急性炎性疾病患者乳酸林格氏液液体动力学

目的:探索炎性疾病患者的乳酸林格氏液（Ringer's lactate,RL）液体动力学特征以及炎性生物标记物是否可以作为协变量影响RL分布和排泄。方法:本研究为前瞻性队列研究。选择40例美国麻醉医师分级（ASA）I-II级，腹腔镜下择期胆囊切除术（胆囊炎组，n=20）或者腹腔镜下急诊阑尾切除术（阑尾炎组，n=20）。所有患者麻醉诱导前开始输注RL，按15 mL/kg，35 min内输毕。采用酶联免疫（enzyme-linked immunosorbent assay,ELISA）方法测定血浆炎症（TNF-α,IL-10和CRP）或者内皮损伤生物标记物（syndecan-1,SDC-1）；利用血红蛋白（Hb）稀释-时间曲线和尿量，使用Phoenix软件，采用非线性混合效应模型分析计算RL液体动力学参数和协变量的影响。结果:与胆囊炎组相比，阑尾炎组RL从组织间隙到血浆的转运速率常数（k21）显著降低（14×10-3min-1 versus 35×10-3min-1;P=0.012）。阑尾炎组C反应蛋白（CRP）升高［中位数38.1(1.8-143.6) μg/mL versus 1.3(0.1-159.0) μg/mL;P<0.001］；与清醒状态相比，麻醉期间（输液开始后30～45 min），液体从中央室中到外周室的转运速率常数（k12）显著增加（57×10-3min-1 versus 32×10-3min-1；P<0.01）。清除速率常数（k10）降低90%（0.6×10-3min-1 versus 5.3×10-3min-1;P<0.001）。无论在清醒状态还是麻醉状态下低血压均能降低液体清除；炎症或者内膜损伤的生物标记物不能作为显著影响RL液体动力学参数的协变量。结论:阑尾炎或者胆囊炎患者术前输入液体后“炎症反应的生物标记物”不是RL的液体动力学的协变量，但是两组患者中，全身麻醉期间输入液体的清除率下降。     

Long-term sustained-released in situ gels of a water-insoluble drug amphotericin B for mycotic arthritis intra-articular administration: preparation,in vitro and in vivo evaluation

Amphotericin B (AMB) was often used in intra-articular injection administration for fungal arthritis, because it could often bring a satisfactory therapeutic efficacy and a minimum systemic toxic side effect. However, because of the multiple operations and the frequent injections, the compliance of the patients was bad. Therefore, to develop a long-term sustained-released preparation of AMB for mycotic arthritis intra-articular administration is of great significance. The purpose of present study was to develop a long-term sustained-released in situ gel of a water-insoluble drug AMB for mycotic arthritis intra-articular administration. Based on the evaluations of the in vitro properties of the formulations, the formulation containing 10% (w/w) ethanol, 15% (w/w) PG, 0.75% (w/w) HA, 5% (w/w) purified soybean oil, 0.03% (w/w) α-tocopherol, 15% (w/w) water and 55% (w/w) glyceryl monooleate was selected as a suitable intra-articular injectable in situ gel drug delivery system for water-insoluble drug AMB. Furthermore, the results of the in vivo study on rabbits showed that the selected formulation was a safe and effective long-term sustained-released intra-articular injectable AMB preparation. Therefore, the presented in situ AMB gel could reduce the frequency of the administration in the AMB treatment of fungal arthritis, and then would get a good patient compliance.     

Nanomaterials for radiotherapeutics-based multimodal synergistic cancer therapy

Over the past decade, numerous studies have attempted to enhance the effectiveness of radiotherapy (external beam radiotherapy and internal radioisotope therapy) for cancer treatment. However, the low radiation absorption coefficient and radiation resistance of tumors remain major critical challenges for radiotherapy in the clinic. With the development of nanomedicine, nanomaterials in combination with radiotherapy offer the possibility to improve the efficiency of radiotherapy in tumors. Nanomaterials act not only as radiosensitizers to enhance radiation energy, but also as nanocarriers to deliver therapeutic units in combating radiation resistance. In this review, we discuss opportunities for a synergistic cancer therapy by combining radiotherapy based on nanomaterials designed for chemotherapy, photodynamic therapy, photothermal therapy, gas therapy, genetic therapy, and immunotherapy. We highlight how nanomaterials can be utilized to amplify antitumor radiation responses and describe cooperative enhancement interactions among these synergistic therapies. Moreover, the potential challenges and future prospects of radio-based nanomedicine to maximize their synergistic efficiency for cancer treatment are identified.

     

NH_3-OH体系中共沉淀法同时回收钕铁硼废料中Nd-Pr-Co-Fe

为了避免回收单一钕铁硼废料中有价元素带来的操作复杂和资源浪费等问题,本研究采用共沉淀法共沉淀出钕铁硼废料中的有价元素Me(Nd,Pr,Co,Fe),制备可用于生产再生钕铁硼的原料;根据质量守恒和同时平衡原理,采用MATLAB软件建立Me(Nd,Pr,Co,Fe)-OH--NH3热力学模型,绘制lg[Me]-p H曲线模拟共沉淀工艺,并根据模拟结果确立了共沉淀工艺;模拟和实验的结果表明:根据lg[Me]-p H模拟结果可以确立一步共沉淀法的p H:6~10,Fe3+比Fe2+更易于沉淀完全;在上述条件下获得的共沉淀粉末主相均为Nd,Pr,Co,Fe的化合物,且有价元素的百分比含量均大于99.4%;其中,当p H值在8左右时回收率最高,在该条件下金属元素Me(Nd,Pr,Co,Fe)的沉淀效率分别为:98.7%,99.9%,93.6%,99.9%。该结果也表明共沉淀法工艺不仅高效,而且所制备的共沉淀粉末可以满足制备二次钕铁硼的需要。     

Isolated hepatic tuberculosis mimicking liver tumors in a dialysis patient

Cases of isolated hepatic tuberculosis (TB) are rare. The diagnosis is often delayed or missed because of nonspecific symptoms and laboratory findings. Besides, the disease is extremely rare even in a country where TB is an alarming public health problem. This report demonstrates the difficulty in correctly diagnosing local hepatic TB. We report the case of a 62‐year‐old male patient with end‐stage renal disease treated with hemodialysis, who developed 2 months of abdominal distension and general anorexia, with hyperechoic hepatic lesions on ultrasound. Computed tomography suspected multiple liver tumors. The liver biopsy finally led to the diagnosis of TB of the liver without other involvements. We conclude that isolated hepatic TB is one of the rare forms of extrapulmonary TB in dialysis patients. A greater awareness of this rare clinical entity may prevent needless surgical interventions.     

核算前移在冶炼企业优化成本控制中的应用

针对国际黄金价格的走低,黄金冶炼企业如何在激烈的市场竞争中寻求更大的利润空间,优化成本控制显得尤为重要。以某冶炼厂为例,阐述核算前移在优化企业成本控制中的应用,以达到降本增效的目的,实现企业利润的最大化。     

Facile synthesis of Li 2 ZrO 3 -modified LiNi 0.5 Mn 0.5 O 2 cathode material from a mechanical milling route for lithium-ion batteries

Li2ZrO3-modified LiNi0.5Mn0.5O2 materials with improved electrochemical performance were directly synthesized by a simple mechanical milling route with ZrO2, Li2CO3 and Ni0.5Mn0.5(OH)2 precursors...