尼美舒利致急性肝肾衰竭1例并文献复习

目的 总结尼美舒利致肝肾衰竭病例的临床特点.方法 总结1例男性患者服用尼美舒利后出现急性肝肾衰竭的临床诊治经过及其转归,分析其病例特点并进行相关文献复习.结果 患者因急性肝肾衰竭入院,相关检查不支持嗜肝病毒及其他病毒感染,组织活检病理学检查提示药物因素所致,患者有尼美舒利服用史,尼美舒利血药浓度高于正常,根据服药史及相关检查,推测为尼美舒利导致急性肝肾衰竭.经保肝、降胆红素、血液静化、强的松等治疗,患者痊愈.结论 尼美舒利可引起肝肾衰竭,与机体免疫及个体代谢差异有关.早期确诊、及时停用可疑药物并积极治疗是改善预后的关键.临床用药中要密切监测肝肾功能,避免尼美舒利与其他解热镇痛药联合应用.     

Extraintestinal dissemination of rotavirus in immunodeficient mice]

OBJECTIVE: To investigate the extraintestinal dissemination of rotavirus (RV) in immunodeficient mice. METHODS: Immunodeficiency mouse model was established by injection of cyclophosphamide into the abdominal cavities of normal mice, then to which RV was administered either orally or intra-abdominally. The pathological changes in the organs were observed by light microscopy and RV was detected by in situ hybridization and PCR. RESULTS: Small intestinal villi, gastric lamina propria and cardiac myocytes exhibited pathological changes in the mice with oral RV administration. Besides these changes, the mice with intra-abdominal RV injection showed changes in the liver and kidneys. The intestinal villi of the mice with oral RV were RV positive by in situ hybridization. Positive results of RV in in situ PCR detection were found in the intestinal villi, intestinal gland cells, epithelial cells of the proximal convoluted tubules and collecting tubes in the kidney of the mice taken RV orally, and in the intestinal villi, kidneys, liver, heart and pancrease of mice with intra-abdominal RV injection. CONCLUSION: Immunodeficiency may be the important factor for inducing and aggravating the infection and extraintestinal dissemination of RV.     

Cross-reactive rubella virus and glutamic acid decarboxylase (65 and 67) protein determinants recognised by T cells of patients with Type I diabetes mellitus

Aims/hypothesis. To examine the cross-reaction between viral and beta-cell protein determinants and to further understand the potential role of this mechanism in Type I (insulind-dependent) diabetes mellitus.¶Methods. Immune responses to a panel of 28 viral and beta-cell protein peptides representing selected sequences of rubella virus (RV), Coxsackie virus, human 38 KDa31G and glutamic acid decarboxylase (GAD 65 and 67) proteins in proliferation or cytotoxicity assays have been studied using uncloned and cloned T-cell cohorts from a group of 60 Type I diabetic patients.¶Results. Peptide GAD65(252–266) induced the responses of patients with recent onset diabetes in proliferation assays at the highest frequency (77 %), whereas GAD67(212–226) stimulated the cellular responses at the highest rate (61 %) in patients with late-onset diabetes. RVE1(157–176) was recognised by all groups of patients at the highest frequency and the largest amplitude among the viral peptides tested. T-cell clones specific to GAD65(252–266), GAD65(274–286) or GAD67(212–226) were tested in cytotoxicity assays for their responses to rubella virus peptides. Each of these T-cell clones cross-reacted with two to four rubella virus peptides, including RVE1(157–176) and RVE2(87–107). Analysis of the sequences of cross-reactive viral and glutamic acid decarboxylase antigens showed that these epitopes shared similar peptide binding motifs to HLA DR3/DR4. There is a statistically significant correlation between the response amplitude of patient's peripheral blood mononuclear cells to RVE1(157–176), RVE2(87–107) and GAD65(274–286) in patients with recent onset diabetes, and to RVE1(157–176) and GAD67(212–226) in patients with late onset diabetes.¶Conclusion/interpretation. Cross-reactive glutamic acid decarboxylase and rubella virus determinants identified by T-cell clones were also recognised at high frequencies by general T-cell populations of Type I diabetic patients. [Diabetologia (2000) 43: 750–762]     

定坤丹结合激素治疗肾虚肝郁证月经过少患者的临床疗效及对子宫内膜厚度的影响

目的:探究定坤丹结合激素治疗肾虚肝郁证月经过少患者的临床疗效及对子宫内膜厚度的影响。方法:选取2011年1月至2015年5月北京中医医院顺义医院妇科门诊收治的确诊为肾虚肝郁证月经过少女性患者300例,随机分为对照组和观察组,每组150例。2组患者同时予雌孕激素周期治疗,观察组在此基础上予定坤丹治疗;连续治疗2个月经周期为1个疗程。共服2个疗程。结果:治疗后2组月经量、子宫内膜厚度、血清LH、E_2及P水平与治疗前相比显著增加,行经时间显著延长(P0.05);且观察组变化幅度均显著大于对照组(P0.05);治疗后观察组总有效率为90.43%,显著高于对照组的64.57%(P0.05)。结论:定坤丹结合激素与单纯应用激素相比治疗肾虚肝郁证月经过少患者可以获得更好的治疗效果,可以明显增加患者的月经量、行经时间、性激素水平、子宫内膜厚度。     

运用文献计量学探讨小建中汤的临床应用情况和用药规律＊

目的 探讨小建中汤的应用情况和用药规律，为临床运用提供参考。方法 检索并收集CNKI、WangFang Data、VIP、SinoMed、PubMed、EMBASE和Cochrane library数据库中有关小建中汤的临床原始研究，检索时限为建库至2020年10月1日。运用VOSviewer软件对纳入文献进行研究热点分析，并使用Excel提取文献中治疗的疾病、证型和用药情况等资料并统计分析。结果 最终纳入文献151篇。统计结果显示治疗的疾病主要集中在消化系统疾病；脾胃虚寒证为主要的治疗证型，其次是脾胃虚弱证；饴糖的平均用量最大，但使用频数少于其他药物，白芍的平均用量大致是桂枝的2倍；大部分文献的治疗时长在4周内；联合使用的西药中奥美拉唑、阿莫西林和克拉霉素出现的频数最多。结论 运用文献计量学的方法有效地挖掘出了小建中汤在相关研究中的应用特点和用药规律，对临床运用具有指导和借鉴意义。     

针刺对老龄大鼠抗皮肤老化作用的实验研究

目的探讨针刺疗法抗皮肤老化的作用机理。方法选用18月龄大鼠为研究对象,随机分为老年围刺组、老年围刺加足三里组、老年空白组,并与8月龄青年大鼠对照,测定各组大鼠腹部皮肤的可溶性羟脯氨酸含量与SOD活性,并应用透射电镜对比观察成纤维细胞的形态以及胶原纤维的排列情况。结果老龄大鼠真皮成纤维细胞的细胞器减少,细胞结构退化,同时胶原纤维之间空隙加宽,老化性架桥增多。通过围刺治疗,可以使其成纤维细胞活性增强。同时,经围刺治疗后大鼠皮肤的可溶性羟脯氨酸含量较老年空白组明显增加,SOD活性无显著变化,而配合足三里穴组皮肤组织中SOD活性增强。结论围刺法可能是通过增强皮肤中成纤维细胞的活性进而增加皮肤中可溶性胶原含量来改变皮肤的老化外观的。配合足三里穴可以增加皮肤SOD活性。     

羧甲基茯苓多糖含量测定

目的：建立羧甲基茯苓多糖含量测定方法。方法：以无水葡萄糖为对照,采用苯酚-硫酸法测定羧甲基茯苓多糖的含量。结果：葡萄糖在0.002～0.012mg·mL^-1范围呈良好的线性关系,回归方程为Y=49.016X-0.002 9（R=0.999 6）。测得羧甲基茯苓多糖含量为57.72%。结论：该方法操作简便,重现性好,测定结果准确可靠,可用于中药多糖含量的分析。     

Effects of Danqidihuang Granules on glucolipid metabolism in insulin-resistant rats

Objective

To explore whether the insulin resistance (IR) model could be established through feeding Sprague-Dawley (SD) rats high-sugar and high-fat diets and to further observe the preventive and treatment effects of different doses of Danqidihuang Granules in rats.

Methods

Thirty-two SD rats were divided randomly into control group A (given regular feed), model group B (food high in sugar and fat), intervention group C (food high in sugar and fat as well as regular doses of Danqidihuang Granules), and intervention group D (food high in sugar and fat as well as double doses of Danqidihuang Granules). The interventions were for 8 weeks. Motion, change in color, body weight, and food intake, as well as plasma lipids (including low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), total cholesterol (TC) and triglyceride (TG), fasting blood glucose (FBG), fasting insulin (FINs) levels, insulin sensitivity index (ISI), and insulin resistance index (HOMO-IR) were observed.

Results

At the end of the second week of the experiment, the appetite and activities of rats in groups B, C and D decreased significantly compared with group A. The fur of the rats in those three groups was curly. After the fourth week, the activities, food intake and color of rats in group B were worse than those in groups C and D, but there were no significant differences in weight (P>0.05). Compared with group A, LDL-C, TC, FBG and HOMO-IR in model group B were increased significantly (P<0.05), whereas the FINs and ISI increased obviously (P<0.05). The levels of LDL-C and TC in group D was decreased obviously compared with those in group C, and HOMO-IR in group D was less than that in group B (P<0.05).

Conclusions

Danqidihuang Granules helped to prevent and improved the insulin resistance of rats.     

海参猴桃液辅以少量rIL-2对免疫杀伤细胞活性的正向调节研究

目的 :探讨用中药海参猴桃液 (SSAP)辅以基因重组人白细胞介素 2 (rIL -2 )体外培养扩增、激活免疫杀伤细胞LAK的机理 ,观察SSAP辅以少量rIL -2能否提高及在多大程度上提高LAK细胞的杀瘤活性。方法 :通过提取健康供血者的外周血单个核细胞作为待培养细胞 ,设空白对照组 (加等量生理盐水 )、阳性对照组 (1 0 0 0U/mlrIL -2 1ml)、实验 1组 (1 0 0 0U/mlrIL -2 0 .5ml +30 0 0 μg/mlSSAP 1ml)、实验 2组 (1 0 0 0U/mlrIL -20 .1ml+30 0 0 μg/mlSSAP 1ml) ,4组在不同条件下培养LAK细胞 ,分别用H -TdR释放法检定其体外对人肝癌BEF -740 4杀伤活性。结果 :30 0 0 μg/ml的SSAP +1 0 0 0U/mlrIL -20 .1ml在培养第 3天便能测出杀伤活性 ,第 9天达峰值 [杀瘤率 (75 .5± 1 3.6 ) % ],杀瘤活性与 1 0倍量rIL -2单独诱导激活的LAK细胞杀瘤活性相近 [杀瘤率 (92 .9± 2 1 .3) % ],两组比较无显著性差异 (P >0 .0 5 ) ,而且杀瘤活性持续 1 8天。结论 :SSAP辅以少量的rIL -2能大量扩增激活LAK细胞 ,增强其对肿瘤细胞的杀伤力 ,更重要的意义在于获得的LAK细胞杀伤力强大而持久 ,同时可减少rIL -2的用量     

大孔吸附树脂对莲子心中有效成分的分离纯化研究

目的研究大孔吸附树脂吸附分离莲子心中莲心碱、异莲心碱及甲基莲心碱的工艺条件及参数。方法考察了AKS-W、AB-8和H214树脂对莲心碱、异莲心碱及甲基莲心碱的静态及动态吸附性能,并采用HPLC定量分析莲心碱、异莲心碱及甲基莲心碱。结果AKS-W树脂对莲子心中有效成分有较好的吸附分离效果,提取物中莲心碱、异莲心碱及甲基莲心碱的质量分数分别提高到10.2%、6.7%和11.9%。结论大孔型非极性吸附树脂AKS-W对莲子心中有效成分是一种较为理想的分离介质。