色谱-质谱联用技术鉴定盐酸咪达唑仑的有关物质

色谱-质谱联用（LC-MS）技术鉴定盐酸咪达唑仑中的有关物质。采用Thermo BDS Hypersil C₁₈ (100 mm×4.6 mm,2.4 μm)色谱柱,以乙腈-25 mmol/L醋酸铵水溶液(冰醋酸调节pH为5.5)为流动相梯度洗脱,对盐酸咪达唑仑有关物质进行分离,电喷雾正离子化-四极杆-飞行时间串联质谱(ESI-Q-TOF/MS)高分辨测定各有关物质母离子及其子离子的准确质量和元素组成,通过光谱解析并结合合成工艺分析鉴定了它们的结构,并对部分杂质进一步采用对照品对照确证。在所建立的分析条件下,盐酸咪达唑仑及其有关物质分离良好,检测并鉴定出盐酸咪达唑仑及其强制降解试验样品中22个主要有关物质,其中8个为美国药典规定的已知杂质。LC-MS技术能有效地分离鉴定盐酸咪达唑仑中的有关物质,可为其贮存条件制定、生产工艺优化和质量控制提供参考依据。     

色谱-质谱联用技术研究盐酸西那卡塞的有关物质

采用LC-MS法分离和鉴定盐酸西那卡塞有关物质。采用Hypersil C₁₈(100 mm×4.6 mm,2.4 μm)色谱柱,以0.1%乙酸铵溶液-乙腈(93∶7)为流动相A相,乙腈为流动相B相进行线性梯度洗脱,对盐酸西那卡塞有关物质及强制降解产物进行分离。经过电喷雾正离子化-高分辨TOF/MS检测,同时结合MS/MS光谱和对照品对照,对各有关物质进行分析鉴定。在所建立的液-质联用分析条件下,盐酸西那卡塞及其有关物质得到有效的分离,共检测到10个有关物质,分别为盐酸西那卡塞合成起始原料(1个)、合成中间体(1个)、合成副产物(4个)和降解产物(5个)。建立的LC-MS法能有效鉴定盐酸西那卡塞有关物质,并为其质量控制和工艺优化研究提供参考依据。     

LC-MS/MS法研究头孢美唑钠中有关物质

建立采用LC-MS/MS法对头孢美唑钠中有关物质进行定性分析。采用ODS色谱柱（250 mm×4.6 mm,5 μm）,以1%甲酸水溶液-乙腈为流动相线性梯度洗脱;柱后分流,80%流出液经PDA检测,20%流出液电喷雾离子化MS测定。采集有关物质的PDA谱、质谱母离子及子离子谱,进行解析推测有关物质的结构。在所建立的条件下,头孢美唑钠及其有关物质分离良好,检测出8个有关物质,对其结构进行解析。建立的LC-MS/MS法有效地分离分析了头孢美唑钠及其有关物质,为其质量控制和工艺优化提供了技术参考。     

LC-MS/MS法分析复方缬沙坦氨氯地平片中的有关物质

目的采用LC-MS/MS法对复方缬沙坦氨氯地平片中有关物质进行定性分析。方法采用Thermosyncronis C18色谱柱(250mm×4.6mm,5μm),以20mmol/L的醋酸铵溶液-乙腈为流动相进行梯度洗脱。采集有关物质的PDA谱、质谱母离子及子离子谱,并进行解析,推测有关物质的结构。结果在所建立的条件下,复方缬沙坦氨氯地平片中有关物质分离良好,检测出11个有关物质。结论本文建立的LC-MS/MS法可有效地分离分析复方缬沙坦氨氯地平片中的有关物质,并为其质量控制和工艺优化提供了技术参考。     

LC-MS/MS法对法罗培南钠中有关物质的研究

采用LC-MS/MS法对法罗培南钠中有关物质进行鉴定研究。采用Lichrospher ODS-3色谱柱(250 mm×4.6 mm,5 μm),以0.2%醋酸铵-0.5%甲酸水溶液-乙腈为流动相,线性梯度洗脱,对法罗培南钠有关物质进行分离;LC-PDA测定各有关物质的紫外吸收,柱后添加乙腈辅助LC-MS/MS测定各有关物质的二级质谱,并进行解析。在所建立的条件下,法罗培南钠及其各有关物质分离良好,检测出5个有关物质,对其进行结构解析。结果显示,法罗培南钠原料药中的有关物质为其降解产物和聚合物。制剂中有关物质的种类和含量较原料药均有所增加,加热处理样品后有关物质含量显著增加。建立的LC-MS/MS法有效地分离分析了法罗培南钠及有关物质,为其质量控制和工艺优化提供参考。     

LC-MS法鉴定利伐沙班有关物质

采用LC-MS法对利伐沙班有关物质进行结构鉴定。采用Inert Sustain C₁₈色谱柱(250 mm×4.6 mm,5 μm),以含0.2%甲酸的乙腈-水为流动相线性梯度洗脱,对利伐沙班及其强制降解产生的有关物质进行分离;电喷雾正离子化高分辨TOF/MS检测,结合MS/MS法和对照品对照鉴定各有关物质的结构。在所建立的条件下,利伐沙班及其有关物质分离良好,检测到15个有关物质,分别为利伐沙班合成起始原料或由起始原料引入的有关物质(3个)、合成副产物(4个)和降解产物(10个)。建立的LC-MS法能有效鉴定利伐沙班有关物质,为其工艺过程控制和质量保障提供参考依据。     

盐酸左氧氟沙星氯化钠注射液致变念反应2例

盐酸左氧氟沙星氯化钠注射液主要成份为盐酸左氧氟沙星,其化学名称为：（-）-（S）-3-甲基-9-氟-2．3-二氢-10-（4-甲基-1-派嗪基）-7氧代-7H-吡定并[1．2．3-de]-1．4苯并噁嗪-6-羧酸盐酸盐-水合物。     

LC-MS/MS法鉴定替米沙坦氨氯地平双层片中有关物质

建立LC-MS/MS法对替米沙坦氨氯地平双层片的有关物质进行鉴定。双层片中的替米沙坦层及氨氯地平层分别取样和反相高效液相色谱线性梯度法分析测定,替米沙坦及氨氯地平均与其有关物质分离良好。检测出替米沙坦中14个有关物质峰,对其中主要7个有关物质经二级质谱测定和解析鉴定了它们的结构,同时检测出氨氯地平中2个为英国药典收载的有关物质。     

注射用苯磺顺阿曲库铵有关物质的LC-MS初步鉴定

采用高效液相色谱-高分辨质谱联用技术对注射用苯磺顺阿曲库铵中有关物质进行初步结构鉴定。采用SEPAX GP-C18(250 mm×4.6 mm,5μm)色谱柱,水-乙腈-甲醇-甲酸(650∶175∶175∶10,1.010 L中含甲酸铵1.3 g)流动相等度洗脱,对注射用苯磺顺阿曲库铵有关物质进行分离;采用LC/TOF-MS测定各有关物质的准确质量,电喷雾离子化LC-MS/MS进行结构解析。共检测出11个有关物质,其中7个的含量在0.1%以上,并初步鉴定了它们的结构,其中5个有关物质在已有药典标准中未明确规定。     

HPLC测定盐酸苯达莫司汀有关物质与含量

目的 建立高效液相色谱法(HPLC)测定盐酸苯达莫司汀有关物质与含量的方法 .方法 采用Extend-C18,5μm,4.6mm×250mm色谱柱;流动相:水-甲醇(36:64)并含0.1％十二烷基硫酸钠(SDS)、0.1％的三乙胺和0.1％磷酸二氢钾(H2PO4);检测波长233nm;流速1.2mL/min;等度洗脱...     

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.     

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.     

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.     

Electro-Acupuncture Combined with the Trigger Point Needle-Embedding for Treatment of Primary Trigeminal Neuralgia in 31 Cases

In recent years, the author of this essay has applied electro-acupuncture combined with the trigger point needle-embedding for treatment of primary trigeminal neuralgia in 31 cases, yielding satis- factory results as reported in the following.     

Investigation of Matrix Metalloproteinase -1, 2 and tissue inhibitor of matrix metalloproteinases-1 in Endometriosis

Objective： To explore the role of matrix metalloproteinase-1,2 （MMP-1, MMP-2） and tissue inhibitor of matrix metalloproteinases-1 （TIMP-1） in endometriosis. Methods： The eutopic and ectopic endometria from 40 subjects suffering from endometriosis and regular.endometria from 40 subjects （excluding endometriosis） were collected and examined by in situ hybridization technology and western blot assay. Results： Both expressions of MMP-1 and -2 were stronger in ectopic endometrium and eutopic endometrium than in normal endometrium. On the contrary, the expression of TIMP-1 in ectopic endometrium and eutopic endometrium was lower. The differences were significant （P 〈 0.01 ）. Moreover, there was no relationship among the expressions of MMP-1, 2 and TIMP-1 in ectopic endometrium. Conclusion： The expressions of MMP-1, 2 and TIMP-1 lose balance and lack of periodic changes in ectopic endometrium , which explains the biological invasive behavior of endometriosis. It was suggested-that regulating the balance between the MMPs and TIMP-1 should be an ideal therapeutic target to endometriosis.     

Shi Da-zhuo (史大卓) —An outstanding cardiologist of integrative medicine

Prof. SHI Da-zhuo, Ph.D., male, was born on March 20, 1960. Prof. SHI entered the Ph.D. program in 1990 at the China Academy of Chinese Medical Sciences under the supervision of Prof. CHEN Ke-ji, majoring in the treatment of cardiovascular diseases. After receiving his Ph.D. degree in 1993, Prof. SHI started working at the Cardiovascular Center in Xiyuan Hospital affiliated to China Academy of Chinese Medical sciences.     

Persist in and Carry Forward the Integrative Medical Research——Speech at the 6th National General Congress of Chinese Association of Integrative Medicine by Academician CHEN Zhu,Minister of Ministry of Health

The 6th National General Congress of Chinese Association of Integrative Medicine （CALM） was convened at 19-20, April 2008 in Beijing. Academician CHEN Zhu, the minister of Ministry of Health indicated at the congress that the integration of Chinese and Western medicine is very well in keeping with the situation of our country and the general rule of development in medical science; and as a good integration of Chinese medicine and Western medicine, it is mutually beneficial and advantageous to both of them. Seeing the creativity shown in integrative medical investigation in theoretic and methodological sides, we should and must persist in and develop it.