糖尿病患者白内障术后焦虑水平对干眼症状及炎症因子的影响

目的：分析糖尿病患者白内障术后焦虑水平对干眼症状及炎症因子的影响。
　　方法：选取2011-01/2015-10我院收治入院的糖尿病白内障患者63例79眼为研究对象。所有患者均符合WHO所制定的糖尿病及白内障的相关诊断标准,并行超声乳化加人工晶状体植入术。术后1d 采用汉密顿焦虑量表( HAMA)对所有患者进行心理评定,按照评定结果将患者分为两组,<14分为非焦虑组,共34例,≥14分为焦虑组,共29例。比较两组的干眼情况与炎症反应程度。
　　结果：术后第1d两组干眼症状得分情况未见统计学差异(P>0.05),术后7d两组干眼症状得分情况存在统计学差异,焦虑组干眼症状重于非焦虑组( P<0.05)。术后3 lo两组干眼症状得分情况未见统计学差异(P>0.05)。术后第1d两组患者的前房炎症反应程度相比未见统计学差异(P>0.05),术后第7d两组炎症反应程度相比,焦虑组较非焦虑组更为严重,差异具有统计学意义(P<0.05)。术后3 lo两组患者的前房炎症反应程度相比未见统计学差异( P>0.05)。术后第1 d两组IL-1β、IL-6及TNF-α水平比较未见统计学差异(P>0.05),术后第7d 焦虑组的IL-1β、IL-6及TNF-α水平显著高于非焦虑组,差异具有统计学意义( P<0.05)。术后3 lo两组IL-1β、IL-6及TNF-α水平比较未见统计学差异( P>0.05)。
　　结论：焦虑因素对于糖尿病合并白内障患者术后干眼症状与炎症反应程度具有显著影响,在术前进行焦虑评估,有针对性地制定心理干预措施,对于患者短时间内的术后恢复具有重要意义。     

炎症免疫相关信号通路在干眼发病机制中的研究进展

干眼是泪液和眼表的一种多因素疾病,其中炎症是干眼发病机制中最关键的因素,因此干眼的炎症机制及抗炎治疗已成为近年研究的热点。但关于干眼患者眼表所发生的信号传导通路改变目前知之甚少,尤其是炎症因子在干眼中激活相关信号传导通路以及受后者所调控的研究还比较少也比较新。本文主要针对炎症因子在干眼中激活相关信号通路及受相关通路调控的研究进展进行综述。     

羧甲基纤维素钠眼液联合rhEGF治疗白内障术后干眼症

目的：探讨羧甲基纤维素钠眼液联合重组人表皮生长因子( recombinant human epidermal growth factor, rhEGF )对白内障患者超声乳化术后干眼的治疗效果。方法：选取2015-10/2016-05于我院接受治疗的白内障超声乳化术后干眼症患者150例150眼,随机分为试验组(75例75眼)和对照组(75例75眼)。试验组采用羧甲基纤维素钠眼液联合rhEGF治疗,对照组采用羧甲基纤维素钠眼液单药治疗。记录患者治疗前及治疗后1wk,1mo的干眼主观症状评分、角膜荧光素染色( FL)情况、泪液分泌试验( SⅠt)以及泪膜破裂时间( BUT)。结果：治疗前,两组患者的干眼主观症状、泪膜稳定性指标(BUT、FL、SⅠt)比较差异无统计学意义(P>0.05)。治疗后,两组患者随时间延长各指标均有明显改善,差异有统计学意义(P<0.01),试验组较对照组干眼主观症状更轻,差异有统计学意义( P<0.05)、BUT明显延长,差异有统计学意义(P<0.05)、FL明显减少,差异有统计学意义(P<0.05)、SⅠt明显增加,差异有统计学意义(P<0.05)。结论：羧甲基纤维素钠眼液联合rhEGF可有效改善白内障术后干眼症状,恢复泪膜稳定性,其疗效显著优于单独使用羧甲基纤维素钠眼液。     

999感冒灵醇沉工艺得失均衡研究

醇沉工艺是现代中药生产中常用的精制方法,其目的是去除杂质而提高药品疗效。但是,由于包裹损失等原因,醇沉过程难免会造成有效成分部分损失。所以,判定醇沉工艺优劣的重要依据在于相关物质的得失均衡。作为感冒药,感冒灵在临床上得到了广泛和良好的使用,其生产工艺的各环节需要有针对性的深入研究。该文着眼于感冒灵水提液醇沉工艺过程的去除杂质和保留有效成分的平衡关系,选择了有效成分蒙花苷的保留率和干浸膏得率作为评价指标,前者反映有效成分保留,而后者反映杂质去除。研究工作用单因素实验,考察了醇沉时间、初始乙醇浓度、终点乙醇含量及初膏密度等多种工艺因素对感冒灵醇沉的影响,在得失均衡的原则下确定了感冒灵醇沉工艺的优化参数是,醇沉时间为16 h,初始乙醇浓度为95%,终点乙醇含量为70%,初膏相对密度为1.10。该研究的意义在于,它为感冒灵醇沉工艺优化提供实验研究基础,同时对于其他中药口服剂的醇沉工艺优化也有借鉴作用。     

小叶榕干浸膏及咳特灵胶囊的HPLC指纹图谱研究及LC-Q-TOF-MS成分分析

目的:建立小叶榕干浸膏及咳特灵胶囊的HPLC指纹图谱,并对其主要成分进行成分鉴定分析。方法:采用高效液相色谱法建立小叶榕干浸膏及其制剂的指纹图谱并用液相色谱-四极杆-飞行时间质谱(LC-Q-TOF-MS)鉴定指纹图谱主要色谱峰。采用Acquity UPLC HSS T₃C₁₈色谱柱(2.1 mm×100 mm,1.7 μm),流动相甲醇-0.05%甲酸梯度洗脱,流速0.2 mL·min^-1,柱温25℃。对指纹图谱所标识色谱峰进行了部分鉴定。结果:建立了小叶榕干浸膏及咳特灵胶囊的HPLC指纹图谱,通过液相色谱-四极杆-飞行时间质谱对其主要成分进行成分鉴定分析,鉴别出了14个化合物组分。结论:该指纹图谱方法适用于小叶榕干浸膏及咳特灵胶囊,化学成分鉴定准确,完善了高效液相指纹图谱,为小叶榕干浸膏及其制剂的整体质量控制提供了一定的依据。     

川麦冬药材中二氧化硫来源及残留积累动态分析

目的:分析川麦冬药材中SO_2来源及残留量积累动态变化,为解决其SO_2残留超标问题提供理论依据。方法:收集主产区不同方法加工的川麦冬药材28份,测定SO_2残留量,根据测定结果对煤炭火烘烤和熏硫2种加工方法在加工过程中川麦冬药材SO_2残留积累动态进行考察。结果:产地收集的28份样品中SO_2残留量超标率35.71%,SO_2来源为煤炭火烘烤和硫磺熏蒸。SO_2残留量和烘烤时间成正比,超标临界时间在8~10 h;SO_2残留量和硫磺熏蒸时间、药材水分含量均呈正比关系,鲜麦冬熏硫1 h后SO_2残留量可高到1 017.69 mg·kg~(-1)。结论:从麦冬药材质量和安全用药考虑,在麦冬产地加工过程中应当禁止熏硫并严格控制煤炭火烘烤时间。     

The ocular surface side effects of an anti-psychotic drug,clozapine

Purpose: The purpose of this study is to investigate the effects of long-term clozapine usage on tear film stability and corneal topographic parameters.

Material and methods: The study was conducted between March 2014 and November 2014. Thirty patients who were diagnosed of schizophrenia and have been under clozapine treatment for 2.73?±?0.73 years (range 2–4 years) were involved in this study (group 1). Thirty healthy subjects (group 2) who have statistically similar demographic features compared with the group 1, were involved as a control group. Full ophthalmologic examination with biomicroscopy and indirect ophthalmoscopy was applied. Corneal topographic parameters were measured using the Pentacam HR and Schirmer test was done. Statistical analysis of the subjects was evaluated by using SPSS (for Windows version 16.0; SPSS Inc., Chicago, IL) program.

Results: K₁ value was measured as 43.39?±?0.17?D (43–43.50?D) and K₂ value was measured as 43.39?±?0.06?D (43.30–43.50?D) in groups 1 and 2, respectively. In groups 1 and 2, K₂ values were noted as 43.86?±?0.27?D (43.50–44.50?D) and 43.72?±?0.18?D (43.50–44.00?D), respectively. Central corneal thickness was found to be 523.93?±?15.66?µm (495–554?µm) and 550.13?±?1.03?µm (520–580?µm) in groups 1 and 2, respectively. Corneal apex thickness was 525.86?±?15.75?µm (497–556?µm) in group 1 and 551.60?±?14.99?µm (521–581?µm) in group 2. The corneal thickness of thinnest location was 520.93?±?15.60?µm (492–551?µm) and 548.06?±?15.17?µm (518–578?µm) in groups 1 and 2, respectively. Corneal volume was determined as 58.13?±?3.46?mm³ (52–64?mm³) in group 1 and 60.73?±?3.76?mm³ (54–66?mm³) in group 2. The Schirmer test showed thichkness of 3.33?±?0.72?mm (2–4?mm) and 13.60?±?1.59?mm (11–16?mm) in groups 1 and 2, respectively. The mean fluorescein break-up time was 5.40?±?1.50?s (3–8?s) and 12.46?±?1.40?s (10–14?s) in groups 1 and 2, respectively. There was a statistically significant difference in the Schirmer test, fluorescein break-up time, central corneal thickness, corneal apex, and the thinnest corneal location thickness between the two groups.

Conclusion: Clozapine may induce dry eye syndrome and thus may lead to morphological alterations in corneal parameters through its anticholinergic and antidopaminergic activities. Because of these corneal alterations, one should be aware of evaluating patients having diseases like glaucoma or preoperative selection of corneal refractive surgery candidates.     

*Inhaled formoterol dry powder in the treatment of patients with reversible obstructive airway disease

Inhaled formoterol is a potent selective β₂-agonist with rapid onset and at least 12-h duration of bronchodilation. The aim of the study was to compare the bronchodilating effect of inhaled formoterol dry powder ‘dp) 12 μg b.i.d. with salbutamol dp 400 μg q.i.d. and placebo in patients with reversible obstructive airway disease ‘ROAD). The study design consisted of a closed 12-week double-blind, placebo-controlled, multicenter trial followed by an open noncomparative, multicenter, 12-month follow-up trial, in which the tolerability of formoterol dp was assessed. A total of 304 patients ‘146 men, 158 women) aged 18-79 years, ill during 0.1-64 years, were randomized. No demographic or baseline differences were found among the different treatment groups. The bronchodilating effect of formoterol, assessed by morning premedication PEFR, was significantly superior to placebo ‘P < 0.0001) and salbutamol ‘P < 0.0001). Efficacy was maintained during the open follow-up study with 12 μg b.i.d. in most of the patients. A few patients, however, needed 24 μg b.i.d. to control their ROAD. Formoterol 12 μg b.i.d. significantly reduced morning and evening asthma symptoms and sleep disturbances, and reduced significantly the need for rescue medication. The tolerability of the three treatment groups was comparable. In conclusion, formoterol 12 μg dp b.i.d. was significantly superior to both salbutamol 400 μg dp q.i.d. and placebo, and reduced asthma symptoms significantly. Overall, formoterol showed a tolerability profile comparable to that of salbutamol, and no tachyphylaxis was observed during 1 year of treatment.     

Local side-effects of inhaled corticosteroids in asthmatic children: influence of drug, dose, age, and device

BACKGROUND: The objective was to investigate the local side-effects of inhaled corticosteroids (ICS) in daily life in asthmatic children, particularly the younger ones, by an observational prospective cross-sectional cohort study. METHODS: Asthmatic children (n=639, 75.9+/-48.9 months, 61.3% boys), treated with beclomethasone dipropionate (BDP) (721.0+/-287.3 microg per day) or budesonide (BUD) (835.5+/-684.9 microg per day) for at least 1 month, were recruited at the time of a scheduled visit. Local side-effects were researched by questionnaire (cough during inhalation, hoarseness, dysphonia, and thirsty feeling) and clinical examination (perioral dermatitis, oral candidiasis, and tongue hypertrophy). RESULTS: Exactly 63.3% of the children aged under 6 years and 59.5% of the older ones reported one local side-effect. Cough (39.7%) was dependent on young age, use of BDP, and mainly use of spacer device, with an OR of 4.7 (95% CI: 2.7-8.2). Thirsty feeling (21.9%) and hoarseness (14.1%) occurred in children using ICS and long-acting beta2-agonists. Dysphonia (11.1%) was favored by high doses of BDP and BUD, and by inhalation from spacer devices or nebulizers. No factor favored oral candidiasis (10.7%). Perioral dermatitis (2.9%) and tongue hypertrophy (0.1%) were associated with nebulization. CONCLUSION: Local side-effects of ICS are common in asthmatic children of all ages, and the device used constitutes the most influential factor.