三种淫羊藿的总黄酮分极提取物对小鼠免疫功能的影响

观察了巫山淫羊藿、柔毛淫羊藿和粗毛淫羊获的总黄酮正丁醇提取物（代号Ａ１、Ａ２、Ａ３）和巫山淫羊藿总黄酮乙酸乙酯提取物（Ｂ１）对正常小鼠免疫功能的影响。结果；Ａ１可以明显促进脾脏抗体形成细胞的功能（Ｐ＜０．０５），Ａ２、Ａ３虽也有一定的促进作用，但无统计学意义；４种提取物在体外实验中均没有协同ＣｏｎＡ诱导牌细胞增殖作用，只有提取物浓度在１００μｇ／ｍｌ时，有一定抑制作用。４种提取物对２４小时培养脾细胞存活率无明显影响。     

慢性砷中毒自觉症状和皮肤改变影响因素的Logistic分析

目的探讨慢性砷中毒患者自觉症状、皮肤色素异常丑过度角化的影响因素。方法选择山西大同地区山阴县黑疙瘩乡大营村进行调查问卷及体检,结果进行单因素及多因素Logistic逐步回归分析。结果单因素分析提示,年龄、迁入时间、饮含砷井水时间、吸烟、饮茶等与自觉症状、色素异常及皮肤角化显著相关,水果是保护因素。多因素Logistic逐步回归分析结果表明,年龄、迁入时间是自觉症状的主要危险因素;年龄是色素异常的主要危险因素,水果摄入是保护因素;年龄、迁入时间、饮含砷井水时间是皮肤过度角化的主要危险因素,水果摄入是保护因素。结论自觉症状及皮肤改变主要与砷的撮入及蓄积量有关。砷中毒病区地理环境背景也是影响皮肤改变的因素之一。水果等抗氧化物质的摄入可能起保护作用。     

富血小板血浆在妇科疾病治疗中应用及其研究现状

富血小板血浆(PRP)是人自体全血经离心后获得的血小板浓缩物,含有大量生长因子及蛋白质。PRP因其有助于组织再生、伤口愈合、瘢痕修复等作用,在骨科、皮肤科、口腔颌面外科、整形美容科等领域应用广泛,而在妇科领域应用迄今相对较少。最新研究结果显示,PRP具有促进子宫内膜和卵泡生长作用,在治疗薄型子宫内膜(TE)、改善子宫内膜容受性(ER)、恢复卵巢功能等方面取得较大进展,并为多种妇科疾病治疗提供新的研究方向和手段。笔者拟就PRP的制备及分类、在妇科疾病治疗中的应用及其前景展望等最新研究现状进行阐述。     

帕瑞昔布对宫颈癌腹腔镜手术患者炎性因子及镇痛效果的影响

目的 分析帕瑞昔布对宫颈癌腹腔镜手术患者炎性因子及镇痛效果的影响.方法 选择宫颈癌患者90例,参照抽签法将患者随机分为对照组与试验组,每组各45例.所有患者均行腹腔镜宫颈癌切除术治疗,对照组患者于麻醉诱导前输注生理盐水,试验组患者于麻醉诱导前输注帕瑞昔布,对比两组患者术后炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)]水平、视觉模拟评分法(VAS)得分、24 h舒芬太尼用量及不良反应发生情况.结果 术后,试验组患者的炎性因子水平明显低于对照组患者(P<0.01);术后12 h、术后24 h,试验组患者的VAS评分均低于对照组患者,两组患者的VAS评分在组间(F=6.814,P=0.000)、不同时间点间(F=6.785,P=0.002)、组间+不同时间点间(F=5.672,P=0.014)相互比较,差异均有统计学意义;术后24 h,试验组患者的舒芬太尼用量低于对照组患者(P<0.05);试验组患者的不良反应总发生率明显低于对照组患者(P<0.01).结论 帕瑞昔布能够有效调节宫颈癌腹腔镜手术患者炎性因子的分泌,进而发挥镇痛作用.     

生殖道沙眼衣原体感染与不孕和自然流产的关系

采用荧光染色技术对１１０例不孕症和３２例自然流产病例的宫颈刮片标本进行检测，其中有３５例（３１．８％）不孕症和１４例（４３．７％）自然而产病人的宫颈上皮细胞内检出沙眼衣原体包涵体。与此同时，对这些阳性病例的配偶进行尿道粘膜印片检查，分别检出尿道粘膜上皮细胞内沙眼衣原体包涵体２９例（８２．６％）和１１例（７８．８％）。对照组系１３６例正常妊娠的孕妇和２００例妇女病普查的病例，分别检出衣原体包涵体５．８％和９．０５％。研究结果表明不孕和自然流产与生殖道沙眼衣原体感染有关。     

基于SPOC混合教学模式的生物药剂学与药物动力学的课堂教学改革

生物药剂学与药物动力学是一门涉及面广、理论性强的学科,知识点多且难,传统课堂教学难以提高学生的学习主动性,且课程结束学生并不能将理论知识应用于实践中。针对传统课堂教学的缺陷,结合内蒙古医科大学的学生学习情况与课程学时,设计小规模限制性在线课程(SPOC)线上线下混合教学模式,线上课堂学习基础知识,线下课堂答疑解惑,以分析案例为重点,提高学生分析、解决问题能力。整个课程设计注重过程考核,充分调动学生的主观能动性,以提高教学效率,培养应用型药学人才。     

Association of body mass index with risk of prediabetes in Chinese adults: A population‐based cohort study

Aims/IntroductionOverweight and obesity in adults are strongly associated with an increased risk of prediabetes, and this study set out to gain a better understanding of the optimal body mass index (BMI) range for assessing the risk of prediabetes in the Chinese population.Materials and MethodsThe cohort study included 100,309 Chinese adults who underwent health screening. Participants were divided into six groups based on the cut‐off point for BMI recommended by the World Health Organization (underweight: <18.5 kg/m², normal‐weight: 18.5–24.9 kg/m², pre‐obese: 25.0–29.9 kg/m², obese class I: 30.0–34.9 kg/m², obese class II: 35.0–39.9 kg/m², and obese class III ≥40 kg/m²). The association of BMI with prediabetes and the shape of the correlation were modeled using multivariate Cox regression and restricted cubic spline regression, respectively.ResultsIn the multivariate Cox regression model, with normal weight as the control group, underweight people had a lower risk of developing prediabetes, whereas obese and pre‐obese people had a higher risk of prediabetes. Additionally, in the restricted cubic spline model, we found that the association of BMI with prediabetes follows a positive dose–response relationship, but does not conform to the pattern of obesity paradox. Among the general population in China, a BMI of 23.03 kg/m² might be a potential intervention threshold for prediabetes.ConclusionsThe national cohort study found that the association of BMI with prediabetes follows a positive dose–response relationship, rather than a pattern of obesity paradox. For Chinese people with normal weight, more attention should be paid to glucose metabolism when BMI exceeds 23.03 kg/m².     

人工流产术后尿绒毛膜促性腺激素的消退

采用人绒毛膜促性腺激紊(HCG)单克隆抗体酶标试剂,对36例停经36d 至60d 的孕妇人工流产术后尿 HCG 消退情况进行观察。从流产术后第5d 起,每天留晨尿测 HCG,结果表明,在流产手术十分成功时,尿 HCG 转阴的时间为手术后第6天至第14天。木法较其他方法简便、迅遗、可靠,易为病人所接受,在随访人工流产和葡萄胎流产术后尿 HCG 的变化时,具有重要性。     

Physiologically based pharmacokinetics model predicts the lack of inhibition by repaglinide on the metabolism of pioglitazone

Purpose: Repaglinide and pioglitazone are both CYP2C8 and CYP3A4 substrates. This study was to determine whether repaglinide has an inhibitory effect on the metabolism of pioglitazone in vitro, in silico and in vivo. Method: In vitro, the effect of repaglinide on the metabolism of pioglitazone was assessed in pooled human liver microsomes. In silico, an IVIVE‐PBPK linked model was built with Simcyp®. Then, a randomized, 2‐phase cross‐over clinical study was conducted in 12 healthy volunteers. Results: Repaglinide showed a strong inhibitory effect on the metabolism of pioglitazone in vitro (K_i = 0.0757 µm ), [I]/K_i > 0.1. The Simcyp® prediction ratios of AUC and C_max between the two treatment groups were both about 1.01. The pharmacokinetics of pioglitazone in clinical trials showed no significant difference between these two treatment groups (p > 0.05). Conclusion: Repaglinide has no significant inhibitory effect on the metabolism of pioglitazone in vivo, which is inconsistent with the in vitro results. The lack of an inhibitory effect was partly due to extensive plasma protein binding and to the high in vivo clearance of repaglinide, for the concentration of repaglinide in vivo was far smaller than in vitro. Copyright © 2015 John Wiley & Sons, Ltd.     

全面质量管理在护理管理中的应用研究

目的评价全面质量管理在护理管理中的应用价值,总结有益经验。方法于2013年2月—2014年8月全面质量管理实施前,评测护士安全认知评分与抑郁焦虑评分、医护人员与患者满意度基线评分,实施后复测、对比。结果实施后患者服务与技术、环境与指导、合计满意度评分,护士、医师护理满意度评分高于基线,实施后护士安全认知评分、抑郁与焦虑评分高于基线,差异有统计学意义(P<0.05)。结论于护理管理中实施全面质量管理,确有助于提高护理质量,提高患者满意度,但可能增加护士职业负担。