Moorfields回归分析及多变量区别分析诊断开角型青光眼

目的研究Moorfields回归分析(MRA)及多变量区别分析(MDA)的2个指标FSM和RB诊断开角型青光眼的能力,及MRA在视盘整体和视盘分区间的差异。方法对23例正常人(26眼)、26例可疑开角型青光眼患者(32眼)和21例开角型青光眼患者(21眼)进行HRT-Ⅱ和OCTOPUS视野计G2-TOP程序两项检查。结果视盘整体MRA、FSM、RB与视野缺损指数间相关系数分别为0.537、-0.565、-0.716(P<0.01),且3个组间差异均有统计学意义(P<0.01),随着视盘面积增大,MRA、FSM和RB特异性均下降。可疑组中视盘分区MRA与视野检查一致率均高于整体,一致率最高分区为颞下(78.13%)。各分区中MRA敏感性、特异性最高的分区为颞上和颞下。结论MRA和MDA检测开角型青光眼能力较强,且与视野检查间存在较好的相关性,但应用于大视盘分析时须谨慎下结论。     

基于化学计量学方法结合正交偏最小二乘判别分析的陈皮饮片HPLC指纹图谱研究

目的建立陈皮饮片HPLC指纹图谱分析方法,为其质量控制提供技术参考。方法采用HPLC法建立17批陈皮饮片的指纹图谱,通过聚类分析(clusteranalysis,CA)、主成分分析(principalcomponentanalysis,PCA)、正交偏最小二乘判别分析(orthogonal partial least square discrimina te analysis,OPLS-DA)对指纹图谱进行评价。结果建立了陈皮饮片指纹图谱,相似度均0.9,确定了25个共有峰,其中14个峰的变量投影重要性(variableimportance projection,VIP)均1,通过与对照品谱图比对,确定了13号峰为芸香柚皮苷、14号峰为橙皮苷、23号峰为川陈皮素、24号峰为3,5,6,7,8,3′,4′-七甲氧基黄酮、25号峰为桔皮素。结论该方法简单可靠,可用于陈皮饮片鉴别和质量控制。     

Prediction of the tissue-specificity of selective estrogen receptor modulators by using a single biochemical method

Here, we demonstrate that a single biochemical assay is able to predict the tissue-selective pharmacology of an array of selective estrogen receptor modulators (SERMs). We describe an approach to classify estrogen receptor (ER) modulators based on dynamics of the receptor-ligand complex as probed with hydrogen/deuterium exchange (HDX) mass spectrometry. Differential HDX mapping coupled with cluster and discriminate analysis effectively predicted tissue-selective function in most, but not all, cases tested. We demonstrate that analysis of dynamics of the receptor-ligand complex facilitates binning of ER modulators into distinct groups based on structural dynamics. Importantly, we were able to differentiate small structural changes within ER ligands of the same chemotype. In addition, HDX revealed differentially stabilized regions within the ligand-binding pocket that may contribute to the different pharmacology phenotypes of the compounds independent of helix 12 positioning. In summary, HDX provides a sensitive and rapid approach to classify modulators of the estrogen receptor that correlates with their pharmacological profile.     

Multivariate analysis of biochemical markers in synovial fluid from the shoulder joint for diagnosis of rotator cuff tears

Multivariate discriminant analysis allowed definition of cytokine, matrix metalloproteinases (MMP), and tissue inhibitors of metalloproteinases (TIMP) levels in synovial fluid (SF) of patients with rotator cuff tears and other shoulder lesions. We analyzed SF aspirated from the glenohumeral joints of 17 patients with rotator cuff tears; SF from nine patients with other shoulder lesions was used to characterize a non-rotator-cuff-tear (NRCT) group. Discriminant analysis demonstrated statistically significant differences in (1) the determination of whether rotator cuff tear patients are separable from the NRCT group using the influential functions, the most influential of which were interleukin 1-beta, MMP-2, and MMP-13, and (2) the assessment of whether full-thickness rotator cuff tears are distinguishable from partial tears using identical influential functions. The most influential function in the latter analysis was MMP-13. Both interleukin 1-beta and MMP-13 might be biochemical markers of impending rotator cuff tears.     

Determinants of ELISA D-dimer sensitivity for unstable angina pectoris as defined by coronary catheterization

Unstable angina pectoris is associated with elevated D-dimer levels. However, the operating characteristics (sensitivity, specificity, positive and negative predictive value) of the D-dimer assay for the diagnosis of coronary artery disease (CAD) are unknown. Using a prospective, observational design, we collected blood from 54 patients with unstable angina pectoris at admission and assayed for ELISA D-dimer levels. The sensitivity, specificity, and negative and positive prediction values for angiographically determined coronary artery disease were calculated at multiple discriminate levels. All patients underwent coronary catheterization. A statistically significant correlation was noted between ELISA D-dimer levels and age, male sex, hypertension, use of beta-blocker, fibrinogen levels and catheterization findings. No correlation was noted between ELISA D-dimer levels and degree of the coronary artery disease. Best results were provided at a discriminate level of 270 ng/ml, with sensitivity 70%, negative predictive value 72%, and overall accuracy 67%. All discriminate levels, however, provided values too low for diagnosis. In conclusion, ELISA D-dimer assay is a non-sensitive, non-specific test for coronary artery disease as defined by coronary catheterization. However, the assay adds information regarding the severity of disease in patients presenting with acute coronary syndrome.     

甘肃省2009-2015年发热呼吸道症候群主要病原的Bayes判别分析法分类研究

目的 了解甘肃省发热呼吸道症候群主要病原体,构建区分主要病原感染病例的Bayes判别函数。方法 以2009-2015年甘肃省各哨点医院监测的发热呼吸道症候群病例为样本,描述其病原谱构成,确定主要病原;并在样本病例中筛选有意义的临床指标进行Bayes判别分析。结果 在发热呼吸道症候群病毒检测中,流感病毒和鼻病毒检测阳性率较高（13.79%和8.63%）,分别占病毒总阳性例数的54.38%和13.73%;细菌中以肺炎链球菌和流感嗜血杆菌检测阳性率较高（44.41%和18.07%）,分别占细菌总阳性例数的66.21%和24.55%。运用筛选后的11个临床指标建立判别函数,其初始验证正确率为73.1%、交叉验证为70.6%。结论 甘肃省发热呼吸道症候群主要病原体为流感病毒、鼻病毒、肺炎链球菌及流感嗜血杆菌;Bayes判别分析在主要病原感染的分类诊断中有较高的正确率,具有一定的应用价值。     

Metabolic profiling reveals therapeutic biomarkers of processed Aconitum Carmichaeli Debx in treating hydrocortisone induced Kidney-Yang deficiency syndrome rats

Ethnopharmacological relevance

Kidney-Yang Deficiency syndrome (KYDS) is a diagnostic pattern in traditional Chinese medicine (TCM) and clinical data showed that the unbalance in adrenal cortical hormone is the key issue in KYDS patients. The processed Ranunculaceae Aconitum carmichaeli debx (Bai-Fu-Pian in Chinese, BFP) is one of the most commonly used Chinese herbs for treating KYDS. The present study was conducted to explore the therapeutic biomarkers of the BFP in treating hydrocortisone administration induced KYDS rats.

Materials and methods

Thirty male Sprague-Dawley rats were randomly divided into five groups with six in each group. KYDS in rats was induced by i.p. injection of hydrocortisone at the dose of 10 mg/kg per day for 15 days as described previously. The rats with KYDS were administered orally, starting from the day of hydrocortisone administration stopped, with BFP extract at the dose of 0.32 g/kg, 0.64 g/kg and 1.28 g/kg per day respectively for 15 days. The blood samples were collected for the liquid chromatography quadruple time-of-flight mass spectrometry (LC-Q-TOF-MS) test, as well as radioimmunoassay to determine the concentrations of cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP) and adrenocorticotrophic hormone (ACTH). The metabolic responses to BFP administration were investigated by using the principal components analysis (PCA) and orthogonal partial least squares analysis (OPLS). Bioinformatics analyses were performed by using the Ingenuity Pathway Analysis (IPA). Variance analysis and linear regression analysis were used in this study.

Results

The signs and concentrations of cAMP, cGMP and ACTH in the model rats were similar to those previously described about KYDS rats and BFP treatment can reverse the changes. Seventeen significantly changed metabolites among different groups were identified. Thirteen metabolites were identified in the KYDS rats comparing to healthy rats with nine up-regulated and four down-regulated. After BFP treatment at three dosages, five up-regulated metabolites including phosphate, betaine, (4-hydroxyphenyl) acetaldehyde, 5-hydroxyindol-3-acetic acid and 5'-phosphoribosyl-N-formylglycinamide were dose-dependently reversed. The network analysis with IPA showed that four canonical pathways including superpathway of methionine degradation, purine nucleotides De Novo biosynthesis II, tyrosine synthesis and serotonin receptor signaling involved the therapeutic mechanism of BFP in treating the KYDS rats.

Conclusions

Five therapeutic biomarkers (phosphate, betaine, (4-hydroxyphenyl) acetaldehyde, 5-hydroxyindol-3-acetic acid and 5'-phosphoribosyl-N-formylglycinamide) and two corresponding canonical pathways (amino acid metabolism and purine nucleotide metabolism) were identified to be involved in the therapeutic mechanism of BFP treating the KYDS.     

浅谈药品批号和有效期的标示与识别

目的探讨药品批号、有效期的规范标示及识别。方法查阅相关资料,综述国产及进口药品批号和有效期的意义、标示管理规定及识别方法,并对药品批号、有效期标示中存在的问题进行分析。结果与结论我国药品批号和有效期的标示亟待规范和统一。药品生产企业应按规定标示药品的批号及有效期;监管机关应加大监管力度,规范药品批号及有效期的标示,确保人民群众用药安全、有效。     

血管内皮生长因子及癌胚抗原对鉴别良、恶性胸腔积液的意义

[目的]通过检测胸腔积液中血管内皮生长因子（VEGF）和癌胚抗原（CEA）的水平,探讨对鉴别良、恶性胸腔积液的意义。[方法]采用酶联免疫吸附试验（ELISA）检测26例恶性胸腔积液和20例良性胸腔积液患者的胸腔积液VEGF和CEA含量。[结果]恶性胸腔积液VEGF含量为（625.3±280.2）pg/ml,良性胸腔积液VEGF的含量为（250.6±110.4）pg/ml,两者比较（P〈0.01）;恶性胸腔积液CEA的含量为（48.6±18.5）μg/L,良性胸腔积液CEA的含量为（5.6±2.2）μg/L,两者比较（P〈0.01）,恶性胸腔积液VEGF和CEA的含量均明显高于良性胸腔积液。胸水VEGF＋胸水CEA对恶性胸腔积液诊断的特异性为95.0%,敏感性为69.2%。[结论]检测胸腔积液VEGF、CEA含量有利于良、恶性胸腔积液的鉴别诊断。     

中晚期非小细胞肺癌中医辨证论治

回顾近年来关于中晚期非小细胞肺癌的中医辨证论治的研究,并对此进行归纳,总结分类,把目前对于该病的辨证分为：气阴两虚证,阳虚寒凝证,痰瘀互结证,癌毒证,邪阻经络证五类,并对其病机稍加论述。文章认为,对于中晚期非小细胞肺癌患者来说,本虚标实为其病机的根本,各医家均基于该基础,侧重于不同的方面,对于该病的治疗提出不同的看法,并且均达到了较好的效果。