紫外分光光度法测定注射用氯诺昔康中氯诺昔康的含量

目的：建立紫外分光光度法,测定注射用氯诺昔康中氯诺昔康的含量。方法：采用紫外分光光度法,检测波长为376nm。结果：氯诺昔康在8.4μg/ml～15.6μg/ml的范围内呈良好的线性关系,r=0.9999,平均回收率为99.76%,RSD为0.13%。结论：本方法可用于注射用氯诺昔康中氯诺昔康的含量测定,简单快捷,结果准确。     

氯诺昔康与术后镇痛

术后疼痛是人体对手术创伤刺激的一种生理反应,但它所引起的病理生理改变能影响术后恢复,导致呼吸、心血管及泌尿系统的并发症,因此完善的术后镇痛是围术期处理的一个重要环节。在传统的术后疼痛治疗中,阿片类药物如吗啡、芬太尼等,是首选治疗用药,但此类药物常会引起恶心、呕吐、呼吸抑制、过度镇静等不良反应。     

氯诺昔康用于脊柱手术后镇痛的观察

目的比较两种方法在脊柱手术后镇痛的效果和并发症。方法60例脊柱手术病人随机分成氯诺昔康组和吗啡组。观察两组病人术后的镇痛效果(VAS评分)和副作用。结果两组镇痛效果无明显差别,但副作用却有显著差别。结论氯诺昔康用于术后镇痛安全有效。     

氯诺昔康静脉给药对人工流产的镇痛效果

目的：探讨氯诺昔康静脉给药用于人工流产术中、术后的镇痛效果。方法：将200例早孕妇女随机分为观察组和对照组,各100例,观察组用氯诺昔康（可赛风）8mg;对照组术前、术中不用任何药物;监测患者术前宫颈扩张情况和术中、术毕的生命体征变化,术后不良反应的发生情况,评定术中及术后的镇痛效果。结果：两组间子宫收缩、失血量差异均无统计学意义（P〉0．05）;对照组术中、术后10min镇痛效果及宫颈扩张情况、人工流产综合征明显优于对照组（P〈0．001）。结论：氯诺昔康可安全用于人工流产术的镇痛,尤其可减轻术中、术后官缩痛,降低不良反应。     

氯诺昔康的临床应用观察

资料与方法 选择行子宫切除术患者60例,ASA1～2级,年龄45～60岁,体重45～60kg;有以下情况者不作为观察对象：（1）对非甾体抗炎药过敏者;（2）正在使用与氯诺昔康有相互作用的药物（如地高辛,速尿,华法令,优降糖,单胺氧化酶抑制剂,苯二氮卓类及巴比妥类药物）;（3）接受细胞毒药物治疗;（4）患出凝血性疾病;（5）术中出现意外情况;（6）术中硬膜外穿刺困难或失效。将60例患者随机分为2组：可塞风组和哌替啶组,每组各30例。     

氯诺昔康对慢性关节炎治疗的实验研究

目的 在大鼠慢性关节炎模型上，研究关节腔内注射氯诺昔康对慢性关节炎的疗效。方法 大鼠慢性关节炎模型上，通过观察治疗前后关节影像学和病理学变化，测定治疗前后关节直径、疼痛评分、运动评分研究关节腔内注射氯诺昔康对慢性关节炎的治疗效果。结果 （1）氯诺昔康治疗两周后影像学显示炎症减轻，病理学显示有新生关节软骨形成；（2）氯诺昔康治疗两周运动评分高于无治疗组（P〈0．05），踝关节直径、疼痛评分低于无治疗组（P〈0．05）。结论 关节腔内注射氯诺昔康可减轻慢性关节炎，还可促进受损关节的修复。     

紫外分光光度法测定氯诺昔康注射液的含量

目的 采用分光光度法测定氯诺昔康注射液的含量。方法 以水为溶媒，测定波长378nm的条件下，对氯诺昔康注射液进行含量测定，另外还对样品的测定条件进行了优选。结果 氯诺昔康浓度在4μg-20μg范围内线性良好，以标准曲线法得其回收率为99.7%(n=5),RSD为0.78%。结论 该方法稳定可靠，重现性好，辅料及杂质无干扰。     

氯诺昔康用于术后镇痛的临床观察

目的 观察硬膜外氯诺昔康复合吗啡持续注入对术后镇痛的效果.方法 选ASA (Ⅰ-Ⅱ)级择期下腹部或下肢手术的患者46例,行腰麻-硬膜外联合麻醉,术毕24mg氯诺昔康加吗啡4mg溶于100mg生理盐水,按2ml/h的速度硬膜外腔持续注入,观察镇痛效果及副作用,监测血压、心率、呼吸频率及脉搏氧饱合度.结果 术后镇痛效果满意,呼吸血压均平稳,恶心呕吐发生率低.结论 氯诺昔康复合吗啡硬膜外镇痛安全有效.     

氯诺昔康的合成

以2，5－二氯噻吩为原料，经氯磺化、甲胺化、N－烷基化、环合、氨基取代等反应合成氯诺昔康。甲胺化时，以30％甲胺水溶液代替气体甲胺，简化了操作；N－烷基化时以相转移催化剂／氯乙酸甲酯代替钠氢／碘乙酸甲酯，提高了收率；环合反应更换溶剂系统使收率可达77％。工艺操作简便、安全，条件温和，成本低，总收率可由0．45％提高至12．3％。     

氯诺昔康 芬太尼用于老年患者术后镇痛的观察

目的探讨氯诺昔康与芬太尼联合用于老年患者术后疼痛的镇痛效果及不良反应。方法48例择期行腹部手术的老年患者随机均分为两组,分别以氯诺昔康加芬太尼（M组）和芬太尼（F组）作为术后静脉自控镇痛（PCIA）药物以视觉模拟评分（VAS）作为疼痛强度指标,观察开始镇痛后24 h两组患者的镇痛效果;记录镇痛期间的不良反应发生情况;镇痛结束后,统计患者对镇痛治疗的总体满意度。结果开始镇痛后1、2、4、8、16、24h,VAS组间比较差异无统计学意义,24h内使用追加药物的例数、镇痛结束后患者对镇痛治疗的总体满意度差异亦无统计学意义,开始镇痛后24h芬太尼消耗量M组明显少于F组（P〈0.05）,M组恶心、轻度呼吸抑制（SpO2〈93%）发生率明显低于F组（P〈0.05）,M组瘙痒、嗜睡及尿潴留的发生率显著低于F组（P〈0.05）。结论与芬太尼联合用于老年患者术后镇痛,氯诺昔康可减少芬太尼使用量（约47.1%）,镇痛效果确切,安全,不良反应发生率低。     

Peak B endorphin concentration in cerebrospinal fluid: reduced in chronic pain patients and increased during the placebo response

The level of an endogenous opioid (peak B endorphin) was measured in chromatographically fractionated cerebrospinal fluid (CSF) sampled from two groups of chronic pain patients before and after intrathecal saline (placebo) injection. As assessed by a verbal rating scale, one group reported no change in their level of pain (non-responders, NR;n=6) while the other group reported complete or >50% pain relief (placebo responders, PR;n=14). We find, as has been reported previously, that initial peak B levels were lower (by 50%) in these chronic pain patients' CSF than in CSF from pain-free (PF) normal controls (P<0.001,t-test). Peak B levels measured from CSF of the NR group undergoing this procedure did not change (P>0.4, pairedt-test). In contrast, a significant 2.3-fold increase was measured in the CSF peak B level of the PR group (P<0.05, pairedt-test). This is the first direct evidence that a CSF opioid is correlated with placebo pain relief in chronic pain patients. Peak B is a potent analgesic substance when administered by the intracerebroventricular route in mice and its level is related to the patients' pain status in a presumably causal manner.     

中风患者血脑脊液酸碱气体分析

目的　探讨中风患者血、脑脊液酸碱气体的变化 ,为临床诊疗中风提供依据。方法　用血气分析仪对 96例中风患者做了血和脑脊液酸碱气体分析。将中经络组、中脏腑组分别与 5 0例正常组和 5 0例对照组进行比较。结果　中风患者的血和脑脊液中PO2 均降低 ,以中经络组血PO2 降低更明显 (P <0 0 1)。中风患者脑脊液中CH增高显示代谢酸中毒 ,以中脏腑组更为明显 (P <0 0 1)。结论　血和脑脊液酸碱气体分析可为中风病的诊断、治疗和预后判断提供客观依据。     

乳铁蛋白在大鼠坐骨神经慢性束缚损伤模型产生镇痛作用

目的:研究乳铁蛋白在大鼠坐骨神经慢性束缚损伤模型的镇痛作用。方法:30只成年SD大鼠被制作为坐骨神经慢性束缚损伤模型,用辐射热刺激法诱发鼠后腿回缩试验测定痛阈,实验动物分为5组,分别腹腔注射生理盐水及乳铁蛋白30mg/kg、100mg/kg、300mg/kg、1000mg/kg。药物效应以最大可能效应百分数(MPE%)表示。以t检验法分析乳铁蛋白各剂量组与对照组之间的差异。结果:腹腔注射乳铁蛋白剂量依赖性地延长大鼠后腿回缩潜伏期;乳铁蛋白的峰值作用时间在用药后60分钟;乳铁蛋白各剂量组的最大可能效应百分数与生理盐水组相比差异有显著性。结论:腹腔注射乳铁蛋白在大鼠坐骨神经慢性束缚损伤模型产生剂量依赖性镇痛作用。     

金刚藤胶囊联合胎盘组织液治疗慢性盆腔痛的疗效观察

目的 探讨金刚藤胶囊联合胎盘组织液治疗慢性盆腔痛的临床疗效.方法 选择2008年1月-2010年12月收治于我院的慢性盆腔痛患者92例,随机分为观察组和对照组,对照组采用普诵西医治疗,观察组采用金刚藤胶囊联合胎盘组织液治疗,比较治疗效果.结果经过治疗,观察组36例患者中,痊愈11例,显效13例,有效10例,无效2例,总...     

脊髓5-HT_(2A)受体对大鼠慢性内脏痛敏反应及其电针治疗的影响

目的探讨脊髓5-羟色胺2A(5-HT2A)受体对大鼠慢性内脏痛敏反应及其电针治疗的影响。方法 SD大鼠分为正常对照组,慢性内脏痛模型组、模型加溶媒对照组、模型加酮色林组、模型加电针组、模型加针药合用组等6组。慢性内脏痛模型采用对新生幼鼠给予结直肠扩张刺激方法制备;电针选取双侧"足三里"和"上巨虚",疏密波,强度1 mA,持续30 min,隔日1次,持续4次。记录各组大鼠在结直肠扩张刺激诱导下腹壁撤退反射评分和腹外斜肌放电幅值。结果①在20和40mmHg压力刺激下,模型加酮色林组大鼠腹壁撤退反射评分高于模型组(P<0.05,P<0.01)和模型加针药合用组大鼠(P<0.05,P<0.01)。②在3种不同压力刺激下,模型加酮色林组大鼠腹外斜肌放电幅值皆高于模型组和模型加针药合用组大鼠(P<0.05)。结论脊髓5-HT2A受体能够降低慢性内脏痛大鼠的痛觉敏化,但在电针治疗慢性内脏痛敏反应中可能不起主要作用。     

Determination of lopinavir cerebral spinal fluid and plasma ultrafiltrate concentrations by liquid chromatography coupled to tandem mass spectrometry

A method for the determination of lopinavir (LPV) concentrations in cerebral spinal fluid (CSF) and plasma ultrafiltrate (UF) was developed and validated to analyze clinical specimens from patients receiving antiretroviral treatment with lopinavir/ritonavir. The CSF (400 μL sample volume) final calibration range for LPV was 0.313–25.0 ng/mL. The final calibration range for UF (50 μL sample volume) was 1.25–100 ng/mL. The samples were prepared using liquid–liquid extraction, concentrated, and analyzed using a reversed phase isocratic separation. Detection was achieved in positive mixed reaction monitoring mode on a triple quadrupole mass spectrometer. Isolation of LPV through chromatographic separation and proper selection of calibration matrix were important factors in achieving accurate results. Plasma UF was found to be an equivalent calibration matrix to CSF whereas plasma matrix produced a positive bias in samples with unknown concentrations. Artificial CSF media prepared chemically were biased and less superior than UF. Sources of plasma for the UF did not affect accuracy. Several CSF sources were tested for specificity of the method and LPV concentrations were accurately produced with atmospheric pressure chemical ionization source producing more accurate results than the electrospray source. The method successfully measured LPV concentrations in CSF that were previously undetectable by HPLC as well as UF from protein binding studies.     

Prescription opioid abuse,chronic pain,and primary care: A Co-Occurring Disorders Clinic in the chronic disease model

Abuse of opioids has become a public health crisis. The historic separation between the addiction and pain communities and a lack of training in medical education have made treatment difficult to provide, especially in primary care. The Co-occurring Disorders Clinic (COD) was established to treat patients with co-morbid chronic pain and addiction. This retrospective chart review reports results of a quality improvement project using buprenorphine/naloxone to treat co-occurring chronic non-cancer pain (CNCP) and opioid dependence in a primary care setting. Data were collected for 143 patients who were induced with buprenorphine/naloxone (BUP/NLX) between June 2009 and November 2011. Ninety-three patients (65%) continued to be maintained on the medication and seven completed treatment and were no longer taking any opioid (5%). Pain scores showed a modest, but statistically significant improvement on BUP/NLX, which was contrary to our expectations and may be an important factor in treatment retention for this challenging population.     

The pharmacological management of dental pain

ABSTRACT

Introduction

Dental pain is primarily treated by dentists and emergency medicine clinicians and may occur because of insult to the tooth or oral surgery. The dental impaction pain model (DIPM) has been widely used in clinical studies of analgesic agents and is generalizable to many other forms of pain.     

脊髓p38MAPK在大鼠背根节慢性压迫神经病理性疼痛中的作用

目的观察背根节慢性压迫(chronic compression of dorsal root ganglion,CCD)痛大鼠脊髓p-p38MAPK表达的变化,探讨p38MAPK与慢性神经病理性痛的相关性。方法♂SD大鼠36只,随机分为正常组(Naive组,n=4)、假手术组(Sham组,n=16)和背根节慢性压迫组(CCD组,n=16),Sham组和CCD组又分别分为5,7,14d和21d4个亚组(n=4),分别用免疫印迹法(Westernblot)检测各组大鼠脊髓磷酸化p38丝裂原活化蛋白激酶(p-p38MAPK)表达的变化。结果3组大鼠脊髓均见p-p38MAPK蛋白表达。Naive组和Sham组间比较差异无统计学意义。CCD组大鼠脊髓p-p38MAPK蛋白表达较Naive组和Sham组明显增多;与Sham组相比,CCD后5,7,14,21d各组大鼠脊髓背角神经元胞质p-p38MAPK蛋白分别增加了138·1%(P<0·01)、184·3%(P<0·01)、247·4%(P<0·01)和90·4%(P<0·05)。胞核p-p38MAPK蛋白分别增加了167·3%(P<0·01)、177·8%(P<0·01)、262·7%(P<0·01)和72·7%(P<0·05)。结论在CCD大鼠模型中,脊髓p38MAPK的活化与背根节慢性压迫致神经病理性痛的形成和发展存在密切联系。     

骨科慢性疼痛的治疗效果观察

目的：探讨慢性疼痛的标准化治疗原则与方法。方法：根据初步总结的标准治疗方案一多模式管理方案,对74例颈肩、腰腿疼痛病例进行治疗,结果与同期38例病例作对比分析。结果：该方案具有相对优良的治疗效果,并可明显减少止痛药物的使用。结论：该方案将生物学治疗与心理学方法相结合,可提高疗效;治疗原则标准化,有利于比较,值得进一步研究。