中药制剂的质量控制与评价研究

目的 介绍近几年中药制剂质量控制与评价研究状况。方法 着重从药材因素、提取工艺选择、质量标准研究、稳定性4个方面综述。结果 需尽快建立现代中药质量标准系统，实现中药质量标准评价的规范化、自动化、现代化。结论 制定中药规范化的质量标准是保证临床用药安全、有效、稳定可靠，促进中药现代化和国际化的关键。     

在军队医院建设中贯彻科学发展观

本文运用科学发展观所蕴含的世界观和方法论,深刻论述了新世纪新阶段军队医院建设发展面临的新机遇与新挑战、新特点与新规律,提出了与之相对应的军队医院实现又好又快发展的新思路、新方法和新举措,旨在为增强军队医院履行新使命、发挥新作用、开创新局面提供思路与建议。     

现代医学教学中流媒体技术的应用研究

阐述了流式媒体技术及其工作原理，介绍了流媒体系统的选用。简述了Windows Media Technology系统组成及利用流媒体技术制作医学教学课件的方法，并对其在局域网中的应用进行了探讨。     

Progressive paradoxical sleep deprivation impairs partial memory following learning tasks in rats*★

BACKGROUND： Complex learning tasks result in a greater number of paradoxical sleep phases, which can improve memory. The effect of paradoxical sleep deprivation, induced by ＂flower pot＂ technique, on spatial reference memory and working memory require further research. OBJECTIVE： To observe the effect of progressive paradoxical sleep deprivation in rats, subsequent to learning, on memory using the Morris Water Maze. DESIGN, TIME AND SETTING： Controlled observation experiment. The experiment was performed at the Laboratory of Neurobiology, Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Lanzhou University from December 2006 to October 2007. MATERIALS： Twenty-eight, male, Wistar rats, 3-4 months old, were provided by the Experimental Animal Center of Lanzhou University. The Morris Water Maze and behavioral analyses system was purchased from Genheart Company, Beijing, China. METHODS： All animals, according to a random digits table, were randomly divided into paradoxical sleep deprivation, tank control, and home cage control groups. Paradoxical sleep deprivation was induced by the ＂flower pot＂ technique for 72 hours, housing the rats on small platforms over water. Rats in the ＂tank control＂ and ＂home cage control＂ groups were housed either in a tank with large platforms over the water or in normal cages without paradoxical sleep deprivation. MAIN OUTCOME MEASURES： Morris Water Maze was employed for task learning and spatial memory testing. Rats in all groups were placed at six random starting points each day for four consecutive days. Each placement was repeated for two trials; the first trial represented reference memory and the second working memory. Rats in the first trial were allowed to locate the submerged platform within 120 seconds. Data, including swimming distance, escape latency, swimming velocity, percentage of time in correct quarter, and memory scores were recorded and analyzed automatically by behavioral analyses systems for Morris Water Ma     

Hepatocyte growth factor gene transfer effects on the femoral and intramuscular nerve in a canine model of lower limb ischemia*☆

BACKGROUND： Recent advancements in gene therapy have provided new methodology for treating ischemia in lower extremities. Gene transfer of angiogenic factors to ischemic tissues may promote local proliferation of new vessels and form collateral circulation. OBJECTIVE： To observe histopathological changes in the femoral and intramuscular nerve three months after intramuscular injection of hepatocyte growth factor （HGF） into the peripheral skeletal muscle in a canine model of lower limb ischemia. DESIGN： Randomized occlusion modelled and verification animal study. SETTING： Experimental Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA. MATERIALS： This study was performed at Animal Experimental Center, Lanzhou General Hospital of Lanzhou Military Area Command of Chinese PLA from September to November 2006. A total of eight male mongrel dogs, weighing 12–15 kg and 1.5–3 years of age, were selected for this study. This experimental study was in accordance with local ethics standards. Recombinant plasmid carrying HGF （pUDKH） and occlusion model plasmid （pUDK） were provided by the Third Laboratory of Radiation Medical Institute, Academy of Military Medical Sciences of PLA. METHODS： Grouping and model establishment： under anesthesia, complete vascular occlusion models were established on the left lower extremities. The experimental dogs were randomly divided into a model group and a pUDKH treatment group, with four dogs in each group. Dogs in the pUDKH group were injected with 0.15 mg/kg pUDKH. Ten minutes later, intramuscular injections were performed at three spots into the peripheral skeletal muscle of the left hind limb, as well as lateral injections at two spots. The injection volume at each spot was 0.2 mL. Dogs in the model group were injected with pUDK, and dosage and injection method were identical to the treatment group. MAIN OUTCOME MEASURES： Histopathological changes in the femoral nerve, as well as internal and external intramuscular nerve tissue     

1350例骨折病人骨密度检测分析

目的检测分析武威地区骨折病人骨密度,以获得当地人群骨密度数据,并探讨骨折的危险性。方法 2008年10月～2009年9月所有骨折住院的当地病人1350例,其中30岁以下339例,30岁以上1011例;城镇人口415例,农村人口935例,均在刚入院时进行骨密度检测,对测定结果按以上分组进行统计分析。结果男性30岁以上骨密度异常者为68.30%,30岁以下为18.30%,女性30岁以上骨密度异常者为77.00%,30岁以下为13.41%,P均〈0.01;农村人口与城镇人口骨密度异常者比例分别为83.53%和83.86%,P〈0.05。结论 30岁以上人群骨密异常者显著高于30岁以下人群,骨折病人不论城市、农村人口,骨密度异常者均较高,骨折的发生有一定的必然性。     

粒生素在治疗化疗导致白细胞减少中的临床应用

为观察粒生素 (rhG CSF)在治疗恶性肿瘤化疗所致白细胞减少的疗效及临床不良反应 ,对 32 7例次恶性肿瘤化疗所致白细胞减少的患者使用粒生素 2 .5 - 5 μg (kg·d) ,皮下注射。结果表明 :Ⅰ和Ⅱ度骨髓抑制白细胞恢复正常所用粒生素的平均剂量为 2 37μg ,Ⅲ和Ⅳ度为 6 75 μg。治疗总有效率为 99.4 %。临床应用中未发现明显副反应。结论 :粒生素在治疗恶性肿瘤化疗所致的白细胞减少中具有良好的临床有效性和安全性。     

不同联合放化疗方式对儿童髓母细胞瘤疗效的系统评价

目的系统评价不同的联合放化疗方式对儿童髓母细胞瘤的疗效。方法计算机检索MEDLINE/Pub Med、Embase和Cochrane Library等数据库,对纳入的随机对照试验(randomized controlled trials,RCT)采用Rev Man5.3进行Meta分析。结果共纳入10篇RCT文献,1807例患者。Meta分析结果显示髓母细胞瘤术后联合放化疗与术后单纯放疗相比,能提高3年总生存率(overall survival,OS)[RR=1.18,95%CI(1.02,1.37),P0.05]和高危险组患者5年无事件生存率(event-free survival,EFS)或无病生存率(disease-free survival,DFS)[RR=1.27,95%CI(1.01,1.59),P0.05]。先放疗后持续化疗的方案和先化疗后放疗的"三明治"方案相比,能提高髓母细胞瘤M0级别患者5年OS[RR=1.46,95%CI(1.19,1.79),P0.05]和5年EFS/DFS[RR=1.29,95%CI(1.06,1.55),P0.05],能提高M1级别患者5年OS[RR=2.26,95%CI(1.03,4.97),P0.05]。结论手术切除后联合放化疗治疗儿童髓母细胞瘤效果优于术后单纯放疗。术后先放疗后化疗的方案优于术后先化疗后放疗的"三明治"方案。     

Association between angiotensin-converting enzyme insertion/deletion polymorphism and migraine: a meta-analysis

Background: Many studies investigated the association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) polymorphism and migraine, with controversial results. Thus, we performed a meta-analysis to better evaluate the correlation of this polymorphism and migraine. Methods: We retrieved studies published up to September 2014 about the ACE gene polymorphism and migraine from electronic database. Pooled odds ratios (ORs) with 95% confidence interval (CI) were calculated to examine the strength of association between the ACE I/D polymorphism and migraine, using random-effects models. Results: We identified 14 separate studies, in which 7334 migraineurs and 22 990 healthy controls were eligible for the meta-analysis. The results showed no relationship between the ACE I/D polymorphism and any migraine. Stratification revealed a protective effect in the Turkish population against migraine with aura for the II genotype model (II vs. DD: pooled OR = 0.366, 95% CI = 0.137–0.980; II vs. DI + DD: pooled OR = 0.370, 95% CI = 0.145–0.945). Similar results were obtained for Turkish people with migraine without aura (II vs. DD: pooled OR = 0.386; 95% CI = 0.166–0.900; II vs. DI + DD: pooled OR = 0.347; 95% CI = 0.156–0.773). Conclusions: The data suggest that the ACE II genotype could exert a protective effect against migraine with aura and without aura at least in the Turkish population.     

混合造血干细胞移植后输注供者淋巴细胞和白细胞介素2对急性髓性白血病疗效的影响

目的:观察急性髓性白血病经混合造血干细胞移植后,应用供者淋巴细胞输注 白细胞介素2治疗的效果,并与移植后未经特殊治疗的效果进行比较。方法:①选取2000-01/2004-07解放军兰州军区兰州总医院全军血液病中心收治的19例急性髓性白血病患者,实验经医院伦理委员会批准,患者均知情同意。随机数字表法分为两组:观察组8例,年龄17～40岁,M2a 4例,M4 1例,M5a 3例;对照组11例,年龄19～39岁,M2a 2例,M3a 2例,M4 3例,M5a 4例。②两组患者采用化疗联合重组人粒细胞集落刺激因子的方法动员自体外周血造血干细胞,采集后液氮中保存5d备用。③术前采用直线加速器对患者全身及肺部照射,预处理完毕后实施混合造血干细胞移植。首先回输自体单个核细胞中位数为4×108/kg,CD34 细胞中位数为6.2×106/kg,粒-巨噬祖细胞集落形成单位中位数为5.8×104/kg。间隔1～6h后,采集人类白细胞抗原半相合异体骨髓,按回输自体单个核细胞数的1/6～1/10输注给患者。④两组患者移植期间均住无菌层流病房,给予相应并发症的防治及支持治疗。在粒细胞降至0时注射重组人粒细胞集落刺激因子150μg/12h,促进造血恢复。观察组给予供者淋巴细胞输注 白细胞介素2治疗,每次采集的供者淋巴细胞中,CD3 淋巴细胞中位数为1.43×108/kg,CD4 细胞中位数为0.97×108/kg,CD8 细胞中位数为0.41×108/kg,中位治疗次数4(1～7)次,回输后即开始应用100wu/d重组人白细胞介素2,共10d。对照组混合造血干细胞移植后未给予特殊治疗。结果:19例急性髓性白血病患者均进入结果分析。①造血恢复:两组患者均获得造血重建,术后4～9d粒细胞均降至0,12～17d粒细胞达0.5×109L-1,16～21d白细胞达4.0×108 L-1,19～23 d血小板达20×108 L-1。16～21 d骨髓检查示恢复期骨髓象。②术后并发症:两组患者不同程度地出现口腔溃疡,随着造血恢复,7～10d溃疡消失。观察组1例患者出现出血性膀胱炎,两组各2例患者出现发热。无肝静脉闭塞病和移植物抗宿主病发生。③嵌合体形成:观察组中1例M4患者形成嵌合体,对照组中2例M4患者与1例M5患者形成嵌合体,嵌合体持续存在3～12个月。④供者淋巴细胞输注 白细胞介素2疗效:观察组中有1例M2a患者在接受2次特殊治疗后7个月复发死亡;1例M2a患者接受2次特殊治疗后1年出现骨髓增生异常综合征,脑出血死亡,1例M5a患者应用特殊治疗1次后出现不明原因高热、抽搐,死于癫痫持续状态,其余5例患者随访2年均健康存活,长期生存率为62.5%(5/8)。对照组有2例M2a患者、2例M4患者、1例M5患者于移植后1～7个月复发死亡,1例M3患者于移植后25d死于脑出血,其余2例M3患者、2例M4患者、1例M5患者随访2年均健康存活,长期生存率为45.4%(5/11)。结论:混合造血干细胞移植后应用供者淋巴细胞输注 白细胞介素2治疗,急性髓性白血病患者均获得造血重建且无移植物抗宿主病发生,其长期生存率有效提高。