复方丹参滴丸在老年慢性阻塞性肺疾病缓解期中的应用效果观察

目的 探讨复方丹参滴丸在老年慢性阻塞性肺疾病缓解期治疗中的应用效果。方法 选取2010年5月～2013年5月来本院就诊的59例老年慢性阻塞性肺疾病缓解期患者,随机分为观察组29例及对照组30例,对照组采用阿莫西林分散片治疗,观察组采用复方丹参滴丸治疗;观察两组患者的临床治疗效果、不良反应发生率及治疗前后QOL评分情况。结果 观察组总有效率为93．10％,对照组为76．67％,差异有统计学意义（P〈0．05）。观察组不良反应发生率为10.35％,对照组为30．00％,差异有统计学意义（P〈0．05）。观察组治疗后QOL评分（良好率＋较好率）明显高于对照组,差异有统计学意义（P〈0．05）。结论 复方丹参滴丸治疗老年慢性阻塞性肺疾病缓解期的效果显著,可明显降低不良反应的发生率。     

参附强心丸治疗慢性心力衰竭的证据概述

目的系统评价参附强心丸联合西药常规治疗慢性心力衰竭的临床疗效及安全性,并进行证据评价。方法计算机检索中国期刊全文数据库、中文科技期刊全文数据库、万方数据库、中国生物医学文献数据库、EMbase、PubMed、the Cochrane Library,检索时间从数据库建库至2019年3月,搜集参附强心丸联合西药常规与西药常规治疗慢性心力衰竭的随机对照试验研究,按照纳入与排除标准筛选及纳入文献,提取病人一般资料、干预措施、观察指标及不良反应等信息,采用RevMan 5.3软件进行Meta分析,并采用GRADE系统对证据质量进行评估。结果共纳入5项研究,涉及421例病人。Meta分析结果显示,参附强心丸联合西药常规治疗心力衰竭可提高左室射血分数[WMD=4.39,95%CI(2.80,5.98),P<0.00001]、降低左室舒张末期内径[WMD=-2.79,95%CI(-3.67,-1.92),P<0.00001]、降低B型利钠肽(P<0.05)、提高6 min步行距离[WMD=40.62,95%CI(6.98,74.25),P=0.02]、改善明尼苏达心力衰竭生活质量量表积分[WMD=-6.83,95%CI(-8.76,-4.90),P<0.00001]、改善中医证候[RR=1.40,95%CI(1.18,1.66),P=0.0001],疗效均优于西药常规治疗,证据评级为低质量;可降低N末端B型脑钠肽前体[SMD=-0.71,95%CI(-0.92,-0.50),P<0.00001],疗效优于西药常规治疗,证据评级为中等质量。结论现有证据表明,参附强心丸联合西药常规治疗慢性心力衰竭可进一步改善病人症状和心功能,提高临床疗效,但临床证据质量偏低。     

Clinical and experimental study of therapeutic effect of Weixibaonizhuan pills on gastric precancerous lesions

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加味左金丸对大鼠胃癌前病变增殖细胞核抗原及B淋巴细胞瘤/白血病-2蛋白表达的影响

[目的] 观察加味左金丸对大鼠萎缩性胃炎(CAG)癌前病变增殖细胞核抗原(PCNA)及B淋巴细胞瘤/白血病-2(Bcl- 2)蛋白表达的影响,并探讨其治疗CAG癌前病变的可能机制。[方法] 采用SP法检测大鼠胃癌前病变自然恢复组,加味左金丸高、中、低剂量组,维甲酸组和正常组大鼠胃黏膜组织中PCNA、Bcl -2 蛋白表达的情况,并计算细胞增殖指数(PI)。[结果] 各治疗组PI及Bcl- 2 蛋白阳性率与自然恢复组比较差异有统计学意义(P<0 .01或<0 .05);其中加味左金丸各治疗组PI值与维甲酸组比较差异有统计学意义(P<0 .05)。[结论] 加味左金丸可能通过对抗PCNA、Bcl 2的激活而抑制PCNA、Bcl -2蛋白的表达发挥治疗作用。     

基于六西格玛管理改进新兴行业从业者职业病风险知晓值研究

目的新兴的高新技术企业职业危害具有隐蔽性、多样性的特点,运用六西格玛质量管理理论在新兴行业中探讨-种循环改进的职业病风险教育体系,以提高从业者对职业病风险的知晓值。方法选取两高新企业根据六西格玛质量管理理论体系,按照定义-测量-分析-改进-控制5步法,对新兴行业企业从业者掌握了解职业病风险的健康教育流程进行分析,找出影响从业者职业病风险知晓值的主要原因。测定该人群职业病风险知晓值、制定改进措施并开展为期1年的基于六西格玛改进的职业病风险健康教育;对照企业则开展1年常规性职业健康教育。两企业从业者职业病风险知晓值采用30％抽样调查获得,差异的比较采用协方差分析。结果影响从业者职业病风险知晓值的主要原因是从业人员基本素质与企业的技术属性之间存在较大落差。改进企业和对照企业从业者职业病风险基线知晓值分别为29．1±13．6和30．9±14．2,差异无统计学意义（P〉0．05）。经过1年的职业病风险健康教育,两企业从业者对职业病风险知晓值分别为76．5±4．3和52．7±1I．9,调整年龄、性别后,风险知晓值的差异仍有统计学意义（P〈0．01）。结论应用六西格玛管理可以有效提高新兴行业从业人员对职业病危害因素的认知程度,有利于开展职业病立体防治工作,既可保障劳动者职业健康又有助于新兴行业的可持续健康发展。     

Quality of life for parents of children with autism spectrum disorders

This project describes health-related quality of life (HRQoL) of parents of children with autism spectrum disorders (ASDs) using mixed methods. Parents of children with ASDs (N = 224) reported on their HRQoL, depression, and caregiving burden using quantitative tools. HRQoL scores were slightly worse than from those in normative populations especially related to stress and mental health. For example, parents reported average HRQoL scores from SF-6D of 0.74, which was clinically significant lower than an average normative U.S. population. 40% of parents reported having clinical depression symptoms. Married parents reported lower depression symptoms than parents who were not. In addition, families with three or more children with special health care needs (CSHCN) reported lower HRQL and higher caregiving burden than families with less CSHCN. In the qualitative study, we conducted five focus groups to gain insight as to the reasons a child's ASD might influence a parent's HRQoL. Qualitative data further supports the notion that parental HRQoL was negatively influenced by their child's ASDs. Studies that seek to quantify the influence of ASDs and to assess the effect of interventions for children with ASDs may consider measuring the effects on family members as well.     

Expression of Eya1 and Six1 is decreased in distal airways of rats with experimental pulmonary hypoplasia

Background/Purpose

Pulmonary hypoplasia (PH) associated with congenital diaphragmatic hernia (CDH) represents one of the major challenges in neonatal intensive care. Eyes absent 1 (Eya1) and sine oculis homebox 1 (Six1) have been identified as essential components of the gene network that regulates foetal lung development. Eya1 and Six1 are expressed in distal epithelial tips of branching airways as well as in surrounding mesenchymal cells, highlighting their important role during branching morphogenesis. Lungs of Eya1^−/− and Six1^−/− knockouts display PH with reduced epithelial branching, appearing to be arrested in the pseudoglandular stage. We hypothesized that Eya1 and Six1 expression is decreased in branching airways of nitrofen-induced PH.

Methods

Time-mated rats received either nitrofen or vehicle on E9.5. Foetal lungs were dissected on E15.5 and divided into control and nitrofen groups, whereas lungs harvested on E18.5 were divided into controls, PH without CDH [PH(−)], and PH with CDH [PH(+)]. Pulmonary gene expression levels of Eya1 and Six1 were analyzed by quantitative real-time PCR. Immunofluorescence staining was performed to investigate Eya1 and Six1 protein expression and localization by confocal laser scanning microscopy (CLSM).

Results

Relative mRNA expression of Eya1 and Six1 was significantly decreased in PH(−) and PH(+) on E18.5 compared to controls. CLSM confirmed markedly diminished immunofluorescence of Eya1 and Six1 in distal airway epithelium as well as in surrounding mesenchymal cells of nitrofen-induced PH on E18.5 compared to controls.

Conclusions

Downregulation of Eya1 and Six1 gene expression in nitrofen-induced PH suggests that decreased Eya1 and Six1 expression during the late pseudoglandular stage may interfere with epithelial branching and distal airway maturation, thus resulting in PH.     

五味安神丸质量标准的建立

摘 要 目的：建立五味安神丸的质量控制标准。 方法: 采用TLC法对方中酸枣仁和白术进行定性鉴别;采用HPLC法测定该药中栀子苷和五味子醇甲的含量。 结果: 酸枣仁和白术的薄层色谱图斑点较为清晰,阴性对照无干扰,具有专属性。HPLC结果显示栀子苷与五味子醇甲分别在6.048~241.920 μg·ml-1（r=0.999 8）与4.392~175.680 μg·ml-1（r=0.999 9）范围内与峰面积呈良好线性关系;平均回收率分别为97.5%（RSD=1.9%）,98.8%（RSD=1.6%）。 结论: 此方法专属性强、精密度高、重复性好,可为建立五味安神丸药品的质量控制提供依据。     

芎麻滴丸对血管性认知障碍大鼠社交行为的影响

目的 观察双侧颈总动脉结扎致血管性认知障碍大鼠社交行为的变化,探讨芎麻滴丸对其干预作用。方法 采用永久性结扎双侧颈总动脉法制备血管性认知障碍模型。实验大鼠随机分为假手术组（生理盐水10 mL·kg^-1）,模型组（生理盐水10 mL·kg^-1）,芎麻滴丸高剂量组（生药1.5 g·kg^-1）,芎麻滴丸低剂量组（生药0.75 g·kg^-1）。模型制备第28,42天采用Morris水迷宫对大鼠的学习记忆能力进行测试;模型制备第7,14,28,42天用社交行为仪检测大鼠社交能力的变化。结果 模型制备第7,14天大鼠社交行为无明显变化,模型制备第28天和第42天,模型组大鼠持续接触时间减少（P<0.05）;模型制备第42天,模型组大鼠接触次数减少,逃避潜伏期显著增加,穿越平台次数显著减少（P<0.01）。与模型组大鼠相比,模型制备第28天,芎麻滴丸高剂量组大鼠接触次数显著增加（P<0.05）;芎麻滴丸高、低剂量组大鼠持续接触时间显著增加（P<0.05或<0.01）;模型制备第42天,芎麻滴丸低剂量组大鼠接触次数和持续接触时间增加（P<0.05）,芎麻滴丸高、低剂量组大鼠逃避潜伏期显著减少（P<0.01）。结论 模型制备第42天大鼠出现学习记忆障碍;模型组大鼠第28天大鼠开始出现社交行为障碍,经芎麻滴丸干预后,接触时间和接触次数增加,即可认为其有效缓解由双侧颈总动脉结扎造成的社交能力障碍,且低剂量效果优于高剂量。     

基于UPLC-Q-TOF-MS和GC-MS的小金丸化学成分识别

目的：采用超高效液相色谱与串联四极杆飞行时间质谱（UPLC-Q-TOF-MS）和气相色谱-质谱联用（GC-MS）技术快速鉴定小金丸中的化学成分,构建较为全面的小金丸化学成分谱,为小金丸药效物质基础研究奠定基础。方法：UPLC-Q-TOF-MS分析采用ACQUITY UPLC BEH C₁₈（Waters,2.1 mm×100 mm,1.7 μm）超高效液相柱,流动相为乙腈-0.1%甲酸水,梯度洗脱;飞行时间质谱采用正、负离子模式扫描,质谱数据以MSE模式采集。UPLC-Q-TOF-MS分析依据离子峰的保留时间、精确分子质量和多级质谱碎片,与文献报道数据和数据库对比,对小金丸的甲醇提取部分化学成分进行在线快速鉴定。GC-MS分析采用Agilent 19091S-433 HP-5MS 5% Phenyl Methyl Silox（Agilent,30 m×250 μm×0.25 μm）毛细管色谱柱,载气为氮气;质谱采用EMV模式：增益因子1.00。GC-MS分析通过增强型NIST4.L标准质谱库进行检索,对小金丸中挥发性成分进行了快速鉴定。结果：从小金丸中共鉴定化学成分118种,主要包括生物碱类24种、有机酸12种、甾体类9种、单萜类5种、倍半萜类16种、二萜类14种、三萜类7种和苯丙素类成分5种,另外还有个别酯类、糖类、氨基酸类和杂环类化合物等。结论：UPLC-Q-TOF-MS和GC-MS方法能快捷、准确、较全面地鉴定小金丸中的化学成分,为小金丸药效物质基础研究提供科学依据,并为中药复方的成分鉴定提供了一种简单快捷的分析鉴定方法。