临床营养制剂灭菌工艺研究进展

临床营养制剂作为全营养药物,在其生产贮存过程中容易滋生微生物,导致营养价值下降,故通过灭菌工艺控制微生物,保障制剂的安全、有效和稳定至关重要。本文通过综述国内外在食品、药品工业中应用的灭菌技术,并与传统的热力灭菌技术作对比分析,提出目前更适合于临床营养制剂保持其营养与活性成分的灭菌工艺,包括超高压灭菌技术、辐照灭菌技术、超高温瞬间灭菌技术、微波灭菌技术等,为高品质临床营养制剂的研究开发提供绿色新技术,保障临床营养制剂使用者的安全,有效康复。

毛细管区带电泳-间接紫外法同时测定多种糖醇及临床营养制剂中麦芽糖醇含量

目的:本文建立毛细管区带电泳-间接紫外法测定多种糖醇及临床营养制剂中麦芽糖醇含量。方法:待测样品加入50 mmol/L醋酸5 mL用于提取后离心,以11 mmol/L DNBA+40 mmol/L硼砂+0.5 mmol/L CTAB为分离缓冲溶液;用熔融石英毛细管(未涂敷)50μm×70 cm(有效长度:60 cm)为分离柱,于200 nm波长处进行检测,分离电压:-25 kV。结果:在优化的实验条件下,检出限20 mg/L(S/N=3),定量限60 mg/L(S/N=9),线性范围60~780 mg/L,线性相关系数r=0.9996。分别测定60、180、300 mg/L低、中、高三个浓度的平均加标回收率,分别为105.6%、102.0%、103.5%,相应相对标准偏差(n=3)分别为1.01%、0.77%、0.31%。方法日内精密度2.59%。结论:该方法快速、简单、准确、灵敏度高,适用于基质复杂的临床营养制剂中麦芽糖醇含量测定,同时也可测定成分明确单一的肠外营养制剂及输注药物中甘露醇、山梨醇、木糖醇、果糖以及蔗糖的含量。

复方夏枯草及其制剂临床研究概况

目的为近年夏枯草单用或与其他中药配伍应用于临床的研究文献做一综述,为夏枯草的进一步开发利用提供理论参考。方法查阅CNKI、维普数据库中相关的文献资料,进行分析。结果夏枯草广泛配伍应用于冠心病、高血压、甲亢、乳腺增生及盆腔炎等疾病的治疗,且有较好的疗效。结论夏枯草有较好的临床应用基础,是值得进一步开发的药物。

桑叶的化学成分及临床应用研究进展

近年桑叶的临床研究应用较为广泛,桑叶含多种化学成分,具有降血糖、降血脂、降血压、镇咳、抗菌、抗病毒、抗丝虫、抗癌、解痉、抗溃疡、延缓衰老、美容等多种药理作用。本文对桑树本草考证、植物来源、桑叶的化学成分、临床应用及其制剂研究进行综述,为桑叶资源将来进一步开发与利用提供科学依据,进一步研究开发桑叶具有广阔的应用前景。

雷公藤的常用制剂与使用

卫矛科植物雷公藤(Tripterygium wilfordii Hook.f.)俗称黄藤、断肠草等,是一种有一定毒性的中草药。经20多年基础研究与临床探索,发现它具有较强的抗炎、免疫抑制等多种药理作用,现在临床上广泛应用。所用制剂有多种,目前已研制出毒性较小、使用较安全的制剂并经药厂批量生产,现将临床所用制剂与使用体会作如下介绍。 临床制剂与用法 一、口服制剂与用法 1.煎剂 带皮全根,每日量10～12g,最大量不超过15g;去皮根芯木质部,每日量15～25g,最大量不超过30g。

蛇毒制剂的发展概况

蛇毒中含有蛇毒类凝血酶、蛇毒神经毒素、蛇毒神经生长因子、蛇毒细胞毒素等有效成分,由此制成的蛇毒制剂在治疗肿瘤、脑血管疾病、神经系统疾病、止血、镇痛等方面有良好的效果。蛇毒制剂在治疗肿瘤、脑血管疾病、神经系统疾病、止血等方面有很大的发展前景。本文通过查阅国内外文献资料进行整理和归纳,总结了蛇毒制剂的发展概况,蛇毒制剂的有效成分和其作用,以及临床应用中应注意的问题。

医院制剂室现状分析及发展策略探讨

随着医药工业的飞速发展，医院制剂正面临着严峻的挑战。本文从医院制剂室面临的现状、医院制剂的优势及今后医院制别工作的发展方向等方面讨论如何适应形势、发挥自身优势，促进医院制剂工作适时发展。

常用中药剂型在临床上的应用体会

近些年来,中药制剂产业迅猛发展,促进了中医药事业的发展,但也带来了一些安全隐患。本文总结了中药制剂在临床应用中给患者带来的方便、快捷、疗效、预后等方面进行综述。并指出了中药制剂具有广泛应用前景,进一步研究开发意义重大。

三七制剂的临床应用和研究进展

目的:为临床合理使用三七制剂和研究提供参考。方法:对三七的临床常用剂型和研发剂型进行分析、总结。结果:临床常用剂型有冻干粉针剂、片剂、胶囊剂、滴丸剂、散剂等,疗效确切且被广大患者接受;研发的剂型有缓控释制剂、水凝胶贴剂、鼻腔给药制剂和肺部给药制剂等。结论:通过结合现代制剂技术工艺的发展,有望开发出更多运用于临床的新剂型,充分发挥其中药大品种的价值。

八种中药注射剂的不良反应分析

中药注射剂是在中医药理论的指导下，运用现代科学技术和方法，从中药或天然物的单方或复方中提取的有效物质制成的无菌溶液和混悬液，或临用前配成溶体的灭菌粉末供注入体内的临床制剂。中药注射剂保留了传统中药的治疗特点，而且起效快，作用迅速，在急危重症的治疗方面发挥着重要作用，由于中药成分对人体的危害小，成为了临床应用的一大类药物。

雷公藤治疗类风湿性关节炎的机理探要

雷公藤作为药用植物有着悠久的使用史.我国50年代开始对其进行药效及临床研究,并用于自身免疫系统疾病的治疗.自1969年用于类风湿性关节炎,取得很大进展.现就近年来雷公藤对该病的治疗作一简述:

国内双歧杆菌制剂预防小儿继发性腹泻临床疗效的Meta分析

目的系统评价国内双歧杆菌制剂临床预防小儿继发性腹泻的效果。方法按照系统评价的要求检索CBMd isc、VIP、CNK I以及万方数据库等,获得18篇符合纳入标准的文献,共计患儿4050例,对其进行M eta分析,并评价M eta分析结果的稳定性和发表偏倚。结果异质性检验χ^2=34.60,P=0.007〈0.05,采用随机效应模型进行M eta分析,合并RR=0.41,95%C I为0.35～0.49,总体效应检验,Z=10.39,P〈0.00001,差异具有非常显著性,固定效应模型RR值和95%C I与随机效应模型完全一致,剔除小样本报道后的合并RR=0.42,95%C I为0.35～0.50,与剔除前的结果基本一致,且本研究的发表偏倚得到了很好地控制。结论从现有的临床证据来看,双歧杆菌制剂能降低小儿继发性腹泻的发生率,对预防小儿继发性腹泻起到了满意的效果。

Clinical significance of mucosal suppressors of cytokine signaling 3 expression in ulcerative colitis

AIM:To investigate the clinical significance of mucosal expression of suppressors of cytokine signaling 1 (SOCS1) and SOCS3 in human ulcerative colitis (UC). METHODS:Biopsy specimens for histological analysis and mRNA detection were obtained endoscopically from the rectum of 62 patients with UC (36 men; age 13-76 years). The patients were classified endoscopically according to Matts' grade (grade 1 to 4). Expression of SOCS1 and SOCS3 mRNAs was quantified in samples by competitive reverse transcription-polymerase chain reaction (RT-PCR). GAPDH was used as an internal control for efficiency of RT-PCR and amount of RNA. RESULTS:SOCS3 mRNA expression was significantly higher in inflamed mucosa of UC than in inactive mucosa. The level of expression was well correlated with the degree of both endoscopic and histologic inflammation. Interestingly,among the patients in remission,the group with relatively low expression of SOCS3 showed a higher rate of remission maintenance over a 12-mo period. In contrast,SOCS1 mRNA was expressed in both inflamed and non-inflamed colonic mucosa and was not correlated with the activity of colonic mucosa or prognosis. CONCLUSION:These observations suggest that increased expression of mucosal SOCS3,but not of SOCS1,may play a critical role in the development of the colonic inflammation of UC.

Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.

Expression of SOCS-1 in the liver tissues of chronic hepatitis B and its clinical significance

AIM： To study the expression of suppressor of cytokine signaling-1 （SOCS-1） in the liver tissues of chronic hepatitis 13 （CHB） and the clinical significance of this expression. METHODS： The expression of SOCS-1 in liver tissues of 45 cases of CHB was investigated by immunohistochemical staining, and its correlations with inflammation grades and fibrosis stage were analyzed by SPSS statistics software. RESULTS： The result showed SOCS-1 expressing could be observed in the liver tissue of CriB. The expression of SOCS-1 was mainly distributed near the portal area in the liver tissue of mild inflammation CriB group, and was diffusely distributed in the liver tissue of moderate and severe inflammation groups. SOCS-1 positive stains mainly appear in the hepatocytes, only a few of liver interstitial cells were involved. Inside the hepatocyte, SOCS-1 positive stains are mainly distributed in the plasma. Some of the staining was observed on the membrane. The inclusion bodies in the plasma of hepatocytes were observed occasionally. There were both obvious correlations between the expression of SOCS-1 and the inflammatory grade, and that between the expression of SOCS-1 and the fibrosis stage, CONCLUSION： The distribution of SOCS-1 in the liver tissue of CriB is variable. This expression was correlated with the inflammation grade and fibrosis stage.

Targeted systemic therapies for hepatocellular carcinoma:Clinical perspectives,challenges and implications

Hepatocellular carcinoma （HCC） is a lethal disease in most patients, due to its aggressive course and a lack of effective systemic therapies for advanced disease. Surgical resection and liver transplantation remain the only curative options for a small subset of patients. Few patients with HCC are diagnosed early enough to be eli- gible for curative treatment. Angiogenesis inhibition is a natural therapeutic target for all solid tumors, but par- ticularly for the highly vascularized HCC tumors. With the approval of the targeted agent sorafenib, there are now additional options for patients with HCC. Although sorafenib does produce some improvement in survival in HCC patients, the responses are not durable. In addi- tion, there are significant dermatologic, gastrointestinal, and metabolic toxicities, and, as importantly, there is still limited knowledge of its usefulness in special sub- populations with HCC. Other angiogenesis inhibitors are in development to treat HCC both in the first-line set- ting and for use following sorafenib failure; the furthest in development is brivanib, a dual fibroblast growth factor pathway and vascular endothelial growth factor receptor inhibitor. Additional agents with antiangiogenic properties also in phase IT and Ⅲ development for the treatment of patients with HCC include bevacizumab, ramucirumab, ABT-869, everolimus and ARQ 197.

Diagnosis of Zollinger-Ellison syndrome:Increasingly difficult

In the present paper the increasing difficulty of diag-nosis of Zollinger-Ellison syndrome (ZES) due to issues raised in two recent papers is discussed. These issues involve the difficulty and need to withdraw patients suspected of ZES from treatment with Proton Pump Inhibitors (omeprazole, esomeprazole, lansoprazole, rabeprazole, pantoprazole) and the unreliability of many gastrin radioimmunoassays. The clinical context of each of these important issues is reviewed and the conclusions in these articles commented from the per-spective of clinical management.

Splenic infarction associated with sorafenib use in a hepatocellular carcinoma patient

Sorafenib,a multitargeted tyrosine kinase inhibitor,has been shown to improve survival in patients with advanced hepatocellular carcinoma(HCC).As the clinical use of sorafenib increases,many adverse effects have been reported,such as hand-foot skin reaction,diarrhea,anorexia,asthenia,alopecia,weight loss,hypertension and arterial thromboembolism.However,there are no prior reports of splenic infarction as an adverse effect of sorafenib.Here,a case of splenic infarction in a patient with HCC who was treated with sorafenib is reported. The patient had no other predisposing factors to explain the splenic infarction except for the administration of sorafenib.The splenic infarction improved after sorafenib was discontinued;however,the HCC progressed.