Metabolic profiles of corydaline in rats by ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry

1. Corydaline, an isoquinoline alkaloid obtained from the rhizomes of Corydalis yanhusuo, exhibits anti-acetylcholinesterase, anti-angiogenic, anti-allergic and gastric-emptying activities. In this study, a rapid and reliable ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-Q/TOF-MS) method was developed and employed for the comprehensive study of the metabolites of corydaline in rats.

2. Altogether, 43 metabolites were identified in the plasma (11), bile (9), urine (34) and feces (21) of rats after oral administration of corydaline at a dose of 4.5mg/kg.

3. It was demonstrated that demethylation, hydroxylation, sulfation and glucuronidation were the major metabolic transformation pathways. Among these, two metabolites were identified as tetrahydropalmatine and isocorybulbine, and 33 phase I and phase II products were inferred to be new metabolites arising from the in vivo metabolism of corydaline.

4. Importantly, this research provides scientific and reliable support for full understanding of the metabolic profiles of corydaline and the results could help to elucidate its safety and efficacy.     

小青龙汤联合穴位贴敷治疗支气管哮喘临床研究

目的:观察小青龙汤联合穴位贴敷治疗支气管哮喘的临床疗效。方法:将80例随机分为2组,每组40例,2组治疗期间均给予必要的护理干预,对照组给予西医常规治疗,观察组在对照组的基础上联合小青龙汤内服及穴位贴敷治疗;疗程均为2个月,评价2组临床疗效,治疗前后哮喘控制水平测试(ACT)评分、肺功能[第1秒用力呼气量(FEV1)、用力肺活量(FVC)]及血清免疫球蛋白E(IgE)水平变化,并记录治疗期间用药安全性。结果:总有效率观察组为95.0%,对照组为70.0%,2组比较,差异有统计学意义(P0.05)。治疗后,2组患者ACT评分较治疗前明显升高(P0.05),IgE水平较治疗前明显降低(P0.05);且观察组2项指标改善均较对照组更显著(P0.05)。治疗后,2组患者FEV1、FVC水平均较治疗前明显升高(P0.05),且观察组FEV1、FVC水平均高于对照组(P0.05)。治疗期间2组均未出现与治疗相关的不良反应。结论:在西医常规治疗的基础上,小青龙汤内服联合穴位贴敷治疗支气管哮喘可有效改善患者临床症状及肺功能,疗效优于单纯西药治疗。     

急性胰腺炎严重程度评分系统的临床研究进展

急性胰腺炎（acute pancreatitis，AP）是临床最常见的急腹症之一，近年来经过国内外学者共同努力，急性胰腺炎病死率和并发症发生率明显下降，但重症急性胰腺炎（severe acute pancreatitis，SAP）的病死率仍居高不下，临床早期识别SAP对改善患者预后至关重要。自提出AP严重程度评分后，临床判断病情严重程度便有了依据。随着疾病研究的进展，对临床初步判断AP病情严重程度的评分系统日益繁多，本文对目前临床使用较广泛的几种AP严重程度经典评估系统及近年来的研究进展做简单综述。     

1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的临床应用

目的探讨1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的临床疗效。方法回顾性分析2018年1月至2019年12月于本院泌尿外科行1470 nm激光解剖性切除浅表性膀胱肿瘤患者60例的临床资料,所有患者均通过膀胱镜检查和CT或MRI检查,术前诊断为非肌层浸润性膀胱癌。分析1470 nm激光在解剖性切除非肌层浸润性膀胱癌中的应用效果。结果所有患者均顺利完成手术,无中转开放手术,并且术中无并发症,手术时间为10~30 min,平均(15.3±4.9)min,术后冲洗液无色或淡粉色,未见血块,术后1周拔除导尿管。结论1470 nm激光应用于解剖性切除浅表性膀胱肿瘤中效果显著,具有无瘤原则,利于肿瘤分期,可减少闭孔反射。     

活血化瘀联合温阳生肌法治疗青斑样血管炎临床分析

目的分析青斑样血管炎的临床特征及中医证候特点,提高对本病的诊断及中医辨证水平。方法对12例确诊的青斑样血管炎患者的临床表现、组织病理、中医证候、中医治则、方药、预后进行回顾性分析。结果12例患者中男3例,女9例,年龄15~45岁,平均年龄20.17岁,中医药治疗时间为14~70 d,平均时间为54.60 d。12例患者均为对称皮疹,均伴有疼痛;皮损特点均为红斑、水疱、紫癜、坏死、水肿、溃疡,呈现线状或放射状分布;皮损痊愈后见色素沉着斑或线状象牙白色萎缩性瘢痕。所有患者经过组织病理确诊。12例患者均符合寒凝血瘀证。坏死期选用活血化瘀法,应用桃红四物汤加减;溃疡期选用温阳生肌法,应用自拟方温阳生肌汤加减。局部使用黄连膏换药。12例患者经中医药治疗后皮损均完全消退,溃疡愈合,遗留色素沉着斑及象牙白色萎缩性瘢痕。停药后随访6个月无1例复发。结论活血化瘀联合温阳生肌法为中医治疗青斑样血管炎提供了新的思路,并能明显降低复发率,值得进一步研究。     

新冠肺炎临床评价核心指标集比较分析＊

目的 对已公开发表的新冠肺炎核心指标集及其研究方法进行比较分析，为临床试验和证据转化研究提供参考信息。方法 计算机检索COMET数据库，并补充检索CNKI、WanFang、PubMed、Web of Science、The Cochrane Library等数据库，收集发表的新型冠状病毒肺炎（Coronavirus Disease 2019，COVID-19）核心指标集（Core Outcome Set，COS）研究，检索时间截至为2021年3月31日。按照纳入排除标准筛选文献，并提取研究基本信息、研究方法及指标数据，对其进行描述性分析。结果 共纳入5项COVID-19核心指标集相关研究（4项为COVID-19-COS研究，1项为COVID-19核心指标测量工具研究）。相同的结局指标包括死亡率、病毒核酸检测、临床进展、恢复期、临床症状评分及临床分型等。指标来源主要来自临床试验注册平台和问卷调查；达成共识的方法主要采用共识会议；利益相关群体中临床专家、方法学专家和医疗管理人员涉及较多。结论 不同的新冠肺炎核心指标集研究有一定的共性，但由于应用场景不同，也存在一定差异。随着对疾病认识的深化，相关COVID-19核心指标需要加强测量方法和疗程推荐。     

Advancement of chimeric antigen receptor-natural killer cells targeting hepatocellular carcinoma

With the advance of genome engineering technology, chimeric antigen receptors (CARs)-based immunotherapy has become an emerging therapeutic strategy for tumors. Although initially designed for T cells in tumor immunotherapy, CARs have been exploited to modify the function of natural killer (NK) cells against a variety of tumors, including hepatocellular carcinoma (HCC). CAR-NK cells have the potential to sufficiently kill tumor antigen-expressing HCC cells, independent of major histocompatibility complex matching or prior priming. In this review, we summarize the recent advances in genetic engineering of CAR-NK cells against HCC and discuss the current challenges and prospects of CAR-NK cells as a revolutionary cellular immunotherapy against HCC.     

Experimental and Numerical Study on the Mechanical Behavior of Composite Steel Structure under Explosion Load

Most engineering structures are composed of basic components such as plates, shells, and beams, and their dynamic characteristics under explosion load determine the impact resistance of the structure. In this paper, a three-dimensional composite steel structure was designed using a beam, plate, and other basic elements to study its mechanical behavior under explosion load. Subsequently, experiments on the composite steel structure under explosion load were carried out to study its mechanical behavior, and the failure mode and deformation data of the composite steel structure were obtained, which provided important experimental data regarding the dynamic response and mechanical behavior of the composite steel structure under explosion load. Then, we independently developed a parallel program with the coupled calculation method to solve the numerical simulation of the dynamic response and failure process of the composite steel structure under explosion load. This program adopts the Euler method as a whole, and Lagrange particles are used for materials that need to be accurately tracked. The numerical calculation results are in good agreement with the experimental data, indicating that the developed parallel program can effectively deal with the large deformation problems of multi-medium materials and the numerical simulation of the complex engineering structure failures subjected to the strong impact load.