小承气汤的质量控制研究

目的 采用RP-HPLC法研究小乘气汤质量控制方法,同时测定橙皮苷、肉桂酸、大黄酸、芦荟大黄素、川陈皮素、和厚朴酚、大黄素、厚朴酚、大黄酚和大黄素甲醚的量。方法 采用Apollo C₁₈柱（150 mm×4.6 mm,5 um）,1.1%醋酸水溶液-乙腈梯度洗脱,洗脱程序：0 min（83∶17）、30 min（70∶30）、50 min（45∶55）、70 min（13∶87）、75 min（83∶17）,体积流量1.0 mL/min,检测波长254 nm。结果 得线性回归方程：橙皮苷Y＝2.469 5 X＋0.019 9（r＝0.999 9）、肉桂酸Y＝2.954 3 X＋0.005 8（r＝0.999 9）、大黄酸Y＝1.176 4 X＋0.036 4（r＝0.999 2）、芦荟大黄素Y＝1.241 4 X－0.002 2（r＝0.999 9）、川陈皮素Y＝0.722 1 X＋0.007 1（r＝0.999 9）、和厚朴酚Y＝1.821 5 X＋0.021 4（r＝0.999 0）、大黄素Y＝1.815 2 X＋0.002 2（r＝0.999 5）、厚朴酚Y＝1.710 4 X－0.010 5（r＝0.999 4）、大黄酚Y＝4.574 8 X－0.007 5（r＝0.999 3）和大黄素甲醚Y＝0.427 2 X－0.002 3（r＝0.999 7）,线性范围分别为20.0～80.0、6.7～30.0、57.6～153.6、18.6～37.1、1.7～139.2、3.1～65.4、8.8～35.2、2.9～73.0、2.0～10.0、10.8～43.2 μg/mL;回收率分别为98.5%、98.9%、99.3%、99.1%、97.8%、98.6%、99.1%、98.7%、99.6%、98.9%,日内和日间精密度分别小于2.0%和2.1%。结论 此方法简单快速灵敏,对于小乘气汤的质量控制有一定的参考价值。     

HPLC法同时测定珍珠菜提取物中5种黄酮

目的 建立同时测定珍珠菜提取物中芦丁、异鼠李素-3-O-芸香糖苷、江户樱花苷、槲皮素、山柰酚的HPLC方法。方法 采用Chromasil C₁₈色谱柱（250 mm×4.6 mm,5.0 μm）,柱温35 ℃,以乙腈-0.1%磷酸水溶液为流动相,梯度洗脱,双波长检测（λ₁＝283 nm,λ₂＝370 nm）,体积流量1.0 mL/min。结果 5个成分均能达到基线分离,线性回归方程分别为芦丁Y＝14 958 X＋179.22（r＝0.999 3）,异鼠李素-3-O-芸香糖苷Y＝12 126 X＋3.14（r＝0.999 4）,江户樱花苷Y＝23 821 X＋76.81（r＝0.999 4）,槲皮素Y＝35 761 X－20.30（r＝0.999 5）,山柰酚Y＝39 078 X＋1.81（r＝0.999 1）,芦丁、异鼠李素-3-O-芸香糖苷、江户樱花苷、槲皮素、山柰酚进样量分别在228.60～1 143.00、99.60～498.00、232.20～1 161.00、22.08～110.40、15.12～75.60 ng与峰面积线性关系良好,平均回收率分别为97.8%、98.9%、102.4%、98.4%、92.2%。结论 本检测方法简便、准确,为珍珠菜提取物中黄酮类成分的质量控制提供了依据。     

高效毛细管电泳法测定小白蒿不同加工品中5种黄酮类成分

目的 建立高效毛细管电泳（HPCE）法同时测定蒙药小白蒿不同加工品中5种黄酮类成分的方法。方法 小白蒿经不同加工工艺处理后,用HPCE法分别测定其中5种黄酮类成分,并对其进行比较。结果 回归方程分别为5,7,3′-三羟基-4′-甲氧基黄酮Y＝0.114 3 X＋0.032 7,r＝0.999 8;5,3′-二羟基-6,7,4′-三甲氧基黄酮Y＝0.100 9 X＋0.048 5,r＝0.999 6;槲皮素Y＝0.055 5 X＋0.026 8,r＝0.999 6;5,7,3′-三羟基-6,4′-二甲氧基黄酮Y＝0.113 2 X－0.016 1,r＝0.999 3;木犀草素Y＝0.097 9 X－0.029 5,r＝0.999 4。5种黄酮类成分分别在1.00～40.00、10.00～200.00、5.00～100.00、1.00～40.00、1.00～40.00 μg/mL线性关系良好。平均回收率分别为98.44%、97.75%、97.73%、97.98%、98.07%;RSD分别为1.60%、1.03%、1.57%、0.94%、1.20%。结论 不同加工工艺对小白蒿中5种黄酮类成分有一定影响;以5种黄酮类成分为分析指标,小白蒿最佳加工工艺为60 ℃加热干燥。     

Box-Behnken效应面法优化多西他赛长循环脂质体处方

目的 优化多西他赛长循环脂质体（DLCL）处方。方法 采用薄膜蒸发法制备DLCL,分别以卵磷脂（PC）与多西他赛（DOC）质量比（X₁）、PC与胆固醇（Chol）质量比（X₂）、DSPE-PEG 2000与PC物质的量之比（X₃）为考察对象,包封率（Y₁）、载药量（Y₂）、综合指标OD值为评价指标,采用Box-Behnken效应面法筛选DLCL的最佳处方。结果 最优处方为X₁＝0.616 2,X₂＝1.0,X₃＝?1.0;DLCL的包封率为（94.71±1.75）%,载药量为（5.37±0.43）%,标准偏差均小于10%;平均粒径139.6 nm,分布均匀,体外释放试验结果表明其具有明显的缓释效果。结论 采用Box-Behnken效应面法优化DLCL处方是有效、可行的。     

乌骨藤总苷H中C21甾体苷的测定

目的 建立乌骨藤总苷H中C₂₁甾体苷的测定方法。方法 采用茴香醛硫酸显色比色法测定乌骨藤总苷H中C₂₁甾体苷的量。结果 选定检测波长432 nm;通光藤苷B在5.05～65.65 μg/mL与吸收度呈良好线性关系,回归方程Y＝0.012 9 X＋0.017 8,R²＝0.999 3;平均回收率为99.3%,RSD为2.16%。结论 该方法简便、灵敏、准确、重现性好,可用于乌骨藤总苷H中C₂₁甾体苷的测定和质量控制。     

HPLC法测定鲜地黄中梓醇和桃叶珊瑚苷

目的 建立HPLC法测定鲜地黄中梓醇及桃叶珊瑚苷的方法,对鲜地黄进行质量控制。方法 采用HPLC法对鲜地黄中梓醇及桃叶珊瑚苷进行定量测定。结果 线性回归方程分别为梓醇Y＝43 800 X＋2 849.2,r＝0.999 9;桃叶珊瑚苷Y＝76 163 X＋1 676.1,r＝0.999 9;梓醇和桃叶珊瑚苷线性范围分别为0.19～2.375 μg、0.152～1.90 μg,回收率分别为99.00%和99.38%。结论 该方法准确、重现性好,可以作为鲜地黄的质量控制方法。     

硫化氢供体型ADT-OH衍生物的合成及其活性

二硫杂环化合物5-对羟基苯基-3H-1,2-二硫杂环戊烯-3-硫酮(ADT-OH)是一种缓释硫化氢供体,并具有一定的神经保护作用。为了研究其构效关系,对其芳环进行改造,合成了17个Y类化合物(Y₁~Y₁₇),其结构均经 ¹H NMR、¹³C NMR 和HR-MS确证,其中6个化合物(Y₄,Y₁₃~Y₁₇)结构是全新的。采用MTT法评价了该类化合物对谷氨酸诱导损伤的HT-22海马神经元细胞生存率的影响,结果发现,这些化合物在1~100 μmol/L浓度范围内具有很强的神经保护作用,其中化合物Y₁~Y₉,Y₁₁在全部测试浓度内均能非常显著地提高受损神经元的生存率(P<0.01),特别是化合物Y₁,Y₄,Y₆~Y₉,Y₁₁在1~10 μmol/L浓度范围内活性比ADT-OH强,值得进一步研究。     

内异消复方缓释滴丸同步释药的处方优化及其释药机制研究

目的 优化内异消复方缓释滴丸各组分同步释药的处方,探讨其释药机制。方法 以药载比（X₁）、乙基纤维素质量分数（X₂）、PEG 6000质量分数（X₃）和硬脂酸质量分数（X₄）为考察因素,以“释放区间”值为指标,采用Doehlert设计-响应曲面优化法对内异消复方缓释滴丸的处方进行优化。用DDsolver软件拟合体外释药规律。结果 优化处方：X₁为1∶12,X₂为12%,X₃为30%,X₄为20%。模拟的胃肠道环境下,阿魏酸与川芎嗪、阿魏酸与延胡索乙素和川芎嗪与延胡索乙素的相似因子（f₂^*）值分别为53.37、56.17、57.85。阿魏酸的释放符合一级动力学方程和Higuchi方程,川芎嗪和延胡索乙素符合Baker-Lonsdale方程和Ritger-Peppas方程。结论 优化的内异消复方缓释滴丸能实现各组分的同步缓慢释放,其释放机制以扩散为主。     

甘草次酸-丹参酮IIA复方脂质体处方优化及制备工艺研究

目的 研究甘草次酸（GA）-丹参酮II_A（Tan II_A）复方脂质体（GT-Lip）的制备工艺。方法 以大豆卵磷脂（SPC）和胆固醇（Ch）为膜材,薄膜分散探头超声法制备GT-Lip。通过单因素考察确定水合温度和探头超声功率,正交设计法优化处方工艺;低速离心法测定脂质体中GA与Tan II_A包封率,动态光散射粒径仪测定脂质体粒径与Zeta电位,透射电镜测定脂质体形态。结果 优化处方工艺为SPC-Ch质量比6∶1,SPC-Tan II_A物质的量之比30∶1,SPC-GA物质的量之比24∶1,水合温度为30 ℃,探头超声条件为380 W超声5 min;制备得到的GT-Lip中Tan II_A、GA的包封率分别为（81.50±0.76）%、（98.63±0.90）%（n＝3）,平均Zeta电位为（?19.00±0.98）mV（n＝3）,平均粒径为（120.5±1.62）nm（n＝3）。结论 优化的GT-Lip制备工艺稳定可行。     

青年乙型肝炎病毒相关慢加急性肝衰竭预后危险因素分析和预后模型建立

目的 探讨青年HBV相关慢加急性肝衰竭（ACLF）预后的危险因素,并建立预后模型。方法 回顾性纳入2019年1月至2021年3月重庆医科大学附属第二医院及重庆医科大学附属大足医院感染科青年（15~44岁）HBV-ACLF患者113例,根据临床结局分为死亡组（64例）和存活组（49例）。通过单因素分析筛选出两组间差异有统计学意义的临床指标,纳入多因素二元logistic回归分析确定青年HBV-ACLF患者预后的独立危险因素并以此建立预后模型,采用ROC曲线评价模型预测价值。结果 113例患者总病死率为56.64%（64/113）。单因素分析显示,白细胞计数、中性粒细胞百分比、白蛋白、血钾、血钠、凝血酶原时间、国际标准化比值、肌酸激酶同工酶、降钙素原、甲胎蛋白、HBV-DNA定量及乙型肝炎e抗原定量水平可能影响HBV-ACLF患者的预后（P均＜0.05）。多因素二元logistic回归分析显示,HBV-DNA定量≥1×10⁶ IU/mL（OR＝19.85,95% CI 1.64~239.84,P＜0.05）、低白蛋白（OR＝0.71,95% CI 0.53~0.96,P＜0.05）和低甲胎蛋白（OR＝0.58,95% CI 0.42~0.81,P＜0.05）是青年HBV-ACLF患者预后的独立危险因素。以此建立的预后模型为P_预后＝1/（1+e^－X）,其中X＝5.82+2.99×HBV-DNA定量（≥1×10⁶ IU/mL为1,＜1×10⁶ IU/mL为0）－0.35×白蛋白（g/L）－0.54×甲胎蛋白（ng/mL）,该模型预测青年HBV-ACLF预后的ROC AUC值为0.98（95% CI 0.97~1.00,P＜0.001）。结论 血清白蛋白、甲胎蛋白及HBV-DNA定量是青年HBV-ACLF预后的独立危险因素,基于此建立的预后模型预测价值较高,可为青年HBV-ACLF患者提前进行肝移植准备提供参考依据。     

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.