中药配方颗粒品种统一标准的有关问题探讨

通过参考《中国药典》2015年版和相关文献,结合国家药典委员会2016年发布的《中药配方颗粒质量控制与标准制定技术要求(征求意见稿)》,综合考虑中药配方颗粒的实际生产情况,对《关于中药配方颗粒品种试点统一标准的公示》中质量标准特异性、定量检测指标的选择和指标性成分转移率等方面进行讨论,根据讨论结果为中药配方颗粒质量标准的完善和提高提出了相关建议,为推进配方颗粒产业健康发展提供参考。     

Persistent Fistula for Treatment of a Failed Periprosthetic Joint Infection: Relic From the Past or a Viable Salvage Procedure?

BackgroundNew treatment algorithms for periprosthetic joint infections (PJIs) show high success rates in achieving permanent infection eradication with some degree of failure. Different salvage procedures are described, but there is no evidence for persistent fistula (PF). The purpose of this study was to analyze PF as a salvage procedure in patients with therapy-resistant PJIs.MethodsThis retrospective analysis included all patients treated with PF (2005-2018) in a maximum care center with PJI (knee or hip). The baseline parameters (age, sex, BMI) and other data (number of surgeries, pathogen spectrum, American Society of Anesthesiologists classification) were recorded. The function was documented using the Harris Hip Score, the Knee Society Score, and the quality of life using the SF-36 Health Survey.ResultsA total of 159 patients were included (80 ± 12 years) and subdivided into four groups: hip (n = 66), knee (n = 13), Girdlestone resection arthroplasty (n = 50), knee arthrodesis (n = 27). Patients stayed 111 ± 87 days in the hospital, underwent six operations and three revisions after establishing PF. The mean American Society of Anesthesiologists score was 2.7. The BMI was 31 ± 3 kg/m² (P = .1). The follow-up was 2.8 ± 0.5 years including 27 patients. The Harris Hip Score and Knee Society Score were 38 and 34, respectively. SF-36 showed no significant difference.ConclusionThe study showed poor outcomes regarding quality of life and the function of the infected joint. Therefore, the indication for establishing a PF in the treatment of PJI must be assessed very critically. PF is only an option for multimorbid patients with a limited life expectancy.     

The secrets of human stem cell-derived transfusable RBC for targeted large-scale production and clinical applications: A fresh look into what we need most and lessons to be learned

Blood transfusion, using the safest conventional blood bioproducts, is an irreplaceable part of substitution therapy. It is considered the most essential supportive clinical intervention aimed to restore the health of patients in need. Nevertheless, numerous unresolved problems are still associated with current blood substitution therapy. To alleviate our dependency on blood donors, many investigators have been focusing on the quest for stem cell-derived blood cells in line with major developments in the field of regenerative medicine. The main objective is to provide a safe and highly standardized universal cultured red cell concentrate [CRBC] for all clinical applications, regardless of blood groups. Currently, we are close to overcoming some of the main obstacles in culturing cells. This concise report is a prelude to the immortalized cell lines that are ready for in vivo clinical trials. It is only through the sharing of experimental ideas and knowledge-based strategies that we will be able to achieve such an enormous task and better understand ‘’the one for all concept’’ of CRBCs and their universal usage in all clinical settings.     

针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响

目的分析针刺联合优质护理干预对周围性面神经麻痹急性期患者的影响。方法以2016年1月—2019年2月60例周围性面神经麻痹急性期患者为研究对象,患者按照护理方法不同,将其分为对照组、观察组各30例患者,对照组进行神经内科的常规护理,观察组进行针刺联合优质护理干预,对2组患者临床疗效和护理满意度等进行观察。结果对照组总有效率为70%,观察组总有效率为96.6%(P<0.05)。对照组护理满意度为63.3%,观察组护理满意度为96.6%(P<0.05)。结论周围性面神经麻痹急性期患者临床治疗中,针刺联合优质护理干预的应用,可以提升患者临床疗效,降低患者住院时间,实现其护理满意度的提升。     

基于网络药理学及定性定量研究的甘草质量标志物预测分析

目的基于中药质量标志物(Q-marker)的理念,对甘草从化学成分有效性和可测性的角度进行Q-marker的初步预测。方法基于文献整合及数据分析对甘草Q-marker的来源范围进行筛选,通过网络药理学进行成分有效性分析,采用高效液相色谱法对4个产地15批甘草药材进行定性和定量研究,运用模式识别方法筛选出造成组间差异的主要标志性成分,结合网络药理学结果进一步确定甘草的Q-marker。结果文献研究确定黄酮类和三萜类成分为甘草Q-marker的主要来源范围;网络药理学结果表明甘草苷、甘草酸等成分在"成分-靶点-通路"网络中具有高连接度,是其主要活性成分;建立15批甘草样品的指纹图谱,通过偏最小二乘法判别分析(PLS-DA)明确了甘草苷、芹糖甘草苷等5个成分为主要标志性成分;甘草苷、芹糖甘草苷、甘草酸、甘草次酸4个成分含量测定结果表明不同产地间成分含量具显著差异,结合网络药理学分析结果进一步明确了甘草苷、芹糖甘草苷、甘草酸、甘草次酸可作为甘草Q-marker。结论以黄酮类和三萜类成分作为甘草Q-marker的来源范围,通过网络药理学(有效性)结合多产地甘草药材定性定量(可测性)研究最终确定甘草苷、芹糖甘草苷、甘草酸和甘草次酸4个成分可作为甘草潜在Q-marker科学合理,为甘草的质量控制提供参考依据。