丹参和异搏定对高能冲击波致兔肾损伤的保护作用

目的: 探讨丹参对高能冲击波致家兔肾损伤的保护作用及机制. 方法: 将家兔45只随机分为3组,丹参组、异搏定组和生理盐水对照组各15只,ESWL前3 d分别iv丹参注射液、异搏定和生理盐水,测定体外冲击波碎石术(ESWL)前后不同时间血浆中内皮素(ET-1)和超氧化物歧化酶(SOD)及血清中丙二醛(MDA)变化. 结果: 对照组ESWL后血浆中ET-1和血清中MDA值较ESWL前显著升高(PET-1=0.015, PMDA =0.01), 而血浆中SOD活性显著性降低(P=0.003). 丹参组和异搏定组ESWL后血浆中ET-1和血清MDA较ESWL前无显著性变化,且高峰值均显著低于对照组;而血浆SOD活性虽较ESWL前降低,但却显著高于对照组(丹参: P=0.001; 异搏定: P=0.022). 丹参组和异搏定组两组间3个指标均无显著性差异. 结论: 丹参与异搏定一样对高能冲击波致家兔肾损伤具有保护作用.     

慢性肾小球肾炎患者血浆内皮素-1的变化及临床意义

目的探讨内皮素-1(ET-1)与原发性肾小球肾炎肾功能损害的关系.方法正常对照组15例,原发性慢性肾小球肾炎38例.根据内生肌酐清除率(Ccr)将患者分四组:Ⅰ组(Ccr≥50ml/min),Ⅱ组(20ml/min≤Ccr＜50ml/min),Ⅲ组(10ml/min≤Ccr＜20ml/min),Ⅳ组(Ccr＜10ml/min).Ⅰ组中根据尿蛋白量分为Ⅰ A与Ⅰ B两组.采用放射免疫法检测各组血浆ET-1,同时检测血浆血管紧张素Ⅱ和醛固酮.结果与对照组相比,Ⅰ、Ⅱ、Ⅲ、Ⅳ组血浆ET-1显著升高(P＜0.05,P＜0.01,P＜0.01,P＜0.01),各组间有显著性差异(F=63.04,P＜0.01).在Ccr相似情况下,尿蛋白多者(Ⅰ B组),血浆ET-1水平较高.血浆ET-1与Scr、MAP、AⅡ和ALD均呈正相关,r值分别为0.7660(P＜0.001)、0.3057(P＜0.05)、0.2846(P＜0.05)和0.6235(P＜0.001).结论ET与肾功能、血压及紧素一血管紧张素一醛固酮系统关系密切.血浆ET-1水平可反映肾功能损害的程度.     

氟伐他汀调脂治疗对血管内皮功能的影响

目的: 探讨高脂血症患者血管内皮细胞功能的变化及氟伐他汀对其的影响.方法: 选高脂血症患者44例为治疗组,血脂正常者20例为对照组,检测氟伐他汀治疗前后血浆内皮素-1浓度(ET-1)和血脂,观察肱动脉血管超声检测血管内皮依赖性舒张功能的变化.结果: 高脂血症组ET-1的水平明显高于对照组(P＜0.01),血管内皮依赖性舒张显著低于对照组(P＜0.01);氟伐他汀治疗后1周血脂水平较治疗前有下降趋势,但无统计学意义(P＞0.05 ),而ET-1明显下降、反应性充血引起的肱动脉内径扩张显著增强(P＜0.05);治疗后8周TC、TG、 LDL-C均有明显降低(P＜0.05～0.01),且 ET-1进一步降低,反应性充血引起的肱动脉内径扩张进一步增强(P＜0.01).结论: 高脂血症患者内皮功能受损,氟伐他汀调脂治疗的同时具有改善内皮功能的作用.     

急性胰腺炎早期脂质过氧化物与血管活性物质的变化

目的: 探讨内皮素(endothlin,ET)、降钙素基因相关肽(calcitonin gene-related peptide,CGRP)与脂质过氧化物(MDA)及自由基清除剂(SOD)在急性胰腺炎(AP)早期发病中的作用及临床意义.方法: 采用放射免疫分析法、硫代巴比妥酸法及黄嘌呤氧化酶法,分别测定急性发病期(24～48 h)重症急性胰腺炎(SAP)17例,轻症急性胰腺炎 (MAP)35例和正常对照组(NC)30例的血浆ET、CGRP和血清MDA及SOD的含量.结果: SAP组血浆ET水平明显增高,MAP明显降低(P＜0.001).SAP组血浆CGRP水平无明显变化(P＞0.05),MAP组明显增高(P＜0.001).AP患者血清MDA水平明显增高,而SOD明显降低,SAP与 MAP比较差异具有显著性(P＜0.01).SAP组ET/CGRP及MDA/SOD比值明显增高(P＜0.01),呈正相关(r值0.741 0,P＜0.01),MAP患者MDP/SOD比值明显增高(P＜0.01),ET/CGRP比值明显降低(P＜0.05).结论: AP早期可能以脂质过氧化损伤为主.ET/CGRP比例失调可能参与了SAP早期胰腺微循环障碍,与脂质过氧化物协同作用导致胰腺组织损伤.MDA/SOD及ET/CGRP比值反映胰腺病变的严重性,可作为判断AP预后的指标.     

通脉汤对动物动脉粥样硬化的影响及其作用机制

目的:探讨动脉粥样硬化(AS)的氧化应激状态以及通脉汤对活性氧的影响.方法:日本大耳白兔40只,随机分为4组:每组10只,正常对照组以普通饲料喂养;模型组以高胆固醇饲料喂养;通脉汤低剂量治疗组以高胆固醇饲料,同时予低剂量通脉汤灌胃;通脉汤高剂量治疗组高胆固醇饲料喂养,同时予高剂量通脉汤灌胃,共喂养16周后,分别测定血清超氧化物歧化酶(SOD)活性,丙二醛(MDA)及血脂水平.结果:模型组血清SOD较正常对照组显著降低(P＜0.01),而血清MDA,CHO及LDL均显著高于对照组(P＜0.01);通脉汤低剂量治疗组血清SOD,MDA与模型组之间无显著差异(P＞0.05),血清CHO及LDL较模型组显著降低(P＜0.05);通脉汤高剂量治疗组血清SOD较模型组显著升高(P＜0.05),MDA,CHO及LDL均较模型组显著下降(P＜0.01).相关分析结果表明动脉粥样硬化时血清MDA与CHO,LDL成显著正相关(分别r=0.397,0.443,P＜0.05);SOD与CHO及LDL成显著负相关(分别r=-0.407,-0.429,P＜0.01).结论:通脉汤能降低血清CHO,LDL,升高SOD水平,在动脉粥样硬化中起抗氧化的作用.     

原发性慢性肾小球肾炎患者血浆肾上腺髓质素、内皮素-1的变化及临床意义

目的:探讨肾上腺髓质素(ADM),内皮素-1(ET-1)与原发性肾小球肾炎肾功能损害的关系及其内在联系.方法:正常对照组15例,原发性慢性肾小球肾炎38例,根据内生肌酐清除率(Ccr)将患者分为4组.采用放射免疫法检测各组血浆ADM,ET-1,同时检测血管紧张素Ⅱ与醛固酮.结果:与正常对照组相比,Ⅰ、Ⅱ、Ⅲ、Ⅳ组血浆ADM显著升高(P＜0.01),血浆ADM与血清肌酐(Scr)、24 h尿蛋白量呈正相关(r=0.885 2,P＜0.001;r=0.457 6,P＜0.05),与平均动脉压(MAP)、血浆血管紧张素(AngⅡ)和醛固酮(ALD)呈负相关(r=-0.386 7,P＜0.01,r=-0.581 3,P＜0.001,r=-0.395 6,P＜0.01).血浆ET-1与Scr、MAP、AngⅡ和ALD均呈正相关(r=0.766 0,P＜0.001,r=0.305 7,P＜0.05,r=0.284 6,P＜0.05,r=0.623 5,P＜0.001).血浆ADM与血浆ET-1呈正相关(r=0.608 6,P＜0.001).结论:血浆ADM的升高可能是代偿ET-1升压和促进肾脏纤维化的结果,对肾脏有一定的保护作用;ADM在肾脏疾病的治疗中可能具有重要的前景.     

卡维地洛与缬沙坦对自发性高血压大鼠心肌细胞凋亡的影响

目的:探讨卡维地洛(Carvedilol,Car)、缬沙坦(Valsatan,Val)及其合用对自发性高血压大鼠(SHR)心肌细胞凋亡及血浆血管紧张素Ⅱ(angiotensin Ⅱ,AngⅡ)、超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)的影响.方法:6周龄雄性SHR 24只,随机分为对照组,其他3组为干预组,即Car组,Val组及Car1-SVal合用组,后3组用药8周后,腹腔麻醉取下腔静脉血3 ml,测AngⅡ、SOD与MDA;开胸取左心室游离壁心肌,采用TUNEL法检测心肌细胞凋亡率(cardiac myocyte apoptosis rate,CMAR).结果:与对照组比较,各干预组CMAR及血浆MDA明显降低,而血浆SOD明显增高,Car组及合用组血浆AngⅡ明显降低,而Val组明显增高(P＜0.01);与Car组、Val组比较,合用组CMAR及血浆MDA明显降低,血浆SOD明显增高,而血浆AngⅡ明显高于Car组,低于Val组(P＜0.01).Val组与Car组比较,CMAR无显著性差异(P＞0.05),而血浆SOD明显降低,血浆MDA、AngⅡ明显升高(P＜0.01);各组中血浆MDA与CMAR均呈正相关,而血浆SOD与其呈负相关;Val组血浆AngⅡ与GMAR呈负相关,其余各组呈正相关(P＜0.05).结论:Car,Val可抑制SHR心肌细胞凋亡,二者合用效应更明显,可能与两药影响血浆AngⅡ、SOD、MDA含量有关.     

罗格列酮对内皮素引起心肌细胞损伤的保护作用及机制

目的:以新生大鼠心肌细胞为模型,探讨罗格列酮(RSG)对内皮素-1(ET-1)引起心肌细胞损伤的保护作用及其机制.方法:将原代培养的心肌细胞分为5组:DMEM组,ET-1组,ET-1 RSG(10-9mol/L)组、ET-1 RSG (10-8mol/L)组、ET-1 RSG (10-7mol/L)组;培养24 h和48h ,吸取培养液;按试剂盒说明书进行测定心肌细胞培养液中LDH,SOD 活性及MDA 含量.结果:药物干预24和48 h后,培养液中LDH的活性,ET-1组均高于对照组(分别为P＜0.05,P＜0.01),ET-1 RSG组均低于ET-1组,其中10-8mol/L和10-7mol/L RSG ET-1组较ET-1组降低有统计学意义(分别为P＜0.05,P＜0.01);SOD 活性:ET-1组均低于对照组(分别为P＜0.05,P＜0.01),ET-1 RSG组均高于ET-1组,其中10-8mol/L和10-7mol/L RSG ET-1组较ET-1升高有统计学意义(分别为P＜0.05,P＜0.01);MDA 含量:ET-1组均高于对照组(分别为P＜0.05,P＜0.01),ET-1 RSG组均低于ET-1组,其中10-8mol/L和10-7mol/L RSG ET-1组较ET-1降低有统计学意义(分别为P＜0.05,P＜0.01).结论:RSG对内皮素引起心肌细胞损伤的保护作用及机制与抗氧化、降低氧自由基的产生有关.     

先天性心脏病患儿血ET-1、VEGF的变化及其与肺动脉压力间的关系

目的:探讨先天性心脏病(Congenital Heart Disease,CHD)患儿血浆内皮素(endothelin-1,ET-1)、血清血管内皮生长因子(vascular endothelial growth factor,VEGF)水平的变化以及与肺动脉压力(pulmonary artery systolic pressure,PASP)间的关系.方法:选择2010年1月～2013年1月左向右分流型CHD患儿80例,根据PASP值将其分成三组,其中无PH组(PASP＜30mmHg) 34例,轻度PH组(30mmHg≤PASP≤49mmHg)24例,中重度PH组(PASP≥50mmHg)22例,另取同期健康体检儿30例为健康对照组;采用放射免疫法(RIA)测定血浆ET-1浓度,采用酶联免疫吸附法(ELISA)检测血清VEGF浓度,比较四组间ET-1、VEGF浓度,分析CHD合并肺动脉高压(Pulmonary hypertension,PH)血ET-1、VEGF浓度与PASP的相关性.结果:CHD合并PH组血VEGF、ET-1明显高于无PH组及正常对照组(P均＜0.05),且血VEGF、ET-1随着肺动脉压力的升高而升高.无肺动脉高压组血VEGF、ET-1与正常对照组差异无显著性(P均＞0.05).CHD合并PH患者血清VEGF与血浆ET-1呈显著正相关(r=0.957,P＜0.05),VEGF与PASP呈显著正相关(r=0.875,P＜0.05),ET-1与PASP呈显著正相关(r=0.898,P＜0.05).结论:VEGF和ET-1参与了PH的发生和发展,其水平变化可以一定程度上反映CHD患儿的肺动脉高压程度.     

家兔肝缺血再灌注损伤时NO、ET-1和炎症细胞因子的变化及灵芝多糖的干预作用

目的 观察家兔肝缺血再灌注损伤(HIRI)时一氧化氮(NO)、内皮素-1(ET-1)和炎症细胞因子的变化以及灵芝多糖(GLP)的干预作用及机制.方法 30只健康家兔随机分为3组:假手术对照组(S组)、生理盐水再灌注组(NS组)和灵芝多糖再灌注组(GLP组).复制家兔肝缺血再灌注损伤动物模型,分别测定缺血前、缺血45 min、再灌注45 min时血浆NO、ET-1、肿瘤坏死因子α(TNF-α)及白细胞介素-6(IL-6)的水平,并于实验结束后测定肝组织中NO、ET-1水平,光镜下观察肝组织形态学改变.结果 与S组比较,NS组血浆及肝组织NO水平显著降低(P＜0.05),ET-1水平升高(P＜0.05),NO/ET-1降低(P＜0.05),血浆TNF-α、IL-6水平均升高(P＜0.05);与NS组比较,GLP组血浆及肝组织NO水平升高(P＜0.05),ET-1水平降低(P＜0.05),NO/ET-1增高(P＜0.05),而血浆TNF-α及IL-6的水平均明显降低(P＜0.05);与NS组比较,GLP组肝组织形态学损伤明显减轻.结论 灵芝多糖可通过调整NO/ET-1的平衡、降低TNF-α及IL-6水平而发挥对肝缺血再灌注损伤的保护作用.     

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.     

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…     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

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.