蒙药小白蒿的炮制工艺及炮制品的药理研究

目的:优选小白蒿蒙医炮制工艺,并观察其饮片安全有效性。方法:以炮制品绿原酸含量为主要指标并参考槲皮素含量进行正交试验,以考察炒制温度、时间和药材粒度的影响,确定最佳工艺;采用小白鼠急性毒性实验,断尾实验测定出血时间,眼眶静脉丛取血测定凝血时间,断头采全血计数血小板总数,评价安全有效性。结果:本品在270℃温度下翻动炒制20 min效果最佳,经方差分析证明炒制温度、时间和粒度因素对所监测的两种成分的含量均没有显著影响;小白蒿炮制后可缩短小白鼠的出血时间,显著增高血小板计数。结论:小白蒿经过合理的炒制后,可提高其安全性和止血药效,为验证传统蒙药小白蒿用药理论,提供了参考依据。     

住院患者入院时血糖水平与医疗费用、疾病预后的相关研究

目的探讨住院患者人院时不同血糖水平与住院时间、医疗费用及疾病预后的关系。方法选取2009年11月至2011年7月期间人院的4868例患者,按入院24h内测得的血糖水平分为非高血糖组3429例、高血糖组1439例,后者包括糖尿病和应激性高血糖患者;根据患者年龄分为非老年组（年龄〈60岁）2532例和老年组（年龄≥60岁）2336例;其中278例冠心病患者再分为高血糖组120例和非高血糖组158例。各组间进行有关数据比较。结果高血糖组患者的住院天数、医疗费用和总病死率均显著高于非高血糖组（中位数住院日：15vs10d,P〈0．01;中位数医疗费用：14064．7vs8980．9元,P〈0．01;死亡率：2．92％vs0．61％,P〈0．01）。按年龄分组后,无论是非老年组还是老年组中糖尿病和应激性高血糖患者的医疗费用均明显高于非高血糖患者,住院日明显延长;应激性高血糖患者的医疗费用明显高于糖尿病患者;非老年组中应激性高血糖患者的死亡率明显高于非高血糖患者,但与糖尿病患者相比无明显差异,老年组糖尿病和应激性高血糖患者的死亡率无明显差异,但均明显高于非高血糖患者。冠心病患者中糖尿病和应激性高血糖患者与非高血糖患者的年龄无明显差异,前两组的医疗费用明显高于非高血糖组,住院日更长（分别为14,15和12d）、死亡率更高（分别为6．41％,7．14％和0．63％）。结论入院时高血糖水平预示患者有更高的医疗花费、更长的住院时间和更高的死亡率。     

高血压患者心脏变时性功能不良及其意义

目的:探讨原发性高血压(EH)患者心脏变时性功能不良(CI)及其意义。方法:随机选择EH患者60例,行活动平板运动试验,记录心率、血压变化,运动时间(time)、代谢当量(METs);计算2级运动的心率变时性反应指数(CRI2)、最大心率收缩压二项乘积(RPP)和心肌耗氧量(MV.O2)并与正常对照组40例比较。结果:EH组峰值心率及心率上升幅度小于对照组(148.75±11.81):(154.27±12.05)次/min,(67.44±13.37):(74.12±14.43)次/min,P<0.05;CRI2低于对照组(0.94±0.22):(1.03±0.15),P<0.05;EH组CI的人数共29例(48.33%)明显多于对照组7例(17.5%),P<0.005,其中CRI2<0.8的人数20例(33.33%),CRI2>1.3的人数9例(15%),对照组为6例(15%)、1例(2.5%),两组间有显著性差异P<0.05;表明EH组存在CI;EH组运动时间(time)缩短(8.78±1.87):(9.77±1.88)min,P<0.05;运动贮量(METs)降低(9.21±1.39):(9.82±1.48),P<0.05;而RPP,MV.O2分别高于对照组[(26484.64±3573.49):(24118.39±3060.76),(30.78±5.0):(27.47±4.23)ml/kg.min,P<0.001]。结论:EH患者存在CI,提示有心脏自主神经损害,临床应引起重视。     

Ghrelin secretion in humans is sexually dimorphic,suppressed by somatostatin,and not affected by the ambient growth hormone levels

We studied plasma ghrelin and GH concentrations over a 24-h period in young healthy men and women and in patients with acromegaly. Healthy subjects were restudied after administration of GH-lowering agents, octreotide or GHRH antagonist. Ghrelin concentrations in women studied during the late follicular stage of the cycle were about 3-fold higher than in men. Suppression of GH secretion by GHRH antagonist did not alter ghrelin concentration profiles. In the presence of high GH levels (acromegaly), ghrelin levels were similar to those found in healthy men. Administration of somatostatin analog octreotide suppressed both GH and ghrelin concentration profiles. We conclude that: 1) ghrelin secretion is sexually dimorphic in humans, with women in the late follicular stage having higher levels than men; 2) ghrelin secretion is suppressed by somatostatin; and 3) GH has no influence over ghrelin secretion.     

Sebaceous carcinoma of the lip: Comparing normal lip and cheek anatomy with the imaging features of a rare cutaneous malignancy

Sebaceous carcinoma is a rare cutaneous malignancy, commonly affecting the eyelids. This case highlights a patient who presented with sebaceous carcinoma of the right upper lip with extensive involvement of the soft tissues of the head and neck. As part of the initial investigation, ultrasound was requested. This case demonstrates the ultrasound features of sebaceous carcinoma as well as revising the normal ultrasound anatomy of the upper lip and muscles of the cheek.