Genex人工骨椎体成形与内固定术治疗老年胸腰椎爆裂性骨折

目的:探讨Genex人工骨作椎体成形材料与椎弓根钉系统复位固定术治疗胸腰椎骨折的方法与疗效。方法:采用Genex人工骨作椎体成形材料与椎弓根钉系统复位固定胸腰椎骨折22例通过影像学检查与ASIA标准评价手术疗效。结果:术后6个月以骨折椎体为中心摄侧位X线片,显示椎体高度恢复未丢失,椎体骨组织密度接近正常。CT扫描发现椎体内骨缺损完全消失,骨缺损区已为正常骨组织。椎体前后缘高度及Cobb角,手术前与手术后及随访期测量,均有显著性差异(P0.01),神经功能均有1～2级的恢复。结论:Genex人工骨作为成形材料进行椎体成形术,生物相容性好,骨诱导能力强,无并发症,椎体高度及Cobb角丢失少。     

Cortisomol根管糊剂根充术后反应的临床观察

目的：观察Cortisomol根管糊剂根充术后反应并与-临床最常用的氧化锌丁香油酚糊剂（ZOE）相比较。方法：门诊就诊的根充术适应证患者180例随机分为实验组（Cortisomol组）112例（126颗）和对照组（ZOE组）68例（72颗）。常规根管预备、根管消毒后,分别用Cortisomol糊剂和氧化锌丁香油酚糊剂进行根管充填术,观察术后的反应。结果：实验组治疗后31．7％患牙未出现疼痛,累计80．2％患牙2天内完全止痛,累计97．6％患牙4天内完全止痛;对照组治疗后12．5％患牙未出现疼痛,累计43．1％患牙2天内完全止痛,累计80．6％患牙4天内完全止痛。根充后疼痛发生率和持续时间实验组明显低于对照组。结论：Cortisomol是一种较为理想的根管充填剂。     

可吸收腰椎椎间融合器的近期疗效观察

目的将可吸收材料聚-D,L-乳酸(PDLLA)制成腰椎间融合器,通过临床应用研究,观察并评估其临床效果,探讨其在临床应用中的意义,为进一步加以改进和临床应用提供基础。方法将可吸收腰椎椎间融合器应用于腰椎疾病患者的后路减压椎间植骨融合内固定术中,术后随访6月,行VAS评分、JOA评分、X线及CT三维重建观察患者症状改善、局部反应、并发症、植骨融合率、神经功能改善、椎间植骨融合情况可吸收椎间融合器(Lumbar Absorbable Design Fu-sion Cage LADFC)的降解情况,评估腰椎可吸收椎间融合器的临床效果。结果所有患者随访6月,术后无明显局部反应;植骨融合率3个月为92.3%,6个月为100%;可吸收椎间融合器的CT值术后1周与术后3月及与术后6相比无显著性差异;VAS评分、JOA评分结果均显示术后6月与术前相比有显著性差异;临床评估良好。结论可吸收椎间融合器在临床应用过程中能够较好的缓解患者的症状;具有良好的植骨融合率,对植骨融合无明显的负面影响,能够逐步降解、吸收,被骨组织替代,但所需时间较长。     

硫酸钙/纳米羟基磷灰石构建人工骨材料的实验研究

目的探索将纳米羟基磷灰石（n-HA）/硫酸钙与半水硫酸钙（2CaSO4·H2O,CSH）组合构建一种新型的人工骨材料,研究其降解速度、理化特性及物质的变化过程,并对该变化与构建人工骨材料的成骨活性的相互作用及关系进行分析。方法模拟人体体液SBF9#浸泡液,将5组样品进行浸泡测试;5组分别是：n-HA、CSH、CSH/10wt%HA、CSH/20wt%HA和CSH/40wt%HA,测定钙磷元素释放速率、失重率及CSH/HA变化并对复合人工骨材料表面形态作扫描电镜观察和XRD分析。结果体外浸泡后,n-HA在24h内质量失重50%,24h后基本稳定;CSH外形及失重变化稳定,但2周后仅剩余少量,到17天时完全降解;3组复合材料质量失重及外形变化不大。5组在浸泡后24h内均有Ca释放,但n-HA组的Ca释放低于其他4组,各组均有P元素释出,但随时间逐渐减少。XRD结果分析：复合人工骨材料浸泡中的峰值下降,HA峰值强度增高。电镜观察到浸泡后复合材料形成新的晶体形态。结论本研究将硫酸钙、纳米羟基磷灰石2种材料复合,其主要成分存在相互作用,在模拟人体体液浸泡的环境下出现表面Ca、P元素的释放-吸附动态过程并新生磷灰石层,材料的降解速度可通过调节成分配比而加以控制。     

四逆散镇静催眠作用的物质基础初步研究

目的初步确认四逆散镇静催眠作用的活性物质,为揭示其镇静催眠作用的机制提供依据。方法采用HPLC方法分析四逆散ig给药后大鼠血中及脑脊液中移行成分,色谱条件为Kromasil C18柱(250 mm×4.6 mm,5μm),体积流量0.8 mL/min,柱温28℃,流动相A为乙腈,流动相B为磷酸水(pH值为3),梯度洗脱(10%～90%A),分析时间为140 min。结果 4种成分辛弗林、芍药苷、柴胡皂苷C、甘草次酸均可使脑脊液中内源性物质5-羟色胺(5-HT)峰面积大于空白脑脊液中峰面积,但作用不如四逆散冻干粉整方强,且混合物组(辛弗林-芍药苷-柴胡皂苷C-甘草次酸)脑脊液中5-HT峰面积是四逆散冻干粉组的3.2倍;在延长戊巴比妥钠所致小鼠睡眠时间方面,辛弗林、芍药苷、柴胡皂苷C、甘草次酸及其混合物和四逆散冻干粉组作用强于对照组,且混合物组优于四逆散冻干粉组。结论通过四逆散冻干粉血和脑脊液中移行成分分析及四逆散冻干粉对戊巴比妥钠所致小鼠睡眠时间影响的药效研究,初步确认了四逆散冻干粉的活性物质是血清中四逆散冻干粉的移行成分辛弗林、芍药苷、柴胡皂苷C及甘草次酸的混合物。     

繁缕属植物抗病毒活性物质基础组分结构研究

繁缕属植物全世界约有120种,是重要的植物资源。近年来因其明确的抗菌、抗病毒活性逐渐成为科研领域的研究热点。繁缕属植物富含黄酮、环肽、酚酸、挥发油、皂苷等多种化学成分,研究表明繁缕多糖及其黄酮碳苷具有一定的抗病毒活性。然而,其抗病毒物质基础研究尚不完善,作用机制不明确,以致于临床应用受到一定限制。在总结繁缕属植物各种化学成分研究概况的基础上,通过分析繁缕属植物抗病毒作用与其化学成分的相关性,指出繁缕属植物抗病毒活性物质基础可能是由多种成分按照一定比例共同作用的结果,最终提出基于"组分结构理论"的繁缕属植物抗病毒活性物质基础的研究思路,为开发抗病毒新药奠定基础。     

雷公藤有效部位提取纯化工艺研究进展

从药效物质基础、提取纯化工艺等方面,对雷公藤有效部位提取纯化工艺研究进行综述。雷公藤提取物具有显著的抗炎及免疫抑制作用,其有效部位主要包括二萜类、生物碱类和三萜类,其中很多成分既是抗炎免疫抑制的有效成分,又是毒性成分。文献报道及市售制剂存在提取纯化工艺不一致、工艺指标选择不够全面、使用毒性大的限制级有机溶剂等问题,造成不同制剂质量和疗效差别很大。有必要引入谱效结合的研究方法,对雷公藤进行更深入研究,建立一种安全、有效的提取纯化工艺。     

Good practice in reviewing and publishing studies on herbal medicine, with special emphasis on traditional Chinese medicine and Chinese materia medica

Ethnopharmacological relevance

Studies on traditional Chinese medicine (TCM), like those of other systems of traditional medicine (TM), are very variable in their quality, content and focus, resulting in issues around their acceptability to the global scientific community. In an attempt to address these issues, an European Union funded FP7 consortium, composed of both Chinese and European scientists and named “Good practice in traditional Chinese medicine” (GP-TCM), has devised a series of guidelines and technical notes to facilitate good practice in collecting, assessing and publishing TCM literature as well as highlighting the scope of information that should be in future publications on TMs. This paper summarises these guidelines, together with what has been learned through GP-TCM collaborations, focusing on some common problems and proposing solutions. The recommendations also provide a template for the evaluation of other types of traditional medicine such as Ayurveda, Kampo and Unani.

Materials and methods

GP-TCM provided a means by which experts in different areas relating to TCM were able to collaborate in forming a literature review good practice panel which operated through e-mail exchanges, teleconferences and focused discussions at annual meetings. The panel involved coordinators and representatives of each GP-TCM work package (WP) with the latter managing the testing and refining of such guidelines within the context of their respective WPs and providing feedback.

Results

A Good Practice Handbook for Scientific Publications on TCM was drafted during the three years of the consortium, showing the value of such networks. A “deliverable – central questions – labour division” model had been established to guide the literature evaluation studies of each WP. The model investigated various scoring systems and their ability to provide consistent and reliable semi-quantitative assessments of the literature, notably in respect of the botanical ingredients involved and the scientific quality of the work described. This resulted in the compilation of (i) a robust scoring system and (ii) a set of minimum standards for publishing in the herbal medicines field, based on an analysis of the main problems identified in published TCM literature.

Conclusion

Good quality, peer-reviewed literature is crucial in maintaining the integrity and the reputation of the herbal scientific community and promoting good research in TCM. These guidelines provide a clear starting point for this important endeavour. They also provide a platform for adaptation, as appropriate, to other systems of traditional medicine.     

采用自动煎药机制备橘红痰咳液的工艺及稳定性研究

目的:研究自动煎药机制备橘红痰咳液的最佳煎药工艺及稳定性。方法:选定影响煎药的3个主要因素,通过正交试验确定最佳煎药工艺;采用HPLC法测定不同贮存方法和贮存时间橘红痰咳液中苦杏仁苷和柚皮苷的含量及其卫生学检测指标。结果:橘红痰咳液在所测定的7周内,药液微生物含量符合《中国药典》2010版中关于合剂的微生物限度要求;苦杏仁苷和柚皮苷在7周内含量比较稳定。结论:煎药机制备橘红痰咳液最佳煎煮工艺为浸泡40min,100℃煎40min;橘红痰咳液在常温和冰箱能保存4周。