高效液相色谱-蒸发光散射法测定人肠黏膜通透性的方法学及其临床应用研究

目的进行高效液相色谱-蒸发光散射法测定人肠黏膜通通性的方法学研究,同时应用此方法研究重度融性乙型病毒性肝炎患者肠道屏障功能的变化并探讨其治疗方法。方法（1）采用高效液相色谱-蒸发光散射法检测30例健康人（正常组）和90例重度慢性乙型病毒性肝炎患者尿乳果糖、甘露醇排泄率比值（L／M）的变化,同时测定血清二胺氧化酶（DAO）的变化,以此两项指标来反映肠道屏障功能的变化并将两组加以比较。（2）将90例重度慢性乙型病毒性肝炎患者按随机数字表法分为对照组、乳果糖组,谷氨酰胺组3组,每组30例。对照组采用常规治疗;乳果糖组在常规治疗的基础上加用乳果糖10g,3：L／d;谷氨酰胺组在常规治疗的基础上加用谷氨酰胺颗粒10g,3：L／d。疗程均为2周。于治疗前后分别测定3组患者的肝功能、内毒素（ET）、肿瘤坏死因子（TNF-α）、DAO、白介素-2（IL-2）、白介素-8（IL-8）、T淋巴细胞亚群、L／M等,并采用协方差分析法加以比较。结果采用高效液相色谱-蒸发光散射法测定L／M的变化,甘露醇和乳果糖能得到很好地分离,乳果糖的线性范围为0．65—13．0μg/L（r=0．9980）,甘露醇的线性范围为0．74～14．7／μg／L（r=0．9983）。乳果糖和甘露醇日内精密度的相对标准偏差（RSD）分别为1．56％、0．65％（n=6）,日间精密度的RSD分别为1．77％、0．99％（n=6）。乳果糖的加样回收率为98．68％～100．4％,平均值为99．51％;甘露醇的加样回收率为99．52％-100．5％,平均值为99．94％。乳果糖在尿中的最低检测浓度为94．2-L,甘露醇在尿中的最低检测浓度为29．9μg/L。重度慢性乙型病毒性肝炎患者L／M、DAO水平明显升高（P〈0．01）。治疗2周后,与对照组相比,乳果糖组TBIL、ET、TNF-α的变化差异有统计学意义（P〈0．05）;与对照?     

高效液相色谱法测定人尿乳果糖及甘露醇

目的：建立一项快速、灵敏测定人尿乳果糖（Ｌ）及甘露醇（Ｍ）的实验方法。方法：烧伤病人口服给药：乳果糖１０ｇ，甘露醇５ｇ，高效液相色谱示差（ＨＰＬＣ－ＲＩ）检测法测定各时段Ｌ、Ｍ的排出量。结果：Ｌ、Ｍ的线性范围为４～５００ｍｇ／Ｌ，平均回收率为９６．３９％～９８．３７％，精密度（ＣＶ％）为２．６８～３．７４，最低检测限０．０５ｍｇ／Ｌ。结论：Ｌ／Ｍ的值增大，可示肠通透性增高     

毛细管色谱法测定丙卡特罗中有机溶剂残留量

目的：建立毛细管气相色谱法测定丙卡特罗中的有机溶剂残留量。方法：用Agilent INNOWax毛细管气相色谱柱、FID检测器,以乙腈为内标进行测定。结果：正己烷、乙酸乙酯、吡啶的线性范围分别为0-464μg／mL（r=0．9999）、0-800μg／mL（r=0．9998）、0～32μg／mL（r=0．9993）,平均回收率分别为99．8％、100．5％、101．3％,RSD分别为0．96％、1．38％、2．18％（n=9）。结论：毛细管气相色谱法简单、准确、灵敏度高、重现性好,适用于丙卡特罗中有机溶剂残留量的测定。     

乳果糖治疗中风卧床病人便秘的疗效和安全性评价

目的：评价乳果糖治疗中风卧床病人便秘的疗效和安全性。方法：治疗组78例中风卧床便秘病人给予乳果糖口服溶液每次30～50ml,清晨顿服。对照组45例给予果导片0．2g,3次／d,口服。10天为1个疗程。结果：治疗组和对照组的治愈率分别为85．9％（67／78）和66．7％（30／45）,好转率分别为11．5％（9／45）和6．7％（3／45）。总有效率分别为97．4％和73．3％,2组比较,差异有统计意义（P〈0．05）。治疗组每周排便次数和排便状况优于对照组（P〈0．05）。不良反应发生率低于对照组（P〈0．05）。结论：乳果糖口服溶液治疗中风卧床便秘病人疗效显著,安全性高。     

HPLC法测定血浆中5-氟尿嘧啶水平

目的：建立快速测定人血浆中5-氟尿嘧啶（5-Fu）浓度的方法。方法：乙酸乙酯提取血浆中5-Fu，高压液相色谱法测定其浓度。色谱柱为YWGC18，流动相为0．03mol磷酸氢二钾（2．5：1），pH7．0，流速为1．0mL／min。紫外检测波长254nm。结果：分别在血浆低浓度（0．1μg／mL～5μg／mL）和高浓度（5μg/mL～40μg／mL）呈良好线性关系。5-Fu在5μg／mL、10μg／mL、40μg／mL、300μg／mL、500μg／mL5个浓度点日间平均回收率和RSD分别为95．2％、4．6％；90．5％、6．9％；95．9％、0．93％；107％、8．5％；106％、6．0％。结论：本方法快速、准确，适合于5-Fu临床用药浓度的观察及个体药代动力学研究。     

正常国人乳果糖和甘露醇排出率比值

目的测定正常国人口服乳果糖、甘露醇测试液后尿中乳果糖／甘露醇排出率比值（Ｌ／Ｍ）。方法用带脉冲电化学检测器的高压液相仪（ＨＰＬＣ－ＰＥＤ）分别测定６０例健康志愿者口服以往剂量（乳果糖１０ｇ、甘露醇５ｇ）和小剂量（乳果糖２ｇ、甘露醇１ｇ）测试液后,尿中乳果糖和甘露醇浓度,并计算乳果糖和甘露醇尿中排出率及其比值。结果口服以往剂量和小剂量测试液６ｈ后,正常国人尿中Ｌ／Ｍ比值分别为０．０２６±０．００６和０．０３６±０．００８。结论ＨＰＬＣ－ＰＥＤ方法检测灵敏度高,可减少乳果糖和甘露醇的测试量,测定乳果糖与甘露醇排出率比值反映肠粘膜通透性是一种实用的临床方法。     

苦豆子总碱注射液中苦参碱和槐果碱的含量测定

目的用反相液相色谱法测定苦豆子总碱注射液中苦参碱、槐果碱的含量。方法用YMC．packed ODS—A（150mmx4．6mm，5pm）色谱柱。以V（乙腈）：V（0．05mol／LKH2PO3）：V（三乙胺）：12：88：0．18为流动相，紫外检测波长210nm，流速1．0mL／min，柱温为25。C。结果在所确立的色谱条件下，两种生物碱得到很好地分离，标准曲线显示苦参碱、槐果碱分别在5-60μg／mL和2-40μg／mL范围内线性关系良好，平均回收率分别为96．4％和95．2％，RSD分别为2．2％和1．2％。结论测定方法简便、快速、准确，可用于苦豆子总碱注射液中苦参碱、槐果碱的含量测定。     

保健食品中甘露醇的毛细管气相色谱分析

目的建立保健食品中甘露醇的毛细管气相色谱分析方法。方法用去离子水超声波提取样品中的甘露醇，经乙酸酐衍生化为沸点较低的甘露醇六乙酯，用SPB-608毛细管色谱柱分离，火焰离子化检测器（FID）进行检测。色谱柱温度为180℃、进样口和检测器的温度均为210℃，氮气流速30mL／min。结果优化了样品衍生化和色谱分析条件，实现了葡萄糖、肌醇和山梨醇与甘露醇的分离，排除了它们对甘露醇测定的干扰。本方法的线性范围为（0．05～10．00）mg／mL，检出限为0．01mg／mL，日内精密度RSD为4．4％，日间精密度RSD为7．3％～7．60%，平均加标回收率为84．6%～107．6%。结论本方法操作简单、灵敏、可靠，能满足保健食品中甘露醇定量分析的要求。     

RP-HPLC同时测定苯巴比妥、苯妥英和卡马西平的血药浓度

目的采用反相高效液相色谱法同时测定苯巴比妥（PB）、苯妥英（PHT）和卡马西平（CBZ）血药浓度。方法色谱柱为Agilent Zorbax 8nm Extend—C18（5μm，4．6mm×150mm），流动相为y（甲醇）：v[v（o．1mol／L乙酸钠）：v（o．05％β环糊精）=32：18]=68：32，柱温为室温，流速为0．8mL／min，检测波长为230nm，进样量为20μL。结果PB、DPH和CBZ分离良好，分离度皆大于1．5；最低检测浓度分别为0．3802、0．1823和0．1444μg／mL；线性范围分别为0．4-60、0．2-30和0．2-30μg／mL；回收率分别为97．04％、96．52％和97．09％；日内和日问相对标准偏差皆小于5．80％。结论本方法简便、快速、重现性好，结果可靠，适用于临床常规检查。     

人血浆中磺胺甲噁唑和代谢产物的HPLC法测定及其药代动力学研究

目的建立人血浆中磺胺甲噁唑及其代谢产物的RP—HPLC测定法,研究磺胺甲噁唑及其代谢产物N4-乙酰磺胺甲噁唑的药代动力学特征。方法血样经高氯酸预处理后,进行HPLC分析,色谱柱为Lichrospher C18（5μm,250inm×4．6mm）,流动相为乙腈-水-冰乙酸-三乙胺（38：62：0．4：0．3,v／v）,流速为1．0ml／min,检测波长为240／lm。结果磺胺甲噁唑和N4-乙酰磺胺甲噁唑分别在1～160μg／ml和0．5～20μg／ml的范围内浓度与峰面积线性关系良好,定量限分别为1μg/ml和0．5μg/ml,日内精密度分别为0．91％～6．83％和1．80％-7．66％,日间精密度分别为2．12％～6．09％和4．16％～8．15％,回收率分别为95．9％～106．0％和98．8％～110．3％。结论建立的人血浆中磺胺甲噁唑及其代谢产物的RP—HPLC分析方法灵敏、准确、简便,适合于磺胺甲噁唑及其代谢产物N4-乙酰磺胺甲噁唑的药代动力学研究。     

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…