基于质量控制检测的预防性维修模式探讨与实践

在医院医疗设备维修中,预防性维修在日常维修中占有越来越重要的地位,基于质量控制检测的预防性维修模式以设备安全运行为目标,以设备质量控制检测为手段,可以最大限度地降低设备的故障率和维修成本,切实保障医疗安全。     

Thermochemical studies on the quantity-antibacterial effect relationship of four organic acids from Radix Isatidis on Escherichia coli growth

In this report, we have investigated the inhibitory action of four organic acids from Radix Isatidis on Escherichia coli growth was investigated at 37 degrees C by using a microcalorimeter. The four organic acids were: syringic acid, 2-amino-benzoic acid, salicylic acid, benzoic acid. In accordance with thermokinetic model, the pertaining relationships of the drugs, such as growth inhibitory ratio vs. concentration, maximal power-output vs. growth rate constant, growth rate constant vs. concentration, were obtained. Half-inhibitory concentration of the drugs, IC(50), was obtained by quantitative analysis. From the view of thermodynamics and molecular structure, the relationship between quantity and effect of the four organic acids has been discussed. The functional groups on phenyl ring had important influence on the antibacterial activities. Our work suggests that microcalorimetry is a fast, simple and more sensitive method that can be easily performed and applied to study the anti-bacterial activities of organic acids from Radix Isatidis on microorganism compared to other biological methods.     

海地地震国际人道主义医疗防疫救援中有害生物控制策略的探讨

北京时间2010年1月12日,海地发生里氏8．0级地震,震中距太子港17km。当地时间1月14日凌晨,中国国际救援队在震后第一时间飞抵海地,成为最早抵达海地的国际救援队之一;1月27日上午,在第一批救援队员完成海地地震抢险应急搜救任务,从太子港乘包机回到北京之时,受军委命令以及国家委派,40名中国国际医疗防疫救援队同时又来到太子港。     

Investigations of Free Anthraquinones from Rhubarb Against α‐Naphthylisothiocyanate‐induced Cholestatic Liver Injury in Rats

Abstract: The protective effects of anthraquinones from Rhubarb, a Chinese herbal medicine, consisting of the root and rhizome of Rheum palmatum L., R. tanguticum Maxim. Ex Balf., or R. officinale Baill. (family Polygonaceae) were investigated and compared in rats with liver injury induced by α‐naphthylisothiocyanate. α‐Naphthylisothiocyanate was given intragastrically in rats, liver injury with cholestasis developed within 36 hrs, as indicated by characteristic serum levels of glutamate‐pyruvate transaminase, glutamic oxaloacetic transaminase, total bilirubin, direct bilirubin, alkaline phosphatase, γ‐glutamyltransferase and total bile acid. The intragastrical administration of rhein, aloe‐emodin and physione to α‐naphthylisothiocyanate‐treated rats reduced significantly the serum level of both glutamate‐pyruvate transaminase, glutamic oxaloacetic transaminase and the serum total bilirubin, direct bilirubin, alkaline phosphatase, γ‐glutamyltransferase and total bile acid. For all hepatic biochemical markers and cholestasis index, rhein was most efficient. By comparison, the administration of emodin and chrysophanol did not reduce the serum levels of hepatic enzymes glutamate‐pyruvate transaminase and glutamic oxaloacetic transaminase but decreased the levels of serum total bilirubin, direct bilirubin, alkaline phosphatase, γ‐glutamyltransferase, and total bile acid, showing their partial protective effects on cholestatic liver injury. The liver in α‐naphthylisothiocyanate‐treated rats showed cholangiolitic hepatitis characterized by intrahepatic cholestasis, necrosis of hepatocytes and biliary epithelial cells and bile obstruction. The concurrent intragastrical administration of rhein reduced the severity of all morphological alteration, especially the neutrophil infiltration and sinusoid congestion. Rhein, aloe‐emodin, and physione all exhibited protective effects on hepatocytes and cholangiocytes against α‐naphthylisothiocyanate‐induced damage, whereas emodin and chrystophanol provided partial protection.     

复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床研究

目的验证复方鳖甲软肝片治疗慢性乙型肝炎肝纤维化的临床疗效和安全性。方法将420例慢性乙型肝炎肝纤维化患者随机分为两组：治疗组300例，口服复方鳖甲软肝片，对照组120例，口服和络舒肝胶囊，6个月为1疗程。结果治疗组的患者在改善症状和体征，恢复肝功能总疗效方面，显效率和总有效率分别为55．67％和81．67％，对照组分别为15．80％和60．00％，治疗组明显优于对照组（P〈0．01）。结论复方鳖甲软肝片在改善中医症状，血清学肝纤维化及肝组织病理指标等方面疗效确切，可以有效治疗慢性乙型肝炎肝纤维化。     

鳖甲药材指纹图谱与其抗肝纤维化作用的谱效关系研究

目的研究不同产地鳖甲药材的HPLC指纹图谱与其抗纤维化作用的谱效关系,揭示鳖甲药材抗肝纤维化作用的"药效成分组"。方法 HPLC-DAD法测定了12个产地鳖甲药材样品,采用中药色谱指纹图谱相似度评价系统2004 A进行评价,建立了共有模式,并进行主成分分析(PCA)。以LX-2肝星状细胞为模型研究其对肝细胞的抑制效果,采用SPSS软件对数据进行相关分析,研究谱效相关性。结果 12个产地鳖甲药材HPLC指纹图谱中共有7个特征共有峰,其中峰2、5与LX-2肝星状细胞抑制效果(A值)的相关性呈现中等程度相关,峰4的相关性最强。由PCA可知,峰4的量对鳖甲质量有着重要的影响。结论 12个产地鳖甲药材对LX-2肝星状细胞均有抑制作用,HPLC指纹图谱与其抗纤维化作用之间有一定的相关性,为进一步控制鳖甲药材内在质量提供参考。     

明胶海绵颗粒与Embosphere微球治疗肝癌破裂出血有效性和安全性的对比分析

目的对比分析明胶海绵颗粒及Embosphere微球栓塞肝癌破裂出血靶血管的安全性和临床疗效。方法采用经导管肝动脉栓塞术(TAE),对422例破裂出血的肝癌患者行肝癌出血靶动脉栓塞止血,其中198例采用明胶海绵颗粒栓塞(明胶海绵组),224例采用Embosphere栓塞微球栓塞(微球组),术后结合生化及影像学检查观察和分析临床疗效与不良反应。结果本组422例均有效止血。明胶海绵组中,34例栓塞术后24~36h有复发出血,122例肝转氨酶有不同程度升高(31例转氨酶升至1000U/L以上),198例胆红素均有不同程度上升;微球组中,术后肝功能指标与术前比较差异无统计学意义。结论与明胶海绵栓塞剂比较,Embosphere栓塞微球颗粒治疗肝癌破裂出血具有很好的疗效及安全性,不良反应轻,再通出血概率低,对术后肝功能的损害甚微,有利于围术期患者的良性恢复,值得在临床上推广应用。     

SARS-CoV特异性抗体产生规律的初步研究

目的 研究严重急性呼吸综合征(SARS)患者感染后体内病毒特异性抗体产生规律。方法 收集临床确诊为SARS患者的血清和非SARS人群血清标本,用IgM捕获法、间接法和抗原夹心法三种不同方法检测抗SARS病毒特异性IgM、IgG和总抗体。结果 检测146份临床诊断为SARS的患者不同发病时间血清标本,三种抗体阳性率分别为61.64％、53.43％和69.86％;SARS病毒特异性IgM、IgG抗体的最早检出时间分别在发病第7天和第12天,特异性IgM抗体最短在发病后42天消失。三种方法检测70份甲型肝炎患者血清时,均有2份非特异阳性反应,检测127份其他病种血清均阴性,1例密切接触SARS患者的医务人员SARS特异性IgG抗体和总抗体均阳性,三种检测方法均不受类风湿因子影响。结论 与其他病毒感染相比,SARS病毒感染者的特异性IgM抗体检出时间较晚,且持续时间较短;三种检测方法均有较好的特异性和敏感性,可用于SARS的流行病学调查和临床诊断的确认和补充,但不适用于SARS的早期诊断。     

Serum Metabolomic Profiling in a Rat Model Reveals Protective Function of Paeoniflorin Against ANIT Induced Cholestasis

Cholestasis is a leading cause of hepatic accumulation of bile acids resulting in liver injury, fibrosis, and liver failure. Paeoniflorin displays bright prospects in liver protective effect. However, its molecular mechanism has not been well‐explored. This study was designed to assess the effects and possible mechanisms of paeoniflorin against alpha‐naphthylisothiocyanate‐induced liver injury. Ultraperformance liquid chromatography coupled with quadrupole time‐of‐flight combined with principle component analysis and partial least squares discriminant analysis were integrated to obtain differentiating metabolites for the pathways and clarify mechanisms of disease. The results indicated that paeoniflorin could remarkably downregulate serum biochemical indexes and alleviate the histological damage of liver tissue. Different expression of 14 metabolites demonstrated that paeoniflorin mainly regulated the dysfunctions of glycerophospholipid metabolism and primary bile acid biosynthesis. Moreover, several pathways such as arginine and proline metabolism, ether lipid metabolism, and arachidonic acid metabolism were also related to the efficacy. In conclusion, paeoniflorin has indicated favorable pharmacological effect on serum biochemical indexes and pathological observation on cholestatic model. And metabolomics is a promising approach to unraveling hepatoprotective effects by partially regulating the perturbed pathways, which provide insights into mechanisms of cholestasis. Copyright © 2016 John Wiley & Sons, Ltd.     

赤芍的化学成分和药理作用研究进展

赤芍为临床常用中药,具有清热凉血、散瘀止痛的功效。其主要化学活性成分为芍药总苷,尚含鞣质类、黄酮类、挥发油类等成分。因具有保肝、抗肿瘤、神经保护、心脏保护、抗血栓、抗氧化等多种显著的药理作用而成为近年研究的热点。查阅近10年国内外文献,就赤芍的化学成分、药理作用等方面进行综述,以期能对赤芍的研究和临床应用提供参考。但针对赤芍开发出安全有效的药物仍相对较少,明确赤芍的作用机制和推广赤芍的临床应用仍是赤芍研究的主要任务。