速效救心丸和麝香保心丸治疗冠心病心绞痛的成本-效果分析

目的 比较速效救心丸和麝香保心丸治疗冠心病心绞痛的经济性。方法 通过文献综述和meta分析计算速效救心丸和麝香保心丸治疗冠心病心绞痛的有效率;根据发改委、省物价局、卫生系统公布的药品价格和检查价格,计算成本数据;在此基础上基于全社会的角度进行成本-效果分析。结果 在确定性分析中,速效救心丸组的总成本低于麝香保心丸组(分别为384.96元和396.70元)、治疗有效率高于麝香保心丸组(分别为88.57%和87.11%);针对文献质量、药品价格、疗程进行敏感性分析,结果基本与确定性分析相一致,但“文献质量”为敏感性因素。结论 速效救心丸治疗冠心病心绞痛的经济性总体上优于麝香保心丸,但还需深入研究。     

Evaluation and Management of Abnormal Uterine Bleeding

Abnormal uterine bleeding (AUB) is a common condition that leads to increased health care costs and decreased quality of life. A systematic approach to AUB evaluation can simplify management and enhance women’s well-being. Abnormal uterine bleeding describes any variation from normal bleeding patterns in nonpregnant, reproductive-aged women beyond menarche lasting for at least 6 months. Ambiguous and inconsistent use of terminology and definitions to characterize AUB in the past decades necessitated a new, consensus-based approach to nomenclature and AUB evaluation. This led to the International Federation of Gynecology and Obstetrics (FIGO) System 1 in 2007, which standardized nomenclature, set parameters, and defined normal and abnormal bleeding based on the 5th to 95th percentile data from available large-scale epidemiologic studies. FIGO System 1, endorsed by several national and international societies, improved worldwide communication among educators, clinicians, and researchers. FIGO System 2, published in 2011, focused on classifications of AUB etiology into structural and nonstructural entities using the PALM-COEIN (polyp[s], adenomyosis, leiomyoma, malignancy, coagulopathy, ovulatory dysfunction, endometrial disorders, iatrogenic, and not yet classified) classification system. The PALM-COEIN classification is facilitated by a complete patient history combined with appropriate imaging, histopathologic analysis, or laboratory evaluation to ensure accurate diagnostic and treatment approaches to AUB. Herein we present the systematic evaluation of AUB.     

自发性高血压大鼠脑出血后NF-κBmRNA的变化及安宫牛黄丸的干预作用

目的观察安宫牛黄丸对自发性高血压大鼠脑出血后NF-κBmRNA表达及血压变化的影响。方法以自体血制作大鼠脑出血模型,将成功模型随机分为模型组、西药治疗组、中药治疗组、中西药治疗组,使用尾袖法监测大鼠血压变化,RT-PCR测定NF-κBmRNA的表达。结果与模型组相比,各治疗组NF-κBmRNA表达明显增加（P〈0.05）,各治疗组间差异无统计学意义（P〉0.05）,造模后1d、2d、3d自发性高中药治疗组血压较模型组降低（P〈0.05）,造模后2d、3d西药治疗组血压较中药治疗组低（P〈0.05）,中西药治疗组血压则处于最低水平（P〈0.05）。结论安宫牛黄丸能够防止SHR大鼠脑出血后血压继发性升高,提高NF-κBmRNA的表达,对脑出血的治疗具有一定的意义。     

山药参芪丸治疗糖尿病的临床及实验研究

目的:观察山药参芪丸治疗糖尿病患者的疗效及安全性做出评价。方法:采用山药参芪丸对门诊糖尿病患者4135例进行治疗,并对实验性糖尿病大鼠进行毒理学和药效学试验。结果:不同年龄的T1MD总有效率为87.0%～93.0%,T2MD的有效率为87.8%～92.4%,两者比较,差异不显著(P>0.05);血糖、血脂及血压治疗前后比较,差异显著(P<0.01)。动物急性和长期毒性试验,未发现明显毒性作用,山药参芪丸可使实验性糖尿病大鼠的血糖降低,并使血清甘油三酯下降。结论:山药参芪丸治疗糖尿病疗效确切,对改善糖尿病临床症状收到较满意效果,未发现明显不良反应。     

中成药为主治疗早期肝硬化疗效分析

目的：观察附子理中丸、大黄庶虫虫丸和金匮肾气丸为主治疗早期肝硬化的临床疗效。方法：74例随机分为两组,两组均服肝泰乐、复合维生素B,对照组37例另服复方丹参滴丸治疗,治疗组37例另服附子理中丸、大黄庶虫虫丸和金匮肾气丸,观察临床疗效和毒副反应。结果：总有效率治疗组86.49%,对照组59.46%,两组比较有统计学意义（P〈0.05）。治疗组症状体征改善明显优于对照组。治疗后,肝功能指标,治疗组与治疗前比较有统计学意义（P〈0.05,P〈0.01）,与对照组治疗后比较有统计学意义（P〈0.05,P〈0.01）。治疗后血清纤维化指标变化,治疗组与治疗前比较有统计学意义（P〈0.05,P〈0.01）,与对照组治疗后比较有统计学意义（P〈0.05）。B超检查治疗组和对照组脾脏厚度恢复正常,门静脉内径明显缩小,与治疗前比较有统计学意义（P〈0.05）,两组脾脏长径、脾静脉宽度较治疗前略有缩小,但无统计学意义（P〉0.05）。治疗期间两组均有月经期妇女月经稍微增多,未出现其他不良反应。结论：附子理中丸、大黄庶虫虫丸和金匮肾气丸治疗早期肝硬化疗效显著。     

钩藤碱缓释滴丸的研制

目的:优选钩藤碱缓释滴丸的制备工艺。方法:采用正交设计优化了药液温度、辅料用量比例及冷凝液温度和滴速等工艺条件,制备钩藤碱缓释滴丸,并初步研究其成型工艺。结果:所得缓释滴丸在pH 1.2盐酸和pH 6.8磷酸盐缓冲液及模拟胃肠道介质中的体外释药行为相似,不受pH变化影响。     

避孕药释放激素激动剂对大鼠卵巢的致癌作用

目的通过实验大鼠的实验研究对避孕药释放激素的致癌作用进行研究。方法选用TR2近交系大鼠分组选用女性外用避孕药膜,针对不同剂量分成实验三组和对照组进行实验研究。结果应用Anthwin软件分析抑制素融合基因表达产物的理化曲线,由Parker法预测的曲线可以看出重组蛋白质N端40-80,100-140,220-258为抗原性较强的区域。不同剂量的抑制素pcINH质粒DNA经脂质体介导免疫大鼠,差异有统计学意义。结论合理剂量的避孕药与致癌性无相关性。     

Pill testing at music festivals: is it evidence‐based harm reduction?

Recent pill‐related deaths of young people at music festivals in Australia have led to a concerted push for on‐site pill testing as a means for preventing such events. However, whether pill testing (also termed ‘safety checking’) is an effective harm reduction strategy remains uncertain. This narrative review concludes that pill testing currently lacks evidence of efficacy sufficient to justify publicly funded national roll‐out of on‐site pill‐testing programmes. Australian governments, addiction specialists and public health experts should collaborate in conducting properly designed field studies aimed at confirming clear benefits from such programmes in reducing pill‐related harm.     

Cytologic and histologic findings of iron pill‐induced injury of the lower respiratory tract

In the airways, iron pill‐induced mucosal injury is uncommon and can lead to necrosis and stricture of the respiratory tracts. The process is characterized by mucosal ulceration with deposition of crystalline iron particles, and the diagnosis is usually made on tissue biopsies. We report a case of iron‐sulfate‐induced mucosal injury in the bronchial washing and biopsy of a patient receiving therapeutic oral iron supplementation with no known aspiration event. Clinically, the patient presented with hemoptysis, and bronchoscopy detected ulcerated main stem bronchus mucosa clinically suspicious for a neoplastic process. Bronchial washings revealed reactive epithelial cells and numerous histiocytes with both intracellular and extracellular refractile brown crystalline material, which was positive on iron stain. The histologic findings on biopsy showed mucosal ulceration with deposits of extracellular crystalline iron particles. These histologic changes are similar to those seen in iron pill‐induced mucosal injury of the upper gastrointestinal tract in patients with “iron pill” gastritis. The cytologic and histologic features of iron pill‐induced airway injury clinically can mimic cancer. The presence of extracellular and intracellular crystalline iron in the airway lumen and/or mucosa with associated varying degrees of ulceration and inflammation confirms the diagnosis. Diagn. Cytopathol. 2013;41:901–903. © 2012 Wiley Periodicals, Inc.