瓜蒌化学、药理及临床应用探讨

总结瓜蒌已有的实验和临床研究成果,分析瓜蒌的化学成分特点,探讨综合利用瓜蒌的途径。瓜蒌含有糖苷类、色素等成分,具有抗心肌缺血、抗心肌纤维化等作用。在冠心病心绞痛、肺源性心脏病等临床方面疗效较好。     

Management of Neurogenic Orthostatic Hypotension

The burden of orthostatic hypotension (OH) on public health is a universally recognized enigmatic clinical condition that is associated with significant increases on morbidity and mortality rates, and can take a major toll on one's quality of life. Orthostatic hypotension is predictive of vascular deaths from acute myocardial infarction, strokes in the middle aged population, and increases mortality rates when associated with diabetes, hypertension, Parkinson's disease, and patients receiving renal dialysis. The consensus definition for OH is a fall in systolic blood pressure of at least 20 mm Hg and/or diastolic blood pressure of at least 10 mm Hg within 3 minutes of quiet standing. Because neurogenic OH is often accompanied by supine hypertension, the treatment program should aim toward minimizing OH and the potential fall injuries related to cerebral hypoperfusion without exacerbating nocturnal hypertension that may lead to excessive cardiovascular complications.     

Parent–child mathematical interactions: examining self-report and direct observation

Variability in children’s early-learning home environments points to the need to better understand specific mechanisms of early mathematical development. We used a sample of 66 parent–preschool child dyads to describe parent-reported mathematical activities in the home and observed parent–child mathematical activities in a semi-structured play session. Data were examined to better understand the two methods of assessing the context of parent–child interactions related to mathematics. Parents reported engaging in a range of mathematical activities about 3–5 times per week, on average. Results from observed interactions indicated that parents engaged in math content/concept interactions in 32.5% of all observed intervals and children engaged in math content/concept interactions in 24.2% of all observed intervals. Although observed parent and child math content interactions were highly correlated, observed parent and child mathematical interactions were not correlated with parent-reported math activities.     

The role of social workers in addressing nonmedical needs in primary health care

Nonmedical needs are intricately linked to health. Unaddressed nonmedical needs often result in poorer health and increased healthcare costs. Although social workers are well positioned to address nonmedical needs, their role in healthcare environments to address nonmedical needs is limited. The limited role relates to a lack of reimbursement streams, which stems from poor articulation about their unique contributions. An analysis of a case study in which a social worker using AIMS, a protocolized care coordination model, was undertaken to highlight specific activities performed by social workers. Implications for patient health outcomes and healthcare costs are discussed.     

Change in quality of life of medically hospitalized patients – A one-year follow-up study

Objectives: To examine changes in quality of life (QOL) among elderly medically hospitalized patients one year after hospitalization, and to explore factors associated with the changes.

Methods: A one-year follow-up study included 363 (175 men) medical inpatients with age range 65–98 (mean 80.2, SD 7.5) years. Information was collected at baseline and follow-up using the WHOQOL-BREF questionnaire assessing the physical, psychological, social and environment domain of QOL as the dependent variable, and the Mini-Mental State Examination, Lawton and Brody's scales for physical self-maintenance and instrumental activities of daily living, the Hospital Anxiety and Depression scale and assistance in living as the independent variables.

Results: The mean score of the physical domain of QOL had increased (mean change 0.6, SD 2.5; p?p? Conclusion: Good cognitive, physical and emotional health at baseline and follow-up were associated with improved QOL in previously hospitalized elderly patients independent of their need for assistance in living.     

雪莲果成分及药理活性研究进展

雪莲果中主要含有酚酸、黄酮、倍半萜内酯、低聚果糖等化合物，在抗氧化、抗炎、降血糖、抑菌、抗癌等方面作用明显。雪莲果根茎及叶中含有大量的酚酸类化合物，主要为咖啡酸及其衍生物，该类物质使得雪莲果具有明显的抗氧化作用。同时，该类物质也可通过改善胰岛素敏感性而产生降低血糖的作用。低聚果糖在雪莲果块茎中含量丰富，可通过调节肠道菌群平衡而改善肠道功能。雪莲果叶表面的香毛簇中含有倍半萜内酯类化合物，该类物质可明显抑制癌细胞的增殖，其中uvedafolin、enhydrofolin活性较强，并且该类物质对革兰氏阳性菌具有明显的抑制作用。在结构上，环氧基团的数量的差异，与抗癌、抑菌作用的强弱有一定关联。除此之外，雪莲果中还含有挥发油、脂肪酸、甾醇、二萜、对羟基苯乙酮衍生物以及辛酮糖酸衍生物等化合物，具有抗阿尔茨海默病、保护肾脏、降血脂等药理作用。然而，目前对雪莲果中化合物的分离鉴定等方面的研究还不完善，相关药理作用仍有待深入。因此通过查阅国内外相关报道，对雪莲果中的化学成分和药理作用进行归纳总结，以期对雪莲果的综合开发利用提供参考。     

Quantitative cancer inhibitory of hydroxytyrosol in olive oil compounds: an overview of observational and experimental studies

Hydroxytyrosol (HTyr), an important phenol present in olives, stands out as a compound of high value due to its excellent antioxidant, antimicrobial and anticarcinogenic activities. Hydroxytyrosol (HTyr, 4-(2-(hydroxyethyl)-1,2-benzendiol)) is one of the main phenolic compounds in olives, virgin oil and waste water obtained during the production of olive oil. HTyr has been confirmed as the antioxidant with the highest free radical scavenging capacity, and is more active than antioxidant vitamins (C and E) as well as the synthetic antioxidants. Studies (human, animal, in vivo and in vitro) have shown many beneficial attributes of this ortho-diphenol compound, e.g. anti-inflammatory activity and inhibition of platelet aggregation. Similar to other polyphenols, HTyr was shown to prevent atherosclerosis through the inhibition of LDL oxidation. Furthermore, polyphenols extracted from the virgin olive oil containing mainly HTyr were also shown to inhibit different kinds of cancer, e.g. proliferation of human leukemia cells and colon carcinogenesis. This work summarizes current knowledge on the bioavailability, biological activities (e.g. anticancer activity, anti-inflammatory activity) and major active components of olive oil (containing mainly HTyr).     

Human urinary kallidinogenase in treating acute ischemic stroke patients: analyses of pooled data from a randomized double-blind placebo-controlled phase IIb and phase III clinical trial

ABSTRACT

Objectives: Intravenous thrombolysis and thrombectomy are recommended for patients whose stroke onsets are within first 6 h, and very few options are available for patients whose stroke onset is more than 6 h, which includes most ischemic stroke patients. Human urinary kallidinogenase (HUK) showed potential clinical benefits in acute ischemic stroke patients. This study aims to investigate the safety and clinical benefits of HUK in ischemic stroke patients.

Patients and methods: Patients were recruited for a multicenter double-blind, placebo-controlled phase II b and phase III trial. Neurophysiological outcomes were assessed by the European Stroke Scale (ESS) and the functional outcomes were assessed by the activity of daily living scale (ADL). Safety was monitored by recording adverse events.

Results: The improvements in ESS scores and ADL scores in the HUK group were significantly greater than that in patients receiving placebo. Furthermore, HUK treatment was also associated with a lower rate of disable, according to ADL. HUK-related adverse events occurred at a low rate, in 1.73% of HUK-treated patients.

Conclusion: HUK is safe and provides potential clinical benefits as a treatment for acute ischemic stroke. Further large post-marketing observational studies are needed.     

恶性黑素瘤免疫检查点抑制疗法研究进展

【摘要】 免疫检查点抑制剂在过去几年中已成为许多恶性黑素瘤患者的重要治疗选择，其旨在恢复并促进效应T细胞特异性识别和杀伤肿瘤细胞的功能，系统性增强全身的抗肿瘤免疫反应，对于手术切除后具有高复发风险或处于疾病晚期（不可切除或存在转移）的患者都是较好的治疗选择。目前免疫检查点抑制的主要目标是程序性死亡受体 1与细胞毒性T淋巴细胞相关抗原4，它们分别是中枢和外周免疫耐受的两个关键受体。本文主要讨论不同免疫检查点抑制剂的临床效应、可能存在的药物反应性预测标志物与相关不良反应。