大柴胡汤加减方治疗急性胰腺炎的临床研究

目的：探讨大柴胡汤加减方治疗急性胰腺炎的临床疗效。方法：将68例急性胰腺炎患者随机分成实验组（34例）和对照组（34例）,实验组在常规治疗基础上联合大柴胡汤加减方经胃管注入进行治疗,对照组在常规治疗基础上,给予5％的红糖水经胃管注入,比较两组疗效。结果：实验组的总有效率（94．2％）优于对照组（73．5％）（P〈0．05）;治疗后．实验组胰腺Balthazar CT评分值、APACHEII评分值明显低于对照组（P〈0．05）。结论：在常规基础上应用大柴胡汤加减方治疗,能明显改善急性胰腺炎患者的临床症状,减少并发症和病死率,改善患者的预后。     

国内外突发事件卫生应急体系和反应能力的比较研究

目的 比较研冤国内外突发手件卫生厘急反应,分析各国哭发手件卫生应急反应体糸建设特点,提出符合我国实际的针对突发事件卫生应急防制策略和应对措施。方法 应用循证医学的思想,采用文献回顾的方法,对Pubmed、国内各大数据库、报纸杂志、官方网站的信息进行广泛收集,对符合研究标准的纳入文献,进行综合评价。结果 美、英、俄、日的法制建设较为健全,组织管理体系也较为健全,应急反应人员也更为专业,应急能力较强;公共卫生方面的投入美国居首,英、日相当,中、俄相对较低,美、英、日信息服务和反馈较迅速,后勤保障良好。结论 应结合我国实际在卫生应急的各个方面有所加强,加强同各国的经验交流,建立健全符合我国实际的应对突发事件的机制,提高我国突发事件卫生应急能力。     

网络游戏成瘾玩家心理健康状况及人格分析

目的探讨网络游戏成瘾玩家心理健康状况及人格特征．方法采用网络成瘾测验、症状自评量表（SCL-90）、艾森克人格问卷（EPQ）对网络游戏魔兽世界79名玩家进行测试．结果在心理症状方面,除精神病性和其他因子外,网络游戏成瘾玩家的SCL-90其余因子和总分均高于网络游戏未成瘾玩家（P〈0.01）．在人格特质方面,网络游戏成瘾玩家在外向性维度上得分低于网络游戏未成瘾玩家（P〈O.01）,网络游戏成瘾玩家在精神质、神经质、掩饰性三个维度上得分高于网络游戏未成瘾玩家（P〈0.01）．结论网络游戏成瘾玩家存在心理健康状况不良现象并具有明显的人格特征．     

Profiling of the pattern of the human TRB/IGH–CDR3 repertoire in primary biliary cholangitis patients

IntroductionPrimary biliary cholangitis (PBC) is characterized by lymphocyte cell-induced immune destruction of cholangiole. However, the immunological characteristics of peripheral blood cells in PBC patients remain unknown. This study was designed to reveal the differences in the immunological characteristics between PBC patients and healthy adults.MethodsWe performed high-throughput sequencing to determine the TRB–CDR3 and IGH–CDR3 repertoires of T and B cells in 19 healthy controls and 29 PBC patients. Different immunological characteristics, such as distinctive complementarity determining region 3 (TRB–CDR3) lengths, usage bias of V and J segments, and random nucleotide addition were identified in PBC and healthy control (HC) groups.ResultsThe diversity of TRB–CDR3 was significantly lower in the PBC group compared with the HC group. CDR3 and the N addition length distribution were significantly changed compared with the HC group. It appeared that the PBC group had more short N additions and the HC group had more long N additions in the TRB–CDR3 repertoire. The results also revealed a set of PBC-associated clonotypes compared with the HC group.ConclusionThis study suggested that PBC is a complex autoimmune disease process with evidence of different TRB–CDR3 rearrangements compared with healthy adults that share IGH–CDR3 peptides with some autoimmune diseases. This new insight may contribute to a better understanding of the immune functions of PBC patients and benefit efficient applications of PBC diagnosis and treatments.     

The occurrence of non-anatomical therapeutic chemical-international nonproprietary name molecules in suspected illegal or illegally traded health products in Europe: A retrospective and prospective study

The General European Official Medicines Control Laboratory (OMCL) Network (GEON), co-ordinated by the European Directorate for the Quality of Medicines & HealthCare (EDQM), regularly organises market surveillance studies on specific categories of suspected illegal or illegally traded products. These studies are generally based on a combination of retrospective and prospective data collection over a defined period of time. This paper reports the results of the most recent study in this context with the focus on health products containing non-Anatomical Therapeutic Chemical-International Nonproprietary Name (ATC-INN) molecules. In total 1104 cases were reported by 16 countries for the period between January 2017 and the end of September 2019. The vast majority of these samples (83%) were collected from the illegal market, while only 3% originated from a legal source. For the rest of the samples, categorisation was not possible. Moreover, 69% of all the reported samples were presented as medicines, including sexual performance enhancers, sports performance enhancers, physical performance enhancers and cognitive enhancers or nootropic molecules that act on the central nervous system (CNS). Although the popularity of anabolics, PDE-5 inhibitors and CNS drugs in illegal products has already been reported, the study showed some new trends and challenges. Indeed, 11% of the samples contained molecules of biological origin, that is, research peptides, representing the second most reported category in this study. Furthermore, the study also clearly shows the increasing popularity of Selective Androgen Receptor Modulators and nootropics, two categories that need attention and should be further monitored.     

中国2009-2017年医疗卫生行政处罚案件情况分析

目的了解中国2009-2017年医疗卫生行政处罚案件情况,以提高医疗卫生监督工作质量。方法对《中国卫生统计年鉴》(2010-2018年)数据进行整理,形成Excel数据库,利用SPSS20. 0进行统计分析。结果 2017年中国医疗卫生处罚案件49 435件,监督员人均办案0. 76件;案均罚款额3 469. 18元;无证行医案件数量占比32. 69%;有证单位以"使用非卫生技术人员"为主要违法行为;"违反抗菌药物临床应用管理规定"案件查处成效显著;执法程序以一般程序为主,且占比处于上升趋势。结论严厉查处各类医疗卫生违法行为的同时严肃查处违反《抗菌药物临床应用管理办法》的案件;规范执法程序,确保履职到位;强化行政干预,提高宏观管理能力。     

Safety and utility of atropine addition during dobutamine stress echocardiography for the assessment of viable myocardium in patients with severe left ventricular dysfunction

Objective To assess the feasibility safety and side effects of the additionof atropine to dobutamine stress echocardio-graphy for the detectionof viable myocardium in patients with left ventricular dysfunction(ejection fraction 35%) prior to coronary revascularization. Background The assessment of viable and/or ischaemic myocardium has highprognostic value as regards improvement of function and survivalafter coronary revasculariz-ation. The addition of atropineto dobutamine during echocardiographic testing for the presenceof viable myocardium is not common practice. Consequently, nodata exist on the safety and additional diagnostic value ofthis practice. Methods Two hundred patients with left ventricular ejection fraction35% were studied. Results Test end-points were: target heart rate in 164 (82%) of thepatients, severe angina in 18 (9%), maximum dobutamine–atropinedose in six (3%), severe ST segment changes in five (2%), cardiacarrhythmias in four (2%), and hypotension in three (1%). Viabilitycould be assessed echocardiogaphically in 105/200 (53%) froma biphasic response (improvement of wall motion with low dosedobutamine and worsening with high dose), in 93 from ischaemiaand in 12 from sustained or late improvements. In 36/105 (34%)patients, ischaemic myocardium could only be assessed afterthe addition of atropine. Cardiac arrhythmias occurred in 11/200(6%) and hypotension (decrease of systolic blood pressure >30mmHg)in 21/200 (11%). Neither the use of atropine nor the inductionof ischaemia were associated with an increased incidence ofcardiac arrhythmias or hypotension. Conclusions In a large group of patients with severe left ventricular dysfunction,dobutamine stress echocardiography is feasible and safe in 186/200(93%); the addition of atropine was necessary in 34% to assessmyocardial viability. Hypotension and cardiac arrhythmias werethe most frequent side effects, but were not related to theinduction of ischaemia or addition of atropine.The EuropeanSociety of Cardiology     

几种常用药物联用计算方法的数学瑕疵和一带一线模型法的解决方案

多药联用在临床实践中很常见,药物间的相互作用会使药物效应发生改变,联用组合有可能使疗效增加和毒性减少,也有可能会带来药效降低和毒性增大的风险。已有多种计算方法用于定量评价药物联用产生的协同、相加和拮抗,但业内所用的许多计算方法均为共识性方法或经验公式,同一组数据用不同的方法处理,常会得出不同的、相互矛盾的结论。本文用数学方法分析了业内常用的几种计算方法的瑕疵,包括:Loewe等效线法、Bliss独立模型法、周氏中效法和金氏法等,并通过介绍本实验室发现的药物联用药效相加的数学规律,发展了具有自主知识产权的一带一线模型法,作为解决多药联用效应定量评价的通用方案,为充分体现多药联用带来的益处和规避多药联用带来的疗效和毒性风险提供可靠的计算方法。     

辣椒粉中非法添加苏丹红的测定方法研究

目的建立HPLC法和液质联用法测定辣椒粉中非法添加的苏丹红。方法供试品用丙酮超声涡旋提取,采用HPLC法和液质联用法进行测定。色谱柱采用Agilent-C_(18)(100mm×4.6mm,3.5μm)柱;流动相为1mL·L~(-1)甲酸溶液-乙腈(85∶15)和1mL·L~(-1)甲酸的乙腈溶液-丙酮(80∶20);梯度洗脱;流速:1.0mL·min~(-1);检测波长:苏丹红Ⅰ478nm;苏丹红Ⅱ、Ⅲ和Ⅳ520nm;柱温:30℃。质谱条件:以三重四级杆电喷雾离子源(ESI+)扫描,干燥气体温度:300℃,干燥气体流速:3.0mL·min~(-1)。结果苏丹红Ⅰ~Ⅳ质量浓度在0~10μg·mL~(-1)范围内线性关系良好(r≥0.998);平均加样回收率均大于85%;质谱分辨率良好,方法专属性强。结论该方法操作简便、灵敏度高、结果准确、专属性强,可用于辣椒粉的质量控制。     

Gold-silver-palladium alloys for laser irradiation —Effects of gold addition—

The clasp arms are fatigued by wearing a denture, by taking it off, and by occlusion. We routinely use laser irradiation to harden only the surface layer of clasp arms consisting of gold-silver-palladium alloy partially hardened by laser irradiation to resist fatigue. Recently we tested laser irradiation on silver-palladium-copper alloys, and obtained the following results: