黄芪对IEC-6肠上皮细胞缺氧复氧损伤保护效应的血清药理学研究

目的:探讨黄芪对IEC-6肠上皮细胞缺氧复氧损伤的保护效应.方法:建立IEC-6细胞缺氧复氧损伤模型;采用血清药理学方法,在细胞培养液中加入不同给药剂量制备的黄芪药物血清[一次和间隔1 h两次给药10 g/kg(DJ-1及SJ-1组),一次和间隔1 h两次给药20 g/kg(DJ-2及SJ-2组)]、参附药物血清(间隔1 h两次给药20 g/kg,SF组)及对照血清.应用噻唑蓝(MTT)法测定LDH漏出量和其细胞生长曲线.结果:与对照组比较,间隔1 h两次给药(10 g/kg,20 g/kg)1 h后制备的药物血清能明显减少IEC-6细胞LDH的漏出量,其中SJ-1组的P＜0.05,SJ-2组的P＜0.01;SJ-2组24 h细胞活力明显高于缺氧复氧细胞损伤组及参附血清组(P＜0.05),并随时间增加而逐渐增强.结论:黄芪对IEC-6肠上皮细胞缺氧复氧损伤具有显著保护效应.     

天花粉对卵巢癌患者红细胞天然免疫活性促进作用的实验研究

目的探讨天花粉对卵巢癌患者的红细胞天然免疫活性的作用.方法采用红细胞C3b受体花环、免疫复合物花环、红细胞黏附肿瘤细胞花环试验.结果天花粉处理组红细胞CR1天然免疫活性(83.5±9.6)明显高于未加天花粉组(11.9±6.4)(P＜0.01),并且红细胞天然免疫活性的程度与天花粉剂量呈剂量依赖性.结论天花粉对卵巢癌患者红细胞天然免疫黏附肿瘤细胞的能力有增强作用.     

大黄醇提液对2.2.15细胞分泌HBsAg、HBeAg的抑制作用

目的:研究大黄醇提液的抗乙型肝炎病毒(HBV)作用.方法:分别以大黄醇提液及大黄蒽醌类衍生物作用于体外培养的2.2.15细胞,观察其对2.2.15细胞HBsAg与HBeAg分泌的影响,评价其抗HBV作用.结果:药物作用于2.2.15细胞11d,大黄醇提液对2.2.15细胞的半数毒性浓度为36.69g/L,大黄蒽醌类衍生物(大黄素、大黄素甲醚、大黄酸、芦荟大黄)对2.2.15细胞的半数毒性浓度分别为1.57g/L、57.30g/L、3.06g/L、＞63g/L.大黄醇提液对HBsAg、HBeAg的半数抑制浓度分别为3.29g/L、2.34g/L,治疗指数分别为12.06、16.96;大黄蒽醌类衍生物(大黄素、大黄素甲醚、大黄酸、芦荟大黄)对HBsAg(HBeAg)的半数抑制浓度分别为1.26(1.74)、3.94(61.16)、0.57(3.54)、1.12(＞63),治疗指数分别为1.24(0.90)、14.54(0.94)、5.37(0.86)、＞52.07(1).结论:大黄醇提液在体外细胞培养中对两抗原的分泌有较好的抑制作用,其作用优于大黄蒽醌类衍生物.     

熟三七联合曲美他嗪治疗冠心病心肌缺血的临床观察

目的:开展熟三七联合曲美他嗪治疗冠心病心肌缺血的临床观察。方法:将冠心病心肌缺血的患者126例随机分为对照组、曲美组和联合用药组,每组42例。对照组口服阿司匹林肠溶片和单硝酸异山梨酯缓释胶囊;曲美组在对照组的基础上,增加口服盐酸曲美他嗪片;联合用药组在对照组的基础上,增加口服盐酸曲美他嗪片和熟三七粉。结果:相较对照组和曲美组,联合用药组能有效降低冠心病患者血液中TC、TG与LDL-C的水平,升高HDL-C的水平,显著改善临床症状。其总有效率可大幅度地提高至95.24%(P<0.05),而总不良反应发生率大幅度地降低至7.14%(P<0.01)。结论:熟三七联合曲美他嗪治疗冠心病心肌缺血疗效明确,建议在临床上推广应用。     

Starch digestibility modulation significantly improves glycemic variability in type 2 diabetic subjects: A pilot study

Background and aimsIn type 2 diabetes (T2D) patients, the reduction of glycemic variability and postprandial glucose excursions is essential to limit diabetes complications, beyond HbA1c level. This study aimed at determining whether increasing the content of Slowly Digestible Starch (SDS) in T2D patients’ diet could reduce postprandial hyperglycemia and glycemic variability compared with a conventional low-SDS diet.Methods and resultsFor this randomized cross-over pilot study, 8 subjects with T2D consumed a controlled diet for one week, containing starchy products high or low in SDS. Glycemic variability parameters were evaluated using a Continuous Glucose Monitoring System.Glycemic variability was significantly lower during High-SDS diet compared to Low-SDS diet for MAGE (Mean Amplitude of Glycemic Excursions, p < 0.01), SD (Standard Deviation, p < 0.05), and CV (Coefficient of Variation, p < 0.01). The TIR (Time In Range) [140–180 mg/dL[ was significantly higher during High-SDS diet (p < 0.0001) whereas TIRs ≥180 mg/dL were significantly lower during High-SDS diet. Post-meals tAUC (total Area Under the Curve) were significantly lower during High-SDS diet.ConclusionOne week of High-SDS Diet in T2D patients significantly improves glycemic variability and reduces postprandial glycemic excursions. Modulation of starch digestibility in the diet could be used as a simple nutritional tool in T2D patients to improve daily glycemic control.Registration numberin clinicaltrials.gov: NCT 03289494.     

Comparison of Turkish Disability Policy,the United Nations Convention on the Rights of Persons with Disabilities,and the core concepts of U.S. disability policy

This article compares Turkey's Constitution and its Disabled Persons Act with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) and the core concepts of United States (U.S.) disability policy. Conclusions are that Turkey's Constitution and statutes are remarkably congruent with the UNCRPD and the core concepts. They are not, however, identical. This fact suggests that Turkey can still improve its statutes to reflect more closely the UNCRPD and core concepts. The review of these policy documents suggests that there are other steps Turkey can take to improve disability policy and its implementation. They are to amend Turkey's laws, determine the status of individuals and families affected by disability, and pursue vigorous implementation of their rights.     

Preclinical coronary endothelial dysfunction in Egyptian Behçet’s disease patients; Tc-99m sestamibi pharmacological Gated-SPECT,is it a useful screening tool?

IntroductionBehçet’s disease (BD) is an idiopathic multisystem disorder. Cardiac involvement[cardio-BD] occurs in 7–60% of BD patients. Technetium 99m-Methoxyisobutyl isonitrile (Tc-99m sestamibi) is a myocardial perfusion imaging agent that is used for evaluation of the coronary flow.Aim of the workTo evaluate the usefulness of Dipyridamole pharmacological stress test in conjunction with Tc-99m sestamibi cardiac gated single photon emission computed tomography (GSPECT) to investigate the prevalence of subclinical coronary endothelial dysfunction[SCED] in asymptomatic Egyptian BD patients; also to assess possibly associated clinical predictive variables.Patients and MethodsTwenty-five BD patients without overt cardiac involvement and fifteen healthy controls matched for age, BMI and sex were included. Database included full history, clinical examination, relevant laboratory tests, and Tc-99m sestamibi myocardial GSPECT with coronary angiography[CAG] in GSPECT positive cases. Disease activity was assessed using Behçet’s Disease Current Activity Form (BDCAF).ResultsSCED detected by reduced flow or left ventricular dysfunction (LVD) or both was found in 13/25[52%] of BD-patients[12 males and 1 female] vs. 1/15[6.7%] of controls[P < 0.0001] with normal CAG. Subjects with positive GSPECT had significantly older age[P = 0.01] and longer disease duration (P = 0.02) and were more frequently males (P < 0.0001) than those with negative GSPECT. No statistically significant differences between cases with negative and positive GSPECT were found regarding other clinical or laboratory parameters.ConclusionTc-99m sestamibi GSPECT could be a useful screening tool for detection of SCED in BD patients, so early prophylactic measures and therapy modifications could be considered.     

Bypassing proximal health care facilities for acute care: a survey of patients in a Ghanaian Accident and Emergency Centre

Objective To characterise the population that presents to the Accident and Emergency Centre (AEC) at Komfo Anokye Teaching Hospital (KATH) and to identify risk factors associated with bypassing proximal care facilities. Methods A structured questionnaire was verbally administered to patients presenting to the AEC over 2 weeks. The questionnaire focused on the use of health care resources and characteristics of current illness or injury. Measures recorded include demographics, socioeconomic status, chief complaint, transportation and mobility, reasons for choosing KATH and health care service utilisation and cost. Results The total rate of bypassing proximal care was 33.9%. On multivariate analysis, factors positively associated with bypassing included age older than 38 years (OR: 2.18, P 0.04) and prior visits to facility (OR 2.88, P 0.01). Bypassers were less likely to be insured (OR 0.31, P 0.01), to be seeking care due to injury (OR 0.42, P 0.03) and to have previously sought care for the problem (OR 0.10, P < 0.001). Conclusions Patients who bypass facilities near them to seek care at an urban AEC in Ghana do so for a combination of reasons including familiarity with the facility, chief complaint and insurance status. Understanding bypassing behaviour is important for guiding health care utilisation policy decisions and streamlining cost‐effective, appropriate access to care for all patients.