利巴韦林对肠道病毒体外抑制作用的研究

目的研究抗病毒药物利巴韦林体外抗肠道病毒（EV）的效果。方法采用细胞病变效应（CPE）法和MTT分析法,观察利巴韦林对肠道病毒（EV71、CAV16、CBV3、ECH011、EV84）的抑制作用。结果利巴韦林对Vero细胞的半数毒性浓度（TC50）为2．09mg／mL,0．2mg／mL浓度的利巴韦林对5种肠道病毒均有抑制作用,对CAV16、EV71、ECHO11、EV84、CBV3的抑制率分别为13％、27％、36％、23％、58％。对EV84、EV71病毒,利巴韦林浓度为0．1mg／mL时其抑制率为16．5％、29．5％;对CBV3病毒,利巴韦林抗病毒作用与其剂量呈正相关,半数有效浓度（IC50）为0．125mg／mL,治疗指数（TI）为16．72。结论利巴韦林在体外对肠道病毒具有抑制作用,对不同的肠道病毒其抑制效率不同,对CVB3的抑制率较高。     

热毒宁、炎琥宁、利巴韦林注射液治疗外感风热证疗效比较

目的:比较热毒宁、炎琥宁、利巴韦林注射液治疗外感风热证患者的临床疗效。方法:150例外感风热证病例随机分为热毒宁组、炎琥宁组、利巴韦林组3组,每组50例。所有病例均给予常规治疗,热毒宁组给予热毒宁注射液静脉滴注治疗,炎琥宁组给予炎琥宁注射液静脉滴注治疗,利巴韦林组给予利巴韦林注射液静脉滴注治疗。结果:热毒宁组与炎琥宁组疗效及72 h退热率与利巴韦林组比较差异有统计学意义(P>0.05);在平均退热时间方面,热毒宁组优于炎琥宁组。结论:热毒宁注射液对外感风热证患者的退热效果优于炎琥宁注射液和利巴韦林注射液。     

炎琥宁治疗小儿病毒性肺炎42例疗效观察

目的探讨炎琥宁治疗病毒性肺炎的疗效。方法 82例小儿病毒性肺炎随机分为炎琥宁治疗组：炎琥宁10mg/（kg·d）加入5%葡萄糖注射液100～200mL,每日1次静滴,疗程5d～7d;利巴韦林对照组：利巴韦林10mg/（kg·d）加入5%葡萄糖注射液100～200mL,每日1次静滴,疗程5d～7d.结果炎琥宁在退热、止咳方面的疗效明显优于利巴韦林,应作为治疗小儿病毒性肺炎的首选药物。结论炎琥宁治疗小儿病毒性肺炎疗效显著。     

四种中药注射液治疗小儿手足口病网状Meta分析

目的:运用网状Meta分析方法比较四种常用中药注射液治疗小儿手足口病的临床疗效与安全性,为临床提供循证依据。方法:全面检索中国期刊全文数据库(CNKI)、中国生物医学数据库(CBM)、维普(VIP)、万方(WanFang Data)中文数据库及The Cochrane library,PubMed,EMbase外文数据库,搜索公开发表的中药注射液热毒宁、痰热清、喜炎平、炎琥宁及利巴韦林注射液(下称热毒宁、痰热清、喜炎平、炎琥宁、利巴韦林)治疗小儿手足口病的临床随机对照试验,检索时间均为自建库至2018年10月30日,筛选出符合纳入标准的研究,按照Cochrane 5.1手册标准对纳入的研究进行文献质量评价与偏倚风险评估,采用ADDIS软件进行网状Meta分析与概率排序。结果:共纳入17项研究,2428例患者。在临床总有效率方面,四种中药注射液皆显著优于利巴韦林(P<0.05),炎琥宁、热毒宁显著优于喜炎平(P<0.05),喜炎平优于痰热清(P<0.05),最佳概率排序:炎琥宁>热毒宁>喜炎平>痰热清>利巴韦林;在口腔溃疡愈合与住院时间方面,喜炎平与热毒宁均显著短于利巴韦林(P<0.05),最佳概率排序:喜炎平=热毒宁>炎琥宁>痰热清>利巴韦林;在退热与皮疹消退时间方面,喜炎平、热毒宁与痰热清皆显著短于利巴韦林(P<0.05),最佳概率排序:喜炎平=热毒宁>痰热清>利巴韦林;在安全性方面,热毒宁、喜炎平显著优于利巴韦林(P<0.05),最佳概率排序:热毒宁>喜炎平>利巴韦林。结论:中药注射液在治疗小儿手足口病方面,炎琥宁临床疗效最高,热毒宁临床安全性最好。本结论仍需要高质量随机对照文献予以进一步验证,并建议结合临床具体情况合理选择中药注射液。     

炎琥宁治疗病毒性上呼吸道感染的效果观察

目的探讨炎琥宁对病毒性上呼吸道感染的治疗作用。方法采用基因芯片检测出急性上呼吸道感染患儿流感病毒、呼吸道合胞体病毒、腺病毒、柯萨奇病毒四种病毒共599例,随机分为炎琥宁治疗组和利巴韦林治疗组。炎琥宁组:炎琥宁5~10mg/kg.d-1加入5%葡萄糖液100~250ml静脉点滴,每天1次,疗程3~5天,利巴韦林组:利巴维林针10~15mg/kg.d-1分2次加入5%葡萄糖液100~250ml静脉点滴,疗程3~5天,观察两组疗效。结果炎琥宁组在退热、流涕鼻塞、咽充血及咳嗽消失时间均较利巴韦林组显著缩短(P均<0.01);治疗总有效率也明显提高(P<0.01)。结论炎琥宁治疗小儿急性病毒性上呼吸道感染疗效明显优于利巴韦林,应作为治疗小儿ARI的推荐首选药物。     

热毒宁治疗慢性阻塞性肺疾病急性上呼吸道感染临床研究

目的:观察热毒宁注射液对慢性阻塞性肺疾病患者急性上呼吸道感染的作用.方法:将80例患者随机分为热毒宁组和利巴韦林组.热毒宁组给予热毒宁治疗,利巴韦林组给予利巴韦林治疗,余对症治疗.观察临床症状、退热情况变化.结果:两组在显效时间上存在显著差异,热毒宁在抗炎、抗病毒、退热方面显效快,不良反应少.结论:热毒宁注射液在治疗慢...     

芪红胶囊对柯萨奇病毒体外感染HeLa细胞的影响

目的 体外观察芪红胶囊对柯萨奇病毒感染HeLa细胞的影响.方法 采用柯萨奇病毒感染HeLa细胞,XTT实验和空斑形成抑制实验测定芪红胶囊和利巴韦林的半数有效量(ED50)、能够减少50%空斑形成的最小药物浓度(IC50)及半数细胞毒性浓度(CC50),并计算治疗指数(SI);抗病毒时程实验比较两者在不同时间点的抗病毒作用;黏附实验和穿入实验观察芪红胶囊对病毒黏附和穿入的抑制作用.结果 芪红胶囊的ED50和IC50分别为(7.16±0.80)和(2.63±0.50)mg/L,利巴韦林分别为(4.35±0.40)和(1.92±0.30)mg/L.芪红胶囊的CC50和SI分别为(1 648±219)mg/L和232及618,明显高于利巴韦林的(103±14)mg/L和24及54(P均＜0.01).两种药物在用药8h和12h时间点的抑制病毒效果差异有统计学意义(P均＜0.05).芪红胶囊对病毒黏附和穿入的抑制作用呈现明显量效关系,当浓度为10 mg/L时,能抑制50%的病毒黏附;当浓度为3 mg/L时,能够抑制50%的病毒穿入.结论 芪红胶囊能够在体外有效抑制病毒对HeLa细胞的入侵,且毒性较低,其抗病毒作用主要源于对病毒黏附和穿入的抑制作用.     

热毒宁注射液佐治婴幼儿轮状病毒性肠炎疗效分析

目的:探讨热毒宁注射液佐治婴幼儿轮状病毒性肠炎是否较利巴韦林疗效好.方法:选择我院48例轮状病毒检测阳性的婴幼儿肠炎患者分为两组,A组使用利巴书林10mg/kg每日治疗;B组采用热毒宁注射液1.0ml/kg每日治疗.结果:热毒宁注射液组、利巴韦林组总有效率分别为88.5%和45.5%,热毒宁注射液组明显优于利巴节林组(P<0.05).结论:热毒宁注射液治疗婴儿轮状病毒性肠炎疗效好.     

卷柏多糖对肠道病毒71型复制的体外抑制作用

目的研究卷柏多糖对EV71病毒复制的体外抑制活性。方法将卷柏多糖不同提取物设置不同剂量作用于人恶性横纹肌肉瘤细胞(RD),采用细胞病变效应(CPE)及细胞计数试剂盒(CCK8法)检测细胞存活率,并计算药物的半数中毒浓度(CC50);培养EV71感染的RD细胞,建立体外病毒感染模型,并设立正常细胞对照组和阳性药物对照组(利巴韦林3.2mg/L),将卷柏多糖不同提取物设置不同剂量作用于EV71感染后的RD细胞,应用CCK8法检测药物抗病毒抑制率,并计算药物的半数抑制浓度(IC50);收集药物作用于感染后RD细胞的培养液上清,进行荧光定量PCR检测,观察药物对EV71病毒RNA表达的影响。结果卷柏30%醇沉多糖和50%醇沉多糖对RD细胞的CC50值分别为396和142 mg/L,抑制EV71病毒致CPE的IC50值分别为40.8和26.2 mg/L。与病毒感染对照组相比较,卷柏30%和50%醇沉多糖作用后,经EV71感染的RD细胞培养液中病毒RNA拷贝数显著降低(P<0.05)。结论卷柏及其30%和50%醇沉多糖可以作为新的抗EV71的潜在药物。     

麻杏石甘汤体外抗A型流感病毒作用靶点的研究

目的研究麻杏石甘汤体外抗A型流感病毒的作用靶点。方法运用细胞培养技术、血凝试验和MTT法检测麻杏石甘汤在4种给药方式中对流感病毒血凝滴度和流感病毒感染的MDCK细胞活性的影响。结果在直接灭活病毒作用中,麻杏石甘汤在3.19￣31.25 mg/mL浓度范围内的血凝滴度低于病毒对照组,在15.63￣31.25mg/mL时病毒血凝滴度低于利巴韦林组;在干预病毒吸附作用中,麻杏石甘汤在1.95￣31.25 mg/mL浓度范围内病毒血凝滴度低于病毒对照组,在7.81￣31.25 mg/mL时病毒血凝滴度低于利巴韦林组;在保护宿主细胞作用中,麻杏石甘汤在3.19￣31.25 mg/mL浓度范围内病毒血凝滴度低于病毒对照组,在7.81￣31.25 mg/mL时病毒血凝滴度低于利巴韦林组,差异均有统计学意义(P<0.01￣0.05)。在这3种给药方式中,麻杏石甘汤对流感病毒感染的MDCK细胞的治疗指数高于利巴韦林。在抑制病毒增殖的作用中,麻杏石甘汤在7.81￣31.25 mg/mL浓度范围内病毒血凝滴度显著低于病毒对照组,差异有统计学意义(P<0.01￣0.05)。与利巴韦林组比较,检测的麻杏石甘汤5个浓度点的作用不明显,在给药方式中,麻杏石甘汤对MDCK细胞的治疗指数也低于利巴韦林组。结论麻杏石甘汤通过直接杀伤病毒、干预病毒吸附、抑制病毒增殖、保护宿主细胞而发挥抗流感病毒作用,该方直接杀伤病毒、干预病毒吸附和保护宿主细胞的作用优于利巴韦林片,抑制病毒增殖的作用不及利巴韦林片。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.