整合药理学在中医药现代研究的若干进展

中药方剂作为临床治疗的主要形式和手段,是中医理法方药的关键环节,是中医学理论和临床实践的桥梁,探索中药方剂的化学物质实体和机体生命活动的关系及其复杂交互规律,是中药现代研究的关键科学问题之一。然因本身组成的复杂性、生物效应表达的多样性,使其“化学成分群-体内过程-药效活性”之间缺乏“完整的证据链”,存在严重的“碎片化”现象。整合药理学的提出,是中药复杂系统分子作用解析的有效策略和方法,特别体现了以生物技术革命为代表的第四次浪潮的时代背景下,利用互联网、大数据、人工智能为代表的新技术驱动中药复杂体系发展的新趋势,为系统揭示多成分药物与机体相互作用及其整合规律和作用原理提供了一条切实可行的途径。该文试从中药整合药理学的形成和发展、研究思路、关键技术及应用等方面进行综述,为阐释中医药理论的科学内涵和中医原创思维的科学价值、总结与传承名医经验、中药质量控制、中药作用原理阐释和中药新药研发等提供强有力支持。     

兰索拉唑与奥美拉唑治疗胃食管反流病的比较观察

目的比较兰索拉唑与奥美拉唑治疗胃食管反流病的疗效。方法将我院2010年1月至2011年6月确诊为胃食管反流病的98名患者随机分为兰索拉唑组和奥美拉唑组,分别服用兰索拉唑30mg/日,奥美拉唑20mg/日,疗程4周,疗程结束后比较症状与胃镜检查结果。结果兰索拉唑组的有效率为95.92%,奥美拉唑组的有效率为79.59%,通过χ2检验,两组有显著性差异,P<0.01。结论兰索拉唑对胃食管反流病的疗效优于奥美拉唑。     

THBS4基因在高原地区胃癌组织中表达的生物学行为及临床意义

目的通过研究高原地区胃癌组织中THBS4基因的表达,探讨THBS4基因对高原地区胃癌生物学行为的影响及为高原地区胃预后的评估提供理论依据。方法收集高原地区无化疗且临床资料完整的胃癌手术标本60例,采用RT．PCR及S．P法,检测60例胃癌标本中THBs4蛋白的表达。结果用RT—PCR技术分析的结果显示,10例高分化胃癌组织中THBS4mRNA有5例表达;29例低分化胃癌中24例表达,高分化癌与中、低分化癌组织中的表达有差异。中、低分化胃癌中的THBs4mRNA水平高于高分化胃癌（P〈0．05）。THBS4mRNA表达与淋巴转移有关。但与临床分期无关。免疫组化S-P法染色分析显示,THBS4蛋白在低分化29例中2l例表达;中分化阳性率8例;均高于高分化（4例）,THBS4在高分化癌和中、低分化癌组织中的表达差异有统计学意义（P〈0．05）;中、低分化胃癌中的的THBS4阳性高于高分化胃癌。THBS4基因在高原地区胃癌组织中表达与胃癌的分化程度有关;与淋巴转移有关。结论THBS4基因可作为判断高原地区胃癌细胞分化不良的指标,对胃癌的预后评估有重要意义。     

核苷类抗病毒药群体药动学研究及应用

群体药动学运用经典药动学统计学相结合的方法来定量考察目标群体中药物浓度的影响因素,并应用于优化临床药物治疗方案。核苷类抗病毒药在临床抗病毒治疗中发挥重要的作用,此类药物的疗效、不良反应与其体内药物浓度息息相关,阿昔洛韦、更昔洛韦、泛昔洛韦、齐多夫定、恩曲他滨、拉米夫定和阿巴卡韦等核苷类抗病毒药的群体药动学研究促进该类药物在临床的合理应用。     

莲子草属植物的化学成分及生物活性研究进展

目的对苋科莲子草属植物的化学成分和生物活性作一综述。方法按照化合物的结构类型对莲子草属植物的化学成分进行分类综述 ,并且对其主要的生物活性进行总结。结果莲子草属植物含有多种活性成分 ,主要有三萜类、甾体类、黄酮类、有机酸类等化合物 ,他们具有抗菌、抗病毒等生物活性。结论为莲子草属植物的研究与开发提供了参考。     

Palladium(II) Complexes with N‐Heteroaromatic Bidentate Hydrazone Ligands: The Effect of the Chelate Ring Size and Lipophilicity on in vitro Cytotoxic Activity

Novel Pd(II) complex with N‐heteroaromatic Schiff base ligand, derived from 8‐quinolinecarboxaldehyde (q8a) and ethyl hydrazinoacetate (haOEt), was synthesized and characterized by analytical and spectroscopy methods. The structure of novel complex, as well as structures of its quinoline and pyridine analogues, was optimized by density functional theory calculations, and theoretical data show good agreement with experimental results. A cytotoxic action of the complexes was evaluated on cultures of human promyelocytic leukemia (HL‐60), human glioma (U251), rat glioma (C6), and mouse fibrosarcoma (L929) cell lines. Among investigated compounds, only complexes with quinoline‐based ligands reduce the cell numbers in a dose‐dependent manner in investigated cell lines. The observed cytotoxic effect of two isomeric quinoline‐based complexes is predominantly mediated through the induction of apoptotic cell death in HL‐60 cell line. The cytotoxicity of most efficient novel Pd(II) complex is comparable to the activity of cisplatin, in all cell lines investigated.     

神经酸及其在预防和治疗脑病中的应用研究进展

神经酸是大脑神经细胞和组织中的一种核心天然成分,具有特殊的生物学功能,对人体健康尤其是脑健康起到至关重要的作用。综述神经酸的生物功能和作用机制、神经酸的制备（包括从元宝枫油中提取分离、化学合成及转基因生物合成）以及神经酸在预防和治疗脑病（包括多发性硬化症、肾上腺脑白质营养不良、Zellweger综合征、阿尔茨海默病等）中的应用研究进展。     

Low surface tension calcium hydroxide solution is an effective antiseptic

The antimicrobial effects of a saturated calcium hydroxide solution, and in combination with 10% and 20% detergent, were evaluated on Streptococcus faecalis. Strepto-coccus sanguis, Streptococcus mutans, Streptococcus salivarius, Neisseria sp., diphlheroid, Staphylococcus aureus, Lactobacillus sp., Staphylococcus epidermidis, Bacillus suhtilis and Candida albicans. The saturated calcium hydroxide solution was effective against only four of the 11 microorganisms studied over a 60-min exposure time. The calcium hydroxide solutions con-taining detergent killed all 11 test organisms over a 30-min exposure time. This difference was statistically significant (P<0.01). No statistically significant difference in antimicrobial action was found between the 10% and 20% detergent calcium hydroxide solutions (F>0.01). However, the low surface tension (46.5 × 10^?3 Nm^?1) and high pH (10.8) of the calcium hydroxide solution with 20% detergent establish it as the more effective solution.     

不同时期放置宫铜200宫内节育器副反应的Meta分析

目的：运用Meta分析评价不同时期放置宫铜200宫内节育器（intrauterine device,IUD）的副反应发生率,为安全避孕提供依据。方法：计算机检索PubMed、EMBASE、CENTRAL等9种数据库和世界卫生组织/美国食品药品监督管理局/临床试验注册中心（WHO/FDA/ClinicalTrials）等相关网站,经质量评价后,采用Open Meta-Analyst软件进行合并分析。结果：共检索到6 864篇文献,根据纳入及排除标准,最终纳入10篇文献,均为随机对照试验（randomized controlled trial,RCT）或准RCT（quasi-RCT）。放置宫铜200 IUD后出血与疼痛的发生率均随使用时间的延长而呈现下降趋势;而感染发生率在使用后的12个月内无差异,至24个月时明显较低。放置宫铜200 IUD后不同随访时间,哺乳期放置组出血发生率低于月经间期放置组和人工流产术后即时放置组,差异均有统计学意义（P＜0.05）,而疼痛和感染发生率的差异均无统计学意义（P＞0.05）。结论：出血是使用宫铜200 IUD的主要副反应,放置IUD后应加强随访,尤其是对宫铜200 IUD使用者应加强使用初期出血的防治,以减少因症取出率。哺乳期放置出血发生率更少,建议选择哺乳期放置。考虑到不同放置时期放置宫铜200 IUD比较的纳入文献较少,该结论还需开展高质量的真实世界研究加以佐证。     

Estimating primary care attendance rates for fever in infants after meningococcal B vaccination in England using national syndromic surveillance data

BackgroundIn September 2015, the United Kingdom became the first country to introduce the multicomponent group B meningococcal vaccine (4CMenB) into a national infant immunisation programme. In early clinical trials 51–61% of infants developed a fever when 4CMenB was administered with other routine vaccines. Whilst administration of prophylactic paracetamol is advised, up to 3% of parents may seek medical advice for fever following vaccination. We used research-level general practitioner consultations to identify any increase in attendances for all-cause fever in vaccine-eligible infants following 4CMenB introduction in England.MethodsConsultations for infant all-cause fever in the year following the vaccine introduction were identified from The Phoenix Partnership (TPP) ResearchOne general practice database using Read (CTV3) codes. Average daily consultation rates and incidence rate ratios (IRRs) were calculated for vaccine-eligible age groups and compared to the two years preceding vaccine introduction. The difference between pre- and post-vaccine all-cause fever consultations was estimated.ResultsAll-cause fever consultations in vaccine-eligible 7–10 week olds were 1.6-fold higher (IRR, 1.58; 95% CI, 1.22–2.05) compared to the two previous years and 1.5-fold higher (IRR 1.47; 95% CI, 1.17–1.86) in 15–18 week-olds. There were no significant differences in 0–6 or 11–14 week-olds. Applying the difference between pre- and post-vaccine consultation rates to the 4CMenB vaccine-eligible age groups across England estimated 1825 additional fever consultations in the year following 4CMenB introduction.ConclusionsWe found a small but significant difference in all-cause fever consultation rates in vaccine-eligible infants who would have received 4CMenB with other vaccines.