格列齐特胶囊人体生物等效性研究

目的 :采用高效液相色谱法测定格列齐特的血药浓度 ,进行两种格列齐特胶囊人体生物等效性比较研究。方法 :12位健康男性受试者采用自身交叉给药方案 ,分别单剂量口服 80mg试验品或对照品。结果 :试验品的主要药代动力学参数分别为AUC0～ 36=(10 0 .19± 10 .34) μg/ (ml·h) ,Cmax=(6 .5 9± 0 .5 9) μg/ml,Tpeak=(4 .33± 1.0 7)h ;对照品的参数分别为AUC0～ 36=(10 3 .41± 9.2 5 ) μg/ (ml·h) ,Cmax=(6 .75± 0 .6 0 ) μg/ml,Tpeak=(4 .5 8± 1.0 8)h ,两制剂的AUC0～ 36、Cmax及Tpeak均无显著性差异。试验品相对于对照品的生物利用度为 (96 .99± 6 .6 2 ) %。结论 :两制剂体内过程相仿 ,具有生物等效性     

大黄及牛黄解毒片大鼠给药后血浆中大黄活性成分的药代动力学比较研究

考察大黄及牛黄解毒片给药后大黄活性成分在大鼠体内药代动力学行为的差异。大鼠分别灌胃给予大黄生药材96 mg/kg(含总蒽醌1.83 mg/kg,相当于大黄酸0.28 mg/kg、大黄素0.30 mg/kg、大黄酚0.81 mg/kg、芦荟大黄素0.23 mg/kg及大黄素甲醚0.20 mg/kg)及牛黄解毒片250 mg/kg(含总蒽醌与大黄生药材等量,相当于大黄酸0.33 mg/kg、大黄素0.38 mg/kg、大黄酚0.71 mg/kg、芦荟大黄素0.24 mg/kg及大黄素甲醚0.17 mg/kg),血浆经甲醇沉淀后,采用LC-MS/MS法测定大黄活性成分血药浓度,WinNonlin 7.0软件计算药代动力学参数。大鼠灌胃大黄及牛黄解毒片后,大黄酸的c_max分别为(121±103)及(474±251)μg/L,AUC0-t分别为(275±176)及(406±194)μg·h/L;大黄酚异构体的c_max分别为(2 325±1 390)及(3 580±2 169)μg/L,AUC0-t分别为(8 170±2 661)及(8 856±4 023)μg·h/L;仅在牛黄解毒片给药大鼠血浆中检测出大黄素,且牛黄解毒片给药后大鼠血浆中大黄酸的c_max、AUC及t1/2,大黄酚异构体的Vd及CL与单味大黄相比显著增加,大黄酚异构体的t_max显著下降。实验结果表明,牛黄解毒片复方配伍增强了大黄活性成分在大鼠体内的吸收利用,改变了大黄活性成分的药代动力学行为。     

新生儿昼夜血浆尿液渗透压变化

目的 :探讨新生儿昼夜血浆尿液渗透压变化。方法 :72例新生 (男 4 2例 ,女 30例 ) ,根据日龄分为A、B、C3组 ,3组日龄分别为～ 3、～ 7、～ 2 8d。记录昼夜尿量 ,以FM 6型全自动冰点渗透压仪测量血浆、尿液渗透压。结果 :①A组昼夜尿量与B、C组比较 ,差异有显著性意义 (P <0 .0 5 )。②A、B、C三组昼夜血浆渗透压分别为 2 85±15、2 86± 13、2 84± 11、2 86± 14、2 84± 11、2 86± 14 (mOm·L-1) ;尿液渗透压分别为 2 0 3± 4 5、189± 4 3、186± 37、194± 5 1、2 17± 35、2 0 3± 4 3(mOsm·L-1) ;三组昼夜血浆、尿液渗透压比较差异无显著性意义 (P >0 .0 5 )。结论 :正常新生儿肾脏浓缩功能无昼夜差异。     

婴儿心脏直视手术中两种超滤法应用的对比研究

目的　比较常规超滤 (CUF)和CUF加改良超滤 (MUF)在婴儿心脏直视手术中应用及效果。方法　选取 4 0例单纯室间隔缺损 (VSD)行修补术的婴儿随机均分为两组 ,C组采用CUF ,M组采用CUF +MUF ,两组用相同的方法进行体外循环 (CPB)。观察 :⑴CPB预充总量、手术总用血量、CPB总入量、红细胞压积 (Hct)、超滤量、尿量、残血量等 ;⑵术前、术毕、术后 4h、术后 2 4h血浆白细胞介素 (IL) - 6 ,IL - 8、肿瘤坏死因子 (TNF -α)水平 ;⑶术后血管活性药物的应用、机械通气时间、ICU停留时间。结果　⑴两组预充总量、手术总用血量、CPB总入量、尿量无统计学差异 ,超滤量M组 (4 36± 82 )ml显著多于C组 (347± 5 7)ml,P <0 .0 5 ;残血量M组 (135± 2 3)ml少于C组(16 8± 32ml) ,P <0 .0 1;术毕HctM组 (0 .36± 0 .0 4 )高于C组 (0 .32± 0 .0 5 ) ,P <0 .0 5。⑵术毕TNF -αM组 (97.6± 18.4 )pg/ml显著高于C组 (83.1± 16 .5 )pg/ml,P <0 .0 5 ;余各时点、各指标 2组间均无统计学差别。⑶术后血管活性药物的使用、机械通气时间、ICU停留时间 2组间无显著差异 ,胸腔引流量M组 (96 .4± 2 8.7)ml少于C组(117.3± 32 .6 )ml,P <0 .0 5 ;术后输血量 (4 6 .4± 17.1)ml少于C组 (6 1.5± 2 5 .0 )ml,P <0 .0 5。结论　与CUF     

米非司酮配伍米索前列醇用于9～24周妊娠引产的效果与孕周的关系

目的　探讨米非司酮配伍米索前列醇用于 9～ 2 4周妊娠引产的效果。　方法　 16 8例 9～ 2 4周妊娠妇女 ,口服米非司酮 75 m g,每 12 h 1次 ,共 2次。末次服药后 1h,阴道后穹窿置米索前列醇 2 0 0μg,间隔 4h重复给药。按孕周分四组观察。　结果　引产成功率 (% )分别为 95 .12 ,10 0 ,96 .6 7,97.96 ,四组比较差异无显著性 (P>0 .0 5 )。产后出血量 (ml)分别为 6 8.2 1± 14.2 1,89.2 5± 2 6 .47,117.18± 18.73,12 6 .2 4± 2 5 .16 ,与孕周呈正相关 (P<0 .0 1)。引产时间(h)分别为 8.0 5± 2 .0 2 ,11.2 7± 4.2 9,15 .35± 1.17,2 1.2 3± 3.32 ,与孕周呈正相关 (P<0 .0 1)。米索前列醇用量 (μg)分别为 5 0 0 .14± 82 .13,490 .0 6± 10 4.2 5 ,5 74.82± 93.0 6 ,482 .5 1± 12 1.34 ,各组米索前列醇用量无显著差异且与孕周无相关 (P>0 .0 5 )。　结论　米非司酮配伍米索前列醇用于 9～ 2 4周妊娠引产有效而且安全。引产时间和出血量与孕周有关。     

自制灌注液在大鼠肝缺血再复流中的作用

目的 :研究自制灌注液在大鼠肝脏低温灌注再复流过程中对肝细胞和肝窦内皮细胞的影响。方法 :运用大鼠肝脏原位低温灌注再复流模型 ,行在体原位低温灌注 ,大鼠 10 2只。随机分成 4组 ,每组 2 4只 ,对照组 (C组 ) 2 4只仅行全肝血流阻断 2 0min ,余各组分别用 0℃乳酸林格氏液 (A组 )、0℃自制灌注液 (B组 )、0℃UW液(D组 )灌注 2 0min ,各组在恢复血流 0 ,30 ,12 0 ,72 0min分别处死 6只 ,取血液和肝脏检测。观察低温灌注及再复流后血清透明质酸 (HA)、TNF -α、ALT、AST和肝组织学变化。其余 6只SD大鼠 (S组 )作正常对照。结果 :C组再复流 30 ,12 0 ,72 0min血清HA浓度为 (12 6 .8± 2 0 .8)ng/ml、(2 5 0 .0± 2 4 .1)ng/ml、(2 90 .4± 37.0 )ng/ml,分别高于乳酸林格氏液灌注组 [(6 8.0± 11.6 )ng/ml、(14 2 .9± 30 .1)ng/ml、(2 0 0 .0± 17.5 )ng/ml]和自制灌注液灌注组 [(6 7.5± 6 .7)ng/ml,(6 3.3± 16 .2 )ng/ml,(6 2 .1± 14 .6 )ng/ml]及UW液组 [(6 6 .3± 8.8)ng/ml,(6 6 .6± 2 1.2 )ng/ml,(5 8.8± 11.0 )ng/ml],差异均有高度显著性意义 (P <0 .0 5 ) ;自制灌注液灌注组与UW液灌注组血清HA浓度在再复流 30 ,12 0 ,72 0min均无显著性差异 (P >0 .0 5 )。再复流 30、12 0min时C组血清TNF     

支气管哮喘患者血清总IgE和外周血嗜酸细胞检测的意义

目的 :探讨支气管哮喘患者血清总IgE及外周血嗜酸细胞的变化在哮喘发作中的作用。方法 :随机选取哮喘发作期患者 2 5例 ,健康体检 1 0人。采用免疫发光方法检测患者血清总IgE的水平 ,应用伊红染色方法检测外周血嗜酸细胞总数 ,并与正常对照比较。结果 :2 5例患者血清中总IgE的含量为 (1 94 8 6 3± 5 2 1 5 9)ng ml,非常显著地高于正常组 (2 6 7 1 6± 1 0 8 2 8)ng ml(P <0 0 0 1 ) ;患者外周血嗜酸细胞计数 (987± 2 2 6 )× 1 0 6 L ,亦显著地高于正常组 (1 2 3± 35 )× 1 0 6 L(P <0 0 0 1 ) ,哮喘患者血清总IgE与外周血嗜酸细胞计数呈正相关 ,r=0 72 5。结论 :支气管哮喘发作期患者血清总IgE和外周血嗜酸细胞计数均明显升高 ,参与支气管哮喘的病理过程     

五味降压散对自发性高血压大鼠降压、利尿作用实验探究

目的:实验探究五味降压散对自发性高血压大鼠(Spontaneously hypertensive rats,SHR)是否有利尿作用。方法:14周龄SHR大鼠随机分为模型组、氢氯噻嗪组(噻嗪组)和五味降压散组(五味组),每组10只。10只WKY大鼠作为正常对照组。五味降压散以3.2 g·kg-1的浓度灌胃给药,连续给药12周;给药期间动态观察4组大鼠的收缩压(SBP)、24 h尿量、24 h尿蛋白含量(TP)变化。每两周固定时间测定大鼠血压1次以观测药物降压效果;每两周做1次代谢笼收集各组大鼠24 h尿液,观察尿量并用双缩脲法做24 h尿蛋白定量(TP)测定。结果:五味组给药0~11周SHR尿量有增加趋势,给药12周时,尿量较模型组明显增加,差异有统计学意义(P0.05)。五味组在给药4周、6周时TP值明显高于正常组,差异有统计学意义(P0.05);12周时TP值明显低于模型组,差异有统计学差异(P0.05)。结论:五味降压散对自发性高血压大鼠具有一定的利尿作用。     

米索前列醇连续阴道给药用于中期妊娠引产的临床分析

【目的】探讨米索前列醇 (米索 )连续阴道给药用于中期妊娠引产的有效性和安全性。【方法】 10 0例孕周为 16～ 2 7w的妇女随机分为两组 ,米索组 5 0例 ,阴道后穹隆首次放置米索 4 0 0 μg ,观察宫缩情况 ,若无宫缩则每 3h重复置药 1次 4 0 0 μg ,直至出现规律宫缩 ;利凡诺尔组 5 0例 ,用羊膜腔内注射利凡诺尔 10 0mg引产作为对照。【结果】米索组和利凡诺尔组引产成功率分别为 96 %和 94 % (P >0 0 5 ) ;引产产程 :米索组为(2 0 2± 6 8)h ,利凡诺尔组为 (42 2± 9 1)h ,差异有显著性 (P <0 0 1) ;产后 2h内出血量 :米索组为(82 6± 32 5 )ml,利凡诺尔组为 (132 5± 6 2 3)ml,差异有显著性 (P <0 0 1) ;米索组副作用较多 ,但无严重的副作用出现 ,无须特殊处理。【结论】单用米索前列醇连续阴道给药用于中期妊娠引产 ,是一种安全有效 ,使用方便 ,低价的方法。     

板蓝根总生物碱中表告依春在发热大鼠体内的药动学-药效学结合模型研究

目的应用药动学与药效学结合模型,研究板蓝根总生物碱中主要成分表告依春在酵母致热大鼠体内的药动学和药效学之间的关系。方法给大鼠ig板蓝根总生物碱,不同时间取血并对体温进行观察,采用高效液相法测定血浆中表告依春的浓度,用一房室模型计算药动学参数,采用3种药动学与药效学拟合模型,分别对药效学参数进行拟合。结果表告依春在正常大鼠和发热大鼠体内的主要药动学参数t1/2、Cmax、AUC分别为:(4.94±0.84)h、(4.01±0.21)μg/mL、(28.37±2.42)μg.h/mL和(5.71±0.91)h、(4.15±0.25)μg/mL、(30.35±2.58)μg.h/mL。药理效应与效应室浓度之间的关系用间接反应中的药效产生抑制模型拟合较好,相应的药效学参数分别为Kin为(0.70±0.10)h-1,Kout为(0.54±0.12)h-1,R0为1.33±0.16,IC50为(0.94±0.66)mg/L。结论板蓝根总生物碱中表告依春在正常大鼠和发热大鼠体内的药动学行为无明显差异,表告依春在发热大鼠体内药动学与药效学间符合间接反应中的药效产生抑制模型。     

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.