注射用哌拉西林钠舒巴坦钠HPLC法含量测定

用HPLC法 ,ODS柱 ,0 .0 0 5mol/L四丁基氢氧化铵磷酸缓冲液 (PH =5 .0 ) -乙腈 ( 81∶19)为流动相 ,检测波长 2 30nm ,柱温 30℃ ,测定哌拉西林纳 /舒巴坦钠的含量。哌拉西林在 0 .0 8～ 1.6 0mg/ml范围 (r1=0 .9996 ) ,舒巴坦在 0 .0 4～ 0 .80mg/ml范围 (r2 =0 .9992 ) ,质量浓度与峰面积线性关系良好。日内精密度良好 (哌拉西林RSD =0 .6 6 % ,舒巴坦RSD =0 .73% ,n =6 )。该法简便准确 ,可用于该制剂的含量测定。     

分光光度法测定注射用头孢哌酮钠/舒巴坦钠药物含量

目的 利用双波长分光光度法测定头孢哌酮钠／舒巴坦钠联合制剂中头孢哌酮钠和舒巴坦钠的含量。方法 双波长分光光度法。结果 头孢哌酮钠在2～20mg／L浓度范围内与吸光度呈良好线性关系，检测限为0．82mg／L，平均回收率99．9％，相对标准偏差3．6％(n=6)。舒巴坦钠在2～20mg／L浓度范围内与吸光度呈良好线性关系，检测限为0．51mg／L，平均回收率为99．9％，相对标准偏差1．6％(n=5)。结论 操作简便，结果准确，可用于该产品的质量控制。     

RP-HPLC法测定注射用哌拉西林钠/舒巴坦钠的含量

目的：建立RP－HPLC法测定注射用哌拉西林钠／舒巴坦钠含量。方法：采用C18柱，以缓冲液（取四丁基氢氧化铵13．2ml，加水稀释至900ml，用1mol/L磷酸溶液调节pH至5.0，加水稀释至1000ml)-乙腈（65：35）为流动相，检测波长为230nm。结果：本方法线性关系良好，哌拉西林和舒巴坦回收率分别为99．71％和99．91％，RSD分别为1．13％和0．45％。结论：该法简便，为注射用哌拉西林钠／舒巴坦钠复方制剂质量控制提供了准确可靠的检测手段。     

复方双氯酚酸钠滴眼液含量测定方法的研究

目的建立测定复方双氯酚酸钠滴眼液中玻璃酸钠和双氯酚酸钠的含量的方法。方法以咔唑试液为显色剂 ,采用比色法测定玻璃酸钠的含量 ,测定波长为 (5 30± 2 )nm ;采用反相高效液相色谱法测定双氯酚酸钠的含量 ,以HPERSILBDS为固定相 ,ψ(甲醇 ∶ 0 .1%冰醋酸 ) =75∶2 5为流动相 ,检测波长为 2 76nm。结果玻璃酸钠的线性范围为 4 .6 8～ 4 6 .8μg/mL ,平均回收率为 97.1% ,RSD为 2 .2 % ;双氯酚酸钠的线性范围为 0 .0 2～ 0 .6mg/mL ,平均回收率为 99.6 % ,RSD为 0 .3%。结论本方法灵敏、准确 ,可用于控制复方双氯酚酸钠滴眼液的质量     

RP-HPLC法同时测定头孢哌酮舒巴坦钠中二组分的含量

目的 :建立HPLC法同时测定头孢哌酮舒巴坦钠中两组分的含量。方法 :以对乙酰氨基酚为内标 ,以 μBondapakC18为固定相 ,以V[0 .0 2 5mol/L四丁基溴化铵 (pH 4.6± 0 .1) ]∶V (甲醇 ) =6 4∶36为流动相 ,检测波长 2 2 0nm ,流速为 1.0mL/min ,同时测定头孢哌酮和舒巴坦钠的含量。结果 :平均回收率及RSD % (n =9)分别为 ,头孢哌酮 10 0 .5 %、0 .95 % ,舒巴坦 10 0 .9%、0 .2 9%。结论 :本法简便、快速、准确、经济。     

双波长分光光度法测定氨氯青霉素栓含量

目的 建立氨氯青霉素栓中氨苄青霉素和邻氯青霉素钠的含量测定方法。方法 采用双波长分光光度法(UV法)。氨苄青霉素的测定波长λA=325nm，参比波长λA=361．4nm；邻氯青霉素钠的测定波长λC=344nm，参比波长λC=303．2nm。结果 北苄青霉素、邻氯青霉素钠分别在1．704～17．040μg/ml、1．672～16．720μg/ml浓度范围内与吸收度差值呈良好的线性关系(rA=0．9999，rC=0．9998)。平均回收率分别为99．5％和98．6％，RSD分别为0．95％和1．10％。结论 该法不经分离直接测定两组分各自的含量，线性关系良好，准确可靠，灵敏度高，重现性好，不受基质和直肠吸收促进剂的影响，可作为氨氯青霉素栓的含量测定方法。     

头孢哌酮钠/舒巴坦钠与5种常用输液的配伍稳定性考察

目的:考察头孢哌酮钠/舒巴坦钠与5种常用输液配伍的稳定性.方法:利用双波长分光光度法测定头孢哌酮钠/舒巴坦钠联合制剂中头孢哌酮钠和舒巴坦钠的含量,并对与5种常用输液配伍的稳定性进行初步考察.结果:头孢哌酮钠在2～20 mg/L范围内浓度与吸收度呈良好的线性关系,检测限为0.56mg/L,平均回收率为99.77%,RSD为1.06%(n=9).舒巴坦钠在2～20 mg/L范围内浓度与吸收度呈良好的线性关系,检测限为0.56 m/L,平均回收率为99.86%,RSD为1.09%(n=9].结论:临床上注射用头孢哌酮钠/舒巴坦钠在配制3 h内含量会有所下降,但变化不大,可与5种常用输液配伍使用,该实验可以为临床配伍提供一些参考.     

注射用哌拉西林钠舒巴坦钠治疗泌尿系感染的临床研究

目的　探讨注射用哌拉西林钠舒巴坦钠治疗泌尿系感染的有效性和安全性。方法　采用随机、双盲、对照的方法 ,观察试验药物哌拉西林钠舒巴坦钠和对照药美洛西林钠舒巴坦钠的临床疗效、细菌清除率和安全性。结果　两组病人经治疗后症状、体征、恢复的时间无显著差异 (P <0 0 5 )。试验组中膀胱炎 3例痊愈 ,急性肾盂肾炎 8例中 4例痊愈、 3例显效、 1例进步 ,复杂型肾盂肾炎 1例治疗无效 ,计治疗有效率 83 3% ;对照组中膀胱炎 3例痊愈 ,急性肾盂肾炎 8例中 6例痊愈、 2例显效 ,复杂型肾盂肾炎 1例治疗无效 ,计治疗有效率 91 7% ;统计学处理表明两组治疗有效率无显著性差异 (P <0 0 5 )。两组细菌清除率无显著性差异 (P <0 0 5 )。观察期间未发现任何不良事件和不良反应。结论　本观察表明哌拉西林钠舒巴坦钠用于泌尿系感染时对常见致病菌大多敏感 ,细菌耐药少见 ,治疗效果好 ,无明显临床不良反应。     

32例注射用哌拉西林钠舒巴坦钠(2:1)不良反应分析

目的:分析注射用哌拉西林钠舒巴坦钠(2:1)的临床不良反应(ADR).方法:我院对2007年5月～2008年12月436例住院患者使用注射用哌拉西林钠舒巴坦钠(2:1)的有关情况进行调查分析,对患者一般情况、用药情况以及不良反应进行统计分析.结果:存使用注射用哌拉西林钠舒巴坦钠(2:1)的436例中,出现不良反应的32例次,不良反应发生率为7.34%.其中以皮肤及其附件损伤、神经系统不良反应和消化系统不良反应为主,分别占2.53%(11,436)、2.06%(9/436)、1.61%(7/436).结论:注射用哌拉两林钠舒巴坦钠(2:1)是一种安全性较高的B一内酰胺类抗生素,但仍有一些不良反应的特性,因此要合理使用注射用哌拉西林钠舒巴坦钠(2:1),尽量避免和减少不良反应的发生.     

哌拉西林钠/舒巴坦钠体外、体内药效学研究

目的 评价哌拉西林钠／舒巴坦钠的体内外抗菌活性。方法 琼脂二倍稀释法测定两药不同配比对临床分离菌最低抑菌浓度(MIC)值及对产β-内酰胺酶耐药菌感染小鼠的体内保护作用。结果 335株细菌体外实验显示：哌拉西林钠／舒巴坦钠(2：1)较哌拉西林钠单用对产酶耐药株的抗菌活性增强1～4倍以上,也增强了哌拉西林钠对革兰阴性菌的抗菌活性。体内试验显示：哌拉西林钠／舒巴坦钠(2：1)及其组分哌拉西林钠、舒巴坦钠及阿莫西林钠／舒巴坦钠(2：1)对产酶的金葡菌、大肠埃希菌、肺炎克雷伯菌及铜绿假单胞菌感染小鼠经静脉注射、皮下注射两种给药途径的体内抗菌作用比较,哌拉西林钠静脉注射单用对四种菌感染小鼠的ED50分别为55．71mg／kg、6．54mg／kg、24．09mg／kg与11．07mg／kg;哌拉西林钠／舒巴坦钠(2：1)者为27．96mg／kg、2．49mg／kg、6．75mg／kg与6．36mg／kg,分别比哌拉西林钠强2、2．5、3．5与1．8倍．哌拉西林钠／舒巴坦钠(2：1)对产酶的革兰阴性菌静脉注射的体内抗菌活性强于对革兰阳性菌者。哌拉西林钠／舒巴坦钠(2：1)皮下注射对四种产酶菌感染小鼠的保护作用弱于静脉注射者。结论 哌拉西林钠／舒巴坦钠对产酶耐药株的抗菌活性强于哌拉西林钠单用,无论静滴或皮下注射,哌拉西林钠／舒巴坦钠(2：1)对产酶菌株感染小鼠的ED50明显优于哌拉西林钠单用。静脉注射是临床应用较恰当的给药途径。     

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.