阿奇霉素-离子交换树脂复合物的制备及其掩味与调控释药作用

为掩盖阿奇霉素(azithromycin,AZI)苦味和个性化调控药物释放速度以减少胃肠道刺激,分别以羟丙基纤维素(hydroxypropyl cellulose,HPC)和尤特奇RS100修饰制备速释型AZI-Amberlite^TM IRP64/HPC和缓释型AZI-Amberlite^TM IRP69/RS100进而组合以实现控制释放。对AZI-离子交换树脂复合物的载药量、药物利用率进行测定,通过差示扫描量热分析和X射线衍射对AZI-离子交换树脂复合物进行结构表征,测定其润湿度、掩味效果、体外溶出和释放行为。结果显示,形成的AZI-离子交换树脂复合物改变了药物原有的结晶状态,2.5%HPC修饰的AZI-Amberlite^TM IRP64/HPC和0.5%RS100修饰的AZI-Amberlite^TM IRP69/RS100掩味效果良好,两者以对应AZI含量为13∶67的比例组合可以实现AZI在前10 min的快速释放和后期的6 h内平稳释药。结果表明,经表面修饰制得的AZI-离子交换树脂复合物及其...     

阿奇霉素明胶微球制备工艺研究

目的对阿奇霉素明胶微球的制备工艺和包封率、粒径等特性进行初步研究。方法以生物降解材料明胶为载体,采用乳化聚合法制备阿奇霉素明胶微球,并采用正交试验优化制备工艺。结果所制备的阿奇霉素明胶微球外观圆整,平均粒径为58.34μm,载药量为20.11%,包封率为59.55%。结论所制备的阿奇霉素明胶微球重现性良好,粒径范围窄,载药量较高,制备工艺可行。     

海藻酸钙掩味微囊的制备

目的:研究海藻酸钙掩味微囊制备工艺与掩味机理。方法:选择阿齐霉素、罗红霉素为模型药物,采用滴制法制备海藻酸钙载药微囊,以人体口腔中的苦味感觉为指标,评价海藻酸钙微囊的掩味效果;并通过差示扫描量热法(DSC)等技术初步探讨了海藻酸钙微囊的掩味机理。结果:制备得到光滑、圆整的海藻酸钙微囊,载药量达90%以上,并具有显著掩味效果。结论:海藻酸钙掩味微囊对以阿齐霉素、罗红霉素为代表的大环内酯类抗生素的苦味具有良好的掩盖效果。     

离子交换型栓塞微球及其载平阳霉素的制备与性质研究

目的：研究离子交换型聚乙烯醇-丙烯酸微球（PVA-AA-Ms）的制备方法及其理化性质和载药性能。方法：采用反相悬浮聚合法制备PVA-AA-Ms,以光学显微镜观察微球的形态、测定粒径大小,以红外光谱法考察微球聚合物的结构,以化学滴定法测定离子交换官能团羧基的含量,以物性测定仪测量微球的抗压弹性。采用平阳霉素为模型药物,制备PVA-AA-Ms载药微球,以紫外分光光度法测定微球的载药量、包封率和体外累积释放百分数。结果：所制备的PVA-AA-Ms圆整,粒径范围为150～1 000 μm,平均粒径为500 μm。红外光谱确证了聚乙烯醇与丙烯酸的聚合交联,微球的羧基含量为8.905 mmol/g,微球具有较好的抗压弹性。微球载药量为30 g/L,包封率为99.4%,药物在磷酸盐缓冲液（PBS）中缓慢释放,24 h累积释放率为88.3%,药物累积释放50%的时间（t₅₀）为2.19 h。结论：PVA-AA-Ms的理化性质达到了栓塞治疗的要求,并且由于其羧基含量较高,具有交换载入阳离子药物（如含氨基的药物）的能力,可望为栓塞化疗提供一种新型的药物输送系统。     

阿奇霉素聚乳酸微球的制备及其体外释药特性的研究

以聚乳酸为载体材料制备阿奇霉素微球(AZM MS)并考察其体外释药特性。方法：采用乳化-溶剂挥发法制备AZM MS,并对其形态、粒径、包封率、结构和质量、体外释药特性等进行研究。结果：微球外观形态为类球形实体,粒径分布较均匀,平均粒径dav=(20.8±0.5)?μm,三批载药微球的包封率为(68.3±1.28)%;体外释药符合Higuchi方程,差示扫描热分析证明微球的形成。结论：本实验筛选的最佳处方工艺可制备性质优良的阿奇霉素肺靶向聚乳酸微球。     

线性-树枝状共聚物载药微球的制备、表征及体外释放

以自制的生物可降解线性-树枝状两嵌段两亲共聚物材料为药物载体,采用透析法制备了雷帕霉素载药微球。通过扫描电子显微镜（SEM）、动态光散射仪（DLS）、紫外分光光度计对雷帕霉素载药微球的表面形貌、粒径分布、载药量及释放行为进行了研究。结果表明：载药微球的载药量和包封率分别可达到40%和90%以上,与哑铃型三嵌段两亲共聚物载药微球相当,但平均粒径大幅降低（粒径约300 nm）,同样具有显著的缓释作用。     

不同添加剂对BSA-PLGA缓释微球特性的影响

目的：探讨不同添加剂对聚乳酸-聚乙二醇酸（PLGA）包裹牛血清白蛋白（BSA）制备的BSA-PLGA微球特性的影响。方法：采用复乳-溶剂挥发法制备BSA-PLGA微球,显微测量微球粒径,以微量BCA法测定微球的蛋白含量并计算包封率,进行体外释放,测定微球的累积释放量。探索添加剂PEG6000、Tween-20、Trehalose对微球粒径、包封率、突释量和累积释放量的影响。结果：加入添加剂制备的微球,粒径增大,突释降低,载药量、包封率、累积释放量均有所提高,且呈浓度依赖性（P〈0.05）。结论：通过加入适当种类和浓度的添加剂,可以得到较高包封率和累积释放量、较小突释、适当载药量和粒径的BSA-PLGA微球。     

幽门螺杆菌重组蛋白PLGA微球和PLGA-壳聚糖复合微球的制备及其释放性能研究

  目的  制备载有幽门螺杆菌重组蛋白（BIB蛋白）的聚乳酸-羟基乙酸共聚物（poly lactic-co-glycolic acid, PLGA）微球和PLGA-壳聚糖复合微球,优化微球制备参数,并分析两种微球在体外胃、肠液中的释放性能。  方法  采用双乳化-溶剂挥发法（W1/O/W2）制备BIB-PLGA微球和BIB-PLGA-壳聚糖复合微球;通过单因素分析方法,研究水相/油相（W1/O）比例、PLGA质量分数、聚乙烯醇（polyvinyl alcohol, PVA）浓度等对微球外观、粒径、分散指数（polydispersity index, PDI）、包封率和载药率的影响,确定最优参数,采用BCA法测定蛋白浓度,计算微球累计释放率。  结果  本研究的最佳参数条件为:W1/O为1∶2,PLGA质量分数5%,PVA质量分数0.2%。BIB-PLGA微球包封率（78.20±1.73）%,载药率（10.58±0.23）%,粒径（2.11±0.08） μm,PDI（0.35±0.18）;BIB-PLGA-壳聚糖复合微球包封率（78.87±1.30）%,载药率（15.50±0.25）%,粒径（2.28±0.52） μm,PDI（0.39±0.54）。BIB-PLGA微球和BIB-PLGA-壳聚糖复合微球在体外胃、肠液中均能缓慢释放,BIB-PLGA-壳聚糖复合微球的缓释效果更明显。  结论  采用双乳化-溶剂挥发法制备的BIB-PLGA微球和BIB-PLGA-壳聚糖复合微球载药率和包封率都较高,粒径可控,外观分散,对胃肠液有缓释作用。     

吉非替尼PLGA微球的制备与体外释放研究

目的：以吉非替尼为模型药物,乳酸-羟基乙酸共聚物（PLGA）为载体,研究制备吉非替尼PLGA缓释微球。方法：选择O/W乳化溶剂扩散法制备微球,在单因素考察的基础上,设计正交试验优化制备工艺;采用光学显微镜、扫描电镜等手段观察微球形貌;差式扫描量热法验证吉非替尼PLGA微球的形成;考察吉非替尼PLGA微球的体外释放行为。结果：差式扫描量热法结果表明,吉非替尼与PLGA分子间作用力发生变化,以分子形式均匀分散在载体中。吉非替尼PLGA微球呈白色球形颗粒,表面平整,平均粒径为（10.35±0.32）μm,包封率为（88.44±1.26）%,载药率为（10.00±0.23）%;体外释药符合零级释放方程Q=0.769t-1.800 9,r2=0.980 8。结论：吉非替尼PLGA微球制备工艺稳定,在体外缓慢释放药物达5 d以上,具有明显的缓释作用。     

曲普瑞林微球的制备及质量控制

目的 制备曲普瑞林微球并建立其质量控制标准.方法 以聚乳酸-羟基乙酸为载体,采用改良的W/O/W复乳-液中蒸发法制备曲普瑞林微球;以包封率为指标,优化微球的制备工艺,建立微球的质量标准.结果 优化后的曲普瑞林微球载药量大于6%,粒径小于100μm,28d累积释放度超过90%.结论 成功制备了曲普瑞林微球并建立了其质量控...     

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.