阿卡波糖联合六味地黄丸治疗早期糖尿病肾病的临床疗效观察

目的 观察六味地黄丸对早期糖尿病肾病患者的临床疗效及其安全性。方法 选择天津市滨海新区大港港西街社区卫生服务中心2010年4月—2013年4月收治的早期糖尿病肾病患者72例,随机分为治疗组（36例）和对照组（36例）,对照组给予饮食及运动疗法,同时用阿卡波糖治疗,餐前服用,100 mg/次,3 次/d;治疗组在对照组治疗的基础上加用六味地黄丸治疗,6 g/次,2 次/d。治疗两个月后,比较两组患者24 h尿蛋白、血糖、血脂及尿微量白蛋白的变化,同时观察两组不良反应的发生情况。结果 两组患者治疗前后24 h尿蛋白、血糖、血脂及尿微量白蛋白自身对照有明显差异（P＜0.05）;治疗组患者各项指标改善明显优于对照组（P＜0.05）,两组患者不良反应发生情况比较差异没有统计学意义。结论 阿卡波糖联合六味地黄丸治疗对于早期糖尿病肾病患者有较好的临床疗效,值得临床应用。     

西黄丸对荷瘤大鼠的抗肿瘤及其对炎性因子的调节作用

目的 研究西黄丸对Walker256乳腺癌细胞荷瘤大鼠的抗肿瘤及对相关炎性因子的调节作用,探讨其抗肿瘤作用机制。方法 60只雌性Wistar大鼠,随机抽取10只设为对照组,剩余50只建立荷瘤大鼠模型,随机分为模型组、西黄丸高、中、低剂量组和香菇多糖组,每组10只,按10 mL/kg ig给药,每天2次,连续14 d。14 d后腹主动脉取血,取瘤组织称定质量,计算抑瘤率;采用ELISA法检测大鼠外周血IL-2、IFN-γ、IL-6、IL-10和TGF-β水平。结果 西黄丸高、中、低剂量组抑瘤率分别为33.1%、30.7%、28.5%;与对照组比较,西黄丸高、中、低剂量均可明显提高荷瘤大鼠外周血IL-2、IFN-γ的水平,降低IL-6、IL-1、GF-β水平（P＜0.05）。结论 西黄丸具有明显的抑制肿瘤生长的作用,可通过提高荷瘤大鼠IL-2、IFN-γ水平增强免疫清除功能;降低IL-6、IL-10、TGF-β水平,减少形成免疫抑制微环境的相关炎性因子,呈现出逆转肿瘤免疫逃逸的趋势。     

犀黄丸对火毒血瘀型鼻咽癌放射治疗患者生活质量的影响

目的 观察犀黄丸对火毒血瘀型鼻咽癌放射治疗患者生活质量的影响。方法 将60例鼻咽癌患者随机分为实验组和对照组，每组30例。对照组仅接受放射治疗，实验组加用犀黄丸口服。观察并比较两组患者治疗前后中医证候积分，比较两组患者生活质量改善情况及不良反应。结果 两组患者治疗后中医证候积分均显著降低（P<0.05），实验组中医证候积分下降程度大于对照组（P<0.05）；实验组患者生活质量的改善优于对照组（P<0.05）；实验组总不良反应率（50.00%）与对照组（73.33%）比较，差异无统计学意义（P>0.05）。结论 犀黄丸可改善鼻咽癌患者的临床症状，提高患者生活质量，减少放射治疗的不良反应。     

Quantifying and characterising multi-compartment compliance aid provision

BackgroundMedication compliance aids (MCAs) to support adherence lack evidence for cost-effectiveness yet a 2001 survey in England estimated 100,000 patients receiving an MCA whilst living in their home.Objective(s): To obtain a contemporary estimate of MCA provision by community pharmacies in England and describe factors influencing pharmacist decision-making regarding MCA initiation.MethodsA stratified random sample of two community pharmacies per county (n = 40) in England were surveyed by telephone and a more detailed postal survey sent to participants expressing an interest. Data were collected to determine magnitude of MCA provision and, professional and administrative factors influencing initiation were reported as percentage (95% confidence interval) respondents reporting a factor.ResultsAn estimated 273,529 MCAs are filled by community pharmacies in England with a median (IQR) of 20(10, 50) MCAs per pharmacy per month provided for patients living in their home. Practitioners' judgement of appropriateness for MCA initiation was reported by 51.3 ± 11% as the primary factor influencing decision-making relative to 16.3 ± 8% and 20 ± 8.8% reporting patient's and carer's opinion respectively. Some form of assessment tool was reported by 13 ± 7.3% respondents.Postal survey respondents (n = 31) indicated that decision-making regarding MCA initiation was often or always affected by suitability of medication for dispensing in an MCA by 58% ± 17% of respondents; 74.2% ± 15.4% and 53.3% ± 17.9% of respondents’ decision-making was never or rarely affected by the risk of adverse events and reduced patient autonomy arising from an MCA respectively.ConclusionsProvision of MCAs by pharmacies in England has more than doubled in the past decade. Beyond considering the practicalities of whether an MCA is suitable for a patient, there is limited evidence of pharmacists considering patient choice or risk of adverse events arising from sudden increased adherence prior to initiation.     

Insulin Resistance in Polycystic Ovary Syndrome Improved by Chinese Medicine Dingkun Pill(定坤丹):A Randomized Controlled Clinical Trial

Objective: To assess the ef?cacy and safety of the Chinese medicine Dingkun Pill(定坤丹,DKP) on insulin resistance in women with polycystic ovary syndrome(PCOS).Methods: A total of 117 women with PCOS were randomly assigned to Group A(38 women),Group B(40 women),or Group C(39 women) in a randomization sequence with SAS software and a 1:1:1 allocation ratio using random block sizes of 6,and were given 7 g of oral DKP daily(Group A),1 tablet of Diane-35 orally daily(Group B),or 7 g of oral DKP daily plus 1 tablet of Diane-35 orally daily(Group C).Patients took all drugs cyclically for 21 consecutive days,followed by 7 drug-free days.The treatment course for the 3 groups was continued for 3 consecutive months.Oral glucose tolerance tests(OGTT)were performed before treatment and again after 2 and 3 months of therapy,respectively,and homeostasis model assessment for insulin resistance(HOMA-IR) and quantitative insulin sensitivity check index(QUICKI) were calculated.Results: Of 117 women with PCOS,110 completed the entire course of therapy: 35 in Group A,36 in Group B,and 39 in Group C.After treatment,all three groups showed signi?cant decreases in fasting glucose: at1 h glucose decreased signi?cantly in Group A(by 0.5±1.4 mmol/L,P=0.028) and Group C(by 0.5±1.2 mmol/L,P=0.045); while showing a tendency to increase in Group B(by 0.4±1.9 mmol/L,P=0.238).HOMA-IR decreased signi?cantly in Group C [by 0.5(–2.2 to 0.5) m IU mmol/L2,P=0.034].QUICKI was signi?cantly increased in Groups A and C(by 0.009±0.02,P=0.033 and by 0.009±0.027,P=0.049,respectively),while no change was observed in Group B.Repeated-measure ANOVA showed that the absolute changes in all parameters(except for glucose at1 h),including glucose and insulin levels at all time-points during OGTT and in HbA1 c,HOMA-IR,and QUICKI,were not signi?cantly different among the 3 groups after treatment(P0.05).Conclusion: DKP or DKP combined with Diane-35 produce a slight improvement in insulin sensitivity compared with Diane-35 alone in PCOS patients(Trial Registration: Clinical Trials.gov,NCT03264638).     

王金贵教授治疗痉挛性斜颈验案1则

王金贵教授临床注重谨守病机，审证求因，辨病与辨证相结合，以指导临床用药。整理王金贵教授治疗痉挛性斜颈验案1则，验案在四诊合参，辨证论治的基础上，辨证为肝郁脾虚，风痰阻络型，治以息风化痰治其标，疏肝健脾治其本，方用定痫丸合越鞠丸加减，切中病机，疗效确切，值得深入学习。     

Hormonal contraception and HIV prevalence in four African countries

BACKGROUND: The HIV seroprevalence among women aged 15-24 years was compared according to their pattern of contraceptive use in four African countries: Kenya, Lesotho, Malawi and Zimbabwe. STUDY DESIGN: Data were derived from Demographic and Health Surveys (DHS) conducted between 2003 and 2006 on representative samples, totaling 4549 women. RESULTS: It is indicated that users of depo-medroxyprogesterone acetate (DMPA) have a significantly higher seroprevalence than nonusers [odds ratio (OR)=1.82, 95% CI=1.63-2.03] and higher than users of oral contraceptives and users of traditional methods. The results were confirmed in a multivariate analysis including as controls, age, duration since first intercourse, urban residence, education, number of sexual partners in the last 12 months and marital status. A somewhat smaller net effect (OR=1.34, 95% CI=1.10-1.63) was found. In contrast, oral contraceptives and traditional methods did not show any risk for HIV (OR=0.96 and 0.92, respectively). CONCLUSION: The increased risk of DMPA was present in three of the four countries investigated, and significant in Zimbabwe and Lesotho, the countries with the highest HIV seroprevalence. The HIV risk attributable to DMPA remained small altogether and was estimated as 6% in the four countries combined.     

寿胎丸对复发性流产小鼠蜕膜组织有氧糖酵解抑制的影响

目的 观察寿胎丸防治复发性流产（RSA）的作用,探讨其调控有氧糖酵解的作用。方法 将40只CBA/J小鼠随机分为正常组、RSA组、地屈孕酮组和寿胎丸组,每组10只,分别灌胃蒸馏水、地屈孕酮溶解剂、寿胎丸14天。14天后将正常组CBA/J雌鼠与BALB/c雄鼠2∶1合笼,其余3组雌鼠与DBA/2雄鼠2∶1合笼,建立RSA模型,并按照前法继续灌胃至见栓第10天。计算各组小鼠胚胎丢失率,HE染色观察蜕膜组织,Western Blot、实时荧光定量PCR技术（qRT-PCR）检测小鼠蜕膜组织己糖激酶（HK）2、M2型丙酮酸激酶（PKM2）、乳酸脱氢酶（LDH）A、B淋巴细胞瘤-2(Bcl-2)、B细胞淋巴瘤-2相关X蛋白（Bax）、半胱氨酸天冬氨酸蛋白酶3(Caspase-3)表达,乳酸脱氢酶比色法检测乳酸（LA）含量,检测HK、PK、LDH活性。结果 与正常组比较,RSA组小鼠胚胎丢失率升高（P<0.05）,蜕膜组织细胞减少,排列疏松,胞浆空泡样变,部分细胞核消失,蜕膜组织HK2、PKM2、LDHA、Bcl-2蛋白及mRNA表达降低（P<0.05）,Bax、Caspase-3蛋白...     

25味珊瑚丸载药纳米颗粒的生物效应研究

目的　探讨25味珊瑚丸载药纳米颗粒（Ershiwuwei Shanhu’ Pill , ESP)于体内外的生物效应。 方法　将ESP纳米颗粒与SH-SY5Y细胞共培养8 h,荧光示踪与透射电镜(Transmission electron microscopy , TEM) 观察其在细胞吸收分布情况。大鼠随机分为空白对照组和用药组,分别通过尾静脉注射生理盐水或ESP, HE染色观察肝脏形态的变化,旷场实验(Open field test)评估大鼠兴奋度变化,扫描电镜(scanning electron microscope , SEM)观察SH-SY5Y细胞在25味珊瑚丸不溶组分上的生长情况。 结果　25味珊瑚丸纳米颗粒出现在各种细胞器中,出现破碎的细胞核。体内实验中,用药组大量肝细胞液化坏死,与模型组相比,用药组大鼠动物总运动距离显著增加（P<0.05）,细胞可在25味珊瑚丸不溶组分生长良好。 结论　25味珊瑚丸载药纳米颗粒可能导致大鼠焦虑并具有强烈的肝毒性。     

补骨脂-肉豆蔻药对现代研究进展

补骨脂-肉豆蔻是临床常用温补脾肾药对,组方名二神丸,是四神丸的核心组成.现代学者主要着眼化学成分、药理作用、临床应用、提取工艺等方面对其进行研究.两种药物配伍后能够增加有效成分的溶出,产生新物质,但目前对配伍比例以及新物质的研究较少;其临床应用和药理作用的相关研究主要集中在消化系统疾病,如通过减轻炎症反应、减缓胃肠蠕动...