小剂量阿司匹林缓释微丸药代动力学及生物等效性研究

用荧光分光光度法测定了口服小剂量阿司匹林缓释微丸在人体内的血药浓度,10名健康志愿受试者体内药代动力学结果显示,缓释微丸的相对生物利用度为Ka=0.4869 h~(-1),K=0.1097 h~(-1),t_(1/2)=6.69 h,C_(mx)=4.47μg/ml,t_(max)=4.52 h。方差分析表明阿司匹林缓释微丸与普通片具有生物等效性。     

硝苯吡啶控释微丸研究

文章报道硝苯吡啶控释微丸的研制、体外溶出、家犬及人体内试验。其体外释药符合一级方程(k=0.23h~(-1)),更符合Higuch方程(k=37.05h~(-1/2);家犬体内血药浓度较国外缓释微丸更平稳;人体血浓     

诺氟沙星胃内滞留漂浮型缓释片的研究

研制了诺氟沙星胃内滞留漂浮型缓释片剂(N-HBS)。实验结果表明:本品的体外溶出符合一级动力学过程;人体胃内γ-闪烁照相显示N-HBS在胃内滞留时间为4～6h,较市售胶囊(0.5～1.0h)明显延长;血浓数据经NONLIN程序计算机处理,结果表明N-HBS体内过程可用单室模型和一级动力学吸收及消除描述。其药动学参数为:K_a=0.6609h~(-1),K=0.1715h~(-1),V_e=329.38L,T_(max)=2.9h,C_(max)=0.379μg/ml。     

盐酸雷尼替丁胃内滞留漂浮型缓释片的制备及药物动力学研究

本文研制了盐酸雷尼替丁胃内滞留漂浮型缓释片剂(RSRT)。本品的体外溶出符合一级动力学过程:RSRT在胃内滞留时间5-6h,明显比普通对照片(2h内)长;RSRT体内以单室模型描述较适宜,RSRT体内为一级释药。药动学参数为:Ka=0.2550h~(-1),K=0.2765h~(-1),Vd=84.38L,t_(max)=3.77h,C_(max)=627.7ng/ml。本品的体内外数据具有显著相关性。     

盐酸雷尼替丁胃内滞留漂浮型缓释片的制备及药物动力学研究

本文研制了盐酸雷尼替丁胃内滞留漂浮型缓释片剂(RSRT)。本品的体外溶出符合一级动力学过程:RSRT在胃内滞留时间5-6h,明显比普通对照片(2h内)长;RSRT体内以单室模型描述较适宜,RSRT体内为一级释药。药动学参数为:Ka=0.2550h~(-1),K=0.2765h~(-1),Vd=84.38L,t_(max)=3.77h,C_(max)=627.7ng/ml。本品的体内外数据具有显著相关性。     

乙酰水杨酸肠溶微丸的研制

采用薄膜包衣法制备乙酰水杨酸肠溶微丸,以转篮法(100 r/min,37 0.5℃)测定了体外溶出速率。实验结果表明:本制剂2 h在人工胃液中的释放量不超过15%,转入人工肠液后在40min内完全释放(Kr=2.975 h~(-1))。体内试验选择了六名健康受试者(平行法单剂量给药900 mg)服用乙酰水杨酸普通片及肠溶微丸,测定了二种制剂在体内的经时过程。药动学参数的求算表明:普通片:Ka=0.309 h~(-1),K=0.309 h~(-1),Cls=1.598 L/h,AUC=563.30 h·μg/ml;肠溶微丸:Ka=0.415h~(-1),K=0.134 h~(-1),Cls=1.235 L/h,AUC=728.66 h·μg/ml。     

炎痛喜康控释片在人体内的药动学研究

本文应用高效液相色谱法测定了8名健康受试者自身交叉服用炎痛喜康普通片与控释片(分别服用单剂量20mg)后的血药浓度。用非线性最小二乘模型嵌合的计算机程序对数据进行处理,表明该药在体内为一室模型,并求得各项参数如下:普通片,k_a=1.568h~(-1),k=0.0191h~(-1),V=7.9201,t_(max)=4.4h,C_(max)=2.502μg/ml,AUC=150.04h·μg/ml;控释片,ka=0.185h~(-1),k=0.0223h~(-1),V=7.3561,t_(max)=15.3h,C_(max)=2.048μg/ml,AUC=129.63h·μg/ml.     

硫酸依替米星的药代动力学及临床疗效观察

目的:了解硫酸依替米星的药代动力学及临床疗效。方法:采用微生物法测定10例肺部感染患者静脉滴注200mg硫酸依替米星血中药物浓度,并进行药代动力学研究。结果:该药在肺部感染患者体内最高血药浓度为14.74μg/ml,12h仍维持在0.29μg/ml。经PKBP-N_1药代动力学程序拟合符合二室开放动力学模型,其参数为T_(1/2)α=0.257h,T_(1/2)β=2.22h,Ve=34.32L,K_(21)=2.14h~(-1),K_(12)=0.48h~(-1),K_(10)=0.39h~(-1)。10例患者经一个疗程治疗后,临床有效率100.0％,细菌阴转率94.2％,清除率89.8％。不良反应发生率10.0％。结论:硫酸依替米星在不同年龄、不同疾病患者体内的吸收分布、代谢、排泄存在明显差异,治疗中应进行血药浓度的监测以防不良反应的发生。该药对呼吸道感染疗效较佳。     

美沙芬缓释微丸的药物动力学及生物利用度

健康志愿和杂种狗一次口服自制的美沙芬缓释微丸后观察其药物动力学和生物利用度，实验结果表明：美沙芬体内药物动力学特征符合０级吸收与一级消除的血管外一室模型，生物利用度有显提高（Ｐ＜０．０５），美沙芬缓释微丸在体内确有缓释作用，美沙芬缓释微丸在人和狗体内吸收百分主经呈显相关（Ｐ＜０．０１）；同时美沙芬缓释微丸的体内吸收百分率与体外溶出百分率亦呈显相关（Ｐ＜０．０１）。因此，美沙芬缓释微丸２次．     

苯扎贝特缓释微丸胶囊的研制及体内外评价

目的:研制苯扎贝特缓释微丸胶囊。方法:采用离心造粒技术制备苯扎贝特缓释微丸胶囊;以体外释药和犬的药代动力学参数进行评价。结果:微丸得率86.5%,载药量87.8%;体外释放曲线符合一级方程,相似因子f2为74.23;自制缓释微丸胶囊单剂量犬口服给药后的tmax(3.7±0.5)h,cmax(36.36±0.98)μg/mL,AUC0-∞(337.83±7.29)μg.h/mL;苯扎贝特缓释片(参比片)的tmax(4.1±0.4)h,cmax(39.66±0.94)μg/mL,AUC0-∞(327.27±8.97)μg.h/mL。结论:以进口的缓释片为参比片,自制的苯扎贝特缓释微丸胶囊具有良好的缓释作用;相对生物利用度为(103.3±2.8)%,两种制剂生物等效。     

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.