RP-HPLC法测定血浆中异烟肼代谢物的含量

目的:建立RP-HPLC法测定血浆中异烟肼毒性代谢物肼的方法.方法:采用反相C18柱,以5mmol/L醋酸钠(用1 mol/L醋酸调节pH至5.0)-乙腈(35:65)为流动相,检测波长300nm.结果:肼血浆浓度在8.5～85.2μmol/L范围内线形关系良好(r=0.999),平均回收率为100.2%,日内、日间RSD均小于2%.结论:本方法准确并较为简便,为测定肼血浓以监测异烟肼毒性提供了实验方法.     

急性脑梗死和脑出血患者血浆同型半胱氨酸水平的观察

目的探讨血浆同型半胱氨酸(tHcy)水平在急性脑梗死和脑出血者中的变化.方法192例急性卒中患者,平均发病时间36h,测定血浆同型半胱氨酸浓度.结果血浆同型半胱氨酸平均水平:116例脑梗死患者Hcy为(23.21±9.56)μmol/L和76例脑出血患者为tHcy(21.76±9.90)μmol/L)中,都高于正常值.缺血性卒中的病因学分布:心源性栓塞22例(19.0%,Hcy 22.1μmol/L);动脉硬化性血栓形成56例(48.3%,Hcy 24.5μmol/L);腔隙性梗死33例(28.5%,Hcy 23.1μmol/L);原因不明5例(4.3%,Hcy 17.3μmol/L),各组同型半胱氨酸水平无显著性差异.结论血浆同型半胱氨酸在缺血性卒中的各个亚型和出血性卒中中均升高.     

异烟肼在电化学预处理玻碳电极上的电化学行为及其痕量测定

目的:研究异烟肼在电化学预处理玻碳电极上的电化学响应。方法:采用三电极系统,以电化学预处理玻碳电极为工作电极,饱和甘汞电极为参比电极,铂电极为对电极,用循环伏安法研究异烟肼的电化学行为。结果:异烟肼在预处理的玻碳电极上产生两个不可逆的还原峰,电位分别为-0.80V和-0.90V,其过程是一个表面吸附过程。发现在-0.90V出现的还原峰的峰电流与异烟肼的浓度在1.2×10-10~1.3×10-3mol/L的范围内成线性关系。异烟肼的检测限低达1.2×10-11mol/L(ta=40 s,S/N=3),平行8次测定1.2×10-6mol/L异烟肼的相对标准偏差为4.5%。在B ritton-Rob inson(B-R)缓冲溶液和在模拟尿样中的回收率分别为(101.7±3.8)%和(96.3±3.3)%。结论:该方法可灵敏测定微量异烟肼,可用于临床结核病患者药物浓度的监测。     

高效液相色谱法同时测定血浆中异烟肼和乙酰异烟肼

目的:建立同时测定血浆中异烟肼和乙酰异烟肼的高效液相色谱(HPLC)法。方法:血浆样品经10%高氯酸沉淀蛋白后,取上清液直接进样分析。选用LichrospherC18柱(250mm×4.6mm,7μm),流动相为乙腈∶20mmol/L磷酸缓冲液(含2mmol/L庚烷磺酸钠)(2∶98,v/v),检测波长266nm。结果:异烟肼和乙酰异烟肼的血药浓度线性范围分别为0.12～15.89mg/L(r=0.998)和0.13～17.08mg/L(r=0.997),提取回收率分别为78.1%～95.6%和83.4%～94.4%,日内和日间变异系数(RSD)均<10%。结论:本研究建立的方法简便、准确,能满足药代动力学研究中生物样品测定的要求。     

原代肝细胞体外培养用于利福平和异烟肼肝毒性的研究

目的:研究利福平(rifampicin,LFP)和异烟肼(isoniazid,INH)对体外大鼠肝细胞的毒性.方法:以乳酸脱氢酶(LDH)释放量反映肝细胞损伤,以尿素分泌量和大鼠白蛋白合成量反映肝功能.结果与结论:15 mg/mL异烟肼(5 mL)、10 mg/mL利福平(5 mL)以及相同剂量两药合用时LDH释放量分别为对照组的1.3倍、1.5倍和1.6倍,产生的白蛋白量分别为不加药时的25%、28%和28%,尿素产量也有相应下降但程度不如白蛋白显著.说明该剂量的利福平和异烟肼对大鼠肝细胞均有毒性作用,但两药合用并不增加毒性.进一步将此原代肝细胞模型与连续细胞系小鼠成纤维细胞株L929、与文献报道的动物模型比较,探索原代肝细胞模型在肝毒性研究中应用的可行性.     

卵巢上皮性癌患者血浆溶血磷脂酸水平变化的临床意义

目的:探讨卵巢上皮性癌患者血浆溶血磷脂酸(LPA)水平变化及其潜在的临床应用价值.方法:分别测定28例卵巢上皮性癌,20例卵巢良性肿瘤,20例卵巢巧克力囊肿及20例正常妇女血浆LPA水平.结果:卵巢上皮性癌组、卵巢良性肿瘤组、卵巢巧克力囊肿组及正常妇女组血浆LPA水平分别为(5.25±1.57)μmol/L、(1.74±0.71)μmol/L、(2.99±1.28)μmol/L、(1.85±0.35)μmol/L,卵巢上皮性癌组血浆LPA水平高于卵巢良性肿瘤组、卵巢巧克力囊肿组及正常妇女组(P均＜0.05).血浆LPA诊断卵巢上皮性癌的敏感性为89.29%(25/28),特异性为85%(51/60);而且,卵巢上皮性癌组患者术后血浆LPA水平为(3.10±1.30)μmol/L,明显低于术前水平(P＜0.01).结论:卵巢上皮性癌患者血浆LPA水平明显升高,术后明显下降,血浆LPA有望成为一种新的卵巢上皮性癌的诊断及术后监测指标.     

利福肼胺片人体内药动学与相对生物利用度

目的研究两种利福肼胺片(利福平、异烟肼和吡嗪酰胺复方制剂)的药动学,评价二者的生物等效性.方法12名志愿受试者单剂量po利福肼胺片供试品与参比品后,采用反相高效液相色谱法测定异烟肼和吡嗪酰胺血药浓度,用3P97药动学程序计算药动学参数.结果两种制剂中异烟肼AUC0→∞.分别为;(43.97±16.81)mg·h-1·ml-1与(43.18±16.33)mg·h-1·ml-1;Tmax分别为:(1.79±0.54)h与(1.63±0.38)h;Cmax分别是:(8.39±4.30)mg/ml与(8.36±4.52)mg/ml.两种制剂的吡嗪酰胺AUC0→∞分别为:(569.87±271.30)mg·h-1·ml-1与(563.55±262.48)mg·h-1·ml-1;Tmax分别为:(1.68±0.58)h与(1.50±0.30)h;Cmax分别是:(34.38±M.55)mg/ml与(36.23±13.47)mg/ml.统计检验结果表明:两种制剂中异烟肼和吡嗪酰胺的AUC0→∞,Tmax和Cmax均无显著性差异(P＞0.05).结论两制剂以异烟肼和吡嗪酰胺两组分的AUC0→∞,Tmax和Cmax为指标评价生物等效性,表明二者为生物等效制剂.利福肼胺片供试品中异烟肼和吡嗪酰胺的相对生物利用度分别为:(101.73±5.95)%和(100.28±10.50)%.     

高效液相色谱法测定复方利福平制剂的利福平血浆浓度

目的 用高效液相色谱法测定复方利福平制剂的利福平血浆浓度.方法 采用反相高效液相色谱法进行检测.色谱柱为Chromasil C18(4.6 mm×250 mm,ID 5μm);流动相:甲醇0.02 mol/L,磷酸二氢钾0.01mol/L,十二烷基磺酸钠(68∶28∶4,V∶V);流速:1.0 ml/min;检测波长333 nm.结果 利福平的回归方程为:C=5.37×10-6A 0.15,r=0.9991;线性范围:0.60～12.00 ng/L;最低检测浓度为0.30 ng/L;高、中、低浓度(12.00mg/L、7.20 mg/L、0.60 mg/L)回收率为(100.01±2.42)%、(98.23±2.05)%、(100.52±5.81)%;日内变异及日间变异均＜10%.结论 本方法可准确、快速测定血浆中利福平的浓度,可用于复方利福平制剂的生物等效性试验和药代动力学研究.     

冠状动脉粥样硬化患者血浆同型半胱氨酸测定的临床意义

目的 :探讨血浆同型半胱氨酸水平测定在冠状动脉粥样硬化患者中的临床意义。方法 :应用荧光偏振免疫分析技术 ,测定 6 8例健康人和 85例冠状动脉粥样硬化患者血浆同型半胱氨酸 (Hcy)水平。结果 :血浆 Hcy水平正常对照组为 (9.31± 3.80 )μmol/L ,其中男性 (10 .5 0± 4 .0 7)μmol/L ,女性 (7.80± 2 .85 )μmol/L,男性明显高于女性 (P<0 .0 0 1) ;冠状动脉粥样硬化患者 (13.39± 6 .0 6 ) μmol/L,其中男性 (13.77± 6 .6 8) μmol/L,显著高于健康男性 (P<0 .0 0 1) ;女性 (11.5 0± 3.5 8) μmol/L,显著高于健康女性 (P<0 .0 0 1)。血浆 Hcy水平随冠脉病变严重程度呈上升趋势 ,冠脉不典型狭窄组 (11.36± 3.86 ) μmol/L,1支病变组 (13.32± 6 .0 9) μmol/L,2支病变组 (13.39±4 .92 ) μmol/L,3支病变组 (18.2 3± 8.98) μmol/L。结论 :冠状动脉粥样硬化患者存在高同型半胱氨酸血症 ,对于冠心病的诊断和治疗有重要价值。     

动脉粥样硬化性脑梗死患者血同型半胱氨酸的变化

目的:探讨同型半胱氨酸(Hcy)与动脉粥样硬化性脑梗死的关系. 方法:采用高效液相色谱法检测98例动脉粥样硬化性脑梗死患者血浆Hcy水平,并与50例对照组进行比较分析. 结果:病例组空腹血浆Hcy含量(21.4±2.3) μmol/L显著高于对照组(10.2±1.5) μmol/L(P﹤0.01). 血浆Hcy升高率,病例组(48.0%)高于对照组(6.0%),两者存在极显著差异. 结论:高Hcy血症作为一种新的独立危险因素参与了动脉粥样硬化性脑梗死的发生、发展过程.     

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.     

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.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

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.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.