新型腹腔化疗管复合材料的制备与性能表征

目的 本研究采用医用硅橡胶经聚四氟乙烯(PTFE)改性,用于制备植入体内的新型腹腔化疗管复合材料.方法 对其材料进行物理机械性能、动物试验安全性进行评价.结果 PTFE添加最对复合材料硬度的影响不大,随着PTFE含量增加,复合材料仍保持较高的物理机械性能;复合材料通过过敏试验、热源试验、全身急性毒性试验表明,所制备的复合材料在生物学评价试验中均呈阴性反应,材料无明显毒性,材料中不存在潜在致敏性物质,所含热原含量符合生物体的要求.具有优良的生物相容性.结论 本文所制备的硅橡胶/PTFE复合材料具有较高的物理机械性能和优良的生物相容性,是制备腹腔化疗导管的良好材料.     

人工气管材料体外细胞毒性和生物相容性研究

目的 :对自行研制的人工气管材料进行体外细胞毒性和生物相容性研究 ,以便为该植入材料应用于临床提供实验依据。方法 :参照 ISO10 993- 1:1992医疗器械生物学评价标准和要求 ,对人工气管材料进行了体外细胞与材料共培养试验、细胞毒性试验、溶血试验、急性全身毒性试验、致敏和热源试验。 结果 :(1)人工气管材料表面的细胞黏附生长良好 ,该材料对体外培养的细胞形态不构成损害 ,对细胞的生长和增殖均无明显抑制作用 ,细胞增殖指数和增殖指数百分率与空白对照组比较无显著性差异 (P>0 .0 5 ) ,而与阳性参照材料组比较差异具有显著性 (P<0 .0 1) ;(2 )溶血率均低于 5 %的国家标准 ,在体外不引起溶血反应 ;(3)该组分材料也无急性全身毒性反应、致敏和热源作用。结论 :该人工气管材料无细胞毒性和热源作用 ,不引起溶血反应和急性全身毒性反应 ,对细胞形态、生长和增殖不构成损害 ,具有良好的生物相容性。     

多功能腹腔化疗管动物安全性评价

目的采用医用硅橡胶经聚四氟乙烯(PTFE)改性复合材料制备植入体内的多功能腹腔化疗管,对其材料进行物理机械性能及动物试验安全性评价。方法用健康成年新西兰兔对复合材料进行过敏试验、热源试验、全身急性毒性试验。结果制备多功能腹腔化疗管的复合材料在生物学评价试验中均呈阴性反应,材料无明显毒性,材料中不存在潜在致敏性物质,所含热原含量符合生物体的要求。结论制备多功能腹腔化疗管的复合材料具有优良的生物相容性。     

纳米羟基磷灰石/聚氨基酸复合材料生物安全性评价

目的 初步评价新型骨修复材料纳米羟基磷灰石/聚氨基酸(nano-hydroxyapatite and poly-amino acid, n-HA/PAA)的生物安全性.方法 按照ISO10993-1标准中规定以自制n-HA/PAA为实验组进行以下实验: ①体外细胞毒性实验:采用L929成纤维细胞,完全培养基为阴性对照,苯酚为阳性对照,通过细胞形态学、MTT试验以及流式细胞进行细胞毒性评价;②全身急性毒性实验:以生理盐水为阴性对照组观察2组小鼠腹腔注射材料浸提液和生理盐水后72 h内有无中毒和死亡现象;③致敏试验:白化豚鼠30只均分3组,以生理盐水为阴性对照组、二硝基氟苯丙酮溶液为阳性对照组观察各组动物致敏区有无红肿和红斑,并记分;④溶血实验:生理盐水作为阴性对照组,灭菌蒸馏水为阳性对照组,分别加入抗凝兔血后计算溶血率;⑤热源实验:新西兰大白兔3只,按10 ml/kg注射材料浸提液,测量正常体温与注射后连续 3 h 内每小时体温的差值;⑥遗传毒性实验:KM小鼠30均分3组,分别按100 g/kg间隔24 h注射材料浸提液、环磷酰胺及生理盐水2次,观察骨髓嗜多染红细胞及含微核小体的骨髓嗜多染红细胞,并计算微核率.结果 体外细胞毒性实验观察材料对细胞形态与生长无明显影响,MTT检测实验组细胞毒性为1级,流式细胞仪检测材料不会引起细胞凋亡;全身急性毒性实验显示实验组动物无中毒及死亡;致敏试验显示致敏区无水肿及红斑;溶血实验表明材料溶血率为0.71%,符合小于5%的实验标准;热源实验显示实验动物无明显体温升高;遗传毒性实验显示材料微核试验阴性,无遗传毒性.结论 n-HA/PAA复合材料具有良好的生物安全性.     

壳聚糖短纤维增强聚己内酯复合材料的体内生物相容性研究

目的:对壳聚糖短纤维增强聚己内酯复合材料进行体内生物相容性和使用安全性研究,为临床应用提供实验依据.方法:将制备好的纯聚己内酯和壳聚糖增强聚己内酯2种材料放入0.9%生理盐水中获取两者的浸提液,然后进行急性全身毒性试验、溶血试验、热源试验、过敏试验;将2种材料分别植入白兔背部(n=6),术后2、4、8、12、16、24周取材,观察一般组织情况及纤维包膜形态和厚度.结果:壳聚糖短纤维增强聚己内酯复合材料中不存在致敏性物质,浸提液无溶血反应和急性全身毒性反应,无热源反应.复合材料体内植入在初期有轻度的炎症反应,12周后炎症反应基本消失,未见巨噬细胞积聚现象.这些反应与纯聚己内酯无显著差别.结论:壳聚糖短纤维增强聚己内酯组复合材料具有良好的生物相容性,其作为胸壁缺损修补材料应用于临床具有可行性和安全性.     

钙磷陶瓷/硅橡胶复合材料的形貌和短期体外试验研究

目的制备钙磷陶瓷／硅橡胶复合材料，对材料进行形貌分析和短期体外试验，了解其微观结构和生物安全性。方法按共混法制备种类和份数不同的两种钙磷陶瓷／硅橡胶复合材料：羟基磷灰石／硅橡胶、磷酸三钙／硅橡胶复合材料，以扫描电镜对复合材料进行形貌分析，参照ISO和国家标准对复合材料进行溶血试验、急性全身毒性试验等短期体外试验，对数据进行统计学分析。结果复合材料中陶瓷材料呈均相分布，并形成裂隙；各复合材料溶血率〈5％，急性毒性试验、致敏试验、皮内试验均为阴性。结论各复合材料的形貌较纯硅橡胶发生改变，短期体外试验表明材料安全可靠。     

纳米复合陶瓷材料的生物相容性研究

目的 通过体内、体外实验,对纳米羟基磷石复合40%二氧化锆材料进行早期生物相容性评价.方法 按照国家标准GB/T16886医疗器械生物学评价标准的要求,同时报据纳米羟基磷灰石复合40%二氧化锆材料的特定用途,选取样本进行如下生物学实验:致敏试验,溶血试验,刺激试验,肌肉植入试验.结论 经体内和体外试验结果显示:纳米羟基磷灰石复合40%二氧化锆材料无致敏、无刺激、无变形,具有良好的血液及生物相容性.     

异种脱蛋白骨的生物相容性研究

目的 评价制备的异种脱蛋白骨植入体内的生物相容性,为临床应用提供实验依据.方法 对猪肋骨进行一系列理化处理后,制成10 mm长脱蛋白骨及浸提液.然后采用标准的毒理学实验方法进行急性、亚急性毒理实验、溶血实验、热源实验、皮内注射实验、肌肉埋植实验及细胞毒性实验.结果 异种脱蛋白骨的毒性程度为无毒,溶血率＜5%,无热源性,对皮肤无刺激,肌肉内埋植后无明显炎症反应,对细胞无明显毒性作用,细胞的毒性均为0级.结论 异种脱蛋白骨具有良好的生物相容性,可满足作为组织工程骨支架材料生物相容性的要求.     

明胶/壳聚糖创伤敷料的生物安全性评价

目的:对明胶/壳聚糖敷料进行生物安全性评价.方法:进行皮肤刺激,皮肤致敏,细胞毒性和溶血实验,并按照统一的标准判定.结果:皮内注射实验:各组各点局部无红斑、水肿反应;皮肤致敏实验:试验组及空白对照组溶液家兔的致敏率为0%,而阳性对照组为100%,二者相比有显著性差异;溶血实验:除阳性对照组外,各组溶血率均在1%以内,符合规定不大于5%的标准;微核实验:材料浸提液组的微核率为1.6%o,与生理盐水对照组比较无显著性差异(P＞0.05),材料浸提液组与阳性对照组(微核率为20%o)比较有显著性差异(P＜0.01);细胞毒性实验:镜下见纤维细胞生长良好,形态和数量均和对照组无显著性差异,MTT法测得细胞活性和对照组无差别,细胞毒性总评级为0.结论:明胶/壳聚糖生物膜不含致热原、致敏原,无皮肤刺激反应,不引起皮肤过敏反应,无溶血反应,生物安全性保证其可望用于临床.     

骨局部植入型硫酸钙/聚乳酸/庆大霉素释放系统的生物相容性研究

目的 以柠檬酸化硫酸钙和聚乳酸的复合物作为抗生素载药基质,构建骨植入型硫酸钙/聚乳酸/庆大霉素药物释放系统,对其生物相容性进行研究.方法 根据医疗器械生物学评价实验选择指南对药物释放系统进行红细胞溶血实验、细胞毒性实验、热原实验、肌肉内植入实验等生物相容性评价.结果 抗生素释放系统红细胞溶血率为3.07%,小于阳性标准;细胞毒性实验中实验组细胞相对增殖率和对照组无统计学差异,毒性评分为0～1级;兔平均体温升高为0.3℃;抗生素释放系统在肌肉组织内可逐渐降解,材料周围未见大量炎性细胞浸润,组织无排斥.结论 抗生素释放系统无溶血作用,无细胞毒性,符合医用材料的热原反应要求,具有良好的生物相容性和安全性,符合医用生物材料的基本要求.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.