成骨细胞的功能与损伤和骨质疏松的防治

骨质疏松是一种全身性骨骼疾病,导致骨折风险增加。成人的骨量通过破骨细胞的骨吸收和成骨细胞的骨形成作用来维持动态平衡,治疗骨质疏松症的理想策略是抑制破骨细胞的骨吸收和/或增强成骨细胞的骨形成功能。目前针对保护成骨细胞及增强其功能的骨质疏松疗法相对较少。因此,本文针对成骨细胞相关功能蛋白、各种细胞损伤机制（内质网应激、氧化应激、机械过载、微小RNA和长链非编码RNA的影响等）及骨质疏松的治疗与预防作一综述,以期为针对增强成骨细胞功能的骨质疏松治疗策略提供新思路。     

PTEN和DNA含量与非小细胞肺癌侵袭转移的关系探讨

目的 研究非小细胞肺癌(NSCLC)组织中抑癌基因PTEN的表达和DNA含量与NSCLC侵袭、转移的关系.方法 采用免疫组织化学SP方法检测PTEN在78例肺癌标本中的表达,并用流式细胞术检测30例肺癌标本中DNA含量.结果:肺癌标本中PTEN蛋白总缺失率为42.3%,有淋巴结转移组和无淋巴结转移组肺癌表达缺失率分别为52.1%和26.7%(P＜0.05),其表达缺失率随TNM分期增加而上升,分期越晚表达缺失率越高.PTEN缺失率高者生存时间短.DNA指数(DI)的分布范围在1.04～1.93.异倍体肿瘤24例,DI值随TNM分期增加而增加(P＜0.05),与淋巴结转移呈正相关.结论 肺癌组织中PTEN的表达与肺癌淋巴结转移有显著相关性,肺癌细胞DNA含量与肺癌TNM分期及淋巴结转移密切相关.检测PTEN蛋白表达和DNA含量将有助于判断肺癌的转移及预后.     

阿立哌唑与利培酮治疗自闭症谱系障碍与注意缺陷多动障碍共病患儿的疗效与安全性评价

目的：评价阿立哌唑与利培酮治疗自闭症谱系障碍（ASD）与注意缺陷多动障碍（ADHD）共病患儿的疗效与安全性。方法：选取在某院精神科治疗的ASD和ADHD共病患儿68例,根据随机数字表法将患儿分为阿立哌唑组（n=34）和利培酮组（n=34）。阿立哌唑组患儿接受起始剂量为5 mg·d^-1的阿立哌唑片口服治疗,最终剂量增加至15 mg·d^-1。利培酮组患儿接受起始剂量为1 mg·d^-1的利培酮片口服治疗,最终剂量增加至2 mg·d^-1;2组患儿均治疗12周。在基线（T₀）、治疗6周（T₁）与12周（T₂）时,采用注意缺陷/多动评定量表（ADHD-RS）评价患儿总体ADHD症状变化情况;采用康纳斯行为评定量表（CRSR）教师用量表多动因子（CRSR-I）评价患儿多动症的改善情况;采用CRSR不注意缺陷-冲动因子（CRSR-H）评价患儿注意力缺陷的改善情况;采用临床整体印象-严重程度量表（CGI-S）及儿童总体评估量表（C-GAS）评分评价患儿整体功能。对患儿的相关临床指标进行常规监测,比较2组患儿药物不良事件与安全性。结果：与T₀时比较,阿立哌唑组患儿T₁与T₂时,ADHD-RS、CRSR-I、CRSR-H与CGI-S评分均显著降低（均P<0.05）,C-GAS评分显著提高（P<0.05）。利培酮组患儿T₂时,ADHD-RS、CRSR-I、CRSR-H与CGI-S评分均显著降低（均P<0.05）,C-GAS评分显著提高（P<0.05）。2组患儿的ADHD症状显著改善,多动症状与不注意缺陷-冲动症状显著改善,患儿的整体功能也显著改善。2组患儿主要的不良事件是食欲增加、体质量增加与嗜睡,但均没有发生严重的不良事件。T₂时,利培酮组患儿催乳素水平显著提高（t=9.619,P<0.001）,其他临床指标没有显著性差异（均P>0.05）。结论：阿立哌唑和利培酮能够通过减少ASD和ADHD共病患儿的注意力涣散和多动症症状来改善患儿整体功能,具有较高的疗效、安全性,值得临床推广应用。     

Whole-body retention of mercury and selenium and histopathological and morphological studies of kidneys and liver of rats exposed repeatedly to mercuric chloride and sodium selenite

Distribution and retention of mercury and selenium was studied in rats exposed repeatedly to HgCl₂ injections (0.5 mg Hg/kg to the tail vein every other day) and intragastrically to Na₂SeO₃ (0.5 mg Se/kg every day), applying combined and separate administration of these metals for 2 weeks. Whole-body retention of mercury in the presence of selenium was augmented by 20% and that of selenium in the presence of mercury by 4% with respect to the administered dose. Combined administration of mercuric chloride and sodium selenite brought about damage to the epithelial cells of renal proximal convolutions and formation of protein casts in their lumen. These changes had the same pattern as those induced by administration of mercuric chloride alone, but the intensity was lower. Submicroscopic studies revealed that repeated combined administration of sodium selenite and mercuric chloride did not completely abolish the mercury-induced mitochondrial swelling and contributed to chromatin destruction in the hepatocyte nuclei.This work was supported by the Section of Medical Sciences of the Polish Academy of Sciences (Agreement 537/VI)     

Comparison of formation of thiolactones and active metabolites of prasugrel and clopidogrel in rats and dogs

1. Prasugrel and clopidogrel are antiplatelet prodrugs that are converted to their respective active metabolites through thiolactone intermediates. Prasugrel is rapidly hydrolysed by esterases to its thiolactone intermediate, while clopidogrel is oxidized by cytochrome P450 (CYP) isoforms to its thiolactone. The conversion of both thiolactones to the active metabolites is CYP mediated. This study compared the efficiency, in vivo, of the formation of prasugrel and clopidogrel thiolactones and their active metabolites.

2. The areas under the plasma concentration versus time curve (AUC) of the thiolactone intermediates in the portal vein plasma after an oral dose of prasugrel (1 mg kg^?1) and clopidogrel (0.77 mg kg^?1) were 15.8 ± 15.9 ng h ml^?1 and 0.113 ± 0.226 ng h ml^?1, respectively, in rats, and 454 ± 104 ng h ml^?1 and 23.3 ± 4.3 ng h ml^?1, respectively, in dogs, indicating efficient hydrolysis of prasugrel and little metabolism of clopidogrel to their thiolactones in the intestine.

3. The relative bioavailability of the active metabolites of prasugrel and clopidogrel calculated by the ratio of active metabolite AUC (prodrug oral administration/active metabolite intravenous administration) were 25% and 7%, respectively, in rats, and 25% and 10%, respectively, in dogs.

4. Single intraduodenal administration of prasugrel showed complete conversion of prasugrel, resulting in high concentrations of the thiolactone and active metabolite of prasugrel in rat portal vein plasma, which demonstrates that these products are generated in the intestine during the absorption process.

5. In conclusion, the extent of in vivo formation of the thiolactone and the active metabolite of prasugrel was greater than for clopidogrel’s thiolactone and active metabolite.

     

军地药品招标模式利弊分析及对军队药品招标的启示

目的分析现阶段全军统筹药材网上集中采购和地方基本药物招标采购实施情况,探索建立具有军队特色的药品招标模式。方法通过文献收集、实地调研和资料分析等方法,对军队和地方省市药品招标模式利弊进行分析。结果全军统筹药材网上集中采购在运行中存在一定问题,各省市基本药物招标有一定借鉴价值。结论建议总部组织专家,建立统一规范的药品质量评分指标体系和相关落实措施。     

阿立哌唑与利培酮治疗痴呆精神行为症状的疗效及安全性比较

目的观察阿立哌唑和利培酮治疗老年痴呆精神行为症状的疗效及安全性。方法采用随机对照研究,将具有精神行为症状的痴呆患者68例完全随机分为阿立哌唑组及利培酮组,各34例。阿立哌唑组患者服用阿立哌唑,起始剂量2．5mg／d,最大剂量不超过15mg／d;利培酮组患者口服利培酮,起始剂量0．5mg／d,最大剂量不超过3mg／d。疗程均为8周。治疗前和治疗第2、4、8周末采用痴呆病理分析评定量表（BEHAVE—AD）评定疗效,用副反应量表（TESS）评定不良反应,并于入组时和治疗第8周末分别检测2组患者空腹血糖、餐后2h血糖、TC、TG、LDL—C、HDL—C及体重。结果阿立哌唑组和利培酮组患者治疗2、4、8周后BEHAVE—AD评分均明显低于治疗前[阿立哌唑组：（14．8±4．2）、（10．2±3．6）、（6．8±2．8）分比（16．4±4．6）分;利培酮组：（15．2±3．9）、（11．8±3．8）、（7．2±3．0）分比（17．2±5．O）分,P〈0．05或P〈0．01]。2组患者间治疗前及治疗后BEHAVE—AD评分比较,差异均无统计学意义（P〉0．05）。2组不良反应发生率均为8．8％（3／34）,差异无统计学意义（P〉0．05）。利培酮组治疗8周末体重较治疗前增加明显[（71±6）kg比（66±6）kg,P〈0．05],TG及LDL—C升高[分别为（1．62±0．46）mmol／L比（0．96±0．29）mmol／L．（3．82±0．86）mmol／L比（3．08±0．74）mmol／L,而阿立哌唑组则改变不明显（均P〉0．05）。结论阿立哌唑治疗老年痴呆精神行为症状总体疗效、安全性与利培酮相当,但阿立哌唑对患者血糖、血脂及体重影响小于利培酮。     

痛经及其药物治疗的研究进展

痛经是妇科常见疾病,在临床上的表现也是轻重不同。在我国古代医学以及现代医学对这一临床病症的分类特点、发病机理、防治措施等多有研究,并且在实践中积累了丰富的药物诊治经验,本文就以上方面近年来的研究进展进行综述。     

京尼平苷和京尼平研究及应用现状

环烯醚萜类化合物京尼平苷(栀子苷)及其苷元京尼平具有多种药理活性和广泛应用价值,一直是国内外学者研究的热点。系统综述了京尼平苷及京尼平在植物中分布、分离(制备)纯化、定量测定、药物代谢、药理活性和应用现状,并对其毒性进行简单概述,为京尼平苷及京尼平的进一步研究和开发提供参考,也为其临床应用提供科学依据。     

Uptake and Cytotoxicity of Chitosan Molecules and Nanoparticles: Effects of Molecular Weight and Degree of Deacetylation

PURPOSE: To evaluate the effects of molecular weight (Mw) and degree of deacetylation (DD) on the cellular uptake and in vitro cytotoxicity of chitosan molecules and nanoparticles. METHODS: Chemical depolymerization and reacetylation produced chitosans of Mw 213,000 to 10,000 and DD 88-46%, respectively. Chitosan was labeled with FITC and transformed into nanoparticles by ionotropic gelation. Uptake of chitosan by confluent A549 cells was quantified by fluorometry, and in vitro cytotoxicity was evaluated by the MTT and neutral red uptakeassays. RESULTS: Nanoparticle uptake was a saturable event for all chitosan samples, with the binding affinity and uptake capacity decreasing with decreasing polymer Mw and DD. Uptake fell by 26% when Mw was decreased from 213,000 to 10,000, and by 41% when DD was lowered from 88% to 46%; the uptake data correlated with the zeta potential of the nanoparticles. Uptake of chitosan molecules did not exhibit saturation kinetics and was less dependent on Mw and DD. Postuptake quenching with trypan blue indicated that the cell-associated chitosan nanoparticles were internalized, but not the cell-associated chitosan molecules. Chitosan molecules and nanoparticles exhibited comparable cytotoxicity, yielding similar IC50 and IC20 values when evaluated against the A549 cells. Cytotoxicity of both chitosan entities was attenuated by decreasing polymer DD but was less affected by a lowering in Mw. CONCLUSIONS: Transforming chitosan into nanoparticles modified the mechanism of cellular uptake but did not change the cytotoxicity of the polymer toward A549 cells. Chitosan DD had a greater influence than Mw on the uptake and cytotoxicity of chitosan nanoparticles because of its effect on the zeta potential of the nanoparticles.     

放射性皮炎的发生机制及药物防治现状

放射性皮炎是肿瘤放疗过程中十分常见的并发症,会导致放疗中断,影响放疗效果.近年来对放射性皮炎的预防和治疗方法有了很多新的进展,现将放射性皮炎的发病机制和药物防治研究做一综述,为临床治疗和科学研究提供一定的理论依据.     

Cannabis and symptoms of PMS and PMDD

Cannabis has been found to alleviate a wide array of medical symptoms, including those that overlap with physical and emotional symptoms of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD), including insomnia, irritability, depression, and joint pain. Little work has addressed the use of cannabis as a treatment for PMS or PMDD or the role of women’s cannabis treatment expectancies as a predictor of consumption. Women who reported having experienced PMS and PMDD and endorsed lifetime cannabis use (N?=?145), completed an online survey assessing their frequency of cannabis use, PMS/PMDD symptoms, expectancies of cannabis-induced relief from symptoms, as well as cannabis-related problems. Women were found to hold meaningful expectancies that cannabis would treat all PMS/PMDD symptoms, except for overeating/food cravings. Cannabis treatment expectancies were positively associated with PMS/PMDD symptoms and with monthly cannabis use, and were negatively associated with cannabis-related problems. Research should further examine the relationship of cannabis treatment expectancies with individuals’ cannabis use, as findings indicate the potential for these expectancies to serve a punitive or protective role in the development of cannabis-related problems. Increased research on how cannabis might ameliorate symptoms of PMS and PMDD could help establish an alternative treatment plan that offers relief with fewer negative side effects.     

《维和医疗队护理工作手册》编写与应用

目的 研究维和医疗队护理管理手段,编写<维和医疗队护理工作手册>,确保维和卫勤保障的整体性与协调性.方法 针对维和医疗队护理工作涉及的组织、管理、人员、环境等因素,设计编写护理组织管理、护理技术管理两个篇章.其中护理组织管理是针对安全展开维和医疗队的护理管理层面设计的内容,包括维和医疗队护理质量管理组织体系、维和二级医院护理人员岗位职责、工作制度与质量标准、护理质量控制、护理职业防护、护理应急管理、护理文书、标示和医疗物资管理.护理技术管理是针对维和护士职业护理行为实施的规范技术设计的内容,包括护理技术标准、常见疾病护理技术、急救战伤护理技术、维和军人心理健康维护.结果 <维和医疗队护理工作手册>的应用为维和保障对象提供了安全、及时、有效的护理保障勤务.结论 通过维和护理勤务研究,探索我军海外医疗队护理勤务保障模式,为战时护理勤务保障管理研究提供平台.     

脑挫裂伤的环池及中脑改变与预后

目的探讨脑挫裂伤后CT扫描征象中环池、中脑受压程度与患者意识和预后的关系。方法回顾分析1999年2月至2006年6月临床和CT资料完整的脑挫裂伤患者169例,依据伤后首次CT扫描的环池、中脑受压情况,与伤后意识和转归进行统计学处理。结果死亡39例,病死率23．1％。其中27例术后由于脑干、丘脑功能衰竭死亡;8例伤后并发肺部感染、高热、上消化道出血死亡;4例减压术后脑内迟发性出血再次开颅术后死亡。结论观察伤后环池及中脑的形态改变不仅能够了解脑挫裂伤或脑组织肿胀挤压中线结构对中脑损害的动态演变过程,而且还能帮助临床医师评估患者的预后、选择治疗方法及评估治疗措施是否有效。     

酸橙和甜橙2种枳实药材HPLC指纹图谱研究及其柚皮苷和辛弗林含量分析

目的:研究酸橙和甜橙2种枳实药材的高效液相色谱(HPLC)指纹图谱并测定药材中柚皮苷和辛弗林的含量,以建立枳实药材有效的质量评价方法。方法:采用高效液相色谱(HPLC)法建立指纹图谱和测定有效成分含量,对来自20个产地的2个种的枳实药材进行分析。色谱柱为AlltimaC18(250mm×4.6mm,5μm),流动相为乙腈-水(含0.1%磷酸或加上0.1%十二烷基硫酸钠),流速为1.0mL·min-1,指纹图谱检测波长为224nm,柚皮苷和辛弗林含量测定的检测波长分别为283、224nm。结果:得到分离度、重复性均较好的枳实药材HPLC指纹图谱。对20批不同产地枳实药材(包含2个种)HPLC指纹图谱的相似度评价结果显示,酸橙和甜橙2种枳实的指纹图谱差异显著,但同种枳实中不同产地的差异不大;含量测定结果显示,不同产地和不同种枳实药材中柚皮苷和辛弗林含量差异较大。结论:该方法简便、准确、灵敏度高、重复性好,可作为枳实药材的质量控制方法,此方法已被《香港中药材标准》采用。不同种和产地的枳实药材有效成分(柚皮苷和辛弗林)的含量具有明显差异,临床处方应当区别应用。     

策划药的发展演变及检测管制分析

目的:介绍策划药的发展演变,促进对策划药的检测和管制。方法:通过查阅文献,对策划药的发展演变、目前国际主要滥用种类、检测现状及我国对策划药的管制、未来趋势等进行分析。结果:策划药的作用效果与毒品类似,但由于未被法律监管,常被用作毒品的替代物。目前国际上滥用的策划药主要种类有卡西酮类、哌嗪类及合成大麻素类。虽然全球并没有建成较为完整且可用的策划药数据库,但联合国毒品与犯罪问题办公室正在积极建立策划药数据库。由于检测策划药对仪器的要求较高且没有科学标准的检测方法,导致我国检测策划药的能力非常有限。近年来,策划药在欧美发达国家的实验室被检出有数百个衍生物,但国内相关报道较为罕见。结论:策划药作为毒品的类似物,在不断地发展演变;提高对策划药的发现、识别、检测、管制能力迫在眉睫,此任务极具专业性及艰巨性。