Growth inhibitory effect of 4-phenyl butyric acid on human gastric cancer cells is associated with cell cycle arrest

AIM: To investigate the growth effects of 4-phenyl butyric acid (PBA) on human gastric carcinoma cells and their mechanisms. METHODS: Moderately-differentiated human gastric carcinoma SGC-7901 and lowly-differentiated MGC-803 cells were treated with 5, 10, 20, 40, and 60 μmol/L PBA for 1-4 d. Cell proliferation was detected using the MTT colorimetric assay. Cell cycle distributions were examined using flow cytometry.RESULTS: The proliferation of gastric carcinoma cells was inhibited by PBA in a doseand time-dependent fashion. Flow cytometry showed that SGC-7901 cells treated with low concentrations of PBA were arrested at the G0/G1 phase, whereas cells treated with high concentrations of PBA were arrested at the G2/M phase. Although MGC-803 cells treated with low concentrations of PBA were also arrested at the G0/G1 phase, cells treated with high concentrations of PBA were arrested at the S phase. CONCLUSION: The growth inhibitory effect of PBA on gastric cancer cells is associated with alteration of the cell cycle. For moderately-differentiated gastric cancer cells, the cell cycle was arrested at the G0/G1 and G2/M phases. For lowly-differentiated gastric cancer cells, the cell cycle was arrested at the G0/G1 and S phases.

Hepatoprotective properties of oleanolic and ursolic acids in anti-tubercular drug-induced liver damage

Objective:To estimate to what extent the mixture of ursolic acid and oleanolic acid,in addition to the antitubercular standard regime,affects the hepatotoxicity profile.Methods:Liver injury was induced in male BALB/c mice by administering,per os and daily for 11 weeks,a combination of anti-Tubercular(anti-TB) agents Rifampicin(10 mg/kg),Isoniazid(10 mg/kg),and Pyrazinamide(30 mg/kg).The ursolic acid and oleanolic acid mixture at doses of 100 or 200 μg/mouse/day was subcutaneously injected throughout the entire study period(11 weeks).Biochemical and hematological analysis was supplemented by liver histological examination.Results:Animals treated with the mixture of triterpenic acids exhibited significantly decreased aspartate transaminase and alanine aminotransferase levels and amelioration of the histopathological alterations produced by the anti-TB drugs.Conclusions:The triterpene mixture is able to prevent the steatosis induced by the anti-TB drugs.

Protective effect of Weikang decoction and partial ingredients on model rat with gastric mucosa ulcer

AIM: To investigate the protective mechanisms of Weikang (WK) decoction on gastric mucosae. METHODS: Ninety rats were randomly divided into nine groups of 10 each, namely group, model group, group with large WK dosage, group with medium WK dosage, group with small WK dosage, group with herbs of jianpiyiqi (strengthening the spleen and replenishing qi), group with herbs of yangxuehuoxue (invigorating the circulation of and nourishing the blood), group with herbs of qingrejiedu (clearing away the heat-evils and toxic materials), group with colloidal bismuth pectin (CBP) capsules. According to the method adopted by Yang Xuesong, except normal control group, chronic gastric ulcer was induced with 100% acetic acid. On the sixth day after moldmaking, WK decoction was administered, respectively at doses of 20, 10 and 5 g/kg to rats of the WK groups, or the groups with herbs of jianpiyiqi, yangxuehuoxue and qingrejiedu, 10 ml/kg was separately administered to each group every day. For the group with CBP capsules, medicine was dissolved with water and doses 15 times of human therapeutic dose were administered (10 mL/kg solution containing 0.35% CBP). Rats of other groups were fed with physiological saline (10 ml/kg every day). Administration lasted for 16 d. Rats were killed on d 22 after mold making to observe changes of gastric mucosa. The mucus thickness of gastric mucosa surface was measured. Levels of epidermal growth factor (EGF) in gastric juice, nitric oxide (NO) in gastric tissue, endothelin (ET) in plasma, superoxide dismutase (SOD) in plasma, malondialdehyde (MDA) in plasma and prostaglandin I2 (PGI2) were examined. RESULTS: Compared with control group, ulceration was found in gastric mucosa of model group rats. The mucus thickness of gastric mucosa surface, the levels of EGF, NO, 6-K-PGF1α and SOD decreased significantly in the model group (EGF: 0.818±0.18 vs 2.168±0.375, NO: 0.213±0.049 vs 0.601±0.081, 6-K-PGF1α 59.7±6.3 vs 96.6±8.30, SOD: 128.6±15.0 vs 196.6±35.3, P<0.01),the levels of ET (179.96±37.40 vs 46.64±21.20, P<0.01) and MDA (48.2±4.5 vs 15.7±4.8, P<0.01) increased. Compared with model group, the thickness of regenerative mucosa increased, glandular arrangement was in order, and cystic dilative glands decreased, while the mucus thickness of gastric mucosa surface increased (20 g/kg WK: 51.3±2.9 vs 23.2±8.4,10 g/kg WK: 43.3±2.9 vs23.2±8.4,, 5 g/kg WK: 36.1±7.2 vs 23.2±8.4, jianpiyiqi: 35.4±5.6 vs 23.2±8.4, yangxuehuoxue: 33.1±8.9 vs 23.2±8.4, qingrejiedu: 31.0±8.0 vs 23.2±8.4 and CBP: 38.2±3.5 vs23.2±8.4, P<0.05-0.01). The levels of EGF (20 g/kg WK: 1.364±0.12 vs 0.818±0.18, 10 g/kg WK: 1.359±0.24 vs 0.818±0.18, 5 g/kg WK: 1.245±0.31 vs 0.818±0.18, jianpiyiqi: 1.025± 0.45 vs 0.818±0.18, yangxuehuoxue: 1.03±0.29 vs 0.818±0.18, qingrejiedu: 1.02±0.47 vs 0.818±0.18 and CBP: 1.237±0.20 VS 0.818±0.18, p<0.05-0.01), NO (20 g/kg WK: 0.480±0.026 vs 0.213±0.049, 10 g/kg WK: 0.390±0.055 vs 0.213±0.049, 5 g/kg WK: 0.394±0.026 vs 0.213±0.049, jianpiyiqi: 0.393±0.123 vs 0.213±0.049, yangxuehuoxue: 0.463±0.077 vs 0.213±0.049, qingrejiedu: 0.382±0.082 vs 50.213±0.049 and CBP: 0.395±0.053 vs 0.213±0.049, P<0.05-0.01), 6-K-PGF1α (20 g/kg WK: 86.8±7.6 vs 59.7±6.3,10 g/kg WK: 77.9±7.0 vs 59.7±6.3, 5 g/kg WK: 70.0±5.4 vs 59.7±6.3, jianpiyiqi: 73.5±12.2 vs 59.7±6.3, yangxuehuoxue: 65.1±5,3 vs 59.7±6.3, qingrejiedu: 76.9±14.6 vs 59.7±6.3,and CBP: 93.7±10.7 vs 59.7±6.3, P<0.05-0.01) and SOD (20 g/kg WK: 186.4±19.9 vs 128.6±15.0,10 g/kg WK: 168.2±21.7 vs 128.6±15.0, 5 g/kg WK: 155.6±21.6 vs 128.6±15.0, jianpiyiqi: 168.0±85.3 vs 128.6±15.0, yangxuehuoxue: 165.0±34.0 vs 128.6±15.0, qingrejiedu: 168.2±24.9 vs 128.6±15.0, and CBP: 156.3±18.1 vs 128.6±15.0, P<0.05-0.01) significantly increased. The levels of ET (20 g/kg WK: 81.30± 17.20 vs 179.96±37.40, 10 g/kg WK: 83.40±25.90 vs 179.96±37.40, 5 g/kg WK: 93.87±20.70 vs 179.96±37.40, jianpiyiqi: 130.67±43.66 vs 179.96±37.40, yangxuehuoxue: 115.88±34.09 vs 179.96±37.40, qingrejiedu: 108.22±36.97 vs 179.96±37.40, and CBP: 91.96±19.0 vs 179.96±37.40, P<0.01) and MDA (20 g/kg WK: 21.6±7.4 vs 48.2±4.5, 10 g/kg WK: 32.2±7.3 vs 48.2±4.5, 5 g/kg WK: 34.2±6.2 vs 48.2±4.5, jianpiyiqi: 34.9±13.8 vs 48.2±4.5, yangxuehuoxue: 35.5±16.7 vs 48.2±4.5, qingrejiedu: 42.2±17.6 vs 48.2±4.5, and CBP: 30.1±6.1 vs 48.2±4.5, P<0.05-0.01) obviously decreased. The 20 g/kg WK group was better than 10 g/kg (the mucus thickness: 51.3±2.9 vs 43.3±2.9, NO: 0.480±0.026 vs 0.390±0.055, SOD: 186.4±19.9 vs 168,2±21.7, P<0.01) and 5 g/kg (the mucus thickness: 51.3±2.9 vs36.1±7.2, NO: 0.480±0.026 vs0.394±0.026, SOD: 186.4±19.9 vs155.6±21.6, P<0.01) groups and CBP group (the mucus thickness: 51.3±2.9 vs 38.2±3.5, NO: 0.480±0.026 vs 0.395±0.053, SOD: 186.4±19.9 vs 156.3±18.1, P<0.01) in the mucus thickness, NO and SOD levels and better than 10 g/kg (86.8±7.6 vs 77.9±7.0, P<0.05) and 5 g/kg (86.8±7.6 vs 70.0±5.4,P<0.05) groups in 6-K-PGF1α level, 10 g/kg WK group was better than 5 g/kg WK (the mucus thickness: 43.3±2.9 vs 36.1±7.2, P<0.01, SOD: 168.2±21.7 vs 155.6±21.6, P<0.05) and CBP groups (the mucus thickness: 43.3±2.9 vs 38.2±3.5, P<0.01, SOD: 168.2±21.7 vs 156.3±18.1, P<0.05) in the mucus thickness and SOD level. In compound group, jianpiyiqi group, yangxuehuoxue group, qingrejiedu group, the level of ET was decreased, NO contents were increased in gastric tissue of ulcers in rats. CONCLUSION: WK decoction and separated recipes have significantly protective effect on ethanol-induced gastric mucosal injury. They can increase the content of EGF in gastric juice, PGI2 SOD in plasma and NO in gastric tissues, thicken the mucus on the gastric mucosa, and decrease the impairing factor MDA, ET in plasma.

Healing effects of heparin on acetic acid-induced gastric ulcers in rats

Abstract Objective To investigate whether or not heparin can accelerate the healing process of acetic acid induced gastric ulcers in rats and to identify the mechanisms for heparin to produce this effect, so that we can develop a new therapeutic application to heparin besides its traditional anticoagulant activity. Methods Male Sprague Dawley rats were used to produce acetic acid induced gastric ulcers. Heparin in the doses of 100, 500, and 1000 U/kg were administered intravenously through the tail vein once daily, starting 1 day after ulcer induction for 7 days in the dose response experiment or heparin 1000 U/kg at a time schedule of 3, 5, and 7 days in the time response study, respectively. The gastric mucosal blood flow (GMBF) was measured using a laser Doppler flowmeter under ether anesthesia. The rats were then sacrificed and the ulcer areas were measured. The gastric mucosa was then scraped for the determinations of mucosal prostaglandin E 2 (PGE 2) level and myeloperoxidase (MPO) activity. Results Heparin in the doses of 500 and 1000 U/kg accelerated the healing of acetic acid ulcers in a dose dependent manner. The highest dose of heparin also reduced the ulcer areas in a time dependent fashion. The effect was accompanied by an increase in gastric mucosal PGE 2 levels. The same dose of heparin not only decreased the gastric mucosal MPO activity but also increased the GMBF in a time related manner. Conclusions Heparin with the doses used in the present study accelerated the healing of acetic acid induced gastric ulcers in rats in a dose and time dependent manner, and this action was related to its effects to increase the levels of gastric mucosal PGE 2 and GMBF as well as to decrease the gastric mucosal MPO activity.

Mathematical modeling of drug release from biodegradable polymeric microneedles

Transdermal drug delivery systems have overcome many limitations of other drug administration routes,such as injection pain and first-pass metabolism following oral route,although transdermal drug delivery systems are limited to drugs with low molecular weight.Hence,new emerging technology allowing high molecular weight drug delivery across the skin—known as‘microneedles’—has been developed,which creates microchannels that facilitate drug delivery.In this report,drug-loaded degradable conic microneedles are modeled to characterize the degradation rate and drug release profile.Since a lot of data are available for polylactic acid-co-glycolic acid(PLGA)degradation in the literature,PLGA of various molecular weights-as a biodegradable polymer in the polyester family-is used for modeling and verification of the drug delivery in themicroneedles.The main reaction occurring during polyester degradation is hydrolysis of steric bonds,leading to molecular weight reduction.The acid produced in the degradation has a catalytic effect on the reaction.Changes in water,acid and steric bond concentrations over time and for different radii of microneedles are investigated.To solve the partial and ordinary differential equations simultaneously,finite difference and Runge–Kutta methods are employed,respectively,with the aid of MATLAB.Correlation of the polymer degradation rate with its molecular weight and molecular weight changes versus time are illustrated.Also,drug diffusivity is related to matrix molecular weight.The molecular weight reduction and accumulative drug release within the system are predicted.In order to validate and assess the proposed model,data series of the hydrolytic degradation of aspirin(180.16 Da)-and albumin(66,000 Da)-loaded PLGA(1:1 molar ratio)are used for comparison.The proposed model is in good agreement with experimental data from the literature.Considering diffusion as themain phenomena and autocatalytic effects in the reaction,the drug release profile is predicted.Based on our results for a microneedle containing drug,we are able to estimate drug release rates before fabrication.

DrugFET的研究(Ⅳ).硅钨酸-麻黄碱FET的研制与应用

将离子敏感场效应晶体管（ＩＳＦＥＴ）与药物敏感膜相结合，研制成一种对盐酸麻黄碱有良好响应的药物敏感场效应晶体管传感器（ＤｒｕｇＦＥＴ）。该器件具有全固态化，体积小，易微型化，集成化和多功能化，响应快速和低输出阻抗等优点。采用硅钨酸作为电活性物质，不必转型，制成ＰＶＣ膜ＩＳＦＥＴ，对麻黄碱响应的线性范围是１．０×１０－１～５．０×１０－６ｍｏｌ／Ｌ，斜率为５９ｍＶ／ｐｃ（ｃ＝ｍｏｌ／Ｌ），检测下限为２．０×１０－６ｍｏｌ／Ｌ，适宜ｐＨ值范围为４．５～８．０。利用该传感器分析盐酸麻黄碱片剂的含量，结果和药典分析方法相一致。

磷钨酸涂覆ISFET制作DrugFET的研究

用磷钨酸涂覆离子敏感场效应晶体管（ＩＳＦＥＴ）制成药物敏感场效应晶体管（ＤｒｕｇＦＥＴ）。该器件具有全固态化、易微型化、集成化和多功能化等特点。用其对药物制剂的含量进行测定，所得结果和药典分析结果一致。

针刺联合止吐药治疗胃癌化疗相关恶心呕吐的临床观察

[目的]本研究观察针刺治疗胃癌化疗相关性恶心呕吐(CINV)的疗效。[方法]收集2022年1月—2023年12月住院的胃癌患者。根据化疗期间是否行针刺治疗,所有患者分为常规治疗组和联合针刺组。观察指标为急性恶心和呕吐及延迟的恶心和呕吐的发生率、化疗期间恶心和呕吐总次数、生活质量、安全性和止吐药物相关不良反应。[结果]与常规治疗组相比,联合针刺组能够减少化疗后急性CINV和延迟CINV的发生(P<0.05),并且能够减少化疗期间恶心和呕吐发生总次数(P<0.05)。针刺能提高胃癌患者生活质量(P=0.028)。针刺治疗安全,并且针刺能够能减少止吐药物相关的便秘(P=0.031)和腹泻(P=0.005)等不良反应的发生。[结论]针刺联合止吐药可降低晚期胃癌CINV的发生,提高患者的生活质量,同时降低止吐药物相关不良反应的发生。

伏诺拉生不良反应研究进展

伏诺拉生是新型的抑酸药物,药理作用与质子泵抑制剂不同,抑酸作用较质子泵抑制剂可能更为强大、持久。随着伏诺拉生临床应用时间和病例数的增加,不良反应报道也逐渐增多,同时随着临床药理研究的深入,伏诺拉生潜在的不良反应也逐渐呈现。本文通过检索文献,了解伏诺拉生抑酸作用导致的潜在不良反应,以及伏诺拉生与其他药物联合应用时可能出现的潜在不良反应。

绿原酸抗菌作用及机制的研究进展

绿原酸是植物体在有氧呼吸过程中经莽草酸途径合成的一种苯丙素类物质,自然存在于多种中药材和食物中,杜仲、金银花和咖啡等植物中含量较高,具有抗菌、抗炎、抗氧化、抗癌和免疫调节等多种药理活性。近年来,绿原酸作为研究活性物质的焦点之一,因其抗菌谱广,对多种细菌和真菌均有较好的抗菌活性,故绿原酸对临床菌株的抗菌作用逐渐被重视和研究。本文综述了近年来国内外关于绿原酸对多种致病菌的抗菌作用及机制的研究进展,旨在为绿原酸抗菌作用的深入研究提供参考,为临床抗感染治疗和控制带来新思路,有助于绿原酸在医药领域的开发。

Ophthalmic complications of injectable facial fillers

The recently published mini-review article by Miotti et al is an effort to clarify various aspects regarding the choice between fat grafts and fillers in facial aesthetic surgery.One of the complications associated with the administration of fillers is the possibility of vascular injury and spread of the dermal filler into the orbit,causing unexpected effects at a site distant from that of the initial injection,including ophthalmoplegia,ptosis and even visual compromise.Acute vision loss following filler injection is a devastating complication,occurring in up to 0.0008%of cases.The greatest risk of this complication occurs with nasal augmentation,followed by glabellar wrinkle treatment.While injected autologous fat predominantly occludes the proximal portion of the ophthalmic artery,hyaluronic acid fillers obstruct the ophthalmic artery comparatively distally.Treatment interventions include thrombolysis,hyperbaric oxygen therapy,oral aspirin,cobamamide and acetazolamide and administration of corticosteroids.However,most studies show a poor prognosis in the form of partial or no recovery of vision.Hence,prevention is of paramount importance.A high index of suspicion is also warranted on the part of both those administering as well as receiving injections of facial fillers to prevent potentially vision-threatening complications of this seemingly innocuous procedure.

Improving treatment plan and mental health in children with abdominal infection for broad-spectrum bacterial infections

BACKGROUND Pediatric abdominal infection is a common but serious disease that requires timely and effective treatment.In surgical treatment,accurate diagnosis and rational application of antibiotics are the keys to improving treatment effects.AIM To investigate the effect of broad-spectrum bacterial detection on postoperative antibiotic therapy.METHODS A total of 100 children with abdominal infection who received surgical treatment in our hospital from September 2020 to July 2021 were grouped.The observation group collected blood samples upon admission and sent them for broad-spectrum bacterial infection nucleic acid testing,and collected pus or exudate during the operation for bacterial culture and drug sensitivity testing;the control group only sent bacterial culture and drug sensitivity testing during the operation.RESULTS White blood cell count,C-reactive protein,procalcitonin,3 days after surgery,showed better postoperative index than the control group(P<0.05).The hospital stay in the observation group was significantly shorter than that in the control group.The hospitalization cost in the observation group was significantly lower than that in the control group,and the difference between the two groups was statistically significant(P<0.05).CONCLUSION Early detection of broad-spectrum bacterial infection nucleic acids in pediatric abdominal infections can help identify pathogens sooner and guide the appropriate use of antibiotics,improving treatment outcomes and reducing medical costs to some extent.

磁性核壳胶囊局域中和胃酸用于活性益生菌的高效递送

近年来基于益生菌的幽门螺旋杆菌感染治疗策略受到了越来越多的关注,然而益生菌在胃部中直接递送会受到胃酸环境的干扰,难以存活,无法有效抑制幽门螺旋杆菌。为了实现益生菌在胃部的高效递送,我们制备了具有核壳结构的益生菌胶囊。胶囊外壳由海藻酸钙(Alg)、碳酸钙(CaCO_(3))以及铁钴磁性石墨纳米囊FeCo@G组成,胶囊内核为益生菌(约氏乳杆菌,Laj)菌液。其中,CaCO_(3)用于局域中和胃酸以保护内核益生菌,而FeCo@G则赋予了胶囊良好的磁驱动性能。我们利用扫描电子显微镜以及细胞显微成像系统等手段考察了益生菌胶囊的形貌和包裹稳定性,结果显示,胶囊能稳定包裹益生菌并抵御模拟胃液(SGF)中盐酸的侵蚀,维持了益生菌活性,并对幽门螺旋杆菌(H.p)具有明显抑制作用。此外,我们进一步探究了Alg/CaCO_(3)/FeCo@G-Laj(ACFL)胶囊在模拟胃部环境内的磁导航运动性能,结果表明,在磁场条件下,ACFL胶囊在不同粘度的介质中均可以实现高效的磁驱动效应,证实了ACFL胶囊的益生菌靶向递送能力。综上,ACFL胶囊为幽门螺旋杆菌的治疗提供新的方法,同时也为胃酸不稳定药物的高效保护以及精准投递提供了新平台。

消化内科胃及十二指肠溃疡药物治疗的临床疗效分析

目的 探究消化内科胃及十二指肠溃疡药物治疗的临床效果。方法 80例胃及十二指肠溃疡患者,随机分为对照组和观察组,每组40例。对照组接受三联疗法进行治疗,观察组在对照组用药基础上加用枸橼酸铋钾治疗。对比两组患者临床疗效、幽门螺杆菌(Hp)清除率、不良反应发生率、满意度及生活质量评分。结果 观察组临床总有效率95.00%高于对照组的70.00%(P<0.05)。观察组患者Hp清除率97.50%高于对照组的72.50%,不良反应发生率15.00%低于对照组的37.50%(P<0.05)。治疗后,观察组患者躯体功能、社会功能、角色功能、认知功能评分分别为(77.88±6.96)、(79.81±7.85)、(86.94±6.88)、(86.58±6.77)分,均高于对照组的(64.14±6.19)、(65.18±7.22)、(73.19±5.33)、(75.20±6.41)分(P<0.05)。观察组患者总满意率为97.50%,高于对照组的72.50%(P<0.05)。结论 针对胃及十二指肠溃疡患者,在三联疗法基础上加用枸橼酸铋钾可显著提升患者临床疗效,提高Hp清除率,降低不良反应发生率,并且可以有效改善患者生活质量,增强患者满意度,值得临床推广应用。

星点设计-效应面法优化阳离子纳米乳递送系统的处方工艺研究

目的采用单因素试验和星点设计-效应面法优化阳离子纳米乳(CNE)的处方工艺,并对其药剂学性能进行评价。方法以平均粒径(D_(50))、粒径范围、离心稳定性常数(Ke)和电位为评价指标,单因素试验筛选CNE的油相种类、乳化剂种类及用量、甘油及十八胺用量、剪切时间,高压均质压力及时间,星点设计效应面法考察均质压力和时间对CNE的影响,用二项式及多元线性回归模型拟合建立指标与因素之间的关系,效应面法获取最佳处方。结果CNE最佳处方组成为中链脂肪酸甘油三酯(MCT)0.5 g,大豆卵磷脂1 g,十八胺53.90 mg,甘油0.8 g,其余为水相;最佳处方所得CNE外观基本圆整,澄清透明,D_(50)为(135.08±5.69)nm,Zeta电位为(43.57±2.51)mV,离心、稀释、时间稳定性均良好。结论优化得到的CNE为淡蓝色均一乳状液、稳定性良好粒径合适,可为核酸药物递送系统的开发提供参考。

绿舒筋多糖的抗炎镇痛作用

目的 评价绿舒筋多糖 (polysaccharidesfromEuonymusmupinensisLoesetRehd ,EMP)的抗炎镇痛作用。方法 用二甲苯致小鼠耳肿胀、鸡蛋清致大鼠足爪肿胀及大鼠肉芽肿炎症模型 (纸片法 ) ,考察绿舒筋多糖的抗炎作用 ;用小鼠醋酸扭体法和热板法 ,观察绿舒筋多糖的镇痛作用。结果 绿舒筋多糖皮下注射给药 ,可明显减轻小鼠耳肿胀度 ,降低鸡蛋清致大鼠足爪肿胀 ,抑制大鼠肉芽肿 ;对小鼠醋酸扭体和热板反应均呈剂量相关性镇痛作用。结论 绿舒筋多糖对急、慢性炎症反应均有明显的抑制作用 ;

以紫杉醇为主的联合化疗方案治疗进展期胃癌随机对照研究

背景与目的:治疗晚期胃癌目前尚无公认的金标准方案。Ⅱ期临床研究发现紫杉醇类药物对胃癌有较好疗效。本研究对比亚叶酸钙/5-氟尿嘧啶(CF/5-FU)联合顺铂(DDP)、紫杉醇(Taxol)联合CF/5-FU、紫杉醇联合草酸铂(Oxaliplatin,OXA)方案治疗晚期胃癌的临床疗效与不良反应。方法:在福建省6家医院进行前瞻性、开放、随机对照研究,将符合入选标准的患者根据随机号码分入CF/5-FU+DDP、CF/5-FU+Taxol及Taxol+OXA3个组,用双周方案进行全身化疗(CF0.2g/m2,静滴,d1、2;5-FU2.0/m2,持续静脉滴注48h;DDP50mg/m2,静滴,d1;Taxol100mg/m2,静滴,d1;OXA100mg/m2,静滴,d1),配合每周一次DDP40mg/m2腹腔灌注化疗。按WHO标准评价疗效及不良反应。结果:2002年5月至2004年5月,入选180例合格病例,随机分入对照组(CF/5-FU+DDP组)60例,研究组120例(研究Ⅰ组:CF/5-FU+Taxol组及研究Ⅱ组:Taxol+OXA组各60例)。其中166例(92.22%)接受了至少2个周期的化疗,152例(84.44%)完成4个周期的化疗,103例(57.22%)完成了8个周期的化疗。166例可评价疗效,Taxol+OXA组疗效较对照组好(P<0.05)。在术前初治患者中,研究组Ⅰ组和Ⅱ组的疗效明显优于对照组(50.00%、80.00%与20.75%,P<0.05);在腹膜后淋巴结转移的患者中,研究组疗效明显优于对照组(65.96%、85.71%与36.36%,P<0.05);而在肝转移的患者中,研究组与对照组疗效近似(28.57%、39.13%与34.62%,P>0.05)。与对照组相比较,研究组患者中任何程度的恶心、呕吐、食欲差、口腔炎及肾功能减退发生率均较低,但骨髓抑制及末梢神经损害相对较严重,并有7例(5.88%)发生不同程度的过敏反应,其中严重过敏反应3例(2.52%)。无治疗相关死亡。结论:晚期胃癌患者采用含紫杉醇方案化疗虽然骨髓抑制较重,但总体疗效优于CF/5-FU+DDP方案,不良反应可以耐受。本研究推荐以紫杉醇为主的联合化疗方案作为晚期胃癌的一线化疗方案。

丙戊酸钠联合拉莫三嗪治疗癫痫疗效及安全性的Meta分析

目的系统评价丙戊酸钠(VPA)联合拉莫三嗪(LTG)治疗癫痫的总有效率及不良反应,为临床癫痫的联合用药提供循证医学证据。方法 2015年12月,计算机检索PubMed、Cochrane Library、EMBase以及万方数据知识服务平台、维普网、中国知网(CNKI)、中国生物医学文献数据库(CBM)中收录的VPA联合LTG治疗癫痫疗效和安全性的随机对照试验,提取第一作者、发表时间、样本量、患者年龄、用药、疗程、癫痫类型、观察指标等资料,并采用改良的Jadad量表评价纳入文献的方法学质量。结果共纳入16篇文献,15篇中文文献,1篇英文文献,1 687例患者。分配方案的隐藏、盲法、选择性报道存在未知风险,纳入文献方法学质量较低。Meta分析显示,VPA联合LTG治疗癫痫的总有效率高于单用VPA[比值比(OR)=5.76,95%CI(3.78,8.78),P<0.001]或LTG[OR=2.80,95%CI(1.83,4.28),P<0.001],神经系统[危险差(RD)=-0.04,95%CI(-0.06,-0.02),P=0.002]、消化系统[RD=-0.05,95%CI(-0.08,-0.02)]、血液系统[RD=-0.03,95%CI(-0.05,-0.01),P=0.040]、皮肤附件[RD=-0.04,95%CI(-0.06,-0.01),P=0.008]不良反应发生率低于单用VPA或LTG。结论 VPA联合LTG治疗癫痫的临床疗效优于单用VPA或LTG,且耐受性好。受纳入文献方法学质量限制,该结论有待大样本、高质量的随机对照试验进一步证实。

左金丸和反左金对大鼠胃粘膜保护机制的比较研究

【目的】比较左金丸(m_(黄连):m_(吴茱萸)=6:1)和反左金(m_(黄连):m_(吴茱萸)=1:6)对胃分泌和粘液屏障的影响。【方法】采用Shay氏大鼠幽门结扎模型,大鼠分为生理盐水对照组,左金丸1.4g/kg、2.8g/kg组以及反左金1.4g/kg、2.8g/kg组,分别从十二指肠给药,观察各组大鼠的胃分泌和粘液合成的变化。【结果】1.4g/kg、2.8g/kg左金丸和反左金都能抑制胃液分泌、降低总酸排出量及胃蛋白酶活性,且随着剂量增加药效更明显;左金丸和反左金都能增加胃壁结合粘液含量,对胃液中粘液成分也有增加的趋势。【结论】左金丸和反左金可能通过影响胃分泌和粘液合成来保护胃粘膜。

加味左金丸抑制大鼠基础及胃泌素诱导泌酸的作用

在大鼠活体胃灌流模型上观察加味左金九的制酸作用。结果表明，该方明显抑制基础泌酸，效价与剂量有关，４ｇ／ｋｇ剂量抑制率８３．６％，优于生理盐水空白组和阳性药雷尼替丁组（Ｐ＜０．０５～０．０１）。此外还抑制五肽胃泌素诱导泌酸，抑制率５３％。提示加味左金丸具有抑制基础和胃泌素诱导泌酸的作用。