炎痛克贴剂药效学作用实验研究

目的:探讨炎痛克贴剂的抗炎作用、镇痛作用和对实验性大鼠子宫内膜粘连的对抗作用。方法:以二甲苯引起小鼠耳肿胀试验观察炎痛克贴剂的抗炎作用;以热板法观察炎痛克贴剂镇痛作用;以苯酚糊剂造实验性大鼠子宫内膜粘连模型,观察炎痛克贴剂的对抗作用。结果:炎痛克贴剂对模型大鼠具有明显的抗炎、镇痛作用(P<0.01),能明显减轻子宫内膜粘连病理模型大鼠的病变程度。结论:提示本药能很好地通过透皮吸收对抗妇科及腹部炎症,实验结果可为新药开发提供药理学依据。     

应用芬太尼透皮贴剂治疗癌痛的临床观察

目的：观察芬太尼透皮贴剂(多瑞吉)在中重度癌痛中的止痛效果和不良作用。方法：选择30例确诊为恶性肿瘤并伴有中重度癌痛患者入组，给与芬太尼透皮贴剂，剂型为25μg/h(芬太尼含量2．5mg)，每三天更换一次贴剂．根据病情酌情调整剂量，观察镇痛效果和相关不良作用。结果：止痛效果较好，中度以上缓解率在70％以上，不良反应少．且患者均能耐受。结论：芬太尼透皮贴剂对中重度癌痛疗效满意，不良反应低，且给药方便。     

电致孔条件下不同促渗剂对青藤碱透皮吸收的影响

目的探索电致孔条件下5种促渗剂对青藤碱透皮吸收的影响。方法采用双室扩散池,HPLC法定量青藤碱。在一定的电致孔参数下观测电致孔与氮酮、薄荷油、聚山梨酯80、丙二醇和PEG400组合后对青藤碱透皮给药的影响。结果在电致孔条件下,氮酮和薄荷油对青藤碱透皮给药有极其显著的促进作用;而聚山梨酯80、丙二醇、PEG400的促透作用甚至低于单独的电致孔促透作用。结论在电致孔条件下不同促渗剂对青藤碱透皮给药的效果差异很大,电致孔与促渗剂组合将有很好的应用前景。     

青藤碱水凝胶贴剂的微针经皮给药的研究

目的 在微针作用下,考察青藤碱水凝胶贴剂透皮给药的特点与规律。 方法 制备不同长度的微针,并制备青藤碱水凝胶贴剂;离体小鼠皮肤经不同针形微针预处理相同时间、相同针形微针预处理不同时间后贴敷青藤碱水凝胶贴剂,用改进的Franz扩散池研究青藤碱的透过规律并与未处理皮肤的被动扩散进行比较;高效液相色谱法测定青藤碱的含量。 结果 100 μm微针、200 μm微针预处理皮肤后青藤碱透皮速率分别是未经微针预处理的40.7、52.4倍;200 μm微针预处理皮肤7 min后青藤碱的透皮速率是未经微针预处理的142.0倍。200 μm微针经不同的力预处理后,青藤碱的透皮速率随着力的增大而增大,当力大于5 N时透皮速率趋于平衡。 结论微针与水凝胶贴剂结合经皮给药时,透皮速率显著提高,并且微针针形、预处理时间和所受的力对药物的经皮渗透具有重要影响。     

炎痛克贴剂镇痛、抗炎作用及对大鼠子宫内膜黏连的对抗作用

目的:探讨炎痛克贴剂的主要药效学作用:(1)镇痛作用;(2)抗炎作用;(3)对实验性大鼠子宫内膜黏连的对抗作用。方法:以热板法观察炎痛克贴剂镇痛作用;以二甲苯引起小鼠耳肿胀试验观察炎痛克贴剂的抗炎作用;以苯酚糊剂造实验性大鼠子宫内膜黏连模型,观察炎痛克贴剂的对抗作用。结果:本药有明显的镇痛、抗炎作用(P＜0．01);对实验模型能明显减轻病变。结论:上述结果提示本药能很好的通过透皮吸收对抗妇科及腹部炎症,为开发为新药提供了药理学依据。     

PCS埋入式镇痛系统对重度癌痛患者抑郁影响的临床研究

目的描述和比较PCS埋入式镇痛系统对重度癌痛患者抑郁的影响。方法对于确诊罹患恶性肿瘤的重度癌痛患者,按照肿瘤姑息(缓和)治疗中癌痛规范化治疗及临床路径将其分为传统镇痛组、芬太尼透皮贴镇痛组、PCS埋入式镇痛组。传统镇痛组以口服WHO三阶梯镇痛药物治疗;透皮贴镇痛组采用芬太尼透皮贴剂治疗;PCS组给予埋入式管道镇痛系统植入治疗。治疗前和治疗4周后使用WHO推荐的NRS疼痛评估法、Hamilton抑郁量表(HAMD)和血浆5-HT水平进行测评。结果接受PCS埋入式镇痛系统治疗的重度癌痛患者与传统镇痛组、透皮贴镇痛组相比,疼痛评分、HAMD评分均显著降低,血浆5-TH水平明显升高(P<0.05)。结论 PCS植入镇痛系统治疗可明显改善重度癌痛患者的抑郁,是恶性肿瘤终末期重度癌痛患者改善生活质量的重要治疗措施。     

马钱子碱经皮给药后在小鼠体内的药动学研究

目的 考察马钱子碱经皮给药后在小鼠体内的药物动力学过程。 方法 建立了利用HPLC法测定小鼠血浆中马钱子碱质量浓度的方法，测定了iv 4 mg/kg马钱子碱溶液、经皮给药40 mg/kg马钱子碱后的血药浓度，并对结果进行药动学拟合。结果 马钱子碱iv和经皮给药后的药动学均符合二室模型。经皮给药后的绝对生物利用度为32.8%，MRT是iv的8倍。结论 经皮给药途径可能有利于马钱子碱的减毒增效。     

葛根通络颗粒的镇痛作用

目的观察葛根通络颗粒的镇痛作用及其机制。方法将48只筛选合格小鼠随机分为:模型组、葛根通络颗粒低、中、高剂量组(3.0、6.0、12.0g·kg-1,以生药计,以下简称GG低组、GG中组、GG高组),模型组仅给予0.5%CMC-Na混悬液(0.2m L/10g),采用热板法观察各组小鼠痛阈值变化情况;将50只筛选合格小鼠随机分为模型组、GG低组、GG中组、GG高组和阿司匹林组(0.2g/kg),模型组仅给予0.5%CMC-Na混悬液(0.2m L/10g),各组小鼠均在给药后1小时按0.1m L/10g腹腔注射0.6%冰醋酸(HAC),观察15min后各组小鼠扭体反应次数,记录次数并计算抑制率;将50只筛选合格小鼠随机分为模型组、GG低组、GG中组、GG高组和空白对照组,除空白对照组外,其余四组各鼠均皮下注射利血平1.0mg/kg,连续注射10天,观察葛根通络颗粒对小鼠脑内5-HT含量的影响。结果痛阈值:给药前及给药0.5h后四组小鼠痛阈值无统计学意义(P≥0.05);GG高组给药后1h、1.5h、2h与模型组相比,痛阈值明显提高,差异有统计学意义(分别为P0.01,P0.01,P0.05);GG中组给药后1.5h、2h与模型组相比,痛阈值明显提高,差异有统计学意义(P0.05);GG低组给药后各个时间点与模型组相比痛阈值差异无统计学意义(P≥0.05)。扭体次数:GG低、中、高剂量组、阿司匹林组与模型组相比,都能显著减少冰醋酸导致小鼠扭体次数,差异有统计学意义(P0.05)。脑内5-HT含量:模型组小鼠脑内递质5-HT较正常小鼠明显降低(P0.05),GG高组对小鼠脑内的递质5-HT有明显的升高作用,与模型组比较差异有统计学意义(P0.05),GG中、GG低组5-HT的含量较模型组也有一定程度的升高,但差异无统计学意义(P≥0.05)。结论葛根通络颗粒有一定的镇痛作用,机制可能与升高脑内5-羟色胺水平有关。     

马钱子碱和可乐定合用对小鼠镇痛作用及耐受性和身体依赖性探讨

采用小鼠热板法:马钱子碱与可乐定两药合用显著提高痛阈,呈剂量依赖性;每天小鼠 ip 马钱子碱12mg/kg 和可乐定100μs/kg,连续给药8天,镇痛作用不产生耐受性。采用小鼠跳跃试验:结果揭示马钱子碱和可乐定两药合用不产生身体依赖性;两药与吗啡合用时,不能阻止吗啡的身体依赖性产生。     

消心痛胶囊镇痛作用的实验研究

目的探讨消心痛胶囊的止痛作用。方法将 5 0只小鼠随机分为空白对照组、阳性对照组、消心痛胶囊低、中、高剂量组。采用热刺激法和化学刺激法造成 2种实验性疼痛模型 ,观察消心痛胶囊对热板致痛及醋酸致痛的影响 ,比较各组给药前后痛阈值及扭体反应次数 ,疼痛潜伏时间。结果消心痛胶囊各剂量组均能提高热板致痛小鼠的痛阈值 ,以中、高剂量组作用为显著 (P <0 .0 5 ) ;各剂量组均能减少醋酸致痛小鼠的扭体反应次数 ,延长疼痛潜伏时间 (P <0 .0 5 )。结论消心痛胶囊各剂量组对小鼠热板法及醋酸扭体法所致疼痛有明显的镇痛作用     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.