不同水飞蓟素制剂的人体药动学研究

目的制备水飞蓟素固体分散体胶囊剂,考察不同水飞蓟素制剂的体外溶出度和人体药动学特性。方法采用溶剂法和熔融法制备水飞蓟素固体分散体,并进行不同水飞蓟素制剂体外溶出度和人体药动学研究。结果制备的水飞蓟素固体分散体胶囊剂的溶出度和生物利用度均高于市售的国产的益肝灵片和进口的利肝隆胶囊。结论水飞蓟素固体分散体胶囊剂能够显著提高水飞蓟素的生物利用度。     

均匀与正交设计法优化水飞蓟宾微粒制备工艺的比较研究

[目的] 通过快速膜乳化耦合溶剂挥发法制备粒径均一可控的水飞蓟宾微粒,对其制备工艺进行考察,优选最佳制备条件,并对均匀设计法和正交设计法进行比较。[方法] 以水飞蓟宾微粒的平均粒径Ｄ(0.5)及径距为指标,用均匀设计法和正交设计法对水相浓度、油水相体积比、过膜压力及固化时间等影响因素进行考察。[结果] 确定制备工艺为水相浓度3 %、油水相体积比1:2、过膜压力0.6 MPa、固化时间60 min。[结论]　该制备工艺简单、快速、稳定、可靠,所得水飞蓟宾微粒粒径均一,均匀设计在水飞蓟宾微粒制备工艺筛选实验中具有很好的可行性。     

热熔挤出技术制备小檗红碱固体分散体及其体外评价

[目的]采用热熔挤出技术制备微溶性药物小檗红碱的固体分散体,以提高其溶解度,延缓其体外释放行为。[方法]以Soluplus^® 为载体,采用同螺杆热熔挤出机制备小檗红碱固体分散体,通过差示扫描量热（DSC）分析、粉末X射线衍射（XRD）分析、扫描电子显微镜（SEM）观察和傅里叶变换红外光谱（FT-IR）分析对制备的固体分散体进行表征,并考察挤出物在不同介质中的溶解度和体外溶出度。[结果]DSC和XRD分析结果显示,固体分散体中小檗红碱的主要特征峰减弱甚至部分消失,SEM结果表明固体分散体为无规则形态。FT-IR结果表明小檗红碱与Soluplus^®之间可能存在氢键作用。所制备的小檗红碱固体分散体在pH 6.8的磷酸盐缓冲液中溶解度为原料药的2.59倍。体外溶出度结果显示,小檗红碱固体分散体具有明显缓释作用。[结论]成功制备了小檗红碱固体分散体,且能显著提高其溶解度,并延缓其体外释放行为。     

番茄红素-泊洛沙姆188固体分散体的制备及溶出度和生物利用度研究

目的： 采用固体分散体技术,提高番茄红素在水中的溶解度和体外溶出度,从而提高其体内的生物利用度。方法： 以泊洛沙姆188为载体,溶剂法制备番茄红素固体分散体,应用光谱分析和DSC考察其分散特征,溶出度试验测定其体外溶出度,大鼠灌胃后测定其体内生物利用度,用HPLC法测定血药浓度,采用Kinetica软件计算药动学参数。结果： 番茄红素可能以分子复合物状态存在于固体分散体中,且显著提高了番茄红素的溶出度,与市售番茄红素油混悬液为对照,其相对生物利用度为(312.2±96.9)%。结论： 番茄红素-泊洛沙姆188固体分散体制备工艺简单,成本较低,能显著改善难溶性药物番茄红素的生物利用度,具有较好的实际应用价值。     

大黄素固体分散体的制备及其溶出度测定

目的 将大黄素制成固体分散体,以提高大黄素的体外溶出速率。方法 选用聚乙烯吡咯烷酮（PVP K30）和聚乙二醇（PEG 8000）为载体,用溶剂法制备大黄素固体分散体;建立测定大黄素固体分散体体外溶出度的HPLC方法;对固体分散体进行差热分析和红外光谱分析。结果 大黄素与PVP K30制成的固体分散体的体外溶出速率最快,大黄素与PVP的质量比为1∶4时,制成的固体分散体在人工肠液中45 min累积溶出率为70%。结论 以PVP K30为载体制备的大黄素固体分散体可以显著提高大黄素的体外溶出速率。     

黄芩素-茶碱共晶的溶剂体系筛选及体外溶出度评价

[目的] 优选制备黄芩素-茶碱共晶的溶剂体系,通过体外溶出实验考察共晶对黄芩素和茶碱各自溶出度的影响。[方法] 通过测定黄芩素-茶碱共晶在茶碱-乙酸乙酯、茶碱-甲醇和茶碱-丙酮溶液中的溶解度,得出三相平衡点,绘制黄芩素-茶碱-溶剂体系的三元相图,筛选最优溶剂体系制备共晶,并以人工肠液和人工胃液为溶出介质,对共晶进行体外溶出度评价。[结果] 丙酮溶液体系中的共晶形成区面积大于乙酸乙酯、甲醇。通过丙酮溶剂挥发法制备的共晶中,黄芩素在人工肠液和人工胃液中的累积溶出度分别是原料药的1.38和2.02倍,分别是物理混合物的1.27和1.80倍。两种介质中共晶对茶碱均起到了一定的缓释作用。[结论] 共晶的形成能够促进难溶性成分黄芩素的体外溶出度,并且对茶碱的溶出度有一定延缓作用,为黄芩素-茶碱共晶的进一步研究和临床应用提供了借鉴。     

复方丹参黏附微丸与普通微丸中隐丹参酮与丹参酮ⅡA体外溶出对比研究

[目的]建立复方丹参微丸中脂溶性成分隐丹参酮与丹参酮ⅡA含量测定方法,并对比不同工艺制备的3种复方丹参微丸（冰片包合复方丹参黏附微丸、冰片不包合复方丹参黏附微丸、普通微丸）中隐丹参酮与丹参酮ⅡA体外溶出度的差异。[方法]采用高效液相色谱（HPLC）法测定3种复方丹参微丸中隐丹参酮与丹参酮ⅡA的含量,计算溶出度,并绘制溶出度曲线,采用相似因子对比不同微丸中这两种成分的体外溶出差异性。[结果]丹参类的脂溶性成分累积溶出度均较低。其中,两种黏附微丸隐丹参酮溶出行为较为相似,24 h的累积溶出度均在40%左右,普通微丸中隐丹参酮的溶出行为与黏附微丸具有明显的差异性,其累积溶出度为64.05%。两种黏附微丸的隐丹参酮溶出更符合Higuchi方程,普通微丸更符合Peppas模型,n<0.43,均符合Fickian扩散。3种制剂中丹参酮ⅡA的溶出过程均较缓慢,3个制剂的溶出行为比较相似,累积溶出曲线接近重合,3种制剂的累积溶出度基本一致,均在40%左右。3种微丸更符合Higuchi方程,同样属于Fickian扩散。[结论]黏附微丸具有一定的缓释效果,丹参类脂溶性成分中,由于溶出度的限制,体外溶出实验评价隐丹参酮缓释效果更为明显。     

测定大黄中总蒽醌含量的分光光度法改进

[目的]改进大黄药材中总蒽醌的含量测定方法。[方法]1,8-二羟基蒽醌与碱显色后,2h内隔时扫描光谱图;对照品和样品同样处理后绘制标准曲线。[结果]确定了最大吸收波长,消除了测定过程中样品湿热降解带来的误差。[结论]通过方法学考察,证明此方法精密准确、回收率高,可以作为大黄中总蒽醌的含量测定方法。     

水飞蓟素固体分散体中水飞蓟宾溶出速度的研究

[目的 ]研究载体和表面活性剂对水飞蓟素固体分散体中水飞蓟宾溶出速度的影响 .[方法 ]采用熔融法制备水飞蓟素固体分散体 ,观察固体分散体中水飞蓟宾在人工肠液中的累积溶出量变化 .[结果 ]水飞蓟素与聚乙二醇为 1∶9比例时固体分散体中水飞蓟宾的溶出速率最佳 ,其最大累积溶出率为6 4 2 7% ;表面活性剂十二烷基硫酸钠组固体分散体的累积溶出率为 6 4 48% .[结论 ]与原料药物相比 ,以聚乙二醇为载体的固体分散体提高了水飞蓟宾的溶出速率     

香加皮有效部位滴丸的质量标准研究

[目的]建立香加皮有效部位滴丸的质量标准。[方法]建立了高效液相色谱(HPLC)法进行杠柳毒苷含量测定和杠柳毒苷的均匀度检查;对滴丸剂进行了常温下的初步稳定性考察。[结果]香加皮有效部位滴丸含量测定方法学考察的指标均符合有关规定;滴丸均匀度符合要求。[结论]建立了有效部位及滴丸的质量标准,方法简便、可靠。滴丸剂质量基本稳定。     

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.