中药研发与质量评价关键技术的探索

中药质量是影响中药临床疗效、产业发展和国际拓展的重大关键科学问题。本文以“中药研发与质量评价关键技术的探索”为主题,介绍了中药质量研究国家重点实验室的建设进展和境外创新平台的定位。同时,从中药质量的研究（有效性、安全性、稳定性、可控性和系统性研究）和创新中药研发等方面,探讨如何将先进的技术真正地应用到药审工作中,以及如何将科学研究基础和前沿的学术进展应用到创新药物的研发当中,从而保障药物的安全有效和质量可控。     

Measuring quality and outcomes in intensive care

Whilst quality measures are integral to the maintenance of a high standard of patient care, high-quality care remains a complicated concept to define in the context of acute care. In this article we explore how quality can be measured in the intensive care unit. Standard outcome metrics such as mortality are tangible comparators, but do not offer a comprehensive assessment of quality for the complex heterogeneity of the Intensive care population. We explore the Donabedian model as a means to describe the importance of outcomes, processes, structure and environment to inform the measurement of quality. These concepts can be more abstract and difficult to measure but can provide significant insight into the culture of a unit and the resulting performance, and thus provide a more comprehensive measure of quality.     

CALB2介导的肿瘤微环境免疫细胞浸润在肝癌复发中的作用机制分析

[摘要] 目的 利用生物信息学技术分析筛选出与肝癌复发相关的核心基因及信号通路,为探索肝癌复发的分子机制提供理论依据。方法 从TCGA和GEO数据库下载肝癌相关数据集,利用edgeR算法筛选差异表达基因。选择关键基因后,应用LASSO-Logistic回归分析构建复发预测模型。 ssGSEA、CIBERSORT和MCP算法用于评估免疫浸润细胞。结果 共筛选出343个复发相关差异表达基因。富集分析表明,大多数基因富集于细胞分化、跨膜转运蛋白、转运乙酰胆碱复合物。蛋白质-蛋白质相互作用网络分析确定了 12 个关键基因。然后,通过 Lasso-logistic 回归分析确定了一个独立的风险评分模型,其中包括3个基因 SST、CALB2 和 DRD2。该风险评分显示出较好的预测能力,并且还构建了基于风险评分的临床列线图。此外,证明了CALB2在肿瘤组织中低表达,与肿瘤微环境中的免疫浸润细胞呈正相关。结论 复发相关基因模型可以提供较好的预测患者复发的能力,其中的核心基因CALB2 可以在肝癌复发中发挥关键作用。     

仲景治血痹用针遣药探析

血痹为体虚受风,卫阳不足,血行不畅所致。若病情属较轻,麻木不甚,脉见微涩,寸、关部微紧,脉微主阳气虚弱,脉涩为血行不畅,紧则是外受风寒之寒闭之脉。用针方面,治疗只需针引阳气令阳气通行,对于血分凝滞之病,不独治血分,可用针刺法引动阳气,亦即"气行则血行"之意。针能导引经络去诸痹,故宜针引气血,以泻其邪,而"用针之类,在于调气""调气"不仅是调阳气,调血气,还调一身之气,气被调动了,阳气行则外邪去,气血调和,则寒散痹除。用药方面,张仲景治血痹用黄芪桂枝五物汤以益气通阳,和营行痹,此方即桂枝汤去甘草加黄芪,倍用生姜。为何要去甘草加黄芪,倍用生姜?去甘草之意在于去掉甘草的缓和之性,使药效更快发挥作用;倍用生姜是取其辛温行阳,温振中阳而行卫表,助桂枝走表散邪,阳通血行,血痹自除。     

补中益气汤“要药”配伍的关键性增效作用对脾虚小鼠的影响

目的:研究补中益气汤"要药"升麻、柴胡的配伍对脾虚小鼠的影响,验证方剂中"要药"的客观存在及其关键性的增效作用。方法:90只小鼠随机分为正常组,脾虚模型组,莫沙必利组(1.93×10-3g·kg-1),补中益气汤组(8.58g·kg-1),原方去当归陈皮汤组(7.41g·kg-1),原方去升麻柴胡汤组(7.02g·kg-1),升麻柴胡汤组(1.56g·kg-1),原方去升柴加羌独防汤组(10.53g·kg-1)、原方去升柴加葛根汤组(8.32g·kg-1),每组10只;除正常组外,其余各组均采用大黄法、游泳力竭法、饥饿法3个因素复合的方法复制脾虚小鼠模型。各组分别ig给药7d后,进行抗疲劳机能试验,并观察不同药物对脾虚小鼠免疫器官脾脏、胸腺的脏器指数及小肠炭末推进率的影响。结果:模型组小鼠的游泳时间、脾脏和胸腺质量及小肠推进率均明显低于正常组(P<0.01);升麻、柴胡汤组小鼠的游泳时间、胸腺质量及小肠推进率与模型组比较差异不显著,但其余各给药组游泳时间和小肠推进率均高于模型组(P<0.01);补中益气汤组小鼠的游泳时间明显长于莫沙必利组(P<0.05),但脾脏和胸腺质量及小肠推进率差异不显著;各加减方组小鼠的游泳时间、脾脏和胸腺质量及小肠推进率均明显低于补中益气汤组(P<0.01);补中益气去升柴汤组小鼠的游泳时间及小肠推进率均明显低于补中益气去归陈组(P<0.01,P<0.05)。结论:补中益气汤的"要药"升麻、柴胡较其他佐药对全方的抗疲劳作用、改善免疫功能作用以及胃肠推进作用的贡献度大,证明了"要药"的关键性增效作用;补中益气汤的"要药"升麻、柴胡不能被羌活、独活和防风等升阳药物及升举脾胃清阳的葛根所替代,证明了"要药"的最佳性配伍;本文从实验研究角度验证了方剂"要药"是客观存在的。     

构建中药饮片质量保障体系的关键问题

通过对近10余年来的科研工作总结及对目前中药饮片质量评价方法的现状分析,凝炼构建中药饮片质量保障体系的关键问题。从炮制工艺技术和饮片质量评价技术的传承与创新、完善中药饮片标准物质体系等方面,阐述构建以稳定临床疗效为核心的中药饮片质量保障体系的关键问题,提出中药炮制学科及饮片产业的发展方向及科研思路。     

Structural and Binding Studies of SAP-1 Protein With Heparin

SAP-1 is a low molecular weight cysteine protease inhibitor (CPI) which belongs to type-2 cystatins family. SAP-1 protein purified from human seminal plasma (HuSP) has been shown to inhibit cysteine and serine proteases and exhibit interesting biological properties, including high temperature and pH stability. Heparin is a naturally occurring glycosaminoglycan (with varied chain length) which interacts with a number of proteins and regulates multiple steps in different biological processes. As an anticoagulant, heparin enhances inhibition of thrombin by the serpin antithrombin III. Therefore, we have employed surface plasmon resonance (SPR) to improve our understanding of the binding interaction between heparin and SAP-1 (protease inhibitor). SPR data suggest that SAP-1 binds to heparin with a significant affinity (K_D = 158 nm ). SPR solution competition studies using heparin oligosaccharides showed that the binding of SAP-1 to heparin is dependent on chain length. Large oligosaccharides show strong binding affinity for SAP-1. Further to get insight into the structural aspect of interactions between SAP-1 and heparin, we used modelled structure of the SAP-1 and docked with heparin and heparin-derived polysaccharides. The results suggest that a positively charged residue lysine plays important role in these interactions. Such information should improve our understanding of how heparin, present in the reproductive tract, regulates cystatins activity.     

加强重点学科建设 推动医院转型升级

本文着眼新形势新任务,以重点学科建设为主要抓手,通过更新发展观念、优化平台建设、打造特色技术、配强人才团队等有力措施,对医院重点学科实施分层分类的目标引导管理,带动医院学科建设整体发展,有力推动医院转型升级.