利巴韦林温度-离子敏感型鼻用原位凝胶喷雾剂的制备及体外性质考察

目的制备具有适宜临界相变温度和临界相变阳离子强度,及适宜的喷雾粒度、使用方便、缓慢释放药物的温度-离子敏感复合型鼻用原位凝胶。方法以临界相变温度、临界相变阳离子强度、喷雾粒度为考察指标筛选温敏及离子敏材料的用量,制备利巴韦林温度-离子敏感复合型原位凝胶。以透析袋法评价该复合凝胶的凝胶外排水量、溶蚀速率、体外释放度,并以断裂距离为指标评价凝胶的黏膜黏附力。结果以质量分数为0.3%的去乙酰化结冷胶和质量分数为18.0%的泊洛沙姆407制备的温度-离子敏感复合型原位凝胶,临界相变温度为32.6℃,临界相变阳离子强度为93.4 mmol.kg-1,喷雾粒度为68.0μm,凝胶外排水质量分数为(13.8±0.8)%,溶蚀速度常数为1×10-4min-1,断裂距离为(1.60±0.06)mm。该混合凝胶具有良好的体外缓释特征。结论该复合型原位凝胶剂适宜作为水溶性药物的鼻用缓释载体。     

无膜释放模型考察直肠用温敏型原位凝胶的体外释放情况

目的:研究直肠用温敏型原位凝胶的体外释药考察方法。方法:采用无膜释放模型,以对乙酰氨基酚为模型药物、泊洛沙姆407为基质制备凝胶;分别采用《中国药典》桨法和常见的水浴振荡法,考察桨法转速(50、75、100r·min-1)、振荡器振荡频率(50、100、150r·min-1)对凝胶中药物释放行为的影响,并对释药数据采用不同的方程进行拟合。结果:桨法释药速率随桨速的增加而加快,但不同桨速间释药行为存在一定差异;振荡法释药速率也随振荡频率的增加而加快,但释药行为基本相似。各释药行为均符合零级方程,并以桨法75r·min-1和振荡法100r·min-1最符合。结论:本文建立的无膜释放模型可用于以泊洛沙姆407为基质的温敏型原位凝胶的释药研究,且桨法宜采用转速为75r·min-1,振荡法宜选用振荡频率为100r·min-1。     

Alginate-poloxamer microparticles for controlled drug delivery to mucosal tissue

Purpose: The aim of this study was to prepare and characterize novel hydrogel-based delivery systems allowing for the controlled release of drugs to mucosal surfaces. Methods: Terbutaline sulfate and bovine serum albumin (BSA)-loaded alginate-poloxamer microparticles were prepared by a w/o-emulsion- and external gelation method. The microparticles were characterized by optical and scanning electron microscopy, laser light diffraction, atomic absorption spectroscopy, energy-dispersive X-ray analysis, via complexation with 1,9-dimethyl methylene blue and using dialysis bags as well as modified Franz diffusion cells for in vitro drug-release measurements. Results: Using heptane as organic phase, homogeneous and almost spherical microparticles were obtained with a high-loading efficiency (>90%). The resulting drug-release patterns could effectively be adjusted by varying the “alginate:poloxamer” blend ratio. In addition, the particle size, morphology, calcium and chloride content as well as alginate-release rates could be altered. Erosion was the predominant release mechanism for BSA. Special attention needs to be paid to the microparticle recovery procedure, which can significantly affect key properties such as the resulting drug-release patterns. Conclusions: The novel hydrogel-based microparticles offering mild conditions for incorporated drugs (e.g., proteins) provide an interesting potential as controlled delivery systems for mucosal surfaces.     

Protective role of Hemidesmus indicus R. Br. root extract against Salmonella typhimurium-induced cytotoxicity in Int 407 cell line

The present investigation deals with the effect of the chloroform fraction composed of sterols and fatty acids isolated from Hemidesmus indicus root extract (CHI) on Salmonella enterica serovar Typhimurium (S. typhimurium)-induced cytotoxicity in a human intestinal epithelial cell line (Int 407). The optimum dose was fixed as 100 microg/mL for CHI against S. typhimurium, which was quite safe for Int 407 cells as the CD(50) concentration (50% cell death) of CHI was determined to be 500 microg/mL in the Int 407 cell line. CHI-treated S. typhimurium were 10-fold less cytotoxic and 40% less adherent to host cells than wild-type. Treatment of CHI significantly abrogated the invasion ability to 10- to 15-fold in S. typhimurium. The cells infected with CHI-treated S. typhimurium had a comparable viability to uninfected cells in the epithelial cell detachment assay. Immunofluorescence showed the CHI-treated bacteria were unhealthy and shrunken rods in comparison with the wild-type bacteria; those were firmly attached and invaded to deceased and hypertrophoid Int 407 cells. Transmission electron micrographs of Int 407 cells infected with wild bacteria showed a coat of adherent and invaded bacteria completely occupying the cytoplasm with characteristic Salmonella-containing vacuoles (SCV). Both necrotic and apoptotic type of cell death were observed in cells infected with wild-type bacteria, whereas most of the cells infected with treated bacteria were normal in morphology and a few had invaded bacteria, but the typical proliferated SCV was not observed in cells infected with CHI-treated S. typhimurium. In summary, the sterols and fatty acids present in CHI may be capable of taming S. typhimurium by suppressing its cytotoxic activity in an intestinal epithelial cell line.     

加替沙星热敏型凝胶滴眼液的制备与质量控制

目的制备加替沙星热敏型眼用凝胶并建立其质量控制方法。方法以泊洛沙姆P407为热敏型材料、加替沙星为主药制备加替沙星热敏凝胶,采用紫外分光光度法测定加替沙星含量,并考察产品的稳定性。结果所得制剂为透明度高、流动性好的凝胶剂;加替沙星检测质量浓度线性范围为1．25～80．00μg／mL（r=0．9989,n=7）,平均回收率99．80％,RSD=0．82％（n=9）;泊洛沙姆P407在处方中的质量分数为19％;产品室温观察1年质量稳定。结论该制剂制备简单、质量稳定可控。     

A Novel Mucoadhesive Polymer Film Composed of Carbopol,Poloxamer and Hydroxypropylmethylcellulose

Using the casting method novel mucoadhesive polymer blend film consisting of Carbopol, poloxamer, and hydroxypropylmethylcellulose (HPMC) was prepared and characterized. Triamcinolone acetonide (TAA) was loaded into Carbopol/poloxamer/HPMC polymer blend film. Carbonyl band of Carbopol in Carbopol/poloxamer/HPMC shifted to longer wavenumber than that of Carbopol in Carbopol/poloxamer due to the hydrogen bonding among Carbopol, poloxamer, and HPMC. Tan delta peak assigned to glass transition temperature (Tg) of HPMC shifted to low temperature due to increased flexibility caused by increased poloxamer content in polymer blend films. Swelling ratio of Carbopol/poloxamer/HPMC films was lowest in Carbopoll poloxamer/HPMC at mixing ratio of 35/30/35 (wt/wt/wt). Adhesive force of Carbopol/poloxamer/HPMC films increased with increasing HPMC content in Carbopol/poloxamer/HPMC polymer blend film and increasing hydroxypropyl group content in HPMC due to hydrophobic property of HPMC although bioadhesive force was highest at mixing ratio of 35/30/35 (wt/wt/ wt). Release of TAA from TAA-loaded Carbopol/poloxamer/HPMC polymer blend film in vitro increased with increasing loading content of drug.     

Protein-Losing Enteropathy Following Fontan Palliation

Protein-losing enteropathy (PLE) is a chronic condition involving multiple organ systems that may develop any time following Fontan completion. The pathogenesis of PLE is complex and multifactorial. Chronic venous hypertension, low cardiac output, and abnormal lymphatics may all play a role in the pathogenesis of PLE. Common signs and symptoms include chronic diarrhea, abdominal pain, and ascites. Diagnosis is based on the presence of signs and symptoms in addition to hypoalbuminemia and elevated stool alpha 1 antitrypsin. Early identification and a comprehensive approach to evaluation and treatment are important, as they may affect survival. The initial evaluation should include cardiac catheterization for hemodynamic assessment. Although an evidence base for treatment is lacking, various medical, interventional, and surgical approaches have been described with variable degrees of success. Commonly used therapies include nutritional support, diuretics, subcutaneous unfractionated heparin, budesonide, and sildenafil. Limited data exist for Fontan conversion or takedown. Assessment for heart transplantation should be considered. PLE mortality is high—approximately 50%—but may be mitigated by aggressive investigation and management. The evolving understanding of the role of lymphatics in the pathophysiology of PLE and the emerging role of interventional lymphatic procedures may further improve outcomes in this patient population.     

Challenges With Severe Coronary Artery Calcification in Percutaneous Coronary Intervention: A Narrative Review of Therapeutic Options

Coronary calcification often complicates atherosclerosis. With an aging population, coinciding with lower thresholds for coronary angiography and percutaneous coronary intervention (PCI), severe calcific coronary stenoses remain a challenge for interventional cardiologists. Although advances in coronary guidewires, percutaneous balloons, and adjunctive procedural devices have improved success of PCI, recalcitrant calcified lesions not amenable to the conventional technique frequently occur. Coronary atherectomy with plaque modification provides a therapeutic alternative. As such, various modalities such as rotational, orbital or laser atherectomy, and more recently shockwave lithoplasty have become therapeutic options for PCI. We provide a summary of the principles, technique, and contemporary evidence for these currently approved devices designed to treat severe coronary calcific lesions.     

缓释载药体泊洛沙姆407圆窗灌注对耳蜗结构与听觉功能的影响

目的观察圆窗局部灌注泊洛沙姆407对耳蜗功能和结构的影响。方法16只健康豚鼠右耳圆窗灌注100μl20％泊洛沙姆407溶液作为实验组,左耳灌注生理盐水作为对照组,另取4只动物不予处理作为阴性对照组。于灌注前、后及灌注后第7、14、28及49d行听性脑干诱发电位（auditorybrainstemresponse,ABR）检测,并于检测后分别处死4只动物,行耳蜗基底膜铺片并计数。结果泊洛沙姆407灌注后ABR阈值较灌注前均有所提高,但在49d时恢复至灌注前水平;耳蜗毛细胞计数显示泊洛沙姆407圆窗灌注后无明显毛细胞缺失。结论泊洛沙姆407圆窗灌注对ABR阈值有暂时性影响,但未对耳蜗功能和结构起到持久性不可逆性损伤,符合中、内耳疾病的缓释给药治疗的条件。     

氨来呫诺鼻用温敏凝胶喷雾剂处方优化及质量控制

摘 要 目的： 研制氨来呫诺鼻用温敏凝胶喷雾剂,建立其质量控制方法。方法: 采用冷法工艺制备氨来呫诺鼻用温敏凝胶喷雾剂,以泊洛沙姆407和泊洛沙姆188为基质,并以胶凝温度与成胶前黏度为考察指标,采用星点设计 效应面法对两种基质的用量进行考察;采用HPLC法测定氨来呫诺的含量,参照《中国药典》2010年版相关规定,对氨来呫诺鼻用温敏凝胶喷雾剂的外观、pH、黏度、含量、装量、每瓶总喷次和每喷主药含量进行测定。结果: 泊洛沙姆407和泊洛沙姆188的最佳配比为17.0%和0.9%;凝胶中氨来呫诺含量测定的平均回收率为98.8%,RSD为1.7%（n = 9）;制备的3批样品各项质量指标均符合规定。结论:氨来呫诺鼻用温敏凝胶喷雾剂处方和制备工艺合理可行,质量可控,可进一步研究开发。