反相高效液相色谱法同时测定人血浆中的帕罗西汀和舍曲林

目的：建立一种简单、快速的同时测定帕罗西汀和舍曲林血药浓度的反相高效液相色谱法。方法：以阿米替林作为内标。色谱条件：C18反相柱，流动相为0．01mol/L磷酸二氢钠(pH2．50)-乙腈(64：36，V／V)溶液，流速为1．0ml/min，在紫外检测波长210nm处进行检测。结果：帕罗西汀、舍曲林及内标在12min内完全分离，帕罗西汀的最低检测浓度为0．010mg／L，在0．015～0．750mg／L时线性关系良好，r=0．9998。舍曲林的最低检测浓度为0．0075mg/L，在0．010～0．750mg/L时线性关系良好，r＝0．9998。低、中、高浓度下的回收率、日间及日内精密度均符合方法学要求。结论：该方法可用于帕罗西汀和舍曲林血药浓度的临床监护。     

高效液相色谱法测定血浆中阿普唑仑浓度

目的：建立反相高效液相色谱法测定血浆中阿普唑仑浓度的方法。方法：以乙腈-50mmol／L磷酸盐缓冲液pH=6．0(35：65V／V)为流动相，三唑仑作内标，在紫外波长220nm处检测。结果：血浆中阿普唑仑的最低检出浓度为2μg／L，平均回收率为90．82％，线性范围10-200μg／L(r=0．9998)。日内和日间差异(RSD)分别小于3％和4％。结论：反相高效液色谱法灵敏、快速、准确，可满足临床治疗监测和药代动力学的研究。     

HPLC法测定紫杉醇血药浓度条件的筛选

目的：筛选小鼠血清中紫杉醇浓度测定的方法。方法：以Agilent C18柱为固定相,检测波长为227 nm,流速为1 mL.min-1,25℃条件下对流动相、内标、提取方法进行筛选。结果：确定以固相萃取方法提取样品,内标为地西泮和多西紫杉醇,流动相为磷酸水溶液-乙腈（50：50 V/V）以达到最佳的分离效果,测定线性范围在0.39～100.00μg.mL-1,回归方程为Y=13.325X＋0.851 9（R2=0.999 3）。结论：筛选出的方法血清干扰少,样品测定周期短、快速、准确,为血清中紫杉醇浓度的测定提供了优选的方法。     

LC／MS／MS测定犬血浆中氯米帕明浓度及体内药动学

目的：建立液相色谱-串联质谱法测定犬血浆中氯米帕明（Clomipramine）。方法：色谱柱为ZorbaxExtend—C18柱（150mm×4．6mm,5μm,美国Agilent公司）;C18保护柱（4．0mm×3．0mm,5μm,迪马公司）;流动相为乙腈-10mmol／L醋酸铵-甲酸（60：40：0．1,V／V／V）;流速为0．5ml／min;进样量为20μl;柱温为20℃;采用三重四极杆串联质谱仪,ESI电离源,以选择反应监测方式进行检测。用于定量分析的离子反应分别为m／z315．2,86．1（氯米帕明）和m／z285．1～86．2（内标异丙嗪）。500μl血浆样品经正己烷液提取后蒸干,流动相复溶,进行分析。结果：测定血浆中氯米帕明的线性范围为1～500ng／ml,定量下限为1ng／ml;日内、日间精密度RSD均小于15％,准确度在85％。115％范围内．符合《中国药典》2010年版二部的规定．结论：本方法可用干氯米帕明的女体内药代动力学研究。     

HPLC法测定地红霉素片含量

目的：建立高效液相色谱法测定地红霉素片的含量。方法：色谱柱为C18，以磷酸盐缓冲液(取磷酸二氢钾1.41g和磷酸氢二钾6．91g，加水至1000ml，使溶解)乙腈-甲醇(20：55：25)为流动相，流速1．1ml／mjn，检测波长为205nm。结果：地红霉素浓度在0．2～1．0mg／ml范围内，线性良好，相关系数r=0．9996(n=5)，平均回收率为99.5％，日间和日内RSD分别为0．6％和0．7％。结论：方法简便、准确、专属。     

灯盏花素注射剂的高效液相色谱法测定

目的：用高效液相色谱法(HPLC)测定灯盏花素注射剂中灯盏花乙素的含量。方法：以Hypersil BDS C18柱为色谱柱；流动相为甲醇磷酸盐缓冲液(35：65，V／V，pH=3．0)，流速1.0ml／min；检测波长为335nm。结果：线性关系好，r=0．9998，平均回收率为100．65％，高、中、低3种浓度日内精密度RSD在1．22％～2．99％，日间精密度RSD在2．32％～4．82％。结论：HPLC法简便、准确，适用于灯盏花素注射剂的质量检验分析。     

对HPLC法测定茶碱血药浓度的改进

目的：使用与日常工作中测定一些常用抗癫痫药物(如：苯妥英钠、卡马西平、苯巴比妥)相同的流动相(甲醇-水1：1)，建立用HPLC法测定茶碱血药浓度的方法，希望在日常治疗药物监测工作中能起到降低成本、提高效率的作用。方法：用二氯甲烷萃取血清中的茶碱，浓集后进样测定，以内标法定量。在室温条件下，使用ELITE C18色谱柱(5μm)，以甲醇-水(1：1)为流动相(流速1．0mL／min)，以咖啡因(0．1g／L)为内标，检测波长275nm。结果：本方法线性范围0．5mg／L～20．0mg/L，相关系数0．9992，检测限0．2mg／L，回收率96％～105％。结论：方法灵敏、简便、准确，适用于对茶碱进行治疗药物监测的需要，在和一些常用抗癫痫药物先后测定时可以有效地降低成本、提高效率。     

RP—HPLC氯氮平血药浓度监测与临床应用

目的:本文应用人血浆中氯氮平的反相高效液相色谱测定方法(RP—HPLC)测定氯氮平血药浓度，采用YWG—C18,反相色谱柱，流动相：甲醇：水：80：20(WV)，内含0．5％三乙胺，用冰醋酸调节pH值为7．7—7．8，检测波长UV254nm，流速1ml／min。方法：用内标法。以乙醚提取血浆中的氯氮平，在紫外波长254nm，反相高效液相色谱法测定氯氮平。本测定方法的提取回收率为99．0％-102．0％，RSD为2．375％。人血浆中氯氮平的最低检测浓度为0．1ng／μl，实验浓度的线性范围约10-50ng/μl。结果：采用本法对7例精神病人进行血药浓度监测，发现氯氮平血药浓度，白细胞计数与时间分别呈正相关(r=0．9543)，负相关(r=-0．6935)，血药浓度与白细胞计数呈负相关(r=-0．6672)，个别病人呈正相关，从而表明个体差异较大，临床血药浓度监测势在必行。     

HPLC—MS法测定克拉霉素浓度

目的建立快速、简便的HPLC—MS法测定人血浆中克拉霉素浓度的方法。方法以罗红霉素为内标,采用Shim—packODSC18柱（250mm×2．0mm5m）甲醇-水溶液（含0．1％甲酸）（60：40v／v）为流动相,流速0．2mL／min,柱温30℃。采用质谱电喷雾离子源正源（ESI＋）将样品离子化,选择性离子监涮（SIM）准分子离子峰。结果克拉霉素在0．025～6．4μg／ml范围内线性关系良好（r=0．999）,最低定量限为0．025μg／ml,提取回收率均大干85％,批内与批间RSD均小于15％。结论该方法简单,快速、灵敏度高、专属性强．可较好应用于临床克拉霉素血浆浓度检测。     

高效液相色谱法测定异丙酚血浆药物浓度

目的建立测定血浆异丙酚浓度的方法。方法应用反相高效液相色谱技术，血浆样本经环己烷提取，以麝香草酚为内标，以乙腈-水（3：2）为流动相，流速1．2ml／min，柱温30℃，进样30μl，经Supelco Discovery C18柱分离后，荧光检测，λex=276nm，λcm=310nm。结果血浆异丙酚浓度测定：浓度范围为16～10000ng／ml（r=0．9995）。高、中、低3个浓度的回收率分别为97．6％、97．4％和101．7％，n=5；日间RSD分别为2．45％、3．15％和4．76％，n=5。日内RSD分别为2．82％、5．48％和4．17％。结论本方法快速、准确、灵敏，可用于血浆异丙酚浓度的测定。     

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.