氟尿嘧啶微球体外释药的影响因素

目的 探讨对以羧甲基壳聚糖为载体的氟尿嘧啶微球体外释药特性的影响因素。方法 超声作用下采用乳化交联法制备氟尿嘧啶羧甲基壳聚糖微球（Fu—CMCS-MS）；光镜观察微球的形态和粒径分布；恒温振荡透析法和紫外分光光度法测定Fu—CMCS-MS的药物释放，考察5种因素对微球体外释药的影响。结果 超声作用下制得Fu—CMCS-MS成球性良好，粒径分布均匀，微球76．4％在1～3μm，平均粒径1．6μm。微球体外释药受投药方式、投药量、交联剂、释放介质和超声作用的影响显著，前期释药速率快，遵守溶胀控制机制，缓释后期释药缓慢，遵守扩散控制机制。结论 超声作用下以戊二醛乳化交联所制Fu—CMCS-MS在体外具有缓释作用。     

生长抑素对急性胃粘膜损伤保护作用的实验研究

为建立癌胚抗原（CEA）尼龙微球固相免疫放射分析法并应用于临床．采用Lodogen法125Ⅰ标记CEA单克隆抗体C－17，用单克隆抗体C－50、C－6化学包被尼龙微球制成固相抗体（N－SP）．建立一步法的CEAN－SPIRMA，灵敏度2μg／L，工作范围为5－80μg／L，批内和批间CV分别为4．63％和8．34％，回收率93．86－104．73％．结果：65例正常人CEA值为5．2±3．8μg／L，78例良性病人为12．3±5．4μg／L，87例恶性肿瘤病人为69．3±51．4μg／L．正常组与良性疾病组比较差异无显著意义（P＞0．05）；正常组与恶性肿瘤组比较差异有显著意义（P＜0．01），以上测定值与CEA放射免疫法结果比较相关系数r＝0.9328，P＜0．01，且提高了恶性肿瘤诊断率．结论：该方法操作简便、快速、准确，是一种新型有效而实用的分析技术，可推广使用．     

盐酸去氢骆驼蓬碱肝动脉栓塞微球处方工艺研究

目的:从新疆民族药蒺藜科植物骆驼蓬种子中提取的抗肿瘤活性生物碱成分——盐酸去氢骆驼蓬碱(HM) ,制成可供肝动脉栓塞的微球新剂型 ,对其处方设计及制备工艺进行研究。方法:选择具有生物可降解性、无毒、价廉且与盐酸 HM无相互作用的明胶为载体 ,采用乳化分散法制备盐酸去氢骆驼蓬碱明胶微球 ,以外观、粒径、载药量、包封率等为考察指标 ,采用正交设计确定了盐酸去氢骆驼蓬碱微球的制备工艺。结果:含药微球为淡黄色粉末 ,光镜及电镜观察微球球形圆整 ,表面附有少量药物结晶。平均产率为 86 .6 3% ,表面药量平均值为 (2 6 .2 4±0 .30 ) % (g/ g) ;载药量为 (34.4 5± 0 .35 ) % (g/ g) ;包封率为 (8.19± 0 .5 1) % (g/ g)。平均算术径为 6 3.0μm ,平均体积径为 6 9.6μm,粒径分布基本属正态 ,跨度 Span为 0 .76 9。 结论:所研制微球符合肝动脉栓塞微球剂的要求     

制备方法和工艺对姜黄素-磷脂复合物-壳聚糖微球体外性质的影响

目的 为提高姜黄素的口服吸收,研制姜黄素-磷脂复合物-壳聚糖微球,优选其制备方法和工艺。方法 分别采用离子凝聚法（滴入法、注入法）和乳化交联法制备姜黄素-磷脂复合物-壳聚糖微球,考察工艺条件对微球载药量和释药速率的影响,并对各方法制备的微球进行表征。结果 DSC、IR和SEM证实,3种方法制得的微球均具有良好的球形,姜黄素仍以磷脂复合物的形式存在于壳聚糖微球中而并未解离。离子凝聚滴入法制备的微球载药量高达5%以上,但粒径大,为（1.11±0.08）mm;无突释效应,累积释药量平稳增加。离子凝聚注入法制备的微球粒径最小,为（16.19±4.91）μm,载药量也达5%以上;虽有较弱的突释效应,但释药最完全。乳化交联法制备的微球粒径居中,为（77.48±19.37）μm,但载药量仅在1%左右,且突释效应强,释药量最低。磷脂复合物并没有改变壳聚糖微球的释药规律,各微球的药物释放均符合Weibull分布。结论 离子凝聚注入法更适合制备姜黄素-磷脂复合物-壳聚糖微球。     

兔蛛网膜下腔注射布比卡因PLGA微球药代动力学研究

目的：研究新西兰兔蛛网膜下腔注射布比卡因PLGA微球的药代动力学：方法：新西兰兔12只,随机分成2组,每组6只。对照组蛛网膜下腔注射盐酸布比卡因注射液,实验组蛛网膜下腔注射布比卡因PLGA微球混悬型注射剂,两组有效布比卡因剂量均为5mg／kg。高效液相色谱法（HPLC）测定血浆中布比卡因浓度。结果：对照组血药浓度在给药后0．5h达到峰值,Cmax为0．5761μg／mL,随后浓度快速下降,至8h已检测不到药物浓度。微球组血药浓度在0．5h和2h产生两个峰值,峰浓度分别为0．332和0．290μg／mL,随后血药浓度下降缓慢并一直维持较低水平至48h,微球组两峰浓度（0．5h,2h）值显著低于对照组（P〈0．05）,微球组MRT明显长于对照组（P〈0．05）。结论：蛛网膜下腔注射布比卡因PLGA微球在新西兰兔体内具有缓释作用。     

对乙酰氨基酚明胶微球的制备及缓释效果研究

目的 将解热镇痛药对乙酰氨基酚制成粒径大小、载药量合乎要求的明胶微球，以减少给药剂量，达到缓释作用。方法 按正交设计法筛选乳化冻凝法制备对乙酰氨基酚明胶微球的最佳制备工艺，并对微球的药物载药量、溶出度及家兔体内药效进行考查。结果 微球粒径范围为12．5～25μm，平均粒径为20μm，对乙酰氨基酚含量为20．47％。24h注射伤寒疫苗后家兔体温不升高。结论 本法制备的对乙酰氨基酚明胶微球粒径分布集中，粒径大小符合要求，能够起到明显缓释作用。     

醛氢叶酸、5—Fu联合化疗方案治疗晚期胃癌的疗效观察

目的 研究醛氢叶酸、5－Fu联合化疗方案（简称CF组）与基本化疗方案）对照组）的疗效观察。方法 对37例晚期胃癌联合化疗治疗时，随机分为两组，CF组为醛氢叶酸加5－Fu静脉给药治疗，对照组为常规化疗方案静脉给药治疗。结果 CF组治疗晚期胃癌的有效率为65．0％，对照组治疗晚期胃癌的有效率为29．5％（P＜0．05）。结论 具有对5－Fu有效增作用的CF与5－Fu的联合化疗方案应用于胃癌治疗，则有可能提高临床疗效。     

丝裂霉素—肝动脉栓塞明胶微球的研究

报道了丝裂霉素明胶微球的研制方法，采用正交设计，优化了制备条件和工艺，采用动态透析法研究了微球的体外释药规律。结果表明：该微球粒径为５０－２００μｍ范围内的占微球总数的９０．２％，平均粒径为（６０．７６±９．６）μｍ，丝裂霉素的包封率为６８．４％，载药量为２０．８μｇ／ｍｇＧＭ。     

草酸铂与5-氟脲嘧啶联合介入治疗结直肠癌肝转移

目的 比较应用草酸铂与5－氟脲嘧啶（5－Fu)联合的介入治疗方案与单用5－Fu介入治疗方案对结直肠癌术后多发性肝转移癌患者的疗效及副作用。方法 观察组（21例）应用草酸铂 5-Fu肝动脉灌注化疗 表阿霉素与碘油乳剂栓塞肝动脉。对照组（30例）术中应用5－Fu肝动脉灌注化疗 表阿霉素与碘油乳剂栓塞肝动脉。两组均以每4周为1周期，重复2－4周期，客观疗效与毒性反应按WHO标准进行评价。结果 观察组、对照组客观疗效（CR＋PR）分别为57％及40％（P＜0．01），中位生存期观察组13．0个月，对照组11．6个月，白细胞减少、恶心、呕吐、腹痛、发热等副作用两组差异无显著性。观察组有4例出现外周神经毒性反应。结论 草酸铂与5－Fu联合用药介入治疗结直肠癌多发性肝转移的治疗效果优于5－Fu单一用药。     

比沙可啶合成工艺研究

以聚丙烯酸树脂肠溶Ⅱ号为囊材,采用相分离－凝聚法制备了克拉霉素微球,该法微球得率为（９０．５±２．０）％（ｎ＝３）,所得微球粒径为１５５．１±２６．３９μｍ（ｎ＝１０００）,载药量为７５％,克拉霉素微球在蒸馏水中几乎不溶出,而在ｐＨ６．８磷酸盐缓冲溶...     

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.