大黄及牛黄解毒片大鼠给药后血浆中大黄活性成分的药代动力学比较研究

考察大黄及牛黄解毒片给药后大黄活性成分在大鼠体内药代动力学行为的差异。大鼠分别灌胃给予大黄生药材96 mg/kg(含总蒽醌1.83 mg/kg,相当于大黄酸0.28 mg/kg、大黄素0.30 mg/kg、大黄酚0.81 mg/kg、芦荟大黄素0.23 mg/kg及大黄素甲醚0.20 mg/kg)及牛黄解毒片250 mg/kg(含总蒽醌与大黄生药材等量,相当于大黄酸0.33 mg/kg、大黄素0.38 mg/kg、大黄酚0.71 mg/kg、芦荟大黄素0.24 mg/kg及大黄素甲醚0.17 mg/kg),血浆经甲醇沉淀后,采用LC-MS/MS法测定大黄活性成分血药浓度,WinNonlin 7.0软件计算药代动力学参数。大鼠灌胃大黄及牛黄解毒片后,大黄酸的c_max分别为(121±103)及(474±251)μg/L,AUC0-t分别为(275±176)及(406±194)μg·h/L;大黄酚异构体的c_max分别为(2 325±1 390)及(3 580±2 169)μg/L,AUC0-t分别为(8 170±2 661)及(8 856±4 023)μg·h/L;仅在牛黄解毒片给药大鼠血浆中检测出大黄素,且牛黄解毒片给药后大鼠血浆中大黄酸的c_max、AUC及t1/2,大黄酚异构体的Vd及CL与单味大黄相比显著增加,大黄酚异构体的t_max显著下降。实验结果表明,牛黄解毒片复方配伍增强了大黄活性成分在大鼠体内的吸收利用,改变了大黄活性成分的药代动力学行为。     

格列齐特胶囊人体生物等效性研究

目的 :采用高效液相色谱法测定格列齐特的血药浓度 ,进行两种格列齐特胶囊人体生物等效性比较研究。方法 :12位健康男性受试者采用自身交叉给药方案 ,分别单剂量口服 80mg试验品或对照品。结果 :试验品的主要药代动力学参数分别为AUC0～ 36=(10 0 .19± 10 .34) μg/ (ml·h) ,Cmax=(6 .5 9± 0 .5 9) μg/ml,Tpeak=(4 .33± 1.0 7)h ;对照品的参数分别为AUC0～ 36=(10 3 .41± 9.2 5 ) μg/ (ml·h) ,Cmax=(6 .75± 0 .6 0 ) μg/ml,Tpeak=(4 .5 8± 1.0 8)h ,两制剂的AUC0～ 36、Cmax及Tpeak均无显著性差异。试验品相对于对照品的生物利用度为 (96 .99± 6 .6 2 ) %。结论 :两制剂体内过程相仿 ,具有生物等效性     

新生儿昼夜血浆尿液渗透压变化

目的 :探讨新生儿昼夜血浆尿液渗透压变化。方法 :72例新生 (男 4 2例 ,女 30例 ) ,根据日龄分为A、B、C3组 ,3组日龄分别为～ 3、～ 7、～ 2 8d。记录昼夜尿量 ,以FM 6型全自动冰点渗透压仪测量血浆、尿液渗透压。结果 :①A组昼夜尿量与B、C组比较 ,差异有显著性意义 (P <0 .0 5 )。②A、B、C三组昼夜血浆渗透压分别为 2 85±15、2 86± 13、2 84± 11、2 86± 14、2 84± 11、2 86± 14 (mOm·L-1) ;尿液渗透压分别为 2 0 3± 4 5、189± 4 3、186± 37、194± 5 1、2 17± 35、2 0 3± 4 3(mOsm·L-1) ;三组昼夜血浆、尿液渗透压比较差异无显著性意义 (P >0 .0 5 )。结论 :正常新生儿肾脏浓缩功能无昼夜差异。     

婴儿心脏直视手术中两种超滤法应用的对比研究

目的　比较常规超滤 (CUF)和CUF加改良超滤 (MUF)在婴儿心脏直视手术中应用及效果。方法　选取 4 0例单纯室间隔缺损 (VSD)行修补术的婴儿随机均分为两组 ,C组采用CUF ,M组采用CUF +MUF ,两组用相同的方法进行体外循环 (CPB)。观察 :⑴CPB预充总量、手术总用血量、CPB总入量、红细胞压积 (Hct)、超滤量、尿量、残血量等 ;⑵术前、术毕、术后 4h、术后 2 4h血浆白细胞介素 (IL) - 6 ,IL - 8、肿瘤坏死因子 (TNF -α)水平 ;⑶术后血管活性药物的应用、机械通气时间、ICU停留时间。结果　⑴两组预充总量、手术总用血量、CPB总入量、尿量无统计学差异 ,超滤量M组 (4 36± 82 )ml显著多于C组 (347± 5 7)ml,P <0 .0 5 ;残血量M组 (135± 2 3)ml少于C组(16 8± 32ml) ,P <0 .0 1;术毕HctM组 (0 .36± 0 .0 4 )高于C组 (0 .32± 0 .0 5 ) ,P <0 .0 5。⑵术毕TNF -αM组 (97.6± 18.4 )pg/ml显著高于C组 (83.1± 16 .5 )pg/ml,P <0 .0 5 ;余各时点、各指标 2组间均无统计学差别。⑶术后血管活性药物的使用、机械通气时间、ICU停留时间 2组间无显著差异 ,胸腔引流量M组 (96 .4± 2 8.7)ml少于C组(117.3± 32 .6 )ml,P <0 .0 5 ;术后输血量 (4 6 .4± 17.1)ml少于C组 (6 1.5± 2 5 .0 )ml,P <0 .0 5。结论　与CUF     

米非司酮配伍米索前列醇用于9～24周妊娠引产的效果与孕周的关系

目的　探讨米非司酮配伍米索前列醇用于 9～ 2 4周妊娠引产的效果。　方法　 16 8例 9～ 2 4周妊娠妇女 ,口服米非司酮 75 m g,每 12 h 1次 ,共 2次。末次服药后 1h,阴道后穹窿置米索前列醇 2 0 0μg,间隔 4h重复给药。按孕周分四组观察。　结果　引产成功率 (% )分别为 95 .12 ,10 0 ,96 .6 7,97.96 ,四组比较差异无显著性 (P>0 .0 5 )。产后出血量 (ml)分别为 6 8.2 1± 14.2 1,89.2 5± 2 6 .47,117.18± 18.73,12 6 .2 4± 2 5 .16 ,与孕周呈正相关 (P<0 .0 1)。引产时间(h)分别为 8.0 5± 2 .0 2 ,11.2 7± 4.2 9,15 .35± 1.17,2 1.2 3± 3.32 ,与孕周呈正相关 (P<0 .0 1)。米索前列醇用量 (μg)分别为 5 0 0 .14± 82 .13,490 .0 6± 10 4.2 5 ,5 74.82± 93.0 6 ,482 .5 1± 12 1.34 ,各组米索前列醇用量无显著差异且与孕周无相关 (P>0 .0 5 )。　结论　米非司酮配伍米索前列醇用于 9～ 2 4周妊娠引产有效而且安全。引产时间和出血量与孕周有关。     

自制灌注液在大鼠肝缺血再复流中的作用

目的 :研究自制灌注液在大鼠肝脏低温灌注再复流过程中对肝细胞和肝窦内皮细胞的影响。方法 :运用大鼠肝脏原位低温灌注再复流模型 ,行在体原位低温灌注 ,大鼠 10 2只。随机分成 4组 ,每组 2 4只 ,对照组 (C组 ) 2 4只仅行全肝血流阻断 2 0min ,余各组分别用 0℃乳酸林格氏液 (A组 )、0℃自制灌注液 (B组 )、0℃UW液(D组 )灌注 2 0min ,各组在恢复血流 0 ,30 ,12 0 ,72 0min分别处死 6只 ,取血液和肝脏检测。观察低温灌注及再复流后血清透明质酸 (HA)、TNF -α、ALT、AST和肝组织学变化。其余 6只SD大鼠 (S组 )作正常对照。结果 :C组再复流 30 ,12 0 ,72 0min血清HA浓度为 (12 6 .8± 2 0 .8)ng/ml、(2 5 0 .0± 2 4 .1)ng/ml、(2 90 .4± 37.0 )ng/ml,分别高于乳酸林格氏液灌注组 [(6 8.0± 11.6 )ng/ml、(14 2 .9± 30 .1)ng/ml、(2 0 0 .0± 17.5 )ng/ml]和自制灌注液灌注组 [(6 7.5± 6 .7)ng/ml,(6 3.3± 16 .2 )ng/ml,(6 2 .1± 14 .6 )ng/ml]及UW液组 [(6 6 .3± 8.8)ng/ml,(6 6 .6± 2 1.2 )ng/ml,(5 8.8± 11.0 )ng/ml],差异均有高度显著性意义 (P <0 .0 5 ) ;自制灌注液灌注组与UW液灌注组血清HA浓度在再复流 30 ,12 0 ,72 0min均无显著性差异 (P >0 .0 5 )。再复流 30、12 0min时C组血清TNF     

五味降压散对自发性高血压大鼠降压、利尿作用实验探究

目的:实验探究五味降压散对自发性高血压大鼠(Spontaneously hypertensive rats,SHR)是否有利尿作用。方法:14周龄SHR大鼠随机分为模型组、氢氯噻嗪组(噻嗪组)和五味降压散组(五味组),每组10只。10只WKY大鼠作为正常对照组。五味降压散以3.2 g·kg-1的浓度灌胃给药,连续给药12周;给药期间动态观察4组大鼠的收缩压(SBP)、24 h尿量、24 h尿蛋白含量(TP)变化。每两周固定时间测定大鼠血压1次以观测药物降压效果;每两周做1次代谢笼收集各组大鼠24 h尿液,观察尿量并用双缩脲法做24 h尿蛋白定量(TP)测定。结果:五味组给药0~11周SHR尿量有增加趋势,给药12周时,尿量较模型组明显增加,差异有统计学意义(P0.05)。五味组在给药4周、6周时TP值明显高于正常组,差异有统计学意义(P0.05);12周时TP值明显低于模型组,差异有统计学差异(P0.05)。结论:五味降压散对自发性高血压大鼠具有一定的利尿作用。     

支气管哮喘患者血清总IgE和外周血嗜酸细胞检测的意义

目的 :探讨支气管哮喘患者血清总IgE及外周血嗜酸细胞的变化在哮喘发作中的作用。方法 :随机选取哮喘发作期患者 2 5例 ,健康体检 1 0人。采用免疫发光方法检测患者血清总IgE的水平 ,应用伊红染色方法检测外周血嗜酸细胞总数 ,并与正常对照比较。结果 :2 5例患者血清中总IgE的含量为 (1 94 8 6 3± 5 2 1 5 9)ng ml,非常显著地高于正常组 (2 6 7 1 6± 1 0 8 2 8)ng ml(P <0 0 0 1 ) ;患者外周血嗜酸细胞计数 (987± 2 2 6 )× 1 0 6 L ,亦显著地高于正常组 (1 2 3± 35 )× 1 0 6 L(P <0 0 0 1 ) ,哮喘患者血清总IgE与外周血嗜酸细胞计数呈正相关 ,r=0 72 5。结论 :支气管哮喘发作期患者血清总IgE和外周血嗜酸细胞计数均明显升高 ,参与支气管哮喘的病理过程     

米索前列醇连续阴道给药用于中期妊娠引产的临床分析

【目的】探讨米索前列醇 (米索 )连续阴道给药用于中期妊娠引产的有效性和安全性。【方法】 10 0例孕周为 16～ 2 7w的妇女随机分为两组 ,米索组 5 0例 ,阴道后穹隆首次放置米索 4 0 0 μg ,观察宫缩情况 ,若无宫缩则每 3h重复置药 1次 4 0 0 μg ,直至出现规律宫缩 ;利凡诺尔组 5 0例 ,用羊膜腔内注射利凡诺尔 10 0mg引产作为对照。【结果】米索组和利凡诺尔组引产成功率分别为 96 %和 94 % (P >0 0 5 ) ;引产产程 :米索组为(2 0 2± 6 8)h ,利凡诺尔组为 (42 2± 9 1)h ,差异有显著性 (P <0 0 1) ;产后 2h内出血量 :米索组为(82 6± 32 5 )ml,利凡诺尔组为 (132 5± 6 2 3)ml,差异有显著性 (P <0 0 1) ;米索组副作用较多 ,但无严重的副作用出现 ,无须特殊处理。【结论】单用米索前列醇连续阴道给药用于中期妊娠引产 ,是一种安全有效 ,使用方便 ,低价的方法。     

板蓝根总生物碱中表告依春在发热大鼠体内的药动学-药效学结合模型研究

目的应用药动学与药效学结合模型,研究板蓝根总生物碱中主要成分表告依春在酵母致热大鼠体内的药动学和药效学之间的关系。方法给大鼠ig板蓝根总生物碱,不同时间取血并对体温进行观察,采用高效液相法测定血浆中表告依春的浓度,用一房室模型计算药动学参数,采用3种药动学与药效学拟合模型,分别对药效学参数进行拟合。结果表告依春在正常大鼠和发热大鼠体内的主要药动学参数t1/2、Cmax、AUC分别为:(4.94±0.84)h、(4.01±0.21)μg/mL、(28.37±2.42)μg.h/mL和(5.71±0.91)h、(4.15±0.25)μg/mL、(30.35±2.58)μg.h/mL。药理效应与效应室浓度之间的关系用间接反应中的药效产生抑制模型拟合较好,相应的药效学参数分别为Kin为(0.70±0.10)h-1,Kout为(0.54±0.12)h-1,R0为1.33±0.16,IC50为(0.94±0.66)mg/L。结论板蓝根总生物碱中表告依春在正常大鼠和发热大鼠体内的药动学行为无明显差异,表告依春在发热大鼠体内药动学与药效学间符合间接反应中的药效产生抑制模型。     

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…     

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.     

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.     

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.     

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.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…