目的:观察采用疏血通注射液联合ACEI/ARB治疗早期糖尿病肾病(DN)的疗效。方法:将78例2型DN患者随机分为对照组(ACEI/ARB)和治疗组(ACEI/ARB+疏血通注射液),疗程4周。比较两组治疗前和治疗后尿微量白蛋白(mAlb),Scr、BUN等指标的变化。结果:(1)治疗后治疗组和对照组尿白蛋白均显著下降(Plt;0.01,Plt;0.05),治疗组比对照组下降更为明显(Plt;0.05)。(2)治疗后两组血浆白蛋白均增加(Plt;0.01),治疗组与对照组治疗后比较无明显差异(Pgt;0.05)。(3)治疗后两组Scr、BUN、TC、TG和血钾均无明显变化。结论:联合应用疏血通注射液能有效减少早期DN患者的蛋白尿,改善肾功能。
A controversy still exists in the management of nerve injection injury. The results of different timing of operation and methods in treating this type of nerve injury were analysed in limb s function, neuroelectrophysiology and histology. The results showed that the recovery of the injuried nerve in the group of operation, was considerably better than that in the group without operation. In the group of operation early incision of the epineurium with saline irrigation! was superior to late neurolysis. It was suggested that the early incision with saline irrigation could be used as an emergency management for this type of nerve injury.
Objective To evaluate the characterization, biocompatibil ity in vitro and in vivo, and antimicrobial activity of an injectable vancomycin-loaded borate glass/chitosan composite (VBC) so as to lay the foundation for its further cl inical application. Methods The sol id phase of VBC was constituted by borate glass and vancomycin, liquid phase was a mixture of chitosan, citric acid, and glucose with the proportion of 1 ∶ 10 ∶ 20. Solid phase and liquid phase was mixed withthe ratio of 2 ∶ 1. Vancomycin-loaded calcium sulfate (VCS) was produced by the same method using calcium sulfate instead of borate glass and sal ine instead of chitosan, as control. High performance liquid chromatography was applied to detect the release rate of antibiotics from VBC and VCS, and minimum inhibitory concentration (MIC) was tested by using an antibiotic tube dilution method. The structure of the VBC and VCS specimens before and 2, 4, 8, 16, and 40 days after immersion in D-Hank’s was examined by scanning electron microscopy, and the phase composition of VBC was analysed by X-ray diffraction after soaked for 40 days. Thirty-three healthy adult New Zealand white rabbits (weighing, 2.25-3.10 kg; male or female) were used to establ ish the osteomyel itis models according to Norden method. After 4 weeks, the models of osteomyel itis were successfully established in 28 rabbits, and they were randomly divided into 4 groups (groups A, B, C, and D). In group A (n=8), simple debridement was performed; in groups B and C (n=8), defect was treated by injecting VCS or VBC after debridement; and in group D (n=4), no treatment was given. The effectiveness of treatment was assessed using radiological and histological techniques after 2 months. Results The releases of vancomycin from VBC lasted for 30 days; the release rate of vancomycin reached 75% at the first 8 days, then could reached more than 90%. The releases of vancomycin from VCS lasted only for 16 days. The MIC of VBC and VCS were both 2 μg/mL. The VCS had a smooth glass crystal surface before immersion, however, it was almost degradated after 4 days. The fairly smooth surface of the VBC pellet became more porous and rougher with time, X-ray diffraction analysis of VBC soaked for 40 days indicated that the borate glass had gradually converted to hydroxyapatite. After 2 months, the best result of treatment was observed in group C, osteomyelitis symptoms disappeared. The X-ray scores of groups A, B, C, and D were 3.50 ± 0.63, 2.29 ± 0.39, 2.00 ± 0.41, and 4.25 ± 0.64, respectively; Smeltzer scores were 6.00 ± 0.89, 4.00 ± 0.82, 3.57 ± 0.98, and 7.25 ± 0.50, respectively. The scores were significantly higher in group D than in groups A, B, and C (P lt; 0.05), and in group A than in groups B and C (P lt; 0.05). The scores were higher in group B than in group C, but no significant difference was found (P gt; 0.05). Conclusion The VBC is effective in treating chronic osteomyelitis of rabbit by providing a sustained release of vancomycin, in addition to stimulating bone regeneration, so it may be a promising biomaterial for treating chronic osteomyelitis.
Objective To observe the distribution and concentration of 125I-nerve growth factor (NGF) in rabbitsprime; eyes after intravitreal injection and posterior juxtascleral injection.Methods Intravitreal injection(group A) and posterior juxtascleral injection (group B) were performed with the dosage of 30mu;g/100mu;l 125I-NGF on left and right eyes in 45 white rabbits respectively. The gamma;-counts and the concentration of 125I-NGF (％ID/g) of each ocular tissue was determined 15 and 30 minutes, and 1,3,6,12,24,and 48 hours after injection. Results The 125I-NGF diffusion in group A was faster in ocular content and ocular inner wall. The vitreous content of 125I-NGF decreased gradually in group A, the curve changes in other eye tissues were normal. The concentration of 125I-NGF reached the peak 3 hours after injection in aqueous humor, iris and ciliary body, retina, and choroids, but 6 hours after injection in sclera and 8 hours in cornea. The changes of concentration of 125I-NGF in group B showed normal curve change. The peak time in group B were all 6 hours in all the tissues except aqueous humor (3 hours). Except the high concentration in vitreous body caused by intravitreal injection, the concentration of 125I-NGF in retina was the highest in group A. Conclusion Intravitreal injection of 125I-NGF can gain higher concentration in each ocular tissue than posterior juxtascleral injection, especially in retina. So intravitreal injection of NGF is a better ocular delivery method to treat the ocular fundus diseases.
目的评价痔上黏膜环切术（PPH)加芍倍注射术治疗中重度（排粪造影检查提示突出深度大于16 mm）直肠前突的疗效。方法回顾性分析我院2006年12月至2010年9月期间应用PPH加芍倍注射术治疗的45例中重度直肠前突患者的临床资料，分析其手术时间、住院时间及复发和并发症发生情况。结果本组患者手术时间为(18.8±2.2) min （15～25 min），住院时间为(7.2±0.6) d (6～8 d)。术后随访(12.3±6.6)个月(6～30个月)。34例(75.6%)排便费力、肛门堵塞、下坠等不适症状完全缓解; 10例(22.2%)症状明显缓解，有轻度肛门下坠感，可忍受; 1例(2.2%)术后排便困难症状缓解，但肛门下坠感明显，6个月后缓解。1例(2.2%)于术后25个月再次出现排便费力症状，排粪造影检查提示直肠前突深度为17 mm(术前34 mm)。45例患者术中及术后均未发生大出血、直肠狭窄、直肠阴道瘘等并发症。结论PPH加芍倍注射术治疗中重度直肠前突具有创伤小、术后恢复快、疗效显著、并发症少等优点，但是患者术后养成良好的排便习惯很重要。
Objective To evaluate the safety and efficacy of procedure for prolapse and hemorrhoids （PPH） combined with Shaobei injection in treatment for obstructed defecation syndrome （ODS） caused by rectocele. Methods Seventy-two female patients with rectocele from December 2009 to January 2011 in this hospital were divided into PPH combined with Shaobei injection group （36 cases） and only PPH group （36 cases）. The Longo ODS score was performed on week one，month one，month three，and month six after operation，respectively；pain was evaluated， complications such as urine retention，postoperative bleeding，and anal function were observed；hospital stay and recovery work time were recorded in two groups. Results All patients were followed up for 6 months，there were no significant differences in complications，hospital stay，and the Longo ODS score on week one and month one after operation between two groups （P＞0.05）. But the Longo ODS score of the PPH combined with Shaobei injection group on month three and month six after operation were significantly lower than those of the only PPH group （P＜0.05）. Conclusion PPH combined with Shaobei injection has a better efficacy as compared with only PPH，and at least as safe as only PPH.