“向日葵”社区模式的治疗管理体系

药物滥用群体是一个具有特殊人格特点的群体，如：反社会、急躁、冲动、易激惹，对自己思想、行为和情绪的控制能力低下，消极、情绪低落、逃避现实、回避困难、遇事退缩，做事难以坚持、容易松懈，对自己估价过低，感觉无能，缺乏重新生活的勇气，做事马虎、容易出错、不切实际，无所追求、懒散，自私说谎，不负责任，对人和事物缺乏信心和信任等，而在治疗社区（therapeutic community，TC）中，药物滥用者自己不但能获得有效的治疗和帮助，使其变态人格得以矫治，还能积极主动地帮助其他滥用者。     

延胡索与其伪品板栗的鉴别

延胡索为常用中药，具有活血、利气、止痛等功效，用于胸胁、脘腹疼痛，经闭痛经，产后瘀阻，跌扑肿痛等症。延胡索主要产于浙江，属“浙八味”之一。近几年来，由于用药量的增长，供不应求的矛盾突出，导致价格上扬，从而也出现个别药贩挖空心思造假掺伪，谋取暴利。因此，市场上先后出现的混淆品有水半夏、夏天无、雷丸、无名异、姜黄、天南星、浙贝母、零余子、阿尔泰牡丹草、块茎参、块茎大戟等。     

中药市场上名贵药材的现状探讨

名贵中药历史悠久，使用广泛，疗效肯定，资源较少，价格较贵，如参类、西洋参类、鹿茸类、冬虫夏草、枫斗、西红花、灵芝、川贝母、海马、燕窝、蛤蟆、沉香、牛黄等，大多作为强身健体、提高免疫力、治疗重大疾病的药物。然而，市场上制假贩假的现象不断，伪品、劣品层出不穷，手法愈加隐蔽，将名称或形态相近的混淆品与正品混为一谈，真伪鉴别更为重要。     

马钱子中毒致肝损害1例

病例：李某，男，57岁，汉族，患类风湿性关节炎7年。双膝关节肿大变形，双手关节梭样改变，腰椎有强直性改变，活动受限，逢阴天及寒冷气候，关节疼痛加重。某三甲医院诊断为类风湿性关节炎。经多方医治无效，患者苦不堪言。后得一方，以马钱子15克，加麻黄、羌活、独活、威灵仙、伸筋草、五加皮、桑寄生、当归共九味，自制蜜丸15粒，每丸重10克，日服一次，每服一粒。     

老年人淡漠型甲亢误诊恶性肿瘤1例

老年人甲亢起病多隐匿，临床症状多不典型，较易误诊，现将我所收治1例并结合文献报告如下。 1 临床资料 患者，男，69岁，因食欲减退、消瘦4个月，一周内明显加重，于2007年8月15日来门诊。病人近4个月来无诱因出现食欲减退，进食减少，体重明显下降，约20公斤，近1周上述症状加重，伴身体、肌肉软弱无力、站起困难、少汗、恶心、未吐、无多饮、心悸、易激，时有便秘。既往无“高血压病、糖尿病”史。查体：Bp16／11kpa，神志清楚，精神淡漠，恶液质状态，眼球不突出，甲状腺不肿大，双肺呼吸音清晰，心律齐，     

肝性脊髓病1例

1一般资料 患者女，44岁，25年前因反复腹胀、乏力，于山东省荣成市人民医院诊断为乙肝肝硬化，15年前因脾功能亢进于我院行脾切除术，2月来无明显诱因出现双下肢无力、行走困难，无双下肢疼痛、麻木不适，无蚁走感，无袜套样改变，无双下肢浮肿，无头痛、头晕，无意识障碍，无发热、畏寒，无胸闷、憋气，无胸痛，无腹痛、腹泻，无腰背部疼痛，饮食睡眠良好，大小便未见异常。既往体健。     

组织现役干部实施乙肝免疫接种的做法（摘要）

1病例报告 患者男，84岁。既往有冠心病、慢性支气管炎，肺气肿，肺源性心脏病等病史。2008—11—09，因咳嗽、咳痰频繁，干休所卫生所给予消炎、止咳、祛痰等对症治疗3天，效果不佳，准备去医院住院治疗。医生和家人从二楼掺扶下楼上救护车时，患者没有气喘，胸闷、心慌、气急等主诉，而当患者上车刚坐下时，突然晕倒，意识丧失，血压、脉搏测不到。医生判定为心脏骤停，立即给予心前区捶击两次，人工呼吸、胸外按压等心肺复苏术，     

金匮温经汤治疗妇科病举隅

温经汤出自《金匮要略·妇人杂病脉证并治》，由吴茱萸、当归、芍药、川芎、人参、桂枝、阿胶、牡丹皮、生姜、甘草、半夏、麦冬组成，具有温经散寒，活血祛瘀，兼有养血清心之功效，主治冲任虚寒，瘀血阻滞证。此方组方有度，配伍严谨，为后世医家所推崇，被视为妇科调经的经典方剂，对后世的影响较大。笔者自近年来应用本方治疗妇科疾病效果满意，特作简要介绍如下：     

沐舒坦用于老年人肺炎的祛痰治疗临床疗效观察

肺炎是老年人较常见的内科疾病，临床症状表现不典型，待发现时病情常较严重，大多数需住院治疗，且病死率高，加之基础疾病的掩盖，肺炎易于漏诊，一般肺炎症状如畏寒、寒战、高热、咳嗽、胸痛可不明显，而常出现心动过速，呼吸急促，且可为早期症状，肺部炎症病变广泛时有低氧血症表现如嗜睡、意识模糊、表情淡漠、反应迟钝，约20％患者临床白细胞不增高，听诊肺局部可闻及湿哕音，通常无实变体征。由于老年人长期卧床患者较多，     

慢性高原红细胞增多症（二）

临床表现本病起病隐袭、缓慢，病程长，症状复杂、多样化。早期症状不明显。随着病情的发展，出现脑、血液、心、肺损害的表现。晚期出现充血性心力衰竭或多器官功能衰竭。1．症状：常见的症状为头昏，头胀痛，疲乏无力，记忆力减退，心悸，胸闷，手足发麻，失眠，恶心，呕吐，上腹部不适，视力障碍，鼻衄，血尿，多汗症（高碳酸血症所致），短暂性脑缺血发作以及脑血栓形成所致症状。2．体征：患者呈多血面容（Plethoricap－pearance）一颜面肤色暗红，皮肤、粘膜紫绀，眼结膜、粘膜血管扩张及明显充血。病情严重者出现浮肿及黄疽。部份病…     

医用纳米与基因药物口服化的探索

口服给药乃是疾病防治的主要手段之一,由于方便、有效、舒适、安全受到患者与医生的普遍欢迎。但是大分子药物在肠道的摄取和吸收仍然缺乏详尽的有效研究。最近十多年来，利用纳米技术开展大分子药物在肠道的摄取和吸收取得了可喜的进展。本文系统地阐述纳米颗粒、蛋白转导、纳米微粒在肠道的摄取位点、摄取细胞种类与吸收的关系。本文对口服给药基因治疗这一新颖的给药途径的探索予以重点介绍，并讨论了目前口服基因药物传递及基因表达的主要障碍和未来发展趋势。     

Caffeine and diazepam: Separate and combined effects on mood,memory, and psychomotor performance

The effects of caffeine and diazepam on several mood, cognitive, learning, memory, and psychomotor tasks were investigated in a double-blind study of 108 young healthy adults who were randomly assigned to nine treatments; oral administration of caffeine (0, 3 and 6 mg/kg), diazepam (0, 0.15, and 0.30 mg/kg) and their combinations. Subjects completed a battery of tasks once before and twice after administration of the drugs. Caffeine alone showed no effects on cognitive, learning, and memory performance, but impaired fine motor coordination and increased anxiety and tenseness. Diazepam alone produced sedation, lowered other ratings of subjective moods, and impaired cognitive, learning, and memory performance. The two drugs did not antagonize the effects of each other, except in the symbol cancellation task.     

Dietary phytochemicals and their potential effects on obesity: A review

The incidence of obesity is rising at an alarming rate and is becoming a major public health concern with incalculable social costs. Indeed, obesity facilitates the development of metabolic disorders such as diabetes, hypertension, and cardiovascular diseases in addition to chronic diseases such as stroke, osteoarthritis, sleep apnea, some cancers, and inflammation-bases pathologies. In this review we summarize the progresses made in our understanding of obesity, including the role of inflammation process, the recently understood endocrine function of adipose tissue, as well as passive roles of processes of energy storage and adipogenesis related to fat cell lifecycle: differentiation, maturation, and apoptosis. In addition, the article discusses the anti-obesity potential of dietary phytochemicals and analyzes their mechanisms of action, e.g. induction of apoptosis and lipolysis and inhibition of inflammation.     

新疆高寒地区家畜、家禽胆汁与肠内容物中的弯曲菌带菌情况的调查分析

目的调查高寒地区家畜、家禽胆汁与肠内容物中弯曲菌的分布情况。方法对12种家畜、家禽胆汁与肠内容物中的弯曲菌进行分离、培养、鉴定,并观察7种家畜、家禽胆汁弯曲菌的存活时间。结果在1814份家畜、家禽胆汁中发现,猪、牛、马、羊、狗、猫、鸡、鹅、鸭、鹌鹑、鸽子、家兔的胆汁中弯曲菌带菌率分别为6.67%、4.17%、4.94%、3.64%、8.93%、19.05%、6.41%、2.78%、6.48%、24.39%、5.66%、0。体外实验证明,弯曲菌在胆汁中可存活4～7周。结论高寒地区家畜、家禽肠内容物的带菌率均高于同种家畜、家禽的胆汁带菌率,提示该区家畜、家禽是弯曲菌的重要传染源。     

Enacting multiple methamphetamines: The ontological politics of public discourse and consumer accounts of a drug and its effects

Over the last decade in Australia, methamphetamine has come to be seen as a significant issue for drug research, policy and practice. Concerns have been expressed over its potency, the increasing prevalence of its use and its potential for producing greater levels, and more severe forms, of harm compared to amphetamine or other drugs. In this article, we critically examine some of the ways in which methamphetamine and its effects are produced and reproduced within and through Australian public discourse, focusing in particular on the associations made between methamphetamine and psychosis. We show how public discourse enacts methamphetamine as an anterior, stable, singular and definite object routinely linked to the severe psychological ‘harm’ of psychosis. We contrast the enactment of methamphetamine within public discourse with how methamphetamine is enacted by consumers of the drug. In their accounts, consumers perform different methamphetamine objects and offer different interpretations of the relationships of these objects to psychological problems and of the ontological nature (i.e. relating to what is real, what is, what exists) of these problems. In examining public discourse and consumer accounts, we challenge conventional ontological understandings of methamphetamine as anterior, singular, stable and definite, and of its psychological effects as indicative of pathology. In line with recent critical social research on drugs, we draw on social studies of science and technology that focus on the performativity of scientific knowledge and material practices. We suggest that recognising the ontological contingency, and therefore the multiplicity, of methamphetamine offers a critical counterpoint to conventional research, policy and practice accounts of methamphetamine and its psychological effects.     

Effects of overexpression of IncRNA AC079466.1 on apoptosis of NSCLC cells through endoplasmic reticulum stress signaling pathway北大核心CSCD

目的初步探讨lncRNA AC079466.1在非小细胞肺癌(non-small cell lung cancer,NSCLC)组织和细胞中的表达,及其过表达对A549和H1299细胞增殖、凋亡、迁移、侵袭的影响。方法收集20例NSCLC患者癌组织及相应的癌旁组织,qRT-PCR检测lncRNA AC079466.1在组织和细胞中的表达。转染过表达质粒为AC079466.1组,转染空质粒为NC组,无转染为Blank组。MTT、流式细胞术、Transwell检测过表达lncRNA AC079466.1对A549和H1299细胞活力、凋亡、迁移和侵袭的影响;Western blot检测过表达lncRNA AC079466.1对内质网应激相关因子GRP78、PERK、eIF2α、ATF4、CHOP,以及Bax、caspase-3表达的影响。结果与癌旁组织相比,癌组织中lncRNA AC079466.1的表达水平明显降低;与HBE细胞相比,lncRNA AC079466.1在A549和H1299细胞的表达量明显降低。与Blank组和NC组相比,AC079466.1组A549和H1299细胞的活力、迁移、侵袭能力均明显下降,凋亡率明显升高,内质网应激相关因子GRP78、p-PERK、eIF2α、ATF4、CHOP,以及Bax、caspase-3表达均明显上调。结论过表达lncRNA AC079466.1可明显抑制A549和H1299细胞的活力、迁移和侵袭能力,并促进细胞的凋亡,其机制可能与促进内质网应激介导的细胞凋亡有关。     

虎杖的化学成分及药理作用研究进展

对近10年来中外期刊有关虎杖Polygonum cuspidatum的研究成果进行了检索,对从虎杖中分离并鉴定的化学成分及药理活性研究进展进行总结。虎杖中主要含有蒽醌类、二苯乙烯类、黄酮类、香豆素类以及一些脂肪酸类化合物,具有多种药理作用,包括抗炎、抗病毒、抗菌、调血脂、抗血栓、改变血流变、扩张血管、保护心肌、抗氧化、抗肿瘤,改善阿尔茨海默病及预防艾滋病等。多年来对虎杖的研究成果证明了其应用前景和开发价值,为更好地利用该资源提供依据。     

Novel modes of antifungal drug administration

Administration of antifungals by routes other than that for which the agent was designed or approved have been utilised in attempts to provide directed therapy, reduce adverse effects and improve drug penetration into selected infection sites, such as the central nervous system, lungs and peritoneum. The most widely investigated agent utilising a novel method of drug delivery is amphotericin B. Dose forms for this agent include topicals (aerosol, nasal spray, irrigations, pastes, absorbable sponges, impregnated bone cement and gelatin), oral dosage forms (solutions, suspensions, tablets and so on) and ophthalmic preparations (drops, ointments and injections). Amphotericin B has been administered by routes such as oral, endobronchial, intrathecal, intracisternal, intra-articular, intraperitoneal, ophthalmic and as an antibiotic ‘line lock’. Nystatin has been administered as an aerosol, percutaneous paste and bladder washes. Azoles, such as miconazole, fluconazole, ketoconazole and posaconazole, have been administered by novel methods but to a lesser degree. Most of these reports involve miconazole. The dose forms and routes of administration for azoles have included irrigants (bladder, joint), ophthalmic preparations (eye drops, intraocular injections, ointments), impregnated bone cement, endobronchial and intrathecal administration. Finally, both methylene blue (bladder washes) and flucytosine (peritoneal lavage, ophthalmic eye drops) have also been employed. Adequate evaluations of both the safety and efficacy of these therapies are most often hindered by prior or concomitant antifungal therapies, comorbidities and the lack of controlled clinical trials. In addition, the availability of newer treatment options, which demonstrate significant improvement in drug distribution and treatment-related adverse effects make many such novel modes of administration less practical or necessary. In contrast, the inhalation of antifungal aerosols, such as amphotericin B, is rapidly becoming a viable prophylactic option.     

Patent News

Septic shock remains as an important cause of morbidity and mortality. In spite of better antimicrobial and support treatment, death due to septic shock has increased in several groups of patients. In recent years, an improved understanding of the pathogenesis of sepsis and the advances in molecular biology and biotechnology, have led to the research on new treatments. Potential therapeutic compounds are able to interfere with endotoxins and cytokine pathways, such as that of TNF-α, and to prevent tissue damage by other inflammatory mediators such as complement, lipid compounds, bradykinins, leukocyte adhesion molecules, nitric oxide (NO), the coagulation cascade, opioids, endothelin and vasopressin. The use of angiotensin-converting enzyme (ACE) inhibitors, protease inhibitors and immune modulation is also discussed. This article reviews the physiopathology, the rationale, efficacy and shortcomings of agents for the treatment of septic shock in human and animal models.     

骨架型别嘌醇缓释微丸的制备及其质量评价

目的：优化骨架型别嘌醇缓释微丸的处方及制备工艺,并对其进行质量评价。方法：采用挤出滚圆法制备微丸;以得率为指标,考察骨架材料、致孔剂、崩解剂及制备工艺过程的滚圆速度和滚圆时间对释放度的影响,并验证处方;以圆整度及粒度分布、流动性、脆碎度为指标,对其进行质量考察。结果：优化的处方以微晶纤维素（Mcc）为骨架材料,以乳糖为致孔剂,交联羧甲基纤维素钠为崩解剂,控制滚圆速度为50Hz,滚圆时间为20rain。通过调节MCC、乳糖和崩解剂的配伍使用,可以起到调节药物释放的作用,得到释放度符合要求的微丸。验证试验所得微丸的平均圆整度为10．2,粒度分布在22~26目最多,占95．63％;平均休止角为23．15,流动性良好;脆碎度为0．08％;其他各项质量指标良好。结论：所选处方及制备工艺合理、可行,所制备微丸质量良好。