氯苄律定对映体的毛细管电泳分离及其在家兔体内手性药代动力学 …

目的：建立氯苄律定（ＣＢＴＨＢ）对遇体的毛细管电泳分离方法,研究家兔体内ＣＢＴＨＢ的手性药代动力学特征。方法：通过羧甲基环糊精手性识别作用和其他电泳条件的比较,确定ＣＢＴＨＢ对映体毛细管电泳体内分析方法,由统计矩方法计算家兔ＣＢＴＨＢ后的药代动力学参数。结果：ＣＢＴＨＢ两个对映体获得理想分离。家兔口服１５０ｍｇ／ｋｇＣＢＴＨＢ后体的过程存在着立体选择性差异,其中Ｒ－ＣＢＴＨＢ与Ｓ－ＣＢＴＨＢ的平均     

氯苄律定对映体的毛细管电泳分离及其在家兔体内手性药代动力学研究*

目的：建立氯苄律定（CBTHB）对映体的毛细管电泳分离方法,研究家兔体内CBTHB的手性药代动力学特征。方法：通过羧甲基环糊精手性识别作用和其他电泳条件的比较,确定CBTHB对映体毛细管电泳体内分析方法,由统计矩方法计算家兔口服CBTHB后的药代动力学参数。结果：CBTHB两个对映体获得理想分离。家兔口服150 mg/kg CBTHB后体内过程存在着立体选择性差异,其中R-CBTHB与S-CBTHB的平均血浆浓度比值为(1.43±0.21)。两个对映体血浆浓度之间存在非常显著性差异（t = 4.14,P＜0.01 ）,R-CBTHB的AUC0？τ 和AUC0？∞也明显大于S-CBTHB（P＜0.05）。结论：手性毛细管电泳分析方法成功地应用于CBTHB对映体的药代动力学研究。     

高效毛细管电泳拆分布洛芬对映异构体

运用高效毛细管电泳（ＨＰＣＥ）成功地拆分了布洛芬对映异构体。以２０ｍｍｏｌ／Ｌ磷酸盐为运行缓冲液（ｐＨ７．１），５０ｍｍｏｌ／Ｌβ－ＣＤ和３０ｍｍｏｌ／ＬＳＤＣ为手性选择剂；运行电压１２ｋＶ，负极端２１４ｎｍ检测。布洛芬对映体的加样回收率分别为９７．８％和１０１．４％，ＲＳＤ分别为０．１４％和０．２６％。     

丝裂霉素缓释剂局部植入药代动力学的实验研究

目的　研究丝裂霉素缓释剂（ Ｍ Ｍ Ｃ Ｓ Ｒ Ｐ） 在大鼠和狗体内的药代动力学。方法　用高效液相色谱法（ Ｈ Ｐ Ｌ Ｃ） 测定血浆丝裂霉素 Ｃ（ Ｍ Ｍ Ｃ） 的浓度。结果　大鼠皮下植入 Ｍ Ｍ Ｃ Ｓ Ｒ Ｐ 后， Ｍ Ｍ Ｃ 可持续、缓慢释放；犬肌肉植入０４ ｍｇ·ｋｇ－ １ Ｍ Ｍ Ｃ Ｓ Ｒ Ｐ 后，其有效血浆浓度曲线呈一室模型特点，其维持有效血浆浓度时间（００１ ｍｇ· Ｌ－ １） 为２４０ ｈ ，其峰值浓度仅为ｉｖ 同剂量 Ｍ Ｍ Ｃ 的２７ ％ 。结论　 Ｍ Ｍ Ｃ Ｓ Ｒ Ｐ 有显著的缓释作用。     

慢性肾功能衰竭患者血清 SIL-2R 水平与外周血 T 淋巴细胞亚群变化的观察

检测３０例慢性肾功能衰竭（ＣＲＦ）患者血清可溶性白介素２受体（ＳＩＬ－２Ｒ）和外周血Ｔ淋巴细胞亚群，结果表明：ＣＲＦ患者ＳＩＬ－２Ｒ水平显著高于正常对照组（Ｐ＜０．０１），ＣＤ３、ＣＤ４、ＣＤ４／ＣＤ８显著低于正常对照组（Ｐ＜０．０１）；ＳＩＬ－２Ｒ水平与ＣＤ３、ＣＤ４呈负相关，与ＣＤ８呈正相关；ＳＩＬ－２Ｒ与ＢＵＮ、ＳＣｒ呈正相关，ＣＤ３、ＣＤ４与ＢＵＮ、ＳＣｒ呈负相关，ＣＤ８与ＢＵＮ、ＳＣｒ呈正相关。提示：ＣＲＦ患者细胞免疫功能低下；ＳＩＬ－２Ｒ水平与Ｔ淋巴细胞亚群变化有一定关系；ＳＩＬ－２Ｒ水平与Ｔ淋巴细胞亚群变化可作为肾功能恶化的指标。     

检测人血浆中利福平及其主要代谢物25-去乙酰利福平浓度的高效液相色谱法

目的：建立检测人血浆中利福平及其主要代谢物２５－去乙酰利福平浓度的高效液相色谱法,并用于药代动力学研究。方法：所用色谱柱是ＺｏｒｂａｘＯＤＳ（５μｍ,４．６ｍｍ×２５０ｍｍ）,采用梯度洗脱,流动相Ａ和Ｂ由甲醇、乙腈和０．１ｍｏｌ·Ｌ－１ＮａＨ２ＰＯ４组成（流动相Ａ三者的体积比为３５∶２５∶４０,Ｂ为５０∶２５∶２５）,以利福贲丁作为内标物,检测波长为３３６ｎｍ。结果：血浆标准曲线为：利福平,ＣＲＭＰ＝６．９１８Ａｐ／Ａｉｎ－０．０６４,ｒ＝０．９９９９;２５－去乙酰利福平,ＣＤＥＳ＝１０．９１Ａｄ／Ａｉｎ－０．０２９,ｒ＝０．９９９７。两者从血浆提取的平均回收率分别为９１．８％和８４．７％。批内和批间ＲＳＤ均＜８．６％。结论：本法可用于药代动力学和临床研究。     

右心室收缩功能与诱发压力感受性反射

家兔２０只经麻醉、制动、人工呼吸后，增／减颈动脉窦压力感受器（ＣＳＢ）的刺激，诱发颈动脉窦压力感受性反射（ＣＳＢＲ）。结果：①增强ＣＳＢ的刺激，ＬＶＳＰ、ＲＶＳＰ、ＬＶ＋ｄｐ／ｄｔ ｍａｘ、ＲＶ＋ｄｐ／ｄｔ ｍａｘ、ＬＶ－ｄｐ／ｄｔ ｍａｘ、ＲＶ－ｄｐ／ｄｔ减小；减弱ＣＳＢ的刺激，上述指标增加（Ｐ均〈０．０１）；②右心室动力学指标的变化与左心室动力学指标及ＭＡＰ的变动值，经统计学分析不相关；③ＣＳ     

RBC—C3b,sIL—2R在服补阳还五合剂家兔体内的变化

目的：观察补阳还五合剂对正常家兔ＲＢＣ－Ｃ３ｂ，ｓＩＬ－２Ｒ的影响。方法：采用胃管灌药，并与灌Ｎ．Ｓ对照，间断取血检测。结果：实验组用药后ｓＩＬ－２Ｒ降低（Ｐ＜０．００１）；ＲＢＣ－Ｃ３ｂ升高（Ｐ＜０．００１）。结论：补阳还五合剂通过ＲＢＣ－Ｃ３ｂ，ｓＩＬ－２Ｒ参与免疫调节。     

慢性肾衰血透患者脂质过氧化损伤与NK细胞活性的临床相关分析

本文测定２３例慢性肾衰血透患者血浆ＬＰＯ、ＳＯＤ、ＲＢＣ－ＬＰＯ及ＮＫ细胞活性。结果表明透前血浆ＬＰＯ、ＳＯＤ、ＲＢＣ－ＬＰＯ及ＮＫ细胞活性分别为１０．８５±２．１１ｎｍｏｌ／ｍｌ、４０．２４±８．０ｕ／ｍｌ、２３．９１±５．４９ｎｍｏｌ／ｇＨｂ和２９．９２±６．０８％（正常对照分别为６．５３±０．６５ｎｍｏｌ／ｍｌ、７９．２５±７．６１ｕ／ｍｌ、１６．３３±３．６１ｎｍｏｌ／ｇＨｂ和５１．２１±８．３３％）。透后血浆ＬＰＯ、ＳＯＤ分别为９．３８±１．５４ｎｍｏｌ／ｍｌ和５１．０７＋９．１６ｕ／ｍｌ，结果均与正常对照有显著差异；且透前、透后血浆ＬＰＯ、ＳＯＤ也有显著差异（Ｐ＜０．０１）。它们之间的相关分析表明血浆ＬＰＯ与ＢＵＮ、Ｃｒ呈正相关（ｒ＝０．３２５１Ｐ＜０．０５、ｒ＝０．４１９１Ｐ＜０．０１），与ＳＯＤ呈负相关（ｒ＝－０．５１１９Ｐ＜０．０１）；血浆ＳＯＤ与ＢＵＮ、Ｃｒ呈负相关（ｒ＝－０．５３５３、ｒ＝－０．４７６１Ｐ＜０．０１），ＮＫ细胞活性与ＲＢＣ－ＬＰＯ呈负相关（ｒ＝－０．４１３２Ｐ＜０．０５），与血浆ＬＰＯ、ＳＯＤ、ＢＵＮ、Ｃｒ无相关。上述表明慢性肾衰血透患者有脂质过氧化损伤，ＳＯＤ酶活性下     

溃疡性结肠炎、肠易激综合征和慢性直肠炎病人肛门、直肠运动功能的初步探讨

目的：探讨溃疡性结肠炎（ＵＣ）、肠易激综合征（ＩＢＳ）和慢性直肠炎（ＣＲ）患者肛门、直肠运动功能的变化及与腹泻的关系。方法：采用ＳＧＹ－３型多功能消化道检测仪、ＧＩ－３三点性气囊测压管对２１例ＵＣ,２０例ＩＢＳ和３０例ＣＲ病人肛门、直肠运动功能进行检测,并与１５例正常人作为对照。结果：ＵＣ,ＩＢＳ和ＣＲ组直肠静息压、肛门内外括约肌静息压和最大缩窄压、肛管直肠屏障压及模拟排便动作后,肛门内外括约肌净增压,减压和对照组无明显差异（Ｐ＞０．０５）,但增加腹压后,肛门内外括约肌净增压,ＵＣ组、ＩＢＳ组、ＣＲ组,均明显低于对照组（Ｐ＜０．０５）。直肠最低敏感量、最大耐受性、最大顺应性,ＵＣ组、ＩＢＳ组、ＣＲ组也明显低于对照组。ＵＣ,ＩＢＳ和ＣＲ三组间各项指标无显著差异（Ｐ＞０．０５）。结论：ＵＣ,ＩＢＳ和ＣＲ均存在直肠高敏感、低耐受、低顺应性和肛门自动控制能力减弱,这些改变可能与腹泻有关。ＵＣ,ＩＢＳ和ＣＲ的肛门、直肠动力改变无特异性。     

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.     

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.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.