基于肠道菌群转化的酸枣仁质量标志物预测分析

目的从肠道菌群代谢转化的角度,研究酸枣仁水提取物转化前后原型及代谢产物。方法酸枣仁水提取物与正常人肠道菌群在厌氧条件下分别共孵育0.083、1、4、12、24h。采用超高效液相色谱-高分辨质谱分析技术,对孵育液中的化合物进行鉴定并分析代谢途径,继而以化合物峰面积百分比为指标,绘制不同时间点孵育液中黄酮、皂苷和生物碱类成分的变化规律。结果酸枣仁水提取物中共表征了31种原型成分,转化后的提取物中鉴定了4个代谢产物。苄基异喹啉类生物碱转化24 h内无明显降解。黄酮类成分的代谢反应类型丰富且反应程度剧烈,在24 h内降解完全。酸枣仁皂苷A和B主要发生水解反应。乌药碱、酸李碱、山柰酚-3-O-芸香糖苷、斯皮诺素、维采宁、酸枣仁皂苷A和B可作为酸枣仁潜在质量标志物(Q-marker)。结论将肠道菌群体外转化作为逆向佐证体内研究结果的一种方式,为中药Q-marker的预测提供一种新思路和新途径。     

委陵菜HPLC指纹图谱及多指标含量测定研究

目的建立委陵菜的指纹图谱及多指标含量测定方法,为委陵菜的质量标准提升提供实验依据。方法采用HPLC法,色谱柱Diamonsil C18(250 mm×4.6 mm,5μm),以乙腈-0.1%磷酸水为流动相,梯度洗脱;体积流量1.0 mL/min;柱温25℃;进样量10μL;检测波长260 nm;建立10批委陵菜的指纹图谱,用中药色谱指纹图谱相似度评价系统软件(2004版)进行评价,聚类分析将10批药材分为2类;建立同时测定委陵菜药材中没食子酸、槲皮素及山柰酚3种成分的含量测定方法。结果建立了委陵菜的HPLC指纹图谱,共标定了12个共有峰;没食子酸、槲皮素和山柰酚线性关系良好,相关系数(r)均大于0.999。精密度、稳定性、重复性的RSD均小于3%,平均回收率分别为97.44%、97.64%、99.19%。结论建立的委陵菜的指纹图谱及多指标含量测定方法专属性强、重复性好,能有效地控制委陵菜的内在质量,为提高委陵菜的质量评价方法提供参考。     

蒙特利尔认知评估量表用于社区轻度认知障碍筛查的初步研究

目的探讨北京版蒙特利尔认知评估量表(MoCA-BJ)用于筛查社区轻度认知障碍(MCI)人群的适用性和最佳分界值。方法以西咸城区50岁以上社区居民为研究对象,采用随机整群抽样方法抽取西咸城区中1195名社区老年人。采用简易精神状态量表(MMSE)对受试者进行认知功能检测,参照MCI诊断标准分为正常组和MCI组,再次进行MoCA-BJ测试。按照受教育程度进行分组,分别绘制各组的受试者工作曲线(ROC),确定最大约登指数所对应的MoCA-BJ截断值。结果MMSE和MoCA-BJ评分显著相关,相关系数为0.791,P<0.001;各组MoCA-BJ最佳分界值分别为19(文盲)、21(小学)、25(初中及以上)。一致性检验Kappa值为0.686,P<0.001,一致性较好。结论MoCA-BJ能有效应用于本地区的MCI人群筛查。     

Two new sesquiterpene lactones from leaves of yacon,Smallanthus sonchifolius

The chemical constituents of 95% EtOH extract of yacon leaves were separated to yield two new sesquiterpene lactones, together with three known compounds. The two new compounds were characterized to be 8β-angeloyloxy-13-methoxyl-11, 13-dihydromelampolid-14-oic acid methyl ester (1) and 8β-(3-methylbut-2-enoyl) oxy-13-methoxyl-11, 13-dihydromelampolid-14-oic acid methyl ester (2) on the basis of NMR spectra, HR-MS and other spectroscopic methods. The cytotoxicity of compounds 1–5 were evaluated on human hepatoma cell Bel-7402 and all the compounds showed moderate cytotoxicity.     

还贝止咳方对肺炎链球菌致大鼠肺热的治疗作用

目的 观察还贝止咳方对肺炎链球菌致肺热模型大鼠的胸腺、脾脏指数,炎性细胞及炎性因子的影响。方法 SD幼年大鼠随机分为对照组、模型组、头孢呋辛酯片组、小儿肺热咳喘颗粒组及还贝止咳方的低、中、高剂量组,采用鼻腔滴入肺炎链球菌的方法建立大鼠肺热模型,造模前后监测大鼠体温,评价大鼠肺热模型;采用流式细胞仪及全血分析仪检测大鼠全血中的炎性细胞;采用酶联免疫技术检测大鼠肺灌洗液（BALF）中的白细胞介素（IL-4、IL-1β、IL-6、IL-10）、肿瘤坏死因子-α（TNF-α）、血清免疫球蛋白E（IgE）水平;完整剥离大鼠脾脏和胸腺,检测脾脏指数和胸腺指数。结果 与对照组比较,模型组大鼠的体温明显升高（P<0.01）,说明造模成功。与模型组比较,还贝止咳方低、中、高剂量组大鼠体温均显著降低（P<0.05、0.01）,全血中的白细胞、嗜酸性粒细胞数目、Th/Ts比值均显著降低（P<0.05、0.01）,CD3⁺CD4⁺、CD3⁺CD8⁺细胞比例显著上升（P<0.05、0.01）;BALF中的IL-10、IL-1β、IL-6、IL-4、TNF-α的水平明显降低（P<0.05、0.01）;且对IL-1β及TNF-α的下调作用优于阳性对照药;脾脏指数明显升高（P<0.05、0.01）。结论 还贝止咳方对细菌性大鼠肺炎模型具有一定的治疗作用,主要通过调节大鼠的免疫功能,减轻炎性反应发挥作用。     

阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死的临床研究

目的探讨应用阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死的临床效果。方法选取2015年1月—2017年12月西宁市第一人民医院收治的急性脑梗死患者82例,随机分成对照组(41例)和治疗组(41例)。对照组静脉滴注银杏二萜内酯葡胺注射液,5 m L加入250 m L生理盐水,1次/d。治疗组在对照组基础上口服阿托伐他汀钙片,20 mg/次,1次/d。两组患者均连续治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者总胆固醇(TC)/高密度脂蛋白胆固醇(HDL-C)、载脂蛋白(Apo)B/Apo A-l比值、国立卫生研究院卒中量表(NIHSS)评分、颈动脉超声参数及白介素(IL)-1β、IL-6、超氧化物歧化酶(SOD)和丙二醛(MDA)水平。结果治疗后,对照组和治疗组临床总有效率分别为75.6%、92.7%,两组比较差异具有统计学意义(P0.05)。治疗后,两组血清TC/HDL-C、Apo B/Apo A-l比值和NIHSS评分均显著降低(P0.05),且治疗组上述指标显著低于对照组(P0.05)。治疗后,两组左、右两侧颈总动脉内径、RI及IMT值较治疗前均显著降低(P0.05),且治疗组颈动脉超声参数显著低于对照组(P0.05)。治疗后,两组血清IL-1β、IL-6、MDA浓度较治疗前显著降低低(P0.05),血清SOD水平显著升高(P0.05),且治疗组IL-1β、IL-6、SOD、MDA水平明显优于对照组(P0.05)。结论阿托伐他汀联合银杏二萜内酯葡胺注射液治疗急性脑梗死可有效改善患者神经功能,减轻机体炎性及氧化应激损伤,疗效确切。     

Effect of different moxibustion interventions on hepatic histomorphology and PD-1 expression in immunosuppressed rabbits: 不同灸法干预对免疫抑制兔肝脏组织形态学及PD-1表达的影响

Objective To observe the changes in hepatic histomorphology and the differences in the expression of PD-1 after different moxibustion interventions in the immunosuppressed rabbits caused by cyclophosphamide and analyze the intervention effects of different moxibustion therapies.Methods A total of 40 big-ear white rabbits were randomized into 4 groups, i.e. a blank group, an immunosuppressed model group, a moxibustion group and a herbal-paste isolated moxibustion group, 10 rabbits in each one. In the immunosuppressed model group, the moxibustion group and the herbal-paste isolated moxibustion group, the intraperitoneal injection with cyclophosphamide was administered consecutively for 7 days, 60 mg/kg, and then, the immunosuppressed models were prepared. After the models were established successfully, in the moxibustion group and the herbal-paste isolated moxibustion group, moxibustion was administer at “Shénquè (神阙CV 8)” “Guānyuán (关元CV 4)” “Zúsānlĭ (足三里ST 36)” “Píshū (脾俞BL20)” and “Shènshū (肾俞BL23)”, once every other day, 10 times in total. In the blank group and the immunosuppressed model group, the rabbits were restricted on the rabbit platform at the same time periods, without intervention. On the second day after the end of intervention, the animals were weighed and anesthetized, and the livers were extracted. After routine HE staining, the changes of hepatic histomorphology were observed under the microscope and the morphometric analysis was conducted in each group. Besides, PD-1 expression was observed with immunohistochemical method.Result Compared with the blank group, after modeling of each animal in three groups, the body mass decreased obviously (all P < 0.01), the hepatocyte count decreased (all P < 0.01), the inflammatory cellular infiltration area was increased obviously (all P < 0.01), necrosis appeared in hepatic tissue and the positive expression of PD-1 in hepatic tissue was significantly increased (all P < 0.01). After moxibustion intervention, compared with the immunosuppressed model group, the body masses of the animals were increased obviously (P < 0.05, P < 0.01), the hepatocyte count was increased obviously (both P < 0.01), the infiltration area of inflammatory cells decreased significantly (both P < 0.01) and the expression of the PD-1 decreased in the hepatic tissue (both P < 0.05) in both the moxibustion group and the herbal-paste isolated moxibustion group. Compared with the moxibustion group, the animal body mass was higher obviously (P < 0.01), the hepatocyte count was raised apparently (P < 0.01) and the infiltration area of inflammatory cells were reduced obviously (P < 0.05) in the herbal-paste isolated moxibustion group.Conclusion The intervention with different moxibustion therapies improves the condition of body mass reduction and hepatic tissue damage of the immunosuppressed rabbits caused by cyclophosphamide. The effect of herbal-paste isolated moxibustion therapy is better than that of simple moxibustion therapy.     

对比基于PET/CT的不同方法定性诊断孤立性肺结节的效能

目的对比观察基于PET/CT的不同方法定性诊断孤立性肺结节(SPN)的效能。方法收集161接受PET/CT检查的SPN患者,比较良恶性SPN患者间临床表现、高分辨率CT(HRCT)征象及SUV max值的差异;通过二元Logistic回归构建SPN的数学诊断模型,比较诊断模型、PET/CT及HRCT的诊断效能。结果161例SPN中,经病理诊断恶性131例,良性30例。PET/CT诊断恶性SPN的灵敏度、特异度及准确率分别为98.47%(129/131)、76.67%(23/30)及94.41%(152/161),HRCT分别为59.54%(78/131)、83.33%(25/30)及63.98%(103/161)。经单因素及多因素分析后,将SUV max、年龄、钙化及气管血管集束纳入回归方程并建立模型,模型诊断恶性SPN的敏感度、特异度及准确率分别为82.44%(108/131)、86.67%(26/30)及83.23%(134/161)。ROC曲线结果显示,模型、PET/CT及HRCT诊断恶性SPN的AUC分别为0.909、0.876及0.714,PET/CT及模型的AUC均高于HRCT(P均<0.001),模型与PET/CT差异无统计学意义(P=0.468)。结论基于PET/CT的Logistic回归模型及PET/CT定性诊断SPN的效能优于HRCT,且特异度高于PET/CT。