N-取代苄基氢化氟哌啶醇氯化物的合成及其初步构效关系的研究

目的:合成一系列N-取代苄基氢化氟哌啶醇氯化物并做初步构效关系分析。方法:以hal为原料,将其氢化再分别与取代氯苄化合物回流下反应得到N-取代苄基氢化氟哌啶醇氯化物(FB8~11、FB13)。采用生物检定法研究目的化合物对KCl致猪冠状动脉收缩曲线的影响。结果:合成了5个新化合物(FB8~11、FB13),药理活性结果显示:多数目的化合物不同程度地表现为舒张血管活性。结论:N-取代苄基氢化氟哌啶醇氯化物分子中羰基还原并不影响化合物的扩冠活性。     

N-取代苄基氟哌啶醇氯化物的合成与生物活性

目的：合成N-取代苄基氟哌啶醇氯化物并研究其心血管活性。方法：在回流情况下使氟哌啶醇与取代氯苄化合物反应.得到N-取代苄基氟哌啶醇氯化物。采用生物检定法，以兔胸主动脉螺旋条为标本，研究其对KCl诱导的血管收缩的作用。结果：合成了6个N-取代苄基氟哌啶醇氯化物(F8-13)。多数化合物表现为不同程度的拮抗KCl所致兔胸主动脉螺旋条收缩血管活性，其中R11的血管收缩抑制活性最强。结论：F11扩张血管活性强于先导化合物，初步构效关系表明，N-取代苄基氟哌啶醇氯化物中苄基苯环上取代基的电性和取代位置可能是影响扩血管活性的重要因素。     

N-取代苄基氟哌啶醇氯化物及其还原物的合成与扩张血管活性

目的 合成N-取代苄基氟哌啶醇氯化物及其还原物并研究它们的扩张血管活性。方法 以氟哌啶醇为原料,通过与取代氯苄化合物在回流下反应得到N-取代苄基氟哌啶醇氯化物;用氢化硼钠将氟哌啶醇还原为氢化氟哌啶醇,再与取代氯苄化合物在回流下反应得到N-取代苄基氢化氟哌啶醇氯化物;以兔胸主动脉螺旋条生物测定法研究其抑制血管收缩的活性。结果 合成了6个N-取代苄基氟哌啶醇氯化物F8-13和5个N-取代苄基氢化氟哌啶醇氯化物FB8-11,FB13;初步生物活性实验结果表明,F8-13表现出不同程度的拮抗KCl所致兔胸主动脉螺旋条收缩血管活性,其中化合物F11的血管收缩抑制活性最强;但FB8-11,FB13的活性均较低。结论 化合物F11扩张血管活性强于先导化合物,初步构效关系表明,N-取代苄基氟哌啶醇氯化物中苄基苯环上取代基的电性和取代位置可能为影响扩血管活性的重要因素。     

氟哌啶醇季铵盐衍生物的合成及其扩冠活性的研究

目的：合成氟哌啶醇季铵盐衍生物并研究其对冠状动脉的作用。方法：以氟哌啶醇为原料，将其与卤代烃在回流的情况下进行反应而得到其季铵盐衍生物。采用猪冠脉条生物测定法和Langendorff灌流法研究这些衍生物对冠状动脉的作用。结果：合成了7个新化合物(1-7)，其中化合物7量效依赖地压低KCl所致的猪冠脉条收缩曲线，阻断较大剂量所致的冠脉条痉挛，并量效依赖地拮抗脑垂体后叶素所致的离体豚鼠心脏冠脉流量减少。结论：化合物7显示了良好的扩张冠状动脉的作用，值得进一步研究。     

氟哌啶醇季铵盐衍生物的合成及其对冠状动脉的作用

目的 :合成氟哌啶醇季铵盐衍生物并研究其对动物冠状动脉的作用。方法 :以氟哌啶醇为原料 ,将其与卤代烃在回流的情况下进行反应而得到其季铵盐衍生物。采用猪冠状动脉条生物测定法和Langendorff灌流法研究这些衍生物对冠状动脉的作用。结果 :合成了 7个新化合物 ( 1～ 7) ,其中化合物 7量效依赖地压低KCl所致的猪冠状动脉条收缩曲线 ,阻断较大剂量所致的冠状动脉条痉挛 ,并量效依赖地拮抗脑垂体后叶素所致的离体豚鼠心脏冠脉流量减少。结论 :化合物 7显示了良好的扩张冠状动脉的作用 ,值得进一步研究     

氟哌啶醇季铵盐衍生物的生物活性研究

目的:探讨氟哌啶醇季铵盐衍生物F8～F13的离体扩冠活性及对麻醉大鼠整体血流动力学的影响,并分析构效关系.方法:采用生物检定法,观察20 μmol/L目的化合物对KC1诱导的猪冠脉螺旋条收缩曲线的影响;麻醉正常血压SD大鼠,经右颈总动脉插管至左心室,右股动脉插管后,分别5 mg/kg静脉注射6个目的化合物,BL-420型生物机能实验系统记录观察血流动力学效应.结果:F11和F13均具强的降压作用:其中F13兼具良好的扩冠活性,同时在其降低血压的同时可能对SD大鼠具心功能抑制作用,而F11对大鼠心功能无影响.结论:苄基苯环上以对位或邻位甲基取代者更适合作为进一步研究与开发心血管药物的理想先导物.     

N-烷基氟哌啶醇季铵盐的合成及对细胞钙离子的影响

目的：合成N-烷基氟哌啶醇季铵盐衍生物并研究其对血管平滑肌细胞钙离子的作用。方法：以氟哌啶醇为原料,将其与碘代烷在回流的情况下进行反应而得到相应季铵盐衍生物。以激光扫描共聚焦显微镜技术测定活细胞内钙离子的动态变化。结果：合成了6个新化合物(Ⅰ—Ⅵ),其中化合物Ⅳ量效依赖地使KCl诱导的细胞内钙荧光强度出现持续性下降。结论：Ⅳ具有抑制KCl诱导的血管平滑肌细胞电压信赖性钙通道的开放作用,从而降低细胞内的钙离子浓度。     

吗啡、芬太尼及其拮抗剂纳络酮对猪离体冠状动脉作用

本实验采用猪离体冠状动脉螺旋条灌流实验,观察阿片类药物吗啡(Morphine)、芬太尼(Fentanyl)及纳络酮(Naloxone)对猪离体冠状动脉的作用。结果表明,吗啡、芬太尼对猪离体冠脉血管有收缩作用,呈剂量依赖关系,酚妥拉明(Phentolamine)和纳络酮对吗啡的收缩作用没有拮抗作用,而纳络酮本身可引起冠脉收缩。上述结果说明吗啡对猪离体冠脉收缩可能不是通过阿片受体起作用。氟哌啶醇(Haloperidol)能抑制吗啡的冠脉收缩作用,因多巴胺(Dopamine)对冠脉有扩张作用,故氟哌啶醇的拮抗作用不是通过多巴胺受体。     

苯环利定致大鼠心肌损伤的研究

作者观察了苯环利定（ＰＣＰ）注入大鼠静脉内可以造成急性心肌损害的心电图变化，即Ｔ波明显抬高；而侧脑室注入ＰＣＰ，在２ｈ内未见这种变化，提示ＰＯＰ致大鼠心肌损害主要通过外周作用。经典扩冠药硝酸甘油和对ＰＣＰ受体具有拮抗作用的氟哌啶醇均完全阻断ＰＣＰ所致的心电图改变，提示ＰＣＰ造成大鼠心肌损伤可能是由于冠脉收缩所致，氟哌啶醇对抗冠状动脉的收缩有一定的作用。     

二丙酰基莲心碱对猪冠状动脉条的影响

目的：观察二丙酰基莲心碱拮抗KCl、乙酰胆碱和组胺所致猪冠状动脉条收缩的作用.方法：体外平滑肌实验方法,观察二丙酰基莲心碱对KCl、乙酰胆碱和组胺所致猪冠状动脉条收缩曲线的影响以及在无Ca2＋克氏液中,对组胺引起猪冠状动脉条第一相收缩和Ca2＋引起第二相收缩的影响.结果：不同剂量二丙酰基莲心碱均可使KCl、乙酰胆碱和组胺所致冠脉条收缩量效曲线呈非竞争性拮抗作用,对冠脉条第一相和第二相收缩都有明显的抑制作用.结论：二丙酰基莲心碱具有扩张冠脉的作用,此作用与拮抗细胞内钙的释放和抑制外钙内流有关.     

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.