高血压老人咳喘慎选止咳祛痰药

<正>联邦止咳露(复方磷酸可待因溶液):主要含磷酸可待因、盐酸麻黄碱、氯苯那敏(扑尔敏)、愈创木酚甘油醚(或氯化铵)等成分,能消除咳嗽和因伤风感冒所引起的多种症状。但高血压老人应慎用联邦止咳露,一因内含可待因较易"成瘾",二因麻黄碱能升高血压诱发危险。联邦止咳露各成分药理作用为:①磷酸可待因是阿片受体激动剂,作为中枢性止咳剂,能直接、强效抑制咳嗽反射。②盐酸麻黄     

联邦止咳露分析方法的研究

用反相离子对色谱法和薄层 紫外分光光度法测定联邦止咳露中主成分的含量。反相离子对色谱法条件为ＳｐｈｅｒｉｓｏｒｂＣ１８柱,１０μｍ,４６ｍｍ×２５０ｍｍ;流动相：甲醇 水 冰醋酸 ＩＰＲ Ｂ６（３０∶６６∶２∶２）。薄层色谱条件为硅胶ＧＦ２５４ ＣＭＣ板,流动相：甲醇 氯仿（４∶１）。分别用两种方法进行了回归方程、线性范围、回收率等测定。并测定了五个批号的样品中主成分磷酸可待因、盐酸麻黄碱、扑尔敏的含量。两法测定结果基本一致。前法准确快速、灵敏;后法不需精密的仪器设备。     

对复方磷酸可待因口服溶液含量测定的建议

复方磷酸可待因口服溶液是一种常见的止咳药，其质量标准收载于《国家药品标准新药转正标准第31册》，复方成份包括磷酸可待因、盐酸麻黄碱、马来酸氯苯那敏、氯化铵等。原质量标准中磷酸可待因、盐酸麻黄碱的含量测定是用HPLC法在一种色谱条件下测定，而马来酸氯苯那敏的含量测定又是在另一种色谱条件下测定，     

高效液相色谱法测定滴通鼻炎水中盐酸麻黄碱的含量

目的建立滴通鼻炎水中盐酸麻黄碱的含量测定方法。方法以Arch Bong色谱柱为分离柱,以乙腈-0.1%磷酸溶液(3∶97)为流动相,采用HPLC法测定。结果本品中盐酸麻黄碱酯含量测定线性范围为(2.10~21.0)μg/ml(r=0.9999),平均回收率为97.0%(RSD%为1.42%,n=5)。结论此法操作简单、结果准确,可用于滴通鼻炎水的质量控制。     

HPLC法同时测定复方磷酸可待因口服溶液中三组份的含量

目的建立HPLC同时测定复方磷酸可待因口服溶液中磷酸可待因、盐酸麻黄碱、马来酸氯苯那敏的含量。方法采用C18柱;以PH6．0磷酸盐缓冲液-甲醇（40：60）为流动相;检测波长：264nm;流速：1．0mL&#183;min^-1。结果样品中三种成份完全分离且线性关系良好,磷酸可待因、盐酸麻黄碱和马来酸氯苯那敏的回收率分别为：99．21％、98．66％、100．50％。结论该方法准确、灵敏度高、重现性好、结果准确。     

RP-HPLC法对千柏鼻炎片中盐酸麻黄碱含量的测定

建立千柏鼻炎片中盐酸麻黄碱含量的测定方法。方法采用反相高效液相色谱法(RP-HPLC法)测定千柏鼻炎片中盐酸麻黄碱的含量,SHIMADZU-ODS(150mm×4.6mm,5μm)色谱柱;甲醇∶水∶三乙胺∶磷酸(10∶90∶0.1∶0.1)为流动相;流速为1.0mL.min-1;柱温为室温;检测波长214nm。结果盐酸麻黄碱在0.010～0.100mg.mL-1内呈现良好的线性关系(r=0.999 9),平均回收率为99.66%,RSD=1.1%。结论 RP-HPLC法简便、稳定、准确、重复性好,可用于千柏鼻炎片的质量控制。     

HPLC法测定复方麻黄碱强滴鼻液中盐酸麻黄碱的含量

目的 建立复方麻黄碱强滴鼻液中盐酸麻黄碱含量的HPLC测定方法.方法 用Kromasil C18色谱柱(250×4.6mm,5μm),以乙腈-0.1%磷酸溶液(30:70)为流动相.流速为1.0ml.min-1,检测波长为273nm.结果 盐酸麻黄碱在92.7～278.1μg(r=0.9995)范围内呈线性关系,平均回收率为99.30%.RSD=0.3%(n=9).结论 本法适用于复方麻黄碱强滴鼻液中盐酸麻黄碱含量的含量测定.     

HPLC测定息喘丸中盐酸麻黄碱的含量

目的 建立用HPLC测定息喘丸中盐酸麻黄碱含量的方法.方法 色谱条件:ODS C18(200 mm×4.6 mm,5 μm)为色谱柱;乙腈-0.2%磷酸溶液(体积比10∶90)为流动相; 207 nm为检测波长.结果 盐酸麻黄碱的质量浓度在4.132～61.98 μg/mL范围内与峰面积呈良好线性关系,r=0.999 9,平均回收率为99.97%,RSD为0.5%(n=6).结论 该方法简便,结果准确、重现性好,可作为该制剂的质量控制方法.     

改进BP网络在联邦镇咳露复方制剂分析中的应用

利用改进ＢＰ网络同时测定了镇咳新药联邦镇咳露中的三组分含量,考察了网络拓扑模型对于分析结果的影响,通过选择合适的网络参数,同时测定模拟样品中的三组分,其中磷酸可待因、扑尔敏和盐酸麻黄碱的平均回收率分别为１００．０３％,１００．１０％和１００．０７％,相对标准偏差分别为０．５４％,０．６５％,０．５１％;与非线性偏最小二乘法结果相比,本文结果更为满意。     

高效液相色谱法测定桂灵丸中盐酸麻黄碱的含量

目的 采用高效液相色谱法测定桂灵丸中盐酸麻黄碱的含量.方法 采用HP1C法,Apo11o-C18(250mm×4.6mm,5μm)色谱柱,流动相为0.1%磷酸溶液-乙腈(94∶6),流速为1.0m1·min-1,紫外检测波长为207nm,柱温为室温.结果 盐酸麻黄碱在2.00～49.95μg·m1-1线性关系良好,r=0.9997,平均回收率99.70%,RSD=0.53%.结论 本方法准确、简便、快速,可作为桂灵丸中盐酸麻黄碱的含量测定.     

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.     

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.     

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.