薄层色谱法在当前中药质量标准中的应用探讨

薄层色谱鉴别在历版《中国药典》中的应用经历了从无到有、从少到多的过程；而薄层扫描含量测定在最近几版《中国药典》中的应用比例逐渐降低。随着对中药质量标准体系要求的进一步提高，薄层色谱法的不足之处陆续显现，如仪器普及率低、设备并不简单、结果重复性和稳定性较差、鉴别速度及准确性不及高效液相色谱法、展开剂毒性大等，逐渐不合时宜。在制定中药质量标准时，研究者不应该墨守成规，薄层色谱鉴别也不应该是雷打不动的定性鉴别必备选项。高效液相色谱法具备完全取代薄层色谱法的可行性，薄层色谱法可作为高效液相色谱法的补充。为充分降低检测成本、缩短检测周期、提高鉴别效率，笔者建议中药质量标准体系应该大幅减少薄层色谱鉴别方法的应用，增加高效液相特征图谱鉴定，尽量做到“一个条件，一张图谱”；除非确有必要，《中国药典》等国家质量标准体系应将薄层色谱鉴别作为推荐方法，而非强制标准。     

Health-related quality of life in glomerular disease

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量化体育锻炼对维持性血液透析患者生活质量和疾病转归的影响

目的:观察量化体育锻炼对维持性血液透析(MHD)患者的应用效果,探讨临床治疗体会。方法:将64例MHD患者随机分成2组各32例,对照组给予常规健康宣教、干预治疗和自主锻炼,观察组在其基础上给予量化体育锻炼干预治疗;观察2组患者的运动量指标变化情况,比较生活质量和疾病转归等相关指标。结果:干预6个月后,2组的上肢锻炼时间和步行运动量均较干预前明显提高(P0.01,0.05),观察组的提高幅度更高于对照组(P0.01);2组的疲乏状态、日常生活活动能力(ADL)、焦虑自评量表(SAS)和睡眠质量评分量表(SPIEGEL)等指标均较干预前明显降低(均P0.05),改良SGA评分明显提高(P0.01,0.05),观察组的改善幅度更高于对照组(P0.01)。治疗后,观察组的内瘘血管良好率和肾功能平稳率高于对照组(均P0.05),并发症率和再入院率降低(P0.05)。结论:对MHD患者给予量化体育锻炼干预治疗,能显著提高康复锻炼的运动量和优化锻炼效果,提高患者的生活质量,改善疾病预后。     

Evaluation of long-term efficacy,safety, and effect on life quality of pulsed dye laser in rosacea patients

Background: Rosacea is a chronic disease affecting the patients’ life quality negatively. Although various laser systems are used in the rosacea treatment, studies reporting efficacy and long-term continuity of benefit of laser therapies are scarce.

Objectives: We aimed to evaluate the efficacy, safety, continuity of benefit, and effect on life quality of pulsed dye laser (PDL) in the rosacea patients.

Methods: Fourteen rosacea patients treated with PDL were enrolled in the study. The number of treatment sessions were varied from one to four. The efficacy was evaluated by the physicians’ clinical assessment (PCA), patients’ self-assessment (PSA), and erythema and telengiectasia grading scores. Additionally, the patients were asked about the continuity of the benefit and improvement in their life qualities after the treatment.

Results: Both the erythema and telangiectasia scores were significantly improved after the treatment (p < 0.001). According to PCA, nine patients had a clinical improvement of >50%. According to PSA, 11 patients had good/excellent improvement. Moderate/significant benefit of treatment continued in 12 patients at the follow-up period (mean 21.64 ± 14.25 months). The life quality scores were significantly improved. No serious side effects were observed.

Conclusion: PDL has high and long-term efficacy in the treatment of rosacea with a good safety profile.