浅析茯苓“角药”在《伤寒杂病论》中的配伍与应用

"角药"是由3味中药联合应用、配伍而成,相辅相成,互为犄角。《伤寒杂病论》中包含着大量的角药运用,根据其在方剂中发挥作用的不同。文章分别从独立成方、方剂中主要作用、方剂中次要或辅助作用以及多组角药联合作用4个方面对经方中茯苓"角药"进行详细的梳理和分析,以期为临床提供指导与参考。     

肝移植术后认知与脑改变的多模态神经成像

肝性脑病是终末期肝硬化的重要并发症,导致病人出现一系列神经及认知功能改变。肝移植术后病人在肝功能恢复的同时其认知功能也可明显改善。MRI可以从脑代谢、结构及功能方面更进一步揭示肝硬化病人移植术后认知及脑改变情况。综述肝移植术后认知改变的研究现状以及最新的多模态MRI技术在术后脑改变中的应用,及其在揭示术后认知恢复及残存损害的神经机制中的价值。     

品管圈在降低静脉用药调配中心贴签差错率的管理效果分析

目的： 通过品管圈活动降低静脉用药调配中心（pharmacy intravenous admixture services， PIVAS）的贴签差错率。方法： 以自愿的方式组成品管圈小组，经过辅导员专业培训后，按照十大品管步骤开展活动。运用了柏拉图，柱状图，鱼骨图，雷达图等多种方法，依据二八原则分析干预重点，并通过头脑风暴制定干预措施。结果： 干预前贴签差错35件/月，干预后降至12件/月，达到了目标值12.62件/月，达标率为102.77%。结论： 通过品管圈活动的方法从管理方面入手能够深入发掘和分析贴签差错，有效降低了贴签差错率，确保患者用药安全。     

某肝病专科医院住院患者肝病疾病谱变化趋势分析

采用SPSS21.0版本统计软件对近10年来收治的所有肝病患者疾病谱特征及比例变化趋势进行分析,结果显示从进展程度来看,肝硬化及肝癌略有上升趋势;肝病的主要病因中,病毒性肝炎比例最高但呈下降趋势,药物性肝损伤及酒精性肝病呈明显上升趋势;病毒性肝炎患者中,乙型肝炎呈下降趋势但仍占大多数,丙型肝炎呈明显上升趋势;非感染性肝病呈现高发态势,应引起关注和重视。     

Nitric oxide producing coating mimicking endothelium function for multifunctional vascular stents

The continuous release of nitric oxide (NO) by the native endothelium of blood vessels plays a substantial role in the cardiovascular physiology, as it influences important pathways of cardiovascular homeostasis, inhibits vascular smooth muscle cell (VSMC) proliferation, inhibits platelet activation and aggregation, and prevents atherosclerosis. In this study, a NO-catalytic bioactive coating that mimics this endothelium functionality was presented as a hemocompatible coating with potential to improve the biocompatibility of vascular stents. The NO-catalytic bioactive coating was obtained by covalent conjugation of 3,3-diselenodipropionic acid (SeDPA) with glutathione peroxidase (GPx)-like catalytic activity to generate NO from S-nitrosothiols (RSNOs) via specific catalytic reaction. The SeDPA was immobilized to an amine bearing plasma polymerized allylamine (PPAam) surface (SeDPA-PPAam). It showed long-term and continuous ability to catalytically decompose endogenous RSNO and generate NO. The generated NO remarkably increased the cGMP synthesis both in platelets and human umbilical artery smooth muscle cells (HUASMCs). The surface exhibited a remarkable suppression of collagen-induced platelet activation and aggregation. It suppressed the adhesion, proliferation and migration of HUASMCs. Additionally, it was found that the NO catalytic surface significantly enhanced human umbilical vein endothelial cell (HUVEC) adhesion, proliferation and migration. The in vivo results indicated that the NO catalytic surface created a favorable microenvironment of competitive growth of HUVECs over HUASMCs for promoting re-endothelialization and reducing restenosis of stents in vivo.