无创血流动力学与热稀释法在急性有机磷农药中毒治疗中精准度与容错率的比对研究

目的对比无创血流动力学(NIH)与热稀释法血流动力学(TDH)监测急性有机磷农药中毒(AOPP)治疗过程中的精准度与容错率,为临床选择更优监测技术提供参考。方法选取本院收治的100例AOPP患者作为研究对象,随机将其分为两组,常规观察联合无创血流动力学(NIH)组,常规观察联合热稀释法血流动力学(TDH)组。比较两组患者的中毒程度打分、住院天数、昏迷复醒时长、并发症率、治愈率等各项指标。结果NIH组相较TDH组的治愈率有显著提高,且在NIH监测过程中,波动性较小,说明NIH方法具有更好的精准度与稳定性;而在TDH组中,少部分患者出现因为创伤导致的并发症。结论针对AOPP患者,采用常规观察联合无创血流动力学作为监测系统,在稳定性与结果一致性上比常规观察联合热稀释法血流动力学更为有效,能对各项治疗药物的应用起到更优的指导作用,进而有效地进行个性化治疗,提高治疗效果。     

系统使用多黏菌素B引起色素沉着4例

例1 　男,31岁,2019年11月3日因脑外伤后意识障碍至福建医科大学附属第一医院就诊,住院期间患者持续发热、昏迷。11月11日脑脊液培养示肺炎克雷伯菌阳性,药敏试验示多黏菌素、米诺环素、替加环素敏感。诊断为脑室炎及肺炎。予静脉注射硫酸多黏菌素B 50 mg/d、脑室内注射5 mg/d,用药后全身皮肤黏膜色素沉着并逐...     

HPLC波长切换法同时测定穴位敷贴方3种成分的含量

目的:建立高效液相色谱(HPLC)波长切换法同时测定穴位敷贴方中芥子碱硫氰酸盐、6-姜辣素、细辛脂素含量。方法:采用HPLC法检测穴位敷贴方中芥子碱硫氰酸盐、6-姜辣素、细辛脂素含量,并进行方法学考察。选用Agilent ZORBAX Extend-C_(18)色谱柱(4.6 mm×250 mm,5μm),以乙腈-0.1%磷酸水溶液(三乙胺调节pH 7.0)为流动相进行梯度洗脱,柱温40℃,流速1.0 ml/min,紫外检测器0～17 min检测波长为326 nm,17～50 min切换波长为280 nm,进样量10μl。结果:芥子碱硫氰酸盐在2.789～178.5μg/ml、6-姜辣素在2.508～160.5μg/ml、细辛脂素在1.134～72.60μg/ml范围内线性关系良好;重复性实验,芥子碱硫氰酸盐、6-姜辣素、细辛脂素的RSD分别为1.20%、1.02%、0.69%;精密度实验,三者的RSD分别为0.50%、0.93%、0.90%;稳定性实验,三者的RSD分别为1.23%、1.05%、1.26%;三者的平均加样回收率分别为100.63%、98.44%、98.87%,RSD分别为2.00%、1.20%、1.10%,均符合测定要求。测得不同配比的组方中3种成分的含量存在明显差异。结论:该方法精密度高,重复性和稳定性好,可用于穴位敷贴方中以上成分的含量测定。     

Study on the correlation between the concentration of plasma lipoprotein-associated phospholipase A2 and coronary heart disease

ObjectiveThis study explores the correlation between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) and coronary heart disease (CHD) by comparing the level of plasma Lp-PLA2 in the plasma of patients with different types of CHD.MethodsBlood samples were collected from 56 patients diagnosed with CHD by the Department of Cardiology of the First People''s Hospital of Foshan and 34 healthy subjects from February 2013 to January 2014. We measured the concentration of plasma Lp-PLA2 and determined the levels of total cholesterol (Tch), triglyceride (TG), apolipoprotein A1 (Apo-A1), apolipoprotein B (Apo-B), high density lipoprotein-cholesterol (HDL-c), low density lipoprotein-cholesterol (LDL-c), lipoprotein a (Lp(a)), glucose (Glu), and high-sensitivity C-reactive protein (hs-CRP). The concentration of plasma Lp-PLA2 in the healthy control group and each subgroup of CHD patients were compared and analyzed for correlations of plasma Lp-PLA2 between the patients in different CHD subgroups and several laboratory indicators.ResultsThe concentration of plasma Lp-PLA2 in each subgroup of CHD was significantly higher than in the control group (P < 0.05). The concentration of Lp-PLA2 in the unstable angina pectoris (UAP) group and acute myocardial infarction (AMI) group were significantly higher than in the stable angina pectoris (SAP) group (P < 0.05), and the concentration of plasma Lp-PLA2 in the AMI group was significantly higher than in the UAP group (P < 0.05). The concentration of plasma Lp-PLA2 in the CHD group merely showed a positive correlation (r = 0.493, P < 0.05) with the hs-CRP group, but the levels of Tch, TG, Apo-A1, Apo-B, HDL-c, LDL-c, Lp(a) and Glu did not.ConclusionsThe concentration of plasma Lp-PLA2 in patients with CHD was higher than that in the control group. The concentration of plasma Lp-PLA2 in the subgroups of CHD patients varied greatly from each other. The inflammatory response of atherosclerosis might be resulted from the synergy of plasma Lp-PLA2 and hs-CRP.     

宁夏西吉县人体两种肝包虫病调查的初步报告

采用梯度筛选后B超检查,对西吉县农民、城镇人员患肝泡球蚴病(LAE)和肝棘球蚴病(LCECE)的情况进行调查。共检查2 389人,检出肝包虫病患者197例,患病率为8.2％,其中LAE 141例,占5.9％;LCR 56例,占2.3％。农民LAE和LCE患病率分别为9.7％和3.8％。城镇的分别为0.4％和0.2％。农民患病率高。LAE与猎狐、捕捉达乌尔黄鼠有密切关系。家犬是LCE的传染源。     

Allogeneic hematopoietic cell transplantation for metastatic breast cancer

We reviewed 66 women with poor-risk metastatic breast cancer from 15 centers to describe the efficacy of allogeneic hematopoietic cell transplantation (HCT). Median follow-up for survivors was 40 months (range, 3-64). A total of 39 patients (59%) received myeloablative and 27 (41%) reduced-intensity conditioning (RIC) regimens. More patients in the RIC group had poor pretransplant performance status (63 vs 26%, P=0.002). RIC group developed less chronic GVHD (8 vs 36% at 1 year, P=0.003). Treatment-related mortality rates were lower with RIC (7 vs 29% at 100 days, P=0.03). A total of 9 of 33 patients (27%) who underwent immune manipulation for persistent or progressive disease had disease control, suggesting a graft-vs-tumor (GVT) effect. Progression-free survival (PFS) at 1 year was 23% with myeloablative conditioning and 8% with RIC (P=0.09). Women who developed acute GVHD after an RIC regimen had lower risks of relapse or progression than those who did not (relative risk, 3.05: P=0.03), consistent with a GVT effect, but this did not affect PFS. These findings support the need for preclinical and clinical studies that facilitate targeted adoptive immunotherapy for breast cancer to explore the benefit of a GVT effect in breast cancer.     

心身疾病“刚柔辨证”四种常见证型焦虑抑郁状态的特征研究

目的探究心身疾病"刚柔辨证"四种常见证型心肝火旺证、心肝阴虚证、肝郁气滞证和肝郁脾虚证焦虑和抑郁状态的特征。方法以"证病结合""以方测证"为研究方法,把经显效方剂对应治疗2~8周后,疗效为显效和临床痊愈的"刚柔辨证"主证为心肝火旺、心肝阴虚、肝郁气滞、肝郁脾虚证的患者治疗前Zung氏焦虑自评量表(Self-Rating Anxiety Scale,SAS)和抑郁自评量表(Self-Rating Depression Scale,SDS)进行对照分析。共纳入100例患者,其中心肝火旺证20例,心肝阴虚证32例,肝郁气滞证27例和肝郁脾虚证21例。结果焦虑程度以心肝火旺证最为突出,与肝郁气滞证、肝郁脾虚证比较,差异有统计学意义(P<0.008);在抑郁程度方面,心肝阴虚证较其他3个证型低,差异有统计学意义(P<0.05)。结论四种证型患者心理状态特征存在差异,可能与性格因素、体质因素、病程因素、负性生活事件等相关。     

骆驼蓬生物碱乳膏剂的质量标准研究

摘 要 目的： 初步建立骆驼蓬生物碱乳膏剂的质量控制方法。方法: 按照《中国药典》2010年版一部附录有关制剂通则要求,对制剂进行一般质量检查。以去氢骆驼蓬碱和骆驼蓬碱为指标,采用薄层色谱法对乳膏剂进行薄层色谱鉴别。以去氢骆驼蓬碱、骆驼蓬碱、鸭嘴花碱为指标,采用高效液相色谱法对制剂进行含量测定。结果: 检查项目均符合《中国药典》要求。薄层色谱中供试品在与对照品相同位置上显相同颜色斑点。去氢骆驼蓬碱、骆驼蓬碱和鸭嘴花碱分别在3.440～110.000 μg·ml^-1、3.340～107.000 μg·ml^-1和1.380～22.000 μg·ml^-1浓度范围内线性关系良好,平均回收率分别为98.1% (RSD=1.75%, n=6)、99.8% (RSD=1.78%,n=6)和99.3% (RSD=1.95%,n=6)。结论:所建立的质量控制方法符合方法学要求,为最终制定骆驼蓬生物碱乳膏剂质量标准奠定了试验基础。