双氯芬酸钠肠溶片的血药浓度测定及人体药代动力学研究

目的 :研究双氯芬酸在正常志愿者的血药浓度及体内的药代动力学 ,为临床用药提供依据。方法 :16名健康男性志愿者 ,单剂量口服双氯芬酸钠肠溶片 10 0 mg,在不同时间点取静脉血 ,血药浓度采用高效液相色谱法 (HPL C)测定。由血药浓度数据获得各自的主要药动力学参数。结果 :志愿者单次服用 10 0 mg双氯芬酸钠肠溶片后的药代动力学参数 AUC0→∞ 、AU C0→ 8、Cmax、Tmax分别为 (5 .98± 1.4 7) mg.h/ L、(6 .15± 1.5 2 ) mg.h/ L、(2 .96± 0 .84 ) m g.h/ L、(2 .2 5± 0 .32 ) h。结论 :双氯芬酸钠肠溶片在我国正常志愿者的药代动力学参数与国外的相似。     

瑞格列奈在中国人体内药代动力学和药效动力学研究

目的:研究瑞格列奈的药代动力学和药效动力学.方法:20名男性健康志愿者单剂量口服4 mg 瑞格列奈片,高效液相色谱法测定血药浓度,生化和放免方法分别测定血糖和血清胰岛素浓度.结果:瑞格列奈体内过程符合一室开放模型,达峰时间tmax为(0.75±0.43) h,峰浓度cmax为(54.44±24.97) ng/ml, t1/2为(0.80±0.31) h,平均滞留时间(MRT)为(1.55±0.41) h, 清除率(Cl/F)为(61.43±20.10) L/h, AUC为 (73.34±29.95) h*ng/ml.给药后胰岛素浓度升高,血糖随之下降,胰岛素浓度于给药后0.75 h 达峰,为(126.24±95.93) mU/L,血糖值给药后1 h 最低,达(2.34±0.44) mmol/L.结论:瑞格列奈起效迅速,作用持续时间短,适用于餐时血糖调节,可用于治疗2型糖尿病.     

卡维地洛人体药代动力学及生物利用度研究

目的测定卡维地洛 (carvedilol)志愿受试者体内的药代动力学 ,并与国外标准品地拉特润 (dilatrend)对照 ,评价其相对生物利用度。方法 10名健康男性志愿受试者 ,年龄 (39± 9)岁 ,随机交叉服用卡维地洛或地拉特润 40mg ,HPLC法测定给药后不同时间的血药浓度 ,并进行药代动力学参数计算和模型拟合。结果 10名受试者 6名符合一房室模型 ,另 4名符合二房室模型。卡维地洛的药代动力学主要参数 :一房室者达峰时间Tmax(1 7± 0 4)h、最大血药浓度Cmax(75± 32 )mg/L、曲线下面积AUC (314± 12 2 )mg/L·h、半衰期t1/2 (1 7± 0 8)h、清除速率CL (141± 43)L/h ;二房室者各值相应为 (1 0± 0 4)h、(113± 89)mg/L、(337± 85 )mg/L·h、(7 9± 5 6 )h、(111± 2 3)L/h。与地拉特润相比 ,两种制剂的药代动力学参数无显著差异(P >0 0 5 )。卡维地洛的相对生物利用度为 (98 9± 11 6 ) %。结论卡维地洛的药代动力学及生物利用度与国外标准品地拉特润近似 ,两种制剂生物等效。     

口服左旋氧氟沙星在呼吸道感染患者中的药动学研究

目的 :口服左旋氧氟沙星在下呼吸道感染患者中的药代动力学研究。　 方法 :8例肺部感染的住院患者 ,单剂量口服左旋氧氟沙星片 30 0 mg后分别测定不同时间血和尿中左旋氧氟沙星浓度。用高效液相色谱法荧光检测。药时数据用 3p87计算机程序拟合求算药动学参数。　 结果 :单剂量口服 30 0 mg左旋氧氟沙星片后的主要参数为 :Cmax 3.32± 0 .4 1μg/ ml,t1/ 2 5.58± 1.86h,Tmax 2 .17± 0 .69h,AUC0 -∞ 2 3.34± 3.0 9μg/ ( ml· h)。 2 4 h尿中累积排出量 2 4 9.8± 2 4 .2 1mg,占给药剂量的 83.3%。　 结论 :左旋氧氟沙星在呼吸道感染患者中的药代动力学参数与氧氟沙星基本一致     

卡维地洛人体药代动力学及生物利用度研究

目的 测定卡维地洛（carvedilol)志愿受试体内的药代动力学,并与国外标准品地拉特润（dilatrend)对照,评价其相对生物利用度。方法 10名健康男性志愿受试,年龄（39±9)岁,随机交叉服用卡维地洛或地拉特润4mg,HPLC法测定约给药后不同时间的血药浓度,并进行药代动力学参数计算和模型拟合。结果 10名受试6名符合一房室模型,另4名符合二房室模型。卡维地洛的药代动力学主要参数;一房室达峰时间Tax(1.7±0.4)h、最大血药浓度Cmax(75±32)mg/L、曲线下面积AUC（314±122)mg/L.h、半衰期t1/2(1.7±0.8)h、清除速率CL（141±43)L/h;二详尽 室各值相应为1.0±0.4)h、（113±89)mg/L、（±85)mg/l.h、（7.9±5.6)h、（111±23)L/h。与地拉特润相比,两种制剂的药代动力学无显差异（P>0.05)。卡维地洛的相对生物利用度为（98.9±11.6)%。结论 卡维地洛的药代动力学及生物利用度与国外标准品地拉特润似,两种制剂生物等效。     

莫达芬尼酸在人体血浆中药动学研究

目的 :观察中国健康成年志愿者单次口服莫达芬尼片剂后 ,其代谢产物莫达芬尼酸血浆浓度 ,为Ⅱ期临床试验提供试验参数。方法 :9名受试者按拉丁方设计随机分组 ,分别依次单次口服 10 0mg、2 0 0mg、30 0mg 3个剂量的莫达芬尼片后 ,应用高效液相色谱法 (HPLC)测定各受试者血浆莫达芬尼酸浓度 ,采用 3P97软件计算药代动力学参数。结果 :10 0mg、2 0 0mg、30 0mg组莫达芬尼酸主要药代动力学参数分别为 :Cmax(1.78± 0 .79)mg·L 1、(3.17± 1.2 7)mg·L 1、(4 .13± 2 .32 )mg·L 1;Tmax1.8h、3.1h、2 .8h ;t1/2 β (2 .35± 1.97)h、(2 .4 5± 1.0 7)h、(1.95± 1.18)h ;AUC0 t(2 1.17± 16 .13)mg·h·L 1、(2 5 .74± 7.74 )mg·h·L 1、(4 1.38± 2 0 .72 )mg·h·L 1;CL (5 .79± 5 .19)L·h$C1、(7.80±3.4 2 )L·h$C 1、(7.95± 2 .97)L·h$C1;结论 :莫达芬尼酸药 时曲线符合二房室模型 ,高、中、低三个剂量的Cmax、AUC0 t随给药剂量加大而增加 ;t1/2 β、Tmax、CL与给药剂量无关     

左旋氧氟沙星在胆道手术患者的药代动力学研究

目的　研究左旋氧氟沙星 (Levofloxacin ,LVFX)在胆道手术患者的药代动力学。方法　 13名施行胆道手术并行T 管引流的患者口服LVFX 2 0 0mg ,q8h ,连服 5d ,用高效液相色谱法测定LVFX在血浆、胆汁、尿中的药物浓度。结果　胆道手术患者术前单次口服LVFX后 ,达峰时间为 (1 95± 1 10 )h ,峰浓度为 (1 5 8± 0 94)mg/L ,消除半衰期为 (3 91± 1 2 8)h ,曲线下面积为 (10 76±5 97)h·mg/L ,其体内药代动力学行为与健康人相比有明显不同 ;无论是单次给药还是多次给药 ,LVFX在胆汁中的浓度均大于血浆浓度 ,胆汁药物浓度均超过胆道常见病原菌的MIC。结论　外科手术影响LVFX的吸收 ,降低体内药物浓度 ;极高的胆汁药物浓度提示该药在治疗和预防胆道感染时具有良好应用前景     

奥美拉唑肠溶胶囊的生物等效性研究

目的:研究奥美拉唑肠溶胶囊在健康人体的药代动力学,并评价其与同剂量制剂间的生物等效性。方法:采用双交叉试验设计,18名健康志愿者口服奥美拉唑肠溶胶囊试验和参比制剂40 mg,服药后0~12 h内间隔取血,用HPLC法测定血药浓度。计算主要药代动力学参数,并以参比制剂计算奥美拉唑肠溶胶囊的相对生物利用度,判断其生物等效性。结果:奥美拉唑肠溶胶囊试验和参比制剂的体内药代动力学参数Cmax(0.632±0.383)mg/L和(0.626±0.415)mg/L、5Tmax(2.39±0.40)h和(2.33±0.42)h、T1/2(1.92±0.64)h和(2.01±0.73)h、Vd/F(81.21±46.68)L和(94.07±89.46)L、CL/F(32.99±20.92)L/h和(31.68±20.41)L/h、AUC0→12(2.03±1.99)mg/(h.L)-1和(1.89±1.62)mg/(h.L)-1;受试奥美拉唑肠溶胶囊的相对生物利用度F=(104.7±17.7)%。结论:2种制剂具有生物等效性。     

5-单硝基异山梨醇酯缓释胶囊的人体药代动力学研究

目的:研究5-单硝基异山梨醇酯(5-ISMN)缓释胶囊的人体药代动力学和相对生物利用度.方法:采用毛细管气相色谱法测定口服40 mg 5-ISMN国产和进口缓释胶囊在健康人体内的血药浓度,以考察达稳态过程和稳态药代动力学特征.结果:连续口服40 mg 5-ISMN缓释胶囊至第4天,体内血药浓度基本达稳态水平.国产和进口缓释胶囊的稳态药代动力学参数如下:tmax为(4.8±0.6)和(4.8±0.9) h, cmax为(802.46±94.45)和(807.09±109.16)μg/L, cmin为(127.83±23.76)和(121.85±22.00)μg/L,AUCss为(8 114.7±1 393.4)和(8 174.8±1 219.7)μgh/L,cav为(338.12±58.06)和 (340.62± 50.82)μg/L, 峰谷波动度(DF)为(2.04±0.39)和(2.03±0.33).口服40 mg国产5-ISMN缓释胶囊的相对生物利用度为(99.07±5.45)％.结果表明5-ISMN国产和进口缓释胶囊的主要稳态药代动力学参数均无显著性差异.结论:两种制剂具有生物等效性.     

布洛芬混悬液人体相对生物利用度和药物代谢动力学研究

目的 :对国产布洛芬混悬液 ( A)与布洛芬片剂 ( B)进行人体药物动力学和相对生物利用度比较。　 方法 :10名健康受试者 ,采用随机自身交叉对照方法分别单剂量口服 30 0 mg布洛芬A药和 B药。布洛芬的血药浓度用作者建立的反相 HPL C法测定。血清样品用甲醇沉淀蛋白后离心上清液直接进样测定。布洛芬药时数据用 3P87程序拟合求算药物动力学参数。用 NDST- 7统计程序处理。　 结果 :布洛芬 A药和 B药的主要药动学参数分别为 :Ka2 .50± 0 .79h-1和 0 .72±0 .18h-1;t1/ 2 2 .15± 0 .4 6h和 2 .0 4± 0 .32 h;Tmax 0 .98± 0 .2 3h和 2 .78± 0 .62 h;Cmax 2 7.32±3.2 8mg/ L 和 19.93± 3.39mg/ L;AUC118.78± 2 8.32 mg/ ( L· h)和 110 .96± 2 4 .96mg/ ( L·h)。　 结论 :布洛芬 A药和 B药比较相对生物利用度为 10 7.16± 8.12     

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.