氯吡格雷与丹参粉针治疗慢性脑供血不足的临床效果比较

目的比较氯吡格雷与丹参粉针治疗慢性脑供血不足的临床疗效,为临床治疗提供实践依据。方法选取我院2009-05—2012-12收治的120例慢性脑供血不足患者,按照随机数字表法随机分为A组与B组各60例,A组给予氯吡格雷治疗,B组给予丹参粉针剂治疗,连续治疗2周为1个疗程,比较临床疗效及血液流变学水平变化。结果治疗1个疗程后,A组总有效率91.7%,B组68.6%,A组明显高于B组,差异有统计学意义(χ2=12.063,P<0.01)。2组治疗前各项血液流变学指标比较差异无统计学意义(P>0.05),治疗后A组患者各项指标均较治疗前、B组明显改善,差异有统计学意义(P<0.05)。A组出现轻微牙龈出血3例,给予减量后消失;B组无明显不良反应发生。结论氯吡格雷治疗慢性脑供血不足效果更加理想,值得推广应用。     

Air pollution and pregnancy outcomes based on exposure evaluation using a land use regression model: A systematic review

This review systematically assessed those studies investigating the association between air pollution and birth outcomes using land use regression (LUR) models for exposure assessment. Fifty-four studies were identified which were published between 2007 and 2019. Most of these were conducted in America, Spain and Canada, while only five were conducted in China. One hundred and ninety-seven LUR models were developed for different pollutants. The main pollutants that these studies assessed were NO₂ and PM_2.5, and the main pregnancy outcomes investigated were preterm birth (PTB), small for gestational age (SGA) and birth weight. Studies consistently found that NO₂ exposure during pregnancy was associated with reduced fetal growth and development. The effect of NO₂ on other adverse pregnancy outcomes is unclear. In addition, it was found that increased PM_2.5 (aerodynamic equivalent diameter ≤ 2.5 um) exposure during pregnancy reduced birth weight. The effect of PM_2.5 on other adverse pregnancy outcomes is also unclear. The relationship between other pollutants and adverse pregnancy outcomes is uncertain based on the existing research. Exposure assessment with LUR modeling has been widely used in Europe and North America, but used less in China. Future studies are recommended to use LUR modeling for individual exposure evaluation in China to better characterize the relationship between air pollution and adverse pregnancy outcomes. In addition, further research is required given that a lot of the associations looked at in the review were inconclusive.     

Simultaneous Determination and Pharmacokinetics of Tetrandrine, Fangchinoline, and Cyclanoline in Rat Plasma by Ultra-High Performance Liquid Chromatography-Mass Spectrometry after Oral Administration of Stephaniae Tetrandrae Radix Extract

Objective: The objective of the study wasto develop a rapid and sensitive ultra?performance liquid chromatography?tandem massspectrometric method for the determination of tetrandrine, fangchinoline, and cyclanoline in rat plasma and to investigate their pharmacokinetics after oral administration of Stephaniae Tetrandrae Radix extracts. Methods: Sample pretreatment involved methanol pretreatment and liquid–liquid extraction of ethyl acetate from plasma with methanol. Tramadol was used as the internal standard. The analysis was performed using an high strength silica T3 column (100 mm × 2.1 mm, 1.8 μm) and a gradient elution method consisting of mobile phase solution A (0.1% formic acid in water) and B (acetonitrile) at a flow rate of 0.4 mL/min. The detection was performed using a triple quadrupole tandem mass spectrometer in the multiple reaction monitoring mode and using an electrospray ionization source in the positive ionization mode. Results: High efficiency was achieved with an analysis time of 4 min/sample. The calibration curve linear in the concentration range of 1250 ng/ml (R2 ≥ 0.9900) and the lower limit of quantification is 1 ng/ml. The intraday and interday precision (relative standard deviation) values were lower than 9.4. Accuracy (relative error) was within 10.3% at all three quality control levels. Conclusions: This method was successfully applied in pharmacokinetics of tetrandrine, fangchinoline, and cyclanoline in rats after oral administration of Stephaniae Tetrandrae Radix extracts. The maximum plasma concentration (Cmax) of tetrandrine, fangchinoline, and cyclanoline was 124.71 ± 16.08, 84.56 ± 3.28, and 57.61 ± 6.26 ng/ mL, respectively. The time to reach Cmax was 10.39 ± 3.04 for tetrandrine, 10.17 ± 3.04 for fangchinoline, and 6.40 ± 3.16 for cyclanoline. The pharmacokinetic results might help further guide the clinical application of Stephaniae Tetrandrae Radix.     

Case of coincident severe acne and psoriasis in AIDS patient successfully treated with antiretroviral therapy

Cutaneous disorders remain a major problem in HIV‐infected patients, even under antiretroviral therapy (ART). Patients at any stage of HIV/AIDS may suffer from skin lesions. Acnes and psoriasis are both common chronic and inflammatory skin diseases, and the treatment becomes more challenging and complex when combined with HIV infection. Whether the incidence and severity of acne and psoriasis are related to HIV infection is still controversial. Here, we report a rare case of an AIDS patient who developed severe acne along with psoriasis. The patient had initially received multiple systemic and topical antipsoriatic and anti‐acne treatments which failed. Ultimately, he achieved dramatic clinical improvement after initiation of ART for main treatment. An 8‐year follow up demonstrated that the patient has been free of symptoms of both psoriasis and acne till now.