经颅多普勒超声联合颈动脉超声对缺血性脑血管病的诊断价值

目的分析经颅多普勒超声(TCD)联合颈动脉超声对缺血性脑血管病的诊断价值。方法选取缺血性脑血管病患者93例,均行数字减影血管造影(DSA)、TCD及颈动脉超声检查,并以DSA结果为诊断标准,比较TCD和颈动脉超声单用及两者联合的检查结果,分析三者在缺血性脑血管病中的诊断灵敏度、特异度、阳性预测值及阴性预测值。结果 93例患者颅内外异常血管共763条。单用TCD显示颅内血管异常73例,异常血管294条;单用颈动脉超声显示颅外血管异常64例,异常血管275条;TCD联合颈动脉超声显示颅内外血管异常89例,异常血管569条。TCD联合颈动脉超声在缺血性脑血管病诊断方面的灵敏度、特异度、阳性预测值及阴性预测值均高于单用TCD及单用颈动脉超声。结论 TCD联合颈动脉超声可提高缺血性脑血管病诊断的准确性,可作为颅内外血管病变诊断的有效检查手段。     

模糊物元模型评价当归不同提取部位的活血作用

目的：筛选当归活血的有效部位;探讨模糊物元模型在当归不同提取部位活血效果综合评价中的应用。方法：以皮下注射盐酸肾上腺素结合冰水浴建立急性大鼠血瘀模型,通过检测血液流变学及凝血4项[凝血酶原时间（PT）,活化部分凝血活酶时间（APTT）和凝血酶时间（TT）,纤维蛋白原含量（FIB）]指标,评价当归不同提取部位的活血效果;运用基于变异系数权重的模糊物元模型对活血的效果进行综合评价。结果：部位1~7均能降低大鼠全血黏度和血浆黏度,部位2能明显延长PT、TT时间（P<0.05）。反映活血总效应的最大贴进度值为0.527（70%乙醇浸渍部位）。结论：70%乙醇浸渍部位为当归活血的有效部位;基于变异系数权重的模糊物元模型可客观、准确地评价当归不同提取部位活血的综合效果。     

Solid lipid nanocarriers in drug delivery: characterization and design

Introduction: Solid lipid nanoparticles are promising drug carriers for systemic circulations as well as local applications. One of the major challenges for drug delivery is designing nanocarriers for efficient delivery of active substances to the target site and facilitating drug absorption.

Areas covered: In this article, the effects of excipients and particle preparation methods on the properties of solid lipid nanocarriers (SLNCs) and their impact on drug absorption and efficacies related to different administration routes are reviewed and discussed.

Expert opinion: SLNCs have special characteristics, making them attractive as drug delivery systems, for parenteral and oral delivery for systemic effects, or ocular, pulmonary and topical delivery to enhance local treatment efficacy and reducing systemic side effects. Both excipients and fabrication methods are crucial for the function and size of nanoparticles and should be considered simultaneously in designing particles to obtain the optimal drug absorption and efficacy, especially for local treatments. Despite the demonstrated advantages by the preclinical studies, further studies on improved understanding of the interactions of SLNCs with biological tissues of the target site is necessary for efficient designing functional nanoparticles for clinical applications.

Abbreviations: DG: diglycerides; FFA: free fatty acids; GMS: glyceryl monostearate; MG: monoglycerides; NLC: nanostructured lipid carriers; PL: phospholipids; SLM: solid lipid microparticles; SLN: solid lipid nanoparticles; SLNC: solid lipid nanocarriers; TG: triglycerides.     

Long-term performance of instrumental activities of daily living (IADL) in young and middle-aged stroke survivors: Results from SAHLSIS outcome

Background: Although stroke prevalence is increasing and large proportions of stroke survivors are expected to live many years after stroke onset, research on the long-term consequences of stroke for instrumental activities of daily living (IADL) is limited.

Aim: To explore performance of IADL seven years post-stroke onset and identify predictors of long-term IADL performance based on commonly employed acute measures and demographic characteristics in young and middle-aged stroke survivors.

Methods: Data on stroke survivors were collected from SAHLSIS. IADL performance was assessed at 7 years using the Frenchay Activities Index (FAI). Demographic data and baseline measures were assessed as predictors of FAI outcome, using logistic regression.

Results: 237 stroke survivors with a median age of 63 at follow-up were included. Participants had predominantly suffered a mild stroke and >90% lived at home with no community services. Mean FAI was 25.7(score range 0-45), indicating reduced levels of participation in IADL. Frequency of performance of IADL was lowest for work/leisure activities. Gender, cohabitation status, initial stroke severity and baseline score on mRS were independently associated with IADL outcome.

Conclusions: Reduced levels of participation in IADL persist many years after stroke onset and indicate a need to adapt a long-term perspective on stroke rehabilitation.     

桂枝茯苓方在脑血管疾病中的应用及作用机制研究进展

脑血管病具有高发病率、高致残率、高死亡率及高再发率的特点,是现代研究重点。现代研究表明桂枝茯苓方具有抗炎、免疫调节、抗氧化等作用,可以用于缺血性脑血管病与出血性脑血管病的治疗,但临床主要运用于缺血性脑血管病,其中又以急性脑梗死为主,并且取得较好的临床疗效。对桂枝茯苓方在脑血管病的临床应用及作用机制研究进展进行综述,以期为桂枝茯苓方在脑血管病的深入研究提供参考。     

益气养阴活血法对糖尿病肾病患者血液流变学的影响

目的:观察益气养阴活血法对糖尿病肾病患者血液流变学的影响。方法:选择本院2015年1月—2016年1月就诊的糖尿病肾病患者72例,随机分为对照组和观察组,每组各36例。对照组给予厄贝沙坦治疗,观察组以益气养阴为治疗大法,给予自拟中药方剂治疗。观察两组患者治疗前后血液流变学指标变化情况及肾功能[血尿素氮(blood urea nitrogen,BUN)、肌酐(serum creatinine,SCR)、尿白蛋白排泄率(urinary albumin excretion rates,UAER)及24 h尿微量白蛋白(uric micro-albumin in 24 h,24h UMA)]相关指标。结果:两组患者治疗后血液流变学指标改善情况优于治疗前,且观察组优于对照组,差异均有统计学意义(P0.05)。观察组治疗后BUN、UAER、Scr及24h UMA低于治疗前,且观察组低于对照组,差异均有统计学意义(P0.05)。结论:益气养阴活血法可有效改善糖尿病肾病患者血液高凝状态,从而促进微循环的改善,减少肾损害,延缓病情的进展。     

尤可调理脾胃治疗急危重症经验

尤老师认为在危重病的抢救治疗中,强化中医药辨证治疗。中医治疗疾病强调"扶正祛邪",脾胃为气血生化之源,脾胃功能正常与否决定了疾病的发展预后,尤老师在诊疗疾病特别是急危重症的过程中时刻不忘顾护脾胃,而调理脾胃,贵在顺应脏腑生理特性,使脾升胃降,通腑泄浊。具体应用在急性心肌梗死、肺炎、脓毒症、呼吸衰竭、胃肠功能障碍、肾功能衰竭、急性脑血管病中,取得较好临床疗效。     

艾灸对介入治疗术后缺血牲脑血管患者血清炎症细胞因子的影响

目的:观察艾灸对介入治疗术后缺血性脑血管患者血清炎症细胞因子的影响.方法:将80例患者随机分为观察组、对照组各40例,2组均给予经皮腔内血管成形和支架植入术(PTAS)介入治疗,观察组同时给予足三里(双侧)、绝骨(双侧)艾灸治疗.测定2组治疗前后血清白细胞介素-1β (IL-1β)、白细胞介素6(IL-6)、高度敏感C反应蛋白(hs-CRP)水平.结果:血浆IL-1β、IL-6、hs-CRP水平观察组治疗后与治疗前比较,差异有统计学意义(P＜0.05),且治疗后各时期与对照组比较,差异也有统计学意义(P＜0.05).结论:艾灸足三里、绝骨穴可显著改善介入治疗后缺血性脑血管病患者的炎症反应,减少血清中的炎症细胞因子.     

活血化瘀法治疗肢体闭塞性动脉硬化症136例效果探讨

目的探讨活血化瘀法治疗肢体闭塞性动脉硬化症临床应用效果。方法对照组接受临床常规西医治疗,研究组在西医常规治疗基础上加用中医活血化瘀法,记录两组肢体闭塞性动脉硬化症患者临床疗效。结果两组肢体闭塞性动脉硬化症患者均顺利完成相应治疗,研究组临床治疗总有效率(86.03%)显著高于对照组(61.76%),数据对比P0.05。结论肢体闭塞性动脉硬化症患者在常规西医治疗基础上加用中医活血化瘀法可显著提高其临床疗效,有利于保障患者生活质量及身心健康。     

补肾活血组方对人流术后月经过少的临床观察

目的探究补肾活血组方对人流术后月经过少的临床疗效。方法将90例人流术后月经过少患者随机分为两组,观察组给予补肾活血组方治疗,对照组给予常规治疗,对比两组疗效。结果观察组有效率显著高于对照组(P0.05);治疗后,观察组行经时间显著高于对照组(P0.05);观察组子宫内膜厚度显著高于对照组(P0.05)。结论人流术后月经过少患者经补肾活血法治疗,可有效促进月经恢复,疗效显著。