强化他汀治疗对急性冠脉综合征患者PCI术后心肌灌注及炎症因子的影响

目的探讨强化他汀治疗对急性冠脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）术后心肌灌注及炎症因子的影响。方法将120例ACS行PCI治疗的患者随机分为对照组与观察组,给予58例对照组患者PCI术前1周20 mg/d阿托伐他汀口服,62例观察组患者于PCI术前1周开始口服40 mg/d阿托伐他汀。比较两组服药前及PCI术后血清炎症因子、心肌灌注分级（TMPG）和不良反应。结果 PCI术后12 h两组血清超敏C反应蛋白（hs-CRP）、IL-6及IL-8水平均显著升高,但观察组上述炎症因子水平显著低于对照组（P〈0.01）;术后观察组心肌灌注分级（TMPG）Ⅱ、Ⅲ级比例显著高于对照组（P〈0.01）;观察组与对照组不良反应发生率分别为21.0%和19.0%,差异无统计学意义（P〉0.05）。结论强化他汀治疗可显著降低ACS患者PCI术后急性炎症反应,显著改善心肌灌注,且不增加不良反应。     

霉酚酸酯与环磷酰胺治疗狼疮肾炎的疗效观察

目的比较霉酚酸酯(MMF)与间断环磷酰胺(CTX)静脉冲击疗法治疗狼疮性肾炎(LN)的临床疗效。方法将60例LN患者随机分为MMF治疗组及CTX治疗组,进行相应治疗,两组均联合标准剂量的泼尼松。结果治疗3个月后,MMF组白蛋白、C3升高,差异有统计学意义,而CTX组仅C3改善有统计学意义。3个月时MMF组在提高白蛋白方面与CTX组比较,差异有统计学意义(P<0.01)。治疗6个月后,两组白蛋白、C3均较治疗前升高,差异有统计学意义(P<0.01),MMF组与CTX组比较,差异有统计学意义(P<0.01)。CTX组治疗6个月时的白蛋白较治疗3个月时提高,差异有统计学意义(P<0.05)。结论 MMF组比CTX组疗效好,更具安全性。     

老年早期糖尿病肾病相关危险因素分析

目的探讨老年2型糖尿病微量清蛋白尿与相关危险因素的关系。方法将150例老年2型糖尿病患者分为合并微量清蛋白尿（MAU）组（76例）与正常微量清蛋白尿（NAU）组（74例）,检测两组体重指数（BMI）、血糖、血脂、胰岛素、肌酐（Cr）、尿酸（UA）、糖化血红蛋白（HbA1c）、超敏C反应蛋白、颈动脉内膜中层厚度（CIMT）等,计算胰岛素抵抗指数（HOMA—IR）,并进行比较。结果MAU组收缩压（SBP）、舒张压（DBP）、UA、Cr、三酰甘油（TG）、空腹血糖（FPG）、HbA1c、空腹胰岛素（FINS）、HOMA—IR、CIMT明显高于NAU组（P〈0．05）。MAU组HDL低于NAU组（P〈0．05）。直线相关性分析显示MAU与UA、TG、、HOMR—IR、空腹血糖、HbA1c、CIMT呈正相关,与HDL呈负相关。结论老年T2DM合并MAU与高血糖、高血压、血脂代谢紊乱、胰岛素抵抗有关．更易发牛大向管病变．     

RP-HPLC法测定盐酸胺碘酮包衣脉冲片中盐酸胺碘酮的含量

目的:建立测定盐酸胺碘酮包衣脉冲片中盐酸胺碘酮含量的方法。方法:采用反相高效液相色谱法。色谱柱为Agilent2C518℃柱。,流结动果相:盐为酸2%胺三碘乙酮胺检(测用浓磷度酸在调0p.H02至0～4.08).2-5乙0腈m(g·4m0L∶6-01)范,检围测内波与长峰为面积24积0n分m值,流线速性为关1系.0良mL好·(mri=n-01.,9进99样9)量,平为均20加μL样,回柱收温率为分别为99.28%、99.53%、99.85%,RSD=0.59%。结论:该方法简便、快速、准确、灵敏度高、重复性好,可用于盐酸胺碘酮包衣脉冲片的质量控制。     

Microwave irradiation synthesis of novel ramose chitosan-based-5-fluorouracil and research on its in vitro release

In order to construct a controlled release system of drugs and to reduce toxic side effects of 5-fluorouracil (5-FU), the novel ramose chitosan-based-5-fluorouracil (CSFU) was synthesized by a two-step method. First, ramose N,N-dicarboxyethyl chitosan (CECS) was efficiently synthesized from chitosan (CS) through microwave irradiation under mild alkaline media. Second, under the catalysis of EDC/NHS and using 5-Fu as a model drug, 1,3-bis(hydroxymethyl)-5-fluorouracil (HMFU) was successfully linked to the ramose CECS. CSFU was characterized by IR spectrum, Raman Spectrum, and UV spectrum. The influence of microwave irradiation time on degree of substitution (DS) of CECS was studied. The content of 5-FU in CSFU and its in vitro release capability in phosphate buffer solution (PBS) were determined by UV spectrum. Results showed the drug loading (DL) was 10.6% and its zero-order release time could sustain 42 h almost without burst release, which indicated its promising application as a potential prodrug in cancer treatment.     

反相高效液相色谱法测定盐酸麻黄碱滴鼻液中主药的含量

目的建立反相高效液相色谱法别定盐酸麻黄碱滴鼻液主药含量的方法。方法色谱柱为Shim—pack VP-ODS C18,流动相为水（含0．1％三乙胺．甲酸调pH值至2．5）甲醇（90：10）,检测波长为200nm,流速为1．0mL·min^-1．柱温为30℃．进样量为20μL。结果盐酸麻黄碱检测浓度的线性范围为1．026～12．825μg·mL^-1（r=0．9999）：最低检出限为513ng·mL^-1;平均回收率为98．88％．RSD=1．33％。结论本法简便、快速．结果准确、可靠,可用于该制剂的质量控制.     

2型糖尿病大鼠骨髓腔内PPARγ和Cbf&agr;1 mRNA的表达与骨折愈合障碍的关系

目的:探讨2型糖尿病大鼠骨髓腔内过氧化物酶体增殖物激活受体γ (peroxisome proliferator-activated receptor gamma, PPARγ)和核心结合因子&agr;1(core binding factor alpha 1,Cbf&agr;1)表达的变化与2型糖尿病骨折愈合障碍之间的关系。方法:雄性SD大鼠随机分为对照组(n=15)和实验组(n=15)分别给予普通饲料、高糖高脂饲料喂养。8周后摘眼球取血,两组分别腹腔注射枸橼酸盐缓冲液和链脲佐菌素(STZ,35 mg/kg)。2周后再次摘眼球取血,并建立大鼠左胫骨牵引成骨模型,牵引14 d后处死动物,收集血液及左胫骨,无菌分离双侧股骨。X线摄片比较两组胫骨牵引间隙内骨痂的形成情况。组织学观察牵引骨痂内微骨柱(MCF)与初始基质前沿(PMF)及骨折两端髓腔内脂肪细胞的形成情况,并计算骨折两端髓腔内脂肪细胞与骨髓腔面积百分比。RT-PCR法检测两组动物股骨骨髓腔内PPARγ和Cbf&agr;1 mRNA的表达。结果:8周后实验组大鼠血清甘油三酯较对照组明显升高(P<0.01),血清总胆固醇较正常组升高(P<0.05),空腹血糖鹊核厮轿廾飨圆钜?P>0.05)。10周后实验组大鼠空腹血糖甯视腿ソ隙哉兆槊飨陨?P<0.01),血清总胆固醇较正常组升高(P<0.05),血胰岛素水平无明显差异(P>0.05),2型糖尿病大鼠模型建立。与对照组比较,2型糖尿病组大鼠X线摄片显示骨折断端之间牵引骨痂形成明显减少,骨痂组织学检查表现为MCF排列紊乱,PMF浅染;骨折两端髓腔内脂肪细胞及脂肪细胞占骨髓腔面积百分比明显增加(P<0.01);RT-PCR法检测显示双侧股骨骨髓腔内PPARγ mRNA表达上调(P<0.05), 而Cbf&agr;1 mRNA的表达下调(P<0.05),而对照组则相反。2型糖尿病对早期骨折愈合表现为明显的抑制作用。结论:2型糖尿病大鼠骨折愈合障碍可能与2型糖尿病条件下骨髓腔内PPARγ mRNA表达增加而Cbf&agr;1 mRNA的表达受抑制有关。     

杂交捕获二代法检测在宫颈癌筛查中的应用价值

目的探讨杂交捕获二代（HCⅡ）法检测高危型人乳头瘤患者（HPV）DNA的临床应用价值。方法对1189例患者进行HCⅡ法HPV检测和液基细胞学（TCT）检测,对高度怀疑病变的患者进行阴道镜多点活检。结合病理结果进行分析。结果1189例样本中,经TCT检测ASC-US 32例（2.69％）,ASCUS-H 35例（2.94％）,LSIL 76例（6.39％）,HSIL 17例（1.43％）。病理证实炎症70例（49.65％）,CINI 19例（13.48％）,CINⅡ 22例（15.60％）,CIN Ⅲ 17例（12.06％）,浸润癌5例（3.55％）,湿疣8例（5.67％）。HPV阳性组年龄明显小于阴性组（P〈0.01）。各病理组HPV感染率分别为炎症59％、CIN I 68％、CIN Ⅱ 77％、CIN Ⅲ 100％、浸润癌100％、湿疣62％。141例阴道镜下多点活检结果：TCT和HPV均（-）者无高度病变发生;TCT（-）和HPV（＋）者中≥CINⅡ的检出率为17％,在TCT异常和HPV阳性同时存在的病例中最高（41％）;仅TCT异常的HPV（-）者为13％,且5例均为CINⅡ,无原住癌和浸润癌的发生。结论持续的HR-HPV感染与宫颈病变的演进有关,HC-Ⅱ法HPV检测是宫颈癌有价值的辅助诊断技术,与细胞学联合检测,为最佳宫颈癌筛查方案。     

Comparison of efficacy of conbercept, aflibercept, and ranibizumab ophthalmic injection in the treatment of macular edema caused by retinal vein occlusion: a Meta-analysis

AIM: To evaluate and compare the anatomical and functional outcomes and negative effects of the three anti-vascular endothelial growth factor (VEGF) drugs in the treatment of macular edema (ME) due to retinal vein occlusion (RVO) based on the evidence pooled from current clinical trials and observational studies. METHODS: A systematic literature search was conducted on nine online databases from inception until April 30, 2022. The main endpoints were best corrected visual acuity (BCVA), central macular thickness (CMT), and adverse events (AEs). Cumulative Meta-analysis was conducted to synthesize the outcomes of the drugs. The retrieved data were analyzed using Stata software (version 12.0). RESULTS: A total of 20 studies comprising 1674 eyes met the inclusion criteria to the Meta-analysis. It was observed that conbercept and aflibercept had better visual acuity effects compared with ranibizumab at 1mo [weight mean difference (WMD)=-0.03, P=0.001; WMD=-0.05, P=0.019], but the effects were not different from that of ranibizumab at 6mo. Moreover, there was not statistically significant difference in the proportion of patients gaining ≥15 letters at 12-24mo between aflibercept and ranibizumab [odds ratio (OR)=1.16, P=0.427]. Conbercept had higher mean CMT change effects at 1mo (WMD= -14.43, P=0.014) and 6mo (WMD=-35.63, P≤0.001) compared with ranibizumab. Meanwhile, the mean CMT change effects at 1mo (WMD=-10.14, P=0.170), 6mo (WMD=-26.98, P=0.140) and 12-24mo (WMD=-12.34, P=0.071) were comparable among the groups. Similarly, AEs were not significantly different among the treatments (OR=0.75, P=0.305; OR=1.04, P=0.89). The stability of effect size of mean BCVA and CMT improved with the increase in sample size. Aflibercept and conbercept required fewer injections compared with ranibizumab. CONCLUSION: This is the first study to evaluate the efficacy and AEs of intravitreal administration of conbercept, ranibizumab, and aflibercept in the treatment of RVO-ME. Intravitreal aflibercept or conbercept results in better mean change in vision and CMT reduction compared with ranibizumab. Conbercept can be considered to be a promising and innovative drug with good anti-VEGF effects.     

连翘及其制剂的分析方法研究

在回顾分析连翘质量控制技术、方法的基础上,归纳了连翘质量控制的成就和存在问题,并提出采用“一测多评”的多成分质量控制新方法来评价其质量,为连翘质量的发展提供一种新思路。