Impact of Smoking Status on Hospital Outcome of Patients with ST-Segment Elevation Myocardial Infarction Either Treated by Pharmaco-Invasive Strategy or Primary Percutaneous Coronary Intervention

Introduction: Smoking is a common public problem with a high health burden. Many studies have shown that there are many hazardous actions of smoking on body systems especially haemostatic, respiratory and circulatory systems. Smoking may increase the thrombus burden in patients with acute coronary syndrome. The “smoker’s paradox” has been described for more than 25 years. Its existence and its effect on patients’ outcome post-myocardial infarction are debatable. Methods: Our prospective observational study was conducted from-August 2018 to August 2019 on STEMI patients with the duration from onset of symptoms to first medical contact were 12 hours or less. We included 199 patients in our study. Patients are divided into 4 groups Group 1 (Smokers treated by PPCI) Group 2 (Non-smokers treated by PPCI) Group 3 (Smoker treated by pharmaco-invasive strategy) Group 4 (Non- smoker treated by pharmaco-invasive strategy) TIMI flow before and after PCI, duration of hospital stay and all caeses of MACE were assessed in each patient. Results: Smokers are younger than non-smokers and have fewer co-mor- bidities. Patients treated by primary PCI and pharmaco-invasive strategy either smokers ornon-smokers showed no significant difference in angiographic data and outcome except that smokers treated by pharmaco-invasive strategy had a lower incidence of TIMI flow III at diagnostic angiography before PCI with P value (0.047). Conclusion: There is no actual smokers paradox. A pharmaco-invasive strategy is a good option when a PPCI is not available. Finally, early transfer of smokers treated with a pharmaco-invasive strategy to a PCI capable hospital for early intervention may be recommended.

Percentage of beta 2 band power of quantitative pharmaco-electroencephalography decreases in propofol anesthetized rabbits A dose-dependent analysis

BACKGROUND： Quantitative pharmaco-electroencephalography can be used for studying the dose-effect and time-effect relationships of drugs affecting central nervous system. Therefore, it may become an effective means for monitoring the anesthetic degree of anesthetic drug in the operation. OBJECTIVE： To observe the dose-effect relationship of propofol influencing β2-band power of quantitative pharmaco-electroencephalography in rabbits. DESIGN： A randomized block design. SETTING： Department of Anesthesiology, Xuzhou Medical College. MATERIALS： Thirty-six healthy adult rabbits of either gender, weighing （2.4 ± 0.5 ） kg, of clean grade, were provided by the Laboratory Animal Center of Xuzhou Medical College. The involved rabbits were randomly divided into 3 groups with 12 in each by table of random digit： high-dose propofol group, moderate-dose propofol group, and low-dose propofol group. The protocol was carried out in accordance with animal ethics guidelines for the use and care of animals. METHODS： This study was carried out in the Department of Anesthesiology, Xuzhou Medical College between August 1999 and April 2000. Rabbits in the high-dose propofol group, moderate-dose propofol group, and low-dose propofol group were injected with 10, 5 and 2.5 mg/kg propofol （ZENECA Company, British, Batch No. 032000）, respectively. Before and after intravenous administration of propofol, percentage of β2-band power of quantitative pharmaco-electroencephalography was measured, and the latent and persistent periods when rabbit righting reflex disappeared were observed by quantitative pharmaco-electroencephalography and power spectrum analysis. MAIN OUTCOME MEASURES： （1） Percentage of β2-band power of quantitative pharmaco-electroencephalography. （2）Latent period and persistent period of abolition of righting reflex of rabbits. RESULTS： Thirty-six rabbits were involved in the final analysis. （1）Effect of propofol on righting reflex of rabbits： Righting reflex disappeared within 1 minute after the rabbits being intravenously injected with propofol. The higher dose, the shorter latent period （r = - 0.94, P 〈 0.01）, and the longer persistent period （r =0.79, P 〈 0.01）. Both latent period and persistent period had good correlation with propofol dose. （2） Effect of propofol on the percentage of β2-band power of quantitative pharmaco-electroencephalography： In the low-dose propofol group, no significant changes in the percentage of β2-band power of quantitative pharmaco-electroencephalography existed between before and after administration within 30 minutes （P 〉 0.05）. In the moderate-dose propofol group, the percentage of β2-band power of quantitative pharmaco-electroencephalography in each brain region except for left and right frontal areas was significantly decreased within 30 s to 5 minutes （P 〈 0.05）, and recovered to the level before administration 10 minutes later. In the high-dose propofol group, the percentage of β2-band power of quantitative pharmaco-electroencephalography in each brain region was significantly decreased from 20 s to 5 minutes after administration （P 〈 0.05 - 0.01）, and that was gradually recovered to the level before administration 5 to 10 minutes after administration. This tendency was basically the same as the changes of latent period and persistent period. CONCLUSION： Propofol decreases the percentage of β2-band power of quantitative pharmacoelectroencephalography in dose-dependent manner, It indicates that β2-band power might become one of indexes for reflecting the anesthetic degree of propofol,

Pharmacogenetics in inflammatory bowel disease

遗传药理学是在在药反应的可变性之间的协会的学习并且(或) 在基因的药毒性和多型性。科学的这个领域的目标是使药适应一个病人的特定的基因背景因此使他们更有效、安全。在这篇文章，我们在影响的基因描述变体在煽动性的肠疾病( IBD )的治疗使用的普通的药的功效或毒性， ulcerative ( UC )，和 Crohn 包括 sulfasalazine 和 mesalazine 是疾病( CD )， azathioprine ( AZA )和 6-mercaptopurine ( 6-MP )， methotrexate ( MTX )， glucocorticosteroids ( CS )和 infliximab 。而且， pharmacogenetic 研究的困难一般来说并且更明确地在 IBD 被描述。尽管遗传药理学是已经贡献了一些药的行动的内在的机制的更好的理解的一个有希望的领域，在 IBD 使用，翻译直到现在成每日的实践的唯一的发现是在 thiopurine S-methyltransferase (TPMT ) 基因多型性和 thiopurine 治疗的 hematological 毒性之间的关系。在未来，在很好描绘的耐心的队组织研究是必要的谁一致地被对待并且系统地评估了以便测定药反应更客观地。一个努力应该被作从为 pharmacogenetic 研究在适当知情同意以后在临床的药试用注册的所有病人收集 genomic DNA。

基于网络药理学和分子对接探讨益气定眩饮治疗脑梗死的作用机制

目的运用网络药理学和分子对接初步探讨益气定眩饮治疗脑梗死(CI)的作用机制。方法通过TCMSP数据库,获取并筛选益气定眩饮治疗CI的潜在靶点及活性成分;利用多个数据库挖掘CI相关靶点并与益气定眩饮潜在靶点取交集,获得益气定眩饮治疗CI的核心靶点,进行蛋白质-蛋白质相互作用(PPI)网络构建,通过R语言对核心靶点进行基因本体(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析;采用分子对接技术将主要活性成分与核心靶点进行分子对接。结果益气定眩饮含30种有效活性成分,8个核心靶点作用于CI,其中涉及调控免疫反应、组织缺氧、信号转导等多条信号通路,且分子对接结果显示木犀草素与抑癌基因(TP53)及豆甾醇与胱天蛋白酶(CASP3)大分子蛋白有良好的结合性。结论益气定眩饮治疗CI具有多靶点、多通路的特点,为后续的研究提供了研究方向提供参考。

Vagus Nerve Stimulation for Pediatric and Adult Patients with Pharmaco-resistant Epilepsy

Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.

花椒挥发油化学成分及药理作用研究进展

花椒挥发油主要包含萜烯类、醇类、醛类、酮类、酯类、环氧化合物类及脂肪烃类成分,具有抗炎、镇痛、抑菌、杀虫、止痒、抗肿瘤、抗氧化、促进透皮吸收、改善中枢神经系统障碍等多种药理作用。通过查阅国内外相关文献,对花椒挥发油的提取方法、化学成分及其影响因素、药理作用进行系统综述,同时指出目前花椒挥发油研究存在的问题,并展望未来研究方向,为花椒挥发油的深入研究和临床应用提供有益参考。参考文献76篇。

盐酸莫西沙星氯化钠注射液在下呼吸道感染治疗中的药效学与药动学分析

目的 分析盐酸莫西沙星氯化钠注射液在下呼吸道感染治疗中的药效学与药动学。方法 选取2021年6月—2023年6月福州市中医院收治的下呼吸道感染住院患者80例,分析其临床疗效、细菌清除率、药物动力学,实验方法包括高效液相色谱法、肉汤稀释法。结果 80例患者共检出菌株80株,总有效率为90.00%,其中肺炎总有效率为100.00%,慢性支气管炎总有效率为79.17%,支气管哮喘合并感染总有效率为78.57%;细菌清除率为90.00%(72例),其中流感嗜血杆菌与肺炎克雷伯杆菌清除率均为100.00%,肺炎支原体清除率为96.43%,肺炎链球菌清除率为92.31%,金黄色葡萄球菌清除率为62.50%。患者血浆中药物峰浓度、谷浓度、稳态血药浓度分别为(4.34±0.06)mg/L、(1.37±0.05)mg/L和(3.71±0.04)mg/L。稳态血药浓度是肺炎支原体和肺炎链球菌MIC的14.84倍,是流感嗜血杆菌和肺炎克雷伯杆菌MIC的7.40倍,是金黄色葡萄糖菌MIC的3.71倍。结论 盐酸莫西沙星氯化钠注射液治疗下呼吸道感染治疗效果确切,有利于清除病原菌。

经皮机械性血栓清除术治疗急性下肢深静脉血栓合并髂静脉压迫综合征的临床疗效观察

目的探讨经皮机械性血栓清除术治疗急性下肢深静脉血栓(DVT)合并髂静脉压迫综合征的疗效及预后。方法收集2019年1月至2020年8月昆山市第一人民医院收治的62例急性下肢DVT合并髂静脉压迫综合征患者的临床资料,按照治疗方案的不同分为治疗组(在下腔静脉滤器保护下行经皮机械性血栓清除术+CDT治疗,同期行髂静脉狭窄腔内球囊扩张成形及支架置入术)和对照组(在下腔静脉滤器保护下行CDT治疗,同期行髂静脉狭窄腔内球囊扩张成形及支架置入术),每组31例。比较两组患者的尿激酶用量、溶栓时间、住院时间、溶栓管造影次数、血栓清除率、消肿程度、静脉临床严重程度评分法(VCSS)评分及血栓后综合征(PTS)发生率。结果治疗组患者的尿激酶用量明显低于对照组患者,血栓清除率明显高于对照组患者,溶栓时间、住院时间均明显短于对照组患者,溶栓管造影次数明显少于对照组患者,差异均有统计学意义(P﹤0.01)。治疗后,治疗组患者的大腿周径差、小腿周径差均小于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后6个月,治疗组患者的VCSS评分和Villata评分﹥4分的患者比例均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论经皮机械性血栓清除术+CDT治疗+腔内球囊扩张成形及支架置入术治疗急性下肢DVT合并髂静脉压迫综合征的疗效显著,患者预后较好。

Pharmacological effects of Astragaloside IV: a literature review

OBJECTIVE: To review the pharmacological effects and mechanisms of action of Astragaloside IV in Huangqi (Radix Astragali Mongolici). METHODS: Aticles focusing on Astragaloside IV in English and Chinese in databases were collected and reviewed in order to summarize the latest extraction separation, pharmacokinetics, and the pharmacological effects of astrageloside IV. RESULTS: Protective effects of Astrageloside IV on the cardiovascular system, immune, digestive, nervous system were identified, and the action mechanisms were associated with regulation of the calcium balance, anti-oxydant, antiapoptosis, antivirus, and so on. CONCLUSION: Astrageloside IV has broad application prospects, especially in cardiovascular diseases, digestive diseases, cancer and other modern high incidence, high-risk diseases, and could be developed as a medicine.

基于网络药理学与分子对接和实验验证探讨费菜抗炎作用的分子机制

目的:本文基于网络药理学技术与分子对接和实验验证探讨费菜抗炎作用机制。方法:利用TCMSP、HERB等数据库,以口服生物利用度≥30%为筛选条件,得到费菜药效成分及其潜在靶点。利用GeneCards、OMIM等数据库查找炎症相关靶点,通过STRING数据库和Cytoscape3.8.0软件绘制PPI蛋白互作图,分析费菜中抗炎的关键药效成分和潜在作用靶点。利用David数据库对潜在作用靶点进行GO富集和KEGG信号通路富集,并进行可视化分析。应用AutoDock软件将药效成分与核心靶点进行分子对接,并进行可视化分析。利用高效液相色谱法分析药效成分。采用LPS诱导的RAW264.7细胞炎症模型,验证药效成分的抗炎作用。结果:筛选得到5个药效成分及相关靶点130个,抗炎靶点421个,两者取交集后获得费菜潜在抗炎靶点22个,其中关键靶点有PPARG、EGFR、TP53等,发挥关键作用的主要成分为β-谷甾醇和没食子酸。GO及KEGG富集分析结果表明,β-谷甾醇和没食子酸主要通过调控聚合酶II启动子的转录正调控、神经元凋亡过程的正调控和脂多糖反应等生物过程,通过癌症通路、乙型肝炎、TNF信号通路、MAPK信号通路等信号通路发挥抗炎作用。分子对接结果显示抗炎药效成分均与靶点蛋白分子对接结果良好。高效液相色谱法证明费菜中含有药效成分β-谷甾醇和没食子酸。实验验证结果表明,β-谷甾醇和没食子酸可显著降低促炎因子NO含量,提高抗炎因子IL-10含量(P<0.05),发挥抗炎作用。结论:本研究揭示了费菜通过调控多靶点、多途径发挥抗炎作用,为费菜的研究和应用奠定了基础。

花类药食同源中药在眼科疾病中药理作用的研究进展

花类中药具有轻扬透散的特质,多散头目之邪,是眼科医家常用的临证要药,多应用于干眼、角膜炎、结膜炎、青光眼、白内障、糖尿病视网膜病变、视网膜静脉阻塞、年龄相关性黄斑变性等常见眼病。本文综述了金银花、藏红花、菊花、红花、野菊花在眼科疾病中药理作用的研究进展,发现这些中药可通过抗炎、抗氧化、抗凋亡及抑制新生血管等途径发挥作用。未来这类药食同源中药在新的给药方式和剂型改进上具有广阔的研究前景和应用潜力,有望在常见眼病的防治中发挥中医特色优势。

神经病理性疼痛的药物治疗研究进展

神经病理性疼痛是一种神经系统损伤引起的慢性疼痛,严重影响患者的生活质量。药物治疗仍是现用治疗神经病理性疼痛的主要方法。本文综述了现用于治疗神经病理性疼痛主要药物的分子药理机制及其临床运用特点,并在总结疼痛的发生机制的基础上对靶向治疗药物的研发进行了展望。

临床药师应重视肿瘤患者的药疗监护

目的 :探讨临床药师对肿瘤患者实施药疗监护的具体方法。方法 :结合肿瘤科临床工作体会 ,并深入分析及总结。结果与结论 :临床药师应做好对护士的指导 ,共同制订护理计划 ,定期整理护理记录 ,以便发现问题并及时解决。

基于亲缘关系的中药药性研究

通过分析中药药性研究的现状及瓶颈问题,提出基于亲缘关系的中药药性研究思路,即按照文献整理和数据挖掘提供的线索,在一定亲缘关系范围内,确定同一药性的共性药理效应,分析与药性相关联的化学成分,进而揭示中药药性-药理效应-化学成分之间的关联规律。将中药药性、药理效应、化学成分有机结合,为突破制约中药药性研究的瓶颈,提供新的思路和视角。

LC-MS测定大鼠血浆中五味子的3个木脂素成分及其药动学研究

目的建立测定大鼠血浆中五味子醇甲、五味子甲素与五味子乙素浓度的LC-MS法，并探讨其在大鼠体内的药代动力学过程。方法SD大鼠6只，按5mg·g^-1。剂量ig给予五味子醇提液，以睾丸酮为内标，血浆样品经甲醇沉淀蛋白后，采用LC—MS法测定不同时间点大鼠血浆中的五味子醇甲、五味子甲素、五昧子乙素的浓度，对其血药浓度-时间采用DAS1．0软件拟合，计算其药动学参数。结果大鼠血浆样品中，五味子醇甲、五味子甲素与五味子乙素的线性范围分别为0．114～3．66mg·L^-1（r=0．9994）、0．0299～0．995mg·L^-1（r=0．9992）和0．0251—0．803mg·L^-1（r=0．9991），提取回收率为83．12％～103．48％，日内与日间精密度均≤14．00％，Cmax分别为（0．54±0．07）、（0．23±0．07）和（0．40±0．04）mg·L^-1，Tmax分别为（4．67±0．26）、（4．33±0．26）和（4．08±0．20）h，q分别为（1．95±0．26）、（8．30±3．36）和（6．46±3．82）h。结论本法专属性强，灵敏度高，快速准确，可作为大鼠血浆中五味子醇甲、五味子甲素与五味子乙素的同时检测及其药动学研究。

药物临床研究的计算机模拟

药物临床研究的计算机模拟是近年来刚兴起的一门交叉学科。该技术的成功运用,可大大降低新药开发费用、缩短研发时间,有广泛的应用前景。本文从药动学和药效学的角度对其发展历史、内容、方法和应用作一综述。

川穹嗪在神经系统的药代动力学及临床药效学应用研究进展

川穹嗪(TMP)是中药川穹中的主要活性生物碱成分,本文将从TMP对神经系统的药效作用机制、药代动力学以及对各种神经系统病理损伤保护作用等方面进行综述。

甲磺酸左氧氟沙星血、尿浓度测定及人体内的药代动力学

采用反相高效液相色谱法测定口服甲磺酸左氧氟沙星后人血清及尿中左旋氧氟沙星药物浓度，色谱柱为ＡＬＬＴＩＭＡＣ１８５μｍ，２５０ｍｍ×４．６ｍｍ。流动相为０．００５ｍｏｌ／Ｌ磷酸溴化四丁基铵乙腈（１１１），ｐＨ＝２．８，流速１．５ｍｌ／ｍｉｎ，荧光检测激发波长２９８ｎｍ，发射波长４５８ｎｍ，以环丙沙星为内标，室温下血、尿样品用１０％三氯乙酸沉淀蛋白后，取上清液进样测定。此方法日内、日间误差均小于６％，平均血清回收率为９４．５２％，尿回收率为９８．６８％。最低检测浓度为２ｎｇ／ｍｌ。应用此方法研究了１６名健康男性志愿者分两组分别单剂口服１００或２００ｍｇ国产甲磺酸左氧氟沙星片的药代动力学。试验结果表明，甲磺酸左氧氟沙星片在健康志愿者体内表现为明显的线性药动学，血药浓度数据符合二室模型，大部分药物以原型从尿中排泄。本项研究结果为国产甲磺酸左氧氟沙星片的临床应用提供了科学依据。

促肝细胞生长素对慢性肝损伤鼠肝部分切除术后肝细胞的影响

目的 研究促肝细胞生长素 (主要成分为肝细胞生长因子 )对慢性肝损伤时肝部分切除术后肝再生和肝功能的影响。 方法 以四氯化碳和乙醇联合诱导大鼠的慢性肝损伤模型 ,对其行 30 %肝部分切除术 ,术后 10d经腹腔注射促肝细胞生长素 (分对照组、小剂量组、大剂量组 ) ,同时建立正常对照组。观察不同剂量促肝细胞生长素对肝再生、肝功能和肝储备功能的影响。 结果 小剂量组与对照组的总蛋白、白蛋白、谷丙转氨酶 (AST )、谷草转氨酶 (ALT)、总胆固醇、动脉血酮体比比较 ,差异无显著性 ( P >0 .0 5 )。大剂量组与对照组的AST ,ALT ,总胆固醇、动脉血酮体比的比较差异显著 ( P <0 .0 1)。电镜和光镜观察显示 ,大剂量的促肝细胞生长素能促进肝再生。 结论 应用大剂量促肝细胞生长素可明显改善肝功能和肝储备功能 。

不同浓度福尔马林对兔疼痛反应和定量药物脑电图α_1频段的影响

目的观察不同浓度福尔马林对兔疼痛反应和定量药物脑电图α1频段的影响。方法成年大耳白兔18只,随机分为3组（n=6）,建立肌松兔模型后分别在右前肢足底皮下注射1%福尔马林（LD组）、8%福尔马林（HD组）或生理盐水（NS组）0.5ml。应用定量药物脑电图（quantitativepharmaco-EEG,QPEEG）,采用功率谱分析技术,观察注射前后兔QPEEGα1频段功率百分比的变化。另取家兔18只,随机分为3组（n=6）,清醒状态下采用上述注射方法建立炎症痛模型。观察兔伤害性行为反应并进行疼痛评分。结果HD组和LD组对福尔马林刺激伤害反应评分均大于NS组（P〈0.01,P〈0.01）,HD组大于LD组（P〈0.01）。与注射前相比,3组兔α1频段功率百分比均增加。HD组增加幅度最大（P〈0.01）,以左侧额、顶区变化最为明显。NS组引起的α1频段功率百分比增加幅度最小,且仅持续1-2min。结论福尔马林所致兔的疼痛反应及兔QPEEGα1频段功率百分比呈浓度依赖性增加,提示α1频段功率百分比有可能成为反映镇痛程度的指标。