婴儿口腔护理器联合三氯新含漱液在脑卒中患者口腔护理中的应用

目的探讨婴儿口腔护理器联合三氯新含漱液进行口腔护理对脑卒中患者的作用。方法将80例入住ICU病房的脑卒中患者随机分成两组,观察组采用婴儿口腔护理器联合三氯新含漱液行口腔护理,对照组使用生理盐水进行常规口腔护理,观察两组患者口腔异味、口腔溃疡、牙菌斑指数及呼吸机相关性肺炎(Ventilator-associated Pneumonia VAP)发生率。结果观察组患者口腔异味、口腔溃疡、牙菌斑指数及VAP发生率、气管插管时间、机械通气时间、住院天数均显著低于对照组(P0.05)。结论婴儿口腔护理器联合三氯新含漱液对脑卒中患者行口腔护理可有效减少患者口腔异味、口腔溃疡、牙菌斑指数、VAP的发生率及住院天数。     

多定量指标研究千里香提取物工艺

目的优选千里香药材乙醇提取物最佳工艺条件。方法以千里香醇提浸膏量、浸膏中九里香酮和5'-九里香酮的含量为考察指标,采用正交实验法对影响醇提工艺的主要因素:乙醇浓度、乙醇用量、提取时间和提取次数进行研究。结果千里香乙醇提取物提取最佳工艺为:用浓度为80%的乙醇提取,乙醇用量为药材量10倍,提取两次,每次1小时。结论该提取工艺方法可行、简便、合理。     

复方氯己定含漱液对老年慢性牙周炎患者牙周临床指标及口气的影响

目的探讨复方氯己定含漱液治疗慢性牙周炎的疗效及对患者牙周临床指标和口气的影响。方法选择2010年9月至2014年9月在该院就诊的老年慢性牙周炎患者120例作为研究对象,随机分成两组,各60例。对照组:牙周袋内注射复方碘甘油。观察组:牙周袋内注射复方碘甘油,同时应用复方氯己定含漱液漱口。结果观察组总有效率(96.7%)高于对照组(76.7%)(P0.01)。治疗后,观察组患者的牙周临床指标菌斑指数(PLI)、牙周袋深度(PD)、牙龈出血指数(BI)水平都低于对照组(P0.05)。治疗后,观察组患者的口气和舌苔指标口腔挥发性硫化物(VSCs)、感官值(OS)、舌苔厚度(Tt)都低于对照组(P0.01)。结论复方氯己定含漱液在老年慢性牙周炎的治疗中具有较高的应用价值,能够有效优化牙周临床指标、改善口气。     

甲硝唑胶浆含漱液控制老年人牙面菌斑和牙龈炎症的作用

目的探讨甲硝唑胶浆含漱液控制老年人牙面菌斑和牙龈炎症的作用。方法选取2012年1月至2014年6月在该院就诊的牙周病患者106例,随机分为观察组和对照组各53例。对照组给予牙菌斑一般治疗。观察组在一般治疗基础上给予甲硝唑胶浆含漱液治疗。比较两组牙周病患者菌斑指数(PI)、牙龈出血指数(BI)、肿瘤坏死因子(TNF)-α与白细胞介素(IL)-1β等水平。结果治疗3 w,观察组PI 0度分布率高于对照组(P0.05)。治疗3、5、7 w,观察组PI及BI都优于同期对照组(P0.01~0.05),TNF-α、IL-1β水平都低于对照组(P0.01~0.05)。观察组治疗满意率高于对照组(P0.01)。结论甲硝唑胶浆含漱液具有控制老年人牙面菌斑和牙龈炎症的作用。     

中药复方制剂干预动脉粥样硬化的实验研究

目的:探究以白藜芦醇、小檗碱、姜黄素和青蒿琥酯单体组合为基础,以合理的剂量配比达到对动脉粥样硬化干预最有效和安全的复方制剂,以期对他汀不耐受患者提供一种干预动脉粥样硬化的方案.方法:通过高脂饲料法建立载脂蛋白E敲除(apolipoprotein E-knockout,ApoE-/-)小鼠动脉粥样硬化模型.选择白藜芦醇、...     

梅花鹿鹿茸多糖的提取工艺优化及抗衰老的作用

目的优化提取梅花鹿鹿茸多糖的工艺,探讨鹿茸多糖的抗衰老作用及机制。方法采用正交实验法考察料液比、提取时间、提取次数对鹿茸多糖提取工艺的影响,确定最优的鹿茸多糖提取工艺,按最佳提取工艺提取鹿茸多糖。将实验动物随机分为正常对照组、衰老模型组、鹿茸多糖低(125 mg/kg)、中(250 mg/kg)、高(500 mg/kg)剂量组。给药30 d后,测定衰老小鼠血清中超氧化物歧化酶(SOD)活力、过氧化氢酶(CAT)活力、谷胱甘肽过氧化物酶(GSH-Px)活力和丙二醛(MDA)含量,同时苏木素-伊红染色观察肝组织结构变化。结果优化后的梅花鹿鹿茸多糖提取率为1.6%,与正常对照组相比,衰老模型组SOD、GSH-Px、CAT活力均明显降低,MDA含量明显升高(P<0.01)。与衰老模型组相比,鹿茸多糖各剂量组SOD、CAT、GSH-Px、活力均明显升高,MDA含量均明显下降;与模型组组相比,鹿茸多糖低、中、高剂量组对衰老小鼠肝组织具有保护作用。结论鹿茸多糖的最佳提取工艺为料液比1∶15的缓冲溶液,100℃提取2 h,提取2次。鹿茸多糖对D-半乳糖诱导的衰老小鼠具有延缓衰老作用,其机制可能与清除体内自由基有关。     

红芪多糖的提取工艺及抗肿瘤研究进展

近年关于中药红芪提取物药理活性的体外研究较多,尤其是红芪多糖的提取工艺及抗肿瘤体内、外研究机制进展较多。通过搜集文献,现将红芪多糖的提取工艺、抗肿瘤药理学活性及机制总结如下。     

鸡眼草总黄酮的提取工艺条件及其体外抗氧化性

目的 研究鸡眼草总黄酮的提取工艺条件及其体外抗氧化活性.方法 通过单因素实验和正交试验对鸡眼草总黄酮的提取工艺条件进行优化.采用清除羟自由基(·OH)、清除超氧阴离子自由基(0(2))、抗O(2)活力和总抗氧化能力(T-AOC)等方法评价其黄酮类化合物的体外抗氧化活性.结果 鸡眼草总黄酮得的最佳提取工艺条件为:取温度为70℃、乙醇浓度为55％、提取时间为2.5h、料液比为1:50.随着鸡眼草总黄酮浓度的增加,对·OH和0(2)的清除率逐渐升高,抗0(2)活力和T-AOC亦随之增强.结论 优选的鸡眼草总黄酮提取工艺合理、稳定可行,鸡眼草总黄酮具有一定的体外抗氧化活性.     

运动试验综合指标诊断冠心病的试验性评价

平板运动试验(TET)是目前诊断可疑冠心病(CHD)或判断其严重程度的重要检查手段.TET中有多项指标,如果将其进行综合分析,可明显提高诊断CHD的可靠性.本研究以冠状动脉造影(CAG)为金标准,利用运动试验中的指标,采用Logistic回归分析方法建立预测CHD的诊断模型.     

化瘀无糖颗粒制备工艺的筛选

目的优选化瘀无糖颗粒的制备工艺,研制无糖剂型。方法采用正交试验法,以干膏量和咖啡酸含量的综合评价为指标进行提取工艺筛选;以颗粒成型性、吸湿性、溶化性为指标确定糊精用量。结果确定的煎煮条件为加10倍量水煎煮3次,2 h/次;糊精用量为干浸膏量的10%;阿斯巴甜用量为粉末总量的0.3%。结论采用加10倍量水煎煮3次、2 h/次,加入干浸膏量10%的糊精、粉末总量0.3%的阿斯巴甜,干法制粒工艺能成功制备化瘀无糖颗粒,且该制备工艺稳定可行,所制得化瘀无糖颗粒各质量指标均符合《中国药典》2010年版规定。     

高效液相色谱法测定砖茶中儿茶素和生物碱含量的研究

目的 建立测定砖茶中儿茶素和生物碱的色谱分析方法,同时寻找出砖茶中儿茶素和生物碱的较优提取条件.方法 采用高效液相色谱法分离检测砖茶中儿茶素和生物碱,并进行回收率、精密度、稳定性实验.分别采用水、乙醇作为提取溶剂对砖茶中儿茶素和生物碱提取情况进行正交实验,再比较水和醇的提取效果,以获得提取砖茶中儿茶素和生物碱的较优提取条件.结果 高效液相色谱法可同时分离并检测出砖茶中儿茶素、表儿茶素、表没食子儿茶素、表没食子儿茶素没食子酸酯、没食子儿茶素、表儿茶素没食子酸酯6种儿茶素以及咖啡碱、可可碱2种生物碱.各组分的峰面积和浓度之间具有良好的线性关系,决定系数(R2)范围为0.9990 ～ 0.9999;加标回收率范围为83.78％～ 106.35％.精密度较好[峰面积相对标准偏差(RSD)范围为0.50％～1.51％].砖茶中儿茶素和生物碱较优提取条件为:乙醇浓度80％、料液比1∶10、温度80℃、时间30 min.结论 乙醇作为提取剂的高效液相色谱法的较优提取条件,对砖茶中6种儿茶素和2种生物碱分离度较好,定性准确,快速灵敏.     

Quantitative evaluation of the diagnostic thinking process in medical students

OBJECTIVE: To explore the diagnostic thinking process of medical students. SUBJECTS AND METHODS: Two hundred twenty-four medical students were presented with 3 clinical scenarios corresponding to high, low, and intermediate pre-test probability of coronary artery disease. Estimates of test characteristics of the exercise stress test, and pre-test and post-test probability for each scenario were elicited from the students (intuitive estimates) and from the literature (reference estimates). Post-test probabilities were calculated using Bayes' theorem based upon the intuitive estimates (Bayesian estimates of post-test probability) and upon the reference estimates (reference estimates of post-test probability). The differences between the reference estimates and the intuitive estimates, and between Bayesian estimates and the intuitive estimates were used for assessing knowledge of test characteristics, and ability of estimating pre-test and post-test probability of disease. RESULTS: Medical students could not rule out disease in low or intermediate pre-test probability settings, mainly because of poor pre-test estimates of disease probability. They were also easily confused by test results that differed from their anticipated results, probably because of their inaptitude in applying Bayes' theorem to real clinical situations. These diagnostic thinking patterns account for medical students or novice physicians repeating unnecessary examinations. CONCLUSIONS: Medical students' diagnostic ability may be enhanced by the following educational strategies: 1) emphasizing the importance of ruling out disease in clinical practice, 2) training in the estimation of pre-test disease probability based upon history and physical examination, and 3) incorporation of the Bayesian probabilistic thinking and its application to real clinical situations.     

Comparative evaluation of freeze-dried and liquid antigens in the direct agglutination test for serodiagnosis of visceral leishmaniasis (ITMA-DAT/VL)

OBJECTIVE: The direct agglutination test (DAT) for visceral leishmaniasis (VL) with liquid (LQ) antigen is known to be only moderately reproducible because of inter-observer and batch-to-batch variability as well as its sensitivity to temperature and shaking during transport. We evaluated a DAT with freeze-dried (FD) antigen and compared it with the LQ antigen version. METHODS: Blood samples of clinical VL suspects and healthy endemic controls were collected in Sudan, Nepal and India. Both test versions were performed in duplicate in the respective countries and in the reference laboratory. Interbatch variability and stability tests were conducted and agreement was examined within and between centres on a dichotomic scale by Cohen's kappa as well as on a continuous scale through Bland-Altman plots. RESULTS: The FD antigen remains fully active even after storage at 45 degrees C for 24 months. Using a cut-off titre of 1:6400, the agreement between the FD and the LQ formats was excellent. CONCLUSION: The major advantages of FD antigen are its better stability at higher temperatures and its longer shelf life, which make it much more suitable than the LQ version for use in the field.