类风搽剂治疗类风湿性关节炎临床观察附：160例临床报告

报告了应用类风搽剂治疗类风湿性关节炎（ＲＡ）的临床疗效。结果表明：本品能改善活动性ＲＡ的主要症状及有关理化指标，总有效率为８７．００％，显效以上疗效为６３．００％。吲哚美辛搽剂对照组总有效率为６５．００％，显效以上疗效为２２．００％，两者相比有高度统计学意义（Ｐ＜０．０５），表明类风搽剂是治疗ＲＡ较理想的外用纯中药制剂。     

复方吲哚美辛酊治疗多形性日光疹疗效观察

目的 探讨非激素类外用搽剂-复方吲哚美辛酊在多形性日光疹治疗中的疗效.方法 将103例多形性日光疹患者随机分为两组,治疗组53例外用复方吲哚美辛酊涂擦患处,每日3次.对照组50例外用艾洛松涂患处,每日1次.疗程均为2 周,治疗结束后比较疗效和不良反应.结果 用药第7 天、第14 天总显效率分别为69.8%和86.8%.结论 复方吲哚美辛酊治疗多形性日光疹疗效确切,不良反应少,值得临床推广.     

吲哚美辛自微乳肠溶胶囊的处方设计及体外溶出度评价

目的制备吲哚美辛自微乳肠溶胶囊,并考察其体外溶出度。方法考察吲哚美辛在不同油、乳化剂及助乳化剂中的溶解度;根据溶解度的结果,采用正交设计试验和伪三元相图进行处方优化,筛选得到吲哚美辛自微乳的最佳工艺;将吲哚美辛自微乳装入肠溶胶囊中考察溶出度。结果吲哚美辛自微乳的处方组成为:吲哚美辛∶油酸乙酯∶吐温-80∶PEG-400的质量比为0.03∶0.135∶0.225∶0.09。制备得到的微乳粒径为21.97 nm,分散系数为0.180。吲哚美辛自微乳在pH 5.0磷酸盐缓冲溶液中,60 min时溶出度超过50%;吲哚美辛自微乳肠溶胶囊在pH 7.2磷酸盐缓冲溶液中,60 min时溶出度超过80%。结论自微乳剂能够改善吲哚美辛的溶解性,吲哚美辛自微乳剂在pH 5.0、pH 7.2磷酸盐缓冲溶液中的溶出均较好,吲哚美辛自微乳肠溶胶囊的制备工艺简单,具有良好开发应用前景。     

吲哚美辛滴眼液对兔眼前房穿刺伤的防治作用

目的：观察吲哚美辛滴眼液对兔眼前房穿刺伤的防治作用。方法：将家兔随机分为3组，行前房穿刺术。分别用0．75％吲哚美辛滴眼液、0．5％醛酸可的松滴眼液和生理盐水滴眼治疗。结果：吲哚美辛滴眼液和醋酸可的松滴眼液均能明显减轻炎症反应强度，缩短炎症反应持续时间。吲哚美辛滴眼液对结膜充血和水肿的疗效优于醋酸可的松滴眼液。结论：吲哚美辛滴眼液对兔眼前穿刺伤有显著抗炎作用。     

阿西美辛壳聚糖凝胶剂的制备与质量标准

目的 制备阿西美辛壳聚糖凝胶剂,并建立其质量控制方法.方法 以壳聚糖为凝胶材料制备阿西美辛凝胶剂;采用紫外分光光度法测定阿西美辛含量.结果 阿西美辛的线性范围为2.8～33.6μg·ml-1;平均回收率为100.3%,RSD为1.2%(n=5).结论 该凝胶剂制备工艺简单,含量测定方法可靠、准确、适用于本制剂的质量控制.     

复方吲哚美辛酊辅助治疗光敏性皮肤病的临床研究

目的　研究口服开瑞坦 ,外搽复方吲哚美辛酊辅助治疗几种光敏性皮肤病的临床疗效。　方法　病例随机分为治疗组和对照组各 2 3例 ,治疗组口服开瑞坦 10mg ,1次 /d ,复方吲哚美辛酊外涂 ,2次 /d ;对照组口服开瑞坦10cm ,1次 /d ,艾洛松霜外涂 ,2次 /d。疗程 6～ 8周。　结果　治疗组和对照组总有效率分别为 82 61%和 73 78% ,两组比较差异有显著性 (χ2 =8 97,P <0 0 1)。　结论　开瑞坦联用复方吲哚美辛酊外搽 ,以里应外和 ,显示中西药优势结合 ,疗效较好。     

复方新霉素炉甘石搽剂的制备及质量控制

目的设计复方新霉素炉甘石搽剂的制备分装，提高混悬液的物理稳定性，建立一种简易，外观均匀，使用方便的配制复方新霉素炉甘石搽剂的方法，并对复方新霉素炉甘石搽剂进行质量控制。方法分别改变樟脑和薄荷脑共熔物的处理方法，加羧甲基纤维素钠作为助悬剂，并通过处方成份加入的先后，考察较理想的配制工艺。结果用95％乙醇可溶解樟脑和薄荷脑共熔物中的颗粒，加羧甲基纤维素钠改善了硫磺的亲水性，制剂的均匀度和稳定性良好。结论改进配制工艺后复方新霉素炉甘石搽剂的外观性状、颗粒均匀度有明显改善，本法可用于复方新霉素炉甘石搽剂的制备质量控制。     

中国埋线针疗专业培训班招生

目的：观察吲哚美辛治疗肾绞痛的临床效果。方法：采用随机、单盲分组对照法，对76例急性肾绞痛患者采取吲哚美辛栓剂治疗和强痛啶治疗。结果：两组比较，两者疗效无明显差异，无统计学意义（P〉0．05）。结论：吲哚美辛栓可代替强痛定治疗肾绞痛。     

创伤灵搽剂的制备与临床应用

目的：创伤灵搽剂的制备、质量标准及临床观察．方法：采用水提醇沉法制备，以主药成份鉴别作为质量控制标准，选取病例118例进行疗效观察．结果：该制剂制备工艺合理，质量标准可靠，疗效确切，总有效率达98．3%     

吡罗昔康搽剂治疗关节炎的临床研究

目的：探讨吡罗昔康搽剂与嘴罗普康片剂和消失痛搽剂的疗效对比情况，方法：采用随机对照方法，应用１％嘴罗昔康搽剂治疗３４例类风湿性关节炎，骨关节炎患者，疗程４周，并与１７例应用吡罗昔康片剂治疗，１７例应用消炎痛搽剂治疗的患者作比较，结果：吡罗昔康搽剂组的显效率为２９．４％，总有效率为８８．２％，片剂组分别为５．９％，８８．２％，消炎痛搽剂组分别为１１．８％，８２．４％，三组疗效差异无显著统计学意义，吡     

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.