二烯丙基三硫化物对大鼠离体肾内动脉血管张力的影响

目的观察二烯丙基三硫化物(diallyl trisulfide,DATS)对离体肾内动脉张力的影响及其机制。方法 SD大鼠体质量250～300 g,脱臼处死后,显微操作下取出肾内动脉,制备成1.8～2.0 mm长的血管条,每根血管条固定于微血管测定仪的浴槽内,记录张力变化。分别给予血管收缩剂苯肾上腺素(Phe)、血栓素A2受体激动剂(U46619)、5-羟色胺(5-HT)和KCl刺激血管产生持续性收缩,采用累积给药法加入DATS,观察不同浓度的DATS对肾内动脉张力的影响。观察DATS舒张效应的同时用等体积的药物溶剂二甲基亚砜(DMSO)作为对照。结果 DATS能呈浓度依赖性诱导舒张1μmol.L-1 Phe、0.1μmol.L-1 U46619和2μmol.L-1 5-HT预收缩内皮完整的肾内动脉环,pD2分别为(6.06±0.17),(6.14±0.26)和(5.37±0.16),其最大舒张率(Emax)分别为(91.24±2.71)%,(93.44±2.14)%和(92.51±1.15)%;但是,对60 mmol.L-1 KCl预收缩的肾内动脉环无明显舒张作用;分别用eNOS抑制剂L-NAME和sGC抑制剂ODQ预处理内皮完整的肾内动脉环不影响DATS舒张效应;去除肾内动脉血管内皮也不影响DATS对其舒张作用。结论 DATS有浓度依赖性舒张大鼠肾内动脉作用,无明显内皮依赖性。     

邻苯二甲酸二丁酯的收缩血管作用及其机制

目的研究邻苯二甲酸二丁酯(di-n-butyl phthalate,DBP)对大鼠动脉血管的作用,并探讨其可能机制。方法采用离体大鼠胸主动脉环灌流模型,观察DBP对动脉血管的收缩效应及其内皮的参与性,并观察相关信号途径工具药的影响。结果 DBP(10-5¹0-3mol·L-1)浓度依赖性收缩血管环,且去内皮血管比内皮完整血管收缩更明显(P<0.05);无Ca2+液中,DBP(10-3mol·L-1)引起的去内皮血管收缩明显低于正常K-H液中的血管收缩(P<0.01),与对照组比较无差异;维拉帕米(10-7mol·L-1)预处理后,DBP(10-3mol·L-1)引起的血管环收缩幅度低于单用DBP组(P<0.01);一氧化氮合酶抑制剂左旋硝基精氨酸甲酯(LNAME,10-4mol·L-1)预处理内皮完整主动脉环,引起的血管收缩幅度明显高于单用DBP组(P<0.01),而前列环素合成酶抑制剂吲哚美辛(Indo,10-5mol·L-1)预处理对血管收缩幅度无明显影响。结论 DBP具有引起血管收缩作用,初步机制可能涉及细胞膜电压门控性钙通道及钙离子内流,NO可能参与DBP的血管反应过程。     

布比卡因增强α_1受体介导大鼠胸主动脉收缩反应中血管内皮的作用

目的分析血管内皮在布比卡因(bupivacaine,BUP)增强苯肾上腺素(phenylephrine,Phe)诱发血管收缩反应中的作用。方法制备大鼠离体胸主动脉血管环,采用机械损伤或工具药干扰血管内皮的舒张功能。记录Phe作为α1受体激动剂诱发的动脉收缩反应。结果 BUP(30μmol·L~(-1))与内皮完整血管标本孵育20 min后,Phe诱发的血管收缩Emax值为(2.50±0.05)g,明显高于对照组标本的Emax值[(2.22±0.07)g,P<0.01]。孵育时间缩短至5、10或15min时,BUP无此增强效应。在内皮损伤动脉标本,同浓度BUP孵育20 min时,轻度但明显抑制低浓度Phe诱发的血管收缩反应(P<0.05)。在吲哚美辛、Ch TX、apamin和LNAME预处理的内皮完整血管标本上,ACh诱发的血管舒张反应消失;此时BUP(30μmol·L~(-1)孵育20 min)对Phe诱发的血管收缩反应无明显影响(P>0.05)。结论在大鼠离体胸主动脉,BUP对α1受体介导收缩的增强作用与其抑制血管内皮的舒张功能密切相关,这种抑制作用间接导致Phe诱发的血管收缩反应明显增强。     

雌酚酮衍生物EA303对家兔离体血管平滑肌的舒张作用

目的研究雌酚酮衍生物EA303对家兔离体血管平滑肌的作用及其机制。方法家兔离体主动脉条为标本,观察EA303对去甲肾上腺素(NE)、高钾液(KCl)引起的主动脉条收缩的影响;对氯化钙(CaCl2)累积收缩量效曲线的影响,并与维拉帕米(Ver)累积收缩量效曲线相比较。通过对比钾通道阻断剂格列苯脲孵育前后EA303对KCl、NE的舒张量效曲线,研究EA303对ATP敏感性钾通道的作用。结果 EA303(3×10-5～10-3mol·L-1可以剂量依赖性地抑制NE、KCl引起的兔主动脉条的收缩;EA303(10-5mol·L-1)使CaCl2累积收缩量效曲线呈剂量依赖性右移,这与Ver(10-7mol·L-1)进行孵育的结果十分相似;加入格列苯脲(10-5mol·L-1)孵育,EA303舒张KCl、NE引起收缩的量效曲线发生与未孵育相比变化明显,格列苯脲抑制了EA303对KCl、NE引起的舒张作用。结论 EA303具有舒张家兔离体血管平滑肌的作用,其作用机制与阻断钾通道和以抑制内钙释放的方式阻断钙通道有关。     

钙感受器STIM1在小鼠主动脉平滑肌收缩反应中的作用研究

目的探讨钙感受器STIM1在小鼠主动脉平滑肌收缩反应中的作用。方法采用Cre-lox重组技术制备平滑肌特异性STIM1敲除小鼠(sm-STIM1-KO);采用离体血管张力测定方法,测定sm-STIM1-KO小鼠主动脉对不同血管收缩剂反应,并给予不同的钙通道阻断剂,观察血管收缩变化。结果sm-STIM1-KO小鼠制备成功。sm-STIM1-KO小鼠钙库操纵的钙通道(SOCC)介导的血管收缩消失;与野生型相比,sm-STIM1-KO小鼠对Phe、5-HT和U46619总的收缩反应无明显变化,但在有钙和无钙的K-H溶液中,经硝苯地平孵育后,两组血管收缩均被抑制,且sm-STIM1-KO小鼠收缩明显低于野生型小鼠(P<0.01);在含硝苯地平的高钾溶液中,Phe引起的快相收缩没有变化,慢相收缩下降(P<0.01);sm-STIM1-KO小鼠肌浆网钙释放介导的血管收缩达峰速度和下降速度明显加快(P<0.05)。结论STIM1是SOCC介导的血管收缩的必须组成成分,且参与肌浆网钙释放介导的血管收缩反应。     

雌酚酮衍生物EA204对离体兔血管平滑肌的舒张作用

目的探讨雌酚酮衍生物(EA204)对离体兔血管平滑肌的作用及其机制。方法以离体兔主动脉条为标本,观察了EA204对去甲肾上腺素(NE)、氯化钾(KCl)引起的兔主动脉条收缩的影响;对氯化钙(CaCl2)累积收缩量效曲线的影响,并与维拉帕米(Ver)相比较。通过对比格列苯脲(10μmol.L-1)孵育前后EA204对BaCl2、KCl的舒张量效曲线,研究EA204对钾通道的作用。结果EA204(10~3 mmol.L-1)可以剂量依赖性地抑制NE、KCl收缩的兔主动脉条;EA204(10μmol.L-1)或Ver(0.1μmol.L-1)都使CaCl2累积收缩量效曲线呈剂量依赖性右移,但EA204孵育后CaCl2量效曲线最大反应基本不变,而Ver使最大反应降低;加入格列苯脲(10μmol.L-1)孵育后EA204对BaCl2、KCl收缩的主动脉条的舒张量效曲线发生明显变化,EA204的舒张作用被抑制。结论EA204具有舒张离体兔血管平滑肌的作用,其作用机制与其钙通道阻断作用和钾通道开放作用有关。     

银杏内酯B对离体大鼠胸主动脉收缩活动的影响

目的:研究银杏内酯B对大鼠离体胸主动脉血管环收缩活动的影响.方法:采用离体血管灌流的方法,观察银杏内酯B对不同浓度氯化钾、去甲肾上腺素引起的大鼠胸主动脉收缩反应的影响,以收缩率为指标.结果:银杏内酯B高浓度(0.1 g·L-1)和中浓度(0.03 g·L-1)对KCl(60 mmol·L-1)引起的胸主动脉收缩具有拮抗作用(P<0.05,P<0.01),并能使20 mmol·L-1～60 mmol·L-1氯化钾对胸主动脉的收缩作用减弱或明显减弱(P<0.05,P<0.01);银杏内酯B高浓度(0.1 g·L-1)和中浓度(0.03 g·L-1)对去甲肾上腺素(10-5 mol·L-1)引起的大鼠胸主动脉收缩具有拮抗作用(P<0.05,P<0.01),并能使0.1～10 μmol·L-1 NE对胸主动脉的收缩作用减弱或明显减弱(P<0.05,P<0.01).结论:银杏内酯B对氯化钾、去甲肾上腺素引起的大鼠离体胸主动脉血管环收缩活动有明显拮抗作用.     

盐酸关附甲素对大鼠血管舒缩功能的影响及其机制

目的研究盐酸关附甲素(guanfu base-A,GFA)对大鼠离体胸主动脉舒缩功能的影响,并探讨其可能机制。方法将SD大鼠胸主动脉分离并制成血管环,分成内皮完整组和去内皮组,采用离体血管环实验,观察GFA对基础状态,氯化钾(KCl)预收缩及苯肾上腺素(phenylephrine,PE)预收缩的血管舒张功能的影响,并结合不同抑制剂及无钙液处理,探讨其舒张血管的可能机制。结果累积浓度的GFA(10-8～10-4mol·L-1)对基础状态或KCl预收缩的有无内皮的血管环的张力均无明显影响(P>0.05);对PE(10-6mol·L-1)预收缩内皮完整的血管有浓度依赖性舒张作用,而与PE预收缩的去内皮组相比,从10-7mol·L-1开始差异有显著性(P<0.01)。一氧化氮合酶抑制剂L-NAME、鸟苷酸环化酶抑制剂亚甲蓝及环氧合酶抑制剂吲哚美辛孵育后,均能明显抑制GFA的扩血管作用(P<0.01);经无钙液及GFA处理后,胸主动脉对PE的反应性降低(P<0.01)。结论 GFA对大鼠胸主动脉的舒张作用主要通过两种途径:内皮依赖性舒张作用的机制主要与NO-GC-cGMP途径及激活环氧合酶有关;非内皮依赖性舒张机制主要与抑制内钙释放有关,与门控钙通道引起的外钙内流无关。     

丁咯地尔对大鼠外周离体血管的药理作用

目的 :分析丁咯地尔对大鼠外周血管的药理作用及机制。方法 :采用离体血管平滑肌张力实验 ,研究其对多种因素引起大鼠尾动脉、胸主动脉收缩作用的影响。结果 :丁咯地尔可浓度依赖性地使去甲肾上腺素、去氧肾上腺素、可乐定和 5 羟色胺引起的大鼠尾动脉收缩的累积对数浓度 反应曲线平行右移 ,最大反应不降低 ,其pA2 分别为 5.4 5,7.2 5,5.97和 6.58。使去甲肾上腺素致大鼠胸主动脉 ;氯化钾、氯化钙致大鼠尾动脉、胸主动脉收缩的累积对数浓度 反应曲线右移 ,最大反应降低 ,其pD′2 分别为 3.88,3.76,3.33,4 .0 3和 3.60。结论 :丁咯地尔可竞争性拮抗大鼠尾动脉的肾上腺素α受体(α1,α2 受体 )和 5 羟色胺受体 ,还可非竞争性拮抗氯化钾、氯化钙致大鼠尾动脉、胸主动脉的收缩     

不同给药方式对P2X_1受体介导大鼠肠系膜动脉收缩反应的影响

目的研究不同方式给予α,β-MeATP对肠系膜动脉P2X1受体介导血管收缩反应的影响。方法制备大鼠离体肠系膜动脉环标本,采用非累积给药法和单浓度给药法两种方式给予α,β-MeATP,记录药物诱发的等长收缩反应。结果两种给药方式给予α,β-MeATP(10-7-10-4mol·L-1)均可使大鼠离体肠系膜动脉产生浓度依赖性收缩反应。以KCl最大收缩反应或以标本湿重标化α,β-MeATP诱发的收缩反应时,α,β-MeATP单浓度给药的收缩反应均大于非累积给药(P<0.01)。以标本湿重标化时,10-4mol·L-1浓度α,β-MeATP诱发的收缩反应分别是(0.73±0.10)g·mg-1(单浓度组)和(0.38±0.05)g·mg-1(非累积组);以KCl最大收缩反应标化时,分别是(53.17±6.0)%(单浓度组)和(36.78±5.71)%(非累积组)。在α,β-MeATP非累积给药组120mmol·L-1KCl诱发的动脉收缩反应小于单浓度给药组和NA对照组(P<0.01)。结论在大鼠肠系膜动脉,非累积给予α,β-MeATP降低P2X1受体介导的收缩反应以及高钾诱发的收缩反应,该给药方式可能导致错误的实验结论 。     

Role of glutathione in reduction of arsenate and of gamma-glutamyltranspeptidase in disposition of arsenite in rats

Arsenate (AsV), the environmentally prevalent form of arsenic, is converted sequentially in the body to arsenite (AsIII), monomethylarsonic acid (MMAsV), monomethylarsonous acid (MMAsIII), and dimethylarsinic acid (DMAsV) and some trimethylated metabolites. Although the biliary excretion of arsenic in rats is known to be glutathione (GSH)-dependent, involving transport of arsenic-GSH conjugates, the role of GSH in the reduction of AsV to the more toxic AsIII in vivo has not been defined. Therefore, we studied how the fate of AsV is influenced by buthionine sulfoximine (BSO), which depletes GSH in tissues. Control and BSO-treated rats were given AsV (50 micromol/kg, i.v.) and arsenic metabolites in bile, urine, blood and tissues were analysed by HPLC-HG-AFS. BSO increased retention of AsV in blood and tissues and decreased appearance of AsIII in blood, bile (by 96%) and urine (by 63%). The biliary excretion of MMAsIII was also nearly abolished, the appearance of MMAsIII and MMAsV in the blood was delayed and the renal concentrations of these monomethylated arsenicals were decreased by BSO. Interestingly, appearance of DMAsV in blood and urine remained unchanged and the concentrations of this metabolite in the kidneys and muscle were even increased in response to BSO. To test the role of gamma-glutamyltranspeptidase (GGT) in arsenic disposition, the effect of the of the GGT inhibitor acivicin was investigated in rats injected with AsIII (50 micromol/kg, i.v.). Acivicin lowered the hepatic and renal GGT activities and increased the biliary as well as urinary excretion of GSH, but failed to alter the disposition (i.e. blood and tissue concentrations, biliary and urinary excretion) of AsIII and its metabolites. In conclusion, shortage of GSH decreases not only the hepatobiliary transport of arsenic, but also reduction of AsV and the formation of monomethylated arsenic, while not hindering the production of dimethylated arsenic. While GSH plays an important role in the disposition and toxicity of arsenic, GGT, which hydrolyses GSH and GSH conjugates, apparently does not influence the fate of the GSH-reactive trivalent arsenicals in rats.     

微透析取样技术在中药体内分析中的应用研究进展

本文综述了微透析取样技术在中药体内分析中的应用,介绍微透析取样技术的原理、组成、探针类型、特点,重点阐述了微透析取样技术在测定脑、血液、皮肤等组织器官中中药有效成分浓度的应用实例。表明微透析取样技术在中药药效研究中具有广阔的前景。     

Role of desacetylation in the detoxification of cephalothin in renal cells in culture

The toxicity of three cephalosporin antibiotics to rabbit kidney cells in culture was compared to their known nephrotoxic potential in vivo (cephaloridine greater than cefazolin greater than cephalothin). While cephalothin is considered to be a relatively nonnephrotoxic cephalosporin when administered to many species including humans and rabbits, in several in vitro systems involving rabbit renal tissue, cephalothin was comparatively more toxic than anticipated based on in vivo data. Cephalothin is extensively desacetylated in rabbits to a less microbiologically active metabolite, desacetylcephalothin. When a microsomal S9 fraction from rabbit kidney was added to the in vitro assay in cultured rabbit renal cells, cephalothin was desacetylated and its toxicity to kidney cells was reduced. The addition of S9 in vitro provided a toxicity ranking of the cephalosporins that correlated with their known in vivo nephrotoxic potentials (cephaloridine greater than cefazolin greater than cephalothin). The in vitro detoxification of cephalothin by S9 was blocked by the coadministration of the esterase inhibitor, aminocarb. Desacetylcephalothin was relatively nontoxic to rabbit renal tissue in vitro. These results suggest that the desacetylation of cephalothin in vivo represents a previously unrecognized mechanism of detoxification of this cephalosporin antibiotic. Furthermore, this mechanism of detoxification may be applicable to other acetylated cephalosporins.     

2009年某院住院患者抗真菌药用药调查

目的:分析讨论某院抗真菌药使用的合理性,为临床安全有效地使用抗真菌药提供参考。方法:回顾性统计分析某院2009年住院患者抗真菌药用药信息。结果:2009年某院住院患者抗真菌药DDDs排名前3名分别为:氟康唑、制霉菌素和伊曲康唑;使用金额排名前3名分别为:氟康唑、米卡芬净及卡泊芬净;更换一种抗真菌药进行治疗的患者数为176人,在全部患者中占13.4%。结论:应进一步强化用药指征的意识,提高标本送检率,同时改善某些抗真菌用药不合理更换的现象,以避免耐药性发生,从而更好更长远地体现抗真菌药的治疗价值。     

应用PASS系统对我院2008年住院医嘱的分析

目的监测分析2008年我院住院患者用药情况。方法将PASS系统嵌入医生工作站、临床药学工作站等子系统,构建合理用药计算机网络系统,对住院医嘱进行及时监测,将监测结果向医生反馈,并对其进行统计、分析。结果2008年共监测医嘱3 620 241条,不合理医嘱908条,占0.02%。不合理医嘱中,配伍禁忌(381条)占41.96%,用法用量(381条)占41.96%,药物相互作用(108条)占11.89%,儿童用药(38条)占4.19%。经与医生沟通后,更改不合理医嘱856条,占94.27%。结论PASS系统可有效监测医嘱中的不合理用药,通过与医生交流,大大减少药物不良事件的发生,值得临床推广应用,也为临床药师开展工作带来了极大的便利。但PASS系统尚存在局限性,有待进一步完善。     

Kinetics of in vitro metabolism of methoxyphenamine in rats

1. Methoxyphenamine (MP) was metabolized in vitro by rat liver preparations to O-desmethylmethoxyphenamine (O-desmethyl-MP), N-desmethylmethoxyphenamine (N-desmethyl-MP) and 5-hydroxymethoxyphenamine (5-hydroxy-MP). These metabolic pathways were inhibited by SKF 525-A and carbon monoxide, which indicates that these reactions were mediated at least partly by an NADPH-dependent cytochrome P-450 system. 2. Strain differences in the metabolism of this drug in vitro were observed in female Lewis and Dark Agouti (DA) rats, which are proposed models for human debrisoquine phenotypes. Methoxyphenamine O-demethylase and 5-hydroxylase activity in DA rats were lower than those in Lewis rats. 3. The metabolic transformation of methoxyphenamine in vitro to O-desmethyl-MP was inhibited competitively by debrisoquine and sparteine. This indicates that the cytochrome P-450 isoenzyme mediating the metabolism of MP to O-desmethyl-MP is similar to that mediating metabolism of debrisoquine and sparteine. However, no inhibition was observed with methenytoin.     

应用PASS系统分析我院2010年住院医嘱

目的:了解我院2010年住院患者的合理用药情况,探讨如何利用合理用药监测系统( PASS)提高合理用药水平.方法:利用PASS对我院2010年15 966例住院患者的1 184 997条用药医嘱进行监测,以黑色警示医嘱为依据,收集不合理用药信息,并对监测结果进行统计、分析.结果:不合理用药医嘱50 261条,发生率为4.24％.绝对禁止黑色医嘱5441条,主要为药物相互作用(66.54％)、注射液体外配伍(17.86％)、用法用量(15.46％)、儿童警告(1.14％).结论:应用PASS系统能有效监测医嘱中的不合理用药情况,有利于提高临床合理用药水平,但PASS系统尚存在局限性,有待进一步完善.     

Changes in levels of dependency and predictors of mortality in elderly people in institutional care in Dunedin

The 1983 study of dependency of subjects in institutional care in Dunedin was repeated two years later. A significant increase in levels of dependency in residential homes, particularly in the Religious and Welfare sector was found. In 1983 there were 29 high dependency residents and 73 medium dependency residents in residential homes. In 1985 these numbers had increased to 55 and 86 respectively. There was no change in the number of low dependency residents. In 1983, 6 high dependency residents had been admitted to residential home care in the year prior to the study. In 1985 the number of high dependency residents recently admitted had increased to 23. There had also been a significant increase in the dependency of patients in Religious and Welfare continuing care hospitals. Of the 933 subjects in institutional care in 1983 who were able to be followed, 354 (37.9%) died in the following 2 years. Mortality rate was higher for those in hospital care (48.1%) than for those in residential home care (29.6%). Mortality rates were higher in more dependent subjects and this was evident for each measure of dependency.     

基层医院护士在临床合理用药中的作用

目的充分利用护士在医师和患者间的特殊地位和作用,促进基层临床合理用药。方法从护士的工作性质出发,论述护士参与促进合理用药的方便和优势。结果通过实践,护士在促进合理用药中的作用得到有效发挥,基层合理用药环境得到极大改善。结论充分利用护士与医师和患者间的特殊桥梁作用,在基层医院促进合理用药,规范医师用药行为,防止药物滥用,引导患者安全用药,降低药源性疾病。