中药儿童群体药动学试验设计要点

儿童由于身体发育尚未完善,药物在体内分布代谢有其自身的特点,且在不同年龄、体质量区间的差别很大,使得儿童用药剂量不能简单地参考成人用药剂量进行折算。群体药动学是研究目标人群药物代谢参数的有效方法,尤其适用于儿童这一特殊群体,可有效避免经典药物代谢取血点多所带来的伤害,并可充分了解协变量影响因素的大小,可见掌握药物在儿童中的群体典型值意义重大。提出了中药在儿童群体中开展药动学研究的试验要点与技术方法。     

电针结合耳穴干预单纯性肥胖伴糖调节受损临床研究

目的观察电针结合耳穴对单纯性肥胖伴糖调节受损（IGR）的影响。方法将64例单纯性肥胖伴IGR患者随机分为针刺治疗组和二甲双胍药物组,分别给予相应的治疗,疗程3个月。观察两组治疗前后体重指数（BMI）、空腹血糖（FPG）、餐后2小时血糖（2hPG）、空腹胰岛素（FINS）及胰岛素抵抗指数（HOMA-IR）的变化情况。结果治疗后两组BMI、FPG、2hPG、FINS和HOMA-IR均较治疗前明显降低（P〈0.01）,且两组BMI、FPG和2hPG治疗前后差值有显著性差异（P〈0.05,P〈0.01）。结论电针结合耳穴可减轻单纯性肥胖伴糖调节受损患者体重,改善糖代谢和胰岛素抵抗。     

食品级磷酸生产企业职业病危害及关键控制点分析

目的通过对食品级磷酸生产企业的职业病危害因素识别与分析,确定职业病危害关键控制点。方法采用现场卫生学调查和职业病危害因素检测检验方法。结果食品级磷酸生产存在的主要职业病危害因素为黄磷、磷酸、五氧化二磷、硫化氢、砷及其化合物、噪声,超标部位为熔磷岗位、磷酸巡检岗位和砷渣岗位,检测毒物合格率为85％。结论食品级磷酸生产职业病危害的防护应从职业病危害关键控制点人手,采取切实可行的职业病防护设施或措施,减少或降低职业病危害。     

新型蒸压粉煤灰砖厂职业病危害调查及关键控制点分析

目的识别与分析某新型蒸压粉煤灰砖厂职业病危害因素,确定职业病危害的关键控制点。方法按照《工作场所空气中粉尘测定》《工作场所物理因素测量》的要求,对该厂作业场所进行职业卫生学调查和职业病危害因素检测检验。结果粉煤灰砖厂主要存在的职业病危害因素为矽尘、石灰石粉尘、石膏粉尘、噪声。矽尘浓度超标点位包括搅拌机、轮碾机和制砖机,其操作人员接触矽尘的时间加权平均浓度分别为2.26、2.17、5.81 mg/m3,噪声强度超标点位包括球磨机、轮碾机和制砖机,其操作工接触噪声强度分别为86.7、89.3、89.8 dB(A)。该厂存在的职业病危害的关键控制点为球磨机、搅拌机、轮碾机、制砖机等操作岗位。结论在职业病危害防护措施可行、有效的前提下,还应重点加强关键控制点的职业卫生管理和防尘降噪的综合措施。     

某低辐射镀膜玻璃生产线职业病危害因素检测结果分析

目的通过对某低辐射镀膜玻璃生产线职业病危害因素的识别与分析,确定职业病危害的关键控制点。方法采用现场职业卫生学调查和职业危害因素检测检验方法进行分析。结果低辐射镀膜玻璃生产线主要存在的职业病危害因素为粉尘、化学毒物、噪声、高温、热辐射。检测结果表明,30个接尘工种中4个工种作业人员接触粉尘浓度CTWA范围为0.4～5.9 mg/m3,超过国家职业接触限值;作业人员接触一氧化碳、氮氧化物、二氧化硫、二氧化锡、碳酸钠浓度低于国家职业接触限值;镀膜操作工接触异丙醇浓度超过国家职业接触限值;对33个接触噪声的工种进行了噪声等效声级测定,其中4个工种作业工人接触的8 h等效声级63.9～88.7 dB(A)超过职业接触限值的规定;高温作业人员WBGT指数符合国家职业卫生标准。结论低辐射镀膜玻璃生产线存在的职业病危害的防治应从职业卫生管理、工程防护设施、严格佩戴个人防护用品以及职业健康监护等方面综合着手采取切实可行的防护设施或措施。     

针刺三阴交穴治疗痛经的即时临床疗效观察

目的：观察针刺三阴交治疗痛经的即时临床疗效。方法：对36例痛经患者应用针刺三阴交穴治疗疗,并与用芬必得胶囊治疗36例进行即时临床疗效对比。结果：自身对照分析治疗前,治疗后30min,治疗后12h,VAS比较差异均有统计学意义（P〈0．05）,治疗后VAS评分下降。两组治疗前比较（P=0．32〉0．05）两组具有可比性。两组治疗后30rain比较（P〈0．05）治疗组明显优于对照组。两组治疗后12h比较（P〈0．05）治疗组明显优于对照组。结论：针刺三阴交配合艾灸神阙穴治疗痛经有确切疗效。     

中风后吞咽困难深刺内大迎穴的疗效分析

目的：探讨中风后吞咽困难患者应用深刺内大迎穴方法治疗的疗效。方法：随机抽选82例中风后出现吞咽困难患者,进行分两组,各41例,均予以“醒脑开窍”的针法进行治疗：对照组选取玉液、金津穴位进行点刺放血,治疗组予以深刺内大迎穴的方法治疗,4周后采用吞咽障碍以及洼田饮水试验评分、临床总体治疗疗效对比来评定两组疗效。结果：治疗组总有效率为85.4%,对照组总有效率为70.7%,两组比较差异具有显著性（P<0.05）;两组组内比较,治疗前、后吞咽障碍评分以及洼田饮水试验评分比较差异具有显著性（P<0.05）;两组组间比较,治疗后吞咽障碍评分以及洼田饮水试验评分比较差异具有显著性（P<0.05）;治疗组疗效优于对照组。结论：在中风后吞咽困难的临床针灸治疗中,深刺内大迎的方法治疗,其临床疗效优于传统针刺组,疗效显著,提高了中风病人的生活质量,值得临床推广。     

Novel point mutations and mutational complexes in the enhancer II,core promoter and precore regions of hepatitis B virus genotype D1 associated with hepatocellular carcinoma in Saudi Arabia

In this study, a cohort of 182 patients [55 hepatocellular carcinoma (HCC) and 127 non‐HCC] infected with hepatitis B virus (HBV) in Saudi Arabia was investigated to study the relationship between sequence variation in the enhancer II (EnhII), basal core promoter (BCP) and precore regions of HBV genotype D (HBV/D) and the risk of HCC. HBV genotypes were determined by sequencing analysis and/or enzyme‐linked immunosorbent assay. Variations in the EnhII, BCP and precore regions were compared between 107 non‐HCC and 45 HCC patients infected with HBV/D, followed by age‐matched analysis of 40 cases versus equal number of controls. Age and male gender were significantly associated with HCC (p = 0.0001 and p = 0.03, respectively). Serological markers such as aspartate aminotransferase, albumin and anti‐HBe were significantly associated with HCC (p = 0.0001 for all), whereas HBeAg positivity was associated with non‐HCC (p = 0.0001). The most prevalent HBV genotype was HBV/D (94%), followed by HBV/E (4%), HBV/A (1.6%) and HBV/C (0.5%). For HBV/D1, genomic mutations associated with HCC were T1673/G1679, G1727, C1741, C1761, A1757/T1764/G1766, T1773, T1773/G1775 and C1909. Age‐ and gender‐adjusted stepwise logistic regression analysis indicated that mutations G1727 [odds ratio (OR) = 18.3; 95% confidence interval (CI) = 2.8–118.4; p = 0.002], A1757/T1764/G1766 (OR = 4.7; 95% CI = 1.3–17.2; p = 0.01) and T1773 (OR = 14.06; 95% CI = 2.3–84.8; p = 0.004) are independent predictors of HCC development. These results implicate novel individual and combination patterns of mutations in the X/precore region of HBV/D1 as predictors of HCC. Risk stratification based on these mutation complexes would be useful in determining high‐risk patients and improving diagnostic and treatment strategies for HBV/D1.     

Dual time point imaging fluorine-18 flourodeoxyglucose positron emission tomography for evaluation of large loco-regional recurrences of breast cancer treated with electrochemotherapy

Background

Electrochemotherapy is a local anticancer treatment very efficient for treatment of small cutaneous metastases. The method is now being investigated for large cutaneous recurrences of breast cancer that are often confluent masses of malignant tumour with various degrees of inflammation. To this end 18-Flourine-Flourodeoxyglucose-Positron Emission Tomography/Computed Tomography (FDG-PET/CT) could be a method for response evaluation. However, a standard FDG-PET/CT scan cannot differentiate inflammatory tissue from malignant tissue. Dual point time imaging (DTPI) FDG-PET has the potential of doing so. The purpose of this study was to investigate if DTPI FDG-PET/CT could assess response to electrochemotherapy and to assess the optimal timing of imaging.

Patients and methods

Within a phase II clinical trial 11 patients with cutaneous recurrences had FDG-PET/CT scans at three time points: 60 min, 120 min and 180 min after FDG injection. The scans were performed before and 3 weeks after electrochemotherapy.

Results

A significant reduction in maximum standard uptake value at 60 min post injection was seen after treatment. Furthermore a change in the FDG uptake pattern was observed; from increasing uptake in up to 180 min post injection before treatment to stabilization of FDG uptake at 120 min post injection after treatment. The change in FDG uptake pattern over time lead to change of response in three target lesions; two lesions changed from stable metabolic disease to partial metabolic response and one lesion changed from partial metabolic response to stable metabolic disease. To ensure detection of the change in uptake pattern, scanning 60 and 180 min post injection seems optimal.

Conclusions

The present study shows that FDG-PET/CT 60 and 180 min after tracer injection is a promising tool for response evaluation of cutaneous recurrences of breast cancer treated with electrochemotherapy.     

皮下种植复方羟磷灰石钛尖根管充填材料的组织学反应

目的：观察复方羟磷灰石钛尖的组织相容性。方法：将填有实验材料或ｏｘｐａｒａ牙胶尖的硅胶管埋植于猴皮下组织内，３个月后，镜下观察组织学反应。结果：实验组不论充填程度如何，均无明显炎症或反应甚微，而对照组的反应较大。结论：复方羟磷灰石钛尖是一种良好的生物相容性根管充填料。