长春西汀辅治急性脑梗死40例疗效观察

目的观察长春西汀辅治急性脑梗死(ACI)的临床疗效。方法将80例ACI患者随机分为治疗组和对照组各40例。对照组给予常规治疗;治疗组在常规治疗基础上给予长春西汀注射液20mg静脉滴注,每天1次。全部患者于治疗14d后评估临床疗效,同时于治疗前和治疗14d后抽血查血液流变学的各项指标(全血黏度、血浆黏度、红细胞聚集指数、纤维蛋白原、血小板聚集率)。结果治疗组总有效率为95.0%显著高于对照组的75.0%,差异有统计学意义(P<0.05)。2组治疗前血液流变学指标比较差异无统计学意义(P>0.05);2组治疗后全血黏度、血浆黏度、红细胞聚集指数、纤维蛋白原及血小板聚集率水平均降低(P<0.05或P<0.01),且治疗组低于对照组(P<0.05)。结论长春西汀辅治ACI安全有效,值得临床推广应用。     

基于Iwao-m生态模型的疾病空间分布动态模型——疾病的空间分布动态模型研究(二)

在生态学研究中,Ｉｗａｏ在１９６８、１９６９年所描述的生物种群空间分布图式为［１３,５］：~ｍ＝α＋βｍ,其中~ｍ为种群平均拥挤度,ｍ为平均密度,并且对α,β的生物学含义作出了明确的解放。本文根据这些生态学研究的基本思想,提出适合描述疾病空间动态的基本流行病学假设,并据此假设建立相应的数学模型,定量地刻划其空间分布动态。我们的流行病学假设是：在某一特定生境内的某病病例,其空间分布格局指标可以由病例平均密度ｍｃ（ｃａｓｅｄｅｎｓｉｔｙ）平均拥挤度及~ｍｃ（ｃａｓｅｃｏｗｄｉｎｇ）来描述。定义如下：…     

丹参多酚酸盐对冠心病稳定型心绞痛患者血小板功能的影响

目的:探讨丹参多酚酸盐对冠心病稳定型心绞痛患者血小板功能的影响。方法:选取我院2010年1月-2014年1月收治入院的冠心病稳定型心绞痛患者200例,根据治疗方法不同分为两组,其中对照组100例采用常规抗血小板聚集、抗凝和抗缺血等药物治疗,观察组100例在常规治疗基础上采用丹参多酚酸盐治疗,测定两组患者治疗前、治疗后两周采集两组患者静脉血,采用比浊法测定血小板聚集率(MPAR),同时监测血流变指标。结果:观察组治疗后心功能改善显效51例,有效40例,无效9例,治疗总有效率为91.0%(91/100);对照组治疗24周后心功能改善显效48例,有效22例,无效30例,治疗总有效率为70.0%(70/100),两组总有效率比较差异有统计学意义(X2=5.638,P<0.05);两组患者治疗后MPAR、全血粘度高切、全血粘度低切、血浆粘度、红细胞聚集指数等指标均明显低于治疗前,且差异有统计学意义(P<0.05);观察组患者治疗后MPAR、全血粘度高切、全血粘度低切、血浆粘度、红细胞聚集指数等指标均明显低于对照组治疗后,且差异有统计学意义(P<0.05)。结论:丹参多酚酸盐注射液可显著降低冠心病稳定型心绞痛患者血小板聚集功能,改善其血液流变学指标,有效缓解症状,减少不良事件的发生。     

川芎嗪注射液联合常规疗法对大面积脑栓塞患者支架植入术后血小板血流变学及疗效的影响

摘 要 目的：探讨川芎嗪注射液联合常规疗法对大面积脑栓塞患者术后血小板及血流变学的影响。方法: 2014年1月~2015年1月,100例大面积脑栓塞患者随机分为对照组和观察组各50例。对照组患者术后采用常规治疗,观察组患者在对照组基础上加用川芎嗪注射液。两组疗程均为2周。比较两组患者治疗前、治疗后1周、治疗后2周的神经功能损失（NIHSS评分）、血小板聚集率及血液流变学（全血黏度、血浆黏度、红细胞变形指数、红细胞聚集指数、纤维蛋白原）指标变化,评价两组疗效与药品不良反应。结果: 治疗后,观察组与对照组的有效率分别为92.00%与80.00%,差异无统计学意义（P>0.05）。治疗后1周、2周,两组NIHSS评分、血小板聚集率、血液流变学各项指标均较治疗前显著改善（P<0.05）;且观察组改善较对照组更为明显（P<0.05）。观察组药品不良反应发生率明显低于对照组（P<0.05）。结论:在常规治疗基础上加用川芎嗪注射液,可抗血小板聚集,改善血液流变学指标,在治疗大面积脑栓塞的疗效确切。     

鹿瓜多肽治疗类风湿关节炎的疗效分析

目的分析鹿瓜多肽治疗类风湿关节炎的效果。方法选择30例类风湿关节炎（RA）患者,静脉滴注鹿瓜多肽8mg＋5%葡萄糖注射液250mL,连续治疗14d,观察临床症状改善、实验室指标变化及不良反应。结果临床治疗的总有效率为83.33%,治疗14d后,关节肿胀指数、关节压痛指数、休息痛、晨僵时间、握力、血沉（ESR）、C-反应蛋白（CRP）等方面均与用药前有极显著性差异（P〈0.01）。结论鹿瓜多肽治疗类风湿关节炎近期疗效满意,不良反应少,远期疗效尚有待进一步观察。     

应用PDCA循环法提高合理用药水平

目的：研究PDCA循环在合理用药管理中的效果。方法收集不合理用药病例,运用PDCA循环法分析问题、找出原因、制定措施并实施干预。对实施PDCA前后不合理用药类型、例数进行研究。结果应用PDCA循环法后本院合理用药水平有了显著提升。改善前不合理用药发生频数为621例次,改善后为326例次;10种不合理用药类型中有7项指标显著下降,差异具有统计学意义(P<0.05),其中6项指标极显著下降,差异具有统计学意义(P<0.01)。结论应用PDCA循环可以有效地减低不合理用药率,提高合理用药水平。     

硝苯吡啶治疗脑血栓时血小板聚集功能变化

本文报道40例脑血栓患者,经口服硝吡苯啶药物治疗,有效率为87.5％,显效率为72.5％,其作用机制与硝苯吡啶能部分抑制缺血后细胞外钙离子进入细胞内,减少缺血性脑损伤有关。在用药前后采用两种诱导剂做了血小板聚集功能动态观察,治疗前血小板聚集性明显高于正常人(P<0.01)。提示:脑血栓患者血小板聚集性增高是形成血栓的关键。治疗后血小板聚集功能明显低于治疗前(P<0.01),说明硝苯吡啶具有降低血小板聚集功能,可能是钙离子拮抗剂抑制钙离子促发血小板聚集作用所致。     

基于GIS的药品抽样点位研究与评价——以北京市海淀区为例

目的：为规范药品抽样工作，解决药品抽检中抽样点位缺乏统筹规划管理的问题，提出可量化的抽样评价指标，提升监管效能，促进药品监管信息化建设。方法：通过GIS对北京市海淀区2019年至2022年药品抽样信息采集分析。利用平均最近邻指数分析法、核密度估计法、空间缓冲区分析法、地理联系率等分析海淀区药品抽样点位的空间分布情况、覆盖情况及影响因素。结果：海淀区药品抽样点位分布呈聚集特点。与海淀区总体可抽样点位相比，克服了部分聚集性，但近年来聚集程度仍有所增加。抽样点位分布表现出沿商业中心、交通要道、综合居民用地分布的特征，在总可抽样点位“三核”“多点”连带、东南聚集、西北稀疏的地理格局上，逐年变化，呈现出“多核”“南移”“两极”的变化态势。以覆盖率为抽样评价指标可见，海淀区抽样点位数量覆盖率4年达35.74%，去除重复点位后为21.28%，年新增覆盖率在3.58%～4.28%，每年逐步增长但增速较为缓慢。各街镇点位数量选取较为平衡，仅个别街道表现出新增覆盖率不足。抽样点位服务面积覆盖率总体趋势表现为与街道行政区域面积呈负相关，80%以上的街道可实现4年监管周期内对点位服务范围全覆盖，40%以上街道...     

注射用血栓通（冻干）与3种生物化学注射剂配伍稳定性研究

目的 从制剂分析角度进行中药注射剂与生物化学注射剂配伍稳定性研究。方法 注射用血栓通（冻干）（XST）分别与注射用脑蛋白水解物（Ⅲ）、小牛血清去蛋白注射液以及骨瓜提取物注射液按临床实际条件进行联合使用,采用2,4-二硝基氟苯（DNFB）柱前衍生HPLC法,测定配伍生物化学制剂中16种氨基酸含量。并以2015版《中国药典》为依据,检查配伍7 h内溶液渗透压、不溶性微粒、粒径、pH值、澄明度、颜色等各项制剂分析指标变化情况,综合评价药物配伍联合使用稳定性变化。结果 XST与3种生物化学药物配伍在7 h内各指标（渗透压、pH值及颜色、澄明度）均保持稳定。与小牛血清去蛋白注射液配伍在生理盐水（NS）和5%葡萄糖注射液（5% GS）中粒径波动均较大,但在NS中配伍1 h内粒径值保持稳定;与骨瓜提取物注射液配伍7 h后,在NS输液基质中,甘氨酸含量略有升高、亮氨酸含量略有下降;在5% GS输液基质中,不溶性微粒数值随时间呈增长趋势,但仍处于合格范围内。结论 建议临床XST与小牛血清去蛋白注射液配伍选用NS作为药物溶媒,现用现配,并慢速滴入,观察患者情况;使用XST与骨瓜提取物注射液配伍时建议选用5% GS作为输液剂基质即配即用;为中药注射剂质量再评价和临床合理应用提供理论参考。     

血液动力学的改善与眼底病治疗的关系研究

目的观察眼底病患者血液流变学学的异常情况与改善后患者的治愈情况。方法通过对我院2009年1月到2011年3月入住的165例眼底病患者根据病因分组,A组:急性缺血性眼底病患者;B组:视网膜静脉阻塞患者;C组:高血压性眼底病患者;D:糖尿病性眼底病患者。分别测量其治疗前和治疗后血流变学指标,测量治疗后视力增加行数,分析血液动力学的改善与眼底病的关系。结果治疗前和治疗后血流变学指标(全血黏度、血浆黏度、红细胞比容、红细胞聚集指数)具有统计学差异(P<0.05)。结论用药物治疗后,微血管循环和血液流变学指标得到改善,改善血液动力学对眼底病的治疗有好的疗效。     

小白菜花叶病流行及其介体种群时空动态的模糊聚类分析

利用模糊聚类分析方法对小白菜花叶病介体蚜虫种群增长和病害流行的时空动态分别进行分析,并对介体种群增长和病害流行时空动态进行概述。田外带毒介体扩散迁入,花叶病开始发生,在病害流行初期,由于介体在本田内未建立种群,来自田外的带毒有翅蚜虫在田内随机扩散,导致病害的空间扩展迅速,病样方率逐渐上升,病株率伴随上升,每病样方多为1株病株;在病害流行前期,随着介体的进一步迁入和定殖,病害的空间扩展加快,病样方率迅速上升,样方内病株数量增加,病害严重度上升缓慢;在病害流行中期,田内介体种群密度上升,有翅介体在田内大量扩散,导致病株遍及全田,病样方率接近饱和,病害的增长以病株率上升为主;在病害流行后期,病株率接近饱和,严重度迅速上升,然后超于平缓。     

甘薯产量形成动态及蛋白质的分配与积累

根据甘薯产量性状形成动态,将全生长过程分为3个时期:前期为植后60d内,中期为60～90d,后期为90～150d。干、鲜蔓重,中期达最大值,以后下降;干、鲜薯重,前期增长慢,中、后期增长快;生物总产量,受薯重影响大,后期增长较快;薯块烘干率、淀粉率,均以中期增长快,并现峰值;薯块可溶性糖的含量和产量,主要在后期递增。 全生长期内,甘薯各器官蛋白质含量的高低顺序:叶片>吸收根>叶柄>地上茎>块根。各器官蛋白质含量,均以植后30d起呈递减。蛋白质分配主流,随生长期进展,从地上部逐渐转向地下部(块根)。蛋白质积累产量,前期直线上升,中期相对稳定,后期缓升,块根蛋白质积累产量与块根干物率和干、鲜薯重,呈极显著正相关。     

应用动态变化空间扫描技术分析2018—2021年广州市肺结核空间聚集性

目的分析2018—2021年广州市肺结核发病空间分布特征, 发现肺结核聚集性的重点区域, 为制定肺结核防控措施提供参考依据。方法通过《中国疾病预防控制信息系统》的子系统《结核病管理信息系统》收集2018—2021年现住址是广州市的肺结核患者信息, 以区级为尺度进行动态空间扫描并绘制空间分布地图, 分析肺结核发病的空间聚集性。结果 2018—2021年广州市共登记肺结核34 306例, 年均发病率为46.46/10万, 男22 891例, 女11 415例, 男女构成比是2.01∶1, 25～<35岁年龄段的青壮年群体占比最高为23.06%(7 910/34 306), 家务及待业职业占比最高为45.77%(15 701/34 306), 本地户籍与流动人口构成比是1.03∶1。肺结核聚集性区域主要为越秀、海珠、荔湾、天河等中心城区以及白云、黄埔等近郊城区, 而随着时间发展, 聚集性区域向增城、从化等广州远郊区延伸。结论 2018—2021年广州市肺结核发病在区级水平上呈现空间聚集性, 以中心城区及近郊区为主, 有向远郊区扩散趋势, 应加强重点区域的监测, 开展科学、客观、可行的肺...     

Platelet Thromboxane A2 Receptor Blockade by Losartan in Hypertensive Patients

It has been shown that losartan inhibits vasoconstriction through binding to the thromboxane A₂ receptors. We investigated whether Thromboxane A₂-induced platelet aggregation can be inhibited by losartan and if this effect is present in losartan treated hypertensive patients. Platelet aggregation was measured in platelet rich plasma from healthy volunteers and hypertensive patients, with the use of an aggregometer. Losartan inhibited the effect of Thomboxane A₂ agonist (U46619)-induced platelet aggregation, with a pA₂ value of 48.9 μM and inhibited both second and first phases of Adenosine diphosphate-induced aggregation, from 109 ± 9 to 65 ± 10 mm and from 62± 8 to 0 mm. U46619's and Adenosine diphosphate's concentration required to produce half-maximal response were higher in normotensive volunteers (EC₅₀ 2.01 ± .3 μM and 2.6 ± .4 μM) compared to the hypertensive patients without treatment (EC₅₀ 0.6 ± .2 μM and 2.0 ± .3 μM). The concentration required to produce half-maximal response in losartan treated patients was similar to the healthy volunteers(EC₅₀ 1.7 ± .2 μM and 1.4 ± .3 μM), whereas in the lisinopril hypertension treated patients the concentrations used, were lower (EC₅₀ 1.4 ± .3 μM and 2.11 ± .5 μM). Losartan plasma concentration of hypertensive patients was 60.3 ± 18.7 ng/ml. Computer analysis showed that losartan, Thromboxane A₂ and the Thromboxane A₂ receptor antagonist, SQ29548 have equivalent functional groups and spatial distribution. Conclusion. We suggest that losartan inhibits platelet aggregation through Thromboxane A₂ dependent and independent mechanisms.     

Tau-aggregation inhibitor therapy for Alzheimer's disease

Many trials of drugs aimed at preventing or clearing β-amyloid pathology have failed to demonstrate efficacy in recent years and further trials continue with drugs aimed at the same targets and mechanisms.The Alzheimer neurofibrillary tangle is composed of tau and the core of its constituent filaments are made of a truncated fragment from the repeat domain of tau. This truncated tau can catalyse the conversion of normal soluble tau into aggregated oligomeric and fibrillar tau which, in turn, can spread to neighbouring neurons. Tau aggregation is not a late-life process and onset of Braak stage 1 peaks in people in their late 40s or early 50s. Tau aggregation pathology at Braak stage 1 or beyond affects 50% of the population over the age of 45.The initiation of tau aggregation requires its binding to a non-specific substrate to expose a high affinity tau–tau binding domain and it is self-propagating thereafter. The initiating substrate complex is most likely formed as a consequence of a progressive loss of endosomal–lysosomal processing of neuronal proteins, particularly of membrane proteins from mitochondria. Mutations in the APP/presenilin membrane complex may simply add to the age-related endosomal–lysosomal processing failure, bringing forward, but not directly causing, the tau aggregation cascade in carriers.Methylthioninium chloride (MTC), the first identified tau aggregation inhibitor (TAI), offers an alternative to the amyloid approach. Phase 3 trials are underway with a novel stabilized reduced form of methylthioninium (LMTX) that has improved tolerability and absorption.     

黑龙江省大豆作物系数的确定

作物系数是计算作物需水量,合理进行灌溉和水分资源调配的重要参数。依据1991—2011年黑龙江10个典型农业气象站大豆农业气象观测记录,运用统计学方法,确定了大豆实际平均生育期,利用FAO推荐的Penman-Monteith公式和根层水分平衡原理,计算出了大豆作物系数,并进一步分析了大豆作物系数的变化规律。结果表明,近20年,黑龙江大豆平均播种时间推迟5 d,收获时间推迟10 d,平均生育期为5月1日到9月30日,生育期延长5 d。大豆作物系数在生育期内呈现出“单峰”变化趋势,结荚期的作物系数最大,为0.96,其次是开花期,为0.75,苗期和成熟期最小,为0.32;三叶期、分枝期和鼓粒期作物系数分别为0.60,0.62和0.71,全生育期平均作物系数为0.61。大豆的水分敏感期为结荚期和开花期。     

格拉姆柱花草在南亚热带典型土壤上对施肥的反应

试验结果表明:施用磷肥对格拉姆柱花草(Stylosonlhes guiancnsis cv.Graham)性状表现普遍较好;钾肥对前期生长不表现作用,而后期表现为一种积累效应。施磷肥在土壤有效磷>5ppm时对柱花草促进作用不明显;在有效磷3～5ppm,pH>7的土壤上施磷也无显著作用;施石灰和土壤pH>7均降低磷的有效性。在土壤缺磷纠正后,施钾肥效果明显;施钾肥容易导致植株钾的奢侈吸收和品质下降,施磷则能降低植株钾含量,提高柱花草品质。石灰的施用在pH<5的第4纪红土母质与花岗岩母质土壤上有显著促进作用,而在pH>5的微酸性及碱性土壤上施石灰的效果不显著或产生负效应。     

Disruptive cell cycle regulation involving epigenetic downregulation of Cdkn2a (p16(Ink4a)) in early-stage liver tumor-promotion facilitating liver cell regeneration in rats

Cell cycle aberration was immunohistochemically examined in relation to preneoplastic liver cell foci expressing glutathione S-transferase placental form (GST-P) at early stages of tumor-promotion in rats with thioacetamide (TAA), a hepatocarcinogen facilitating liver cell regeneration. Immunoexpression of p16(Ink4a) following exposure to other hepatocarcinogens/promoters and its DNA methylation status were also analyzed during early and late tumor-promotion stages. GST-P(+) liver cell foci increased cell proliferation and decreased apoptosis when compared with surrounding liver cells. In concordance with GST-P(+) foci, checkpoint proteins at G(1)/S (p21(Cip1), p27(Kip1) and p16(Ink4a)) and G(2)/M (phospho-checkpoint kinase 1, Cdc25c and phospho-Wee1) were either up- or downregulated. Cellular distribution within GST-P(+) foci was either increased or decreased with proteins related to G(2)-M phase or DNA damage (topoisomerase IIα, phospho-histone H2AX, phospho-histone H3 and Cdc2). In particular, p16(Ink4a) typically downregulated in GST-P(+) foci and regenerative nodules at early tumor-promotion stage with hepatocarcinogens facilitating liver cell regeneration and in neoplastic lesions at late tumor-promotion stage with hepatocarcinogens/promoters irrespective of regenerating potential. Hypermethylation at exon 2 of Cdkn2a was detected at both early- and late-stages. Thus, diverse disruptive expression of G(1)/S and G(2)/M proteins, which allows for clonal selection of GST-P(+) foci, results in the acquisition of multiple aberrant phenotypes to disrupt checkpoint function. Moreover, increased DNA-damage responses within GST-P(+) foci may be the signature of genetic alterations. Intraexonic hypermethylation may be responsible for p16(Ink4a)-downregulation, which facilitates cell cycle progression in early preneoplastic lesions produced by repeated cell regeneration and late-stage neoplastic lesions irrespective of the carcinogenic mechanism.     

Standard error correction in two‐stage estimation with nested samples

Data at different levels of aggregation are often used in two‐stage estimation, with estimates obtained at the higher level of aggregation entering the estimation at the lower level of aggregation. An example is customers within markets: first‐stage estimates on market data provide variables that enter the second‐stage model on customers. We derive the asymptotic covariance matrix of the second‐stage estimates for situations such as these. We implement the formulae in the Petrin–Train application of households’ choice of TV reception and compare the calculated standard errors with those obtained without correction. In this application, ignoring the sampling variance in the first‐stage estimates would be seriously misleading.     

Galanin receptor plasticity within the nucleus basalis in early and late Alzheimer's disease: an in vitro autoradiographic analysis

Hypertrophy of fibers containing galanin (GAL), the inhibitory neurotransmitter of acetylcholine, occur on remaining cholinergic nucleus basalis neurons in late stage Alzheimer's disease (AD). The present investigation evaluated whether changes in the number of GAL receptors (GALR) were detectable within the nucleus basalis in the early or late stage of AD when compared to age-matched controls. Postmortem neuropathological specimens were obtained at autopsy from three groups: late AD, early (possible) AD, and normal (age-matched controls) human subjects. Autoradiography of GALR binding was performed on human brain sections from each of the three groups. Analysis of autoradiographic images show no change in the distribution of ([125])hGAL binding sites in early AD cases throughout the nucleus basalis. In contrast, the number of ([125])hGAL binding sites was increased over the anterior nucleus basalis subfield in late stage AD. A region-of-interest densitometric analysis of the anterior nucleus basalis in the late stage AD cases depict an increase in the number of ([125])hGAL binding sites by approximately two-three-fold when compared to normal (age-matched controls). Quantitative measures of ([125])hGAL binding densities were not significantly different in the anterolateral, intermediate or posterior nucleus basalis subsectors of early or late stage AD when compared to age-matched controls. These observations show that the occurrence of overexpression of GALRs coincide with earlier reports showing galaninergic fibers hyperinnervating surviving cholinergic basal forebrain neurons in late stage AD.