培氟沙星C-3(绕丹宁不饱和酮)酰胺的合成及抗肿瘤活性

为发现将抗菌药氟喹诺酮转化为抗肿瘤药的结构修饰新策略,用酰氨基和绕丹宁不饱和酮分别作为培氟沙星(1)C-3羧基的等排体和修饰基,设计合成了12个新的培氟沙星C-3(绕丹宁不饱和酮)酰胺类目标化合物(6a~6l),其结构经元素分析和光谱数据确证。体外抗增殖活性结果显示,目标化合物对Hep-3B、Capan-1和L1210 3种肿瘤细胞株的活性显著高于母体培氟沙星,含芳杂环或氟苯基化合物的活性与对照抗肿瘤药阿霉素相当。由此推测酰氨基绕丹宁不饱和酮杂合骨架替代C-3羧基有利于提高氟喹诺酮的抗肿瘤活性。     

3-(5-苄叉基噻唑并均三唑酮)氟喹诺酮类化合物的合成及其抗肿瘤活性

为发现氟喹诺酮抗菌活性向抗肿瘤活性转化的有效方法,用稠杂环噻唑并均三唑酮作为培氟沙星(1)C-3羧基的生物等排体,芳甲叉基为其修饰基团,设计合成了12个新的C-3噻唑并均三唑不饱和酮目标化合物(6a~6l),其结构经元素分析和光谱数据确证,评价了它们体外对SMMC-7721、Capan-1和HL60 3种肿瘤细胞株的抗增殖活性。初步药理筛选结果表明,目标化合物的活性显著高于母体化合物1的抗肿瘤活性,含氟苯基和邻甲氧苯基化合物的活性与对照抗肿瘤药阿霉素相当。因此,噻唑并均三唑不饱和酮骨架替代氟喹诺酮C-3羧基有利于提高其抗肿瘤活性。     

1-环丙基-6-氟-7-(芳甲叉肼基)-喹诺酮羧酸的合成及抗菌抗肿瘤活性

为发现具有抗菌抗肿瘤活性的氟喹诺酮羧酸先导化合物,用芳腙类作为环丙沙星C-7哌嗪基的等排体,设计合成了15个新的1-环丙基-6-氟-7-(芳甲叉肼基)-喹诺酮羧酸(4a~4o)目标化合物,其结构经元素分析和光谱数据确证。目标化合物体外对金黄色葡萄球菌(S.aureus)和大肠埃希菌(E.coli)的抗菌活性弱于对照药环丙沙星,然而对人肝癌(SMMC-7721)株、鼠白血病细胞(L1210)和人白血病细胞(HL60)3种肿瘤细胞株的抑制活性强于环丙沙星,尤其是腙基芳香环上带吸电子取代基的化合物,其抗肿瘤活性显著高于供电子基的活性,其抑制活性与对照药阿霉素相当。这表明C-7哌嗪基的存在有利于提高其抗菌活性而不利于提高抗肿瘤活性,而C-7芳腙基的引入可提高抗肿瘤活性,进一步扩展了氟喹诺酮类化合物结构修饰的范围。     

氟喹诺酮C-3羧基等排体的合成及抗肿瘤活性Ⅲ.均三唑噁二唑甲硫醚衍生物

为寻找由氟喹诺酮抗菌活性到抗肿瘤活性转化的有效途径,用均三唑和GFDA2二唑分别作为培氟沙星C-3羧基的等排体和修饰基,设计合成了10个未见文献报道的双杂环硫醚1-乙基-6-氟-7-(4-甲基哌嗪-1-基)-3-［5-(5-芳基-［1,3,4］GFDA2二唑-2-甲硫基)-4H-［1,2,4］-三唑-3-基］-喹啉(1H)-4-酮新化合物(7a~7j)。结果显示:对L1210、HL60和CHO 3种肿瘤细胞的体外抑制活性显著高于母体培氟沙星,表明C-3羧基不是抗肿瘤活性所必需的药效团,可被杂环等排体替换,进一步扩展了结构修饰的途径。     

C-3噻唑并均三唑取代的培氟沙星衍生物的合成及抗肿瘤活性(Ⅸ)

为寻找抗肿瘤氟喹诺酮类化合物的新方法,用稠杂环核作为培氟沙星(1)C-3羧基的生物电子等排体,设计合成了12个新的噻唑并［3,2-b］［1,2,4］三唑类目标化合物(6a~6l),其结构经元素分析和光谱数据确证。选择SMMC-7721、L1210和HL60 3种肿瘤细胞株进行体外抗增殖活性实验,结果表明目标化合物的抗肿瘤活性高于先导化合物1和相应的开环中间体硫醚酮(5a~5l),其中苯环上有羟基或氟原子取代的目标化合物对SMMC-7721肿瘤细胞显示出较强的活性。基于此,噻唑并均三唑稠杂环可作为氟喹诺酮C-3羧基的等排体用于抗肿瘤氟喹诺酮类化合物的设计。     

氟喹诺酮C-3均三唑席夫碱硫乙酸的合成及抗肿瘤活性(X)

为进一步发现培氟沙星C-3羧基等排体-均三唑的结构优化新方法,用硫乙酸和席夫碱侧链作为其修饰基团,设计合成了12个新的C-3均三唑硫乙酸席夫碱目标化合物(7a~7l),其结构经元素分析和光谱数据确证,评价了它们对SMMC-7721、L1210和HL60 3种肿瘤细胞株的体外抗增殖活性。初步药理筛选结果表明,目标化合物的抗肿瘤活性显著高于母体化合物1和前体胺6,尤其是苯环含氟原子和硝基的目标化合物(7j,7l)对SMMC-7721的IC₅₀已达到毫摩尔浓度。实验结果表明,氟喹诺酮C-3羧基的等排体均三唑杂环用席夫碱和硫乙酸这两种功能基侧链修饰有利于提高氟喹诺酮的抗肿瘤活性。     

氟喹诺酮C-3羧基等排体的合成及抗肿瘤活性V.环丙沙星酰腙的合成及构效关系

为发现转化抗菌氟喹诺酮到抗肿瘤氟喹诺酮的策略及其构-效关系,用酰腙作为环丙沙星C3羧基的生物电子等排体,合成了12个未见报道的环丙沙星酰腙(3a~3l)目标化合物。结果显示:体外对SMMC-7721、L1210和HL60 3种肿瘤细胞的抑制活性显著强于母体,但都低于对照药阿霉素,尤其对肝癌SMMC-7721细胞的活性与阿霉素相当。构效关系表明,取代链苯环带吸电子基团的活性强于供电子基团的活性,酰腙还原产物酰肼取代物的活性消失。结果说明酰腙可作为C-3羧基的等排体,酰腙亚胺双键是抗肿瘤活性所必需的药效团部位。     

氟喹诺酮C-3羧基等排体的合成及抗肿瘤活性:均三唑-噁二唑甲硫醚曼尼希碱衍生物

为寻找抗肿瘤氟喹诺酮C-3羧酸等排体的有效优化策略,基于C-3 均三唑-噁二唑甲硫醚(6a~6j)结构特征,在培氟沙星(1)羧基等排体均三唑环上发生氨甲基化反应得新的曼尼希碱目标化合物(7a~7j),其结构经元素分析和光谱数据确证。用MTT方法评价了硫醚及其曼尼希碱化合物体外对SMMC-7721、L1210和HL60 3种肿瘤细胞的生长抑制活性。结果表明,硫醚及其曼尼希碱对3种肿瘤细胞的生长抑制活性不但显著强于母体化合物1,而且曼尼希碱的活性也高于其相应硫醚的活性,尤其对肝癌SMMC-7721细胞的活性明显高于对白血病细胞L1210和HL60的活性,显示出了一定的抗肿瘤选择性。     

培氟沙星C-3羧基等排体的合成及抗肿瘤活性(Ⅷ).均三唑硫醚酮缩氨基硫脲衍生物

以均三唑杂环作为培氟沙星C-3羧基的等排体,功能侧链-硫醚酮缩氨基硫脲为其修饰基,设计合成了12个C-3均三唑硫醚酮缩氨基硫脲目标化合物(6a~6l),其结构经元素分析和光谱数据确证,评价了它们体外对SMMC-7721、L1210和HL60 3种肿瘤细胞株的抗增殖活性。初步药理学实验结果表明:目标化合物的抗肿瘤活性显著高于母体化合物1和相应中间体硫醚酮(5a~5l),尤其是苯环含羟基和氟原子的目标化合物IC₅₀已达到微摩尔水平,与阳性对照药阿霉素的效力相当。这提示被功能基侧链修饰的唑杂环替代C-3羧基有利于提高其抗肿瘤活性。     

氟喹诺酮C-3羧基等排体的合成及抗肿瘤活性VI.均三唑-酰腙甲硫醚衍生物

为寻找氟喹诺酮羧基等排体的优化方法,基于药效团拼合原理,用功能酰腙链作为培氟沙星C-3羧基等排体均三唑的修饰基团,设计合成了C-3均三唑酰腙硫醚衍生物17个(6a~6q),其结构经元素分析和光谱数据确证,并评价其对SMMC-7721、L1210和HL60 3种肿瘤细胞株的体外增殖抑制活性。初步研究表明,目标化合物的抗肿瘤活性显著高于母体化合物;同时,酰腙修饰基芳香环上带吸电子取代基的化合物其抗肿瘤活性显著高于供电子基的活性,尤其是苯环带羧酸基的化合物其活性与对照阿霉素相当,这提示等排体修饰基羧基的存在有利于提高抗肿瘤活性。     

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.