基于中医诊疗指南的冠心病知识图谱构建

目的：运用知识图谱技术将诊疗指南中的辨证论治过程构建为可视化的知识图谱,通过程序将输入临床表现到输出相应的中医诊断和处方用药的过程进行可视化,为中医医师直观地显示诊疗过程和数据关系,为中医药诊治冠心病的标准化和规范化提供助力,为中医药诊疗的传承和推广提供技术依托。方法：采用Neo4j联合py2neo知识图谱技术,以中华中医药学会心血管病分会发布的《冠心病稳定型心绞痛中医诊疗指南》为模式构建知识图谱,通过编程实现以临床表现的输入调用知识图谱,可视化展示冠心病稳定型心绞痛的中医规范化诊疗过程。结果：使用py2neo库调用Neo4j,从诊疗指南中提取整理好的结构化数据导入Neo4j,构建基于冠心病稳定型心绞痛中医诊疗指南的知识图谱,且该知识图谱支持图数据库查询功能。结论：该研究结合目前中医诊疗经验传承中存在的问题,针对冠心病稳定型心绞痛这个单一病种,笔者提出了一种基于凝结了中医行业专家经验和循证证据所形成的诊疗指南,实现基于中医诊疗指南和专家经验的知识图谱可视化展示过程,为直观地展现从症状输入到遣方用药的整个中医诊疗过程和辅助中医经验传承提供助力,为中医的标准化和规范化诊疗提供了一种可参考的...     

Effect of Slip Time in Forming Neo‐Esophageal Stenosis After Replacement of a Thoracic Esophagus With Nitinol Artificial Esophagus

Attempts have been made to investigate the effect of slip time of nitinol artificial esophagus for forming neo‐esophageal stenosis after replacement of a thoracic esophagus with nitinol artificial esophagus in 20 experimental pigs. The pigs whose slip time was less than 90 days postoperatively had severe dysphagia (Bown's III) immediately after they were fed, and the dysphagia aggravated gradually later on (Bown's III–IV). The pigs whose slip time was more than 90 days postoperatively had mild/moderate dysphagia (Bown's I–II) immediately after they were fed, and the dysphagia relieved gradually later on (Bown's II‐I‐0). The ratios between the diameter of neo‐esophagus in different slip time and normal esophagus were 25% (at 2 months postoperatively), 58% (at 4 months postoperatively), and 93% (at 6 months postoperatively), respectively. The relationship between nitinol artificial esophagus slip time and neo‐esophageal stenosis showed a positive correlation. After replacement of a thoracic esophagus with nitinol artificial esophagus, the artificial esophageal slip time not only affected the original diameter of the neo‐esophagus immediately, but also affected the neo‐esophageal scar stricture forming process later on. The narrowing of neo‐esophagus is caused by overgrowth of scar tissue. But there is the positive correlation between artificial esophagus slip time and neo‐esophageal stenosis, so this can be a way of overcoming neo‐esophageal stenosis by delaying slip time of artificial esophagus.     

贲门癌术后吻合口复发的再手术治疗

目的探讨贲门癌术后吻合口复发外科再治疗的手术指征及术式选择.方法对23例贲门癌术后吻合口复发,再手术患者的临床资料进行回顾性分析.结果本组患者的手术切除率、手术并发症发生率及手术病死率分别为69.6%、17.4%和8.7%,胸、腹腔粘连率为87.0%.肿瘤切除患者平均术后存活15.0个月,明显长于未切除患者的4.1个月(P＜0.05).无淋巴结转移患者术后存活21.3个月,虽较有淋巴结转移患者的10.2个月长,但差异无显著性意义(P＞0.05).根治性切除和姑息性切除患者的术后生存期分别为15.8个月和13.3个月,差异无显著性意义(P＞0.05).结论由于胸、腹腔的广泛粘连及二次手术后的消化道重建,贲门癌术后吻合口复发再手术有一定难度,手术风险较大,加之贲门癌患者本身预后较差,因此应严格把握手术指征.术式选择应根据患者病变的分期、分级等具体情况而定.     

Coronary Vascular Bed Perfusion with a Polyethylene Glycol-Modified Hemoglobin-Encapsulated Liposome, Neo Red Cell, in Rats

Whether hemoglobin (Hb) encapsulated liposomes have vasoconstrictive activity remains controversial. We therefore examined the vascular activity of a liposome Hb, Neo red cell (NRC), in a simple in vitro model of Langendorff perfusion of the rat heart using Krebs-Henseleit (KH) solution as the perfusate. In the KH solution, NRC (Hb at 1 mg/ml), however, induced an immediate and abnormal increase in perfusion pressure. Histological examinations revealed that embolisms were the likely cause of this disturbance. Inorganic crystals formed by the mixing of NRC with the perfusate were a possible source of the embolisms. We found that the addition of bovine serum albumin to the perfusate was effective in avoiding embolic events. This protocol was used to compare the vasoconstrictive properties of unmodified bovine Hb and NRC. Unmodified bovine Hb (1 mg/ml) caused an increase in perfusion pressure and a decrease in the duration of bradykinin-induced relaxation. In contrast, NRC (Hb at 1 mg/ml) had no such vasoconstrictive effects. These results provide the first information regarding perfusion of the circulatory vascular bed by NRC and further evidence that the encapsulation of Hb into liposomes is an effective approach to modulate Hb-related vasoconstrictive activity.     

复方甘草酸苷片联合伐昔洛韦治疗带状疱疹疗效观察

目的探讨复方甘草酸苷片联合伐昔洛韦治疗带状疱疹的疗效。方法选取2011年1月至2012年3月收治的带状疱疹患者共76例,随机分为治疗组和对照组,其中治疗组采用复方甘草酸苷片联合伐昔洛韦治疗,而对照组仅用伐昔洛韦治疗。结果治疗组的平均止疱、止痛、结痂时间均明显短于对照组(P<0.05);治疗组患者的总有效率明显高于对照组,差异具有统计学意义(94.74%vs.68.42%,P<0.05)。结论复方甘草酸苷片联合伐昔洛韦治疗带状疤疹可明显地缩短患者的止痛、止疱和结痴时间,迅速消退皮损及缓解疼痛,及早改善患者的临床症状,且不良反应少。     

术前5-FU持续静脉输注联合CF治疗Ⅱ期乳腺癌的近期疗效分析

目的：探讨长时间静脉输注５－ＦＵ加口服甲酰四氢叶酸钙（ｃａｌｃｉｕｍ ｆｏｌｉｎａｔｅ,ＣＦ）片剂,在Ⅱ期乳腺癌术前新辅助化疗中的应用,并与ＣＭＦ方案进行疗效及毒副反应比较。方法：以随机对照研究,对两组共７０例乳腺癌患者术前化疗疗效及毒副反应进行观察、比较与分析。结果：５－ＦＵ静滴加口服ＣＦ组有效率达７１．９％,ＣＭＦ组３１．６％。结论：５－ＦＵ静滴加口服ＣＦ方案作乳腺癌术前新辅助化疗疗效明显,毒副反应可耐受,值得在临床进一步探索。     

基于Heracles Neo超快速气相电子鼻对广藿香饮片的快速鉴别及气味指纹图谱研究

目的 通过Heracles Neo超快速气相电子鼻技术,建立广藿香饮片快速鉴别方法,建立专属性特征性强的广藿香饮片气味指纹图谱.方法 采用Heracles Neo超快速气相电子鼻对广藿香饮片及黑龙江、四川和湖南3个产地的藿香饮片样品进行气味分析,根据获取的气味色谱信息,结合Kovats保留指数及Arochembase数...     

低剂量新三联疗法根除幽门螺杆菌40例

目的探讨低剂量新三联疗法根除幽门螺杆菌(Hp)的临床疗效.方法将80例消化性溃疡Hp阳性患者随机分成两组,治疗组40例,予低剂量新三联疗法治疗(奥美拉唑20mg,qd,克拉霉素250mg,qd,阿莫西林500mg,bid,共口服1周),对照组40例,予新三联疗法治疗,对比1周后Hp根除率及6周后溃疡愈合情况,随访半年后Hp再感染及溃疡的复发率.结果1周后低剂量新三联疗法与新三联疗法Hp根除率均为95%(P＞0.05),且溃疡愈合情况、Hp再感染及溃疡的复发率差异均无显著性.结论低剂量新三联疗法与新三联疗法疗效相近,但价格较便宜,易被患者接受,适合临床推广.     

高效液相色谱 蒸发光散射检测法对藤黄中藤黄酸及其衍生物的含量测定

为了测定中药藤黄中藤黄酸及其衍生物的含量,本文建立了HPLC 蒸发光散射检测器测定其含量的方法。色谱条件是C18 柱;流动相:甲醇 乙腈 水 冰乙酸(6∶2∶1∶0 .3) ,流速0 .8 ml/ min ;检测器温度75 ℃,N2压力2 .1 L/ min ,进样量20 μl。结果表明藤黄酸及其衍生物响应峰面积回归方程是Y= 1 .582 X 16 .207 ,r =0 .9996 ,5 种商品藤黄中藤黄酸含量为22 .75 % 34 .58 % ,新藤黄酸含量为12 .75 % 21 .79 % ,其回收率分别为95 .89 % ,98 .04 % ;RSD3 .4 % 。方法快速简便,结果准确,只需藤黄酸的回归方程即可对藤黄酸衍生物等未知成分进行初步定量。     

Nuciferine stimulates insulin secretion from beta cells-an in vitro comparison with glibenclamide

Ethnopharmacological relevance

Several Asian plants are known for their anti-diabetic properties and produce alkaloids and flavonoids that may stimulate insulin secretion.

Materials and methods

Using Vietnamese plants (Nelumbo nucifera, Gynostemma pentaphyllum, Smilax glabra, and Stemona tuberosa), we extracted two alkaloids (neotuberostemonine, nuciferine) and four flavonoids (astilbin, engeletin, smitilbin, and 3,5,3′-trihydroxy-7,4′-dimethoxyflavone), and studied their insulin stimulatory effects.

Results

Nuciferine, extracted from Nelumbo nucifera, stimulated both phases of insulin secretion in isolated islets, whereas the other compounds had no effect. The effect of nuciferine was totally abolished by diazoxide and nimodipine, and diminished by protein kinase A and protein kinase C inhibition. Nuciferine and potassium had additive effects on insulin secretion. Nuciferine also stimulated insulin secretion in INS-1E cells at both 3.3 and 16.7 mM glucose concentrations. Compared with glibenclamide, nuciferine had a stronger effect on insulin secretion and less beta-cell toxicity. However, nuciferine did not compete with glibenclamide for binding to the sulfonylurea receptor.

Conclusions

Among several compounds extracted from anti-diabetic plants, nuciferine was found to stimulate insulin secretion by closing potassium-adenosine triphosphate channels, explaining anti-diabetic effects of Nelumbo nucifera.