Objective:To evaluate the clinical value of 64-slice spiral coronary CT angiography(CTA)in diagnosis of in-stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with coronary artery disease.Methods:CTA was used to reconstruct and analyze the 345 segments(each stent was divided into three segments:proximal,middle and distal)of 115 stents in 60 patients with coronary heart disease after PCI.The results of selective coronary angiography(SCA)were taken as the golden standard to evaluate the sensitivity and specificity of CTA in diagnosis of ISR after PCI.Results:CTA clearly showed the location and length of the stents,the stenosis at stent and the characteristics of restenosis plaques.Thirty-nine in-stent restenosis lesions were found by CTA,including 8 calcified lesions and 31 non-calcified lesions.There were 25 lesions at the proximal end of the stent,7 at the middle and 7 at the distal end.Forty-two lesions were found by CTA,including 9 calcified lesions and 33 non-calcified lesions,with 26 at the proximal end,8 at the middle and 8 at the distal end.CTA correctly diagnosed 36 segments,missed 6,and misdiagnosed 3.The sensitivity,specificity,PPV,NPV and accuracy of CTA were 85.71%,99.01%,92.31%,98.04% and 97.39%,respectively.CTA had the highest sensitivity and specificity for diagnosis of the proximal ISR,being 96.15% and 100%,respectively.Proximal stent restenosis accounted for 64.10% of the total.Conclusion:CTA can clearly demonstrate the in-stent restenosis and has a high accuracy in diagnosing restenosis after PCI.CTA is a safe,simple and reliable noninvasive diagnostic method for diagnosis of in-stent restenosis after PCI.

Objective To observe the abnormality of gray matter volume and density in patients undergoing postoperative delirium (POD).Methods Forty-seven cases of aged patients, 26 males and 21 females, aged 60-75 years, ASA physical status Ⅱ or Ⅲ, were selected.On the third day after operation, cognitive function estimation was performed.The patients were assigned into group POD and group C according to whether POD occurred and brain magnetic resonance imaging (MRI) scanning was implemented.The discrepancy in gray matter volume and density between the two groups were compared using voxel-based morphometry method (VBM).Correlation analysis was performed between the corresponding parameters in the regions where notable differences between the two groups existed and minimum mental state examination (MMSE) score were found.Results Global gray matter volume of group POD was notably lower than that of group C (P<0.01).Cerebrospinal fluid volume of group POD was significantly higher than that of group C (P<0.01).Gray matter volume of bilateral frontal gyrus and right parahippocampus was remarkably reduced in group POD (P<0.001).Gray matter density of bilateral hippocampus and right parahippocampus decreased significantly (P<0.001).Right parahippocampal gray matter volume was positively correlated with MMSE score in POD patients (P<0.05).Conclusion Structural abnormality in frontal regions, hippocampus and parahippocampus may play an important role in pathogenetic and developing process of POD.Gray matter volume in the right parahippocampus may be one of reference index for POD severity.

A new dynamic in vitro intestinal absorption model for screening and evaluating lipid formulations was established by means of the characteristics of the intestinal digestion and absorption of the lipid formulations. This model was composed of two systems, including intestinal digestion and the intestinal tissue culture, which drew the evaluation method of intestinal absorption into the in vitro lipolysis model. The influence of several important model parameters such as Ca2+, D-glucose, K+ on the two systems of this model has been investigated. The results showed that increasing of Ca2+ concentration could be significantly conductive to intestinal digestion. The increasing of D-glucose concentration could stepped significantly down the decay of the intestinal activity. K+ was able to maintain intestinal activity, but the influence of different concentration levels on the decay of the intestinal activity was of no significant difference. Thus the model parameters were set up as follows: Ca2+ for 10 mmol x L(-1), D-glucose for 15 mmol x L(-1) and K+ for 5.5 mmol x L(-1). Type I lipid formulation was evaluated with this model, and there was a significant correlation between the absorption curve in vitro and absorption curve in vivo of rats (r = 0.995 6, P < 0.01). These results demonstrated that this model can be an attractive and great potential method for the screening, evaluating and predicting of the lipid formulations.

This paper report the development of a new dosage form - self-microemulsifying mouth dissolving films, which can improve the oral bioavailability of water insoluble drugs and have good compliance. A three factor, three-level Box-Behnken design was used for optimizing formulation, investigated the effect of amounts of microcrystalline cellulose, low-substituted hydroxypropyl cellulose and hypromellose on the weight, disintegration time, cumulative release of indomethacin after 2 min, microemulsified particle size and stretchability. Optimized self-microemulsifying mouth dissolving films could fast disintegrate in (17.09 +/- 0.72) s; obtain microemulsified particle size at (28.81 +/- 3.26) nm; and release in vitro at 2 min to (66.18 +/- 1.94)%. Self-microemulsifying mouth dissolving films with broad application prospects have good compliance, strong tensile and can be released rapidly in the mouth through fast self-microemulsifying.

Solid carriers had important effects on the properties of solid self-microemulsifying drug delivery systems (S-SMEDDS). In order to make the basis for further development of S-SMEDDS, the influences of silica on the absorption of S-SMEDDS were investigated. An in vitro lipolysis model was used to evaluate the influence of silica on self-microemulsifying drug delivery system digestion from intestinal tract. S-SMEDDS containing silica were prepared by extrusion/spheronization. The drug release and absorption were investigated. The results showed that lipolysis rate and drug concentration in aqueous phase after intestinal lipolysis both increased by adding silica, which was benefit to drug absorption. And silica was not benefit to absorption for slowing drug release. Consistently, there was no significant influence of silica on intestinal absorption. This study implied that the influences of silica on lipolysis rate and drug release were both amount dependent and it is suggested that silica could be used as the solid carrier but the proportion needs to be optimized.

The distribution fate and solubilization behavior of indomethacin through the intestinal tract were investigated with in vitro lipolysis model, by comparing the Capmul MCM and Labrafil M 1944 CS type I lipid formulations. The results showed that the more favorable solubilization was in the aqueous digestion phase from each lipid formulations for indomethacin. The lipolysis rate and extent were decided with chemical constitution of the lipid excipients, which meant that less indomethacin was transferred from the long chain polar oil lipid solution into the aqueous digestion phase. Increasing the concentration of indomethacin in the lipid formualitons from a solution to a suspension led to a linear increase in the concentration of indomethacin attained in the aqueous digestion phase from lipid formulations. This study also implied that adverse effects of the lipolysis rate and extent on drug absorption were could be taken into consideration when screening lipid formulations. Lipid suspensions likely had better enhancement of drug absorption. Last, this study demonstrated that a potential basis for optimizing and assessing type I lipid formulations and also researching in vivo-in vitro correlations of lipid formulations were provided by an in vitro lipolysis model.

Objective:To observe different effects of moxibustion at Zusanli (ST 36) and Yanglingquan (GB 34) on electrogastrogram (EGG) of patients with functional dyspepsia (FD). Methods:A total of 65 cases were randomized into a Zusanli (ST 36) group (n=33) and a Yanglingquan (GB 34) group (n=32) by random serial number, to receive moxibustion therapy to the corresponding point respectively. The 8-lead EGG was used before and after treatment to collect EGG parameter of the gastric body, antrum of stomach, lesser curvature and greater curvature, including the dominant frequency, slow wave percentage, average frequency, response area and motility index. Results:After treatment, the dominant frequency and slow wave percentage were improved in nearly the whole stomach area in Zusanli (ST 36) group, showing statistical significances (bothP<0.05); the slow wave percentage and average frequency were improved in stomach body and antrum of stomach in Yanglingquan (GB 34) group, showing statistical significances (bothP<0.05); moxibustion at Zusanli (ST 36) had a significantly higher influence on EGG than Yanglingquan (GB 34) , in which the lifting of slow wave percentage was significantly higher than Yanglingquan (GB 34) group (P<0.05). Conclusion: Moxibustion at Zusanli (ST 36) and Yanglingquan (GB 34) has the effect of adjusting abnormal EGG pattern in FD patients. Compared with Yanglingquan (GB 34), Zusanli (ST 36) has a superior effect in improving EGG in stomach area.

Objective To investigate the expression of paired box2(Pax2),proliferation cell nuclear antigen(PCNA) and cell apoptosis in steroid-sensitive and steroid-resistant groups with primary nephrotic syndrome(PNS) and to find out the action of Pax2 expression in PNS with steroid-resistance.Method The expressions of Pax2,PCNA were evaluated by immunohistochemistry and cell apoptosis by fluorescence micoscope.Results Pax2 expression in renal tubule had a positive correlation with PCNA expression in steroid-sensitive group.In steroid-resistant group,Pax2 expression had no correlation with PCNA.Pax2 had a negative correlation with cell apoptosis.Conclusions Pax2 proper expression facilitate PCNA expression and repair tubulointerstitial lesions in steroid-sensitive group.Renal tubular epithelial cell proliferation coordinated with cell apoptosis.Pax2 overexpression in steroid-resistant group lead to the decrease of cell proliferation and cell apoptosis and lead to the severe tubule lesions,which made to glucocorticoid resistance.

Objective To explore the clinical value of imaging examinations of medullary sponge kidney with the literature reviewed.Methods The features of X-ray plain film (1 case),IVP (2 cases),B-mode US(3 cases) and CT images (9 cases) of medullary sponge kidney (MSK) in 11 cases were analysed retrospectively.Results X-ray plain film showed a cluster of round and oval high density images in renal papillae and renal medulla in one case one kidney.Collecting tubes were showed as like line,brush and sac like dilatation on IVP in 2 cases 3 kidneys.B-mode US revealed a cluster of high echo spots scattered in renal medulla in 3 cases 5 kidneys and sac like dilatation of collecting tubes in 2 cases 3 kidneys.CT images showed the stones of spongiform kidney scattered alone renal medulla in 9 cases 16 kidneys,while the stones covered by contrast media on enhanced CT images in 3 cases 5 kidneys,and enhanced stripes of high density projected from renal papillae to renal medulla.Conclusion X-ray plain film,IVP,B-made US and CT all can be used in diagnosing spongiform kidney.Plain film and IVP are yet the first selected methods and IVP is specific and direct in showing collecting tubes dilatation.B-mode US especially CT have a high showing rate of stone in spongiform kidney and can be helpful to evaluate the collecting tube dilatation.

Objective:To establish an HPLC method for the determination of entrapment efficiency of matrine microspheres .Meth-ods:A Fortis XiC18 (250 mm ×4.6 mm, 5μm) column was used , the mobile phase consisted of methanol-acetonitrile-3%phosphoric acid solution (11∶80∶9).The flow rate was 0.6 ml· min-1.The detection wavelength was 210 nm, the column temperature was at 25℃and the sample size was 20 μl.Results: The linear range of matrine was 3-150 μg · ml-1 ( r =0.999 7).The recovery was 99.92%(RSD=0.97%, n=9).The entrapment efficiency of matrine microspheres was 81.85%±3.22%(n=3).Conclusion: The method is suitable for the determination of entrapment efficiency of matrine microspheres .