盐酸奥昔布宁醇脂质体的制备及体外透皮吸收研究

研究采用乙醇注入均质法制备盐酸奥昔布宁醇质体,正交设计优化处方。用动态光散射测定平均粒径及粒径分布;扫描电子显微镜观测其形态;水平透皮扩散试验仪考察其大鼠离体皮肤经皮渗透量。蛋黄卵磷脂、乙醇、盐酸奥昔布宁的质量分数分别为3%,45%和5%时,制备的醇质体平均粒径为(98±12)nm,包封率为(48.1±1.4)%。各种盐酸奥昔布宁制品24 h的经皮渗透量由大到小依次为:醇脂质体(盐酸奥昔布宁5%)、除去游离药物的醇脂质体(盐酸奥昔布宁2.4%)、物理混合物(盐酸奥昔布宁5%)、无水乙醇(盐酸奥昔布宁5%)、质量分数为45%的乙醇溶液(盐酸奥昔布宁5%)。研究表明醇脂质体是盐酸奥昔布宁经皮给药系统的良好载体。     

自制奥昔布宁渗透泵控释片的体内外相关性研究

目的:研究自制奥昔布宁渗透泵控释片在体内外的相关性.方法:以HPLC法(Irregular-H C18柱,4.6 mm×150 mm,流动相为甲醇∶水∶1 mol/L醋酸铵＝85∶13∶2,流速为1.0 ml/min,检测波长220 nm)测定奥昔布宁渗透泵控释片体外释放浓度(释放介质:200 ml 蒸馏水,37℃,转速:100 r/min,分别在2、4、8、12、16、24 h各取样1 ml),用LC-MS法测定渗透泵控释片在Beagle犬体内的血药浓度(8条犬禁食过夜后口服自制奥昔布宁渗透泵片10 mg,于给药前及给药后2.5、5.0、8.0、12.0、16.0、24.0、27.0、30.0、36.0、48.0 h在犬一侧后肢静脉取血1 ml分离血浆待测),用Wanger-Nelson法计算体内吸收百分数,并与相应时间体外累积溶出度线性回归,进行体内外相关性考察.结果:药物恒速释放达24 h,累积释放率达90%以上.体内药动学特征符合单室一级吸收模型,血药浓度在48 h内表现平稳.以体内吸收百分率(Y)与体外释放百分率(X)进行线性回归,方程如下:Y=0.978 2X 12.501 9,r＝0.937 3 (P<0.01).结论:自制奥昔布宁渗透泵控释片体外释放百分率和体内吸收百分率呈显著相关.     

健康志愿者盐酸奥昔布宁缓释制剂与普通制剂药代动力学及生物等效性研究

目的:对健康男性志愿者进行单剂量和多剂量口服奥昔布宁缓释片/胶囊药代动力学的研究,考察缓释制剂达稳态的趋势和程度。方法:18名健康志愿者分别口服试验制剂奥昔布宁缓释片(T1)、缓释胶囊(T2)和参比制剂(R)10mg,取血浆经去蛋白处理,采用液相-质谱法(LC-MS)测定单剂量和多剂量给药奥昔布宁血浓度,计算各制剂奥昔布宁主要药代动力学参数。结果:单剂量给药奥昔布宁缓释胶囊、缓释片半衰期延长,血药浓度峰值降低,相对于普通片生物利用度F(%)分别为(107.17±10.89)%和(104.52±10.48)%。多剂量给药,奥昔布宁缓释胶囊波动系数明显小于普通片。结论:试验制剂与参比制剂为生物等效制剂。试验制剂具有释放缓慢(达峰时延迟)、波动度小的特点。     

东莨菪碱透皮控释膜剂的研究

本文研制了东莨菪碱透皮控释膜剂。采用自行设计的体外扩散装置,分别研究了药库、含药压敏胶和复合膜等各层次及控释膜剂的体外释药速率,该制剂在最初4h释放初始剂量约200μg。达到稳态释放阶段后(4～72h),由控释膜控制其释药速率为2.8μg/cm~2·h。用大鼠离体皮肤研究渗透速率,药物以零级速率经皮渗透,0～12h内渗透速率为3.52μg/cm~2·h。     

三元乳癖消凝胶膏剂体外透皮给药研究

目的:通过研究三元乳癖消凝胶膏剂中延胡索乙素(tetrahydropalmatine,THP)透皮给药的行为特点与机制,为其临床应用提供依据。方法:在三元乳癖消凝胶膏剂优化的制剂处方(sanyuan rupixiao hydrogel paste,SRHP)、含体积分数5%月桂氮卓酮的处方(SRHP containing 5%azone,SRHP+A)与不含二氧化钛的制剂处方(SRHP without titanium dioxide,SRHP-T)中,采用高效液相色谱法测定THP的含量,并采用立式双室扩散池法研究贴剂中THP透皮给药的行为特点。将凝胶膏剂贴敷过的皮肤制备成切片,并用扫描电镜观察皮肤的结构变化。结果:凝胶膏剂贴敷皮肤后0.5 h,即可在接收液中检测到THP;0.5~2.0 h,3种处方SRHP、SRHP+A与SRHP-T的药物累积透过量无显著性差异(t-test,P0.05)。2 h后,SRHP的药物累积透过量逐渐高于SRHP+A与SRHP-T;48 h时,SRHP、SRHP+A与SRHP-T的THP累积透过量分别为7.154 3μg·cm~(-2)、4.774 8μg·cm~(-2)与3.988 6μg·cm~(-2),三者之间存在显著性差异(t-test,P0.05)。给药后2 h,各组药物渗透速率达到峰值,随后缓缓降低;0~24 h的药物平均渗透速率(JSRHP:0→24=0.178 2μg·cm~(-2)·h~(-1),JSRHP+A:0→24=0.145 7μg·cm~(-2)·h~(-1),JSRHP-T:0→24=0.103 6μg·cm~(-2)·h~(-1))高于24~48 h的平均渗透速率(JSRHP:24→48=0.119 9μg·cm~(-2)·h~(-1),JSRHP+A:24→48=0.053 2μg·cm~(-2)·h~(-1),J_(SRHP-T:24→48)=0.077 7μg·cm~(-2)·h~(-1));整个实验过程中,SRHP的药物平均渗透速率(0.149 1μg·cm~(-2)·h~(-1))显著高于SRHP+A(0.099 4μg·cm~(-2)·h~(-1))与SRHP-T(0.090 6μg·cm~(-2)·h~(-1))(t-test,P0.05)。扫描电镜显示凝胶膏剂贴敷皮肤后使皮肤表面粗糙不平、层状结构疏松且有角质细胞脱落,角质细胞间隙有所增大。结论:三元乳癖消凝胶膏剂处方设计合理,可通过扰乱皮肤角质层的致密有序排列,使角质层结构变的疏松无序而提高皮肤对药物的渗透性,使药物活性成分持续释放并有效通过皮肤吸收。     

不同产地银耳的多糖含量及体外透皮吸收性能研究

【目的】分析不同产地银耳中多糖含量及其体外透皮吸收性能的差异,为其质量控制及应用提供评价依据。【方法】将不同产地银耳进行提取纯化制备多糖,同时以大鼠离体皮肤为微渗透屏障,采用Franz扩散池装置进行体外透皮实验,通过苯酚—硫酸法对多糖溶液进行反应后,利用紫外—可见分光光度计测定银耳中多糖质量分数及接收池中银耳多糖累积渗透量。【结果】不同产地银耳的多糖质量分数、稳态透皮速率qm、12 h透过率分别为:福建古田31.25%、1.962μg·cm~(-2)·h~(-1)、3.38%;四川通江30.31%、1.902μg·cm~(-2)·h~(-1)、3.19%;云南玉龙28.98%、1.829μg·cm~(-2)·h~(-1)、2.87%;浙江庆元25.17%、1.757μg·cm~(-2)·h~(-1)、2.70%;甘肃康县24.73%、1.815μg·cm~(-2)·h~(-1)、2.76%;江西吉安28.66%、1.852μg·cm~(-2)·h~(-1)、3.02%;湖北神农架林区30.67%、1.955μg·cm~(-2)·h~(-1)、3.38%;黑龙江大杨树镇27.22%、1.836μg·cm~(-2)·h~(-1)、2.86%。【结论】不同产地银耳的多糖含量均较高,但具有一定差异性,以福建古田最高、甘肃康县最低;同时银耳多糖的经皮渗透性能较好,且与其含量具有一定的相关性。     

乙酰水杨酸肠溶微丸的研制

采用薄膜包衣法制备乙酰水杨酸肠溶微丸,以转篮法(100 r/min,37 0.5℃)测定了体外溶出速率。实验结果表明:本制剂2 h在人工胃液中的释放量不超过15%,转入人工肠液后在40min内完全释放(Kr=2.975 h~(-1))。体内试验选择了六名健康受试者(平行法单剂量给药900 mg)服用乙酰水杨酸普通片及肠溶微丸,测定了二种制剂在体内的经时过程。药动学参数的求算表明:普通片:Ka=0.309 h~(-1),K=0.309 h~(-1),Cls=1.598 L/h,AUC=563.30 h·μg/ml;肠溶微丸:Ka=0.415h~(-1),K=0.134 h~(-1),Cls=1.235 L/h,AUC=728.66 h·μg/ml。     

酮洛芬醇质体凝胶与脂质体凝胶的体外经皮渗透动力学的比较研究

目的比较酮洛芬醇质体(KPFE)凝胶与脂质体(KPFL)凝胶的体外经皮渗透行为,以期为筛选出较优的KPF外用制剂奠定基础。方法制备KPFE凝胶与KPFL凝胶;以离体鼠皮为屏障,采用Franz扩散池法对KPF这2种凝胶的体外经皮渗透行为进行比较研究。结果 2种凝胶的经皮渗透动力学均符合Higuchi方程,KPFL凝胶剂:Q=28.65 t1/2-16.88(R2=0.995);KPFE凝胶剂:Q=35.22 t1/2-20.62(R2=0.988),稳态透皮速率分别为28.65μg·cm-2·h-1和35.22μg·cm-2·h-1,在经皮渗透24 h后,皮肤中的蓄积量分别为22.16μg·cm-2和19.95μg·cm-2,凝胶层中的残留量为56.25μg·cm-2和50.62μg·cm-2,4个指标之间比较差异均有统计学意义(P<0.05)。结论与KPFL凝胶相比,KPFE凝胶在促进药物经皮吸收方面具有更好的效果。     

左旋18-甲基炔诺酮经皮吸收膜剂研究

本文研制了左旋18-甲基炔诺酮经皮吸收膜剂。采用HPLC法进行了膜剂的体外释放与渗透实验,结果表明药物的体外释放符合Higuchi方程,而经皮渗透则可用零级动力学加入表述。处方A经大鼠皮肤及人体皮肤的渗透速率分别为0.23,0.21 μg/cm~2/h。药物的体外释放和渗透受到多种处方因素的调节。处方A的体内研究证明,药物2 h内经皮吸收进入血液循环,逐渐达到200 pg/ml的峰值,并维持该血浓水平直到膜剂撕除。     

止痛微乳凝胶膏的制备及体外评价

目的探讨微乳技术对凝胶膏中药物释放及透皮性能的影响。方法以初黏力、180°剥离强度和综合感官评分为指标,结合单因素实验与星点设计-效应面法优选止痛微乳凝胶膏处方。采用改良Franz扩散池法,以有效成分阿魏酸和欧前胡素为指标,对比微乳凝胶膏和普通凝胶膏体外释放和经皮渗透性能。结果最终优选出基质配方为NP700,卡波姆-941,卡波姆-934,铝化合物,酒石酸,丙三醇(1∶0.1∶0.25∶0.04∶0.04∶6)。2种凝胶膏中有效成分的体外释放均符合零级动力学方程,具有扩散和溶蚀的双重机制。微乳凝胶膏和普通凝胶膏中阿魏酸的透皮速率分别为1.92、0.97μg/(h·cm2),欧前胡素的透皮速率分别为0.28、0.09μg/(h·cm2)。与普通凝胶膏相比,微乳凝胶膏中有效成分的累积透过率成倍数增加。结论微乳技术能促进凝胶膏中药物的经皮渗透。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.