Outcome of the isolated SLAP lesions and analysis of the results according to the injury mechanisms

Superior labral anterior posterior (SLAP) lesions of the shoulder arise from various causes and have some controversies in their treatment. The purpose of this study is to evaluate the outcomes of arthroscopic SLAP repair and the relationship between injury mechanisms and outcomes. We evaluated the clinical results of 24 patients (mean 33 months follow-up) who had an arthroscopic isolated SLAP (type II: 21, type III: 1, type IV: 2 patients) repair with suture anchors. These labral tears were arthroscopically repaired with 1–4 anchors (mean 1.8). All patients were evaluated with University of California, Los Angeles (UCLA) and Visual Analogue Scale (VAS) scores. There were the following injury mechanisms: compression-type, 10; traction-type, 9; combined or other-type, 5 patients. We also compared the clinical results according to the injury mechanisms. Preoperatively, the mean of UCLA and VAS scores were 22.7 and 6.4 points, respectively. At an average of 33 months postoperatively, the mean of UCLA and VAS scores were 29.9 and 2.1 points, respectively. There was statistical improvement in the subjective scores from the pre- to post-operation. UCLA and VAS scores of the pre- and post-operation were not statistically different according to the injury mechanisms. Arthroscopic repair is effective in the treatment of isolated SLAP lesion and injury mechanisms do not affect the clinical outcomes.     

数控凸轮

针对机械凸轮的某些不足，提出了数控凸轮的概念．介绍了数控凸轮的工作原理、实现方法及应用前景．     

Polymeric nanoparticles of cholesterol‐modified glycol chitosan for doxorubicin delivery: preparation and in‐vitro and in‐vivo characterization

Objectives Polymeric nanoparticles have been extensively studied as drug carriers. Chitosan and its derivatives have attracted significant attention in this regard but have limited application because of insolubility in biological solution. In this work, we attempted to utilize cholesterol‐modified glycol chitosan (CHGC) self‐aggregated nanoparticles to increase aqueous solubility, and to reduce side effects and enhance the antitumour efficacy of the anticancer drug doxorubicin. Methods CHGC nanoparticles were loaded with doxorubicin by a dialysis method, and their characteristics were determined by transmission electron microscopy examination, light‐scattering study, in‐vitro drug‐release study, pharmacokinetic study in rats and in‐vivo antitumour activity in mice. Key findings The resulting doxorubicin‐loaded CHGC nanoparticles (DCNs) formed self‐assembled aggregates in aqueous medium. From the observation by transmission electron microscopy, DCNs were almost spherical in shape. The mean diameters of these nanoparticles determined by dynamic light scattering were in the range of 237–336 nm as the doxorubicin‐loading content increased from 1.73% to 9.36%. In‐vitro data indicated that doxorubicin release from DCNs was much faster in phosphate‐buffered saline at pH 5.5 than at pH 6.5 and 7.4, and the release rate was dependent on the loading content of doxorubicin in these nanoparticles. It was observed that DCN‐16 (drug loaded content: 9.36%) exhibited prolonged circulation time in rat plasma and showed higher antitumour efficacy against S180‐bearing mice than free doxorubicin. Conclusions These results indicated that CHGC nanoparticles had potential as a carrier for insoluble anticancer drugs in cancer therapy.     

川芎嗪对妥布霉素肾毒性保护作用及机理的实验研究

目的：为减轻妥布霉素的肾毒性．应用川芎嗪进行预防其肾毒性的实验研究。方法：实验大鼠分三组：Ⅰ组正常对照组、Ⅱ组中毒模型组、Ⅲ组川芎嗪预防组。给大鼠腹腔注射妥布霉紊制成中毒模型。注射川芎嗪预防肾毒性。用药前、后检测大鼠的肾功能、尿酶等指标，实验结束后进行肾组织学检查。结果：发现模型组尿NAG酶（N-乙酰-β—D氨基葡萄糖苷酶）比正常组增高．血清中超氧化物歧化酶（SOD）活性低于正常组．血中的尿素氮（BUN）及肌酐（Cr）含量均比正常组增高。形态学检查可见模型组肾近曲小管上皮细胞广泛性坏死。川芎嗪预防组各项功能指标有所改善．形态学检查变性情况减轻。结论：川芎嗪对妥布霉素的肾毒性有预防保护作用。     

Some Properties of Pineal Gland Hydroxyindole-O-Methyltransferase From Black Rhinoceros (Diceros bicornis)

Pineal glands were obtained from two young female black rhinoceri that had died as a result of postcapture trauma during a translocation exercise. Hydroxyindole-O-methyltransferase (HIOMT) from these pineal glands showed a peak activity at pH 8.2, although high activity extended over a fairly wide pH range (7.8-8.4). N-acetylserotonin was the best hydroxyindolic substrate for the enzyme, although other hydroxyindoles were methylated, the relative affinities being similar to values previously reported for bovine HIOMT. Kinetic analyses revealed that black rhinoceros HIOMT was subject to substrate inhibition by both substrates at high concentration; this observation is unlikely to have physiological significance. The catalytic mechanism was found to be ordered Bi-Bi, in which S-adenosylmethionine is the obligatory first substrate to bind to the enzyme, such binding allowing for binding of the hydroxyindolic substrate followed by catalysis, products again leaving the catalytic site in a sequential fashion.     

墓头回止血作用机制的探讨

大、小鼠 P.0给予墓头回(PSB)20g/kg、26g/kg,qd×4d 或 qd×7d,能有效地防治5-FU 所致血小板减少。ip PSB3g/kg、5g/kg 可明显促进家兔循环血小板聚集。小鼠 P.0给予PSB14g/kg、20g/kg,qd×5d,其能显著降低毛细血管通透性;PSB 对大鼠、蟾蜍下肢血管具收缩作用。初步认为,PSB 止血作用机制可能与其对血小板和血管的作用有关。     

Molecular interactions, internal structure and drug release kinetics of rationally developed polymer–lipid hybrid nanoparticles

This paper presents the first study of molecular interactions of ingredients and internal nanostructure in relation to drug loading and release mechanisms/kinetics of rationally designed solid polymer–lipid hybrid nanoparticles (PLN). The PLN were prepared by using a rationally selected composition that was found in our previous work to provide optimized interactions of verapamil hydrochloride (VRP) with dextran sulfate sodium (DS) and then the VRP–DS complex with dodecanoic acid (DA). The solid-state properties of the components, their molecular interactions and the morphology, particle size and internal structure of PLN were determined by use of differential scanning calorimetry, powder X-ray diffraction, ¹³C nuclear magnetic resonance, Fourier transform infrared spectroscopy, transmission electron microscopy (TEM) and dynamic light scattering. The distribution of VRP in PLN was examined by TEM imaging using a cationic gold tracer. Drug release studies were conducted in various media. Drug loading as high as 36% and loading efficiencies up to 99% were achieved in the rationally formulated PLN. Hydrogen bonding between drug, polymer and lipid and a uniform distribution of amorphous VRP within the solid lipid matrix were evident. Sustained drug release from the PLN was mainly controlled by ion exchange and diffusion processes. The results demonstrated that strong molecular interactions among the drug, the polymer and the lipid in the optimized formulation were responsible for the improved drug loading and release performance of the PLN.     

Barbiturates in severe head injuries?

Possible mechanisms for the therapeutic effects of barbituric acid derivatives in severe head injuries have been discussed for half a century. In the following, a survey of the literature, and a discussion of three controlled clinical studies available until now is presented. A proven effect in terms of a beneficial long-term outcome for all injured patients has not been established.On the other hand there might be a subgroup of patients with an intact CO₂ reactivity of the brain vessels who may profit from barbiturates administered after head trauma.Dedicated to Marianne and Gerhard Winkler     

乡镇卫生院管理体制与运行机制研究

针对江西省乡镇卫生院现行管理与运行机制，建议采取多种措施尽快将乡镇卫生院上划“县管”，卫生院为非营利性医疗机构，不宜拍卖，可进行产权制度改革的试点，要加大投入，差补应有刚性规定，由财政转移支付逐步归还拖欠的费用及退休人员的工资，要积极探索卫生院公有制形式下经营模式，筹资渠道的多样化；鼓励城镇医疗机构或卫生人员联营，领办，协办卫生院；深化人事与分配制度的改革；提高卫生技术人员的待遇和素质，严格控制非卫生技术人员。     

医疗、医保、医药三方发展失调的恶性循环模型

分析了次均费用过快增长的原因和作用机制，并将之用于补充课题组前期研制的医院补偿机制恶性循环模型，提出了医疗、医保，医药三方发展有失协调的恶性循环模型，研究认国，基于医疗费用这一纽带，医疗保障制度，医院，药品生产和营销商处于同一系统中，彼此之间相互影响，任何一方的操作失当必将引起其他方面的联动反应，正由于这样一种联动反应，导致医疗，医保，医药三方处于恶性循环当中。