化疗联合养正消积胶囊治疗中晚期大肠癌临床研究

目的:观察化疗联合养正消积胶囊治疗中晚期大肠癌的临床疗效。方法:将78例中晚期大肠癌患者随机分为观察组和对照组,对照组患者采用化疗治疗,观察组在化疗方案基础上加用养正消积胶囊口服,两组均治疗2个月。比较两组患者治疗后生存质量评分、临床疗效及临床症状改善情况。结果:观察组治疗后生存质量评分为(74.32±12.31)分,明显高于对照组的(67.24±11.98)分,两组比较,差异有统计学意义(P0.05);观察组治疗后有效率为89.74%,对照组有效率为61.54%,两组比较,差异有统计学意义(P0.01);观察组恶心、呕吐、食欲减退症状改善情况优于对照组,差异有统计学意义(P0.01);观察组不良反应明显低于对照组,差异有统计学意义(P0.01)。结论:化疗联合养正消积胶囊治疗中晚期大肠癌可明显提高患者生存质量,改善临床症状,减轻不良反应。     

正交设计结合药效学实验优选桂栀助眠胶囊提取工艺研究

目的优选桂栀助眠胶囊最佳提取工艺。方法在单因素实验结果基础上,采取正交试验法,以干膏得率和栀子苷转移率为指标,考察加水量、提取时间、提取次数3个因素,优选桂栀助眠胶囊最佳水提工艺;以药液浓度、药液含醇量、醇沉时间为考察因素,优选桂栀助眠胶囊最佳醇沉工艺;通过改善睡眠药效学实验对醇沉前后提取物进行比较。结果桂栀助眠胶囊最佳水提工艺为加10倍量水煎煮3次,每次0.5 h;最佳醇沉工艺为水提滤液浓缩至1 mL药液相当于原药材1 g,药液含醇量为80%,醇沉时间为12 h。与阴性对照组比较,桂栀助眠胶囊水提取物能延长戊巴比妥钠小鼠睡眠时间(P0.01),且能增加戊巴比妥钠阈下剂量小鼠入睡率(P0.05);水提醇沉物有延长巴比妥钠小鼠睡眠时间,增加小鼠入睡率的趋势,但差异无显著性(P0.05)。结论醇沉前后提取物药效存在差异,为不影响药效,最终选择水提工艺作为制剂的最佳提取工艺。     

杜仲补天素胶囊改善环磷酰胺诱导的小鼠生精障碍研究

目的采用环磷酰胺(cyclophosphamide,CP)诱导的小鼠生精障碍模型,探究杜仲补天素胶囊(Duzhong Butiansu Capsule,DBC)的生殖保护作用及其机制。方法采用昆明种小鼠ipCP(60mg/kg)制备生精障碍模型,连续5d,第8天起ig给予DBC高、低剂量(1.388、0.694 g/kg)干预4周,给药结束后检测各组小鼠体质量、脏器指数变化,HE染色检测睾丸病理结构变化,ELISA法测定血清睾酮(T)、促卵泡激素(FSH)、促黄体生成素(LH)、丙二醛(MDA)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平;Western blotting及免疫组化法分析睾丸组织中转录因子NF-E2相关因子2(Nrf2)、血红素氧合酶-1(HO-1)、醌氧化还原酶1(NQO1)、组蛋白脱乙酰基酶2(HDAC2)与磷酸化蛋白激酶C(p-PKC)表达。结果与模型组比较,DBC对小鼠体质量下降有极显著干预作用,能够增加睾丸、附睾及肾脏指数,改善睾丸病理形态损伤,增加精子数、提高精子活力、降低精子畸形率,提高T水平,降低LH、FSH水平,降低MDA含量,提高SOD、GSH-Px活性,提高Nrf2、HO-1、NQO1、HDAC2与p-PKC蛋白的表达水平(P0.05、0.01)。结论 DBC能够改善CP诱导的小鼠生精障碍,其机制可能与调节氧化应激相关的Nrf2/抗氧化作用元件(ARE)信号通路有关。     

通络生骨胶囊治疗股骨头坏死(筋脉瘀滞证)的多中心随机、双盲、双模拟、阳性药对照临床研究

目的观察通络生骨胶囊治疗股骨头坏死(筋脉瘀滞证)的有效性及安全性。方法采用多中心随机、双盲、双模拟、阳性药对照临床研究设计,将600例股骨头坏死患者按照2∶1的比例随机分为试验组及对照组。对照组予口服通络生骨胶囊模拟剂、健骨生丸治疗,试验组予口服通络生骨胶囊、健骨生丸模拟剂治疗。两组疗程均为12周,比较两组不同观察时间点(治疗前、治疗4周、治疗8周、治疗12周、停药后4周)的髋关节Harris评分、中医证候积分、股骨头坏死ARCO分期的变化情况,同时评价安全性。结果①治疗4周、治疗8周、治疗12周和停药后4周,两组Harris评分较本组治疗前基线变化率差异有统计学意义(P0.05)。治疗12周、停药后4周组间比较,试验组Harris评分高于对照组(P0.05);治疗8周、治疗12周、停药后4周组间比较,Harris评分较基线变化率差异有统计学意义(P0.05)。②治疗4周、治疗8周、治疗12周、停药后4周,两组中医证候积分较本组治疗前基线下降率差异有统计学意义(P0.05)。治疗4周、治疗8周、治疗12周、停药后4周组间比较,中医证候积分及较基线下降率差异均无统计学意义(P0.05)。③治疗12周组间比较,ARCO分期差异无统计学意义(P0.05)。④两组安全性评价差异无统计学意义(P0.05)。结论通络生骨胶囊治疗股骨头坏死(筋脉瘀滞证)疗效满意,与健骨生丸相比,能更好地改善患者的髋关节功能功能,且安全可靠。     

Acellular dermal matrix reduces capsule formation in two‐stage breast reconstruction

Acellular dermal matrix (ADM) is commonly employed to create an inferior pocket for the tissue expander in two‐stage breast reconstruction. The authors sought to determine whether placement of ADM during the first stage of reconstruction decreases the amount of capsule formation at implant exchange. Patients who underwent mastectomy and tissue expander reconstruction were included in this study. Two biopsies were obtained at the time of implant exchange, one from the pocket adjacent to the ADM and the other from the area adjacent to the pectoralis muscle. Pathology analysis was performed on each sample. Ten patients underwent immediate breast reconstruction with Alloderm during the 3‐month study period. Capsule thickness was significantly greater in the areas where the expander was in direct contact with the pectoralis muscle (782 ± 194 µm) compared to those in contact with human acellular dermal matrix (hADM) (47·91 ± 110·82 µm; P < 0·05). Analysis of the sub‐pectoral capsule demonstrated diffuse deposition of collagen, neutrophils, contractile myofibroblasts and synovia‐like metaplasia, characteristic of a foreign body response. Conversely, within the inferior pocket where the hADM was in direct contact with the expander, we noted migration of host epithelial cells, fibroblasts, mesenchymal cells and angiogenesis, indicating host tissue regeneration. Acellular dermal matrix, when placed at the first stage of breast reconstruction, significantly reduces thickness and inflammatory character of the capsule in comparison to the patient's native tissue.     

Laparoscopic management of a small bowel obstruction secondary to Elipse intragastric balloon migration: A case report

IntroductionThe Elipse™ intragastric balloon (IGB) for weight loss is a swallowable capsule that is filled with 550 mL of fluid and resides in the stomach for four months before being excreted from the gastrointestinal tract. Although initial data showed that use of this device is safe and free from serious complications, we report for the first time the successful management of an Elipse™ IGB-related adverse event.Presentation of caseA 41-year-old woman presented to our emergency department following two days of abdominal pain, vomiting, and constipation. Her medical history included four caesarean sections and insertion of the Elipse™ IGB 16 weeks prior to presentation. The patient was vitally stable at presentation and abdominal examination revealed a mildly distended abdomen. Plain X-ray revealed a small bowel obstruction (SBO), and a double contrast computed tomography scan showed a dilated small bowel with mild free fluid proximal to a transition zone at the distal jejunum. Laparoscopic enterotomy was performed just proximal to the obstruction site, and the balloon was visualized and extracted after it had been incised and emptied. The enterotomy incision was closed with an intracorporeal continuous absorbable suture. The patient’s recovery was uneventful and she was discharged on postoperative day 4.DiscussionWe discuss the possible etiologies of SBO following Elipse™ IGB insertion, and present a brief literature review regarding surgical and nonsurgical management options for such cases.ConclusionAlthough initial data showed the Elipse™ IGB to be safe, complications can occur and be managed successfully.     

百乐眠胶囊治疗非器质性失眠症的对照研究

目的：观察百乐眠胶囊治疗失眠症的疗效和安全性。方法：将120例非器质性失眠症患者随机分成百乐眠胶囊治疗组(n=44),乌灵胶囊治疗组(n=39)以及奥沙西泮治疗组(n=41),其中百乐眠胶囊组服用百乐眠胶囊2粒每日二次治疗,乌灵胶囊组治疗剂量服用乌灵胶囊3粒每日三次,奥沙西泮组服用奥沙西泮15-30mg/日治疗,治疗持续4周,治疗前及治疗第4周末用匹兹堡睡眠质量指数(PSQI)和失眠严重程度指数(ISI)评定患者的失眠严重程度及疗效,同时用副反应量表(TESS)和实验室检查评估治疗安全性。结果：治疗后百乐眠胶囊组,乌灵胶囊组,奥沙西泮组的PSQI分数分别为(6.14±2.11),(7.45±2.42),(6.10±1.90),均较治疗前显著下降,三组间存在差异(F=5.12,P<0.01),百乐眠组PSQI分数显著低于乌灵胶囊组(Q=3.9213,P<0.01),但是与奥沙西泮组相比没有显著差异(Q=0.1213,P>0.05)。同时治疗后三组的ISI分数分别为(12.30±3.55),(14.42±4.18),(11.93±3.19),均较治疗前显著下降,(F=10.19,P<0.01),百乐眠胶囊组ISI分数显著低于乌灵胶囊组(Q=5.1262,P<0.01),但是与奥沙西泮组相比没有显著差异(Q=0.9065,P>0.05)。奥沙西泮组不良反应显著高于百乐眠胶囊组。结论：百乐眠胶囊治疗非器质性失眠症疗效良好,不良反应少,患者依从性较好。     

基于二维斑点追踪成像技术探讨参松养心胶囊对阵发房颤患者左心房功能影响的临床研究

[目的]应用二维斑点追踪成像技术评价参松养心胶囊对阵发性房颤患者左心房功能的影响及临床疗效观察。[方法]选取来本院就诊的气阴两虚型阵发房颤住院患者60例随机分为对照组和观察组,对照组给予单纯胺碘酮治疗,观察组给予参松养心胶囊联合胺碘酮治疗,疗程为3个月。应用超声心动图二维斑点追踪成像技术检测左心房功能的变化并观察临床疗效。[结果]两组患者治疗后与治疗前自身比较收缩期左心房整体长轴应变(GLS)、左心房壁各节段收缩期平均峰值应变率(mSRs)、舒张早期平均峰值应变率(m SRe)、舒张晚期平均峰值应变率(mSRa)均显著增加(P0.05),治疗后观察组左心房GLS、mSRs、m SRe、m SRa均显著高于对照组(P0.05)。治疗后观察组患者症状总积分和显效率与对照组相比差异有统计学意义(P0.05)。[结论]参松养心胶囊有助于改善阵发房颤患者左心房的储存器功能、管道功能及辅泵功能,改善症状,提高治疗显效率,具有良好的临床效果。     

归芪活血胶囊联合硫酸氨基葡萄糖治疗颈椎病的临床疗效观察

目的:探讨归芪活血胶囊联合硫酸氨基葡萄糖对颈椎病的治疗效果。方法:选取2016年6月至2018年6月青海大学附属医院收治的颈椎病患者100例作为研究对象,随机分为对照组和观察组,每组50例。对照组患者口服硫酸氨基葡萄糖,2次/d,500 mg/次;观察组在对照组基础上口服归芪活血胶囊,1粒/次,3次/d,2组均连续治疗1个月。通过治疗后临床疗效,X线片检测治疗前后颈椎弧度变化;经颅多普勒(TCD)检测治疗前后基底动脉(BA)和左右双侧椎动脉(LVA和RVA)血流速度变化评价2组的治疗效果。结果:观察组临床总有效率达到96%,无效率仅为4%;对照组总有效率达到84%,无效率为6%,观察组效果显著优于对照组,2组比较差异有统计学意义(P 0. 05)。2组治疗后颈椎弧度均有改善,观察组增大到(11. 62±3. 78) mm,2组比较差异有统计学意义(P 0. 05)。治疗后2组基底动脉和左右双侧椎动脉血流速度均有改善,2组治疗前后比较,差异均有统计学意义(P 0. 05),观察组效果优于对照组,2组比较差异有统计学意义(P 0. 05)。结论:归芪活血胶囊联合硫酸氨基葡萄糖对颈椎病效果显著,适合推广。     

桂枝茯苓胶囊对实验性子宫内膜异位症痛经作用及机制

目的：研究桂枝茯苓胶囊（GZFLC）对实验性子宫内膜异位症痛经作用机制。方法：将60只SD雌性大鼠随机分为假手术组、模型组、散结镇痛胶囊组、GZFLC高、中、低剂量组（0.54、0.27、0.14 g?kg-1）组,每组10只。每天灌胃给药,连续28 d。观察各组扭体反应,测量移植物体积并进行病理检测,采用免疫组化法检测异位灶NGF、TRPV1 蛋白的表达。结果：与模型组比较,散结镇痛胶囊组和GZFLC高、中、低剂量组大鼠扭体次数显著减少（P ＜ 0.01）,其抑制率分别为51.1%、63.2%、60.4%、47.1%。与模型组比较,散结镇痛胶囊组和GZFLC高、中、低剂量组大鼠移植物体积显著减少（P ＜ 0.01）,其抑制率分别为61.9%、66.0%、59.1%、56.6%。与模型组比较,GZFLC高、中剂量组可显著降低子宫内膜异位症痛经大鼠异位组织的病理学评分及NGF、TRPV1 蛋白的表达。结论：GZFLC对实验性子宫内膜异位症痛经具有一定治疗作用,其机制与抑制NGF、TRPV1蛋白表达相关。