动态血压监测的临床应用

1动态血压监测的介绍 1．1动态血压监测的概念所谓的24小时动态血压监测，就是应用动态血压记录仪测量高血压患者24小时内、每间隔一定时间的血压值的方法。它测量的数值包括收缩压、舒张压、24小时平均动脉压、心率、日间平均血压、夜间平均血压、每小时平均血压、血压负荷以及夜间血压较日间血压平均下降的百分数等数据。其最大的优点是：既没有“白大衣”效应的影响，又不影响患者的日常活动和生活方式。能够更真实的反应24小时血压的动态节律变化。     

Effects of Rubiadin isolated from Prismatomeris connata on anti‐hepatitis B virus activity in vitro

Prismatomeris connata was a kind of Rubiaceae plant for treatment of hepatitis, hepatic fibrosis and silicosis. Whereas, the effective components of Prismatomeris connata remains unexplored. The aim of this study was to investigate the inhibitory effects and mechanisms of Rubiadin isolated from Prismatomeris connata against HBV using HepG2.2.15 cells. The levels of hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B core antigen (HBcAg) in the supernatants or cytoplasm were examined using by enzyme‐linked immunosorbent assay. HBV DNA was qualified q‐PCR. Rubiadin was isolated by silica gel column. The structure of the compound was elucidated by HPLC, FT‐IR, ¹H‐NMR, ¹³C‐NMR and identified as 1,3‐Dihydroxy‐2‐methyl‐9, 10‐anthraquinone. Rubiadin significantly decreased HBeAg,HBcAg secretion level and inhibit HBV DNA replication. Rubiadin inhibits the proliferation of the cells and HBx protein expression in a dose‐dependent manner. The intracellular calcium concentration was significantly reduced. These results demonstrated that Rubiadin could inhibit HepG2.2.15 cells proliferation, reduce the level of HBx expression, and intracellular free calcium, which might become a novel anti‐HBV drug candidate.     

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??OBJECTIVE To investigate the correlation of blood concentration and drug dose and reducing lipid efficacy of tectorigenin in atherosclerosis rabbits. METHODS Forty-eight Japanese white rabbits were randomly divided into six groups, the normal control group, model group, high-, middle-and low-dose (50, 25, 12.5 mg??kg^-1??d^-1) tectorigenin groups and atorvastatin (5 mg??kg^-1??d^-1) group. The normal control group was fed with routine forage, and the other groups were fed with high fat forage for the establishment of atherosclerosis model. After 8 weeks, tectorigenin blood concentration was detected by HPLC. After 12 weeks, blood lipids were detected with automatic biochemical analyzer. We sheared the thoracic and abdominal aorta to observe the formation of atherosclerotic plaque and make pathologic examination. RESULTS Steady-state blood concentration increased with the increase of drug dose, there was a positive relationship (r=0.969 1) between them, but not the same proportion. After treatment, serum total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol (LDL-C ) levels were decreased and high density lipoprotein cholesterol (HDL-C) were increased in the tectorigenin each dose group, but the effect was weaker than atorvastatin group. CONCLUSION Tectorigenin has obvious effect on reducing blood lipid and anti-atherosclerosis in rabbits, and it is related to the blood concentration and the drug dose.     

基于电子舌技术的豨莶草炮制前后滋味比较

目的研究豨莶草炮制前后滋味的变化,建立生、制品豨莶草滋味判别模型。方法通过电子舌测量12批生品豨莶草与12批炮制品豨莶草的酸、苦、涩、咸、甜味值,利用配对t检验、主成分分析(PCA)和线性判别因子分析(LDA)等方法研究豨莶草炮制前后各味道的变化情况。结果通过配对t检验发现豨莶草炮制后,苦、咸味下降,酸、涩、甜没有明显变化;通过PCA可以区分生品与制品豨莶草;通过LDA可以建立生品、制品味道判别模型,并进行交叉验证,正确率达到100%;通过雷达图建立了豨莶草生品与制品的滋味指纹图谱。结论电子舌能够对中药豨莶草的酸、苦、涩、咸、甜味值进行准确的辨识,结合统计方法,可以从数值上体现豨莶草炮制前后滋味的改变,并以此推测豨莶草炮制前后滋味的改变与功效的改变之间的关系。另外,建立的生、制品判别函数模型及雷达图指纹图谱可以用于生、制品豨莶草的判别。     

丹参胶囊在欧盟药品注册中的可读性测试研究和实践

药品说明书是载明药品信息的法定文件,对指导公众合理用药起着至关重要的作用。在欧美药品的申报体系和指南中,均要求申请者在药品上市前必须完成药品说明书可读性测试研究,以保证说明书内容通俗易懂,指导公众合理安全用药,避免用药不当可能导致的风险。由于审评理念和标准的差距,目前中国在新药评审的过程中缺乏药品说明书可读性测试研究的要求、法规和指南。以国内申报欧盟成功的品种丹参胶囊注册上市实践为案例,分析欧盟对于药品说明书可读性测试研究的要求,以期为我国建立和实施药品说明书可读性研究的管理思路提供借鉴和参考。     

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??OBJECTIVE To compare and optimize the analytical methods for detection of related substances of etimicin sulfate injection. METHODS For the HPLC-CAD (charge aerosol detector)method, the mobile phase was 0.2 mol·L^-1 trifluoroacetic acid aqueous solution-methanol (95:5), the flow rate was 1.0 mL·min^-1 and the column temperature was maintained at 30 ??. The nebulization temperature for the CAD was maintained at 30 ?? and the gas pressure was 0.24 MPa.The HPLC-ELSD and HPLC-PAD methods adopted by the Ch.P 2015 were also used to detect the related substances of etimicin sulfate injection for the purpose of comparison. RESULTS Compared with the HPLC-ELSD method, the HPLC-CAD method showed higher selectivity and sensitivity; compared with the HPLC-PAD method, the results of the determination of the impurities were more accurate for the HPLC-CAD method. CONCLUSION The separation capability of the new HPLC-CAD method for detection of the related substances of etimicin sulfate injection is superior to HPLC-PAD and HPLC-ELSD methods and can detect more impurities, which is suitable for the quality control of etimicin sulfate injection.     

The efficacy of probucol combined with hydration in preventing contrast-induced nephropathy in patients with coronary heart disease undergoing percutaneous coronary intervention: a multicenter,prospective, randomized controlled study

Purpose

To investigate the preventive effect of probucol combined with hydration on contrast-induced nephropathy (CIN) in patients with coronary heart disease undergoing percutaneous coronary intervention (PCI).

Methods

A total of 641 patients undergoing PCI were randomly assigned to either a probucol group (probucol 500 mg twice daily and hydration; n = 321) or a control group (hydration only; n = 320). The primary endpoint was the incidence of CIN, defined as an increase in serum creatinine (Scr) by ≥ 44.2 μmol/L or ≥ 25% within 72 h after the administration of contrast agent. Secondary endpoints were changes in Scr, cystatin-C (Cys-C), creatinine clearance rate (Ccr), C-reactive protein (CRP), superoxide dismutase (SOD), and glutathione (GSH) within 72 h, and major adverse events during hospitalization or the 14-day follow-up period.

Results

The incidence of CIN was 4.0% (13/321) in the probucol group and 10.9% (35/320) in the control group. The probucol group had lower Cys-C and higher Ccr at 48 and 72 h after PCI compared with the control group. At 48 and 72 h following the operation, Cys-C and CRP were lower in the probucol group compared with the control group, but Ccr, SOD, and GSH were higher. There were no differences in the incidence of major adverse events during hospitalization or the 14-day follow-up between the groups. Multivariate logistic regression analysis showed that probucol was an independent protective factor for CIN.

Conclusions

Probucol combined with hydration more effectively decreased the incidence of CIN in patients with coronary heart disease undergoing PCI compared with hydration alone.

     

Clinicopathological study of male and female patients with lupus nephritis: a retrospective study

Purpose

The aim of this study was to assess the impact of sex on long-term outcomes in patients with lupus nephritis (LN).

Methods

Data of patients were collected at a single tertiary hospital from June 2010 to June 2016. Clinicopathological features and treatment responses of LN patients with different genders were compared. The primary endpoint was serum creatinine level doubled, GFR < 15 mL/min, initiation of renal replacement treatment or death. The secondary endpoint was complete remission or partial remission.

Results

In total, 101 male patients and 579 females were included. The follow-up time was 49.7 ± 15.2 months. In clinical data, photosensitivity and mouth ulcers were more common in the female patients, while males had more serositis and vasculitis. In laboratory data, males had higher values of blood pressure, hemoglobin, urine protein, serum creatinine and a lower level of serum albumin. Activity index and endocapillary hypercellularity scores in the male group were significantly increased. No sex disparity was identified across secondary endpoints in all cases, despite a lower ratio of CR in males. As for the long-term survival, no statistic difference between the two groups was observed. In a further multivariate Cox hazard analysis, male gender was not identified as an independent risk factor for poor outcomes.

Conclusion

Despite a greater disease activity and more severe organ damage in males with LN, we did not observe any significant gender disparity in long-term survival. Large multicenter collaborative efforts are necessary.

     

Abilities and barriers to practicing evidence-based nursing for burn specialist nurses

Objective

To explore the abilities and barriers of practicing evidence-based nursing (EBN) for burn specialist nurses so as to provide rationales for its clinical training and practice.