毒性中药狼毒质量标准研究

目的:建立毒性中药狼毒的质量标准。方法:采用显微、化学、液相色谱/质谱等方法进行定性鉴别,以液相色谱及液相/质谱法测定含量。结果:狼毒大戟中月腺大戟乙素含量为0.01%w/w,月腺大戟中月腺大戟乙素含量范围为0.01%~0.02%w/w,均未检出瑞香内酯、狼毒色原酮和新狼毒素A。瑞香狼毒中瑞香内酯、狼毒色原酮及新狼毒素A等成分含量范围分别为0.57%~2.12%w/w、0.86%~1.6%w/w及0.45%~0.96%w/w,但未检出含月腺大戟乙素成分。结论:各法能用于常规检测狼毒属植物。     

Relationship between β1‐adrenergic receptor polymorphisms and cardiovascular disease in patients with diabetic nephropathy

Aim: Activation of β1‐adrenergic receptor (β1AR) enhances contractility and heart rate. The polymorphism Arg389Gly in the β1AR gene was found to be functionally important in determining receptor activity. The relationship between this polymorphism and the risk of cardiovascular disease was investigated in Chinese subjects with overt diabetic nephropathy. Methods: A total of 219 type 2 diabetic subjects with nephropathy were recruited. Genotyping of the β1AR Arg389Gly polymorphism was determined. Patients were followed up to 96 months for the development of cardiovascular events. Results: There were 122, 86 and 11 patients with Arg/Arg, Arg/Gly and Gly/Gly genotype, respectively. At 96 months, the event‐free survival of primary composite cardiovascular end‐point was 33.0% and 44.3% for Gly⁺ and Gly^‐ groups, respectively (log–rank test, P = 0.105), while the event‐free survival for first ischaemic heart disease was 62.4% and 75.9%, respectively (log–rank test, P = 0.038). However, with multivariate analysis by the Cox proportional hazard model to adjust for confounders, only low‐density lipoprotein and baseline glomerular filtration rate were independent predictors of first ischaemic heart event. Conclusion: The β1AR Arg389Gly polymorphism is not an independent predictor of cardiovascular events in subjects with overt diabetic nephropathy.     

毒性中药白降丹质量标准研究

目的:建立毒性中药白降丹的质量标准。方法:采用显微、X-衍射方法进行定性鉴别,以滴定法测定含量。结果:各方法可用于白降丹的鉴定。结论:本文建立的显微、X-衍射、滴定等方法可对其进行定性定量分析。     

Nutrition Intervention Program of the Modification of Diet in Renal Disease Study: A Self-Management Approach

Objective To characterize the Modification of Diet in Renal Disease (MDRD) Study nutrition intervention program by determining the frequency of intervention strategies used by the dietitians and the usefulness of program components as rated by participants.Design Dietitians recorded which of 32 intervention strategies they used at each monthly visit. Participants rated the usefulness of 19 program components.Subjects 840 adults with renal insufficiency.Intervention Participants were assigned randomly to usual-, low-, or very-low-protein diet groups. Each eating pattern also specified a phosphorus intake goal. Each participant met monthly with a dietitian for an average of 26 months.Statistical analyses Analyses of variance and χ² analyses.Results Dietitians used the following intervention strategies most often in all groups: providing feedback based on self-monitoring and/or food records, reviewing adherence or biochemistry data, providing low-protein foods, and reviewing graphs of adherence progress. In general, the dietitians used feedback, modeling, and support strategies more often, and knowledge and skills strategies less often, with participants who had to make the greatest reductions in protein intake and those with more advanced disease. In all groups, the dietitians’ use of knowledge and skills, feedback, and modeling strategies decreased over time (P<.001), whereas use of support strategies was maintained. The type and frequency of intervention strategies used by dietitians and the usefulness ratings of participants did not vary by educational level of the participant. Both self-monitoring and dietitian support were rated as “very useful” by 88% of the participants.Conclusions Three features were central to the MDRD Study nutrition intervention program: feedback, particularly from self-monitoring and from measures of adherence; modeling, particularly by providing low-protein food products; and dietitian support. We recommend the self-management approach. J Am Diet Assoc. 1995; 95:1288-1294.     

Risk of stroke after acute myocardial infarction among Chinese

Following an acute myocardial infarction (AMI), patients have an increased risk of stroke. Estimates of risk are mainly derived from AMI treatment trials or secondary prevention studies. The reported incidence of stroke in Caucasians in the early phase after AMI ranged from 0.5% to 2.5%.1-3 Similar assessment of risk in the Chinese population is lacking. As thrombolytic therapy becomes standard treatment for AMI, there is concern that there may be an increase in haemorrhagic stroke complicating AMI treatment, especially since haemorrhagic stroke is more common in Asian populations.     

Deaf Culture,Cochlear Implants,and Elective Disability

The use of cochlear implants, especially for prelingually deafened children, has aroused heated debate. Members and proponents of Deaf culture vigorously oppose implants both as a seriously invasive treatment of dubious efficacy and as a threat to Deaf culture. Some find these arguments persuasive; others do not. And in this context arise questions about the extent to which individuals with disabilities may decline treatments to ameliorate disabling conditions. When they do so, to what extent may they call upon society to provide supportive services and accommodations?     

Aftercare telephone contacts with problem drinkers can serve a clinical and research function

Research staff typically gather treatment outcome data, whereas clinicians perform aftercare contacts. To date no alcohol treatment outcome study has examined the utility of therapists collecting outcome data through aftercare contacts. Using the Alcohol Timeline Followback (TLFB) method modified for clinical aftercare contacts, 154 problem drinkers who were part of a cognitive-behavioral intervention completed the modified TLFB with their primary therapist during aftercare telephone contacts conducted 1 and 3 months after their last treatment session. Clients reported their daily alcohol use over the past 30 days using four consumption categories (i.e. 0 drinks, 1-4 drinks, 5-9 drinks and 10+ drinks). At a 6-month follow-up research interview, a trained research assistant gathered standard TLFB data from the clients that included the time period for aftercare contacts. Correlations between the two TLFB formats showed good alternate form reliability, especially for frequency of alcohol use. Discrepancies between reports were positively associated with heavier pre-treatment and post-treatment drinking, suggesting possible memory biases among heavier drinkers. Subject reports also closely paralleled collateral reports of the subjects' drinking. These results support the utility of a brief TLFB instrument for use by therapists in assessing clients' outcomes by telephone during aftercare contacts.     

三七皂甙对血管平滑肌上受体操纵Ca~(2 )通道的特异性作用(英文)

三七皂甙能明显抑制狗肠系膜动脉及大隐静脉α肾上腺素能受体触发的收缩反应及~(45)Ca内流(从0.36±0.03降至0.14±0.05μmol·g~(-1)组织湿重),但对高K~ 引起的Ca~(2 )内流无影响。三七皂甙不影响Ca~(2 )释放及受体的亲和力。提示三七皂甙具有特异性阻断受体操纵Ca~(2 )通道的特性,对电位依赖性Ca~(2 )通道无作用。