Pharmacokinetics of tacrolimus and mycophenolic acid are altered, but recover at different times during hepatic regeneration in rats.

Hepatic regeneration is very critical to the success of living donor liver transplantation, which allows a reduced size liver to grow in size to accommodate the requirements of both the donor and the recipient. The objectives of this study were to evaluate 1) the hepatic metabolism of the two immunosuppressive drugs, tacrolimus and mycophenolic acid (MPA), and 2) the pharmacokinetics of tacrolimus and mycophenolic acid at various time points after initiation of hepatic regeneration by partial hepatectomy in rats. The hepatic intrinsic clearance of tacrolimus was decreased to 70% and 51% of the control level at the 24th h and the 6th day, respectively, but returned to normal level by day 14. The total body clearance of tacrolimus was reduced transiently but recovered completely by day 18. The hepatic intrinsic clearance of MPA was decreased to 52% and 51% of that in control rats at the 24th h and the 6th day, respectively, but recovered to normal level by day 14. The total body clearance of MPA was reduced at the 24th h but recovered by day 6. The magnitude of reduction in the clearance of tacrolimus and MPA was much smaller than what was predicted from in vitro data. The elimination clearance of MPA glucuronide was also impaired during hepatic regeneration but recovered to normal level with time. In conclusion, the pharmacokinetics of tacrolimus and mycophenolic acid were altered during hepatic regeneration but recovered completely at different rates over time. Caution must be exercised in extrapolating in vitro data to in vivo conditions during hepatic regeneration.     

米非司酮致子宫内膜简单型增生二例临床分析

近年来，随着米非司酮应用的日趋广泛，其并发症亦不断增加，尤其是一些少见的以及一些始料未及的并发症，更应引起注意。我院2004年门诊诊治的二例病例，1例为子宫肌瘤剜除术后，1例为子宫腺肌症，在连续口服米非司酮4～6个月后，出现不规则的阴道多量流血，后经诊断性刮宫，二例病理检查均提示为子宫内膜简单型增生。现报道如下：     

三叉神经痛的辨证施治略述

三叉神经痛是指三叉神经分布范围内反复出现的阵发性短暂剧烈疼痛。罹患此病，轻者影响正常生活，重者痛不欲生。患者自觉痛如刀割、锥刺、火灼、电击、常伴有同侧面部肌肉抽搐，一般无感觉缺失等神经传导功能障碍。并常见到有激发点（扳机点）的存在，即如在刷牙、洗脸、进食、言语等动作时，接触三叉神经分布区某一部皮肤或粘膜等，均可激发疼痛发作。     

酸对乳酸杆菌泡腾片的影响

通过对4种不同弱酸制成的乳酸杆菌阴道泡腾片质量的比较,探讨生物泡腾制剂中酸对乳酸杆菌的影响.     

β1肾上腺素能受体反义寡核苷酸对肾性高血压大鼠血流动力学及心肌肥厚的影响

目的 :观察阳离子脂质体 (DOTAP DOPE)介导的 β1肾上腺素能受体mRNA反义寡核苷酸 (β1 AS ODN)对肾性高血压大鼠血流动力学及心肌肥厚的影响。方法 :建立二肾一夹 (2K1C)肾性高血压大鼠模型 ,随机分为假手术组、模型组、反向寡核苷酸组、反义寡核苷酸组和卡维地洛 (carvedilol)组。ODN与DOTAP DOPE以 1 2摩尔比混合 ,4周末尾静脉注射 0 .5mg·kg-1,卡维地洛 10mg·kg-1·d-1灌胃 4周。定期测血压 ,8周末测血流动力学参数 ,左室重量指数 (LVWI)及血浆内皮素 1(ET 1)浓度 ,并对LVWI与ET 1进行线性相关分析。结果 :与反向寡核苷酸组比 ,β1 AS ODN能降低血压最高达39mmHg并持续 2 7d(30 .4 4± 6 .5 0 ,P <0 .0 1) ,降低左室收缩压 (LVSP) (P <0 .0 5 )、左室舒张末压 (LV EDP) (P <0 .0 1) ,升高左室最大收缩和舒张速率 (±dp dtmax) (P <0 .0 1) ,降低LVWI(P <0 .0 5 )及血浆ET 1(P <0 .0 1) ;与卡维地洛组比 ,各指标均无显著性差异。LVWI与ET 1显著正相关 (r =0 .74 9,P <0 .0 1)。结论 :DOTAP DOPE介导的 β1 AS ODN单剂量静脉注射能持续降压 ,改善血流动力学 ,预防心肌肥厚 ,可能与其降低血浆ET 1有关。     

Prediction of Hidden Blood Loss During Posterior Spinal Surgery

Objective Identification of the risk factors for extraordinary hidden blood loss (HBL) could clarify the underlying causes and provide more appropriate management. This study aims to identify the predictors of HBL in spinal surgery.     

补肾行气活血法对骨髓基质干细胞诱导成软骨细胞作用的影响

[目的]观察补肾行气活血法对诱导骨髓基质干细胞(BMSCs)成软骨细胞作用的影响.[方法]将传至第3代的BMSCs分为阴性对照组和治疗组,分别采用软骨细胞诱导培养基加体积分数为10%的空白对照血清和诱导培养基加体积分数10%的骨炎定含药血清培养诱导成软骨细胞,观察软骨细胞的生长状况及细胞表型特征.[结果]治疗组在细胞贴壁、生长形态及成软骨特性方面明显优于对照组,细胞表型的免疫组化染色均为阳性.[结论]以补肾行气活血法为组方依据的骨炎定含药血清既可促进BMSCs的增殖,又可促进诱导的软骨细胞分化.     

决明子富铬培育的实验研究

目的探讨决明子生芽及三氯化铬浓度和培育时间对决明予富铬的影响。方法用不同浓度的三氯化铬水溶液,37℃浸泡决明子过夜,收获浸泡后的决明子,作为0h时间点的样品,然后分别收获24、48、72、96h的决明子芽,用石墨炉原子吸收分光光度法测定铬含量。结果决明子富铬的最短培育时间是72h,适宜的三氯化铬浓度为600mg／L。结论三氯化铬浓度、培育时间对决明子富铬有影响。     

IgE介导的食物过敏诊断程序及临床评价

目的 对IgE介导的食物过敏的诊断流程进行临床评价。探讨高效的食物过敏诊断程序。方法 0～6岁患儿88例,以支气管哮喘、过敏性鼻炎、特应性皮炎以及消化道症状为主要临床表现,进行食物过敏原皮肤点刺试验（skin prick test,SPT）,皮肤试验阳性者检测血清特异性IgE（sIgE）、sIgE阳性者进一步进行双盲安慰剂食物激发试验（double-blind placebo-control food challenge,DBPCFC）证实诊断。sIsE阴性者通过DBPCFC建立或排除诊断。结果 88例患儿中SPT（＋）者25例。其中SPT（＋）sIgE（＋）者16例,SPT（＋）sIsE（-）者9例;前者经DBPCFC进一步证实为食物过敏的有14例;后者通过DBPCFC建立诊断的3例。排除诊断的6例,根据SPT（＋）sIgE（＋）或SPT（＋）sIsE（-）诊断食物过敏的阳性预计值为87．5％．阴性预计值为77．8％。结论 皮肤点刺试验结合sIgE检测有较高的食物过敏确诊率,当前两者不一致时,需要通过DBPCFC建立诊断。     

保罗青光眼植入物治疗青光眼的初步观察

目的：初步评估保罗青光眼植入物在青光眼治疗中的有效性和安全性。

方法：回顾性分析2022-03/2023-01接受保罗青光眼植入物治疗的青光眼患者10例10眼的临床资料。至少随访12 mo,观察手术前后视力、眼压和抗青光眼用药数量等指标的变化。

结果：纳入患者末次随访时视力较术前无明显变化; 术前眼压19-60(中位数28)mmHg,末次随访时眼压为10-18(中位数14)mmHg。术前所有患者均需使用2-4种抗青光眼药物,末次随访时仅1例患者需使用。4例患者末次随访时角膜内皮细胞密度较术前明显下降,未发生角膜相关并发症。截至末次随访,10例患者均获得手术成功。

结论：保罗青光眼植入物具有显著的降眼压疗效,角膜内皮细胞损害可能是其存在的隐患。