除湿健骨饮治疗膝关节骨关节炎临床观察

目的:观察除湿健骨饮治疗膝关节骨关节炎的临床疗效。方法:将60例膝关节骨关节炎患者随机分为治疗组、对照组各30例,治疗组以除湿健骨饮内服外洗治疗,并辅以功能锻炼;对照组塞来昔布片治疗,同样辅以功能锻炼。比较两组治疗4周后的综合疗效。结果:治疗组临床总有效率86.67%,对照组为70.00%。两组综合疗效比较,差异有统计学意义(P<0.05)。结论:除湿健骨饮治疗膝关节骨关节炎,能显著提高近期疗效。     

全血胆碱酯酶在老年COPD患者中的表达研究和临床价值分析

目的探讨老年慢性阻塞性肺病（COPD）与全血胆碱酯酶的关系及相关临床意义。方法选取65例老年COPD患者作为观察组,80例健康老年人作为对照组,两组均清晨空腹抽取静脉血,采用IL-1620血气分析仪测定全血胆碱酯酶的水平。结果COPD患者bl—ChE各临床分级与对照组比较,差异有统计学意义（F=3．830,P=0．011）;两两比较,COPDII、III、IV级的bl-ChE水平低于对照组（P〈0．05或0．01）。e—ChE各临床分级与对照组比较,差异有统计学意义（F=6．328,P=0．042）;两两比较,COPDIII、IV级的e—ChE低于对照组（P〈0．05）。p-ChE各临床分级与对照组比较,差异无统计学意义（F=1．062,P=0．563）。COPDII、III、IV级治疗前后差异均有统计学意义（P〈0．05或0．01）,治疗后全血胆碱酯酶活力升高。结论全血胆碱酯酶可作为评价老年COPD的有效指标,有重要临床参考价值。     

Radioiodinated Hypericin: Its Biodistribution, Necrosis Avidity and Therapeutic Efficacy are Influenced by Formulation

Purpose

To study whether formulation influences biodistribution, necrosis avidity and tumoricidal effects of the radioiodinated hypericin, a necrosis avid agent for a dual-targeting anticancer radiotherapy.

Methods

Iodine-123- and 131-labeled hypericin (¹²³I-Hyp and ¹³¹I-Hyp) were prepared with Iodogen as oxidant, and formulated in dimethyl sulfoxide (DMSO)/PEG400 (polyethylene glycol 400)/water (25/60/15, v/v/v) or DMSO/saline (20:80, v/v). The formulations with excessive Hyp were optically characterized. Biodistribution, necrosis avidity and tumoricidal effects were studied in rats (n?=?42) without and with reperfused liver infarction and implanted rhabdomyosarcomas (R1). To induce tumor necrosis, R1-rats were pre-treated with a vascular disrupting agent. Magnetic resonance imaging, tissue-gamma counting, autoradiography and histology were used.

Results

The two formulations differed significantly in fluorescence and precipitation. ¹²³I-Hyp/Hyp in DMSO/PEG400/water exhibited high uptake in necrosis but lower concentration in the lung, spleen and liver (p?<?0.01). Tumor volumes of 0.9?±?0.3 cm³ with high radioactivity (3.1?±?0.3% ID/g) were detected 6 days post-treatment. By contrast, ¹³¹I-Hyp/Hypin DMSO/saline showed low uptake in necrosis but high retention in the spleen and liver (p?<?0.01). Tumor volumes reached 2.6?±?0.7 cm³ with low tracer accumulation (0.1?±?0.04%ID/g).

Conclusions

The formulation of radioiodinated hypericin/hypericin appears crucial for its physical property, biodistribution, necrosis avidity and tumoricidal effects.     

医学工程保障中的质量控制的研究

目的探讨医学工程保障中的问题及质量控制措施。方法对273台常用医疗设备进行风险检测,根据检测结果分析异常情况的发生因素并探讨医学工程保障中的质量控制措施。结果婴儿暖箱中箱内湿度不合格比例最高(20.00%),心电监护仪中呼吸监测不合格率最高(36.51%),微量注射泵中高阻塞压力报警不合格率最高(11.94%),呼吸机中氧气精度不合格率最高(15.00%),医学影像设备中球管电压不合格率最高(28.57%),除颤心电监护仪中同步模式不合格率最高(16.67%),这些设备与同类型设备的其他不合格率对比具有统计学意义(P<0.05)。结论医疗机构根据自身实际情况制定医疗设备质量控制措施,可有效提高医学工程保障效果,为医生提供疾病诊疗依据。为患者提供疾病治疗的技术支持是确保患者疗效及预后的关键因素。     

肠康方对肠易激综合征内脏高敏感模型大鼠的作用

[目的]探讨肠康方对肠易激综合征(IBS)内脏高敏感模型大鼠的作用.[方法]制备肠易激综合征内脏高敏感模型,将72只Sprague-Dawley大鼠随机分为6组,即模型组,空白对照组,阳性药物对照组,肠康方高、中、低剂量组.在造模第60天开始灌胃给药或0.9％氯化钠溶液共10d,干预后通过腹肌回缩反射(AWR)半定量评分测定大鼠内脏敏感性.[结果]不同压力下模型组AWR评分显著高于空白对照组,肠康方高、中、低剂量组治疗后AWR评分均显著低于模型组(P＜0.05或P＜0.01).[结论]肠康方可通过改善内脏高敏感治疗IBS.     

Paeoniflorin Attenuates Lipopolysaccharide-Induced Permeability of Endothelial Cells: Involvements of F-Actin Expression and Phosphorylations of PI3K/Akt and PKC

This study aimed to investigate the effects of paeoniflorin, the main active ingredient of the medicinal plant Paeonia lactiflora Pall., on the permeability of endothelial cells induced by lipopolysaccharide (LPS) and the underlying mechanisms. Human umbilical vein endothelial cells (HUVECs) were stimulated by LPS. Extravasated FITC-dextran reflecting permeability was assessed by multimode microplate reader, and the migration of bis-carboxyethyl-carboxyfluorescein acetoxy-methyl-labeled human acute monocytic leukemia cell line and leukemia cell line cells through HUVECs were analyzed by fluorescence microscopy. The phosphorylations of phosphatidylinositol 3-kinase (PI3K)/Akt, protein kinase C (PKC), and cofilin in HUVECs were assessed by western blotting, and the F-actin level was detected by laser scanning confocal microscopy. After LPS stimulation, inflammatory endothelial cells exhibited significantly increased permeability. Paeoniflorin (10, 30, and 100 μM) inhibited dextran extravasation and leukocyte migration through HUVECs induced by LPS in a concentration-dependent manner. Moreover, paeoniflorin was able to suppress the phosphorylations of PI3K/Akt, PKC, and cofilin, as well as F-actin reorganization in HUVECs induced by LPS. These findings revealed that paeoniflorin partly blocked LPS-induced endothelium permeability, supporting a new explanation for its anti-inflammatory effects.     

免疫检查点抑制剂诱发甲状腺功能紊乱的研究进展

随着免疫检查点抑制剂(immune checkpoint inhibitors,ICIs)在肿瘤领域的广泛应用,其诱发的免疫相关不良事件(immune-related adverse events,irAEs)愈发多见。甲状腺功能紊乱在ICIs治疗过程中最为常见,包括甲状腺毒症和甲状腺功能减退,但常因其症状轻微且缺乏特异性易被漏诊或误诊。掌握ICIs相关甲状腺功能紊乱的发病特点和诊断治疗要点,有助于临床医师对肿瘤免疫治疗相关的常见内分泌不良反应及时识别和处理。     

苦地丁化学成分和体内代谢产物的LC-MS鉴定

目的 研究苦地丁Corydalis bungeana提取物中的化学成分和体内代谢产物,探究其代表性成分质谱裂解规律。方法采用高效液相色谱-电喷雾质谱联用技术（HPLC-Q-TOF/MS）,正离子模式扫描,对苦地丁提取物和大鼠口服苦地丁提取物后不同时间段内的血浆、胆汁、尿液和粪便分别进行检测分析,通过与对照品和文献比对保留时间和质谱碎片信息,确定化学成分归属及其裂解方式,预测代谢产物的动态变化。结果 在苦地丁提取物中共鉴定得31个化合物,其中共有21个化合物以原型进入体内;并以紫堇灵为研究对象,在大鼠血浆、胆汁、尿液和粪便中分别发现3、3、4、4个代谢产物。结论 借助HPLC-Q-TOF/MS方法鉴定了苦地丁体外化学成分和体内以原型存在的化学成分,阐明了代表性成分紫堇灵的代谢产物及代谢规律,推测苦地丁在体内发生了I相和II相代谢,其中以II相代谢方式为主（硫酸化、糖基化、甲基化和去甲基化）,为阐明苦地丁的药效物质基础提供依据。     

番荔枝子中4个新的邻双四氢呋喃型番荔枝内酯

目的 研究番荔枝Annona squamosa种子的化学成分。方法 通过多种现代色谱技术对番荔枝子超临界CO₂提取物的化学成分进行分离纯化,并根据理化性质和谱学数据确定其结构。结果 从番荔枝子中分离得到7个化合物,分别鉴定为3-[12-[5-[5-(1-羟基十二烷基)-2-四氢呋喃基]-2-四氢呋喃基]-9,12-二羟基十二烷基]-5-甲基-2(5H)-呋喃酮（1）、3-[11-[5-[5-(1-羟基癸烷基)-2-四氢呋喃基]-2-四氢呋喃基]-8,11-二羟基十一烷基]-5-甲基-2(5H)-呋喃酮（2）、3-[9-[5-[5-(1,3-二羟基十四烷基)-2-四氢呋喃基]-2-四氢呋喃基]-9-羟基壬烷基]-5-甲基-2(5H)-呋喃酮（3）、3-[8-[5-[5-(1-羟基十四烷基)-2-四氢呋喃基]-2-四氢呋喃基]-2,8-二羟基辛烷基]-5-甲基-2(5H)-呋喃酮（4）、阿诺西林甲（5）、annosquacin A（6）和乙酰紫玉盘素（7）。结论 化合物1～4为4个未见报道的新邻双四氢呋喃型番荔枝内酯类化合物,分别命名为顺式-11-羟基鳞状辛素丙（1）、10-羟基鳞状辛素（2）、鳞状亭素戊（3）和鳞状亭素己（4）。     

脑梗死患者医院感染因素分析及护理干预

目的探讨降低脑梗死患者医院内感染发生率的护理干预措施。方法对1 945例脑梗死患者住院期间发生医院内感染的资料进行回顾性分析。结果采取护理干预前脑梗死患者972例发生医院内感染114例次,医院内感染发生率为11.6%,发生的首要部位是下呼吸道、泌尿道和上呼吸道;护理干预组脑梗死患者973例,感染73例次,感染率7.4%,明显低于护理干预前(P<0.01)。结论有效的护理干预可减少脑梗死患者医院内感染的发生。