狂犬病诊治进展

人类的狂犬病是一种中枢神经系统病毒感染性疾病,常由患狂犬病动物的唾液污染伤口而传染;一旦出现症状,病人基本上100%死亡,从狂犬病后康复的病例极为罕见,仅有3例报道。临床表现为特有的恐水怕风、咽肌痉挛、进行性瘫痪等。狂犬病在87个国家有流行,主要流行于东南亚、非洲及拉     

布洛芬对乙酰氨基酚退热疗效对比

长期以来,发热是儿科关注的问题,发热程度有助于判断病情,儿童多因与病情不成比例,轻微疾病即可出现发烧,父母常常不了解这一现象而引起不必要的恐慌,随意应用退热药即成为儿科普遍的现象[1].采用安全有效的退热药物值得临床探讨.     

Establishment of a mouse model of cancer cachexia with spleen deficiency syndrome and the effects of atractylenolide I

Cancer cachexia is a multifactorial metabolic syndrome that affects～50%–80%of cancer patients,and no effective therapy for cancer cachexia is presently available.In traditional Chinese medicine,a large portion of patients with cancer cachexia was diagnosed as spleen deficiency syndrome and treated with tonifying TCMs that produce clinic benefits.In this study we established a new animal model of spleen deficiency and cancer cachexia in mice and evaluated the therapeutic effects of atractylenolide I,an active component of tonifying TCM BaiZhu,in the mouse model.Cancer cachexia was induced in male BALB/c mice by inoculation of mouse C26 colon adenocarcinoma cells,whereas spleen deficiency syndrome was induced by treating the mice with spleen deficiency-inducing factors,including limited feeding,fatigue,and purging.The mouse model was characterized by both cachexia and spleen deficiency characteristics,including significant body weight loss,cancer growth,muscle atrophy,fat lipolysis,spleen,and thymus atrophy as compared with healthy control mice,cancer cachexia mice,and spleen deficiency mice.Oral administration of atractylenolide I(20 mg·kg?1per day,for 30 days)significantly ameliorated the reduction in body weight and atrophy of muscle,fat,spleen,and thymus in mice with spleen deficiency and cachexia.The established model of spleen deficiency and cancer cachexia might be useful in the future for screening possible anticachexia TCMs and clarifying their mechanisms.     

精于颐养走过百年——许德珩的长寿要诀

许德珩一生精于摄生颐养,享年100岁.他的养生要诀主要有如下几条: 重视饮食条理 许老的饮食以清淡为主,定时定量,不饱食,不偏食,不挑食.早餐一般是一碗稀饭,一个小馒头,少许咸菜;午餐以蔬菜为主,加上少许牛肉(晚年不食猪肉),主食100克;晚餐则以素为主.一日三餐既不随意增减,更不暴饮暴食.饮酒微量,只喝一点果酒,不饮白酒等烈性酒.爱吃新鲜水果,不吃甜食.     

浅谈如何加强医疗器械的管理

医疗器械的应用在疾病的诊断、治疗及预防等各个环节都发挥着不可替代的作用,其质量的好坏直接关系到人民群众的身体健康和生命安危.2000年国务院颁布了第一部医疗器械监管法规-<医疗器械监督管理条例>,标志着我国医疗器械监管正式走上了法制化轨道,但是由于种种原因,目前我国在医疗器械的生产、经营以及使用等各个环节都存在着较为普遍和严重的问题,其监管已显得相对滞后,成为食品药品部门监管中的一个"软肋",以至于频频出现像钢板等植入性器械断裂现象和发生举国震惊的"眼球事件".本文就我县医疗器械的经营、使用现状和如何加强对医疗器械的监管作以下分析和探讨.     

黑米:滋肾补胃益气血

黑米因外皮乌黑而得名,又称补血糯米、贡米、黑珍珠,是一种具有诸多保健功效的珍贵稻米.黑米含有淀粉、蛋白质、脂肪、多种维生素,又含钙、磷、镁、铁、锌、钼、硒等多种矿物质和微量元素.黑米所含蛋白质不但比普通大米高37%,而且其中氨基酸的含量亦比白米高25.4%,人体所需的赖氨酸、精氨酸、氮氨酸、色氨酸等,黑米中也都具有,营养价值很高.     

捕捉蛛丝马迹,让恶性肿瘤早现身——常见恶性肿瘤发病的早期信号(二)

痣 痣可发生在皮肤的任何部位,如面部、手掌、脚底、腰部、前胸、后背和阴囊等处.痣如出现下述现象,可能是癌变信号:反复发生感染;突然有痒感,不由自主地用手搔抓,甚至抓破出血;表面潮湿或有结痂形成;原为棕色,逐渐颜色变深变黑;有出血倾向,稍微触碰即发生出血;周围有炎性红晕,触之有痛感;痣上原有毛发突然自行脱落;痣的中央部出现硬结或自发性出血、溃疡形成和周围出现散在的呈卫星状小黑痣.     

克隆病并穿孔1例

1病例介绍病人,女,35岁,因突发下腹部疼痛半小时就诊,病史诉说欠清,(家属补充,腹痛时间约4～5年),查体:脉搏96次/分,血压84/60 mmHg,表情淡漠、四肢湿冷。全腹压痛呈板状腹,叩诊移动浊音可疑,以脐下压痛明显,B超提示腹腔内有少许积液,右侧卵巢囊肿,约44 cm大小。实验室检查白细胞16×109/L,中性0.80。考虑腹腔脏器穿孔,在全麻下行剖腹探查,取下腹正中切口进腹,腹腔内有臭味溢出,吸出浑浊性液体约250 ml,有食物残渣,距回盲部约50 cm处,向上见约45 cm长的回肠充血水肿     

刺五加注射液致过敏反应2例报告

例1:患者男性,51岁,因患冠心病人院治疗.给予刺五加注射液60mL加5%葡萄糖250mL中静脉注射.输人约50mL时,患者面色潮红,瘙痒感,开始发现前臂有散在的米粒大小的红色小点,继而遍及颈、四肢部以及全身出现点状红色皮疹,甚痒.立即停药,给予扑尔敏、Vc、葡萄糖酸钙口服无效.改为肌注盐酸肾上腺素、静滴地塞米松,1天后上述症状逐渐减轻.     

小便带血,源于结石

市运动会就要开幕了,体校的学生都在紧张地"备战",准备在运动会上崭露头角.小董一直是学校的"尖子生",这段时间练得更加刻苦.可是,最近每次锻炼小董都会感到小腹疼痛难忍,而且小便常常带血,他又怕去医院会耽误比赛,一直不敢告诉老师和家人.后来,还是同宿舍的小张告诉了老师.老师得知这种情况后,马上带着小董到了医院.医生做了X线摄片检查,才知道小董是患了尿路结石.     

CYP3A5*3 and MDR-1 C3435T single nucleotide polymorphisms in six Chinese ethnic groups

The prevalent CYP3A5 *3 and the functional multi-drug resistance gene (MDR1) C3435T show marked interethnic variation among Orientals, Caucasians and Africans. This study aimed to investigate the distribution of CYP3A5*3 and MDR1 C3435T among Chinese ethnic groups. Genotypes of the CYP3A5*3 and MDR1 C3435T were determined in 839 unrelated healthy Chinese subjects by using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Frequencies (P < 0.05) of CYP3A5*3 variant alleles observed in Uygur Chinese, Kazakh Chinese and Tibetan Chinese (88.1%, 84.5% and 80.7%, respectively) were Significantly higher than those in Han Chinese, Wa Chinese and Bai Chinese (67.3%, 56.3% and 70.2%, respectively). Significantly higher 3435T variant frequencies (P < 0.05) were observed in Uygur Chinese (58.4%) and Kazakh Chinese (56.8%) compared with Han Chinese (44.2%), Tibetan Chinese (43.9%), Wa Chinese (45.8%) and Bai Chinese (44.2%). These results indicate that there were marked ethnic differences in the mutant frequencies of CYP3A5*3 and MDR1 C3435T among Chinese ethnic groups. Frequencies of those variants observed in Uygur Chinese, Kazakh Chinese, Tibetan Chinese, Wa Chinese and Bai Chinese wereintermediate between those seen in Han Chinese and African-American.     

A comparison of glutathione S-transferase mutant frequencies in healthy Han and Uygur Chinese.

OBJECTIVE: This study was to compare the frequencies of genetic polymorphisms of GSTM1, GSTT1, and GSTP1 in Uygur Chinese with those in Han Chinese. METHODS: GSTM1 and GSTT1 polymorphisms were analyzed by a PCR-Multiplex procedure, whereas GSTP1 polymorphism was analyzed by PCR-RFLP. RESULTS: The frequency of GSTM1 null genotype in Han Chinese (56.1%) was similar to that in Uygur Chinese (53.2%) (P = 0.592), whilst the frequency of GSTT1 null genotype in Han Chinese (50.0%) was significantly (P < 0.05) higher than that of Uygur Chinese (26.6%). GSTP1 had a genotype distribution of 60.7% I/I, 35.2% I/V and 4.1% V/V in Han Chinese, and 51.3% I/I, 40.2% I/V and 8.4% V/V in Uygur Chinese. CONCLUSION: There is marked ethnic difference in the mutant frequencies of GSTT1 and GSTP1, but not GSTM1, between Uygur and Han Chinese.     

Paracetamol elimination in Chinese and Indians in Singapore

Summary The 24 h urinary excretion of paracetamol and its conjugates after oral administration of about 15 mg/kg was studied in 24 Chinese and 24 Indian healthy young adult male volunteers living in Singapore.The Indians excreted a significantly lower fraction of sulphate conjugate (28.9% compared to 35.9% in the Chinese), and a correspondingly higher fraction as glucuronide conjugate (62.2% compared to 54.5% in the Chinese). There was no difference between the ethnic groups in terms of the urinary recovery of unchanged paracetamol (Indians 3.4%, Chinese 3.6%), glutathione-derived cysteine (Indians 2.3% and Chinese 2.2%) and mercapturic acid (Indians 3.6%, Chinese 3.8%) conjugates. The total fraction of administered paracetamol recovered in the urine was 84.7% and 85.7% in the Indian and the Chinese groups, respectively. Although the total glutathione derived conjugates recovered in the two ethnic groups were similar (Indians 5.9%, Chinese 6%), the values were lower than those reported previously for Caucasians in Scotland (9.3%).     

中国健康汉族和维吾尔族人谷胱甘肽硫转移酶的基因多态性

目的 比较中国健康汉族人和维吾尔族人GSTM1、GSTT1和GSTP1基因多态性分布。方法 用多重PCR分析GSTM1和GSTT1基因多态性，PCR—RFLP检测GSTP15号外显子105位密码子基因多态性。结果 汉族人与维吾尔族人的GSTM1纯合缺失频率接近。分别为56.1％和53.2％。而汉族人的GSTT1纯合缺失频率（50．0％）较维吾尔族人（26．6％）高。汉族人GSTP1 105I／I、I／V和V／V基因型频率分别为60．7％，35．2％和4．1％；维吾尔族人分别为51．3％，40．2％and 8．4％。结论 维吾尔族人与汉族人，除GSTM1外，GSTT1与GSTP1突变基因型频率存在明显种族差异。     

某院中药饮片处方点评细则与方法

目的：分享中药饮片处方点评的方法,促进中药饮片合理使用。方法：根据处方管理办法（2007）、医院处方点评管理规范（2010）、中药处方格式及书写规范（2010）等相关内容,并参考2015年版《中国药典》一部、《中华本草》、2006年版《中药大辞典》、2002年版《江苏省中药饮片炮制规范》等相关典籍,修订中药饮片处方点评的具体方法。结果：分享某院中药饮片处方点评的细则和处方点评工作表,提出促进中药饮片合理使用的干预方法。结论：制定的中药饮片处方点评细则和设计的处方点评工作表可为规范中药饮片处方点评提供参考,提出的干预方法可促进中药饮片的合理使用。     

我国居民中药材中铅暴露的风险评估

目地:评估我国居民中药材铅暴露量及其潜在的健康风险,评价我国当前执行的中药材中铅限量标准的适宜性。方法2008-2016年在全国采集各类中药材2056份,检测铅含量水平。采用多阶段分层随机抽样方法,在黑龙江、辽宁、江西、贵州和甘肃5省份采用入户面对面问卷方式调查5739名18岁及以上成年人中药材消费情况。结合中药材中铅含量水平和中药材消费量数据,采用确定性评估方法,对我国居民中药材中铅暴露风险进行评估。并对我国当前执行的中药材中铅限量标准的适宜性进行评价。结果检测的2056份中药材样本,铅平均含量为1.04mg/kg,超标率3.79%,其中动物类药材铅平均含量2.96mg/kg,高于植物类药材平均含量0.97mg/kg。暴露评估结果显示,常规服用中药材人群铅暴露的健康风险较低;但对于作为药膳食用中药材的人群和长期以较高剂量服用/食用中药材者,铅暴露导致的健康风险相对较高。结论在当前中药材铅残留量水平下,我国大部分居民因中药材导致铅暴露的健康风险较低,但对于终生长期服用或作为药膳大量食用中药材者,铅暴露导致的健康风险需要关注。     

23种中药材中农药残留量的研究

有机氯农药残留早已引起人们的高度重视 ,1983年我国宣布禁止使用六六六 (ｈｅｘａｃｈｌｏｒｏｃｙ ｃｌｏｈｅｘａｎｅ ,ＢＨＣ)、滴滴涕 (ｄｉｃｈｌｏｒｏｄｉｐｈｅｎｙｌｔｒｉｃｈｌｏｒｏｅｔｈ ａｎｅ,ＤＤＴ) ,但由于ＢＨＣ ,ＤＤＴ及五氯硝基苯 (ｐｅｎｔａ ｃｈｌｏｒｏｎｉｔｒｏｂｅｎｚｅｎｅ ,ＰＣＮＢ)在历史上曾广泛使用 ,而且半衰期特别长 ,目前仍是国内外监控的主要对象。国家标准局 1995年颁布的《人参加工产品分等质量标准》中规定了人参及其制品中ＢＨＣ ,ＤＤＴ和ＰＣＮＢ的限量标准和测定方法 ,但其标准过于严格 ,…     

悬艾结合淋巴引流技术对脑卒中后肩手综合征Ⅰ期患者的临床疗效

目的探讨应用悬艾结合手法淋巴引流(MLD)技术对脑卒中后肩手综合征Ⅰ期患者的临床疗效。方法120例神经内科患者,随机分为常规治疗组、悬艾组、手法淋巴引流组、悬艾+手法淋巴引流组,每组30例。常规治疗组采用基本的康复治疗,悬艾组在基本的康复治疗基础上联合悬艾治疗,手法淋巴引流组在基本的康复治疗基础上联合淋巴引流。悬艾+手法淋巴引流组在基本的康复治疗基础上联合悬艾+手法淋巴引流治疗。比较两组视觉模拟评分法(VAS)评分、肿胀程度、Fugl-Meyer上肢运动功能评分法(FMA)评分、总被动关节活动度(TPM)、改良Barthel指数(MBI)评分以及临床效果。结果悬艾组与悬艾+手法淋巴引流组的VAS评分分别为(4.90±1.12)、(3.54±1.78)分,均低于常规治疗组的(6.21±0.78)分和手法淋巴引流组的(5.92±1.08)分,差异均具有统计学意义(P<0.05)。悬艾+手法淋巴引流组与手法淋巴引流组的肿胀程度分别为(5.31±1.54)、(7.21±1.87)ml,均低于悬艾组的(11.09±2.08)ml和常规治疗组的(12.56±1.22)ml,差异具有统计学意义(P<0.05)。悬艾+手法淋巴引流组的FMA评分(23.76±4.67)分和TPM(227.17±10.18)°高于悬艾组的(13.57±4.12)分、(198.87±11.34)°,常规治疗组的(14.11±3.24)分、(192.34±14.23)°和手法淋巴引流组的(15.23±2.78)分、(197.42±17.07)°,差异具有统计学意义(P<0.05)。治疗前后四组MBI评分比较,差异均无统计学意义(P>0.05)。悬艾+手法淋巴引流组治疗总有效率93.33%高于常规治疗组的50.00%、悬艾组的56.67%、手法淋巴引流组的60.00%,差异均具有统计学意义(P>0.05)。结论利用悬艾的温热效应结合手法淋巴引流的消肿作用对脑卒中后肩手综合征Ⅰ期患者进行结合治疗,能够对肩手综合征患者上肢功能的康复起到非常显著的疗效,此方法安全有效,值得临床推广。     

《中华人民共和国药典（2015年版）》（四部）中微生物检验相关通则的增、修订情况介绍

目的：介绍《中华人民共和国药典（2015年版）》（四部）中微生物检验相关通则的主要增、修订情况。方法：比较本版和前版药典相关内容的主要差异。结果：本版药典中微生物检验相关通则体现了新的检验理念,在检验技术、检验方法、环境设施、培养体系和质量管理等方面均进行了增、修订。结论：本版药典中微生物检验相关通则更趋完善,已与国际全面接轨。