建昌帮姜制工艺对天麻质量标准的影响研究

[摘 要]目的: 检测建昌帮炮制品姜天麻与天麻生品的水分、总灰分、二氧化硫残留量、浸出物、天麻素和对羟基苯甲醇总含量等指标，并对建昌帮姜天麻特征图谱进行检测，以研究制定建昌帮姜天麻的质量标准，为建昌帮炮制品姜天麻特色炮制工艺提供科学的评价依据。方法: 测定建昌帮姜天麻和天麻生品进行水分、总灰分、二氧化硫残留量、浸出物、天麻素和对羟基苯甲醇总含量测定，并进行比较。水分按照《中国药典》（2020版）（通则0832）项下烘干法测定；总灰分按照《中国药典》（2020版）（通则2302）测定；二氧化硫残留量 照按照《中国药典》（2020版）（通则2331）测定；浸出物按照《中国药典》（2020版）天麻浸出物—照醇溶性浸出物测定法（通则2201)项下的热浸法测定；天麻素按照《中国药典》（2020版）照高效液相色谱法（通则0512）测定；特征图谱按照《中国药典》（2020版）照高效液相色谱法（通则0512）测定。结果: 建昌帮姜天麻的水分、总灰分、二氧化硫残留量、浸出物、天麻素和对羟基苯甲醇的总量的平均值分别为10.73%、2.0%、2.6mg/Kg、21.9%、0.56%；天麻生品的水分、总灰分、二氧化硫残留量、浸出物、天麻素和对羟基苯甲醇的总量的平均值分别为14.7%、2.0%、13mg/Kg、18.6%、0.41%。建昌帮姜天麻供试品色谱峰中呈现6个特征峰，并与天麻对照药材色谱中呈现的6个特征峰对应一致，其中1号峰和2号峰分别与天麻素和对羟基苯甲醇对照品特征峰保留时间一致。结论: 建昌帮姜天麻水分、总灰分、二氧化硫残留量、浸出物、天麻素和对羟基苯甲醇的总含量及特征图谱均符合《中国药典》（2020版）天麻饮片标准要求。天麻经姜制后，水分和二氧化硫残留量减少，尤其是二氧化硫残留量下降明显，浸出物及天麻素和对羟基苯甲醇总含量增加。     

人纤维蛋白原制剂中蛋白质含量测定方法的探究

目的：探究适宜的人纤维蛋白原制剂中蛋白质含量测定方法。方法：分别应用《中国药典》三部（2010年版）中蛋白质测定法项下三氯醋酸沉淀法和两种改良后的三氯醋酸法测定6批人纤维蛋白原制剂中的蛋白质含量,比较三种方法的稳定性和平行性。结果：改良后的三氯醋酸沉淀2法[用三氯醋酸代替《中国药典》三部（2010年版）钨酸钠沉淀法中钨酸钠和硫酸溶液]的稳定性和平行性明显比《中国药典》三部（2010年版）中蛋白质测定法项下三氯醋酸沉淀法和改良后的三氯醋酸沉淀3法更好,相对标准偏差（RSD）更低。结论：改良后的三氯醋酸沉淀2法更适合人纤维蛋白原制剂中蛋白质含量的测定。     

北五味子一种新醋制方法的研究

目的:研究北五味子一种新醋制方法.方法:比较新醋制方法和最佳醋制方法所得五味子甲素、五味子乙素的含量以及水溶性浸出物、醇溶性浸出物的情况.结果:新醋制方法五味子水溶性浸出物、醇溶性浸出物、五味子乙素含量分别为41.63%、33.73%、0.2083%.结论:新醋制方法优于最佳醋制方法.     

黄药子炮制前后4个主要指标变化的研究

目的:比较不同炮制方法对黄药子4个有效指标的影响.方法:用热浸法测水溶性浸出物含量和醇溶性浸出物含量,用硫酸-苯酚法测多糖含量.结果:水溶性浸出物、醇溶性浸出物、多糖重量、多糖含量大小次序均为:当归水提液煮的黄药子>与当归同煮的黄药子>生黄药子>单独水煮的黄药子;结论:用当归炮制后的黄药子中有效指标的含量明显高于生黄药子和单独水煮的黄药子中有效指标的含量.其中当归水提液炮制黄药子其4种有效指标含量最高.     

不同途径获取的苍术饮片质量情况分析

方法：采用《中国药典》2020年版一部苍术项下方法。目的：对不同途径获取的苍术饮片进行质量评价，了解市售苍术整体质量现状，为监管部门严格苍术药材和饮片市场监管提供建议。结果：从淘宝网以低价购入的10批苍术饮片，均不合格；从药材市场购入的19批苍术饮片中，14批不合格，不合格率73.7%；从药店和医院购入的10批苍术饮片，均合格。结论：药店、医院销售的中药饮片质量逐渐得到提升，而网络平台和中药材交易市场苍术伪品流入量大，需加大对该两种销售渠道的监管。     

不同年份和不同大小太子参的质量研究

目的:比较不同大小和不同年份太子参的外观性状、薄层鉴别、太子参多糖含量和太子参皂苷含量等指标,以期为鉴别不同大小和不同年份的太子参品质提供依据。方法:薄层鉴别按照《中国药典》2015年版一部太子参项下进行鉴别;太子参外观性状主要根据色泽和气味进行鉴别,用图片及文字的形式进行描述;太子参皂苷和太子参多糖的含量测定采用紫外分光光度法。结果:不同年份的太子参的性状存在明显差异,比如断面颜色和气味等,可作为鉴别太子参年份的依据;不同年份太子参的薄层鉴别、皂苷含量及多糖含量无明显差异;不同大小的太子参的薄层鉴别、皂苷含量及多糖含量也无明显差异。结论:太子参的内在质量与其年份和大小无明显关系。     

按2010版《中国药典》要求研制的丙型肝炎病毒抗体检测试剂性能验证

目的对按新版《中国药典》要求研制的丙型肝炎病毒抗体(下称丙肝抗体)试剂的方法学性能进行评价和分析。方法结合美国临床实验室标准化协会(CLIS)发布的EP12-A2文件《定性试验评价方法用户协议和提议指南》和中国合格评定国家认可委员会(CNAS)颁发的《医学实验室质量和能力认可准则在临床免疫学检验领域的指南》对丙肝抗体进行性能评价。结果丙肝抗体定性试验的临界值为0.3NCU/mL;诊断敏感性为95.83%,特异性为100%,符合率为97.5%;批内精密度高值:12.94%,低值:13.67%;批间精密度CV是14.83%。结论丙肝抗体试剂的方法学性能符合2010版《中国药典》要求,且比以前同类产品检测性能优良。     

5种中成药中铅、镉、砷含量测定

目的测定复方丹参片、小柴胡颗粒、补中益气丸、板蓝根颗粒和妇科千金片5种中成药中铅、镉、砷的含量。方法按照2005版《中国药典》采用石墨炉原子吸收光谱法测定其中的铅、镉的含量；用氢化物发生一原子荧光法测定砷的含量。结果5种中成药中铅、镉、砷的含量较低，低于相关标准的规定。结论5种中成药中铅、镉、砷的含量合格。     

乳疾2号微生物限度检查方法学验证

目的:建立乳疾2号微生物限度检查法,确保其检测方法的科学性和检验结果的准确性。方法:采用2005年版《中国药典(》一部)附录"微生物限度检查法"项下相关内容进行方法学验证。结果:采用薄膜过滤法,各试验菌在样品中的回收率均达到70%以上。结论:采用薄膜过滤法能够更好地消除乳疾2号的抑菌作用,使微生物限度检查测定结果准确。     

4种枳壳醇溶性浸出物、挥发油的含量测定

枳壳为常用中药，中医理论认为枳壳性浮而立上，长于入脾肺经，以破气消积、行气除痞为主。自古以来，中药材枳壳品种繁杂，古人皆以翻肚如盆口唇状嘲。《中国药典（2000版）》收载了酸橙Citrus aurantium L．及其栽培变种的干燥未成熟果实为药用枳壳来源标准，但今人对各种来源不同的枳壳质量优劣还是争论不休。同时，由于各地用药习惯和历史原因，给临床用药也带来了极大的不便，因而要建立统一的药源非常困难。为此，本实验选用江枳壳、绿衣枳壳、香圆枳壳、苏枳壳4种全国有代表性的原药材，拟用醇溶性浸出物、挥发油有生理活性的化学成分为指标，对4种枳壳进行研究比较。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

手转胎头术失败的原因与分娩结局临床分析

目的 探讨手转胎头术失败的原因与分娩结局.方法 选择2008年1月至2010年12月于我院住院分娩的持续性枕横位、枕后位产妇198例,根据行手转胎头术后结果分为成功组126例、失败组72例.比较两组分娩结局,对比分析失败原因.结果 失败组胎儿体质量≥3500 g的发生率[76.4％(55/72)]明显高于成功组[31.7％(40/126)],差异有统计学意义(x2=30.177,P=0.001)、失败组宫缩乏力发生率[58.3％(42/72)]高于成功组[38.1％ (48/126)],差异有统计学意义(x2=7.569,P=0.006)、失败组骨盆临界或轻度狭窄发生率[38.9％ (28/72)]高于成功组[23.8％(30/126)],差异有统计学意义(x2 =5.030,P=0.002)、失败组手转胎头时机不当(宫口开大＜6 cm、胎头位于坐骨棘上及宫口开大8～10 cm、胎头位于坐骨棘下≥2 cm)发生率[61.1％(44/72)]高于成功组[38.9％(49/126)],差异有统计学意义(x2=9.084,P=0.003).失败组母儿并发症(产后出血、产褥病率、胎儿窘迫、新生儿窒息)发生率高于成功组(x2 =9.586,P=0.002、x2=9.334,P=0.002、x2=5.910,P=0.015、x2=5.240,P=0.022)、失败组剖宫产发生率[72.2％(52/72)]明显高于成功组[34.1 ％(43/126),x2=26.641,P=0.001)].结论 手转胎头术能使难产变顺产,降低剖宫产率,减少母儿并发症,但须积极预防、处理导致手转胎头术失败的原因,对矫正失败后继续矫正及试产应慎重.