载BDNF脂质体纳米微粒脂膜微泡超声造影剂的制备与初步评价

目的 探索制备一种新型的耦连包载BDNF脂质体纳米颗粒的脂膜微泡超声造影剂(BDNF-UMCA)。方法 以冷冻干燥法在“脂氟显”制备的基础上加入一定比例的含生物素化棕榈酰磷脂酰甘油钠-聚乙二醇2000-生物素[DPPG-PEG(2000)-Biotin]制备含生物素的脂质超声微泡造影剂,通过链亲和素来耦连含生物素化PEG载BDNF脂质体纳米微粒制备BDNF-UMCA,检测其理化性质、载药量、包封率、稳定性和体内声学特性进行检测。结果 BDNF-UMCA平均粒径4.2±0.79 μm,浓度为1.02×10₉/ml;总药物含量为1.18±1.96 mg/mL,包封率为71.6±2.6%;BDNF-UMCA在4℃条件下,平均粒径和包封率均无明显的变化;在24℃条件下,载BDNF脂质体纳米微粒的平均粒径随时间逐渐增大,第1、3、5、7天的粒径与初始粒径比较具有明显的统计学差异(均P<0.05),包封率在24℃下各个时间点无明显的统计学差异(均P>0.05);BDNF-UMCA能显著增强实验动物肝脏显影,平均峰值强度为21.4±0.9 dB,平均达峰时间为4.7±0.4 s。结论 应用生物素-亲和素偶联可成功制备载BDNF脂质体纳米微粒的脂膜超声微泡造影剂,为靶向显影及药物通过血脑屏障释放提供工具。     

包裹吲哚菁绿的靶向相变型阳离子脂质纳米粒的制备及体外显像

目的制备一种包裹吲哚菁绿(ICG)的靶向相变型阳离子脂质纳米粒(INP),连接CD105抗体,检测其光热效应、体外相变、光声及超声显像规律。方法采用双乳化法制备包裹ICG及液态氟碳的INP;链霉亲和素法连接CD105抗体,流式细胞仪及激光共聚焦显微镜下观察INP与抗体结合情况;脉冲激光激发观察其光热效应及相变情况;体外低强度聚焦超声辐照,记录各时间点超声显影效果;光声成像仪检测其光声显像能力。结果制备的INP平均粒径(354.20±93.85)nm,平均电位(25.20±3.29)m V,测得ICG包封率为(89.56±0.79)%;与CD105抗体结合率为99.89%。纳米粒具有良好光热效应,其中在浓度5 mg/ml、功率2 W/cm2激光辐照180 s时其温度可升至63℃;可发生液气相变。体外低强度聚焦超声于3 W功率作用0.5、2.5、5.0、7.5 min,B-mode模式及Contrast模式均显示5 min时回声强度升至最高。光声信号随纳米粒浓度升高而增强,具有良好的线性关系。结论成功制备了包裹ICG的靶向相变型阳离子INP,其与CD105抗体结合率高,且光热效应好,光声及超声显影效果均佳。     

载脑源性神经营养因子脂质体纳米微粒脂膜微泡超声造影剂的制备与初步评价

目的制备一种新型的载脑源性神经营养因子(BDNF)脂质体纳米微粒脂膜微泡超声造影剂(BDNF-UMCA),并对其应用进行初步评价。方法以冷冻干燥法在"脂氟显"制备的基础上加入与二棕榈酰磷脂酰胆碱等量的含生物素化棕榈酰磷脂酰甘油钠-聚乙二醇2000-生物素,制备含生物素化脂膜超声微泡造影剂,通过链亲和素耦连含生物素化聚乙二醇载BDNF脂质体纳米微粒制备BDNF-UMCA,检测其物理性质、载药量、包封率、稳定性及体内声学特性。结果 BDNF-UMCA平均粒径(4.20±0.79)μm,浓度1.02×109/ml,总药物含量(1.18±1.96)mg/ml,包封率(71.6±2.6)%。在4℃下,BDNF-UMCA平均粒径和包封率各时间点无明显变化;在(24±2)℃下,BDNF-UMCA的平均粒径随时间推移逐渐增大,第1、3、5、7天的粒径与初始粒径比较差异均有统计学意义(均P0.05),包封率在(24±2)℃下各时间点比较差异无统计学意义。BDNF-UMCA能显著增强实验动物肝脏显影,平均峰值强度(21.5±3.5)d B,平均达峰时间(19.2±5.2)s。结论应用生物素-亲和素耦连可成功制备BDNF-UMCA;BDNF-UMCA可为靶向显影及药物通过血脑屏障释放提供工具。     

载ICG和PFH的光致相变型纳米粒—一种双模态分子探针宫玉萍 陈澄 孙阳 王志刚

目的 制备一种光致相变型液态氟碳纳米粒,研究其体外相变及体内增强光声、超声成像能力。方法 采用三步乳化技术制备出以PLGA为载体,液态氟碳(PFH)及吲哚菁绿(ICG)为内核的纳米粒,检测该纳米粒的的粒径、电位,然后体外激光辐照激发纳米粒相变,体内观察该纳米粒增强超声及光声成像的能力。结果 成功制备出包裹PFH和ICG的光致相变纳米粒,为球形,其平均粒径为599.2nm,平均电位为-24.1mv。激光辐照纳米粒时,纳米粒可发生相变转变成微米级的微泡,体内增强了裸鼠移植瘤的光声及超声信号。结论 制备的光致相变型纳米粒在激光作用下发生相变并增强体内超声、光声成像,为临床疾病的诊断提供新思路。     

相变型液态氟碳纳米粒造影剂的制备及相变超声显影研究

目的制备一种相变型液态氟碳纳米粒超声造影剂(PC-PNPCA),研究其在体外相变及增强超声显影作用的能力。方法首先采用双步乳化法制备出以脂质为包壳、液态氟碳PFH为内核的纳米粒超声造影剂,检测该造影剂的粒径、电荷。然后分别用升高温度、低功率治疗超声及高强度聚焦超声辐照三种方法来激发纳米粒相变,用显微镜观察相变后产生的微泡,使用诊断超声仪在造影模式下观察造影剂相变后增强超声显影的情况。结果成功制备出脂质包裹PFH的PC-PNPCA,PC-PNPCA平均粒径为(206.87±21.29)nm。当温度升高至70℃以上,低功率治疗超声辐照10 s或高强度聚焦超声辐照2 s后,乳液内的纳米粒均可发生相变产生微泡,且能促进超声显影。结论制备的PC-PNPCA能在一定条件下发生相变并增强超声显影,为超声分子影像学提供了新型、可靠的研究平台。     

载吲哚菁绿和液态氟碳的光致相变型纳米粒的制备及增强体内成像的实验研究

目的制备一种光致相变型液态氟碳纳米粒,研究其体外相变及体内增强光声、超声成像能力。方法采用三步乳化技术制备出以聚乳酸-羟基乙酸共聚物(PLGA)为载体,液态氟碳(PFH)和吲哚菁绿(ICG)为内核的纳米粒,检测该纳米粒的粒径和电位,然后体外激光辐照激发纳米粒相变,体内观察该纳米粒增强超声及光声成像的能力。结果成功制备出包裹PFH和ICG的光致相变型纳米粒,该纳米粒平均粒径(599.2±134.3)nm,平均电位(-24.10±4.09)m V。激光辐照后,纳米粒可发生相变转变成微米级的微泡,体内增强了裸鼠移植瘤的光声及超声信号。结论制备的光致相变型纳米粒在激光作用下发生相变,并可增强体内超声、光声成像,为临床疾病的诊断提供了新的思路。     

靶向相变型载药纳米造影剂的制备及其基本性能和显像特性检测

目的 制备一种叶酸靶向相变型载羟基喜树碱(HCPT)的纳米粒(FA-HCPT-Fe3O4-PFP NDs),检测其基本性能和多模态显像特性.方法 采用旋转蒸发-超声法制备FA-HCPT-Fe3O4-PFP NDs.于制备后不同时间点使用电子显微镜测定纳米粒粒径以检测其稳定性;将纳米粒乳液加热后置于显微镜下观察其相变特性...     

聚乳酸羟基乙酸CXCR4-miRNA纳米微粒的制备及其特征

背景：有关研究表明聚乳酸羟基乙酸能够有效包裹反义寡核苷酸、小的干扰 RNA、微小RNA等,可以较好地保护其在体内不受各种酶的破坏,并可以起到缓慢释放药物的作用,从而可以减少药物的给药次数,达到长期、有效的治疗效果。 目的：制备聚乳酸羟基乙酸CXCR4-miRNA纳米微粒,并研究纳米微粒的特性。 方法：运用二次超声乳化溶剂挥发法制备聚乳酸羟基乙酸CXCR4-miRNA纳米微粒,采用紫外分光光度法测定纳米微粒的载药量及包封率,透射电镜观察微粒形态,激光粒径仪测定纳米微粒的大小和分布;将纳米微粒悬浮于磷酸盐缓冲液中观察其缓释特性。 结果与结论：制备的纳米微粒形态呈圆形,表面光滑,分散性好,不粘连,其粒径分布在143-502 nm,平均粒径为280 nm,平均载药量为（0.515±0.023）%,平均包封率为50.2%,批间差异小。纳米微球在体外可以缓慢释放,经过前几天的快速释放后,在第14天进入平台期。结果充分表明运用二次超声乳化溶剂挥发法制备聚乳酸-羟基乙酸CXCR4-miRNA纳米微粒的工艺过程简单,粒子性状符合要求且具有缓释性。     

甲壳素微结晶分散体系的研制：一种新的甲壳素溶解环试验

目的:鉴定细菌是否分泌甲壳素酶,并分解利用甲壳素的经典方法是甲壳素缺刻试验,但其需时较长,结果不明显,为解决以上缺点,研制甲壳素微结晶分散体系,拟创造一种新的实验方法甲壳素溶解环试验,并探讨其影响因素。方法:实验于2005-04/2006-12在浙江省医学科学院医学生物工程研究所完成。①通过高温高压、超声等综合手段,制备乳白色的甲壳素微结晶分散体系,并进行透射电镜观察。②采用制备的甲壳素微结晶分散体系,制造甲壳素培养基,取副溶血弧菌和致病性大肠杆菌44815菌悬液106cfu/mL各1μL,分别注入甲壳素培养基中,37℃培养72h,如接种点周围出现明显的透明环,即为阳性,反之为阴性。③制备2%,1%,0.5%3种不同浓度的NaCl及相应8.0,7.0和6.0不同pH值组合的3种甲壳素培养基,分别接种副溶血弧菌菌悬液106cfu/mL各1μL,37℃培养72h后测量溶解环直径。④菌量和培养温度的影响:将3种浓度菌悬液(108,106和104cfu/mL)各1μL注入甲壳素培养基中,37℃培养72h;固定菌量(2.8×106cfu/mL)接种后,分别在40℃、37℃和25℃培养72h,测量溶解环直径。结果:①成功制备了甲壳素微结晶分散体系,甲壳素浓度为4%,微粒粒径<0.5μm。②培养72h后,接种副溶血弧菌甲壳素培基上呈现阳性反应。③在NaCl浓度为2.0%,pH为8.0环境条件下,溶解环直径最大。④在菌量108￣104cuf/mL范围内,菌量与溶解环直径大小呈正比,但最适浓度为106cuf/mL;在37℃环境中溶解环直径最大。结论:①甲壳素溶解环试验是鉴定细菌能否分泌甲壳素酶、并分解利用甲壳素的一种直观、快速、准确的方法。②甲壳素培养基NaCl、pH值、培养温度及菌量等对甲壳素溶解环试验均有直接的影响。     

新型聚内酯超声造影剂的体外基本特性研究

目的观察新型聚内酯微泡的体外物理化学特性及声学特性,以评价其作为超声造影剂的可行性。方法采用水/油/水乳液-溶剂蒸发法制备聚内酯中空微泡,部分在制备过程中加入荧光剂。光学显微镜、扫描电镜及激光共聚焦显微镜观察微泡大小形态及内部特征;Coulter计数仪测定粒径分布和微泡浓度;体外声学装置测试微泡的体外背向散射和声衰减特性。结果该新型聚内酯超声造影剂为含空气的冻干粉剂,扫描电镜和激光共聚焦显微镜证明该聚内酯微球是中空微泡,平均粒径1.5μm,98%的微泡粒径<8μm,0.1 g多聚体微泡干粉溶于5 ml蒸馏水中的浓度为0.1×109~1×109/ml。体外声学测试微泡具有较强的散射性能。结论该聚内酯微泡符合作为超声造影剂的条件,是一种新型的超声造影剂。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Dissociable correlates of two classes of retrieval processing in prefrontal cortex

Although substantial evidence suggests that the prefrontal cortex (PFC) implements processes that are critical for accurate episodic memory judgments, the specific roles of different PFC subregions remain unclear. Here, we used event-related functional magnetic resonance imaging to distinguish between prefrontal activity related to operations that (1) influence processing of retrieval cues based on current task demands, or (2) are involved in monitoring the outputs of retrieval. Fourteen participants studied auditory words spoken by a male or female speaker and completed memory tests in which the stimuli were unstudied foil words and studied words spoken by either the same speaker at study, or the alternate speaker. On "general" test trials, participants were to determine whether each word was studied, regardless of the voice of the speaker, whereas on "specific" test trials, participants were to additionally distinguish between studied words that were spoken in the same voice or a different voice at study. Thus, on specific test trials, participants were explicitly required to attend to voice information in order to evaluate each test item. Anterior (right BA 10), dorsolateral prefrontal (right BA 46), and inferior frontal (bilateral BA 47/12) regions were more active during specific than during general trials. Activation in anterior and dorsolateral PFC was enhanced during specific test trials even in response to unstudied items, suggesting that activation in these regions was related to the differential processing of retrieval cues in the two tasks. In contrast, differences between specific and general test trials in inferior frontal regions (bilateral BA 47/12) were seen only for studied items, suggesting a role for these regions in post-retrieval monitoring processes. Results from this study are consistent with the idea that different PFC subregions implement distinct, but complementary processes that collectively support accurate episodic memory judgments.     

俯卧位通气对高海拔地区肺复张治疗无效急性呼吸窘迫综合征患者氧合的影响

目的 探讨俯卧位通气对高海拔地区肺复张术(RM)治疗无效急性呼吸窘迫综合征(ARDS)患者的治疗作用.方法 从海拔2260m的地区医院筛选RM治疗无效的41例ARDS患者[平均氧合指数( PaO2/FiO2)较RM前升高＜20％视为RM无效],依不同病因分为肺内源性ARDS组(ARDSp组)和肺外源性ARDS组(ARDSexp组),每组再按信封法随机分为俯卧位组和仰卧位组,即ARDSp俯卧位组(11例)、ARDSp仰卧位组(9例)、ARDSexp俯卧位组(10例)、ARDSexp仰卧位组(11例).在通气前及通气1、2、3、4h监测动脉血氧分压( PaO2)、PaO2/FiO2、静态顺应性(Cst)、气道阻力(Raw)的变化.结果 通气lh时,ARDSexp俯卧位组PaO2/FiO2( mm Hg,l mm Hg=0.133 kPa)即较通气前显著升高(157.4±40.6比129.3±48.7,P＜0.05),并随通气时间延长呈持续增高趋势,4h达峰值(219.1 ±41.1);且ARDSexp俯卧位组通气3h内PaO2/FiO2较其他3组显著增高,另3组间则差异无统计学意义.ARDSp俯卧位组、ARDSexp俯卧位组通气4h时PaO2/FiO2均较相应仰卧位组显著增高(208.8±39.7比127.4±47.1,219.1±41.1比124.9±50.8,均P＜0.05).4组通气前后Cst无显著改变,各组间差异也无统计学意义.ARDSp俯卧位组通气4h时Raw(cmH2O·L-1·s-1)较通气前显著降低(6.8±1.7比10.7±1.8,P＜0.05),且明显低于其他3组;其他3组各时间点Raw组内及组间比较差异均无统计学意义.结论 俯卧位通气作为ARDS机械通气重要策略之一,可以改善RM无效高原ARDS患者的氧合,为抢救患者赢得宝贵的时间.     

Digital imaging among medical facilities

The Department of Veterans Affairs (VA) in the USA operates a network of 172 medical centres which all utilize a hospital information system (HIS) which has been developed and is currently maintained by the VA. During the past several years, an image management and communication module has been developed, installed and clinically utilized at the Washington DC and Maryland VA Medical Centres. This image management and communication system, referred to as the decentralized hospital computer program (DHCP) imaging system, is fully integrated with a commercial picture archiving and communication system (PACS). The system is utilized to capture, archive, and display all images generated within the hospital including radiology, nuclear medicine, pathology, endoscopy, bronchoscopy, and dermatology, intraoperative photographs, ECG data, and a limited number of paper documents. The ultimate goal of the project is to have all patient text and image data available at any clinical workstation to any authorized user anywhere within the network of medical centres. Clinical requirements for an imaging workstation include ease of use, rapid and reliable access to the complete set of patient information, and images which are of acceptable quality to meet the requirements of the user and the subspecialty. Patient confidentiality and data security must be safeguarded at all times. Integration of the images with the remainder of the patient's database was found to be critical to the success of the project. The experience at the Washington and Maryland facilities suggests that an imaging system that is successfully integrated with a hospital information system can provide substantial clinical and economic benefits both within and among medical centres. Clinical acceptance and utilization of the system has been excellent, particularly in diagnostic radiology where DHCP Imaging has been interfaced to a commercial PAC system. Based upon this initial experience, the VA has begun to deploy the system throughout its large network of medical centres.     

Myocardial elastography at both high temporal and spatial resolution for the detection of infarcts

Myocardial elastography is a novel method for noninvasively assessing regional myocardial function, with the advantages of high spatial and temporal resolution and high signal-to-noise ratio (SNR). In this paper, in-vivo experiments were performed in anesthetized normal and infarcted mice (one day after left anterior descending coronary artery [LAD] ligation) using a high-resolution (30 MHz) ultrasound system (Vevo 770, VisualSonics Inc., Toronto, ON, Canada). Radiofrequency (RF) signals of the left ventricle (LV) in longitudinal (long-axis) view and the associated electrocardiogram (ECG) were simultaneously acquired. Using a retrospective ECG gating technique, 2-D full field-of-view RF frames were acquired at an extremely high frame rate (8 kHz) that resulted in high-quality incremental displacement and strain estimation of the myocardium. The incremental results were further accumulated to obtain the cumulative displacements and strains. Two-dimensional and M-mode displacement images and strain images (elastograms), as well as displacement and strain profiles as a function of time, were compared between normal and infarcted mice. Incremental results clearly depicted cardiac events including LV contraction, LV relaxation and isovolumetric phases in both normal and infarcted mice, and also evidently indicated reduced motion and deformation in the infarcted myocardium. The elastograms indicated that the infarcted regions underwent thinning during systole rather than thickening, as in the normal case. The cumulative elastograms were found to have higher elastographic SNR (SNR(e)) than the incremental elastograms (e.g., 10.6 vs. 4.7 in a normal myocardium, and 6.0 vs. 2.4 in an infarcted myocardium). Finally, preliminary statistical results from nine normal (m = 9) and seven infarcted (n = 7) mice indicated the capability of the cumulative strain in differentiating infracted from normal myocardia. In conclusion, myocardial elastography could provide regional strain information at simultaneously high temporal (>/=0.125 ms) and spatial ( approximately 55 microm) resolution as well as high precision ( approximately 0.05 microm displacement). This technique was thus capable of accurately characterizing normal myocardial function throughout an entire cardiac cycle, at the same high resolution, and detecting and localizing myocardial infarction in vivo.     

Clinical Pharmacokinetics of Morphine

Morphine, the most widely used mu-opioid analgesic for acute and chronic pain, is the standard against which new analgesics are measured. A thorough understanding of the pharmacokinetics of morphine is required in order to safely and effectively use this analgesic in a wide variety of patients with different levels of organ function. A MEDLINE search was conducted to identify literature published between 1966 and January 2002 relevant to the pharmacokinetics of morphine. These publications were reviewed and the literature summarized regarding unique and clinically important elements of morphine disposition relative to its parenteral administration (including intravenous, intramuscular, subcutaneous, epidural and intrathecal administration), absorption profile (immediate release, controlled release, and sublingual/buccal, and rectal administration), distribution, and its metabolism/ excretion. Special populations, including infants, elderly, and those with renal/liver failure, have a unique morphine pharmacokinetic profile that must be taken into account in order to maximize analgesic efficacy and reduce the risk of adverse events.