349例药物不良反应报告分析

目的：观察药品不良反应（ADR）发生情况,探讨药品不良反应发生因素,总结药品不良反应发生规律,促进合理用药。方法：选取349例药品不良反应报告作为研究对象,从患者年龄、性别、药品种类、给药途径、器官损害表现及程度等方面进行统计分析。结果：经调查分析,年龄较大人群有170例（48．71％）,静脉注射、口服给药引起的ADR分别有161例（46．13％）、177例（50．72％）,中药制剂类不良反应发生率为32．95％。结论：增强合理用药意识,完善防范处理方案,指导患者合理服用药物,同时加强ADR监测,保障用药安全。     

宁心痛颗粒含药血清对THP-1源性巨噬细胞TLR4、Syk、ERK、Paxillin蛋白磷酸化水平与细胞吞噬功能的影响

目的观察宁心痛颗粒含药血清对"轻度氧化修饰低密度脂蛋白-Toll样受体4-巨噬细胞"途径的干预作用,探讨其稳定动脉粥样硬化(Atherosclerosis,AS)斑块、抑制AS进展的分子机制。方法将THP-1源性巨噬细胞分为空白组、模型组、空白血清组、宁心痛颗粒含药血清组4组。采用免疫印迹法检测脾酪氨酸激酶(spleen tyrosine kinase,Syk)、细胞外信号调节激酶(extracellular regulated protein kinases,ERK1/2)、桩蛋白(Paxillin)磷酸化水平随时间变化情况,以及宁心痛颗粒含药血清对Syk、ERK、Paxillin蛋白磷酸化水平的影响;采用免疫沉淀联合免疫印迹法检测Toll样受体4(Toll like receptor 4,TLR4)蛋白磷酸化水平随时间变化情况,以及宁心痛颗粒含药血清对TLR4蛋白磷酸化水平的影响;采用中性红吞噬实验检测巨噬细胞吞噬功能改变。结果 TLR4、Syk、ERK、Paxillin分别于15,10,15,30min达到磷酸化水平高峰;与空白组相比,模型组及空白血清组TLR4、Syk、ERK、Paxillin磷酸化水平升高、细胞吞噬功能增强(P0.05);与模型组和空白血清组相比,含药血清组TLR4、Syk、ERK、Paxillin磷酸化水平降低、细胞吞噬功能减弱(P0.05),但仍高于空白组。结论宁心痛颗粒含药血清可能通过"mm LDL-TLR4-巨噬细胞"途径影响巨噬细胞吞噬功能从而具有稳定AS斑块、干预AS作用。     

Dravet综合征研究进展

Dravet综合征是难治性癫癎综合征的一种类型,婴儿期发病,病初呈现与发热相关的惊厥发作,随后表现为多种类型的无热惊厥包括肌阵挛,并伴有精神智力运动倒退.目前病因尚不明确,近年研究发现,编码钠离子通道基因突变与该病关系密切.患儿临床发作类型多样且较易出现发作持续状态,对传统抗癫癎药物不敏感,预后较差.     

慢病管理模式在低龄儿童龋中的应用

低龄儿童龋（early childhood caries,ECC）对儿童的口腔乃至全身都会产生危害,ECC防治受到政府及相关卫生部门的日益重视,但目前应对ECC的主要措施还是传统的充填修复治疗。慢病管理模式可以对慢性非传染性疾病及其风险因素进行定期检测,为患者提供长期且有效的专业管理,由医生、护士和药师共同监护及建议,在减缓慢病发展、提高患者生活质量以及节约公共卫生资源上均有较好效果。ECC作为一种常见慢性非传染性疾病,适合通过慢病管理方式对其进行防治。近年来慢病管理模式也越来越多应用于龋病管理中,目前常见的慢病管理模式包括慢病照护模式、慢病创新照护、英国慢病管理系统模式等,以上模式在低龄儿童龋的管理中均有一定的应用。如何建立适合我国诊疗模式的龋病风险评估系统,通过逐级防控网络筛选高患龋风险儿童进行个性化预防尚有待进一步研究。     

剖宫产术中妇科肿瘤的处理

妊娠期合并肿瘤发病率虽然不高,但却是重要的临床问题。不少良性肿瘤如子宫肌瘤及卵巢良性肿瘤常可与妊娠同在。妊娠合并恶性妇科肿瘤临床少见,主要是宫颈癌、卵巢癌等[1]。由于妊娠对肿瘤可能存在影响,而肿瘤对妊娠、胎儿以及分娩均存在影响,且肿瘤的治疗对妊娠也存在影响。因     

盐酸安非他酮有关物质的HPLC测定

用HPLC测定盐酸安非他酮中有关物质和降解产物，与主药有较好的分离效果。色谱柱为HypersilC18，流动相0.01mol/L磷酸二氢钾（三乙胺调pH7.0)-甲醇（25：75），检测波长244nm。     

解偶联蛋白在脑缺血疾病中的作用研究进展

解偶联蛋白(uncoupling proteins,UCPs)是一类位于线粒体内膜上的阴离子载体蛋白,属于线粒体载体蛋白超家族。到目前为止,已经发现并确认UCPs同系物为5种,即UCP1～UCP5,中枢神经系统中主要含有UCP2,UCP4和UCP5 3种亚型,已经证实其对于脑缺血后的氧化应激、线粒体膜电势及ATP绝对水平的维持具有重要的作用,本文主要将UCPs在脑缺血疾病中相关作用进行综述,希望可以为脑缺血疾病的治疗提供新的研究思路。     

手法治疗原发性膝关节骨关节病37例疗效观察

采用按摩膝关节痛点为主的手法，治疗原发性膝关节骨关节病３７例（４６个膝关节）．根据膝关节局部压痛点多少、髌骨活动程度是否异常、髌股关节磨擦疼痛程度、浮髌程度等体征和膝关节主动屈伸能力、行走能力等功能，对患者的严重程度进行评分和疗效判定。结果优１６膝、良１４膝、可１１膝、差５膝。笔者认为膝关节原发性骨关节病是一种软骨及周围软组织的综合性病损。以点揉痛点为主的手法具有促进病变部位组织血液循环，松解髌骨周围软组织粘连，恢复纤维组织弹性，增加髌骨活动度，减小髌股关节压力，促进膝关节软骨新陈代谢等作用。     

Observation on clinical effect of tuina plus Western medication for functional dyspepsia due to liver qi stagnation and spleen deficiency

Objective

To observe the clinical effects of tuina plus Western medication for functional dyspepsia (FD) due to liver qi stagnation and spleen deficiency.

Methods

total of 72 patients in conformity with the inclusion criteria of FD were randomly divided into an observation group and a control group based upon the random number table, 36 cases in each group. The control group was treated with mosapride citrate dispersible tablets, and the observation group was treated with the same tablets plus tuina. Before the treatment and 4 weeks after the treatment, the clinical symptoms, quality of life (QOL) and depression severity were observed by the scale, and were followed up two months later after the treatment for assessment of the clinical effects.

Results

After the treatment and at the follow-up, the symptom scores of FD and the sores of Hamilton depression rating scale (HAMD) in both groups decreased, and the scores in Chinese version of quality of life questionnaire for functional digestive disorders (Chin-FDDQL) increased, with statistically significant differences in comparison with the same group before the treatment (all P<0.05). In comparison between the two groups at the same time point after the treatment, the scores of FD symptoms, HAMD and Chin-FDDQL were improved better in the observation group than those in the control group, with statistically significant differences (all P<0.05). The total effective rates at the follow-up were 91.7% in the observation group and 75.0% in the control group, without statistical difference between the two groups (P>0.05). The rate of clinical cure and remarkable effect was 66.7% in the observation group, higher than 41.7% in the control group, it is higher in the observation group than that in the control group, with a statistically significant difference between the two groups (P<0.05).

Conclusion

Tuina plus Western medication is precise in the therapeutic effects for FD due to liver qi stagnation and spleen deficiency and can effectively relieve clinical symptoms, elevate the QOL and alleviate depression severity of the patients. Moreover, it’s better than the treatment by Western medication alone in the long-term therapeutic effects.

     

Sleep‐disordered breathing in heart failure patients with different etiologies

BackgroundThe prevalence of sleep‐disordered breathing (SDB) is closely related to the severity of heart failure (HF), and the severity of HF is different in patients with HF of different etiologies. Hypothesis: This study aimed to explore the prevalence of SDB in patients with HFof different etiologies.MethodsHospitalized HF patients were consecutively enrolled. All patients underwent portable overnight cardiorespiratory polygraphy. Patients were divided into five groups according to the etiology of HF: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB and clinical data was compared among the five groups.ResultsIn total, 248 patients were enrolled in this study. The prevalence of SDB in HF was 70.6%, with the prevalence of obstructive sleep apnea (OSA) at 47.6% and central sleep apnea (CSA) at 23.0%. Patients were divided into five groups: ischemic, hypertensive, myocardial, valvular, and arrhythmic. The prevalence of SDB among the five groups was 75.3%, 81.4%, 77.8%, 51.9%, and 58.5% (p = .014), respectively. The prevalence of OSA among the five groups was 42.7%, 72.1%, 36.1%, 37.0%, and 49.1% (p = .009), whereas the CSA was 32.6%, 9.3%, 41.7%, 14.8%, and 9.4% (p < .001), respectively.ConclusionsSDB is common in HF patients. The prevalence and types of SDB varied in HF with different etiologies, which may be related to the different severities of HF. SDB was highly prevalent in patients with ischemic, hypertensive, and myocardial HF. Hypertensive HF patients were mainly complicated with OSA, while myocardial HF patients were mainly complicated with CSA. Both conditions were highly prevalent in ischemic HF patients. The prevalence of SDB was relatively low in valvular and arrhythmic HF patients, and OSA was the main type.