磁共振高分辨率T2加权成像联合分段读出平面回波成像鉴别诊断肌层和非肌层浸润性膀胱癌的临床价值

目的 评估磁共振高分辨率T₂加权成像（HR-T₂WI）、分段读出平面回波成像（RS-EPI）和两者联合鉴别肌层与非肌层浸润性膀胱癌的临床价值。方法 前瞻性纳入2016年6月至2017年12月于我院经膀胱镜活组织检查证实为膀胱癌、最终行手术治疗并明确病理分期的9 5例患者,所有患者均行HR-T₂WI、RS-EPI检查。分别应用HR-T₂WI、RS-EPI及HR-T₂WI+RS-EPI图像明确膀胱癌是否浸润肌层,并采用Kappa检验将3种方法的诊断结果与病理结果进行比较。绘制受试者工作特征（ROC）曲线并计算曲线下面积（AUC）,评估3种诊断方法的灵敏度、特异度和准确度,采用DeLong检验对3种诊断方法的AUC进行两两比较。结果 HR-T₂WI、RS-EPI和HR-T₂WI+RS-EPI的诊断结果与病理结果的一致性均较好,Kappa值分别为0.770、0.787、0.936（P均<0.01）。3种方法鉴别肌层与非肌层浸润性膀胱癌的AUC、灵敏度、特异度和准确度分别为0.899、95.5%（42/44）、82.4%（42/51）和88.4%（84/95）,0.891、84.1%（37/44）、94.1%（48/51）和89.5%（85/95）,以及0.966、93.2%（41/44）、100.0%（51/51）和96.8%（92/95）。HR-T₂WI+RS-EPI鉴别诊断肌层与非肌层浸润性膀胱癌的AUC大于HR-T₂WI和RS-EPI（Z=-2.627 8、-2.720 5,P=0.008 6、0.006 5）。结论 HR-T₂WI联合RS-EPI可作为术前无创、准确鉴别诊断肌层和非肌层浸润性膀胱癌的方法。     

Box-Behnken效应面法优化多西他赛长循环脂质体处方

目的 优化多西他赛长循环脂质体（DLCL）处方。方法 采用薄膜蒸发法制备DLCL,分别以卵磷脂（PC）与多西他赛（DOC）质量比（X₁）、PC与胆固醇（Chol）质量比（X₂）、DSPE-PEG 2000与PC物质的量之比（X₃）为考察对象,包封率（Y₁）、载药量（Y₂）、综合指标OD值为评价指标,采用Box-Behnken效应面法筛选DLCL的最佳处方。结果 最优处方为X₁＝0.616 2,X₂＝1.0,X₃＝?1.0;DLCL的包封率为（94.71±1.75）%,载药量为（5.37±0.43）%,标准偏差均小于10%;平均粒径139.6 nm,分布均匀,体外释放试验结果表明其具有明显的缓释效果。结论 采用Box-Behnken效应面法优化DLCL处方是有效、可行的。     

HPLC法测定稳心颗粒中三七皂苷R1、人参皂苷Rg1、Rb1、Rd与党参炔苷的含量

[目的] 建立高效液相法（HPLC）同时测定稳心颗粒中三七皂苷R₁、人参皂苷Rg₁、Rb₁、Rd与党参炔苷的含量。[方法] 采用Agilent1260 DAD高效液相色谱仪,Amethyst C₁₈色谱柱（4.6 mm×250 mm,4μm）,乙腈-水为流动相,检测波长为210 nm,流速1 mL/min。[结果] 三七皂苷R₁对照品在8~247 mg/L线性关系良好,平均回收率为102.69%,RSD=2.74%（n=6）;人参皂苷Rg₁对照品在14~422 mg/L线性关系良好,平均回收率为98.72%,RSD=1.85%（n=6）;党参炔苷对照品在1.5~42 mg/L线性关系良好,平均回收率为97.69%,RSD=1.94%（n=6）;人参皂苷Rb₁对照品在2.65~847 mg/L线性关系良好,回收率为102.11%,RSD=1.96%（n=6）;人参皂苷Rd对照品在8~255 mg/L线性关系良好,平均回收率为99.66%,RSD=2.49%（n=6）。[结论] 本实验中三七皂苷R₁、人参皂苷Rg₁、Rb₁、Rd和党参炔苷的含量测定方法稳定可靠,可作为稳心颗粒中三七皂苷R₁、人参皂苷Rg₁、Rb₁、Rd与党参炔苷含量测定方法。     

血府逐瘀胶囊二次开发中原料药材质量控制的研究

目的：建立血府逐瘀胶囊原料药材红花中羟基红花黄色素A和芦丁,川芎中生物碱类成分川芎嗪和有机酸类物质阿魏酸的定量的测定方法,从而建立多成分的定量标准。方法：采用HPLC法,色谱条件（红花）：C₁₈色谱柱,以甲醇-0.4%磷酸水溶液为流动相进行梯度洗脱,体积流量 0.5 mL/min,柱温 40 ℃。色谱条件（川芎）：C₁₈色谱柱,以甲醇-1%冰醋酸水溶液（32︰68）为流动相,体积流量 1.0 mL/min,柱温30 ℃。结果： 平均回收率分别为羟基红花黄色素A 97.2%、RSD为2.3%（n＝6）;芦丁99.6%、RSD为3.2%（n＝6）;川芎嗪100.9%、RSD为2.2%（n＝6）阿魏酸98.6%、RSD为2.6%（n＝6）。结论：本方法简便、快速、准确,可作为血府逐瘀胶囊的原料药材的质量控制方法。     

姜黄素固体脂质纳米粒的制备及表征

目的：制备姜黄素（Cur）固体脂质纳米粒（SLN）。方法：用薄膜超声法制备Cur-SLN,以m_cur︰m_{单硬脂酸甘油酯}、m_{单硬脂酸甘油酯}︰m_卵磷脂、聚山梨酯-80质量浓度、超声时间为考察因素,以包封率为指标,用正交试验优选处方,并考察其粒径分布、Zeta电位。结果：当m_cur︰m_{单硬脂酸甘油酯}=1︰3、m_{单硬脂酸甘油酯}︰m_卵磷脂=1︰2.5、聚山梨酯-80质量浓度2.5%、超声时间12 min时,所制得的Cur-SLN平均粒径为（145.6±5）nm,Zeta电位为（－31.9±1.5）mV,包封率为（97.42±0.39）%,载药量为(7.92 ± 0.05)%。结论：采用薄膜-超声法制备Cur-SLN可行,为开发姜黄素新型给药系统提供试验依据。     

注射用苦参素纳米球与普通粉针剂在大鼠体内药动学比较

目的 比较注射用苦参素纳米球（KU-PLGA-NS）与注射用苦参素普通粉针剂（KUI）在大鼠体内的药动学特性。方法 建立HPLC法检测大鼠血浆中苦参素,采用ANOVA法选择房室模型,将所测得的血药浓度-时间数据,采用DAS程序进行分析,根据F值与AIC选择房室模型求算药动学参数。结果 等剂量KU-PLGA-NS和KUI的AUC_0-t分别为（785.57±170.92）、（342.43±54.49）mg·L^?1·min,C_max为（18.51±2.47）、（28.48±5.40）mg/L,t_1/2Ke为（91.69±1.94）、（11.51±2.47）min。结论 KU-PLGA-NS在大鼠体内的药动学特性与KUI比较AUC和C_max增加,t_1/2延长。     

阿魏酸在Caco-2 细胞模型的通透性及其在大鼠体内吸收特性研究

目的 研究阿魏酸在大鼠体内的绝对生物利用度（F_abs）及其吸收特点。方法 建立人源结肠腺癌细胞系Caco-2单层细胞模型,LC-MS/MS法分析阿魏酸由绒毛面（AP侧）到基底面（BL侧）和由BL侧到AP侧两个方向的转运过程;用大鼠原位肠肝血管灌流模型研究阿魏酸在肠道的吸收率;通过测定大鼠ig和iv阿魏酸后的血药浓度计算其F_abs。结果 阿魏酸的表观渗透系数（P_app）分别为P_{app AP→BL}：（10.24±1.58）×10^?6 cm/s,P_{app BL→AP}：（11.25±1.45）×10^?6 cm/s;在肠肝血管灌流模型中的吸收率为59.00%;在大鼠体内的F_abs为64.91%。结论 LC-MS/MS定量分析法灵敏、简单、专属性强;阿魏酸在Caco-2细胞具有良好的转运,在肠肝血管灌流模型中吸收速度快,主要吸收部位为小肠,阿魏酸ig给药后在大鼠体内达峰时间短,吸收、分布、消除较快。     

亚精胺对盐胁迫下紫苏种子萌发和幼苗生理特性的影响

目的 通过对紫苏种子萌发和幼苗生理特性的研究,寻找提高紫苏种子及幼苗在盐胁迫条件下的抗盐能力的方法。方法 测定不同浓度亚精胺（Spd）处理后的盐胁迫下紫苏种子的发芽势（G_v）、发芽率（G_r）和发芽指数（G_i）,并对紫苏幼苗叶片的相对含水量、丙二醛（MDA）和超氧化物歧化酶（SOD）、过氧化物酶（POD）和过氧化氢酶（CAT）的活性进行了测定。结果 盐胁迫下的紫苏种子萌发受到显著抑制,但是经过不同浓度的Spd处理后,萌发指标均有所升高,其中经过0.25 mmol/L Spd处理,各项指标均达到最大,G_v为59.7%,G_r为69.4%,G_i为12.8。Spd处理减缓了盐胁迫下紫苏叶片的相对含水量和总黄酮降低的趋势,并且降低了叶片MDA的量。Spd处理后SOD、POD和CAT 3种酶的活性均有所增加,但在Spd为0.25 mmol/L时达到最大值,分别为72.4 U/g、8.7 U/mg、8.8 U/mg。结论 0.25 mmol/L的Spd能够有效地减缓盐胁迫对紫苏种子及幼苗产生的伤害,提高了种子及幼苗的抗盐能力。     

丹酚酸B及其活性代谢产物在大鼠体内药动学研究

目的 建立了灵敏快速的同时测定大鼠血浆中丹酚酸B及其主要代谢产物丹参素的LC-MS/MS方法。方法 以氯霉素为内标,用醋酸乙酯萃取,色谱柱为Symmetry C₁₈柱,流动相为甲醇-乙腈-0.5%甲酸（55︰5︰40）,体积流量为0.4 mL/min。选用电喷雾电离（ESI）三重四极杆串联质谱仪,在负离子模式下以选择反应监测（SRM）方式进行检测,用于定量分析的离子反应分别为m/z 717→519（丹酚酸B）、m/z 197→135（丹参素）和m/z 321→152（氯霉素）。结果 在该测定条件下丹酚酸B、丹参素和内标物的保留时间分别为3.12、2.60、3.98 min。丹酚酸B的线性范围为10～5 000 ng/mL,r＞0.995;丹参素的线性范围为5～5 000 ng/mL,r＞0.995,丹酚酸B和丹参素定量限分别为10、5 ng/mL。批内、批间精密度（RSD）均小于12.6%。大鼠ig给予丹酚酸B后,迅速吸收并逐渐转化成丹参素,丹酚酸B和丹参素的C_max分别为（1.21±0.31）、（0.27±0.05）μg/mL,t_max分别为（0.50±0.00）、（0.56±0.18）h,t_1/2分别为（1.20±0.11）、（1.57±0.16）h,AUC_0～t分别为（1.31±0.30）、（0.39±0.05）μg·mL^?1·h。结论 本方法可用于大鼠ig丹酚酸B后的血浆中丹酚酸B及其代谢产物丹参素药动学研究。     

RP-HPLC法同时测定石榴皮提取物阴道泡腾片中安石榴苷和鞣花酸

目的 建立RP-HPLC法同时测定石榴皮提取物阴道泡腾片中安石榴苷和鞣花酸的方法。方法 色谱柱为Phenomenex Gemini C₁₈柱（250 mm×4.6 mm,5 μm）,流动相为甲醇-乙腈-0.2%三氟乙酸水溶液,梯度洗脱,体积流量为0.8 mL/min,检测波长280 nm。结果 安石榴苷在0.098～0.610 mg/mL（r＝0.999 1）、鞣花酸在0.011～0.060 mg/mL（r＝0.999 8）有良好的线性关系;平均回收率分别为102.0%、100.4%（n＝9）,RSD均小于1.5%。结论 本方法简便、准确、专属性强,为石榴皮提取物阴道泡腾片的质量控制建立了方法。     

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.     

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.