青海省鼠疫患者血清抗体谱研究

目的研究在鼠疫感染过程中,患者对鼠疫耶尔森菌产生体液免疫反应的规律.寻找鼠疫菌新的具有免疫原性的蛋白。方法利用鼠疫耶尔森菌重要毒力相关蛋白芯片对鼠疫患者的血清抗体谱进行检测。结果利用含145个鼠疫耶尔森菌蛋白质的蛋白芯片。共检测到鼠疫患者血清中29个蛋白的抗体。其中13种蛋白的抗体在患者体内明显上升,除已知的8个具有免疫原性的蛋白外,发现了鼠疫菌5个新的具有免疫原性的蛋白(SycE、SycH、OmpA、pH6与YPO2098)。结论这5个新的具有免疫原性的蛋白将是下一步鼠疫疫苗研究的靶点。     

中药扶正抗癌方治疗中、晚期消化道肿瘤160例临床观察

14年来，以中药扶正抗癌方（自拟）治疗中、晚期消化道肿瘤160例，收到了较为满意的疗效。患者症状改善，血象升高，免疫指标提升，癌胚抗原含量下降．患者的体质增强，体重增加．其它疾病少发等，有的患者癌灶缩小，甚至消失，绝大多数的患者经治疗后生存期得以延长。     

苍脂颗粒剂对鼠胃粘膜细胞保护作用的研究

为了探讨苍脂颗粒剂治疗脾胃病的胃粘膜保护作用，采用利血平模拟的大鼠脾虚证及亚急性阿斯匹林胃粘膜损伤模型，测定其对非蛋白质流基物质（NPSH）、谷胱甘肽过氧化物酶（GSH－px）、过氧化氢酶（CAT）、超氧化物歧化酶（SOD）及血浆过氧化脂质（LPO）等具有胃粘膜细胞保护作用物质的含量或活性的影响。结果显示，苍脂颗粒剂可以明显改善脾虚伴慢性胃粘膜病变大鼠及亚急性阿期匹林胃粘膜损伤大鼠的粘膜损伤程度，显著提高胃粘膜NPSH（F＜0．01）、GSH-px（P＜0．01）等细胞保护物质的水平．提示苍脂颗粒剂具有一定的胃粘膜细胞保护作用。     

Acute allograft rejection and immunosuppression: influence on endogenous melatonin secretion

Abstract: Melatonin displays a dose‐dependent immunoregulatory effect in vitro and in vivo. Exogenous high‐dose melatonin therapy exerted an immunosuppressive effect, abrogating acute rejection (AR), significantly prolonging transplant survival. Endogenous melatonin secretion, in response to heterotopic rat cardiac allograft transplantation (Tx), was investigated during the AR response and under standardized immunosuppressive maintenance therapy with cyclosporin A (CsA) and rapamycin (RPM). Recipients of syngeneic transplants, and recipients of allogeneic grafts, either untreated or receiving immunosuppressive therapy constituted the experimental groups. Endogenous circadian melatonin levels were measured at 07:00, 19:00, and 24:00 hr, using a novel radioimmunoassay (RIA) procedure, under standardized 12‐hr‐light/dark‐conditions (light off: 19:00 hr; light on: 07:00 hr), before and after Tx. Neither the operative trauma, nor the challenge with a perfused allograft or the AR response influenced endogenous melatonin peak secretion. Immunosuppressive therapy with CsA led to a significant increase in peak secretion, measured for days 7 (212 ± 40.7 pg/mL; P < 0.05), 14 (255 ± 13.9 pg/mL; P < 0.001), and 21 (219 ± 34 pg/mL; P < 0.01) after Tx, as compared with naïve animals (155 ± 25.8 pg/mL). In contrast, treatment with RPM significantly decreased the melatonin peak post‐Tx up to day 7 (87 ± 25.2 pg/mL; P < 0.001), compared with naïve animals (155 ± 25.8 pg/mL). These findings imply a robust nature of the endogenous circadian melatonin secretion kinetics, even against the background of profound allogeneic stimuli. Immunosuppressive maintenance therapy with CsA and RPM modulated early melatonin secretion, indicating a specific secondary action of these drugs. Further studies are necessary to disclose the long‐term effect of immunosuppressive therapy on circadian melatonin secretion in transplant recipients.     

Thromboelastography (TEG) in normal pregnancy and its diagnostic efficacy in patients with gestational hypertension,gestational diabetes mellitus,or preeclampsia

BackgroundThromboelastography (TEG) provides global assessment of hemostatic function and has been recommended to monitor potential coagulopathies during pregnancy in which hypercoagulable state is favored. In present study, we established the reference intervals (RIs) of the TEG parameters (R, K, MA, and α‐angle) with Chinese pregnant women of third trimester. In addition, we examined the diagnostic efficacies of the TEG parameters in the patients diagnosed of gestational hypertension (GH), gestational diabetes mellitus (GDM), or preeclampsia (PE).MethodsWith specified including and excluding criteria, non‐pregnant controls, healthy pregnant women, and pregnant women with GH, GDM, or PE had their venous blood drawn at Beijing Obstetrics and Gynecology Hospital, followed by TEG tests performed in the clinical laboratory.ResultsThe RIs determined with the healthy pregnant women (in third trimester) for R, K, MA, and α‐angle were 4.0‐7.7, 1.2‐3.2, 51.9‐70.1, and 41.4‐74.4, respectively. When compared with the healthy pregnancy group, the K value was significantly decreased in GH patients but increased in PE patients; MA was significantly lower in the PE group. In the receiver operating characteristic curve (ROC) analyses, K value was able to efficiently distinguish normal pregnancy from the GH patients, with an AUC of 0.86 which is far better than those of R (AUC = 0.57) and MA (AUC = 0.56). For the PE patients, the AUC of MA (0.69) was significantly greater than that of R (0.50).ConclusionsThromboelastography may provide more accurate experimental basis for monitoring coagulation functions especially in pregnant women with complications of GH and PE.     

Preoperative Aspiration Culture for Preoperative Diagnosis of Infection in Total Hip or Knee Arthroplasty

This meta-analysis evaluated preoperative aspiration culture for diagnosing prosthetic joint infection (PJI) in total hip arthroplasty (THA) and total knee arthroplasty (TKA). The pooled sensitivity and specificity were 0.72 (95% confidence interval, 0.65 to 0.78) and 0.95 (0.93 to 0.97), respectively. Subgroup analyses revealed nonsignificant worse diagnostic performance for THA than for TKA (sensitivity, 0.70 versus 0.78; specificity, 0.94 versus 0.96). Preoperative aspiration culture has moderate to high sensitivity and very high specificity for diagnosing PJI.     

A sensor for needle puncture force measurement during interventional radiological procedures

Computer-based simulation for interventional radiology training has attracted increasing attention in recent years because of its potential to train remotely from patients and to provide objective assessment of proficiency. Yet developing a high fidelity simulator with realistic tactile feedback requires accurate knowledge of forces exerted on medical devices during interventional radiology procedures. This paper presents the development and validation of a force sensor for the measurement of axial forces generated during needle, and combined cannula/trocar, puncture procedures in patients. In order to assess the performance of this sensor, in vitro measurements were obtained using needle penetration of porcine liver, kidney and muscle. The results were compared with forces measured by means of a tensile tester.Calibration results showed that the force sensor has high sensitivity and linearity. Comparison of the force profiles obtained from the sensor and the tensile tester shows that good agreement was achieved in the in vitro studies for all the tissues tested.Preliminary clinical force measurements during arterial puncture and liver biopsy procedures have been performed in patients. An example of force recording for each procedure type is presented.     

关于磷酸氯喹治疗新型冠状病毒肺炎给药方案的安全性刍议

国家卫生健康委员会和国家中医药管理局2020年2月18日发布的《新型冠状病毒肺炎诊疗方案(试行第六版)》将磷酸氯喹作为抗病毒试用药物之一,其后又于同月26日发布了《关于调整试用磷酸氯喹治疗新冠肺炎用法用量的通知》,2020年3月3日发布的《新型冠状病毒肺炎诊疗方案(试行第七版)》对磷酸氯喹给药方案进行了修订。磷酸氯喹半衰期长、全身分布广泛,易在体内蓄积,且不良反应与剂量相关。本文结合磷酸氯喹的药代动力学特点对给药方案进行了安全性分析,供临床医师和药师在诊治新型冠状病毒肺炎患者时参考,以降低发生不良反应的风险。     

药品批发企业质量管理体系运行中内审问题分析与对策研究

目的： 分析药品批发企业质量管理体系运行中存在的普遍问题,提出改善药品批发企业质量体系内审管理水平的具体实施建议,持续改进批发企业质量管理水平,控制药品经营环节风险,保证药品质量。方法： 对328家药品批发企业GSP认证申报资料及现场检查报告中发现的企业内审工作中存在的具体问题进行汇总、整理、分析原因,发现当前企业普遍存在的问题,并探讨改进措施。结果与结论： 药品批发企业应通过完善内审管理,建立完整严谨的标准和工作流程,强化企业内审工作的权威性和独立性,建立企业全员参与机制,提高内审人员的综合素质和能力;寻找质量管理体系文件贯彻执行的偏差;在体系关键要素发生重大变化或调整后,完善新经营环境下质量管理体系。从而确保企业在药品采购、储存、销售、运输等日常经营过程中均严格执行药品GSP,确保企业质量管理体系保持健康正常的运行。