3-(4′-苯甲酰基氨基-苯基)-香豆素衍生物的合成及体外降血糖活性

首先以对氨基苯乙酸和水杨醛类化合物为原料,通过Perkin缩合反应,再经盐酸酸化合成了3个3-芳基香豆素类化合物4a~4c;再与取代苯甲酰氯6a~6h通过酰胺化反应合成得到了10个3-(4′-苯甲酰基氨基-苯基)香豆素类化合物7a~7j。所有目标化合物的结构均经过¹H NMR,¹³C NMR,ESI-MS进行了确证。通过测定α-葡萄糖苷酶抑制活性和晚期糖基化终产物(AGEs)形成抑制活性评价了目标化合物的体外降血糖活性。结果表明化合物7f(IC₅₀=10.84±0.36 μmol/L)表现出较好的α-葡萄糖苷酶的抑制活性;化合物7g(IC₅₀=5.01±0.55 μmol/L)对AGEs形成抑制活性远高于阳性药氨基胍盐酸盐(AG,IC₅₀=290.31±7.32 μmol/L),这些结果为抗糖尿病药物的进一步研究提供了理论基础。     

(E)-1,2-二芳基取代乙烯类化合物的合成及抗血小板聚集活性

在2-溴苄基膦酸二乙酯结构基础上,合成两个系列(E)-1,2-二芳基取代乙烯类化合物Ⅴ₁～Ⅴ₉ ,Ⅵ₁～Ⅵ₄),并对所合成的化合物进行抗血小板聚集活性实验。合成了13个未见文献报道的目标化合物,结构经元素分析、红外光谱、核磁共振氢谱、质谱确证。初步生物活性测试表明,多数化合物具有不同程度的抗血小板聚集活性,其中化合物Ⅴ₄、Ⅴ₉的活性较好。结果表明,(E)-1,2-二芳基取代乙烯类化合物是一类新型的具有潜在价值的抗血小板聚集活性的化合物。     

4-(N-芳基)胺基-6-长链烷氧基取代蝶啶类化合物的合成及其抗肿瘤活性

采用具有喹唑啉为母核的抗肿瘤药物作为先导化合物,利用生物电子等排原理,设计并合成一系列4-(N-芳基)胺基-6-长链烷氧基取代蝶啶类化合物7a~7l,并利用MTT法测试其对A549、KG1a和HGC-27肿瘤细胞的增殖抑制作用。以3-氨基吡嗪-2-羧酸甲酯为起始底物,通过6步反应合成12种目标化合物(7a~7l)并确证其结构(¹H NMR、¹³C NMR、MS)。生物活性试验表明,蝶啶4位为2-氯-5-硝基苯胺基取代时,其活性均高于其他苯胺基取代的产物。化合物7b对A549的活性(IC₅₀=11.55 μmol/L)与阳性对照物吉非替尼(IC₅₀=5.95 μmol/L)十分接近;化合物7k对3组细胞的IC₅₀均十分接近对照物吉非替尼。由于筛选出的化合物均有2-氯-5-硝基苯胺基片段,可以此结构为基础进行深入研究。     

HPLC法测定(E)-4-[2-(4-氯苯氧基)-2-甲基丙酰氧基]-3-甲氧基苯基丙烯酸的有关物质

采用HPLC法分析（E）-4-［2-（4-氯苯氧基）-2-甲基丙酰氧基］-3-甲氧基苯基丙烯酸的有关物质,采用Ultimate XB-C₁₈色谱柱（4.6 mm×150 mm,5 μm）,甲醇-1%乙酸水（70∶30）为流动相,检测波长为275 nm。结果显示,（E）-4-［2-（4-氯苯氧基）-2-甲基丙酰氧基］-3-甲氧基苯基丙烯酸与各中间体及强制破坏产生的降解产物均分离良好,3批原料药中杂质限量均小于0.1%,分离并鉴定了其主要杂质C,在0.20～59.96 μg/mL范围内,杂质C的质量浓度与峰面积呈良好的线性关系（r=0.999 9）。采用杂质对照品法和自身高低浓度对比法建立了（E）-4-［2-（4-氯苯氧基）-2-甲基丙酰氧基］-3-甲氧基苯基丙烯酸的有关物质控制方法。经方法学验证可用于（E）-4-［2-（4-氯苯氧基）-2-甲基丙酰氧基］-3-甲氧基苯基丙烯酸有关物质的检测。     

探讨慢性阻塞性肺疾病患者血清中1α, 25-二羟维生素D水平及其影响因素

目的 1α, 25-二羟维生素D [1α,25(OH)₂D₃]是维生素D信号生物学功能的主要执行者,其血清水平不仅受其前体25-羟维生素D[25(OH)D]水平的调控,还受体内炎性状态的影响。本研究旨在分析慢性阻塞性肺疾病(COPD)患者中血清1α,25(OH)₂D₃水平及其影响因素。 方法 收集124例COPD患者和188名健康对照者,采用酶联免疫吸附法检测血清1α,25(OH)₂D₃及25(OH)D水平,同期收集COPD患者血清C反应蛋白(CRP)、白细胞计数(WBC)、血红蛋白量(Hb)及白蛋白(Alb)等实验室资料。 结果 经两独立样本t检验,与对照组相比,COPD组中血清1α,25(OH)₂D₃和25(OH)D平均水平明显降低,分别为:28.33±5.87 vs 30.58±6.48pg/ml, t=3.108, P=0.002; 25.73±5.44 vs 27.14±5.89ng/ml, t=2.128, P=0.034。根据患者病程分层分析,与稳定期COPD相比,急性加重期患者中血清1α,25(OH)₂D₃和25(OH)D平均水平亦显著降低,分别为:27.04±4.67 vs 29.17±5.01pg/ml, t=2.377, P=0.019; 24.31±4.22 vs 26.66±4.56ng/ml, t=2.888, P=0.005。采用Spearman相关分析法检验COPD组中血清1α,25(OH)₂D₃水平的相关影响因素,纳入的变量包括血清25(OH)D水平及CRP、WBC、Hb、Alb等血清学指标。结果显示COPD组中血清1α,25(OH)₂D₃水平与25(OH)D和CRP呈正相关(r=0.291, P=0.002; r=0.352, P=0.004),与Alb呈负相关(r=-0.346, P=0.001),而与WBC和Hb无关(P>0.05)。 结论 COPD患者中血清1α,25(OH)₂D₃水平与血清25(OH)D、CRP和Alb水平密切相关,并可能影响患者的病程。     

α-芳基-3，5-二甲氧基苯丙烯酰胺的合成及抗炎活性

目的： 寻找高效低毒的非甾体抗炎药。方法： 将具有抗炎活性的2-(2,4-二氯苯基)-3-(3,5-二甲氧基苯基)丙烯酸（I）转化为酰胺衍生物,应用二甲苯致小鼠耳肿胀模型评价其抗炎活性。结果： 合成了12个新化合物（Ⅱ_1-12）,其结构经IR、¹H NMR和高分辨MS确证。其中化合物Ⅱ₃与阴性对照CMC-Na相比呈现显著的抗炎活性(P<0.01),与阳性对照阿司匹林相比有较强的抗炎活性(P<0.05)。结论： 化合物Ⅱ₃值得进一步研究。     

3-乙酰基-11-羰基-β-乙酰乳香酸在Caco-2和MDCK细胞模型中的吸收研究

目的 研究乳香提取物中3-乙酰基-11-羰基-β-乙酰乳香酸（AKBA）在Caco-2、MDCK-MDR1和MDCK-Wild细胞模型中的吸收转运机制。方法 利用Caco-2、MDCK-MDR1和MDCK-Wild细胞模型,研究AKBA由细胞层顶端（AP）→基底端（BL）和BL→AP的双向转运过程;采用LC-MS/MS法测定AKBA的量,计算表观渗透系数（P_app）。结果 在Caco-2细胞模型中,50 μmol/L AKBA 由AP→BL、BL→AP的P_app分别为7.9×10^?7、1.5×10^?7 cm/s,在MDCK-MDR1细胞模型中,50 μmol/L AKBA由AP→BL、BL→AP的P_app分别为2.6×10^?7、0.8×10^?7 cm/s,在MDCK-Wild细胞模型中,50μmol/L AKBA由AP→BL、BL→AP的P_app分别为2.4×10^?7、0.6×10^?7 cm/s,3种细胞模型中外排率均小于2。结论 AKBA在肠道中吸收不良,不是P-糖蛋白的底物,推测其通过摄入型主动转运和被动扩散两种机制透过小肠上皮细胞。     

N-酰化壳聚糖的合成及其修饰多西他赛脂质体的体外性质研究

目的： 合成N-酰化壳聚糖并用其修饰多西他赛脂质体以期延缓药物的释放。方法： 用合成的长链脂肪酸酰化的壳聚糖修饰脂质体,体外血浆释放实验比较脂质体修饰前后的释放性质。结果： 合成了正己酰（C₆）、月桂酰（C_12）和棕榈酰（C₁₆）3种N-酰化壳聚糖。普通脂质体于24 h内释药70%,而N-酰化壳聚糖修饰的脂质体24 h仅释药39%。结论： 用N-酰化壳聚糖修饰脂质体可以减缓释药,具有缓释作用。     

β-葡萄糖苷酶水解黄芪甲苷的研究

目的 采用β-葡萄糖苷酶水解黄芪甲苷,并对其酶水解动力学进行初步研究。方法 以HPLC-ELSD法检测水解液中黄芪甲苷及水解产物环黄芪醇-6-O-β-D-葡萄糖苷（CMG）的量,以黄芪甲苷的水解转化率为指标,考察各反应因素对转化率的影响,并对该反应进行动力学研究。结果 最佳反应条件为反应温度50 ℃,溶液pH值5.0,酶浓度460 U/mL,底物初始浓度0.1 mmol/L,反应时间48 h;在此条件下,水解转化率达到90%以上。在最佳反应条件下,该水解反应过程符合单底物Michaelis Menten方程,其中最大反应速率（V_m）值为0.037 mmol/(L?min),米氏常数（K_m）值为5.8 mmol/L。结论 采用β-葡萄糖苷酶水解黄芪甲苷制备CMG可行;商品化的β-葡萄糖苷酶并非黄芪甲苷的特异性水解酶。     

1-(1,4-苯并二噁烷-2-羰基)-4-取代芳氧烷基哌嗪类α1受体拮抗剂的合成、生物活性及3D-QSAR研究

为寻找新的1,4-苯并二噁烷类α₁受体拮抗剂,选取1,4-苯并二噁烷为母核,以儿茶酚和取代苯酚为原料,分别经关环、水解、成酰胺、取代、成盐等反应合成了6个新的目标化合物(7a-7f),结构已通过ESI-MS、¹H NMR、IR及HR-MS确证。初步药理活性实验结果表明,受试化合物具有中等强度的α₁-肾上腺素受体拮抗活性,其中目标化合物7e pA₂值大于7.00,有进一步研究的价值。运用Sybyl软件对本类化合物开展了3D-QSAR研究,结合本课题组前期工作,构建了1-(1,4-苯并二噁烷-2-羰基)-4-取代芳氧烷基哌嗪类化合物的CoMFA模型,q²=0.753,r²=0.986,为该类α₁受体拮抗剂进一步的结构优化提供了理论依据。     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.