In vitro dissolution and oral bioavailability study of fenofibrate nanomatrix system prepared by hot-melt extrusion

Solvent evaporation method for preparation of nanomatrix has the disadvantages, such as residual organic solvent, environmental pollution, explosion-proofing and so on. To overcome these shortcomings, a series of fenofibrate nanomatrix drug delivery system (NDDS) consisting of nano-porous silica Sylysia^®350 (S350) and pH sensitive material Eudragit^® L100-55 (EL100-55) were prepared using hot-melt extrusion (HME), and their in vitro dissolution and in vivo bioavailability were compared. Finally, the formulation with the highest in vivo bioavailability was selected as the optimized formulation for DSC and PXRD characterization. The results showed that the optimized NDDS showed a higher bioavailability than the reference formulation, although there was crystalline form drug remaining in NDDS. The relative bioavailability of the optimized formulation was 157.1% compared with the commercial product Lipanthyl^®. In addition, the relative bioavailability of the optimized formulation was 124.8% in comparison with the formulation prepared by solvent evaporation method, showing that the NDDS prepared by the HME method was effective in improving the bioavailability of fenofibrate. In conclusion, HME was a promising method to prepare NDDS.     

基于"能力本位"理念的分层带教在呼吸科护生规培中的应用

目的　探究基于"能力本位"理念的分层带教在呼吸科护生规培中的作用。方法　选取2019年9月至2020年8月期间到北京积水潭医院呼吸科进行规范化培训的70名护生作为研究对象。采用掷硬币法随机分为研究组和对照组，各35名。研究组采用基于"能力本位"理念的分层带教，对照组采用常规分层带教。比较两组规培护生护理能力及带教质量。运用SPSS 23.0进行t检验和卡方检验。结果　两组护生规培后理论知识成绩[（95.29±3.13）、（86.29±5.13）]均高于规培前[（78.22±4.48）、（77.29±5.13）]。研究组规培后理论知识、操作技能、病案汇报等3项成绩及综合素质成绩均高于对照组，差异均有统计学意义（P<0.05）。研究组对带教质量的各项指标的满意度高于对照组，差异均有统计学意义（P<0.05）。结论　基于"能力本位"理念的分层带教可提高呼吸科护生规培教学的质量及护生的综合素质，值得应用推广。     

基于子宫内膜异位症与恶性肿瘤的相关性探析补肾化瘀法作用机制及中医理论依据

子宫内膜异位症其异位内膜组织虽然在形态学上呈良性表现，却具有类似恶性肿瘤的生物学特性。中医学一般认为，“正虚伏邪”为恶性肿瘤的病机特点；那么，肾虚血瘀既属于“正虚伏邪”的范畴，又体现了EMs发病学和疾病发生、发展过程中的主要特点。在“病证相应”的中医治则之下，补肾化瘀法的临床疗效主要表现为：缓解痛经症状、提高受孕率，以及调整月经周期。本文基于EMs与恶性肿瘤的相关性，通过分析补肾化瘀法治疗EMs的理论依据及其抑制异位内膜侵袭的调控机制，主要包括解除免疫抑制、阻断局部微血管新生等，旨在阐明其疗效显著的原因，为临床推广提供可靠的基础研究证据。     

学校结核病影响因素及防控策略概述

结核病是一种严重的呼吸系统传染性疾病,在世界范围内广泛传播。某些特殊群体结核病发病风险较高,如学校学生及相关工作人员。学校学生聚集,人口密度大,有利于疾病的传播与扩散,导致聚集性疫情的发生。学校结核病疫情的出现主要与学生免疫力低、就诊延误现象、人口密度大、性别、年龄、知晓率等因素有关。为了尽早发现传染源,减少结核病在校园内的传播,使用合理的方法对密切接触者进行筛查极为重要。应明确各机构在学校结核病防控工作中的职责与重点,共同做好防控工作,减少学校结核病疫情的发生。     

Comparison of survival between adolescent and young adult vs older patients with hepatocellular carcinoma

BACKGROUNDDue to the special clinical features and biologic characteristics of adolescent and young adult (AYA) cancers, AYA cancers are different from cancers in children and elderly individuals. However, there are few reports on AYA hepatocellular carcinoma (HCC).AIMTo investigate the overall survival (OS) of AYA (15-39 years) and elderly (40-74 years) patients with HCC.METHODSThe data of all the HCC cases were extracted from the Surveillance, Epidemiology, and End Results database from 2004 to 2015 and were then divided into two groups based on age: AYA group (15-39 years) and older group (40-74 years). Kaplan-Meier curves and log-rank tests were used to compare the OS of the two groups. Propensity score matching (PSM) was employed to analyze the OS difference between the two groups. The Cox proportional hazards regression model was used to perform multivariate analysis to explore the risk factors for OS of HCC patients.RESULTSCompared to elderly cancer patients, AYA patients with HCC had a worse Surveillance, Epidemiology, and End Results stage, including the distant stage (22.1% vs 15.4%, P < 0.001), and a more advanced American Joint Committee on Cancer (AJCC) stage, including AJCC III and IV (49.2% vs 38.3%, P < 0.001), and were more likely to receive surgery (64.5% vs 47.5%, P < 0.001). Before PSM, the AYA group had a longer survival in months (median: 20.00, interquartile range [IQR]: 5.00-62.50) than the older group (median: 15.00, IQR: 4.00-40.00) (P < 0.001). After PSM, the AYA group still had a longer survival in months (median: 21.00, IQR: 5.00-64.50) than the older group (median: 18.00, IQR: 6.00-53.00) (P < 0.001). The Cox proportional hazards regression model showed that advanced age (hazard ratio [HR] = 1.405, 95%CI: 1.218-1.621, P < 0.001) was a risk factor for OS of HCC patients. In the subgroup analysis, the Cox proportional hazards regression model showed that in AJCC I/II HCC patients, advanced age (HR = 1.749, 95%CI: 1.352-2.263, P < 0.001) was a risk factor for OS, while it was not a risk factor in AJCC III/IV HCC patients (HR = 1.186, 95%CI: 0.997-1.410, P = 0.054) before PSM. After PSM, advanced age (HR = 1.891, 95%CI: 1.356-2.637, P < 0.001) was still a risk factor for OS in AJCC I/II HCC patients, but was not a risk factor for OS in AJCC III/IV HCC patients (HR = 1.192, 95%CI: 0.934-1.521, P = 0.157) after PSM.CONCLUSIONAYA patients with HCC have different clinical characteristics from older adults. In different AJCC stages, the two groups of patients have different OS: In AJCC I/II HCC patients, advanced age is a risk factor for OS, but it is not a risk factor for OS in the AJCC III/IV HCC patient group.     

Multi‐scale network regression for brain‐phenotype associations

Brain networks are increasingly characterized at different scales, including summary statistics, community connectivity, and individual edges. While research relating brain networks to behavioral measurements has yielded many insights into brain‐phenotype relationships, common analytical approaches only consider network information at a single scale. Here, we designed, implemented, and deployed Multi‐Scale Network Regression (MSNR), a penalized multivariate approach for modeling brain networks that explicitly respects both edge‐ and community‐level information by assuming a low rank and sparse structure, both encouraging less complex and more interpretable modeling. Capitalizing on a large neuroimaging cohort (n = 1, 051) , we demonstrate that MSNR recapitulates interpretable and statistically significant connectivity patterns associated with brain development, sex differences, and motion‐related artifacts. Compared to single‐scale methods, MSNR achieves a balance between prediction performance and model complexity, with improved interpretability. Together, by jointly exploiting both edge‐ and community‐level information, MSNR has the potential to yield novel insights into brain‐behavior relationships.     

Exendin-4 attenuates pain-induced cognitive impairment by alleviating hippocampal neuroinflammation in a rat model of spinal nerve ligation

Glucagon-like peptide-1 receptor has anti-apoptotic,anti-inflammatory,and neuroprotective effects.It is now recognized that the occurrence and development of chronic pain are strongly associated with anti-inflammatory responses;however,it is not clear whether glucagon-like peptide-1 receptor regulates chronic pain via anti-inflammatory mechanisms.We explored the effects of glucagon-like peptide-1 receptor on nociception,cognition,and neuroinflammation in chronic pain.A rat model of chronic pain was established using left L5 spinal nerve ligation.The glucagon-like peptide-1 receptor agonist exendin-4 was intrathecally injected into rats from 10 to 21 days after spinal nerve ligation.Electrophysiological examinations showed that,after treatment with exendin-4,paw withdrawal frequency of the left limb was significantly reduced,and pain was relieved.In addition,in the Morris water maze test,escape latency increased and the time to reach the platform decreased following exendin-4 treatment.Immunohistochemical staining and western blot assays revealed an increase in the numbers of activated microglia and astrocytes in the dentate gyrus of rat hippocampus,as well as an increase in the expression of tumor necrosis factor alpha,interleukin 1 beta,and interleukin 6.All of these effects could be reversed by exendin-4 treatment.These findings suggest that exendin-4 can alleviate pain-induced neuroinflammatory responses and promote the recovery of cognitive function via the glucagon-like peptide-1 receptor pathway.All experimental procedures and protocols were approved by the Experimental Animal Ethics Committee of Renmin Hospital of Wuhan University of China(approval No.WDRM 20171214)on September 22,2017.     

Larger regional volume of the thalamus in diarrhea-predominant irritable bowel syndrome: a cross-sectional study

Brain Imaging and Behavior - As a relay center between the cerebral cortex and various subcortical brain areas, the thalamus is repeatedly associated with the dysfunction of brain-gut interaction...     

基于“互联网+”探索针对2型糖尿病出院患者的创新型药学随访服务模式

目的 利用“互联网+”技术手段,探索针对2型糖尿病出院患者的创新型药学随访服务模式。方法 选取2019年1月至2019年5月于我院内分泌科住院治疗好转后出院2型糖尿病患者,开展“互联网+”药学随访3个月,通过比较患者随访前后用药依从性Morisky问卷评分、2型糖尿病患者自我管理能力评分以及糖尿病综合控制指标的变化情况,评估“互联网+”药学随访的干预效果。结果 药学随访3个月后,2型糖尿病出院患者用药依从性得分从1.94±1.32下降至1.09±0.95(P＜0.05),自我管理能力评分由61.91±19.36提高到79.12±13.62(P＜0.05)；糖化血红蛋白水平从(9.49±2.31)%下降至(6.69±1.49)%(P＜0.05),低密度脂蛋白胆固醇水平从(2.65±0.95)mmol/L下降至(2.22±0.71)mmol/L(P＜0.05),空腹血糖水平随访前后分别为(6.72±1.38)mmol/L、(6.79±1.07)mmol/L(P>0.05)无显著性差异,基础血糖保持良好。结论 “互联网+”药学随访模式,能显著提高2型糖尿病出院患者的用药依从性、自我管理能力以及糖尿病综合指标的控制水平,拓展了医疗机构临床药师的药学服务空间,值得在临床实践中进一步完善推广。     

彩色多普勒超声对肝圆韧带架桥门-腔静脉分流术后桥血管通畅性的评价

目的 探讨彩色多普勒超声对肝圆韧带架桥门-腔静脉分流术后桥血管通畅性的观察,进而对手术疗效进行评价。方法 肝圆韧带架桥门-腔静脉分流术后病人共43例 ,用二维超声及彩色多普勒分别于术后3、12及24个月观察桥血管通畅情况,依据桥血管不同的超声表现,分为桥血管通畅组和桥血管狭窄组两组。结果 术后3个月,有41例血管通畅,2例血管狭窄;术后12个月38例血管通畅,5例血管狭窄;术后24个月30例血管通畅,13例血管狭窄,随着时间的延长桥血管发生狭窄的概率增加,术后3个月与24个月比较,P<0.05。结论 术后彩色多普勒超声监测桥血管是评价手术效果的重要手段。