消疣颗粒对U_（14）宫颈癌小鼠免疫功能影响的实验研究

目的观察消疣颗粒对U14荷瘤小鼠外周血IL-2、TNF-α含量及对外周血T细胞亚群的影响。方法将模型小鼠随机分为消疣颗粒高、中、低剂量组,模型对照组,阳性对照组,连续给药11 d。用夹心ELISA法检测U14荷瘤小鼠外周血IL-2含量,双抗夹心ELISA法检测U14荷瘤小鼠外周血TNF-α含量,流式细胞仪检测U14荷瘤小鼠外周血CD4＋、CD8＋计数及CD4＋/CD8＋比值。结果消疣颗粒各处理组血清中TNF-α与IL-2的含量显著增高,消疣颗粒中、低剂量组CD4＋数量显著增加,CD8＋数量明显减少,CD4＋/CD8＋比值显著增加,对T淋巴细胞具有增殖的作用。结论消疣颗粒能调节荷瘤小鼠的免疫功能,达到治疗肿瘤的目的。     

芪明颗粒联合羟苯磺酸钙治疗非增殖性糖尿病视网膜病变有效性及安全性的Meta分析＊

目的 系统评价芪明颗粒联合羟苯磺酸钙治疗非增殖性糖尿病视网膜病变（NPDR）的有效性及安全性。方法 计算机检索CNKI、万方、PubMed、Cochrane Library等数据库，检索时间截止至2021年9月，纳入试验组为芪明颗粒联合使用羟苯磺酸钙治疗NPDR的随机对照试验，应用Revman5.3软件对文献进行分析，系统评价对总有效率、血糖指标、视力、黄斑厚度、视网膜循环时间、血清细胞因子含量以及支链氨基酸含量的影响，同时评价芪明颗粒联合羟苯磺酸钙的用药安全性。结果 最终纳入14篇RCT，共计1299例患者。Meta分析结果示：试验组相对于对照组可以有效提高临床疗效（OR=4.22， 95%CI （3.02， 5.90）， Z=8.41， P<0.01，恢复视力（MD=0.14，95%CI （0.11， 0.16），Z=9.28，P<0.01），降低空腹血糖（MD=-0.17， 95%CI （-0.33， -0.01）， Z=2.07，P<0.05）及糖化血红蛋白（MD=-0.42，95%CI （-0.73， -0.11）， Z=2.68，P<0.01），降低黄斑厚度（MD=-7.30，95%CI （-9.86， -4.74）， Z=5.59，P<0.01），缩短视网膜循环时间（MD=-0.49，95%CI （-0.74， -0.23）， Z=3.73，P<0.01），同时可以调节血清因子含量以及支链氨基酸含量，降低不良反应发生率。结论 芪明颗粒联合羟苯磺酸钙治疗NPDR有良好临床疗效，可以有效改善视力情况及视网膜循环状况，改善体内血清支链氨基酸代谢情况，够抑制NPDR患者视网膜内多种细胞因子所介导的血管新生，降低不良反应，但受纳入文献质量和数量的限制，上述结论仍需更多试验进一步验证。     

枯草杆菌二联活菌颗粒对厌食症患儿血清神经肽Y和肿瘤坏死因子-α水平影响及疗效

目的探讨枯草杆菌二联活菌颗粒对厌食症患儿血清神经肽Y(NPY)和肿瘤坏死因子-α(TNF-α)水平影响及疗效。方法选取2012年6月~2014年6月在浙江省嘉兴市妇幼保健院儿童厌食症患者86例,采用随机数字表将其分为观察组(43例)和对照组(43例)。两组患儿均予以纠正患儿不良饮食习惯、健胃消食药和葡萄糖酸锌等常规治疗。观察组患儿加用枯草杆菌二联活菌颗粒1.0 g/次,2次/d,温开水冲服。疗程为6周。对照组患儿除不使用枯草杆菌二联活菌颗粒外余治疗基本同观察组。观察并记录两组患儿治疗前和治疗6周后血清NPY和TNF-α水平的变化,并比较其治疗后的临床效果及药物不良反应。结果治疗6周后,两组患儿血清NPY和TNF-α水平[观察组:(45.53±7.82)pg/m L,(10.24±2.74)mmol/L;对照组:(37.39±7.53)pg/m L,(8.19±2.13)mmol/L]较治疗前[观察组:(32.17±5.18)pg/m L,(6.82±1.76)mmol/L;对照组:(32.79±4.23)pg/m L,(7.03±1.54)mmol/L]明显上升(t=2.89、3.12、2.31、2.45,P<0.05或P<0.01),且观察组上升程度较对照组更明显(t=2.19、2.24,P<0.05);同时观察组患儿临床总有效率(93.02%)较对照组(76.74%)更佳(χ2=4.44,P<0.05)。两组患儿治疗中无明显的药物不良反应发生。结论枯草杆菌二联活菌颗粒治疗儿童厌食症的效果较确切,且安全性较好,其作用机制可能与其升高血清NPY和TNF-α水平,提高患儿的食欲密切相关。     

HPLC同时测定慢性阻塞性肺病患者血浆中的茶碱和1,3-二甲基尿酸

目的 采用HPLC法同时测定慢性阻塞性肺病(COPD)患者血浆中的茶碱及其代谢物1,3-二甲基尿酸(1,3-DMU).方法 色谱柱为Hypersil BDS C18柱(250 mm×4.6 mm,5μm),流动相为乙腈-水(7∶93),流速1 mL·min-1,检测波长280 nm.43名COPD患者连续服用茶碱(100 mg,bid)两周后,测定茶碱及1,3-DMU的血药浓度.结果 茶碱、1,3-DMU的线性范围分别为0.20 ～ 10.00 μg∶ mL-1(r=0.9998)、0.05 ～ 2.00 μg∶ mL-(r=0.9996);日内、日间RSD均≤12.91％,提取回收率分别为77.52％ ～79.22％、71.69％ ～ 74.02％;患者的平均茶碱血药浓度为3.57±1.59 μg∶ mL-1,茶碱和1,3-DMU的浓度呈强相关(r=0.672),1,3-DMU/茶碱为0.064±0.024.结论 所用方法简便、快速、准确,可用于COPD患者茶碱血药浓度的监测,1,3-DMU与茶碱浓度的比值可评估不同个体对茶碱清除率的差异.     

Prognostic Value of Renal Function for Cardiac Events in Patients Without Significant Stenosis on Coronary Computed Tomography Angiography

This study was conducted to determine clinical parameters predicting future major adverse cardiovascular events (MACEs) in patients without significant stenosis on coronary computed tomographic angiography (CCTA). A total of 625 patients with suspected coronary artery disease (CAD) who underwent CCTA that revealed insignificant (< 50%) CAD was reviewed in three cardiac centers. The MACEs including cardiac death, non-fatal myocardial infarction (MI), unstable angina and late (> 90 days after CCTA) revascularization were assessed. During the mean follow-up period of 819 ± 529 days (median 837 days), there were 28 cases of MACEs (4.5%). In multivariable Cox regression analysis, independent predictors for MACEs were male sex (hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.01-5.69; P = 0.046) and low estimated creatinine clearance (eCCr) (< 60 mL/min/1.73 m²) (HR, 3.07; 95% CI, 1.22-7.74; P = 0.017). Low eCCr was the only independent predictor for hard events including cardiac death and MI (HR, 17.6, 95% CI, 1.44-215.7; P = 0.025). In conclusion, renal function is an independent predictor for cardiovascular events among patients without significant CAD by CCTA. Careful monitoring and preventive strategy are warranted in patients with impaired renal function even without significant CAD.

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Long-term renal and cardiovascular effects of antihypertensive treatment regimens based upon isradipine, perindopril and thiazide

The aim of this study was to describe the renal function (renal hemodynamics, water and sodium handling) and its relation to cardiovascular structural changes in a population of essential hypertensive patients before and after antihypertensive treatment. Glomerular filtration rate and renal plasma flow were measured by a constant infusion technique. The reference substances used were [¹³¹I]iodohippurate (Hippuran) and [¹²⁵I]iothalamate. The lithium clearance method was used for measuring renal water and sodium handling. Microalbuminuria was measured. A subcutaneous gluteal biopsy was taken and the media thickness to lumen diameter ratio of small resistance vessels was determined. Left ventricular mass index was determined by echocardiography. Thirty-seven patients with newly diagnosed or poorly controlled essential hypertension were randomized to treatment with regimens based upon either isradipine, perindopril or hydrochlorothiazide-amiloride. Atenolol and hydralazine were added as secondary and tertiary drugs, respectively, when needed for normalization of diastolic blood pressure. Investigations were performed before and after 9 months of normalization of blood pressure. Renal function in untreated hypertensive patients was characterized by increased renal vascular resistance, decreased renal blood flow, normal glomerular filtration fraction and normal serum creatinine. No association was found between peripheral resistance vessel structure in subcutaneous vessels and renal hemodynamic parameters. Patients with severe left ventricular hypertrophy (left ventricular mass >360 g) had lower glomerular filtration fraction, greater renal vascular resistance, lower renal blood flow and increased microalbuminuria in comparison with patients with less pronounced cardiac changes. After 1 year of treatment, which had a profound effect on heart and vessel structure, renal hemodynamics were unchanged in patients receiving antihypertensive treatment regimens based on the ACE inhibitor perindopril or the Ca-antagonist isradipine, whereas renal plasma flow was reduced, glomerular filtration rate preserved and filtration fraction significantly increased in those treated with a regimen based on diuretics. The serum creatinine concentration was decreased in the former group, whereas it was unchanged in the latter two. Significantly detrimental effect on uric acid homeostasis was only found in patients treated with a regimen based on diuretics.     

燮理糖肾颗粒降糖作用的实验研究

目的 观察以肾主藏精泻浊为理论基础,采用补肾泻浊化瘀法配制燮理糖肾颗粒的降糖效果.方法 分别选用自发性糖尿病KKAy小鼠、四氧嘧啶致高血糖大鼠、四氧嘧啶致高血糖小鼠及正常大鼠,4种模型随机分为模型组,燮理糖肾颗粒4、8、16 g生药/kg剂量组,西药组,并设正常对照组,观察给药前、后血糖变化.结果 与正常组比较,模型组动物血糖明显升高,并稳定到实验结束,糖尿病模型成立.与模型组比较,燮理糖肾颗粒8、16 g生药/ks剂量组,动物血糖明显降低,燮理糖肾颗粒各剂量组对正常大鼠血糖无明显影响.结论 以肾主藏精泻浊为理论基础,采用补肾泻浊化瘀法配制燮理糖肾颗粒有降糖效果.     

The role of growth hormone in the glucose intolerance of uremia

Summary The fasting plasma growth hormone (GH) concentration and the plasma growth hormone response to sustained hyperglycemia was examined in 8 chronically uremic subjects before and after hemodialysis employing the hyperglycemic clamp technique. The plasma glucose concentration was actuely raised and maintained at +125 mg/100 ml above basal levels. Since the glucose concentration was held constant, the glucose infusion rate is an index of glucose metabolism (M) and M divided by the plasma insulin response (I) is a measure of tissue sensitivity to insulin. Predialysis, the fasting GH concentration, 4.0±1.0 ng/ml, was significantly greater than controls, 0.3±0.1 ng/ml (p<0.01), and failed to suppress normally following sustained hyperglycemia. Both M, 4.23±0.36 mg/kg·min, and M/I, 5.05±0.79 mg/kg·min per μU/ml, were significantly reduced compared to controls (p<0.001). There was no correlation between either the fasting GH concentration or the GH response to sustained hyperglycemia and either M or M/I. Following dialysis both M, 6.30±0.64 mg/kg·min, and M/I, 8.39±1.06 mg/kg·min per μU/ml, increased (p<0.01) without significant change in either the fasting GH level, 4.0 ± 1.2 ng/ml, or the plasma GH response to hyperglycemia. It is concluded that while deranged GH physiology is a common accompaniment of the uremic state, it is not responsible for the glucose intolerance and tissue insensitivity to insulin observed in uremia. The middle of the weight range for subjects of medium frame from the 1959 Metropolitan Life Insurance Company table for desirable weight was used.     

正交试验法优选宣郁通经汤颗粒的提取工艺

目的 优选宣郁通经汤颗粒的最佳提取工艺。方法 用正交试验法优选宣郁通经汤颗粒水提工艺的加水量、提取时间和次数,以提取液中芍药苷含量和出干膏率为指标,每个因素3个水平,优选最佳水提工艺。结果 宣郁通经汤颗粒的最佳水提工艺为饮片加8倍量水浸泡30 min,提取3次,每次60 min。结论 优选的宣郁通经汤颗粒提取工艺稳定、可行。