微针阵列经皮促透NGF对家兔皮肤感觉神经再生的影响

目的探索NGF（Nerve growth factor,NGF）促进移植皮肤感觉恢复的微创给药方法。方法亚甲蓝染色经微针阵列处理后的离体兔皮,观察微孔的分布和排列,冰冻切片HE染色观察微孔的深度。兔皮片移植模型分别采用直接涂布、微针促透和皮内注射给药,ELISA法检测皮肤匀浆液中NGF的含量。皮肤组织切片免疫组化染色观察NGF的分布和神经纤维的再生情况。结果微针阵列处理后离体兔皮微孔排列均匀,深度可达真皮浅层。动物模型给药6h后,微针促透组和皮内注射组皮肤组织匀浆液中NGF含量分别高于直接涂布组5.48倍和6.45倍,差异均有统计学意义（P〈0.05）;NGF免疫组化染色显示,微针促透组真皮组织中有大量NGF存在,且分布均匀;动物模型给药30d后,皮肤组织S100免疫组化染色显示,微针促透组和皮内注射组真皮中可见再生的神经纤维,两组差异无统计学意义（q=2.36,P〉0.05）,并均显著高于直接涂布组（q1=7.74,q2=6.15,P〈0.05）。结论通过微针阵列可使NGF透过兔皮肤角质层到达真皮,促进兔移植皮肤感觉重建。     

醋酸曲安奈德利多卡因局部封闭注射治疗瘢痕疙瘩效果评价

目的探讨醋酸曲安奈德利多卡因局部封闭注射治疗瘢痕疙瘩的临床效果。方法随机提取经醋酸曲安奈德利多卡因局部的封闭注射治疗的175例瘢痕疙瘩患者临床资料,对其治疗效果、不良反应进行统计分析。结果醋酸曲安奈德局部封闭注射治疗瘢痕疙瘩3个疗程后,总有效率96％,随访6个月,有2例瘢痕体质者复发。结论醋酸曲安奈德治疗瘢痕疙瘩治疗次数少．操作简便。疗效好,不良反应轻微,具有临床应用价值。     

醋酸曲安奈德益康唑乳膏体外透皮吸收的评价试验

目的建立高效液相色谱(HPLC)法测定醋酸曲安奈德益康唑乳膏体外透皮接收液中药物的含量,验证自制与上市产品体外透皮吸收的一致性。方法采用色谱柱:辛烷基硅烷键合硅胶为填充剂(250mm×4.6mm,5μm);流动相:以0.094%无水己烷磺酸钠(水-乙腈-异丙醇)溶液为流动相A,以0.094%己烷磺酸钠(水-甲醇)溶液为流动相B,梯度洗脱;柱温40℃;检测波长227 nm;流速1.0 mL/min;进样量20μL。体外透皮实验采用改进的Franz立式扩散池,以实验用离体乳猪皮为透皮屏障,对比自制醋酸曲安奈德益康唑乳膏与市售乳膏的透皮效果,分别在一定时间点取样测定透皮接收液中醋酸曲安奈德和硝酸益康唑的浓度,计算其累积透皮吸收量、皮肤残留量及皮肤表面剩余量。结果自制乳膏和市售乳膏12h平均累计渗透量分别为11.1085μg/cm~2、11.7150μg/cm~2;透皮速率分别为1.3733μg/(cm~2·h)、1.4441μg/(cm~2·h);醋酸曲安奈德总体平均回收率分别为100.9%、99.9%;硝酸益康唑总体平均回收率分别为88.8%、86.8%,两者平均累计渗透量和总体平均回收率均无显著性差异(P0.05)。结论自制和市售乳膏在透皮吸收上具有一致性。     

高效液相色谱法测定醋酸曲安奈德尿素乳膏中醋酸曲安奈德的含量

目的:建立醋酸曲安奈德尿素乳膏中醋酸曲安奈德含量的HPLC测定方法.方法:用Suntek Kromasil-C8(4.6 mm×200 mm,5μm)色谱柱;流动相:甲醇-水(75:25);流速:1.0 ml/min;检测波长:240 nm;柱温:30℃.结果:醋酸曲安奈德在6.25～50.00μg范围内与峰面积呈良好的线性关系(r=0.999 9),平均回收率为99.60％.RSD=0.40％(n=9).结论:该法简便、准确、重现性好,可用于醋酸曲安奈德尿素乳膏中醋酸曲安奈德的质量控制.     

醋酸曲安奈德利多卡因局部封闭注射治疗瘢痕疙瘩效果评价

目的探讨醋酸曲安奈德利多卡因局部注射治疗瘢痕疙瘩的临床效果。方法选取2016年6月至2017年8月我院收治的瘢痕疙瘩患者100例,按随机数字表法将其分成实验组50例,对照组50例,实验组应用醋酸曲安奈德+利多卡因局部注射治疗,对照组行冷冻治疗。对比两组疗效。结果实验组瘢痕疙瘩治疗有效率为96.0%,高于对照组的56.0%,差异有统计学意义(P0.05)。结论醋酸曲安奈德利多卡因局部封闭注射治疗瘢痕疙瘩,效果满意,值得临床进一步借鉴、应用。     

醋酸曲安奈德在兔眼玻璃体腔不同部位注射后药物浓度比较

目的在结膜下、球后和玻璃体内3个不同部位注射醋酸曲安奈德悬浊液,比较其在兔玻璃体腔内药物浓度的变化。方法将醋酸曲安奈德悬浊液以玻璃体内、球后和结膜下3个部位注射入兔眼,分别于给药后1、2、4、8、24 h取出玻璃体样本,以紫外分光法测定醋酸曲安奈德浓度。结果三组中球后注射组与玻璃体内注射组在注射后1、2、4、8、24 h,两组的玻璃体内醋酸曲安奈德浓度比较差异均无统计学意义(P>0.05)。结膜下注射组与玻璃体内注射组在注射后1 h药物浓度比较差异无统计学意义(P>0.05),而在注射后2、4、8、24 h两组的药物浓度比较差异均有统计学意义(P<0.01)。结论球后和玻璃体内注射曲安奈德悬浊液在治疗眼后段疾病上是较为合适的给药方式。球后给药在剂量加倍后24 h内能维持相当的治疗效果,操作更简便,并发症风险更小。     

醋酸曲安奈德在兔眼玻璃体腔不同部位注射后药物浓度比较

目的 在结膜下、球后和玻璃体内3个不同部位注射醋酸曲安奈德悬浊液,比较其在兔玻璃体腔内药物浓度的变化.方法 将醋酸曲安奈德悬浊液以玻璃体内、球后和结膜下3个部位注射入兔眼,分别于给药后1、2、4、8、24 h取出玻璃体样本,以紫外分光法测定醋酸曲安奈德浓度.结果 三组中球后注射组与玻璃体内注射组在注射后1、2、4、8、24 h,两组的玻璃体内醋酸曲安奈德浓度比较差异均无统计学意义(P>0.05).结膜下注射组与玻璃体内注射组在注射后1 h药物浓度比较差异无统计学意义(P>0.05),而在注射后2、4、8、24 h两组的药物浓度比较差异均有统计学意义(P<0.01).结论 球后和玻璃体内注射曲安奈德悬浊液在治疗眼后段疾病上是较为合适的给药方式.球后给药在剂量加倍后24 h内能维持相当的治疗效果,操作更简便,并发症风险更小.     

丹皮酚泡囊乳膏的制备及其体外透皮吸收考察

目的 以泡囊为载体制备丹皮酚乳膏,优化丹皮酚乳膏的制备工艺及制备处方,并考察体外透皮吸收情况。方法 用乙醇注入法制备丹皮酚泡囊;用乳化法制备丹皮酚乳膏;应用控制变量法优化制备工艺;采用正交设计优化制备处方;并采用TP-6型透皮扩散实验仪,以大鼠腹部离体皮肤作为渗透屏障,通过高效液相色谱法测定药物的累计渗透量来考察丹皮酚乳膏体外透皮吸收情况。结果 基于丹皮酚泡囊制得的乳膏在12 h和24 h的累积渗透量分别是丹皮酚原料药的1.1倍和1.2倍,在24 h时皮内药物滞留量是丹皮酚原料药乳膏的1.26倍。结论 基于丹皮酚泡囊制得的乳膏在有效期内各时间段的体外透皮吸收高于原料药乳膏,且丹皮酚泡囊乳膏的皮内滞留量明显高于丹皮酚原料药乳膏。     

异维A酸联合曲安奈德局部注射治疗重度痤疮30例疗效观察

目的探讨异维A酸联合醋酸曲安奈德治疗重度痤疮临床治疗疗效。方法采用局部注射异维A酸联合醋酸曲安奈德方法。结果治疗组痊愈19例,显效6例,有效3例,无效2例,总有效率83.33%。对照组痊愈4例,显效5例,有效9例,无效12例,总有效率30.00%。经卡方检验x2=17.38,P0.001,两组疗效差异有非常显著性。结论异维A酸联合醋酸曲安奈德局部皮损内注射,治疗效果满意。     

脉冲染料激光和曲安奈德局部注射治疗病理性瘢痕的临床体会

目的:探讨585 nm闪光灯泵浦脉冲染料激光和曲安奈德注射联合治疗病理性瘢痕的治疗方案及临床效果.方法:采用585 nm闪光灯泵浦脉冲染料激光局部加醋酸曲安奈德局部注射治疗389例病理性瘢痕患者,并用回顾性分析法对389例病理性瘢痕临床资料进行分析.结果:接受该方案治疗的389例患者中,治愈231例,显效137例,无效21例,总有效率94.6%.不良反应16例(4.1%),为注射局部皮损有轻度萎缩和周围皮肤轻微脱色,其余患者未见明显不良反应.结论:585 nm闪光灯泵浦脉冲染料激光和曲安奈德注射联合治疗增生性瘢痕和瘢痕疙瘩疗效肯定,治愈率高,不良反应少.     

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.