Colovaginal anastomosis: an unusual complication of stapler use in restorative procedure after Hartmann operation

BACKGROUND: Rectovaginal fistula is uncommon after lower anterior resection for rectal cancer. The most leading cause of this complication is involvement of the posterior wall of the vagina into the staple line when firing the circular stapler. CASE PRESENTATION: A 50-year-old women underwent resection for obstructed carcinoma of the sigmoid colon with Hartmann procedure. Four months later she underwent restorative surgery with circular stapler. Following which she developed rectovaginal fistula. A transvaginal repair was performed but stool passing from vagina not per rectum. Laporotomy revealed colovaginal anastomosis, which was corrected accordingly. Patient had an uneventful recovery. CONCLUSION: Inadvertent formation of colovaginal anastomosis associated with a rectovaginal fistula is a rare complication caused by the operator's error. The present case again highlights the importance of ensuring that the posterior wall of vagina is away from the staple line

Application Research and Practice of TBL Innovative Teaching Method in the Course of Clinical Biochemical Testing Technology

The purpose of this study is to explore the practical application effect of TBL innovative teaching method in the course of clinical biochemistry test technology. The research object is all undergraduate students in the laboratory major of 2018 medical school of our university. The research method is comparative experiment method, the teaching method of LBL teaching is set as control group, while the experimental group adopts TBL teaching method. By the final teaching evaluation and the data collected in the process, the influence of TBL teaching methods on the teaching effect of the course is compared and analyzed. The evaluation methods are combined with subjective and objective evaluation. The evaluation methods include questionnaire, student mutual evaluation, final test and other multiple ways. And the results of this study showed that the average score of the experimental group using TBL teaching method was significantly higher than that of the control group using traditional teaching method. In addition, through the process evaluation, it was found that the students in the experimental group were superior to the students in the control group in terms of learning interest, communication ability and learning methods. As a result, the application of TBL teaching method in the teaching of clinical biochemistry test obviously promotes the teaching quality and effect of this course

Preparation and in vitro/in vivo evaluation of orally disintegrating/modified-release praziquantel tablets

This study was designed to develop orally disintegrating/sustained-release praziquantel (PZQ) tablets using the hot-melt extrusion (HME) technique and direct compression, and subse-quently evaluate their release in in vitro and in vivo pharmacokinetics. For the extrusion process, hypromellose acetate succinate (HPMCAS)-LG was the carrier of pure PZQ, with a standard screw configuration used at an extrusion temperature of 140◦ C and a screw rotation speed of 100 rpm. Differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), powder X-ray diffraction (PXRD) and Fourier-transform infrared spectroscopy (FTIR) were performed to characterize the extru-date. Orally disintegrating/sustained-release praziquantel tablets (PZQ ODSRTs) were prepared by direct compression after appropriate excipients were blended with the extrudate. The release amount was 5.10% in pH 1.0 hydrochloric acid at 2 h and over 90% in phosphoric acid buffer at 45 min, indicating the enteric-coating character of PZQ ODSRTs. Compared with the pharmacokinetics of marketed PZQ tablets (Aipuruike®) in dogs, the times to peak (Tmax), elimination half-life (t1/2λ) and mean residence time (MRT) were extended in PZQ ODSRTs, and the relative bioavailability of PZQ ODSRTs was up to 184.48% of that of Aipuruike®. This study suggested that PZQ ODSRTs may have potential for the clinical treatment of parasitosis

Preparation, evaluation, and pharmacokinetics in beagle dogs of a taste-masked flunixin meglumine orally disintegrating tablet prepared using hot-melt extrusion technology and D-optimal mixture design

Flunixin meglumine (FM) is a nonsteroidal anti-inflammatory drug limited by irritation of the respiratory tract and mucosa in veterinary tissue. This study aimed to develop a taste-masked FM solid dispersion (SD) by hot-melt extrusion (HME) and formulate an orally disintegrating tablet (ODT) with selected excipients by direct compression. Eudragit® E PO was chosen as the matrix, and HME parameters were optimized: extrusion temperature, 135℃; screw speed, 100 rpm; and drug loading, 20%. Characterization techniques proved that FM was rendered amorphous in the HME extrudate. In vitro dissolution studies showed that FM SD released significantly slower than the corresponding physical mixture in artificial saliva. Excipients were selected based on compression formability, disintegration, and solubility. A D-optimal mixture design was used to optimize the composition: 25% FM SD, 18.75% microcrystalline cellulose, 52.5% mannitol, 3.75% low-substituted hydroxypropyl cellulose, and 1% magnesium stearate. Taste-masked FM ODT had a tensile strength of 0.7 ± 0.01 MPa and a disintegration time of 17.6 ± 0.1 s. E-tongue and E-nose analysis showed that FM ODT had a better taste-masked effect than commercial granules. Finally, a pharmacokinetic study proved that the main pharmacokinetic parameters of FM ODT were not significantly different from those of commercial granules, which indicated that these formulations had similar pharmacokinetic behaviours in beagles

ADOPTION OF OPEN SOURCE SOFTWARE IN GOVERNMENTAL CONTEXT: A POSITIVISTIC CASE STUDY IN CHINA

As the rapid development of open source software (OSS) has deeply impacted global software industry, government agencies in different countries all over the world have started to realize the huge potentials of OSS application. Based on the TOE framework for organizational level IT/IS adoption, this paper proposes a conceptual model for examining the adoption of open source software in the governmental organizational context. A positivistic case study is conducted in the government agencies of Beijing, China, so as to validate and develop the proposed model, as well as to investigate the adoption status and related influence mechanisms. Findings from the analysis demonstrate the explanatory validity of the model, and provide potentially helpful insights for future practice

Improved resolution optical time stretch imaging based on high efficiency in-fiber diffraction

Most overlooked challenges in ultrafast optical time stretch imaging (OTSI) are sacrificed spatial resolution and higher optical loss. These challenges are originated from optical diffraction devices used in OTSI, which encode image into spectra of ultrashort optical pulses. Conventional free-space diffraction gratings, as widely used in existing OTSI systems, suffer from several inherent drawbacks: limited diffraction efficiency in a non-Littrow configuration due to inherent zeroth-order reflection, high coupling loss between free-space gratings and optical fibers, bulky footprint, and more importantly, sacrificed imaging resolution due to non-full-aperture illumination for individual wavelengths. Here we report resolution-improved and diffraction-efficient OTSI using in-fiber diffraction for the first time to our knowledge. The key to overcome the existing challenges is a 45° tilted fiber grating (TFG), which serves as a compact in-fiber diffraction device offering improved diffraction efficiency (up to 97%), inherent compatibility with optical fibers, and improved imaging resolution owning to almost full-aperture illumination for all illumination wavelengths. 50 million frames per second imaging of fast moving object at 46 m/s with improved imaging resolution has been demonstrated. This conceptually new in-fiber diffraction design opens the way towards cost-effective, compact and high-resolution OTSI systems for image-based high-throughput detection and measurement