麻黄-甘草药对抑制过敏性哮喘的效应及机制初探

目的 研究麻黄-甘草药对对过敏性哮喘的影响,并初步探讨其作用机制。方法 建立屋尘螨（HDM）诱导的过敏性哮喘模型,造模同时给予麻黄-甘草药对提取物（MG）。使用无创肺功能仪检测小鼠气道反应性,HE染色观察小鼠肺组织病理学变化,Masson染色观察小鼠肺组织的胶原沉积情况,进行血液嗜酸性粒细胞（EOS）计数,ELISA法检测支气管肺泡灌洗液（BALF）及肺组织IL-4、IL-5、IL-13、TGF-β1及血清IgE的表达,免疫组化检测肺组织E-cadherin、N-cadherin、Vimentin、α-SMA和TGF-β1蛋白表达情况。结果 MG可显著降低气道高反应性,抑制BALF及肺组织IL-4、IL-5和IL-13的表达,降低血液EOS及血清IgE的表达,并且减轻肺组织的炎症浸润及胶原沉积。进一步结果表明MG可抑制肺组织TGF-β1的表达,上调E-cadherin以及下调N-cadherin、Vimentin、α-SMA的表达。结论 MG能够通过抑制支气管上皮间质转化,从而缓解气道的炎症状态以及改善哮喘的气道重塑,进而发挥对过敏性哮喘的治疗作用。      

尤昭玲教授运用炒炭类药物治疗子宫切口假腔经验

子宫切口假腔即剖宫产术后子宫切口憩室,该病作为剖宫产术后的远期并发症之一,严重影响育龄妇女的身心健康,属于现代临床中较难治愈的妇科疾病之一。目前,现代医学对此尚无确切有效且系统的治疗方法。根据患者的临床症状,可归纳为"经期延长"、"崩漏"、"月经过多"等范畴。尤昭玲教授认为,气虚不摄,瘀热互结是本病基本病机,自创"三期三法"诊疗理论,运用炒炭药收涩、止血、抗炎等功效治疗子宫切口假腔,在临床治疗中疗效显著。     

金银花配方颗粒评价性抽验结果分析与建议

目的：通过开展金银花配方颗粒评价性抽验,比较分析不同厂家金银花配方颗粒的质量情况,并提出监管建议。方法：收集各企业金银花配方颗粒质量标准,依据企业标准进行法定检验。结果：共抽验117批金银花配方颗粒,涉及9家生产企业。按各自企业标准进行检验,总体合格率为100%。但是各企业之间金银花配方颗粒含量差异较大且每克颗粒相当的药材（饮片）量不同,转移率不同。结论：通过本次抽验发现金银花配方颗粒的整体质量较高,但是不同厂家之间所用原料药材及生产工艺存在一定差异,导致最终产品质量参差不齐。因此,有必要规范中药配方颗粒生产工艺,尽快统一标准,加强监管。     

Prescribing of the antidepressant duloxetine: Can local clinical audit findings facilitate medicines management decisions?

Introduction. Discussions regarding the inclusion of a new antidepressant within local formulary lists and prescribing guidelines may be facilitated by audits of local prescribing practice, conducted some months after the drug first becomes available for clinical use. Method. Development of five audit standards and retrospective case-note review of prescribing recommendations for the serotonin-noradrenaline reuptake inhibitor duloxetine, made in five local outpatient clinics. Results. Follow-up data were available for audit in 27 of 43 sets of medical notes. In the majority of patients (84%), the primary diagnosis was recurrent unipolar depressive disorder, the current episode having proven resistant to treatment with two other antidepressants. Where comments were made, notes indicated that 81% of patients that received duloxetine had improved and 94% had tolerated it without reported problems. Conclusions. In this sample, duloxetine prescribing in the first months after it became available appeared to occur within an appropriate patient group. Prospective evaluations in other clinical samples are warranted.     

Antithrombotic effects of Huanglian Jiedu decoction in a rat model of ischaemia-reperfusion-induced cerebral stroke

ContextHuanglian Jiedu Decoction (HLJJD) has a variety of pharmacological activities, such as anti-inflammatory and neuroprotection against ischaemic brain injury.ObjectivesThis ex vivo study explores its antithrombosis activity and inhibition of platelet aggregation.Material and methodsTo study the antithrombosis activity of HLJJD ex vivo, saline, or HLJDD (100, 200, and 500 mg/kg) was treated prophylactically by gavage for 3 days in Wistar rats (n = 4). Based on the rat model of transient middle cerebral artery infarction (MCAO) or normal rats (n = 4), the antithrombotic activity in the normal group and HLJDD subgroups on prothrombin time, thrombus weight, platelet aggregation, and others was evaluated, followed by the antiplatelet aggregation of its main components (n = 4).ResultsThe weight of the thrombus increased significantly at 24 h after MCAO onset. HLJJD did not influence the change of PT, but significantly inhibited thrombosis by 12.5, 20.0, and 20.5% in reducing the dry weight of thrombus, and blocked collagen-induced platelet aggregation by 25.5, 39.0, and 42.7% and adhesion of blood platelet by 17.3, 26.2, and 27.3%. The IC₅₀ value of HLJJD on collagen-induced platelet aggregation was 670 mg/kg. Geniposide only facilitated antiplatelet aggregation induced by collagen, but not AA or ADP. Both baicalin and berberine showed markedly antiplatelet aggregation induced by all activators. The antithrombotic activity of baicalin was relatively higher than that of berberine (35.0–47.8% vs. 20.6–33.5%).ConclusionOur results indicated that HLJDD regulated blood circulation by inhibiting platelet aggregation and thrombosis, which might also extensively contribute to the clinical prevention and treatment of cerebrovascular diseases.     

Access to Cytotoxic Medicines by Children With Cancer: A Focus on Low and Middle Income Countries

Background

The Essential Medicines Working Group of the International Society of Pediatric Oncology (SIOP) has proposed a list of antineoplastic drugs that should be available in low and middle income countries.

Procedure

Data were extracted on the listing of 18 essential and 8 ancillary antineoplastic medicines in the national essential medicines lists (NEMLs) or national reimbursable medicines lists (NRMLs) of 135 countries with gross national income (GNI) per capita of less than US $25,000. Correlations between numbers of medicines listed and GNI per capita, annual government health expenditure (AGHE) per capita, and the number of physicians per million people were examined.

Results

Listing of the 18 essential antineoplastic drugs ranged from 27% (thioguanine) to 95% (methotrexate). The median number of medicines listed was 7 (0–18) in low income countries (n = 26) and 14 in lower‐middle (n = 42), upper‐middle (n = 44), and high income countries (n = 20). For the ancillary eight medicines, the median was one (0–8) across the 135 countries. Correlations with GNI per capita (r = 0.17, P = 0.0266) and physician density (r = 0.25, P = 0.0017) were statistically significant; not so for AGHE per capita (r = 0.00, P = 0.5000).

Conclusions

There was large variability within income groups in numbers of antineoplastic agents identified as essential in NEMLs and NRMLs. While not a direct measure of availability, listing is an important step, guiding procurement for the public sector. These results focus attention on deficits in NEMLs and NMRLs as a step to improving access to effective antineoplastic medicines for cancers in children in low and middle income countries. Pediatr Blood Cancer © 2015 Wiley Periodicals, Inc.     

The Internet and lifestyle drugs: an analysis of demographic characteristics,methods, and motives of online purchasers of illicit lifestyle drugs in the Netherlands

Abstract

Aims: The Internet has marked a revolution in the supply of illegal drugs, while at the same time, new types of illegal and semilegal drugs increasingly are becoming available. In order to deepen our understanding of the demand and supply of these new drugs on the Internet, this study focuses on the demographic characteristics, methods and preferences of people who purchase ‘lifestyle drugs’ through the surface web.

Methods: Data were obtained through the following two surveys: a prevalence study of 50,848 Dutch respondents and an in-depth study of 153 people who have purchased lifestyle drugs online.

Findings: At least 10.2% of the Dutch adult population has bought medicines online; the majority being lifestyle drugs (5.2%). In addition, an estimated 1.6% of the Dutch population has purchased medicines illicitly, with the majority of products concerning lifestyle drugs (0.9%). Illicit lifestyle drugs are primarily purchased through e-commerce sites and online pharmacies, and users report high satisfaction rates.

Conclusion: Purchasing lifestyle drugs is characterised by specific online dynamics, as the drugs are often openly accessible and the boundaries between legal and illegal sale blurred. As new types of drugs become available, it is important to further monitor customers’ preferences and experiences.     

对上海青浦区基本药物目录中抗高血压药物可负担性的实证研究

目的 评估基本药物制度下上海青浦区口服抗高血压药物的可负担性,为促进社区慢性病基本药物价格合理性提供实证依据。方法 采用WHO/HAI标准化法和贫化法对该地区口服抗高血压药物的可负担性进行评价。结果 用WHO/HAI标准化法评价结果显示,医疗保险患者对原研药和仿制药的可负担性都较好,而自费患者对原研药的可负担性较差。贫化法结果显示,使用同一通用名的5种原研药和仿制药的致贫人口数量差距较小。厄贝沙坦原研药的可负担性高于仿制药。结论 医疗保险对提高基本药物可负担性作用明显,同时要对一些具有明确循证学证据和使用人群广泛的药物给予合理的定价,以提高治疗高血压药物的可负担性。