银杏达莫注射液治疗早期糖尿病肾病临床观察

目的观察银杏达莫注射液对早期糖尿病肾病患者的血糖、尿蛋白、血流变及氧化应激等的影响。方法将尿微量蛋白排泄率30~300m g/24h的糖尿病患者60例随机分为两组,对照组28例,进行常规降血糖、控制血压、调脂等治疗;治疗组32例,在对照组治疗基础上静脉滴注银杏达莫注射液2周。比较两组治疗前后血糖、肾功能、24h尿微量蛋白排泄率、血流变、超氧化物歧化酶、丙二醛及一氧化氮水平等变化。结果治疗组治疗后24h尿微量蛋白排泄率、血流变明显改善,超氧化物歧化酶、一氧化氮水平明显升高,丙二醛水平明显降低;而对照组无明显变化。两组比较,差异有显著性意义(P<0.01)。结论银杏达莫注射液通过扩血管、抗血栓、抗自由基损伤、改善微循环等作用对糖尿病肾病产生一定的保护作用。     

卵胞浆内单精子显微注射技术治疗男性不育127个周期的研究

目的常规体外受精与胚胎移植辅助生殖技术在治疗男性少、弱、畸精症和无精症时,常因受精障碍而失败。本研究对采用卵胞浆内单精子显微注射技术治疗男性不育的临床效果进行分析。方法采用常规超排卵方案,在B超引导下经阴道取卵,取新鲜精液或附睾睾丸取精,对MⅡ期成熟卵进行单精子显微注射。结果127个周期取1142个MⅡ期成熟卵进行单精子显微注射,受精率为75％,卵裂率为96％,临床妊娠率33％。结论卵胞浆内单精子显微注射技术是治疗男性不育的有效方法。     

间断冷含血停跳液在心脏瓣膜置换术中的心肌保护作用

目的评价间断冷含血停跳液在心脏瓣膜置换术中心肌保护的临床效果。方法54例心瓣膜置换术的患者,均使用按4:1比例灌注冷含血停跳液,观察体外循环时间、主动脉阻断时间、自动复跳率、住院死亡率。结果体外循环时间47～218mins,阻断主动脉时间26～102mins,心脏自动复跳43例,占80%,住院死亡2例,死亡率3.7%。结论间断冷含血停跳液在心瓣膜置换术中有良好的心肌保护作用。     

Association of admission blood glucose level and clinical outcomes in elderly community‐acquired pneumonia patients with or without diabetes

IntroductionCommunity‐acquired pneumonia (CAP) is the major cause of infection‐related mortality worldwide. Patients with CAP frequently present with admission hyperglycemia.ObjectivesThe aim of this study was to evaluate the association between admission blood glucose (ABG) level and clinical outcomes in elderly CAP patients (≥80 years of age) with or without diabetes.MethodsIn this single center retrospective study, 290 elderly patients diagnosed with CAP were included. Demographic and clinical information were collected and compared. The associations between admission blood glucose level and the 30‐day mortality as well as intensive care unit (ICU) admission and invasive mechanical ventilation (IMV) in elderly CAP patients with or without diabetes were assessed.ResultsOf the 290 eligible patients with CAP, 159 (66.5%) patients were male, and 64 (22.1%) had a known history of diabetes at hospital admission. After adjusting for age and sex, the logistic regression analysis had identified several risk factors that might be associated with clinical outcomes in elderly patients with CAP. Multivariable logistic regression analysis revealed that admission glucose level > 11.1 mmol/L was significant associated with ICU admission, IMV, and 30‐day mortality both in non‐diabetic and diabetic patients. Furthermore, Kaplan–Meier analysis indicated that patients with higher admission glucose level were correlated statistically significantly with 30‐day mortality in patients with CAP (P < 0.001).ConclusionAdmission blood glucose is correlated with 30‐day hospital mortality, ICU admission, and IMV of CAP in elderly patients with and without diabetes. Specially, admission glucose > 11.1 mmol/L was a significant risk factor for 30‐day hospital mortality.     

Rapid and sensitive HPLC-MS/MS method for quantitative determination of isochlorogenic acid B in rat plasma and its application in pharmacokinetic study

Asensitive LC-ESI-MS/MS method for determination of isochlorogenic acid B in rat plasma was developed and validated in the present study. Plasma samples were prepared by a simple protein precipitation with methanol containing resveratrol as internal standard (IS). The chromatographic separation was performed on a Zorbax SB-C₁₈ column (3.5 μm, 2.1 mm×100 mm, Agilent, USA) at a flow rate of 0.2 mL/min using methanol/water containing 0.1% formic acid (v/v) as mobile phase. The detectionwas performed on a triple quadrupole tandem mass spectrometer equipped with Electronic Spray Ion by selected reaction monitoring (SRM) of the transitions at m/z 515.3→352.9 for isochlorogenic acid B and m/z 227.1→143.1 for IS, respectively. The calibration curve of the method was linear over the range of 5–2500 ng/mL (r² = 0.9982). The intra- and inter-day precisions (R.S.D.%) were less than 12.46%, and the accuracy (R.E.%) was within ±5.80%. Isochlorogenic acid B was sufficiently stable under all relevant analytical conditions. The validated method was successfully applied to the plasma pharmacokinetic studies of isochlorogenic acid B in rats. It was found that isochlorogenic acid B had non-linear pharmacokinetic characteristics in rats within the dosage ranges from 5 to 20 mg/kg.     

白首乌化学成分的研究

自白首乌主要品种耳叶牛皮消(Cynanchum auriculatum Royle ex Wight)根中首次分得三个已知甾体酯型甙元:告达亭(caudatin),开德甙元(kidjolanin),萝藦甙元(Metaplexigenin)和一种新的二苯酮衍生物(Ⅳ),经光谱分析推定其结构为2,6,2′,5′-四羟基,3-乙酰基,6′-甲基二苯酮,命名白首乌二苯酮。     

“证”是论治依据,“和”是疗效标准

针对把症状当论治目标,把症状的增减变化当中医的疗效标准等西化中医的论调,作者根据经典理论和临床实际,提出以生命联系为客观,个体存在为真实,证候病机为目标,＂形与神俱,尽终其天年＂为最终目的,三因制宜、与时俱进地进行辨证论治的基本论点。     

宋敏教授诊治椎动脉型颈椎病思路与经验＊

本文总结了宋敏诊治椎动脉型颈椎病的经验，宋敏教授认为椎动脉颈椎病的主要病因病机为虚和瘀，属于本虚标实。其思路与经验为：中西医并重，重视临床查体；辨病与辨证相结合，重视整体观念；临床与实验相印证，重视科学前沿。在此基础上形成了一套中药为主、手法为辅、心理疏导综合治疗的三位一体治疗方案。     

青蒿素诱导肝癌细胞凋亡的电镜观察

目的：探讨抗疟药青蒿琥酯对肝癌细胞株HepG2凋亡的诱导作用。方法：用青蒿琥酯对肝癌细胞株HepG2进行研究，以阿霉素作为对照药，观察使用青蒿琥酯后肝癌细胞在电镜下的形态变化，结果：透射电镜下见经青蒿琥酯处理的HepG2细胞与用阿霉素处理的肝癌细胞相似，出现了凋亡小体这一现象，结论：青蒿琥酯可诱导肝癌细胞凋 亡。     

刺五加化学药理研究的新进展

近年来从刺五加的根、叶中又分离出数种新皂苷,并对刺五加抗肿瘤、抗疲劳、抗衰老及对心血管、免疫功能方面的药理研究又有新的进展。