双(水杨醛亚胺)镍配合物催化乙烯-甲基丙烯酸甲酯共聚

研究了3个在苯胺基邻位含有不同位阻效应的双（水杨醛亚胺）镍配合物C1~C3的合成及其结构的分析与表征。在助催化剂甲基铝氧烷（MAO）作用下,以C3为主催化剂,考察了Al与Ni物质的量之比（n_Al/n_Ni）、催化剂用量、反应温度、压力、甲基丙烯酸甲酯（MMA）浓度、时间等对乙烯与甲基丙烯酸甲酯共聚的影响,得到最佳聚合条件为：n_Al/n_Ni为150,温度25℃,压力2 MPa,反应时间2 h。在此条件下评价了C1、C2和C3催化剂结构对聚合反应的影响,发现在苯胺基邻位的取代基位阻较小时,催化活性较好,但所得聚合物分子量较低,并对共聚物结构进行了¹H-NMR、¹³C-NMR、FT-IR等分析和表征。     

醇钾及酚钾在甲基丙烯酸甲酯阴离子聚合中的应用

以正丁基锂（n-BuLi）为引发剂,叔丁醇钾（t-BuOK）和苯酚钾（POK）为副反应抑制剂,实现了甲基丙烯酸甲酯（MMA）在四氢呋喃（THF）溶剂中的阴离子聚合。采用凝胶渗透色谱（GPC）、核磁共振氢谱（¹H-NMR）等研究了产物的数均分子量、分子量分布（MWD）和分子结构。结果表明：t-BuOK与n-BuLi之间发生反离子交换反应使活性中心的反离子Li⁺被K⁺替换,从而在一定程度上抑制了MMA聚合过程中的副反应,当n（t-BuOK）/n（n-BuLi）≥10时,可在0℃下实现MMA的可控阴离子聚合;PMMA分子量分布较窄（1.22）,且数均分子量与设计值十分接近,MMA聚合的副反应得到了有效控制;进一步添加的POK能与活性中心的K⁺配合,促进对MMA聚合副反应的抑制,使MMA的可控阴离子聚合能在较高温度（40℃）下得以实现,所合成的聚甲基丙烯酸甲酯（PMMA）数均分子量分布窄（1.24）且数均分子量符合设计值。     

聚醋酸乙烯酯的可逆加成断裂链转移溶液聚合

以二硫化二异丙基黄原酸酯(DIP)为链转移剂前驱体,偶氮二异丁腈(AIBN)为引发剂,采用可逆加成断裂链转移(RAFT)溶液聚合合成了低数均分子量(M_n < 1.0×10⁴)和窄分子量分布(M_w/M_n < 1.5)的聚醋酸乙烯酯(PVAc)。用核磁共振(¹H-NMR)、凝胶渗透色谱(GPC)表征了PVAc的结构与分子量。结果表明:溶剂类型、引发剂浓度、链转移剂浓度和聚合反应温度对醋酸乙烯酯RAFT自由基聚合的转化率及可控/"活性"特征有重要影响。在相同条件下,溶剂极性较大的四氢呋喃对PVAc的分子量及其分布的可控性要优于极性较小的苯溶剂;聚合速率及产物分子量分布均随着引发剂浓度的增加而增大;增大DIP的浓度,聚合速率降低,聚合过程的可控性变好;温度升高聚合速率加快,分子量分布指数(PDI)增大。     

酶-有机金属催化合成阳离子聚己内酯

首先以4-甲酸苄基哌啶内酯（NPIL）为原料,采用钯碳（Pd-C）催化加氢脱保护的方法合成了4-哌啶内酯单体（PIL）;然后以苯甲醇为引发剂,分别采用酶（Novozym 435）和异辛酸亚锡（Sn（Oct）₂）催化己内酯（CL）和PIL开环聚合,制备了阳离子共聚物聚（4-哌啶内酯）-co-聚己内酯（P（PIL-co-CL））。通过核磁共振氢谱（¹H-NMR）、红外光谱（FT-IR）、凝胶渗透色谱（GPC）、差示扫描量热仪（DSC）等方法对共聚物的结构组成、数均分子量以及热性能等进行了表征。结果表明：成功制备了阳离子聚合物P（PIL-co-CL）,相较于有机金属催化剂Sn（Oct）₂,固定化酶Novozym 435催化内酯开环聚合表现出聚合可控且无副反应的优点。     

水杨醛亚胺类镍系配合物的合成及其催化乙烯聚合

合成了一系列含不同取代基水杨醛亚胺配体L₁~L₅,及相应镍配合物C₁~C₅,并用核磁共振(¹H-NMR)、红外光谱(IR)、质谱(Mass)和元素分析(EA)等手段对配体及配合物进行了表征。以C₃为单组分催化剂,研究了在不同聚合条件下单组分催化剂对乙烯聚合的影响,结果表明在极性溶剂二氯甲烷中单组分催化剂显示出高的催化活性,甚至在二氯甲烷与水的混合溶剂中也具有一定的聚合活性。以     

预聚物分子量对立体复合聚乳酸固相缩聚产物结构和性质的影响

采用乳酸作为引发剂、辛酸亚锡作为催化剂,引发丙交酯开环聚合制得分子量不同的具备缩聚活性的预聚物L-聚乳酸（PLLA）和D-聚乳酸（PDLA）,将重均分子量（M_w）相近的预聚物熔融共混后制成前体进行固相缩聚。采用核磁共振（NMR）、凝胶渗透色谱（GPC）、差示扫描量热（DSC）及X射线衍射（XRD）分析了固相缩聚产物的链结构、分子量、热性能及晶体结构。结果表明,固相缩聚产物具有立体嵌段结构。预聚物的分子量大小将影响固相缩聚前体中均相晶体和立体复合晶体的相对含量,进而影响固相缩聚产物的结构。当预聚物PLLA和PDLA的M_w≈5×10⁴时,固相缩聚产物重均分子量的涨幅最大,最终达到1.83×10⁵。因此,采用M_w≈5×10⁴的预聚物进行固相缩聚有利于产物中立体复合晶体结晶度的提高。     

线性-树枝状两亲聚合物及其胶束的制备和聚集行为

以聚乙二醇单甲醚（mPEG）为原料,制备大分子引发剂mPEG-G_n-OH_2ⁿ（n=1,2,3,4）,以异辛酸亚锡为催化剂,引发L-丙交酯开环聚合,通过控制丙交酯和大分子引发剂的投料比,合成1~4代线性-树枝状两亲聚合物。基于聚合物自组装特性,通过透析法制备聚合物胶束,采用核磁氢谱、渗透凝胶色谱对聚合物结构进行表征,使用动态激光光散射技术、电子扫描显微镜和透射电镜对其聚集体进行观测。研究表明,胶束流体力学直径主要受代数影响,并随PEG链段增加而增大,胶束粒径为200~300 nm。胶束形状反映聚合物分子中亲水、亲油比,当聚合物分子中亲水链段EO体积分数φ_EO<0.35时,线性-树枝状两亲聚合物才能形成空心胶束。     

18F-FDG PET-CT与乳腺癌新辅助化疗疗效中的关联性分析

目的 本研究旨在探讨¹⁸F-FDG PET-CT与乳腺癌新辅助化疗疗效的关联性。方法 2014年1月~2015年12月,收集笔者医院收治的行新辅助化疗的乳腺癌患者98例。前瞻性分析¹⁸F-FDG PET-CT与乳腺癌新辅助化疗疗效的关联性。结果 与病理无效组相比,病理有效组患者SUV_max0显著增加（9.54±3.11 vs 6.12±3.21,P=0.015）;SUV_max1变化率显著增加（53%±17% vs 29%±11%,P=0.000）;SUV_max2变化率显著增加（61%±21% vs 34%±12%,P=0.000）。与未pCR组相比,pCR组患者SUV_max0显著增加（10.54±4.11 vs 5.87±2.21,P=0.000）;SUV_max1变化率显著增加（57%±17% vs 28%±10%,P=0.000）;SUV_max2变化率显著增加（64%±23% vs 33%±11%,P=0.000）。结论 ¹⁸F-FDG PET-CT可作为评价乳腺癌新辅助化疗效果的一种影像学方式,值得临床进一步推广。     

基于三(2-氨基乙基)胺和6-羧基荧光素的双模式核磁共振成像造影剂

通过将三（2-氨基乙基）胺（TREN）、6-羧基荧光素与溴乙酸苄酯结合而合成出多胺多羧型配体,并赋予化合物荧光成像的功能。进一步与顺磁性的六水合氯化钆（Ⅲ）反应获得兼具核磁共振成像（Magnetic Resonance Imaging,MRI）和光学成像功能的双模式核磁共振成像造影剂。通过核磁氢谱、碳谱、高分辨质谱和ICP-AES表征了配体和金属配合物的结构。研究结果表明,该配合物的纵向弛豫率（r₁）为3.46 mM^-1·s^-1,与小分子型商用造影剂如马根维显^®（Gd-DTPA）接近。该配合物同时拥有66%的荧光量子产率,在紫外光照射下显示明亮的绿色荧光,为以后进行生物体内研究打下坚实基础。     

不同血液净化方式对中分子及小分子物质的清除效果研究

目的 观察不同血液净化方式对中分子尿毒症毒素β₂-微球蛋白（β₂-MG）、甲状旁腺素（PTH）等的清除效果,为临床合理选择尿毒症患者血液净化方式提供依据。方法 研究是64例在笔者医院进行血液净化治疗的尿毒症患者,同时根据血液净化方式的差异进行分组∶单纯血液透析组（HD,n=30）,血液透析合并血液灌流组（HD＋HP,n=15）,血液透析滤过组（HDF,n=19）。采集治疗前后患者血清,ELISA法检测β₂-MG、PTH水平以评价不同净化方式对中分子尿毒症毒素的清除率;检测临床肾功能指标和钙离子（Ca²⁺）、钾离子（K⁺）、钠离子（Na⁺）、氯离子（Cl^-）,反映不同净化方式对低分子物质的清除率。结果 与HD、HD＋HP组比较,HDF组治疗后血液中分子物质β₂-MG和PTH水平均显著下降（P<0.01）,清除效果明显;与HD组比较,HD+HP组治疗后PTH显著下降（P<0.01）,治疗后β₂-MG的清除率比较,差异无统计学意义（P>0.05）;3组BUN、Scr清除率、KT/V值透析前后血差异无统计学意义,Ca²⁺、K⁺、Na⁺、Cl^-改善比较,差异无统计学意义（P>0.05）。结论 对于尿毒症患者体内毒素的清除,HDF的清除效果最佳,其次是HD+HP,HD对中分子物质的清除无明显效果。     

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.