野艾蒿中黄酮类成分的研究

目的 研究野艾蒿的化学成分.方法 采用色谱方法进行分离、纯化,通过波谱技术对化合物进行结构鉴定.结果 从野艾蒿中分离得到11个黄酮类化合物,其结构鉴定分别为山柰酚( kaempferol,1)、芒柄花素(formononetin,2)、异鼠李素(isorhamnetin,3)、洋芹素(apigenin,4)、苜蓿素(tricin,5)、槲皮素-7-O-β-D-葡萄糖苷(6),槲皮素-7-O-α-L-鼠李糖苷(7),槲皮素-3-O-β-D-葡萄糖苷(8),山柰酚-3-O-β-D-葡萄糖苷(9),芹菜素-7-O-β-D-葡萄糖苷(10),山柰酚-3-O-芸香糖苷(11).结论 化合物1～11均为首次从该植物中分离得到.     

颈部骨外尤文氏肉瘤1例报道并文献复习

目的 探讨骨外尤文氏肉瘤(EES)的疾病特征,了解其临床表现、诊断及治疗方案.方法 对1例颈部EES患者的临床资料进行回顾性分析,复习相关文献并进行讨论.结果 该例EES患者临床表现及影像学特征缺乏特异性,确诊依赖于术后病检,其中免疫组化结果为PAS(+)、CD99(+)、Vimentin(+),基因检测EWSR1基因...     

A2M inhibits inflammatory mediators of chondrocytes by blocking IL-1β/NF-κB pathway

A hallmark of osteoarthritis (OA) is cartilage degeneration, which has been previously correlated with dramatic increases in inflammatory enzymes. Specifically, interleukin-1β (IL-1β) and subsequent upregulation of nuclear factor kappa B (NF-κB) is implicated as an important player in the development of posttraumatic osteoarthritis (PTOA). Alpha 2-macroglobulin (A2M) can inhibit this inflammatory pathway, making it a promising therapy for PTOA. Herein, we demonstrate that A2M binds and neutralizes IL-1β, blocking downstream NF-κB-induced catabolism seen in in vitro. Human chondrocytes (cell line C28) were incubated with A2M protein and then treated with IL-1β. A2M was labeled with VivoTag™ 680 to localize the protein postincubation. The degree of binding between A2M and IL-1β was evaluated through immunoprecipitation (IP). Catabolic proteins, including IL-1β and NF-kB, were detected by Western blot. Pro-inflammatory and chondrocyte-related gene expression was examined by qRT-PCR. VivoTag™ 680-labeled A2M was observed in the cytoplasm of C28 human chondrocytes by fluorescence microscopy. IP experiments demonstrated that A2M could bind IL-1β. Additionally, western blot analysis revealed that A2M neutralized IL-1β and NF-κB in a dose-dependent manner. Moreover, A2M decreased levels of MMPs and TNF-α and increased the expression of cartilage protective genes Col2, Type2, Smad4, and aggrecan. Mostly importantly, A2M was shown to directly neutralize IL-1β to downregulate the pro-inflammatory responses mediated by the NF-kB pathway. These results demonstrate a mechanism by which A2M reduces inflammatory catabolic activity and protects cartilage after joint injury. Further in vivo studies are needed to fully understand the potential of A2M as a novel PTOA therapy.     

基于跨理论模型和健康信念模式的护理干预对缺血性脑卒中患者服药依从性和mRs评分的影响

目的探讨基于跨理论模型和健康信念模式的护理干预对缺血性脑卒中患者服药依从性和mRs评分的影响。方法选取2020年9月—2021年3月医院神经内科收治的96例缺血性脑卒中患者作为研究对象,按照组间基本特征匹配的原则分为对照组和干预组,每组48例。对照组实施缺血性脑卒中常规护理及出院随访,干预组实施基于跨理论模型和健康信念模式的护理干预6个月,比较两组患者行为阶段的改变、服药依从性及mRs评分。结果两组患者在护理干预3个月、6个月时行为阶段发生改变,差异均有统计学意义(P<0.05);干预组服药依从性评分高于对照组,差异均有统计学意义(P<0.05);干预后1、3、6个月,两组mRs评分比较差异无统计学意义(P>0.05)。结论基于跨理论模型和健康信念模式的护理干预,可有效促进缺血性脑卒中患者行为阶段的改变,提高患者服药依从性,对改善患者生活活动能力效果不明显。     

藏药"巴夏嘎"品种考证、药性分析与用药规律研究

藏药“巴夏嘎”基原复杂，混用及替代使用现象较为严重，影响其临床疗效和使用安全。本文通过查阅《四部医典》《晶珠本草》等藏医药经典著作，结合藏医医院，野外产地等实地调查明确了藏药巴夏嘎的基原，引用“藏药味性化味”（Ro Nus Zhur Jes）矢量结构模型、中医辅助传承软件等方法分析藏药巴夏嘎的药性和临床用药规律。确定藏药巴夏嘎原植物为鸭嘴花Adhatoda vasica Nees.，并考证出有长果婆婆纳Veronica ciliata Fisch.、毛果婆婆纳Veronica eriogyne H. Winki.、塞北紫堇Corydalis impatiens （Pall.） Fisch.、皱波黄堇Corydalis crispa Prain.等多种植物在各地以巴夏嘎替代品入药。通过药性分析发现巴夏嘎以苦味、凉性为主，在临床多用于治疗热病、赤巴病、高血压、多血症、肝病、血病等疾病，且常与余甘子、诃子、西红花等配伍使用。本文从基原-药性-用药规律等多角度，对藏药巴夏嘎“一物多名”现象进行品种整理和考证，促进其临床合理用药和资源可持续利用。     

扁桃体、腺样体切除术对语音及嗓音影响研究进展

扁桃体、腺样体肥大是临床上最常见的疾病之一,儿童期多表现为腺体增生与肥大,成人期多表现为炎性改变。扁桃体、腺样体切除术作为扁桃体、腺样体肥大常规治疗手段,二者切除后人体鼻腔、咽腔及喉腔的声道形状发生改变,导致患者讲话时气流改变,进而使语音及各类嗓音参数值变化。目前,随着二者肥大发病率和检出率的增高,作为其最主要的治疗手段,扁桃体、腺样体切除术对语音及嗓音影响评估的临床指导意义亦与日俱增。现就扁桃体、腺样体切除术对语音及嗓音影响的机制进行综述。     

The effect of refined nursing education on improving the urination of patients after renal biopsy

Background

To investigate the clinical effect of better nursing education on patients' postoperative urination after renal biopsy.

Methods

In this study, patients who underwent renal biopsy in the Department of Nephrology at our hospital were selected as the observation group (July–December 2018, n = 120) and control group (January–June 2018, n = 110) and received refined nursing education and routine nursing education, respectively. Postoperatively, the causes of dysuria after puncture, the degree of postoperative pain, and the urination mode were compared between the two groups.

Results

Six patients in the observation group and 23 patients in the control group needed urethral catheterization, accounting for about 5% and 15.2%, respectively. Therefore, the postoperative catheterization rate in the observation group was significantly lower than the control group, with a statistically significant difference.

Conclusion

The refined nursing education proposed in this study can effectively improve urinary dysfunction after renal biopsy and has a clinical promotional value.     

密骨胶囊通过NF-𝜅B和AKT-mTOR信号通路对肌少症的作用机制

目的 利用网络药理学和小鼠C2C12肌细胞体外细胞实验，研究密骨胶囊治疗肌少症的主要活性成分和潜在作用机制。方法 从TCMSP等网络数据库对密骨胶囊的中药成分进行活性成分和主要靶点的收集，并从GeneCards等数据库中对肌少症的疾病基因进行搜索，交集预测密骨胶囊作用于肌少症的靶点和通路。体外实验对小鼠C2C12肌细胞进行培养及诱导分化。用密骨胶囊含药血清预处理细胞，再用TNF-??炎症因子进行刺激，造成肌细胞萎缩。免疫印迹法和聚合酶链式反应法证明其对肌细胞内NF-??B通路和AKT-mTOR通路中相关蛋白表达情况。结果 在密骨胶囊对肌肉的作用中，核心靶点为MTOR、ESR1、EGFR、SIRT1、CTNNB1、VEGFA、ALB、IL6、TP53、TNF、AKT1，可能干预HIF-1、AGE-RAGE、TNF、PI3K-AKT-mTOR等信号通路。密骨胶囊含药血清干预后C2C12肌细胞增粗，降低MuRF1 mRNA表达。免疫印迹实验结果中，密骨胶囊含药血清降低TNF-??刺激的Atrogin-1蛋白量，抑制i??b??磷酸化降解，减少蛋白降解。密骨胶囊含药血清减少TNF-??对p-AKT、p-4EBP1的抑制，增加蛋白合成。结论 通过网络药理学和体外实验验证，密骨胶囊可能对肌少症有防治作用。密骨胶囊抑制NF-??B通路，减缓肌蛋白降解。密骨胶囊激活AKT-mTOR通路，促进肌细胞内蛋白合成。     

河南省基层医疗卫生人员中医药健康文化知识普及和素养水平调查研究

目的：调查研究河南省基层医疗卫生人员中医药健康文化知识普及和素养水平。方法：使用国家中医药管理局编制的《中国公民中医药健康文化素养调查问卷》，采用分层多阶段随机抽样，抽取河南省16家社区卫生服务中心及24家乡镇卫生院的基层医疗卫生人员进行线上调查。结果：共调查河南省基层医疗卫生工作人员2 123人，剔除不合格问卷29份，纳入分析的问卷2 094份，有效率为98.6%。河南省基层医疗卫生工作中医药健康文化知识普及率、阅读率、信任率、行动率分别为96.6%、93.9%、90.2%、69.9%，具备中医药健康文化素养的人数为1 438人，占比68.7%。不同地区、性别、年龄、文化程度、专业结构的基层医疗卫生人员中医药健康文化知识普及率、阅读率、信任率、行动率比较，差异均有统计学意义（P<0.05）。影响河南省基层医疗卫生人员中医药健康文化素养的主要因素为地区、文化程度、专业结构和个人月收入。其中，城市、文化程度本科及以上、专业结构为医疗和公共卫生、个人月收入高的基层医疗卫生人员中医药健康文化素养水平较高。结论：河南省基层医疗卫生人员中医药健康文化普及率、阅读率均较高，但行动率低，存在知...