中西医结合康复模式研究思路探讨

中西医结合是我国康复医学的特色和优势,充分发挥中、西医康复的优势和特长,将两者有机地结合起来,最大限度促进康复疗效十分重要.通过对中医康复理论、诊疗方法进行挖掘、整理;进行中医循证康复回顾性研究;结合专家研讨、论证;进行中西医结合康复现状调研.从而研究中西医结合模式的适应症;明确中西医结合康复手段介入的时机、时限;总结中西医结合康复的运行机制.     

HPLC法同时测定不同产地广陈皮中5种活性黄酮成分

目的 建立HPLC法测定12批不同产地广陈皮中5种活性黄酮的量.方法 采用超声法提取药材,通过对提取工艺及色谱条件进行优化建立测定方法,同时测定不同产地广陈皮中橙皮苷(1)、川陈皮素(2)、3,5,6,7,8,3',4'-七甲氧基黄酮(3)、橘皮素(4)和5-羟基-6,7,8,3',4'-五甲氧基黄酮(5)5种活性黄酮的量.结果 12批广陈皮中橙皮苷的量在38.021～70.735 mg/g,均符合药典标准(≥35 mg/g),其中,产于新会的广陈皮中橙皮苷的量低于广东其他两个产地(高要和龙门);另外,广陈皮中多甲氧基黄酮类成分的量以川陈皮素、橘皮素为高.结论 该方法简单、准确,其结果可为广陈皮质量标准的制定提供一定的依据.     

蒲葵籽提取物体外抗HIV-1活性及机制的初步研究

目的研究蒲葵籽提取物的体外抗HIV-1活性,对有活性粗提物进行初步机制研究。方法采用细胞毒性、合胞体抑制、HIV-1感染细胞保护实验和HIV-1 p24抗原测定等实验对蒲葵籽提取物体外抗HIV-1活性进行筛选和确认;采用重组HIV-1逆转录酶和蛋白酶活性抑制实验,融合阻断实验初步探讨活性粗提物的作用机制。结果蒲葵籽的醋酸乙酯(P3)提取物具有较强的体外抗HIV-1活性,P3抑制HIV-1诱导C8166细胞形成合胞体的EC50为5.64μg/mL,对C8166细胞的毒性较小,CC50大于200μg/mL,治疗指数(TI)大于35.46;P3抑制HIV-1急性感染中p24抗原表达的EC50为23.04μg/mL,抑制正常C8166细胞与慢性感染细胞H9/HIV-1 B融合的EC50为8.00μg/mL;P3在质量浓度为200μg/mL时,对HIV-1逆转录酶的抑制率为28.86%;P3抑制重组HIV-1蛋白酶活性的EC50为1.77μg/mL。结论蒲葵籽的醋酸乙酯提取物(P3)具有较强的体外抗HIV-1活性,其作用机制可能主要为阻断病毒进入和抑制HIV-1蛋白酶活性。     

Differentiating Microaneurysm Pathophysiology in Diabetic Retinopathy Through Objective Analysis of Capillary Nonperfusion,Inflammation, and Pericytes

Microaneurysms are biomarkers of microvascular injury in diabetic retinopathy (DR). Impaired retinal capillary perfusion is a critical pathogenic mechanism in the development of microvascular abnormalities. Targeting fundamental molecular disturbances resulting from capillary nonperfusion, such as increased vascular endothelial growth factor expression, does not always reverse the anatomic complications of DR, suggesting that other pathogenic mechanisms independent of perfusion also play a role. We stratify the effects of capillary nonperfusion, inflammation, and pericyte loss on microaneurysm size and leakage in DR through three-dimensional analysis of 636 microaneurysms using high-resolution confocal scanning laser microscopy. Capillary nonperfusion, pericyte loss, and inflammatory cells were found to be independent predictors of microaneurysm size. Nonperfusion alone without pericyte loss or inflammation was not a significant predictor of microaneurysm leakage. Microaneurysms found in regions without nonperfusion were significantly smaller than those found in regions with nonperfusion, and their size was not associated with pericyte loss or inflammation. In addition, microaneurysm size was a significant predictor of leakage in regions with nonperfusion only. This report refines our understanding of the disparate pathophysiologic mechanisms in DR and provides a histologic rationale for understanding treatment failure for microvascular complications in DR.     

利用LC-MS和二维色谱相关光谱技术识别HPLC色谱图中杂质峰

采用二维色谱相关光谱技术,实现质控HPLC方法与LC-MS色谱系统色谱峰的相互识别。本文采用HPLC-DAD(中国药典2010版方法)得到头孢唑肟和头孢地尼混合降解杂质的色谱图,建立降解杂质标准色谱光谱数据;采用LC-MS的方法结合MassWorks软件的应用鉴别出头孢唑肟和头孢地尼的主要降解产物;通过计算光谱相关性对杂质色谱峰进行归属。色谱二维光谱相关法在不同色谱系统下能够准确定性,在没有杂质对照品的情况下,可为质控HPLC方法中的杂质峰的归属提供新的途径和新的思路。     

清热解毒法治疗急性放射性口腔黏膜炎临床观察43例

目的本研究旨在探讨清热解毒法在治疗急性放射性口腔黏膜炎中的临床疗效。方法89例头颈部肿瘤放射治疗的患者随机分为两组,试验组43例用自拟清热解毒法治疗。对照组46例用常规西药的方法进行治疗。观察在出现急性放射性口腔黏膜炎时的放射治疗剂量及粘膜炎的程度等两个方面的情况。结果试验组在急性放射性口腔黏膜炎出现时的放射治疗剂量高于对照组（P〈0．05）,差异有统计学意义。同时试验组IV度口腔黏膜炎的发生率较低（P〈0．05）,与对照组相比差异有统计学意义。结论清热解毒法可以延缓放射性口腔黏膜炎出现的时间,同时还降低了重度口腔黏膜炎的发生率,具有临床应用价值。     

同伴教育在美沙酮门诊的应用

所谓同伴可以是同龄人、同性别的人、有同一种生理变化、同一种行为的人(如孕妇、吸烟者、吸毒者、患某种疾病的人等等).同伴侧重正确知识和核心信息的传达,而不将知识的讲解作为重点.     

Predicting Nonlinear Pharmacokinetics of Omeprazole Enantiomers and Racemic Drug Using Physiologically Based Pharmacokinetic Modeling and Simulation: Application to Predict Drug/Genetic Interactions

Purpose

The objective of this study is to develop a physiologically-based pharmacokinetic (PBPK) model for each omeprazole enantiomer that accounts for nonlinear PK of the two enantiomers as well as omeprazole racemic drug.

Methods

By integrating in vitro, in silico and human PK data, we first developed PBPK models for each enantiomer. Simulation of racemic omeprazole PK was accomplished by combining enantiomer models that allow mutual drug interactions to occur.

Results

The established PBPK models for the first time satisfactorily predicted the nonlinear PK of esomeprazole, R-omeprazole and the racemic drug. The modeling exercises revealed that the strong time-dependent inhibition of CYP2C19 by esomeprazole greatly altered the R-omeprazole PK following administration of racemic omeprazole as in contrast to R-omeprazole given alone. When PBPK models incorporated both autoinhibition of each enantiomer and mutual interactions, the ratios between predicted and observed AUC following single and multiple dosing of omeprazole were 0.97 and 0.94, respectively.

Conclusions

PBPK models of omeprazole enantiomers and racemic drug were developed. These models can be utilized to assess CYP2C19-mediated drug and genetic interaction potential for omeprazole and esomeprazole.     

外伤性血气胸中心静脉导管置管引流术的护理

目的 探讨中心静脉导管胸腔闭式引流术在外伤性血气胸患者的临床疗效及护理体会.方法 对62例外伤性血气胸的患者采用中心静脉导管胸腔闭式引流法治疗血气胸,护理并观察患者疗效及并发症.结果 本组病例患者疼痛少,引流口创伤小、愈合佳,血气胸吸收满意.结论 中心静脉导管胸腔闭式引流术对外伤性血气胸的治疗有积极的作用,可减轻患者的痛苦,利于血气胸吸收,缩短住院时间,值得临床推广.     

miR-101下调c-met的表达提高宫颈癌干细胞对5-氟尿嘧啶的敏感性

目的 探讨miR-101与宫颈癌干细胞对5-氟尿嘧啶敏感性的关系并研究其机制。方法 流式细胞术分选Hela细胞系的肿瘤干细胞。荧光定量PCR检测Hela肿瘤干细胞中miR-101的表达水平。MTT法检测Hela肿瘤干细胞在5-氟尿嘧啶和miR-101处理下的细胞活力。Western blot试验检测5-氟尿嘧啶和miR-101对Hela肿瘤干细胞c-met表达水平,PI3K、AKT磷酸化水平及caspases 活化水平的影响。流式细胞术检测Hela肿瘤干细胞在5-氟尿嘧啶和miR-101处理下的凋亡率。结果 Hela干细胞中miR-101的表达水平相较Hela非干细胞细胞显著下降。Hela干细胞转染miR-101后,其对5-氟尿嘧啶的敏感性显著上升。Western blot试验显示miR-101能显著降低Hela肿瘤干细胞的c-met蛋白表达水平,表明c-met是miR-101的靶点。western blot流式细胞实验结果表明在Hela肿瘤干细胞中,miR-101通过下调c-met的表达抑制PI3K和AKT的磷酸化,从而提高Hela肿瘤干细胞对5-氟尿嘧啶依赖的凋亡信号的敏感性,促进caspase-9和caspase-3的活化。结论 miR-101通过下调c-met的表达提高宫颈癌干细胞对5-氟尿嘧啶的敏感性。