健脾扶正方对接受新辅助化疗胃癌患者近期疗效和免疫功能的影响

目的:探讨健脾扶正方应用于胃癌患者新辅助化疗的疗效。方法:将90例进展期胃癌患者按照随机数字表法分为2个组,每组45例。2组均接受新辅助化疗和胃癌根治术,中药组在新辅助化疗期间应用中药健脾扶正方,对照组仅接受新辅助化疗。比较2组近期疗效和免疫功能。结果:化疗后中药组客观有效率、疾病控制率、R0切除率均高于对照组(P<0.05),化疗后、术后第7天中药组CD3^+、CD4^+、CD4^+/CD8^+值高于对照组(P<0.05);化疗后中药组血清癌胚抗原、糖类抗原724、基质金属蛋白酶-9、血管内皮生长因子水平均低于对照组(P<0.05);中药组白细胞减少、血小板减少、贫血、恶心呕吐、食欲减退、全身乏力、脱发、口腔黏膜炎发生率低于对照组,均差异有统计学意义(P<0.05)。结论:健脾扶正方可调节细胞免疫功能,提高近期疗效,下调肿瘤标志物水平,减少不良反应发生,应用于进展期胃癌的新辅助化疗效果显著,值得临床借鉴。     

某平板电脑显示模组项目职业病危害控制效果评价

目的为预防控制职业病危害、保护劳动者健康,对某平板电脑显示模组生产企业进行职业病危害控制效果评价。方法采用职业卫生调查、职业健康检查、职业卫生检测和检查表等方法对某平板电脑显示模组项目进行职业病危害定性和定量评价。对无接触限值、无检测方法的物质进行风险评估。结果该项目存在的职业病危害因素为：甲苯、甲醇、丙酮、丁酮、环己酮、甲缩醛、N,N-二甲基丙烯酰胺（DMAA）、氢氧化钠、氢氧化钾、氟化氢、乙酸、粉尘（其他粉尘）、矽尘、噪声、高温、工频电场、激光等。噪声合格率为84.4%,其余各种职业病危害因素检测结果均符合国家卫生标准。结论该建设项目职业病危害较重,针对各职业病危害因素采取了相应的防护措施,产生的职业病危害因素可得到预防和控制。     

The pharmacokinetics of the effervescent vs. conventional tramadol/paracetamol fixed-dose combination tablet in patients after total gastric resection

BackgroundTramadol/paracetamol is a fixed-dose combination prescribed for the relief of moderate to severe pain. The combination acts synergistically and guarantees the rapid onset of paracetamol and the prolonged analgesic effect of tramadol with good tolerability. These drugs are often used in various formulations in the treatment of patients with postoperative pain, e.g. after stomach resection. Gastrectomy leads to pathophysiological changes within the alimentary tract, which may affect the process of drug absorption. The aim of the research was an analysis of the pharmacokinetics of tramadol/paracetamol from effervescent and conventional tablets in patients after total gastrectomy.MethodsThe research was carried out on patients after gastrectomy with Roux-en-Y reconstruction. The patients received two tramadol/paracetamol fixed-dose combination tablets in a single orally administered dose of 75/650 mg (2 × 37.5/325 mg). The patients were subjected to one of the two study drug group with: I. effervescent tablet (ET) (n = 14; mean [SD] age, 63.4 [10.1] years; weight, 75.5 [15.3] kg; and BMI, 26.0 [4.6] kg/m²) and II. conventional tablet (CT) (n = 12; mean [SD] age, 66.8 [7.7] years; weight, 79.8 [17.8] kg; and BMI, 27.4 [5.3] kg/m²). Blood samples were collected within 10 h after the drug administration. The plasma concentrations of tramadol and paracetamol were measured with validated HPLC (high-performance liquid chromatography) method with UV detection.ResultsThe comparison of the paracetamol and tramadol C_max ratio for the ET group with that of the CT group gave ratios of 1.16 [90% confidence interval (CI) 1.06, 1.27] and 0.86 (90% CI 0.72, 1.02), respectively. The comparison of the paracetamol and tramadol AUC_0–t ratio for the ET group with that of the CT group showed ratios of 0.99 (90% CI 0.88, 1.10) and 1.00 (90% CI 0.82, 1.22), respectively. The comparison of the difference for the effervescent and conventional formulation gave an estimated decrease in t_max of 0.5 h for paracetamol and 0.13 h for tramadol.ConclusionsIn view of the changes in the pharmacokinetics of paracetamol and tramadol in the patients after gastric resection for both formulations compared the conventional tablet seems to be more appropriate due to the comparable rate of absorption of both substances, higher concentrations of tramadol and comparable exposure to paracetamol.     

健脾止遗片对儿童遗尿症的临床疗效观察

目的验证健脾止遗片对儿童遗尿症的治疗作用。方法将诊断为脾肺气虚型遗尿症的412例患儿,随机分为2组,治疗组309例,采用健脾止遗片治疗,对照组103例,采用遗尿停胶囊治疗,2周为1个疗程。治疗4个疗程后,统计分析疗效。结果治疗组临床痊愈率43．67％,总有效率91．33％;对照组临床痊愈率36．00％,总有效率90．00％,组问比较,治疗组疗效优于对照组（P〉0．05）;在改善睡中遗尿、尿频量多方面,治疗组疗效优于对照组（P〉0．05）。结论健脾止遗片对脾肺气虚型儿童遗尿症具有显著的治疗作用,尤其在改善睡中遗尿、尿频量多方面具有较好的疗效。     

肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响

目的 探讨肾炎清片对无症状性血尿患者IL-6和VEGF水平的影响.方法 将76例临床诊断为无症状性血尿患者随机分为治疗组和对照组各38例,对照分析肾炎清片治疗前和治疗后无症状血尿患者的IL-6和VEGF的水平.结果 肾炎清片治疗组无症状性血尿患者的IL-6和VEGF的水平较对照组明显降低,结果显示组间的差异具有统计学意义(P＜0.05).结论 肾炎清片能够改变无症状性血尿患者IL-6和VEGF的水平,可能对无症状性血尿患者血尿症状的改善具有一定的作用.     

参芪扶正注射液联和血必净对脓毒性休克患者早期复苏及氧代谢的影响

目的探究参芪扶正注射液联合血必净对脓毒性休克患者液体复苏的干预作用及氧代谢的影响.方法选取2016年8月至2018年10月承德市中心医院急诊科收治的64例脓毒性休克患者,随机分为联合治疗组、参芪扶正注射液组、血必净组和对照组(每组各16例).四组患者进行目标导向性治疗(EGDT),对照组仅给0.9%氯化钠注射液和白蛋白液体复苏,必要时使用多巴酚丁胺或去甲肾上腺素升压;联合治疗组在对照组基础上早期加用参芪扶正注射液(250 mL/d)联合血必净(50 mL血必净加0.9%氯化钠注射液100 mL,200 mL/d),参芪扶正注射组和血必净注射液组是在对照组的基础上早期只加参芪扶正注射液(250 mL/d)或血必净(50 mL血必净加0.9%氯化钠注射液100 mL,200 mL/d)进行液体复苏.观察四组患者达到EGDT目标所需要的液体量、复苏完成时间、血管活性药物种类及剂量,以及氧代谢指标变化情况、并发症发生率和28 d病死率.结果四组患者EGDT时,联合治疗组复苏液体量、所需的多巴酚丁胺剂量及去甲肾上腺素均明显少于其他三组(均P<0.05),而四组复苏时间差异无统计学意义(P>0.05).联合治疗组试验过程中1例发生急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS),3例死亡;参芪扶正注射组和血必净注射液组试验过程中发生ARDS均为2例,3例死亡;对照组试验过程中4例发生ARDS,3例死亡,而病死率差异无统计学意义(P>0.05).联合治疗组、参芪扶正注射液组和血必净注射液组自复苏后24 h起氧输送(DO2)、中心静脉血氧饱和度(ScvO2)明显上升,而VO2、O2ER明显下降,均较复苏前明显改善(均P<0.05),而对照组多数指标在复苏后48 h才有明显变化,且联合治疗组的改善程度明显优于其他三组(P<0.05).结论参芪扶正注射液联合血必净能更早帮助脓毒性休克患者脱离休克状态,降低并发症的发生风险,改善体内氧代谢,是脓毒性休克患者较理想的复苏液体.     

益气法对SMMC-7721和Hepa1-6肝癌细胞体外抑瘤作用和细胞周期影响的实验研究

目的:观察中医益气法对SMMC-7721和Hepa1-6肝癌细胞的体外抗癌作用;从细胞周期揭示扶正抗癌的作用机制;为采用中西结合治疗肝癌提供理论与实验依据,为肝癌的防治开辟新的研究领域。方法:运用细胞培养技术,采用现代药理学方法,MTT法从细胞水平评价益气法对肝癌细胞增殖的抑制作用。并采用流式细胞术(FCM)检测细胞周期变化,从细胞周期角度观察中医扶正治法对肝癌细胞周期的影响。结果:体外研究提示益气法对肝癌细胞具有不同程度的抑制作用,且这种抑制作用在一定范围内呈浓度依赖性,与空白组比较在50mg/mL浓度以上有统计学意义(P<0.05),益气各浓度组对两种不同的肝癌细胞有不同程度的G2/M期阻滞作用。结论:益气法在体外对肝癌细胞有抑制作用,益气法有G2/M阻滞作用。     

The Influence of Engravings on the Sticking of Tablets. Investigations with an Instrumented Upper Punch

The purpose of this study was to investigate the influence of engravings on the sticking of tablets. Therefore, an instrumented upper punch capable of measuring the pull-off force, which occurs when the punch detaches itself from the upper surface of a tablet, was equipped with small cones of different angles between the punch face and the cones’ lateral face. The cones could be screwed into a threaded hole at the center of the punch face. The adhesion forces of two formulations known to stick to engravings during production increased with a greater steepness of the cones’ lateral face. With microencapsulated acetylsalicylic acid, no quantitative differences could be found between the adhesion forces obtained with plain and modified punch faces, indicating that the sticking behavior of the substance was not affected by shear forces. Starch 1500® showed higher adhesion force signals in comparison to those obtained with a plain punch face. Microcrystalline cellulose, which gave no adhesion force signals with a plain punch face and did not stick to the cones, showed distinct pull-off signals. The instrumented upper punch equipped with shear cones is a valuable instrument for detecting the adhesion caused by engravings and is therefore a helpful tool for tablet formulation development and the design optimization of tablet identification.     

抗毒扶正1、2号方提取液体外抗SRS病毒细胞活性作用

目的:探讨抗毒扶正1、2号方提取液对SRS病毒细胞增殖的抑制作用,为艾滋病临床治疗提供实验依据。方法:将抗毒扶正1、2号方提取液倍比稀释若干浓度,加入SRS细胞体系。以[3H]-TdR掺入法和RT-PCR法观测抗毒扶正1、2号方提取液对SRS细胞增殖的影响。结果:抗毒扶正1、2号方提取液组cpm值均较阴性对照组有所降低,SRSmRNA表达较阴性对照组有所降低。结论:抗毒扶正1、2号方提取液均有抑制SRS病毒细胞增殖的作用,且随药物浓度的升高,抑制作用也逐渐增强。提示抗毒扶正1、2号方对SRS病毒细胞具杀伤作用,对艾滋病临床治疗中药抗毒扶正方的筛选具实用价值。