舒血宁联合复方丹参片对急性脑梗塞患者血清超敏C反应蛋白、脂蛋白的影响及其临床疗效

目的 探讨舒血宁联合复方丹参片对急性脑梗塞患者（ACI）血清超敏C反应蛋白、脂蛋白的影响及其临床疗效。方法 选取青海省人民医院2014年4月～2015年9月收治的80例ACI患者,随机分为对照组和观察组,每组40例。对照组给予舒血宁注射液静脉滴注,研究组在此基础上,再予以复方丹参片口服。检测两组相关生化指标及血液流变学的变化,NIHSS及BI评分评估治疗前后神经功能及日常生活能力,NIHSS评分比较其临床疗效。结果 与治疗前比较,两组hs-CRP、LP、PAF及LP-PLA2水平均明显降低(P＜0.05),血液流变学指标亦明显降低(均P＜0.05),NIHSS评分显著降低(P＜0.05),BI评分显著升高(P＜0.05);与对照组比较,观察组hs-CRP、LP、PAF及LP-PLA2水平均较低(均P＜0.05),血液流变学指标及NIHSS评分均较低(均P＜0.05),但BI评分较高(P＜0.05),治疗有效率较高(P＜0.05)。结论 舒血宁联合复方丹参片能有效治疗急性脑梗塞,改善血液流变学,促进神经功能的恢复及预后,且能降低hs-CRP及LP水平。     

Fulfilling the psychological and information need of the family members of critically ill patients using interactive mobile technology: A randomised controlled trial

BackgroundIntensive care nurses may have an important role in empowering families by providing psychological support and fulfilling the family's pivotal need for information.AimTo determine whether ‘education of families by tab’ about the patient’s condition was more associated with improved anxiety, stress, and depression levels than the ‘education of families by routine’.Research designA randomized control trial of 74 main family caregivers (intervention: 39; control: 35).SettingAn adult intensive care unit.Main outcome measuresDepression Anxiety Stress Scale, and Communication and Physical Comfort Scale.ResultsAlthough information need satisfaction was not significantly different between intervention and control groups, the former reported significantly better depression score on Depression Anxiety Stress Scale comparing to the control group (p < 0.01; η² = 0.09) with a medium effect size. Reduction of anxiety in the intervention group were clinically significant.ConclusionThe results suggest that use of ‘education of family by tab’ is promising for intensive care nurses to provide psychological support for family members. More studies are needed to investigate this aspect of family care for better psychological support and information need satisfaction that contributes to the evidence-based practice of intensive care nursing.     

Formulation and optimization of potassium iodide tablets

The use of potassium iodide (KI) as a protective agent against accidental radioactive exposure is well established. In this study, we aimed to prepare a KI tablet formulation using a direct compression method. We utilized Design of Experiment (DoE)/mixture design to define the best formulation with predetermined physical qualities as to its dissolution, hardness, assay, disintegration, and angle of repose. Based on the results from the DoE, the formulation had the following components (%w/w): Avicel 48.70%, silicon dioxide 0.27%, stearic acid (1.00%), magnesium stearate 2.45%, and dicalcium phosphate 18.69%, in addition to potassium iodide 28.89% (130 mg/tablet). This formulation was scaled-up using two tablet presses, a single-punch press and a rotary mini tablet press. The final scaled-up formulation was subjected to a variety of quality control tests, including photo-stability testing. The results indicate that potassium iodide tablets prepared by a rotary mini tablet press had good pharmaceutical characteristics and a shelf-life of 25 days when stored at room temperature protected from light.     

温阳散瘀方联合贝前列素钠片治疗下肢动脉粥样硬化性闭塞症的临床研究

目的观察温阳散瘀方辅助贝前列素钠片治疗下肢动脉粥样硬化性闭塞症的效果。方法采用简单随机抽样方法从2016年3月至2018年4月于该院接受诊治的下肢动脉粥样硬化性闭塞症患者中选取86例纳入研究,依据随机数字表法进行分组,对照组43例患者接受贝前列素钠片治疗,研究组43例患者接受温阳散瘀方联合贝前列素钠片治疗,治疗6周后评价两组临床疗效,测定两组患者血脂水平、踝肱指数(ABI)、6min步行试验(6-MWT)、无痛行走距离、超敏C反应蛋白(hs-CRP)以及血液流变学相关指标。结果研究组临床总有效率(88.37%)明显高于对照组(69.77%),差异有统计学意义(P<0.05);治疗后两组患者总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)水平均明显下降(P<0.05),且组间比较差异有统计学意义(P<0.05);治疗后研究组ABI、6-MWT、无痛行走距离和hs-CRP水平均明显优于对照组(P<0.05);治疗后两组血液流变学相关指标均明显下降(P<0.05),且组间比较差异有统计学意义(P<0.05)。结论温阳散瘀方辅助贝前列素钠片应用于下肢动脉粥样硬化性闭塞症的临床治疗,在平衡血脂水平、改善血液流变学相关指标方面效果明显,可有效改善ABI、6-MWT、无痛行走距离和hs-CRP等指标,增进疗效。     

复方鳖甲软肝片治疗慢性乙型肝炎早期肝硬化的临床研究

慢性乙型肝炎患者由于体内乙型肝炎病毒的持续复制，造成肝细胞反复的炎症损伤，诱发大量炎症细胞因子的产生，激活肝脏中的贮脂细胞转化为成纤维母细胞，成纤维母细胞产生大量纤维结缔组织．最终导致肝脏正常结构丧失，形成肝硬化。肝脏纤维化的增生性变化在肝硬化的形成中起着重要的作用，故早期肝硬化的治疗具有十分重要的意义。本文对复方鳖甲软肝片治疗慢性乙型肝炎早期肝硬化的疗效及安全性进行了以下的临床研究。     

银杏酮酯片联合丁苯酞软胶囊治疗血管性轻度认知功能障碍的临床研究

目的探讨银杏酮酯片联合丁苯酞软胶囊治疗血管性轻度认知功能障碍的临床疗效。方法选取2018年3月—2019年11月在天津市中医药研究院附属医院就诊的102例血管性轻度认知功能障碍患者作为本研究对象,按照随机数字表法将全部患者分为对照组和治疗组,每组各51例。对照组口服丁苯酞软胶囊,0.2g/次,3次/d。治疗组在对照组基础上口服银杏酮酯片,0.15 g/次,3次/d。两组患者连续治疗12周。观察两组的临床疗效,比较两组的治疗前后生活质量情况、血清炎症因子、血清神经功能指标水平。结果治疗后,治疗组患者的总有效率(94.12%)比对照组高(80.39%)(P0.05)。治疗后,两组的白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)水平明显降低(P0.05);治疗后治疗组的IL-6、TNF-α、Hcy水平比对照组低(P0.05)。治疗后,两组的脑髓鞘碱性蛋白(MBP)、中枢神经特异蛋白(S100β)、神经元特异性烯醇化酶(NSE)水平明显降低(P0.05);治疗后治疗组的MBP、S100β、NSE水平低于对照组(P0.05)。治疗后,两组的简易精神状态量表(MMSE)评分、日常生活能力量表(ADL)评分明显升高(P0.05);治疗后治疗组的MMSE评分、ADL评分高于对照组(P0.05)。结论银杏酮酯片联合丁苯酞软胶囊治疗血管性轻度认知功能障碍的临床疗效较好,可改善认知功能和生活质量,减轻炎症反应和降低神经功能的损伤,具有良好的临床研究价值。     

伤科接骨片治疗大鼠骨折模型的影像学评价

[摘要] 目的 借助于X-射线、CT扫描成像、MRI等医学成像技术评价中成药伤科接骨片对大鼠骨折模型的治疗作用。 方法 大鼠麻醉后手术分离右前肢桡骨,于中段形成横断的完全骨折,随后随机分为模型组、药物治疗组,另设伪手术组进行平行对照。治疗组按0.33g/kg的剂量灌胃给药,模型组和伪手术组等量灌胃生理盐水,连续给药4周,给药结束后以X射线、CT和MRI图像观察和记录骨折部位的愈合情况。最后麻醉处死动物,经解剖取骨折部位进行抗折力测定和HE染色的病理组织学检查。 结果 X射线、CT和MRI检查结果清楚地表明,给药治疗后骨折部位可见有明显的致密性骨痂形成,骨折线模糊不清或消失,多数可见大量的钙盐沉积,趋于愈合,与骨折部位的病理组织学检查结果基本一致,愈合后的前肢桡骨的抗折力也明显地增强。而CT四维成像技术能更加直观、清晰地反映骨折部位的恢复情况。 结论 借助于医学影像技术可以更加客观地评价药物对大鼠骨折模型的治疗作用,尤以CT四维成像技术更加直观、清晰,值得进一步地推广应用。     

HPLC指纹图谱结合化学模式识别评价舒筋活血制剂的整体质量

目的建立舒筋活血制剂(舒筋活血胶囊、舒筋活血片)HPLC指纹图谱的方法,为其整体质量评价提供参考。方法色谱柱为Agilent Poroshell 120 SB-C18(150 mm×4.6 mm,2.7μm),以乙腈-0.2%甲酸水溶液为流动相,进行梯度洗脱;体积流量0.5mL/min,检测波长277nm,柱温30℃。采用"中药色谱指纹图谱相似度评价系统"(2012版)考察23批舒筋活血制剂的相似度,结合主成分分析(principal component analysis,PCA)、聚类分析(cluster analysis,CA)以及正交偏最小二乘判别分析(orthogonal partial least squares discriminant analysis,OPLS-DA)对舒筋活血制剂进行整体质量评价。结果舒筋活血制剂的HPLC指纹图谱中18批样品(S1～S17和S23)的相似度0.900,通过PCA、CA和OPLS-DA,23批样品聚成3类,S1～S16来自同一厂家为一类;S23和S17为一类;S18～S22为一类,并从10个共有峰中确定差异较大的4个共有峰,分别为1、3(5-羟甲基糠醛)、6(苯乙酸)和10(4-甲氧基水杨醛)号峰。结论所建立的指纹图谱结合化学模式识别方法稳定、简单,可用于评价舒筋活血制剂质量。     

Demonstration of pharmaceutical tablet coating process by injection molding technology

We demonstrate the coating of tablets using an injection molding (IM) process that has advantage of being solvent free and can provide precision coat features. The selected core tablets comprising 10% w/w griseofulvin were prepared by an integrated hot melt extrusion-injection molding (HME-IM) process. Coating trials were conducted on a vertical injection mold machine. Polyethylene glycol and polyethylene oxide based hot melt extruded coat compositions were used. Tablet coating process feasibility was successfully demonstrated using different coating mold designs (with both overlapping and non-overlapping coatings at the weld) and coat thicknesses of 150 and 300?μm. The resultant coated tablets had acceptable appearance, seal at the weld, and immediate drug release profile (with an acceptable lag time). Since IM is a continuous process, this study opens opportunities to develop HME-IM continuous processes for transforming powder to coated tablets.