蒙药广枣抗心律失常作用有效成分的分离

目的:前期实验采用不同大孔吸附树脂柱及硅胶柱分离广枣并从中得到3个复合物样品(即样品1、2、3),发现样品1和2对乌头碱、哇巴因和心肌缺血所致的豚鼠心律失常有明显抑制作用,而样品3对上述模型出现了加重心律失常的作用,提示广枣中既有抗心律失常作用的成分,又有致心律失常的成分。本实验拟对样品1、2、3做进一步的分离,探讨样品1、2、3的化学成分,揭示广枣中抗心律失常作用的有效成分。方法:利用大孔树脂柱色谱、硅胶柱色谱、薄层层析色谱法等色谱技术对广枣的70%乙醇提取物进行分离,并利用理化常数测定和波谱分析鉴定化合物的结构。结果:分离得到7个化合物,其中样品1中分离得到的化合物为β-谷甾醇、山奈酚、槲皮素,样品2中分离得到的化合物为没食子酸、原儿茶酸、香草酸,样品3中分离得到大量鞣质。结论:广枣中具有抗心律失常作用的化合物可能为β-谷甾醇、山奈酚、槲皮素、没食子酸和原儿茶酸,而对心律失常有加重作用的化合物可能为鞣质。     

4-芳环及芳杂环胺甲基酚类化合物的合成

为了寻找新的抗心律失常药物,本文根据常咯啉部分结构特征,设计并合成了24个4-芳环及芳杂环胺甲基酚类化合物。对其中大部分化合物进行了抗心律失常和抗胆碱动物试验,发现四个化合物:4′-甲氧基-4-羟基-3,5-双吡咯烷甲基-联苯(Ⅳ_(12)),4-(2-噻吩甲酰基)-3,5-双吡咯烷甲基-苯酚盐酸盐(Ⅸ_1),4-(1-咪唑)-3,5-双吡咯烷甲基-苯酚盐酸盐(Ⅸ_3)4-苄基-2-[1-(4甲基-哌嗪)甲基]-苯酚盐酸盐(Ⅸ_4),其抗心律失常活性均强于常咯啉。     

1,2—二取代四氢异喹咻衍生物的合成及其抗心律失常作用

从Morgan和Mathison等所综述的抗心律失常药构效关系出发,以利多卡因和安搏律定(Aprindine)的结构作为先导化合物,设计并合成了33个1,2-二取代四氢异喹啉的酰胺类和烷胺类衍生物。经乌头碱致大鼠心律失常模型初步试验结果,发现绝大多数化合物均具有很强的抗心律失常作用。并对其构效关系作了初步小结。其中1-对甲苯基四氢异喹啉衍生物的抗心律失常作用最强,对心脏毒性小,并与安搏律定作了比较,其最小中毒量/最小有效量和最小致死量/最小有效量之值大大超过安搏律定。     

牛磺酸抗肾上腺素诱发Langendorff家兔心脏心律失常的作用

本实验采用Langendorff家兔心脏观察了牛磺酸抗肾上腺素诱发心律失常的作用.实验发现10~(-5)～10~(-4)mol/L的牛磺酸不仅能减少肾上腺素诱发心律失常发生率,而且能延长诱发心律失常潜伏期和缩短心律失常持续时间的作用.     

碘杂环化合物Ⅰ-65的抗实验性心律失常作用

静注Ⅰ-65 3～5mg/kg能防治BaCl_2氯仿-肾上腺素及哇巴因诱发的心律失常,降低缺血性心律失常的发生.表明Ⅰ-65具有抗实验性心律失常作用。Ⅰ-65对离体豚鼠右心房呈剂量依赖性负性变时作用,能明显延长乳头肌的功能不应期,抑制肾上腺素诱发的异常自律性。这可能是其抗心律失常的机理之一。     

苯海索抗实验性心律失常作用

在五种实验性心律失常动物模型上,观察苯海索(THP)的抗心律失常作用,结果发现THP1.5 mg/kg、3 mg/kg可对抗氯化钡、哇巴因和结扎大鼠冠状动脉引起的室性心律失常及增加兔电室颠阈值;THP 3 mg/kg可对抗乌头碱引起的室性心律失常。提示THP有抗实验性心律失常作用。     

3-取代二碘苯甲酰吲哚衍生物的合成

为了寻找活性高,毒副作用小的抗心律失常药物,设计并合成了3-[3,5-二碘-4-(烷胺基烷氧基)苯甲酰]吲哚和2-甲基-3-[3,5-二碘-4-(烷胺基烷氧基)苯甲酰]吲哚类等12个化合物。初步药理试验表明,它们都有不同程度的抗心律失常活性,其中2-甲基-3-[3,5-二碘-4-(N-吗啡啉乙氧基)苯甲酰]吲哚对氯仿诱发的小鼠心律失常具有明显的保护作用。     

3-取代二碘苯甲酰吲哚衍生物的合成

为了寻找活性高,毒副作用小的抗心律失常药物,设计并合成了3-[3,5-二碘-4-(烷胺基烷氧基)苯甲酰]吲哚和2-甲基-3-[3,5-二碘-4-(烷胺基烷氧基)苯甲酰]吲哚类等12个化合物。初步药理试验表明,它们都有不同程度的抗心律失常活性,其中2-甲基-3-[3,5-二碘-4-(N-吗啡啉乙氧基)苯甲酰]吲哚对氯仿诱发的小鼠心律失常具有明显的保护作用。     

3-O-酰基熊果酸衍生物的抗HIV活性

作者在筛选具抗 HIV 活性的天然产物中发现桦木酸(1)结构修饰所得的3-O-(3′,3′-二甲基琥珀酰)-桦木酸(2)具强抗 HIV 活性。相关化合物齐墩果酸(3)抗 HIV 活性较弱,但其衍生物3-O-(3′,3′-二甲基琥珀酰)-齐墩果酸(4)具强抗 HIV 活性。熊果酸与齐墩果酸的抗 HIV 活性相当,结构相似,如对     

他汀类药物防治心房颤动的机制进展

心房颤动(房颤)是临床上最常见的心律失常之一。房颤使心房发生电重构及结构重构,而心房重构的发生同时加重房颤的发生及维持。目前研究发现,他汀类药物具有潜在的抗心律失常作用,能有效降低房颤的发生,并可预防房颤引起的血栓栓塞性疾病。其作用机制可能与改变心肌离子通道与载体、抗炎抗氧化作用、抑制肾素-血管紧张素系统活性、改善自主神经功能、改善血管内皮细胞功能及减少血管内血栓形成等有关。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.