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Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 108 μm3, 0.44 × 108 μm3 and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 108 μm3, 0.38 × 108 μm3 and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.
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Objective:To determine the difference of curative effects of gamma knife treatment and microsurgery on patients with recurrent trigeminal neuralgia (TN) after microvascular decompression (MVD).Methods:From January 2011 to December 2018, 65 patients with recurrent TN after MVD were enrolled in the study; 40 patients received gamma knife treatment and 25 patients received secondary microsurgical treatment. Barrow Neurological Institute (BNI) proposed pain grading was used to evaluate the efficacies right after treatment and 3 years after follow-up in all patients, and grading I-III was defined as pain relief.Results:Patients received gamma knife treatment had pain relief within 4-10 weeks of treatment and disappeared gradually; patients received secondary microsurgical treatment had disappeared facial pain immediately after waking up from anesthesia or completely alleviated facial pain within one week of treatment. Up to 3 years after surgery, follow-up results showed that 17 patients (68.0%) in the gamma knife treatment group had pain relief, and 16 patients (94.1%) in the microsurgical treatment group had pain relief; the difference in pain relief rate between the two groups was statistically significant ( χ2=4.100, P=0.043). Facial numbness was noted in the gamma knife treatment group, with an incidence of 24.0%; in the microsurgical treatment group, hemiplegia was noted in one patient and facial numbness was noted in the left ones, with complication rate of 29.4%; and the difference in complication rate between the two groups was not statistically significant ( χ2=0.010, P=0.921). Conclusion:For patients with recurrent TN after MVD, secondary microsurgical treatment and gamma knife treatment are safe and effective, among which secondary microsurgical treatment is more effective than gamma knife treatment.
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Objective:To study dynamic change of brain natriuretic peptide (BNP),left ventricular ejection fraction (LVEF)and prognosis improvement in patients with acute anterior myocardial infarction (AAMI)complicated hy-poxemia after noninvasive mechanical ventilation therapy.Methods:A total of 60 patients with AAMI complicated hypoxemia,who were hospitalized in our hospital from Mar 2011 to Oct 2013,were divided into noninvasive venti-lation group (n=28)and routine treatment group (n=32)according to number table.Dynamic change of BNP, LVEF and prognosis were observed and compared between two groups.Results:After treatment,BNP level and LVEF significantly improved in both groups (P<0.05 all),compared with routine treatment group,there was more significant reduction in BNP level [24h:(263.6±23.3)μmol/L vs.(126.2±21.9)μmol/L]and significant rise in LVEF [(40.6±13.1)% vs.(47.3±14.7)%]in noninvasive ventilation group after treatment (P<0.01 both);af-ter 30d follow-up,there were significant rise in 6min walking distance (percentage of 426~550m,59.3% vs. 75.0%),LVEF [(41.1±11.7)% vs.(49.4±12.5)%]and survival rate (90.6% vs.96.4%),and significant re-duction in rehospitalization rate (12.5% vs.7.1%)in noninvasive ventilation group,P<0.01 all.Conclusion:Ear-ly noninvasive mechanical ventilation therapy can significantly improve cardiac function,exercise tolerance and short-term prognosis in patients with acute anterior myocardial infarction complicated hypoxemia.
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Objective To observe the correlation between plasma brain natriuretic peptide (BNP) level and atrial fibrillation (AF) in old patients with acute left heart failure.Methods 86 old patients with acute left heart failure were randomly divided into two groups according to AF and sinus rhythm.The plasma BNP level was compared between the twogroups.And the relationship between plasma BNP level and the results of ultrasonic cardiography was also assessed.Results Significant difference existed in BNP level between individuals with AF and sinus rhythm [(1 320.66 ± 1 546.41) pg/L vs (989.43 ± 1 042.57) pg/L,t =2.651,P ＜ 0.05] ; BNP level of the rhythm AF significantly correlated with LAD and LVEDD (r =0.723,0.645,all P ＜ 0.01).Conclusion The old patients with acute left heart failure and AF had higher BNP level than those with sinus rhythm.And BNP level of the rhythm AF significantly correlated with LAD and LVEDD.
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Objective To discuss the application effect of brain natriuretic peptide (BNP)and QRS wave in nursing intervention of postmenopausal women with heart failure.Methods 85 postmenopausal women with heart failure in our department were chosen.43 patients in the control group were given routine nursing,42 patients in the observation group were given pertinent nursing according to BNP concentration and QRS wave.The alleviation rate of symptoms,reoccurrence rate of heart failure,mortality rate,NP concentration and QRS wave time limit and hospitalization days were compared between two groups.Results The reoccurrence rate of heart failure,mortality rate,NP concentration and QRS wave time limit and hospitalization days in the observation group were lower than those of the control group,but the alleviation rate of symptoms was higher than that of the observation group.Conclusions To give pertinent nursing according to BNP concentration and QRS wave for postmenopausal women with heart failure can alleviate symptoms,decrease attack of heart failure,shorten hospitalization days,improve cardiac function and prognosis,which is worthy of clinical application.
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ObjectiveTo define the high intraarterial signals on conventional MRI. Methods Review the conventional MRI data in all of the acute ischemic stroke patients in the First Affiliated Hospital,School of Medicine, Zhejiang University from January 2010 to December 2010. ResultsIn year 2010,according to the diagnostic criteria of China, there were 280 cases of acute cerebral infarction, all underwent conventional MRI. Twenty six patients (9. 29％ ) showed high intraarterial signals on conventional MRI.There were 14 cases with high signals in the anterior circulation, including 11 cases in the carotid artery, 2 cases in the anterior cerebral artery, and 1 case in the middle cerebral artery combined with the anterior cerebral artery. In the 11 patients with high signals in the carotid artery, MRA confirmed 14 internal carotid arteries stenosis, with 100％ specificity and 78.6％ sensitivity. There were 12 cases with high signals in the posterior circulation, including 5 cases in the vertebral artery, 3 cases in the basilar artery, and 4 cases in the basilar artery with vertebral artery. One patient did not undergo MRA. MRA confirmed 14 arteries with stenosis, with 100％ specificity and 78.5％ sensitivity. ConclusionsIntravascular high signals showed by conventional MR sequences have high clinical specificity, and its vascular lesions are consistent with the results of MRA.
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Objective To investigate the characteristic of type 2 diabetes (T2DM) patients with coronary heart disease (CHD),and provide methods for prevention and treatment for patients who suffered from CHD.Methods The hospitalized patients were divided into three groups.The treatment group contains 46 cases who were T2D with CHD;The control group Ⅰ contains 30 cases who were T2DM without CHD;The control group Ⅱ contains 50 cases who were CHD without T2DM.Their ordinary circumstances were compared;the blood sugar,BP,TC,TG,HDL,LDL,HbA1c,C-P,Ins were measured.Insulin sensitive index(ISI) was calculated.Results Three groups had obvious statistical differences in BP,TC,LDL-C,ISI,HbA1 c.Diabetic patients with CHD have more common with three lesions.Conclusion In the clinical job,the composite observation should be strengthened and treatment because the factors of atherosclerosis in T2DM patients were numerous and complex.
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Objective To investigate the clinical efficacy of drug-eluting stent( DES) combined with clopi-dogrel therapy in patients with coronary heart disease. Methods 123 patients underwent percutaneous coronary intervention (PCI) were randomly divided into observation group (DES) of 60 cases and the control group ( bare-metal stent,BMS) of 63 cases. The observation group was given the treatment of DES combined clopidogrel, the control group was given the treatment of BMS combined clopidogrel. The stent implantation and the follow-up two-year MACE were observed. Results (1) The average implanted stent length of the observation group was longer than that of the control group(P<(0.05) ,the angiography in vascular disease and complexity between the two groups had no significant difference ( P > 0. 05 ) ; the success rate of surgery in the two groups was 100% , after operation the TIMI flow reached grade 3. (2) The incidence of angina pectoris and revascularization rate of the observation group was significantly lower than that of the control group (P < 0.05); the rate of coronary angiography, recurrent myocardial infarction and the incidence of cardiac death between the two groups had no significant difference ( P > 0.05). Conclusion DES combined with clopidogrel maintenance therapy for a year in patients with coronary heart disease had a good long-term efficacy.