目的 探讨大蒜素对糖尿病大鼠心肌损伤的影响及其可能的作用机制.方法 将60只实验用SD大鼠随机数字表法分为对照组、模型组、二甲双胍组和大蒜素低、中、高剂量组.对照组大鼠常规饲养,其余各组采用高糖高脂饲料喂养加腹腔注射链尿佐菌素的方法建立糖尿病大鼠模型.造模完成后,各组均1次/d灌胃给药.4周后,血糖仪测定空腹血糖(FBG)水平;生化分析法检测谷草转氨酶(AST)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnI)水平;超声心动图检测左心室舒张末期内径(LVIDd)、左心室收缩末期内径(LVIDs)、射血分数(EF)、每搏输出量(SV);苏木精-尹红(HE)染色法观察心肌组织病理学改变,天狼猩红染色观察心肌组织纤维化状况并计算胶原容积分数(CVF),免疫蛋白印迹(Western blotting)法检测心肌组织转化生长因子-β1(TGF-β1)、磷酸化Smad同源物2/3(p-Smad 2/3)、Smad同源物7(Smad 7)、胶原蛋白Ⅰ(Collagen Ⅰ)、胶原蛋白Ⅱ(Collagen Ⅲ)表达.结果 与对照组比较,模型组大鼠FBG水平和AST、CK-MB、cTnI水平显著升高(P＜0.05),LVIDd、LVIDs显著升高而EF、SV显著降低(P＜0.05);心肌组织呈现心肌纤维断裂、排列紊乱,大量炎性细胞浸润等病理学改变,心肌间质胶原纤维明显增多,CVF显著升高(P＜0.05);心肌组织TGF-β1、p-Smad2/3、Collagen Ⅰ、Collagen Ⅲ表达显著上调而Smad 7表达显著下调(P＜0.05).与模型组比较,大蒜素中、高剂量组和二甲双胍组大鼠FBG水平和AST、CK-MB、cTnI水平显著降低(P＜0.05);LVIDd、LVIDs显著降低且EF、SV显著升高(P＜0.05);心肌组织病理学改变和纤维化状况均明显改善,CVF 显著降低(P＜0.05);心肌组织 TGF-β1、p-Smad 2/3,Collagen Ⅰ、Collagen Ⅲ表达显著下调且Smad 7表达显著上调(P＜0.05).与二甲双胍组比较,大蒜素高剂量组大鼠AST、CK-MB水平显著降低(P＜0.05);LVIDd、LVIDs显著降低且EF、SV显著升高(P＜0.05);其心肌纤维排列整齐,细胞形态正常,CVF显著降低(P＜0.05);心肌组织TGF-β1、p-Smad2/3、Collagen Ⅰ、Collagen Ⅲ表达显著下调(P＜0.05).结论 大蒜素对糖尿病大鼠心肌损伤具有抑制作用,机制可能与通过直接或间接调控TGF-β1/Smads信号通路而抑制心肌纤维化有关.

目的:研究大蒜素对糖尿病大鼠血糖的影响.方法:将用链脲佐菌素造模成功的糖尿病大鼠随机分为4组,即阳性对照组(喂基础饲料),高、中、低剂量组,服用不同剂量的大蒜素[按60mg/(kg?d),40mg/(kg?d),30mg/(kg?d)]和基础饲料,3周后测大鼠血糖.结果:用药前后比较,高剂量组血糖由24.86 mmol/L降至7.26 mmol/L(t=3.77,P<0.01);中剂量组血糖由23.15 mmol/L降至15.80 mmol/L(t=4.78,P<0.01);低剂量组血糖由21.20 mmol/L降至17.60 mmol/L(t=2.65,P<0.05),与阳性组比较差异有显著性意义(t值分别为11.78,7.38,5.03,P<0.01)结论:大蒜素能够降低大鼠的血糖,降糖效果与给药剂量成正相关.

Objective:To analyze the outpatient prescriptions of basic medical institutions and to promote rational clinical use of drugs. Methods:According to Prescription management method and Management Standards of Hospital Prescription Evaluation (trail) , 2000 pieces of outpatient prescriptions were randomly selected from 20 basic medical institutions and analyzed. Results:The usage rate of antibiotics in 20 basic medical institutions was 35.10%, which was above the state-specified standard. The Non-standard prescriptions accounts for the highest percentage of the unreasonable prescriptions and the rate reached 60.76%. Conclusion: The rate of qualified prescriptions was low and many problems existed in outpatient prescription in basic medical institutions. It is necessary to strengthen the training and improve the qualified rate of prescription, and thus promote the rational use of drugs.

目的:通过对邯郸市中心医院2011-2013年门诊处方点评,提高处方质量,促进临床合理用药.方法:对我院2011-2013年抽查的10800张处方点评结果进行统计、分析和总结.结果:处方合格率94.33％,平均每张处方用药品种数为1.73种,抗菌药物使用率13.85％,注射剂使用率15.77％.处方通用名使用率100％,平均每张处方金额131.56元.不合理处方比例6.4％.其中不规范处方占不合理处方比例77.45％;用药不适宜处方占不合理处方比例18.46％;超常处方占不合理处方比例4.08％.结论:通过处方点评工作,有利于提高医师的医疗水平、对促进临床合理、安全用药具有重要意义.

To study clinical efficacy of Zhennaoning capsules in treating cases with cerebral arteriosclerosis, and analyze its economic benefits. Totally 254 cases with cerebral arteriosclerosis were randomly divided into two groups according to their doctor-consulting sequence: the test group (n = 128) that was administered with Zhennaoning capsules, and the control group (n = 126) that was administered with Yangxueqingnao granules. A double-blind parallel-controlled study was conducted for four weeks, in order to observe the clinical efficacy and adverse effects of the two groups, and evaluate their pharmacoeconomics. Additionally, the clinical efficacy and safety of Zhennaoning capsules in treating cerebral arteriosclerosis, as well as its pharmacoeconomics were also discussed. This study showed that Zhennaoning capsules had a better efficacy than its control drug Yangxueqingnao granules in relieving traditional Chinese medicinal syndromes (according to traditional Chinese medicinal syndrome coring, efficacy and cure rate), suggesting a statistical significance (P < 0.01). Despite statistical significance showed from the differences in the remaining indexes and the occurrence rate of adverse effects, the test group displayed a lower cost effectives than the control group (P < 0.01). Zhennaoning capsules have a better clinical efficacy in treating cases with cerebral arteriosclerosis than Yangxueqingnao granules, demonstrating safe clinical application and better economic advantages.

目的观察镇脑宁胶囊治疗偏头痛、紧张性头痛的临床疗效。方法将300例偏头痛及268例紧张性头痛患者随机分为2组:治疗组280例给予镇脑宁胶囊1.2 g口服3次/d;对照组288例给予正天丸6 g口服3次/d,比较2组临床疗效。结果治疗组疗效显著,头痛月发作次数、发作持续时间、VAS评分及中医证候疗效均显著优于对照组。结论镇脑宁胶囊治疗偏头痛和紧张性头痛疗效显著。

Objective To investigate the compatible stability of cefoxintin sodium for injection and Yinzhihuang Injection(a compound injection of Chinese materia medica) in 5% glucose injection.Methods high performance liquid chromatography(HPLC) was established for the quantitative determination of cefoxintin and baicalin within 4 h after the compatibility of cefoxintin sodium for injection and Yinzhihuang Injection,and the changes of solution color,pH value,and insoluble particles were observed.Results The solution color and pH value showed no obvious changes.But the contents of cefoxintin and baicalin as well as the insoluble particles were increased with the compatible time extending.Conclusion The solution is unstable within 4 h after the compatibility of cefoxintin sodium for injection and Yinzhihuang Injection.So it should not be used in the compatibility.

Objective To evaluate the clinical efficacy and safety of Zhennaoning Capsule(ZC) in the treatment of hypertension headache and to evaluate its pharmacoeconomics.Methods The patients(243 cases) with hypertension headache were randomly divided into the treatment(120 cases) and control(123 cases) groups.The patients in the treatment group were po administered with ZC,4 capsules once,three times daily,and at the same time,they were po administered with Yangxue Qingnao Granules(YQG)simulated agent,1 bag once,three times daily.Patients in the control group were po administered with YQG,1 bag once,three times daily,and at the same time,they were po administered with ZC simulated agent,4 capsules once,three times daily.All the patients continued taking antihypertensive drugs,but the Chinese materia medica for hypertension headache and kidney yin dificiency were prohibited.The course of the treatment was eight weeks,and the single-blind and parallel-controlled contrast studies were adopted.The clinical efficacy and safety of the two groups were observed and evaluated by the cost-effectiveness method of pharmacoeconomics.Results There were no differences between the two groups on the clinical efficacy and safety,but the cost-effectiveness of the treatment group was lower than that of the control group(P<0.01).Conclusion Compared with YQG,ZC is better in the treatment of hypertension headache.The therapeutic effect is reliable and safe and has more obvious economic advantages.