论国家主体医疗卫生事业中医患关系的法律属性

国家主体医疗卫生事业中医患关系的法律属性问题是卫生法制建设的一个基本课题。本文认为,国家主体医疗卫生事业,是实际负责向全民提供医疗保障的部门。医患关系不具备民法调整的平等主体间的横向经济关系的三大特征,不是民事法律关系,而是行政法律关系。     

Antifibrosis effects of total glucosides of Danggui-Buxue-Tang in a rat model of bleomycin-induced pulmonary fibrosis

Aim of the study

The present study examined the antifibrosis effects of DBTG (total glucosides of Danggui-Buxue-Tang) on bleomycin-induced pulmonary injury and fibrosis in rats.

Materials and methods

Animals were randomly divided into six groups: (1) saline control group; (2) Bleomycin group in which rats were endotracheally instillated with bleomycin (5 mg/kg); (3-5) Bleomycin and DBTG group, in which DBTG were given to rats daily (16.32 or 64 mg/kg/day, i.g.) one day after bleomycin injection for 4 weeks until the end of the treatment; (6) Bleomycin and positive control group. Animals were sacrificed at 7, 14, and 28 days post bleomycin administration and lungs were removed. Lung specimens were stained with hematoxylin and eosin (HE) and Masson trichrome for histological evaluation of lung injury and fibrosis by light microscopy. Body weight and lung index from various groups were measured, as well as TNF-α, TGF-β1 and type I collagen concentrations in lung homogenates.

Results

DBTG reduced bleomycin-induced weight loss, decreased the lung index and histological evidence supported the ability of DBTG to attenuate bleomycin-induced lung fibrosis and consolidation. DBTG could partly dose-dependently decrease TNF-α and TGF-β1 activity, as well as it decrease type I collagen expression in lung tissues.

Conclusions

The findings of the present study provide evidence that DBTG may serve as a novel target for potential therapeutic treatment of lung fibrosis.     

Cytotoxic norsesquiterpene peroxides from the endophytic fungus Talaromyces flavus isolated from the mangrove plant Sonneratia apetala

Four new norsesquiterpene peroxides, named talaperoxides A-D (1-4), as well as one known analogue, steperoxide B (5, or merulin A), have been isolated from a mangrove endophytic fungus, Talaromyces flavus. Their structures were elucidated mainly by 1D and 2D NMR. Structures of 1, 2, and 5 were further confirmed by single-crystal X-ray diffraction, and their absolute configurations were also determined using copper radiation. Cytotoxic activities of compounds 1-5 were evaluated in vitro against human cancer cell lines MCF-7, MDA-MB-435, HepG2, HeLa, and PC-3. Compounds 2 and 4 showed cytotoxicity against the five human cancer cell lines with IC50 values between 0.70 and 2.78 μg/mL.     

电针治疗周围神经损伤的临床观察

目的观察针灸对促进周围神经再生的影响。方法采用电针治疗,并以西药口服对照。结果电针组的优良率为９２．８６％,西药组的优良率为５４．５５％,两组经ｘ２检验,差异有显著性意义（Ｐ＜０．０５）。结论说明电针组治疗神经损伤的疗效明显优于西药组     

基于聚类分析和主成分分析的叶下珠多酚部位HPLC指纹图谱研究

目的：建立基于聚类分析和主成分分析的不同产地叶下珠多酚部位高效液相色谱（HPLC）指纹图谱分析方法。方法：采用HPLC法测定9个不同产地叶下珠多酚部位指纹图谱,对其进行相似度分析、聚类分析和主成分分析,高效液相色谱-质谱（HPLC-MS）指认主要成分。结果：叶下珠多酚部位指纹图谱检出7个共有峰,指认了其中5个共有峰,9个不同产地叶下珠多酚部位相似度达到0.972-0.998,聚类分析和主成分分析从化学成分上说明了9批样品的相似性及差异性。结论：以指纹图谱数据为基础,将聚类分析与主成分分析结合起来进行识别,为叶下珠药材的资源利用提供依据。     

磷脂复合物对大鼠延缓衰老的作用

本文报告了磷脂复合物对９月龄ＳＤ大鼠血红细胞ＳＯＤ活力，心肌丙二醛（ＭＤＡ）含量及尾动脉容积脉搏图的影响，试验表明，基础饲料添加１０％磷脂复合物原粉或稀释粉均能使血红细胞ＳＯＤ活力显著增加，（Ｐ＜０．０１，Ｐ＜０．０５）。其中高剂量组心肌丙二醛含量显著降低（Ｐ＜０．０５），且容积脉搏图中降中峡相对深度显著增加（Ｐ＜０．０５）。结果提示，磷脂复合物有增加血红细胞ＳＯＤ活力，降低脂质过氧化和减少尾动脉外周阻力的作用。     

The comparative trial of TCu 380A IUD and progesterone-releasing vaginal ring used by lactating women

The objective of this paper was to compare the efficacy, acceptability, safety, and bleeding patterns of TCu 380A intrauterine device (IUD) and progesterone-releasing vaginal ring used by breastfeeding women. The study population included 97 breastfeeding women using IUD and 100 women using vaginal ring. Of the IUD users, no insertion failure, perforation, or accidental pregnancy occurred in 12 months. There was one IUD expulsion. There were no discontinuations of IUD due to medical reasons other than expulsion. The total discontinuation rate was 2.3%. In the ring group, no accidental pregnancy occurred. The major reasons for discontinuation were ring use-related problems and vaginal problems. The total discontinuation rate was 65.4% within 1 year. The frequency of any one complaint among the ring users was higher than that among the IUD users. There were no differences in the proportion of women having no sexual activity and in the weight of their babies between the two groups. Compared with the IUD users, the median number of bleeding/spotting (B/S) episodes and B/S days of the vaginal ring users were fewer; consequently, the mean length of B/S-free interval was longer in all four reference periods; the mean length of B/S episode and segment were the same; the occurrence of amenorrhea was more frequent; in contrast, the proportions of normal bleeding patterns were fewer. The frequencies of prolonged bleeding, frequent bleeding, and infrequent bleeding patterns did not differ between the two groups. The percentage of irregular bleeding was fewer only in the first two reference periods. It is concluded that the TCu 380A IUD and progesterone-releasing vaginal ring used by breastfeeding women are safe and effective. The higher discontinuation rate of the ring users was mainly because of use-related problems. Breastfeeding women with TCu 380A IUD had better tolerance and acceptability. The TCu 380A IUD does not, but the progesterone-releasing vaginal ring does, suppress the recovery of ovarian function. However, once return of menstruation occurred, there were no differences in bleeding patterns between the two contraceptive methods.     

Pharmacokinetics of medroxyprogesterone acetate after single and multiple injection of cyclofem® in Chinese women

To provide pharmacokinetic data for safety evaluation on prolonged treatment with Cyclofem®, which contains 25 mg medroxyprogesterone acetate (MPA) and 5 mg estradiol cypionate in 0.5 mL microcrystalline aqueous suspension, the pharmacokinetic profiles of MPA after single and multiple administration of this monthly injectable contraceptive were investigated in Chinese women. Nine healthy fertile women received Cyclofem based on a once-a-month regimen for up to 1 year. Blood samples were collected immediately prior to drug administration and on days 1, 3, 5, 7, 14, 21, and 28 after injection. After the 1st, 6th, and 12th injection, the maximum serum concentrations (C_max) of MPA were observed on days 3.4 ± 0.9, 4.3 ± 2.2, and 3.7 ± 2.6, respectively. C_max of serum MPA during the 1st, 6th, and 12th treatment cycles were 3.75 ± 1.27, 5.54 ± 1.79, and 5.55 ± 1.80 nmol/L, whereas the areas under the curve (AUC_{0–28 days}) were 55.84 ± 28.15, 95.45 ± 26.56, and 98.81 ± 21.84 nmol/L·day, respectively. There was significant interindividual variation in the pharmacokinetics of MPA after intramuscular injection of Cyclofem. No significant change was demonstrated in mean residence time (MRT) of MPA after single and multiple injection. There was a tendency of increase in C_max and AUC_{0–28 days} of MPA during the first 6 months of treatment, whereas no further enhancement was found between the 6th and 12th injection (p > 0.05). Peak levels of estradiol (E₂) observed in Cyclofem users were within the normal range of the preovulatory phase. Results of this long-term study suggest that no drug accumulation occurred after repeated administration of Cyclofem in the Chinese women.     

93例儿童血脂谱水平与ApoB基因多态性关系的研究

目的观察儿童血脂谱水平与载脂蛋白Ｂ（ＡｐｏＢ）基因变异的关系。方法对９３名８～１１岁汉族儿童进行了ＡｐｏＢ基因ＸｂａⅠ位点多态性基因型频率及基因型与血脂谱水平关系的研究。结果此人群中ＸｂａⅠ位点优势等位基因Ｘ－频率为０．９６７，少见等位基因Ｘ＋频率为０．０３３；Ｘ－Ｘ＋基因型者（此人群中无Ｘ＋Ｘ＋者）血浆总胆固醇、低密度脂蛋白－胆固醇（ＬＤＬ－ｃｈ）水平均值（４．５９和２．９８ｍｍｏｌ／Ｌ）显著高于Ｘ－Ｘ－基因型者（３．８４和２．３２ｍｍｏｌ／Ｌ），全部６例Ｘ－Ｘ＋者中的４例，其总胆固醇和／或ＬＤＬ－ｃｈ测定值分别超过了Ｐ９０，显示了Ｘ＋等位基因与高血浆胆固醇水平的联系。结论ＡｐｏＢ基因ＸｂａⅠ位点多态性与儿童血脂谱水平有一定程度的关联，有可能是儿童血脂谱水平异常的遗传标志之一。     

努力创建现代继续护理教育管理模式

邵逸夫医院自1994年起在美国护理专家的帮助和指导下,借鉴90年代美国继续护理教育管理模式,创建了一套中西方结合的继续护理教育管理模式。经过三年的实践和中西双方管理者的共同努力,取得了一定的成效。文中从继续护理教育的组织、管理、效果观察等方面进行了阐述。