肝纤维化门静脉压力改变与血清ET-1/NO关系的实验研究

目的制作兔肝纤维化模型，观察血管活性物质与门静脉压力变化的关系。方法40只家兔采用口服硫代乙酰胺方法造模，分别于造模第8、12、16、20周时检测内皮素（ET-1）及NO浓度，超声观察胆囊壁及肝脏血流动力学指标，直接穿刺测量不同时期门静脉压力。分析血管活性物质与肝脏血流动力学指标及门静脉压力变化间的关系。结果胆囊壁增厚是肝纤维化阶段的二维超声表现；随着纤维化程度的加重，血清ET-1、NO浓度逐渐增加，且以ET-1／N0比值增加更为明显；门静脉内压力、肠系膜上动脉、脾动脉搏动指数（PI）随纤维化程度逐渐增加，实验组与对照组间差异有统计学意义（P〈0．05），且与ET-1／NO值呈正相关（P〈0．01）。结论通过超声可无创检测肝脏血流动力学变化，对肝纤维化临床诊断及治疗效果的观察，具有积极的作用。     

Universal Mindfulness Training in Schools for Adolescents: a Scoping Review and Conceptual Model of Moderators,Mediators, and Implementation Factors

Prevention Science - There is evidence that universal school-based mindfulness training (SBMT) can have positive effects for young people. However, it is unknown who benefits most from such...     

Pregnancy outcomes among visually impaired women in Washington State, 1987–2014

BackgroundWomen with visual impairment may have reduced ability to access standard care resources, however, information on their pregnancy and neonatal outcomes is limited.ObjectiveTo assess risk of adverse pregnancy and neonatal outcomes among visually impaired women in Washington State from 1987 to 2014.MethodsWe conducted a retrospective cohort study using linked Washington State birth/fetal death hospital discharge records to compare outcomes among women with and without visual impairment noted at their delivery hospitalization. Pregnancy conditions and outcomes evaluated included gestational diabetes, pre-eclampsia, labor induction and cesarean delivery. Neonatal outcomes included preterm delivery and birth weight <2500 g. We assessed length of maternal and infant delivery hospitalization. We performed Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CIs) for each outcome, adjusting for year of delivery, maternal age, and parity.ResultsMost adverse pregnancy and neonatal outcomes were similar for visually impaired (N = 232) and comparison women (N = 2362). However, visually impaired women had increased risks of severe pre-eclampsia (RR 3.77, 95% CI 1.69–8.43), labor induction (RR 1.33, 95% CI 1.10–1.61) and preterm delivery (RR 1.60, 95% CI 1.06–2.42). They were also more likely to have delivery hospitalizations of 3 or more days following a vaginal (RR 1.86, 95% CI 1.41–2.47). Among cesarean deliveries, infants of visually impaired women had increased risk (RR 1.24, 95% CI 1.02–1.51) of hospitalization for 3 or more days postpartum.ConclusionOur findings may be useful for obstetric providers in counseling their visually impaired patients.     

碘化钾、碘酸钾对缺碘大鼠甲状腺形态与作用的实验研究

目的：研究碘化钾、碘酸钾对大鼠甲状腺形态学结构的影响。方法：将Wistar大鼠随机分为4组,低碘组（LI）、正常组（NI）、碘化钾组（KI）、碘酸钾组（KIO3）,3个月后观察形态学变化,并做体视学分析,获得定量参数后进行统计学处理。结果：LI组滤泡及滤泡腔的平均体积VQ、平均表面积SQ、体积密度VV、表面积密度SV均明显小于NI组,而数密度NV及比表面积S/V均明显高于NI组;经治疗3个月后,KI组和KIO3组的上述指标均有明显恢复,但尚未完全恢复正常。KI组和KIO3组之间无显著性差异。结论：低碘可致大鼠甲状腺形态典型的小滤泡增生性改变,而KI和KIO3在治疗缺碘性甲状腺肿方面均有很好的疗效,且在本实验期间两者的疗效无显著性差异。     

基于证效相关研究清利湿热方中医功效及降血尿酸作用机制

目的：建立湿热内蕴证候大鼠模型,研究具有降血尿酸作用的清利湿热方的中医功效,以证测效揭示清利湿热降血尿酸作用机制。方法：将48只SD大鼠随机分为空白组、模型组、四妙丸组以及清利湿热方低、中、高剂量组,每组8只。采用饲喂高脂高糖饲料,自由饮用蜂蜜水,并隔天灌胃猪油脂或酒,建立湿热内蕴证候大鼠模型,观察清利湿热方对大鼠一般状态的影响。采用酶联免疫吸附试验检测血清热激蛋白70（HSP70）、肿瘤坏死因子-α（TNF-α）、白细胞介素-1β（IL-1β）,促胃液素（GAS）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）含量以及血浆胃动素（MTL）、肝脏组织Na+-K+-ATP酶含量,免疫组织化学法检测胃肠组织水孔蛋白3（AQP3）、水孔蛋白4（AQP4）含量,采用蛋白质印迹法检测结肠组织中TOLL样受体4(TLR4)、核因子κBp65表达量。结果：模型组体质量下降（P<0.05,P<0.01）,HSP70、TNF-α、IL-1β升高（P<0.05,P<0.01,P<0.001）,胃肠组织中AQP3表达量下降（P<0.05）,AQP4表达量上升（P<0.01,P<0.001）,GAS含量下降（P<0.01）,IgM含量升高（P<0.01）,结肠组织TLR4表达量增加（P<0.01）。清利湿热方能增加大鼠体质量,降低HSP70、TNF-α、IL-1β含量（P<0.05,P<0.01,P<0.001）,升高胃肠组织AQP3表达量（P<0.05,P<0.01,P<0.001）,降低AQP4表达量（P<0.05）,升高GAS、Na+-K+-ATP酶含量（P<0.05,P<0.001）,降低IgM含量（P<0.05,P<0.01）。结论：饲喂高脂高糖饲料,自由饮用蜂蜜水,并隔天灌胃油脂/酒,可以成功建立高尿酸血症湿热内蕴证候模型,清利湿热方可以从大鼠一般状态、体质量、热激蛋白以及炎症介质、水孔蛋白、胃肠激素、免疫等多方面改善大鼠湿热状态,发挥清利湿热功效。清利湿热方具有降血尿酸作用,其作用机制可能与下调TLR4,核因子κBp65有关。     

五味子中1个新的联苯环辛烯类木脂素

目的 研究中药五味子Schisandra chinensis的木脂素类化学成分。方法 采用硅胶柱色谱、中压反相柱色谱、半制备和制备液相对五味子中富含木脂素类成分的石油醚萃取部位进行分离、纯化,通过波谱数据鉴定化合物的结构。结果 从五味子中分离得到了26个化合物,分别鉴定为绿叶五味子素B(1)、sphaerandrin A(2)、sieverlignan E(3)、arisanschinin G(4)、widdaranalF(5)、戈米辛A(6)、戈米辛B(7)、戈米辛D(8)、戈米辛G(9)、(-)-戈米辛K1(10)、(+)-戈米辛K2(11)、(-)-戈米辛L₁(12)、(+)-戈米辛M1(13)、戈米辛N(14)、当归酰戈米辛H(15)、当归酰戈米辛O(16)、当归酰戈米辛Q(17)、苯甲酰戈米辛Q(18)、五味子醇甲(19)、五味子甲素(20)、五味子乙素(21)、五味子丙素(22)、五味子酯丙(23)、neglschisandrin E(24)、7(18)-dehydroschisandro A(25)、安五脂素(26),其中24个为联苯环辛烯类木脂素(...     

Patterns of E-Cigarette Use Among Primary Care Patients at an Urban Community Center

Tobacco use remains the leading cause of preventable disease and death in the US. The number of tobacco products has grown over the past decade. E-cigarette use has increased rapidly in recent years, but patterns and correlates of use have not been thoroughly assessed. We examined relationships among demographic factors, e-cigarette and conventional cigarette use in a large sample (N?=?12,409) of adult patients at a community health center in the Northeastern US. Overall, 13% (N?=?1675) of the sample reported ever using e-cigarettes. In logistic regression models, ever having used e-cigarettes was associated with younger age (ages 18–25; OR?=?3.5, p?<?0.001). Being transgender (OR?=?1.8, p?<?0.001), bisexual (OR?=?1.5, p?<?0.001), un-partnered (OR?=?1.5, p?<?0.001), having a lower income (OR?=?1.6, p?<?0.001) or a high BMI (OR?=?1.4, p?=?0.009) were associated with increased odds of use, whereas being a woman (OR?=?0.7, p?<?0.001) or Black/African American (OR?=?0.7, p?=?0.007) were associated with lower odds of use. Of the participants who reported e-cigarette use, a majority also endorsed current or former use of conventional cigarettes. Individuals who formerly used conventional cigarettes were nearly three times more likely to report daily e-cigarette use than current users. Among primary care patients at a community health center, e-cigarette use was reported by a sizeable portion of the sample. Overall, odds of use were higher in certain patient populations, and individuals who formally used cigarettes were more likely to report e-cigarette use than individuals who currently smoke, suggesting that e-cigarettes may be functioning as a cessation aid or a strategy to reduce conventional cigarette use.

     

Familial congenital diaphragmatic hernia: Prenatal diagnostic approach and analysis of twelve families

Congenital diaphragmatic hernia is generally recognized as a sporadic malformation with little or no risk of recurrence. A family with three affected individuals in two generations is presented. In addition, new prenatal diagnostic techniques including ultrasonography and amniography are discussed. A comparison of associated physical characteristics in isolated versus twelve familial cases of diaphragmatic hernia is presented. In the familial group, there was a higher incidence of affected males (M:F ratio = 2.1 versus 0.67), a higher incidence of bilateral defects (20% versus 3%) and a lower incidence of additional life-threatening malforamtions 3.6% versus 47%). Analysis of available pedigree data favors multifactorial inheritance with a high male: female sex ratio as the most probable mode of transmission.     

A pharmaceutical care challenge: recruiting, training, and retaining pharmaceutical care practitioners

We do not claim to have all the answers when it comes to implementing an ideal pharmaceutical care model. We are not even sure what all the characteristics of such a model should be. We have recognized, based on our interpretation of the model, that meeting the demands of pharmaceutical care will require changes and advanced skills in our staff. We continue to work in creating an environment where the concept of pharmaceutical care can flourish. Our department has focused on defining and then providing pharmaceutical care through individual practitioners and patient care teams. More employee empowerment with less management control was the key to facilitating initial phases in our pharmaceutical care model. A successful orientation process has further enhanced our abilities to hire new graduates and/or experienced practitioners for our open positions. We believe we have taken some significant first steps toward recruiting, training, and developing our staff to become competent and satisfied with their newly developing role as pharmaceutical care practitioners.