基于“互联网+”探索药事服务模式的问卷调查研究

目的 研究患者对"互联网+"药事服务的接受程度及未来搭建网上药事服务平台的方向,探讨"互联网+"时代下药事服务类型及模式。方法 自制调查问卷,经过三轮专家审阅后形成问卷,在省内的3家"三甲"医院对600例门诊患者发放问卷。结果 488例患者中417例（85.5%）认为药师通过互联网提供药学服务是有必要的,其中网上预约药物配送、网上药师咨询、网上用药教育、药学知识的科普及网上售药的接受程度分别为73.5%,78.2%,64.3%,70.4%,47.4%。网上药师咨询中微信（68.8%）最受中青年患者的欢迎,中老年患者偏爱电话及短信等服务。当前"互联网+"药事服务在医保报销、运营监管、物流配送等方面存在问题。结论 "互联网+"药事服务是一种值得探讨的新型服务模式,其开展需完善相关的法律法规并加强监管,为患者的权益提供保障。     

C反应蛋白和肺功能测定在哮喘患者中的临床意义

目的研究哮喘患者不同时期血清C反应蛋白(CRP)和肺功能测定的临床意义。方法 85例哮喘患者(哮喘组)和23例健康对照者(对照组)为研究对象,测定哮喘组急性发作期、慢性持续期、缓解期及对照组的血清CRP、血常规、肺功能及动脉血气。结果哮喘组急性发作期血清CRP、外周血白细胞计数(WBC)及动脉血二氧化碳分压(p(CO2))均明显高于慢性持续期、缓解期和对照组(P均<0.01);哮喘组急性发作期FEV1%、FEV1/FVC%及动脉血氧分压(p(O2))均明显低于慢性持续期、缓解期和对照组(P均<0.01);哮喘组慢性持续期、缓解期CRP水平均高于对照组(P均<0.05)。病情3,4级哮喘患者慢性持续期FEV1%、FEV1/FVC%较第1,2级明显下降(P<0.05或0.01)。结论血清CRP可作为判断哮喘患者病情的一个炎性反应指标,有助于哮喘的诊断与疗效观察。     

PDGF与肝素对动脉SMCI,Ⅲ型前胶原mRNA表达及胶原蛋白合成？…

目的 研究,探讨血小板源生长因子（ｐｌａｔｅｌｅｔｄｅｒｉｖｅｄｇｒｏｗｔｈｆａｃｔｏｒ,ＰＤＧＦ）和肝素对人主动脉平滑肌细胞（ｈｕｍａｎａｏｒｔａａｍｏｏｔｈｍｕｓｃｌｅ,ｃｅｌｌ,ｈＡＳＭＣ）增殖,胶原蛋白的合成,分泌以及Ｉ,Ⅲ型前胶原ｍＲＮＡ表达和转移生长因子β（ｔｒａｎｓｆｏｒｍｉｎｇｇｒｏｗｔｈｆａｃｔｏｒβ－ＴＧＦ－β）ｍＲＮＡ表达的调节作用,方法＾３Ｈ－ＴｄＲ,＾３Ｈ－脯氨酸掺入及Ｎ     

陕西省姬鼠型出血热疫源地宿主动物和恙螨的调查研究

本文报道１９９２年１２月至１９９３年１２月对户县惠安化工厂肾综合征出血热（ＨＦＲＳ）自然疫源地宿主动物和恙螨的调查结果。１．捕获４０３只小兽，隶属２目７属８种，黑线姬鼠占捕获数的７３．７％为优势种，其带螨率较高（７４．６５％）；鼠密度高峰在１０～１２月份，１１月份最高。２．收集恙螨３９２３９只，隶属３亚科５属６种，亚须纤恙螨占６０．３４％，季节高峰在１１，１２月份，指数分别为３１４．８３和２３９．７５，占该两月恙螨总数的９９．３％和９９．６％；小盾纤恙螨占３９．３９％，季节高峰在１０月份，指数为５１４．４８，占该月份恙螨总数的９９．９％。３．大仓鼠寄生恙螨６种，黑线姬鼠寄生４种；亚须纤恙螨和小盾纤恙螨宿主广泛，无特异宿主。４．本文结果表明：亚须纤恙螨在ＨＦＲＳ传播中可能起重要作用，这为进一步开展病毒学研究提供了线索。     

荧光原位杂交技术检测沙眼衣原体的可行性研究

目的：探讨荧光原位杂交（FISH）技术检测沙眼衣原体（CT）的临床应用及其意义.方法：将超高倍多媒体显微仪检测法（MMDI）和荧光定量PCR结果一致作为判定衣原体是否感染的扩大金标准,取符合扩大金标准判定的宫颈棉拭子标本纳入FISH技术检测.结果：130例样本中MMDI和荧光定量PCR检测均为CT阳性的有52例,CT阴性的有78例.FISH技术检测阳性的46例,阴性84例.FISH技术检测CT的灵敏度为84.62％,特异度为97.44％,阳性预测值为95.65％,阴性预测值为90.48％.结论：成功构建了FISH技术检测沙眼衣原体的技术平台,该技术弥补了MMDI特异性低及PCR可视性不足的缺点.     

苏州市区环境辐射水平的监测研究报告

苏州市距秦山直线约８５ｋｍ，１９９０～１９９２年，我们针对秦山核电站监测结果：（１）环境空气ｒ连续监测，正常情况下剂量率０．０９～０．１３μＧｙ／ｈ，１９９２年平均剂量率为１０．１×１０－８Ｇｙｈ－１；（２）１９９１年本市调查和估算结果室内、外ｒ辐射剂量率分别为１０１和６４ｎＧｙ·ｈ－１；室内、外宇宙射线电离成分（不包括中子）所致空气吸收剂量率分别为２６．０和２８．８ｎＧｙ·ｈ－１；宇宙射线、天然辐射和天然贯穿辐射所致居民人均年有效剂量当量分别为０．２４ｍＳｖ、０．５６ｍＳｖ和０．８ｍＳｖ；所致集体年有效剂量当量分别为０．１８．０．４２和０．６×１０３人·Ｓｖ；（３）大气气溶胶总ａ平均为４．５×１０－４Ｂｑ·Ｍ－３；总Ｂ为２．８１×１０－３Ｂｑ·Ｍ－３，α／β比值约０．１６；（４）１９９２年大气沉降约总β全年月平均为２．４８×１０７Ｂｑ·ｋｍ－２月－１；（５）环境水体除雪水（１９９０年）１３４，１３７Ｃｓ高出其他水体５０倍外，无异常发现；（６）土壤、食品中天然和人工放射性核素分析除个别偏高外，均属本底水平。     

人野生型p53基因与逆转录病毒载体的构建及转染

应用逆转录病毒为载体构建了含人野生型ｐ５３基因的重组质粒，并成功地转染ψｃｒｉｐ包装细胞。本实验应用ＰＬＸＳＮ为载体，１．８ｋｂ野生型ｐ５３基因作为插入片段，通过Ｔ＿４ＤＮＡ连接酶进行连接。用〔α—￣（３２）Ｐ〕ｄＣＴＰ标记野生型ｐ５３基因片段（１．８ｋｂ）为探针进行原位杂交。筛选出重组体，将其命名为ＰＬＸＳＮ－５３，然后用该重组体对ψｃｒｉｐ包装细胞进行转染。收集转染后的细胞，准备下一步感染ｐ５３突变细胞株研究之用。该质粒的构建和细胞转染实验为进一步研究野生型ｐ５３基因的抑癌作用及其表达与调控原理奠定了基础。     

模拟定位导向Max—Core活检针经皮肺活检临床评价

目的 探讨模拟定位机下经皮穿刺肺活检对周围性肿块的临床诊断价值。方法 采用模拟定位机导向对47例肺周围性肿块进行模拟定位导向，经皮肺活检后作病理诊断。结果 肺癌43例，结核2例，炎性假瘤2例，阳性率93％．且并发症少．操作简便、快捷、安全。结论 模拟定位导向经皮穿刺肺活检对肺部周围性肿块是一种较为安全有效的诊断技术。     

紫外线致皮肤光老化及光癌变机制的研究进展

日光的累计照射可加速皮肤老化与癌变,使皮肤的生物学及临床反应发生改变,包括急性损伤(日晒伤)和慢性损伤(光老化、光癌变或色素沉着等)。文章概述了近年来紫外线对皮肤光老化及光癌变影响的研究进展,揭示光老化和光致癌机制是通过紫外线照射产生活性氧和DNA损伤,以及由此引起的细胞损伤、炎症、免疫抑制、细胞外基质重塑及血管生成改变所致,为临床防治光老化和光癌变提供帮助。     

Phase I and scintigraphy studies to evaluate safety,tolerability, pharmacokinetics,and lung deposition of inhaled GDC‐0214 in healthy volunteers

Several inflammatory cytokines that promote inflammation and pathogenesis in asthma signal through the Janus kinase 1 (JAK1) pathway. This phase I, randomized, placebo‐controlled trial assessed the pharmacokinetics and safety of single and multiple ascending doses up to 15 mg twice daily for 14 days of a JAK1 inhibitor, GDC‐0214, in healthy volunteers (HVs; n = 66). Doses were administered with a dry powder, capsule‐based inhaler. An accompanying open‐label gamma scintigraphy study in HVs examined the lung deposition of a single dose of inhaled Technetium‐99m (^99mTc)‐radiolabeled GDC‐0214. GDC‐0214 plasma concentrations were linear and approximately dose‐proportional after both single and multiple doses. Peak plasma concentrations occurred at 15–30 min after dosing. The mean apparent elimination half‐life ranged from 32 to 56 h across all single and multiple dose cohorts. After single and multiple doses, all adverse events were mild or moderate, and none led to treatment withdrawal. There was no clear evidence of systemic toxicity due to JAK1 inhibition, and systemic exposure was low, with plasma concentrations at least 15‐fold less than the plasma protein binding‐corrected IC50 of JAK1 at the highest dose. Scintigraphy showed that approximately 50% of the emitted dose of radiolabeled GDC‐0214 was deposited in the lungs and was distributed well to the peripheral airways. ^99mTc‐radiolabeled GDC‐0214 (1 mg) exhibited a mean plasma C_max similar to that observed in phase I at the same dose level. Overall, inhaled GDC‐0214 exhibited pharmacokinetic properties favorable for inhaled administration.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

Many factors drive asthma pathogenesis, including several cytokines that signal through the Janus kinase 1 (JAK1) pathway. Inhibition of JAK1 is a possible target for asthma treatments, but previous studies show oral JAK1 inhibitors lead to increased risk of severe infections, malignancy and cardiovascular events.

• WHAT QUESTION DID THIS STUDY ADDRESS?

This study investigated the safety, pharmacokinetics, and lung deposition of GDC‐0214, an inhaled JAK1 inhibitor designed to target the lungs.

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

Inhaled delivery of a JAK inhibitor for 14 days exhibited low systemic exposure, leading to few adverse events and limited systemic toxicity, while demonstrating high deposition in the lungs.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

Local pulmonary application of JAK inhibitors may be an effective treatment for asthma with limited systemic risks.