可显影固体栓塞剂硫酸钡海藻酸钠微球的研制

目的:研制可显影固体栓塞剂硫酸钡海藻酸钠微球.方法:采用乳化-离子交联法制备微球,正交设计优化工艺,并考察微球的粒径、形态、分布、稳定性、悬浮性、包封率及X线显影性等理化特性.结果:微球平均粒径为(53.08±32.72) μm,分散良好,形态圆整;微球100℃水浴加热2 h、-4℃冰冻24 h、37℃振摇24 h、钴60(10 kGy)照射0.5 h各组的破损率分别为(2.0±1.1)%、(86.0±19.2)%、(39.0±14.7)%和(10.3±3.2)%;0.25%海藻酸钠微球混悬液的沉降体积比为(0.92±0.018);硫酸钡投料量为2.0 g时包封率为(69.2±13.2)%,且显影效果佳.结论:海藻酸钠、壳聚糖可作为硫酸钡微球的包封材料,乳化-离子交联法适用于此微球的制备.     

不透X射线栓塞微球的制备及其性质评价

目的：研究包载碘油的海藻酸钙微球（lipiodol-containing calcium alginate microspheres,LAMs）的制备方法、理化性质、栓塞性能和不透X射线的效果。方法：采用滴制法制备LAMs。通过正交实验考察乳剂处方中碘油与水相的比例、滴制操作中气流大小、砝码重量这3个因素对微球的数均粒径、粒径多分散性及碘油包封率的影响。以光学显微镜观察微球的形态,以物性测定仪考察微球的弹性,以视频旋转滴张力仪考察微球在导管内的推注性能,以X射线摄影系统考察微球在大鼠血管内的显影效果。结果：制备微球的最佳条件是碘油与水相的比例为3∶10,气流速度为40 g/mL,所用砝码质量为100 g。按正交实验优化工艺制备的微球,平均数均粒径为(493.9±42.6) μm,多分散性系数为1.02,碘油包封率为(88.97±1.09)%,微球圆整、表面光滑,微球变形60%时可承受的最大力平均值为(1.09±0.18)N,导管内推注性能良好。微球注入大鼠血管后,在X射线下显影效果清晰。结论：研制出的不透X射线微球外观圆整、粒径在栓塞所需范围内、弹性良好、导管内易推注、动物体内显影清晰,为介入栓塞治疗提供了一种新型的栓塞剂。     

二甲双胍缓释明胶微球的制备及其性质考察

制备二甲双胍缓释明胶微球并对其进行包衣,同时对其相关性质进行考察.以天然可生物降解的明胶为载体材料,液体石蜡为油相,司盘-80为乳化剂,用乳化-交联法制备二甲双胍明胶微球并考察了微球形态、粒径大小和分布、载药量和包封率等性质.此工艺制得的明胶微球粒径分布良好,包衣微球达到了缓释口服微球制剂学的要求.制备工艺简便、重现性好.     

可显影碘化油-氟尿嘧啶聚乳酸微球的研制

目的制备用于肝动脉栓塞的可显影碘化油-氟尿嘧啶(iodized oil-5-fluorouracil,iodized oil-5-Fu)聚乳酸(polylactide acid,PLA)微球。方法选择具有良好生物相容性及生物可降解性的聚乳酸为载体,加入阳性造影剂碘化油,采用复乳法制备可显影碘化油-氟尿嘧啶聚乳酸微球。以外观、粒径、载药量、包封率为考察指标,采用正交设计确定可显影碘化油-氟尿嘧啶聚乳酸微球的制备工艺。结果显微镜下微球球形圆整,粒径分布均匀,扫描电镜下微球表面有孔,平均粒径约100μm;载药量(10.78%±0.14%),包封率(63.34%±0.545%),微球显影效果好。结论以可生物降解的PLA材料可制备显影效果好的氟尿嘧啶微球,并且微球具有一定的缓释作用。     

正交法筛选莪术油微球制备工艺

目的通过正交设计法筛选出制备符合肝动脉栓塞要求的莪术油明胶微球的最佳工艺。方法以微球粒径、分布、栽药量、包封率等为指标,采用正交设计法优化微球的制备工艺。结果按优化工艺参数制备的微球外观形态良好,粒径符舍肝动脉栓塞的要求,平均载药量为9．45％,包封率为32．34％,平均收率为85,19％,重现性良好。结论确立的莪术油微球的制备工艺切实可行。      

正交设计优化吗啡明胶微球的制备工艺

目的通过正交设计筛选出吗啡明胶微球的最佳制备工艺。方法以微球粒径分布、载药量、包封率等为指标,采用正交设计法优化微球的制备工艺。结果微球形态良好,粒径符合要求,平均载药量为20．94％,包封率为86．27％,重现性良好。结论采用正交实验完成了吗啡明胶微球的制备工艺优化。     

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。     

白及微球的研制及其肝动脉栓塞实验研究

用乳化－冷凝技术首次制备出白及微球,并通过正交实验,确定了制备特定粒径微球的最佳工艺条件。对微球的外观、粒径与分布、溶胀度及血液相容性等进行了研究。微球平均粒径为５４．３６μｍ,粒径范围５０～９０μｍ,占总数的７８．３７％;微球在ｐＨ＝７．４的缓冲液中有一定的溶胀性;血液相溶性良好。实验小猪微球栓塞后的肝动脉造影表明白及微球可致肝右动脉一级、二级分支完全栓塞;病理检查表明梗死区可见肝组织呈肝硬化改变,大量的假小叶形成。微球栓塞后,ＧＰＴ有一过性升高,３周后恢复正常。实验结果表明,以白及胶为材料制备的微球将为癌症的治疗提供一种新型的栓塞治疗剂     

新型可显影复合栓塞微球的制备与评价

【立论依据】 我国肝癌发病率高,确诊时多为晚期,而且伴有严重的肝硬化,手术切除率低,迫切需要非手术治疗方法。化疗药物的疗效与肿瘤所在部位药物的有效血浓度及药物与肿瘤接触的时间呈正相关关系。而原发性肿瘤的血液供应90%~95%来自肝动脉,这就为TACE(transcatheterarter arterial chemoembolization)治疗肝癌提供了解剖学基础。肝癌的局部化疗使肝癌组织内药物浓度高出常规给药的10~30倍,全身副作用明显减少,疗效增加。如能与栓塞结合,使肝癌组织缺血,则两者之间有协同作用。因此,TACE是对不能手术切除的肝癌最有效的治疗方法之一。鉴于TACE疗法在现今临床的治疗比重逐步提升,栓塞化疗开始在肝癌治疗中普及,我们认为研发一款成本较为低廉、更宜被人体耐受且能自带显影功能的栓塞微球,能够在肝癌介入治疗的广泛普及中起到重要的作用。 【设计思路】 利用水相油相互不相溶的原理,选取价格低廉的生物医学上常用的胶质明胶和卡拉胶,以油-水-油结构制备可显影复合栓塞微球,并通过原位家兔肝癌模型评价栓塞微球的疗效。 【实验内容】 (1)制备结构为油-水-油/水,对应功能为稳定隔水-塑型载药-显影的两种带有不同显影剂和不同复合水溶胶的三相栓塞微球;(2)体外测定栓塞微球的性能:包括载药率、溶胀率、显影强度、生物利用率以及体外释药曲线;(3)建立原位家兔肝癌模型;(4)进行栓塞微球TACE试验,观察家兔肿瘤变化及存活率,进行体内栓塞微球自然降解时间、释药曲线、家兔对微球排异反应强度等的测定,并根据动物试验情况对栓塞微球的制备条件进行微调整。 【材料】 明胶、卡拉胶、石蜡、乳化剂、交联剂、脱水剂、碘化物显影剂。 【可行性】 (1)前期实验基础:已成功研制出油-水-油相微球,并且进行了多次载药率、溶胀率的测定,并将微球直径筛分成0~200 μm、200~300 μm、300~450 μm、450~1 200 μm四组微球。(2)实验平台:纳米生物纳米材料江苏省重点实验室。 【创新性】 本研究制备的具有自主知识产权新型可显影复合栓塞微球,成本低廉、自备显影功能、为人体可降解材料,具有一定的临床应用前景。     

顺铂微球支气管动脉栓塞治疗肺癌伴大咯血4例

<正> 我院自1997年以来采用顺铂微球支气管动脉栓塞(BAE)治疗肺癌伴大咯血4例,近期疗效较满意,现报告如下。 1 材料与方法 1.1 栓塞剂:顺铂微球为选用非生物降解材料乙基纤维素为膜材,抗癌药物顺铂为囊心,硫酸钡为示踪剂制成抗癌药物微球栓塞剂,微球粒径200+50μ,顺铂含量为20％,包封率70％,硫酸钡含量为40％,微球为淡黄色规则球形,可缓慢释放顺铂,T 50为     

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.