氨溴索对实验性肺纤维化的干预作用

目的:探讨氨溴索对博莱霉素所致大鼠肺间质纤维化的干预作用及机制。方法:健康雌性 SD大鼠 45只,随机分为3组。治疗组:15只,气管内一次性注入博莱霉素5 mg·kg-1,当日予氨溴索20 mg·kg-1灌胃,每日一次,于第7,14和28 d各处死5只;模型组:15只,以生理盐水代替氨溴索灌胃,余同治疗组;对照组:15 只,大鼠气管内注入生理盐水0.2~0.3 ml,于第7,14和28 d各处死5只。各组动物处死后提取肺组织,作HE染色,进行病理分析,并测定肺匀浆中谷胱甘肽(GSH)、超氧化物歧化酶(SOD)和羟脯氨酸(HYP)的含量。结果:对照组无明显病理改变;治疗组7 d时肺泡炎较模型组减轻,28 d时纤维化病变较模型组好转。模型组 7 d肺匀浆中 GSH含量和14 d SOD含量低于对照组(P<0.01),治疗组上述指标较模型组升高(P<0.05, P<0.01)。模型组 28 d时肺匀浆HYP含量均明显高于对照组和治疗组(P<0.05)。结论: 氨溴索能通过增强肺局部抗氧化能力,减轻博莱霉素诱导的肺泡炎和肺纤维化程度,是治疗肺纤维化的可能途径之一。     

汉防己甲素对肺纤维化大鼠肺组织钙-钙调素系统的影响

目的　探讨汉防己甲素 (Tet)防治肺纤维化的机制。方法　 48只SD大鼠一次性气管内注入博莱霉素A5,制备肺纤维化模型 ,随机分为两组 :模型组 (n =2 4 )及Tet组 (n =2 4 ) ,在实验d7、d1 4、d2 8分批处死后作病理切片 ,应用电子计算机图像分析仪进行肺泡炎和肺间质纤维化定量分析 ;采用火焰原子吸收分光光度法及磷酸二酯酶 (PDE)法分析测定各组给药后肺组织钙含量及钙调素活性 ,并与正常对照组 (n =8)比较。结果　模型组肺组织钙含量及钙调素活性较正常组明显增高 (P <0 .0 1 ,P <0 .0 0 1 )。Tet组各期钙含量及钙调素活性均低于模型组 (P <0 .0 1 ) ,组织病理学显示肺泡炎及肺纤维化程度均较模型组明显减轻。结论　Tet防治鼠肺纤维化的机制可能与拮抗钙、钙调素系统有关     

肺特灵Ⅵ号对博莱霉素诱导的小鼠肺纤维化的干预作用及其机制

目的观察肺特灵Ⅵ号对博莱霉素诱导的小鼠肺纤维化的干预作用。方法采用气管内注入博莱霉素法制备小鼠肺纤维化模型。给药28d后处死,计算肺系数;观察肺脏病理形态学改变,并对肺泡炎和肺纤维化程度进行评分;测定小鼠肺组织中超氧化物歧化酶（SOD）、丙二醛（MDA）、总抗氧化能力（T-AOC）与羟脯氨酸（HYP）等生化指标。结果与模型组相比,肺特灵Ⅵ号各剂量组可明显增加小鼠体质量,降低肺系数,减轻肺泡炎与肺纤维化程度,提高肺组织SOD活性与T-AOC,降低MDA与HYP含量（P〈0.05或〈0.01）。结论肺特灵Ⅵ号对博莱霉素诱导的小鼠肺纤维化有一定的防治作用。     

抗纤益肺胶囊对肺纤维化大鼠肺组织病理变化及血清TGF-β1、TNF-α的影响

目的观察抗纤益肺胶囊对博莱霉素致大鼠肺纤维化的病理改变及血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)的影响。方法选用60只健康Wistar大鼠,随机分为正常组,模型组,阳性对照组,抗纤益肺胶囊高、中、低剂量组,采用经气管滴注博莱霉素溶液建立肺纤维化大鼠模型。在造模48h后,各组分别予生理盐水,泼尼松混悬液,抗纤益肺胶囊高、中、低剂量药物,每日1次,共28d。观察大鼠肺组织形态学变化,以及对肺系数测定和肺组织羟脯氨酸(HYP)、血清TGF-β1及TNF-α的影响。结果与模型组比较,抗纤益肺胶囊各组和阳性对照组的病理形态学变化明显减轻,随着抗纤益肺胶囊剂量增加,肺纤维化程度降低。抗纤益肺胶囊各组HYP、TGF-β1和TNF-α均明显低于模型组(P<0.05),而且随着剂量增加,降低更明显。与阳性对照组比较,抗纤益肺胶囊高剂量组HYP有明显降低(P<0.05)。结论抑制肺组织中TGF-β1和TNF-α的表达,以及抑制胶原蛋白合成,可能是抗纤益肺胶囊抗肺纤维化作用的机制之一。     

卡托普利对实验性肺间质纤维化的干预作用

目的 :观察血管紧张素转换酶 (ACE)活性在博莱霉素 (BLM)所致大鼠肺间质纤维化过程中的动态变化 ,了解ACE抑制剂卡托普利 (CPT)对大鼠肺纤维化模型的影响。方法 :4 5只SD大鼠随机分为 3组 :对照组、模型组和用药组。模型组和用药组经气管内注入BLM诱导肺纤维化 ,随即分别每日胃管内灌注生理盐水和CPT(6 0mg·kg- 1·d- 1 )进行干预 ;对照组气管和胃管内灌注均以生理盐水代替。各组动物均于气管内灌药后 7,14 ,2 8d分别处死 5只 ,测动物体重及肺湿重 ,取肺组织做HE染色 ,Ⅰ、Ⅲ型胶原的免疫组化 ,并行图像分析 ;心腔内取血测ACE的活性。结果 :血清ACE活性在气管内灌注BLM后迅速上升 ,第 7d达到高峰 (与对照组比P <0 .0 1) ,随后下降 ,到第2 8d基本恢复正常。CPT能显著降低血清中ACE的活性 ,减少肺内胶原的表达 ,减轻肺泡炎和肺纤维化的程度。结论 :CPT能减轻BLM诱导的大鼠肺泡炎和肺纤维化     

虎杖对肺纤维化大鼠肺组织中SOD、GSH、MDA的影响

目的：通过观察虎杖干预后肺纤维化大鼠肺组织中超氧化物歧化酶（SOD）活性及谷胱甘肽（GSH）、丙二醛（MDA）含量的影响,探讨虎杖防治肺纤维化的作用机制。方法健康雄性SD大鼠120只,随机分为5组：模型组30只,气管内一次性注入博莱霉素50.5mg/100g制作肺纤维化大鼠模型,当日予0.9%氯化钠溶液5ml/100g灌胃;预防组30只,于造模前2d开始予虎杖5ml/100g灌胃;肺泡炎组20只,于造模后第7天开始虎杖灌胃;肺纤维化组10只,于造模后第28天开始虎杖灌胃;对照组30只,于造模当日开始0.9%氯化钠溶液5ml/100g灌胃。各组大鼠灌胃均1次/d。5组大鼠分别于第3、7、14、28、42或56天分阶段处死5只,取肺组织制成匀浆,测定SOD活性及GSH、MDA的含量。结果模型组第3、7、14天肺组织中SOD活性及GSH含量低于对照组（均P＜0.05）,预防组上述指标较模型组升高（P＜0.05或0.01）,肺泡炎组、肺纤维化组与模型组的差异均无统计学意义（均P＞0.05）。模型组第7、14天肺组织中MDA含量明显高于对照组和预防组（均P＜0.05）。结论虎杖能通过增强肺组织局部抗氧化能力,减轻博莱霉素诱导的肺泡炎和肺纤维化程度,可能是治疗肺纤维化的有效药物。     

汉防已甲素治疗博莱霉素诱导的大鼠肺间质纤维化实验研究

目的　观察中西药钙拮抗剂对肺间质纤维化的治疗作用。方法　将 72只SD大鼠一次性气管内注入博莱霉素A5制备肺纤维化模型 ,次日随机给药 ,并测定分析各组给后d7、d14、d2 8肺组织内羟脯氨酸、脂质过氧化物含量、组织病理学变化以及比较各组d2 8肺系数。结果　汉防己甲素组及维拉帕米组各期肺组织脂质过氧化物及羟脯氨酸含量均较模型组明显降低 (p <0 .0 5 ,p<0 .0 1) ,肺系数明显减小 (p <0 .0 1,p<0 .0 1) ,组织病理学显示肺泡炎及肺纤维化程度均明显减轻 ,其中汉防己甲素优于维拉帕米。结论　中药钙拮抗剂汉防己甲素治疗肺间质纤维化疗效满意 ,值得进一步研究。     

RT-PCR方法分析益气养阴活血法对肺纤维化大鼠肺组织TGF-β1mRNA影响

目的:观察益气养阴法中药组方——抗纤合剂对博莱霉素诱导的肺纤维化大鼠肺组织中TGF-β1 mRNA蛋白质表达的影响,在分子层面探讨抗纤合剂的可能作用机制。方法:将健康雄性Wistar大鼠120只随机分为对照组、模型组、强的松组、抗纤合剂组。每组30只。除正常对照组,其他3组采用博莱霉素(BLM)致肺纤维化大鼠模型。模型建成后,强的松组以6.25 mg·kg~(-1)的强的松溶液灌胃,抗纤合剂组以5 g·kg~(-1)灌胃。正常对照组与模型组以等溶生理盐水灌胃,观察大鼠一般状态,分别于7、14、28 d 3个时间点处死大鼠并取材。每个时间点每组大鼠10只。取肺组织固定包埋切片后,应用病理图像分析系统对病理切片进行扫描,观察大鼠组织病理学改变,用HE染色观察肺组织肺泡炎变化程度,用胶原纤维的特异染色Masson染色观察肺组织纤维化变化程度;用RTPCR方法,动态观察肺组织TGF-β1 mRNA的表达。结果:HE染色及Masson染色显示:正常组肺内结构清晰,肺泡间隔未见增厚,模型组:各时期均表现有程度不等的肺泡炎,大量炎性细胞浸润,28 d时肺组织以胶原沉积为主,呈中、重度肺纤维化改变。强的松组、抗纤合剂组肺组织炎细胞浸润区域较模型组明显减少,28 d时胸膜和肺泡间隔胶原纤维沉积呈束状,显示轻、中度肺纤维化改变。除正常组外,其他各组TGF-β1 mRNA表达于第7天明显增强,模型组14 d达到高峰,其余两组与模型组相比,差异显著,强的松组、抗纤合剂组统计无明显差异。结论:以益气养阴活血法立方的抗纤合剂可降低BLM致肺纤维化大鼠肺组织炎症和肺纤维化程度,下调BLM致肺纤维化大鼠TGF-β1 mRNA表达,对肺纤维化有一定的治疗作用。     

抗纤丸联合氧化物歧化酶脂质体治疗肝纤维化

目的 :探讨抗纤丸联合氧化物歧化酶脂质体治疗肝纤维化的疗效。方法 :治疗组用抗纤丸联合氧化物歧化酶脂质体治疗肝纤维化 33例 ,抗纤丸 7.5g/d ,分 3次口服 ,SOD -l2 0ml/d分 2次口服 ,并以维生素C ,复合维生素B ,肝泰乐口服液治疗肝纤维化 30例为对照组。结果 :治疗组ALT、r -GT治疗后明显下降 ,与对照组比较 ,差异显著(P <0 .0 5 ) ;治疗后治疗组HN、LN、PCⅢ值均明显低于治疗前 ,与对照组比较有显著差异 (P <0 .0 1) ;用药后治疗组LPO下降以及SOD升高幅度与对照组比较有显著差异 (P <0 .0 1)。结论 :以抗纤丸联合氧化物歧化酶脂质体治疗肝纤维化疗效显著     

实验性大鼠肺纤维化病理形态及超微结构观察

目的 从形态学上研究肺纤维化的形成过程，为防治研究和客观地评价用药物治疗肺纤维化的疗效提供依据。方法 向大鼠气管内一次性注入博莱霉素(5mg／kg)，观察注药后各模型组的肺系数、肺组织定量分析、肺组织病理及超微结构的变化。结果 模型组肺系数从第7d开始呈逐渐升高趋势；定量分析：7d组肺泡炎最严重，28d组肺泡腔明显缩小，胶原纤维成分增加；光镜下7d组肺泡腔及肺泡间质内以炎细胞浸润为主，14d时肺泡间质增宽，成纤维细胞增多，28d时胶原纤维增生，部分肺泡腔萎缩消失；电镜下3d和7d时肺泡上皮线粒体肿胀，空泡化，核固缩或核染色质边集，肺毛细血管基膜水肿或增厚，14d时Ⅱ型肺泡上皮细胞增生，其内板层小体增多，成纤维细胞增多；28d时肺间质增宽，巨噬细胞及成纤维细胞增多，胶原纤维呈灶性沉集。结论 建立的大鼠肺纤维化模型符合肺泡炎一纤维化的早期演变过程。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

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.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Dr.Zhang Ren's Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

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.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.