金银花配方颗粒评价性抽验结果分析与建议

目的：通过开展金银花配方颗粒评价性抽验,比较分析不同厂家金银花配方颗粒的质量情况,并提出监管建议。方法：收集各企业金银花配方颗粒质量标准,依据企业标准进行法定检验。结果：共抽验117批金银花配方颗粒,涉及9家生产企业。按各自企业标准进行检验,总体合格率为100%。但是各企业之间金银花配方颗粒含量差异较大且每克颗粒相当的药材（饮片）量不同,转移率不同。结论：通过本次抽验发现金银花配方颗粒的整体质量较高,但是不同厂家之间所用原料药材及生产工艺存在一定差异,导致最终产品质量参差不齐。因此,有必要规范中药配方颗粒生产工艺,尽快统一标准,加强监管。     

卡铂按AUC计算剂量的计算方法研究进展

血小板减少症是卡铂的剂量限制性毒性。根据肾小球滤过率（GFR）的变量改变影响游离卡铂曲线下面积（AUC）与所给剂量的线性关系,提出了卡铂按AUC给药的计算方法。目前临床上使用Calvert公式计算卡铂剂量,用Cockcroft-Gault公式计算出的肌酐清除率（CrCl）来代替GFR。但是Cockcroft-Gault公式在临床应用中也存在一些局限性。对卡铂的给药剂量计算策略进行综述,找到最佳剂量的计算方法,以供卡铂在临床合理用药和个体化治疗中参考。     

深度水解蛋白配方奶对极低出生体质量儿喂养的影响

目的 探讨深度水解蛋白配方奶(HPF)开奶与标准早产儿配方奶(SPF)相比,是否能减少极低出生体质量儿(VLBWI)喂养不耐受,使VLBWI更早达到全肠道喂养,促进VLBWI的生长发育.方法 随机将2009年1-6月本院NICU收治的VLBWI 30例分为HPF组及 SPF组,2组均以20 mL·kg-1·d-1开奶,并在能耐受的情况下按此速度加奶.HPF组在日龄14 d结束HPF喂养,换等量的SPF喂养;SPF组持续以SPF喂养.观察2组患儿开奶前7 d胃潴留总次数、第7天餐前胃残留奶量(包括最大胃残留量、全天胃残留总量/全天预计喂奶量)、体质量增长速度、达完全肠道喂养时间、28 d时体格发育情况及是否合并坏死性小肠结肠炎(NEC).结果 与SPF组相比,HPF组开奶前7 d胃残留总次数[(15.5±2.9)次 vs(17.1±4.5次)]、第7天最大胃残留量[(0.9±1.0) mL vs (1.8±1.3) mL]、第7天全天胃残留量/全天预计奶量[(3.1±4.8)% vs (8.7±6.9)%]降低,胃排空改善,胃潴留量减少,达完全肠内喂养时间缩短[(12.7±4.2) d vs (16.6±4.8) d],平均每日体质量增长加快[(15.37±4.08) g·d-1 vs (11.02±3.49) g·d-1],差异均有统计学意义(Pa<0.05).2组患儿28 d时头围[(30.01±1.11) cm vs (29.05±1.20) cm]、身长[(42.85±1.62) cm vs (41.55±1.51) cm]、体质量[(1.792±0.213) kg vs (1.617±0.187) kg]比较,差异均有统计学意义(Pa<0.05).2组患儿NEC发病率有明显差异.结论 HPF能够促进胃排空,改善VLBWI的喂养不耐受,并使其更早达到完全肠道内喂养,从而促进VLBWI的生长发育,可将HPF用于VLBWI的开奶.     

去乳糖奶粉喂养联合专案管理对新生儿抗生素相关性腹泻患儿预后的影响

[目的]探讨去乳糖奶粉喂养联合专案管理对新生儿抗生素相关性腹泻患儿预后的影响。[方法]选取本院新生儿科收治的新生儿抗生素相关性腹泻(AAD)患儿96例,根据随机数字表法将病人分为对照组及观察组各48例,对照组常规护理及去乳糖奶粉喂养,观察组在对照组基础上实施专案管理,比较两组患儿胃肠功能改善情况、治疗效果及家属满意率。[结果]观察组腹胀消失时间、腹泻消失时间、腹痛消失时间、肠鸣音恢复时间显著短于对照组(P<0.05)。观察组治疗总有效率及家属满意率均高于对照组(P<0.05)。[结论]去乳糖奶粉喂养联合专案管理能有效减轻新生儿抗生素相关腹泻患儿临床症状,促进患儿康复,提高家属治疗满意率。     

和解聚散方对单侧输尿管梗阻肾间质纤维化大鼠细胞外基质表达的影响

目的:研究和解聚散方对单侧输尿管梗阻(unilateral ureteral obstruction,UUO)大鼠肾间质纤维化(renal interstitial fibrosis,RIF)、细胞外基质(extracellular matrix,ECM)、纤维连接蛋白(FN)和Ⅳ型胶原(Col Ⅳ)表达的影响.方法:...     

Effects of the Ganning Formula (肝宁方) on Liver Fibrosis in Patients With Chronic Hepatitis B

Objective: To investigate the clinical efficacy and safety of the Ganning formula (肝宁方) for the treatment of liver fibrosis in patients with chronic hepatitis B. Methods: In a multicenter, randomized, controlled clinical trial, 150 patients with liver fibrosis secondary to hepatitis B virus (HBV) infection were randomly assigned in equal numbers to receive either the Ganning formula (a Chinese herbal decoction; active treatment group) or oral entecavir (control group) for two 3-month courses. Patients were ...     

IOLMaster测量超长眼轴眼人工晶状体计算公式准确性比较

目的 比较IOLMaster测量超长眼轴眼时,各人工晶状体计算公式(Haigis、SRK Ⅱ、Hoffer Q、Holladay 1及SRK/T公式)准确性,指导临床工作中超长眼轴眼人工晶状体计算公式的选择以及术后屈光度的预留.方法 前瞻性临床病例研究.收集以IOLMaster测量眼轴且眼轴长度大于28.5mm的白内障患者34例(46只眼).所有患者均行白内障超声乳化人工晶状体植入术.通过IOLMaster仪器内置软件计算各个人工晶状体计算公式的预测术后屈光度.术后3个月后,验光明确患者实际术后屈光度.比较各个人工晶状体计算公式的预测术后屈光度与实际术后屈光度的直线相关性,绝对预测误差的分布以及预测误差值平均值的差异.结果 各人工晶状体计算公式的预测术后屈光度与实际术后屈光度直线相关系数分别是:Haigis公式r=0.902,SRK Ⅱ公式r=0.696,Hoffer Q公式r=0.871,Holladay 1公式r=0.896,SRK/T公式r=0.783.各人工晶状体计算公式的绝对误差分布均较为分散,仅Haigis公式在1.01～1.50 D百分率超过60％.各人工晶状体计算公式的预测误差平均值分别是:Haigis公式(1.12±0.40) D,SRK Ⅱ公式(0.82±1.53)D,Hoffer Q公式(1.91±0.46) D,Holladay 1公式(1.67±0.41) D,SRK/T公式(1.31 ±0.59)D,除SRK Ⅱ公式外,其他人工晶状体计算公式的预测误差值均为正值.结论 在IOLMater测量超长眼轴眼中,Haigis公式的预测术后屈光度与实际术后屈光度相关性最强,Haigis公式的绝对预测误差值61％分布在1.01～1.50 D,临床应用中可根据Haigis公式预测误差平均值调整术前预留屈光度.     

六字诀联合吸气肌训练对脑卒中偏瘫患者肺功能的影响

目的:探讨六字诀联合吸气肌训练在脑卒中偏瘫患者肺功能的影响。方法:将75例脑卒中偏瘫患者随机分为联合组、训练组和对照组,每组25例。3组均给予常规的康复训练(PT、OT),训练组在此基础上进行吸气肌肌力训练,联合吸组在此基础上进行六字呼吸训练。练习3个月后,对患者的肺通气功能和吸气肌功能进行检测,并比较各组间差异。结果:干预3个月后,联合组和训练组患者的肺通气功能均较治疗前明显提高(均P0.05),对照组治疗前后比较差异无统计学意义;联合组干预后的FVC、FEV1、MVV均明显高于对照组(均P0.05);训练组干预后的FEV1、MVV均明显高于对照组(均P0.05);联合组干预后的FEV1、MVV均明显高于训练组(均P0.05);训练组与对照组间、联合组与训练组间的FVC比较差异无统计学意义。干预后,联合组和训练组患者的MIP、PIF均较治疗前明显提高(均P0.05),对照组治疗前后比较差异无统计学意义;且联合组患者干预后的MIP、PIF均明显高于训练组及对照组(均P0.05);训练组干预后的MIP、PIF均明显高于对照组(均P0.05)。结论:与单独的吸气肌训练相比,对脑卒中偏瘫患者给予六字诀联合吸气肌训练,能够显著提高患者的肺通气功能和吸气肌功能,对患者肺功能的改善作用显著。     

Method for Approximating Colloid Osmotic Pressure in Long‐Term Hemodialysis Patients

Colloid osmotic pressure (COP) is important in calculating vascular permeability during hemodialysis (HD). However, few reports have directly measured COP in HD patients. Therefore, the currently published formulas may not be clinically optimal for predicting COP for HD patients. Here, the study aims were (i) to directly measure COP in HD patients and compare the measured and predicted COP values using four previously reported formulas, and (ii) to develop a formula for approximating COP using clinical parameters. We obtained 212 measured COP values using an osmometer; the average value was 22.0 ± 0.2 mm Hg. The predicted COP based on the four different formulas was positively correlated with the measured COP (0.87 < r < 0.89), but was significantly overestimated compared to it (P < 0.001). We also performed a stepwise analysis using serum albumin and non‐albumin protein concentrations and obtained the following simple formula for COP approximation: COP (mm Hg) = ?7.91 + 5.64 × albumin (g/dL) + 3.00 × non‐albumin proteins (g/dL). A positive linear correlation was observed between the measured COP and approximated COP using this formula (r = 0.90, P < 0.001). We calculated the mean Kr (plasma‐refilling coefficient) as a marker for determining dry weight in HD patients using the measured COP and approximated COP. No differences were observed between the mean Kr derived from the measured and approximated COP. We report here significant differences between measured and predicted COP values, and have devised a simple formula for COP approximation in HD patients.     

Combinative Effects of Thanh Hao Miet Giap Thang (Sweet Wormwood and Tortoise Shell Decoction) Ingredients on Antioxidative Activity In Vitro

Background

Traditional formulae usually exhibit therapeutic effects through the combinations of different ingredients. The purpose of this study was to investigate in vitro anti-oxidative activity of Thanh Hao Miet Giap Thang (THMGT) (Sweet Wormwood and Tortoise Shell Decoction) formula and the interactions of its ingredients leading to the overall anti-oxidative effect.

Materials and Methods

We prepared 31 combinations containing two to four of the five ingredients including Herba Artemisia apiacea L (HbA), Carapax Trionycis (Tryonix sinensis) (CT), Rhizoma Anemarrhenae (Anemarrhena asphodeloides) (RzA), Radix Rehmanniae (Rehmannia glutinosa Libosch) (RdR), Moutan Cortex (Paeonia suffruticosa) (MC). These combinations were tested for anti-oxidative activity using DCFH-DA and DPPH assays on Hep G2 cells. We also analyzed changes in expression of genes involved in antioxidant defense system including Nuclear Factor Erythroid-Derived 2-Like 2 (NFE2L2), catalase (CAT), heme oxygenase-1 (HO-1), glutathione peroxidase (GPx), cytoplasmic superoxide dismutase (SOD1), mitochondrial superoxide dismutase (SOD2).

Results

The complete formula and all combinations containing Moutan Cortex showed high antioxidant activity in both radical solution-based chemical assay and cellular-based assay. On the contrary, Carapax Trionycis displayed inhibitory effect on the overall antioxidant activity when present in a combination, an effect clearly emphasized in cellular-based assay. Hep G2 cells treated with the formula showed increased gene expression of HO-1 and SOD2 while expression of CAT, SOD1, GPx was unchanged.

Conclusion

Our results suggested that THMGT had anti-oxidative activity essentially through intrinsic reducing capacities and the overall activity of the formula resulted from enhancing and inhibiting interactions of ingredients.