复方丹参滴丸联合替米沙坦治疗糖尿病肾病临床观察

目的观察复方丹参滴丸联合替米沙坦治疗糖尿病肾病（DN）的疗效。方法将63例临床DN患者随机分为治疗组和对照组,两组均严格控制血糖,给予低盐、低蛋白饮食等基础治疗,对照组单纯使用替米沙坦,治疗组在替米沙坦的基础上联合复方丹参滴丸治疗6个月。观察24h尿白蛋白（uAlb）、血肌酐（Ccr）变化。结果两组患者uAlb和尿白蛋白／肌酐（uAlb／Ccr）比值均较治疗前显著下降,而治疗组下降显著高于对照组（P〈0．01）,治疗过程中无明显不良反应。结论复方丹参滴丸联合替米沙坦治疗DN安全、高效,值得临床推广应用。     

人参细粉与超微颗粒的急性毒性实验——半数致死量（LD50）与最大耐受量（MTD）的测定

目的：评价人参细粉与人参超微颗粒的急性毒性。方法：对小鼠1日3次分别灌胃人参细粉和人参超微颗粒,观察7d内小鼠的毒性反应及死亡情况。结果：小鼠的人参细粉和人参超微颗粒的半数致死量（LD50）未测得,最大耐受量（MTD）是7.38g/kg。结论：人参细粉和人参超微颗粒在临床常用剂量口服给药是安全的。     

马来酸依那普利和硝苯地平缓释片治疗2型糖尿病肾病合并蛋白尿和高血压的临床分析

目的比较和分析血管紧张素转换酶（ACE）抑制剂（依那普利）和长效钙离子拮抗荆（硝苯地平缓释片）对2型糖尿病肾病（Diabetic nephropathy．DN）尿蛋白、高血压、及肾功能的治疗效果。方法将74例DN患者（男51例,女23倒,平均年龄62±7岁）随机分为三组：马来酸依那普利组（27例）、硝苯地平缓释片组（24例）及两药联合治疗组（23例）。三组在严格控制血糖和饮食的基础上,分别服用依那普剩5mg、硝苯地平缓释片5mg,清晨口服,每日1次,如果治疗2周后血压仍未降至正常（〉140／90mmH：g）,则马来酸依那普利、硝苯地平缓释片分别增加至10mg,共用12周。结果两药单独治疗均可明显降低DN高血压（P〈0．01）,减少24小时尿白蛋白排出（P〈0．05）。两药联合治疗降低血压和降低尿蛋白的幅度明显优于单独治疗（P〈0．01）。结论马来酸依那普利和硝苯地平缓释片治疗DN所引起的高血压均有较好的降压作用,且能减少24小时尿蛋白的排泄,两药联合治疗疗效具有协同作用。     

Box-Behnken设计-效应面法优化根皮素纳米结构脂质载体处方研究

目的： Box-Behnken设计-效应面法优化根皮素纳米结构脂质载体处方。方法： 乳化超声法制备根皮素纳米结构脂质载体，采用包封率（Y₁）和粒径（Y₂）作为考察指标，选择脂-药比（X₁）、固液脂质比（X₂）、表面活性剂浓度（X₃）为主要影响因素，通过二次多元回归模型拟合根皮素纳米结构脂质载体的影响因素与响应值之间的关系，绘制模型效应面图，并验证最佳处方。结果： 最佳处方为：脂-药比为16.4，固液脂质比为4.7，表面活性剂浓度为1.3%。所得3批根皮素纳米结构脂质载体包封率分别为85.7%、84.9%和85.1%；粒径分别为166.9 nm、168.4 nm和170.3 nm，与模型预测值接近。制备的根皮素纳米结构脂质载体基本外貌为圆形，无粘连现象。根皮素存在状态由结晶态转变为无定型态。体外释药具有明显的缓释特征，释药过程符合Weibull模型。结论： Box-Behnken实验设计可用于根皮素纳米结构脂质载体处方的筛选，为后续体内外研究奠定了基础。     

The Sustained-Release Dexamethasone Implant: Expanding Indications in Vitreoretinal Disease

Abstract

Corticosteroids play an important role in the therapeutic approach to vitreoretinal disease. The Ozurdex® implant (DEX Implant 0.7?mg, Ozurdex®, Allergan Inc., Irvine, CA, USA) offers sustained release of dexamethasone in the vitreous cavity, and this novel drug delivery system has proven useful both in improving clinical outcomes and in reducing injection burden. While the Food and Drug Administration approves the use of the DEX implant in retinal vein occlusions and non-infectious posterior uveitis, its utilization continues to expand in its breadth of diversity across myriad vitreoretinal conditions. Additionally, modified injection techniques are evolving to improve the safety profile of the DEX implant in eyes that are often considered to have relative contraindications to its use, further extending its application. This review aims to evaluate the evidence supporting the expanding indications and injection techniques of the DEX sustained-release implant in vitreoretinal disease, and explores potential future indications for its use. Arenas for future research are also identified to further elucidate the precise role of the DEX implant in our current treatment model. Increased awareness of effective and safe uses of the DEX implant can refine our therapeutic approach to vitreoretinal disease and ultimately improve patient outcomes.     

Poloxamer-based in situ hydrogels for controlled delivery of hydrophilic macromolecules after intramuscular injection in rats

Abstract

This study is aimed to investigate the applicability of poloxamer 407 (P407) and 188 (P188)-based temperature-sensitive in situ hydrogel (TSHG) in sustained delivery of hydrophilic macromolecules following intramuscular administration. Polyethylene glycols (PEGs) with molecular weight of 5-, 20-, and 40-kDa were used as model drugs, which can represent the common size range of hydrophilic macromolecular drugs using TSHG. The correlation between the level of poloxamers and thermogelling transition temperatures (T_sol–gel) was established and two formulations “20% P407/10% P188” and “24% P407/10% P188” were chosen for further study. The results showed that the release kinetics of PEGs was close to zero order. Sustained in vivo behaviors were achieved by both of the two formulations for all the PEGs though variations were seen. Lower molecular weight PEG showed more remarkable pharmacokinetic improvements. No significant differences in pharmacokinetics were observed between the two formulations for the same PEG. This suggested that 20–24% P407/10% P188 formulations, with accordingly T_sol–gel in the range of 24.6?°C–31.7?°C, might be freely chosen to achieve comparable pharmacokinetics for hydrophilic macromolecular drugs after intramuscular injection.     

超临界CO2抗溶剂法制备姜黄素-EC缓释复合微粒的工艺研究

采用超临界CO₂抗溶剂法制备具有缓释效果的姜黄素-乙基纤维素(EC)复合微粒.以载药量和回收率为综合评价指标,在单因素的基础上采用正交试验设计优选姜黄素-EC缓释复合微粒的制备工艺,并对优选的工艺组合进行了载药量、回收率、粒径分布、扫描电镜(SEM)、红外光谱(IR)、差示扫描量热法(DSC)以及体外溶出等实验分析.正交试验得到的优选工艺为结晶温度45 ℃,结晶压力10 MPa,姜黄素质量浓度8 g·L^-1,溶液体积流量0.9 mL·min^-1,动态CO₂流出速度4 L·min^-1.此工艺条件下,制备的复合微粒的平均载药量和回收率分别为33.01%,83.97%,体积平均粒径为20.632 μm;IR与DSC分析表明姜黄素与EC可能发生了相互作用;体外溶出实验表明姜黄素-EC复合微粒具有良好的缓释效果.超临界CO₂抗溶剂法可制备具有缓释效果的姜黄素-EC复合微粒.     

Comparison of platelet pellet and bioactive glass in periodontal regenerative therapy

Objective. In recent years, platelet-rich plasma combined with graft materials has been used for periodontal regeneration. The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration (PP/GTR) and bioactive glass/GTR (BG/GTR) treatments in patients with periodontal disease.

Material and methods. Using a split mouth design, 15 chronic periodontitis patients with pocket depths?≥?6 mm following periodontal initial therapy were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas. An absorbable membrane of polylactic acid was used GTR. The criteria for the comparative study were preoperative and postoperative 6 months pocket depth, clinical attachment level, and radiological alveolar bone level.

Results. Both treatment modalities resulted in significant pocket depth reduction and gain in clinical attachment and alveolar bone level compared to the preoperative values (p<0.01). Reduction in pocket depth, gain in clinical attachment and alveolar bone level were 4(3–6), 4.1±0.7, 4.9±1.4 mm in the PP/GTR group and 4(3–7), 4.1±1.2, 5.9±1.7 mm in the BG/GTR group, respectively. The differences between the two groups were not statistically significant (p>0.05).

Conclusions. Within the limits of this study, it was concluded that PP may be effective as a bioactive glass graft material and used as a graft material for treating intrabony defects. PP thus appears to be a suitable alternative in the regenerative treatment of intrabony periodontal defects.     

参松养心胶囊联合美托洛尔缓释片治疗老年冠心病心律失常疗效观察

目的观察参松养心胶囊联合琥珀酸美托洛尔缓释片治疗老年冠心病心律失常的疗效。方法选取120例老年冠心病合并心律失常患者随机分为两组,治疗组60例,采用参松养心胶囊口服,3次/d,3粒/次,琥珀酸美托洛尔缓释片1次/d,初始剂量23.75mg,目标剂量47.5～95mg,参考患者心率和血压水平调整剂量;对照组60例,单用琥珀酸美托洛尔缓释片治疗。疗程4周。分别观察两组治疗前后临床症状、心律失常和心肌供血情况,以及血压、血脂、肝功能、肾功能、B型尿钠肽(BNP)等变化。结果症状改善情况,治疗组显效29例,有效26例,无效5例,总有效率91.7%,对照组显效19例,有效25例,无效16例,总有效率73.3%,两组比较差异有统计学意义(u=2.530,P0.05)。心律失常改善情况,治疗组显效29例,有效24例,无效7例,总有效率88.3%,对照组显效19例,有效24例,无效17例,总有效率71.7%,两组比较差异有统计学意义(u=2.372,P0.05)。心电图改善情况,治疗组显效25例,有效31例,无效4例,总有效率93.3%,对照组显效18例,有效29例,无效13例,总有效率78.3%,两组比较差异有统计学意义(u=2.041,P0.05)。血压及生化变化情况,治疗组在治疗前、治疗后同组间,以及治疗后与对照组比较,其血压、总胆固醇、低密度脂蛋白胆固醇、脂蛋白α和BNP亦明显下降,差异有统计学意义(P0.05)。治疗组与对照组不良反应发生均较少,不良反应发生率比较差异无统计学意义(χ2=2.157,P0.05)。结论参松养心胶囊联合琥珀酸美托洛尔缓释片治疗老年冠心病心律失常患者有较好的疗效和安全性,值得临床应用。     

音猬因子缓释聚多巴胺纤维蛋白支架促进大鼠脊髓损伤的修复

BACKGROUND: Recently, most studies have combined tissue engineering materials with stem cells or factors to improve the microenvironment of animal models of spinal cord injury to increase the duration of action, improve the recovery effect and prognosis.