二甲双胍对2型糖尿病模型大鼠尿nephrin排泄的影响

目的:观察二甲双胍对2型糖尿病模型大鼠尿nephrin(UNE)排泄的动态影响,探讨二甲双胍对糖尿病肾小球足细胞的保护作用?方法:将高脂膳食联合小剂量链脲佐菌素(streptozotocin,STZ)诱导的2型糖尿病大鼠随机分为3组:糖尿病模型组?二甲双胍干预组?优降糖干预组,并设正常对照组?干预前后监测血糖(BG)以及尿白蛋白(UALB)和尿nephrin排泄?8周末糖化血红蛋白(HbA1c)的变化?结果:①3组糖尿病大鼠BG及HbA1c均明显高于正常组(P < 0.05);经二甲双胍和优降糖干预后,4?8周末2组BG和HbA1c均明显低于2型糖尿病模型组(P < 0.05),但差异无统计学意义(P > 0.05);②4?8周末各糖尿病大鼠尿白蛋白/肌酐比(UACR)明显高于正常组(P < 0.05);与2型糖尿病模型组比较,二甲双胍和优降糖组UACR值明显降低(P < 0.05),4周末,两干预组间无显著性差异(P > 0.05),8周末,两组间差异有统计学意义(P < 0.05);③0?2周末,4组大鼠尿nephrin/肌酐比(UNER)差异无统计学意义,4?8周末,各糖尿病大鼠UNER均明显高于正常组(P < 0.05),二甲双胍和优降糖干预组UNER明显低于糖尿病模型组(P < 0.05),且二甲双胍组低于优降糖组(P < 0.05);④Pearson相关分析显示UNER与UACR存在正相关(r=0.846,P < 0.05)?结论:二甲双胍可以降低糖尿病肾病大鼠尿nephrin的排泄,提示对肾小球足细胞可能存在保护作用,该作用不完全依赖于血糖的降低?     

Automated clinical trial eligibility prescreening: increasing the efficiency of patient identification for clinical trials in the emergency department

Objectives (1) To develop an automated eligibility screening (ES) approach for clinical trials in an urban tertiary care pediatric emergency department (ED); (2) to assess the effectiveness of natural language processing (NLP), information extraction (IE), and machine learning (ML) techniques on real-world clinical data and trials.Data and methods We collected eligibility criteria for 13 randomly selected, disease-specific clinical trials actively enrolling patients between January 1, 2010 and August 31, 2012. In parallel, we retrospectively selected data fields including demographics, laboratory data, and clinical notes from the electronic health record (EHR) to represent profiles of all 202795 patients visiting the ED during the same period. Leveraging NLP, IE, and ML technologies, the automated ES algorithms identified patients whose profiles matched the trial criteria to reduce the pool of candidates for staff screening. The performance was validated on both a physician-generated gold standard of trial–patient matches and a reference standard of historical trial–patient enrollment decisions, where workload, mean average precision (MAP), and recall were assessed.Results Compared with the case without automation, the workload with automated ES was reduced by 92% on the gold standard set, with a MAP of 62.9%. The automated ES achieved a 450% increase in trial screening efficiency. The findings on the gold standard set were confirmed by large-scale evaluation on the reference set of trial–patient matches.Discussion and conclusion By exploiting the text of trial criteria and the content of EHRs, we demonstrated that NLP-, IE-, and ML-based automated ES could successfully identify patients for clinical trials.     

A systematic review and meta‐analysis of randomized controlled trials: Skin‐patch of Chinese herbal medicine for patients with acute gouty arthritis

Aims

To evaluate the evidence of the effectiveness and safety of Chinese herbal medicine skin‐patches for patients with acute gouty arthritis.

Background

Acute gouty arthritis is a problem that can limit the level of activity and impair the quality of life. In China, many clinical studies have demonstrated that skin‐patches of Chinese herbal medicines benefit patients with acute gouty arthritis. However, the reported clinical effects vary.

Design

A systematic review and meta‐analysis of randomized controlled trials.

Data sources

Three English databases including CENTRAL (1993 to February 2017), PubMed (1966 to February 2017) and EMBASE (1974 to February 2017) and four Chinese databases including Chinese National Knowledge Infrastructure, Chinese VIP Information, SinoMed and Wanfang (all, 1949 ‐ February 2017) were searched. Randomized controlled trials that compared skin‐patches of Chinese herbal medicine with or without conventional treatments to conventional treatments, no treatment or a placebo treatment for patients with acute gouty arthritis were included.

Review methods

We conducted a systematic review and meta‐analysis following the Cochrane process. Two authors selected the studies, extracted the data and evaluated the risk of bias of the included trials.

Results

Nineteen studies met our inclusion criteria. After synthesizing the data, the results showed that skin‐patches of CHM combined with Western medicine seemed to be more effective than Western medicine alone for pain relief in patients with acute gouty arthritis and had fewer adverse events.

Conclusion

Due to the quality of the data, larger and more rigorously designed clinical trials with proper outcome measures are necessary.     

Superlattice-like structure and enhanced ferroelectric properties of intergrowth Aurivillius oxides

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties. In this work, Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ and Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ compounds were successfully synthetised using a simple solid-state reaction method. X-Ray diffraction patterns and scanning transmission electron microscopy high angle annular dark field (STEM-HAADF) images confirm the 2–3 and the 3–4 intergrowth structures in Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ compounds, respectively. A superlattice-like distortion in these oxides was proposed resulting from the combination of sub-lattices with different a and b parameters, which was validated by XRD refinements and Raman spectra. Polarization-electric field tests and pulsed polarization positive-up negative-down measurements demonstrate that such superlattice-like structures can effectively enhance the intrinsic ferroelectric polarization and coercive field of these oxides, especially when compared with their component oxides Bi₃TiNbO₉, Bi₃LaTiNbFeO₁₂ and Bi₅Ti₃FeO₁₅. Simultaneously, ferroelectric Curie temperatures of Bi₃TiNbO₉–Bi₃LaTiNbFeO₁₂ and Bi₃LaTiNbFeO₁₂–Bi₅Ti₃FeO₁₅ oxides are lowered because of the internal stress in the superlattice-like structure. Nevertheless, the paramagnetism of the samples is hardly influenced by their structure, while mainly related to their iron content, in which iron has a similar effective magnetic moment around 3.4–3.9.

Aurivillius oxides with an intergrowth structures have been receiving increasing interest because of their special structures and potential outstanding ferroelectric properties.     

江苏省医院非技术服务质量评价指标体系的研究

非技术性服务质量对于现代医院来讲意义重大。评价指标体系是对其进行评价而改进其质量为前提和关键。该研究从指标体系的构建、指标体系的确立以及指标体系的考核三个方面研究了江苏省医院非技术服务质量评价指标体系。     

中西医结合治疗脑卒中后焦虑障碍45例临床研究

目的：观察中西医结合治疗脑卒中后焦虑障碍（PSAD）的临床疗效。方法；对45例PSAD病人于治疗前后进行SAS测评，并对所获资料进行统计学分析。结果：焦虑症状消失率为88．89％；SAS标准分均数值经治疗后明显下降，有统计学意义（P＜0．001）；各项目所引起的症状得分均数值亦明显下降。结论：中西医结合治疗PSAD可取得较好疗效。     

中药扶正抗癌方治疗中、晚期消化道肿瘤160例临床观察

14年来，以中药扶正抗癌方（自拟）治疗中、晚期消化道肿瘤160例，收到了较为满意的疗效。患者症状改善，血象升高，免疫指标提升，癌胚抗原含量下降．患者的体质增强，体重增加．其它疾病少发等，有的患者癌灶缩小，甚至消失，绝大多数的患者经治疗后生存期得以延长。     

苍脂颗粒剂对鼠胃粘膜细胞保护作用的研究

为了探讨苍脂颗粒剂治疗脾胃病的胃粘膜保护作用，采用利血平模拟的大鼠脾虚证及亚急性阿斯匹林胃粘膜损伤模型，测定其对非蛋白质流基物质（NPSH）、谷胱甘肽过氧化物酶（GSH－px）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）及血浆过氧化脂质（LPO）等具有胃粘膜细胞保护作用物质的含量或活性的影响。结果显示，苍脂颗粒剂可以明显改善脾虚伴慢性胃粘膜病变大鼠及亚急性阿期匹林胃粘膜损伤大鼠的粘膜损伤程度，显著提高胃粘膜NPSH（F＜0．01）、GSH-px（P＜0．01）等细胞保护物质的水平．提示苍脂颗粒剂具有一定的胃粘膜细胞保护作用。     

Acute allograft rejection and immunosuppression: influence on endogenous melatonin secretion

Abstract: Melatonin displays a dose‐dependent immunoregulatory effect in vitro and in vivo. Exogenous high‐dose melatonin therapy exerted an immunosuppressive effect, abrogating acute rejection (AR), significantly prolonging transplant survival. Endogenous melatonin secretion, in response to heterotopic rat cardiac allograft transplantation (Tx), was investigated during the AR response and under standardized immunosuppressive maintenance therapy with cyclosporin A (CsA) and rapamycin (RPM). Recipients of syngeneic transplants, and recipients of allogeneic grafts, either untreated or receiving immunosuppressive therapy constituted the experimental groups. Endogenous circadian melatonin levels were measured at 07:00, 19:00, and 24:00 hr, using a novel radioimmunoassay (RIA) procedure, under standardized 12‐hr‐light/dark‐conditions (light off: 19:00 hr; light on: 07:00 hr), before and after Tx. Neither the operative trauma, nor the challenge with a perfused allograft or the AR response influenced endogenous melatonin peak secretion. Immunosuppressive therapy with CsA led to a significant increase in peak secretion, measured for days 7 (212 ± 40.7 pg/mL; P < 0.05), 14 (255 ± 13.9 pg/mL; P < 0.001), and 21 (219 ± 34 pg/mL; P < 0.01) after Tx, as compared with naïve animals (155 ± 25.8 pg/mL). In contrast, treatment with RPM significantly decreased the melatonin peak post‐Tx up to day 7 (87 ± 25.2 pg/mL; P < 0.001), compared with naïve animals (155 ± 25.8 pg/mL). These findings imply a robust nature of the endogenous circadian melatonin secretion kinetics, even against the background of profound allogeneic stimuli. Immunosuppressive maintenance therapy with CsA and RPM modulated early melatonin secretion, indicating a specific secondary action of these drugs. Further studies are necessary to disclose the long‐term effect of immunosuppressive therapy on circadian melatonin secretion in transplant recipients.