蒙药绿松石的质量标准研究＊

目的 建立蒙药绿松石的质量标准。方法 收集不同产地绿松石，共10批。观察绿松石样品和粉末的性状并进行理化鉴别；按2020年版《中国药典》（四部）通则方法测定绿松石样品中水分、浸出物含量；采用原子吸收光谱法测定绿松石样品铜元素含量。结果 绿松石为不规则、周围带有黑石的块状物，表面蓝绿色，体重，质硬脆，难砸碎，断面呈贝壳状，蜡样光泽，粉末呈灰绿色，无臭，味淡；理化鉴别结果显示，呈铜盐反应；10批次样品中水分含量为0.41%-3.94%（SD=1.37%），浸出物含量为0.21%-0.81%（SD=0.21%），铜元素含量为3.03%-4.63%（SD=0.63%）。结论 初步拟定绿松石中水分含量不得超多5.0%、浸出物含量不得低于0.10%，铜元素含量应为2.60%-4.84%，制定的标准可用于蒙药材绿松石的质量控制。     

Dry eye in chronic stroke patients with hemiplegia: A cross-sectional study

ABSTRACT

Objective: Dry eye is reported to be associated with several neurological diseases. The aim of this study is to evaluate the patients with hemiplegia after stroke for dry eye and compare their results with a control group.

Materials and methods: Forty-five patients with hemiplegia and 45 individuals as the control group were included in the study. Tear function tests (Schirmer and tear breakup time) and a dry eye questionnaire for dry eye symptoms (ocular surface disease index) were performed and the results of the two groups were compared.

Results: Schirmer test results were significantly lower in the post-stroke hemiplegia group compared to the control group (11.3 ± 8.2 mm and 20.6 ± 11.6 mm, respectively, p < .001). Tear breakup time results were significantly lower in the post-stroke hemiplegia group compared to the control group (7.9 ± 3.1 s and 12.1 ± 4.3 s, respectively, p < .001). Ocular surface disease index scores were not significantly different between hemiplegia and control groups (21.6 ± 20.0 and 19.8 ± 13.9, respectively, p = .635). Schirmer scores lower than 10 mm (60% and 30%, p < .001) and tear breakup time results lower than 10 s (65.6% and 28.9%, p < .001) were also higher in the hemiplegia group compared to control group.

Conclusion: We found lower Schirmer test and tear breakup time results and similar OSDI scores in hemiplegia patients compared to controls. Hemiplegia patients may have dry eye without typical symptoms. This should be taken into consideration in the follow-up and rehabilitation of post-stroke hemiplegia patients.     

The quality of spontaneous adverse drug reaction reports from the pharmacovigilance centre in western China

Background: High-quality adverse drug reaction (ADR) reports are essential for conducting drug safety monitoring in pharmacovigilance. The study aim was to assess the current quality of ADR reports in western China, and to identify problems with ADR report quality.

Research design and methods: A sample of 1139 reports received by the Shaanxi ADR Monitoring Center from January 2015 to December 2017 was selected. ADR report quality was evaluated using an ADR report quality evaluation system.

Results: None of the reports were rated as excellent and 1.40% (n = 16) as good. Report quality was better for new and serious reports than for general reports. Medical institutions generated higher quality reports than pharmaceutical manufacturers. Nurses generated higher quality reports than doctors, pharmacists, and other professionals. Reporters of different occupations showed significant differences in the quality of the indicators Reporting time limit, Intervention ADR time, ADR termination time, ADR intervention measures, Original disease, and Cause of medication (P = 0.000).

Conclusions: The ADR data quality was poor in western China, and of lower quality than reported data from previous research in other regions. Improvements in the quality and availability of ADR reports are urgently needed.     

Subscapularis Transthoracic Versus Posterolateral Approaches in the Surgical Management of Upper Thoracic Tuberculosis: A Prospective,Randomized Controlled Study

The objective of the present study was to evaluate the clinical, radiological, and functional outcomes of a subscapularis transthoracic surgical approach and a posterolateral surgical approach with debridement, bone graft fusion, and internal fixation for the treatment of upper thoracic tuberculosis.There is currently debate over the best surgical approach for the treatment of upper thoracic tuberculosis. Traditionally, the subscapularis transthoracic approach has been preferred; however, the posterolateral approach has gained popularity in the past few years.A prospective, consecutive cohort of 43 upper thoracic tuberculosis patients with a mean age of 39 years (range: 20–52 years) was followed up for a minimum of 12 months (range: 12–60 months). Patients were randomly divided into 2 groups. Group A (n = 21) was treated by the subscapularis transthoracic approach and group B (n = 22) was treated by the posterolateral approach. All cases were evaluated for clinical, radiological, and functional outcomes. Intraoperative blood loss, operative duration, intraoperative and postoperative complications, hospital stay, the cure rate, fusion time, and the Frankel scale were used for clinical and functional evaluation, whereas the kyphosis angle was used for radiological evaluation.Grafted bones were fused by 10 months in all cases. There was no statistically significant difference between groups before surgery in terms of gender, age, segmental tuberculosis, erythrocyte sedimentation rate (ESR), Frankel scale, or Cobb''s angle (P > 0.05). The average operative duration for Group B was lower than that of Group A. There were no significant differences in intraoperative blood loss, intraoperative and postoperative complications, hospital stay, grafted bone fusion time, or cure rate between groups (P > 0.05). The Cobb''s angle correction rate for group B (68.5%) was significantly better than that of group A (30.9%). The neurological score showed significant postoperative improvement in both groups, with no significant difference between the groups.The subscapularis transthoracic approach and the posterolateral approach with debridement, bone graft fusion, and internal fixation are both sufficient and satisfactory for the surgical treatment of upper thoracic tuberculosis. However, the posterolateral approach is superior to the subscapularis transthoracic approach in terms of surgical trauma, operative time, and kyphosis correction.     

不同低浓度罗哌卡因低位硬膜外镇痛对运动神经阻滞的临床观察

目的 观察不同低浓度罗哌卡因（ropivacaine,Rop）低位硬膜外镇痛对运动神经的阻滞作用。探讨罗哌卡因低位硬膜外镇痛的最佳药物浓度。方法 随机选择我院67例下腹部择期手术患者，术后随机分为5个治疗组（A、B、C、D、E）和一个对照组（F），3h后硬膜外腔用药。前5组使用不同浓度罗哌卡因（A：0.1%;B:0.15%;C:0.2%;D:0.25%;E:0.3%），F组使用0.9%生理盐水。注药前后20分钟分别观察、记录以下项目：1.视觉模拟评分（Visual analogue scale,VAS）；2.阻滞区运动神经反射；3. 下肢指令运动。结果 不同低浓度罗哌卡因均有程度不同的术后镇痛作用。对运动神经的阻滞作用A、B、C三组与对照组无显著性差异（P＞0.05），而D、E两组有显著性差异（P＜0.05）。结论 选择浓度为0.2%的罗哌卡因低位硬膜外镇痛既可以有效地发挥术后镇痛作用，又最大程度地减少了对运动神经的阻滞作用，有利患者术后恢复。     

中风毒邪论与神经保护治疗的研究

中风毒邪论是一种与传统中医中风病理有所不同的理论 ,在中风毒邪论指导下形成解毒通络方是较为理想的神经保护剂 ,可解决目前神经保护治疗的主要障碍 ,有望成为提高中医治疗中风急性期疗效的关键     

低温保存同种心脏瓣膜活性及临床应用的研究

取正常成人心脏瓣膜３６个，置于低浓度广谱抗生素的营养液（ＲＰ－ＭＩ１６４０细胞培养液）中灭菌４８ｈ，－８０℃冰箱初冻，置于液氮中长期保存。灭菌前后瓣膜细菌培养阴性率分别为９４．３％和１００％，解冻后经光镜、电镜检查证实瓣组织细胞结构正常，组织培养葡萄糖消耗率测定示瓣组织存活良好。临床同种心脏瓣膜原位移植３例，随访６～３０个月，瓣功能良好     

卷柏抗肿瘤药理作用研究

目的：为寻找高效低毒的抗肿瘤药物，探究卷柏抗肿瘤的药理作用。方法：采用卷柏水提物及其各个萃取部位对小鼠肉瘤S180，肝癌H22模型腹腔注射给药，并观察两肿瘤体重量变化。实验结果表明：卷柏水提取物及其各个萃取部位对两种瘤株均有不同程度的抑制作用，其中JB-W-2(水萃取部位)作用最强，且存在着剂量依赖性；其次是JB-W-3在大剂量时仅对肉瘤呈现较强的抑制作用。     

沙丁胺醇与布地奈德联合应用和双倍沙丁胺醇治疗支气管哮喘的疗效观察

目的:比较联合吸入沙丁胺醇与布地奈德和双倍吸入沙丁胺醇在治疗轻中度支气管哮喘患者的临床疗效。方法:80例患者随机分成两组:①观察组沙丁胺醇6~12m g/d加用布地奈德400~800ug/d,每日两次;②对照组沙丁胺醇双倍使用即剂量为12~24 m g/d,每日两次。疗程均为8周。结果:观察组患者临床症状明显缓解,早、晚最大呼气流量(PEF)改善,较对照组有明显统计学差异(P<0.05)。药物不良反应观察组与对照组之间无统计学差异。结论:沙丁胺醇、布地奈德联合应用,通过两者之间协调互补可有效改善肺功能,使哮喘患者得到很好治疗。