抗心律失常药物的联合应用

本文介绍抗心律失常药物联合应用的原则,扼要叙述美西律和普萘洛尔,美西律和奎尼丁,美西律和胺碘酮,氟卡胺和普萘洛尔,维拉帕米和普萘洛尔,胺碘酮和奎尼丁,奎尼丁和吡二丙胺联合用药的相互作用,药代动力学改变,电生理变化,临床疗效和副作用。     

基于WHO/HAI标准化法的山东省50种药品价格及可获得性研究

摘要：目的:分析山东省药品在公立医院和零售药店药品的价格和可获得性情况,为药品政策研究提供数据支持。方法:应用世界卫生组织和健康行动国际组织共同制定的标准化法,于2018年对山东省6个市的47家公立医院和46家零售药店的50种药品的价格和可获得性进行调研,并与国际药品参考价格进行对比分析,评价药物的可负担性。结果:原研药和最低价格仿制药在公立医院的可获得性分别为10.3%和32.4%,在零售药店的可获得性分别为和13.7%和32.3%。原研药和最低价格仿制药在公立医院的中位中位价格比分别为8.44和1.96,在零售药店分别为7.77和2.97。原研药和最低价格仿制药可负担性较好的品种数占比在公立医院分别为28.57%和81.82%,在零售药店分别为33.33%和77.78%。结论:原研药的可获得性低,最低价格仿制药的可获得性一般;原研药价格远高于国际参考价;公立医院的药品价格低于零售药店;原研药的可负担性一般,最低价格仿制药的可负担性较好。     

抗凝剂和抗血小板制剂的临床应用指导

血栓由纤维蛋白和血细胞组成,可发生于心血管系统的多个部位,包括静脉、动脉、心脏和微循环.由于细胞和纤维蛋白的相对含量决定于血流动力学因素,因此动脉血栓和静脉血栓的成分并不相同,由此产生的临床表现和治疗方法亦有区别.     

山参与移山参的鉴定

目的增强对山参和移山参的认识及鉴别能力，提高山参和移山参的检验水平。方法根据山参和移山参生态 特点和形态特征，介绍其质量情况和鉴别方法。结果通过性状特征对各类山参和移山参进行鉴定。结论性状特征和五形特点可作为山参和移山参的鉴定依据。     

医学论文科学性的标准

科学性就是客观真实性。医学论文的科学性就是指作者(研究者)认真贯彻三严精神,尊重事实和原始材料,恰如其分地总结自己的经验和研究成果,或说明和解决基础医学和临床医学的问题。     

癌症患者的情感障碍分析及心理干预

近年来癌症的发病率和死亡率正在逐年增加,成为最常见的死因.癌症作为身心疾病,患者的不良心理反应和应对方式可通过影响机体的内分泌和免疫功能.进而影响癌症的发展和转归.采用支持性和行为干预等心理治疗方法.可使癌症患者的平均生存期延长[1].     

灯盏花素对UL补硒大鼠谷胱甘肽过氧化物酶和硫氧还蛋白还原酶基因表达和活性的影响

目的　观察灯盏花素对允许的最高摄入量硒大鼠肝脏、肾脏、睾丸组织中谷胱甘肽过氧化物酶 (GSH Px)和硫氧还蛋白还原酶 (TR)基因表达和活性的影响。方法　采用RT PCR方法和酶活性测定分析GSH Px和TR基因表达水平和活性。结果　UL硒能降低大鼠肝脏组织中GSH Px和TRmRNA表达水平及活性 ,灯盏花素能增加补硒大鼠肝脏中GSH Px和TRmRNA表达水平和活性。UL硒对大鼠肾脏、睾丸组织GSH Px和TRmRNA表达水平和活性无明显影响。结论　灯盏花素能有效拮抗UL硒所致的GSH Px和TRmRNA表达和活性的下降 ,且UL硒所致的GSH Px和TRmRNA表达和活性的下降具有组织特异性。提示补硒不宜取允许的最高摄入量     

大数据和人工智能技术用于计算机辅助药物设计的研究进展

大数据和人工智能（AI）技术不仅可以对海量的生物医学数据进行准确和综合地分析,而且可以帮助构建药物设计领域的预测模型。随着算法和统计方法的发展,大数据和AI技术已应用于计算机辅助药物设计（CADD）。CADD可被用于有效克服药物设计领域的困难,从而高效地设计和开发新药。介绍了药物设计和发现过程中数据预处理和建模步骤、药物设计和发现过程中基于AI的建模方法、大数据和AI技术在CADD中的最新应用,以期为我国药物设计和开发提供参考。     

医学论文科学性的标准

科学性就是客观真实性。医学论文的科学性就是指作者(研究者)认真贯彻"三严"精神,尊重事实和原始材料,恰如其分地总结自己的经验和研究成果,或说明和解决基础医学和临床医学的问题。     

医学论文科学性的标准

科学性就是客观真实性。医学论文的科学性就是指作者(研究者)认真贯彻"三严"精神,尊重事实和原始材料,恰如其分地总结自己的经验和研究成果,或说明和解决基础医学和临床医学的问题。     

5%咪喹莫特与0.5%鬼臼毒素治疗尖锐湿疣的成本-效果分析

目的 :评价5 %咪喹莫特与0 5 %鬼臼毒素治疗尖锐湿疣的成本 -效果。方法 :收集1966年～2003年间有关咪喹莫特与鬼臼毒素治疗尖锐湿疣的随机双盲安慰剂对照临床研究文献 ,比较两种药物的临床疗效和不良反应 ,并作成本 -效果分析。结果 :咪喹莫特与鬼臼毒素治疗尖锐湿疣的治愈率分别为48 48 %、46 62 % ,无显著性差异 (P>0 05)。咪喹莫特最常见的不良反应为红斑、糜烂、瘙痒和表皮脱落、结痂、水肿 ;鬼臼毒素最常见的不良反应为灼热、炎症、糜烂、疼痛、瘙痒、出血。二者比较 ,鬼臼毒素不良反应发生率较高 ,也较严重。咪喹莫特与鬼臼毒素治疗尖锐湿疣的成本 -效果比分别为36 88、8 15。结论 :咪喹莫特与鬼臼毒素治疗尖锐湿疣具有相似的疗效 ,虽然鬼臼毒素成本 -效果比较低 ,但其不良反应却较多和较严重。     

鬼臼毒素二棕榈酰磷胆碱脂质体治疗尖锐湿疣的临床研究

目的评价0.5%鬼臼毒素二棕榈酰磷脂酰胆碱(DPPC)脂质体治疗尖锐湿疣的临床效果和安全性。方法73例尖锐湿疣患者随机分为两组,治疗组(51例)用0.5%鬼臼毒素DPPC脂质体,对照组(58例)用0.5%鬼臼毒素酊剂。两组给药途径为外用,疗程7～21d。结果0.5%鬼臼毒素DPPC脂质体与0.5%鬼臼毒素酊剂治疗尖锐湿疣的治愈率分别为90.20%和91.38%,无显著性差异(P>0.05)。但治疗组不良反应和复发率明显低于对照组(P<0.05)。结论0.5%鬼臼毒素DPPC脂质体与0.5%鬼臼毒素酊剂具有相似的疗效,但其安全性高,复发率低。     

Design, synthesis, and biological testing of 4beta-[(4-substituted)-1,2,3-triazol-1-yl]podophyllotoxin analogues as antitumor agents

A series of 4beta-[(4-substituted)-1,2,3-triazol-1-yl]podophyllotoxin analogues have been synthesized with high regio-selectivity by employing copper(I)-catalyzed 1,3-dipolar cycloaddition of 1-O-propargyl monosaccharides with C4beta-azido podophyllotoxin and C4beta-azido-4'-O-demethyl podophyllotoxin. All the compounds were evaluated for their anticancer activity against a panel of six human cancer cell lines. Among these, 4'-O-demethyl podophyllotoxin congeners are showing promising anticancer activity mainly against HCT-15 (colon) and DU-145 (prostate) cells.     

Drugs that inhibit tubulin polymerization: the particular case of podophyllotoxin and analogues

Tubulin being a major cellular target for antitumor drugs, tubulin-interacting compounds have attracted great attention as antimitotic agents. Two main classes of antimitotic drugs are known and one of them includes podophyllotoxin, a natural product. The clinical use of podophyllotoxin in the treatment of cancer has been limited by severe toxic side effects. In an attempt to find less toxic analogues, many podophyllotoxin derivatives have been prepared. Identification of two types of mechanisms of action has led to the development of two groups of podophyllotoxin analogues: tubulin polymerisation inhibitors and topoisomerase II inhibitors. The present article focuses on the first group of podophyllotoxin analogues i.e. those that retain "podophyllotoxin-like" activity. The review starts with a short summary of the structural characteristics of tubulin and its interactions with drugs that affect the microtubule dynamics and then deals with the particular case of podophyllotoxin. Particular attention is given to the nature and the location of the binding sites compared to those of colchicine. The main purpose of the present review being the search for structure-activity relationships, the structural significant features required for antitubulin activity are described and discussed in details.     

鬼臼毒素涂膜剂的制备及质量控制

目的 :研究鬼臼毒素涂膜剂的制备及其质量控制方法。方法 :采用正交函数法筛选鬼臼毒素涂膜剂的处方 ,二阶导数紫外分光光度法对其进行含量测定。结果 :所选处方的鬼臼毒素在80～180μg/ml范围内 ,浓度与二阶导数光谱301 5nm～315nm波长处的峰面积呈线形关系 ,C=1052 41Au—8 74 ,r=0 9999。结论 :鬼臼毒素涂膜剂的制备工艺简单 ,质量控制方法可行     

鬼臼毒素脂质体的稳定性研究

目的预测鬼臼毒素脂质体的稳定性。方法采用离心-分光光度法测定稳定性参数(KE)值。采用经典恒温加速试验法分别在25,30,40℃恒温条件下,在不同间隔时间用高效液相色谱法测定鬼臼毒素脂质体中药物浓度,预测鬼臼毒素脂质体在4℃下的有效期t0.9。结果在光照条件下放置10 d的KE值较0 d增加的最多,增加了12.21倍,而在4,25,30,40℃放置10 d的KE值较0 d分别增加了3.88,5.85,6.96,8.12倍;鬼臼毒素脂质体在4℃下的有效期t0.9为5 d,t0.5为60 d。结论鬼臼毒素脂质体的稳定性与温度有关,温度越高,稳定性越差,应低温保存。     

咪喹莫特乳膏和鬼臼毒素酊治疗尖锐湿疣疗效对照观察

目的对比观察咪喹莫特乳膏和鬼臼毒素酊治疗尖锐湿疣的疗效。方法将98例患者分为咪喹莫特乳膏组与鬼臼毒素酊组,咪喹莫特乳膏组肌注重组人干扰素a-2b,口服盐酸伐昔洛韦片,病灶局部涂抹咪喹莫特乳膏;鬼臼毒素酊组：肌注重组人干扰素a－2b,口服盐酸伐昔洛韦片,病灶局部涂抹鬼臼毒素酊。结果咪喹莫特乳膏组痊愈53例,复发5例,有效率为91．2％,鬼臼毒素酊组痊愈30例,复发10例,有效率为75．0％,两组比较差异有显著性（P〈0．05）。结论咪喹莫特乳膏较鬼臼毒素酊治疗尖锐湿疣疗效更理想,复发率低。     

Comparison of different extraction methods for the determination of podophyllotoxin and 6-methoxypodophyllotoxin in Linum species

Three extraction methods for analysis of podophyllotoxin and its derivatives from Linum species were compared. No statistical difference on the percentage of recovery were found between the methods. The "glycosidase-method" showed the best result with respect to the accuracy studies; the "acetone-method" has an advantage compared to the other methods due to its capability to calculate the aglycone, lignan glycoside and total lignan. The content of podophyllotoxin and 6-methoxypodophyllotoxin in Linum mucronatum subsp. mucronatum Bertol, Linum arboreum L., and the endemic Turkey species of Linum flavum subsp. scabrinerve Davis were determined. This is the first report on the analysis of podophyllotoxin and 6-methoxy podophyllotoxin of natural collected Linum flavum subsp. scabrinerve and Linum arboreum.     

鬼臼毒素人工抗原的合成与鉴定

目的合成和鉴定鬼臼毒素人工抗原，以获取具有特异性和高度亲和性的鬼臼毒素多克隆抗体。方法 通过酯化反应合成半抗原鬼臼毒素半琥珀酰酯；利用活泼酯法和混合酸酐法偶联成免疫和包被所需的人工抗原；按常规免疫法，从免疫的兔血清中获取高效的抗鬼臼毒素抗体。结果质谱、核磁共振和红外分析表明两种不同方法均成功地合成了半抗原鬼臼毒素半琥珀酰酯。人工抗原的偶联比因载体蛋白和合成方法的不同而有所不同，Hapten-BSA₁为88.6，Hapten-BSA₂为40.3，Hapten-OVA₁为17.8和Hapten-OVA₂为54.2。利用兔M4440产生的抗血清建立的ELISA方法对鬼臼毒素的最低检测浓度为0.12 μg·mL^-1，半数抑制浓度为221 μg·mL^-1。结论成功地合成了鬼臼毒素人工抗原，并获得了抗鬼臼毒素抗体，为鬼臼毒素免疫分析方法的进一步研究提供了条件。     

Mucor fragilis as a novel source of the key pharmaceutical agents podophyllotoxin and kaempferol

Context: Podophyllotoxin, a pharmaceutically important bioactive compound of Podophyllum sps. (Berberidaceae), is in great demand worldwide as an anticancer and antivirus drug precursor. However, the source of podophyllotoxin is very limited due to the endangered status of the Podophyllum plant.

Objective: The aim of this study was to isolate podophyllotoxin-producing endophytic fungi from Sinopodophyllum hexandrum (Royle) Ying (1979) (Berberidaceae) plants of the Taibai Mountains of China in order to obtain bioactive compounds.

Materials and methods: The strains producing kaempferol and podophyllotoxin were screened by thin-layer chromatography (TLC) analysis. The presence of kaempferol and podophyllotoxin in extracts of these strains was further confirmed by high-performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR) analyses.

Results: Among six endophytic fungi isolated from the rhizomes of S. hexandrum, one strain was able to produce kaempferol. Another strain, named TW5, was able to produce both kaempferol and podophyllotoxin simultaneously according to the TLC, HPLC, and NMR results. The podophyllotoxin yield of TW5 was calculated to be 49.3?μg/g of mycelial dry weight after 7-d fermentation. Strain TW5 was identified morphologically and phylogenetically to be Mucor fragilis Fresen. (Mucoraceae). These results suggest that the podophyllotoxin-synthesizing ability is obtained by uptaking genes involved in the podophyllotoxin synthesis from the host plant into endophytic fungal genomes.

Conclusion: Our results showed, for the first time, that the endophytic fungus M. fragilis is able to produce simultaneously the same two bioactive metabolites, podophyllotoxin and kaempferol, as its host plant. Furthermore, the relatively high podophyllotoxin yield obtained may improve the industrial production of podophyllotoxin, which may help protect this endangered plant.