药学服务转型与药学志愿服务模式初探

目的：探索新时期药学服务转型与药学志愿者服务模式的转型。方法：伴随着医院药学服务转型，探索该院药学志愿者服务的三阶段发展模式。结果：药学服务逐渐转型的同时，药学志愿服务作为一种新型的药学服务模式，对合理用药带来了巨大的影响。结论：互联网+时代的药学志愿服务是我院药事科的一项新举措。如何更好地发展信息时代的药学服务与药学志愿服务，是药学人员需要深入思考的问题之一。     

谷氨酸受体在左旋多巴诱导的异动症中的相关研究进展

在帕金森病(PD)患者中,长期使用左旋多巴而诱导的异动症(LID)显著影响着左旋多巴的疗效及患者的生活质量,现有的应对方案效果也均不甚理想,其原因与LID的机制目前尚未完全阐明密切相关。近年来越来越多的研究证实,谷氨酸能系统与多巴胺能系统紧密关联,谷氨酸受体在LID中的作用也日益凸显,特别是代谢型谷氨酸受体(mGluR)4、mGluR5以及部分离子型谷氨酸受体(iGluRs)在LID的机制研究和临床药物研究中更是关注热点。笔者现对各类谷氨酸受体在LID中的变化、作用以及相关的临床研究进展进行综述,以期为PD患者中LID的诊治和机制阐明提供新思路。     

Factors associated with the publication outcomes of paediatric proceedings presented at 2010‐2016 the International Associations for Dental Research annual meetings

The International Associations for Dental Research (IADR) annual meeting is one of the most important dental meetings throughout the world, and researches about paediatric dentistry presented in this platform are often used to guide clinical work. To evaluate the publication outcomes of oral and poster paediatric proceedings, which were accepted by the International Associations for Dental Research (IADR), annual meetings from 2010 to 2016 and to analyse the possible factors influencing an abstract's progression to publication. Oral and poster abstracts were retrieved from the official website of IADR (2010‐2016). Searching for subsequent publications was conducted in PubMed and Google Scholar (up to March 2019). Two authors independently selected studies, collected, and analysed data. A total of 1396 abstracts were identified, including 275 oral presentations and 1121 poster presentations. Finally, 606 were published in peer‐reviewed journals, with a publication rate of 43.41%. Abstracts were published earlier if it is from Europe, well funded, presented orally, or with large sample size. The high publication rate of the IADR proceedings supported the impact of IADR annual meetings on paediatric dentistry in the last 10 years.     

Liquid chromatography as candidate reference method for the determination of vitamins A and E in human serum

BackgroundOwing to the increasing interest in public health research of antioxidant micronutrients and the inaccuracy of routine serum concentrations of the fat‐soluble vitamins A (retinol) and E (DL‐α‐tocopherol) measurements, we developed a reliable, highly sensitive, robust and rapid method for the quantification of two clinically important lipophilic antioxidants in serum using a reverse‐phase HPLC/DAD method.MethodSample preparation and analytical conditions that would affect extraction efficiency and quantitative results of vitamins A and E were investigated and optimized. Vitamins A and E were extracted from serum via liquid‐liquid extraction (LLE). After adequate sample preparation, the samples were injected directly into the HPLC system with diode‐array detector (DAD). Chromatographic separation was completed in 7 minutes for vitamins A and E. With vitamin A acetate and vitamin E acetate as internal standards, the method was applied to the measurement of vitamins A and E in human serum.ResultsWe evaluated method linearity, accuracy (recovery rate and trueness), precision, carryover, limit of quantitation and limit of detection, and measurement uncertainty. The method was evaluated for trueness using NIST Standard Reference Material SRM 968f. The serum concentration of the studied compounds had a good linear relationship in the range of 0.05 ~ 3.0 μg/mL concentration (r ＝ 0.9998), with 0.0077 μg/mL detection limit and 0.025 μg/mL quantitative limit for vitamin A, respectively, and 1.0 ~ 60.0 μg/mL concentration (r ＝ 0.9999), with 0.40 μg/mL detection limit and 0.50 μg/mL quantitative limit for vitamin E, respectively. The intra‐ and inter‐assay coefficients of variation were calculated by using three concentrations (1, 2, and 3) of the studied compounds in human serum samples. Intra‐assay and inter‐assay precision were 1.23%‐4.97% and 0.97%‐3.79% for vitamin A, respectively, and 0.64%‐4.07% and 0.81%‐5.96% for vitamin E, respectively. The average recovery rates were 100.98% for vitamin A, and 99.21% for vitamin E, respectively. The carryover rate of vitamins A and E was below 1%. As for the evaluation of accuracy, the biases were <± 5% by comparing with NIST standard reference material SRM 968f.ConclusionThe method is a simple sample treatment procedure for the determination of fat‐soluble vitamins A and E in human serum with high sensitivity and specificity. The proposed method could be recommended as a candidate reference method for the determination of serum concentrations of the fat‐soluble vitamins A and E in human serum.     

皮下脂膜炎样T细胞淋巴瘤叠加红斑狼疮病理特征一例

患者男，49岁。因皮下结节9个月余，发热5 d，于2018年11月19日至我院就诊。患者9个月前无明显诱因全身出现多个散在直径2 ~ 5 cm皮下结节，曾于我院行皮损活检，提示“皮下脂膜炎，不除外皮肤T细胞淋巴瘤”，当时未予特殊处理……     

双相障碍的功能损害及相关因素

本文目的是探讨双相障碍社会功能和认知功能的特点及其影响因素，为临床识别与干预提供参考。研究显示，双相障碍功能损害显著，即使在稳定期，双相障碍患者仍存在不同程度的认知功能和社会功能损害，双相障碍的功能损害可能存在病理心理机制和相关影响因素。本文从双相障碍社会功能损害、认知功能损害和二者的关系等方面进行阐述，并总结当前研究的不足之处。     

卒中类型、卒中部位与卒中后癫痫的多因素关系

目的探讨卒中类型、卒中部位与卒中后癫痫的多因素关系,为卒中后癫痫的防治提供参考。方法以1804例卒中患者为研究对象,收集其性别、年龄、卒中类型、卒中部位、卒中后癫痫发生的时间等资料,根据卒中后是否发生癫痫,将患者分为卒中后无癫痫组(n=1487)和卒中后癫痫组(n=317),分析卒中后癫痫发作的危险因素。结果共317例卒中后癫痫发作患者,其中早发性癫痫141例(44.48%),迟发性癫痫176例(55.52%)。不同卒中部位及卒中类型的癫痫发病率为17.57%。多因素logistic回归分析显示,卒中部位中的顶叶合并蛛网膜下腔、额叶合并颞叶、额叶合并颞叶和枕叶、单一颞叶是卒中后发生癫痫的危险因素(P<0.01),其中单一颞叶是卒中后早发性癫痫的危险因素(P<0.01)。脑梗死患者常见早发性癫痫(23.66%),脑出血患者常见迟发性癫痫(47.95%)。结论卒中类型中的脑梗死、脑出血、蛛网膜下腔出血与卒中后癫痫有关;卒中部位中顶叶合并蛛网膜下腔、额叶合并颞叶、额叶合并颞叶和枕叶、单一颞叶与卒中后癫痫有关。     

雅安市精神障碍患者就诊情况及影响因素

目的 了解雅安市精神障碍患者就诊情况及影响因素，提高雅安市精神卫生服务利用质量。方法 采用分层整群随机抽样方法抽取雅安市6县2区9 000名居民作为调查对象，实际共8 876名完成调查。其中符合《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准共1 106例，使用精神卫生服务利用调查表对精神障碍患者的就诊情况进行调查。采用χ²检验及Logistic二元回归对患者就诊情况的影响因素进行分析。结果 1 106例精神障碍患者中，曾到精神卫生专业机构就诊共173例，就诊率为15.64%（标化就诊率为15.62%）。就诊率排名后三位的病种为：物质相关及成瘾障碍（7.92%）、创伤及应激相关障碍（6.12%）、强迫及相关障碍（0.00%）。未就诊而采用自助方式者（求神拜佛、咨询亲友）共42例，其中汉族28例，少数民族14例。居住地为城市（OR=2.36，P<0.01）对精神障碍患者就诊有正向影响，家族史阴性（OR=0.49，P<0.01）、无就诊意愿（OR=0.07，P<0.01）对精神障碍患者就诊有负向影响。结论 雅安市精神障碍患者就诊率偏低，就诊方式以精神科住院及门诊就诊为主，居住地、家族史和就诊意愿影响精神障碍患者的就诊。