信息化管理系统在门诊尪痹片中的用药评价

目的：介绍信息化管理系统嵌入扶正祛湿剂的相关信息，利用智能化知识库为门诊医师开具处方提供在线用药服务。方法：通过信息技术数字化采集尪痹片的用药知识。收集2019年7月1日至2021年6月30日尪痹片在门诊的不同年龄段患者用药情况，结合文献分析评价用药的合理性。结果：门诊453例使用尪痹片患者中，男148例，女305例；年龄26～98岁，平均年龄(67.91±10.52)岁，以50～89岁患者为主[96.91%(439/453)],70～79岁居第一[32.23%(146/453)]。单一诊断378例[83.44%(378/453)],涉及疾病42种，排前3位的依次为关节炎92例、骨关节炎39例、膝关节退行性病变32例。所有患者的用药剂量符合药品说明书规定的每天剂量。结论：借助信息化管理平台，利用互联网技术形成融合基层用药特色的智能化知识库系统，为患者提供个体化服务，有助于合理使用门诊尪痹片，印证了该药学服务模式可供社区医院药师探索和借鉴。     

Role and mechanism of NR1D1 in proliferation and migration of vascular adventitial fibroblasts北大核心CSCD

Aim To explore the role and mechanism of nuclear receptor subfamily 1,group D,member 1(NR1D1)in the proliferation and migration of mouse adventitial fibroblasts(AFs). Methods Primary AFs isolated from C57BL/6J mice were cultured. Adenovirus carrying Nr1d1 gene was used to overexpress NR1D1 in AFs. The expression of β-catenin was restored by SKL2001. Proliferating cell nuclear antigen(Ki-67)immunofluorescence staining and CCK-8 staining were used to determine cell proliferation,and scratch test was used to determine cell migration. qPCR was used to determine the mRNA level of Nr1d1. Western blot was used to determine the protein levels of NR1D1 and β-catenin. To investigate the role of NR1D1 in intimal hyperplasia,20 male wild type C57BL/6J mice were randomly divided into sham group,carotid artery endothelial injury,sham+SR9009(NR1D1 agonist)group and carotid artery endothelial injury+SR9009(n=5 in each group). They were treated with DMSO or SR9009(100 mg·kg-1·d-1)via intraperitoneal injection for 14 days after operation,respectively. The degree of carotid intimal hyperplasia was measured by HE staining 28 days after operation. Results NR1D1 overexpression significantly reduced the percentage of Ki-67-positive cells(P<0.01),total cell number(P<0.01)and slowed down the rate of wound-healing(P<0.01). NR1D1 overexpression significantly inhibited the expression of β-catenin(P<0.05). After the expression of β-catenin was restored by SKL2001,the inhibitory effects of NR1D1 overexpression on the proliferation and migration of AFs were abolished(P<0.01). Enhanced activity of NR1D1 significantly ameliorated intimal hyperplasia after carotid endothelial injury(P<0.01). Conclusion NR1D1 may inhibit the proliferation and migration of AFs via suppressing the expression of β-catenin. © 2023 Publication Centre of Anhui Medical University. All rights reserved.     

上海市闵行区不同级别医院口服降糖药的应用分析

目的:分析上海市闵行区不同级别医院口服降糖药用药特点,为临床合理用药提供参考。方法:采用回顾性分析方法,对区内16家医院2015年12月—2016年11月口服降糖药用药金额、用药频度(DDDs)及日均费用(DDC)等指标进行统计分析。结果:2015年12月—2016年11月本区口服降糖药购药总金额6 751.05万元,其中一级医院占76.89%,阿卡波糖在一、二、三级医院分别排名第1。一级医院有5个品种购药金额在300~800万元之间,格列吡嗪控释片排名第2。瑞格列奈购药金额在二、三级医院排名第2。一级医院二甲双胍用药频度最高为834.02万日。DDC最高为阿卡波糖在一、二、三级医院分别排名第1,沙格列汀在二、三级医院排名第2。一、二、三级医院用药一致性为28.13%。结论:我区糖尿病患者主要在社区配药,医生和患者更趋向选择基本药物,价格合理,一、二级医院用药品规更接近。     

程丑夫从气机升降论治高血压病经验

总结程丑夫教授基于气机升降理论辨治高血压病的临证经验。认为高血压病属于中医学“眩晕”范畴，其病机或为脾胃虚弱，致脾胃升降失常，清阳不升而致眩；或为肝升太过，肺降不及，肝阳上亢而致眩；或为肾水不足，心肾不交，心火独亢上攻脑窍而致眩。治疗强调一身之气需升中有降、降中有升，具体组方从调畅脾胃或平肝降肺或交通心肾入手，基于调整脾胃、肝肺、心肾的整体气机达到周身气机升降平衡以治疗眩晕的目的。