患者的心理状态和氯胺酮麻醉前后的特殊护理方法进行全面评估.在制定科学的护理计划后我们有效地实施计划,包括做好氯胺酮麻醉前后患者的心理护理,做好氯胺酮麻醉前的准备,麻醉中要合理配置人员,分工协作,配合默契,麻醉后对患者进行随时的监护,密切观察心率,心律,呼吸,血压及病情,做好相应的护理.结果 氯胺酮麻醉患者经过麻醉前、麻醉后的护理,安全地度过苏醒期,手术顺利完成.结论 通过有效的护理措施,避免了并发症发生.

OBJECTIVE To prepare ZL-004 loaded PLGA nanoparticles(ZL-004-NP) and evaluate its release characteristics in vitro and pharmacokinetics in rats.METHODS In order to determine physico-chemical property of ZL-004,saturation-constant temperature method,potentiometric method and shake flask method were employed to obtain relative parameters,respectively.After investigating single factors,the orthogonal design was used to gain optimal fonnulatiun.Then characteristic of ZL-004-NP prepared under condition of best formulation was determined by scanning electronmicroscopy,laser particle size analyzer,dialysis method,respectively.Afterward,amounts of ZL-004 in plasma were determined under UPLC-MS/MS and relative bioavailability between ZL-004-NP and its raw material was calculated.RESULTS The feature of ZL-004-NP met aim of experiment,which contained smooth spheres, 121.34 nm of diameter,0.16 of PDI,89.63%of encapsulation efficiency,7.65%of loading drug content,sustained release about 216 h in vitro and less burst in initiate stage.In vivo,c_(max) of ZL-004-NP was increased robustly 1.7 times,which reached to 125 μg · L~(-1) and t_(max) was cut down rapidly from(6.47 ±0.51) h to(4.13 ±0.48) h,compared with crude ZL-004.Relative bioavailability between ZL-004-NP and crude ZL-004 was 200.99%,which gready improved effect of oral absorption.CONCLUSION ZL-004-NP might be developed to improve water-insolube nature of ZL-004,which could increase oral relative bioavailability.

目的:探讨封闭负压引流技术(Vacuum Sealing Drainage,VSD)治疗四肢感染性皮肤缺损的效果及护理要点.方法:对40例四肢皮肤缺损、感染、长期不愈合的创面进行清创及VSD治疗,术后加强对封闭负压引流装置的管理,观察患者预后.结果:32例患者经过VSD治疗后,缺损创面肉芽组织生长良好;7例患者经过二次VSD治疗后,缺损创面肉芽组织生长新鲜,创面逐步完全闭合;1例未成功.结论:对于四肢皮肤缺损、感染、长期不愈合的创面使用VSD治疗,可促进创面愈合,能缩短病程,减轻患者痛苦,术后加强对封闭负压引流装置的管理,是创面早期愈合的关键.

<正>下颈椎骨折脱位是一种严重的创伤性损伤,治疗目的是保护脊髓,减轻或防止继发损害保持颈椎的长期稳定性。我科从2007年6月~2010年5月应用颈椎椎弓根钉棒内固定系统治疗严重下颈椎骨折脱位的患者18例,获得满意疗效,现将护理体会

目的探讨足踝部皮肤缺损患者应用显微外科皮瓣修复的疗效,术前术后护理要点。方法术前做好皮肤准备,戒烟宣教,心理护理。术后密切观察皮瓣供血,保暖,及时处理血管危象。结果 34例全部成活。术后随访3个月～1a,皮瓣成活良好,大部分恢复保护性感觉。6例皮瓣臃肿,皮瓣消薄后满意。结论护理人员只有掌握皮瓣的观察和护理方法,才是提高显微外科皮瓣修复足踝部皮肤缺损皮瓣成活率的关键。

目的:探讨腓肠神经营养血管逆行岛状皮瓣修复足部、踝部大面积软组织缺损病人的护理。方法:术前做好心理护理,讲解手术做法风险,做好术前病人皮肤清洁,注意保护供区皮肤血管,术后密切观察皮瓣供血,及时发现处理动、静脉血管危象,术后2~4周开始主被动功能锻炼。结果:本组皮瓣全部成活,术后随访3~12个月,皮瓣成活良好,大部分病人恢复保护性感觉。成功率100%,功能优良率95%。结论:腓肠神经营养血管逆行岛状皮瓣修复术,对于足部及踝部大面积软组织缺损病人,疗效显著。

<正>内蒙古医学院第二附属医院是一所集医疗、教学、科研为一体的骨专科三级甲等医院,"科技兴院、人才强院"是医院发展的基本方针,院领导在重视医疗质量的同时,始终把提高医院科技水平做为医院工作的重点,大力支持青年科技人员