陈皮枳术汤对大鼠胃动力障碍的实验研究

目的：探讨陈皮枳术汤对模型大鼠胃动力障碍的实验研究。方法：采用左旋精氨酸复制大鼠胃动力障碍中胃动力低下的模型,观察不同剂量陈皮枳术汤对大鼠胃排空作用以及胃动素、胃泌素含量的影响。结果：陈皮枳术汤可以明显提高模型大鼠血浆中胃动素与胃泌素含量,明显改善胃动力障碍大鼠的胃肠机能状态,增加胃肠运动功能。结论：陈皮枳术汤具有显著的促胃动力作用。     

Combination of CRAFITY score with Alpha-fetoprotein response predicts a favorable outcome of atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma

Immune checkpoint inhibitors (ICIs) with atezolizumab plus bevacizumab are promising agents for unresectable hepatocellular carcinoma (HCC). We tried to guide the treatment based on recent developed CRAFITY score combining with on-treatment AFP response. Eighty-nine patients who received atezolizumab plus bevacizumab regardless of as a first-line therapy or not for unresectable HCC were enrolled for analyses. Radiologic evaluation was based on modified Response Evaluation Criteria in Solid Tumors (mRECIST). The objective response rate (ORR) and disease control rate (DCR) were 25.0% and 65.5%, respectively. Multivariate analysis showed that low CRAFITY score (AFP<100 ng/ml or CRP<10 mg/l) and satisfactory AFP response at 6 weeks (≥75% decrease or ≤10% increase from baseline) were independent factors determining good overall survival (OS) (hazard ratio [HR]=0.143, P=0.002 & HR=0.337, P=0.031), progression-free survival (PFS) (HR=0.419, P=0.022 & HR=0.429, P=0.025) and good responder (odds ratio [OR]=1.763, P=0.044 & OR=3.881, P=0.011). Patients were further divided into three classes by combination of CRAFITY score and AFP response at 6 weeks [The CAR (CRAFITY score and AFP-Response) classification)]: low CRAFITY score with satisfactory AFP response at 6 weeks (class I), either high CRAFITY score or unsatisfactory AFP response at 6 weeks (class II) and high CRAFITY score together with unsatisfactory AFP response at 6 weeks (class III). ORR was 35.0%, 18.2%, and 0% in class I, II and III patients, respectively (overall P=0.034). Patients in the class I had the best OS and PFS, followed by class II and class III (median OS: not reached vs. 11.1 vs. 4.3 months, log-rank P<0.001; median PFS: 7.9 vs. 6.6 vs. 2.6 months, log-rank P=0.001). Combination CRAFITY score and AFP response at 6 weeks with AUROC predicts OS and tumor response to be 0.809 and 0.798, respectively, better than either CRAFITY score (0.771 & 0.750) or AFP response at 6 weeks (0.725 & 0.680) alone. In conclusions, the CAR classification which combining CRAFITY score and AFP response at 6 weeks provides a practical guidance for atezolizumab plus bevacizumab therapy in unresectable HCC patients.     

四君子合温胆汤加减方治疗痛风性肾病的临床疗效观察

[目的]评价四君子合温胆汤加减方治疗脾肾气虚夹痰瘀型早期痛风性肾病[肾小球滤过率(GFR)≥30 mL/(min·1.73 m2)]的有效性及安全性.[方法]将74例脾肾气虚夹痰瘀型早期痛风性肾病患者随机分为治疗组和对照组,每组各37例.2组患者均给予常规治疗(包括饮食治疗、碱化尿液和对症治疗等),在此基础上,对照组给...     

“互联网+”形势下移动针灸医疗平台接受度调查和分析

采用调查问卷对居民使用针灸治疗情况、居民对针灸治疗优势病种的认识、移动医疗APP居民使用率、对移动医疗平台的接受度等问题进行调查分析,探讨移动针灸医疗平台的发展方向前景。     

根治术后辅助化疗胃癌患者生活质量影响因素的多元logistic回归分析

  目的  通过分析干预实施后贫困地区实验组和对照组生活质量的差异情况,对干预效果进行评估,为提高海南居民的生活质量及脱贫攻坚提供参考措施。  方法  于2019年1月采用典型抽样方法,抽取海南省琼中县新林村（实施远程医疗干预）281人为实验组,乐东县番豆村（不实施干预）156人为对照组,共437人。采用SF-36量表对研究对象进行评估。  结果  实验组在生理功能、情感职能、精神健康与对照组差异有统计学意义（P < 0.05）;生理职能、躯体疼痛、总体健康、活力、社会活动,差异无统计学意义（P > 0.05）。多重线性回归分析结果显示,是否干预（β = 7.36）、年龄（β = – 6.81）、是否喝酒（β = – 6.04）是贫困地区居民生活质量的影响因素。  结论  居民生活质量受年龄、喝酒史、是否干预等因素的影响;实施互联网 + 医疗助力远程医疗服务可以有效改善贫困地区居民生活质量。     

52例踝关节骨折的治疗

目的：探讨应用手法复位外固定和手术治疗踝关节骨折的临床效果。方法：将52例踝关节骨折患者分为手法组21例（采用手法复位外固定）和手术组31例（采用手术治疗）,观察两组患者的治疗效果。结果：手法组21例患者中,优17例、良4例;手术组31例中,优25例、良3例、可2例、差1例。结论：根据患者手术适应证的不同,采取不同的治疗方法及有效的复位可使大部分踝关节骨折患者恢复踝关节的正常功能。     

Randomized,double-blind,placebo-controlled,safety and immunogenicity study of 4 formulations of Anthrax Vaccine Adsorbed plus CPG 7909 (AV7909) in healthy adult volunteers

A new anthrax vaccine that could accelerate the immune response and possibly reduce the number of injections needed for protection would be desirable in a post-exposure setting.     

Treatment of Patients with Metastatic Hormone-Sensitive Prostate Cancer: A Systematic Review of Economic Evaluations

The management of patients with metastatic hormone-sensitive prostate cancer (mHSPC) has been significantly modified by the availability of innovative but expensive treatments, increasing the economic burden of prostate cancer. Here, we aimed to systematically identify and review published economic evaluations (EEs) related to the treatment of mHSPC and assess their quality. A systematic search was performed of the PubMed and Cochrane databases. Three reviewers independently selected EEs by defined inclusion and exclusion criteria. They extracted all data from each EE (general information, study population, data about the EE, interventions and comparators, and outcomes). They also assessed the quality of the selected EEs according to Drummond's checklist. Fourteen EEs published between 2016 and 2021 were eligible for the systematic review. The EEs found ADT + docetaxel to be the most cost-effective of all available treatments as a first-line strategy for mHSPC (abiraterone acetate plus prednisone, enzalutamide, and apalutamide). Five EEs showed that a simple price reduction of abiraterone acetate of 50% to 75% could change the results to render this treatment also cost-effective relative to that with docetaxel. Twelve EEs were of high quality, with a Drummond score ≥ 7. Analysis of the 14 EEs identified by our systematic review, amongst which 78.6% met high quality standards, showed that ADT + docetaxel tends to be the most cost-effective alternative for mHSPC. These results were assessed by sensitivity analysis. The data provided by this systematic review help to provide a better understanding of these treatments and the better use of healthcare resources.     

Stimulus-dependent changes of extracellular glucose in the rat hippocampus determined by in vivo microdialysis

Neuronal activity is tightly coupled with brain energy metabolism; and glucose is an important energy substrate for neurons. The present in vivo microdialysis study was aimed at investigating changes in extracellular glucose concentrations in the rat ventral hippocampus due to exposure to the elevated plus maze. Determination of basal hippocampal glucose and lactate/pyruvate ratio in male Wistar rats was conducted in the home cage using in vivo microdialysis. Rats were exposed to the elevated plus maze, a rodent model of anxiety-related behaviour, or to unspecific stress induced by white noise (95 dB) as a control condition.Basal hippocampal levels of glucose, as determined by zero-net-flux, and the basal lactate/pyruvate ratio were 1.49 ± 0.05 mmol/l and 13.8 ± 1.1, respectively.In rats without manipulation, glucose levels remained constant throughout the experiment (120 min). By contrast, exposure to the elevated plus maze led to a temporary decline in hippocampal glucose (− 33.2 ± 4.4%) which returned to baseline level in the home cage. White noise caused only a non-significant decrease in extracellular glucose level (− 9.3 ± 3.5%). In all groups, the lactate/pyruvate ratio remained unchanged by the experimental procedures. Our microdialysis study demonstrates that exposure to the elevated plus maze induces a transient decrease in extracellular hippocampal glucose concentration. In contrast, an unspecific stimulus did not change hippocampal glucose. The latter suggests that only specific behavioural stimuli increase hippocampal glucose utilization in the ventral hippocampus.     

Toxicological aspects of trans fat consumption over two sequential generations of rats: Oxidative damage and preference for amphetamine

Chronic consumption of processed food causes structural changes in membrane phospholipids, affecting brain neurotransmission. Here we evaluated noxious influences of dietary fats over two generations of rats on amphetamine (AMPH)-conditioned place preference (CPP). Female rats received soybean oil (SO, rich in n-6 fatty acids (FA)), fish oil (FO, rich in n-3 FA) and hydrogenated vegetable fat (HVF, rich in trans fatty acids (TFA)) for two successive generations. Male pups from the 2nd generation were maintained on the same supplementation until 41 days of age, when they were conditioned with AMPH in CPP. While the FO group showed higher incorporation of n-3 polyunsaturated-FA (PUFA) in cortex/hippocampus, the HVF group showed TFA incorporation in these same brain areas. The SO and HVF groups showed AMPH-preference and anxiety-like symptoms during abstinence. Higher levels of protein carbonyl (PC) and lower levels of non-protein thiols (NPSH) were observed in cortex/hippocampus of the HVF group, indicating antioxidant defense system impairment. In contrast, the FO group showed no drug-preference and lower PC levels in cortex. Cortical PC was positively correlated with n-6/n-3 PUFA ratio, locomotion and anxiety-like behavior, and hippocampal PC was positively correlated with AMPH-preference, reinforcing connections between oxidative damage and AMPH-induced preference/abstinence behaviors. As brain incorporation of trans and n-6 PUFA modifies its physiological functions, it may facilitate drug addiction.