不同剂量丙泊酚预防小儿术后躁动的效果和安全性分析

目的：探讨不同剂量丙泊酚对预防小儿术后躁动的影响。方法选择2012年9月至2013年6月在泸州医学院附属中医院择期行斜疝修补术的小儿60例,分为Ⅰ、Ⅱ、Ⅲ3组,3组患儿均采用七氟醚进行全身麻醉,术后分别采用0．10 mL／kg 的0．90％氯化钠注射液静脉注射、1．00 mg／kg 丙泊酚静脉注射1次和1．00 mg／kg 丙泊酚静脉注射2次,比较 3组患儿术后30 min 内躁动的发生率,并对患儿进行麻醉苏醒烦躁评分、Aldrete 改良评分和苏醒时间及出室时间比较。结果Ⅰ、Ⅱ、Ⅲ组患儿30 min 内躁动发生率分别为65．00％、25．00％及15．00％,3组患儿比较差异有统计学意义（P ＜0．05）;3组患儿在麻醉苏醒烦躁评分、Aldrete 改良评分和苏醒时间比较,差异有统计学意义（P ＜0．05）,3组患儿出室时间比较,差异无统计学意义（P ＞0．05）。结论术后采用1．00 mg／kg 丙泊酚静脉注射2次,预防小儿术后躁动效果明显,安全性好,具有重要的临床参考价值。     

石菖蒲大孔树脂不同洗脱部位高效液相图谱与抗抑郁效应的关联性研究

目的：研究石菖蒲大孔树脂不同洗脱部位高效液相图谱与抗抑郁效应的关联性。方法采用AB‐8大孔树脂制备石菖蒲不同部位。采用梯度洗脱法建立石菖蒲原药材及不同树脂洗脱部位的高效液相特征图谱,并确认图谱中特征峰及对应特征峰之间的峰面积数据关系。运用小鼠悬尾实验（TST）、游泳实验（FST）等小鼠行为学实验,观察口服石菖蒲及不同树脂洗脱部位抗抑郁效应。结果石菖蒲原药材及不同AB‐8树脂洗脱部位的特征图谱具有特征共有峰。石菖蒲大孔树脂90％及70％乙醇洗脱部分能显著缩短TST和FST。石菖蒲抗抑郁效应与特征峰具有关联性。结论石菖蒲具有抗抑郁作用,其主要抗抑郁效应来源于AB‐8树脂70％及90％乙醇洗脱部位。石菖蒲液相特征图谱及相关峰数据关系可用于衡量石菖蒲的抗抑郁效应,为今后石菖蒲用于抗抑郁效应研究及开发提供依据。     

张锡纯镇肝熄风汤中茵陈品种初探

笔者通过研究张锡纯的生活地域,行医地域,探究张锡纯镇肝熄风汤中茵陈这味药的来源。虽然仍然无法最终确定张锡纯镇肝熄风汤中所用茵陈的品种究竟为何,但至少可以确定:1张锡纯所用茵陈的分布范围应包括华北东北一带,所以主要在南方才被称作茵陈的品种,可判定其并非镇肝熄风汤中所用。2由于生长周期的差异,可以判定这里的茵陈并不是现代植物学意义上的青蒿,也即并非菊科植物黄蒿,张锡纯在《医学衷中参西录》里记载"青蒿之幼苗"等语当有其他原因,因此并不能用现代意义上的青蒿的嫩苗来代替茵陈。3从性状上对比,不论是在分布地域上与张氏生前活动地域有所重叠的玄参科植物阴行草,还是药典所载的菊科植物滨蒿和茵陈蒿,与张锡纯所载茵陈都有所出入。因此亦不能简单认为张锡纯镇肝熄风汤中所载茵陈便是现代植物学意义上的茵陈。     

Toxicity profiles and solvent–toxicant interference in the planarian Schmidtea mediterranea after dimethylsulfoxide (DMSO) exposure

To investigate hydrophobic test compounds in toxicological studies, solvents like dimethylsulfoxide (DMSO) are inevitable. However, using these solvents, the interpretation of test compound‐induced responses can be biased. DMSO concentration guidelines are available, but are mostly based on acute exposures involving one specific toxicity endpoint. Hence, to avoid solvent–toxicant interference, we use multiple chronic test endpoints for additional interpretation of DMSO concentrations and propose a statistical model to assess possible synergistic, antagonistic or additive effects of test compounds and their solvents. In this study, the effects of both short‐ (1 day) and long‐term (2 weeks) exposures to low DMSO concentrations (up to 1000 µl l^?1) were studied in the planarian Schmidtea mediterranea. We measured different biological levels in both fully developed and developing animals. In a long‐term exposure set‐up, a concentration of 500 µl l^?1 DMSO interfered with processes on different biological levels, e.g. behaviour, stem cell proliferation and gene expression profiles. After short exposure times, 500 µl l^?1 DMSO only affected motility, whereas the most significant changes on different parameters were observed at a concentration of 1000 µl l^?1 DMSO. As small sensitivity differences exist between biological levels and developmental stages, we advise the use of this solvent in concentrations below 500 µl l^?1 in this organism. In the second part of our study, we propose a statistical approach to account for solvent–toxicant interactions and discuss full‐scale solvent toxicity studies. In conclusion, we reassessed DMSO concentration limits for different experimental endpoints in the planarian S. mediterranea. Copyright © 2014 John Wiley & Sons, Ltd.     

不同稀释浓度的痰热清注射液对急性上呼吸道感染患儿的疗效与安全性影响

目的:考察不同稀释浓度的痰热清注射液对儿童急性上呼吸道感染(children with acute upper respiratory tract infection,AURTI)的疗效与安全性。方法:抽取2018年1月—12月间收治的采用痰热清注射液治疗的AURTI患儿108例资料,按照痰热清注射液的稀释浓度不同将其分为高浓度组29例、中浓度组40例和低浓度组39例;分析不同痰热清注射液的稀释浓度对各组患儿的临床症状复常时间、总有效率和用药期间不良反应发生率差异。结果:高、中浓度组患儿用药后症状和体征的恢复时间相当(<5 d),但早于低浓度组(<7 d);高、中浓度组用药后的总有效率分别为89.66%和87.50%,经两组间比较其差异无统计学意义(P>0.05),但均显著高于低浓度组(64.10%);中、低浓度组患儿治疗期间不良反应发生率分别为7.50%和5.13%,经两组间比较其差异无统计学意义(P>0.05),但均显著低于高浓度组(31.03%)。结论:痰热清注射液不同稀释浓度对治疗AURTI患儿的疗效和安全性影响较大;适当稀释痰热清注射液的浓度不仅具有良好的临床疗效,而且安全性较高。     

Searching for the elusive neural substrates of body part terms: A neuropsychological study

Previous neuropsychological studies suggest that, compared to other categories of concrete entities, lexical and conceptual aspects of body part knowledge are frequently spared in brain-damaged patients. To further investigate this issue, we administered a battery of 12 tests assessing lexical and conceptual aspects of body part knowledge to 104 brain-damaged patients with lesions distributed throughout the telencephalon. There were two main outcomes. First, impaired oral naming of body parts, attributable to a disturbance of the mapping between lexical-semantic and lexical-phonological structures, was most reliably and specifically associated with lesions in the left frontal opercular and anterior/inferior parietal opercular cortices and in the white matter underlying these regions (8 patients). Also, 1 patient with body part anomia had a left occipital lesion that included the “extrastriate body area” (EBA). Second, knowledge of the meanings of body part terms was remarkably resistant to impairment, regardless of lesion site; in fact, we did not uncover a single patient who exhibited significantly impaired understanding of the meanings of these terms. In the 9 patients with body part anomia, oral naming of concrete entities was evaluated, and this revealed that 4 patients had disproportionately worse naming of body parts relative to other types of concrete entities. Taken together, these findings extend previous neuropsychological and functional neuroimaging studies of body part knowledge and add to our growing understanding of the nuances of how different linguistic and conceptual categories are operated by left frontal and parietal structures.     

半夏-陈皮“异病同治”咳嗽和冠心病的网络药理学作用机制研究

目的：通过网络药理学探讨中药药对半夏-陈皮治疗咳嗽、冠心病的分子机制,以探究该药对“异病同治”的共同作用机制。方法：从TCMSP、BATMAN-TCM数据库得出半夏-陈皮的活性成分及潜在靶标,从DisGeNET 、OMIM、Drug Bank数据库得出与咳嗽、冠心病相关的疾病基因,并与半夏-陈皮潜在靶标进行映射,得出药对治疗两种疾病的共同靶标,将其输入String数据库及DAVID数据库,分别构建PPI网络、GO分析及KEGG PATHWAY分析。将半夏-陈皮治疗咳嗽、冠心病的活性成分及疾病基因输入Cytoscape软件,分别构建半夏-陈皮治疗咳嗽、冠心病的“活性成分-靶标”网络图。结果:研究发现半夏-陈皮治疗咳嗽的基因有49个、有效成分69个,治疗冠心病的基因有342个,有效成分87个,其中治疗两种疾病的交集靶标共有24个。构建PPI网络发现,交集靶标中排名前3的靶标蛋白为IL1B、TNF、CXCL8。DAVID分析发现,治疗咳嗽的作用机制与TNF通路、T细胞受体信号通路、Toll样受体通路等25个通路相关。药对治疗冠心病的主要通路涉及HIF-1通路、TNF通路、AMPK通路等127个通路。“异病同治”的主要信号通路涉及NOD样受体信号通路、TNF通路、NF-κB通路、TGF-β等30个信号通路相关。结论：通过此次分析发现,半夏-陈皮药对“异病同治”的作用机制可能与作用NOD样受体信号通路、TNF通路、NF-κB通路、TGF-β等炎症相关通路。     

从ICU继发感染者不同标本中分离鲍曼不动杆菌耐药性分析

目的分析从ICU重症患者不同标本类型中分离出的鲍曼不动杆菌的耐药性差异,为有效预防和控制ICU内鲍曼不动杆菌感染提供依据。方法回顾性分析本院2010年1月至2014年12月住院ICU患者送检标本中分离的568株鲍曼不动杆菌临床资料。结果从ICU感染患者中分离的鲍曼不动杆菌主要来源为痰液(60.0%);药敏试验表明鲍曼不动杆菌对常用抗菌药物的耐药率呈普遍多重耐药,对替加环素、头孢哌酮/舒巴坦最敏感,耐药率小于40.0%;从痰液和无菌体液中分离的鲍曼不动杆菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、环丙沙星、左氧氟沙星、阿米卡星的耐药率普遍高于血液和尿液,差异有统计学意义(P0.05)。结论鲍曼不动杆菌对常用抗菌药物多重耐药,在ICU中不同标本类型的耐药性存在差异,临床必须加强耐药性监测,治疗该菌感染时首选替加环素、头孢哌酮/舒巴坦。