不同浓度氮酮对双氯灭痛凝胶剂的透皮扩散影响

目的：为双氯灭痛凝胶剂筛选一定浓度的氮酮（Azone)作为渗透促进剂。方法：本实验采用改良Franz扩散装置及离体鼠皮为屏障．以生理盐水为接受介质，研究了不同浓度的氯酮(0％，1％．2％．3％，5％Azone)对双氯灭痛凝胶剂透皮吸收的影响。结果：双氯灭痛凝胶剂12小时累积透皮释药百分率依次分别为38.42％、62.35％、72.80％、32．10％、55.36％。结论．筛选了含氯酮2％作为促进剂，制备了有良好的经皮吸收性能的凝胶剂。     

小剂量双氯灭痛,透明质酸混合凝胶减轻复发性阿弗它口疮疼 …

验证３％双氯灭痛、２．５％透明质酸混合凝胶能减复发性阿弗它口疮（ＲＡＵ）疼痛的假设。方法：采用随机双盲对照临床试验,对６０例未伴有系统性疾病的ＲＡＵ病人进行单一剂量研究,分为三个治疗组：３％双氯灭痛与２．５％透明质酸混合凝胶组,２．５％透明质酸凝胶组,３％利多卡因凝胶组。治疗前与治疗后１至８小时作视觉模拟拟评分法（ＶＡＳ）疼痛评分。结果：治疗后２至６小时区间３％双氯灭痛与２．５％透明质酸凝胶联合应     

不同浓度酒精湿化给氧对改善肺水肿所致缺氧的实验研究

为探讨肺水肿吸氧时，湿化瓶内酒精最佳浓度，作者将３２只家兔分为４组，以快速输液的方法，复制为肺水肿模型后，分别以２０％、５０％、７０％、９０％浓度酒精作为湿化剂进行吸氧（简称为酒精氧），结果显示：吸入２０％浓度酒精氧后，血ＰａＯ_２增幅为１４７．３０％（Ｐ＜０．００１），对支气管粘膜及肺泡壁损伤较轻；吸入５０％浓度酒精氧后，血ＰａＯ_２增幅为３９．４６％（Ｐ＜０．００１），上述部位损伤加重，小支气管腔粘膜有轻度出血；吸入７０％浓度酒精氧后，血ＰａＯ_２增幅为２１．９７％（Ｐ＜０．０５），有肺出血发生；吸入９０％浓度酒精氧后，血ＰａＯ_２增幅为９４．４６％（Ｐ＜０．０１），肺泡和小支气管内有大量红细胞聚集。本研究提示：２０％浓度酒精作为湿化剂效果最好。另外还提示：酒精消泡机理单纯以能降低肺泡内泡沫表面张力的解释是不够全面，还与形成泡沫物质本身性质有关。     

月桂氮Zhuo酮对氟脲嘧啶直流电导入的促进作用

为研究皮肤促渗剂月桂氮Ｚｈｕｏ酮（Ａｚｏｎｅ）对药物直流电导入的促进作用，我们采用大鼠腹部皮肤作模型，在双室扩散池中研究药物氟脲嘧啶（５－ＦＵ）两种解离状态下的直流电导入，并以被动扩展作对照。其结果，药物以解离型或非离型存在时，皮肤经月桂氮Ｚｈｕｏ酮预处理后直流电导入的伪稳态透皮速率比单用直流电导入的速率分别增大１．４和２．７倍，说明了月桂氮Ｚｈｕｏ酮预处理和直流电导入有协同作用。     

偶氮胂Ⅲ比色法测定血清（浆）钙

对偶氮肿Ⅲ（ＡｒｓｅｎａｚｏⅢ）比色法测定血清（浆）钙的方法学作了系统研究。结果表明：反应混合液的吸收光谱呈Ｍ型，两个吸收峰分别为６００ｎｍ和６５０～６６０ｎｍ，但以６６０ｎｍ为适。试剂中ＡｒｓｅｎａｚｏＩＩＩ的最适浓度为１５０μｎｏｌ／Ｌ，试剂空白Ａ（吸光度曾称光密度ＯＤ）受ｐＨ的影响，当ｐＨ为７．０　时Ａ值最低。本法批内（ｎ＝２０）和批间（ｎ＝４０）ＣＶ分别为２．８％～２．９６％、３．１５％～３．３７％，平均回收率为９９．３％，线性高达６．０ｍｍｏｌ／Ｌ，灵敏度为１ｍｍｏｌ／Ｌ＝０．１７Ａ。本法Ｙ与ＥＤＴＡ自动滴定法Ｘ比较：Ｙ＝１．００５９Ｘ－０．０１４１，ｒ＝０．９９８５、Ｐ＜０．００１、ｎ＝２０。Ｍｇ￣（２＋）、Ｃｕ￣（２＋）、Ｆｅ￣（２＋）、Ｚｎ￣（２＋），Ｈｂ、Ｂｉｌ均不干扰测定。     

血清腺苷脱氨酶同工酶琼脂糖凝胶电泳测定法

介绍了一种用琼脂糖凝胶电泳法分离血清腺苷脱氨酶（ＡＤＡ）同工酶。利用琼脂糖凝胶缓冲液与电泳液的不连续性，成功地分离出人血清中的两条同工酶带ＡＤＡ＿（１＋ｃｐ）、ＡＤＡ＿２。并对底物液中各成分的浓度进行了选择。酶促反应的最适ｐＨ为７．４，底物液中含腺苷为５．３４ｍｇ／ｍｌ、ＸＯＤ为０．２Ｕ／ｍｌ、ＰＮＰ为０．４Ｕ／ｍｌ时呈色最佳。方法的最小检出限ＡＤＡ（１＋ｃｐ）为２．３～４．６Ｕ／Ｌ，ＡＤＡ＿２为２．７～５．４Ｕ／Ｌ；批内ＣＶ３．２％、批间ＣＶ４．３％。２３份健康人血清ＡＤＡ同工酶谱带的百分率为ＡＤＡ＿（１＋ｃｐ）３０．９±３．１２％、ＡＤＡ＿２为６９．１±３．１２％。初步临床应用结果显示ＡＤＡ同工酶谱带百分率的变化对肝炎和急性淋巴细胞白血病有辅助诊断价值，对癌性和结核性胸腹水有鉴别诊断的价值。     

全自动凝血分析仪检测 ２ 种诱导剂诱导的血小板聚集 试验参考区间的建立

摘要：目的 基于全自动凝血分析仪血小板聚集试验通道，建立表观健康人群血小板最大聚集率（ＭＰＡＲ）的参考区间。方法 募集表观健康人 １３４ 例，采用 Ｓｙｓｍｅｘ ＣＮ３０００ 和 Ｓｙｓｍｅｘ ＣＳ５１００ 全自动凝血分析仪进行不同终浓度二磷酸腺苷（ＡＤＰ）和花 生四烯酸（ＡＡ）诱导的血小板聚集试验检测。根据美国临床和实验室标准协会（ＣＬＳＩ）ＥＰ２８ Ａ３ｃ 文件，按照非参数法计算 ＭＰＡＲ 的参考区间。结果 不同终浓度 ＡＤＰ 和 ＡＡ 诱导的 ＭＰＡＲ 重复性为 ２．０３％ ～ ４．９２％。不同终浓度 ＡＤＰ 和 ＡＡ 诱导的 ＭＰＡＲ 在不同性别和年龄组之间差异均无统计学意义（Ｐ 均＞０．０５）。２ 个检测系统各自 ＡＤＰ 终浓度 ２ 和 ５ μｍｏｌ ／ Ｌ 之间、ＣＳ 系列 ＡＡ 终浓度 ０．５ 和 １．０ ｍｍｏｌ ／ Ｌ 之间 ＭＰＡＲ 差异均有统计学意义（Ｐ 均＜０．０５）。除 ＡＡ 终浓度 １．０ ｍｍｏｌ ／ Ｌ（Ｚ ＝ －２．３１９，Ｐ ＝ ０．０２０），余不同终浓度诱导的 ＭＰＡＲ 在 ２ 个系统间差异均无统计学意义（Ｐ 均＞０．０５）。ＡＤＰ 终浓度 ２、５ 和 １０ μｍｏｌ ／ Ｌ 诱导的 ＭＰＡＲ 生物参考区间在 ＣＮ３０００ 分别为 ４５．４％ ～ ９５．７％、７２．０％ ～ ９４．３％和 ７６．３％ ～ ９５．１％，在 ＣＳ５１００ 分别为 ４５．３％ ～ ９３．７％、 ７３．１％ ～ ９９．１％和 ７５．９％ ～ ９７．６％；ＡＡ 终浓度 ０．５ 和 １．０ ｍｍｏｌ ／ Ｌ 诱导的 ＭＰＡＲ 参考区间在 ＣＮ３０００ 分别为 ７２．１％ ～ ９５．７％和 ８１．０％ ～ ９５．９％，在 ＣＳ５１００ 分别为 ７７．１％ ～ ９６．９％和 ８１．１％ ～ ９９．５％。结论 本研究初步建立了 ＣＮ３０００ 和 ＣＳ５１００ 不同终浓度 ＡＤＰ 和 ＡＡ 诱导的血小板聚集试验 ＭＰＡＲ 参考区间。     

新生儿心肺复苏时肾上腺浓度和剂量的临床研究

目的 探讨新生儿心血肺复苏（ＣＰＲ）时肾上腺素的最佳用药浓度及剂量。方法 ３８例新生儿ＣＰＲ病例，按静注肾上腺素的不同用药浓度和剂量归类为Ａ、Ｂ、Ｃ三组。Ａ组用１：１０００肾上腺素０．０１～０．０３ｍｇ／ｋｇ；Ｂ三组肾上腺素首剂有效率、短期存活期存活率和长期存活率的差异。结果 Ａ组和Ｂ组肾上腺首剂有效率均明显高于Ｃ组（ｘ１＾２＝４．９９，ｘ２＾２＝６．１４，Ｐ〈０．０５），而在Ａ、Ｂ两组间无统计学     

腹膜透析治疗急性肾功能衰竭的疗效和安全性观察

目的：探讨腹膜透析（腹透）治疗急性肾功能衰竭（ＡＲＦ），尤其是高分解型ＡＲＦ、伴多器官衰竭（ＭＯＦ）、低血压和活动性出血时的疗效和安全性。方法：６２例ＡＲＦ患者，年龄１６岁～７３岁，平均（５０±１８）岁；其中内科、外科和产科病因分别为４３例、１５例和４例。腹透液糖浓度为８３．３３ｍｍｏｌ／Ｌ～２３６．０９ｍｍｏｌ／Ｌ，每日交换８Ｌ～３０Ｌ。结果：９０％以上患者经腹透治疗能满意控制水、电解质和酸碱平衡，减轻氮质血症。腹透有关并发症发生率为３０．６％，主要为腹部切口渗漏和腹透液引流不畅，高渗性非酮症昏迷１例。存活率为７４．２％，其中８７．０％患者肾功能恢复正常，死亡原因主要为严重的原发病和并发症。老年、少尿或无尿型ＡＲＦ、高分解型ＡＲＦ、严重感染、ＭＯＦ、呼吸衰竭、肝功能衰竭、透析前尿素氮较高和透析较迟为与死亡有关的危险因素。早期透析者严重感染和ＭＯＦ发生率较低。结论：腹透治疗ＡＲＦ包括伴高分解、ＭＯＦ、腹部大手术后早期出血、活动性出血和低血压时有较好疗效，且严重并发症少，必要时结合内科保守治疗和其它透析方法。早期透析可预防严重感染和ＭＯＦ，降低病死率     

以羟丙基甲基纤维素为基质的塞来昔布凝胶中透皮促进剂配方研究

目的评价不同配方的的透皮促渗剂对塞来昔布凝胶剂皮肤渗透性的影响,为优化透皮促渗剂配方提供实验依据。方法以羟丙基甲基纤维素为基质,采用析因设计的方法选用四种不同配方的透皮促渗剂制备凝胶剂;用改良的Franz扩散池,以高效液相色谱法测定凝胶剂中塞来昔布在12 h内的累积渗透量(Q),并计算其稳态流量(J)和渗透系数(Kp)。结果四个实验组中塞来昔布在12 h内的Q值分别为26.51、13.87、14.92和27.51μg/cm~2,其中促渗剂以2%氮酮和0.5%薄荷醇配方时Q值最大,达27.51μg/cm~2;且塞来昔布的渗透过程符合Higuchi方程,J值及Kp也均高于其它三个实验组。结论以羟丙基甲基纤维素为凝胶基质时,氮酮与薄荷醇联用对塞来昔布透皮特性具有协同增效作用,在实验配方浓度内,两者最佳配方浓度分别为2%氮酮和0.5%薄荷醇。     

Effect of aggregates on albumin standardization.

In order to investigate the consequences of presence of aggregates in human albumin standards, pools of monomer, dimer and polymer albumin were prepared and quantitated by three total-protein methods (biuret, Folin-Lowry and spectrophotometry at 279 nm) and by four different albumin methods (dye-binding by bromcresol green, electroimmunoassay, radial immunodiffusion and automated immunoprecipitation). Biuret was chosen as the reference method and the monomer was used as the standard in all methods. Both the total-protein and albumin methods gave values for aggregated albumin different from the biuret values. The maximal bias occurred in radial immunodiffusion where quantitation of the dimer and polymer pools gave only 67% and 48% of the biuret values, respectively. In five commercial albumin preparations investigated, the content of di- and polymer varied from 3 to 34%. Uncritical use of albumin preparations in standardization may thus introduce bias in the measurements.     

2014~2020年陕西省人民医院耐碳青霉烯类肺炎克雷伯菌检出率与同期抗生素暴露及相关危险因素分析

目的　探究临床耐碳青霉烯类肺炎克雷伯菌（carbapenem-resistant klebsiella pneumoniae, CRKP）产生的相关危险因素,剖析引起耐药菌株增加的关键点,以期对抑制CRKP的产生提供重要信息。方法　选取2014~2020年陕西省人民医院CRKP检出率快速上升期患者病例资料,对比同期检出的碳青霉烯类敏感的肺炎克雷伯菌患者病例资料,分析产生CRKP的危险因素,并统计同期抗生素的消耗量以验证抗生素的使用与CRKP检出率的相关性。结果　2014~2020年CRKP检出率分别为9.47%,15.98%,14.5%,42.1%,48.5%,28.2%和20.6%。2016~2017年为快速上升期,抗生素的前期暴露（特别是碳青霉烯类抗生素和β-内酰胺酶抑制剂复合制剂的前期使用）、机械通气均为引起CRKP检出的危险因素（OR=4.0~11.9,均P<0.05）。碳青霉烯类抗生素和β-内酰胺酶抑制剂复合制剂的消耗量与CRKP的检出率具有显著相关性（r=0.273,0.452,均P=0.016）,且在CRKP检出率快速上升期,β-内酰胺酶抑制剂复合制剂的消耗量与CRKP检出率呈高度正相关（r=0.784,P=0.021）,在CRKP检出率下降期碳青霉烯类抗生素消耗量与CRKP检出率也呈正相关（r=0.215,P=0.035）。结论　碳青霉烯类抗生素及β-内酰胺酶抑制剂复合制剂的使用会使CRKP检出率上升。需要加强抗生素合理使用,降低CRKP检出率,遏制细菌耐药态势发展。     

Design of rolipram-loaded nanoparticles: comparison of two preparation methods.

The aim of the present work was to investigate the preparation of nanoparticles as a potential drug carrier and targeting system for the treatment of inflammatory bowel disease. Rolipram was chosen as the model drug to be incorporated within nanoparticles. Pressure homogenization-emulsification (PHE) with a microfluidizer or a modified spontaneous emulsification solvent diffusion method (SESD) were used in order to select the most appropriate preparation method. Poly(epsilon-caprolactone) has been used for all preparations. The drug loading has been optimized by varying the concentration of the drug and polymer in the organic phase, the surfactants (polyvinyl alcohol, sodium cholate) as well as the volume of the external aqueous phase. The rolipram encapsulation efficiency was high (>85%) with the PHE method in all cases, whereas with the SESD method encapsulation efficiencies were lower (<40%) when lower surfactant concentrations and reduced volume of aqueous phase were used. Release profiles were characterized by a substantial initial burst release with the PHE method (25-35%) as well as with the SESD method (70-90%). A more controlled release was obtained after 2 days of dissolution with the PHE method (70-90%), no further significant drug release was observed with the SESD method.     

A comparative clinical study focusing on the antimicrobial efficacies of chlorhexidine gluconate alcohol for patient skin preparations

Comparative efficacy study data showed that skin preparations formulated with more than 0.5% chlorhexidine gluconate (CHG) in alcohol produced significant reductions in microbial populations at the inguinal, abdominal, and antecubital sites at each sample time (P < .05) relative to baseline, and there were no significant differences statistically, including persistent effects within 24 hours (P > .05). It would be reasonable to expect that a 1% CHG-ethanol skin preparation (with >0.5% CHG in alcohol) could be chosen in Japan that would perform well and have promising potential for catheter preparation/maintenance preparation with consideration for recommendation of the Centers for Disease Control and Prevention's guideline issued in 2011.     

Decreased sialic acid and altered binding to lectins of purified alpha 2-macroglobulin from patients with cystic fibrosis.

Purified preparations of plasma alpha 2-macroglobulin from patients with cystic fibrosis are shown to have normal amounts of total hexose but as much as 40% decrease in their sialic acid content. The binding of these preparations to concanavalin A and wheat-germ agglutinin was markedly reduced as compared to normal values in controls. Intermediate values were found in obligate heterozygotes. These results suggest a possible alteration in the carbohydrate moiety of alpha 2-macroglobulin in cystic fibrosis, presumably due to a defective posttranslational process.     

Key safety issues of bowel preparations for colonoscopy and importance of adequate hydration

Although screening colonoscopy is effective for early detection of colorectal cancer, screening rates remain low. Multiple factors are thought to be responsible for the low rates of screening colonoscopy, but bowel preparation appears to be a key deterrent. Tolerability issues with bowel preparations may lead to poor patient compliance, inadequate colon cleansing, and reduced detection of colonic polyps. Successful colon cleansing requires careful selection of the appropriate bowel purgative regimen, as well as patient acceptance of and compliance with the chosen regimen. The two major classes of bowel preparations include polyethylene glycol solutions and sodium phosphate preparations. Patient preference for tablet versus liquid formulations and medical history (e.g., renal impairment) should be considered when choosing the appropriate bowel preparation. Regardless of the bowel preparation administered, adequate hydration is important before, during, and after bowel preparation. Appropriate patient education regarding hydration and individualized patient instructions may increase compliance, reduce adverse events, promote successful bowel preparation for colonoscopy, and enhance the probability of a quality exam.     

Evaluation by enzyme-linked immunosorbent assay of IgG anti-D and IgG subclass concentrations in immunoglobulin preparations

BACKGROUND: Anti-D immunoglobulin preparations are injected to prevent hemolytic disease of the newborn. The concentration of IgG anti-D in these preparations is usually determined by an automated hemagglutination technique using as a reference a calibrated preparation of anti-D, but the method requires special equipment and cannot be routinely applied to measure the IgG subclasses of anti-D in these preparations. STUDY DESIGN AND METHODS:Taking advantage of a recently described enzyme-linked immunosorbent assay (ELISA) for the determination of the anti-D concentration in sera of alloimmunized pregnant women, IgG anti-D and IgG subclass concentrations were measured in the international reference preparation (IRP) coded 68/419, 10 anti-D immunoglobulin preparations, and sera of 15 D-immunized volunteers. RESULTS: An IgG anti-D concentration of 61.5 +/- 4.8 microg per ampoule (mean +/- SD) was found by ELISA in IRP 68/419.This result was in agreement with previous determinations obtained by radioimmunoassay (60 microg/ampoule). The IgG subclass concentration of anti-D in this preparation was 48.4 microg of IgG1 (78.6%), 3.0 microg of IgG2 (4.8%), 9.7 microg of IgG3 (15.8%), and 0.4 microg of IgG4 (0.7%). The mean proportion of IgG subclasses of anti-D in 10 immunoglobulin preparations was similar (81.7% for IgG1, 5.0% for IgG2, 12.7% for IgG3, and 0.6% for IgG4). In the sera of 15 immunized volunteers, the IgG anti-D concentration varied from 3.1 to 68.4 microg per mL. The mean IgG subclass composition of anti-D was 79.3 percent for IgG1, 2.2 percent for IgG2, 18.1 percent for IgG3, and 0.4 percent for IgG4. The proportions of IgG3 anti-D in these sera were found to range between 1 percent and 87 percent, as in the sera of D-alloimmunized pregnant women. CONCLUSION: ELISA provides an alternative to the radioimmunoassay and the automated hemagglutination technique. In addition, it allows the evaluation of the absolute concentration of each IgG subclass of anti-D in immunoglobulin preparations and necessitates only the conventional equipment required for an immunoenzymatic assay.     

Skeletal Muscle Protein and Amino Acid Metabolism in Experimental Chronic Uremia in the Rat: ACCELERATED ALANINE AND GLUTAMINE FORMATION AND RELEASE

The kinetics and factors regulating alanine and glutamine formation and release were investigated in skeletal muscle preparations from control and experimentally uremic rats. These preparations maintained phosphocreatine and ATP levels in vitro which closely approximated levels found in vivo. Alanine and glutamine release from uremic muscle were increased 45.8 and 36.0%, respectively, but tissue levels were unaltered. The increased release of alanine by uremic muscle was not accounted for by decreased rates of medium alanine reutilization via oxidation to CO₂ or incorporation into muscle protein. The maximal capacity of added amino acids such as aspartate, cysteine, leucine, and valine to stimulate net alanine and glutamine formation was the same in uremic and control muscle. Epitrochlearis preparations were partially labeled in vivo with [guanido-¹⁴C]-arginine. On incubation, preparations from uremic animals showed a 54.6% increase in the rate of loss of ¹⁴C-label in acid precipitable protein. Correspondingly, these same uremic preparations showed a 62.7% increase in ¹⁴C-label appearance in the acid-soluble fraction of muscle and in the incubation media. Insulin decreased alanine and glutamine release to an extent threefold greater in uremic than in control preparations, and increased muscle glucose uptake approximately threefold in all preparations. Although basal rates of [4,5-³H]leucine incorporation into protein were decreased 25% in uremic muscles as compared with control muscles, insulin stimulated [³H]leucine incorporation nearly equally in both preparations.     

Cutaneous atrophy after corticosteroid injection

Soft tissue inflammatory disorders can be treated by regional administration of corticosteroid preparations. However, the local catabolic effects of these agents can result in cutaneous atrophy and pigmentary changes. Since all injectable steroid agents may produce these adverse effects, corticosteroids must be used judiciously. The physician must be familiar with the chosen steroid and its recommended dosage.     

Why do dyspeptic patients prefer one liquid antacid to another?

The motives of dyspeptic patients for preferring one treatment over another were examined. In a conventional double-blind study, no difference with respect to the effectiveness of two liquid antacid preparations in symptomatic relief of dyspeptic symptoms was found. In a double-blind randomized self-controlled crossover 'preference study', the two preparations were given in coloured bags. The patients were asked to switch from one type of bag to another until they had a preference. Most patients finally preferred bags displaying the colour which they had initially chosen. The reasons given for preferring one of the drugs were better effectiveness on symptoms, less side effects and better taste. Colour of the bags was not given as a reason. Thus, the patients may prefer drugs on the basis of the external appearance of the wrapping without being aware of the true reason for their choice.