阿奇霉素片的人体相对生物利用度及药代动力学

目的研究阿奇霉素片受试制剂与参比制剂人体相对生物利用度及药代动力学。方法18名健康受试者自身交叉单剂量口服阿奇霉素受试制剂和参比制剂各500 mg,定时取血,用微生物法测定血药浓度。结果阿奇霉素片受试制剂与参比制剂的血药浓度时间曲线基本一致,符合一级吸收二房室模型。受试制剂与参比制剂的主要药动学参数分别为:消除半衰期t1/2β:(36.48±9.45)h,(38.10±9.39)h;Tmax:(2.39±0.61)h,(2.44±0.61)h;Cmax:(509.10±106.08)μg/L,(505.20±89.91)μg/L。药代动力学参数经配对t检验,差异均无显著性意义(P>0.05)。两种制剂的药时曲线下面积(AUC0-t)平均值分别为:受试制剂(9 080±1 339)(μg.h)/L,参比制剂:(9 308±1 390)(μg.h)/L;受试制剂的相对生物利用度为(98.0±10.1)%。结论受试制剂阿奇霉素与参比制剂生物等效。     

阿昔洛韦片在健康人体内的药代动力学及相对生物利用度

目的 测定阿昔洛韦片在健康人体内的药代动力学参数及相对生物利用度.方法 18名健康男性志愿者单剂量随机交叉口服500 mg阿昔洛韦片后,用高效液相色谱法测定血浆药物浓度.结果 口服海南金晓制药有限公司或天津药业集团新郑股份有限公司生产的阿昔洛韦片后的药代动力学参数分别为:T12(4.53±0.59)h和(4.65±0.55)h,Cmax分别为(451.08±77.19)μg·L-1(454.88±72.62)μg·L-1,Tmax分别为(1.67±0.24)h和(1.72±0.31)h,AUG01(2 312.1±372.2)μg·h·L-1和(2 249.8±258.9)μg·h·L-1.AuCo→∞.分别为(2 516.6±393.0)μg·h·L"和(2 446.1±272.5)μg·h.·L-1.两种阿昔洛韦片主要药动学参数间均无统计学意义(P＞0.05),受试阿昔洛韦片的相对生物利用度F为103.01%.结论 两种制剂具有生物等效性.可确保临床用药的安全有效.     

盐酸伐昔洛韦片在健康人体的药代动力学和相对生物利用度

目的:研究盐酸伐昔洛韦片在健康人体的药代动力学和相对生物利用度,为临床合理用药提供依据.方法:采用双周期、单中心、开放、自身交叉对照的研究方法,18例健康志愿者随机分为两组,单次,交叉口服盐酸伐昔洛韦片600 mg后,以HPLC法测定血浆中阿昔洛韦的浓度,采用BAPP2.0软件进行数据处理,计算药代动力学参数.结果:HPLC法测定阿昔洛韦的线性范围为0.1～4.0 μg/mL(r=0.9999),日内和日间RSD均小于7.00%.试验与参比制剂的药时曲线可用一室模型拟合,两者主要药代动力学参数Tmax分别为(1.50±0.40),(1.40±0.40) h;Cmax分别为(2.70±0.68),(2.87±0.75) μg/mL.t1/2分别为(3.00±0.65),(3.28±0.67) h;AUC0-14分别为(9.07±2.43),(9.71±2.70)μg·h/mL.两种盐酸伐昔洛韦片主要药动学参数间均无显著性差异(P＞0.05).供试制剂对参比制剂的相对生物利用度为 (96.4±23.7)%.结论:供试制剂和参比制剂具有生物等效性.     

左氧氟沙星胶囊人体相对生物利用度和生物等效性研究

目的:研究左氧氟沙星胶囊与上市产品左氧氟沙星片生物等效性.方法:采用HPLC-紫外法,测定20名健康男性志愿者,单次交叉口服试验制剂及参比制剂各0.2g后不同时间血浆中左氧氟沙星浓度.运用DAS软件处理血药浓度数据和计算参数,对两种制剂作出生物等效性评价.结果:单剂量口服0.2g的左氧氟沙星胶囊试验药和参比片,测得Cmax分别为(2.51±0.61)ng/ml、(2.4±0.5)μg/ml;tmax分别为(0.95±0.41)h、(0.99±0.6)h;AUC0→t分别为(17.3±2.0)μg·h-1·ml-1、(16.5±1.9)μg·h-1·ml-1,AUC0→∞分别为(18.7±2.1)μg·h-1·ml-1、(18.01±2.43)μg·h-1·ml-1;用药时曲线下面积AUC0→24计算,20名健康志愿者单剂量口服左氧氟沙星胶囊试验药相对生物利用度为(105.4±12.8)%.结论:统计学检验表明,试验胶囊与参比片具生物等效性.     

替米沙坦片和胶囊的人体相对生物利用度和生物等效性研究

目的 研究替米沙坦片及胶囊的人体相对生物利用度和生物等效性.方法 18名男性健康志愿者随机分别服用单剂量替米沙坦试验片剂、试验胶囊和参比制剂80 mg,采用高效液相色谱荧光法(HPLC)测定.用DAS 1.0程序计算药代动力学参数和相对生物利用度,并进行等效性评价.结果 单剂量口服80 mg的替米沙坦参比制剂和试验药片剂与胶囊的药代动力学参数:AUC(O→t)分别为(3 310.2±1 969.5)、(3 454.7±2 311.2)和(3 215.0±1925.8)(μg·h)/L,AUC(O→t)分别为(3 642.3±2 156.1)、(3 704.7±2 425.5)和(3 587.0±2 123.1)(μg·h)/L;Cmax分别为(888.5±586.0)、(746.1±497.1)和(814.9±598.4)μg/L;Tmax,分别为(1.0±0.7)、(1.2±0.6)、(1.2±0.6)h.试验药片剂与胶囊分别以AUC(O→t)与AUG(O→∞)计算其相对生物利用度分别为(105.77±18.21)%、(100.97±37.61)%和(105.63±29.14)%、(103.10±40.65)%.结论 两种受试制剂与参比制剂具有生物等效性.     

盐酸奈福泮缓释片人体药代动力学和生物等效性实验

目的:评价国产盐酸奈福泮缓释片在健康人体内的药物代谢动力学和生物等效性,为临床合理用药提供依据.方法:健康男性志愿者20名完全随机分成两组,采用双周期自身交叉对照实验设计,单次和多次口服盐酸奈福泮缓释片和普通片,运用液相色谱质谱联用法测定血清中奈福泮的药物浓度.结果:单剂量口服缓释片和普通片的峰值浓度ρmax分别为(72±18)和(105±25)μg/L,达峰时间Tpeak分别为(5.1±0.6)和(2.1±0.7)h;药时曲线下面积(AUC)(0-24h)分别为(907±340)μg·h/L和(865±287)μg·h/L,多剂量给药AUCSS(0-24h)为(1308±313)和(504±109)μg·h/L,峰值浓度ρmax分别为(101±20),(114±28)μg/L和谷值浓度为ρmin(29±13),(20±12)μg/L.缓释片相对普通片的达峰时间Tmax延迟,体内滞留时间(MRT)和半衰期(t1/2)延长,盐酸奈福泮缓释片相对普通片的相对生物利用度为(111±43)%.结论:盐酸奈福泮缓释片和普通片生物等效且缓释片具有缓释特征.     

氯氮平口腔崩解片与普通片的人体生物等效性研究

目的研究国产氯氮平口腔崩解片和普通片的人体生物等效性。方法18例健康男性志愿者2×2交叉试验方案设计,分别口服受试制剂和参比制剂25mg,并采集60小时内动态血标本;用HPLC-MS/MS法测定血浆中氯氮平的浓度,计算药动学参数,并判定两种制剂的生物等效性。结果受试制剂和参比制剂的主要药动学参数Cmax分别为（69.65±14.36）μg/L和（71.48±15.20）μg/L,tmax分别为（0.9±0.3）h和（1.0±0.3）h,AUC0-60分别为（569.1±201.1）μg/h·L和（565.3±193.5）μg/h·L,AUC0-∞分别为（609.6±230.3）μg/h·L和（606.9±193.4）μg/h·L,t1/2（ke）分别为（13.7±4.4）h和（14.1±3.6）h,两制剂主要药动学参数经对数转换后进行方差分析及双单侧t检验,并计算90%置信区间,表明两种制剂生物等效,受试制剂的人体生物利用度为（100.7±16.9）%。结论两种制剂生物等效。     

米诺环素片生物等效性研究

目的:研究米诺环素片的药代动力学和相对生物利用度.方法:采用HPLC法测定20名健康男性志愿受试者随机自身交叉单剂量口服米诺环素片和米诺环素胶囊200 mg后的血药浓度,得出相应的药时曲线,计算各药代参数和相对生物利用度.结果:半衰期T1/2分别为(19.53±2.67)和(19.52±2.32)h,达峰时间Tmax分别为(1.72±0.41)和(1.72±0.70)h,峰值血浆浓度Cmax分别为(3.404±1.050)和(3.284±0.472)mg/L,药时曲线下面积AUC(0～60 h)分别为(62.50±11.77)和(56.93±7.33)(mg·h)/L.两种制剂的药动学参数差异无统计学意义(P>0.05),受试制剂的相对生物利用度(F)为111.5%.结论:两种制剂具有生物等效性.     

利福肼胺片人体内药动学与相对生物利用度

目的研究两种利福肼胺片(利福平、异烟肼和吡嗪酰胺复方制剂)的药动学,评价二者的生物等效性.方法12名志愿受试者单剂量po利福肼胺片供试品与参比品后,采用反相高效液相色谱法测定异烟肼和吡嗪酰胺血药浓度,用3P97药动学程序计算药动学参数.结果两种制剂中异烟肼AUC0→∞.分别为;(43.97±16.81)mg·h-1·ml-1与(43.18±16.33)mg·h-1·ml-1;Tmax分别为:(1.79±0.54)h与(1.63±0.38)h;Cmax分别是:(8.39±4.30)mg/ml与(8.36±4.52)mg/ml.两种制剂的吡嗪酰胺AUC0→∞分别为:(569.87±271.30)mg·h-1·ml-1与(563.55±262.48)mg·h-1·ml-1;Tmax分别为:(1.68±0.58)h与(1.50±0.30)h;Cmax分别是:(34.38±M.55)mg/ml与(36.23±13.47)mg/ml.统计检验结果表明:两种制剂中异烟肼和吡嗪酰胺的AUC0→∞,Tmax和Cmax均无显著性差异(P＞0.05).结论两制剂以异烟肼和吡嗪酰胺两组分的AUC0→∞,Tmax和Cmax为指标评价生物等效性,表明二者为生物等效制剂.利福肼胺片供试品中异烟肼和吡嗪酰胺的相对生物利用度分别为:(101.73±5.95)%和(100.28±10.50)%.     

阿昔洛韦片剂人体相对生物利用度研究

选用8名健康男性自愿受试者,随机交叉口服深圳海王药业有限公司生产的阿昔洛韦片剂及湖北省医药工业研究所科益制药厂生产的阿昔洛韦（参比制剂）片剂各400mg,采用高效液相色谱（HPLC）法测定血药浓度,进行相对生物利用度研究。结果表明,本品药代动力学过程符合线性—房室模型特征.受试片剂及参比片剂的达峰时间（Tmax）分别为（0.968±0.224）h和(1.157±O.336）h,峰浓度（Cmax）分别为（O.555±0.221)μg/ml和（O.496±0.149)μg/ml,消除半衰期（T_(1/2)kc）分别为（1.426±0.486）h和(1.630±0.405）h,药—时曲线下面积（AUC）分别为（1.844±0.535）μg/（ml·h）和（1.934±0.483)μg/（ml·h）,受试片剂与参比片剂比较的相对生物利用度为（95.18±12.48）%,变异系数:13.11％。两种口服片剂的达峰时间、峰浓度、消除半衰期和药—时曲线下面积说明两种片剂的吸收速度及吸收程度无明显统计学差异.表明该药品相对生物利用度符合临床应用的要求。     

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.     

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.     

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.     

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.