药用植物蓝刺头的研究进展

摘 要 蓝刺头（Echinops latifolius Tausch）为菊科蓝刺头属植物,其干燥根作为中药禹州漏芦用,其干燥花絮作为蒙药蓝刺头用。本文对近几年来中药禹州漏芦和蒙药蓝刺头的研究成果进行了整理,并从化学成分、工艺研究、质量控制和药理作用四个方面对两种药材进行了比较和综述,以期为药用植物蓝刺头的进一步开发和利用提供科学依据。     

加校正因子的自身对照法测定淫羊藿饮片中6种成分含量

摘 要 目的： 采用加校正因子的自身对照法测定淫羊藿饮片中6种成分含量。方法: Agilent ZORBAX Eclipse XDB-C₁₈(150 mm×4.6 mm,5 μm)色谱柱,流动相为乙腈 水梯度洗脱,检测波长268 nm,柱温30℃。通过加入自身内标物色谱峰峰面积增加值建立校正因子,用相对保留时间和光谱对照法确定其他成分位置,采用HPLC色谱法对其他成分进行定量分析。结果:淫羊藿饮片中朝藿定A、朝藿定A1、朝藿定B、朝藿定C、宝藿苷Ｉ相对于淫羊藿苷的保留时间分别为0.750,0.810,0.865,0.939,1.651;校正因子分别为0.998 6,0.998 7,0.998 8,0.989 4,0.985 6。结论: 加校正因子的自身对照法可以用于相同类型化学环境成分的定量测定,该方法简便、快捷,适合中药多成分的定量分析。     

右旋糖酐在注射用醋酸卡泊芬净无菌检查中的应用

目的：通过无菌方法学验证试验,建立注射用醋酸卡泊芬净的无菌检查法。方法：样品分别用0.9%无菌氯化钠溶液溶解,采用薄膜过滤法处理,每膜分别用0.9%无菌氯化钠溶液和右旋糖酐40葡萄糖注射液冲洗若干次,并在培养基中加入右旋糖酐1g,以白色念珠菌为阳性对照菌。结果：各验证菌株均能够正常生长,方法可行。结论：通过添加外源的右旋糖酐,使真菌通过利用外源的肽聚糖用于自身细胞壁的合成,从而消除了醋酸卡泊芬净的抑菌作用,建立了抗真菌药物注射用醋酸卡泊芬净的无菌检查法。     

气囊辅助内镜治疗小肠息肉的临床价值研究

目的：探讨应用气囊辅助内镜（ BAE）治疗小肠息肉的可行性、安全性及临床价值。方法回顾性总结2006年8月至2014年7月对199例小肠息肉患者行BAE检查及内镜下息肉切除治疗情况,评价其可行性、安全性及小肠息肉内镜治疗的临床价值。结果199例小肠息肉患者共接受558例次BAE诊治术,摘除小肠息肉共3391枚,其中直径5～10 mm 801枚（23．62％）,11～30 mm 1887枚（55．65％）,31～50 mm 563枚（16．60％）,＞50 mm 140枚（4．13％）,最大者约为7 cm ×10 cm。发生21例次（3．76％）手术相关并发症,包括15例息肉残根出血和6例肠穿孔。结论 BAE是一种安全有效的小肠息肉治疗方法,对大多数小肠息肉患者,可替代外科手术而作为首选治疗方法,具有较好的临床应用价值及发展前景。     

Efficacy of Acetazolamide for the Prophylaxis of Acute Mountain Sickness: A Systematic Review,Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials

BackgroundAcute mountain sickness (AMS) is a benign and self-limiting syndrome but can progress to life-threatening conditions if leave untreated. This study aimed to assess the efficacy of acetazolamide for the prophylaxis of AMS and disclose potential factors that affect the treatment effect of acetazolamide.Materials and MethodsRandomized controlled trials comparing the use of acetazolamide versus placebo for the prevention of AMS were included. The incidence of AMS was the primary endpoint. Meta-regression analysis was conducted to explore potential factors associated with acetazolamide efficacy. Trial sequential analysis (TSA) was conducted to estimate the statistical power of the available data.ResultsA total of 22 trials were included. Acetazolamide at 125, 250, and 375 mg/ twice daily (bid) significantly reduced incidence of AMS compared to placebo. TAS indicated that the current evidence was adequate confirming the efficacy of acetazolamide at 125, 250, and 375 mg/bid in lowering incidence of AMS. There was no evidence of an association between efficacy and dose of acetazolamide, timing at start of acetazolamide treatment, mode of ascent, AMS assessment score, timing of AMS assessment, baseline altitude, and endpoint altitude.ConclusionAcetazolamide is effective prophylaxis for the prevention of AMS in doses of 125, 250, and 375 mg/bid. Future investigations should focus on personal characteristics, disclosing the correlation between acetazolamide efficacy and body mass, height, degree of prior acclimatization, individual inborn susceptibility, and history of AMS.     

Acupoint catgut embedding therapy for functional constipation: A protocol for systematic review and meta-analysis

Background:This review will assess current evidence related to the effectiveness and safety of acupoint catgut embedding therapy for functional constipation (FC) and provide efficacy assessments for clinical applications.Methods:We will search the following databases for relevant trials: PubMed, EMBASE OVID, Cumulative Index of Nursing and Allied Health Literature, OVID MEDLINE, Web of Science, the Cochrane Central Register of Controlled Trials, Cochrane library, and Scopus. We will also search the following Chinese databases for trials published in the Chinese literature: China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journals Database, Wan Fang Database, Chinese Biomedicine and other resources from inception to December 2020. Only randomized controlled trials comparing acupoint catgut embedding versus acupuncture or sham acupuncture or placebo or other therapies will be included. The outcomes involved mean spontaneous bowel movements, complete spontaneous bowel movements, the Bristol Stool Form Scale, the Cleveland Clinic Score, Patient Assessment of Constipation symptom and so on. The risk of bias assessment and quality of evidence for outcomes will be appraised using the Cochrane Risk of Bias Tool and the Grading of Recommendations, Assessment, Development and Evaluation guidelines. RevMan 5.3 software will be employed for the meta-analysis.Results:This work will compare and arrange the comparative efficacy of acupoint catgut embedding with different treatments for FC by summarizing the current evidences.Conclusion:The results of this meta-analysis may help doctors determine the best treatments for patients to manage FC.Ethics and dissemination:This is a protocol with no patient recruitment and personal information collection, approval by the ethics committee is not required.OSF Registration number:DOI 10.17605/OSF.IO/XTKE2.     

Effects of Baduanjin on glucose and lipid metabolism in diabetic patients: A protocol for systematic review and meta-analysis

Background:Baduanjin is an ancient technique of physical and breathing exercises (Dao Yin). This technique is divided into eight sections and each section is a motion, so it is called “Baduanjin”. It is practice without equipment, simple and easy to learn, whose effect is significant leading to good fitness effect. Diabetes mellitus is a chronic metabolic disease. Clinical studies have reported that Baduanjin can affect the metabolism of blood glucose and blood lipid in diabetic patients, but the reported efficacy is different among different studies. Therefore, the study is aimed to systematically evaluate the size and differences of the impact of Baduanjin on the metabolism of glucose and lipid in diabetic patients.Methods:Retrieved randomized controlled trials(RCTs) on effects of Baduanjin on glucose and lipid metabolism in diabetic patients from PubMed, Web of Science, the Cochrane Library, Embase, CNKI with computer while mutually retrieved the same things from Chinese Clinical Trial Registry(ChiCTR), Google Academic and Baidu Academic. The retrieval time was from their establishment to October 2020. Then 2 researchers independently extracted relevant data and evaluated the quality of the included literatures, and meta-analysis was conducted on the included literatures using RevMan5.3.Results:This research used outcome indicators like fasting blood glucose, postprandial blood glucose, glycosylated hemoglobin, total cholesterol content and triglyceride content to explore the effect of Baduanjin on glucose and lipid metabolism in diabetic patients specifically.Conclusion:The research will provide reliable evidence-based proof for Baduanjin improving glucose and lipid metabolism of diabetic patients.Ethics and dissemination:Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number:DOI 10.17605/ OSF.IO/AGJHQ.     

The value of repeated CT in monitoring the disease progression in moderate COVID-19 pneumonia: A single-center,retrospective study

The role of thoracic CT (computerized tomography) in monitoring disease course of COVID-19 is controversial. The purpose of this study is to investigate the risk factors and predictive value of deterioration on repeatedly performed CT scan during hospitalization.All COVID-19 patients treated in our isolation ward, from January 22, 2020 to February 7, 2020, were reviewed. Patients included were categorized into RD (Radiological Deterioration) group or NRD (No Radiological Deterioration) group according to the manifestation on the CT routinely performed during the hospitalization. All clinical data and CT images were analyzed.Forty three patients were included in our study. All are moderate cases with at least 4 CT scans each. Eighteen (42.9%) patients had radiological deteriorations which were all identified in CT2 (the first CT after admission). Patients in RD group had lower leukocyte count (P = .003), lymphocyte count (P = .030), and higher prevalence (P = .012) of elevated C-reactive protein (CRP) at admission. NRD patients had a lower prevalence of reticulations (P = .034) on baseline CT (CT1, performed within 2 days before admission) and a longer duration between symptom onset and the time of CT2 (P < .01). There was no significant difference in hospital stay or fibrotic change on CT4 (follow-up CT scan performed 4 weeks after discharge) between 2 groups. Shorter duration between symptom onset and CT2 time (odds ratio [OR], 0.436; 95% confidence interval: 0.233–0.816; P < .01) and lower leukocyte count in baseline evaluation (OR, 0.316; 95% CI: 0.116–0.859; P < .05) were associated with increased odds of radiological deterioration on CT image during hospitalization.For moderate COVID-19 patients, the value of routinely performed CT during the treatment is limited. We recommend avoiding using CT as a routine monitor in moderate COVID-19 patients.     

Tumor microenvironment immune subtypes for classification of novel clear cell renal cell carcinoma profiles with prognostic and therapeutic implications

Currently, no effective prognostic model of clear cell renal cell carcinoma (ccRCC) based on immune cell infiltration has been developed. Recent studies have identified 6 immune groups (IS) in 33 solid tumors. We aimed to characterize the expression pattern of IS in ccRCC and evaluate the potential in predicting patient prognosis. The clinical information, immune subgroup, somatic mutation, copy number variation, and methylation score of patients with TCGA ccRCC cohort were downloaded from UCSC Xena for further analysis. The most dominant IS in ccRCC was the inflammatory subgroup (immune C3) (86.5%), regardless of different pathological stages, pathological grades, and genders. In the C3 subgroup, stage IV (69.1%) and grade 4 (69.9%) were the least presented. Survival analysis showed that the IS could effectively predict the overall survival (OS) (P < .0001) and disease-specific survival (DSS) (P < .0001) of ccRCC alone, of which group C3 (OS, HR = 2.3, P < .001; DSS, HR = 2.84, P < .001) exhibited the best prognosis. Among the most frequently mutated ccRCC genes, only VHL and PBRM1 were found to be common in the C3 group. The homologous recombination deficiency score was also lower. High heterogeneity was observed in immune cells and immunoregulatory genes of IS. Notably, CD4+ memory resting T cells were highly infiltrating, regulatory T cells (Treg) showed low infiltration, and most immunoregulatory genes (such as CX3CL1, IFNA2, TLR4, SELP, HMGB1, and TNFRSF14) were highly expressed in the C3 subgroup than in other subgroups. Enrichment analysis showed that adipogenesis, apical junction, hypoxia, IL2 STAT5 signaling, TGF-beta signaling, and UV response DN were activated, whereas E2F targets, G2M checkpoint, and MYC targets V2 were downregulated in the C3 group. Immune classification can more accurately classify ccRCC patients and predict OS and DSS. Thus, IS-based classification may be a valuable tool that enables individualized treatment of patients with ccRCC.