复方烟酸辛伐他汀双层缓释片的制备及Beagle犬体内药代动力学

以烟酸和辛伐他汀为模型药物制备复方双层缓释片,并评价其体外释放特性。采用双周期双交叉给药方案,LC-MS/MS法同时测定自制制剂和市售制剂中烟酸和辛伐他汀的血药浓度,对6只Beagle犬进行了药代动力学和生物利用度的初步研究。自制制剂和市售制剂给药后烟酸的c_max分别为（6.43±0.80）和（6.38±0.47）μg/mL,t_max分别为（2.80±1.00）和（2.50±1.00）h,AUC分别为（30.16±4.51）和（27.49±4.04） μg·h/mL;辛伐他汀的c_max分别为（38.65±1.71）和（40.54±2.33）ng/mL,t_max均为（1.50±0.40）h,AUC分别为（118.76±11.83）和（115.76±5.46）ng·h/mL。结果表明两种制剂中烟酸和辛伐他汀的AUC,c_max和t_max都等效,说明自制制剂和市售制剂在Beagle犬体内具有生物等效性。     

硝酸布康唑栓的人体药代动力学

研究单次及多次阴道给药后硝酸布康唑栓在中国健康女性体内的药代动力学特征。12名健康女性受试者依次进行硝酸布康唑栓低(0.05 g)、高(0.1 g)剂量单次给药以及高剂量(0.1 g)连续给药3 d和连续给药5 d药代动力学试验。受试者单次阴道给予0.05和0.1 g受试制剂后,布康唑的c_max分别为(0.895 0±0.261 0)、(1.740±0.511)ng/mL,AUC_{0-96 h}分别为(36.38±10.82)、(73.48±28.99)ng·h/mL,t_1/2分别为(23.0±4.4)、(21.5±5.9)h。结果表明:布康唑在0.05~0.1 g剂量范围内呈线性药代动力学特征。受试者连续3 d给予硝酸布康唑栓后,布康唑的血药浓度波动度(DF)为(0.54±0.27),累积常数Rc_max为(1.3±0.3),R_AUC0-τ为(1.4±0.3)。连续给药5 d后,布康唑的血药浓度DF为(0.64±0.25),累积常数Rc_max为(1.4±0.3),R_AUC0-τ为(1.6±0.2),在人体内的暴露量增加约60%。连续给药3 d与连续给药5 d的各项药动学参数均无显著性差异。     

HPLC法测定丹皮酚制剂在犬体内血药浓度及生物利用度

目的 研究丹皮酚3种制剂在犬体内的药动学及生物利用度。方法 6条犬采用三制剂三周期随机交叉试验设计,分别单剂量口服对照制剂丹皮酚片（R）40 mg;被试制剂丹皮酚软胶囊（T₁）;被试制剂丹皮酚滴丸（T₂）;HPLC测定血药浓度。结果 T₁、T₂与R的主要药动学参数：t_max分别为(1.42±0.38)、(0.96±0.10)、(1.08±0.20) h; C_max分别为(2.23±0.50)、(2.56±0.58)、(1.94±0.40) μg/mL; t_1/2(ke)分别为(3.09±0.40)、(2.88±0.51)、(2.62±0.52) h; AUC_0~12分别为(11.62±1.07)、(12.57±1.80)、(10.32±1.63) h·μg/mL; AUC_0~∞分别为(14.56±1.41)、(15.41±1.70)、(12.70±2.12) h·μg/mL。相对生物利用度为：T₁(114.1±14.3)%和(116.3±15.1)%,T₂(122.6±12.4)%和(122.8±13.9)%。结论 药动学参数经多因素方差分析显示AUC_0~12、AUC_0~∞、C_max和t_max在药物间有显著的统计学差异（P<0.05）,双单侧t检验表明,两种被试制剂与参比制剂不等效。     

哈巴俄苷及其代谢产物在大鼠体内的药代动力学

采用LC-MS技术对哈巴俄苷单体给药后在大鼠体内的药动学进行了研究,发现并鉴定其主要代谢产物可能为肉桂酸,在此基础上应用HPLC法测定了哈巴俄苷经口给药或静脉给药后的药代动力学特征。色谱分离采用C₁₈色谱柱（250 mm×4.6 mm,5 μm）;流动相为甲醇-水-醋酸溶液（60∶40∶0.1）,检测波长为279 nm。结果表明,哈巴俄苷经口给药后吸收迅速,达峰后迅速消除,t_max和t_1/2分别为（0.47 ± 0.21 ）h和（4.96 ± 0.98）h,4 h后血药浓度降至约0.1 μg/mL。其代谢产物肉桂酸在给药后迅速出现并缓慢消除,t_max和t_1/2分别为（4.17 ± 1.39）h和（5.78 ± 2.67）h。哈巴俄苷静脉给药后消除迅速,t_1/2为 （1.89 ± 0.32）h,而肉桂酸的消除速度仍与口服相近,t_1/2为（5.16 ± 2.27）h。实验结果显示哈巴俄苷口服吸收迅速,生物利用度低,在大鼠体内可能主要代谢为肉桂酸,后者在给药后迅速出现并缓慢消除。     

磷酸二甲啡烷在中国健康人体的口服药代动力学

采用LC-MS/MS研究单次及多次口服给药后磷酸二甲啡烷在中国健康受试者体内药代动力学特征。单剂量试验的12例受试者采用两周期、交叉设计,分别口服本品10 mg、40 mg,以及其余12例受试者单次口服20 mg后的药代动力学参数:AUC_{0-48 h}(11.81±14.46)、(52.60±96.01)、(34.70±29.59)ng·h/mL;t_1/2(12.11±2.54)、(12.16±2.01)、(12.77±1.27)h;c_max(0.965 3±0.817 8)、(3.150±3.451)、(2.167±1.650)ng/mL。多剂量试验的12例受试者接受单剂量20 mg后,开始每天3次服用磷酸二甲啡烷20 mg,连服至第8天晨采集血样的药代动力学参数:AUC_{0-48 h}(115.9±135.2)ng·h/mL;t_1/2(11.22±1.61)h;c_max(7.418±7.010)ng/mL;累积常数R_cmax为(3.14±1.34),R_AUC为(3.38±1.22)。置信区间法表明磷酸二甲啡烷在10~40 mg范围内,药代动力学参数与剂量无线性关系;多次给药后在体内存在蓄积;磷酸二甲啡烷在中国健康受试者中存在显著的个体差异。     

奥替拉西钾血药和尿药浓度的测定及其药代动力学和药物蓄积性评价

本实验建立了人血浆及尿液中奥替拉西钾（potassium oxonate,Oxo）的LC-MS/MS测定方法,研究单次及多次给药替吉奥胶囊（S-1）后,Oxo在晚期胃癌患者体内的药代动力学特征,并评价多次给药后Oxo在人体内的药物蓄积情况。12名晚期胃癌患者分别按体表面积（BSA）口服S-1：单次给药,受试者于早餐后给药60 mg;多次给药,连续28d,每天2次,于早餐后给药60mg;晚餐后给药60 mg（BSA≥1.5m ²）或40 mg（1.25m ² 2）。采用LC-MS/MS法分别测定血浆及尿液中Oxo药物浓度,计算其药代动力学参数,评价其药代动力学特征和药物蓄积现象。血浆及尿液中Oxo测定的线性范围为分别为2~400 ng/mL,0.02~10 μg/mL。单次给药后 c_max为（110.5±100.8）ng/mL,t_1/2为（3.4±1.4）h,t_max为（2.2 ±0.7）h,36 h内有（1.7±1.2）%的Oxo以原型方式从尿中排出;多次给药后,稳态平均血药浓度c_ss-av为（36.89±29.35）ng/mL,稳态血药浓度波动度(DF)为2.4±0.8,经统计分析,多次给药28 d后Oxo在胃癌患者体内药代动力学特征与单次给药相比并未发生变化,多次给药后未产生药物蓄积现象。与文献数据对照,Oxo在中国晚期胃癌患者与国外患者体内的药代动力学参数基本一致。     

基于LC-MS/MS 研究异夏佛塔苷在大鼠体内药代动力学及其绝对生物利用度

建立LC-MS/MS法测定大鼠血浆中异夏佛塔苷的浓度，研究异夏佛塔苷在大鼠体内的药代动力学特性及其绝对生物利用度。分别灌胃给药1.5、3.0、6.0 mg/kg和静脉注射异夏佛塔苷0.5 mg/kg后，建立LC-MS/MS分析方法测定大鼠血浆中异夏佛塔苷的含量，运用 DAS 3.0软件计算药代动力学参数。异夏佛塔苷在1.0~500.0 ng/mL内线性良好(r=0.997 6)，专属性、精密度和准确度、基质效应和提取回收率以及稳定性均符合生物样本分析要求。药代动力学参数显示:灌胃给药低、中、高3个剂量组，c_max分别为(109.34±22.87)、(259.84±95.35)、(499.26±288.09)ng/mL，AUC_0-t分别为(310.57±46.18)、(552.67±207.14)、(1 075.03±371.19)h·ng/mL，t_1/2分别为(2.36±0.22)、(2.91±0.19)、(3.04±0.86)h，t_max分别为(1.03±0.25)、(1.18±0.17)、(1.5±0.43)h，MRT_0-t分别为(11.33±1.53)、(11.27±1.09)、(8.29±0.76)h；静脉注射后，AUC_0-t为(1 536±421.3)h·ng/mL，t_1/2为(2.57±0.46)h，MRT_0-t为(9.55±2.37)h，绝对生物利用度分别为6.73%，5.99%，5.80%。结果表明，本研究所建立的LC-MS/MS分析方法可应用于异夏佛塔苷在大鼠体内的药代动力学特性研究。     

大黄及牛黄解毒片大鼠给药后血浆中大黄活性成分的药代动力学比较研究

考察大黄及牛黄解毒片给药后大黄活性成分在大鼠体内药代动力学行为的差异。大鼠分别灌胃给予大黄生药材96 mg/kg(含总蒽醌1.83 mg/kg,相当于大黄酸0.28 mg/kg、大黄素0.30 mg/kg、大黄酚0.81 mg/kg、芦荟大黄素0.23 mg/kg及大黄素甲醚0.20 mg/kg)及牛黄解毒片250 mg/kg(含总蒽醌与大黄生药材等量,相当于大黄酸0.33 mg/kg、大黄素0.38 mg/kg、大黄酚0.71 mg/kg、芦荟大黄素0.24 mg/kg及大黄素甲醚0.17 mg/kg),血浆经甲醇沉淀后,采用LC-MS/MS法测定大黄活性成分血药浓度,WinNonlin 7.0软件计算药代动力学参数。大鼠灌胃大黄及牛黄解毒片后,大黄酸的c_max分别为(121±103)及(474±251)μg/L,AUC0-t分别为(275±176)及(406±194)μg·h/L;大黄酚异构体的c_max分别为(2 325±1 390)及(3 580±2 169)μg/L,AUC0-t分别为(8 170±2 661)及(8 856±4 023)μg·h/L;仅在牛黄解毒片给药大鼠血浆中检测出大黄素,且牛黄解毒片给药后大鼠血浆中大黄酸的c_max、AUC及t1/2,大黄酚异构体的Vd及CL与单味大黄相比显著增加,大黄酚异构体的t_max显著下降。实验结果表明,牛黄解毒片复方配伍增强了大黄活性成分在大鼠体内的吸收利用,改变了大黄活性成分的药代动力学行为。     

复方丹参缓释胶囊在犬体内的药动学研究

目的 考察复方丹参缓释胶囊在犬体内的药效动力学。方法 采用多元定时释药技术制备复方丹参缓释胶囊,以血小板聚集抑制率为评价指标,以市售复方丹参片为参比制剂,对自制复方丹参缓释胶囊进行犬体内药效动力学研究。结果 犬单剂量口服给药后,复方丹参缓释胶囊的效应峰值(E_max)为18.62％,效应达峰时间(t_max)为8 h,效应半衰期(t_1/2)为2.40 h,平均效应滞留时间（MRT）为8.11 h;而市售复方丹参片的E_max为44.34％,t_max为3.5 h,t_1/2为1.54 h,MRT为4.57 h。结论 与复方丹参片相比,复方丹参缓释胶囊的药效更加温和而持久,达到了预期的缓释效果。     

水飞蓟宾过饱和自微乳给药系统在大鼠体内的药动学研究

目的 研究水飞蓟宾过饱和自微乳给药系统（S-SMEDDS）在大鼠体内的药动学特征。方法 12只雄性SD大鼠随机分为对照组和实验组,每组6只,对照组大鼠ig给予水飞蓟宾自微乳（SMEDDS）533 mg/kg,实验组大鼠ig给予水飞蓟宾-S-SMEDDS 533 mg/kg。采用Accusampler清醒动物自动采血装置于不同时间点采血,HPLC法测定大鼠ig水飞蓟宾- S-SMEDDS后水飞蓟宾的血药浓度,非房室模型的统计矩分析方法计算药动学参数。结果 对照组和实验组的t_max分别为（1.00±0.40）、（1.50±0.84）h,C_max分别为（5.68±0.52）、（16.10±4.06）μg/mL,AUC_0→t分别为（27.30±3.29）、（82.64±12.36）μg?h?mL^?1。结论 将水飞蓟宾制成S-SMEDDS可进一步提高其口服生物利用度。     

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.