穴位与非穴位皮肤生物物理学性质影响芥子碱渗透特性研究

目的 比较穴位与非穴位皮肤的电阻、角质层厚度、生物化学组成,并研究白芥子涂方经穴位和非穴位给药芥子碱的渗透特性,探讨皮肤生物物理学性质对芥子碱经皮给药的影响,为白芥子涂方临床穴位贴敷预防和治疗哮喘提供实验支持。方法 以自制装置测定穴位与非穴位皮肤电阻;皮肤组织切片经HE染色后,在光学显微镜下测量皮肤和角质层厚度;以激光显微拉曼光谱法比较皮肤的生物化学组成;以芥子碱为评价指标,采用HPLC法定量,用Franz扩散池法研究白芥子涂方离体经穴位和非穴位皮肤的渗透特性;在体渗透实验采用胶带粘贴法剥离角质层,比较穴位与非穴位皮肤各层中药物的分布。结果 穴位皮肤电阻在给药前后各时间点均显著低于非穴位皮肤（P＜0.05）;穴位皮肤角质层厚度显著低于非穴位（P＜0.05）;激光显微拉曼光谱显示穴位与非穴位皮肤的生物化学组成基本一致。给药24 h后,离体实验中芥子碱经穴位皮肤的单位面积累积透过量是经非穴位皮肤的6.8倍（P＜0.05）;穴位皮肤稳态透皮速率是非穴位的6.1倍;离体透皮实验和在体渗透实验中,24 h皮肤中药物滞留量均为穴位＞非穴位（P＜0.05）,各时间点角质层中药物滞留量均为穴位＞非穴位（P＜0.05）。结论 芥子碱经穴位皮肤的透过量和皮肤滞留量均显著高于经非穴位皮肤。穴位皮肤的低电阻、角质层薄有利于药物的经皮吸收和贮存,验证了涂方临床使用以穴位经皮给药的科学性。     

乙酰葛根素在大鼠体内的药动学研究

目的 考察乙酰葛根素ig和iv给药后葛根素在大鼠体内的药动学特征。方法 大鼠ig给予400 mg/kg或尾iv给予160 mg/kg乙酰葛根素。采用高效液相色谱（HPLC）法检测血浆样品中葛根素。结果 乙酰葛根素在大鼠体内代谢为葛根素,葛根素药动学过程符合二室模型,主要药动学参数：ig给药葛根素AUC_0～∞为（44.76±4.13）mg?h?L^?1,iv给药葛根素AUC为（36.67±5.3）mg?h?L^?1,ig给予乙酰葛根素后大鼠体内葛根素的暴露水平（生物利用度）为48.12%,ig给药的C_max为（12.07±0.15）μg/mL,t_max（1±0.33）h,t_1/2为（2.52±0.21）h。结论 HPLC法可作为乙酰葛根素在大鼠体内药动学的检测手段,ig乙酰葛根素后,葛根素在大鼠体内的暴露水平得到显著提高。     

大鼠静脉注射康莱特注射液的药动学研究

目的：研究康莱特注射液在正常大鼠体内的药动学。方法：采用甘油三酯试剂盒检测康莱特注射液经尾iv后大鼠血清中外源性甘油三酯的浓度变化,外源性甘油三酯浓度为测定血样中甘油三酯扣除本底后的浓度,采用3P97药代软件计算药动学参数。C_max为实测值,AUC计算采用梯形法。结果：康莱特注射液10、5 mL/kg剂量的主要药动学参数：C_max分别为（8.532±1.031）、（5.418±0.764）mmol/L,AUC_0-t分别为（13.248±3.692）、（5.339±1.219）mmol/L?h,V_c分别为（1.030±0.131）、（0.756±0.150）L²/（kg·mol）,CL_s分别为（0.838±0.319）、（0.975±0.330）L²/（kg·mol·h）,t _1/2α 分别为（0.481±0.168）、（0.322±0.109）h,t _1/2β分别为（1.452±0.776）、（1.384±0.404）h。结论：康莱特注射液经尾iv给药后在大鼠体内的药动学过程经拟合为二室模型。     

重组人甲状旁腺素类似物PTH（1-34）在大鼠体内药动学研究

目的：研究大鼠sc PTH（1-34）的药动学特征。方法：用¹²⁵I标记PTH（1-34）示踪法对大鼠sc PTH（1-34）后的血清药物浓度进行了测定,并用3P97程序拟和分析并计算药动学参数,采用超滤离心的方法进行药物与血浆蛋白结合率的研究。结果：大鼠sc PTH（1-34）10、20和40 μg/kg后,药物消除符合一房室模型。平均t_1/2ke为（0.92±0.04）h;平均CL为（0.56±0.05）L/（kg·h）;C_max和AUC_{0-8 h}均与剂量呈线性正相关,不同剂量药物与血浆蛋白平均结合率为13.4％。结论：大鼠sc PTH（1-34）后,药物消除符合线性动力学特征。     

杜鹃素在大鼠体内的药动学研究

目的 研究杜鹃素在正常大鼠体内的药动学特征。方法 杜鹃素单剂量ig给予大鼠后,采用HPLC法测定给药后不同时间点大鼠血浆中的杜鹃素,通过DAS软件程序模拟计算,得出杜鹃素在大鼠体内相应的药动学参数。结果 杜鹃素在大鼠体内的药动学模型符合二室模型,主要药动学参数为：t_1/2α＝（0.33±0.10）h,t_1/2β＝（15.22±8.98）h,CL/F＝（14.89±3.45）L/(h?kg),C_max＝（1.61±0.14）mg/L,T_max＝（0.25±0.01）h,MRT_(0-t)＝（2.35±0.08）h,AUC_(0-t)＝（3.06±0.16）mg?h/L。结论 本研究建立的HPLC方法专属性强,简便、准确,可用于杜鹃素在大鼠体内的药动学研究;大鼠ig给予杜鹃素后,其在血浆中分布较快,半衰期较短。     

逍遥散在肝损伤模型大鼠体内的药效学和药动学研究

目的 研究逍遥散降酶的药效学、药动学过程,为合理用药提供参考。方法 大鼠sc含40% CCl₄的橄榄油溶液2 mL/kg,每2天1次,首次给药4 mL/kg,连续12 d。以天冬氨酸转氨酶（AST）降低量为药效学指标,进行逍遥散的药效学研究;通过PKSolver 2.0统计距分析求算相关药动学和药效学参数。结果 逍遥散的降酶时-效曲线具有显著的双峰特性,其t_d、t_1/2（ED）、AUC、MRT分别为17.79 h、3.73 h、657.07 U?L^?1?h、6.23 h。结论 逍遥散在肝损伤大鼠体内具有吸收快,消除慢,作用维持时间较长的特点。     

射干提取物在大鼠体内的药动学研究

目的 研究射干提取物中鸢尾苷及鸢尾黄素在大鼠体内的药动学。方法 Wistar 大鼠一次性 ig 给予相当于 32 倍临床等效剂量即 10.8 g/kg 射干提取物 (每 1 g 提取物相当于 5 g 生药量),采用高效液相色谱法对血浆中鸢尾苷和鸢尾黄素进行定量测定,应用 DAS 软件计算主要药动学参数。结果 鸢尾苷及鸢尾黄素在大鼠体内的药时过程符合二室模型,t_max均为 1.5 h,C_max 分别为 0.89、3.35 μg/mL,AUC_0-t 分别为 0.983、19.769 mg·L^-1·h,AUC_0-∞ 分别为 1.034、23.927 mg·L^-1·h;鸢尾苷及鸢尾黄素的 t_1/2 分别为 1.05、8.863 h。结论 鸢尾黄素与鸢尾苷的达峰时间相同,但鸢尾黄素的消除半衰期比鸢尾苷消除半衰期长,说明鸢尾黄素在体内的药效有可能发挥得更持久。     

川芎挥发油中藁本内酯在大鼠体内的药动学研究

目的 测定川芎挥发油中藁本内酯在大鼠体内的药动学。方法 采用RP-HPLC法,以蛇床子素为内标物测定大鼠口服川芎挥发油的β-环糊精包合物后藁本内酯的血药浓度,使用3P97药动学软件计算其药动学参数。结果 藁本内酯在大鼠体内符合二室模型,主要的药动学参数：t_l/2 (α)为(1.429±1.161) h, t_l/2 (β)为(6.877±2.275) h, t (peak)为(3.401±1.951) h,AUC为(70.87±25.92) μg/mL·h。结论 以蛇床子素为内标,RP-HPLC法能够准确、灵敏地测定藁本内酯在大鼠体内的药动学。     

支气管哮喘患者穴位贴敷治疗中皮肤反应与临床疗效的相关性研究

[目的] 观察穴位贴敷法治疗支气管哮喘的临床疗效,探讨穴位贴敷治疗中皮肤反应程度与临床疗效的相关性。[方法] 根据323例哮喘患者贴敷后的皮肤反应程度分为无反应组、轻度反应组、中度反应组和重度反应组,分析各组在不同时间点主要症状积分,次要症状积分,哮喘控制测试（ACT）评分,第一秒用力呼气容积（FEV1）及冬季发病次数的变化规律。[结果] 各组主要症状积分,次要症状积分、ACT评分治疗前与治疗后各时间点,治疗后与6个月后相比均有统计学意义（P<0.05）。FEV1治疗前与治疗6个月后相比有统计学意义（P=0.001）。各组治疗前与治疗后冬季发作次数的差值具有统计学意义（P<0.05）。主要症状积分、ACT评分在治疗后各时间点中,无反应组与轻、中、重各组相比均有统计学意义（P<0.05）。次要症状积分、FEV1在6个月后,无反应组分别与轻、中、重各组比较,有统计学意义（P<0.01）。主要症状积分、ACT评分、次要症状评分、FEV1在治疗6个月后,轻、中度反应组与重度反应组之间有统计学意义（P<0.05）。[结论] 穴位贴敷疗法治疗哮喘临床疗效确切,同时具有近期疗效及远期疗效。贴敷治疗中皮肤反应程度与临床疗效具有相关性,有皮肤反应各组在近期疗效、远期疗效上均优于无反应组,轻、中、重各反应组在近期疗效上无统计学意义,但远期疗效上轻、中度皮肤反应优于重度皮肤反应。     

水飞蓟宾过饱和自微乳给药系统在大鼠体内的药动学研究

目的 研究水飞蓟宾过饱和自微乳给药系统（S-SMEDDS）在大鼠体内的药动学特征。方法 12只雄性SD大鼠随机分为对照组和实验组,每组6只,对照组大鼠ig给予水飞蓟宾自微乳（SMEDDS）533 mg/kg,实验组大鼠ig给予水飞蓟宾-S-SMEDDS 533 mg/kg。采用Accusampler清醒动物自动采血装置于不同时间点采血,HPLC法测定大鼠ig水飞蓟宾- S-SMEDDS后水飞蓟宾的血药浓度,非房室模型的统计矩分析方法计算药动学参数。结果 对照组和实验组的t_max分别为（1.00±0.40）、（1.50±0.84）h,C_max分别为（5.68±0.52）、（16.10±4.06）μg/mL,AUC_0→t分别为（27.30±3.29）、（82.64±12.36）μg?h?mL^?1。结论 将水飞蓟宾制成S-SMEDDS可进一步提高其口服生物利用度。     

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.     

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.     

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.