塔斯品碱在Caco－2细胞模型中的吸收机制研究

目的研究塔斯品碱在Caco-2细胞模型中的吸收机制。方法用Caco-2细胞单层模型研究塔斯品碱的双向转运,考察时间、药物质量浓度对塔斯品碱吸收的影响。采用高效液相色谱法检测塔斯品碱的质量浓度,计算其表观渗透系数（Papp）。结果塔斯品碱在Caco-2细胞模型中,从单层细胞层顶端到基底端的转运与基底端到顶端的转运大致相同。结论塔斯品碱在Caco-2细胞模型中的吸收主要是被动转运。     

白坚木碱类二聚体在Caco- 2细胞模型中的吸收机制研究

目的 考察白坚木碱二聚体（10- dehydroxyl- 12- demethoxy- conophylline,wtdr- 11）在人类结肠癌细胞系Caco- 2细胞模型中吸收和转运机制。方法 建立Caco- 2单层细胞完整模型,采用超高效液相色谱- 荧光法（ultra- high performance liquid chromatography- fluorescence, UPLC- FLR）测定细胞模型中wtdr- 11的浓度并计算表观渗透系数（apparent permeability coefficient,Papp）;分别考察不同浓度、时间、温度、pH值、P- 糖蛋白（P- glycoprotein, P- gp）抑制剂（维拉帕米和环孢素A）对wtdr- 11在Caco- 2细胞内摄取的影响;考察时间变化对wtdr- 11在Caco- 2细胞中双向转运［分别从细胞刷状缘侧（apical,AP）→细胞基底侧（basolateral,BL）和BL→AP方向］的影响。结果 wtdr- 11的吸收随着时间和药物浓度的增加而增加,但温度、pH值和P- gp抑制剂等因素对Caco- 2细胞吸收该药物的影响无统计学意义（P>0.05）。跨膜转运实验中,Papp＞10-6 cm/s,外排率<1.5。结论 wtdr- 11的主要吸收机制可能是被动扩散,wtdr- 11可能不是P- gp转运蛋白的底物。     

芍药苷在Caco-2细胞模型中吸收机制的研究

目的 研究芍药苷在Caco-2细胞模型中的吸收机制.方法 用Caco-2细胞单层模型研究芍药苷的双向转运,考察时间、药物质量浓度对芍药苷吸收的影响.采用高效液相色谱法检测芍药苷质量浓度,计算其表观渗透系数(Papp).结果 芍药苷在Caco-2细胞模型中,从单层细胞层顶端到基底端的转运与基底端到顶端的转运大致相同;随着芍药苷质量浓度的增加,顶端到基底端方向的吸收量近似线性增加,基底端到顶端方向的分泌量近似线性增加.结论 芍药苷在Caco-2细胞模型中吸收主要是被动转运.     

脱水穿心莲内酯在Caco-2细胞单层模型中的吸收机制

目的 研究脱水穿心莲内酯（DAL）在Caco-2细胞单层模型中的吸收机制。方法 观察DAL在Caco-2细胞单层模型中的双向转运,考察时间、DAL浓度、温度和P-糖蛋白（P-gp）抑制剂维拉帕米对DAL吸收的影响。采用LC/MS/MS方法检测DAL浓度,计算其表观渗透系数（P_app）。结果 DAL在Caco-2细胞模型中的双向转运,随时间和浓度的增加,DAL的吸收具有时间、浓度依赖性,未出现饱和趋势;不受温度和P-gp抑制剂维拉帕米的影响。结论 DAL在Caco-2细胞模型中的吸收主要是靠浓度扩散的被动转运。     

钩藤碱在Caco-2细胞模型中吸收规律研究

目的 建立体外模拟体内肠道细胞——人结肠癌上皮细胞（the human colon adenocarcinoma cell line,Caco-2）的Transwell模型,以此研究钩藤碱在Caco-2细胞模型上的跨膜转运特征。方法 采用聚酯碳酸酯膜连续培养Caco-2细胞21 d,形成致密的单层细胞模型。然后对影响钩藤碱在Caco-2细胞模型上转运特征的因素(包括浓度、时间及跨膜转运蛋白P-糖蛋白)进行考察;同时采用液相色谱-质谱法对溶液中钩藤碱的含量进行测定。结果 钩藤碱在Millicell系统上的转运量具有一定的浓度-时间依赖性,主要以主动转运的方式进行吸收,且随着时间和药物浓度的增加,转运量明显增加。不同浓度钩藤碱从细胞基底侧（basolateral, BL）到细胞刷状缘侧（apical,AP）的表观渗透系数（apparent permeability coefficient, Papp）与AP侧到BL侧的Papp比值均在1.5以上,且钩藤碱从BL侧到AP侧的外排速率明显高于从AP侧到BL侧的吸收速率。当加入P-糖蛋白抑制剂后,药物由BL侧向AP侧的转运量显著减少,而由AP侧到BL侧的转运量显著增加。结论 钩藤碱在Caco-2细胞上转运存在一定的浓度及时间依赖性,且P-糖蛋白介导钩藤碱在Caco-2细胞上转运。     

川芎嗪在Caco-2细胞单层模型的转运特征及对P-糖蛋白表达的影响

目的 研究川芎嗪在Caco-2细胞单层模型的转运特征以及对P-糖蛋白（P-gp）表达的影响。方法 MTT法确定川芎嗪对Caco-2细胞单层模型作用的安全浓度范围;以Caco-2细胞单层模型研究川芎嗪的双向转运机制,以表观渗透系数（P_app）为检测指标,考察时间、药物浓度以及P-gp抑制剂维拉帕米对川芎嗪转运的影响;Western blotting法检测川芎嗪对P-gp表达的影响。结果 从顶侧（AP）到底侧（BL）（AP→BL）,川芎嗪的P_app＞10^?6 cm/s,表明其吸收性良好;川芎嗪的转运量与其浓度和时间呈正相关,且川芎嗪AP→BL的转运量明显大于BL→AP的转运量;川芎嗪不仅受到P-gp的外排作用,同时也抑制P-gp表达。结论 川芎嗪在Caco-2细胞模型的转运方式为被动转运,且受到P-gp的外排作用,并对P-gp的表达有抑制作用。     

穿心莲内酯在Caco-2细胞单层模型中的吸收机制

目的 研究穿心莲内酯在Caco-2细胞单层模型中的吸收机制。方法 观察穿心莲内酯在Caco-2细胞模型中的双向转运,考察时间、药物浓度、温度和抑制剂对穿心莲内酯吸收的影响。用LC/MS/MS检测药物浓度,计算其表观渗透系数（P_app）。结果 穿心莲内酯在Caco-2细胞模型中,随时间和浓度的增加,药物吸收呈饱和趋势,且受温度和碘乙酰胺影响,但不受外排抑制剂维拉帕米和MK-571的影响。结论 穿心莲内酯在Caco-2细胞中的吸收主要是由载体介导的主动转运。     

补阳还五汤黄酮类有效成分在Caco-2细胞单层模型的转运特征及对CYP450酶活性的影响

目的研究补阳还五汤3个黄酮类有效成分(羟基红花黄色素A、毛蕊异黄酮、芒柄花素)在Caco-2细胞单层模型中的转运特征及其在大鼠肝微粒体中对CYP450酶亚型活性的影响。方法 MTT法研究药物在Caco-2细胞单层模型的安全浓度范围,以Caco-2细胞单层模型研究黄酮类有效成分的双向转运机制,以表观渗透系数(Papp)为检测指标,考察时间、浓度以及P-gp抑制剂维拉帕米对转运的影响,利用Cocktail探针法研究药物对CYP450亚型的体外抑制作用。结果从顶侧(apical,AP)到底外侧(basolateral,BL)(AP→BL),芒柄花素、毛蕊异黄酮的Papp>10-6 cm/s,表明其吸收性良好,羟基红花黄色素A的Papp为10-6cm/s,表明其吸收性一般;且三者的转运量随浓度升高和时间延长而显著升高,BL→AP的转运量与AP→BL的转运量的比值小于1.5,其中芒柄花素、毛蕊异黄酮的转运都受到P-gp外排蛋白的外排作用;补阳还五汤黄酮类有效成分明显降低了CYP2E1、CYP1A2酶探针底物的代谢量(P<0.05)。结论 3种黄酮类有效成分在Caco-2细胞模型的转运方式均为被动转运,毛蕊异黄酮与芒柄花素明显受到P-gp的外排作用,补阳还五汤黄酮类有效成分可以增加主要通过CYP2E1、CYP1A2酶代谢的药物浓度。     

茯苓酸在人源肠Caco-2细胞单层模型的吸收和转运

目的：研究中药茯苓中茯苓酸（pachymic acid，PA）在人肠的吸收和转运。 方法：人源肠Caco－2细胞单层作为药物的肠吸收转运模型，测定PA从绒毛面（AP）到基底面（BL）的渗透性；反相高效液相色谱法测定PA在AP和BL的浓度，紫外检测波长为210nm；计算转运参数和表观渗透系数（Papp），并与在Caco-2细胞单层模型呈良好吸收转运的阳性对照药普萘洛尔和不良吸收转运的阳性对照药阿替洛尔进行比较。 结果：PA由AP到BL方向的Papp值为（9．50±2．20）×10^-7cm／s，由BL到AP方向的Papp值为（11．30±5．90）×10^-7cm／s。在本项研究条件下，普萘洛尔和阿替洛尔的Papp值分别为1．45×10^-5cm／s和4．22×10^-7cm／s。 结论：PA在Caco-2细胞单层馍型的吸收转运呈浓度依赖性，与转运时间呈线性关系；由AP到BL和BL到AP两个方向的转运不良，其Papp值与阿替洛尔的接近；除被动扩散机制外，ATP部分地参与了PA的转运。     

葛根素在Caco-2细胞模型中的吸收特性

目的研究葛根素在Caco-2细胞中的吸收特性。方法改变药物浓度、实验温度和使用合适的抑制剂,测定葛根素在Caco-2细胞中的跨膜转运特性。结果葛根素在Caco-2细胞的转运呈现较强的方向性,随着葛根素质量浓度的增加,其表观渗透率(PDR)降低(2.1~1.4)。随着温度升高PDR增大。当加入代谢抑制剂KCN和2,4-二硝基苯酚时,葛根素的PDR降低(由1.7分别降至1.0和1.2)。当加入100mg/L维拉帕米时,A面到B面的表观渗透系数Papp(A→B)从(0.84±0.18)×10-7cm/s增加到(1.01±0.17)×10-7cm/s,而B面到A面的Papp(B→A)从(1.43±0.18)×10-7cm/s降低到(1.11±0.24)×10-7cm/s。结论葛根素在Caco-2细胞模型中的转运受到P-糖蛋白的外排作用。     

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…     

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.     

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.     

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.     

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.     

Acupuncture Treatment of Vomiting

CASE HISTORY A female patient, 46 years old, head of the foreign affairs department of a certain university in Beijing, paid her first visit on October 9, 2006, with the chief complaint of vomiting for one month. She got vomiting after meals in early September. Before that, she had discomfortable sensation in the stomach due to angry with others, but she didn't pay much attention. Later, it developed into vomiting after eating. After the vomiting, the discomfort would be relieved, but with slight hypodynamia. She was once diagnosed as having 'neurogenic vomiting'. Having taken some western and Chinese drugs, the above symptoms were a little bit improved, but she would have nausea upon eating and with regurgitation. Because of the fear for vomiting, she did not dare to have food intake, with body weight reduction of 6 kilos in one month.     

Qiu Baoguo''''s Experience in Treating Consumptive Syndromes after Radio-Chemotherapies

Radiotherapy and chemotherapy are the important modern medical therapies for malignant tumors,yet they can also bring about serious local and systemic toxic side reactions so to decrease the patient;'s life quality,manifested by a series of consumptive symptoms.Having engaged in the combined work of Chinese and western medicine for nearly 50 years,the research fellow Qiu Baoguo in Henan Provincial Academy of TCM has developed his unique views on the TCM study of consumptive syndromes.The author of this essay had once the fortune tO follow Dr.Qiu in clinic,and specially would like to introduce in the following Dr.Qiu's experience in treating consumptive syndromes after radio-chemotherapies for patients with malignant tumor.     

Insomnia Due to Deficiency of Both the Heart and Spleen Treated by Acupuncture-Moxibustion and Chinese Tuina

OBJECTIVE: To observe therapeutic effects of the comprehensive therapy of acupuncture-moxibustion and Chinese Tuina for treatment of insomnia due to deficiency of both the heart and spleen. METHODS: 92 cases were divided randomly into the treatment group (treated by acupuncture-moxibustion and Chinese Tuina) and the control group (treated by acupuncture-moxibustion). RESULTS: The therapeutic effect of the treatment group was obviously superior to that of the control group (the CHI2 test showed P < 0.01). CONCLUSIONS: The comprehensive therapy of acupuncture-moxibustion and Chinese Tuina can give marked therapeutic effects for treatment of insomnia due to deficiency of both the heart and spleen.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.