芡实的化学成分、药理作用及临床应用研究进展

芡实主要含有甾醇类、黄酮类、环肽类、脂类等成分。具有抗氧化、延缓衰老、抗疲劳、抗心肌缺血、抗癌等药理作用。临床上在肾脏疾病、乳糜血尿、慢性肠炎等病的治疗中具有显著效果。文章就近年来国内外对芡实的化学成分、药理作用和临床应用的研究进展作了综述,为芡实的进一步开发利用提供参考。     

针刺治疗血管性认知障碍的系统评价再评价

目的:对针刺治疗血管性认知障碍的系统评价(SR)进行方法学质量、报告质量和证据质量等级的再评价。方法:计算机检索PubMed、Cochrane Library、EMbase、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(SinoMed)、万方数据库(Wanfang)、维普数据库(VIP)收录的中英文公开发表的针刺治疗血管性认知障碍的SR,检索时限均为建库至2020年9月24日。采用PRISMA声明、AMSTAR 2工具和GRADE分级系统分别评价所纳入SR的报告质量、方法学质量和证据质量。结果:最终纳入22篇SR,包含102个结局指标。方法学质量整体偏低,得分较差的条目为条目2、5、7、10、14、15、16。22篇SR的报告质量较好,得分在19～24.5分,报告质量问题主要体现在结构式摘要、方案与注册、其他分析及资金支持方面。SR结局指标的等级大部分为低或极低,导致降级的最主要因素为局限性,其次为不一致性和不精确性。结论:针刺治疗血管性认知障碍有低质量循证医学证据支持,但相关系统评价的方法学质量及证据质量较差,规范性仍有待提高。     

野灯心草地上部分菲类成分及其抗焦虑作用研究

运用正相硅胶、Sephadex LH-20、聚酰胺、制备型HPLC等多种色谱方法从野灯心草地上部分分离纯化得到10个菲类化合物和4个其他类化合物。经质谱、NMR谱图解析鉴定结构,分别为厄弗酚(1)、灯心草酚(2)、juncuenin D(3)、去氢厄弗酚(4)、去氢灯心草酚(5)、juncuenin B(6)、dehydrojuncuenin B(7)、2-甲氧基-7-羟基-1-甲基-5-乙烯基菲(8)、2-羟基-7-羧基-1-甲基-5-乙烯基-9,10-二氢菲(9)、2-羟基-7-羧基-1-甲基-5-乙烯基菲(10)、木犀草素(11),香草酸(12)、瑞香素(13)、对香豆酸(14)。其中,化合物13为首次从该属植物中分离得到,化合物5,8~12为首次从该植物中分离得到。采用小鼠高架十字迷宫实验评价菲类化合物6和7的抗焦虑活性,结果表明化合物6和7均具有抗焦虑作用。     

基于“调枢通胃”的脑卒中后便秘针灸治疗

便秘是脑卒中常见并发症之一,并与脑卒中相互影响,形成恶性循环。"调枢通胃"是通过调节脏腑之枢脾胃、开阖之枢少阳和神明之枢脑治疗脾胃功能失调及其他脏腑失调所引发的消化系统疾病。本文介绍基于"调枢通胃",以理气通腑、醒神益智、益气健脾为基本治法,取胃经、大肠经及腹部腧穴,采用针灸治疗脑卒中后便秘的新思路。     

披针叶黄华种子中金雀花碱的定性和定量分析

目的应用HPLC和TLC建立披针叶黄华种子中金雀花碱的定量和定性分析方法。方法采用超声提取的方法获得样品,分别采用TLC和HPLC对披针叶黄华种子中的金雀花碱进行定性鉴别和定量测定。结果 TLC采用碱性硅胶为固定相,以苯-丙酮-醋酸乙酯-甲醇(4∶2∶1∶1)为展开剂,可清晰检出金雀花碱斑点;HPLC分析中,金雀花碱在0.04～1.2 mg/mL与峰面积呈良好的线性关系。结论本方法样品处理快速简便,定性与定量分析分离效果好,准确、快速、干扰少,可用于披针叶黄华种子原料和金雀花碱产品的质量控制。     

针刺治疗慢性功能性便秘的临床观察

目的:观察针刺对功能性便秘的疗效,并探讨其作用机理.方法:选择功能性便秘患者40例,随机分成治疗组及对照组各20例,治疗组每日针刺1次,每次15～20min,5天为1疗程,隔两天继续第2个疗程,共3个疗程;对照组以西沙比利片10mg,每天3次,餐前半小时服用,连续4周.观察两组治疗前后大便次数,大便性状,排便困难程度以及结肠通过时间的变化.结果:两组治疗后各观察指标较治疗前有明显改善(P＜0.01),两组治疗后比较差异无显著性(P＞0.05).结论:针刺能够改善功能性便秘的结肠动力,对功能性便秘疗效确切.     

超滤膜分离地龙匀浆液中蛋白物质的操作条件优化研究

目的:重点在于摸索超滤膜分离地龙匀浆液中蛋白物质的最佳操作条件。方法:以新鲜红地龙的匀浆液为分离对象,以10万膜分离过程为目标过程,以膜通量为指标,来优化压力、温度、表面转速、料液浓度等操作条件。结果:(1)最佳操作条件为:0.25MPa,30°C,200r/min,pH=6.7,地龙浓度为33.3%(w:w),氯化钠的加入量为0。(2)红地龙匀浆液中蛋白物质分子量主要分布在5万~10万。结论:所得实验结果为中试或工业生产提供理论基础和数据支持。     

基于文本挖掘的流行性乙型脑炎用药规律研究

目的利用文本挖掘技术探索流行性乙型脑炎(简称“乙脑”)临床用药规律。方法检索中国生物医学文献数据库,收集有关乙脑文献数据,采用基于敏感关键词频数统计的数据分层算法,挖掘乙脑中药、中成药、西药及西药与中成药联合应用规律,并利用Cytoscape 2.8软件进行可视化展示。结果中药以生地黄、板蓝根、大青叶、生石膏、黄芩等清热解毒药最为常用;中成药以安宫牛黄丸、清开灵注射液等应用为多;西药以干扰素、利巴韦林等抗病毒药为基础,常常与其他抗病毒药、脑细胞营养药、激素类等药联合应用,这些西药也经常与安宫牛黄丸、清开灵等中成药联合应用。结论文本挖掘能够比较客观地总结疾病用药规律,为临床应用提供参考。     

信息-动机-行为技巧模式结合爱立敷泡沫敷料对下肢手术后患者压力性损伤发生率及健康行为的影响

目的 探讨信息-动机-行为技巧模式结合爱立敷泡沫敷料对下肢手术后患者压力性损伤发生率及健康行为的影响。方法 选取2018年12月至2020年12月收治的66例下肢手术患者为研究对象,以抽签法将其随机分为对照组和观察组,各33例。对照组采取常规护理干预,观察组在常规护理基础上同时展开信息-动机-行为技巧模式结合爱立敷泡沫敷料干预。比较两组的干预效果。结果 观察组的压力性损伤、感染发生率均低于对照组,差异具有统计学意义（P<0.05）;两组的下肢深静脉血栓发生率比较,差异无统计学意义（P>0.05）。干预前,两组的身体活动、营养、用药、SER、ESCA评分比较,差异无统计学意义（P>0.05）;干预后,两组的身体活动、营养、用药、SER、ESCA评分均较干预前升高,且观察组高于对照组,差异具有统计学意义（P<0.05）。结论 信息-动机-行为技巧模式结合爱立敷泡沫敷料干预应用于下肢手术后患者中,有助于降低压力性损伤、感染发生率,促进其健康行为养成,提高其自我效能感和自我护理能力。     

孕妇血浆中sCD40及其配体与子痫前期发病及肾功能损害的关系

目的 探讨孕妇血浆中可溶性白细胞分化抗原(sCD40)和sCD40配体(sCD40L)水平变化与子痫前期发病及肾功能损害的关系.方法 选择2008年8月-2010年6月在青岛大学医学院附属医院产科分娩的轻度子痫前期孕妇28例(轻度子痫前期组),重度子痫前期孕妇35例(重度子痫前期组);另选同期妊娠结局良好的健康孕妇30例为对照组.比较3组孕妇分娩孕周及血压变化、血小板计数并检测其血常规、C反应蛋白(CRP)、尿常规、24h尿蛋白定量,以及血清尿酸(UA)、肌酐(Cr)、尿素氮(BUN)等生化指标.采用ELISA法检测3组孕妇血浆中sCD40和sCD40L的水平,并对血浆sCD40和sCD40L的水平与各临床指标的相关性进行分析.结果 (1)血常规及l临床指标:重度子痫前期组和轻度子痫前期组孕妇血浆CRP水平(分别为10.8及7.1 mg/L)均明显高于对照组(3.3 mg/L),前后两者分别比较,差异均有统计学意义(P＜0.05);重度子痫前期组高于轻度子痫前期组,两组比较,差异也有统计学意义(P＜0.05).重度子痫前期组孕妇分娩孕周(32.5周)明显低于轻度子痫前期组(37.2周)和对照组(38.6周),分别与对照组比较,差异均有统计学意义(P＜0.01);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).重度子痫前期组孕妇血小板计数(132×109/L)明显低于轻度子痫前期组(212×109/L)和对照组(216×109/L),分别比较,差异有统计学意义(P＜0.01);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).3组孕妇之间血红蛋白水平及白细胞数分别比较,差异均无统计学意义(P＞0.05).(2)血浆sCD40及sCD40L水平:重度子痫前期组、轻度子痫前期组和对照组孕妇血浆sCD40水平分别为133.6、126.5和90.7 ng/L,sCD40L水平分别为12.5、10.4和4.4 ng/L,24h尿蛋白定量分别为4.5、0.8 g和0,UA水平分别为486、289和162 μmol/L,重度子痫前期组以上各指标均明显高于轻度子痫前期组和对照组,差异均有统计学意义(P＜0.01);轻度子痫前期组也明显高于对照组,差异也有统计学意义(P＜0.01).重度子痫前期组孕妇血浆Cr(89 μmol/L)、BUN(5.32 mmol/L)水平高于轻度子痫前期组(分别为66μmol/L及4.49mmol/L)和对照组(分别为57 μmol/L及3.32 mmol/L),分别比较,差异均有统计学意义(P＜0.05);轻度子痫前期组与对照组比较,差异无统计学意义(P＞0.05).(3)相关性分析:轻、重度子痫前期组孕妇血浆sCD40水平与24 h尿蛋白定量呈正相关(r=0.434,P＜0.05),与UA、CRP呈明显正相关(r=0.536、0.528,P＜0.01),与收缩压、舒张压、分娩孕周、Cr、BUN、血小板计数无明显相关(r分别为0.135、0.183、-0.133、0.190、0.167、-0.221,P均＞0.05).轻、重度子痫前期组孕妇血浆sCD40L水平与24 h尿蛋白定量、UA、CRP均呈明显正相关(r分别为0.591、0.445、0.539,P均＜0.01),与收缩压、舒张压、分娩孕周、Cr、BUN、血小板计数无明显相关(r分别为0.178、0.212、-0.292、0.144、0.135、-0.273,P均＞0.05).轻、重度子痫前期组孕妇血浆sCD40L水平与sCD40呈明显正相关(r均为0.707,P＜0.01).对照组孕妇血浆sCD40、sCD40L水平与各项临床指标均无相关性(P＞0.05).结论 子痫前期孕妇血浆中sCD40和sCD40L水平明显升高,可能参与了子痫前期的发病,并导致肾功能损害.sCD40和sCD40L水平变化也与子痫前期的严重程度相关.

Abstract：

Objective To investigate the variance levels of plasma soluble leukocyte differentiation antigens CD40 (sCD40) and soluble CD40 ligand (sCD40L) in preeclamptic patients with renal damage and its relationship. Methods A total of 63 pregnant women attended the Department of Obstetrics, Affiliated Hospital of Qingdao University Medical College between August 2008 and June 2010. In the present study included 28 pregnant women with mild preeclampsia and 35 patients with severe preeclampsia. Thirty matched normotensive pregnant women were enrolled in the study as the control group. Expression of sCD40 and sCD40L were determined by ELISA. At the same time, the blood routine, C reaction protein ( CRP),urine routine, 24 hours urine protein excretion, and serum uric acid (UA), creatinine (Cr), blood urea nitrogen (BUN) were measured. The correlation analysis was performed between the sCD40/sCD40L and the blood biochemical indexes in 3 groups. Results ( 1 ) The median levels of CRP in severe preeclampsia (10. 8 mg/L)and mild preeclampsia group(7. I mg/L)are significantly higher than that of control group (3. 3 mg/L,P ＜ 0. 05 ); The level of CRP in severe preeclampsia group was also higher than that of mild preeclampsia group ( P ＜ 0. 05 ). The median gestational age at delivery in severe preeclampsia ( 32. 5 weeks)was significantly less than that of mild preeclampsia group ( 37. 2 weeks) and normal group ( 38. 6 weeks,P ＜ 0. 05). However no significant differences were observed between mild preeclampsia group and normal group ( P ＞0. 05 ). The platelet count in severe preeclampsia ( 132 × 109/L) was significantly less than those of mild preeclampsia group (212 × 109/L) and normal group ( 216 × 109/L, P ＜ 0. 01 ), but no significant differences were observed in blood platelet amount between mild preeclampsia group and normal group ( P ＞0. 05 ). There was no significant difference in hemoglobin level and white blood cell in three groups ( P ＞0. 05). (2) The sCD40 plasma concentration in severe, mild preeclampsia and normal group was 133.6,126. 5 and 90. 7 ng/L, respectively. The sCD40 L plasma concentrations were 12. 5, 10. 4 and 4. 4 ng/L respectively in the 3 groups. 24 hours urinary protein quantitative was 4. 5 g/d,0. 8 g/d and 0 in the 3 groups respectively. And the UA level was 486 μ mol/L,289 μmol/L and 162 μmol/L. In the above three groups,the monitoring indicators were significantly higher in women with severe preeclampsia group compared with mild preeclampsia and control groups (P ＜ 0. 01 ), and there were also higher in mild preeclampsia group than that in control groups ( P ＜ 0. 01 ). The level of plasma Cr ( 89 μmol/L) and BUN ( 5. 32 mmol/L) in severe preeclampsia group were higher than those of mild preeclampsia group (66 μmol/L and 4. 49mmol/L) and control group ( 57 μmol/L and 3.32 mmol/L, P ＜ 0. 05 ). There was no significant difference between mild preeclampsia group and normal group (P ＞ 0. 05 ). (3) The correlation analysis indicated that the level of sCD40 has a positive correlation with 24 hours urinary protein quantitative( r = 0. 434, P ＜ 0. 05 ),also significant positive correlation( r =0. 536,0. 528 ,P ＜ 0. 01 ) between the level of sCD40 and UA or CRP in women with preeclampsia. There was no significant correlation between the level of sCD40 and systolic blood pressure, diastolic blood pressure, delivery gestational age, Cr, BUN, and platelet count(r =0. 135,0. 183, -0. 133,0. 190,0. 167, -0. 221 ,all P ＞0. 05 ). There were positive correlation between the level of sCD40L and 24 hours urine protein excretion, either UA or CRP( r =0. 591,0. 445,0. 539 ,all P ＜0. 01 ). No significant correlation was found between sCD40 L and systolic blood pressure, diastolic blood pressure,delivery gestational age, Cr, BUN, and platelet count( r =0. 178,0. 212, -0. 292,0. 144,0. 135, -0. 273,all P ＞0. 05). There was significant positive correlation between plasma sCD40 and sCD40L ( r =0. 707 ,P ＜0. 01 ). There was no relationship between the level of sCD40, sCD40L and the blood biochemical indexes in normotensive pregnant women ( P ＞ 0. 05 ). Conclusions The plasma concentrations of sCD40 and sCD40 L are significantly higher in pregnant women with preeclampsia compared with the control, which may be involved in the development of preeclampsia and contribute to the kidney damage. The variance levels of sCD40 and sCD40L may be also related to the severity of preeclampsia.