固体分散技术在中药给药系统中的研究和应用

本文以水飞蓟素滴丸和五仁醇固体分散体的研究为例，对固体分散技术在中药给药系统中的研究方法、技术优势及对中药给药系统发展的促进作用进行了综合分析与评价。并根据文献资料以及研究过程中的体会，分析概括了研究的难点及发展趋势。随着固体分散理论的进一步完善以及新型载体材料、新型制剂设备的不断出现，固体分散技术必将在中药给药系统现代化进程中发挥重要作用。     

本刊制剂与技术栏目介绍

介绍普通药物制剂的制备工艺、质量控制,新剂型的研究,药物传递系统和制剂新技术,包括控缓释与靶向制剂、经皮给药系统、植入剂与黏膜给药系统、生物药物制剂、中药现代化制剂、制剂新技术（脂质体、微乳与纳米乳、微球与球囊、纳米粒、固体分散和包合技术）,对新剂型和新技术的特点、作用机制、影响因素、质量评价等进行介绍。     

中药靶向给药系统的研究进展

中药靶向给药系统是指将中药或天然药物经提取分离得到有效部位或单体采用不同的载体制成的制剂,能直接定向浓集于靶器官、靶组织、靶细胞或细胞内。按载体分类综述了近年来的脂质体、微球、纳米粒、乳剂等几类中药靶向给药系统的研究进展。此外,由于中药对肠道疾病的特殊作用,口服结肠靶向给药系统也是中药靶向给药的一个重要部分。中药靶向给药系统的研究在我国还处于试探阶段,目前的研究大多数以天然有效成分为原料药物,而用中药有效部位及中药复方研制的靶向制剂屈指可数,这与制定中药有效部位及复方的质量标准及制剂工艺难度大有关,靶向给药系统是中药制剂今后发展的一个重要方向。     

新型给药系统及其在中药现代化中的应用

本论述了近年来国际上新型给药系统——缓控释给药系统、靶向给药系统、透皮给药系统、黏附给药系统、无针粉末喷射给药系统、自乳化药物传递系统等的特点及其在中药制剂中的应用，并扼要介绍了一些国际上应用前景良好的最新给药系统——药物涂层支架、基因治疗载体系统、生物芯片、分子马达、纳米陷阱等，以期为中药剂型改革与中药现代化研究提供参考。     

几种纳米给药系统在改善中药ADME/Tox性质方面的应用

纳米制剂具有独特的微小体积和微观结构,与传统制剂相比,其显著优势在于能够在一定程度上改善药物体内过程。根据药物生物药剂学性质及各纳米给药系统在改善药物吸收、分布、代谢、排泄(ADME),减低药物毒性(Tox)等方面的特点和优势综合考察,进行选择性中药纳米给药剂型研发具有深远意义。重点以近年来国内外研究较为活跃的纳米脂质体、微乳、自微乳、固体脂质纳米粒为例,与中药成分体内过程研究相结合,从ADME/Tox角度,阐述各纳米给药系统在改善中药及其活性成分体内过程方面的应用,以期对中药纳米给药系统研究提供一定的理论指导。     

纳米乳在透皮给药系统中的应用概况

纳米乳（nanoemulsion,NE）是粒径10～100nm的乳滴分散在另一种液体中形成的胶体分散体系,其乳滴多为球形,呈透明或半透明。纳米乳曾称微乳（microemulsion,ME）,由油相、水相、表面活性剂及助表面活性剂组成的光学上各向同性、热力学及动力学稳定的体系。按结构可分为水包油（O／W）型、油包水（W／O）型和双连续型纳米乳。因纳米乳具有良好的局部给药和透皮特性,从20世纪90年代开始,纳米乳作为透皮给药系统的研究成为药剂学研究的热点。本文着重对纳米乳经皮给药系统的特性、影响纳米乳制剂透皮的主要因素、促进纳米乳经皮渗透的方法、纳米乳透皮给药系统的评价等方面进行综述。     

口服液体控释给药系统研究进展(综述)

口服液体控释给药系统是一种新型药物传递系统,因其存在物理不稳定性,所以能上市的品种较少。本文提出了解决物理稳定性的技术,如：选择具有水难溶性的药物：用药物饱和水溶液作为混悬介质;用非水溶液作为混悬介质;制成临用前重新配制的干混悬剂;优化混悬介质处方;采用定位（ｉｎｓｉｔｕ）凝胶机制;缓释乳剂;用离子交换树脂作为药物载体等。并着重介绍了口服药物脂液体控释系统的设计原理     

本刊制剂与技术栏目介绍

d介绍普通药物制剂的制备工艺、质量控制,新剂型的研究,药物传递系统和制剂新技术,包括控缓释与靶向制剂、经皮给药系统、植入剂与黏膜给药系统、生物药物制剂、中药现代化制剂、制剂新技术（脂质体、微乳与纳米乳、微球与球囊、纳米粒、固体分散和包合技术）,对新剂型和新技术的特点、作用机制、影响因素、质量评价等进行介绍。须附300字符以内的中英文摘要（采用结构式摘要：目的、方法、结果、结论）,     

用冻干工艺生产“口中即融片”

用冻干工艺生产“口中即融片”第一个用冻干工艺制成的“口中即融片”新产品在英国已问世。这是根据Ｓｃｈｅｒｅｒ给药系统开发的专利工艺制成的，放在嘴里能立即分散，其名叫Ｚｙｄｉｓ。生产工艺：先将药物在水基质中溶解或混悬，水基质随后按一定剂量进入预先制成的水...     

纳米技术的应用对中药研究的影响

笔者阐述了纳米技术的优越性以及纳米技术在中药领域中的运用,指出纳米控释给药系统是纳米技术在药学领域中应用最活跃的研究方向.运用纳米技术有利于研制开发出高效、速效、长效、安全、方便的中药新制剂.     

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.