蕲蛇的鉴别研究进展＊

蕲蛇是《中国药典》收载的三种蛇类药材（含蕲蛇、乌梢蛇、金钱白花蛇）之一，具有祛风、通络、定惊止痉等功效，其药用价值和经济价值较高，市场需求量较大，为贵细药材。近年来，由于野生资源逐渐匮乏，在经济利益驱使下，蕲蛇商品普遍存在着伪品、混淆品、掺假品，这种质量不一、以次充好、以假代真的情况容易导致用药安全问题。本文通过总结蕲蛇的性状鉴别、显微鉴别、理化鉴别和分子鉴别，以期为蕲蛇等蛇类药材的真伪鉴别和质量的优劣检测提供思路，为进一步鉴别研究、制剂开发提供参考依据，确保用药质量。     

Microsurgical or endovascular strategy for complete obliteration of spinal arteriovenous shunts in a single-institute 10-year retrospective study

The objective of this retrospective study is to more fully understand the optimal strategy to manage spinal arteriovenous (AV) shunts. This study included a cohort of 35 patients with a diagnosis of spinal AV shunts who were treated over the past 10 years at a single institute. Angiographic diagnosis of intramedullary AV malformations (IM-AVM), perimedullary AV fistulas (PM-AVF), dural AV fistulas (D-AVF), or epidural AV fistulas (ED-AVF) was carefully made, and the microsurgical or endovascular strategy for them was determined at the interdisciplinary meeting consisting of neurospinal surgeons and endovascular specialists. Endovascular surgery was first considered whenever safely possible. Microscopic direct surgery using intraoperative image guidance was considered for cases in which endovascular access was challenging or not safely possible. Combined treatment was another option. The clinical condition was assessed using the modified Rankin scale (mRS). Seventeen of 35 cases were treated with microscopic direct surgery, 13 cases with endovascular surgery, and the remaining five cases with the combination. Complete angiographic obliteration was achieved in 30 of 35 cases (85.7%). Although residual AV shunts was recognized in 3 cases of IM-AVM, 1 case of PM-AVF and 1 case of ED-AVF, no angiographic recurrence was present with an average postoperative follow-up period of 44 months. The average mRS before surgery was 2.37 and significantly improved to 1.94 at the most recent follow-up. Interdisciplinary collaboration between neurospinal surgeons and endovascular specialists should be standard to achieve safe and successful outcomes in treating such rare and difficult spinal disorders.     

忍冬藤饮片质量标准研究

目的 制定忍冬藤饮片的质量控制方法。方法 采用显微鉴别、薄层鉴别定性鉴别,采用高效液相色谱法测定饮片中的马钱苷。色谱条件：苯基硅烷键合硅胶色谱柱（4.6 mm×250 mm,5 μm）,流动相为乙腈-0.4％磷酸溶液(12:88),检测波长236 nm,流速1 mL·min^-1,柱温40 ℃。结果 非腺毛、木纤维、皮层纤维、表皮细胞、草酸钙簇晶、木化薄壁细胞等显微特征明显,显微鉴别方法专属性强;薄层色谱斑点清晰,阴性对照无干扰。马钱苷的进样量在0.086 8～1.302 0 μg范围内与峰面积积分值呈良好的线性关系,相关系数r=0.999 9。平均回收率为100.0%,RSD=0.38%。测定山东、安徽、浙江等不同产地的19批样品,马钱苷含量以干燥品计算,结果在0.058%～0.863%区间分布。结论 本方法准确可靠、重现性好,可有效控制该饮片的质量。     

花芪灵丹丸质控标准研究

目的建立花芪灵丹丸的质量控制标准。方法采用显微鉴别法鉴别花芪灵丹丸中茯苓、牡丹皮、肉桂;采用薄层色谱法鉴别花芪灵丹丸中黄芪、红花、延胡索;采用高效液相色谱法定量检测花芪灵丹丸中丹参酮ⅡA的含量,建立质量控制标准。结果显微鉴别和薄层色谱鉴别效果好,专属性强;含量测定丹参酮ⅡA在0.01592μg~0.796μg范围内,进样量与峰面积积分值呈良好的线性关系,平均加样回收率为101.5%(RSD值3.8%)。结论花芪灵丹丸的质控方法操作简便、结果准确、重现性好,而且能够对花芪灵丹丸进行定性和定量质控,符合中药制剂的质控要求,可用于花芪灵丹丸质量的控制。     

MTA根尖倒封闭边缘微渗漏的比较研究

目的：比较MTA与银汞合金，Super—EBA根尖倒封闭的性能。方法：用染料渗透法分析离体牙根尖倒封闭术后不同时间的边缘微渗漏情况。结果：染料渗透30d时MTA组边缘微渗漏情况明显优于银汞合金组（P〈0．001）与Super—EBA组相当。60d时，MTA组明显优于Super—EBA组（P〈0．05）和银汞合金组（P〈0．001）。结论：MTA比银汞合金、Super—EBA具有更好的根尖倒封闭性能。     

Micro-CT扫描下舟月骨间韧带的显微解剖学研究

目的研究舟月骨间韧带(SLIL)的形态和血供分布,并从解剖学角度探讨临床上SLIL损伤对其血供的影响及重建的方法。方法2018年10月至2018年12月,选取12例新鲜成人前臂标本,从尺动脉或桡动脉灌注明胶-氧化铅溶液,于Micro-CT下扫描,通过Mimics软件三维重建图像,观察SLIL在中立位的形态和韧带内滋养血管分布,测量韧带掌侧、背侧和近端的宽度、长度、厚度,测量SLIL内滋养血管入口处的解剖参数,并分析其与舟、月骨的血供关系。结果①数字化技术三维重建SLIL的大体形态并测量其解剖参数,近端长度均值最大,掌侧、背侧长度相近;韧带掌侧最宽,厚度最小,而背侧与近端在厚度与宽度上相近。②SLIL的近端无滋养血管分布,掌侧与背侧均有丰富的滋养血管分布,其血供分布差异无统计学意义(P>0.05)。③SLIL的掌侧与背侧内滋养血管从SLIL附着处进入舟、月骨内形成吻合。结论SLIL掌侧较宽且厚度小,从解剖学角度分析其较其它亚区更易损伤;其掌侧与背侧亚区均有丰富的血供且与舟、月骨内相吻合,而近端无血管分布,因此,掌、背侧韧带早期轻度损伤有一定的自我修复能力,而近端损伤则较难修复,韧带掌侧与背侧损伤对舟、月骨血供会产生一定影响。     

列当的生药鉴别

目的 对列当Orobanche caerulescens进行生药学研究.方法 采用性状及显微鉴别的方法,对列当的性状,茎的组织构造和粉末的显微特征进行鉴别.结果 列当茎的横切面由表皮、皮层、维管束和髓组成.外韧型维管束呈深波状环列;木质部细胞全部木化;具较发达的木纤维和明显的髓射线.粉末中可见花粉粒、非腺毛、网纹细胞、淀粉粒、纤维及导管.结论 列当的以上特征可为鉴别其真伪及制定其质量标准提供可靠的依据.