厚朴总酚固体分散体不同制备方法的比较研究

比较研究厚朴总酚固体分散体不同制备方法之间的差异。分别使用热熔挤出法、溶剂蒸发法、熔融冷却法制备厚朴总酚Plastone S-630及HPC 2种辅料固体分散体。采用DSC,X-射线衍射评价所制备固体分散体中药物的分散状态;通过FT-IR分析药物与辅料之间可能存在的连接方式;最后通过加速稳定性-溶出试验比较3种工艺的稳定性差异。DSC及X-射线衍射结果显示3种工艺制备的固体分散体中药物均能以无定形态存在;FT-IR结果也无法区别3种工艺间的差异;加速稳定性-溶出试验表明HPC所制备的固体分散体稳定性明显优于Plastone S-630,同种辅料间热熔挤出技术制备的固体分散体稳定性要好于其他2种工艺。     

白及多糖配伍对三七总皂苷中10种成分药动学的影响

目的建立UPLC-MS/MS法同时测定三七总皂苷中10种皂苷成分的分析方法,并研究白及多糖对三七总皂苷各成分药动学参数的影响。方法大鼠分为三七总皂苷组(P组)、三七总皂苷配伍白及多糖组(BP组),分别ig给药,UPLC-MS/MS法测定10种皂苷单体成分的血药浓度,DAS软件计算各成分药动学参数。结果分析方法符合生物样品测定要求。与P组相比,BP组人参皂苷Rb1的AUC显著降低(P0.01),三七皂苷R1及人参皂苷Rd、Rg1、Rf、CK、Rc、Rh1、Rg2、Rg3的AUC有所降低,但无显著性差异。10种成分总AUC为P组BP组,差异显著(P0.01)。与P组相比,BP组人参皂苷Rg1的Cmax降低(P0.05)。且BP组各成分的tmax普遍延迟,其中人参皂苷Rg1、Rb1、Rf显著延迟(P0.01),人参皂苷Rg2和三七皂苷R1延迟(P0.05)。结论所建立的UPLC-MS/MS分析方法适于10种皂苷成分在生物样品中的测定;配伍白及多糖可降低三七总皂苷的血药浓度,减少AUC暴露,延长tmax,说明白及多糖可能增加了三七总皂苷在胃肠道的暴露水平,从而增加作用于胃肠道的药效。     

Surgery of the Primary Tumor Offers Survival Benefits of Breast Cancer with Synchronous Ipsilateral Supraclavicular Lymph Node Metastasis

Background

Controversy exists around the locoregional management of the primary tumor for breast cancer associated with synchronous ipsilateral supraclavicular lymph node metastasis (sISLM) due to the rarity of the disease and limited available data. This study aimed to compare outcomes of patients in the Surveillance, Epidemiology, and End Results (SEER) database with sISLM who underwent surgical resection and radiation of the primary tumor with those who did not.

Methods

This population-based retrospective study included breast cancer patients with sISLM without distant metastases from 2004 to 2016 in the SEER database. In this study, patients had been stratified by operative management, and propensity score matching (PSM) had been successfully applied.

Results

A total of 1172 breast cancer patients with sISLM were included in the study: 863 (73.6%) of patients underwent the primary tumor resection, and 309 (26.4%) patients did not undergo surgery. The median survival time in the surgery group was longer compared to the nonsurgery group in the overall cohort and the PSM cohort. We concluded that the primary tumor resection was associated with improved survival. Subgroup analysis further demonstrated that local surgery was not inferior to radical surgery.

Conclusion

For selected breast cancer patients with sISLM, surgery is a promising local intervention which may improve the survival.

     

中药制剂指标性成分群辨识思路与方法解析

中药制剂具有多成分、多靶点、多环节整体作用的特点,使得其制备工艺优化及质量标准体系构建困难,正确辨识中药制剂中与功效密切相关的主要活性成分群并以此构建中药制剂工艺、质量评价体系成为中药制剂工艺设计与质量控制亟待解决的关键科学问题。较为全面地分析了谱-效相关、中药药动学、血清药物化学和血清药理学、整合效应关联性分析、计算机虚拟筛选以及敲入/敲除对比分析等研究方法的可行性,以期为中药制剂工艺与质量评价基于标志性活性成分群的辨识思路提供借鉴。     

从缄默知识角度谈中医教育改革

英国思想家迈克尔·波兰尼明确提出“缄默知识”这一概念，他指出显性知识是用书面文字、图标和数学公式表示出来，易于存储、交流和共享的知识，而缄默知识就是存在于个人的头脑之中，存在于某个特定环境下，存在着只可意会不可言传、尚未被语言或者其他形式表述的知识。就知识的个人性、默会性和寄托而言，中医知识的大部分完全符合波兰尼关于缄默知识的标准。“医者意也，意者医也”，可以说，中医作为一种知识其神韵正在于它的“可以意会，难于言传”的特性。这种特性突显了中医领域中掌握独特的个体性的“缄默知识人才”的重要性，也表明培养这种缄默知识人才正是中医教育的目标。