国医大师禤国维应用酸敛法治疗小儿特应性皮炎经验

介绍禤国维教授应用酸敛法治疗小儿特应性皮炎的临床经验。认为表虚兼有表燥是本病的基本病机特点,酸敛法可调理肺气、收敛心神、收敛肝气;治疗上注重散收并用,乌梅、五味子、白芍为其最常用的酸敛药,可调理肺、心、肝三脏的功能,并通过与辛散类药物(紫苏叶、防风、蝉蜕等)的配合,达到敛阴而不留邪、祛邪而不伤正的效果。并附验案1则。     

益气活血通络汤治疗原发性高血压合并糖耐量减低临床研究

目的:观察中药益气活血通络汤治疗高血压合并糖耐量减低的临床疗效。方法:将64例高血压合并糖尿病患者,随机分为2组各32例,对照组口服硝苯地平片治疗;观察组加用中药益气活血通络汤,以治疗前后收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血糖、胰岛素、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(HOMA-IR)为观察指标。结果:治疗3个月后,观察组疗效优于对照组(Z=-1.998,P<0.05)。与治疗前比较,2组经治疗后SBP、DBP、TC、TG、LDL-C均下降,HDL-C上升,差异有统计学意义(P<0.05);观察组治疗后SBP、DBP、TC、TG、LDL-C、HDL-C与对照组治疗后比较,差异有统计学意义(P<0.05)。与治疗前比较,2组经治疗后空腹和餐后2 h血糖、胰岛素、HOMA-IR均下降,ISI上升,差异有统计学意义(P<0.05);且经治疗后,观察组上述所有指标改善情况均优于对照组,差异有统计学意义(P<0.05)。2组患者在3个月的治疗期间中均未出现严重不良反应。结论:中药益气活血通络汤治疗高血压合并糖耐量降低疗效较好且安全性高,能显著降低血压,改善血脂。     

Recent advances in preclinical in vitro approaches towards quantitative prediction of hepatic clearance and drug-drug interactions involving organic anion transporting polypeptide (OATP) 1B transporters

Hepatic uptake mediated by organic anion transporting polypeptide (OATP) 1B1 and 1B3 can serve as a major elimination pathway for various anionic drugs and as a site of drug-drug interactions (DDIs). This article provides an overview of the in vitro approaches used to predict human hepatic clearance (CL_h) and the risk of DDIs involving OATP1Bs. On the basis of the so-called extended clearance concept, in vitro–in vivo extrapolation methods using human hepatocytes as in vitro systems have been used to predict the CL_h involving OATP1B-mediated hepatic uptake. CL_h can be quantitatively predicted using human donor lots possessing adequate OATP1B activities. The contribution of OATP1Bs to hepatic uptake can be estimated by the relative activity factor, the relative expression factor, or selective inhibitor approaches, which offer generally consistent outcomes. In OATP1B1 inhibition assays, substantial substrate dependency was observed. The time-dependent inhibition of OATP1B1 was also noted and may be a mechanism underlying the in vitro–in vivo differences in the inhibition constant of cyclosporine A. Although it is still challenging to quantitatively predict CL_h and DDIs involving OATP1Bs from only preclinical data, understanding the utility and limitation of the current in vitro methods will pave the way for better prediction.     

Pharmacotherapeutic strategies for critical asthma syndrome: a look at the state of the art

ABSTRACT

Introduction

‘Critical Asthma Syndrome’ (CAS) is an umbrella term proposed to include several forms of asthma, responsible for acute and life-threatening exacerbations. CAS requires urgent and adequate supportive and pharmacological treatments to prevent serious outcomes.     

Baicalin-loaded PEGylated lipid nanoparticles: characterization,pharmacokinetics, and protective effects on acute myocardial ischemia in rats

Context: Baicalin has many pharmacological activities, including protective function against myocardial ischemia by antioxidant effects and free radical scavenging activity. However, its rapid elimination half-life in plasma and poor water solubility limits its clinical efficacy.

Objective: Novel baicalin-loaded PEGylated nanostructured lipid carriers (BN-PEG-NLC) were developed to improve bioavailability of BN, to prolong retention time in vivo and to enhance its protective effect.

Methods: In this study, BN-PEG-NLC were prepared by the emulsion-evaporation and low temperature-solidification method using a mixture of glycerol monostearate and polyethylene glycol monostearate as solid lipids, and oleic acid as the liquid lipid. The physicochemical properties of NLC were characterized. The pharmacokinetic and pharmacodynamic behaviors of BN-PEG-NLC or BN-NLC were evaluated in acute MI rats.

Results and discussion: The particle size, zeta potential, and entrapment efficiency for BN-PEG-NLC were observed as 83.9?nm, ?32.1?mV, and 83.5%, respectively. The release profiles of BN from both BN-PEG-NLC and BN-NLC were fitted to the Ritger–Peppas modal, which presented burst release initially and prolonged release afterwards. Pharmacokinetics results indicated that BN-PEG-NLC exhibited a 7.2-fold increase in AUC in comparison to BN solution, while a 3-fold increase in comparison to BN-NLC. Biodistribution results revealed that BN-PEG-NLC exhibited higher heart drug concentration compared with BN-NLC as well as BN solution. In the present study, BN-PEG-NLC significantly ameliorated infarct size.

Conclusion: The results of the present study imply that PEG-NLC could be the biocompatible carriers for heart-targeted drug delivery to improve myocardial ischemia.     

高压氧治疗对局灶性脑梗死大鼠的神经保护作用

目的 观察单次9 h高压氧（hyp erbaric oxygen，HBO）治疗对局灶性脑梗死大鼠凋亡诱导因子 （apoptosis-inducing factor，AIF）、线粒体膜电位（mitochondrial membrane potential，MMPo）的影响，探讨 HBO治疗的神经保护作用。 方法 108只SD大鼠制作永久性大脑中动脉闭塞模型，随机分为对照组和HBO组，每组各54只。造 模成功3 h后，HBO组实行HBO干预，压力0.2 MPa持续9 h，对照组呼吸常压空气。采用Garcia评分评估 大鼠神经功能，比较两组造模后13 h、24 h和72 h神经功能改善情况，并在各时间点检测大鼠缺血半 暗带脑组织凋亡细胞数、线粒体和细胞核AIF表达及MMPo水平。 结果 ①神经功能评分：HBO组13 h（P <0.001）、24 h（P =0.04）神经功能评分改善比对照组更明显。 ②凋亡细胞数：HBO组13 h、24 h凋亡细胞数较对照组更少（均P <0.001）。③AIF在线粒体和细胞核的 表达：13 h、24 h、72 h各时间点HBO组AI F在线粒体的表达均较对照组多（均P <0.001）；各时间点HBO 组AIF在细胞核的表达均较对照组少（均P <0.001）。④MMPo：各时间点HBO组MMPo均高于对照组（均 P <0.001）。 结论 HBO治疗可改善大鼠神经功能，稳定MMPo，抑制AIF由线粒体向细胞核转移可能是其神经保 护作用的机制之一。     

中低度近视SMILE术后超早期视觉质量变化的研究

目的观察飞秒激光小切口角膜基质透镜取出术(SMILE)术后超早期患者视觉质量变化,探讨其变化发生的可能原因。方法选取中低度近视患者23例46眼行SMILE术,术前及术后24 h超早期行主观视觉质量问卷,测量最佳矫正视力的全程视力(远视力5 m,中视力60 cm,近视力33 cm)、对比敏感度(CS)、眩光敏感度(GS)及集合近点(NPC)和调节幅度(AA)。结果视觉质量主观问卷显示术后超早期主观视觉质量较术前下降(P=0.001)。术后裸眼视力(UCVA)明显提高(P=0.0001)。术前与术后最佳矫正视力(BCVA)中远视力没有变化(P=0.096),而中视力和近视力均较术前下降(P=0.039,0.003)。术后CS、GS降低(PCS=0.0001,PGS=0.04),NPC、AA较术前无明显变化(P=0.68,0.13)。结论SMILE术后超早期患者可获得预期理想远视力,但中、近视力尚未恢复。超早期中出现的异常视觉质量改变可能与对比敏感度和眩光敏感度的改变有关。