预聚物分子量对立体复合聚乳酸固相缩聚产物结构和性质的影响

采用乳酸作为引发剂、辛酸亚锡作为催化剂,引发丙交酯开环聚合制得分子量不同的具备缩聚活性的预聚物L-聚乳酸（PLLA）和D-聚乳酸（PDLA）,将重均分子量（M_w）相近的预聚物熔融共混后制成前体进行固相缩聚。采用核磁共振（NMR）、凝胶渗透色谱（GPC）、差示扫描量热（DSC）及X射线衍射（XRD）分析了固相缩聚产物的链结构、分子量、热性能及晶体结构。结果表明,固相缩聚产物具有立体嵌段结构。预聚物的分子量大小将影响固相缩聚前体中均相晶体和立体复合晶体的相对含量,进而影响固相缩聚产物的结构。当预聚物PLLA和PDLA的M_w≈5×10⁴时,固相缩聚产物重均分子量的涨幅最大,最终达到1.83×10⁵。因此,采用M_w≈5×10⁴的预聚物进行固相缩聚有利于产物中立体复合晶体结晶度的提高。     

开环聚合-固相缩聚法制备立体嵌段聚乳酸

首先,采用乳酸为引发剂,辛酸亚锡为催化剂,引发丙交酯开环聚合制得具有缩聚活性的L-聚乳酸和D-聚乳酸;然后,将两者熔融共混后进行固相缩聚,合成了一系列立体嵌段聚乳酸。采用核磁共振（NMR）、凝胶渗透色谱（GPC）及差示扫描量热仪（DSC）分析了产物的链结构、重均分子量、热性能,并探讨了均相晶体和立体复合晶体共存情况下的固相缩聚机理。结果表明,固相缩聚产物分子量增长的适宜反应条件为：反应时间30 h,较低的催化剂含量,L-聚乳酸质量分数为80%。L-聚乳酸和D-聚乳酸共混物较低的初始立体复合晶体结晶度有利于后续固相缩聚过程中产物分子量的增长;固相缩聚不仅发生在异链之间,而且也发生在同链之间。     

线性-树枝状两亲聚合物及其胶束的制备和聚集行为

以聚乙二醇单甲醚（mPEG）为原料,制备大分子引发剂mPEG-G_n-OH_2ⁿ（n=1,2,3,4）,以异辛酸亚锡为催化剂,引发L-丙交酯开环聚合,通过控制丙交酯和大分子引发剂的投料比,合成1~4代线性-树枝状两亲聚合物。基于聚合物自组装特性,通过透析法制备聚合物胶束,采用核磁氢谱、渗透凝胶色谱对聚合物结构进行表征,使用动态激光光散射技术、电子扫描显微镜和透射电镜对其聚集体进行观测。研究表明,胶束流体力学直径主要受代数影响,并随PEG链段增加而增大,胶束粒径为200~300 nm。胶束形状反映聚合物分子中亲水、亲油比,当聚合物分子中亲水链段EO体积分数φ_EO<0.35时,线性-树枝状两亲聚合物才能形成空心胶束。     

基于瞬时纳米沉淀法制备尺寸可控载药纳米粒子

合成了5种具有不同分子量、不同亲疏水链段比例的两亲性嵌段共聚物——甲氧基聚乙二醇-b-聚己内酯（mPEG-b-PCL）,并以其为表面活性剂,采用瞬时纳米沉淀（Flash Nano Precipitation,FNP）法制备出一系列包裹模型药物β-胡萝卜素的纳米粒子。通过改变两亲性共聚物的结构、分子量、浓度及溶剂体积比（V（H₂O）：V（THF））,成功实现了对纳米粒子尺寸的调控。实验结果表明：聚合物亲水链段分子量比例增大,则纳米粒子尺寸减小;当亲水链段分子量比例相同时,聚合物分子量越大,则纳米粒子尺寸越小;当聚合物质量浓度较高（10.0 g/L）时,制备的纳米粒子粒径分布较窄,粒子性能较稳定。     

甲氧基聚乙二醇-b-聚L-半胱氨酸两亲性嵌段共聚物的合成与表征

首先以聚乙二醇单甲醚(mPEG-OH)为单体,采用经典的盖布瑞尔伯胺合成法合成了端氨基聚乙二醇单甲醚(mPEG-NH₂); 然后以mPEG-NH₂为引发剂,S-苄基L-半胱氨酸N-羧酸内酸酐(BCys-NCA)为原料,通过N-羧酸内酸酐(NCA)开环聚合反应和液氨/钠处理脱除侧链上的保护基团,合成了两亲性嵌段共聚物甲氧基聚乙二醇-b-聚L-半胱氨酸(mPEG-b-PCys)。采用傅里叶变换红外光谱、核磁共振氢谱对聚合物的结构和组成进行了表征。结果表明:成功制备了侧链具有还原性巯基的两亲性嵌段共聚物mPEG-b-PCys,并且其聚合度可控性良好。     

mPEG-PLA共聚物胶束对DHA的增溶及光保护作用

以聚乙二醇单甲醚（mPEG）和外消旋丙交酯（D,L-LA）为原料,采用开环聚合法合成聚乙二醇单甲醚-聚乳酸（mPEG-PLA）共聚物,并用溶剂挥发法制备包载双氢青蒿素（DHA）的共聚物胶束（DHA/mPEG-PLA）。利用红外光谱（FT-IR）、核磁共振氢谱（¹H-NMR）和接触角测量仪研究了共聚物的结构和性质;利用激光粒度分析仪和扫描电镜（SEM）研究了胶束的粒径和形貌。结果表明mPEG-PLA共聚物的临界胶束浓度（CMC）为7.71 mg/L。DHA/mPEG-PLA共聚物胶束呈球形,平均粒径（118.1±1.9） nm,载药量和包封率分别为（2.7±0.1）%和（77.1±0.3）%。胶束对DHA的水相表观溶解度增大约1.5倍。紫外光光照39 h,纯DHA在混悬液中降解率达37%且持续增长,胶束中DHA降解率达到10%后基本保持不变。     

基于噻吩并吡嗪类的-(D-A1)m-(D-A2)n-型三元无规共聚物的合成及光电性能

选用苯并二噻吩（BDT）类衍生物作为给体单元D,并选用噻吩并吡咯二酮（TPD）类衍生物（A₁）和噻吩并吡嗪（TP）类衍生物（A₂）作为共同的受体单元,通过Stille偶联聚合制备了-（D-A₁）_m-（D-A₂）_n-型三元无规共聚物,并同时合成了基于BDT和TP的二元共聚物。采用核磁共振氢谱（¹H-NMR）、凝胶液相色谱（GPC）和热重（TG）表征聚合物的结构与性能;采用紫外-可见光谱和循环伏安法测试聚合物的光电性能,研究了以这类聚合物为给体材料制备的太阳能器件的光伏性能。结果表明：三元无规共聚物具有较高的相对分子量和热稳定性,在太阳光范围具有强而宽的吸收,同时具有相对较低的最高电子占用轨道HOMO和最低电子占用轨道LUMO能级。基于三元无规共聚物P2的器件,其光电转换效率可达到1.22%,优于相应的二元共聚物P1的1.15%。     

苯乙烯-苯乙烯磺酸钠共聚物的制备及其流变性能

采用乳液聚合合成了一种可作为聚丙烯（PP）纤维可染改性添加剂的苯乙烯-苯乙烯磺酸钠共聚物P（St-co-NaSS）。通过傅里叶转换红外光谱仪（FT-IR）和核磁共振氢谱仪（¹H-NMR）对共聚物的苯乙烯磺酸钠结构单元进行了表征,研究了反应条件对共聚物磺化度的影响;通过差示扫描量热仪（DSC）和热重分析仪（TG）研究了磺酸基团的引入对共聚物的玻璃化转变温度和起始分解温度的影响;通过旋转流变仪研究了磺化度对共聚物剪切黏度的影响;初步探讨了PP/P（St-co-NaSS）共混体系的染色性能。结果表明：当反应时间为2 h,反应温度为70℃,引发剂质量分数为0.6%,苯乙烯磺酸钠的摩尔分数为0.01时,共聚物的磺化度f=6.68%（零切黏度η₀=19 620 Pa·s,属牛顿流体）;在10^-2~10^-1 s^-1的剪切速率范围内,P（St-co-NaSS）表现出假塑性流体的特征,具有较好的加工流动性。对于PP/P（St-co-NaSS）共混体系,使用阳离子染料染色时,染色深度（K/S值）为2.603 2,使用分散染料染色时,K/S值为10.168 8。P（St-co-NaSS）适合作为聚丙烯纤维的可染改性添加剂。     

N-酰化壳聚糖的合成及其修饰多西他赛脂质体的体外性质研究

目的： 合成N-酰化壳聚糖并用其修饰多西他赛脂质体以期延缓药物的释放。方法： 用合成的长链脂肪酸酰化的壳聚糖修饰脂质体,体外血浆释放实验比较脂质体修饰前后的释放性质。结果： 合成了正己酰（C₆）、月桂酰（C_12）和棕榈酰（C₁₆）3种N-酰化壳聚糖。普通脂质体于24 h内释药70%,而N-酰化壳聚糖修饰的脂质体24 h仅释药39%。结论： 用N-酰化壳聚糖修饰脂质体可以减缓释药,具有缓释作用。     

两亲性聚合物聚乙二醇单甲醚-聚乳酸-β-环糊精的合成、表征及载药性能

以丁二酸酐为连接臂,将不同相对分子质量的聚乙二醇单甲醚-聚乳酸（MPEG-PLA）分别连接到N-(2-氨乙基)胺基-β-环糊精上,制备得4个未见文献报道的不同相对分子质量的两亲性聚乙二醇单甲醚-聚乳酸-β-环糊精(MPEG-PLA-β-CD)。采用FT-IR与¹H NMR对其结构进行表征,采用芘荧光探针光谱法测定其临界胶束浓度(critical micelle concentration,CMC)。并以布洛芬为模型药物初步考察4个聚合物的载药性能。其中MPEG 2K-PLA 6.6K-β-CD具有较小的CMC和较高的载药能力,有望成为良好的药物载体材料。     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.