《温州医科大学实验动物中心动物实验伦理审查表范例.doc》由会员分享，可在线阅读，更多相关《温州医科大学实验动物中心动物实验伦理审查表范例.doc（2页珍藏版）》请在三一办公上搜索。
1、温州医科大学实验动物中心动物实验伦理审查表范例The Tab of Animal Experimental Ethical Inspection of Laboratory Animal Centre, Wenzhou Medical University 批准编号(ID Number)：申请人填写的相关信息(Relatedinformationfilledbyapplicant)申请单位(Name of organization): 温州医科大学药学院School of Pharmaceutics Sicience, Wenzhou Medical University申请人学历(Educa
2、tion of applicant)：硕士 Master技术职称(Professional title)：副教授 associate professor实验名称(Experiment title)：淫羊藿苷丙二醇脂质体小鼠腹腔注射后药动学与分布研究Pharmacokinetics and tissue distribution profile of icariin propylene glycol liposomes intraperitoneal injection in mice项目来源(Project sources)：温州市科学技术局Medicine and Health Grant
3、from Wenzhou Bureau of Science and Technology (S20100049) et al. 实验目的(Aim of experiment)：研究淫羊藿苷丙二醇脂质体在小鼠体内的药动学特点和组织分布To investigate Pharmacokinetics and tissue distribution of icariin propylene glycol-liposomes suspension (ICA-PG-liposomes) 实验动物使用许可证号(Number of the using of Laboratory Animal)：SYXK（浙
4、）2010-0150 拟进动物情况动物来源(Source of animal)：温州医科大学实验动物中心 Laboratory Animal Centre, Wenzhou Medical University品种品系(Species or strain)：Swiss hasse 等级(Grade)： SPF 规格(Specifications)：25-30g数量(Number)： 35 只( 0 只； 35 只)申请日期(Application date)： 2009 年 03月 21 日进驻日期(Entering date)：2009 年 8 月 6 日结束日期(Ending date)：
5、2010 年 9 月 3 日实验要点，包括实验方法、观测指标、实验结束后处死动物的方法等：(Outline of experiments, experimental methods, observational index, executing animal method, et. al)：该研究本着实验动物福利和伦理的原则，本实验项目优化设计方案，严格计划动物需要数量，计划需要35只 Swiis hasse 小鼠。实验方法涉及动物单次给药后的药物动力学和分布研究。在设定的给药时间点0, 0.083, 0.167, 0.333, 0.667, 1.333, 2.0, 4.0, 8.0 h和 2
6、4h，采用水合氯醛麻醉下采集血液，分离心、肝、脾、肺、肾和脑用于淫羊藿苷的检测。各药均无毒性。实验结束后，麻醉小鼠，使小鼠安乐死，经打包，最后统一焚烧。In this study, the one hundred Swiss hasse male mice were used for pharmacokinetics and distriburtion evaluation of icariin propylene glycol-liposomes (n=5 each time point). After ICA-PG-liposomes or ICA-PG-Solution i. p., t
7、he mice were sacrificed by anesthesia with chloral hydrate at 0, 0.083, 0.167, 0.333, 0.667, 1.333, 2.0, 4.0, 8.0 and 24h. plasma collected at 0 min were served as blank samples. Blood samples were collected in haprinized tubes. Spleen, kidney, liver, lung, heart and brain were also collected from a
8、ll mice. The concentration of ICA in plasma and tissues were determined by HPLC. After the experiments, all mice were burned. 申请人签名 (Signature of applicant)： 王小明（旁边签字）联系电话 (Telephone)：13706664500（664500）项目负责人签名(Signature of Project director)：爱因斯坦（旁边签字）联系电话 (Telephone)：10086声明(Statement)：我将自觉遵守实验动物福利
9、伦理原则，随时接受委员会的监督与检查，如违反规定，自愿接受处罚。(I will conscientiously abide by the ethical principles of animal welfare, accept the supervision and inspection of the committee at any time, and voluntarily accept the punishment if any infringement.)项目负责人签名(Signature of Project director)：（项目负责人比如导师，这里直接签名）项目执行人签章(S
10、ignature of Project implementation)：（项目执行人比如研究生，这里直接签名）审查依据(Inspection contents)1. 该项目是否必须用实验动物进行实验，即能否用计算机模拟、细胞培养等非生命方法替代动物或用低等动物替代高等动物进行实验?(Does laboratory animal must be used in the project? Could other methods such as computer simulation, cell cultivation or using the low-grade animal instead of
11、 the high-grade animal?)2. 表中所填申请人资格和所用动物的品种品系、质量等级、规格是否合适，能否通过改良设计方案或用高质量的动物来减少所用动物的数量?(Are the qualification of applicant，species or strain, grade and specifications of animals suitable? Could the quantity of animals be reduced by improving the study design or using high quality animals?)3. 能否通过改进
12、实验方法、调整实验观测指标、改良处死动物的方法，来优化实验方案、善待动物?(Could the study design and animal treatment be refined by ameliorating experimental method, adjusting observational index, executing animal method?)审查结果(是否同意申请人的实验方案)(Results ofinspection)实验动物管理和伦理委员会意见(Attitude of the Animal Management and Ethics Committee)：同意(Agree)不同意(Disagree)修改后同意（Agree after revised）伦理委员会主任委员签名(Signature of Ethics Committee Director)：温州医科大学实验动物伦理委员会温州医科大学实验动物中心（代章） (Laboratory Animal Ethics Committee of Wenzhou Medical University &Laboratory Animal Centre of Wenzhou Medical University)(Stamp)年 月 日
