Herceptin介导的肿瘤靶向治疗用免疫磁性纳米微粒的制备

目的 制备人源性单抗Herceptin介导的靶向HER-2/neu癌基因的免疫磁性纳米微粒.方法 采用部分还原沉淀法制备四氧化三铁磁微粒子,并用硅烷偶联剂进行表面修饰,利用戊二醛作为交联剂,将单抗Herceptin与磁性纳米微粒进行交联构建免疫磁性纳米微粒.用扫描电镜(SEM)、X-射线粉晶衍射(XRD)、磁强计(VSM)、X射线能谱仪(EDS)等分析仪器对磁性纳米微粒的特性进行表征,并对免疫磁性纳米微粒的免疫活性进行测定.结果 磁性纳米微粒经表面硅烷修饰后平均粒径在20 nm左右,磁饱和强度为65 emu/g.磁性纳米微粒表面经氨基官能团化后,表面氨基密度为0.5μmol/mg,固载有组氨酸的磁性纳米微粒与人源性单抗Herceptin偶联后平均粒径在60 nm左右,且保持较好的Herceptin的免疫结合活性.结论 通过化学偶联方法将针对HER-2/neu癌基因的人源化单抗Heceptin固定在磁性纳米微粒的表面,可满足进一步的肿瘤靶向治疗的要求.     

医用葡聚糖磁性纳米微粒的制备及特性研究

目的制备磁响应性强、粒径小且分布均匀的磁性纳米微粒,为消化道恶性肿瘤的磁控靶向治疗提供一种新型载体。方法利用超声波的粉碎空化作用,采用化学共沉淀法合成葡聚糖磁性纳米微粒。通过扫描电镜和原子力显微镜观察微粒的形态和大小,激光光散射粒度分析仪检测微粒的粒径及分布,磁强计检测微粒的磁响应性。结果该法制备的葡聚糖磁性微粒多呈球形或椭圆形,有效粒径为(93.1±2.2)nm,半峰宽为(26.7±1.3)nm,显示其粒径为纳米级,且大小均一。在外加场强为104Oe、外部温度为18℃的条件下微粒的磁响应强度为(26.0±1.1)emu/g,撤除磁场时剩磁为零,提示微粒具有顺磁性。结论用该法制备的葡聚糖磁性微粒,具有有效粒径小、粒径分布窄以及磁响应性好的优点,可作为一种新型靶向磁性载体,进行恶性肿瘤的磁控靶向治疗。     

纳米As2O3磁性脂质体的制备及表征

目的:制备将药物治疗与热疗相结合的靶向抗癌药物新剂型-As2O3磁性脂质体。方法:用改良的湿化学法制备MnxZn(1鄄x)Fe2O4(锰锌铁氧体)纳米磁性粒子,运用透射电镜和PE热分析系统进行表征,在高频交变磁场下进行体外加热试验,MTT实验检测其细胞毒性;采用薄膜-超声法加高速搅拌制备纳米As2O3磁性脂质体,用透射电镜、图像分析系统和能谱仪对其进行表征,原子荧光光度计检验脂质体中As2O3的包封率。结果:MnxZn(1鄄x)Fe2O4纳米磁性粒子近似球形,粒径20～40nm,无细胞毒性,居里温度随锰锌比例的不同分布在97℃~140℃之间,其磁流体在高频交变磁场下可升温至35℃~47℃并保持恒定。以此磁性材料为载体制成的As2O3磁性脂质体的平均粒径为(182±125)nm,其中含有As2O3和MnxZn(1鄄x)Fe2O4的成份,药物包封率达到71.16%。结论:MnxZn(1鄄x)Fe2O4纳米粒子是制备医用磁性脂质体的良好载体,采用薄膜-超声法加高速搅拌可制备纳米级As2O3磁性脂质体。     

As2O3磁性纳米微球的制备及其联合磁流体热疗对宫颈癌治疗的体外实验研究

目的：研究As2O3磁性纳米微球的制备及其联合磁流体热疗（MFH）对宫颈癌Siha细胞株的治疗作用。方法：采用改良的乳化冷冻凝聚法制备As2O3磁性纳米微球，能谱仪、原子荧光光谱仪对其进行表征；高频交变磁场中进行体外升温实验。四甲基偶氮唑蓝（MTT）比色法检测As2O3磁性纳米微球联合MFH对宫颈癌Siha细胞株生长的影响，流式细胞仪（FCM）检测凋亡。结果：所制备As2O3磁性纳米微球近似球形，粒径约为120nm，含砷量为0．61％，在输出电流I=300A的高频交变磁场中具有升温能力，且能达到肿瘤治疗的有效温度（41℃～46℃）；As2O3磁性纳米微球联合MFH能抑制宫颈癌Siha细胞株的生长，促进其凋亡，且均较单纯As2O3液及单纯MFH明显。结论：As2O3磁性纳米微球可同时发挥As2O3的细胞毒性作用和磁感应加热的联合定向治疗作用，效果优于单一治疗，为临床治疗宫颈癌提供新的方法。     

磁共振单克隆抗体免疫靶向对比剂McAb-DMP的制备

目的 探讨磁共振单克隆抗体靶向对比剂McAb-DMP的制备方法。方法 以葡聚糖为载体，采用氧化法制备免疫靶向磁性微粒，结果 制备的磁性纳米微粒与单抗相比保持了较高的结合活性和免疫活性。结论 合成CEA单克隆抗体标记磁性微粒，保证了结合活性免疫活性，为活体动物实验奠定了基础。     

C225偶联磁性白蛋白纳米球的制备、表征及联合磁流体热疗体外靶向抗肺癌的研究

目的：制备抗表皮生长因子受体（epithelial growth factor receptor,EGFR）单抗西妥昔（C225）偶联的磁性白蛋白纳米球,对其表征并联合磁流体热疗观察其体外抑制肺癌细胞的效果。方法：化学共沉淀法制备Fe3O4磁性纳米粒,去溶剂化?交联法制备磁性白蛋白纳米球（magnetic albumin nanospheres,MANs）,然后用双功能交联剂N?琥珀酰亚胺?3?（2?吡啶二硫代）丙酸酯［N?succinimidyl?3?（2?pyridyldithio）propionate,SPDP］将C225偶联其上制备C225?MANs。纳米球的形态、平均粒径、zeta电位、抗体结合率、含铁量、细胞靶向性及磁热动力学均被表征。最后采用CCK?8及流式细胞（flow cytometry,FCM）分析检测C225?MANs介导的体外双靶向磁流体热治疗肺腺癌细胞GLC?82的效果。结果：透射电镜显示制备的C225?MANs为球形,Fe3O4纳米粒被封装其内,Fe含量约2.0 mg/mL;平均水合粒径约为140 nm,带负电;在输出电流20 A、输出频率200 kHz的交变磁场作用下,不同Fe含量的C225?MANs能在 60 min内升温到39.3 ℃~52.0 ℃,且加热30 min后温度能保持恒定。FCM荧光检测显示抗体结合率为79.74%。免疫荧光实验和细胞MRI成像证实C225?MANs能够靶向GLC?82细胞。CCK?8与FCM分析显示双靶向联合治疗组的细胞增殖率明显低于其他治疗组,而凋亡率明显高于其他治疗组（P < 0.05）。结论：C225?MANs对肺腺癌细胞GLC?82具有良好的靶向效应,且双靶向磁流体热疗联合分子靶向治疗在体外能有效抑制肺癌细胞。     

磁性阿克拉霉素纳米粒的研制和理化性质

目的制备纳米级磁性阿克拉霉素微粒,考察其理化性质和磁场响应性。方法运用化学沉淀法制备Fe3O4纳米颗粒,并与阿克拉霉素水溶液分散在正己烷油相体系。采用反相微乳液界面聚合的方法生成聚合物将水液滴包埋,由此制备内含磁性颗粒和阿克拉霉素的磁性纳米载药系统,并通过扫描电镜、透射电镜、动态光散射磁强计等考察磁性阿克拉霉素纳米粒的理化性质及体内外磁场响应性。结果磁性阿克拉霉素纳米粒平均粒径210m,阿克拉霉素载药率100％,包封率362％。制备过程中的各参数包括单体用量、体系油水相体积比例、有机溶剂的种类和乳化剂的用量等都会影响磁性阿克拉霉素纳米粒粒径和阿克拉霉素包封率。制备后4℃保存,3个月稳定性好。结论磁性阿克拉霉素纳米粒粒径小,载药率和包封率高,体外具有良好的磁场响应性。     

半乳糖白蛋白磁性阿霉素纳米粒的制备及性质评价

目的 制备具有半乳糖基和稳定磁性的半乳糖白蛋白磁性阿霉素纳米粒,并对半乳糖白蛋白磁性纳米粒的糖化比率、磁性及药物含量进行检测.方法 将乳糖和白蛋白用还原胺法合成半乳糖基人血白蛋白(galactosylated human serum albumin,Gal-HAS);采用滴定水解法制备直径在70mm左右Fe3O4磁性纳米粒.再将半乳糖白蛋白、Fe3O4磁性纳米粒及纯盐酸阿霉素按一定的比率混合,通过在精制棉子油中超声乳化、加热固化变性、乙醚洗涤等工艺制备出半乳糖白蛋白磁性阿霉素纳米粒;用苯酚-硫酸比色法测定半乳糖白蛋白的糖化比率;用乙醇提取法提取半乳糖白蛋白磁性阿霉素纳米粒中的阿霉素,并用液相色谱仪测定其含量.将纳米粒溶于生理盐水中,并在光学显微镜下观察在磁场的作用下,半乳糖基磁性纳米粒的运动情况,用激光粒度分析仪、原子力显微镜和透射电子显微镜观察纳米粒粒径的大小和内部结构.结果 半乳糖白蛋白磁性阿霉素纳米粒的糖化比率为32;Fe3O4纳米粒径在(70±30)nm左右,粒径均匀;阿霉素的含量为58.45μg/g,阿霉素的包含率为97.53%;半乳糖白蛋白磁性阿霉素纳米粒溶液在光学显微镜下观察,在磁场的作用下,纳米粒迅速向磁铁的方向移动并发生聚集,当磁铁与纳米粒的距离加大时,纳米粒运动速度减慢,并沿磁力线的方向成串珠状聚集.透射电子显微镜下观察Fe3O4颗粒均匀分布在半乳糖白蛋白磁性阿霉素纳米粒中.结论 半乳糖白蛋白磁性阿霉素纳米粒具有较高糖化比率、稳定的磁性、靶向性强、药物包含率高以及释药速率可控制等特点,为靶向药物治疗,提供了可靠的载药工具.     

磁性纳米介孔材料携载尿激酶的体外溶栓实验研究

目的 评价携载尿激酶的磁性纳米介孔材料在体外流体环境中的溶栓效果.方法 制备血栓,接入体外流体模型中,分为4组,分别注入生理盐水、尿激酶、磁性尿激酶和磁性尿激酶加外磁场.称量溶栓前后的血栓质量,计算溶栓率,并记录再通的液体量.结果 磁性尿激酶加外磁场组在靶位置可见明显的磁性尿激酶聚集.尿激酶组和磁性尿激酶组溶栓率相近,分别为(76.89±0.048)%和(75.42±0.094)%(P>0.05),磁性尿激酶加外磁场组溶解率达到(90.45±0.076)%,高于尿激酶组和磁性尿激酶组(P<0.05).尿激酶组和磁性尿激酶组收集到再通的液体量分别为(42.47±1.834)mL和(39.70±5.028)mL(P>0.05);磁性尿激酶加外磁场组收集到的液体量达到(60.29±3.216)mL,高于前两组(P<0.05).结论 磁性纳米介孔材料作为溶栓药物的载体可以增强尿激酶溶栓的靶向性,能在流体条件下提高血栓的溶解率,为在体研究静脉阻塞的靶向性溶栓治疗奠定基础.     

阿司匹林磁性壳聚糖微球的制备及其性能

目的 以阿司匹林为药物模型,制备阿司匹林磁性壳聚糖微球(AMCM),研究其体外释放度与体内靶向性.方法 利用壳聚糖为骨架材料,以Fe3O4作为磁性内核,戊二醛作为交联剂,固载阿司匹林,研制AMCM,采用动态透析法及分光光度法进行体外释药实验;设定纯种兔为一靶区,外加磁场,经兔耳缘静脉注射AMCM,观察AMCM在体内分布情况,并观察外加磁场强度对微球在靶区定位的影响.结果 制备的AMCM成球性能好,无粘连,粒径1～8 μm,载药率0.922(W/W),包封率82.4%,具有显著的缓释阿司匹林作用,经外加磁场下的AMCM有较好的靶向分布性且与磁场强度相平行.结论 自制的AMCM具有显著的体外缓释与体内靶向作用.     

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.