更昔洛韦对肾移植患者环孢菌素A药代动力学的影响

 目的：观察更昔洛韦对肾移植患者环孢菌素A药代动力学参数的影响,以促进临床合理用药,提高肾移植存活率。方法：分别对10例肾移植患者单用环孢菌素A与合用更昔洛韦后环孢菌素A的药代动力学参数进行研究和评价,采用荧光偏振免疫法测定各时刻环孢菌素A血中浓度,3P87程序拟合药代动力学参数,t检验比较组间差异。结果：合用更昔洛韦后,环孢菌素AKe,t_1/2（Ka）分别由单用组的（0.16±0.04）h^-1和（1.39±0.76）h降至（0.09±0.05）h^-1和（0.50±0.32）h（P＜0.05）,t_max由（3.67±0.77）h^-1减至（2.00±0.78）h^-1（P＜0.01）,t_1-2（Ke）由（4.08±1.85）h^-1增至（10.51±6.42）h^-1,峰浓度c_max平均升高27％。结论：更昔洛韦使肾移植患者对环孢菌素A的吸收显著加快,而使环孢菌素A在体内的消除减慢,对血中环孢菌素A的峰浓度也有一定影响,揭示临床调整用药方案。     

Research on Modern Nonlinear Dynamic Model of Five-Elements Theory

This article studied on five elements system and set general and strict model expectations combining with Traditional Chinese Medicine Zang-fu organs theory,in which absolute stable state,conditional stable state or transient stability and instability in mathematical models were corresponding to human healthy state,sub-healthy state(pathological plateau phase) and health deterioration state respectively.Model parameters were set up according to the mutual generation and restriction relations among five elements.The dynamic model of Five-Elements System was built,of which impulse responses were corresponding to human response under TCM treatment.Analyses of initial value and excitation response were conducted by numerical simulation and results turned out to meet the requirements of general model expectation:five elements system dynamic model had self-organization function;there existed only one non-global stable point and instability region in the five-dimensional space consisting of variables,in which instability was corresponding to pathological deterioration;system stable region was an unbounded domain and it included the stable sub-regions of special straight line-type,ray-type and line segment-type.Among those ray-types,some contained "Regression Peak" were classed as conditional stable regions while others as absolute ones.The existence of this peak indicates that our body must exceed a "Regression Threshold" when transiting from sub-healthy state(pathological plateau phase) to healthy state through self-regulation mechanism.Impulse excitation can reduce certain threshold and then increase the system health level,which is complied with the operating principle of Five-Elements System and the empirical rule of TCM clinical practice.This model has revealed qualitatively the inherent movement law of Five-Elements System and thus provides a new analysis tool for basic theoretical study on TCM.     

低分子肝素对人胃癌裸鼠原位移植模型肿瘤生长、转移及趋化因子受体4表达的影响

目的:探讨低分子肝素(low molecular weight heparin ,LMWH)对人胃癌裸鼠原位移植模型中肿瘤生长、转移及趋化因子受体4(chemokine receptor 4,CXCR4)表达的影响.方法:应用原位移植方法建立人胃癌裸鼠原位移植模型,模型建立后7 d时将裸鼠随机分为对照组(0.9%氯化钠溶液)、化疗组(5-氟尿嘧啶)和LMWH组(低分子肝素钙),分别每周给药2次,共5周.第6周牺牲动物,观察裸鼠胃癌原位模型的肿瘤生长及转移情况.应用RT-PCR和免疫组织化学法检测胃癌组织中CXCR4 mRNA和蛋白的表达水平.结果:化疗组和LMWH组的肿瘤体积比对照组明显缩小,差异有统计学意义(P＜0.05);LMWH组胃癌原位模型的肿瘤转移率(20%)低于对照组(70%),差异有统计学意义(P＜0.05),而与化疗组(11%)之间无明显差异(P＞0.05);LMWH组CXCR4 mRNA和蛋白的表达均较对照组和化疗组下降,差异有统计学意义(P＜0.05).结论:LMWH具有抑制人胃癌裸鼠原位移植模型中肿瘤生长和转移的作用,可能与肿瘤组织中CXCR4表达下降有关.     

彩色多普勒超声对成人肠套叠肿瘤性病因筛查

目的 探讨成人肿瘤性肠套叠声像图特征.方法 对12例经手术确诊的成人肠套叠声像图进行分析,总结其声像图特征.结果 12例肠套叠,均具有典型声像图表现即:横断面呈"同心圆征"、纵断面呈"套管征",特异性为100%.9例肿瘤引起的肠套叠,超声术前明确诊断7例(78%).其中,同心圆或套筒征内肿瘤2例,表现为同心圆结构偏心性突然改变、套筒征中相平行的强弱回声线之间分离或抬高;肠套叠顶(远心)端肿瘤5例,表现为肠套叠顶(远心)端实性回声;4例实性肿块内呈现相对丰富的彩色血流信号,3例实性肿块内呈现彩色血流信号缺失表现.结论 彩色多普勒超声在对成人肠套叠肿瘤性病因筛查中有重要的诊断价值.     

抗鸭乙型肝炎病毒实验研究

鸭乙肝病毒与人乙肝病毒在复制途径、形态结构和DNA多聚酶性状等方面均相似。作者取北京雏鸭于破壳后4h内经足静脉接种鸭乙型肝炎病毒阳性血清，制成鸭乙型肝炎模型。用不同剂量C84（茶叶中提取成分，儿茶素衍生内含量为93．7％）经口滴饲，于不同时间取血测定DHBSAg、DHBVDNA及ALT、AST含量。结果发现C84对鸭乙型肝炎病毒有抑制作用。     

穴位注射组胺在急性佐剂性关节炎大鼠上引起的镇痛效应

目的:观察组胺对穴位处肥大细胞的激活作用,以及其引起的类似针刺的镇痛效应,讨论穴位注射疗法可能存在的机制。方法:SD大鼠60只,随机分为空白对照组、模型组、生理盐水对照组、手针组和组胺注射组。大鼠左踝关节腔注射完全弗氏佐剂0.05 mL制作佐剂性关节炎模型。测量各组痛阈变化,并对穴位组织进行组织学观察,统计肥大细胞脱颗粒率。比较在"足三里"穴位注射100μg/mL的组胺溶液50μL和手针刺激20 min下的镇痛效应的差异性。结果:组胺注射和手针针刺,都能提高大鼠的痛阈达到镇痛效果,与模型组相比治疗后痛阈都有显著提高(P0.01)。组胺引起的肥大细胞脱颗粒率与生理盐水相比明显增高(P0.01),与针刺相比差异无统计学意义(P0.05)。结论:在佐剂性关节炎大鼠模型中,组胺可以引起穴位处肥大细胞脱颗粒,产生与针刺类似的镇痛效应。以刺激肥大细胞为目的的新型穴位注射疗法存在可行性。     

无痛人流术中丙泊酚靶控输注的临床观察

目的 探讨丙泊酚靶控输注在无痛人流术中的临床应用.方法 对门诊ASAⅠ～Ⅱ级的人工流产患者160例,根据麻醉用药方法不同按手术顺序间隔随机分为两组,A组为人工控制输注组,B组为靶控输注组,每组各80例.分别统计两组麻醉诱导时间、苏醒时间、丙泊酚总用量、自行行走时间、生命体征变化、呼吸抑制情况、术中出血量及麻醉效果.结果 B组麻醉效果优良率达95.0%,与A组的85.0%比较差异有显著性(P＜0.05);麻醉诱导后平均动脉压下降30%以上者A组有13例,占16.3%;B组4例,占5.0%,两组比较差异有显著性(P＜0.05);苏醒时间、丙泊酚总用量、自行行走时间、呼吸抑制情况及术中出血量两组比较差异无显著性(P＞0.05).结论 丙泊酚靶控输注在无病人流术中使用更方便,麻醉深度易调控,减少操作盲目性,提高麻醉效果,值得在临床推广应用.