新型醒脑静大鼠鼻腔及静脉注射给药后龙脑的药代动力学研究

目的:研究新型醒脑静中艾片有效成分龙脑在大鼠鼻腔给药和静注给药后的药代动力学。方法:醒脑静静注给药剂量为12 mg.kg-1,鼻腔给药剂量为150 mg.kg-1。采用气相色谱法测定血中龙脑的浓度,以Kinetica 4.4软件计算药代动力学参数。结果:鼻腔给药醒脑静滴鼻液后,艾片有效成分龙脑能迅速进入血液中,生物利用度可达83%。结论:鼻腔给药后龙脑能迅速而较完全地吸收进入体循环。     

黄芪桂枝五物汤对胶原诱导性关节炎大鼠血清中白细胞介素-20的影响

目的观察黄芪桂枝五物汤对胶原诱导性关节炎(CIA)大鼠的一般情况、体质量、血红蛋白、血清中白细胞介素-20(IL-20)水平的影响,以阐明黄芪桂枝五物汤治疗类风湿关节炎的作用机制。方法选用健康清洁级SD大鼠32只,随机分为4组,正常对照组、模型组、雷公藤多苷组、黄芪桂枝五物汤组。除正常对照组外,其余各组均行CIA大鼠模型。观察造模后大鼠一般情况及造模后第1、2、3、4周的体质量变化情况;采用全自动血细胞分析仪测定各组大鼠血红蛋白含量,采用酶联免疫吸附试验(ELISA)方法测定各组大鼠血清中IL-20的水平。结果造模后第1、2、3周大鼠体质量各组之间差异无统计学意义(P>0.05),造模后第4周模型组体质量低于正常对照组、雷公藤多苷组、黄芪桂枝五物汤组,差异有统计学意义(P<0.05)。治疗1个月后,与正常对照组相比,模型组大鼠血清中IL-20水平升高,差异有统计学意义(P<0.05);与模型组比较,黄芪桂枝五物汤组血红蛋白水平高于模型组,差异有统计学意义(P<0.05);经雷公藤多苷、黄芪桂枝五物汤治疗后大鼠血清中IL-20的水平下降,差异有统计学意义(P<0.05);雷公藤多苷组、黄芪桂枝五物汤组血清IL-20差异无统计学意义(P>0.05)。结论黄芪桂枝五物汤能升高CIA大鼠血红蛋白含量,有抑制CIA大鼠血清中IL-20升高的作用。     

枸橼酸二甲双胍阿霉素脂质体的制备

目的制备二甲双胍阿霉素脂质体并对其制备工艺进行优化。方法以二甲双胍阿霉素脂质体的包封率为评价指标,对其处方和制备工艺进行筛选和优化。分别考察了磷脂与胆固醇的比例、水化介质中阴离子的种类、水化介质的浓度、水化介质的pH值、载药温度、载药时间对二甲双胍阿霉素脂质体包封率的影响。结果最终优化的处方为m(hydrogenated soybean phosphatidylcho-line,HSPC)∶m(cholesterol,CH)∶m(polyethylene glycol 2000-cholesteryl hemisuccinate,mPEG2000-CHEMS)=3.0∶1.0∶1.0,以pH为7.00的300 mmol.L-1的枸橼酸二甲双胍为水化介质,60℃载药60 min,所制备的脂质体包封率可达98.7%。结论以枸橼酸二甲双胍离子梯度法制备的阿霉素脂质体包封率高,方法可行。     

低分子质量肝素-枸橼酸铵混合离子梯度法制备阿霉素脂质体

目的制备低分子质量肝素-枸橼酸铵混合离子梯度的阿霉素脂质体,并对其处方和制备工艺进行优化。方法采用离子交换树脂法建立脂质体内外水相低分子量肝素与枸橼酸铵的混合离子梯度,考察建立离子梯度的不同方法、脂质体处方及水化介质种类对阿霉素脂质体包封率的影响。结果最终优化的处方为m(hydrogenated soybean phosphatidylcholine,HSPC)∶m(cholesterol,CH)∶m(polyethylene glycol 2000-cholesteryl hemisuccinate,mPEG2000-CHEMS)=3.0∶1.0∶1.5;制备工艺为以100 mmol.L-1枸橼酸铵联同10 g.L-1低分子质量肝素铵为水化介质,除盐时间为15 min。加入低分子量肝素后,可使枸橼酸铵阿霉素脂质体的包封率由78.0%提高到95.5%。结论低分子量肝素的加入可显著提高枸橼酸铵阿霉素脂质体的包封率。     

脑钠肽及高敏C反应蛋白检测与慢性心力衰竭的关系

目的 探讨脑钠肽（BNP）与高敏C反应蛋白（hs-CRP）在辛伐他汀治疗慢性心力衰竭前后检测值的变化,了解二者的关系.方法 将门诊及住院患者共85例分为左室收缩功能衰竭常规治疗组40例、辛伐他汀治疗组45例,同时设心功能正常对照组35例.辛伐他汀组在常规治疗基础上再加用辛伐他汀20 mg/d治疗,治疗前及治疗后12周均测BNP、hs-CRP.结果 BNP和hs-CRP与心力衰竭严重程度相关,治疗12周后,2组BNP活性均下降（P〈0.05）,且以他汀组变化更明显,与对照组比较差异有统计学意义（P〈0.05）.结论 慢性心力衰竭患者在接受常规治疗的同时,加用辛伐他汀治疗可明显降低BNP和hs-CRP的含量;hs-CRP及BNP联合检测可作为慢性心力衰竭诊断、病情评估及疗效监测的重要临床指标.     

基于谱效相关的生地黄多指标成分定量分析方法的研究

目的建立谱效相关的生地黄多指标定量分析方法。方法采用高效液相色谱法建立生地黄止血作用指纹图谱,以梓醇为对照品,对达到基线分离的色谱峰进行定量,计算出各指纹峰相对于梓醇的含量。结果确定出13个指纹峰,计算其相对于梓醇的含量。结论所建方法简便、准确、可靠,可作为生地黄止血作用的质量控制方法。     

Complications of posterior cranial fossa surgery—an institutional experience of 500 patients

BackgroundThe complication of the posterior fossa surgery is seldom described in the literature. The purposes of this retrospective study are to draw attention to the potential complications associated with posterior fossa surgery and to critically review the predisposing factors that might influence the complication rate.MethodsWe undertook a 10-year (1992-2002) retrospective study of all posterior fossa surgery performed at LSUHSC. A total of 500 patients were obtained from the operation database, and they were categorized into 5 groups based on the surgical approaches: (1) cerebellopontine angle lesion, (2) microvascular decompression for facial pain and spasm, (3) cerebellar lesions, (4) Chiari I decompression, and (5) petroclival lesions. Data collected for analysis included patient demographics, pathological characteristics of the lesions, and the postoperative complications that occurred as unexpected and undesirable events that prolonged hospital stay and may require surgical/medical intervention.ResultsOf the 500 patients reviewed, 220 (44%) patients had tumor resections at the cerebellopontine angle; 110 (22%) patients had microvascular decompression for trigeminal neuralgia and hemifacial spasm; 86 (17.2%) patients had cerebellar lesions; 60 (12%) patients had Chiari I decompression; and 24 (4.8%) patients required transpetrosal approaches for petroclival lesions. The overall complication rate in our study was 31.8%, affecting 159 patients. Cerebrospinal fluid leaks were the most frequently encountered, presenting in 65 (13%) patients followed by meningitis in 46 (9.2%) patients, wound infection in 35 (7%) patients, and CN palsies in 24 (4.8%) patients. Other complications that were observed to develop almost exclusively in patients undergoing cerebellar parenchymal tumor resection included cerebellar edema in 25 (5%) patients, hydrocephalus in 23 (4.6%) patients, cerebellar hematoma in 15 (3%) patients, and cerebellar mutism in 6 (1.2%) patients. The overall mortality rate related to surgery was 2.6% occurring in 13 patients.ConclusionPosterior fossa surgery involves greater morbidity and mortality and has a wider variety of complications than surgery in the supratentorial compartment. These complications may be avoided by careful perioperative planning, strict adherence to aseptic technique, meticulous microsurgical dissection, proper wound closure, and the judicious use of prophylactic agent. A thorough understanding of the patient's history, neurological findings, imaging studies, operative anatomy, as well as all potential adverse events associated with the procedure is also essential to minimize complications.     

肾功检验结果互认研究及其相关分析

目的探讨区域性二甲以上六家医院肾功血清尿素氮（BUN）与肌酐（cREA）检验结果能否互认,为该区域实行检验结果互认提供依据。方法收集组值不同的新鲜血清3批,每批5份标本,每份标本分成6小份,每小份1 ml分装于灭菌带盖塑料管中,3批标本分3次分别送于六家医院检验科,自动生化分析仪检测,要求其与患者或体检者标本同时出结果,结果由组织单位统一收集。结果按照CLIA标准,六家医院BUN检验结果3次PT得分均≥80％;CREA四家医院3次PT=100％,两家医院3次PT≤80％。结论咸阳市区二甲以上六家医院血清BUN可实现检验结果互认;CREA检验结果目前不能互认,实现互认尚待进一步研究。     

Activation of Group III Metabotropic Glutamate Receptor Reduces Intracellular Calcium in β-Amyloid Peptide [31–35]-Treated Cortical Neurons

It is unknown whether amyloid beta-protein 31–35 (Aβ[31–35]) has effects similar to Aβ[1–40] and Aβ[25–35] on the intracellular calcium ([Ca²⁺]i) to induce a disruption of calcium homeostasis. In this study, we investigated the effects of Aβ[31–35] on [Ca²⁺]i in primary cultured cortical neurons using real time fluorescence imaging technique and the Ca²⁺-sensitive dye Furo-2/AM. It was found that Aβ[31–35] (25 μM) could induce a significant elevation in [Ca²⁺]i and a decrease in the average latency in the cortical neurons in a dose-dependent manner. To examine whether the activation of group III mGluRs could block the changes in [Ca²⁺]i and protect neurons from apoptosis induced by Aβ[31–35], we then investigated the effects of l-serine-O-phosphate (l-SOP) and (R,S)-4-phosphonophenylglycine ((R,S)-PPG), the selective agonists of group III metabotropic glutamate receptors (mGluRs), on [Ca²⁺]i and apoptosis in neurons treated by Aβ[31–35]. We demonstrated that l-SOP or (R,S)-PPG (100 μM) treatment suppresses significantly the elevation of [Ca²⁺]i induced by Aβ[31–35] and also induces an almost complete recovery of both the fluorescence intensity and apoptotic cells (%) to the control level in the neurons. These results suggest that Aβ[31–35] may be the shortest sequence responsible for the neuronal toxicity of Aβ protein and that the neuroprotective role of the activation of group III mGluRs from the apoptosis induced by Aβ[31–35] might be partly due to its ability to inhibit the increased calcium influx, which results from Aβ[31–35].