阿奇霉素口服微球的制备及其评价

为改善阿奇霉素（AZI）苦味与服药顺应性,以乙基纤维素（EC）为载体,采用O/W乳化溶剂挥发法制备载阿奇霉素口服微球（AZI-EC MS）,对其释放与掩味效果进行初步考察,并通过差式扫描量热法、红外光谱和扫描电镜表征。通过联合应用不同相对分子质量EC解决了微球突释问题,当药载质量比1∶1、混合EC（N22/T10,7∶3）为载体时,微球0.5 h累积释放量小于40%,8 h累积释放量可达90%;该微球载药量为(48.95±0.86)%,形态圆整,表面光滑。AZI味道极苦,苦味阈值浓度为9.93 μg/mL,所制备的AZI-EC MS掩味效果良好。结果表明,混合EC为载体的AZI-EC MS能够改善AZI苦味,提高患者顺应性,为AZI新制剂的研究开发奠定基础。     

曲马多药树脂速释混悬剂的研制

为掩盖盐酸曲马多的苦味 ,并达到迅速镇痛的目的 ,利用盐酸曲马多与离子交换树脂结合制成药物树脂的制备方法 ,进行了曲马多药树脂速释混悬剂的研制实验。实验结果表明 ,该制备方法简单 ,研制出的曲马多药树脂速释混悬剂稳定、口味好、释放迅速     

口服缓解树脂锑剂的研究

口服缓介锑剂已被认为是全面消灭血吸虫病的重要方向,但目前尚没有满意的副反应小、疗效高的制剂。离子交换树脂能够与一定性质的药物进行离子交换,据文献报导口服此种含药树脂复合物,在肠胃道中遇适宜离子后,逐渐将药物释放出来,由于消化液内含有的离子总浓度在一般情况下改变不大,故药物释放速度较为均匀持久,同时此种复合物在释放药物时不受肠胃道pH,蠕动,内容物,酶以及其他生理作用的影响,因而由此等原因可能引起的疗效差異亦较小。     

氟比洛芬聚丙烯酸树脂RL/RS缓释微球的制备

目的观察溶剂挥发法制备的氟比洛芬聚丙烯酸树脂RL/RS微球的体外释药特性。方法以氟比洛芬为主药,司盘-80为乳化剂,硬脂酸镁为抗黏剂,丙酮-液状石蜡挥发法制备氟比洛芬微球。通过紫外分光光度仪、电镜扫描及差热分析研究微球的性质,并于pH 7.2的磷酸盐缓冲溶液中测试体外释放。结果制备的微球为白色、流动性好的粉末;用显微镜观察微球为圆形的球体,直径为50～190μm;差热分析表明,药物具有稳定性且药物与聚合物间不存在反应;体外释放度测试显示,微球能稳定地在pH 7.2磷酸盐缓冲溶液中释放,药物4 h累积释放量约50%,12 h不少于80%。结论溶剂挥发法制备的微球工艺稳定,得到的氟比洛芬聚丙烯酸树脂RL/RS微球呈现缓释特性,微球体外释放过程符合Higuchi方程。     

药物掩味技术及其味觉评价技术的研究进展

多数药物味道苦涩、口感刺激，导致患者顺应性差，其不良气味严重影响药物治疗效率。一款药物的成功研发不仅应满足有效性、稳定性、安全性、均一性、经济性的五大质量特征，同时患者对不良气味药物的顺应性也不容忽视。味觉掩蔽技术针对不同性质药物进行掩味，其发展对改善药物口感具有重要意义。本文综述了传统掩味技术的原理及优缺点，并介绍了新型掩味技术如熔融制粒、热熔挤出、3D打印、药物复合物制备、苦味抑制剂的掩味机制和适用范围。针对药物掩味效果阐述体外评测方法如功能性磁共振成像、体外溶出、味觉指纹分析技术以及体内评测手段如动物、人体口尝在掩味效果领域的应用，并提出BP神经网络评价预测模型对药物口感评测的新策略，以期为今后药物掩味研究提供理论参考。     

正交设计优化苦参碱聚丙烯酸树脂微球的制备工艺

目的优化苦参碱聚丙烯酸树脂Eudragit RS100微球的制备工艺。方法采用o/o型乳化溶剂挥发法制备微球。以包封率为优化指标,选择药物和Eudragit RS100的重量比、Eudragit RS100在内相的浓度、司盘-80在外相的浓度、搅拌速度为因素,每个因素各取3个水平,按L9(34)正交设计优化制备工艺。结果优化制备工艺为药物和Eudragit RS100的重量比为1:1,Eudragit RS100的浓度为10%,司盘-80的浓度为2%,搅拌速度为350r/min。结论采用正交实验完成了苦参碱微球的制备工艺优化。     

影响羧甲基魔芋胶骨架片体外释药的处方和工艺因素

目的考察影响羧甲基魔芋胶骨架片体外释药的因素。方法以羧甲基魔芋胶(CMKGM)为骨架材料,用湿法制粒压片和粉末直接压片法制备缓释骨架片,并考察CMKGM粒径、骨架材料的用量、填充剂种类、制备工艺和压片压力对羧甲基魔芋胶骨架片体外释放速率的影响。结果氨茶碱羧甲基魔芋胶骨架片的释药均符合Peppas方程,释药机制为药物扩散和骨架溶蚀协同作用;填充剂种类、骨架材料用量对氨茶碱的释放速率有显著影响;骨架片的释药速率随骨架材料用量的增加而减慢;聚丙烯酸树脂L100减慢药物释放,而乳糖则加快药物的释放;CMKGM粒径、制备工艺和压片压力对药物释放无显著影响。结论羧甲基魔芋胶骨架片具有缓慢释药特性,其释药机理为溶蚀释放和扩散释放协同作用;影响氨茶碱CMKGM骨架片释药速率的主要因素为骨架材料用量和填充剂种类。     

叶酸偶联壳聚糖载羟基喜树碱纳米药物制剂的体外释药性能

目的:探讨叶酸偶联壳聚糖载羟基喜树碱纳米药物制剂(FA-NPs)的体外释药性能。方法:按照浆-反向动态透析法进行体外模拟释放实验,建立高效液相色谱法测定药物释放量,观察FA-NPs的体外释药性能。分别考察不同释放介质(人工胃液,人工肠液和pH7.4的PBS)、搅拌速度(50、75和100r/min)和载药纳米粒的粒径(604、250和190nm)条件下FA-NPs的体外释药性能。结果:与pH7.4的PBS条件下的药物释放速率比较,FA-NPs在人工胃液中药物释放速率加快,在人工肠液中减慢,但在3种释放介质中均表现为先快速释放后缓慢释放的现象。在75和100r/min搅拌速度下FA-NPs具有相似的释药曲线,50r/min搅拌速度条件下FA-NPs的累积释放量较前两者降低。随着纳米粒粒径的增大,FA-NPs药物释放速率减慢。250nm粒径的FA-NPs在pH7.4的PBS中的累积释放时间超过40h,符合药物释放Higuchi方程:Q=0.0908t1/2+0.0324(R2=0.9844)。结论:FA-NPs体外表现出明显的先快速后缓慢释药现象,符合临床用药目的;药物的释放受释放介质、粒径大小和对释放介质的搅拌速度的影响。     

研究分析丙烯酸树脂包衣材料制备pH依赖型新雪缓释微丸的制备工艺

目的回顾性分析丙烯酸树脂包衣材料制备pH依赖型新雪缓释微丸的制备工艺。方法采用包衣锅滚制法,水为粘合剂,以蔗糖型空白丸芯制备含药微丸,分别用一种胃溶型包衣材料（丙烯酸树脂Ⅳ号）和2种肠溶型包衣材料（丙烯酸树脂Ⅱ号、Ⅲ号和聚丙烯酸树脂乳胶液）对微丸进行包衣,将上述3种微丸按l∶l∶1比例装袋,制备成pH依赖型缓释微丸剂。并以栀子苷为指标进行体外释放度的研究。结果释放度测定结果表明,释放曲线呈现出pH依赖型的梯度释药特征。结论用丙烯酸树脂包衣材料制备pH依赖型新雪缓释微丸工艺可行,质量可靠,可达到较好的梯度释药效果。     

氟尿嘧啶纳米粒表面修饰人工晶状体的制备及体外性质

目的:以氟尿嘧啶纳米粒(5-Fu-NP)对聚甲基丙烯酸甲酯(PMMA)人工晶状体进行表面修饰,并测定其体外性质。方法:将壳聚糖、聚丙烯酸与氟尿嘧啶通过滴入分散法制备5-Fu-CS-NP。利用载能离子束技术对PMMA人工晶状体进行5-Fu-NP表面修饰。考察人工晶状体表面纳米粒粒径、含药量以及体外释药特性。结果:表面修饰人工晶状体氟离子束剂量为5×1013 ~5×1015ions/cm2,表面分布有大小不等的5-Fu-NP球形颗粒,多数小颗粒粒径在100 nm以下,少数大颗粒粒径主要集中在100~400 nm,含药量为19.55～35.94 μg/枚。5-Fu-NP表面修饰人工晶状体能在4 d内持续释放药物。结论:5-Fu-NP表面修饰人工晶状体缓释作用较好,有望成为可预防后发性白内障的新型人工晶状体。     

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.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.